Yet another anti-vax doctor claims vaccines ‘shed’. Where did this myth originate?

It’s been too short a time since I last wrote about the antivaccine myth of “shedding,” particularly in the context of COVID-19 vaccines. As you might recall, shedding is a real phenomenon, but only for vaccines made from live attenuated virus (LAV); i.e. vaccines that use a weakened version of the pathogenic virus in order to cause a harmless infection that can stimulate an immune response that protects against the fully pathogenic version of the virus causing the disease targeted. Examples of currently used LAV vaccines include vaccines against measles, mumps, rubella, rotavirus, varicella, and influenza (the intranasally administered vaccine). Because LAV vaccines contain live virus, people vaccinated with them can in some cases “shed” vaccine-strain virus for a period of time afterward. However, the “attenuated” in LAV means that this virus is attenuated, which means that infection caused by it is asymptomatic or very weakly symptomatic. In the age of the pandemic, I must admit that I was surprised when this particularly antivax myth reared its ugly head mere weeks after the mRNA-based vaccines were released, mainly because with these viruses there is no molecular or biological mechanism for “shedding” of mRNA, the spike protein it produces, or anything else to affect others. Yet the myth persists, What inspired me to write about it again after all this time was a post by an antivax quack who goes by the ‘nym A Midwestern Doctor (AMD) entitled What Is The Current Evidence for mRNA Vaccine Shedding? Even as AMD asks, “And how can you protect yourself from it?” I started to realize just how much his arguments remind me of those of homeopaths.

I also note that COVID-19 antivax quack Pierre Kory has also written a whole long nine-part series on shedding that turns out to be in essence a much longer version of the same sorts of tactics AMD used. I might well address parts of Dr. Kory’s posts that are not included in AMD’s post in a future SBM post, but for purposes of this one I will (mostly) refer to AMD’s “musings.”

First, though, let’s delve into a bit of background, and then I will discuss AMD’s claims about COVID-19 vaccine shedding, concluding with why such rationales remind me very much of the “scientific” rationales proposed by homeopaths and defenders of other incredibly implausible alternative medicine treatments—I’m also talking about you, reiki and other forms of “energy medicine”—to try to deceive people that something that is so implausible from a basic science standpoint as to be, for all intents and purposes, impossible is actually plausible.

How big a deal is shedding in real life?

As I wrote above, LAV vaccines generally don’t replicate as well as and are much less virulent than the original strains causing disease. They thus produce immunity to wild-type pathogenic organisms—wild type (WT) denotes the unmodified virus “out in the wild” that causes disease—without the patient’s having to endure the risks of going through the disease caused by the virus. Still, because an actual viral infection is involved, no matter how mild or even asymptomatic, when LAV vaccines produce immunity, generally this type of vaccine is not recommended for patients who have an impaired immune system due to concern about even the weakened virus strains used in LAV vaccines being able to cause significant infection.

Prepandemic, one precaution frequently recommended at pediatric cancer centers regarding LAV vaccines was to keep children whose immune systems had been impaired by chemotherapy away from their siblings who had received LAV vaccines, such as MMR, for a period of time. Guidelines published a decade ago by the Infectious Disease Society of America (IDSA) include different recommendations for different LAV vaccines. For example, the IDSA states that healthy people who live with an immunocompromised person can receive the following live vaccines without endangering that person:

• MMR (measles, mumps and rubella)
• Varicella & Zoster (chickenpox and shingles)
• Rotavirus
• Yellow Fever
• Typhoid

However, the guidelines also stated that persons living with anyone who is immunocompromised should not receive the OPV, because of the risk of transmitting vaccine strain polio to others and the possibility of that strain reverting to wild-type polio. The IDSA also recommended that highly immunocompromised patients—e.g., those receiving cancer therapy or a bone marrow transplant—should not handle the diapers of infants who received rotavirus vaccine for 4 weeks after the vaccination and should avoid contact with people who develop skin lesions after receiving varicella or zoster vaccines until the lesions resolve. Last year, the CDC Advisory Committee on Immunization Practices incorporated the 2013 IDSA guidelines and updated them to state:

