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Comment by oldgradstudent | Hacker News Reader

> However, vaccines only target spike protein, while a previous infection will cause your body to produce antibodies for a much larger set of targets on the virus, which in practice leads to a more robust immunity. This is supported by data from Israel and some recent studies

No, it does not.

The data from Israel only supports the claim that immunity from infection is longer lasting than from the vaccine, which should not have been a surprise to anyone.

It does not support any specific mechanistic explanation.

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From the last link: "Conclusions: This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. 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 the "longer lasting and stronger".

GP is not disputing that. They're pointing out that we know this, but not why.

It might seem small but they only said it was longer lasting, not that it was stronger:

> is longer lasting than from the vaccine

Hmm. This smells of literal survivor bias. The group that survives the delta variant is a smaller set than all who got infected while all vaccinated persons survived, even ones that wouldn’t have survived without the vaccine.

While true, it's not by much; mortality for covid-19 is less than a percent of all hospitalizations, iirc.

Right. The point of the vaccines is to not have to find out if you are in the 99% who survive Covid or the 1% who don’t.

and if virus keeps mutating... twice-annual booster shots all over the earth?

I really hope we don't end up with a Marek's disease, but in humans.

https://en.wikipedia.org/wiki/Marek%27s_disease#Prevention

It seems more likely that after we've all developed some immunity to it and some variants, we'll have some level of resistance to what most strains bring to bear, and so milder and less lethal, like existing colds (also a coronavirus...) and flus.

You make it sound as if that's good news.

If this was missed in the design of the study, why would it be good news?

I do not think you remember it correctly. Cumulatively mortality is around 2% and sometimes higher of all known cases.

That seems wildly optimistic.

In the UK, 2% of people who tested positive have died. In the US, 1.7% of people who tested positive have died.

The mortality rate among hospitalized people even higher.

[1] https://coronavirus.jhu.edu/data/mortality

That's about right for those who tested positive, but current CDC estimate is that for each one that tests positive, 3.3 others got it and never got tested. That makes the actual rate something like 0.38%. Which is a lot more than 0, and is even a lot more than a normal flu, but it's not 1.7%.

Sure, but the CDC is mostly talking about the United States and the world is a lot larger than that. People are still dying all over the globe from this in fairly high numbers. And in the developing part of the world we don't even really know the numbers at all, we only do for those places that have a reasonable infrastructure and where healthcare did not completely collapse.

Developing countries will probably have a larger undercount so estimates derived from the US may already be projecting a more conservative figure.

I wasn't impressed by your point at first, but it occurs to me that the vaccination rate was way higher among older people, at least in the U.S. and probably in many countries. On the other hand, the rate of those who got covid-19 was higher among younger people. So, you may have a point there.

Honestly I have yet to see any convincing scientific evidence that is free from confounding factors which suggests that there is waning immunity.

And there's reason to believe from HCoV-229E that immunity against coronaviruses is actually durable and that reinfection is due to mutation and immune escape.

https://journals.plos.org/plospathogens/article?id=10.1371/j...

Thank you. I don’t understand why more people won’t argue like you do. We have 4 endemic human CoVs. Why not learn from the experience we had there?

I get the impression anything we could learn which doesn't support a foregone hyperbolic conclusion gets vastly ignored by the media and misconstrued as fringe in the court of popular opinion. All of this started with panic-buying toilet paper and baker's yeast from the grocery stores. I'm not surprised despite a considerable majority of US citizens being vaccinated, all reporting is underscored by pandemic levels of fear and sensation. The general public will still hatefully rebuke any claim that among a significantly vaccinated population Covid-19 statistics are largely comparable to many other endemic diseases. We were told this whole time that it wasn't just another flu, but to a vaccinated person it is just another illness. You don't want to get the flu, you don't want to spread it around, but you don't let fear of it consume your everyday life. But here we are, front page circa 2021, a bunch of vaccinated adults obsessing over reinfection.

Millions of people have died in less than two years, 650,000 where I live in the US. More specifically here in Florida, ICU capacity is at 93%, and cases/hospitalizations/deaths are at record highs for the entire duration of the pandemic. People are being turned away for cancer treatments because there is simply no room at the hospital. The peak of daily deaths and infections in our state is right now.

This is news because the flu doesn’t do that every year or any year since 1919. It’s news because it’s the deadliest pandemic in over a century, and the death rate in some areas is at its peak and climbing, despite higher vaccination rates then a typical flu season.

I cannot understand why denial of this information is so important to you, but if you continue to spread doubt about taking more precautions than the flu, people may listen to you and those people may die.

Exactly. Modern day healthcare is keeping most Covid patients alive. But the disease is also putting a strain on modern day healthcare more than anything else ever has.

