Evaluating necessity of Covid-19 vaccination in previously infected individuals
medrxiv.org
medrxiv.org
“The cumulative incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vaccinated, compared with a steady increase in cumulative incidence among previously uninfected subjects who remained unvaccinated.
Not one of the 1359 previously infected subjects who remained unvaccinated had a SARS-CoV-2 infection over the duration of the study.”
[EDIT: I read further down this page, dang commented that he'd edited in the 'evaluating' just 1m before parent's comment: https://news.ycombinator.com/item?id=27453952 So, yes, fair enough, 'necessity of' is ambiguous, as I went on to say in my original comment continuing below.]
Necessity is the concept as well as describing one possible state of it.
Another example: when 'my hunger is sated', I do not 'have a hunger', I am 'not hungry'.
This study helps us put some bounds on how many people this might happen to (assuming there are no mutations to the virus) but it doesn't rule it out completely, because of the prior existence proofs
Remember that immunisation makes antibodies but only provides something like 50-95% protection (depending on the vaccine) - it's not surprising that actually catching it does the same thing
You could be PCR tested positive, while experiencing a cold or flu (which you would now understandably think were Covid symptoms), but would not have immunity for a future, larger infection from Covid.
Though statistically unlikely, it's bound to happen sometimes.
10 months separated the first and the second infections.
Both were mild, the second was worse (English variant).
The important point here is that we got re-infected almost a year later with a variant.
From my experience, it looks like the flu.
Sure, but these things are rare enough that it can be only people with a wonky immune system or some other exotic condition.
The early Nevada case involved a relatively younger person who caught it once. Then they caught it again while caring for a parent who also had it and was hospitalized. The case was confirmed by PCR analysis of the samples that were taken combined with validating that the samples had the subjects DNA in them.
But they likely had a very mild initial infection and being young they fought it off with mostly an innate immune system response and didn't generate a lot of antibodies or adaptive response.
Then when their parent got sick (in the same household) I would bet money the cared for that parent taking little to no precautions believing that their prior infection granted them survivor-island-style invincible immunity to disease (which is how most people think the immune system works). They likely got a whopping large viral dose which (probably combined with a bit of bad luck) is what caused the second infection to be severe and require hospitalization.
And due to selection effects that unusual case bubbled up to the top early because it was someone in the hospital with covid who had positive evidence that they'd caught it 3 months earlier. A lot of people with mild covid both times would never have landed into a study and the clinicians wouldn't have bothered with genetic sequencing.
The duration of the study being 5 months.
There's no indication from this study what would happen after 5 months.
As such, most infected participants would have been recently infected in a situation with low and decreasing virus circulation. Nobody thinks there's any risk of reinfection at that point.
> This study was not specifically designed to determine the duration of protection afforded by natural infection, but for the previously infected subjects the median duration since prior infection was 143 days (IQR 76 – 179 days), and no one had SARS-CoV-2 infection over the following five months, suggesting that SARS-CoV-2 infection may provide protection against reinfection for 10 months or longer.
Non-huge indoor spaces, absence of masks, breathing the same air for longer than 15-20 min all increase infection rates.
Not OP.
He wouldn't wear a mask in the house (because "I'm fine") and kept coughing up the place, though.
I wear an N95 or KF94 - I like the ones with the valve / vents so do a surgical over that if I use one of those.
I've got friends in covid care who had pretty high exposure with a good N95 and face shield without being infected.
So when people say they were masked up and got infected, you need to ask, was this just some fleece cloth or a mask designed for infection control.
Even these slow down transmission so it’s a function of having a mask, time spent together, flow/amount of air, proximity.
What was her name? ;-)
Got it at Christmas from a gathering with only 3 other family members.
They then went on to unwittingly spread the infection at a small gathering of friends, even though their rapid tests were negative. A subsequent rapid test showed negative for one, positive for the other. PCR tests nailed it down, and they went through the whole contact tracing malarkey to get everyone tested.
It may be as simple as someone not taking it completely seriously, or someone 100% unwittingly becoming a carrier, even with negative tests.
We had a late night call saying he was unlikely to last the night, so we were allowed in to see him.
The next morning we were waiting for the phone call. And we had one. From Test and Fucking Trace, who wanted to speak to him. They were insistent he wasn't in hospital so we hung up on them with a rather non-polite scream.
His swab (which was from before we saw him) came back and he was positive, so we had to isolate. He did last the night, and then was moved to a covid ward.
So he clearly caught it in hospital on a non-covid ward. While I was holding his hand a nurse came along to give him an injection. She had a mask on, over her mouth - not her nose. Clearly lots of unconcious people who had frequent negative tests and weren't moving around a ward aren't going to be spreading covid, the only close contacts were the medical staff.
As it happens he lasted another 3 weeks before he came home for palative care. The vaccine presumably helped with fighting covid, but the damage caused by the siezures meant he couldn't even swallow.
He died 29 days after the positive test, so didn't go on the T+28 day stats.
- Me: no idea, we were careful :(
- Friend 1: had son in school, son's classmate's father got it and by the time they knew, the kids had met. This was during a wave and contacts weren't tested, only symptomatic people.
- Friend 2: stupid, stupid colleague came to work to pick up laptop when she got quarantined.
a) Just go to the store and back wearing a mask while indoors b) Spend most of their leisure time outdoors - because what else can you do?
I haven't been holed up this whole time. I'm outside multiple times every day (dog walks, kids playground etc.) and I don't know anyone who works in a factory, meat processing plant, hospital etc. hence my curiosity how people think they're getting it.
He was admitted with suspected sepsis, and tested negative on admission. He had a new cough when he was discharged, but we didn't think much of it as he had COPD so periods of coughing weren't unusual. A few days later, he was readmitted with a recurrence of his original symptoms, but this time his admission test was positive. Six of the other family members tested positive the next day, and developed symptoms over the following days.
[1] The only other person in the house who hadn't been isolating subsequently tested negative. Everyone else had been nowhere but home for at least the proceeding two weeks, so the chance of another vector seems remote.
