Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity [pdf]
medrxiv.org
medrxiv.org
agreed we should warp speed, but not so warp as to pile hypothesis upon hypothesis.
This will change if pre-prints ever offer bona fide academic points, but for now, there is no difference in quality.
* determine whether the numbers are intentionally fudged.
* read the methods and results and check for possible systematic errors.
* see if the data supports the conclusions of the authors.
* make sure you understand the limits and implications of what the authors claim.
as a layperson, I can't really do this for biology. so inevitably, I give things a quick once-over, come up with questions and look to the people I trust for answers or contradictory data. so it's basically an ad-hoc peer review.
Of the papers I've submitted, exactly one received a quality peer review. The rest were nonsense. Both accepted and rejected papers clearly weren't read. All incentives align to giving a paper a quick skim and being done with it. NIPS showed the process is indistinguishable from noise in an experiment a few years back.
It's like QA testing with a six-sided die.
Peer review is more like code reviews... but the code is hidden and you can only see the comments.
Since this story ( which smells a lot like corruption and lobbyist work) i must say i'm a bit confused about the true value of publication for things related to covid
https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-hea...
Fewer than half replicate. I would estimate a lot of that comes from softer research malpractice.
Being confused about the value is a fair reaction. It is high; without scientific research, though, we wouldn't have vaccines or monoclonal antibodies. On the other hand, it is lower than assumed, and trusting individual papers and peer review processes is a mistake.
How much value would Facebook have if it were your only source of information? A lot, actually. Imperfect information is valuable too.
I can't imagine the journal's reviewers being careless.
I haven't seen many careful reviewers. It's an anonymous process, and no reason to put in any effort at all. On the procrastination list, peer reviews are the very last thing scientists do.
it is an ongoing continuum of process
It's important to note the tremendous amount of evidence from a wide body of peer-reviewed literature which supports the fact that immunity acquired through natural infection provides protection against reinfection that is at least equally effective as vaccination. This fact has been repeatedly demonstrated in multiple large scale and long term serological studies [1][2][3][4][5].
- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)
- The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075)
- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)
- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials. [5] (N=3,257,478)
The OP is one of the first and largest scale studies to evaluate the risk of reinfection - in the context of the delta variant which is currently dominant in many countries around the world - by directly comparing naturally acquired immunity to vaccine-induced immunity.
> those vaccinated are still at a 5.96-fold increased risk for breakthrough infection and at a 7.13-fold increased risk for symptomatic disease compared to those previously infected.
> SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalization compared to those who were previously infected.
If the OP study holds up to peer-review (which it likely will), then we can expect further studies attempting to replicate this finding, and even more studies attempting to explain why naturally acquired immunity induces a more robust immune response. The findings from those studies will be leveraged in the design of future vaccines - so these results will be a win just about any way you look at them.
[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/
[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...
[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Other than that, I agree with pretty much everything you just said. One thing to keep in mind when it comes to policy however, is data quality. The vaccine trials were double blind, controlled studies, which are the highest quality of medical study. This is why the short term, vaccine efficacy results were quickly acted on. By necessity, the OP and the studies you linked are retrospective, observational studies which are considerably more difficult to analyze correctly, and usually provide lower confidence results. Which is why the Israel study is so important (they seem to have high data quality) and why we're waiting for so many of these studies to come in before changing public health recommendation.
One concern I do have about the Israeli data is that the paper on waning vaccine efficacy is using de-anonymized data, which means that for privacy and national security reasons, it's more difficult for the scientific community to double check their results.
Out of the people with natural immunity from previous infection: only 1 out of 337 unvaccinated people were reinfected, and 0 out of 343 vaccinated people were reinfected.
Admittedly they didn't have a large number of participants in this cohort, so their statistical power was limited in this respect, perhaps contributing to their rational for not mentioning it as a primary finding.
[1] Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine (Moderna) https://www.nejm.org/doi/full/10.1056/nejmoa2035389
[2] Table S17. Vaccine Efficacy by SARS-COV-2 Status, Modified Intent-to-Treat https://www.nejm.org/doi/suppl/10.1056/NEJMoa2035389/suppl_f...
First, even group with the largest infection rate was still under 1.5% in all applicable models. Whether immunity is achieved via vaccine or natural immunity, it appears that it will overwhelmingly prevent you from being re-infected. There's obviously a ton of variables here (are vaccinated individuals being overly cautious or reckless after vaccination, are natural infections more likely to receive repeat exposures to build immunity, etc).
Second, by my count there were a total of ~106k-152k subjects observed in that study across all groups and models (not sure if there is overlap between models). Across all subjects, only 34 hospitalizations were reported, and there were no recorded deaths. A hospitalization rate of <= 0.032% is pretty damn impressive. Zero deaths is phenomenal.
Finally, across all models the only factors outside of immunity type affecting reinfection were socio-economic status and age > 60. Comorbidities don't appear to affect the chance of reinfection, though I'm sure a breakthrough infection/re-infection would still likely be more severe in cases with co-morbidities.
Nonetheless, the interrogation of natural immunity (+1 dose of pfizer) against naive with 2 doses of pfizer is incredibly valuable and I am intrigued by the outcomes here. What this suggests to me is the vaccines are good, but we can do even better with careful applications of science. I look forward to what scientists and drug companies produce over the next few years.
Yes the paper is certainly not an attack on vaccines. The crucial implications of the findings in OP are especially relevant to public health policy:
1) There are diminishing returns to vaccinating individuals who have already acquired immunity through natural infection. The benefits are borderline insignificant. Therefore when faced with a limited supply of vaccines, vaccination strategies should be highly focused on immunologically naive or vulnerable individuals.
2) Compulsory mass vaccination mandates need to accommodate naturally immune individuals. If they do not, such mandates are not only wasteful, but are also effectively ordering unnecessary medical procedures which is a violation of medical ethics and likely a violation of constitutional rights to bodily integrity and informed consent.
