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Comment by jjtheblunt | Hacker News Reader

I think these headlines, possibly purposefully, overlook the possibility that vaccine antibodies eased acquisition of infection induced antibodies to the point of being subclinical events.

That is, a vaccinated person could be exposed to a variant for which they are partially protected, not notice clinical symptoms, while the person's immune system still remembers the details of the variant.

As an iterative process, this is akin to software updates (for a running immune system).

So to say that variant A.30 isn't covered by the mRNA induced spike protein antibodies is a very different statement than to say it's able to evade an immune system primed by mRNA antibodies which then re-entered daily life and thereby was able to continuously adapt to variants.

View on HN

It's also worth noting that the most people still had antibodies effective against A.30-- just not as effective. So the existing antibody response would be expected to slow infection and then the body is primed to broaden the variety and quantity of antibodies after infection.

It's only a small portion of those receiving the AZ vaccine whose serum had no significant activity against A.30-- all of those with the mRNA vaccine did and most of those receiving AZ did.

> It's only a small portion of those receiving the AZ vaccine whose serum had no significant activity against A.30-- all of those with the mRNA vaccine did and most of those receiving AZ did.

How about those that received no vaccine, but have previously recovered from Covid? Is it an insignificant number because I rarely hear it discussed.

I think it is due to politics that you don't hear this discussed; seemingly, nuance makes it more difficult to convey a message. The number of people who are known to have been infected is not insignificant, and the number who have been infected but it isn't known is much higher. (I thought estimated were that at least 4x as many people have had Covid as show up in the published results).

There is every reason to expect that natural immunity (derived from a previous infection) is better (than that conferred by a vaccine), simply because the immune system will recognize the entire virus and not just the spike cell.

This pre-print paper (https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...) concludes:

"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."

If having pre-delta covid made it more likely that your immune system could face delta, then I think it would stand true for other variants, too.

Let's just say it was "on par" with a vaccine for the sake of argument, even if it is suggested it might be better/work more broadly. Is there a scientific reason, as opposed to political, why this would not exempt one from a mandated vaccine?

Since initial infectious doses and peak viral loads seem to vary wildly in people who've been infected, I would speculate that it's much easier to quantify vaccine-induced immunity in a public health context relative to so-called "natural immunity", since those initial variables can be tightly controlled. This is a practical matter for making consistent and effective public health policy, as well as a scientific matter (viz. establishing the relative effectiveness of various forms of immunity for diverse and uncertain infection scenarios). Experts in public health and/or infectious diseases, epidemiology, etc. may feel free to correct me if I'm substantially incorrect.

However, for people who see the world through a lens that paints all public health policy with the brush of partisan politics, the distinction may be difficult to grasp.

> Since initial infectious doses and peak viral loads seem to vary wildly in people who've been infected, I would speculate that it's much easier to quantify vaccine-induced immunity in a public health context relative to so-called "natural immunity", since those initial variables can be tightly controlled.

I think you are missing the largest discriminator.

The US Vaccines[1], and the related vaccines, are highly limited resistance specific to a spike protein only, perhaps with boosters, to a number of spikes seen. Total = 1, perhaps 2 if it includes a delta variant spike booster also.

Natural immunity confers with it resistance to a number of different covid-19 viral proteins, not just the spike. We know Covid-19 has 29 proteins

Now, we know that researchers saw these antibodies, as they were the ones that said, "all these antibodies could be the target of future vaccines", and the idea is there. However, we don't know the exactly count of antibodies to all these viral proteins, we just know of their existence from research. [2]

But, to compare the strength of natural immunity to a vaccine is to fail at elementary math.

However, I am not saying that people at a high risk from age, comorbidities, or both, should not take the vaccine. That is their own decision. On the other hand, the vast majority of the research indicates that natural immunity actually provides superior immunity from a breadth perspective, since a legacy vaccine protection is comparatively challenged against a mutated spike.

[1] This is not true for all vaccines, merely "spike" vaccines. So, it wouldn't apply to an attenuated viral vaccine. However, attenuated vaccines do not prompt as strong an immune response.

[2] https://pubmed.ncbi.nlm.nih.gov/32555388/

I'm not sure where you imagine I made any statement directly comparing the efficacy of vaccines to natural immunity. The substance of my comment is limited to the problem of quantifying the efficacy of natural immunity in the real world, from the perspective of public health policy.

> quantify vaccine-induced immunity

This is a non-sequitur.

These vaccines are leaky & non-sterilizing; these are not remotely comparable to the vaccines we have had throughout most of our normal lives that grant something like 99.99999% protection with minimal side effects. I'm saying that as someone as who has had a number of vaccines during my life - I am not an antivaxx.

However, these vaccines are not comparable.

You are, apparently, not even making a token effort to understand my comments.

If you want to talk about how much better natural immunity is than vaccines, there are plenty of subthreads in these comments where your contributions--while possibly controversial--would not be completely irrelevant. But this is not one of those subthreads. I have not expressed an opinion on that matter and I have no intention of doing so in this particular context.