I'm not sure how I caught it. I had left my car into the garage a few days before I showed symptoms and had to get an Uber home, then back to the garage to pick it up, so my strongest suspicion is one of the Uber drivers or previous passengers had it or potentially a mechanic had it and it remained in the car.
The strangest thing is my girlfriend and I had spent the day before I showed symptoms together and she slept over that night but she didn't seem to catch it off me. She even had an antibody test about a month after which was negative suggesting she hadn't already had asymptomatic Covid.
So this study doesn't have enough statistical power to say how vaccines compare to previous infection. Could be better, could be up to 3 times worse within a high confidence interval.
(disclamer: back-of-the-napkin math, did not double check everything)
Could be. But it would be great if they'd just say having had a confirmed case is equivalent to getting the vaccine because several studies have now shown that to be roughly the case. It's also conventional medical wisdom although it varies by virus.
The same goes for variants, which a lot of people expect to break through vaccines because that's how the flu works, but it doesn't actually seem like they will.
You'll notice they say - we don't have enough data. Then data is incomplete. Then we can't really say because study was X / Y / Z.
They ignore the MASSIVE difference in your chance of being infected if you are unvaccinated and have not been infected vs many other combos.
Just treat folks who've been infected as vaccinated, they can get booster / variant shots with everyone else when the time comes.
The UK is enterring a third wave, and has a high number of elderly people having been fully (2 shot, mainly AZ) vaccinated. Early indications are that those enterring hospitals now on the whole have not been fully vaccinated.
There are still many over 70s who haven't had any shots though. My (estranged) uncle and his mother-in-law haven't left the house for 18 months, he disinfects his food deliveries and leaves the post in a box for 3 days. He refuses to get the vaccine because he's worried about catching it. Chances are he won't end up in hospital either, but people like that could skew the cases as more data comes out to allow spurious claims from anti-vaxers (They might claim that 'before 2 in every 100 over 80s were going into hospital) , now it's only 1 in every 100 unvaccinated over 80s going in to hospital), because the chance of catching covid from the population still unvaccinated dwindles because of continued isolation
Edit: nicely presented here: https://www.bmj.com/content/370/bmj.m3259
This is a weird trend these days. Medical science refuses to take an engineering approach to anything and only accepts statements based on controlled studies. That includes rejecting previous understanding of how immunity works in general. Early on when claims were made about HCQ, Zinc, or whatever, they were shot down as "not approved treatment" even though there were no approved treatments! The utter failure to recommend vitamin D supplements is another failure - we know deficiency weakens immune response, we know most (Americans) are deficient in the winter, it's a no-brainer but in their mind it was not "proven" so not even mentioned or recommended for anyone.
The only pattern I see considering all cases like that is the underlying notion that people must not do anything for themselves.
Total participants: 52238.
Previously infected: 2579, of whom 1220 vaccinated, 1359 not vaccinated. No subsequent infections in either of these groups.
Not previously infected: 49659, of whom 29461 vaccinated (15 subsequent infections), 20198 not vaccinated (2139 subsequent infections).
Comparing previous infection with vaccination, we have 0/1359 infections in the previously infected and 15/29461 infections otherwise. According to Fisher's exact test, the two-tailed P-value for this is 1.0, which is very much not significant. You're correct to say that the study doesn't show how vaccines compare to previous infection. The study is way underpowered to show that.
For the unvaccinated, it gets more interesting. We have 0/1359 infections versus 2139/20198. According to Fisher, that has a P-value of 2 * 10^-64, which is most definitely significant. The study is not underpowered to show this at all. A previous infection is definitely protective.
With the caveat that the participants didn't have asymptomatic screening, so there is quite possibly bias due to people with a previous infection getting a second milder case and not being tested.
Using the exact method, 95% confidence intervals for infection rate are:
Previously infected, not vaccinated: 0% to 0.3%
Previously infected, vaccinated: 0% to 0.3%
Not previously infected, not vaccinated: 10.1% to 11.0%
Not previously infected, vaccinated: 0.03% to 0.08%
> Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.
> Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response. Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature. The other study, posted online at BioRxiv, a site for biology research, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.
> “The papers are consistent with the growing body of literature that suggests that immunity elicited by infection and vaccination for SARS-CoV-2 appears to be long-lived,” said Scott Hensley, an immunologist at the University of Pennsylvania who was not involved in the research.
https://www.nytimes.com/2021/05/26/health/coronavirus-immuni...
They also mentioned 0 infections in fully vaccinated which is odd as other countries are seeing a number of infections in their vaccinated front line workers.
https://twitter.com/sporeMOH/status/1402637555263098884?s=20
No, they had infections in the vaccinated. They had 0 infections in the previously infected, although another poster pointed out that the vaccinated (but never infected) group is much larger than the unvaccinated but previously exposed.
Frankly since the vaccine trains the immune system on the spike proteins I would think they're roughly equivalent and either both will offer similar duration of protection. If that turns out to be only a year I'm going for the vaccine next time, as the infection kinda sucked.
The spike protein has been picked for the reason that it's unlikely to change.
As another comment mentioned though, the spike protein is unlikely to change much, and if it did, the virus would loose a major weapon in infecting people. So the vaccine is probably as effective as natural immunity in practice.
(1) A friend of mine who works as a doctor in one of the vaccination centers in South Germany told me that re-infection rates with problematic outcome after full vaccinations are ~5%. This is what they tell their patients in the information talk before the shot. Note that my friend could not give me a higher resolution of the data (age, etc).
(2) I think I wrote that in one of my prior comments ~ 9 month or so ago - Another medical doctor aquaintance of mine that was working in the local health department Corona group told me that in the town of Tuttlingen (pop ~ 100K) there habe been 9 re-infections with the SARS-CoV2. At the time there were only 7 known cases in literature.
sorry for the late reply. Had to get back to my contacts re your questions. I did not check or ask for reference / primary data sources, but I was talking to medical doctor directly involved in the German SARS-CoV2 vaccination program on a local level.
