Having SARS-CoV-2 once confers much greater immunity than a vaccine | Hacker News Reader

Having SARS-CoV-2 once confers much greater immunity than a vaccine

sciencemag.org

227 pointspeteradio351 comments

Long term it seems pretty straightforward.

It is almost certain COVID will become endemic, and no known form of immunity whether from vaccination or prior infection confers sufficient permanent immunity against infection to stop re-infection but prior immunity (from vaccine or prior infection) does greatly reduce the chances that your infection will give you serious illness.

You assumption therefore should be that over the rest of your life you will get COVID multiple times.

The question then is whether you want your first infection to be with or without prior immunity. If you want that first time to be with prior immunity get vaccinated as that is the only known way to get immunity before your first infection.

> The question then is whether you want your first infection to be with or without prior immunity. If you want that first time to be with prior immunity get vaccinated as that is the only known way to get immunity before your first infection.

You get vaccinated against an extremely specific variant, that does not guarantee any immunity for other variants unlike immunity from infection. Did you get vaccinated every year for the seasonal flu pre 2020? If not, why do you sustain vaccination when it is clear that you will have to take boosters and variant specific vaccines every year? Why would you suggest anyone that is not in a risk group and is healthy to vaccinate when his body is better prepared to withstand and easily battle any sars-cov-19 variant?

The vaccine does not “guarantee” protection from other variants, but it does have some, more for some variants and apparently less for others (delta). But, the same can be said about prior infection: it does not “guarantee” protection from other variants either. The paper here provides evidence that even though neither of them “guarantee” immunity for other variants or reinfection, prior infection provides more protection from COVID-19 than currently used vaccines.

Vaccination guarantees some immunity for all existing variants. Just because it is impossible to say for all hypothetical future variants doesn't mean you need to spread misinformation like that

> You get vaccinated against an extremely specific variant, that does not guarantee any immunity for other variants unlike immunity from infection.

The current vaccines in the US provide excellent protection against serious illness or death from all current variations. It is only protection against infection that has fallen off some with the variations.

> Did you get vaccinated every year for the seasonal flu pre 2020?

Yes.

> Why would you suggest anyone that is not in a risk group and is healthy to vaccinate when his body is better prepared to withstand and easily battle any sars-cov-19 variant?

Because P(serious illness or death from their first COVID infection|not vaccinated) is much greater than P(serious illness or death from vaccination) + (1 - P(serious illness or death from vaccination)) x P(serious illness or death from their first COVID infection|vaccinated).

Did you read the article?

> Still, Thålin and other researchers stress that deliberate infection among unvaccinated people would put them at significant risk of severe disease and death, or the lingering, significant symptoms of what has been dubbed Long Covid.

> The study shows the benefits of natural immunity, but “doesn’t take into account what this virus does to the body to get to that point,” says Marion Pepper, an immunologist at the University of Washington, Seattle.

> COVID-19 has already killed more than 4 million people worldwide and there are concerns that Delta and other SARS-CoV-2 variants are deadlier than the original virus.

These are valid points, not sure why you are downvoted. One more question: What is the epidemiological profile (LongCovid/IHR/IFR) by age group, compared with the flu?

Exactly. The only reason that the other four endemic human coronaviruses don't kill many people today is that most of us get infected as children and build up natural immunity which protects us later. But they can still be deadly to people with weak immune systems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102597/

Obviously most people weren't infected with SARS-CoV-2 as children so the smart move is to get vaccinated and jump start your immune system. Non-pharmaceutical interventions like masks and social distancing are only marginally effective so everyone will eventually get exposed to the virus no matter what we do.

That paper did not age well.

Some of their numbers are a bit off due to lack of data early in the pandemic. For example they stated COVID-19 mortality rate as 1.3%, whereas we now know that in the US it was only 0.6%. But qualitatively their conclusions still seem to have aged well.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

The other influence is the evolution of the virus itself. A longer lasting less-than-lethal infection is, in the long term, is selected for by evolutionary pressure.

In the short term though the biggest selection pressure on the virus is vaccine evasion.

Longer lasting, sure. Less-than-lethal (or otherwise less harmful), not necessarily. Whether the host dies a few weeks after contracting the virus is not really relevant for transmissibility.

Actually, several viruses have evolved to become deadlier:

https://apnews.com/article/fact-checking-011488089270

https://www.usatoday.com/story/news/factcheck/2021/07/14/fac...

https://translate.google.com/translate?sl=auto&tl=en&u=https...

> If you want that first time to be with prior immunity get vaccinated as that is the only known way to get immunity before your first infection.

Not disagreeing with your general point, but this statement is not accurate. For example, cross-reactive antibodies from other common cold coronaviruses can provide immune protection [1], which may partially explain why a large fraction of people are completely asymptomatic after initial SARS-COV-2 infection.

> COVID-19 patients elicit strong responses to the nucleocapsid (N) protein of SARS-CoV-2 but binding antibodies are also detected in prepandemic individuals, indicating potential crossreactivity with common cold human coronaviruses (HCoV) [1]

> In our study, we speculate that preexisting OC43 HCoV IgGs to N protein could be protective and, as a result, incoming SARS-CoV-2 infections would be more controlled and thus fewer antibodies induced against them.

> In conclusion, N protein is a primary target of SARS-CoV-2-specific and HCoV crossreactive antibodies, both of which may affect the acquisition of immunity to COVID-19. [1]

[1] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/

This feels like an irresponsible title on behalf of the author. People don’t get the vaccine strictly on the strength of the vaccine. It’s considering the risk of getting COVID, understanding the long term side effects, and minimizing risk for those around you. It’s also about avoiding mutations of the virus as the higher availability of the virus only provides more opportunities for it to mutate into something more resistant or possessing other less desirable traits. I understand that the post goes into these types of details but with the proliferation of “I read the title so I read the article” types a much less clickbait title should have been chosen. This only vindicates people looking to confirm their biases and leaves out the nuance that is so important to science.

What is the harm?

"I'm very worried about getting Covid, but I'm also worried about the vaccine, so I'll get Covid to protect me against Covid?"

This is an important public health topic to model how the pandemic proceeds as more and more are naturally infected.

Some folks are looking for any excuse to not get the vaccine.

And so what ? We should lie so that they take it ?

You appear to believe it would be immoral to lie to people to get them to take the vaccine. I don't believe anti-vaxxers want to die from COVID. Is it not also immoral to allow people who don't wish to die to die needlessly? It would seem to be a "lesser of two evils" sort of situation, and, in that case, the harm of lying is probably less than the harm of allowing people to die senselessly.

I don't want to be lied to in any form by my government. I believe they can always govern by telling the truth, and if they did so they would find themselves commanding more respect from the people.

I suggest, if you are unfamiliar with his work, that you read up on Kant's categorical imperative, in particular his absolute prohibition against lying. He argues that lying, even noble lying, is bad because it dehumanises the ones being lied to. If we stop treating each other as humans with rights, needs and desires, we will find ourselves in a very bad place - history has shown us that.

> I don't want to be lied to in any form by my government.

Completely understandable, and, I agree.

> I believe they can always govern by telling the truth, and if they did so they would find themselves commanding more respect from the people.

Regarding "can always govern by telling the truth," that's demonstrably untrue. For instance, there is such a thing as classified information for a reason (that reason ostensibly being national security). Yes, this does get abused at times, but that's not an argument that the government should not classify any information. Given your reference to Kant, I don't necessarily expect you to find this persuasive, but, I wager many reasonable people would.

> ...Kant's categorical imperative....

I am actually familiar, but I reject the logic of it. It's... well... too categorical. I can't accept a principle that forbids me to take an action that may save a life. For example, I would be prohibited from hiding someone in my home who's being pursued by people who want to kill them, if the pursuers asked me directly where that person was.

> If we stop treating each other as humans with rights, needs and desires, we will find ourselves in a very bad place - history has shown us that.

I agree with this, but I reject the idea that not following the categorical imperative at all times necessarily deprives anyone of any right.

The Murderer at the Door hypothetical is commonly mentioned in response to Kant, but I don't think this serves as reason to reject the overall thesis. Kant also said that there is no right for someone to obtain information from another against their will. You don't need to tell someone who comes to your house looking for someone they plan to harm that they are there. You simply tell them they have no right to know who is in your house, and that they should bugger off! In the context of the current discussion, the government doesn't have the moral duty to reply to requests for classified information, they simply say they cannot provide classified information. If the public are unsatisfied with that answer, they need to vote them out.

Now I understand that, stretched to extremes, Kant's theory gets rather tricky to defend, such as a hypothetical situation of a Nazi coming to your house to ask if you are harbouring Jews he plans to kill. But Kant and others since have argued ways to deal with such situations too, though I must admit I haven't studied their arguments in detail and wouldn't do them justice to try to paraphrase. But I don't think we're really dealing with such a high stakes situation in the context of this discussion, so I think "lower order" arguments in favour of Kant (like mine) suffice. This is something I expect you'll disagree with given your response.

Coming back to the original context of governments lying to people to get them to have vaccines: I think it's possible to do huge damage to public trust in government and science if lies are told for the (always subjective) "greater good", even if the immediate outcome is positive. Governments should understand Kant.

P.S. thanks for your level headed response, it's refreshing and rare to see in threads that discuss COVID.

P.P.S. sometimes it needs to be said explicitly: I am open to changing my views on this if I hear a convincing argument.

I'm not sure the specific rationalizations are as relevant as the moral questions.

Do individuals have a right to their own body?

Does a collective or a technocrat have a right to coerce an individual into a medical procedure?

If we answer "yes" to the second question, only then does it become relevant because we must next ask:

Is there a limit to what a collective or technocrat can medically impose upon an individual, where and why do we draw this line?

> Do individuals have a right to their own body?

Insofar as their rights don't impact the rights of others.

Individuals have a right to drink alcohol. They do not have a right to then drive a car.

Vaccination by mandate is an extension of that reasoning. You have a right not to get vaccinated, but you don't have a right to participate in the public. Because restricting public interaction is neigh impossible (Even with imprisonment) the lesser of the two evils is mandated vaccination.

> Is there a limit to what a collective or technocrat can medically impose upon an individual, where and why do we draw this line?

Yes, communicable illnesses prevention. That's the line. It's something that seems to have been lost on the modern era. It was not controversial 50, 100, or 150+ years ago to quarantine people with disease by force of government (but often just voluntarily). This notion that there is no public interest in disease prevention and instead it's a "individual choice" is modern. Likely due to the advances in medicine, ironically vaccination, that have weakened the effects of most diseases.

I dislike this moral pearl clutching. Perhaps it's because I'm more morally a utilitarian.

At the end of the day, the harm caused by vaccination is next to 0 for almost all the population. The small percentage with adverse reactions is a small price to pay for society to work in general. The alternative is a lot more harm that we are currently seeing from the covid deaths.

Thanks for your response.

>It was not controversial 50, 100, or 150+ years ago to quarantine people

However there are unprecedented measures taken today. We're nearly 2 years into lockdowns. Moratoriums on rent, unemployment subsidies, massive increases in gov spending and a host of other unprecedented economic interventions.

There are debates over why the least vulnerable, healthy populations are subject to the same restrictions as the obese and elderly. If obesity is a risk factor and we have a "collective responsibility", then why hasn't the gov mandated exercise?

>At the end of the day, the harm caused by vaccination is next to 0 for almost all the population. The small percentage with adverse reactions is a small price to pay for society...

And if this were untrue, where would we see this information? Are there no other incentives we should be considering, such as the great reset, vaccine passports, digital ID, CBDCs or even vanilla economic interventions? We're dealing with a trust deficit in public figures and media institutions. It is hard to blame the cynic for previous incidents of propaganda.

> The alternative is a lot more harm that we are currently seeing from the covid deaths.

I'm not convinced a voluntary quarantine of high risk groups would be more harmful medically or economically. The response has caused incalculable economic damage and disruption of individual's lives.

These are ineffective because of people's refusal to cooperate. These methods work best if we work together. Because some people chose to ignore measures, it means we're prolonging the misery.

Because the least vulnerable and healthy population can spread diseases to the obese and the elderly.

Exercise is a useful health intervention. It's also not very effective for losing weight. It's also the government's fault that we are obese to begin with, because the governments are responsible for urban design, dietary and market regulation.

I'm not convinced a voluntary quarantine of high risk groups would be more harmful medically or economically. The response has caused incalculable economic damage and disruption of individual's lives.

It is unclear to me why only partial quarantine would be useful. It just means that the virus are spreading among the healthy. The moment we stop the quarantine, the moment people starts dying.

> These are ineffective because of people's refusal to cooperate.

In what sense is this not an unfalsifiable hypothesis? Are cases exploding in Japan because of the 1% of people who don't wear masks in public there? Are Australia and New Zealand trapped in dystopian house arrest because there are just boatloads of degenerates who won't follow the rules?

What the hell good is a public health intervention if it requires an impossibly perfect 100% level of compliance to even work? And crumbles to pieces the second you relax the restriction?

If 10% or 20% weren't following the rules, it'd probably be fine.

However, because COVID in the US is a political thing, it's easily 30%+ of americans that aren't "following the rules". In my state of Idaho, there were rallies to get together and burn masks. [1]

Have you ever heard of mask burning rallies in either Japan or Australia?

It's not political in most nations. This is primarily a US problem.

Anecdotally, at the height of COVID compliance in Idaho I never saw > 50% masking participation.

[1] https://www.opb.org/article/2021/03/08/mask-burning-idaho-or...

> There are debates over why the least vulnerable, healthy populations are subject to the same restrictions as the obese and elderly.

The studies are still out, but early reports are showing that delta is hitting more than just the old and the fat [1].

In particular, pregnant woman seem to be at particularly high risk of death. [2]

The problem with these communicable disease is they can mutate. Delta appears to be breaking a lot of the older assumptions about who is at risk. Perhaps that's because the older population is better vaccinated than the younger population and delta is just more deadly for all.