Household contacts and other close contacts of persons with altered immunocompetence should receive all age- and exposure-appropriate vaccines, with the exception of smallpox vaccine (12,13). Receipt of vaccines will prevent the vaccine-preventable disease, so there can be no potential transmission to the contact with altered immunocompetence. The live MMR, varicella, and rotavirus vaccines should be administered to susceptible household contacts and other close contacts of immunocompromised patients when indicated. No specific precautions are needed unless the varicella vaccine recipient has a rash after vaccination, in which case direct contact with susceptible household contacts with altered immunocompetence should be avoided until the rash resolves (14,15). All members of the household should wash their hands after changing the diaper of an infant who received rotavirus vaccine. This minimizes rotavirus transmission, as shedding may occur up to one month after the last dose (16,17). Household and other close contacts of persons with altered immunocompetence should receive annual influenza vaccination. Introduction of low levels of vaccine viruses into the environment likely is unavoidable when administering LAIV. LAIV vaccine viruses are cold-adapted, so they can replicate in the nose and generate an immune response without entering the lungs (i.e., they are temperature sensitive and replicate poorly at core body temperatures). No instances have been reported of illness caused by attenuated vaccine virus infections among health-care providers or immunocompromised patients. LAIV may be administered to healthy household and other close contacts of persons with altered immunocompetence unless the person with altered immunocompetence is in a protective environment, typically defined as a specialized patient-care area with a positive airflow relative to the corridor, high-efficiency particulate air filtration, and frequent air changes (3). No preference exists for inactivated influenza vaccine use by health-care workers or other persons who have close contact with persons with lesser degrees of immunosuppression (e.g., persons with diabetes, persons with asthma taking high-dose corticosteroids, or persons infected with HIV), and no preference exists for inactivated influenza vaccine use by health-care workers or other healthy persons aged 5-49 years in close contact with all other groups at high risk.

There you have it, reasonable precautions based on copious evidence. As for vaccinating patients with significant immunocompromised, all indicated non-live vaccines continue to be recommended, although they might not generate as much of an immune response, and there is even emerging evidence that some LAV vaccines can be safely administered to immunosuppressed people. Despite that, before the pandemic, antivaxxers would routinely engage in fear mongering about LAV vaccines that was unwarranted and not based in science or evidence. Let’s just say that antivax fear mongering about COVID-19 vaccine “shedding” is even less based in science than prepandemic fear mongering about vaccine shedding before the pandemic. That was a real thing, but nowhere near as dangerous as portrayed by antivaxxers.

In contrast, COVID-19 vaccine shedding is not a real thing because it can’t be, much as homeopathy doesn’t work because the laws of physics and chemistry say that it can’t.

A Midwestern doctor addresses “shedding” due to COVID-19 vaccines. Hilarity ensues.

With that science- and evidence-based background regarding the real issues involved with LAV vaccines and the shedding of vaccine strain viruses, let’s take a look at what AMD writes. As is frequently my won’t, I will start at the beginning of his Substack (of course) post:

When doctors in this movement speak at events about the vaccines, by far the most common question they receive is “is vaccine shedding real?”

This is understandable as this vaccine shedding (becoming ill from vaccinated individuals) represents the one way the unvaccinated are also at risk from the vaccines and hence still need to be directly concerned about them.

Simultaneously, this is a difficult question to answer for a few key reasons.

No, it’s actually not a difficult question to answer for a few key reasons. First, as I will explain in a moment, from a basic science standpoint, the claim that COVID-19 vaccines shed anything—mRNA, spike protein, lipid nanoparticles, evil humors, anything—is so incredibly implausible as to be, for all intents and purposes, impossible. I will grant you that the contention is not (quite) homeopathy-level impossible, mainly because there is actual mRNA, spike protein, and lipid nanoparticles. involved, but the amounts and concentrations are minuscule.

But let’s see what AMD’s “few key reasons” are, starting with his last reason first, well, just because:

Finally, in theory, shedding with the mRNA vaccines should be “impossible.” Because of this, stating it’s real puts anyone who does so in a very awkward position.

If by “awkward position,” AMD means the position of arguing for something that is, for all intents and practical purposes, scientifically impossible, I’ll concede his point. That certainly would be an “awkward position”; that is if you have a sense of shame. Most antivaxxers do not; so arguing for something so unsupported by science is really not an “awkward position” for most of them to be in.