> Is that with AZ or an mRNA vaccine?
It seems to be unclear by now which combination of vaccination dosages (and their timing) gives the best results. When it comes to double shots, I was told that
- AZ: 1 in 5 get infected
- Biontech: 1 in 20 get infected
> Also by "problematic", do you know if they meant WHO's "mild" or "severe"? "Mild" is still quite bad, just not enough to hospitalize you.
Unfortunately, I did not ask regarding these specifics, but I believe that the wording was according to WHO standards.
According to my source, after two shots:
- AZ: 90% less severe cases, 85% less infections
- Biontech: 85% less severe cases, 95% less infections.
So, statistically speaking, AZ is better to avoid bad cases, while Biontech is better for spread.
In southern Germany, it seems that there is increased activity in administration a combination of both vaccines. This is done because there seems to be an indication that a combination might be better than a mono-vaccine, and/or because of the supply situation / available vaccines.
There is a meta study coming out in the UK regarding AZ/Biontech/Moderna vaccine combination and vaccination timing effects.
Hope it helps a bit.
I’m convinced I had Covid twice, in March 2020 and again in December 2020. So in my case, “natural” immunity did not last 9 months. (Although there were presumably different Covid variants at play here. I’m in London where the “Kent” variant was dominant in the December peak)
Only the second time was confirmed by PCR test (no testing available in March 2020), but symptoms and progression were nearly identical both times.
But it has some distinct features: high fever/temperature which lasts < 24 hours, changes in taste (foods which I normally enjoy tasting bitter and disgusting, toothpaste tasting like bitter chemicals, etc), severe fatigue, mild-to-moderate nausea, shortness of breath, and muscle and joint pains. Some of these symptoms lingered for quite a few weeks.
I only know 1 person who almost died from it, my friend's mother who had to be put on a ventilator, but she survived.
> "Almost everyone I know that had COVID said that the flu was worse."
I'm inclined to agree. I've had a few severe flus in my lifetime that felt worse and more intense, but again, in my experience the symptoms of flu feel quite different to Covid.
That said, I certainly don't recommend getting Covid!
> "Change in taste can be attributed to blocked nose which radiacally changes the taste of food."
I did not get a blocked nose/sinus from Covid.
Also I never really had that much of a cough. Just a mild, intermittent dry cough.
Just yesterday the news had an article about how a national level soccer player for Sweden who had been infected previously in the past managed to get infected again and infect parts of the team.
The player in question had been infected about a year ago initially (before the British strain was found) and with the British strain now being the main one in Sweden I don't think it's a far fetch to say that re-infections of a different strain is actually quite likely once a certain amount of time has passed.
Off topic, but at this stage I find this geographical naming of strains being much more confusing than useful.
Besides risking moral overtones ("the British strain? Typical - when they aren't being Hollywood baddies they're busy incubating viruses") it only tagged where a strain was first isolated, not necessarily its geographic origin (not that it actually matters whether the Kent variant actually came from that Home County)
[1] https://www.abc.net.au/news/2021-06-08/covid-19-variants-del...
So a geographic label was widely used before Biden without apparently causing ructions. It was adopted because the released name for the variant, lineage B.1.1.7, was less convenient or distinctively memorable for the public. If it had been repeatedly referred to as the "Kentish virus" by senior politicians then a similarly hostile reaction might have been seen as was for "Chinese virus".
> Coronavirus variants get Greek names — but will scientists use them? From Alpha to Omega, the labelling system aims to avoid confusion and stigmatization.
Based on my own personal experience (see my other post in this thread), I agree.
Unless someone gets a PCR positive, has the virus sequenced, and then gets a separate positive later, has the virus sequenced again and can confirm they were actually infected again with live virus (perhaps using live viral culture) they can’t really be sure.
It's also good to help them along sometimes.
Edit: most bubonic plague infections didn’t kill so I don’t know what the point of “most people survive” is. The problem is that some don’t.
When you say "our", who do you mean? 30yo with no underlying health conditions? A leukemia patient? An HIV-positive person? A 50yo diabetic? 40% of the adult obese Americans?
Yes, healthy immune system can be effective at fighting covid. But vaccination is a matter of public health. You aim to eradicate the disease so that everyone is safe.
But really, I think many people are laser focused on not just minimizing risk of COVID, but now trying to zero out COVID risk, that having any reason to delay receipt of a vaccine isn't a pre-existing medical condition is considered a form of aggression.
At some point we transitioned from "bend the curve" to "eradicate the virus", and this seems like a byproduct of that mental shift.
I ask such an absurd question in response to your equally absurd question because of course everyone wants to eradicate these issues! But it is not possible to fully eliminate being monetarily poor (by somehow making everyone wealthy), or hunger (by overproducing food and creating distribution), etc.... and so a realization that tradeoffs must be made given our finite resources will better frame our collective decisions as a society.
In the US, over 40% of Democrats think that hospitalization rates for COVID are 50% or higher, and 28% of Democrats tink that hospitalization from COVID is 20-49%. It's really 1-5%.So the vast majority of Democrats think that COVID is over an order of magnitude worse than it actually is. So people who don't want to take the vaccine because they are concerned about taking a new medication or they already have been infected and don't need it, are now "immoral right wing Trumpists".
I read on the Bay Area subreddit how someone was called a 'Republican' for not wearing a mask outside, even though the mandate now is that you don't need to wear a mask outside if you're vaccinated and not in a large group of people.
Our immune system didn't evolve to cope with living in incredibly tight spaces surrounded by millions of people. Our immune system also isn't good at dealing with infections as we age: it's simply unnatural to survive past 70. We need to keep vaccinating, to create a collective immunity that protects the vulnerable.
When your immune system learns how to fight off a virus, it does it by creating antibodies for a specific protein - treating that protein as a threat.
They're effectively the same thing. The only thing the vaccine does differently is it doesn't exponentially reproduce in your cells.