> If obesity is a risk factor and we have a "collective responsibility", then why hasn't the gov mandated exercise?

Because whether or not you exercise does not change your ability to spread COVID. It may improve your chances of survival but it does not change the burden one way or another on how you are affecting society around.

Further, it will take months/years to lose enough weight to eventually move out of the risk category for COVID. A vaccine takes minutes.

> And if this were untrue, where would we see this information? Are there no other incentives we should be considering, such as the great reset, vaccine passports, digital ID, CBDCs or even vanilla economic interventions? We're dealing with a trust deficit in public figures and media institutions. It is hard to blame the cynic for previous incidents of propaganda.

The trust problem is precisely from propaganda. It's because, frankly, Trump kept saying "fake news" and casting doubt on experts without a shred of evidence backing his assertions. Pushing untested and unproven medications which ultimately spawned the "ivermectin" crowd which is now taking horse dewormer to try and combat covid.

The deficit because an autocrat got power and pulled the typical move of an autocrat.

The experts have been straight through covid. It's the yellow journalists and russian interference [3] that have been spitting out mistrust where none existed previously.

[1] https://www.infectioncontroltoday.com/view/younger-people-in...

[2] https://www.nbcnews.com/health/health-news/covid-icus-doctor...

[3] https://www.intelligence.senate.gov/sites/default/files/docu...

>Because whether or not you exercise does not change your ability to spread COVID. It may improve your chances of survival but it does not change the burden one way or another on how you are affecting society around.

Yes, but under your theory of collectivism, we all have a responsibility to protect these obese individuals via authoritarian measures. Therefore, if they were not obese, we would not be burdened by the collective responsibility they impose upon us.

I'm disappointed that you've brought Trump into the discussion. I'm not a fan of the political classes as a rule, so it pains me to defend him here. He was recently panned for recommending the vaccine to his followers at a rally in Alabama.

As for autocracy, it seems a bit ironic to level this accusation in a discussion defending authoritarian lockdowns and medical interventions.

If you can't see any other problems with the mainstream political landscape outside of your focus on Mr. Trump, then there's really nothing more to say here. I could cite Iraqi WMD, Snowden's revelations, Obama's Nobel Peace Prize, the lab leak controversy or a number of other incidents, but it seems futile at this point.

When you play the Trump card you reveal your hand as a partisan.

Wild.

'you don't have a right to participate in the public'.

Universal Declaration of Human Rights

Article 3. Everyone has the right to life, liberty and security of person.

Article 9. No one shall be subjected to arbitrary arrest, detention or exile.

Article 13.1. Everyone has the right to freedom of movement and residence within the borders of each state.

https://www.un.org/en/about-us/universal-declaration-of-huma...

'quarantine people with disease'.

This is an elementary precaution that everyone, vaccinated or not, should voluntarily take at symptom onset. Not only for covid, but for flu as well. However, preemptively restricting the rights of healthy people, just because they may eventually catch a disease, is unheard of.

> However, preemptively restricting the rights of healthy people, just because they may eventually catch a disease, is unheard of.

It is not. In fact, most quarantines take exactly that form where entire households, communities, or in the extreme case cities are locked down. [1]

COVID is unique in that it is both more deadly and more infectious than the flu. That's why the measures have been so extreme. They are warranted.

Further, COVID has the major issue that a large number of people are asymptomatic. It doesn't work to say "Well, just have people feeling sick stay home" when a large number of people that are spreading the disease don't even know they have it. [2]

> 'you don't have a right to participate in the public'.

I was perhaps unclear, I mean "being infected with a disease removes your right to participate in public". Without the disease modifier, yes, you have a right to public interaction. Just like you have a right to drive without the drunk modifier.

In any event, even the UN agrees that quarantining seemingly healthy people in the face of covid isn't a human rights violation. [3]

[1] https://www.cdc.gov/quarantine/historyquarantine.html

[2] https://hartfordhealthcare.org/about-us/news-press/news-deta...

[3] https://www.un.org/sites/un2.un.org/files/guidance_on_quaran...

'quarantine' comes from Italian 'quarantina': ‘forty days’. It's not 'persempre'. By its very name it implies a time limited action.

Link 3 does not support your point: 'The term “quarantine” refers to the separation and restriction of movement of non-sick persons to see if they become sick.'. There is no blanket support for indefinite restriction of rights.

Furthermore, the 'line' is muddy. Vaccines are only 66% effective against delta. This means that 33% of vaccinated people are, under your definition, walking public health risks that may catch covid and start shedding virus in the population. Thus we should also indefinitely quarantine vaccinated people.

https://www.webmd.com/vaccines/covid-19-vaccine/news/2021082...

> Link 3 does not support your point: 'The term “quarantine” refers to the separation and restriction of movement of non-sick persons to see if they become sick.'. There is no blanket support for indefinite restriction of rights.

What "rights" are is muddy. I'm not proposing an outright quarantine. Nobody is. However, I thought it prudent to point out that the "quarantining of healthy individuals" is not unique or unjustified. Your previous comment suggested that all quarantines are human rights violations.

However, what I see from all medical experts is social distancing, masking, and getting vaccination. Those are the "rights" being infringed on at the moment.

At one point, the CDC did recommend that someone vaccinated didn't need to mask up. Unfortunately, that changed with Delta as you correctly point out.

A vaccine + mask would be highly effective at stopping the spread of delta.

Perpetually quarantining certain classes of people is abject tyranny. Worse, the line is muddy: there are false positives (unvaccinated, but with solid post-covid immunity) and false negatives (vaccinated, but with breakthrough infections). Doing a 40 day isolation to see if there is an active outbreak is completely different than isolation in perpetuity: 'you don't have a right to participate in the public'.

I have yet to see medical evidence that vaccinating under 20s, for which the risk of covid-infection complications are vanishingly small, has significant positive effects for them. There are people that have already got covid, and their immunity to covid is much stronger than that of mRNA vaccinated people (see the OP article). These 2 classes of unvaccinated people should not be forced to undertake an unnecessary medical procedure with an unclear long-term risk profile.

Covid is endemic, there is no path to ZeroCovid. Thus population-level arguments are uncompelling: we are all going to be exposed to one or more covid strains during our lifetime. Given how post-infection immunity is strong (see the OP article), the bulk of the argument comes down to how to manage the first exposure.

Riddle me out: There are vaccines, they work really well, I am vaccinated, you probably are vaccinated. Vaccinate your loved ones. We are safe, to the extent of mRNA vaccines are long-term safe. Why do you have to insist that everyone has to take them, to the extent of proposing abject tyranny to accomplish this goal? What are you afraid of?

Not a rhetorical question, I stumbled upon an intriguing piece recently: https://thestoa.substack.com/p/ontological-flooding-towards-...

> The fears that come online for the COVID thesis: I fear dying from the virus and being responsible for the death of others. I also fear being called dumb for not understanding the science and shamed for being called a bad person by failing to act in ways that would protect others.

> The fears that come online for the COVID antithesis: I fear losing freedoms and giving my power away to top-down control structures that can slip into totalitarianism. I also fear being societally segregated and persecuted by those scapegoating me for this mess.

(If it wasn't clear yet, I also worry about a medical covid antithesis: for <20s, getting the mRNA vaccines is unnecessary and potentially long-term worse than doing nothing.)

> Perpetually quarantining certain classes of people is abject tyranny.

Where do you see anyone proposing a perpetual quarantine? Do you feel we are currently under one?

> has significant positive effects for them

Because covid has something like a 1->2% mortality rate among the unvacinated, for 98%+ of the entire population a covid vaccine doesn't provide any positive effects.

Indeed, most diseases we vaccinate follow a similar pattern.

So why should any vaccination be applied?

At the end of the day it's a numbers game, the more people that are vaccinated and continue to keep their vaccinations up to date, the fewer people will be killed by illness. Vaccinations prevent more suffering than they cause. A little arm soreness is a small price to pay if it saves several lives.

This is especially important for herd immunity. The more people are vaccinated the more protected vulnerable populations are (including the vaccinated population).

> Covid is endemic, there is no path to ZeroCovid. Thus population-level arguments are uncompelling: we are all going to be exposed to one or more covid strains during our lifetime. Given how post-infection immunity is strong (see the OP article), the bulk of the argument comes down to how to manage the first exposure.

Sadly, I agree that we are past ever eliminating COVID. So next steps are what's reasonable.

With that, I think we aren't out of the woods for government and public actions against covid. We are currently in a state of being overwhelmed in our ICUs by covid. That says to me that masking and vaccination pushes should be pushed longer. Until we've exited the stage where our ICUs are overburdened it's hard to think that we should be lifting restrictions. [1]

> Riddle me out: There are vaccines, they work really well, I am vaccinated, you probably are vaccinated. Vaccinate your loved ones. We are safe, to the extent of mRNA vaccines are long-term safe. Why do you have to insist that everyone has to take them, to the extent of proposing abject tyranny to accomplish this goal? What are you afraid of?

I think saying that a vaccination mandate is "abject tyranny" is hyperbole. The vast majority of children have vaccine mandates against a bunch of diseases. Are they under an oppressive thumb? Are their lives ruined or harmed?

It is reasonable to push, and push hard, for people to be vaccinated. It isn't asking people to sell their souls, chop off an arm, or anything else. It's a small prick that you've been through. Anyone can get it, nobody is restricted from getting it.

The "tyranny" they'd experience by refusing to take the vaccine is the same sort of "tyranny" someone would experience if they decided to walk around a public park refusing clothing.

What freedoms are actually lost by a vaccine mandate? Vaccines aren't an inherent quality of anyone. It's not immutable like age or race. Tyranny is specifically persecution over aspects individuals can't control. Tyranny doesn't have a quick escape hatch of being poked in the arm.

The fact is, a switch out of the oppressed group takes 10 seconds.

The fear that this is a "slippery slope" is moot, because we already have vaccine mandates for other diseases. The only slip here is adding one more disease to the list.

You fear tyranny, can you see why I'd see that as irrational? Are you really afraid that the unvaccinated will be sent to the gas chambers? Even if this were a slope, how do you see the next steps of tyranny? "Oh, we mandated a vaccine and that went well, now let's round up the xxxxxx and oppress them!".

[1] https://www.kmvt.com/2021/08/18/covid-19-cases-are-rising-id...

abject tyranny = 'you don't have a right to participate in the public'. I have a right to participate in society. My kids have a right to participate in society. Nobody can take away that right in perpetuity, under no circumstances. Including conditioning on (miraculous, but shoddy) mRNA vaccines.

Covid does not have 1-2% mortality rate among the unvaccinated. The difference between <20s and >70s is orders of magnitude. From BBC: 'Data from the first 12 months of the pandemic in England shows 25 under-18s died from Covid. [...] 13 living with complex neuro-disabilities [...] 6 had no underlying conditions recorded in the last five years. [...] 25 deaths in a population of some 12 million children in England gives a broad, overall mortality rate of 2 per million children.' For comparison, the death rate from drowning for 5-19s in US is 1/100k, 5x larger (20x if we only count healthy children). For 1-4s the drowning death rate is a calamitous 3/100k, 15x larger (60x if we only count healthy children). And that's just drowning.

We need to get a grip.

Traditional vaccines provide long term, often lifelong protection against nasty diseases. Some of them are sterilizing the virus, leading to eradication of the disease. mRNA vaccines do not prevent infection, do not prevent transmission, need a 6 month booster and are at risk of becoming obsolete and require a different vaccine strain (and then we boost each vaccine strain every 6 months?!)

> Pfizer CEO Albert Bourla told Fox it was likely a vaccine-resistant variant would emerge.

> Bourla said Pfizer could make a shot tailor-made for such a variant within 95 days of its discovery.

> The CDC director said the virus could be "a few mutations" away from evolving to evade vaccines.

https://www.bbc.com/news/health-57766717

https://www.cdc.gov/nchs/products/databriefs/db149.htm

https://www.insider.com/pfizer-ceo-vaccine-resistant-coronav...

Don't forget:

Article 29. Everyone has duties to the community in which alone the free and full development of his personality is possible. ... In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare in a democratic society. ... These rights and freedoms may in no case be exercised contrary to the purposes and principles of the United Nations.

Article 30. Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein.

Which between them basically nullify articles 1 though 28 to the extent that the infringement can be justified on the basis of "morality" or "public order" or "duties the community"… which is how governments aiming to present themselves as anything more than petty criminal gangs have always justified violating human rights, with or without the UDHR.

Regarding the original quote, though:

> you don't have a right to participate in the public

You do have a right to participate in the public—or more precisely, no one has the right to stop you from interacting voluntarily with whichever members of the public you choose, so long as the other parties consent to the interaction. However, if that participation in the public leads to you getting someone else sick through your own negligence or reckless disregard for others' welfare then you are morally responsible for the consequences of that infection and liable to make the injured party whole, or as close to whole as they can possibly get. Ergo, you ought to take steps to ensure that doesn't happen, for example though vaccination, for your own sake as well as others'.

Got it. There are no human rights. Thanks for spelling it out for the rest of us.

How did you read that into my comment? There certainly are human rights. The UDHR just doesn't protect them nearly as well as it should. Eliminating the limitations that articles 29 and 30 impose on the rights enumerated in the rest of the document would be a good start, along with certain other contradictions (articles 22, 23, 24, 25, 26.1-2, 27.2, and 28—you can't have a natural right to services which someone else would have to provide to you; that implies slavery, which is contrary to article 4) and some irrelevant commentary (articles 13.3, 25.2) about the authors' preferences about how society is organized which has no bearing on human rights. But the first 20 articles are mostly fine. They should have just stopped there.

Sorry. I quoted a somewhat non-controversial source, then didn't pick up that you were rightfully describing that UDHR is weak, not prescribing that human rights are obsolete unless we all just take the vaccine.