3) If vaccine effectiveness at preventing infections continues to be undermined by viral evolution, new formulations will need to be tested and deployed. The mRNA delivery mechanism supports rapid iteration in that respect, but those efforts will still take months at minimum. Consequently it will likely be necessary to supplement mass vaccination with other viral elimination strategies, such as early treatment with multi-drug therapy based on existing and widely available medicines [1][2][3][4][5].
[1] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...
[2] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1... Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a...
[3] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S03069...
[4] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/
[5] Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19 https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...
The other potential that jumps out to me is that only targeting the spike protein is causing the drop in protection, as in theory that should be the only type of antibody a only-vaccinated person would have. The potential conclusion to draw there is that antibodies developed for other antigens on the virus may not be as effective as the spike protein, but when combined help retain that higher level of effectiveness when the spike protein mutates. If that's the case, I wonder if having a inactivated/attenuated vaccine as the "third-dose" may end up being more effective, or if the immune system would ignore the additional antigens in favor of the one it already has.
[1]: https://www.wsj.com/articles/covid-19-third-shot-booster-116...
Do the people who are refusing a vaccine because they were already infected have a good point now?
"Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant."
if those with natural antibodies are encouraged to get a vaccination in order to gain "additional protection"...
those with a vaccination be encouraged to expose themselves to covid-19 in hope to get a breakthrough infection to generate natural antibodies for "additional protection"?
Not just to the individual, people getting infected after vaccination are more likely to spread the infection to people that are immunologically naive to the virus than people getting vaccinated after recovery.
> Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.
Note also...
> evidence of waning natural immunity was demonstrated,
they didn't compare against 2 dose vaccinated, presumably because of lack of data.
1. Two-dose vaccinated 2. Previously infected and not vaccinated 3. Previously infected and single-dose vaccinated
this is not evidence of waning immunity this is evidence of efficiency and conservation of function
the presence of antibodies has been used as an indicator that vaccination produces an immune response, unfortunately far too many people have conflated reduction of this antibody titre over time as a reduction of immunity, when it is a modality of immunity.
antibody titre is a better indicator of prophylactic efficacy than immune status.
unfortunately it is very inconveinient to work with T cells and B cells as a measure of intensity of immune response.
this however can be inferred by observation of changes in antibody titre following infections/challenges subsequent to reduction of post innocual antibody titre
So someone could (in theory) get the vaccine, have tons of antibodies 6 weeks later, then have greatly reduced antibodies and it doesn’t tell us anything about whether or how much immunity that person will have if they’re infected?
Having lots of antibodies when exposed can maybe prevent infection or lessen severity, so it isn't a complete non-concern that they fade.
This is literally how the Adaptive immune system works.
Initial adaptive response, production of IgM, Vdj recombination, class switching and global proliferation (especially in the face of a repeated antigen insult), followed by a tone down of B cells as the memory effect is preserved and the antibody titre falls back (antibodies have a half life of 3-4 weeks).
Because (at least currently) the antibody response in humans is non-sterilising (talk of boosters to generate IgA abound, along with a more specific Delta variant vaccine may change this) you can’t equate a titre in humans yet with a ‘level’ of immunity
the durability of immunity may be inferred by observing the increased response to challenge over points in time.
https://www.fda.gov/news-events/press-announcements/coronavi...
this should not be taken casually, and perturberance of memory immunity should it occur would be a variant profile of high concern.
I assume they are tracking how long their test detects T cells in subjects who had confirmed infections and hope they will provide public updates on this more frequently because "up to 5 months" is of limited value to people like me who were interested in knowing if they had the virus back in the earliest days of the pandemic.
There’s got to be a point where we say, it’s “good enough” to not warrant exposure to 50 Billion copies of mRNA.
0. Less exposure to spike proteins the better: in all cases the less one is exposed to novel, man made stimuli into intimate bodily functions (read less than 1000 years of human existence) the better. And a counter point to the benefit of modern medicine… many still die in their sleep, if one is exceedingly lucky and very healthy, then they will have no need for the man made interventions.
1. Inadvertent intravenous injection: lack of properly aspirated needles can potentially send a majority of the mRNA into a vein, producing complications. This is my hypothesis for the wide range in side effects
2. Faulty Fatty Anchors: it is claimed that the lipid anchor keeps the spike protein in a safe state. Potentially this is not true and potentially when your body attacks the vaccine the protein is set free due to incomplete distraction
There are quite a few others, but these I’ve found to be the most compelling.
These and the others I will reserve unless anyone is curios.. these all require much more observation than a few years to complete.
Clearly, you want natural immunity if you can get it safely, which is a big question. It still makes sense to get vaccinated for most adults. You can always get your natural immunity through a break-through infection, which you'll ride out more easily having been vaccinated.
https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...
If anything comes from this particular pandemic I'm hoping that one of them is that we need to be honest and transparent about risk/benefit and knowns/unknowns rather that try to brush the long tails under the rug as if they don't exist.
As of 2021, we do not have long term (e.g. five years) data on either vaccines or Covid.
https://www.nejm.org/doi/full/10.1056/NEJMoa2109072
In breakthrough cases where the individual has a high viral load and typical COVID symptoms (shortness of breath, fatigue, etc.) it's not unreasonable to assume that the person might suffer from the same course of illness as an unvaccinated person. While the vaccines clearly reduce the incidence of hospitalization and death, there are people whose breakthrough cases aren't exactly what the average person would call "mild".
One has to weigh the guaranteed exposure to risks of the vaccine, which currently appear to be extremely low but not zero, versus the less certain exposure to the demonstrably greater short term and long-term risks of a covid infection.
Ultimately that wasn’t my point, my main point is that transparency and humility in communication will likely create less of a backlash than what we are seeing today.
If you have a risk of autoimmune disorders because of genes or other factors you would weight it against other factors.