But before discussing that point further, let’s see what AMD lists as the other “key reasons” that make arguing for COVID-19 vaccine shedding a “difficult question” to him:

First and foremost, we believe it is critical to not publicly espouse divisive ideas (e.g., “PureBloods” vs. those who were vaccinated) that prevent the public from coming together and helping everyone. The vaccines were marketed on the basis of division (e.g., by encouraging immense discrimination against the unvaccinated), and many unvaccinated individuals thus understandably hold a lot of resentment for how the vaccinated treated them. We do not want to perpetuate anything similar (e.g., discrimination in the other direction).

Likewise, we don’t want to create any more unnecessary fear—which is an inevitable consequence of opening up a conversation about shedding.

I get it. AMD is one of those antivaxxers who wants to be seen as rational and scientific; so of course he doesn’t like the idea of “purebloods” adopted by the antivaccine movement.

One point I’ve long made about so-called “alternative” medicine is to emphasize just how many of its precepts are more religious than rational or scientific in nature. In particular, a huge part of alternative medicine relies on the concept that “contamination” (these days more frequently referred to as “toxins”) cause most, if not all, disease. Several years ago, I started pointing out how the various “detoxification” regimens that make up so much of alternative medicine (and, not coincidentally, the basis of many treatments for many conditions—like autism—that antivaxxers used to attribute to vaccines) had more in common with religious ritual purification rituals than they did with science or medicine. This concept of “purity” versus “contamination” (the latter implied to be with evil) also has a lot to do with the idea that “natural immunity” to a disease (which in reality should be called post-infection immunity given that vaccine-induced immunity is natural) and has infected the discourse over COVID-19 vaccines, so much so that one of my go-to video clips when discussing this topic is of Brigadier General Jack D. Ripper from one of my favorite movies of all time, Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb explaining how fluoridation is a Communist plot to “sap and impurify” the “precious bodily fluids” of real Americans. Why? Because anti-fluoridation, antivaccine, and anti-GMO pseudoscience all tap into the alternative medicine fear of “contamination” as a cause of ill health and “purity of essence” (again, from Dr. Strangelove) as key to good health. Not coincidentally, concepts of “contamination” versus “purity” (or even “pureblood” or “purebloods”) are also behind the fear stoked by antivaxxers that mRNA-based COVID-19 vaccines “permanently alter” your DNA, thus contaminating and corrupting it with evil (the SARS-CoV-2 spike protein).

The term “purebloods” comes, of course, from the Harry Potter novels and movies, in which a “pureblood” denoted a wizard without any muggle ancestry, “muggles” being the term for non-magical humans. In the Harry Potter universe, the main villain Lord Voldemort, as well as his followers, preached an ideology in which “purebloods” were considered superior (and thus born to rule the wizard world) compared to “half-bloods” (wizards with some muggle ancestry) and muggles, who were viewed as lesser beings, as denoted by the slur used by “purebloods” to describe them, “mudblood.” The term “pureblood” thus not-so-subtly echoes Nazi ideology. After all, it’s not as though it wasn’t incredibly clear in the Harry Potter novels and movies that the magical “pureblood”/”mudblood” dichotomy was a very obvious metaphor for Nazi beliefs about racial “purity” and the superiority of the “Aryan” race. Indeed, muggles were viewed (with disgust) by Voldemort and his followers as inferiors (much like the way Nazis viewed Jews and other “inferior races”) and were thought to be “contaminating” the pure wizard race. Voldemort even expressed horror at the thought of wizards mating with Muggles and having children that was every bit as strong as the disgust that Nazis expressed at the thought of Jews mixing with “pure Aryans.”

No wonder AMD doesn’t want to be associated with this idea! Who would, other than actual fascists? Besides being fascist and racist in origin, the idea of the COVID vaccine “pureblood” has led to all sorts of embarrassing antics by antivaxxers, including dating services for the unvaccinated, “unvaccinated” blood banks (using the term “SafeBlood“), and an antivaxxer like Del Bigtree actually refusing transfusion for a life-threatening hemorrhage until he could fly to a quack clinic in Mexico to receive “unvaccinated blood.”

