If you want to put down or yell at people on the other side of this $hot-topic, or any topic, please do that somewhere else. We're trying for a little better than internet default here.
Not to disagree with the effectiveness of immunity gained by getting Covid-19, but also:
"The evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants ... compared to antibodies acquired from an infection."
I am a believer in vaccines, but you're mischaracterizing the first link by selective omission. You've cut out the critical words of the sentence (emphasized):
> The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.
The paper shows that vaccines produce a more diverse antibody response to the RBD, which is one portion of the spike protein. They admit that natural infection produces antibodies targeted to other portions of the spike protein (also, presumably, to other parts of the virus, though that isn't discussed in this press release):
> Specifically, antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein.
Is this evidence that vaccines are "better" than natural infection? No. It can't be. The paper shows that there's a difference between the antibody responses, but beyond that, it's impossible to know what the practical impacts of that difference might be from this paper.
This is a perfect example of the political weaponization of pre-prints that has happened throughout the pandemic. People read these things, don't fully understand what they're reading or what questions they answer, and immediately jump to social media to start waving them around like team flags (and worse, people who should know better -- like Francis Collins -- seem to encourage the behavior. This PR seems to be trying very hard to mislead, without actually stepping over the line.)
This is an interesting paper, but it is in no way a definitive statement about the relative benefits of vaccination vs. natural immunity.
Thanks for trying to bring more precision to the discussion. I also cited that blog post elsethread, and, having reviewed it, agree it's not the single best piece of evidence. It establishes a narrow result which suggests a generally better immune response from vaccines, but does not prove it.
If I had to cite a single preprint to support the assertion, it would probably be this one:
Obviously this study also has limitations: it speaks only to Ab levels, while obviously the overall immune response is a lot more complicated.
I agree with the "waving of preprints" claim. Unfortunately, hyperskepticism, rejecting drawing conclusions because of the inevitable limitations of any study, is also a politicized position, and unfortunately I see a fair amount of that as well.
We know based on past corornaviruses that natural infection can lead to durable immunity up to 20 years, and like you mentioned with T-cells and more. We also have data showing the current ones so far last as long as we’ve tested them, while vaccines have waned once near a year out. The consensus hasn’t been reached, by my current beliefs strongly tend towards (based on many past similar viruses and all current studies) that vaccine is far less efficacious.
Note: that’s 6.7 times stronger immunity from natural vs vaccinated! If anything we should have “previously-infected” cards that confer far greater privileges than vaccination cards, if we’re going to be playing that silly game.
Antibodies wane, but B-cell and T-cell response is important for longer term protection. Fortunately, we have results (including [B] and [T]) that vaccines also induce these memory cell responses.
Also, the durability of immunity from coronavirus probably depends on the exact coronavirus. It does seem to be true for SARS, but possibly less so for the seasonal coronaviruses that cause a respectable fraction of common colds[3]. We don't really know yet where SARS-CoV-2 falls on that spectrum.
While they may stimulate some B and T, they aren’t close to the levels from infection.
From what I’ve seen many coronavirus have durable immunity from infection, you’d need to cite that they vary. Also, from what I’ve seen the T and B cell response is not nearly the same effect, nor as durable.
Further, like the Israeli report, there are a handful more reports of previously infected not getting reinfected at nearly the same rates. The Israeli report has hard numbers in the article you ignored.
The Science cite shows something that's very different than what people might take from your comment. Briefly, prior infection plus one mRNA dose induces a very good immune response, much better than a single dose without prior infection. It does not compare two mRNA doses against prior infection.
I believe the cite I provided does support the idea that coronaviruses vary, in particular that HCoV-229E exhibits continuous genetic drift. But here's an excellent paper that goes into a lot more detail on that: https://journals.plos.org/plospathogens/article?id=10.1371/j...
Thanks for the citation, I hadn't seen that paper yet.
I agree it predominantly speaks to antibody levels. For others reading who don't already know - antibody levels are used as proxy to measure immune protection, but currently there is no scientific consensus that increasingly higher antibody levels correspond to increasingly better protection. Similarly, it is difficult to determine at what antibody levels an individual is "protected enough". So answering those questions is an ongoing scientific endeavor.
With that said, the literature is rapidly approaching (and likely has already established) scientific consensus that vaccination increases many components of the humoral response to SARS-CoV-2 infection. But for the reasons I previously stated, this has not been proven to translate into better protection or additional benefits for previously infected individuals.
So while antibody levels are a useful measure, another important factor is the robustness of the vaccine induced immune responses in comparison to the response induced in naturally infected individuals. There is a relevant section in the paper you cited titled 'mRNA vaccines induce higher Ab levels and greater Ab breadth than natural exposure to infection'.
My takeaway is that the authors are concluding that the vaccine induces a more robust antibody response because "the vaccine induced significant cross-reactive Abs against the SARS spike and SARS RBD". However they also clearly state that the vaccine does not induce antibodies against the nucleocapsid protein, which natural infection does.