Maybe you have left the house 4 times in the last year and you have an autoimmune worries perhaps avoiding the vaccine makes sense. Your risk rises wheb even going to the place to get the vaccine.
Everyone wants one piece of advice to fit everyone. Everyone is different.
If you get the vaccine and go out three times to every one time an unvaccinated person goes out you both have the same risk profile. If you go out 4 times you are more likely to catch it.
If you really want to stop this, stay at home unless you must go out. The vaccine adds 3x the protection.. not 10x or 100x
Vaccination induced immunity levels were sufficient, but now that natural immunity levels are higher, that's not good enough?
Since I've been told over and over that the vaccine reduces the severity of breakthrough infections, shouldn't we also demand vaccinated people intentionally catch covid and quarantine, since that will also boost their immunity and prevent public spread?
Where's the study that shows breakthrough cases are any greater of a risk than vaccine side-effects?
And if the risks are comparable, why wouldn't it be reasonable to demand vaccinated individuals intentionally catch the virus to also boost their immunity?
> ... to evaluate the occurrence of myocarditis and pericarditis following administration of COMIRNATY ... substudy to describe the natural history of myocarditis and pericarditis following administration of COMIRNATY ... prospective cohort study with at least 5 years of follow-up for potential long-term sequelae of myocarditis after vaccination
Vaccine injuries are rare but nonzero. A German pathologist has been performing autopsies, https://translate.google.com/translate?sl=auto&tl=en&u=https...
> The doctor now wants to get to the bottom of rare, serious side effects of the vaccination - such as cerebral vein thrombosis or autoimmune diseases. The problem from his point of view: Vaccinated people usually do not die under clinical observation ... More than 40 people have already been autopsied who died within two weeks of being vaccinated. Schirmacher estimates that 30 to 40 percent of them died from the vaccination. In his opinion, the frequency of fatal consequences of vaccinations is underestimated
Self-reported VAERS lists 5,000+ US deaths after [does not imply causality] Covid vaccination, but such reports are much less informative than tissue samples from an expensive autopsy. Note that if someone develops Covid or dies within two weeks of being vaccinated, CDC statistics categorize that person as unvaccinated. It would be more accurate to create a new U.S. reporting category for those who are partly vaccinated.
> For the purpose of this surveillance, a vaccine breakthrough infection is defined as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S. Food and Drug Administration (FDA)-authorized COVID-19 vaccine.
Redline changes were made in April 2021, https://www.cms.gov/files/document/qso-20-38-nh.pdf
> Fully vaccinated” refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine. “Unvaccinated” refers to a person who does not fit the definition of “fully vaccinated,” including people whose vaccination status is not known, for the purposes of this guidance
That might not be an excuse to not get vaccinated, but it's absolutely a reason that individuals with natural immunity should not be treated any worse or differently than vaccinated individuals.
Regardless of whether vaccination improves on extant natural immunity.
And based on what we know about sars-1 and mers, that's not necessarily a safe assumption. For cases of repeated exposure and vaccination over time, the problems with those vaccine attempts were primarily over-stimulating an immune response.
The discourse has become politicized, unfortunately, and for whatever reasons the voices of the pro-vaccine faction in the U.S. have become dominated by people who reflexively discount the science. This doesn't seem to be the case in Europe, where the EU-wide immunity passport treats those with prior documented infection the same as the fully vaccinated. This was pointed out to me on HN a few weeks ago, when I opined that it would be logistically impractical to verify and issue immunity passports to the previously infected.
Would it be better if those with a previous infection received a vaccine? Maybe. That's a more complex question. But at this juncture that's moving the goal posts; it's scientifically and politically unreasonable to make that demand.
If one is donating blood etc, this information is available such as in the Red Cross donor app.
The push by the pro-vaccine groups in the US without accounting for folks who have antibodies acquired naturally - reeks of ignorance from those who are supposedly 'of science'
Here's the rub: is previous infection as good as Moderna? Probably not, especially given the new variants. (Though last year studies were showing infection providing 90%+ immunity.) But nothing is as good as Moderna. (Except maybe Novavax?) Should we require J&J vaccine recipients to be re-vaccinated with Moderna? Nobody is demanding that, though very roughly speaking J&J-level immunity may be about where things stand now for the previously infected.
This seems to be another unforced err by the CDC. Not as bad as some others, but unforced and very politically costly. It also complicates things going forward because it seems we're quickly approaching the point where we'll need to begin requiring a 2nd round of vaccinations. The CDC will need every last shred of credibility and good will left for that initiative. It could have been in a position where it could say, "hey, we tolerated the previously infected skipping vaccination before, but now the situation has changed." Instead, they'll have much less capital to work with.
I was trying to be conservative. I don't have any hard opinion on this one way or another. It seems like a degree of precision we'd be lucky to achieve in the best of times--i.e. when the virus and demographics aren't constantly evolving. And it's a degree of precision that is unnecessary to establish in this particular debate, even if we could. It feels like bike shedding.
The question isn't which is better--infection or vaccination. The question is, do we demand that the infected be vaccinated even though the substantial and consistent weight of scientific evidence gives us little reason to believe the previously infected put the population at more risk than the vaccinated, especially relative to vaccines that we affirmatively accept as sufficiently efficacious? The only scientifically justified answer is an unqualified, "No".
There are innumerable other questions people can debate, but from a pandemic policy perspective there's no need to venture there. And, frankly, it seems imprudent considering the level of uncertainty surrounding everything--not just the quality and relevance of data, but even if you're technically correct one moment, things can go sideways the next moment, necessitating a change in policy.
The CDC study you're pointing to says that among people who have been previously infected, those who have been given vaccines are less likely to be reinfected than those who have not.
There is no error from the CDC here, nor any lost credibility.
With the absence of evidence in either direction, it is unwise to draw either conclusion.
An alternate conclusion to your own is that people who get the vaccine did so in order to take advantage of the reduced restrictions on vaccinated people at the time.
