Covid Vaccines and West Nile Virus: A Case for Immune Suppression

In 2021, the state of Arizona has seen a dramatic increase in the number of West Nile Virus cases. What is even more concerning is the number of cases of neuroinvasive disease and deaths resulting from West Nile virus infection. The 1114 cases of neuroinvasive disease and the 112 deaths seen in Arizona in 2021 are the highest on record for any state in the U.S. since West Nile first emerged in 1999. Public health officials and healthcare providers in Arizona attribute the skyrocketing numbers seen this past year to a very wet monsoon season. But is it possible that Covid-19 vaccines have anything to do with the drastic increase in disease severity?

A recent study from the Netherlands suggests that Covid mRNA vaccine “induces complex functional reprogramming of innate immune responses” that needs to be considered in the use of this new technology. The paper states that the “response of innate immune cells to TLR4 and TLR7/8 ligands was lower” after Covid mRNA vaccination (https://www.medrxiv.org/content/10.1101/2021.05.03.21256520v1). TLR stands for toll-like receptor. These TLRs are found in the immune cells of our body and numerous studies have demonstrated that TLR7 and TLR8 play a critical role in the recognition of and defense against single-stranded RNA virus infections. Suppression of these TLRs would prevent an appropriate immune response to invading RNA viruses. What this recent study suggests is that following Covid vaccination, we may be more susceptible to infection by other single-stranded RNA viruses because our body cannot mount an appropriate immune response. West Nile virus is a single-stranded RNA virus.

Case Report
A 57-year-old healthy caucasian female with no known medical problems received her initial 2 doses of Covid-19 vaccine in March of 2021. In August of 2021 she developed a documented breakthrough case of Covid-19 and was symptomatic for approximately one week. On October 9th the patient received a Covid-19 vaccine booster shot. During the week following the booster shot the patient complained of fatigue and myalgia which she attributed to the Covid vaccine. On Saturday October 16th, one week after the booster, the patient developed significant vertigo which progressed over the next 2 days to include mental status changes and upper extremity weakness. On Monday October 18th, she became unresponsive with complete flaccid paralysis of the bilateral upper and lower extremities. She required intubation and ventilatory support and remained in a coma. Lumbar puncture revealed elevated monocytes and protein suggesting a viral cause of illness. Subsequent serology confirmed West Nile virus and a diagnosis of West Nile virus encephalitis with acute flaccid paralysis was made. While in the ICU she was unable to be weaned from the ventilator and required tracheostomy. After 120 days she remains ventilator dependent with ongoing complete flaccid paralysis of all 4 extremities and severe cognitive deficits.

West Nile virus is a single-stranded RNA virus that spreads to humans from bites of infected mosquitoes. Most people (~80%) infected with West Nile virus will have no symptoms. Approximately 20% of infected people will have a mild febrile illness. Less than 1% of all infected people will develop severe illness with central nervous system involvement (neuroinvasive disease). In patients with neuroinvasive disease, the neurologic manifestations may include disorientation, tremors, convulsions, muscle weakness, coma, and flaccid paralysis. The acute flaccid paralysis is presumed to be caused by direct infection of the anterior horn cells of the spinal cord. In those patients with acute flaccid paralysis, the majority do not recover fully.

West Nile virus was first detected in Arizona in 2003. Maricopa County is the largest county in Arizona and is the 4th largest county in the United States. It accounts, by far, for the largest number of West Nile virus cases in the state. As of December 2021, 1417 cases had been recorded with 112 deaths. This compares with 3 cases and only 1 death in 2020. The monsoon activity typically seen in that region of the country did produce a particularly wet summer and fall and public health officials have been attributing the increased number of cases to this increased precipitation. However, when reviewing the previous annual West Nile virus case counts, it becomes clear that something else must be going on to account for the dramatic increase in cases and deaths seen this year. Previous annual West Nile virus human case counts, according to Maricopa County Department of Public Health records are as follows:

• 2011: 50 cases and 2 deaths

• 2012: 98 cases and 4 deaths

• 2013: 52 cases and 6 deaths

• 2014: 93 cases and 12 deaths

• 2015: 62 cases and 2 deaths

• 2016: 63 cases and 5 deaths

• 2017: 93 cases and 6 deaths

• 2018: 24 cases and 6 deaths

• 2019: 155 cases and 17 deaths

• 2020: 3 cases and 1 death

• 2021: 1417 cases and 112 deaths

Over the last 12 years the state of Arizona has seen significant annual variability in the amount of monsoon rainfall. While public health officials this year have attributed the significant increase in neuroinvasive West Nile disease to heavy monsoon precipitation, an evaluation of past rainfall data indicates that there has been no correlation between annual monsoon rainfall and the number of neuroinvasive cases of West Nile virus. The 10-fold increase in neuroinvasive disease seen this year cannot be accounted for by heavy monsoon rainfall. 

• 2010: 107 cases and 2 inches

• 2011: 49 cases and 1.5 inches

• 2012: 87 cases and 4.0 inches

• 2013: 50 cases and 3.3 inches

• 2014: 80 cases and 6.9 inches

• 2015: 67 cases and 2.1 inches 

• 2016: 57 cases and 2.6 inches

• 2017: 15 cases and 3.0 inches

• 2018: 25 cases and 3.1 inches

• 2019: 132 cases and 2.6 inches

• 2020: 7 cases and 0.8 inches

• 2021: 1114 cases and 6.1 inches

In the spring of 2021 the CDC formally recommended Covid-19 vaccination for all adults. In the fall of 2021 the CDC formally recommended Covid-19 vaccine boosters for all adults. In the fall of 2021 the state of Arizona has seen an avalanche of cases of West Nile virus infection, neuroinvasive disease, and death. Recent studies suggest that Covid vaccination suppresses the immune system and, specifically, the part of the immune system that protects us from single-stranded RNA virus infection. West Nile virus is a single-stranded RNA virus and the recent dramatic increase in cases and deaths seems to correspond with the Covid-19 vaccination program. It is the responsibility of the CDC and other public health officials to explore the potentially severe and serious relationship between Covid vaccination and RNA virus infections. If this relationship is confirmed then, at the very least, the public should be directed to avoid receiving Covid vaccination and boosters in areas of the country that are experiencing outbreaks of other RNA viral infections such as West Nile virus.