The heart of the issue, and the one we seem most unable to talk about productively is "I'm worried about the vaccine".

In Minnesota 645k people had covid and 7k died. In contrast 3M are vaccinated and basically nobody has died from the vaccine. In the US 363M vaccine doses have been given and about 7k may have died from vaccination side effects vs 628k who have died from covid from covid.

So the vaccine is safe and effective.

No one in this forum says otherwise.

But you miss human emotions 101: If someone tells you they are worried about something, you don’t throw facts at them as the first thing. You ask them to tell more about their emotions, hear them and make them feel heard. They might as well be missing factual data (as the case with vaccine hesitating folks) but their emotions are real, and unless they are treated as a person they’d be close to influence because they are in a skeptic, anxious state to begin with.

Often people barge in like performing an exorcism expecting the power of data compelling the “possessed” demonized other to the “light”. Such vilification is a self-fulfilling process.

You are more likely to get hurt or die in car accident on the way to get your vaccine then from the vaccine itself. After that car accident when you are in the hospital recovering you will probably get covid there.

I don't see the relevance of your point. Perhaps you replied to the wrong thread or misunderstood what you've read?

The point is to translate it into a related human experience vs "throwing out a bunch of numbers and data".

Not only you are still throwing bunch of numbers and data only this time using comparatives ("more likely"), you seem to have also mistaken me as someone in need of convincing, which shows you haven't listened to what I've said careful enough to understand it. If I was a person that needed to be convinced, I would trust you even less just on that basis.

Finally you make the assumption that people have a problem with understanding the propositions. I'm saying they have a problem with not being heard about their emotions. You've just demonstrated that, in addition to not listening well.

At this point in the pandemic I would suggest they see a therapist.

Vaccine protection is weakening over time (boosters), mutations evading the vaccine are around the corner (Pfizer CEO), epidemiological profile is vastly different between <20 and >70. There are 4 other coronaviruses kids get exposed to when young with no vaccine and naturally build immunity for it for a lifetime.

Over 30: Take the vaccine and hope for the best.

Under 20:

a. Take the vaccine and be naked when the vaccine resistant variant eventually emerges.

b. Don't take the vaccine and build wide spectrum immunity to infections from covid family. Considering that the risk of complications from covid infection for this age group is in the same ballpark as the flu.

> a. Take the vaccine and be naked when the vaccine resistant variant eventually emerges.

First, this is deeply deeply misleading, to the point of being misinformation. The idea that a version of COVID will pop out that renders the current vaccines completely useless is founded in nothing but alarmist speculation. Could it happen? Maybe. But we have a virus now that's known to be dangerous, for which we have a vaccine that's very effective. To not take that vaccine, now, based on this speculative fear is completely nonsensical.

Second, it's a false dichotomy:

c. Take the vaccine, get a mild breakthrough case of covid later that builds even stronger protection.

This is also a possibility. The open scenario is: take the vaccine, don't get a breakthrough case (vaccines work as intended and quickly suppress it), but do get a vaccine-resistant infection later on.

If there is more information on the long-term behavior of the immune system conditioned on vaccines and/or natural immunity and/or mutations, please share. My understanding is that nobody has a complete understanding and a reliable prediction model. Everybody is making educated guesses in the dark, though I am very open to learn more from credible sources.

> Everybody is making educated guesses in the dark,

We are absolutely not.

Are there many things we don't know about the function of the immune system?

Sure.

Are we "in the dark"? This couldn't be more incorrect, and again, borders on deeply misleading misinformation.

Frankly, this smells a lot like the kind of climate change denial we used to hear. i.e., because there was uncertainty, we therefore can trust nothing and know nothing. And that "logic" was just as flawed, then, as it is now.

Did we know ahead of time if mRNA vaccine immunity is stronger / weaker than post covid-infection natural immunity? For each strain?

Did we know ahead of time when/where Delta will arise? Did we know ahead of time its infectiousness / virulence parameters?

Do we know when / where the next strain will arise? Do we know if it will be more/less infectious than Delta? Do we know if it will be more/less virulent than Delta? How about per age group?

Do we know whether vaccines protect against potential future vaccine resistant strains? Admittedly an oxymoron, but such is the ridiculousness of this conversation.

What we do know is that the virus is likely to mutate to avoid the narrow spectrum mRNA vaccines. We don't know when / where / how.

That's what I call educated guesses in the dark.

PS. Please do us a favor and keep your ad-hominems for yourself. It may feel good in the moment, but it doesn't strengthen your arguments.

The virus will mutate no matter what regardless of vaccine. It's not the vaccines that are driving mutations. The vaccine basically programs a set of immune system regex stream filters. Maybe some mutants get past it, well then the immune system will generates another response to it as it goes on to infect other cells in the body etc...

Some of the original variants are thought to have arisen out of immuno-compromised pre-vaccinated patients. Maybe they got IVIg, monoclonal antibodies, or convalescent plasma.

Umm. Presumably you've had the chickenpox vaccine, the TDAP vaccine, and a bunch of others as a kid as a condition to go to school. These have been well studied for decades.

> but do get a vaccine-resistant infection later on.

This is a redherring.

This would be the equivalent to have never encountered covid and getting infected by that variant then. So you know maybe a new kid born in the next few months or something.

It'd also be equivalent to someone getting chemo that wipes out their immune system and now gets covid after they recover.

We are taking an open bet: will the vaccine resistant covid strain(s) that are likely to emerge be more/less virulent than Delta or not? I don't have a crystal ball, but given that we know that for <20s the risk of complications from Delta is vanishingly small, why take the bet?

All signs point to lambda being more virulent/deadly etc…. Still has nothing to do with the vaccines.

If covid mutates sufficiently fast, say as fast as HIV then we will have a big time problem.

That's exactly it. Almost everyone in my immediate family is more concerned about getting the vaccine than they are covid. And this is AFTER someone in the family has died from it. It is extremely concerning how bad this has gotten. My own mother literally had a panic attack after getting her first shot. My kids' school administrators are making decisions based on these illogical conclusions. I have had school staff tell me that it's best that they all go ahead and get covid. They compared it to chicken pox parties from the 80s. When I mentioned shingles, they told me that was a different disease. I have an at risk child at home. My tolerance for stupidity is waning.

I'm afraid the general publicly is woefully underequipped to engage in nuanced discussions around this topic. They need simple and clear instructions.

I wish I was more surprised about how easily covid made people rationalize authoritarianism.

Yeah. Should be "If you survive covid 19, you will have greater immunity to covid that you would get from a vaccine"

Pedantically, dying from covid makes it even less likely you'll catch it again... Really this is all just confusing what the actual goal is: to end the pandemic while minimizing death and suffering

Well, actually pedantic anti-vaxers would formulate it as "If you survive covid 19, you will have greater immunity to covid than you would get from surviving taking the vaccine"

>the actual goal is: to end the pandemic while minimizing death and suffering

We can all agree we want less death and suffering. However, it isn't difficult to imagine that other goals may exist.

"The pandemic represents a rare but narrow window of opportunity to reflect, reimagine, and reset our world" - Professor Klaus Schwab, Founder and Executive Chairman, World Economic Forum

https://www.weforum.org/focus/the-great-reset

This assumes the audience for this title are people that have not yet been infected.

It could also apply, for example, to the hundreds of millions of people world wide who have already been infected.

I don't think a fact should assume an audience.

Yes, but strategically we should probably write headlines that be can't taken out of context to disingenuously argue that they "prove" that vaccines are worthless.

Anyway, re-reading your point... My headline wasn't intended to be aimed at any person. It's a hypothetical statement about covid immunity level after surviving covid. Glad I didn't go into journalism.

Agreed, the original paper title is more appropriate: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

Based on the number of deaths, a very large percentage of people have already had COVID.

Given that there is a non-0% chance of death or harm from taking the vaccine, why should they then get vaccinated? They are already less of a risk to themselves and others than someone who has been vaccinated.

Serological tests have consistently shown that far fewer people have had COVID than have been vaccinated, for instance.

What's a good source of those numbers?

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

The CDC estimates that 36% of Americans have been infected.

> why should they then get vaccinated?

I haven't done the sums but I suspect the risk of harm from the vaccine is less than the benefits the vaccine gives (especially when you factor in the duration of protecection depending when you had Covid vs when you had the vaccine).

I know people who've recovered from serious Covid and still got vaccinated. I would.

RTFA

> The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated.

Which is still a good argument against double-vaccinating them, at least when vaccines were hard to come by (which is still the case in most of the world).

At least that’s how France does it, and that strategy might come in handy again as they plan to give boosters with influenza vaccines to everyone over 65.

Single dose has been the recommendation for a while in the US.

Only for JNJ vaccine which has been 1-shot for everyone.

> a much less clickbait title should have been chosen

It is not clickbait, (if true) this is just a fact.

Clickbait and truth are not mutually exclusive. In fact I would suggest that most clickbait is true.

This isn't just some random fact. It's extremely relevant to the pandemic.

Knowing that previously infected people maintain immunity high levels against variants is important for people making informed decisions about their situations.

What GP is really worried about is this fact being misused to incentivize people NOT to get the vaccine.

I don't quite understand your point. GP said

> It is not clickbait, (if true) this is just a fact.

And I was pointing out that this statement is based on flawed logic. I wasn't commenting on truth/falsehood or clickbait/non-clickbait. I'm just objecting to incorrectly reasoning from one to the other.

I agree that it can be both. In this case, imo, it is not both.

This isn't clickbait because this fact is pertinent.

> This isn't just some random fact. It's extremely relevant to the pandemic.

I don't disagree with it being relevant but if one reads just the title of this article and had previously been infected they may believe they do not need to be vaccinated, but that isn't the case.

According to this study folks who were infected previously are more than 2x as likely to be reinfected than those who were previously infected and then vaccinated: https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...

Reducing a 1% chance of re-infection to .5% does not imply that population needs to get vaccinated.

This is why we rely on medical professionals to inform these decisions and they do say the population should be vaccinated:

https://www.healthline.com/health-news/people-whove-had-covi...

https://www.usatoday.com/story/news/health/2021/08/09/covid-...

I disagree and there are also doctors and experts that disagree.

There is no reason to assume medical experts are free of groupthink. There is also no reason to assume the medical industrial and related government regulators are free from corruption. Which makes it all the more important to question the advice we are given by “experts” and ask if it makes any sense. To me it doesn’t.

There is no reason to assume that medical professionals are corrupt in encouraging people to be vaccinated, either. Especially given that the data shows better protection among the vaccinated than the unvaccinated.

I generally agree, but it's important to remember that public health officials are not infallible.

In the beginning of the pandemic, most of them told us NOT to wear masks.

Totally. The key is, once new information comes in to base decisions on the updated information. I'm glad that our public health officials are doing so.

The volume of criticism for posting verifiable facts that might be misused in illogical arguments, is really frustrating.

It's as if we need to post a disclaimer in advance that we agree with the consensus first in order to post a fact like OP.

For example, OP's fact correlates with the recent study that demonstrated that getting one shot of Moderna and one shot of Pfizer was more effective than getting two shots of either.

...and none of that is a surprise to virologists, because a diversity of antibodies is obviously going to be more effective at combating infection, and more importantly, provide broader protection against variants.

...but instead OP gets downvotes because of the fear that some imbecile is going to repost this all over Facebook in order to convince people to not get vaccinated.

Think about the consequences of this reflex. We cannot talk about the truth in-depth because less informed people might be mislead by misinterpreting it. This diminishes the quality of our conversations. It puts a cap on the intelligence of this community.

...and when you first identify this phenomenon - you begin to recognize it all over the place on social media. True verifiable facts being downvoted because they might maybe work against the "greater good" agenda in a less sophisticated forum. ...and that ultimately causes a dumbing down of the conversations - something very noticeable on Reddit and Twitter.

> This feels like an irresponsible title on behalf of the author

The title describes the content of the article. I think people should be treated as adults (esp. on HN). We should be able to discuss Covid-19 science and data without always fearing misinterpretation from anti-vaxxers.

Sorry, no. This is why there are anti-vaxxers to begin with. Communication is key. Scientists and health professionals fail at it. Listing cold facts does not effectively communicate to the broad public, because they receive the message not by learning the new facts to change their word view, but by trying to fit it in their world view. Messaging is critical in public communication.

+1 and an example would make your argument even more persuasive

Here is the full conclusion of the paper, rather than the blog post which summarizes the paper:

> 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.

Sorry, no. This is why there are anti-vaxxers to begin with. Trying to hide crucial information inside the article or censor it altogether just fuels all these misinformation campaigns.

No - we have anti-vaxxers because nobody will debate them. Instead we ask them not to post their nonsense and so they just retreat to their echo-chambers and begin reinforcing their views to each other.

I've seen many online debates with antivaxers and nobody convinces anybody of anything. People just get angrier and more hardened in their opinions. Everyone goes into it with an us vs them mentality instead of open minded.

I think this attitude is actually what leads to a lot of hesitancy.

> Listing cold facts does not effectively communicate to the broad public

It’s very patronizing.

You're right that communication is critical, but it's precisely because facts are omitted that causes the problem. Those facts just come out later, and that only makes things worse. Instead of transparency and straight forward communication, public health officials are engaging in manipulation of the public. So called noble lies, like telling people masks don't work in order to cover for the lack of mask availability. That burned their credibility and is just one example.

The lies and lies by omission are literal oxygen to anti-vaxxers because they can point out, with proof, that we were lied to. Naturally the next question is, what else are we being lied to about?

Stop lying, start treating people like adults, be upfront from the start, and you'll see anti-vax and anti-expert sentiment dissipate.

I would also point out that there is an intentional conflation between anti-vaxxers (those opposed to all vaccines) and vaccine hesitant (those who are pro-vaccine generally, but are weary about a new vaccine or were already infected and have natural immunity). The latter are being grouped with the former, and this has also destroyed a great amount of credibility and trust.