So anyone who survived Covid by definition has an immune system which can recognise the virus and attack it. Otherwise they wouldn't have survived.
Similarly, if you get a rabies infection you're going to die, even though you have an immune system.
There were a number of cases of individuals being infected a second time after covid recovery. This article corroborates the evidence that individuals that had covid might have a low chance of reinfection and therefore might not need a vaccine. If you look at some other comments here you will see that still the evidence is not 100% clear cut, so good that data analysis continues in the future, e.g. to see if there are differences in how long the effect lasts between different kinds of vaccines and natural infection (there is also more than one way to have covid).
Here is Switzerland the government specifically says if you have had a positive Corona test you should not vaccinate for at least 6 month and if you do after that only 1 shot not 2.
Then again we had a vaccine shortage so that may also have something to do with it.
-- biochemist
Attempting to discuss it here will still commonly get you downvoted. HN is not a particularly rational forum. People make the mistake of thinking it is because a lot of engineers hang out here. Engineers are not especially rational, that's a common myth derived from failing to understand the way people mentally compartmentalize; how they can frequently be rational about one subject and irrational about another.
Try this one for example: the numbers they've been reporting about Covid infections the past year are not the actual infection numbers, not even remotely close. Yet they're held up everywhere as being representative of how many infections there have been.
This is still the biggest comedy going about the pandemic. It's hilarious how batshit crazy people can be.
If the US were a sane nation, the people that have been trying to represent the supposedly official infection count as being fully representative of the number of infections that have occurred - those people would be publicly mocked and shamed for being anti-science, the equivalent of flat-earthers. Instead, the flat-earthers dominate the media and national discussion. That's why the lab-leak theory was buried under so much censorship and for so long, those same people have been holding that conversation back very aggressively.
Most people know on some level that the held-up official infection tally is not representative of the real number of infections. And yet the mainstream media, without exception, pretends those are the legitimate infection numbers. Any attempt to discuss how many infections have really occurred, will be shouted down. The shrieking emotionalism that pours out when you open this can of worms, is endlessly fascinating to me.
If you say: how many people in the US have had Covid, they'll point at the magic official number, which is not correct.
If we wanted to have a serious discussion nationally about herd immunity (for example), one of the most important steps is one they intentionally refuse to take: let's try to get a more serious estimate on how many people nationally have actually had Covid.
They won't have that conversation and the media goes out of its way to avoid it (and has done so for a year now). Why? Pick your poison on the why answer. Political psychopaths lusting for control, looking to prolong their ability to take advantage of a disaster (the 'ol never waste a good crisis mentality). Wildly irrational anti-science types in power that pretend they represent science, which is the wing that Fauci belongs to. Maybe a combination. Maybe it's just the fear that if the masses of people think we're anywhere near herd immunity, the vaccination rates will plunge even faster, so some people want to maintain the false illusion (on the actual infection counts) as long as possible.
No scientist ever believes any measurement to be perfectly accurate, and different types of random error, systematic errors, and statistical biases always need to be accounted for.
And they are.
I think most on HN would agree with your assessment that the real number of cases are somewhat higher than the official count, although I haven’t seen any evidence indicating exactly how much higher or lower. The Dakota states did seem to taper off cases immensely before the vaccines were distributed, indicating a possible early herd immunity.
That's so unlikely it's laughable, but it's widely reported and accepted.
Owing to the dramatic risk asymmetry between vaccine and disease, it's probably better to implement a policy that optimizes more for expediency, simplicity (fewer rules and fewer exceptions) and, in this case, minimizing the number of false assumptions made about the status of individuals. ie.: in the context of vaccination it's sometimes better to not assume that everyone who claims to have been previously infected was actually infected, even if we have lab data to back up this assumption.
I'm not saying current policies all make perfect sense or anything, but it doesn't particularly surprise me that everyone is being accounted for in the same way WRT the vaccine.
Still, I don't see how public health would benefit from not recommending shots to everyone as there is no downside.
You'd get all the never infected people vaccinated sooner; so 'everyone' (except anti-vax not infected prior to effective 'herd immunity') would be immune sooner.
In practice, don't underestimate how much more inefficient or troublesome a seemingly simple additional rule or exception might be to administer... :P
And while trying to predict second-order behavior effects is tricky either way it is pretty clear that saying "don't get the vaccine if you already had Covid" would scare some people away.
I had quite the opposite experience ; plenty of people told me they had (mild) flu symptoms - a lot of TMI, to be honest - and assumed they had had COVID already. It later turned out, with no exception, that they absolutely did not.
Scaring those people away would probably hurt a lot, at least in my anecdotal experience.
Do you mean tested for antibodies with finger prick blood test, or PCR random number generator (see elon musk wild PCR results).
I was sick, had test that showed antibodies, and a confirmation letter from my Dr.
Since the EUA to rush out the vaccines does not include those who had it and recovered, it needs more testing and study before it is approved for those who have antibodies. The jab is not risk-free.
I was in a similar position as you: possible early COVID exposure (though no symptoms), several positive antibody tests, but absolutely zero side effects from either Pfizer shot. Annoyed not a few people though by my lack of any reaction to the shots, so that was kinda fun.
The VAERS data suggests there are numerous groups at very low risk from Covid for which this may not be the case.
VAERS data needs to be interpreted with special care. It's not equivalent to a safety study with a proper experimental design. It has a whole lot of legal and administrative context to account for.
Dying or having an adverse event after vaccination also isn't the same as dying from vaccination; even the genuine VAERS reports don't permit teasing this wrinkle out on their own.
And you'd be committing a felony. I see this idea tossed around all the time that tons of the reports coming in are fake, but so far have seen scant evidence that that's the case.
> Dying or having an adverse event after vaccination also isn't the same as dying from vaccination; even the genuine VAERS reports don't permit teasing this wrinkle out on their own.
Okay, but then why are so many more people reporting dying after Covid-19 vaccination than have reported dying after flu shots which have been administered to millions of people for decades?
https://www.politifact.com/factchecks/2017/may/11/bill-zedle...