>had a number of vaccines during my life - I am not an antivaxx

"Antivaxx" in today's context has nothing to do with whether you've ever accepted a vaccine in your life, and everything to do with whether you reject COVID vaccines. In fact, that's as much the meaning as anything: that people who were previously OK with vaccines (including the regimen of sometimes experimental vaccines required by the military) are somehow now vociferously opposed to COVID vaccines.

And, on that measure, even a cursory glance at your recent comment history reveals that you are unequivocally antivaxx.

> you are unequivocally antivaxx

My vaccine record says otherwise.

To quote the sibling of my previous comment:

"You are, apparently, not even making a token effort to understand my comments"

You are using a pejorative directed at me, by calling me antivaxx, or, an antivaxxer.

That is actually an insult. Please refrain from insulting me.

I am not antivaxx. I am pro-vaccine, and as a veteran I am actually quite immunized. Heavily immunized in fact. Far more so than most of the civilian population.

However, this is a question of an unlike comparison.

I am vaccine hesistant in this case.

Thanks for prompting this clarification.

>You are using a pejorative directed at me

Nope. You voluntarily made the claim that you were "not antivaxx". I merely clarified for you that your previous acceptance of other vaccines has nothing to do with the definition of "antivaxx" in today's COVID context.

You are clearly anti-COVID vaccines, as indicated by a number of your comments here. That makes your assertion that you are "not antivaxx" untrue in any contemporary discussion.

Relentlessly searching for ways to discredit COVID vaccines and spreading FUD are not mere "hesitance".

If you find the plain identification of your own behavior "insulting", then I would offer that you consider not engaging in that behavior.

> You are clearly anti-COVID vaccines, as indicated by a number of your comments here. That makes your assertion that you are "not antivaxx" untrue in any contemporary discussion.

> Relentlessly searching for ways to discredit COVID vaccines and spreading FUD are not mere "hesitance".

Critical skepticism is an important element of science.

Do No Harm is a key part of the Hippocratic Oath

Just like Informed Consent with Medical Ethics.

> Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention. The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention. Informed consent is both an ethical and legal obligation of medical practitioners in the US and originates from the patient's right to direct what happens to their body. Implicit in providing informed consent is an assessment of the patient's understanding, rendering an actual recommendation, and documentation of the process. The Joint Commission requires documentation of all the elements of informed consent "in a form, progress notes or elsewhere in the record." The following are the required elements for documentation of the informed consent discussion: (1) the nature of the procedure, (2) the risks and benefits and the procedure, (3) reasonable alternatives, (4) risks and benefits of alternatives, and (5) assessment of the patient's understanding of elements 1 through 4.

[1]

> It is the obligation of the provider to make it clear that the patient is participating in the decision-making process and avoid making the patient feel forced to agree to with the provider. The provider must make a recommendation and provide their reasoning for said recommendation

[1]

[1] https://www.ncbi.nlm.nih.gov/books/NBK430827/

You really could save a lot of time by just saying you're "anti-vaxx".

Maybe you're not familiar with the contemporary meaning of the phrase, but it perfectly encapsulates your behavior here and throughout HN.

Antivaxx is a syndrome. Some tell-tale symptoms are:

1) a scattershot litany of objections based on vague pseudo-scientific conclusions, cherry-picked de-contextualized data, and deployment of hypotheticals that, in total, amount to FUD;

2) Antivaxx denialism: that is, retreating to a position of nuanced skepticism when called on their clearly manic anti-vaccine FUD tactics, "hey, I'm just cautious/hesitant/skeptical".

3) an effort to characterize COVID vaccines as somehow nefarious or "illegitimate" versus previous vaccines because they seek primarily to prevent serious disease;

4) a relentless emphasis on natural immunity as superior to vaccines;

5) and the dispositive test that is perhaps the gold standard for an antivaxx diagnosis: deploying a range of pseudo-ethical arguments that seek to paint COVID vaccines or their advocacy as somehow immoral. This is usually deployed via vague rantings that, say, inexplicably invoke the Hippocratic Oath.

> Critical skepticism is an important element of science.

There's a continuum here. I guess we might say that at one end is blindly trusting whatever you're told, and at the other end is skepticism to the point of divergent irrationality, e.g. believing the Earth is hollow because you haven't personally been to the North Pole to check for a big hole leading to Inner Earth (where the meat goes on the outside of the sandwich). Of course, satellite imagery is all doctored to cover up the truth.

Interestingly, those extremes seem to curve back toward each other.

Skepticism is important, but it can be taken to harmful extremes, and it's important to examine "skeptical" impulses to make sure that's actually what they are. When you find yourself clinging to a "skeptical" position as evidence to the contrary continues to mount, squeezed into an ever-tinier corner of what-ifs and statistical improbabilities--or just cherry-picking data and presenting it out of context to rationalize your position--you have to know when to throw in the towel.

