Any vaccine with very-long-term side effects?

Some of the current COVID vaccine hesitancy is among people who claim to be concerned about side effects. And indeed there are side effects - some of which are severe - but AIUI, not dramatically different in severity or incidence from most other vaccines. Also, the side effects I’m aware of tend to manifest within the first 24-48 hours after being vaccinated.

But since we’ve been vaccinating people for seven months now (over a year if you count the early trials), these short-term side effects are pretty well understood. So I guess people who express concern about side effects could really only be concerned about the ones that happen in the very long term? I guess we won’t know about those for a very long time, but are they even plausible?

Has there ever been a vaccine with side effects that show up years after administration?

The idea of a vaccine side effect only showing up years after administration can’t be utterly and conclusively rejected - it just hasn’t happened in all the many decades and billions of doses of vaccines administered.

"As far as long-term effects of the vaccines, Salmon agrees that “we can’t say with absolute certainty that there won’t be some problem 20 years later because of COVID vaccines.”

“But throughout the history of vaccines, adverse events have always occurred within the first six months after vaccination, he said.”

  • Daniel Salmon, the director of the Institute for Vaccine Safety at Johns Hopkins School of Public Health

Every negative effect of vaccine administration supposedly showing up years later, as proposed by antivaxers (including autism*, diabetes, MS, loss of fertility etc.) has been refuted by solid research showing no association.

There’s such a thing as a vaccine-preventable disease with severe consequences showing up many years after infection (SSPE, a rare but fatal sequela of measles), but the corresponding vaccine has not been implicated.

*some anti-vaccine types think autism is an immediate effect of vaccines.

You can’t completely prove a negative so there could possibly be some rare side effect to the vaccine that is lost among the overall prevalence. For example if 1/10,000 people who were vaccinated had a long term reaction that caused diabetes, then you would not be able to detect the difference between the 10% prevalence among the unvaccinated and the 10.01% prevalence among the vaccinated.) All we can say is that of the things we looked at none of them have demonstrated significance, nor do we have any mechanism that would indicate a causal difference.

Now anti-vaxers are working overtime to try to find connections between vaccination status and any negative condition. It is almost guaranteed that they will from time to time come up with a negative condition that is significantly associated with vaccine status. But then comes the reality check. If you roll the dice enough times you are eventually going to get snake eyes twice in a row. Similarly if you look at enough different studies, in different combinations you are going to eventually get a positive looking connections purely by chance. Also there may be difference between vaccinated and unvaccinated populations when it comes to demographics. It may be that those people who get vaccinated are more medically conscious and so are more likely to get tested of another condition. So unless it is a well controlled study looking at a pre-defined fixed set of conditions, with a mechanism of action in mind be very skeptical.

Sure, but to be fair you can’t completely rule out potential zombification from vaccines either. We have no reason to believe that either is the case.

Well, I think we actually can rule out potential zombification as a vaccine side effect since given the millions of doses of vaccines we have never seen an example of zombification.

If we did start having zombification popping up, and if we did a study that showed that every one of the 1,000 people who rose from the dead, all of them got their HPV vaccine, that would suggest their zombification was in some way tied to their getting the HPV vaccine, even though it still would be a very rare side effect. This in turn might lead us to avenues of research into the mechanism of zombification centering around the HPV.

But to put this into perspective of why avoiding vaccines based on the possibility of rare unknown side effects is foolish, we also can’t prove that eating celery doesn’t increase your diabetes chance by 1 in 10,000.

Another issue is that just saying “vaccinations” is uselessly broad. Vaccines stimulate the immune system to create a long term immunity. Same as the immune system does every time it fights off an infection, or indeed if you were infected with and recovered from the infection that the particular vaccine is designed to protect you from. So, you start from the position that injecting you with something that won’t create the disease, but does induce the immune system to create an immunity to that disease, is in some manner intrinsically a problem.

Vaccines present the immune system with something that looks a lot like a very specific part of the bad pathogen. They a designed in lots of different ways. Everything from pathogens that look a lot like the bad one, but are actually benign (cow pox for smallpox, and the origin of the word vaccine), actual pathogens that have been bashed and mangled so badly that they can’t cause disease (attenuated vaccines), actually dead pathogen particles (killed virus vaccines), just chopped up bits of the pathogen, carefully crafted manufactured bits of virus, through to vaccines that use your cellular machinery to create lots of copies of just the right tiny specific bit of the virus to stimulate the immune system. (mRNA, adenovirus - like Sputnik and AstraZeneka).
This is a huge range of techniques, and there is not a lot of commonality other than stimulation of the immune system to recognise a chosen target. Which is exactly what the immune system does naturally all the time anyway.

The anti-vaxxers have latched on preservatives and adjuvants as possible whipping boys. Adjuvants are used to stir up the immune system in a general way, basically revving it up so that it does a better and faster job with the vaccine. But not every vaccine needs or uses an adjuvant.

Could there be unexpected long term side effects. Of course. Noting is sure in life. But given the job of a vaccine is to induce a natural behaviour of the immune system in a manner that avoids actual infection with the pathogen, it is hard to make a case that vaccination per se has some intrinsic deep evil effect.

I’m not aware that there was ever a vaccine with side effects that showed up years later.

A live, attenuated, vaccine could, in theory, give you a live, attenuated infection that didn’t become evident until years later – like shingles from a chicken pox infection. I’m not aware of any vaccines where ‘years later’ has been demonstrated – most viruses don’t seem to have that capacity to hide and then come back, and the ones where successful live vaccination has been developed haven’t been that subset. In any case: there aren’t any live attenuated COVID vaccines, so that (purely theoretical) idea isn’t possible for COVID.