Yet from a science perspective they have a point, already having the disease matters.
Getting the Vaccine is easy. What is hard is to trust the what every biased, safety studies done on it and the fact the AEFI reporting system is not strictly mandated, indicating a bias from the authorities to not want to know about potential vaccine injuries.
As usual, this comment will get flagged. If you see this comment check back a bit later to see the shilling on HN.
There is nothing to hide if there is no data collected in the first place. Here in this video, you can see that even injuries sustained by people who took part in the trials are being rejected by the doctors citing as caused by "anxiety".
https://www.youtube.com/watch?v=6mxqC9SiRh8
I think people are completely oblivious to this issue, and is under this fallacy that if there was something wrong with the vaccines, then the information will automatically appear in public perception. If you think this, you need to only look at how smoking went on for a long time without the people noticing any problem with it.
With vaccines, we know that the signal is killed right at the point of generation, because the medical practicioners are conditioned (being charitable here) to reject any injury as not being caused by the Vaccines.
AstraZeneca has not been approved in the US because of potential blood clot risks.
Nearly 2 billion people have been vaccinated against COVID-19, including >150 million people in the US, and hundreds of millions in the EU. There are very few adverse reactions, and no deaths. The risks of COVID-19 injury and death are far higher.
> [FDA] blocked Americans from finding out the status of their antibody immunity to SARS-CoV-2 ... prevents un-immune Americans from knowing that they are vulnerable ... exposes already immune Americans to the risk of an unnecessary or marginally beneficial vaccination ... prevents vaccinated Americans in whom the vaccine has not induced good immunity from knowing that they remain vulnerable ... discourages a vast majority of American physicians from providing the people with the necessary prescriptions to obtain COVID-19 antibody blood tests ... Every American deserves easy access to information about their personal immunity status in order to make a cogent decision to maximally protect themselves. Am I immune? Did my vaccine work for me? Am I still immune?
The lack of guidance for those who were previously infected was strange. When I'd read about immunization rates and progress towards "herd immunity", previous infections also weren't included in these stats, which again was strange.
I'm in Europe now, and here it seems like natural immunity is essentially as valid as vaccination, at least for travel.
I can't explain why previous infections seem so widely discounted in the US. It feels like an intentional omission, which makes it hard for me to trust at face value what I hear and read about the pandemic.
Read the next sentence in the paper.
I think they still have a point. How much more? 95% efficacy to 96% efficacy?
Yes. But this has been speculated about for several months now. I'm not an anti-vaxxer but was holding out. On the verge of getting the vaccine I caught covid. I currently see no point in getting the vaccine. With indications that the real deal is more effective at providing future immunity (simple logic suggests that too) I think someone needs to prove some benefit to me getting the vaccine.
This is not my fight, I do find it annoying that people forget about us previously infected folks and act like there are 2 categories - vaxxed or not.
Even if there's no proven benefit, there's plenty of things in life we almost all do because of possible benefit, so this just seems like another one of those case. We buy insurance in case we might need it. We wear seat belts even though the crash might be such that they provide no benefit. What's the point that tips you over the edge of not wanting the vaccine in this case? My understanding is that for a short inconvenience (in both time and physical well being) and zero cost you get something that might prove extremely beneficial later.
Maybe someone could do the math but the chances of catching covid again with natural immunity should be lower than the chance of a side effect from the vaccine.
More so, the effects of covid with immunity are much more diminished. The side effects of the vaccine range from very mild to very severe (death). https://openvaers.com/covid-data
I don't see a good reason for a person with natural immunity to get the vaccine if there is no benefit and some, even if slight, risk.
"Because everyone else is doing it" is not a good reason for people to do it because the more you scale the more side effects you get, the more absolute deaths and critical conditions.
It's weird. And it's everywhere.
It's just that simple.
And that's whether I decide to get vaccinated or not.
All I see is a bunch of selfish people with incredibly weak excuses not to get vax'ed or wear masks, often for ostensibly stupid political reasons (e.g. "I'm a libertarian/conservative and no one tells me what to do! Freedom!!!!!" As in, I know motorcycle helmets will save my life, but I refuse to wear one if you tell me I need to, so there!), or based on astronomically rare vaccine complications well below the risk of the disease complications themselves.
Antivaccination beliefs are on par with moon landing hoaxers and flat earthers and deepak chopra followers IMHO. It's intellectual snake oil.
Lol- any other result and it'd be plastered on billboards along with the hospital population scare numbers.
>motorcycle helmets will save my life
Do you wear a helmet, fire-retardant suit, and 5-point harness in a car? It will save your life.
>based on astronomically rare vaccine complications well below the risk of the disease complications themselves.
Oh- we're saying the jury isn't still out on this one? Even though we've got less than a year of data?
And besides the fact that it ignores individual risk factors, including age, weight, and natural immunity?
My family got it when the cdc said it couldn't possibly be here yet, that masks were worse than no masks, and back before Trump was called xenophobic for wanting to shut down international travel and Nancy said we should go spend money in Chinatown.
And we got it because family members are the front line, dealing with "safe-side" idiots who are the infected ones, but are more worried about catching it "again" from hospital staff with 3 layers of uncomfortable ppe on because they heard that 4 layers is safer.
So take your conspiracy theory projections and shove it. Some people still value autonomy, even if you don't. You have no problem with unnecessary mandated medical treatments, but probably were part of the choir on here last week complaining about "muh device privacy! and muh software freedom!" with apple scanning for blacklisted hashes, and government wanting e2ee backdoors. Why are you worried if you have nothing to hide?
>Antivaccination beliefs are on par with moon landing hoaxers and flat earthers and deepak chopra followers IMHO. It's intellectual snake oil.
LOL- you forgot "Think of the Children!"
You could get the vaccine, and then days later, you get diarrhea, or a headache, or a charlie horse in your calf, and you reason "oh, it must have been the vaccine", and boom it goes into VAERS: garbage in, garbage out.