> Start treating people like adults, be upfront from the start, and you'll see anti-vax sentiment dissipate.

I've only seen Anti-vaxxers treated as adults from the onset, being upfront about the data etc. It just get disputed, debated and then denied.

I'm burnt out and numb to them at this point. I do agree with you that information shouldn't be omitted; However, the damage is done at this point. It's not going to stop either.

"Do this willingly and this can all be over...okay, that didn't work, now we're going to make you" isn't exactly what I'd call treating someone like an adult.

I'm not convinced the biosecurity state will go away anymore than the TSA will disappear tomorrow. Government agencies rarely cede power back to the citizenry.

Every single government, bureaucracy, expert, official, authority in anyway all gained power during covid. A lot of them “discovering” powers they had no idea they had (CDC, evictions).

I agree it’s unlikely anyone will give it up willingly.

> This is why there are anti-vaxxers to begin with.

No, this isn't the reason. Straight, clear communication of facts from professionals is one of the best ways to combat erroneous viewpoints.

Telling people the truth (including what you don't yet know) and letting them freely assume their own risks is a powerful way to win them over.

> because they receive the message not by learning the new facts to change their word view, but by trying to fit it in their world view

People don't change their worldview because someone tries to change it for them. Straight facts without manipulation of any sort is the best way.

People know when they're being manipulated, talked down to, and lied to. That's the worst way to try to change their opinion. Fauci and other officials did a lot of this early on, unfortunately, and they lost credibility with large swaths of the public, leaving a truth vacuum that badly misinformed youtubers rushed in to fill.

> No, this isn't the reason. Straight, clear communication of facts from professionals is one of the best ways to combat erroneous viewpoints.

For better and for worse, this is not true with most people. Most people are most open to changing their viewpoints if you engage them in a manner where you try to take their side, first, and then lead them in a new direction.

Straight facts might work best for you, but I'm afraid they're pretty much a sure-fire away to turn off most adults who've already made up their minds and don't already agree with you.

Search for "people don't change their views based on facts" with your engine of choice for a plethora of articles that confirm the query.

I don't remember the source but I read recently that peer pressure is far more likely to change someones mind about a given subject.

I think the fact approach works well for rational and logical thinking persons.

As for the rest, yes other approaches must be employed instead.

As long as the approach is respectful and not manipulative... anything less will backfire.

Sorry, no. Hiding facts from responsible adults is a great way to breed resistance to any subject being discussed. Stop infantilizing your neighbors.

>Scientists and health professionals fail at it.

They do just fine.

The problem is "science" "journalism".

go step into the world of "covid vaccines are bad!" for a second (/r/newnormal) and you'll rescind this statement. It's getting out of hand, between misinformation and politicizing how we treat an infectious virus.

You're right. Data is data. That being said there is a pretty irrational contingent on HN these days.

The original title of the paper was "Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections." It's important to point out that the paper isn't just one fact but a collection of facts that form nuance.

To me science mags title is much more sensationalistic and there is a reason they did not chose a title more closely aligned to what the authors of the original study chose.

> The research impresses Nussenzweig and other scientists who have reviewed a preprint of the results, posted yesterday on medRxiv

Its very irresponsible, look at this nonsense masquarading as peer review of a preprint 24 hours ago

Furthermore, getting a vaccine for last year’s ailment cannot be compared to this year’s ailment, although its obvious people dont really have a choice in the matter the study should at least lead with that. There will be delta specific vaccines soon, compare to natural immunity then.

> People don’t get the vaccine strictly on the strength of the vaccine. It’s considering the risk of getting COVID, understanding the long term side effects, and minimizing risk for those around you. It’s also about avoiding mutations of the virus as the higher availability of the virus only provides more opportunities for it to mutate into something more resistant or possessing other less desirable traits.

Erm everyone I know under 40 got it because of a huge marketing campaign, wanting to travel with as few restrictions as possible and not wanting a vaccine passport to party.

>the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher

This sounds convincing, but then in the next graf:

>For instance, the higher hospitalization rate in the 32,000-person analysis was based on just eight hospitalizations in a vaccinated group and one in a previously infected group. And the 13-fold increased risk of infection in the same analysis was based on just 238 infections in the vaccinated population, less than 1.5% of the more than 16,000 people, versus 19 reinfections among a similar number of people who once had SARS-CoV-2.

Are you saying 32,000 people isn't a large enough study to be meaningful?

For low-prevalence events the number of events that happened is just as important for statistical power as the big 32,000.

Especially when doing relative risk, the confidence interval on that "27 times" could be extremely large.

True, but we aren't comparing a 1 to 0 or 1 to 2. Its 238 to 19. sqrt(238)=+/-15 sqrt(19)=+/-4 (if the numbers are to be believed) . 238/19=12.5 (238-15)/(19+4)=9.7 so it becomes 20% less on the lower end of the fluctuation which is only nominal.

It's more about the small effect sizes of 8 people vs 1. Still a lot of room for noise in the result.

True, but where's a better study at the moment? I think it would be easier to gather more studies and do a cross-study meta analysis rather than recruiting a million people into a single study to eliminate the effects of noise.

The "27 times" is factually their finding in one study, which someone might read as being given too much weight in the article but doesn't change the data.

Have you ever looked at the numbers on the vaccine trials? Especially the ones in children under 18?

To develop natural immunity, you would need to get infected with the virus, no? That's considerably more risky than getting the vaccine.

If you do get infected with the virus after vaccination, wouldn't you also develop natural immunity?

I think the worry with natural infection is if the timing is such to provide durable immunity. But it’s not like the vaccines have had 5 years of trials to determine the best wait between the 2 and 3 doses so kind of a moot point.

Why 5 years? Why not 1? Why not 50? What's so special to people about 5 years? I keep hearing people say "it hasn't been tested long enough" followed by "I'd take it in about 5 to 10 years" which is a HUGE difference. Is it just that "time has passed", because a year has passed since the Pfizer-BioNTech vaccine was first given to test subjects. But I guess it's up to people - their body, their choice.

Even though we live in what is commonly referred to as a "society". We agree to live by certain rules and norms that allow us to coexist. There is a faction of fools out there who resist being a part of society, but claim all of its privileges. These are sub-human individuals who just seek some form of control over others. That has to stop.

>Why 5 years? Why not 1? Why not 50? What's so special to people about 5 years?

Clinical trials are conducted over many years (rather than just 1) for historical safety reasons[1]

>There is a faction of fools out there who resist being a part of society, but claim all of its privileges. These are sub-human individuals

This is hate speech, especially considering the disproportionate rates of black and hispanic people who are unvaccinated.

[1]https://www.brightfocus.org/clinical-trials/how-clinical-tri...

> This is hate speech, especially considering the disproportionate rates of black and hispanic people who are unvaccinated.

It is not. Black & hispanic people are vaccinated at lower rates than white people mostly due to access issues, not refusal to get the vaccine. One of those access issues is, in fact, that they are disproportionately members of a part of society we've demanded to take a lot of risk: essential workers.

https://www.npr.org/sections/health-shots/2021/04/26/9899620...

That's right, vaccine doesn't prevent you from getting the virus so if you get it you'd then amount an immune response of some sort which is on top of the one provided by the vaccine.

Or that goes to "fill up" again the immunity lost due to the time which went by since the vaccination.

If you got Covid before vaccines were available that risk assessment is irrelevant.

If you get COVID after vaccination, your immune system may not learn how to fight COVID-19 as well, because the vaccine is present and doing something.

The vaccine isn't doing anything in your body to fight COVID-19 infection actively. Your immune system is doing the fighting regardless.

That is not what I said.

“ your immune system may not learn how to fight COVID-19 as well, because the vaccine is present and doing something.”

But the vaccine being present isn't "doing something". The thing it did has already happened.

If you develop covid-19 symptomatic disease after vaccination, you will likely still get natural immunity.

The immune system "doing something" is why you feel sick.

The vaccine fighting the virus doesn't make you feel sick because it's just antibodies clumping on virus particles, preventing them from infecting cells.

There are also inactivated-virus covid-19 vaccines [0] in trials that one could expect to impart more broad-based immunity than the mrna vaccines which are designed to target only one part of the virus.

[0] https://en.wikipedia.org/wiki/Sinovac#COVID-19_vaccine_devel...

The bigger problem is that the risk of hospitalization post-vaccine appears to be lower than the risk of death pre-vaccine. If seven of those eight hospitalized post-vaccine would have died when naively infected, then the difference disappears. Seven out of 32000 is 0.02%, while the risk of death from COVID-19 is 0.4%.

And if you remove hospitalization as an endpoint, you're basically dependent on self-reports. That's not to say I don't believe the conclusions -- they should survive this critique -- but there is reason to expect a little inflation of the ORs.

But that seems intuitive? If you survive the first Covid infection, you’re biased towards less severe symptoms for the 2nd infection (ignoring even any immune response).

Basically all the folks who died from Covid are excluded from this population.

>the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher

The denominator in those odds ratios seem to fishy to me. Comparing people who were previously infected with COVID and vaccine recipients does some weird conditioning on getting COVID, so it should hide risks of developing symptomatic COVID and hospitalization for people who got COVID previously. It seems to me that the risks should be "cumulative" for people who were previously infected (i.e., the denominator should include symptomatic infections and hospitalizations for previous COVID variants and not just delta) rather than "zeroing" those risks for this group and just focus on delta re-infection. The decision to only focus on delta infections will bias up the OR estimates for vaccine (in)effectiveness, so we should read the results of this paper as the possible upper bound of the ORs.

Also, the study compares the risk of delta infection, meaning that people cannot really just say "I won't get vaccinated because natural immunity is better" as the variants that provided that natural immunity are not "dominant" anymore, meaning that the opportunity to acquire natural immunity against delta is probably close to zero at this time.

Also also, isn't it something that is known that natural immunity is better than vaccine-acquired immunity? The trade-off is that natural immunity has the "side effect" of actually having to fight off and survive the illness?

> Also also, isn't it something that is known that natural immunity is better than vaccine-acquired immunity?

Yes, I pointed this out elsewhere in the thread, but it has somehow been verboten until very recently to state it in regards to Covid. My brother-in-law was even told by the people administering his vaccine that having had a prior Covid case put him at more risk and made it even more essential that he get vaccinated.

It does not seem unreasonable to me to extrapolate that people who caught COVID-19 once are more likely, as a group, to be exposed to it again in the future. That would be a matter of their environment rather than their individual resistance to the virus. I haven't seen any studies on that issue, though.

In any case the vaccine is safe, effective, and way better than actually catching COVID-19. And in the event that you did already recover from COVID-19, getting the vaccine doesn't hurt and will boost your immunity even further. So—unless you have a specific medical condition which dramatically increases your changes of an adverse reaction–you should just get the vaccine.

You raise a good point that it would be useful to report the "cumulative" risk for people previously infected.

However the goal of this research is specifically evaluating risk of reinfection, not the cumulative risk of SARS-COV-2 infection. The fact is that a vast majority of people survive initial SARS-COV-2 infection, so the pure risks associated with reinfection are also equally useful to know.

The decision to focus on delta infections does impact the OR estimates for vaccine effectiveness as you mention. But again this was one of the primary research goals of the paper - to evaluate the risk of reinfection by comparing natural immunity to vaccine-induced immunity in the context of a variant with mutations conferring immune escape.

> the variants that provided that natural immunity are not "dominant" anymore

This was controlled for in the study by censoring data based on the date of previous infection.

> The trade-off is that natural immunity has the "side effect" of actually having to fight off and survive the illness?

Yes, and people need to stop interpreting the title and cited paper as a manifesto against vaccination. Rather, the study provides valuable data on the efficacy of natural and vaccine induced immunity in the context of evolving variants, which will be useful in guiding public health policy and also formulating next generation vaccines that improve upon the current formulations.

The term ”survivor bias” is usually used metaphorically, but in this case it applies literally.

Putting in some caveats about the risks associated with infection is not enough. This is a garbage analysis that should never have been accepted for publication.

I don't see survivor bias here at all. This is simply a study that caters to a rather significant population who justifiably want to know what they stand to gain from this vaccine.

What this study has done is identified a sub population who stand to gain such minuscule benefit from vaccination that it would be unethical to include them in a study (most studies DO exclude previously infected individuals, huh wonder why?) Furthermore it is unscientific discrimination to penalize people when they could prove prior infection and/or immunity.

The study appears to be reporting at least a further 50% reduction in risk for previously infected people who get a vaccine.

One might debate whether the probabilities involved are so low as to be irrelevant, but the study absolutely supports the existence of a benefit.

Fair point. I hold my ground on the discrimination point.

Nobody died from vaccine but all the weak ones died from first infection so the surviving infected have survivorship bias.

> Nobody died from vaccine

That’s not strictly true. There have been deaths, but this can be attributed to components in the vaccines that these unlucky people may have gotten at any time. There have been rare and unusual vaccine caused deaths.

In this study nobody died from vaccine. But the big thing thats not adjusted for is once you got Covid you will wear mask and won't go to restaurant, this is not adjusted for in this study.

Do you honestly think its wrong or uncommon to study a group of people who have experienced a disease? Perhaps in an effort to make them informed about their particular risks?

You haven't read the replied upthread where people use research like this to suggest "Corona parties" (like chickenpox parties) and how many people think it's safer to catch the virus than get the vaccine?

This article will absolutely not just be used by already-infected people trying to make a decision.

You are right, but are you suggesting this should be censored? This is important information that is very relevant to a sizable population.

No, but it should make clear that this study is absolutely not recommending getting infected over getting vaccinated.

Its a problem for the main narrative but that is because the main narrative is brittle and stupid. I don't see why scientific news ought to be forced to cater to a particular political narrative. Let the main narrative fold this in along with whatever caveats they wish, leave the science publications out of it.

peterbonney's right for exactly the reasons that the public trying to reason its way through interpreting studies like this unaided is dangerous to public health.