---

The above is presented as a reply to your comment about critical skepticism being important, because I think that's a line that's often used to defend irrational positions, often to the point of doing real harm when it's deployed in the public discourse. But I am not talking specifically about COVID or anything to do with it, so--again--please don't imagine that I've made any substantive statement wrt. the efficacy and/or risk profile of COVID vaccines, because I haven't.

> Natural immunity confers with it resistance to a number of different covid-19 viral proteins, not just the spike

I am personally closer to the antivax group than the provax group( at least in terms of mandates, because abrogation of bodily autonomy is straight up evil ), but I have to take issue with this statement.

While you are probably correct, we need to worry about biomechanics and effectiveness. If the S protein is the specific means of entry, that's definitely the one we should target. There's no reason to target proteins that don't actually bind to anything.

There are other issues regarding what are the limits to the memory of our circulating B cells. If my immune system has to "swap out" memory of, say, polio, in order to accommodate antibodies to eight different viral proteins, I'd rather it only remember one, if it's just as effective.

> The US Vaccines[1], and the related vaccines, are highly limited resistance specific to a spike protein only, perhaps with boosters, to a number of spikes seen. Total = 1, perhaps 2 if it includes a delta variant spike booster also.

This is bogus. A broad spectrum of immune response develops through mutation and maturation of B cells. This is why we see broad neutralizing activity-- even against Delta without a Delta-specific booster-- against all variants from vaccination.

Because it is purely political in the USA. Many other countries do classify people who gained immunity from exposure the same as vaccinated.

> Many other countries do classify people who gained immunity from exposure the same as vaccinated.

Can you point out an example of any country that exempts those who were already infected with COVID from taking the vaccine? As far as I can tell, no European country does anything of the sort, neither does the US and definitely not Canada, and a quick Google search returns no search hit.

> As far as I can tell, no European country does anything of the sort

This data is pretty easy to find. One tip is to look at the requirements of vaccine certificates in use in Europe. Modern life is all about knowing which keywords to search for.

In the Swiss system, if you have a positive antibody test from a previous infection, you get a certificate for 180 days. Then you need another test. As long as you have antibodies detectable by the PCR test, you will have a certificate for the next 180 days. No vaccine needed. If you have covid, odds are you will have antibodies for the rest of your life[1].

https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-...

The EU covid certificate is given along similar lines as the Swiss. You need either have a vaccine, have a PCR that detects antibodies (180 day validity), or received a negative test (72 hour validity). You can find details here:

https://ec.europa.eu/info/live-work-travel-eu/coronavirus-re...

[1] https://www.nature.com/articles/d41586-021-01442-9

> This data is pretty easy to find, so not sure what was stopping you from gathering it. One tip is to look at the requirements of vaccine certificates in use in Europe.

Actually, it isn't because your claim goes against pretty much all the information made available. Thus, the onus to substantiate your extraordinary claim is on you, specially because the odds that you've misunderstood or misrepresented your assertion are quite high.

> In the Swiss system, if you have a positive antibody test from a previous infection, you get a certificate for 180 days.

And here lies your mistake. Contrary to the original claim, Switzerland absolutely does not classify people who gained immunity from exposure the same as vaccinated. At all. If you take the time to read your own source, you'll notice that a) Switzerland supports both vaccine passports and certificate of prior infection, which are entirely different classifications, b) those who decide to only present a certificate of prior infection are forced to go through additional checks such as mandatory PCR tests prior to travel and after arriving, c) this only limited to international travel.

> The EU covid certificate is given along similar lines as the Swiss.

If you read up on the EU's COVID certificate you'll find out that the EU imposes high requirements for the certificate, such as not accepting PCR tests as proof of a prior COVID infection. Also, the same EU requires that those who were verifiably infected with COVID take at least a single vaccination dose to be deemed fully vaccinated.

I don't think you read my comment at all. Odd.

Yes, like I pointed out, you need a PCR test every 180 days to get the certificate. But it's the same certificate as if you had a vaccine with the same access rights. That means that no, you don't need to get a vaccine as long as you got the disease (it's extremely unlike no antibodies will be detected if you were truly infected and recovered, but if you were diagnosed with a false positive, then no, a PCR test wont detect antibodies).

And expect to be required to get regular boosters on the vaccine side as well, so everyone will need to go through a process to keep the certificate, it does not last forever.

> Yes, you need a PCR test every 180 days to get the certificate, but it's the same certificate as if you had a vaccine.

You should read your own source. Even though the swiss COVID certificate applies to those who "have had a COVID-19 vaccination, have had and recovered from the disease or have tested negative", neither case is treated the same at all. You already admitted that by referring to the additional requirements for those who did not took the vaccine, such as a series of mandatory tests.

[1] https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-...

So now I am confused. How are they treated differently other than requiring the PCR test twice a year? You just keep saying "you should read your own source" with increasing hostility but no actual argument that says the individual without a vaccine but with the bi-annual PCR test is treated differently in any meaningful way.

Honestly there is a lot of bluster and emotion in your responses, and I'm having a hard time extracting signal from noise. Lots of people in the EU who had covid are doing just fine with getting biannual PCR tests and don't need to get a vaccine as they can get the covid certificate and have access to the same things as someone with a vaccine.