For these reasons I feel that characterizing the vaccine induced immune response as "more robust" doesn't really paint an accurate picture. Especially when it has yet to be proven that this difference in immune response is actually beneficial for health outcomes in people infected with the virus.
Here are some key excerpts:
- "The nucleocapsid protein (NP) is an immunodominant antigen for which the antibody response increases in concordance with natural exposure (Figure 2A,3A and 4)."
- "However, nucleocapsid is not a component of the mRNA vaccines and consequently there is no vaccine-induced increase in Ab against this antigen. Accordingly, anti-spike antibody levels increased in vaccinees while the nucleocapsid protein Ab level remained constant."
- "Natural exposure in seropositive people induces high antibody levels against nucleocapsid protein (NP), full-length spike (S1+S2) and the S2 domain. Antibodies against S1 and the RBD domains are lower."
- "Vaccinated individuals have high Ab levels against full-length spike and the S2 domain of SARS-CoV-2 spike, and significantly higher antibody levels against S1 and the RBD domains compared to naturally exposed individuals."
- "In natural exposure there was no significant cross-reactivity against SARS S1 or the RBD domains. Surprisingly, the vaccine induced significant cross-reactive Abs against the SARS spike and SARS RBD."
- "Vaccination induces a more robust antibody response than natural exposure alone, SUGGESTING that those who have recovered from COVID benefit from the vaccination with stronger and broader antibody response."
What!? This is an extraordinary claim that you state with zero evidence. It relies entirely on the naturalistic fallacy.
Not only is it possible for vaccines to confer better immunity but there are clear ways to test this empirically, which studies certainly have, like this one:
The article referenced by GP cites the same paper mentioned in a different comment, see that thread for some additional discussion and citations that provide counter evidence: https://news.ycombinator.com/item?id=28108039.
In summary, there is currently no scientific consensus that vaccines provide 'better' immunity compared to natural infection. There is evidence that they induce similar but subtly different immune responses.
Nobody claimed there is currently "scientific consensus" (but there is currently a lot of scientific evidence). What we're taking issue with is the unfounded claim that 'natural immunity' must be better than vaccine induced immunity.
The idea that vaccines provide more antibodies that fight a wider variety of COVID can indeed suggest that vaccines create better immunity. The writer here makes a firm denial of this and then uses their denial to offer a fatalistic take on what is possible to show about vaccines with this paper. Of course, outside of this paper there are very simple studies that have been conducted which contradict the bias illustrated here.
"Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.58–3.47). These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection."
Here is a paper (not yet peer-reviewed) which presents statistically strong evidence (N = 52,238) that vaccinating previously infected individuals provides practically no benefit [1].
Quote from [1]:
- "The cumulative incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vaccinated, compared with a steady increase in cumulative incidence among previously uninfected subjects who remained unvaccinated."
Right now there is no scientific consensus that full vaccination of previously infected individuals provides any additional protection that is meaningfully beneficial. In fact there is a lot of evidence pointing the other way - supporting the idea that vaccination strategies should be highly targeted at only the most vulnerable populations.
Thanks for bringing this paper, it's relevant to the conversation. A couple of points of context.
First, this study is quite early on in the vaccination campaign, when supplies were very short. The main conclusion is that they should be prioritized to people who have not had prior infection. That advice was not followed, largely because determining prior infection status complicates the protocols for vaccination quite a bit, and simpler is better. Now, at least in the US, we're in a situation where we are literally throwing vaccine down the drain[1, 2].
Second, this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant[3]. Vaccine effectiveness appears to be somewhat reduced compared with the original variant, but still pretty good.
This is definitely an area where more science is needed.
> The main conclusion is that they should be prioritized to people who have not had prior infection
You're leaving out the primary finding, here is the actual conclusion from the study I previously cited [1]:
- "Individuals who have had SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination, and vaccines can be safely prioritized to those who have not been infected before."
> this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant
I agree on the general point. Relevant to the discussion is the fact that the OP paper addresses this, here are relevant excerpts:
- "Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells."
- "The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved."
- "Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains."
These findings hint that naturally acquired immunity may actually be more robust to variants of concern in comparison to the immune response induced by vaccination. But admittedly this has not been proven yet.
See my top level post on this thread for more details and citations.
Probably not as clear cut as that. The OP study suggests that vaccines can be improved from learnings from natural immunity.
> "Overcoming the challenges to end the pandemic is accentuated by the recognition that SARS-CoV-2 can undergo rapid antigenic variation that may lower vaccine effectiveness in preventing new cases and progression to severe disease. Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells. The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved. Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains."
We can cherry pick papers all day long to support or refute the idea that having had Covid19 is equivalent/better/worse than getting the vaccine. Anyone being honest can see that the jury is still out on the issue. But I can state 2 things with certainty. 1) having had it does offer some degree of immunization. 2) there is a lot of evidence that those spike proteins do damage. Given that, I dont know why some people lump previously infected folks in with anti-vaxxers. It's not even close to the same thinking.
