NEJM commentary: Is face mask a form of crude COVID-19 vaccine?

The world is eagerly waiting for a new and effective coronavirus vaccine. But a new theory is doing its rounds in the medical circle. Could face masks be serving as a crude vaccine already? Could the face masks be exposing the wearer to a decreased dose of the virus that would be just enough to induce a protective immune response? This theory has been put forward as a NEJM commentary.

Face masks-the crude vaccine? What does the NEJM commentary say?

There is an unproven theory currently in the medical circle. A commentary published in the New England Journal of Medicine (NEJM commentary) last month has put forth this idea that face masks might already be a form of a crude vaccine. This is based on the old concept of variolation. In this, a person is deliberately exposed to a smaller dose of the pathogen to build a protective immune response. It was done for smallpox and now for chickenpox (chickenpox parties). This idea was the inspiration for the development of vaccines.

Face masks in public [Source: Stylist]
Of course, a face mask is not a substitute for a bonafide vaccine. But it could assist in protection through this mechanism as well.

Face masks and its role in the COVID-19 pandemic

Face masks have been made mandatory during the current COVID-19 pandemic. It cuts down on the transmission of the virus. For the wearer, it decreases the viral load and hence the chances of the person getting sick. But researchers theorize that if by chance a small number of the virus slips through the face mask, it might act as a crude vaccine. These might induce the body to start a protective immune response and thus assist the wearer to fight off the virus with a second viral exposure. Dr. Monica Gandhi from the University of California states:

“You can have this virus but be asymptomatic. So if you can drive up rates of asymptomatic infection with masks, maybe that becomes a way to variolate the population.”

Face masks in public places [Source: Daily Mail UK]
But she clarified:

“This is not the recommendation at all. Neither are pox parties.”

Unethical to study the theory

In order to prove the theory, one will have to compare the infection rate in those who are exposed with a face mask on and those who are exposed with no face mask on. But such a study set-up in the current scenario would be an unethical one. Saskia Popescu from Arizona was skeptical. Saskia said:

“It seems like a leap. We don’t have a lot to support it.”

If the public takes this theory in the wrong way, it might end up that the masked people might get a false sense of complacency and put themselves at more risk.

Face mask-the crude vaccine? [Source: Yahoo News]
Also, read Niqab: Is this religious face covering considered as a face mask?

These people might refuse a vaccine whenever it is available. Or some people might start believing that face masks are useless and stop wearing them. But with the current limited knowledge about the deadly virus, it is best to leave this idea as a theory and not decide anything on it!