This is an observational study. It's not possible for it to control for (among other things) the possibility that those who were infected and survived already possessed enhanced natural immunity due to some other cause. All we know is that people who get COVID-19 and don't die from it are less likely to become symptomatic with the delta variant than people who are inoculated, not whether or not they were always less likely to become symptomatic with the delta variant.

People who interpret this study to mean "I don't need the vaccine" are really rolling the dice on the possibility that there's an X-factor here to COVID-19 survival... And they don't have it.

Apparently a high percentage of X-factor was present in this study. Do you see something funny in the demographics of the recovered?

I see they recovered. You're correct... One interpretation could be that a high percentage of X-factor was present in this study's recovered group. But since we don't know what the X-factor is, an unvaccinated person is rolling dice by assuming they have it.

Nothing about this study guarantees an unvaccinated individual survives a brush with COVID-19; it suggests they're likely to survive a second brush with it (and likelier still if they get vaccinated).

I see what you are saying.

The study is not relevant for unvaccinated and uninfected people.

I'm fully vaccinated as is my whole family but you're the one showing bias here. The data is the data. Obviously the data set is only recovered patients. That has no bearing on the analysis. It's not a recommendation to go get infected or anything ridiculous like that. It's not a recommendation of anything. It's just data.

It’s math for the sake of math with no actual scientific value.

Here, let me help:

“Car crash survivors show greater seat belt compliance than people who watch a seat belt PSA.” Useless analysis.

That's the wrong analogy. Seat belts only work while you're wearing them. They don't prevent crashes. Imagine if the study found the opposite conclusion. That vaccines produced a stronger immune response than a live infection. We'd have a whole different take if that were the result so it's extremely valuable to have an answer.

You’re missing my point. We know nothing about the sample that was excluded (the people who died). Were the survivors already more prone to wearing seat belts, or did the accident change their behavior?

In the Covid case, is the sample more weighted towards people who are more naturally prone to have a robust immune response (in contrast to the missing sample, I.e. everyone who died), or is the disease alone responsible for the immune response?

It’s not an apples-to-apples comparison, so no valid conclusions can be drawn.

That's still irrelevant. They asked a specific question and got an answer. That answer adds to our knowledge. That's it. We already have data telling us how many people who contract covid will have life-threatening symptoms without treatment.

What does it add to our knowledge? That some sample of people have more antibodies than a non-equivalent sample? I could have told you that without a scientific study.

That same sample of people who had the illness may have had more, fewer or equal antibodies if they had not gotten sick and instead got vaccinated. This study does not tell us anything about which is the more likely possibility.

No you couldn't. You could have guessed but you wouldn't know. Now we have numbers. We know the level of immune response and the distribution. Like I said, imagine the opposite. If convalescence produced a weaker response than vaccines. That's equally possible and would have lead to some serious policy shift. Now we have a clear answer and can make informed decisions.

I couldn’t have guessed that we could find two samples of people such that antibodies in one group exceeded antibodies in the other? That is true for any non-uniform data set.

As for your other point, I also maintain that the opposite finding would have told us equally little. Perhaps they had lower antibodies because they had less virulent variants/cases on average, which is why none of them died - again, “survivor bias”. It would still tell us nothing about how their immune response would compare between the case where they got sick and the case where they got vaccinated.

Edit: here is a simple challenge that can resolve this discussion in your favor. If you can tell me definitively what the expected antibody level for the survivor dataset was prior to this study, I will concede that you are right and this is a meaningful analysis.

I'm confused. If I could tell you want the expected level was before the study, then you'd be right not me. My point is that we didn't know for certain until the study was done. We could reasonably predict it would be "some" but not that if it was more or less than a vaccine response.

Scientists can’t develop a null hypothesis about the impact of the most studied virus in the history of humanity? If you have no null hypothesis then you shouldn’t be drawing conclusions from data, period.

Anyone who reads this site regularly is probably aware of the problems with non-registered data analyses in academia (often referred to as the “replication crisis”). We should be incredibly skeptical of any non-registered analysis, even when sample controls are used. When the study is unregistered AND the sample is uncontrolled the default posture should way beyond skepticism - it should be considered meaningless until reproduced by a better-structured analysis.

I got downvoted for saying this here a while back. Anyone with good immunology experience would guess this to be accurate no matter what some half baked study says (which was what a bunch of people were telling in that earlier thread). Again doesn’t mean you should go get Covid or avoid the vaccine. The vaccine only helps. If you got Covid and then also got the vaccine it only helps more.

Not sure if it was you but I might have been one of the skeptics (don't think it was with this user though). Many of the comments I saw sounded like conspiracy fuel. I didn't downvote anything that sounded substantial (for example if it had references, or at least the disclaimer that this doesn't mean you shouldn't get vaccinated). Makes me wonder how to tell cherry picking science for conspiracy (I saw that heavily with 5G for example) from reality, especially when official outlets are not agreeing with the latest research yet.

But the risk of dying of COVID for most age groups is basically zero.

The opposite view was a mainstream media narrative last year, in that a suggestion as such was very widely reported:

'The rapid waning of antibodies did not necessarily have implications for the efficacy of vaccine candidates currently in clinical trials, Imperial’s [Wendy] Barclay said.'

“A good vaccine may well be better than natural immunity,” she said.

https://www.reuters.com/article/uk-health-coronavirus-britai...

https://www.google.com/search?q=“A+good+vaccine+may+well+be+...

Why is "natural infections and recovery produce a better immune response than a vaccine" so controversial? Has it been this controversial for any other disease?

I think it's because people draw the wrong conclusions. Sure, if your body was stuck fighting COVID19 for two weeks and you then survived (i.e. excluding those pesky 700k Americans who didn't make it), then you are better prepared than if your body was stuck "fighting" COVID19 vaccine for half a day (of sleepiness or at most mild fever).

The PROBLEM is that people then say "oh well then to protect myself better against COVID19 what I should do is get infected with COVID19, rather than get vaccinated". I have NO IDEA why so many people are jumping to that conclusion.. but oh well..

> The PROBLEM is that people then say "oh well then to protect myself better against COVID19 what I should do is get infected

Both approaches carry risk, yet your statement presents as if the risk of vaccination is 0. And also excludes the idea that opting not to be vaccinated is a legitimate choice for the millions and millions of “cases” that have already been infected.

The risks of the vaccine have been shown to be a minuscule fraction of the risks of being infected with covid.

If one has acquired immunity then the risk of taking the vaccine is entirely unnecessary.

> Sure, if your body was stuck fighting COVID19 for two weeks and you then survived ... then you are better prepared than if your body was stuck "fighting" COVID19 vaccine for half a day

From what I've read, it's less about severity of infection and more about the fact that the vaccine only introduces one specific aspect of the virus (the spike protein) to the immune system, while the actual virus introduces... all of itself to the immune system. So natural immunity ends up being more comprehensive and resistant to variants than the vaccines.

imo people seem to be stuck in a somewhat contrived line of reasoning about the 'choice' between taking the vaccine or getting infected. hundreds of millions of people, possibly the majority of the adult population have already contracted covid 19 involuntarily, and the vast majority of these people survived which suggests they should have developed natural immunity and yet increasingly within the first world, this immune but unvaccinated population is being faced by public and private mandates that restrict their rights and possibly put their employment at risk unless they take part in what is effectively an ongoing experiment with mrna vaccination, one that increasingly seems to confer them little actual benefit.

It makes it very easy for people to lie about. Both to themselves, ("well i was a little sick around month X, so that was probably covid, so i don't need a vaccine") and to others.

It's no easier than lying about vaccination status. Antibody tests are widely available, yet none of the pro-vaxers are willing to accept them as evidence of immunity. Why do you think that is?

As I understand it, Israel does count previous infection similar to vaccinated status.

Not an argument, just a data point.

I wasn't aware of that, but that's good to know. It's certainly not counted anywhere in America that I'm aware of.

> Why is "natural infections and recovery produce a better immune response than a vaccine" so controversial? Has it been this controversial for any other disease?

Confirmation bias

As you can see from some previous replies, it’s because people are less concerned with what’s true than with how (they believe) information will influence the behavior of others.

The apparent prevalence of this attitude in media and public health is eroding the credibility of those institutions, imo.

Sort of like when the FDA insinuates that Ivermectin is unsafe because it has also been used by veterinarians in addition to its human indications.

Off-topic but does anyone have a mechanism by which Ivermectin would be helpful with Coronavirus? It seems bizarre that an anti-parasite medicine targeting a eukaryote would have any efficacy against a virus.

I'll give you one (total supposition, I Am Not A Veterinarian): most people don't "get infected" with worms, but some have exposure and have immune responses that may not ever rise to the level of "symptoms". anti-parasitcs might assist and allow more robust responses to other health challenges.

Don't look too deep into how much life we host even when healthy; it'll squick you out.

So far a multitude of randomized clinical trials (RCTs) have tried but not found significant benefits from using Ivermectin to treat COVID-19 in a single-drug treatment regime.

However it's worth noting that certain multi-drug treatment regimes are looking quite promising [1][2].

Furthermore, early multi-drug treatment (before severe symptoms) using existing widely available medicines has been proven effective at reducing hospitalization and death [3][4][5][6][7]. Many front-line doctors have been using such techniques since the beginning of the pandemic, because they had to - as there were no vaccines yet and no RCTs to guide them so naturally the only option was using and combining existing medicines with established safety and efficacy profiles, the same strategy used for other difficult to treat diseases and cancers.

[1] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/

[2] Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 https://pubmed.ncbi.nlm.nih.gov/33306283/

[3] 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...

[4] 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...

[5] 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...

[6] 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...

[7] Multidrug treatment for COVID-19 https://www.jstage.jst.go.jp/article/ddt/advpub/0/advpub_202...

“You are not a horse. You are not a cow. Seriously y’all. Stop it.”

FDA… You approved the drug for use in humans and it has less side effects than acetaminophen / paracetamol… y’all.

That was bs from the FDA, but it’s ok because the folksy “y’all” is endearing to who I assume they were internally calling ”flyover hicks self-medicating with horse paste”.

All they had to say was we have not approved this medication for covid and the animal applications are not approved for use in humans, their dosages can be very dangerous.

Agreed, it's very much an attempted form of manipulation by hardcore pro-vaccine people. There's a line of logic among anti-vaxxers of "I'll take my chances", and studies like these -- which show that taking your chances with COVID, surviving (which might be overwhelmingly likely), and then going on your merry way gives you equal or greater protection than the vaccine. Hardcore pro-vaxxers would much rather the narrative be "the vaccine, and only the vaccine, will protect you."

There are some diseases it is not true for. Mostly ones that attack parts of the immune system (eg. Measles). Probably wouldn't be true for HIV either.

I remember reports of the first reinfections as well as early talk of asymptomatic cases, where the news then tentatively concluded: and thus we hope a vaccine will be able to get good immunity where the having of covid does not. A few days ago was the first time I heard that knowledge challenged.

So it's not so much that it's unbelievable, more that it was established knowledge for more than a year and only now we're finding out these people were fine the whole time? Why then do we give them a booster dose that could be going to Africa?

(I don't mean to have those questions answered by the way since it's off topic; the questions this information conjures up are in answer to why it, at first glance, sounds controversial.)

It’s controversial because nobody can package and sell “natural” immunity. Given that there are about 7.5B people in the world, RNA injections are, apparently, only good for 90 days, and that Pfizer (or someone) gets $20/injection, the market is about $600B a year.

Do you remember 20 years ago when the people on TV said that terrorism was an existential and imminent threat and the result was defense and surveillance companies made massive fortunes? The more things change…

Just kidding. Public opinion shaping campaigns are a dangerous conspiracy theory and nobody of any public office or Fortune 500 company ever lied for money and nobody ever tried RNA injections for humans until, like, just now.

Please also consider the incentives for vaccine passports and "verified digital identities".

> RNA injections are, apparently, only good for 90 days

Er, what?

Perhaps they're referring to 90 days of storage?

Just like encouraging people to run around unvaccinated and mask free keeps your donors who make a $2000 per treatment Regeneron very happy.

Is this a dig on Fauci who just decided he recommendeds it?

Or on DeSantis who has a investment firm donor who is not even in the top100 investors in the antibody treatment company?

Side question, do you fall for smear campaigns without fact checking the claims yourself?

You can only get natural immunity by getting the virus and hoping you don't die.

Sure Pfizer makes lot of money from the living, but I guess they will make less money since some of us are no longer among the living.

I guess the funeral industry will be very happy, indeed. The welfare state saves money on not having to care for a sick elderly person...

> Why is "natural infections and recovery produce a better immune response than a vaccine" so controversial?

Why would that be your default assumption? Is it because ""natural infections" are natural and natural "should" be better? That is straight-up https://en.wikipedia.org/wiki/Naturalistic_fallacy

Have you considered the counternarrative that "vaccines are engineered to produce a strongest possible response" and you should therefore expect them to perform as designed, unlike haphazard nature.

Or perhaps consider that either might be true, and discard any prior assumptions about "natural = better".

> Has it been this controversial for any other disease

It's "controversial" because politics this time. It's not the default assumption in this or previous diseases, because it's often not true.

The last time this was raised: https://news.ycombinator.com/item?id=28107854

Not to claim now that those links are the whole story, but they do represent a whole lot of prior knowledge.

So it seems that there is some debate and nuance on this topic. My (simplistic) understanding is that vaccines produce a different and in some ways stronger response than the disease that they mimic, as they are literally designed to do. The COVID vaccines mostly contain Spike protein and therefor produce a very strong response ... but only to spike protein. recovery from infection produces response to that and other parts of the virus.

What about a person who is vaccinated and then has an asymptotic case? Do they still build up even better immunity? If so, that’s still a great reason to vaccinate.

