It’s Tick Season

The winter Influenza peak is quickly passing, and COVID, which never really had the typical winter surge this year is plateaued at a low level across the country. It’s well into spring weather across much of the US (even as I’m skiing in a blizzard and 25 degrees in Telluride). Tick season is here, or shortly coming, and I want to discuss an increasingly common complication of tick bites that many people are unaware of or feel that they are not at risk on their home turf. Alpha-Gal syndrome (AGS) is not the development of highly aggressive, domineering female personality traits, but the somewhat bizarre occurrence of serious allergy to meat which develops as a consequence of a tick bite. The condition was first described in 2009, and was initially felt to be confined to the geographic range of the Lone Star Tick. The following map illustrates how that tick species has expanded northward from its historic south-central range in the last several decades.

Recently however, reports are beginning to emerge of cases from both coasts where the syndrome is a result of black leg ticks (Ixodes scapularis and Ixodes pacificus) frequently called deer ticks, which have a wide distribution around the country. These are the tiny ticks which transmit Lyme Disease, and the less frequent anaplasmosis, ehrlichiosis, babesiosis, Powasson virus disease, and Borrelia myamotoi.

The mechanism for meat allergy developing after a tick bite is the result of your immune system being exposed, and mounting an IgE response, to proteins in the tick’s saliva which contain a disaccharide (two types of sugar molecules) which is present in the muscle proteins of many mammals. The sensitized individual can then experience a range of symptoms from gastrointestinal upset, pain, hives, and even anaphylaxis after ingesting meat. The likely explanation as to why we don’t get sensitized from eating meat is that the digestive process breaks down the particular epitope (fancy name for a 3-dimensional shape) on the meat protein which triggers the immune response. The tick is essentially vaccinating us against meat when it injects the hundreds of proteins found in its saliva. Just one more reason to use every method at your disposal to avoid tick bites, as there is no known treatment that will reverse this condition.

Some years ago there was vaccine for Lyme Disease which was moderately effective, but there was so little demand for the shot that it was withdrawn from production. A generally more useful approach would be a vaccine that could protect us from tick bites in the first place, thus offering protection from all the diseases they transmit. That’s not beyond the realm of possibility since ticks don’t deliver these illnesses the second they bite in; transmission seems to occur later in the feeding cycle, after the initial injection of the brew of chemicals which cement the tick in place, anti-coagulate our blood, plus pain killers and anti-itch compounds to distract us. A recent article in Science Translational Medicine reports some fascinating work in which the researchers looked at antibodies in the blood of a person with a history of myriad tick bites, and currently resistant to bites. (As in ticks which bite him are unable to stay attached and quickly fall off). Looking at the entire tick proteome, they identified the tick proteins the resistant individual has mounted an immune response to, and then immunized guinea pigs with these proteins, producing animals also resistant to tick bites. Just identifying the panel of proteins which may be a target for future vaccine research is a big step. I know you may be thinking, “Yea, but cockroaches and ticks will inherit the earth after we have destroyed ourselves”, and you probably are correct—but it would be nice to avoid Lyme Disease and continue to enjoy a nice steak au poivre until then.

Tick feeding or vaccination with tick antigens elicits immunity to the Ixodes scapularis exoproteome in guinea pigs and humans SCIENCE TRANSLATIONAL MEDICINE

26 Mar 2025. Vol 17, Issue 791

DOI: 10.1126/scitranslmed.ads9207

The best health care in the world isn’t very useful when you can’t afford it. A recent Gallup and Western Health poll shows that from the beginning of 2021 through the end of 2024, the percentage of Americans who are “cost desperate” and unable to afford health care has risen to the highest levels overall since 2005, and for certain demographic groups is now even higher. The following table shows the increased percentages of cost desperate individuals, and it should come as no surprise that Hispanics (up 8% to 18%) and Blacks (up 5% to 14%) and those with incomes lower than $24,000 (up 11% to 25%) have fared the worst. Remember when Obama Care was sold as guaranteed to lower the cost of healthcare and insure everybody? The biggest results of the social experiments to push HMOs and government subsidized healthcare has been the corporatization of medicine, and the consolidation of power within a handful of insurance companies, that somehow along the way were also given the right to practice medicine and decide which tests and treatments you may receive.