> So now I am confused. How are they treated differently other than requiring the PCR test twice a year?

Please read your own source, particularly the section on "I am not vaccinated or recently recovered from COVID-19. What should I bear in mind?". They are quite clear in stating the additional requirements for continuous testing, both before and after entering Switzerland.

Fully vaccinated travellers do not have to deal with nothing of the sort.

Don't you agree that imposing entirely different sets of requirements to those who are not vaccinated demonstrates that vaccinated and non-vaccinated but recovered from Covid is a clear indication that both cases are indeed not classified, and treated, the same?

the "recently recovered from covid" is the 180 day PCR test case, because it's defined as having a positive antibody test in the last 180 days ("recently"). So no I am not going to apply the section that is not relevant to those who have recovered with a positive antibody test in the last 6 months.

By reading the wrong section, you've come to the wrong conclusion as to how the recovered are treated.

"So now I am confused." We can tell. It is as if you are comprehending none of it and talking right past them.

Well some countries are saying proven infection is good for 7 months worth of vaccine coverage. But the length and time period of the immune response is likely much more variable than those who received vaccination

Most people in the US who have contracted COVID-19 don't have proof of it. Vaccinating everyone is cheaper and more consistent than trying to build out mass testing infrastructure. Plus if you can convince people to show up for a test, it's better to just vaccinate them. Tests can come back negative, or give false positives, in which case those people still won't have immunity, but the benefits of the vaccine are pretty well understood. AFAIK it's more of an issue of ensuring public safety and efficiency than whether your immune system produced good enough antibodies from an infection.

The Red Cross and the regional blood bank in my area both test for COVID19 antibodies. Seems extremely unrealistic that testing infrastructure would be too difficult considering how much we've done for the pandemic. "Just jab everyone and we're done!" sounds like a desire for a simple silver bullet solution, which is a very common Silicon Valley way of seeing the world.

Equating antibody presence to be the same as having been vaccinated would give health officials a much more accurate view of the pandemic and where resources need to be allocated instead of this odd ideologically driven need to demand conformity from everyone even if they already have immunity that appears to be an order of magnitude more durable than the jab. It makes clear that this is almost entirely about a pathological need to round off all the corners in the world and almost nothing at all about fighting the pandemic itself. But what a wonderful opportunity this pandemic has been for the authoritarian types. For them, this truly is the golden age and should be extended for as long as possible.

The Red Cross has ~7 million donors per year (~2% of the population). That's not really evidence that they could sample a large enough portion of the population as quickly as they could be vaccinated. And again, it doesn't increase herd immunity. It does at least have a side benefit of increasing our blood inventory, but also has the downside of potentially spreading infection among the unvaccinated while they donate.

> Most people in the US who have contracted COVID-19 don't have proof of it.

There have been over 45 million laboratory-confirmed COVID cases in the US. Basically all of these people can easily prove that they were infected and recovered by showing a copy of their positive result.

For those who believe they had a past infection that wasn't lab-confirmed, antibody testing costs around $50[1].

I'm sure some people will say "but lab results can easily be faked!", which is true. But the CDC cards for the vaccines aren't exactly forgery-proof either.

> AFAIK it's more of an issue of ensuring public safety...

To protect the vaccinated from the unvaccinated? And how? Vaccinated individuals can get breakthrough infections and spread the virus to others too. And you could make the argument that some vaccinated individuals, overconfident in the protection they have, will engage in riskier behavior (having close contact with others, not wearing masks, visiting poorly-ventilated indoor spaces, etc.).

[1] https://www.labcorp.com/coronavirus-disease-covid-19/individ...

> Is there a scientific reason, as opposed to political, why this would not exempt one from a mandated vaccine?

First of all, taking the vaccine is not political. What is political is the contrarian stance against vaccinating against COVID-19. This sad state of affairs was the direct result of an election campaign which was deeply invested in denying that COVID-19 was a public health concern, or even that it existed at all, and thus recognizing the vaccine's importance and effectiveness was deemed a sign of a political defeat and admission of responsibility for countless unnecessary deaths.

Secondly, natural immunity against COVID-19 is not a sure thing, with the risk of reinfection being as high as 17%, and subsequent infections are known to be more severe than the first[1]. In contrast, immunity through vaccination is believed to be not only more effective but also last longer[2].

Consequently, there is absolutely no reason at all, other than political beliefs, to refuse to get the vaccine.

[1] https://www.nature.com/articles/s41591-020-01202-8

[2] https://www.immunology.org/coronavirus/connect-coronavirus-p...

Your comment is full of misinformation.

> This sad state of affairs was the direct result of an election campaign which was deeply invested in denying that COVID-19 was a public health concern, or even that it existed at all, and thus recognizing the vaccine's importance and effectiveness was deemed a sign of a political defeat and admission of responsibility for countless unnecessary deaths.

