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Comment by hammock | Hacker News Reader

>It is this weighing of risks and benefits, in all their many facets, that informs the chorus of health-care professionals imploring their families, neighbors, co-workers, and friends, along with everyone else, to please get vaccinated against covid-19. They urge vaccination because they see its ratio of risks to benefits as incredibly, unbelievably good.

For someone who has already had Covid and recovered, there is no benefit. Only risk.[1] But they are not allowed to make this calculation for themselves and instead are treated to constant social pressure campaigns like this piece.

[1]https://www.news-medical.net/news/20210608/No-point-vaccinat...

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Not true. Vaccinated and previously infected people are much less likely to be reinfected than unvaccinated previously infected. Here is a recent study:

https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...

Reinfection was twice as likely among unvaccinated previously infected. The more recent data includes the effects of the delta variant. So, the risk of Covid is much higher and the risk of adverse effects are approximately zero for getting the vaccine.

Note that I am not commenting on vaccine prioritization and allocation, just the assertion of the post that vaccination has no benefit to previously infected people.

>risk of Covid is much higher and the risk of adverse effects are approximately zero for getting the vaccine.

Where is your data for this?

What is the risk of a naturally immune person catching Covid, and being either a)symptomatic, b)hospitalized, or c)killed?

How does this risk compare to the risk of a serious adverse event or long-term consequence such as autoimmune disease from the vaccine in a healthy young man?

You asserted that there was no benefit to getting the vaccine for previously infected. I pointed you to a reference that shows that that is not true. The original article to which we are all responding pointed out the minuscule levels of risk associated with getting the vaccine.

With respect to autoimmune disease, I think we are seeing that long covid is becoming a significant health concern among even healthy young people with only a mild response to Covid infection. Here is an example article:

https://www.wsj.com/articles/as-vaccines-do-their-work-focus...

Relevant quote: "Long Covid—a term referring to symptoms that linger for weeks or months beyond infection—affects between 10% and 30% of people who catch the virus, including those with mild or asymptomatic infections, according to experts. In some cases, symptoms persist for more than a year."

At any rate, I imagine none of this will persuade you, so I simply wish you good luck and hope you remain healthy. My strongest hope is that things can improve enough that we can all go back to arguing about linux user interface schemes.

I would like to point out that long-term effects are a possible outcome in many types of flu, not just covid ex. [1][2]. Given the combination of relatively short timeframe for covid studies, the unknown complications of living in lockdowns, and the general "don't care" attitude toward these effects in previous flus, the whole "Long Covid" story at least seems rather overblown.

[1] https://www.nature.com/articles/s41598-017-17497-6

[2] https://www.labmate-online.com/news/chromatography/1/breakin...

As someone who is close to a person who suffers from an infection triggered autoimmune condition that has led to severe and long term neurological effects, I would agree that conditions similar to long covid have been occurring for quite a while. However, just because they have been ignored does not mean they aren't real and that the issue is "overblown." While I take no joy from the suffering of others, having more attention being paid to this very real and at times devastating condition is one of the few upsides of the virus.

> How does this risk compare to the risk of a serious adverse event or long-term consequence such as autoimmune disease from the vaccine in a healthy young man?

Where is your data that serious adverse effects are even possible beyond an absurdly tiny statistic?

And how does that compare to the risk of a break-through re-infection and the well documented long-term health issues people have developed with Covid?

Don't talk like the data is on your side when it isn't. You are being childish. Full stop.

See [1]. I'm sure you'll redefine "serious" however you want to try and retain your point. Which is, of course, childish as you say. Your comment here is disappointing. I'd expect you to actually do some research on your own before posting like this and making inflammatory statements.

[1] https://covid.joinzoe.com/post/vaccine-after-effects-more-co...

The paper you cite describes them as mild. "...COVID-19 infection are almost twice as likely to experience one or more MILD whole body..."

So if I am taking the paper you cite as gospel, I would say they are mild as described. I think perhaps you are the one who needs to do a closer reading.

We've given literally billions of vaccine doses at this point. The post-vaccination tracking has been able to pick up side-effects affecting 1/100k patients. Those side-effects have also been made public by the relevant authorities immediately when concerns were raised. This tracking has not produced any kind of evidence for auto-immune disease for the mRNA vaccines.

And no, it cannot be that the side-effects you're worried about haven't happened yet. If they happened, they'd happen within weeks of the vaccination.

Look, the position that you don't think the risk-reward ratio is good enough for somebody who has recovered is pretty reasonable. But for some reason you're not satisfied with that, and are instead making factually incorrect statements both about the benefits and the risks. That makes it pretty hard to believe you're actually making that argument in good faith.