“Acquiring” natural immunity also has the following side effects at a much higher rate than the vaccine:
- Death
- Hospitalization
- Chronic illness, which can include long-term neurological impairment
I feel like it’s important to keep that in mind if you’re either advocating “natural immunity” as a public health strategy, or considering it a personal strategy.
That's a strawman. Can you instead address this particular bucket: people who have had Covid, and are now wondering if they are as immune as they can hope for, considering all other available interventions.
I absolutely don't think it's a strawman. Nearly to a person, the people in my life who have not gotten vaccinated and have not yet gotten Covid-19, if asked, have been making this argument: it's not that bad, it's not worth getting the vaccine.
Actually being infected with Covid (symptomatic) probably does confer the best immunity possible, for sure. You should still get vaccinated after that though, because research suggests that vaccination can significantly help alleviate long COViD symptoms which a large fraction of patients have. Haven’t seen actual numbers on the immunity boost conferred by post-Covid vaccination though (no reason to think it’ll not add at least a slight bit).
The stabilized spike used in several of the vaccines appears to offer better resistance to new infection than convalescent immunity.
(The theory is that the vaccine antibodies do a better job of binding to the active site on infectious virus particles than the antibodies induced from infection, which bind to whichever part of the virus, and may bind to the form the active site takes after attaching to a cell, rather than prior)
Also, getting the vaccine as early as it is available is a better way to avoid long Covid than getting the vaccine after you've had a course of infection.
This study shows that those who have had COVID but are unvaccinated have 2.3x the risk of reinfection compared to those who had COVID and are vaccinated. 246 patients, 492 controls.
> First, reinfection was not confirmed through whole genome sequencing, which would be necessary to definitively prove that the reinfection was caused from a distinct virus relative to the first infection.
I’m sorry you got sick, and I’m glad to see this study suggesting you have durable immunity! I worry that since it’s dated July 14 it may not have enough data on the Delta variant to be useful in considering your risk going forward. I hope you remain in good health.
A broader set of antibodies does not necessarily have to be beneficial. They might be targeting parts of the virus that could change without it losing its function. The spike protein seems to be close to indispensable for this virus. Targetting it specifically instead of just 'something', might therefore be the preferable thing.
Right, but it is harder for an organism to make multiple adaptations at once. Natural infection produces antibodies that target the spike protein as well as other sites. To evade immunity, the virus would need to change both sites.
It is very clear that the vaccine is putting selective pressure on spike protein evolution. Having alternative targets makes it harder to escape.
We currently don’t know if those other sites are beneficial or not. Sometimes they can even be counter productive (ADE, but we don’t really see that yet?)
https://theconversation.com/covid-vaccines-focus-on-the-spik... is probably relevant to your question. The short answer (this was also discussed recently on TWiV) is that spike is the earliest interaction with cells, so focusing on it hopefully causes the immune response to mount earlier as well. But, as described in the link, other proteins may be viable targets as well.
Another issue is, other targets may not provide neutralizing immunity and may facilitate ADE. I don't think we've seen ADE in natural infection yet, so it may just be a theoretical issue, but I also don't know if we've really looked for ADE in natural infection either.
We do know that other similar coronavirus vaccine candidates (a candidate for SARS-COV-1) exhibited ADE in primate studies. So since the spike protein appears effective currently, maybe it's best to stick with that.
For people curious about ADE (a fascinating topic that so far doesn't seem to have caused problems with SARS-CoV-2), here is some excellent background reading that covers many of the points made in the above comment, with citations and deeper discussion:
I remember when this whole thing originally broke out, ADE was my biggest fear. Even when China was talking about a 2-3% infection fatality rate, it's like ok.. well that's not going to shatter society. But ADE... the prospect that getting it a 2nd time would raise the IFR to who knows... 20+%? That was scary.
> The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.
You can’t compare a longitudinal study with a cross sectional study. This study doesn’t account for the time dependent decay of vaccines’ immunity. There is more than one dimension to optimize for.
>Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells.
Meaning that natural immunity may be better, because it targets not just the spike protein like the vaccine, but also other parts of the virus.
Much of the death toll centers on those who are already sick, obese, and otherwise compromised. Age groups of children and young adults show remarkable resilience to infection. There is not one outcome.
I’m not sure this is clear. Yes, this is what has been stated in the media, but I have yet to see data to back the claim.
And in particular it has been shown that natural immunity produces a much broader set of antibodies that may allow the immune system to cope with variants better.
I’m not advocating natural immunity btw. I completely agree people should get the vaccine.
That’s actually incorrect. Someone was kind enough to cite in another reply to me.
I’m honestly a bit disturbed how much confidence software engineers have in their consumption of virology research. My good friend has worked in it for 10+ years not including a doctorate and worked on an mRNA vaccine.
I trust his takes more than any media and certainly more than some of these folks replying doubting the state of the science. Vaccines are the safest and best protection against COVID one can get.