Great point, the research should also investigate more about this case, since its get published it will create more negative effect to people who dont believe in vaccine but believe in themselves they will never die because of Covid

And does that affect the timing or need for booster shots?

Wouldn’t the Hoskins effect [1], or “original antigenic sin”, apply in this case?

> the propensity of the body's immune system to preferentially utilize immunological memory based on a previous infection when a second slightly different version of that foreign pathogen (e.g. a virus or bacterium) is encountered. This leaves the immune system "trapped" by the first response it has made to each antigen, and unable to mount potentially more effective responses during subsequent infections.

[1] https://en.m.wikipedia.org/wiki/Original_antigenic_sin

Probably not. B cells can return to germinal centers and undergo further affinity maturation.

Hoskins effect does not block this process, but may slow it down. If the original antibody is still effective, no problem.

Now, if the virus mutates to completely escape existing antibodies, we might have a different story. But in that story, the vaccinated are probably better off than the natural infection crowd.

The vaccine targets a highly conserved region of the RBD; it is largely essential to bind to ACE2. Mutation there is likely to reduce binding affinity and thus become less infectious / virulent.

Natural immunity however suffers from the problem that the body builds antibodies against other regions that are more prone to mutation. Some of those mutations have been shown to enhance infectiousness. So you could end up with a scenario where non RBD targeted antibodies enhance infectiousness while simultaneously you have slowed affinity maturation.

Individuals who were naturally infected and then vaccinated, or vice-versa, should be well protected. It is unclear if a combination of the two provides better immunity especially when challenged by variants of concern. However, preliminary in vitro evidence (cited in OP) suggests that yes, a combination of the two may confer better short-term protection than either one alone [1].

> The data suggest that immunity in convalescent individuals will be very long lasting and that convalescent individuals who receive available mRNA vaccines will produce antibodies and memory B cells that should be protective against circulating SARS-CoV-2 variants. [1]

[1] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9

It would be great if the people who had covid and developed immunity will finally become recognized by governments on par with vaccinated. Currently, they virtually don't exist for governments and media in many countries who prefer to divide everybody into just two groups: vaccinated and anti-vaxxers. A third group does exist and deserves to be heard.

A fourth group: vaccinated with (potential) breakthrough infections. Non-trivial numbers, as the vaccine is only 66% effective in preventing covid infections. According to the manichean logic of the media, this group of people is an immediate public health danger, therefore must be subjected to the same draconian measures as the unvaccinated.

But don’t you risk long hauler symptoms or worse? Meaning, it’s an interesting datapoint but not a viable strategy.

Long haul Covid is generally associated with severe cases. The question then becomes, how much does getting the vaccine reduce a recovered individual's probability of having a severe case? Given that it's pretty rare for reinfections to be serious, and the vaccine does not prevent infection or even serious breakthrough cases, the answer would seem to be "not much."

Working very viably for myself.

Well, we should just scale your experience/anecdote up by 8 billion and we’re good then.

Are you saying you didn't get vaccinated and have yet to get COVID so your strategy is working? Or you already got COVID but it wasn't serious so it is working? Either way it seems like saying "I've been smoking all my life and never got cancer. Not sure why everyone is so worried about smoking."

I’m very confident I’ve been exposed to covid, yet never had any test or conclusive symptoms.

I’m also confident that people like me do not experience problems from covid. At least not any more problems than a flu. A 1/3000 risk of myocarditis is not something I will risk. That’s a long term scarring of heart tissue, similar to how my father died in his 30s from teenage medical treatment.

The difference in your statement is that covid is an acute condition rather than a chronic slow growing tumor. If covid took years to show symptoms it’d be a reasonable comparison, but it’s very silly to make otherwise.

Okay so a case fatality rate of 1.65% is fine with you, but a 0.003% chance of Myocarditis is not okay? Yes another difference is COVID is easily spread through the air amongst people so yeah it is much worse than a slow growing tumor you are correct.

The European total was 145 cases of myocarditis on 177 million vaccinations. Assuming 2 vaccinations per person, that's 145 cases in 88.5 million people or a 0,00016% chance. That's less than 1 in 600.000 not the 3000 you claim.

And even then, a very big majority of the myocarditis cases were mild enough to go away on their own. Only 5 people died from it and all were elderly with other pre-existing conditions.

I don’t know much about myocarditis, but isn’t it possible and even likely a large number of those cases would be undiagnosed?

We know as much about “long Covid, as we know about “long covid vaccine“.

That’s not pro or con anything, it’s just the truth that some are having a hard time admitting.

I’m not sure at what point in the last year “we don’t know” became taboo. Maybe when we wrapped unknowns in policy decisions?

EDIT: yes, we have data for that long Covid symptoms especially in severe cases, and suspected in mild cases, my point was that we do not have enough data to make policy decisions based on this. Currently hard to quantify, as the CDC has anxiety and depression listed as long Covid symptoms.

> We know as much about “long Covid, as we know about “long covid vaccine“

As in we have proof one exists and none of the other?

I’m a little out of loop, but isn’t it true that there can be no possible studies for long covid more than a year and half or so?

Of course there is long Covid, and of course there is the possibility of long Covid vaccine regardless of how ridiculous and unlikely that surely is. But from a scientific standpoint, it seems all we have could be initial studies at best.

> all we have could be initial studies at best

Correct. But at t+1.5 we have evidence long COVID exists. At t+1 we have zero evidence of long-term vaccine side effects.

Its not about vaccine vs natural immunity. Its about immunity vs mandates.

Getting covid intentionally is stupid. If you feel up to it, get the vaccine. Any encounter with covid will be milder.

However, some people have already had it and are frankly being unjustly discriminated in some states and institutions.

I'm not against vaccines but the treatment of previously infected people as second tier has got to stop.

there is a point to be made here. in Israel for example, a verified blood test with high antibody levels gets you a "vaccine passport", without the need of a vaccine

it only lasts a limited time though, and these measured antibodies fade within months. so people that have been sick are still encouraged to get at least 1 shot of Pfizer

It's important to add antibody levels for people that have been sick are very different. I know many sick people who got under 150 (the stated minimum to get the passport) a few weeks after being sick. With 2 shots of Pfizer I got over 12,000 units. So it's not even the same ballpark. At least for the measurable antibody tests we currently have

I suspect, if the government offered a monitored blood test to prove antibodies, the "but muh mandates" crowd will still be just as angry

I would equate it to hiring for a job: saying you have a college degree (history of infection) < showing the degree (proof of vaccination) < showing your GPA (antibody levels). This is because my colleagues say of covid: "oh, just sniffles" versus "worst sore throat and muscle aches of my life". Unlikely both these immune systems are similarly trained to fight covid

Would getting infected _after_ being vaccinated, which doesn't seem totally unheard of, confer an additional boost to one's immunity?

and vice versa?

I'd specifically prefer to be infected after if I had to choose, on the assumption it'd be milder.

I've been wondering the same. Heck, perhaps get a third shot just to be safe and then get covid for good measure. But then we don't have enough production capacity for the vaccines worldwide as it is, and I'm not sure about my current chances with 2x mRNA so... it'd be interesting but I don't think I'd actually do it given the chance.

Absolutely it would. Which is why it's a good idea to get vaccinated even if you have been infected or think you may have been.

The article backs this position up as well, though the headline belies that:

"The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated."

It's a good idea why, exactly? Because previously-infected people tend to experience worse vaccine side-effects for little to no additional benefit?

> Because previously-infected people tend to experience worse vaccine side-effects for little to no additional benefit?

This is not the case. Research it yourself:

"Evidence is emerging that people get better protection by being fully vaccinated compared with having had COVID-19. One study showed that unvaccinated people who already had COVID-19 are more than 2 times as likely than fully vaccinated people to get COVID-19 again." https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...

https://www.usatoday.com/story/news/health/2021/08/09/covid-...

https://www.healthline.com/health-news/people-whove-had-covi...

Folks who are downvoting, please engage with my comments instead.

FYI, it doesn't pay to make these kinds of comments here. People will downvote both your comment asking why they downvoted, and your original comment. You're just exposing yourself to almost twice as many downvotes, while few people will bother to explain themselves.

I have personal experience with this.

I appreciate your reply, thanks.

Still, I would like to help bring the level of discourse on the site up and hopefully some folks are influenced by my comment to abide by the guidelines and engage.

don't your links directly contradict the article that was posted? The article states infection from COVID seems to produce better immunity than the vaccines.

If I'm understanding correctly, no. These things can both be true:

- Being previously infected with COVID-19 confers greater immunity than the COVID-19 vaccines

- Being previously infected with COVID-19 and being vaccinated confers >2x the immunity than being previously infected alone

The posted article seems to agree as well, but it's unfortunate many folks seem to just be taking the headline at face value:

The Lancet just published a study yesterday on natural infection still causing symptoms one year later (“long Covid”) for 49% of unvaccinated people.

I’ll stick to the vaccine.

* among patients hospitalized with severe illness in one Wuhan hospital between Jan and Feb 2020, self-reporting at least one symptom from a long list, such as fatigue, joint pain, etc, vs 33% of a control group without Covid infection reporting the same.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Yes thank you. GPs comment is completely inaccurate, and the referenced study does not make any claims about natural infection, only about patients hospitalized with severe illness.

Multiple recent large scale studies have estimated an asymptomatic proportion lower bound of at least ~33% [1], and an upper bound of 65% (and even higher for young adults) [2]. This implies a significant proportion of people infected by SARS-COV-2 will not experience any noticeable symptoms.

Furthermore, there is strong evidence that infections and cases are massively under-reported (by 10x to 100x) [3][4], so it's exceedingly likely that such estimates are underestimates of the true asymptomatic rate.

[1] The Proportion of SARS-CoV-2 Infections That Are Asymptomatic https://www.acpjournals.org/doi/full/10.7326/M20-6976

[2] Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands https://link.springer.com/article/10.1007/s10654-021-00768-y

[3] Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters https://www.sciencedirect.com/science/article/pii/S253104372...

[4] Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States https://stm.sciencemag.org/content/13/601/eabh3826

49% of infected having symptoms a year later is ridiculous and obviously not true. Unless you define symptoms extremely broadly.

I have not read the study you are referring to. Are you sure it is not specifically about hospitalized patients? Even then it sounds extreme.

But you are right that vaccines are clearly better when given a choice.

If you have a disease that causes organ damage, it's not that ridiculous. Look at the referenced studies. Multiple studies by different organizations performed 6-12 months out showing persistent fatigue, body aches, headaches, cognitive issues, loss of taste/smell, kidney function. Seems to be a real phenomenon.

The study you're probably talking about focuses on hospital survivors, not on the broad group of "naturally infected people".

I assume you're referring to this study.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

They studied hospitalized patients, who by definition had severe symptoms. We would expect more severe symptoms to take longer to resolve. I don't know the exact numbers in China but in the US 95% of cases were never hospitalized.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

The study also counted anxiety and depression as "long COVID" symptoms which doesn't make much sense; they haven't proposed a biological mechanism of action for SARS-CoV-2 to directly cause such psychiatric symptoms.

I would still encourage everyone to get vaccinated if they can because the data shows it cuts the risk of death to virtually zero.

Studies have already linked the inflammatory response in acute COVID to disruptions of the gut microbiome. This is a plausible route for long term, post-COVID neurological complications (anxiety, depression, neurosensory disturbances, insomnia etc).

I can only consider this a positive for those who are vaccine hesitant, as they will probably be getting it, but I can't see how, considering the realistic dangers of a vaccine, a rational individual wouldn't want both forms of protection even if they were previously infected.

What is the realistic marginal increase in protection from the vaccine for someone who has recovered and is in a very low risk age/comorbidities cohort? Is reducing their absolute risk of a really bad Covid outcome by 0.00001% really worth the risks attendant in the vaccine?

Also, at least one study has hinted that the second dose may reduce humoral immunity.

I'm not sure, but we'd need to be dealing with something like your 0.000001% number before the risks started to outweigh the benefits, wouldn't we? Even a half or a tenth or a hundredth of a percent increase would be far beyond any sort of vaccination risk.

> Also, at least one study has hinted that the second dose may reduce humoral immunity.

I don't think we can base current best choices upon things which are merely hinted, especially when they are so counter intuitive, and as far as I'm aware, outside of our experience with other vaccinations.

It also highlights that we still don't know everything, and I'd definitely make decisions based upon an abundance of caution, leaning towards more protection.

I guess it would be comparing the improvement from a vaccine to the better natural immunity versus the risks from a vaccine. I don't know that this is obvious.

For example, a hundredth of a percent improvement is 1 in 10k. And an already exposed person would be expected to have a less severe reaction if exposed again.

Also some people worry about certain aspects of the vaccine. Did you know that it took over 25 years to develop a lipid delivery system for mrna vaccines that wasn't toxic in animal tests? Or that they have concerns about accumulation of these lipids in organs like the liver? Or that getting sick after the vaccine may not be healthy? Or that they don't do a great job of looking for auto-immune reactions when it comes to vaccines?

It's a lot to think about. I'm a numbers guy and am happy with my conclusions on this. But I don't think it's right to force anything on others. The media often seem to do a better job of coming to conclusions for people rather than educating them.

> Did you know that it took over 25 years to develop a lipid delivery system for mrna vaccines that wasn't toxic in animal tests?

I'm not sure why the length of time it took to reach an accomplishment should undermine said accomplishment. They killed a lot of animals before they landed on the moon.

> Or that they have concerns about accumulation of these lipids in organs like the liver?

Who is they? How can you quantify and qualify this risk? Being "a numbers guy" why did you weight the odds of this potential issue as being more important than the known death risk and long term complications from COVID itself? Given the sheer number of immunized individuals we should be seeing hundreds of thousands of cases now, shouldn't we?

> Or that getting sick after the vaccine may not be healthy?