> In a July 2005 web post, Dr. James R. Laidler wrote: "The chief problem with the VAERS data is that reports can be entered by anyone and are not routinely verified. To demonstrate this, a few years ago I entered a report that an influenza vaccine had turned me into The Hulk. The report was accepted and entered into the database.
> "Because the reported adverse event was so… unusual," Laidler wrote, "a representative of VAERS contacted me. After a discussion of the VAERS database and its limitations, they asked for my permission to delete the record, which I granted. If I had not agreed, the record would be there still, showing that any claim can become part of the database, no matter how outrageous or improbable."
As for your question about the numbers:
https://www.politifact.com/article/2021/may/03/vaers-governm...
> Moss explained one way VAERS can amplify fears about the COVID-19 vaccine in particular. Most vaccinations are given to a small segment of the population: young, healthy children, who are generally less likely to have health problems afterward. But the COVID-19 vaccine is given to a much larger group — all Americans 16 and older are eligible now. And the earliest recipients included a large number of elderly patients and adults with preexisting health problems.
https://www.reuters.com/article/uk-factcheck-vaers/fact-chec...
> “To date, VAERS has not detected patterns in cause of death that would indicate a safety problem with COVID-19 vaccines.”
> Moss explained one way VAERS can amplify fears about the COVID-19 vaccine in particular. Most vaccinations are given to a small segment of the population: young, healthy children, who are generally less likely to have health problems afterward. But the COVID-19 vaccine is given to a much larger group — all Americans 16 and older are eligible now. And the earliest recipients included a large number of elderly patients and adults with preexisting health problems.
This is trivially accounted for by comparing Covid and influenza vaccines. If I limit to ages 18-59 I get ~73,000 total adverse events for influenza vaccines across their entire history, and 173,000 adverse events for Covid vaccines since they started to be administered at the beginning of the year.
- The vast majority of new drugs that undergo safety trials are found to have serious side effects.
- The near totality of new vaccines that undergo safety trials are found to have a formidably beneficial risk profile.
Don't make the mistake of applying the same risk heuristic in your mind for both things. Risk assessments in science have absolutely nothing to do with politics.
[1] https://www.kfyrtv.com/2021/03/15/health-experts-say-those-p...
This study appears to be based on following up with a single hospital's own database of people who tested positive. But I imagine you would get different results if you just found a bunch of people and asked them to self-report their prior infection status before enrolling them in the study.
Agree on the self-reporting, but I guess my larger point is he already doesn't want to get the vax and people telling him that his natural immunity is not sufficient makes him even more distrustful since he does know enough about science/statistics to see that natural immunity is about equal with a vaccine as far as we can tell.
The vaccines are important in establishing herd immunity, but I don’t understand the desire to jab people who already have established immunity.
You don’t need to convince me to get vaccinated, but this is a profoundly unscientific statement. The mRNA vaccines are a brand new technology that would not have been approved without several years of human trials if there was not a pandemic justifying rushing through the normal process.
So far so good, but the immune system is a complex system and we can’t rule out some unexpected side effects for some people some of the time.
I'm not a "anti-vaxxer" "conspiracy theorist" "racist" "sexist" "nazi" but the risk is just too low for me to care. If you think covid can affect you, take the vaccine and don't bother me. I self isolated weeks before the government told me so because we didn't know what the risk involved was. By the time the government approved a 2 weeks lockdown which turned into 1 year and a half, it was already evident the risks were minimal. This is all a political play and I shudder when I think about what's coming next. Shall we do a climate change lockdown next? Or shall we try some more covid variants first?
I also don't think vaccines are likely to be dangerous (minus the platelets / blood clots issue - hopefully no long term issues pop up in 10 years).
Also, the downside is that everyone is paying for these shots, they're not free and they come out of the taxes the government steals from me every month - and they accomplish very little. Same as the flu shots.
Just get it in everyone's arms as fast as possible, all this dicking around with rules around who can or should get it now that it's plentiful is just slowing everything down.
[1] to the point that 'we' should be doing a lot more to get our excess to countries that are still struggling.
PS.: my 99.99% refers to the state of human knowledge and is more about what experts in the field know than what the general public knows.
Doesn't really seem that mind boggling to me. The clear public health impetus at this point is simply to get shots in as many arms as possible. We've already had Fauci openly admit that he gave guidance against masking and low-balled herd immunity threshold estimates because he presumed it would not lead to the behavior he desired from the public at the time. It's not hard to imagine that mentality has made its way into the rank-and-file somewhat.
Does that really boggle your mind? We're all human. I don't think there's a relationship between being an expert and being honest.
Just a reminder that these are actually good heuristics to live by, in life in general:
- https://en.wikipedia.org/wiki/Wikipedia:Assume_good_faith
- https://en.wikipedia.org/wiki/Wikipedia:Assume_the_assumptio...
Regardless, this study is good news — because it means that every person who is infected and then recovers contributes towards herd immunity, regardless of their outlook on vaccines.
Is it actually the case that immunocompromised people cannot be vaccinated? The ones that I know have been; as far as I know, the mRNA vaccines by virtue of not being based on live virus are not dangerous to those with weakened immune systems.
In recent studies something like half of organ transplant recipients did not produce antibodies after being vaccinated, and there have been a few cases where a group of vaccinated transplant recipients caught Covid (e.g. from a vaccinated nurse who had an asymptomatic infection) and had severe symptoms including some deaths.
We both got vaccinated as soon as we could.
If so you should probably email these researchers or something. Bet they would be interested
This year I've been heavily sick several times (and the flu almost never caused me all this pain before in my life) and it was never covid.
If one of the test returned a false positive I would have been convinced it was covid. If I actually got covid again I would have believed I was one of the rare reinfections.
It's not like bringing your bomb onto a plane decreases the odds of an attack, because what are the odds of two bombs.
The devil is in the details here. If natural immunity wears off after 6-9 months (as some studies suggest), and one spouse got infected again after that period, then the odds of the other one of getting re-infected too are pretty high.
