Recently, I wrote an article about measles immune suppression, a serious complication of the disease, and one of the great reasons to get the measles vaccine. According to two peer-reviewed articles, one published in the prestigious journal Science and the other article in a sister journal Science Immunology, researchers described that measles infections destroyed some immune memory cells, causing the individual to lose protection to some diseases.
Of course, the anti-vaccine zealots’ favorite false authority, Tetyana Obukhanych, decided to deny the solid scientific articles that established one of the well-known complications of measles. It’s not like anyone should take her babbling pseudoscience seriously, but just in case someone does, it’s important that we point out that Obukhanych is wrong once again.
Quick review of measles immune suppression
As I mentioned above, I wrote about measles immune suppression recently. There’s no official name for it, I’ve seen it called measles immune amnesia too, but I’ll just stick with measles immune suppression. I’m sure one day we’ll have some simple name for the condition that we’ll all use to remind ourselves of the bad old days before we eliminated measles.
Back to reality.
Measles (also called rubeola, not to be confused with rubella, or German measles) is a respiratory disease caused by the measles virus. The virus normally grows in the cells that line the back of the throat and lungs.
The virus is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious — 90% of people without immunity sharing living space with an infected person will catch it.
There are no specific treatments for the disease. There are no miracle preventions. Oh, wait, there’s the extremely safe and effective MMR vaccine.
So, why causes measles immune suppression? We need to get into some science, so here we go.
As children, we are exposed to pathogens, which causes us to accumulate specialized B-lymphocyte cells, which produce antibodies against those pathogens. These cells are the main weapons of the body’s immune system (for a simple description of the immune system, see this article) to battle those pathogens. Once we are sensitized to a pathogen’s antigen, these antibodies and immune cells are always on the “lookout” for those pathogens, destroying them before they can harm us.
Unfortunately, the measles virus kills these B-lymphocytes, and once that happens, the immune system loses the “memory” of those pathogens. Dr. Michael Mina et al. determined that measles destroys between 11-73% of the B-lymphocytes, which are lost forever, essentially losing that amount of their antibody “library.” And then those children are susceptible to those pathogens all over again.
And just in case you were wondering, Dr. Mina also determined that the MMR vaccine had no such effect on the immune system. We could have predicted this result since the living measles virus can replicate and attack lymphocytes. The weakened virus in the MMR vaccine is not pathogenic, it just provides antigens to train the immune system.
Dr. Mina speculated that those children who contracted measles had to be re-exposed to all of the pathogens that they had encountered in their lives. Of course, every pathogen has some risk, so these children will be at risk of infectious diseases that they had already contracted, but their immune system lost the “memory” of them.
In the second study, by Dr. Velislava N. Petrova et al., uncovered data that the damage might be worse than that. The immune system starts with what are called “naive cells” that are the precursors to all of the adaptive immune system cells.
As these cells mature, they diversify to recognize unique molecules on different pathogens. It allows them to quickly learn, remember, and respond to new pathogens. Measles causes the immune system to essentially reset to infancy, meaning the child’s immune system has to be exposed to many different pathogens to build up the immune system’s memory, in effect, immune system amnesia.
Individuals who have contracted measles had lowered immunity for up to five years!
Who is Tetyana Obukhanych?
She is the darling of the anti-vaccine crowd because she has a science background. But, as I’ve written on a number of occasions, credentials don’t matter. Only evidence matters.
But we’ll get to her evidence. Or lack thereof.
This is all about Obukhanych:
- Obukhanych received a Ph.D. in immunology from Rockefeller University in New York City in 2006. Her thesis was entitled Immunologic Memory to Polysaccharide Antigens. Ironically, her research showed how vaccines work. Yes, she provided us with strong evidence on the effectiveness of vaccines.
- I want something to be perfectly clear – despite having a doctorate in “immunology,” that does not make her an immunologist, which is a clinical specialty. Only an MD, with five or more years of residency and post-residency training, is considered an “immunologist.” Obukhanych is not competent or trained to clinically diagnose any immune disease.
- Although a lot of pro-vaccine websites state that she was a postdoctoral researcher (post-doc) at Harvard, and Obukhanych states she was a post-doc there on her website, I can find little corroboration of it. If she were a post-doc at Harvard, she failed to publish even one study while there. On the other hand, Harvard Medical School is decidedly pro-vaccine.
- Obukhanych was once a post-doc in the Department of Psychiatry and Behavioral Science at the Stanford University School of Medicine. However, she is no longer a researcher, post-doctoral fellow, or faculty member at Stanford University School of Medicine.
- I cannot determine what her current position is, other than making fairly unscientific and uneducated opinions about vaccines. As far as I can tell, she is unemployed, at least in the field of immunology. On her website, she claims that “During my post-doctoral years, I realized that the so-called ‘academic freedom’ of the mainstream research establishment has been subjugated to a pharmaceutically-driven mainstream paradigm. Built on fear and misunderstanding of our relationship with Mother Nature, the mainstream paradigm capitalizes on manmade chronic disease created as a collateral damage in our never-ending war on viruses and ‘germs.’ At the end of my post-doctoral training, I made the decision to leave the mainstream establishment, whose value system, priorities, and directions I could no longer embrace.” Pure, unfiltered obfuscation – she couldn’t get any other position in academic research, so she invented some excuse as to why she moved on.