You seem to be implying that the former president, whose administration helped fund the vaccine development, was responsible for all of the anti-vaxxer sentiment. Even as someone who is very happy Trump is gone, I must say this type of dishonesty has no place in a civil discourse about vaccination.

https://www.politifact.com/factchecks/2021/mar/04/rachel-mad...

> ...and subsequent infections are known to be more severe than the first

You have conveniently misconstrued what your own citation says:

> Reinfections have been reported, and in a few instances, the second infection was more severe than the first, but serological responses suggest that patients never seroconverted after initial infection and ADE is a less likely cause of a more severe second infection

Some people don't seroconvert after vaccination either. Using outliers to make broad claims is not appropriate.

> ...immunity through vaccination is believed to be not only more effective but also last longer.

Linking to an infographic that doesn't provide citations for its statements isn't exactly convincing, especially when there is evidence that what is claimed might not be accurate. For example see, https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

Conclusion:

> 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.

No. The majority of Americans now have antibodies one way or another. In significant excess of the 60 to 70 percent Fauci and other public servants were rooting for this entire year. Some 80 to 85 percent of the population by now has antibodies.

More than 80% of Americans have coronavirus antibodies acquired through infection or vaccination, according to a new study of over 1.4 million blood donations across the U.S. https://www.miamiherald.com/news/coronavirus/article25398704...

And as reported on by Bloomberg and other media, the antibodies from past infection confer protection equal to or greater than Pfizer.

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

"Previous Covid Prevents Delta Infection Better Than Pfizer Shot"

And those are slated to last for decades. Source:

https://www.nature.com/articles/d41586-021-01442-9

"Had COVID? You’ll probably make antibodies for a lifetime"

On the exact terms given to us by Fauci and other public servants, there is no more reason for these covid mandates to exist. Not from a scientific point of view based on these links.

> The majority of Americans now have antibodies one way or another

Why are some hospital systems still overwhelmed? Where are all these very sick people coming from if almost everyone has been in contact with the virus?

Because hospitals operate with minimal spare capacity. Any epidemic wave will overwhelm the system. That being said, hospitals are not overwhelmed. There may be a handful of hot areas where that is marginally true, but generally speaking the vast majority of the country is doing just fine. I just threw a dart at Iowa: 69% beds occupancy, 10% covid. This is not what "overwhelmed" looks like.

https://coronavirus.jhu.edu/region/us/iowa

> There is every reason to expect that natural immunity (derived from a previous infection) is better (than that conferred by a vaccine), simply because the immune system will recognize the entire virus and not just the spike cell.

No - we do not have "every reason" to expect, quite the opposite. As a starter, for many infectious diseases (incl. viral diseases) vaccine-induced immunity is better, see e.g. the commentary and examples here [1].

Regarding SARS-CoV-2, the picture is a lot more subtle. Directly from German virologist Christian Drosten:

"If you look closely at the data in the studies, the situation is much more complicated. What one should say and be aware of is vaccination, which provides a relatively constant protection, which is very well described in studies. You actually pretty much know what you have. While there is a greater spread in the case of infection. Quite simply, we get different amounts of virus in the infection. Some have a silent infection that they don't even notice, others have a symptomatic infection. And you have to be aware that in such studies, which are primarily based on PCR test results, there will always be a certain emphasis on symptomatic courses. That means saying that if I know I have survived an infection and it was confirmed by PCR testing, then that also implies that I had symptoms, otherwise I would hardly have had a PCR test at the time. So then I had a symptomatic course. I think that for this situation you can now say very well, whoever had the whole thing symptomatically, will be well protected afterwards, almost like a vaccination." [2]

The study you picked in its current pre-print form does not adequately address this obvious selection bias, nor does it address the inherent survivorship bias. I´m not a medical expert though, so we will see if it passes peer review.

In any case, please do not perpetuate the myth that natural immunity is superior per se. If you had a symptomatic infection plus a PCR test, you are likely well protected, very similar to (mRNA) vaccination. If your infection is more than 6 months old, get a booster.

[1] https://twitter.com/ENirenberg/status/1412865782862725125

[2] https://www.ndr.de/nachrichten/info/coronaskript334.pdf page 7 (via Google Translate)

Can you link to studies mentioned in your quote ? - "If you look closely at the data in the studies, [..]"

Also, you seem to be rightfully cautious that the situation is fluid, but also calling natural immunity being better a 'myth'. This may just be the word you chose, but myth to me is something that is complete BS. Are you also intending to use it that way?

> Can you link to studies mentioned in your quote ? - "If you look closely at the data in the studies, [..]"

See e.g. papers mentioned here: https://g-f-v.org/2021/09/30/4411/

> myth to me is something that is complete BS

I chose myth to describe the pattern of something that seems correct for seemingly obvious reasons but is actually incorrect for more complicated reasons.

In particular the black and white belief that natural immunity is superior because

a) it is 'natural' (this is a such a great example of extrapolating from a kernel of truth and can have interesting notions packed into it, like the superiority of divine creation and/or nature),

b) the vaccine only encodes the spike protein (one of the reasons the spike protein was chosen is because it is more robust w.r.t. to variation relative to other components of the virus).

