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Comment by barbazoo | Hacker News Reader

> The immune systems of more than 95% of people who recovered from COVID-19 had durable memories of the virus up to eight months after infection.

> The results provide hope that people receiving SARS-CoV-2 vaccines will develop similar lasting immune memories after vaccination.

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The consensus I’m hearing from epidemiologists is the mRNA vaccines should offer better immunity than infection. So it would seem the 8 month for immunity after infection should be a lower bound for the vaccine effectiveness.

> The consensus I’m hearing from epidemiologists is the mRNA vaccines should offer better immunity than infection

Serious question: How can we possibly know this? I'm all for vaccinations (I'm going in for my second shot this weekend), but I just worry about commentary backed by intuition that doesn't carry sufficient disclaiming.

I had this exact question and asked around before finding out a friend's brother specializes in immunology. Apparently two separate exposures triggers a much longer lasting immune response, and because of the nature of the vaccine it's much more targeted to one specific aspect of the virus, and consequently more potent in a way. Moderna also made a statement that they expected their vaccine to last for 2 years based on their ability to measure the number of antibodies and its decline over time [1].

[1] https://www.reuters.com/article/us-health-coronavirus-modern...

They also measured significantly higher density of antibodies at the six week mark in people who had their second vaccine dose vs people who recovered from an infection.

Source?

https://www.nejm.org/doi/full/10.1056/NEJMc2032195

> They also measured significantly higher density of antibodies at the six week mark in people who had their second vaccine dose vs people who recovered from an infection.

I am not seeing evidence of this from the source you provided. It only mentions that natural infection "produces variable antibody longevity and may induce robust memory B-cell responses despite low plasma neutralizing activity."

My original intuition was it would be the opposite.

This actually makes a lot of sense.

Thanks for sharing and correcting my line of thinking on it.

It's also consistent with other vaccines - for example, HPV vaccination confers better immune protection than a natural infection. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813740/ vs. https://pubmed.ncbi.nlm.nih.gov/29029053/

All the data and research I've seen so far show that they are roughly equivalent. Here are some more articles:

https://www.latimes.com/science/story/2021-02-24/coronavirus... https://www.medrxiv.org/content/10.1101/2021.02.14.21251715v

Yes. So long as no mutation takes place on the protein spike.

And this part I'm less confident in, but my understanding is the protein spike is unlikely to mutate because it's exactly what allows the virus to bind where it does. If that mutated and that mutation was still somehow successful, I believe it likely wouldn't be as bad a virus.

My understanding is that virologists and immunologists can't really estimate the chance of a more virulent strain that escapes antibodies analytically, because the probability space is too big. A mutation might escape antibodies but also greatly inhibit how fast it spreads, and so on.

Its been passed around on TWiV and immunologist twitter awhile back that there's ~20 different epitopes on the spike protein that would need to mutate in order to achieve immune escape.

The read on that is that immune escape should come at a cost to fitness and less virulence and transmissibility. The virus will have to "pay" with fitness in order to buy stealth.

At the same time though there have very obviously been multiple different mutations on the spike protein which have enhanced binding / viral load / transmissibility / virulence. So the virus clearly has some room to maneuver in that space.

Mind you, it is a protein. So you're banking on the virus encoding a different/new protein that still binds to ACE2.

Depends on the significance of the mutation. The vaccines have shown to be pretty good at protecting at the mutations we have observed so far. However, it is right to assume, that eventually a mutation comes around which evades any existing immunity. That is one the biggest reasons to reduce infection count globally. The higher the infection count, the larger the risk of a mutation that resets everything back to the beginning immunity-wise.

Sure, there's mechanistic reason to believe that this is the case, but to I'd still like to see the actual data that this is the case.

From my understanding, there are two main reasons. 1) The two spaced exposures. Repeated spaced exposures build a significantly stronger response. 2) Isolation of the spike protein. Just like ML might pick up on a correlated part of the image while learning to recognize things (many examples, no good links), your immune system may learn to react to different parts of the virus. The spike protein is the most unchanging part, and all the vaccine will teach your body to attack.