Nonetheless, AMD states:

That being said, from having looked into this extensively, I am relatively sure of the following:

1. Shedding is very real.
2. People’s sensitivity to it greatly varies.
3. Most of the people who are highly sensitive to shedding have already figured it out, so if you do not already believe it is an issue for you, you probably don’t need to worry about it.
4. There is still no agreed upon mechanism to explain why it happens.

For all of these reasons, we would greatly appreciated if you could share your shedding experiences. Those stories are being collected here.

Anecdotes. Of course, AMD wants anecdotes. Let’s see what “evidence” he can muster to support his contentions that shedding is “very real” and that people’s “sensitivity to it greatly varies.”

The mechanistic “trap”?

AMD, like many homeopaths, is at least smart enough to know that basic science doesn’t support what he’s laying down. Remember that homeopathy is based on two main principles, which homeopaths call “laws”: the Law of Similars and the Law of Infinitesimals. The Law of Similars is often paraphrased as “like cures like” and states that to cure a disease or relieve a symptom, you treat the patient with something that causes that symptom. There is, of course, no scientific basis for a general rule or “Law” that using something that causes a symptom will relieve a symptom. Homeopathy’s founder Samuel Hahneman made that up based on late 18th century beliefs about medicine and how the human body worked. (I note that theories that diseases were caused by “miasmas” or imbalances in the four humors still predominated then.)

The Law of Infinitesimals is even less plausible or supported by evidence.I also find it the easiest to explain to the uninitiated why this “law” is utter bunk. In brief, the Law of Infinitesimals states that homeopathic remedies become stronger with dilution. Indeed, the process of making a homeopathic remedy involves serial dilution, usually 1:100. The mother tincture (or original compound or medicine) is diluted 1:100 and then shaken vigorously (succussed), the succussion step being claimed by homeopaths to be absolutely essential to “potentize” the remedy. After that, the remedy is diluted again in the same way. Each 1:100 dilution is designated by “C”, such that a 6C dilution equals six 1:100 dilutions. The problem comes with the higher dilutions. For instance, a 12C solution is on the order of a 10^-24 dilution ((10^-2)¹² = 10^-24). Many homeopathic remedies are on the order of 30C, which is a 10-60 dilution, or more than 10³⁶-fold greater than Avogadro’s number. Some homeopathic remedies go up to 100C or more, or 10^-200. Here’s a hint: The number of atoms in the known universe is estimated to be around 10⁷⁸ to 10⁸². The math just doesn’t work, and remedies over around 12C are basically water. “Lesser” dilutions contain so little remedy that it’s highly unlikely that they have a pharmacological effect. How do homeopaths explain this? They then concede that there isn’t any actual remedy left in the “stronger” homeopathic dilutions, but that water retains the “memory” of the substance that it had been in contact with.

As is often my wont, too, I will include this video of Richard Dawkins explaining why homeopathy is pure pseudoscience, as it is, despite some of Dawkins’ hot takes on social issues, the best two minute encapsulation of why homeopathy is nonsense:

And, because of the humor potential, I also can’t resist including this Mitchell & Webb sketch. It makes fun of more than just homeopathy, but the parts of the sketch about homeopathy—homeopathic lager, anyone?—are particularly cutting:

Why did I just explain for the umpteenth time on this blog why homeopathy is physically impossible or, as I like to say, how for homeopathy to work large swaths of well-established physics and chemistry would have to be not just wrong, but spectacularly wrong? (I mean, I just did it last week.) Simple. Homeopaths make an argument very much like what AMD uses, namely that focusing on “mechanism” doesn’t mean that homeopathy doesn’t work, much less that it can’t work. Check out what I mean in this quote by AMD:

In the previous article (which provides important context for the ideas laid forth in this one) I discussed the habitual tendency of science to reject observations which have no mechanism that could explain how they are happening. In turn, I argued this was problematic as it results in many critically important observations being dismissed since their “mechanism” lies outside the existing scientific paradigm.

One of the most common ways this happens is for logical arguments to be put together which assert the observation cannot be real. In some cases, the argument is quite compelling, while in others (provided you understand the subject) it’s actually ridiculous.