I mean, by definition being sick is not being healthy. You'll need to expand this a bit for it to make sense. What type of sick, what type of unhealthy. Why? What evidence do they have for such a concern?

> Or that they don't do a great job of looking for auto-immune reactions when it comes to vaccines?

Again, you're not saying who it is that doesn't do a great job, nor why this is important to be concerned about, or indeed if this concern has any sort of precedence. And again, why are you not concerned that COVID may introduce similar auto-immune reactions?

EDIT: My reply above was in regards to vaccines for those who already have caught covid and presumably have natural immunity, immunity that looks like it is better than vaccine immunity. The equation for those people to get the vaccine is different than the equation for the non-vaccinated.

I listed questions some people may have. I don't have all the answers. I consider that running numbers for stuff like this involves a certain amount of guesswork, things that can't be well qualified.

> I mean, by definition being sick is not being healthy. You'll need to expand this a bit for it to make sense.

I was thinking of the many healthy people who got very sick (collapsing, bedridden, etc) for a short time (24-36 hours) after getting the vaccine. Does that mean their immune system was already primed and went on the attack? I've heard that can cause autoimmune reactions - the immune system attacking something that is part of the body accidentally (collateral damage).

> How can you quantify and qualify this risk?

I did the best I could for myself, trying to prioritize. I may be more comfortable than most working with ambiguity. The biggest factors obviously were known covid risks based my age and health, numbers from the vaccine trials (which I wish were more easily available) and an awareness of all these other less quantifiable things (a lot of reading and learning).

EDIT: If I had confirmation that I already had covid my calculations would have changed. I don't know by how much, to be honest! I certainly would have felt substantially less need to get a vaccination, and it looks like science is bearing that out. If I have to deal with a lot of unknowns for a 1 in 10k improvement in my odds after I already have the better natural immunity, I might rather not deal with the unknowns.

There were some adjustments made by authorities, like those around the AZ risk for young women, because the odds didn't favor that treatment for those people. This is all new, and still developing. The number of breakthrough infections in Israel is interesting, for example. Hopefully that doesn't lead to any kind of weird/bad evolution of the virus.

> auto-immune reactions

You are certainly correct that covid includes the risk of autoimmune reactions, also! And other risks. As time goes on we have better numbers for covid, and better numbers for the vaccines. I made my decision with the best numbers that I could find at the time.

On the topic of vaccine autoimmune reactions in general, I looked into it and it was difficult to find good data, it looked like the immune system was complicated enough that science doesn't have stuff like that all figured out.

> Again, you're not saying who it is that doesn't do a great job

I'm not saying that I have the answers. These are questions that some vaccine-hesitant people have. Ideally the experts would do a good job of answering them, including admitting where they don't have good answers. Lots of people are resistant to being forced into something through social/financial/government pressure.

I personally assume this is going to reverberate around the world a bit more, waves of decreasing intensity until most of us have been exposed, becoming endemic and not so big a deal (like the other coronaviruses that are endemic). It might be hard to know how much of anything we did made a difference.

Meta-reply: at time of writing your comment is grey enough to be on -2, yet nothing you say is trolling or unhelpful. In fact, your comment contains merely two questions and a supposition. I've seen this on HN particularly for COVID related topics and I don't think it's at all helpful. I reckon very few on here are outright anti-vaxxers in the traditional sense of the term (e.g. given to those implying a link between MMR and autism, etc.) yet these days anyone asking questions that may portray, perhaps merely indirectly, some SARS-CoV-2 prophylactics/treatments in a bad light are downvoted. It's not good for curiosity and doesn't help us collectively get to the truth on matters and I think we can do better as a community.

"Damn the downvotes, full speed ahead"

I appreciate posters who are willing to go ahead in these scenarios instead of self-censoring. When these individuals give up on this site, what will we be left with?

I think people in high risk groups should get it, i.e., the elderly and people with weak immune systems or other health issues. Those who are strong health wise ok, they stand a good chance.

That said, I am totally against this blanket insistence on passports. There may be some situations which warrant vaccinations where the subject has no acquired immunity, health workers, etc. But being denied access to govt services because you lack the papers is not a good thing.

Edit: asking for a mask is okay. I don’t think that’s too much to ask. It’s when they require proof of vaccination that I have problem (mind you, I’m vaccinated).

> But being denied access to govt services because you lack the papers is not a good thing.

What gov services are people being denied? legit question - I hear this, but unsure what is being referred to.

How about "vaccine proof or wear a mask" to get/access govt services/buildings/etc?

That works for me. This is a compromise I agree with.

Not really a govt service but here in Italy my friends can't enter college (the structure itself) without a green pass, and exams have to be taken in person.

Public funded education is a government service.

In ny country, the library for example. Also some public baths. But my main concern is the restrictions on freedom of movement.

At least places like Isreal issue you a green pass for naturally acquired immunity. In the US, people with natural antibodies who are refusing the vaccine are being fired. Basically measuring output rather than outcomes (for all you PMs out there).

That would seem to be a logical choice. I would welcome this decision in the US.

Wearing a mask is a mild annoyance. With vaccine, you might suffer side effects, but even that is short term.

It's basically no-brainer, since getting infected with the virus is more likely to kill you than getting the vaccine.

The only reason people are not getting the vaccine is for various reasons they don't trust that the vaccine is going to help them. Everything else is justification.

Did you miss the part of the fda statement this week where they said they have no long term data available?

Do you also realize the disease has only been around for maybe around 2 years at most? So we really have no long term data on effects from getting COVID naturally either. Considering we have plenty of data on other vaccines being quite safe in the long term. I would rather play that game than the "I am relatively healthy so I'll risk getting a deadly disease" I am aware I could still get COVID while vaccinated, but I also know that the chances of getting serious illness while vaccinated are much much lower than if I wasn't.

We have no encouraging long term data from any mRNA therapy. this is brand new. The animal tests were concerning to put it mildly.

Your chances of serious illness are lower for now. ADE shows dose dependent acceleration, so by the 4th or 5th booster it may be a different story.

What animal tests? Are there even any hypothesized mechanisms by which an mRNA therapy, as a general method, would produce long term consequences? It's fragile and decomposes in the body over the course of a couple weeks, leaving no trace except whatever proteins the sequence describes. That's not to say the specific proteins produced couldn't engender longer-term consequences, but I'm missing how that can be generalized to human-devised mRNA in total.

This says that there was a viral Facebook post making claims about animal tests, which are very much wrong: https://fullfact.org/online/covid-vaccine-animal-testing/

Also, this says that the covid vaccines specifically passed animal trials: https://www.reuters.com/article/factcheck-covid-vaccine-anim...

https://www.bbc.com/news/uk-england-tyne-58330796

2.5 billion people have had at least one vaccine.

> 2.5 billion people have had at least one vaccine.

Does that mean Lisa Shaw did not die? Or that we would still have known about the cause of her death if she were not well known?

Or, is the number of people who are vaccinated enough of a reason to ignore the concerns of people who got Covid19 and recovered?

How much of "long Covid19" due to horrendous treatment at hospitals of Covid19 patients with unnecessary intubations, severe isolation from friends and family, and the general medial establishment panic?

In the U.S., 95% of deaths with Covid19 are in people over 50. Covid19 accounts for 0.7% of deaths among people under 18.[1]

I am sure, the case surveillance data[2] has more interesting nuggets. So, given low risk to an otherwise well person who has not been living in complete isolation since March 2020 (there are a lot of them in the world), given the trend of increasing breakthrough infections and deaths, it is not obvious that averages are very meaningful to individual decision making.

[1]: https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-by-Sex...

[2]: https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveil...

> The clots are considered extremely rare - there have been 417 reported cases and 72 deaths - after 24.8 million first doses and 23.9 million second doses of the AstraZeneca vaccine in the UK.

That's 72 deaths among millions. You're trying to describe COVID as "given low risk to an otherwise well person", but you're still off by many orders of magnitude. Using this site[1] we see that he current 0-59 death rate is 0.2%. That would be nearly 100,000 dead to get a comparable rate.

> we see that he current 0-59 death rate is 0.2%

I made a statement about the percentage of deaths among people over 50 (not death rate).

Computing an IFR (infection fatality rate) is difficult because so many infections are unrecorded. For example, consider this paper[1]:

> We found that these antibodies were present in 42.4% of the individuals tested and that the majority of these infections, which were generally mild, had not been previously detected.

It seems to me a ton of infections occur and go away without anyone recording them. We only see information about infections which result in worse outcomes.

Given the desire to avoid any negative information about vaccine efficacy and safety, it is also reasonable to assume that we are only seeing a smaller number of people who died after the injection.

Especially games played by agencies in how they count the vaccinated (if you die/get sick between your first shot and two weeks after the second shot, you are not counted among the vaccinated) do not instill confidence. The arbitrary insistence in certain areas of the U.S. that even people who've had Covid19 must get vaccinated before they can be allowed to live life breeds suspicion.

PS: Since the beginning, people all over the world suffered and are continuing to suffer under delusional policies implemented to support the fiction that "zero Covid19" is possible if you just "do as I say!" Now, the repeat is coming in the form of "90 - 100% vaccination" where fully vaccinated status seems like it is going to be a moving target. See https://threadreaderapp.com/thread/1430186661556727808.html

[1]: https://www.nature.com/articles/s43856-021-00007-1

In order for those numbers to align to such a point where vaccines are more deadly we'd need to either have 1000x more vaccine related deaths or 1000x more infections undetected. Which do you think it would be?

From the perspective of the person who's been OK since the beginning, those numbers don't really matter. What matters is that they are fine now, they've been fine for a while, and now they are being coerced into taking an action which they don't think will benefit them and might hurt them worse than whatever their experience has been.

Do not expect resistance to coercion to melt away when you dial up coercion.

Add to that the fact that very incompletely counted known deaths from Covid19 among those fully vaccinated against Covid19 just jumped 11% since Monday[1], one might ask why one is being coerced to take a discreet step to assume a new risk.

[1]: https://www.cdc.gov/vaccines/covid-19/health-departments/bre...

[2]: https://archive.is/https://www.cdc.gov/vaccines/covid-19/hea...

So the death rate is now less than 0.0006% / shot? This is why I started this thread off by specifying "rational individual".

Nobody's being coerced to do anything. They have the completely free choice to take the shot, or not. Either way, they must accept the consequences of their choice. This is not coercion; nobody's holding any guns to anyone's heads or holding people down and forcing the shot on them. What's being dialed up is the severity of consequences of not taking the shot.

Let's say that an American municipality instituted a rule that people who profess Muslim beliefs are to be excluded from gathering in public establishments. No one would be physically forced to abandon their faith, and they would have the completely free choice to remain Islamic and accept the consequences.

Would you not perceive any coercion here?

Correct. It's not coercion. The fact that it's wrong to discriminate against someone due to their religious faith and to violate peoples' right to free assembly is orthogonal to the question of whether it's coercive or not. In other words, this is a false equivalence.

It means that, statistically, for purposes of determining the safety of the vaccine, her death counts for such a tiny amount that it's effectively zero evidence against the vaccine.

In Europe you can show a recent test or your Vax passport anywhere (e.g. you need one or the other to travel or go to the gym) and I really don't see the issue.

I'm glad there's a way to ensure only low risk people are in the places I go to and the privacy risks are comparable or smaller than for things with lesser benefits.

Consider the realistic uncertainty and probability from previous study of antibody dependent enhancement. It’s not proven that the mRNA therapy won’t worsen covid reaction in the long run.

> It’s not proven that the mRNA therapy won’t worsen covid reaction in the long run.

What are you defining by "long run"? We're quickly moving into a year with mRNA therapies. I'm not aware of any instance of this occurring with previous vaccines, and we can't just say "well mRNA could be different" because if we do that all the possible "what-ifs" we quickly swing into the absurd.

Dengue is the notable counterexample, but that seems unlikely to be an issue with COVID. AFAIK, it’s the virus’ behavior that matters, not the vaccine.

https://en.wikipedia.org/wiki/Dengue_fever#Vaccine

What the study says is out of 20k people that had the vaccine or previous infection only 200 got reinfected and nobody died. Yes in the 200 there were more vaccinated but imaging how many people died from the first round of infections. How the people who were sick are much more cautious and wear masks than vaccinated. None of this is adjusted for (ie they don’t ask a sample of the groups a question how often do you wear mask, all they needed to do was ask from 300 people from both groups and you could adjust for risky behaviors and I bet the effect would be much smaller). In any case both vaccine and previous infection provides plenty of protection.

Are there credible papers which estimate the percentage of Covid survivors in one or more countries, i.e. those with natural immunity? During the first half of 2020, there were several attempts to estimate these numbers in the USA. Are some regions or countries doing statistical population sampling, e.g. blood tests for antibodies?

The UK has been estimating their percentage of population with antibodies which includes both people who were infected and vaccinated. Scroll to Figure 1 for the charts, but before vaccination their levels in the different regions (England, Scotland, NI, Wales) were <20%.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

To me I think that it's kind of surprising how low the percentages are.

One of the biggest issues with this discussion is that we call these current round of therapeutics, "vaccines". They aren't. They don't prevent infection. They don't prevent transmission. At best, they reduce symptoms.

This sounds conflicting I read somewhere else earlier today, that the immunity you get from the actual disease is tailored towards the specific variant/strain.

Whereas the vaccines (at least the mRNA ones) confer immunity against multiple strains.

Why? The vaccine is literally a carbon copy of one of the early variants. It just makes the protein without infection.

This whole idea that the vaccine has magical properties to substantially exceed natural immunity on basic dimensions is straightforward BS.

I meant the article said that the actual disease confers greater immunity than a vaccine.

While that might be true, that immunity would only be good for one particular strain of the virus as opposed to the vaccine which provides you protection against a wider variety of strains.

One can argue that the protection from the vaccine is better in the sense, that it protects you from a wider variety of Covid strains.