> The spike protein is the most unchanging part, and all the vaccine will teach your body to attack.

Does that mean that a natural immunity may offer protection against other coronaviruses that have a different spike protein structure? The logic being that the less targeted defenses built through a natural immunity would latch onto some other commonality?

Not necessarily. They will likely try to key on something very specific, as this reduces the risk of it triggering on you (creating an autoimmune disorder). So natural infection may be less effective. We assume that mutations to the virus that hide it from the natural defenses against a random part, but have no impact on the virility, are generally more frequent and numerous than mutations to the important spike protein.

As far as I understand it is less likely for the spike protein to have a radical mutation and keep the ability to attach to cells at the same time. That's why the variants we are seeing have the same spike protein as other mutations of the virus tend to quickly disappear.

If a new variant with a different spike emerges, I guess we'll call it SARS-CoV-3 and produce a new mRNA vaccine for it.

Worse, it’s actually commentary backed by politics and virtue signalling to encourage people who have had COVID to still get vaccinated.

Real world experience doesn't show that.

Protection of previous SARS-CoV-2 infection is similar to that of BNT162b2 vaccine protection: A three-month nationwide experience from Israel https://www.medrxiv.org/content/10.1101/2021.04.20.21255670v...

Given the amount of pseudo-science, false claims, wishful thinking, etc - got a source on that?

The consensus one year ago was that immunity doesn’t last longer than 6 months (hint: it does). I’ve learned to mostly disregard “expert opinion”, especially when they’re talking straight out of their asses as in this case (we haven’t had the vaccine long enough yet to have any kind of experimentally informed view on this topic).

> The consensus one year ago was that immunity doesn’t last longer than 6 months

No, it wasn’t.

The consensus was that it was uncertain the degree and duration of immunity conferred because the available evidence was insufficient and contradictory.

As much as I'd like that to be true, I think it's impossible to separate that statement from the political pressure to motivate vaccination.

ie, if the opposite was true — vaccination did not provide the same strength of immunity as infection — no epidemiologist would ever state this publicly.

So I'll be happy if it's true, but this statement doesn't move my belief-meter one way or another.

Do you know why there’s political pressure to motivate vaccination?

Because vaccines work.

Political pressure or rather information on the benefits of the vaccine is the best way to improve the situation for any country.

Where it goes wrong is if said country begins to deny participation in society, by for example requiring continuous testing for those who are not vaccinated. These measures in reality decreases your ability to participate.

Israel is one example where their Green Pass system denies you access if you dont have the green pass: https://corona.health.gov.il/en/directives/green-pass-info/

While Texas among other US states has the complete opposite approach: https://www.texastribune.org/2021/04/06/texas-greg-abbott-co...

And the EU is somewhere in the middle, though it does consider limiting free movement if you are not vaccinated. https://ec.europa.eu/commission/presscorner/detail/en/IP_21_...

I much prefer the American approach, as the other approaches force the individual to be vaccinated.

The public health profession has lost so much credibility over the last year. No one should feel the need to reverse engineer latent preemptive anticipatory inverted Stockholm syndrome like this, but here we are.

They've lost credibility because of a concerted effort to discredit them. An effort that was initiated specifically by people who didn't want to follow their broadly reasonable medical advice.

There's been plenty of unforced errors on the part of the government agencies. Claiming that masks don't help because they didn't want average citizens to buy them all up and still saying you shouldn't wear a K/N95 mask come to mind. Also, the horrific early failures with broken tests and bans on testing anyone who hadn't been in a specific area of China until it was far too late. Heck, the CDC just this week finally admitted the virus was airborne, something that anyone paying attention knew literally a year ago just from looking at early contact tracing of how the virus spread.

Beginning in early April 2020, everyone promoted the usage of masks.

