Rethinking next-generation vaccines for coronaviruses, influenzaviruses, and other respiratory viruses is a paper by Anthony Fauci and two colleagues. It examines the reasons that vaccines against flu and COVID don’t work very well. This is a startling statement after all the public and repeated admonitions from Dr Fauci that everyone be vaccinated repeatedly. The summary of the paper is below. A link to a download of the entire article is at the end of this piece.

Viruses that replicate in the human respiratory mucosa without infecting systemically, including influenza A, SARS-CoV-2, endemic coronaviruses, RSV, and many other “common cold” viruses, cause significant mortality and morbidity and are important public health concerns. Because these viruses generally do not elicit complete and durable protective immunity by themselves, they have not to date been effectively controlled by licensed or experimental vaccines. In this review, we examine challenges that have impeded development of effective mucosal respiratory vaccines, emphasizing that all of these viruses replicate extremely rapidly in the surface epithelium and are quickly transmitted to other hosts, within a narrow window of time before adaptive immune responses are fully marshaled. We discuss possible approaches to developing next-generation vaccines against these viruses, in consideration of several variables such as vaccine antigen configuration, dose and adjuventation, route and timing of vaccination, vaccine boosting, adjunctive therapies, and options for public health vaccination polices (sic).

That respiratory viruses mutate rapidly and loutwit vaccines designed to protect people from their ill effects has been known for decades. That Dr Fauci decided to examine the issue at this late date in the pandemic is welcome though surprising given his previous positions on the issue. The authors discuss numerous reasons why the human immune system has evolved in such a way as to make vaccines poorly operative. They also consider future strategies that may result in better vaccines. These antivirus efforts will take time to develop. For now one must wonder at the continued commands to use the currently available flu and COVID vaccines.

The following table from the paper lists the infections that have effective vaccines followed by those that don’t (click to enlarge). VZV is varicella-zoster virus.

That the flu vaccine doesn’t work very well is not classified information. Yet the public, especially the elderly, are urged (and even required) yearly to get the vaccine. This policy definitely benefits the companies that manufacture the vaccines and the pharmacies that dispense them at no cost to Medicare beneficiaries, but at great profit to the drug stores. The same appears true for the COVID vaccines. We likely are at a point where these vaccines have an unfavorable risk:benefit ratio.