I see these "arguments" often politicised with terms such as 'gold standard immunity'.

Your claim that natural immunity superiority is a myth is based on which scientific principles? Please throw all the science you can at me, I am genuinely interested.

Also, I'm curious if you read the studies you're linking to?

This is literally the conclusion from link #8

Please re-read what I wrote: It's BS to call natural immunity superior for the reasons of being "natural" or because "vaccines only encode the spike protein".

There is no black and white argument why natural immunity should be superior - it can be worse, similar or better than vaccine-induced immunity. It all depends on the amount of viral particles you were exposed to in the first place.

Any study that compares natural immunity to vaccine-induced has to deal with a selection bias (as stated in the quote by somebody who is a professional at designing such studies).

Let me know if that clears things up.

>There is no black and white argument why natural immunity should be superior - it can be worse, similar or better than vaccine-induced immunity. It all depends on the amount of viral particles you were exposed to in the first place.

Logical arguments for a position don't equate to empirical truths. Data is preferred over argument/opinion.

>Any study that compares natural immunity to vaccine-induced has to deal with a selection bias (as stated in the quote by somebody who is a professional at designing such studies).

Do you have any evidence that the study you linked to is biased? If so, why even link to it?

In any case, I think this thread is not going anywhere, so I will just let you have the last word.

I also wonder whether the reason the "natural vs vaccine" immunity question may not have a great, direct answer is it wasn't asked until covid-19.

When I was asked about this by a 'vaccine skeptic', I said having the vaccine after an infection was clearly a huge benefit over having just the vaccine or just the infection - so do it. I've also seen a study where the super rare, problematic responses to the vaccine seemed to be the same symptoms someone would experience with an infection sans the vaccine - only the effect would be dramatically worse with an infection. (Sorry I can't offer sources at the moment - moments from sleep.)

Of course it was asked before COVID-19: there's no point in taking a vaccine for a disease you already had because the vaccine is not more virus-like than the virus itself. By definition there is no event closer to infection than infection; for the body, a vaccine is always a trial run. Hence things like chickenpox parties. There wasn't raging debate about this because it's obvious and uncontested.

It's quite sad to see people now claiming it's some kind of novel scientific question about natural immunity vs not. This is basic, high school level biology. It's not advanced stuff and the people claiming otherwise are invariably using bad science to do so. For example, claims that infection doesn't stop reinfection are often based on studies with so few cases of reinfection that it'd fall below the noise floor for almost any testing system. The belief that these events are real relies on yet more bad science (the belief that mass testing has an FP rate of zero).

The reality is that natural immunity is suddenly being questioned because "vaccine zealots" are desperate to suppress any messaging that might discourage people from taking it. They've lost all perspective, which means they're making claims that are contradicting biology considered so basic and important that it's literally taught to children in school. Then they sit around looking confused, wondering why suddenly so many "anti-vaxxers" and "skeptics" came out of the woodwork.

> By definition there is no event closer to infection than infection [...] Hence things like chickenpox parties.

Glad you mention chickenpox. Could you help me understand why the protein vaccine is much more effective than the attenuated virus vaccine? Following your argument there should be nothing better than the virus vaccine, because it is closest to infection?

It's not more effective, is it? The mRNA vaccines have proven to have zero efficacy after only a few months, at least for the goal they were judged against in the trials. They don't reduce the rate of infection at all. Even Boris Johnson has admitted that now.

Actually it is good to be vaccinated even if you have already had a disease. This confers greater immunity than the infection or just the vaccine.

Whether or not the vaccine or natural immunity is better protection isn't as clear as suggested either, generally the vaccines will give more reliable resistance.

Please read: https://www.nebraskamed.com/COVID/covid-19-studies-natural-i...:

"Natural immunity can be spotty. Some people can react vigorously and get a great antibody response. Other people don't get such a great response," says infectious diseases expert Mark Rupp, MD. "Clearly, vaccine-induced immunity is more standardized and can be longer-lasting."

> Whether or not the vaccine or natural immunity is better protection isn't as clear as suggested either, generally the vaccines will give more reliable resistance.

Yah, perhaps it'd be best to talk about mean and variance.

For COVID-19, it looks like natural infection provides a somewhat better neutralizing titer of antibodies than vaccination on average. But there's a much larger variation in the response than vaccination provides. The people with the lowest responses are in the natural infection group, too.

No it isn't. That's extremely bad advice, please don't tell people to get vaccinated if they don't need to. The vaccines can have nasty side effects and if you've had the disease you are hardly at any risk of being reinfected, let alone actually suffering disease. The data on this is quite clear, there are many studies that look at the testing data to find this.

Example: https://www.medrxiv.org/content/10.1101/2021.03.06.21253051v...

"Out of 149,735 individuals with a documented positive PCR test between March 2020 and January 2021, 154 had two positive PCR tests at least 100 days apart, reflecting a reinfection proportion of 1 per 1000"

So that's really incredibly low. Note that this paper, like so many others, assumes a false positive rate of zero: with such a low number of reinfections they could easily just be testing errors and thus the reinfection rate can easily be even lower still.