It’s unfortunate that we were worried about consumers buying all the medical masks but in March 2020, it was a legitimate concern

They’ve proven already that they’ll sacrifice the health of the masses for the greater good when they lied about masks. I don’t think it’s a stretch to consider that they may be doing the same with vaccines.

It was a legitimate concern and a ruinous strategy.

I believe that competent leadership could have rallied the public to the cause of reserving PPE for hospitals for a month. Even if you don't believe in the basic nobility of the common person, congress could easily have passed emergency confiscatory legislation to pull all PPE off consumer markets without public health officials knowingly misrepresenting the truth.

Trust in institutions was already low at the start of this, and the sort of misdirection that a series of supposedly noble lies has evinced has taken it to a new low and left us where we are now.

This is a conspiracy theory. An alternative observation is that some very credible critics see failure andrer failure and report on it.

Here’s an article in today’s New York Times just to pluck one of dozens of data points out of the air. To the extent that the amateur game theory, vulgar p-fishing, and playing of telephone that is public health qualifies as a science, it is the most dismal. Rather than communicate the truth about unknowns, or maybe even be curious about the data that they were basing the guidance to mask outdoors on, the CDC scores another own-goal by seemingly misreporting the threat of ourdoor transmission by 3 orders of magnitude.

> Saying that less than 10 percent of Covid transmission occurs outdoors is akin to saying that sharks attack fewer than 20,000 swimmers a year. (The actual worldwide number is around 150.) It’s both true and deceiving.

…

> In one study, 95 of 10,926 worldwide instances of transmission are classified as outdoors; all 95 are from Singapore construction sites. In another study, four of 103 instances are classified as outdoors; again, all four are from Singapore construction sites.

> This obviously doesn’t make much sense. It instead appears to be a misunderstanding that resembles the childhood game of telephone, in which a message gets garbled as it passes from one person to the next.

> The Singapore data originally comes from a government database there. That database does not categorize the construction-site cases as outdoor transmission, Yap Wei Qiang, a spokesman for the Ministry of Health, told my colleague Shashank Bengali. “We didn’t classify it according to outdoors or indoors,” Yap said. “It could have been workplace transmission where it happens outdoors at the site, or it could also have happened indoors within the construction site.”

This sort of institutional negligence makes the Challenger o-ring disaster look like a paragon of careful professional judgement. Intelligent reporters with an ounce of capacity for independent thought like Zeynep Tufecki are able to get up to speed on the subject and single-handedly provide better guidance than the entire CDC. An institution that can put out false information and bad guidance with all the attendant psychological, political, and economic costs, where no one lifts their hand to argue against the group think is broken at a deep level.

If I sound frustrated it’s because we do need a credible source of information and the CDC should provide that. Every time they do stuff like this they lose more institutional credibility. Instead we get more conspiracy theories in every direction. Even worse state and local governments make policy based on CDC guidance that mis-measures risk and results in worse spread of the virus. See for instance California’s sudden decision to halt outdoor dining which many have argued caused people to substitute a low risk activity for a higher risk activity (meeting anyway, but indoors at someone’s house) potentially resulting in a surge of cases.

https://www.nytimes.com/2021/05/11/briefing/outdoor-covid-tr...

They did this themselves. Fauci, CDC and WHO constantly have gone back and forth between each other and themselves.

scientific approach requires changing your mind in presence of new evidence and when there's not enough evidence, there will be differences in opinions. duh.

Scientific approach requires you not to proclaim something as “true” if it’s likely that new information would change that.

The 5-sigma approach used in physics is science. The “no evidence of human-to-human transmission” used by the WHO isn’t science.

> The “no evidence of human-to-human transmission” used by the WHO isn’t science.

You've misquoted them, for starters. The actual quote is "no clear evidence", and they make it clear it's based on what data they had from China at that point. https://twitter.com/WHO/status/1217043229427761152

https://www.who.int/news/item/29-06-2020-covidtimeline

Same day:

> WHO held a press briefing during which it stated that, based on experience with respiratory pathogens, the potential for human-to-human transmission in the 41 confirmed cases in the People’s Republic of China existed: “it is certainly possible that there is limited human-to-human transmission”.

