Getting boosted with the bivalent vaccine was a 51% go / 49% no-go decision for me. I stayed up far too late the night before trying to find an answer to the question, “How does immune imprinting work, and will getting the vaccine compromise my immune system in the long-term?” Okay, technically two questions. As I researched and researched (never finding an answer, by the way), I thought to myself, “Wouldn’t it be wonderful if someone explained how the vaccines work in detail and how the virus and the vaccines affect the female body?” I’ll tackle the second question in another blog post. This one will focus on immune imprinting.
Disclaimer: I am not a scientist trained to interpret scientific literature, nor should my opinion be taken as medical advice. From one curious soul to another, this is my interpretation of the available research and areas in which I’m looking forward to an expanded volume of research.
To start, let’s define “immune imprinting.” What is it, and why hadn’t I heard of it until this past week? Immune imprinting is the concept that your body’s immune response to whatever form of a specific illness your body is exposed to first is the response it will have each subsequent time it is exposed to that illness or ones like it. It’s like your immune system’s memory. I first read about it in this article from the Washington Post and read about it in more detail in this article from Fortune (open with Chrome; does not work in Safari). Kaiser Health News included the latter in its roundup from just this past October — little over a month ago.
Scientists appear to be divided over the role of immune imprinting in our body’s ability to adapt its immune response to variants of COVID-19. The news section of the highly regarded scientific journal Nature reported on two papers, one of which found that some of the body’s memory B cells adapted to fight the new variant. The other paper found that the body adapted its antibodies. It is worth noting that both papers are preprints, which means that they have not undergone the rigorous process of peer review (typically, at least three scientists in the same field read the paper and interrogate the process by which the study was conducted, sometimes leading the authors of the paper to go back to the lab to collect more data before the paper can be published). It’s also worth noting that both studies investigated a BA.1 bivalent vaccine (the booster currently available is for BA.4 and BA.5).
I am more inclined to take as truth the viewpoint featured at only the very end of the Nature article, (formally) published in the Journal of Experimental Medicine this past September. The study also looked at BA.1, but the paper draws an analogy to a situation in which we find ourselves: the question of whether to get a fourth vaccine or to leave things as they are with the third, akin to the first booster. Essentially, the study found that the first booster was a more effective booster than the second one is. The second one does increase variant-specific plasma antibody and memory B cell responses, but unlike the first booster, is does not increase the overall number, potency, or breadth of memory B cells. I read this to mean that the benefit to getting the second booster is to teach your body to respond to an antigen that is genetically a little bit closer to what’s currently circulating in the world.
The paper used the term “antigen exposure” to refer to a given dose/booster of a vaccine, which raised the question for me: What if you’ve had COVID (as most of us have)? How does that antigen exposure affect the effectiveness of boosters? Of the immune system, which is the whole point?
These studies also focused only on the way in which the boosters enhance the body’s present ability to fight variants of COVID-19, not its ability to fight COVID-19 (or any disease, for that matter) in the long term. Clearly there is concern about the boosters’ overuse, as demonstrated by the European Medicines Agency’s issuing a warning at the beginning of 2022 not to get them too close together and maybe to only get them once a year before the winter, like a flu shot. Healthline echoes this message. The reason, “T cell exhaustion,” has been written about by the Harvard School of Public Health.
I’m partial to naturopathic medicine, which is defined by six principles. The first is, “First, Do No Harm.” Whether the boosters do harm is an open question. Over the past year, in contexts other than COVID-19, I’ve learned how to move forward without answers, to wade through mud and emerge transformed, as the lotus does, and so, without an answer to this question, I decided to get the booster. At the end of all of my research, my reason for making an appointment hadn’t changed: in two weeks I’m going to San Francisco, which is a hotbed of new variants and awful-sounding cases of which I’ve heard anecdotally. I wouldn’t like to be one of them. Was it the right choice? I don’t know. I won’t know. The present situation asks us to research, to decide what we think is right for ourselves, and to reserve the right to change our minds.