Question from BL Facebook pg about vaccination & evolution

Yup.

I’m shielded from the human reality of dying children, even though a lot of my work does involve such deaths.

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I wonder if this will show up more with decreased pressure on sickle cell and other genes if we ever do get a malaria vaccine. We might have less sickle cell disease.

I understand you work with malaria–blessings on you. In Galmi, Niger, where I grew up, the burden is unimaginable to me. Every rainy season, people are put on the floor in wards, just to give them a space to get the right meds. From parasite-mediated blood breakdown, I saw a hemoglobin of about 4 in an adult–that might have been both bilharzia/schistosomiasis and malaria–but kids were as low as 3, as I recall (most normal levels for men are 14 and females, 12 in the West). One of our neighbors’ kids never was the same after cerebral malaria. Malaria delenda est, as you said :slight_smile:

@jpm Phil, I was amazed at the effectiveness of effectiveness for H flu and pneumococcus vaccines-when I was in med school and residency, they drilled the lumbar puncture and septic workup in kids into us with the Sanford guide, etc; but that time they were starting the vaccines. By the time I graduated from residency in ‘04, there were almost no meningitis cases. It was amazing. In Africa, one of the missionaries’ kids died of meningitis in just a few hours, and I saw other kids die similarly. Almost everyone in the US is immunized against Hep B–which can cause cirrhosis and cancer in up to 2/3 of cases. 1/3 of all people in Niger carry Hep B–we had folks dying of cancer, cirrhosis and intraabdominal hemorrhage related to that in their 30s. I’m so grateful for vaccines.

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