> WHO tweeted that preliminary investigations by the Chinese authorities had found “no clear evidence of human-to-human transmission”. In its risk assessment, WHO said additional investigation was “needed to ascertain the presence of human-to-human transmission, modes of transmission, common source of exposure and the presence of asymptomatic or mildly symptomatic cases that are undetected”.

Five days later:

> The WHO Western Pacific Regional Office (WHO/WPRO) tweeted that, according to the latest information received and WHO analysis, there was evidence of limited human-to-human transmission.

"The 5-sigma approach used in physics is science."

So is the process used to get to a five-sigma result. Hypothesis, data gathering, analysis, etc. Like the WHO was having to do back in January of 2020.

You’ve quoted the WHO accurately which is actually more damning.

Taiwanese scientists had observed evidence of human-to-human transmission and submitted it to the WHO well before that and they ignored it. Positive evidence of human-to-human transmission had also been reported in Thailand.

See Zeynep Tufecki’s Account of the timeline from last April.

https://www.google.ca/amp/s/amp.theatlantic.com/amp/article/...

> Hong Kong and Taiwan remembered that China has a history of covering up epidemics. In 2003, the world didn’t learn about SARS until after it had escaped China and become impossible to deny. (Back then, the WHO openly criticized China for its lack of transparency and cover-up, and we contained the epidemic just in the nick of time.) This time, the WHO was told the truth early on: Taiwanese health authorities sent their own medical teams to Wuhan in December. Those scientists confirmed human-to-human transmission—the most crucial piece of information for determining the difference between a local tragedy (if viruses are only jumping from infected bats or pangolins to humans in wildlife markets where people interact directly with them) and a brewing global pandemic. Taiwan isn’t allowed to be a member of the WHO, because of China’s objections, but it still informed the organization. Hong Kong health authorities, too, announced as early as January 4 that they suspected human-to-human transmission was already occurring, as they also looked at the evidence and their own contacts in Wuhan.

Do you have any other examples other than saying very early that people needn't mask up and then reversing on that point?

Here’s a handful of reversals from the first half of 2020 alone. It wouldn’t be so bad if they didn’t speak with such certainty about things that are not in fact certain.

https://www.fumento.com/articles/erosion-of-trust-10-things-...

Fauci was also notoriously resistant to coming around on the evidence around aerosol spread.

Michael Fumento author of "The Myth of Heterosexual AIDS: How a Tragedy Has Been Distorted by the Media and Partisan Politics"

He's been wrong about a lot of things and its usually most evident after the fact but I'm sure THIS time he is prescient instead of completely full of it unlike with every other major issue he's taken a stand on.

* “We don’t need to ban travelers from China, that’s absurd and xenophobic!”

* “2 weeks to slow the spread, then this will all be over”

> * “We don’t need to ban travelers from China, that’s absurd and xenophobic!”

Fauci and the CDC were the ones who told Trump in January to ban travel, if you didn’t know. Fauci spoke in public in January 30, 2020 in favor of the ban.

Trump claimed many months later the opposite but he is a known liar.

https://www.snopes.com/fact-check/fauci-china-restrictions/

“ According to a March 2020 Wall Street Journal article, it was HHS health officials (including Fauci) who had to convince Trump to agree to the China travel ban, not the other way around:”

> 2 weeks to slow the spread, then this will all be over”

Unclear why you put this in quotes. This was the message from certain politicians like Trump, but it was never said by anyone who would typically be called an expert.

Nobody in the infectious medicine field actually said it will be over in 2 weeks and the travel ban proposal under trump was xenophobic theater because it made a point of banning only some travel after we had community spread and didn't even stop a lot of travel after that. It was the worst of both worlds.

Rofl Fauci was on the money 95% of the time.

Trump was utterly wrong 95% of the time. His misinformation led people to die lol!

You know these studies publish their data, right? You can look at it yourself.

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