Not specifically replying to you with that, just the general tone of these threads. Folks are out of their depth.
My statement literally starts with "I'm not sure...". You begin yours with "That's actually incorrect." Which expresses more confidence?
My opinion is based on a conversation with a Ph.D immunologist that happens to be a friend as well. And if that's not enough here is a paper from a totally separate lab that has similar conclusions, with actual data https://www.biorxiv.org/content/10.1101/2021.07.29.454333v1
mRNA vaccines are obviously much better at generating antibodies for the RBD. That's an empirical fact, no one is disputing that. But natural immunity presents antibody targets beyond the RBD.
You’re not aware of all of the literature, then. Vaccination results in fewer reinfections, less severe reinfections, and of course doesn’t require you risk a course of the virus upfront to get said protection.
Maybe reach out to an immunologist. There is a lot of literature and you shouldn’t trust my or anyone’s take, but expecting you’ll have a better take than several actual career immunologists based on some google scholar research is ill-founded.
> Now, a new NIH-supported study shows that the answer to this question will vary based on how an individual’s antibodies against SARS-CoV-2 were generated: over the course of a naturally acquired infection or from a COVID-19 vaccine. The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.
Its important to keep studies like this in mind when talking with people who refuse to take the vaccine because they "already had COVID". In a very real sense, if natural antibodies are durable, persistent, and effective; the vaccine is an unnecessary medical procedure. Doctors would not cut off your legs for no reason; that would be unethical. The vaccine is a medical procedure like any other; if the benefit is questionable, it would be unethical for doctors to administer it.
Yet, we have an increasing number of venues, workplaces, and events which are requiring proof of vaccination to participate. This is forcing both people who already have antibodies, and even people who can't make antibodies (e.g. immunocompromised, solid organ transplant, etc), to undergo a medical procedure for little to no benefit.
I know this thread is catnip for the antivax contingent that reliably appears, but this argument has several problems.
First, our vaccines provide a stronger immune response than infection, as has been well documented by now[1]. Vaccination on top of prior infection boosts the response[2].
Second, the harm from the vaccine is minimal, and comparing it with an amputation is ridiculous (in spite of the large number of superstitious people who believe otherwise).
There are subtle arguments to be made for adjusting vaccination (one shot is almost certainly enough) when prior infection is documented, but from a public health perspective it's simple enough: pretty much everybody (over 12 until trials complete) should get vaccinated, and if they did, illness and death would decrease dramatically.
I don't think you can state that the vaccines provide a stronger immune response. There is a lot of evidence to the contrary, including this OP. They may provide a stronger single-antibody response as measured at some point in time, but there's no evidence that that results in "better" immunity.
To measure immunity you need to see who gets re-infected and how seriously. Of what I've seen, those studies either show no difference or an advantage for natural immunity.
I don't think the information that natural immunity might be better, is all that helpful. But the growing evidence that it is (at least) as good, is very relevant, since it means vaccines can be prioritized to those who have not yet had Covid-19.
And people who have had it, should certainly not be discriminated against in any way.
> vaccines provide a stronger immune response than infection
This is a blatant oversimplification & misrepresentation of the article you referenced, and the paper which it cites [1]. The paper makes no claims that vaccine induced immune responses are more or less superior than the immune response induced by natural infection.
Quote from [1]:
- "Specifically, antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein."
Counterintuitively, this property of the current mRNA vaccines - the induction of an immune response highly targeted toward the spike protein RBD - when combined with compulsory mass vaccination, could result in widespread proliferation of vaccine resistant variants [2][3][4][5]. This is a serious concern that is on the radar of many top experts in the field.
The second and third order consequences of mass vaccination using an imperfect vaccine are anything but simple, and very much pose a public health risk.
When you consider the evidence supporting the fact that natural immunity is at least equally effective as vaccination (a few more supporting references here [6][7]), it becomes very difficult to defend the idea you're advocating:
> it's simple enough: pretty much everybody (over 12 until trials complete) should get vaccinated
[1] is not generally supportive of your very broad statement. You must qualify you statement with some indication of this stated limitation: "carrying “single letter” changes in a key portion of their spike protein"
I couldn't put the quote into context properly, so in case you are also wondering, here is the full quote:
"The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.", excerpt from the article
It is one datapoint among many, but I found it interesting because it is based on careful biological experimentation and directly compares immune response from vaccination and prior infection. Another relevant quote: "Importantly, the vaccine-elicited antibodies targeted a broader range of places on the RBD than those elicited by natural infection." This is not an intuitively obvious result.
But, since it was asked, here are more studies that support the broader point:
It seems odd to present these tangential measurements when what I think most people are interested in is personal outcomes. How can one relate relative increases in seropositivity to patient outcomes? Why don't we see studies which conclusively nail this down? I'm well aware of this study https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7032e1-H.pdf, I'm unmoved by it, see this comment: https://news.ycombinator.com/item?id=28106987 . Are you aware of more substantial studies to date? Thank you for the links and the discussion. I personally have yet to get the vaccine but do consider myself persuadable.