See what I mean? There is, of course, a germ of truth in this deceptive argument in that sometimes science is too quick to reject a claim based on known science and known biological or physical mechanisms. (Indeed, I was shocked that AMD didn’t cite Ignaz Semmelweis, handwashing, and puerperal fever; Barry Marshall, Robin Warren, and the discovery of H. pylori as a major cause of peptic ulcer disease; or citrus fruits as a preventative for scurvy in the 18th century, those being three of the favorite go-to examples that quacks love to cite of real medical phenomena initially dismissed because there was no known biological mechanism for them at the time they were proposed.) Homeopaths love to claim that a lack of a known mechanism doesn’t mean that their quackery works, too, even though the physics and chemistry demonstrating that homeopathy is physically impossible are even stronger than the chemistry and biology showing that COVID-19 vaccine “shedding” doesn’t and can’t happen. Like antivaxxers, COVID-19 quacks often make up fantastical implausible and unproven physical “mechanisms” like “water memory” being due to “chains of nano-pearls.”

Indeed, we at SBM frequently point out a couple of things in response to these sorts of arguments. First, it is not necessary to know the exact mechanism of some putative effect in order to deem that effect plausible. This seems so obvious that it ought not be necessary to repeat it over and over again, and yet the topic can’t be broached without some nebbishy South Park do-gooder chanting a litany of “just because you don’t know how it works doesn’t mean it can’t work,” as if that were a compelling or even relevant rebuttal. Let’s get this straight once and for all: IT ISN’T. Let’s put it this way (as I like to phrase it), “plausibility ≠ knowing the biological mechanism.” Revisiting homeopathy, the point is not that we don’t know a particular mechanism for homeopathy, for example; the point is that any proposed mechanism would necessarily violate scientific principles that rest on far more solid ground than any number of equivocal, bias-and-error-prone clinical trials could ever hope to overturn. The same is true for “energy medicine” and for claims based on non-existent anatomical structures (iridology, reflexology, auricular acupuncture, meridians, chiropractic “subluxations”), non-existent physiologic functions (“craniosacral rhythms“), or non-existent anatomic-physiologic relations (“neurocranial restructuring,” “detoxification” with coffee enemas, dissolving tumors with orally administered pancreatic enzymes). The spectrum of implausible health claims euphemistically dubbed “CAM” or “integrative medicine” is full of such nonsense, and so is the spectrum of implausible claims by people like AMD related to COVID-19 vaccines, including “shedding.”

In light of that discussion, here’s the example that AMD uses to justify his dismissal of biological plausibility as a reason that COVID-19 vaccine shedding doesn’t occur, much less sicken those who come into contact with those vaccinated against COVID-19:

For example, since the mRNA vaccines were an experimental gene therapy, one of the immediate fears people had about them (myself included) was that they would permanently alter your DNA.

To address this, countless articles were written which ridiculed that notion. This was done by repeating a few logical arguments which sounded nice and were deemed to be “true” because the “experts” had espoused them (e.g. consider these frequently cited pronouncements by Paul Offit and Anthony Fauci). Those arguments were as follows:

1. The vaccines cannot enter the nucleus of the cell
2. mRNA from the vaccines breaks down rapidly in the cell, so it does not have time to enter the nucleus and change your DNA.
3. mRNA is not DNA, and hence believing mRNA can change DNA represents a fundamental lack of knowledge of biology.

On the surface, that train of logic effectively “refutes” the DNA alteration hypothesis. However, in reality, each of the above premises was false or highly misleading (e.g., the mRNA was designed to resist being broken down so it could remain active for a prolonged period).

AMD then goes on to cite the usual dubious studies and “evidence” supposedly showing that the mRNA in the vaccine (or the plasmid DNA left over in the vaccine) can get into the nucleus and “permanently alter your DNA,” even causing “turbo cancers.” Given that I’ve written about just about all of these studies before over the last three and a half years, I see no need to refute this in depth other than to cite the posts (here, here, here, here, here, here, here, and here, among other places) and point out that this is a common quack technique, to propose a “mechanism” for quackery based on poor quality studies or the willful misinterpretation of decent studies. Again, this is a lot like homeopaths, reiki practitioners, acupuncturists, and other advocates of implausible/impossible treatments.