VAERS is best realized as a regulatory capture of the personal injury lawyer industry.
The reported adverse reactions are very serious and only occurred after the vaccine a lot of times in an otherwise healthy individual.
It should be used as a canary of safety and each report should be evaluated to see if the vaccine is the causation, especially when the individual was healthy.
Ignoring reports of adverse reactions is not proper science. Sure, we could dismiss ALL of the reports as coincidences, but is that right?
VAERS also states the data is under-reported, because not all side effects are reported to VAERS. This means for all false reports there could be true side effects not reported, this evens out the cases to some extent.
> You could get the vaccine, and then days later, you get diarrhea, or a headache, or a charlie horse in your calf,
Look at the side effects listed, it's full paralysis, death, miscarriages, etc. These are serious events that should be looked into. Those are much more rare cases than a "headache", or "diarrhea". Headaches are not reported to VAERS.
The safety monitoring is actually pretty good as well. We caught a 1 in ~100k issue with AZ/JnJ vaccine very early on in the rollout. We caught mild myocarditis (though COVID risk > vaccine for myocarditis). There was even a massive preprint today from Israel around vaccine side effects. Few were concerning. Link to study + summary https://twitter.com/erictopol/status/1430636357626466307?s=2...
> “ Bob Wachter of UCSF had a very good thread on Twitter about vaccine rollouts the other day, and one of the good points he made was this one. We’re talking about treating very, very large populations, which means that you’re going to see the usual run of mortality and morbidity that you see across large samples. Specifically, if you take 10 million people and just wave your hand back and forth over their upper arms, in the next two months you would expect to see about 4,000 heart attacks. About 4,000 strokes. Over 9,000 new diagnoses of cancer. And about 14,000 of that ten million will die, out of usual all-causes mortality. No one would notice. That’s how many people die and get sick anyway”
Exactly, that's why I said when you scale up you will get more absolute deaths and critical conditions. There's no point for those very few deaths or reactions to occur if those people had better natural immunity through previous infection.
Edit: I think you have a point about whether those who have previous infection truly need the vaccine, but the way you are using VAERS data diminishes your point
In short: in a large enough population with a random distribution of outcomes, you'll eventually have one member of the population who sees "you" (who is picking results at random, but mutually exclusively to individuals) pick the correct result of a sportsgame everytime.
This is the VAERS dataset: because it records any event proximate to vaccination, eventually every event is proximate to vaccination on a long enough timeline with a large enough population. It exists because, yes, they should be looked into...but only if they're occurring at a statistically higher rate then the average rate for the population over the time after vaccination. This is, for example, how AstraZeneca's clotting risk was identified and how the Pfizer myocarditis risk was identified.
There's about 16,000 new cases of Lupus ever year, there should be around 2,500 cases of Lupus following vaccination that could be reported into VAERS.
My Covid experience was not life threatening, but it was no walk in the park either. I've had more than enough of that crap in my body, thank you very much. (Yes, I understand the difference between the virus and the vaccine, in fact that's why the real deal is thought to offer better immunity.)
There really is no argument in favor of getting it at this time, just peoples cognitive bias.
For someone who already has natural immunity, that matters.
If serious adverse events are 1 in 100,000 - and I believe they are higher the younger you are - then that's significantly better odds than playing the lottery to end up hurt.
And for what?
"The greater benefit for society" is actually negative if you've been confirmed to have natural immunity.
If there's any point that you have to argue against this, I'd hope you make it instead of throwing out assertions.
The risk of hospitalisation/death wasn’t zero. And yet… they chose COVID through inaction.
And for what?
“I am not an anti-vaxxer but was holding out” spells “I am an anti-vaxxer but I lucked out”.
And, in the early days, there was no vaccine.
In the middle days, the vaccines that were made were used.
Now, those who shun a free vaccine - and haven't already caught COVID - are choosing not to lower their risk of contracting COVID in that one way... But that doesn't really help your argument.
Choosing not to choose commits you to the status quo: risk of COVID hospitalisation/death.
No, it's not. The very linked article and many others agree that people exposed to both scenarios have more effective, longer lasting immunity than the ones affected by either scenario individually.
And the adverse effect risk of a vaccine is not a lottery. At this point with billions of people vaccinated around the world, the risk profiles are pretty accurate, the side effects very well known and unless you are a kid under 18, all vaccines being widely distributed in western countries - which are the ones I cared to do any research on - are effectively zero risk.
No. With out no strictly mandated reporting of AEFIs, billions of administrated doses cannot indicate a safety profile..
Even with around 1% events reported, the serious events are around 1 in 5000
They are not. They are like 1 in 5000 (still based on volutary reporting)
https://www.medsafe.govt.nz/COVID-19/vaccine-report-overview...
Because breakthrough severity risk is "minimal" and the greater benefit for society is enormous.
There are plenty of arguments for increasing your immunity by catching it.
Also, this study doesn't seem to segment what the strain the 'natural infection'. The current vaccines are not engineered from the delta strain, but the alpha strains, and therefore it is not surprising you get breakthrough infections. But they don't seem to distinguish in this study between a natural alpha or a natural delta infection.
And there is an argument for getting it at this time:
1) If you get a booster, the chances of re-infection/breakthrough go down. In other words, you will not be an infectious disease vector that spreads to other people and increases the R0 value.
2) If you don't, and get re-infected, you will go on to infect other people. Maybe the symptoms won't be bad for you, but they may be deadly to someone else.
Whenever these debates about vaccines or masks come up, people always talk about my body and my freedom, but they never seem to consider the fact that their decisions are actually impacting the wider community. This isn't like a libertarian property rights decision about your own fenced in property, when you are infected by COVID, you are invading other people's bodies from your territory, and it behooves you to try and stop spreading to other people.
Anyone who used a plane. Went to work. Went out to eat. Left their home. All put society are risk. Have you left your home in the last year? If so you have put others at risk.