The social burden of dementia continues to grow as the population ages. Neurotropic herpes group viruses have long been considered possible contributing factors in cognitive decline, and a new study from Wales, published in Nature, adds some further evidence to an earlier study suggesting that Shingles vaccine may have a protective effect against dementia. This is described as a natural experiment—as close to a randomized controlled trial as you can get in a situation like this where the therapeutic intervention is already approved and recommended for everyone over a certain age. The “experiment” was a product of the Welsh NHS’s decision to recommend and begin dispensing Shingles vaccine (the older attenuated live virus vaccine) to everyone born after a certain date in 1933—those born before that date would forever be ineligible. (Don’t enquire too deeply, it’s the National Health Service where every intervention is dependent on cost and availability, and the value of your life and health are perfectly calculated by government bureaucrats). They looked at a large number of people born in the week before that date (.01% received the vaccine) and another group born during the following week (47.5% vaccinated). As you can see this is essentially a randomized group with almost no expected difference in all other potential confounders. The results over the next 7 years of follow up were an 3.5% lower diagnosis of dementia in the vaccine recipients or a 20% relative reduction. This study confirms the finding of a previously published study in Nature Medicine of this association between Shingles vaccine and some reduction in dementia risk.

A natural experiment on the effect of herpes zoster vaccination on dementia Nature (2025). https://doi.org/10.1038/s41586-025-08800-x

the zoster vaccine reduced the probability of a new dementia diagnosis over a follow-up period of 7 years by 3.5 percentage points (95% confidence interval (CI) = 0.6–7.1, P = 0.019), corresponding to a 20.0% (95% CI = 6.5–33.4) relative reduction. This protective effect was stronger among women than men. We successfully confirm our findings in a different population (England and Wales’s combined population), with a different type of data (death certificates) and using an outcome (deaths with dementia as primary cause) that is closely related to dementia, but less reliant on a timely diagnosis of dementia by the healthcare system¹⁰. Through the use of a unique natural experiment, this study provides evidence of a dementia-preventing or dementia-delaying effect from zoster vaccination that is less vulnerable to confounding and bias than the existing associational evidence.

As Woody Allen famously said, “My brain is my second favorite organ”.

The Texas measles epidemic continues apace with 422 cases, 42 hospitalizations, and one death as of April 1st. Only four of these cases had received vaccination, confirming what we have always known—the vaccine is extraordinarily effective. Why one vaccine works so well at completely preventing disease and other vaccines like Influenza or COVID have a meager track record at preventing infection, but only reduce the severity of illness is complicated. The Measles virus and SARS2 (COVID) are both single stranded RNA viruses which are prone to frequent mutations. In the case of SARS2, many changes in the S (spike protein) leave it both functional and able to defeat the vaccine induced antibodies. Measles virus utilizes its hemagglutinin protein to attach to a receptor molecule CD150 on our immune cells. It has been suggested that this interaction is very prone to disruption by any mutational changes in the hemagglutinin. Consequently the vast majority of mutations lead to noninfectious viral particles, and immunity to the hemagglutinin is very stable. A greater impact is likely from the nature of the vaccines. The COVID vaccine (either RNA or protein versions) deliver the single S protein for the immune system to target. The response is short lived, and of course circumvented by mutations in that protein. The Measles vaccine is a live attenuated virus causing a wide ranging, robust, and extremely long lasting immune response to many targets on the virus; more closely simulating the natural immunity from infection.

I’ve been asked why I haven’t been more rabid in my criticism of RFK Jr’s response to this measles outbreak. There’s quite enough rabies going around in our political and social commentary these days, and parroting what others flood the bandwidth with doesn’t particularly interest me. The sticking point for the media of course is that while he urged people to get their kids vaccinated, saying it was the best way to prevent measles, he also said it was a personal choice. The latest news from Texas however, is that Bobby is personally going door to door with a mobile vaccine van and pleading with people to vaccinate their children. He has disavowed all the vaccine autism stuff and says he is hopeful that a new randomized trial sponsored by the NIH will convince hesitant people of the vaccine’s complete safety. Closely following the scientific data, RFK Jr. is actively promoting multiple Shingles vaccinations now, citing his own success in reversing dementia. Given his own experience with this anti-dementia therapy, President Biden may be joining him in a bipartisan national campaign to promote annual Shingles vaccinations. (This story was reported in the April 1st edition of Lone Star Tick Chronicle).

You should forward Clear and Present Thinking to your friends, if only to annoy them.