Well, I'm currently in quarantine from my 4 month old and wife because an acquaintance refused to get vaccinated. "young people don't die from COVID" type mentality.
I attended my brother's bachelor party - of which we all thought everyone was vaccinated. Turns out this person, not only refused to get vaccinated - but had COVID exposure and still decided to attend. He told us the day after being in close contact for 3 days, that he tested positive and had symptoms during our contact with him.
Of the unvaccinated people I know, this mentality is the large majority of them. They refuse to get vaccinated because they refuse to consider how their actions might actually impact someone else.
Also, presumably, this person would now be as immune as someone who's gotten the vaccine, based on this study.
What mentality is this? It is well known that young people are at extremely low risk of dying, even more so than the average person.
> He told us the day after being in close contact for 3 days, that he tested positive and had symptoms during our contact with him.
The problem wasn't that your acquaintance refused the vaccine. The problem is that he didn't stay home. You could say the same thing about the flu. If you have it, don't go to parties. Who goes to a party with a flu? A cold even?
I hardly think this guy is representative. There's also evidence that asymptomatic people don't spread COVID. This would mean that if they don't have symptoms, you won't get it, and if they do and they're like most people, they'll stay home which means no transmission.
> Of the unvaccinated [sic] people I know, this mentality is the large majority of them. They refuse to get vaccinated because they refuse to consider how their actions might actually impact someone else.
This seems unnecessarily hostile. Plenty of people don't want to be vaccinated either because they've had COVID and don't need it (this study isn't the first; Peter McCullough for example has spoken about other studies), they don't want to risk the potential side effects, including long term, of an experimental vaccine that is not technically approved by the FDA, ethical/religious reasons (the use of stem cell lines derived from aborted children during vaccine research, etc), and because the virus is not a serious threat to most people.
It is disturbing how the media is lumping those wary of the COVID vaccine in with antivaxers (~2% of the population; 98% of Americans get all common immunizations), COVID deniers, or "grandma killers". Let's not do that, as the OP recommends.
We wouldn’t be in the middle of a pandemic if this were true.
> This would mean that if they don't have symptoms, you won't get it
It's flu-like transmission - which is mostly through droplets. If you're not sneezing in the face of people you don't have high chances of passing it around
"When taken together, I think these two studies show that people with asymptomatic covid-19 can and do spread the disease, and the best estimate from both studies is that those with symptomatic disease are about three to four times more infectious than those with asymptomatic disease. That is not a huge difference. Even though people with symptoms are a couple of times more infectious than people without symptoms, those without symptoms could still be causing more infections overall."
[0] https://sebastianrushworth.com/2021/06/06/can-asymptomatic-p...
They've considered it, they just don't care. What they actually care more about is the insinuation that they should care at all.
To not trust vaccination is to not trust science.
However, that's across the population. Factors like extended contact period increase viral load intake, could further decrease the effectiveness. Since my 4 month old can't get vaccinated against COVID yet, we decided it wasn't worth taking the risk.
Most vaccines have an efficacy lower than the COVID vaccines. Basically you are feeding off of your own fear, and you don't trust science. That's your right, but don't blame anyone for your self-imposed quarantine but yourself at this point.
OK, I think I can agree with this, I've seen lots of "getting the vaccine provides much better immunity than getting Covid"-type statements that seemed more like conjecture.
> The more widely this spreads, the more people will realize it's ok to rely on natural immunity, and to not blanket demonize those who are unvaccinated.
Is this a serious statement? The problem isn't that natural immunity doesn't keep make you immune, the problem is that "acquiring natural immunity" often results in death, especially for vulnerable populations.
> Is this a serious statement? The problem isn't that natural immunity doesn't keep make you immune, the problem is that "acquiring natural immunity" often results in death, especially for vulnerable populations.
It's a real policy question: how much to worry about vaccinating people who already had COVID. The confusion (or propaganda?) downplaying natural immunity means that many people would needlessly get the vaccine while already possessing immunity from prior infection.
In the US, this no longer matters, as we already have more vaccine supply than we have people willing to receive it. Elsewhere, though, where supplies remain scarce, we absolutely should be focusing efforts around vaccinating people who have not yet gotten the disease.
You're reading beyond what I'm saying. My point is that there is no need to push those who have already gotten Covid to also get the vaccine. I'm not saying anything about getting sick as an alternative to getting the vaccine.
It would be a shame if such people avoided the vaccine under a disinformation-driven impression that the vaccines are risky, and ended up catching/spreading Covid later on.
Anecdotal data: my wife and I got COVID twice 9 months apart last year. The second time my wife ended up in the hospital.
Hopefully, like we see with the wuhan lab theory suppression, as time goes on, a lot of what people suffered will come to light, and be contrasted by the benefit of the elite and political class during all this.
The vast majority of people are consuming propaganda or crazy shit (MSM and conspiracy theories) but don't know how to filter the info to find a narrative that most accurately represents reality.
Because of this, the mainstream media will ALWAYS be able to dismiss strawman arguments and label dissidents as conspiracy theorists. Conspiracy theorists will also ALWAYS be able to poke holes in the propaganda and spin convincing alternate narratives.
In any valid disagreement with the popular narrative, you WILL find conspiracy theorists.
One caveat to this situation is that IF the mainstream institutions were able to rebuild trust (by telling the truth), then you would have far less people poking holes in their narratives and therefore fewer conspiracy theories. So, I don't get angry at conspiracy theorists because I understand that they're created by a lying state and media - they're canaries not a cancer.
Now it seems to be a badge of honor, or at least a popular opinion, amongst educated people, to lean in to being part of a herd.
Doing stuff because it makes sense is one thing, but praising the abstract act of being peer pressured is ridiculous.
I close my mouth when I chew because of social pressure.
Someone might choose not to pick their nose in public because of social pressure.
Someone else might put the toilet seat down because of social pressure.
The amount of time I spend changing lanes before a turn is because of social pressure.
And yet someone else may not take the last helping of a treat because of social pressure.