Remember - COVID is a mild disease for the vast majority. Having been infected reduces your chance of infection so low that it takes you from a very low chance of having serious problems to "you need scientific notation to express the probability of having problems". Vaccines can only make things worse for those people, not better.

Unfortunately our society has completely lost all rationality over vaccines. Your so-called infectious disease expert is a great example of that. Firstly, he's dead wrong that vaccine-induced immunity is longer lasting. It lasts months at most, which is why even vaccine-pushers have given up claiming it stops you getting COVID. And antibody titers are not the end goal here! The goal is to avoid getting sick. They've completely substituted the means for the end, which is the sort of contempt-worthy irrationality that makes people reject the vaccination programme.

> The vaccines can have nasty side effects and if you've had the disease you are hardly at any risk of being reinfected,

This is wrong, the vaccines are safe and effective - much moreso than getting reinfected with COVID-19. As a former medical professional who works with medical professionals today, you are completely misguided. Please don't repeat this stuff.

Parent's comment will not cease to amaze me: We are going through a pandemic that has cost more lives in the US than the Spanish flu (absolute numbers) and there are still folks running around proclaiming that

> Remember - COVID is a mild disease for the vast majority.

If you had told me in 2019 that we will experience something like it in our lifetime I would not have believed you.

COVID is in fact mild for the vast majority. That is a simple fact, and not one that can be dismissed with strange non-population adjusted comparisons. Actually nobody really knows how many people died from the Spanish flu, so I really wonder where you heard that idea. Wikipedia says:

"Estimates of deaths range from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in human history."

NB: The high estimates come from epidemiological modelling so should probably be ignored as such modelling has no legitimacy. But even for the USA alone, there's no agreement on how many died, especially as many people (especially in the USA) seem to have been killed by aspirin overdoses rather than the flu itself. At the time aspirin was new and considered a miracle cure. Doctors panicked prescribed doses that we now know are far, far too high. From a paper published in 2009:

https://www.sciencedaily.com/releases/2009/10/091002132346.h...

High aspirin dosing levels used to treat patients during the 1918-1919 pandemic are now known to cause, in some cases, toxicity and a dangerous build up of fluid in the lungs, which may have contributed to the incidence and severity of symptoms, bacterial infections, and mortality. Additionally, autopsy reports from 1918 are consistent with what we know today about the dangers of aspirin toxicity, as well as the expected viral causes of death.

The motivation behind the improper use of aspirin is a cautionary tale, said author Karen Starko, MD. In 1918, physicians did not fully understand either the dosing or pharmacology of aspirin, yet they were willing to recommend it. Its use was promoted by the drug industry, endorsed by doctors wanting to “do something,” and accepted by families and institutions desperate for hope. “Understanding these natural forces is important when considering choices in the future,” Dr. Starko said. “Interventions cut both ways. Medicines can save and improve our lives. Yet we must be ever mindful of the importance of dose, of balancing benefits and risks, and of the limitations of our studies.”

The vaccines were released to the public barely a year ago. There is no way to know exactly how safe or effective they are, supposing they are. We just don't have the data yet. What we have, however, is an aggressive censorship of any information or person critical of the vaccines.

This is wrong. We know how the ingredients of the vaccine interact inside the body and we know they leave the body pretty rapidly. We have a good idea of the side effects as over 6 billion doses have been administered worldwide.

> I said having the vaccine after an infection was clearly a huge benefit over having just the vaccine or just the infection - so do it.

Yes --- amazingly so. We don't have wonderful data for SARS-COV-2 yet, but some number of recipients of mRNA vaccines who are survivors of the original SARS apparently have strong antibody responses to all coronaviruses. https://www.nejm.org/doi/full/10.1056/NEJMoa2108453

Yes, but even if

P(Survive infection|Survive first infection) > P(Survive infection|Have been vaccinated),

in general the far more interesting inequality is

P(Survive first infection) * P(Survive infection|Survive first infection) << P(Survive having been vaccinated) * P(Survive infection|Have been vaccinated)

So it usually is still a better strategy to get vaccinated than to get infected.

They don't include the data in the paper, but they do have that data in the supplemental charts under "Convalescent". Looks like a similar dropoff as scene in people vaccinated with BNT162b2.

It should be noted that this convalescent plasma was taken from ICU patients, not people that were asymptomatic or had minor symptoms.

There's convalescent plasma in the study we're all looking at.

Looks like a similar difference.

- People given AZ required 8.8x the concentration of their serum to neutralize A.30 vs. B.1

- For mRNA vaccines, this was 4.6x.

- Convalescent plasma-- those infected-- this was 4.4x.

- AZ dose 1, mRNA dose 2 was by far the smallest difference, 1.8x.

I'd caution in reading too much into these numbers. Comparing titers in general between the groups in this study is problematic because of vastly varying times since infection/administration. And the size of the populations is small.