Then they can hide behind equivocation.
Risk is risk! Even manifest risk is risk!
The cost-benefit of a mask compared with the cost-benefit of never leaving your home. You sure these two scenarios are equal?
If they are covid infectious, I've already inhaled their particles before they sneezed if we were both wearing surgical masks. See that study I referenced.
The aerosol spray from even an elbow-covered sneezed is something to behold.
It has never been the case that anyone suggested that N95 masks could stop the passage of naked SARS-COV-2 particles.
However, when ejected from the respiratory passages during breathing, coughing, sneezing, the viral particles are not naked, but bound into much larger particles comprised mostly of bodily fluids. N95 masks do a stellar job of preventing the passage of such particles. Yes, edge sealing is an issue, but it is completely incorrect to claim that as a result "they don't do anything beneficial". Citing a single statistic from schools in Florida is not a legitimate way of overturning worldwide, vast-N studies that support the efficacy of mask wearing.
The vaccines are based on the original strain, not the alpha variant.
there is a feature of the spike protien that is partially stealthy; it is conformational change.
the vaccine generates modified spike protien that is locked into conformation so that immune response is biased toward a spike protien with RBD extended to infect a cell.
natural infection will generate such response however to a lower degree, further however opsinizing responses are generated, thus provoking memory immunity.
the vaccine is biased toward producing antibodies that bind to the receptor binding domain of the spike, thus producing binding inhibition of RBD ACE2 recognition thus prophylaxis.
there is a hypothetical sweet spot where vaccine induced antibody titre is at peak and will inhibit viral entry and spike RBD dynamics, meaning reduced chance of unmanaged infection and reduced severity of illness due to perturbation of the RAS system via ACE2 interference
(It's the only target they present to the immune system is why I put reliably; there's no saying infection doesn't induce similar antibodies)
e.g, Vaccine-induced immunity provides more robust heterotypic immunity than natural infection to emerging SARS-CoV-2 variants of concern:
No judgement, just genuinely curious, but what was your reason for holding out?
There's been a total of 67 deaths in my age group for entire Canada in entire 20 months of the disease. Even the hospitalization in the entire 20 months for my age group has been 3,144 which isn't much in my eyes. And vast majority of these occurred in people who had pre-existing conditions.
And as it has now been widely reported, vaccinated can not only catch covid, they have the same (and sometimes higher) viral load as unvaccinated and can infect others. And the vaccine is waning off in 3-6 months. So I don't see how me getting vaccinated is "for the common good".
Canada is also 2-3 months behind Israel in terms of COVID trends (case peaks). So what's happening in Israel right now will happen in 2-3 months from Canada.
So I don't see how I can benefit from it and am willing to take chances.
What we should be doing is saving the vaccines for the elders for booster shots and working on improved vaccines for the new variants. There's a huge population in the world which can't even get their first dose of vaccine while here we are giving out 3rd doses.
Widely reported and wildly inaccurate.
They studied patients with ‘breakthrough’ infections, i.e. where the vaccine didn’t work. And guess what they found? The vaccine didn’t work!!
(This whole "vaccinated people have higher viral loads of Delta in their mouths" thing makes me doubt your understanding of the science, as well.)
Why are changing what I said? I never said mouth. Where are you getting that from?
Please refrain from using snark and ad-hominem attacks on HN. Especially when you yourself seem to not understand that kids are the least vulnerable group.
They have the same viral load if they get infected. But the mRNA vaccines still reduce the chance of being infected by about 80% (according to [1]), which in effect reduces the chance of infecting others.
> And the vaccine is waning off in 3-6 months.
Its effectiveness goes down, but it would likely take years for it to go to zero. Regardless, that's what booster shots are for.
> There's a huge population in the world which can't even get their first dose of vaccine while here we are giving out 3rd doses.
True.
[1] https://www.medrxiv.org/content/10.1101/2021.08.18.21262237v...
The higher part is categorically untrue. The 'same' part is only true in a very narrow sense. Yes, vaccinated individuals have peak viral titers that are the same level as unvaccinated. But vaccinated individual titer levels drop off substantially faster than unvaccinated individuals. So, while an immunologically naive individual might be infectious for 5 or 6 days, a vaccinated individual may only be infectious for 1 or 2.
This is exactly what one would predict based on our understanding of the human immune system. Memory B cells that respond to the antigen would start kicking out antibodies. Some will also undergo further affinity maturation with the Delta antigen. Affinity maturation of these B cells will occur much faster since the target is already very close.
>And the vaccine is waning off in 3-6 months. So I don't see how me getting vaccinated is "for the common good".
As stated above, you would be less infectious having had the vaccine.
One thing to consider is that the outcome of COVID is not 'alive or dead'. There is a spectrum of outcomes that are not captured in official mortality statistics. While it's not clear exactly what that spectrum is (e.g. how many long covid cases really exist), I would note that there are a lot of anecdotes out there about athletes that can't climb a flight of stairs 12 months out after covid.
https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/as...
3 studies showing that vaccinated have the same viral load as unvaccinated. When we are talking about many variable numbers, especially of a highly transmissible one, if something can be same, then there are also cases of them being higher.
https://www.medrxiv.org/content/10.1101/2021.07.31.21261387v...
https://www.medrxiv.org/content/10.1101/2021.07.19.21260808v...
https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
> We find no difference in viral loads when comparing unvaccinated individuals to those who have vaccine “breakthrough” infections. Furthermore, individuals with vaccine breakthrough infections frequently test positive with viral loads consistent with the ability to shed infectious viruses. Our results, while preliminary, suggest that if vaccinated individuals become infected with the delta variant, they may be sources of SARS-CoV-2 transmission to others.