Basically, there is no known plausible biological mechanism by which mRNA vaccines can “permanently alter” your DNA in the ways claimed by antivaxxers like AMD. This statement is based on a body of scientific evidence so large that all you really need to do is to read an introductory-level book on molecular biology to understand why the claim is so incredibly implausible. To overturn biology as established as the “central dogma,” you need very compelling counterevidence, and nothing presented by AMD or other antivaxxers qualifies. As I also like to say, it is theoretically possible to demonstrate that homeopathy works, but that would require evidence so clear-cut and irrefutable that it leads us to question very well-established physics and chemistry. Similarly, it is theoretically possible that somehow mRNA vaccines “permanently alter your DNA” in a way to cause harm (such as “turbo cancer”), but demonstrating such a phenomenon would require clear-cut and irrefutable evidence that leads virologists and molecular biologists to question very well-established biology and genetics. That’s incredibly unlikely. I will concede that it’s not as unlikely as a discovery by homeopaths leading physicists and chemists to question well established laws of physics and chemistry, but it’s pretty damned unlikely, so much so as to be, for all practical purposes, impossible.

Look for COVID-19 quacks to misrepresent what I just wrote; that is, if they respond at all.

mRNA vaccines and COVID-19

mRNA vaccines rely on something I’ve discussed before, namely the “central dogma” of molecular biology. I must admit, I’ve always hated the use of the word “dogma” associated with science, but no less a luminary than Francis Crick first stated it in 1958, and it has been restated over the years in various ways. Perhaps my favorite version of the central dogma was succinctly stated by Marshall Nirenberg in 1958 and has since been commonly paraphrased to say, “DNA makes RNA makes protein”, which about summed up all of molecular biology in five words. (Why I used the past tense in a moment.) In any event, for purposes of understanding RNA viruses, this is the main sequence that you need to understand:

Basically, DNA replicates from a DNA template and results in a double-stranded molecule that is very stable, as it has complementary sequences that tightly bind to each other in a sequence-specific fashion. This DNA template is unwound by enzymes that use the template to make RNA strands, which are single-stranded, which is then used by a ribosome to make protein out of amino acids. Again, to put it simply, each nucleotide equals one letter of the code; each three-nucleotide sequence (codon) equals one “word” that translates to an amino acid. Given that there are four nucleotides, there are 64 possible codons. Since there are only 20 amino acids, that means that most amino acids are encoded by more than one combination of nucleotides or more than one codon; i.e., the genetic code is redundant. Of course, it’s more complicated than that, as this diagram shows:

For instance, messenger RNA (mRNA) doesn’t always start out fully formed. Often it’s made as a longer precursor molecule that is spliced to the final mRNA sequence before being transported out of the nucleus into the cytoplasm to be used to make protein. In fact, it’s even more complicated than that. Remember how I used the past tense when I said that the central dogma summed up all of molecular biology? It did, but then we started finding exceptions to the central dogma, such as retroviruses and microRNAs that can regulate gene expression, for instance. You don’t really need to know the gory details of many of these, although I will mention a couple of relevant ones and refer you to a post that does go into the gory details, for anyone who’s really interested.

Exceptions aside, RNA vaccines consist mainly of, well, RNA. One problem with RNA vaccines is that RNA is an inherently unstable molecule. It is, after all, a messenger. It doesn’t need to persist any longer than the message needs to be made. In aqueous solution, RNA molecules rapidly degrade. Indeed, the instability of RNA is why public health experts have been concerned about distributing RNA vaccines. Both companies adopted a similar strategy in designing their mRNA to encode the SARS-CoV-2 spike protein with stabilizing mutations added to lock this surface protein into a form easily recognizable to the immune system and therefore make it a better antigen. Pfizer and Moderna also used modified nucleosides (the RNA equivalent to DNA nucleotides) that are more stable to make their RNAs, and placed their RNA within a lipid nanoparticle (LNP) delivery system in which LNPs fuse with the cell membrane to deliver the RNA to the cytoplasm. Together, this system leads the mRNA for the SARS-CoV-2 spike protein being delivered to the cytoplasm of the muscle cells, where the ribosomes use it as a template to make the spike protein, which then serves as the antigen that stimulates the immune system to produce antibodies against it.