Note that I actually agree more with you two about the overall impact of the pandemic and the collapse of the hospital system, not with ManBlanket up there.

I'm coming at this more from the perspective that the panic over delta being something straight out of a Big Bad TV Trope that breaks all the previous rules, is that it completely undermines the effectiveness of the vaccination campaign. The current best antivaxxer argument right now is just that all the headlines show that the vaccines don't work. I'm pushing back against that. It still looks to me like nobody has given me any indications the vaccines don't work. I think their VE against delta has been dramatically understated, the waning immunity has not been proven, and their efficacy against transmission is probably a lot higher than currently assumed.

At some point in the future I'll agree with the perspective that we need to start treating this more like the flu, but if the hospital systems are falling over we aren't there yet.

COVID-19 just recently surpassed the number of war casualties from World War I forward.

625K war casualties[1] < 635K COVID-19 casualties[2]

[1]: https://en.wikipedia.org/wiki/United_States_military_casualt... [2]: https://www.nytimes.com/interactive/2021/us/covid-cases.html

I don't deny any of this information, on the contrary I'm well aware of it. Average age 79, 99% of had a significant confounding illness. The vast majority of people who have died were already sick and living in a nursing home, literally waiting to die. Meanwhile in my state until March of last year deaths from child abuse, which has sky-rocketed at unprecedented rates world wide since the start of the pandemic, outstripped deaths from Covid. I don't understand why you and so many other are living in denial of that information. It's like you don't even care about the costs of your actions, just a the vague justification of the number of people who have died from covid. The fact is people are going to die no matter what you do about it, so not acknowledging these policies themselves have caused suffering, let alone seriously consider whether or not they were effective, is a more egregious sleight than not doing anything at all. 5 years from now people are going to look back at humanity's reaction to Covid and say, "wow, that was astonishingly stupid."

There may be no scientific reason but it would make focusing on mRNA vaccine exclusively look like a strategic mistake. The driving factor behind the approach is the belief that the encoded domain is essential to virulence. Immune escape from mutation would imply failure of that reasoning. Unfortunately other approaches that focus exlusively on a segment of the S protein would face the same challenges.

You're thinking in absolutes, and there very likely will be immune escape eventually against the mRNA vaccines, and that is pretty much expected.

But that doesn't mean the mRNA vaccines would be failures.

Focusing on the spike was also done because mRNA vaccines against the nucleocapsid protein of SARS-CoV-1 showed evidence of ADE in animals models so nobody wanted to go down that road. That decision to run with the spike protein is very unlikely to be shown to ever be a mistake in hindsight and will have been the right choice (and certainly the right choice given the information at the right time and a decision which produced an entirely successful vaccine).

It is also a really pretty safe bet that this virus will evolve to achieve immune escape just like HCoV-229E does and will start reinfecting everyone again. That won't make this vaccine a failure. And that's a good thing since its more likely that forcing it to evolve to achieve immune escape will force it to made tradeoffs between immune escape and transmissibility/virulence/fitness.

> It does not support any specific mechanistic explanation.

You're right that the recent pre-print cited by GP - regarding the data out of Israel - does not prove or disprove any specific mechanistic explanation.

However, interpreting GPs comment charitably, that study does support the notion that immunity acquired through natural infection may be more robust to mutations and variants - the mechanisms of which have been articulated in a variety of other literature. See my sibling comment [1] for supporting citations and excerpts.

[1] https://news.ycombinator.com/item?id=28320340

>> No, it does not.

But is is acknowledged in the article linked here:

>> Specifically, antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein. Importantly, the vaccine-elicited antibodies targeted a broader range of places on the RBD than those elicited by natural infection.

It does not follow that vaccination conveys better immunity than previous infection. Only better response to mutations in one area of the spike protein. Nothing else is being claimed in this paper.

which should not have been a surprise to anyone

Why is that? I have no background in immunology so it's mildly surprising to me.

The vaccine is a basically partial copy of the virus, so it stands to reason that the virus would be more dangerous as well as trigger a broader immune response.

But now we're back to speculation about mechanism, which GP was opposed to.

>The data from Israel only supports the claim that immunity from infection is longer lasting than from the vaccine, which should not have been a surprise to anyone.

I find that surprising. Why did you expect that? Why should I have expected that?

The vaccine is effectively a small part of the virus, for the immune system to learn to recognise. The virus itself has many parts for which an immune response can be developed.

>>>> The data from Israel only supports the claim that immunity from infection is longer lasting than from the vaccine, which should not have been a surprise to anyone.

Apparently it is a surprise for USA and Europe as the former only recognize infection based immunity for three months and the latter recognizes it for 6 months, while some EU member states recognize vaccine based immunity for 8 months.

please do not make stuff up to fit your narrative.

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