> And no, it cannot be that the side-effects you're worried about haven't happened yet. If they happened, they'd happen within weeks of the vaccination.

What evidence is there of this?

That CDC report is very careful to word its abstract to hide that the findings are from a very small group of people (a whopping 50 fully vaccinated) without even mentioning overall immunity levels across the general population. I'm not arguing that vaccine + natural antibodies aren't more effective - they are - but you're going to have to do a lot better than that to justify wanting to vaccinate everyone who's already been infected despite the known risks [1].

[1] https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v...

GP was referencing this study [0] when claiming "Reinfection was twice as likely among unvaccinated previously infected".

That CDC study has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature contradicts those findings.

Nearly every large scale and long term serological study has demonstrated that immunity acquired through previous infection is at least equally effective as vaccination in preventing reinfection. I have yet to see any CDC publication that acknowledges or cites these reputable findings. Why is that?

- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)

- In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494)

- The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075)

- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)

- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials. [5] (N=3,257,478)

[0] https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

[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...

There's always a risk-benefit calculation, depending on the person and their medical status it might not be worth it (for that person) to get vaccinated if they already had the disease. Of course for the society as a whole there might be big benefits even if some of these people stand to loose their health or even their life as with the Astra vaccine and the atypical blood clots.

There's a study out of Israel that say the exact opposite

https://www.bloomberg.com/news/articles/2021-08-27/previous-...

This isn't something that can just be hand-waved way

No, the Israel study is vaccinated vs previously infected. The study I pointed to was vaccinated and previously infected vs only previously infected. I was responding to an assertion that vaccination offers no benefit to the previously infected. The article you reference confirms the point I made. Here is the quote from the article:

"Giving a single shot of the vaccine to those who had been previously infected also appeared to boost their protection."

I thought you were talking about only previous infection versus vaccinated, my mistake

Maybe those who disagree with you think that you should make a more subtle argument. For those who are convalescent, the risk / benefit ratio of the vaccine is very different than for someone who is immunologically naive. And, to my knowledge, the vaccines have not been carefully validated in a convalescent population, on the same level as the clinical trials on which their efficacy estimates are founded. The idea of getting an illness and then immediately double vaccinating oneself against it should give any rational person pause. This is at very least marginally beneficial, and at worst downright risky. A single dose might make sense, but there should be no rush to apply one.

The chance of an otherwise healthy COVID-19 convalescent person ending up hospitalized from reinfection appears to be almost immeasurably low. But the risk of a severe reaction to the vaccine is low but not immeasurable. And it could be worse for someone whose immune system is primed against the vaccine, but that's also not clear.

Yes the lack of significant benefit from vaccinating individuals who have already acquired immunity has direct implications for public health policy. It’s not an efficient use of limited vaccine doses, especially when many vulnerable or immunologically naive people around the world have not received even one dose. These factors need to be considered because they could help reduce the total mortality from this pandemic [1].

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

How good and available is the testing to prove you have natural immunity?

Antibody tests are instant and widely available. These tests are (I believe) what the natural immunity studies use to establish history of prior infection.

Detractors will say that there is no established level of antibodies that means "immunity."

Ironically, it is declining antibodies though (and no set threshold) that is being used to justify "booster" jabs around the world!

So how could a threshold be established?

Immunity is more complicated than that. Antibody titers is not the metric we would want.

This study is based on 2020 data, pre Delta.

Here is the latest data. https://www.sciencemag.org/news/2021/08/having-sars-cov-2-on...

  Vaccinated person 13x more likely than the naturally immune to catch delta

  7x more likely to be symptomatic

  More likely to be hospitalized

Take back you downvote and educate yourself.

Perhaps, as is a common argument from the vaccine-hesitant, we should wait for more scientific data before concluding that previous infection provides more protection than the vaccine? :)

After all, this whole thing has happened quite quickly.

The commenter stated that the vaccine had no benefit to previously infected. That is not true. From the article you reference:

"The researchers also found that people who had SARS-CoV-2 previously and 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."

At what cost? What is the risk vs benefit for this particular scenario?

Yes agreed, but the benefits appear to be insignificant relative to the benefits of giving that vaccine dose to an immunologically naive or otherwise vulnerable individual.

Far from that clear cut, other results show booster shots on top of previous infection perform better than just natural immunity - and we will see how the longevity of both works out with future data, and can adjust accordingly. (and e.g. the current policy here in Germany: immunity counts for X (I think 6) months, afterwards a single booster shot counts as fully vaccinated.)

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