It's time to fight guys from that country or we'll throw you in a cage. Obey our rules or we'll throw you in a cage.
I hope if something good comes up out of covid, it will be people realising that and vote for limiting government's power.
Most countries in the EU just relaxed the requirements to travel before the summer vacations. You don't need a PCR test anymore to travel: just an antibody test (at least for Spain / France / Belgium but I take it many others are doing the same). And there's no requirement to be vaccinated.
They also raised the age at which you need a test from 6 to 12 years old.
Source: always living/traveling across France/Belgium/Spain.
Fun fact: when you travel by car in the EU they typically do not bother to check. You can cross several countries and they're not verifying anything. Another fun thing: test is supposed to be less than 72 hours old, so if you're traveling over more than 3 days, you need to get re-tested during your trip.
Where I live, you need to meet one of three conditions for things like indoor dining:
- proof of a full course of vaccination (2 weeks after the final shot)
- proof of prior infection - antibody test not accepted, only positive PCR between 1 and 6 months ago
- proof of an antigen test (rapid test) that's at most 24h old
Duration of protection
This study was not specifically designed to determine the duration of protection afforded by natural infection, but for the previously infected subjects the median duration since prior infection was 143 days (IQR 76 – 179 days), and no one had SARS-CoV-2 infection over the following five months, suggesting that SARS-CoV-2 infection may provide protection against reinfection for 10 months or longer.Had COVID? You’ll probably make antibodies for a lifetime https://www.nature.com/articles/d41586-021-01442-9
> Lastly, it is necessary to emphasize that these findings are based on the prevailing assortment of virus variants in the community during the study. It is not known how well these results will hold if or when some of the newer variants of concern become prominent.
Here in Brazil, I've heard news that the P.1 variant can cause reinfections but is still stopped by vaccines. This would point towards also vaccinating those who were already infected
https://jornal.usp.br/ciencias/primeira-dose-da-coronavac-e-...
It’s odd that the public health messaging seems to have always been worst-case-least-likely scenario until we can prove differently.
Obv everybody should've worn a mask. Everybody who hasn't had it should get vaccinated etc. Pretty much what the authorities have been saying the whole time.
What do you mean? Immunity of naturally infected individuals has been tracked far longer than five months, with both empirical evidence of lasting immunity along with obvious community evidence.
Do you know why the infection rate in San Francisco was so low? There was already a ton of natural immunity due to community spread. The majority of my office in downtown SF caught COVID in January 2020, which was confirmed by negative influenza A & B tests followed by positive antibody tests once they were made available.
What is particular disturbing to me is that, despite the fact that the CDC estimates total infections to be over a third of the U.S. population (and that estimate only accounts for February 2020 onward and doesn't include last two months), natural immunity is never, ever discussed by policy makers. Why? That's a massive amount of natural immunity that continues to be purposely ignored.
After the symptoms were identified as "COVID", we knew what had happened. At this point, I assumed the infections were endemic and I had no idea if we could be re-infected. I went remote early on, as infections started to be tracked and we had stocked up on plastic gloves, toilet paper, masks etc. before many other people.
I suspect, a number of people know that this virus was always going to be around. I expect the situation was watched to see how to best manage the fact that every person on earth was going to get exposed, by community spread or vaccine.
I'm interested in the survival rate differences between the vaccinated and those infected through community spread. I suspect, it's not very different due to deaths in my family from the vaccinated who had access to every treatment (including plasma) through Kaiser, before passing. I also suspect it's more or less surviving the flu (tough for the elderly) + a particular genetic interaction, that makes you susceptible.
"The health system never had a requirement for asymptomatic employee test screening. Most of the positive tests, therefore, would have been tests done to evaluate suspicious symptoms."
In other words, there could have been people who caught Covid-19, but because they had already had it, the symptoms were mild and they didn't get tested. It may be possible for these people to still be infectious (we don't really know this). For a proper study, they need to look at a decent population of people who have regular asymptomatic screening.
there is also the instability of the spike protien in its natural form. when spike is cloven at it cleavage site it changes conformation, thus there are two faces available to the immune system; the default state, the cloven prefusion state. This makes a Naturally aquired immunity biased toward opsonizing antbodies.
the vaccine version of spike has been stabilized so as to remain in the default state resulting in a bias toward neutralizing antibodies.
so neutralizing antibodies bind to the viral spike at locations that interfere with receptor docking thus ideally preventing viral entry, while the immune system operates upon the many other viral epitopes, to produce a variant array of antibodies. This gives Tcell based [longterm] immunity.
the naturally aquired immunity involves Tcell activity upon infection, but that is the risk, as virus is capable of entering the cells before immune system begins to work against it.
this is why boosting is required beyond initial vaccine dose.
and this is why i believe it would be a good idea to take a vaccine along with naturally aquired immunity due to recovery, and you can have the best of both worlds, while not relying solely on naturally based immunity.
I'm not strong in molecular immunology. Does that also hold for the mRNA vaccines? Or only those that ship the spike protein itself?
this took the better part of 12 years to understand the virus to the point that we knew how to stabilize tthe spike.
If you are infected, you probably have about 85% resistance to infection. Getting an addition shot of moderna, pfizer, J&J is pretty much like getting a booster and gets you to 95%.
Preprint, non-peer reviewed.
a while back I looked to see how long it actually took for the peer reviewed studies to come out for previous diseases and outbreaks, such as SARS 1. It was too long and we have to weigh inputs right now and react now.
So let me ask you this, what's the worst case scenario if they're right but had waited 6 months to get it reviewed? Then consider, what's the worst case scenario if they're wrong?
I say this about every study
My main point is that it likely wont get peer reviewed, ever, unless it goes viral and people ask questions
So.. no change? At least in the US, we're already at the point where we have more vaccines than people who want them.
We need replication.
If anything has shown up the weakness in science over the last few years it is this veneration of peer review. It ain't working that well any more.