Now here’s the thing. Unlike LAV vaccines, mRNA vaccines cannot replicate. They do not contain a viable virus. Moreover, each dose of vaccine only contains either 30 μg (Pfizer) or 100 μg (Moderna) of mRNA. That’s micrograms—not a lot. In addition, the amount of spike protein made as a result of vaccination with mRNA vaccines is tiny, as I discussed before; the amount detectable in the bloodstream after vaccination is on the 30-40 pg/mL (1 pg = 10^-12 g) for a few days. This makes the frequent fear mongering by antivaxxers about “shedding” of spike protein from the vaccinated somehow causing illness in people who come into contact with them approach almost homeopathy-level implausibility, particularly when you remember that the experiments showing toxicity due to spike protein in cell culture frequently cited by antivaxxers as a reason that “shedding” of the spike protein might sicken others used a 100,000x higher concentration of spike protein than can be detected in the bloodstream after vaccination. That’s not homeopathy-level, but it’s getting there.

That doesn’t even ask the question: Can spike protein even be shed? There is no good evidence that it can, much less that it can sicken others. Similarly, even though there is some evidence that mRNA fragments from the vaccine can find their way into breast milk, again, it’s important to remember that mRNA consisted of fragments, the concentration was tiny, and none was detected later than 48 hours after vaccination. Some “shedding”!

Anecdotes and conspiracy theories: The commonalities between “shedding,” homeopathy, and other impossibly implausible treatments

Amusingly, AMD even basically concedes all what I just discussed in the previous section, in essence admitting that “shedding” should be impossible:

In the case of shedding, a few major points argued against it being possible.

• The design of the mRNA vaccines was that lipid nanoparticles containing mRNA were injected in the body, after which they made their way into cells and causes cells to begin producing vaccine spike protein for an unspecified amount of time.
• Because of this, there were relatively few options of what could be shed. For instance, while it is unlikely the lipid nanoparticles or the mRNA it contained could be transmitted from the vaccinated individuals to their environment, if it could be, there was very little to transmit, so it was simply not possible a single injection could contain enough vaccine material to perpetually sicken those around the vaccinated individual.
• The only other option was the spike protein being produced by the vaccine was the agent that “shed” (e.g., because the mRNA didn’t break down and hence produced spike indefinitely or because the mRNA had integrated into the cell genome and hence the body was producing spike indefinitely).
• Spike “shedding” didn’t make sense either because the concentration of spike protein (which is rapidly broken down in the environment) would have to be orders of magnitude higher within the vaccinated individual than in the area around them. In turn, this argues against the shedding being able to affect others if an infinitely higher concentration did not affect the vaccinated individual.

I forgot to mention that last bit, which is actually true, although “infinitely” is a bit of an exaggeration. In any event, there is no evidence that the vaccine produces spike protein indefinitely. Even the longest estimates for how long it can produce spike are only on the order of a few weeks, tops, and, again, the amount produced is truly minuscule.

AMD was doing so well here, at least until this part:

Since I was nonetheless seeing numerous clear cut cases of shedding occurring, this suggested to me that I was missing a huge piece of the puzzle which once known invalidated much of the above logic.

Whenever I see this, I ask: How do you know that what you are “seeing” is “shedding”? No, seriously. How? To prove “shedding” you need to show a number of things:

• mRNA, spike protein, LNPs or something else attributable to the vaccine is somehow “excreted” or “shed” into the environment in measurable quantities. This has never been demonstrated to my knowledge, other than the finding that tiny amounts of mRNA fragments from the vaccines can be excreted in breast milk for up to 48 hours after vaccination.
• Whatever is “shed” or “excreted” that is attributable to the vaccine can be transmitted to other people. This, too, has never been demonstrated to occur, much less a mechanism shown.
• Whatever is “shed” or “excreted” that is attributable to the vaccine is, when transmitted to other humans, present in a sufficient quantity to be toxic and to cause all the symptoms and ailments attributed by antivaxxers to “shedding.” None of this has ever been shown either.