> One thing to consider is that the outcome of COVID is not 'alive or dead'. There is a spectrum of outcomes that are not captured in official mortality statistics. While it's not clear exactly what that spectrum is (e.g. how many long covid cases really exist), I would note that there are a lot of anecdotes out there about athletes that can't climb a flight of stairs 12 months out after covid.
I am aware. And that's why I have made my own calculated decision. Things such as what to inject in my body are deeply personal choices and I have done my cost vs benefit analysis to conclude I will skip the current vaccine until it gets updated to be more effective for longer periods of time and when long term studies have been done. There's a certain risk we are all willing to take in making decisions. I am willing to take this risk.
Especially when the data is consistently changing. What's the guarantee than the efficacy won't further drop in the next 3-6 months? Nor will there be any long term studies for a while. I can also sympathize with many in the black, hispanic and Philippine community who have severe distrust in the medical community.
Just look at the number of deaths and serious injuries which happen in my age group of 20-29:
https://tc.canada.ca/en/road-transportation/motor-vehicle-sa...
That doesn't mean I stop being in a car (even though I don't drive).
Plus I have most likely already caught covid last year (I have never been sick in over 11 years except last year with very similar symptoms).
So, you went with your feelings as opposed to scientific backing on that one. By that rational, they could also be lower too. In fact, they could be on average lower. That statement, however, has some backing. From a vastly larger and more random survey:
https://www.imperial.ac.uk/medicine/research-and-impact/grou...
>The 13th round of the REACT-1 study looked at swab test data from almost 100,000 people in England between 24 June and 12 July. The research found that infections were three times lower in people who were fully vaccinated, compared to unvaccinated people. The data also suggested that people who were fully vaccinated were less likely to pass the virus on to others, due to having a lower viral load on average and therefore shedding less virus.
> they have the same (and sometimes higher) viral load
The "same" is surely a fact as has been shown by 3 studies. The sometimes higher doesn't mean always higher - it means it can be sometimes higher, sometimes lower but on average, it's been determined to be the same. So it's not based on my "feelings".
What matters is how these will turn out in 3-6 more months. When vast majority of people around the world still haven't gotten a single dose while us healthy and young people are being pushed to take it, it doesn't seem well advised in my eyes. They should be saving these for the elders and especially the ones in poorer countries.
> They should be saving these for the elders and especially the ones in poorer countries.
if that's true, im not sure how declining to get a free vaccine helps the elderly...
It's important to note the population of those 3 studies. For generally symptomatic individuals that sought testing, were hospital system patients, or were contact traced individuals, respectively, viral loads(Ct values) are similar between vaccinated and unvaccinated.
Even your first cited paper mentions deficiencies for asymptomatic individuals: >It is also difficult to determine the rate of asymptomatic or paucisymptomatic breakthrough infections and to ascertain whether viral loads in such cases are as high as those in symptomatic breakthrough infections. The “true” proportion of breakthrough infections with high viral loads would require comprehensive, frequent surveillance testing of vaccinated populations to identify these individuals.
The REACT-1 study data is from a large, random sampling of the population.
Simple logic does not suggest that at all. When you're infected, your immune system crushes up and snorts various pieces of the virus to try to understand how to recognize it. The antibodies it makes "naturally" are only effective for the bits on the virus' surface that it can see. It also does so in a moderated way so it doesn't accidentally kill healthy cells. If it happened to snort up a bit on the inside of the virus, it won't help as much as if it snorted up a surface bit.
The RNA vaccine specifically encodes for a highly visible, relatively well-preserved segment of virus (the spike protein), and it comes with an adjuvant that makes your immune system ever so slightly overreact at the site of injection. Your immune system will then go on to "naturally" create antibodies via the same crush and snort process, but they'll tend to be specifically tailored to recognizing the surface spike.
So no, it's not simple logic at all. A simpleton's logic maybe, but not simple.
>they'll tend to be specifically tailored to recognizing the surface spike
the situation is worse than that. Most of the current covid vaccines are targeting only a segment of the spike protein, and all those segments are largely overlap, ie. union of those segments of different vaccines isn't much bigger than their intersection, so just a couple of mutations (https://journals.plos.org/plosone/article?id=10.1371/journal...) is enough for the virus to escape almost all of those vaccines.
> There is a whole different suite of antibodies (known as immunoglobulin As) in the nose and lungs, compared with those (immunoglobulin Gs) that we measure in the blood. The former is more important as a barrier to infection. Natural infection, because it is in the nose rather than a jab in the arm, may be a better route to those antibodies, and nasal vaccines are being investigated too.
Intramuscular (arm injection) vs intranasal (inhaled) vaccines: https://news.ycombinator.com/item?id=28165287
Nasal vaccine trials: https://news.ycombinator.com/item?id=28284504
edit- this post has made me realize how many people on hn are holding out on th vaccines. Kinda unexpected and sad.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...
"Among Kentucky residents infected with SARS-CoV-2 in 2020, vaccination status of those reinfected during May–June 2021 was compared with that of residents who were not reinfected. In this case-control study, being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated."
Additionally, there have also been some preprints indicating reduction of long covid symptoms following vaccination in a good portion of those surveyed.
> Our study has several limitations. First, as the Delta variant was the dominant strain in Israel during the outcome period, the decreased long-term protection of the vaccine compared to that afforded by previous infection cannot be ascertained against other strains.
Second... how do you reconcile your position with [1]?
> Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated.
Third, note that they describe another limitation:
> Additionally, as this is an observational real-world study, where PCR screening was not performed by protocol, we might be underestimating asymptomatic infections, as these individuals often do not get tested.
This is particularly important given that vaccines appeared to reduce viral loads (and thus transmission) for strains preceding the Delta variant, but they don't seem to have this effect for Delta anymore. One huge reason the CDC kept telling people to get vaccinated was to reduce transmission rates. It's not just about your personal health here. Yet people didn't listen, and now we have a strain whose transmission appears to be far less affected by vaccination. So if people are refusing it on that basis for Delta, that doesn't make it a "good point", but rather a self-fulfilling prophecy (and one that quite possibly sabotaged a public health campaign).
