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PaperclipPerfector  10mo ago (text post)   3146 thread views

Small-Scale Question Sunday for December 31, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

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Yes, that's the "immune debt" hypothesis. It's a completely reasonable internally consistent hypothesis; it's not at all obvious that it's better to avoid infection entirely as opposed to hopefully getting minor infections that train the immune system while not being severe enough to do any lasting damage.

... but as far as I can tell, every vaguely reputable scientist with knowledge of the immune system or epidemiology thinks it is wrong and the odds don't work out that way.

To be clear, I'm merely claiming less exposure to pathogens is healthier. There are obviously costs to going out of your way to reduce your exposure to pathogens and the trade-off may not be worth it.

I'm not sure I share your views on whether immune debt is an unsupported position in the broader scientific community, but suspect that appealing to consensus may be unproductive.

Maybe the difference arises in the type of pathogen being discussed. A brief taxonomy could be the below:

  1. Rabies- no benefit to natural exposure as exposure is lethal. Vaccination/avoidance only means of reducing this.
  2. Cholera etc- natural exposure should be avoided due to high risk. Avoidance of causative agent possible.
  3. Influenza- high but limited number of strains. Some strains (e.g. Spanish Flu) lethal. Prognosis depends on strain, previous exposure, general immune strength.
  4. Colds etc- lots of disease causing agents. Prognosis typically mild or subclinical depending on prior exposure and general immune strength.

I agree that you avoid (1) and (2) if possible.

For (3), it depends on the costs and consequences. Through the veil of ignorance, I personally think we opt for as high an exposure as possible to the extent this is typically mild. This can be via vaccinations or general exposure: to the extent that lower cost options such as vaccines are available, they should be taken, and the equation may change as technology moves ( for example a universal flu vaccine would negate the benefits of natural exposure).

For (4) I think you just take the mild cost.

So in this view, avoiding some pathogens is healthier, but for others it increases the effects of related pathogens so it is not healthier on the net.

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