Maybe the comparison with amputation is a little over-the-top but let me illustrate with a few other real-world examples why this kind of concern is not completely illegitimate.
The health policy in some countries e.g. in France (and maybe large parts of Europe?) actually allow you to have an "health passport" just because you recovered from Covid recently enough.
It would actually be illegal in France to privately require proof of vaccination if not exceptionally allowed by a narrow law (as a general principle, medical information are very protected here).
Some Covid vaccines have been forbidden for people under a specific age limit, although they were allowed for a while, but the risk has eventually been reassessed after a few suspects side effects (very very rare, but considered a risk important enough to change the policy, esp since the risk of covid itself decrease greatly the younger you are, and there are arguably safer alternatives in other models of vaccines).
Of course it is still probably "on average" better to get vaccinated on top of recovering from Covid, and of course the comparison with amputation was probably over-the-top (at the very least it should have been stated as a risk of "amputation" with a very very low proba); but overly constraining people is debatable -- especially when tons of factor are hard to be synthetized to "everybody should just get vaccinated right now, unconditionally, -- and accept to be privately controlled by anybody -- or they are horrible antivax people and people will die because of them"; not everybody has the same amount of social contacts with the same categories of people and/or live in the same kind of city and accommodations, public health is not something that appears in empty social contexts just because of raw numbers and models, etc.
Yes it probably would be better if "everybody" was vaccinated. Willingly. And if we had decades of feedback to convince people. And if they were vaccinated against other diseases too. Now welcome to the real world and think of how to navigate efficiently with imperfect knowledge, including how to avoid entirely dismissing concerns.
Primum non nocere certainly does not to be dropped and hopefully will not: the situation is shitty but will become clearer with time, and if we detect either more risks or more safety for various vaccines hopefully the policies will evolve accordingly, and individual opinions too. Note that they already are not completely binary and that it is still kind of hard to decide from which age we should allow / incite / require vaccination -- and the "optimal" solution probably depends on the coverage of the rest of the population too.
And that's because of that very principle. There is no exact obvious point where all-in starts to be required. It maybe would be useful to make regular-flu shots more or less mandatory (and now even the interest of flu-shots is debated by serious scientists because it may be counter productive for the state of the immune system latter in life; or that may depend on people -- maybe new strains of covid would yield to similar debates in a few years?). They are typically not.
That being said my current understanding make me wish more people go get vaccinated, but just do not pretend it is all black & white and that people should not have subtle/reserved opinions.
I haven’t seen almost any comments on HN which can be qualified as anti-vaccine, so I find your assertion unjustified. But the real issue I have with such comments is that now apparently someone that does not want a specific medical treatment is being smeared as “antivax”.
Rejecting a medical intervention is a right people have. It doesn’t matter it’s because of 5G, fertility, medical conditions or them merely not being in the mood to take the vaccine.
Adverse reactions are real, but they are orders of magnitude less likely than those caused by Covid itself and Covid is capable of causing basically all the same long tail harms the vaccines can.
Which makes sense--many of them are made of some part of the virus, so how can they be more deadly than Covid itself if they're just a piece of it?
It's weird to me that people aren't willing to trade a 2% risk for a 0.0002% risk when both have similar types of horrible outcomes.
Even if the percentages are exaggerated, it also depends on lifestyles. If you WFH and closest contact with people is that of grocery shopping, the 2% becomes closer to 0% because you aren't going to contract the virus.
But it's logical to calculate a risk percentage and then make a decision. Easy for the brain. But it simplifies reality down to a number, ignoring all those people that had adverse effects and took it on the chin in solidarity "for humanity". What did they get in return? It is a bit unethical.
As far I’m aware this is an American thing. I’m from Finland (no vaccine pass yet) but travelling in Germany/Austria right now. They have the concept of 3G (don’t ask me to translate) but basically you can’t eat, drink or stay anywhere without either a vaccine, recovery or negative test.
There is a pop up antigen test facility about 100m from the restaurant where anyone can go get a quick negative result and go do their thing for a set period of time. I’m conflicted on this given the inaccuracy of the antigen tests.
I’m currently sat in a restaurant typing this message, and have been served food and drink and yet to be asked to verify my EU certificate of vaccination. So your mileage may vary.
Most of the pushback I hear here (Italy) about the ability to just get tested as an alternative to vaccine certification is the cost. It's perceived as a tax on the freedom to not vaccinate.
I just looked it up. Where I'm staying the tests are 57e, you do it yourself, and get a result within 20mins which is valid for 24h. That definitely is a high cost.
Probably as a tourist it is different? I live in Germany and you can get an antigen test for free per day. They are valid for 24 hours, so it costs 0€ To get tested for any event.
In Italy they are not free, not even if you're a resident.
I think the system is explicitly designed to create inconvenience for those who decide not to vaccinate.
IIRC Germany has a strong culture on trying to not force things on people; not sure if that's really true, but it's certainly brought as an example here in Italy.