Injecting something into your body could, in theory, cause some damage that you don’t notice until years later. But the damage would be already present, and would show up on examination.

Cancer tumors wouldn’t show up until years later, but you’d be able to demonstrate the carcinogenic nature of the injection.

Heavy metals can react with many/several parts of your body, it’s a special characteristic of heavy metals. But heavy metals can react in the same way with other things first, so that they then don’t have that characteristic any more. Like lead in amalgam fillings and mercury in thimerosal. And there aren’t any heavy metals in COVID vaccines.

Side effects from live polio vaccination and from live smallpox vaccination were a real thing, but they showed up immediately, and were from live viruses.

There aren’t many things that ‘show up later’. Cancer tumors, unnoticed damage and persistent infection. It’s an interesting question, but I don’t think there is anything there.

There is a high incidence of mortality within 100 years of being vaccinated.

And no zombification either. Seems a bad deal to me.

A lack of mechanism for purported long-term effects is important. When there’s no coherent and logical means to explain how a vaccine could cause X, there that much steeper a mountain to climb to contort evidence into supporting your theory.

Before claims about Covid-19 vaccination impairing fertility, antivaxers targeted HPV vaccination for allegedly doing this. It was inevitable that among a large population of young women being vaccinated, a small number would later present with difficulty conceiving a child, by chance alone. In addition to studies demonstrating no association between HPV vaccination and (for example) premature ovarian failure, no one to my knowledge ever came up with a rational mechanism as to how the vaccine would cause infertility.

Here’s a tangentially related anecdote - long delayed side effects (and I mean long), but not from a vaccine.

Quite a few years ago I was involved in a MHRA (UK FDA equivalent) pharmacovigilance inspection of a pharma company (I was on the company side). Now, so long as you were doing a decent job, these were generally non-adversarial occasions, with the general thrust of “we are here to check what you are doing and to help you do it better”, and the inspectors could be very approachable. At one point in the summary discussions at the end of the inspection, conversation turned to practical aspects of monitoring, and the question of how long after treatment could a possible side effect occur? The inspector’s answer was along the lines of “Well long delays before side effects are seen are uncommon; but in the case of X, for example, very long delays have been observed, even next-generation effects. So I guess the theoretical answer is a generation”.

I think, but I can’t be certain (it was a long time ago), that X was Diethylstilbestrol

As I said, only tangentially related, not a vaccine, different mechanisms of action and so forth. But worth a mention in passing, I thought.

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Deleterious long-term i.e.transgenerational effects of DES (notably increased risk of reproductive tract cancers) are thought to be due to persistent alterations in hormone-sensitive gene expression.

This isn’t a mechanism seen with vaccines.

“But Covid-19 vaccines alter your DNA!”

No, they don’t.

A potential mechanism is creating an auto-immune disease much later. It is conjectured that at least some auto-immune diseases are caused by the immune system creating antibodies that then attack normal body cells. I had an aunt who had a severe stomach upset apparently caused by some contaminated fruit. When she didn’t recover she was tested for celiac disease and thereafter had to avoid even a trace of gluten. There is some thought of an association between measles and MS later on.

So one could imagine a mechanism. On the other hand, it would be even likelier for it to be a long-term reaction to the actual disease.

Evidence for such being caused by vaccines is weak to nonexistent.

Not surprising, considering how revved up the immune system gets in respond to a full-blown infection, compared to much lesser activation from a vaccine.

Doubt continues to exist about this association.

*In 2018, a study team including CDC scientists analyzed and published vaccine safety data on adjuvanted pH1N1 vaccines (arenaprix-AS03, Focetria-MF59, and Pandemrix-AS03) from 10 global study sites. Researchers did not detect any associations between the vaccines and narcolepsy.

  • Incidence rate study data did not show a rise in the rate of narcolepsy following vaccination except in the one signaling country included (Sweden, which used Pandemrix).
  • Case-control analyses for Arepanrix-AS03 did not show evidence of an increased risk of narcolepsy.
  • Case-coverage analysis for Pandemrix-ASO3 in children in the Netherlands did not show evidence of an increased risk of narcolepsy, but the number of exposed cases was small (N=7).
  • Cases-control analysis for Focetria-MF59 did not show evidence of an increased risk of narcolepsy."

I don’t doubt what you say. I just wanted to point out that there was a conceivable mechanism for a long-term side-effect, not that it was likely.

Auto-immune episodes are commonly /triggered/ by all kinds of things: sunlight, anxiety, whatever. So maybe you miss a meal and get sunburnt while getting your COVID vaccination.

Auto-immune diseases are /caused/ by changes to the body similar to the way viruses and prions hijack the body. It has been suggested that the Epstein-Barr virus makes modifications to the body causing immune disease.

It’s easy to imagine that mechanism for a live whole-virus like COVID, and for a live whole-virus vaccine, (although obviously rare: most of us get viruses all the time, but don’t die of auto-immune disease). It doesn’t work for mRNA vaccines, because mRNA vaccines aren’t virus infections. They both trigger the immune system, but one infects your body and triggers an immune reaction: the other just triggers an immune reaction.

It’s the difference between making a car and driving a car.

The smallpox and BCG vaccines leave a scar that never completely fades. Would that count?

I have long heard that one of the anthrax vaccines given to troops in the 1990s caused a higher-than-background incidence of various long-term effects, often autoimmune, although the only links I saw were to law firms and woo sites, which may say something.

Indeed. This strongly suggests all vaccinations are ultimately deadly, similar to the lethality of small amounts of saliva if swallowed over long periods of time.