The Case of New Zealand's Baby Will
Are we engaging in an academic exercise to the detriment of this child.
I’m going to go out of my specialty and make some measured recommendations regarding this case. If there are any specialists among my subscribers, please chime in and/or correct me.
Will is a four-month-old baby boy at the center of a controversy. He has a serious heart condition called pulmonary stenosis that needs surgical attention. If the stenosis is severe it is a medical emergency and needs immediate correction. Parents want Will to receive donated blood from unvaxed donors only. The surgeons have refused Will on this basis. They want Will to avail himself to a greater donor pool including the vaccinated because they believe a better match will be found.
This is not necessarily the case but it is more likely. Will should go ahead and have this necessary surgery done, however,
Look, you all know I am against this vaccine. It doesn’t work. It generates a toxic molecule. The side effects including death are off the charts. It’s not really a vaccine, etc. And there is definitely a chance that Will could acquire some spike protein in a transfusion of whole blood. This depends somewhat on when the donor got vaccinated but there is lots of evidence the vax components hang around for a very long time on the order of months.
Here’s the point. Will doesn’t need whole blood! PRBCs would do Will just fine and a good washing will remove all the mRNA, spike proteins, prions, etc that might be floating around in the plasma.
Remember, whole blood is made up of plasma and RBCs Let’s ditch the plasma part and give him entirely adequate washed PRBCs if he needs blood. Why are we going through all these machinations with a critically-ill child in need of immediate care?
OK this leaves us with RBCs. Could the mRNA or spikes be inside or on the RBC’s? First we must review RBC characteristics. They carry O2 from lungs to the periphery via their hemoglobin molecules with associated iron ion (the “heme” in hemoglobin). They have no nucleus or replication machinery or any other kinds of organelles inside their membranes. They have no means to carry spikes and even if mRNA could get inside their membranes there would be no nucleus containing DNA to incorporate into and no replication machinery to translate it into spike proteins and no presentation on the surface for the MHC to recognize. . They are essentially, donut-shaped (without the center actually having a hole) sacks of hemoglobin.
I’m as concerned about tainted blood as much as anyone. I’m not sure washed, PRBCs couldn’t be tainted. I don’t know but I doubt it. I would even say I’m pretty sure on this. I know this isn’t good enough for the parents. It’s almost a 50-50 call. Let’s hope the baby won’t need blood but if the stenosis is severe, this baby needs surgery “immediately”.
Maybe go ahead with matching protocol on unvaxed blood (blood type, Rh factor, crossmatch). If less than an ideal match is found, open up the donors to the vaxed and use thoroughly washed PRBCs. But you have to get this child on the table and fix his heart.
I am a long-time blood bank director. Directed donations are discouraged primarily because it is almost impossible to accommodate a long list of people coming in and saying "I only want blood from these people". It is already hard enough to make this all work. (And as you can imagine, the requests quickly go from “no mRNA vax blood” to “No vax of any sort blood” or “No black blood” or “No blood from anyone who drinks” ad infinitum. We have seen it all.)
Reports are that the parents had recruited a large pool of potential donors. While they all claim to not have been spikeshotted, we assume at least 10% of the responses we get to questions are not correct. And many of those patients will have had covid (which makes the same spikes) and, for that matter, may have it at the time they are donating -- many cases remain subclinical
Matching is pretty arbitrary: Units are ABO/Rh typed and then pretty randomly selected (usually by expiration date) to be crossmatched. A major side crossmatch is all that is generally done which makes sure that there are no antibodies in the baby's blood that will clot the incoming transfusion. (A minor side crossmatch, seldom done but considered when volumes are equally small, checks the reverse.) Most matches get through first time. If not, one moves on to another type/rH compatible unit.
There is a further layer to put on this. Red cells (which is all they really need to transfuse) are just sacks of hemoglobin with a membrane. They do not contain organelles (like a nucleus) and I expect would not contain (internally) spike protein either...no place internal to attach since the red cell has just a simple unit membrane. But the red cell DOES have CD147 receptors on the membrane (https://doi.org/10.4236/oalib.1108300), so spike proteins could stick to it.
As you noted, one would by default use packed, washed RBCs. Whole blood does not keep well and is seldom banked except for special needs. Most of the adhered spikes (if any) would have been washed off. And this, of course, beggars the question as to whether someone vaccinated, let us say one year ago, or someone who had covid six months ago would have any spike protein floating around in any case. Most would think not. (More on this below.)
Of course, one could test the units for spike protein if that were of merit. We test for many other things (among them: HIV, Hepatitis B, Hepatitis C, Chaga's disease, HTLV, West Nile, Zika, Babesiosis, sometimes others.) It would not be that difficult to test for spike protein as well. That, too, would have helped everyone feel better. I believe the worry of the NZ health system is that everyone will then want every unit tested. If there were an indication that transfusing units were spreading disease it would already be tested; that is how all those other diseases got onto the testing list.
I am not aware of any published report of covid being transmitted through transfusion or of post-transfusion spike protein damage. Even though those are surely possible, most blood transfusions are pretty carefully monitored and such issues are usually exposed early. That is doubly true for something like covid where virtually everyone has already had it; if there were to be serious consequences, they likely would have already been detected.
One has to assume that most transfusions given in the last year have come from covid infected (and/or vaxxed) patients. The spikes are the same. One can anguish over some of the other spikeshot components (lipid nanoparticles, etc.) but these are unlikely to have a long lifespan or to survive washing.
As an aside, people underestimate how much “stuff” there is in EVERY transfusion – even with washed, packed cells, there is likely to be detritus in tiny amounts from many previous infections the donor has had, whether or not they even knew about many of such infections. Luckily, recipients, even tiny babies, are quite good at dealing with such – after all, it is the whole point of the immune system. And it is why we screen for the things we know are an issue. But many transfusion patients do run fevers, etc. as they process the “non-RBC” components of the transfusion that were not screened out. This virtually never results in significant morbidity, however.
Most patients do OK with their transfusions -- usually if you are being transfused you have far larger issues with which to deal and having tissue oxygenation is more important than the other potential transfusion issues. (This goes without saying if you are going on the pump.) We monitor each transfusion to see if we are seeing effects from covid and, for that matter, anything else. As readers of various stacks know, I am a long-term opponent of spikeshotting most patients, but that does not necessarily extend to assuming that such blood is contaminated in some way.
Another approach: The beauty of RBCs is they last only 120 days which means the average lifespan of an RBC in a sample is only 60 days. It would be relatively easy to use the general pool but to screen (we screen for endless things) patients who were last spikeshotted six or 12 months before and who have had no known covid in the past six months. As long as giving packed, washed red cells, the chance of spike contamination would be virtually zero. This is likely unnecessary but could be covered under precautionary principles for those concerned.
Good insights. Thank you.