I think other comments may have pointed this out already, but there are several problems with this line of reasoning.
When deciding on whether or not to administer a procedure or treatment, one must consider the balance of potential harms and benefits, while accounting for uncertainty.
In this particular case, the potential for harm from the vaccine is quite low (this is borne out by the data), and the benefits are mostly unknown. The potential harms of NOT taking the vaccine are mostly unknown (data is still coming in), and the potential benefit of that course of action is quite low. So it seems like the positive expected value / utility decision here is for them to get the vaccine.
In your comment you use the analogy of a procedure with a much different risk / benefit profile. So that does not really hold up. A much better analogy would be something like routine screening for prostate cancer once you pass a certain age.
This line of thinking assumes you can reliably separate people that have had covid from those that haven’t. In the real world requiring vaccines for everyone means vaccination of people that thought they had covid but didn’t.
Which I suspect may be the underlying reason studies are showing the vaccines are more effective than getting covid.
You have evidence of infection from several tests, they could still be false positives.
Even ignoring that I t’s really difficult to have a policy around this because of how limited and error prone testing was early on. Many people where told they had covid based on symptoms or a single low accuracy test. Things have improved, but when you start talking millions of people being tested it’s really just a question of the rate of false positives not their existence.
It seems to me very reasonable to worry about long-term outcomes when we are talking about vaccinating every man woman child. Maybe its got precedence but damn if its not worrying, and honest skepticism ought to be treated with respect not derided.
I'm not deriding the honest worry. Nobody can know with certainty anything about the future.
I'm worrying about the paralyzing effects of a meme that says that since it's technically possible for an adverse affect to happen at an arbitrary point in the future, we cannot consider an option to curb the effects of a known problem we have right now.
Often I'm accused of dismissing the possibility of adverse effects like if I knew with certainty that they can't happen. How could I? Nobody knows. That's not the point. The point is to make a guess and take balanced risks. We take risks all the time, about everything.
What's so special about vaccines that causes such widespread reaction? Is it because people feel forced to take them? Is it something about the way they work that triggers such a reaction in people that often (anecdotally) don't care about things like effects of second hand smoke?
I will try to answer your questions from my point of view.
It appears "off" that there is no nuance to this vaccination strategy. It seems especially odd to advocate for vaccinating children who stand to benefit very little personally. I had planned to get vaccinated but have been pretty concerned by the totalitarian vibes I've been getting lately. So I guess I've decided to let my civics slide to match. I will get the vaccine for my own personal benefit (if I deem it so) and I expect that is basically what's motivated everyone else anyway. So far I've not seen a clear benefit to me. According to this page https://19andme.covid19.mathematica.org/ these are my stats:
"probability of catching COVID-19 through community transmission in a week is 0.027%"
"If you get sick from COVID-19, the risk of hospitalization is 1.3% , the risk of requiring an ICU is 0.67% , and the risk of not surviving is 0.053%"
If I tell the calculator I'm vaccinated then most those stats go down by 2 which is good but my threshold for action is on an absolute scale and staying unvaccinated does not trip the sensor.
I choose to live life in rural America in some part to avoid such calamities. As an unvaccinated person I am less of a risk to other people person than a vaccinated person in da big city.
To me personally the main issue has little to do with vaccines and more to do with frankly unnecessary (in some cases) overreach. I'm not saying overreach has happened already, but recent overtures are quite alarming to me.
Are those stats based on the alpha variant (COVID-classic) or the delta variant (new and improved)? Also worth considering that rural areas are underserved wrt to healthcare, and typically experience worse outcomes under the same disease burden.
Your risk of catastrophic illness from COVID may be low - keeping in mind that population level statistics are not very good predictors of individual outcomes - but significantly higher than zero. Vaccination would reduce catastrophic risk to just about zero, with very little cost to you both in terms of risk and time/money. I guess what I am failing to understand is what possible benefit you are getting out of not getting vaccinated.
The way I see it, you can eliminate catastrophic risk to yourself (and reduce it for others) at very little personal cost, but are choosing not to for seemingly no benefit.
Submitting to what I see as overreaching propaganda when my own county has reached herd immunity is stupid plain and simple. Whoever thought of the idea to "blame the unvaccinated" as a strategy lost my cooperation because the stats say our rural community already succeeded.
Why isn't the guidance a bit more tailored?
"If your community is below herd immunity ur gonna have bad time mmmkkk, especially if you have comorbidities"
Instead in popular media it seems to be edging towards:
"Vaccinate the babies in the womb!!! Its the only way to be sure!!!"
Now the above is absurd today but 2 years ago if someone told you where we'd be today would you have believed them?
Vaccinating every man woman child was not the original bargain. A renewed discussion is needed with a clean slate. I don't think we even have an agreed set of goals anymore nor common modelling which explains the choices.
What would be your risk threshold (hypothetically speaking, if we could know it) that would make it for you a no-brainer to just take the vaccine assuming that you taking it would encourage other people who do fall in a higher risk bracket to also take it?