>These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection
What "2.34 times" is referencing is two groups had COVID-19 but one of them got the vaccine as well. In which case the COVID-19 + Vaccine group has less chance of reinfection compared to those who only had COVID-19.
The original article does mention that COVID-19 + infection does provide more protection as well I believe.
Think about it this way: if we could tell already-vaccinated people to get COVID for extra reduction of transmissions (!), we would do that too. For obvious reasons, we don't do that. But this clearly doesn't apply in the reverse direction!
Simple. Not vaccinated != infected previously
Those who are both not vaccinated, and not previously infected, will raise that number significantly.
However I will say, in a lot of the CDC literature they inconsistently refer to "unvaccinated" individuals in a manner that often does not distinguish between those with prior infection and those who are immunologically naive. I think this has been a major point of confusion for the general public who are trying to interpret the results of such studies.
The CDC publication you cited has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature has contradicted their findings.
Multiple large scale and long term serological studies have demonstrated that immunity acquired through previous infection has been at least equally durable and effective as vaccination in preventing reinfection.
- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)
- In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494)
- The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075)
- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)
- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials. [5] (N=3,257,478)
> One huge reason the CDC kept telling people to get vaccinated was to reduce transmission rates
It's important to note that transmission is also equally well reduced by immunity acquired through natural infection.
> It's not just about your personal health here. Yet people didn't listen, and now we have a strain whose transmission appears to be far less affected by vaccination.
You seem to be implying that if everyone had been vaccinated the virus wouldn't have mutated into a variant with increased transmission/virulence. That fact is that the current vaccines do not provide sterilizing immunity. Therefore transmission, mutation, and selective pressure would have continued at a rate that would still be extremely likely to evolve into VOCs [6]. Moreover, analogous to antibiotic resistance, evolution of vaccine resistance is a non-trivial risk associated with mass vaccination strategies [7][8]. This brings us back to OP which is strong evidence suggesting that natural infection may induce an immune response that is more robust to variants of concern such as delta.
Considering all of these facts, the optimal public health strategy will likely involve a mix of vaccination, naturally acquired immunity, and other viral elimination strategies such as early treatment using multi-drug therapies based on existing and widely available medications which have been proven to be effective at reducing hospitalization and death [9][10][11][12][13][14].
[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/
[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...
[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[6] The total number and mass of SARS-CoV-2 virions https://www.pnas.org/content/118/25/e2024815118
[7] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/
[8] Can we predict the limits of SARS-CoV-2 variants and their phenotypic consequences? https://www.gov.uk/government/publications/long-term-evoluti...
[9] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...
[10] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1...
[11] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a...
[12] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S03069...
[13] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/
[14] Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19 https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...
Not from this, because a vaccine does not cancel 'natural' immunity. In fact this study and others show previously infected people which get vaccinated get better immunity.
If their argument was that they'd rather have the dose go for someone else they would have had a better point, but it's obvious they'd benefit from a single dose.
The unvaccinated can take it. That is of better community benefit.
There is barely any additional protection for you.
For the individual, the risk of reinfection is still higher than the risk of a vaccine. Also note the small risk of a false positive for the initial COVID diagnosis.
https://www.sciencemag.org/news/2021/08/us-chimp-sanctuary-p...
this is comparing two different things, which is a facepalm
but just like the last 18 months it is not possible to compare the things you actually want because the data and materials dont even exist yet and wont for another year
leaving us at square one: react
but your reaction cant be based on things merely tangentially related like natural immunity to this years virus versus vaccine immunity to last years virus
here, finally an actually flu analogy can be used: “natural immunity to this years flu works better than vaccine immunity to last years flu” wooowww stop the presses, uhm except not really its not news
The downside is of course the risk of severe illness and having to quarantine until the virus is cleared, but the upside is that the resulting natural immunity might be effective against a possible future vaccine escaping variant.
On a personal level, it seems like if you succeed in getting it you're likely going to be feel fairly sick (a fairly substantial downside in my opinion), and the upside seems to be relatively minor since in the case of a vaccine escaping variant we will be well positioned to make a variant of the vaccine for it quickly and with minimal red tape.
And hope you don’t end up with an a overly aggressive response to COVID triggering a cytokine storm. This is one of the big reasons to get tested with flu-like symptoms, and why steroids are a go to drug.
> ... we found that the latter group had a significant 0.53-fold (95% CI, 0.3 to 0.92) (Table 4a) decreased risk for reinfection, as 20 had a positive RT-PCR test, compared to 37 in the previously infected and unvaccinated group. Symptomatic disease was present in 16 single dose vaccinees and in 23 of their unvaccinated counterparts.
20/37=0.54, not 0.53... ;-)
EDIT: An obvious problem if you are looking at deaths is (literal) survival bias.
“natural immunity to this years flu works better than vaccine immunity to last years flu”
sounds silly right?
there will eventually be delta specific vaccines, compare then.
The data from this study could not have come out earlier; we needed to wait until there were large enough samples infected with Delta to even know this.
But this study doesn't imply vaccines are not the right answer. It just says natural infection provides stronger immunity. What it leaves out is the price you pay to achieve natural immunity.
>The data from this study could not have come out earlier; we needed to wait until there were large enough samples infected with Delta to even know this.
The situation should then be re-evaluated while studies are done
>But this study doesn't imply vaccines are not the right answer. It just says natural infection provides stronger immunity. What it leaves out is the price you pay to achieve natural immunity.
How can people be so sure that they are the right answer? You just admitted that the data is only just coming out to begin to study it. Delta has changed the situation significantly
The cost of vaccination is a day or so of malaise. The cost of infection is 10+ days of flu like symptoms, the possibility of hospitalization, the possibility of death and the possibility of long term morbidity. It's a pretty straight forward computation; vaccination has very low cost vs. natural disease course.