It's a significant number. The CDC estimated that about 36% of Americans had been infected as of May (more by now).

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

I recommend that everyone get vaccinated if they can, especially if they haven't had a confirmed infection. For most patients natural immunity provides protection as good or better than vaccination.

https://www.medrxiv.org/content/10.1101/2021.09.12.21263461v...

I have an open question that I've never been able to find the answer to:

What are the limits to the memory of our immune system? Surely there are limits, to the extent that our blood can only carry N number of Memory B cells, and those cells that still exist carry some degree of senescence, and we need M of them to mount an timely response to a recurrence of infection, how many protein antigens can our immune system actually remember and respond to over long periods of time?

Short answer: nobody knows. In any case, I don't believe an answer is realistically even possible because we can't easily isolate all the other factors involved. Also, you'll have to consider affinity maturation and the cutoff for B-cell specificity for an antigen to clearly define what you even mean by 'remembering a protein antigen'.

https://en.wikipedia.org/wiki/Activation-induced_cytidine_de...

https://en.wikipedia.org/wiki/Affinity_maturation

^ and many more that will probably just end up amounting to a couple of years of study!

You might want to read up on “original antigenic sin” before you assume the immune system is iterative in the way software is.

https://en.m.wikipedia.org/wiki/Original_antigenic_sin

super cool ; thank you

Except that data from the UK shows that’s precisely what’s not happening. Those who were immunologically naive when receiving the vaccine continue to not have N protein antibodies after subsequent infection. That is they did not gain new immunity that would have been gained in the reverse order of events.

> this is akin to software updates

That is blatant fear mongering. :)

It depends if the person who got vaccinated was exposed to the virus before the vaccination. If not, it is very likely that these variants will escape the vaccine induced immunity due to original antigenic sin, especially considering that mRNA vaccines only stimulate the production of spike ABs and not other ABs such as nucleocapsid ABs which target proteins that do not mutate as much as spike.

Antibodies is also just one part of the immune response, memory T cells are just as important.

We know the vaccines are not sterilizing so you can still catch and spread it. They do reduce the likelihood of hospitalization and that seems to be about that.

They do a lot more than that. A lot of the symptoms (coughing, sneezing, etc.) increase infectivity. The vaccines reduce not only the likelihood you'll get symptoms at all but if you do they reduce both the longevity and severity.

Saying "well you're just less likely to go to the hospital" underplays their importance and gives unnecessary credence to the completely false notion that if you don't get vaccinated the only person you're potentially hurting is yourself.

So you're saying a vaccinated person is likely to unknowingly infect other people around them?

There is a slight chance, but it is not different than an unvaccinated person having an asymptomatic case (which is also common). That being said, the possibility of infecting others is much less when you don't have symptoms.

That's not really correct. I encourage everyone to get vaccinated but it only has temporary and limited effect on reducing transmission.

https://www.nature.com/articles/d41586-021-02689-y

What interpretation are you expecting people to make? Because there's a huge impact from vaccination.

The chances of having a breakthrough infection and passing it to someone else are quite a lot smaller than the chances of getting infected while being unvaccinated and passing it to someone else, just because breakthrough infections aren't that high (Even if they are higher than we'd like).

> The risk of spreading the Delta infection soon after vaccination with that jab was 42%, but increased to 58% with time.

42% (and even 58%) is still a huge improvement since the article says that the likelihood that an unvaccinated person will spread is around 67%.

The R0 value for Delta is between 6 and 7. So while an unvaccinated person might pass it on to ~6.7 people you will pass it on to only 4.2 people in the beginning (37% reduction), then to 5.8 people (13% reduction).

This calculation also assumes that your chance of getting Covid is the same as an unvaccinated person, which is not correct.

No, breakthrough infections are not common enough to justify the description 'likely'.

Having such an obvious sign of infection is a reason to stay at home and minimize human contact? Something we did for thousands of years...

They’re partially sterilising, with studies showing up to six times lower infection rates amongst the vaccinated than the unvaccinated.

That’s a huge difference, and not just reducing the likelihood of hospitalisation.

COVID-19 vaccines aren't sterilizing to any meaningful extent. They provide only limited and temporary protection against infection. The real benefit is in protection against severe symptoms.

https://www.nature.com/articles/d41586-021-02689-y

Not sterilising, but they do reduce viral load and hence also the probability of spreading.

I don't think there is consensus about that unfortunately. I see plenty of pre-prints going both ways.

https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v...

I think the only conclusion that can be supported truly at this point is that you seem to be less likely to get a severe disease progression.

And before anyone jumps on the whole political thing. Yes I have taken two doses of the biogen vaccine.

> We know the vaccines are not sterilizing so you can still catch and spread it

Unfortunately US media and government messaging at the beginning of this year touted the vaccines effectiveness as we historically understood vaccines to be, which was relatively sterilizing and a preventative. When Delta started infecting the fully vaccinated, it underscored the skepticism around these vaccines.

Ironically, right now, I know more people in my social circle that have had breakthrough cases then people who had Covid prior to vaccine’s release.

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