Would 0.0001% risk be acceptable for you, hypothetically, as a civic duty?
I'm not even assessing the risk of the vaccine in my judgement.
I'm saying the apparent risk of the disease to myself and from me to others is not above the necessary level to stir an action from me.
I'm probably going to get the vaccine if I see some sense of nuance to the guidance. Such as reasonable advice properly and publicly discussing the relative risk/rewards for our various demographics. The current attitude that I'm confronted with in my day-to-day is "wow what a dumb fuck hes hurting himself and everyone around him", for me the stats say otherwise.
I'm pulling a different angle into the equation: an altruistic angle. Are you a priori not interested in participating in an effort that would require an action from you (and possibly also a risk) unless you're directly beneficiary of such action?
I'd assert that in such an experiment I would already be doing my part to reduce the impact of covid mainly due to where I live and minorly by my choices of how I live. The extra utility of that vaccine is effectively lost on me when that is figured in. When there is 0 utility then any altruistic action is nothing more than signaling. If I could be convinced there is serious utility for others by getting vaccinated then of course I would get it. Nobody seems willing to put real numbers to this, its simply "DO IT EVERYONE!"
Lets say there are only 2 reasons to get the vaccine:
1) To protect yourself
2) To protect all those you care for.
I'm not worried about 1 due to the apparently very low likelihood I will have some terrible personal covid outcome.
I'm not worried about 2 due to the apparent very low likelihood of even catching covid.
Reasonable skepticism should not be derided. But I would say (a) the skepticism is borderline, and (b) poor decision making is what is being derided.
So why is the skepticism borderline? Well we have over 100 years of data showing that vaccines I’m general are safe and effective. The safety and effectiveness of vaccines has drastically improved during that century - especially in the last 20 years. mRNA vaccines is a new platform, but all the preclinical and clinical data tee have shows they are safe and effective, and if we were going to see long term effects (which would be related to abnormal inflammatory / immune) response; it is highly likely we would have seen some indicator by now. Which specific long term effects are people even worried about?
And this brings us to why it is a poor decision. SARS-COV2 rewires your innate immune response, and has been observed to cause abnormal inflammatory/ immune responses that cause to death and long term disability with alarming frequency. So it seems like extremely poor judgement to be worried about long term effects from the vaccine more than the virus. The first concern is largely unsupported by the data, while the second is unquestionably supported by the data.
"The history of vaccines shows that delayed effects following vaccination can occur. But when they do, these effects tend to happen within two months of vaccination: ...<some examples>"
Whenever I show this kind of info to my family/friends that are against vaccines the response follow the three categories I posted earlier above.
I categorically do not want to make fun of anybody. I really want to understand either:
a) what's wrong about my understanding of the safety of this vaccination campaign (i.e. can really the world governments conspire so efficiently to hide the real data, or other arguments above)
Or is it just a big identity politics problem, where we all think we engage in a rational discussion while each of us has already taken a stance that we cannot be moved out with arguments? (I'm putting myself into question too)
b) how can I understand and reach my family members and friends and engage in a discussion that is not shut off quickly by one of the aforementioned unfalsifiable positions
First of all, if you've recovered from COVID then you've fought off the whole virus before, not just the spike RNA. You shouldn't have issues with the vaccine.
Secondly, you could have had mild COVID and if you were "young" (under 30) then your innate immune system may have been sufficient to clear the virus and you may not have formed a lasting humoral immune memory.
Third, you may have had a false positive with a high Ct.
And Fourth, many people never got tested, and people really cannot self-diagnose (particularly the people in the USA who think they caught it in late 2019).
If you've caught COVID just take the vaccine, you've already had the spike RNA in your body once. You're like an open water swimmer worried they might drown in the pool.
Of course I really suspect that this argument is being made in bad faith so people have a backdoor to avoid vaccination and to undermine vaccination mandates. And the harm caused by the virus spreading vastly exceeds the putative harm done by an "unnecessary procedure" -- just look at Florida right now.
it is a scandal, especially considering the amount of non-immunised people at risk in the rest of the world. i fall in that category (recovered) and i would even pay to give my vaccines away.
yeah. obviously mine is a half provocation because shipping "two vaccines" to "one person" isn't feasible considering temperature etc., but if countries had the balls (which they don't) they should take a bit of a U-turn and allow bulks of unused vaccines, perhaps even asking the people "are you sure you don't want to get vaccinated this year? y/n", to get shipped elsewhere once they reach a feasible number.
I think the EU timeout for the proved infection is 6 months unfortunately. So someone in the EU decided that a COVID infection's protection only lasts 6 months.
>The first vaccines distributed in the United States induce antibodies to S protein. Thus, presence of antibodies to N protein indicates previous natural infection regardless of vaccination status, while presence of antibodies to S protein indicates either previous natural infection or vaccination.
In my experience, the finger prick blood test cost $25 and 15 minutes. This test is for blood antibodies.