- Her research consists of precisely eight published articles. Two of them (here and here), very small clinical trials, examined amino acid relationships to autism spectrum disorder. Neither of these two articles even mention vaccines, so don’t invent some trope where Obukhanych published an article linking vaccines to autism – we know that there is no link. None.
- Other than one article, Obukhanych was never the first or last author. In most papers, the first author is generally the individual who did the bulk of the research work. In that one paper, she concluded that “As the generation and regulation of immunologic memory are central to vaccination, our findings help explain the mode of action of the few existing polysaccharide vaccines and provide a rationale for a wider application of polysaccharide-based strategies in vaccination.” Yes, that was a pro-vaccine paper.
- Ironically, of the eight articles that have her name as a co-author, some of them actually supported the use of vaccines (see one, two, three).
- Sure, she possibly assisted in some interesting research in the immune response, but as far as I can tell, it wasn’t much more than doing assays, something a basic research technologist could do.
- There is nothing in her background that indicates she has compiled robust and scientifically important evidence about vaccines.
- She was interviewed for an antivaccine article in the lunatic website, whale.to, an anti-semitic, hate-filled, conspiracy-laden website run by a pig farmer. It’s really hard to get beyond this point.
- She thinks homeopathy works. Yeah, once someone buys into that pseudoscience, it’s hard to take them seriously on any topic.
We can conclude only one thing – Obukhanych lacks any credibility or competence in the study of vaccines. Of course, if she did, she’d publish it.
Oh right, she did publish science that supported vaccines.
So Obukhanych decides to attack peer-reviewed articles about measles immune suppression published in prestigious journals by writing, “Does measles suppress your immune system via immune amnesia? Let’s do some ‘fact-checking.’”
I guess by fact-checking she means cherry-picking, employing pseudoscientific methods, and relying on her false authority.
Let’s take this at a meta-level. If she’s really going to criticize what was published, she should do the following:
- Do real scientific research. The two articles published in Science were based on “boots on the ground” research of actual patients using actual diagnostic techniques. The researchers, who have expertise in immunology, didn’t invent the immune amnesia hypothesis out of thin air – it was based on decades of observations of immune suppression post measles infection. Those researchers used the scientific method to ascertain why it happened. Obukhanych did none of this.
- Publish in real journals. Obukhanych, who couldn’t be bothered with doing real science, also decided to publish her editorial piece on her website. It’s OK to use a blog to discuss science, but it’s critical to actually use real scientific evidence to support that. Obukhanych decided to play to her anti-vaccine audience, who will consume her pseudoscience without any critical analysis.
Obukhanych is the master of cherry-picking – her self-indulgent blog post has so many cherries, I’m considering asking her to send me some cherries for a good Thanksgiving Day pie. I like cherry pie.
Dr. Aaby and co-authors were testing a commonly held assumption that after surviving measles, children would have a higher mortality rate from other infections due to long-term immune-suppression, which is thought to follow measles. But they got the opposite results. In fact, they found that “exposed children developing clinical measles had lower age-adjusted mortality over the next 4 years than exposed children who did not develop clinical measles.”
Except that’s not quite what Dr. Aaby concluded. In fact, he found that all mortality for children who received the measles vaccine dropped – this would be predicted by measles immune suppression since individuals who contracted measles would be at greater risk of other dangerous pathogens.
To be fair, it’s not even very good cherry-picking on the part of Obukhanych. It’s more like picking lemons and trying to tell us that it’s cherries.
Then Obukhanych wrote something that I found curious:
OK, here we have a preferential infection of memory lymphocytes by the measles virus resulting in a temporary loss of immunologic memory. So what? When was it ever proven that immunologic memory has anything to do with protection from re-infection? In fact, the opposite has been demonstrated by the research conducted in the lab of Swiss scientist (and a Nobel Prize winner in 1996) Dr. Rolf Zinkernagel. In the title of his 2012 critical review, he clearly states: “Immunologic memory does not equal protective immunity.”
There are two points here that need to be addressed. First, we have evidence, by the aforementioned Dr. Aaby that the measles immune suppression may lead to a higher mortality rate. That’s “so what.”
Second, Dr. Zinkernagel’s article was “demonstrated by the research,” but the paper is nothing more than another editorial piece that doesn’t include more original research.
The disapproving Orac wrote, in his own special snark that:
One notes that, were Zinkernagel actually correct that immunological memory has little or nothing to do with long term immunity, he could very well have won his second Nobel Prize. Remember the Nobel Disease? It’s a term I coined (at least I think I was the first to coin it—I can never be 100% sure—but I certainly adopted it and popularized it). Basically, it’s a term that describes the propensity of Nobel Prize winners to adopt contrarian views later in their careers or to become outright quacks or cranks, as, for example, Luc Montagnier and Louis Ignarro did.