All AMD has boils down to anecdotes and conspiracy mongering. For instance, he points out that the Pfizer clinical trial protocol excluded pregnant and lactating women. Of course, anyone who has ever been involved in a clinical trial knows that this is a pretty standard exclusion ever since the thalidomide disaster over 60 years ago; AMD even mentions this! He then concludes that “suggested either that Pfizer knew shedding was a real problem, or that they were following the existing standards—the FDA stipulates that gene therapies need to be evaluated for shedding before being given to humans (and furthermore be subsequently tested in humans)” and then adds that “both the FDA and the EMA classify the mRNA vaccines as a gene therapy.” I note that that FDA link is exclusively about virus- and bacterial-based gene therapy (which the vaccines are not) and how shedding data are required for gene therapies using such vectors. Ditto the EMA link, which also discusses viral vectors, DNA vectors, and bacterial vectors, although it does mention that the testing “of of RNA and DNA vectors, plasmids or artificial chromosome DNA should include tests for genetic identity and integrity including confirmation of the therapeutic sequence and regulatory/controlling sequences, freedom from extraneous agents, sterility and endotoxin levels,” which was done for the mRNA vaccines.

In other words, AMD is either ignorant or being deceptive (i.e., lying). Take your pick.

As for the rest, all the evidence that AMD can muster consists of anecdotes, in which he cites “the strongest proof for shedding” as coming “from the observations by Pierre Kory and Scott Marsland at their clinical practice which is dedicated to treating vaccine injuries (which places them in a unique position to observe and evaluate this phenomenon).” This is some seriously thin gruel, even as described by AMD:

They have:

• Seen more than twenty patients develop similar symptoms after a shedding exposure, particularly after a “strong” shedding exposure.
• Found that those symptoms resemble what is seen in other spike protein pathologies (e.g., long COVID or a mRNA vaccine injury).
• Found those symptoms often respond to the same treatments used for treating other spike protein pathologies (e.g., ivermectin which binds the spike protein).
• Found many patients will repeatedly have shedding symptoms emerge after the same exposure (e.g., always feeling ill when a vaccinated husband returns from a long trip away).
• Been able to determine that those they suspect are a shedder (e.g., the husband) test positive (through an antibody test) for a high spike protein levels.
• Found that eliminating the shedder from the patient’s life or treating the (asymptomatic) shedder with a vaccine injury protocol significantly helps their patient get well.

Twenty patients? Out of how many patients seeking out these quacks? Color me unimpressed. None of this demonstrates “shedding.” It might be worth investigating Dr. Kory’s “case reports” further in a follow-up post, either here or at my not-so-secret other blog, but this post is already getting too long to do it here. In particular, many of the bullet points above are consistent with the power of suggestion in which the persons, because they believe in shedding, feel ill when the vaccinated person is around. Seriously, contrary to what AMD claims, mechanism does matter. If you can’t demonstrate a biological, it’s hard to take such dubious anecdotes seriously as evidence for shedding. If you’re going to claim that shedding occurs in the face of the overwhelming body of evidence from basic science demonstrating that it can’t occur you damned well need to provide much more compelling clinical evidence than the vague anecdotes like this if you expect to persuade scientists to start to doubt the scientific consensus (and the evidence supporting it) that COVID-19 “shedding” occurs and can cause others to become sick is a real phenomenon:

The sensitive patients tend to be the most susceptible to shedding, and I’ve seen numerous reports of individuals (e.g., consider this report from one of Pierre Kory’s patients) who can immediately tell if they are around individuals who have been vaccinated (e.g., because they immediately feel a “toxic” presence or feel a shedder injure them).

Psychic mediums claim to be able to “feel” the presence of ghosts, too, and homeopaths claim that magic shaking of each dilution “potentizes” it to make it more powerful. They also say that mechanism doesn’t matter, and neither does all the science demonstrating that homeopathy can’t work, because they know it does and just need to figure out the mechanism.

Which reminds me of antivaxxers like AMD and Dr. Kory, who claims such harms from vaccine “shedding.”

David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. Find David on X @gorskon

A version of this article was originally posted at Respectful Insolence and has been reposted here with permission.