Also, just so you know, that while the (mRNA) vaccine replicates protein, it is still your body and immune system which reacts to this protein and creates the antibodies.

So even in case of the vaccine, strictly speaking the immunity is natural.

It's an interesting concept. When your body makes antibodies against an active infection, it targets more than just the spike protein. Against the vaccine, it targets the spike protein 100% because that's all it has. As variants come and go, you should expect that the spike protein will change -- but it can't change that much because changing too much will reduce its ability to infect cells -- so it's a good thing to have a wide variety of antibodies against. However, having antibodies against other parts of the virus is useful too, since those might be more conserved with variants, but also they could be conserved less -- we don't really know.

Survivorship bias comes to mind https://en.wikipedia.org/wiki/Survivorship_bias

Not sure how that's really relevant when over 99% of people in both the vaccinated and unvaccinated cohorts do not die from Covid.

The entire point of vaccintation is to enable a road to immunity which kills less people than simply getting infected.

If we were OK with the death rate of naturally-attained immunity we didn't need a vaccine.

There are other bad outcomes besides death.

From the point of view that there is some risk involved from the first covid infection in order to get the immunity, so people will be less likely to correctly assess the risk of getting natural immunity vs getting vaccine in order to end up to the study's cohorts.

It's relevant because of the 1%. The numbers in the study are so low (8 people hospitalized in one, 1 person in the other group) that 1% makes a difference.

The people infected by covid who died do not appear in this study.

32,000 people in the study, of which 16,000 had previously had Covid.

They found a total of 238 re-infections.

Assuming 1% mortality from Covid, that group of 16,000 would have previously been 16,162, before being culled down to the study size by deaths.

You don't think an additional 162 would make a difference to the results?

(Obviously it doesn't make a difference if you read this study as "given someone survived Covid, what are the odds..." but lots of people are reading this study as "It's safer to catch Covid than get vaccinated." Given that, the deaths absolutely matter.)

> if you read this study as "given someone survived Covid, what are the odds..."

How else are we supposed to read it? I just don't understand what point is being made with "survivorship bias" here. It's not like individuals who have recovered from Covid have gone through some hyperselective winnowing process leaving only those with superheroic immune systems or something.

Obviously the study does not support the conclusion "it's safer to catch Covid than get vaccinated." However, for the millions of people who have had a confirmed infection and recovered, it is absolutely relevant to their risk calculus around whether to take the vaccine, and given that they are survivors, there is no "bias" to speak of.

> How else are we supposed to read it?

You're assuming everyone read it the same as you, and now can't imagine differently.

There have been several mentions in this thread alone about how people have been using studies like this to recommend "Covid parties" (like chickenpox parties), or generally use it as further fuel to stay away from the vaccine, because they believe catching Covid is safer.

Tasteless/careless, IMO, especially living (in Texas) where “covid parties” have happened and people lost their lives right around the block last year. Although, it may be of relevance to my younger unvaccinated nephew that survived a rough case last December and is worried about being in school over in Tennessee without masks.

Is it still possible to detect whether you had COVID in the past, after already getting the vaccine?

Yes, I believe the right test can differentiate between the different antibody responses, telling you if you reacted to the virus, reacted to the vaccine, or both. I looked into this at one time and think I found one that cost $220. Sorry I don not have the link handy.

If you or anyone could post more info i’d be grateful. Like what specifications to look for in a test.

Also i wonder (approximately) how long after infection it would still be possible to test.

Get an antibody test that's for something other than the spike. If the vaccine you got only has the spike (all EUA/BLA in the US) the vaccine won't boost anything else.

Thanks for your reply, that’s good to know; I got the Pfizer vaccine by the way (only 1 shot.)

Except for the people who died of it, presumably? A perfectly self-reinforcing thesis; whoever didn't die clearly developed strong enough immunity, and those that did, well we don't count them here.

In other news:

Having a $3 million mansion at the beach confers much greater happiness than an affordable house in the suburbs!

Having a new top-of-the-line Mercedes SUV confers much greater status than a used Honda minivan!

Having a beautiful face and 6-pack abs confers much greater attractiveness than looking like Shrek!

There are two mutually exclusive questions at play here... and I'm totally convinced the population at large has ability to discern the difference and not conflate one with the other.

1. What is the best/strongest/longest lasting type of immunity, natural or vaccine?

2. What is the safest type of immunity, natural or vaccine?

Is natural immunity better? There's some data to show it is. Should you risk your life to get? Probably not.

There is a simple solution to the conundrum: a standardised vaccine passport plus a separate, standardised proof of prior infection.

Then let each business and jurisdiction choose whom to admit. Part of the problem with the prior-infection claim is it’s harder to verify than vaccination. Solving that would go a long way towards letting those individuals participate in normal life without compromising public health or the right to choose with whom one assembles.

Broadly, the Israeli data seem to favour natural immunity while the British data, very slightly, vaccination. We need more data. In the meantime, let people make their own choices.

It may be in their rights to bar immune people who refuse vaccination but its plainly unscientific discrimination.

> may be in their rights to bar immune people who refuse vaccination but its plainly unscientific discrimination

We don’t have strong evidence either way. Neither choice—vaccinated only or both—is unscientific. (It is understandable that, without reliable proof, the unvaccinated would be barred.)

In any case, this is a problem we need to solve soon. The mRNA platform looks promising. We don’t want to back into a future where a diseased minority is barred from our urban cores. Particularly if they pose little risk to others.

Vaccinating everyone was always about protecting the immunocompromised, for those who can’t defend themselves.

The way the study is presented is extremely disingenuous in my opinion.

My natural antibodies "protect the immunocompromised" just as much if not more than any antibodies stemming from vaccination.

Isn't there some selection bias going on here? Having covid once protects against getting it again - if the first one didn't kill you that is.

Its relevant to survivors.

By survivors you include the vaccine survivors?

It's important to be aware of 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].

It's still an open question whether natural infection confers better protection than vaccine-induced immunity, or if some combination of the two is even better. That's why the primary pre-print cited in OP is so important [6]. It 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.

The other cited papers in OP give some reasoning why natural infection might confer more robust protection, particularly when challenged by variants of concern [7][8][9]. The gist is that the immune response acquired through natural infection evolves in such a way that broader and more diverse antibodies can be developed. Another major difference is that natural infection induces antibodies against the nucleocapsid (N) protein, whereas vaccination with the current mRNA based spike protein focused formulations do not [10][11].

All of these findings have major implications for public health policy. In particular, optimal vaccination strategy should likely be targeted towards immunologically naive individuals, or individuals more vulnerable due to age and poor health [12].

- 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)

- 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)

> 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. [6]

> SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalization compared to those who were previously infected. [6]

[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] Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

[7] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9

[8] Affinity maturation of SARS-CoV-2 neutralizing antibodies confers potency, breadth, and resilience to viral escape mutations https://pubmed.ncbi.nlm.nih.gov/34331873/

[9] High genetic barrier to escape from human polyclonal SARS-CoV-2 neutralizing antibodies https://www.biorxiv.org/content/10.1101/2021.08.06.455491v1

[10] Combining spike- and nucleocapsid-based vaccines improves distal control of SARS-CoV-2 https://www.cell.com/cell-reports/pdf/S2211-1247(21)01108-6....

[11] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/

[12] Model-informed COVID-19 vaccine prioritization strategies by age and serostatus https://science.sciencemag.org/content/sci/371/6532/916.full...

Yeah, it also confers organ damage for life and/or death. lol. Get the vaccine, nerds.

Those who think this is supporting evidence for not getting vaccinated should think it again.

You must think in terms of risk of hospitalization and/or long covid with or without vaccination over the course of the whole path you choose.

ps. Moderna seems to be much more effective against Delta than Pfizer-BioNTech.

The problem with these articles is that while it tries to inform. The people who don't understant the implications of getting covid will use it as support for their bias not to get vaccinated.

Yeah, the sheeple can't handle the truth.

Vaccines are NOT a treatment for individuals.

Vaccines are for populations.

We seem so wrapped up in our own precious snowflake egos now that we seem to have lost the ability to think of ourselves as part of a group.

Good news for survivors, but this is going to make battles about vaccine passports much worse as anti-vax covid survivors demand exemption from the program.

I think most health policy decisionmakers would happily accept a positive test result for covid in place of a vaccination as long as this science is replicated by other parties.

Sorry? Not exemption. Inclusion! Why there is some process that treats some antibodies better compared to others is beyond my understanding.

But In my view it is unscientific and as a result I can’t trust that the rest of the program of passports is designed properly and based on facts.

I don't think being against vaccine passports necessarily makes you an anti-vaxxer. I've had both shots of the vaccine and I strongly oppose any sort of mandatory government ID card health-related or not, to the point I'll avoid patronising domestic businesses that voluntarily (ie without strong government coercion) impose them.

I'm not a fan of any form of authoritarianism really, let alone the overtly authoritarian "papers please" brand of it. One of the key parts of a free country is that you can be anywhere within it without some nosy government inspector (in person or by proxy electronically) demanding that you justify your presence there.

Exactly this. And all it takes is for this scanning system to be centralized and then they can turn you off and geo fence you in. You may trust the current government to not abuse it but do you trust the next ten?

If you survive it, that is.

One can observe how this topic has become political, and is no longer scientific. Our focus and concerns are now all about existing and forthcoming restrictions and mandates for vaccinations and masks -- so much that information like this is no longer even interesting to most people. Not only uninteresting, but vulnerable to censors.

For those who haven't observed this, what are your observations? Does this apply to the article we are discussing, too, or is it more of a general concern about mandates?

Comments like these about censorship keep coming up, yet this is the third straight day this topic is being discussed on the front page of HN.

I see the same thing on Facebook. Half of my family is still complaining about censorship and how everything is politicized while they continue to post political memes about Hilary Clinton, false or misleading information about vaccines, etc. The other half quit facebook or occasionally post family pictures.

Censorship is happening. A friend of mine (who happens to be a former Congressman) was silenced by Facebook for 30 days for merely citing Pfizer’s profit on the vaccine as reported in a WSJ Article.

Don’t be fooled by the narratives Facebook permits.

Earlier this month Rand Paul, a U.S. Senator and a former physician, was banned from YouTube for a week for simply saying that cloth masks are ineffective.

YouTube et al. could just as easily decide that discussion of natural immunity from prior infection is also "dangerous" (it might discourage vaccination) and ban it.

Nobody censored anything in this case on this platform -> therefore there is no censorship on the subject of covid

Logic

Uuuh, you're writing a comment about how COVID has become political on a scientific article about COVID that doesn't mention any politics.

One could believe you are actively working against your best interests here by leaving this type of comment. You'd be better at making things scientific again by behaving the one you'd like others to behave.

Yesterday NPR was shaming US Military memebers for spreading this information as COVID misinformation.

I'm so disqusted with the media right now.

There's really nothing surprising about this conclusion. Before Covid came along and the focus inexplicably shifted to antibodies-only, it was well understood that infection with a pathogen was always likely to result in better immunity than vaccination.

The drawback of an infection on weak/strong immune systems can be death.

kinda.

its more complex and nuanced than this. I had thought that the chickenpox vaccine gave you a higher chance of shingles in later life. However that appears to be the opposite of what actually happens.

The crucial thing is that its dependent on the vaccine and the thing infecting you.

For example the BCG jab which protects against TB is wild. Its a live vaccine that has been evolving, got lost once, and its kinda black magic. In older people it has a ~33% efficacy. its much more effective in babies and children though.

However we've got to the point that TB is so rare in the UK that targeted vaccination is more than enough to keep it under control.

With covid, we need to make sure that when people get it, they don't get seriously ill. Ideally they wont get it at all, but alas thats not the case, the vaccines are not effective enough for that against this variant.

I assume that altering the mrna vaccines would have a similar speed as the annual flu vaccine, so changes for new variants would require less development time.

But as someone pointed out, if you have a vaccine, and you get covid, te seems reasonable to assume that you will have a better immunity.

Also with just 8 cases out 32k, it seems a small dataset to draw conclusions on.

Not that I doubt you, but where can I read more about this? I know nothing about epidemiology or immunology and reading threads like this makes me realise I need to get more informed.

Except it was widely reported that natural immunity lasted 3 to 6 months and that the vaccines would last 2 years (at least Moderna), and the nuances there I think would be lost on a lay person. I even had an immunologist explain to me in detail why the immunity from the vaccine would be way stronger than acquired immunity. It doesn't really build confidence in science if, while we're finding new things, everyone pretends that the conclusion du jour was always obvious.

I think we're in agreement here -- I did not mean to imply that a lay person following the claims bandied about in the mass media this year would have been under this impression. In fact, six months ago a claim like this would have been likely to be labeled misinformation on Twitter. I'm just saying that for the Covid vaccines to have provided better immunity than recovery from infection would have been very divergent from what is observed for the vast majority of other pathogens.

Okay but when I was asking questions about why we didn't expect booster shots from the mRNA vaccines, that is the opposite of what and immunologist at my local hospital told me. So I'm not sure it is obvious.

Maybe if they dose with some hydroxycholorquine, ivermectin, and shoot some UV up their bum, they will get AMAZING protection??

Isn't age a factor? I don't understand if the study considered the age of the participants. So, could it be that the people who were vaccinated tended to be older and thus more vulnerable?

Is there any information on how both or either current means of gaining some level of immunity measure up to lesser known "newer" variants such as b.1.621 (Colombian variant), lambda, iota, eta, etc?

It was a legit question. Not sure why I'm being downvoted.

Here's the important bit:

Get the vaccine.

The title is a fake news. The same goes for the article on sciencemag and conclusions of the research. Researchers did not prove that vaccines cause higher risk.

I love these threads about the virus. Where else can you get the thrill of considering your own and your loved ones' mortality, and pump the illusion that what you say matters in the big picture?

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