Of course, Zinkernagel wrote that:
These often do correlate with, but are not the key mechanisms of, protection. Protection depends on pre-existing neutralizing antibodies or pre-activated T cells at the time of infection—as documented by the importance of maternal antibodies around birth for survival of the offspring. Importantly, both high levels of antibodies and of activated T cells are antigen driven.
In other words, he’s saying that we need these antibodies that are destroyed by measles for survival. Again, her cherry-picking is the worst.
Then, Obukhanych writes:
Furthermore, the varicella (chickenpox) virus does exactly the same thing as the measles virus – infects memory lymphocytes – as reported by another research paper published in PLoS Pathogens in 2013: “During viremia the virus preferentially infected memory T-cells, initially central memory T-cells and subsequently effector memory T-cells.”
Again, let me make two points. First, this is a huge strawman, because varicella and measles viruses are completely different. It’s possible that varicella doesn’t do this. Second, maybe it does, and Obukhanych has inadvertently described potential long-term complications from chickenpox – think about that Dr. Not-Harvard-trained Not-an-immunologist.
She also writes that:
Now, let’s address yet another facet of memory lymphocytes. A subset of them (memory Th2) is known to be an immunologic reservoir for allergic diseases, including asthma. In fact, it was even proposed in a 2006 publication in Pharmacology & Therapeutics that drugs are needed to target and eliminate these pesky memory Th2 cells, in order to reduce their contribution to allergic asthma.
And if the measles and chickenpox viruses already do just that – kill memory T cells – shouldn’t that lead to a reduced risk of asthma and other allergic diseases following these childhood diseases? Indeed, it should. And there are publications documenting such effects for measles in Africa and Europe, and for chickenpox in the USA.
Again, where does she come up with this nonsense?
- The papers on measles immune suppression aren’t looking into allergies, it’s talking about pathogenic diseases that return because of immune amnesia. That’s the danger.
- Despite the wild claims on the internet, allergies and asthma are not a rampant epidemic. Setting aside the fact that measles suppresses the immune system, it also has other dangerous complications such as the 1-2 out of 1000 children with measles, who develop subacute sclerosing panencephalitis (SSPE), a rare chronic, progressive encephalitis that affects primarily children and young adults– it is caused by a persistent infection of the measles virus.
I just can’t read any more of her nonsense. Every paragraph contains logical fallacies, false conclusions, and claims not based on the evidence presented. If this was her “fact-checking,” I think we need a new definition of that term.
And in conclusion
Tetyana Obukhanych is so intent on her need to push her pseudoscience anti-vaccine beliefs, she ignores logic and evidence. She is all about the narrative that measles is good.
Of course, those of us with critical eyes can see through this. Unfortunately, too many people will take her unpublished commentary as “fact,” putting children at risk of measles immune suppression, along with many other complications from the disease.
Right now, we have powerful evidence that measles damages immune memory cells. If Obukhanych wants to contradict those claims, then do real scientific research and publish the results in real biomedical journals.
I’m not holding my breath.
- Aaby P, Simondon F, Samb B, Cisse B, Jensen H, Lisse IM, Soumaré M, Whittle H. Low mortality after mild measles infection compared to uninfected children in rural West Africa. Vaccine. 2002 Nov 22;21(1-2):120-6. doi: 10.1016/s0264-410x(02)00430-9. PubMed PMID: 12443670.
- Aaby P, Samb B, Andersen M, Simondon F. No long-term excess mortality after measles infection: a community study from Senegal. Am J Epidemiol. 1996 May 15;143(10):1035-41. doi: 10.1093/oxfordjournals.aje.a008667. PubMed PMID: 8629610.
- Aaby P, Lisse IM, Mølbak K, Knudsen K, Whittle H. No persistent T lymphocyte immunosuppression or increased mortality after measles infection: a community study from Guinea-Bissau. Pediatr Infect Dis J. 1996 Jan;15(1):39-44. doi: 10.1097/00006454-199601000-00009. PubMed PMID: 8684874.
- Mina MJ, Kula T, Leng Y, Li M, de Vries RD, Knip M, Siljander H, Rewers M, Choy DF, Wilson MS, Larman HB, Nelson AN, Griffin DE, de Swart RL, Elledge SJ. Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens. Science. 2019 Nov 1;366(6465):599-606. doi: 10.1126/science.aay6485. PubMed PMID: 31672891.
- Petrova VN, Sawatsky B, Han AX, Laksono BM, Walz L, Parker E, Pieper K, Anderson CA, de Vries RD, Lanzavecchia A, Kellam P, von Messling V, de Swart RL, Russell CA. Incomplete genetic reconstitution of B cell pools contributes to prolonged immunosuppression after measles. Sci Immunol. 2019 Nov 1;4(41). doi: 10.1126/sciimmunol.aay6125. PubMed PMID: 31672862.