This is about vaccination not providing any further benefit to those who have recovered and cleared from covid.
this is ^not^ saying you need to be vaccinated even if you have gone through covid
not only that there is a comparison of vaccine generated Ab titre reacting with spike receptor domain
vs naturally generated Ab titre reacting with spike receptor domain, and with nucleocapsid features thus the naturall immunity is broader, and is long lasting based on opsonizing immunity.
Arguably this variant isn't a big deal for now (compared to spreading out vaccine doses), but I suspect previously infected individuals will need to get a single shot eventually.
We know that past infection greatly reduces risk (and this helps quantify it). At the same time, vaccination is thought to cause a much broader and more durable immune response than natural infection. We'd like people who were previously infected to get vaccinated eventually for these benefits, but they're not who you'd want to vaccinate first.
Why? Is there any data to support this assertion?
If anything, being ill (symptomatic) means the viral load was high in the body, so the immune system response should be as well, and in addition, infection should cause the immune system to produce antibodies to all parts of the virus, not just the spike protein, as with mRNA vaccines.
Shows a slow decay in neutralizing antibody titers in those vaccinated, with a greater degree of viral inhibition months later than convalescent plasma at a month.
"At day 119, the binding and neutralizing GMTs exceeded the median GMTs in a panel of 41 controls who were convalescing from Covid-19, with a median of 34 days since diagnosis (range, 23 to 54)."
There's also data showing much higher neutralization titers against variants in those vaccinated vs. those naturally infected.
Of course, this is only one measure of immune response. Many other things are more difficult to measure, so we don't know too much about e.g. T cell responses from natural infection vs. vaccination. So it's hardly proven but there is some highly suggestive evidence.
Shows a slow decay in neutralizing antibody titers, with a greater degree of viral inhibition months later than convalescent plasma at a month.
"At day 119, the binding and neutralizing GMTs exceeded the median GMTs in a panel of 41 controls who were convalescing from Covid-19, with a median of 34 days since diagnosis (range, 23 to 54)."
Note that antibodies to all parts of the virus aren't necessarily equally beneficial, because only a few functional areas are neutralizing.
The paper shows high binding affinities and high neutralization titers in comparison to convalescent plasma.
For a long time (from the phase 2 trials of the vaccines) we knew that they generated a very large immune response compared to natural infection: https://www.nejm.org/na101/home/literatum/publisher/mms/jour...
And recent research shows vaccination far outperforming past history of natural infection wrt: variants--https://www.nature.com/articles/s41586-021-03324-6/figures/1
If the spike protein is absolutely critical to the virus, but can't change too much without affecting function, an immune response that is specifically targetted against it would be better than an immune response against any other protein that could change without affecting the function.
Would be curious on this forum on how many people got sick from Moderna.My wife and I are in our 40s. I had a really sore arm (like, the whole arm, not the injection site) and we were both tired for a day afterwards.
Problem is, the "some other part" can mutate more easily into a form that the immune system no longer recognizes than the spike protein can, because the spike protein has to keep its form in order to react with the ACE2 receptors and enter a human cell. So the concern isn't that a real infection doesn't leave you immune to the virus you got sick with, but that the immunity might not apply or be as robust against a variant where the "some other part" has mutated into a different form.
The mRNA vaccines only cause your cells to make the (difficult to significantly mutate) spike protein, so the expectation is that vaccinated people would have a robust immune response against any variants which have that spike protein, regardless of whatever else changed, and a variant with an unrecognizable mutation of the spike protein would be less infectious anyway, as it could no longer successfully enter human cells either.
The results of the paper seem to indicate that this is not a problem in practice (so far - new variants are still evolving), but it's nice that someone checked.
Who's doing that? Isn't the separation 3 weeks for Pfizer and 4 for Moderna?
Odds are it does make things more effective rather than less, based on our experience with other vaccines. But IMO it's not wise, because it wasn't studied.
Still, 2 huge peaks separated by 3-4 weeks provokes really big immune responses.
It has since been studied[1] (preprint) and that was exactly what was found -- delaying the second dose provoked a stronger response, similar to many other vaccines.
[1] https://www.birmingham.ac.uk/news/latest/2021/05/covid-pfize...
For example, in Brazil there is evidence that the P.1 variant can lead to reinfections.
So, it's otherwise functional but also chosen to have an adjuvant effect.
https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behi...
But the reasons don't really matter -- studies like https://www.nejm.org/doi/full/10.1056/NEJMc2032195 have shown those vaccinated have significantly higher neutralizing antibody titers in their plasma than convalescent plasma, and slow decay of this response.
Of course, this isn't perfect evidence, as it is just the neutralizing antibody responses and the adaptive immune system response is much more complicated than this single measure.
The major covid vaccines have fewer adjuvants (to allow for boosters) and 2 shots because that's just how the trial was run, and it turned out to work, but later testing shows they're pretty effective just with one and some countries have been delaying the second one until everyone gets their first.
Why do you believe that confirming suspected immunity response and subsequent protection, as is the case with so many other diseases, is in any way connected to the belief that COVID is a hoax?
I agree with that comment—that there is a mainstream narrative that says those who've already recovered from COVID still need a vaccine as much as anyone else, and that this narrative is propaganda in terms of its truth value and in terms of how it originated and was spread around—and I also think COVID isn't a hoax and that vaccines are good.
It harms rational discussion and thinking, when you take one claim and attribute additional claims the author didn't make and denigrate the author for the latter. It pushes the discussion towards a "declare allegiance to one side, attack others who appear to be on the other side" fight, and away from exploration of any nuanced position other than the two extremes—when such exploration should be one of the attractions of a site like this.
She presumed she couldn't get it again. She did in May of 2021. Less serious, but tested positive this time with mild symptoms.
Perhaps the first infection wasn't covid-19, but something very similar. My guess is that immunity after infection doesn't last as long as we might all like. Which is why we all need to get vaccinated as quickly as possible.
Since we are dealing with a corona virus and the common cold corona virus forms have been with us for many years I am not expecting that this will ever be completely gone, just managed.