This is not the test for active infection, such as nasal PCR.
The test is easy, but has a relatively high false positive rate. It also may use up lab resources that could be put to other uses.
The other wrinkle (and possibly the most important one) is that we don’t want to create a system where antivaxxers have an incentive to deliberately infect themselves and/or others.
I was under the impressing that the Roche test was an outlier, and that most other tests do not match that. Most other tests have issues with cross reactivity with common cold antibodies.
The risks of amputation are relatively well-known and understood.
The risks, especially long-term, of mass, imperfect vaccination, using an entirely brand new development technology; not well known. Not understood. Are there long-term, rare side-effects of the vaccine we don't know about? Will the imperfect nature of the vaccine and its rollout cause wider evolution of vaccine-resistant coronaviruses? We don't know.
Its a ridiculous comparison because one of these things is dangerous; the other has unquantified risk.
That's why "First, Do No Harm" is such an important foundation of medical ethics. We are dealing with systems more complex than you can even imagine; between the human body, multi-human interactions, and planet-scale resource allocation during a pandemic. There is a LOT we don't know.
This doesn't mean you shouldn't get vaccinated. I have. Many people should. The benefits are well-known and understood; they're pretty strong. But it does mean, maybe there's a middleground we need to find which doesn't involve demonizing and ostracizing the people who choose not to. We should be better at understanding each-other, and understanding how dangerous unknown risks can be, especially when we're put into a position of making decisions out of fear.
Ok, doctors would not administer steroids for long term use for minor pain, that would be unethical and highly dangerous (except they do, from first hand experience)
> and allows health officials to make informed decisions based on vaccination rates.
Barely. Forecasting is being done on antibody levels at least in countries that are running good real-time surveillance studies. Hence why Israel/Germany/UK are deploying third shots and many other countries will do the same.
Just a note to non-immunologists - Immunity means different things to health and science professionals vs the general public.
Edit: I'm not going into detail in this comment because I am not an immunologist and I cannot express clearly and correctly what the difference is, but just be aware that "Immunity" may not mean 100% protection in the way that the general public thinks that word means.
Sorry this is incomplete, but "Natural Immunity" means a person's immune system will mount an effective response to an infectious agent. However, that person may still be infected, and may be contagious to some degree while the body is fighting off the contagion.
I'm not a doctor or biologist, but I've been learning over the past year. For instance, people generally think of things like "infected", "sick", and "contagious" as being the same thing (or nearly the same thing). If you're talking about one person in everyday context, that's fine. If you're talking in a clinical or epidemiological context, you have to be more careful.
A simple example is a person with antibodies being sneezed on with infectious agents. That person could coincidentally sneeze on another person who lacks antibodies, but wouldn't worsen themselves since the contagion in the original sneeze would get met with prepared antibodies killing off the "population" faster than it could replicate.
I’m still learning, but the concept of “sterilizing immunity” has started to come up recently. What I infer from cursory reading is that “immunity” means the body will mount an immune response immediately upon exposure to the virus, but it doesn’t mean that an infection won’t take hold. “Sterilizing immunity” means immunity strong enough to prevent the virus from growing at all.
The issue at hand is that those who have been vaccinated and/or recovered from COVID seem to be able to contract the disease again, even to the point where they can be infectious to others, even if they don’t get terribly ill or even show symptoms.
If I understand correctly, it means that the immune system launches an immediate response to the new infection, it doesn't mean that the immune system successfully defeats the new infection, just makes it more likely. And then there's the problem of variants.
This seems like the most important unasked question. Common sense would suggest the best case would be vaccination followed by repeated exposure to the virus yet hardly anyone is talking about it.
i wonder if that's what normally happens in nature across many viruses. like a primed immune system exposed to a new variant runs a minor "software update" now and then.
...more or less like most infections, as has been known for centuries. And yet, due to the current "anything which doesn't make people more fearful must be suppressed" attitude, this kind of thing is news. Or would be, if the U.S. newsmedia were willing to report it, which I suspect they will not.
Is this offering anything more substantive than you own bias and suspicions?
Is there any response that could get you to consider that the comment "anything which doesn't make people more fearful must be suppressed" is as harmful or even more harmful than the media itself?
Asking because I'd like to better understand how to address people with your beliefs in the future.
Not the poster you are replying to, but I'll bite, out of curiosity about your thinking...
> Is this offering anything more substantive than you own bias and suspicions?
My take-away from the article is that they found all the bits of the immune system primed for long term protection after covid infections. Which is not entirely unexpected, this is what happens with sars, also.
> Is there any response that could get you to consider that the comment "anything which doesn't make people more fearful must be suppressed" is as harmful or even more harmful than the media itself?
I got pretty fed up the news other day when the front page of the BBC led with the an article about leaked CNN memo and three unnamed employees who were fired for not getting vaccinated, and another about Jennifer Aniston apparently cutting off contact with unvaccinated friends. I felt manipulated. I consider stuff like this to be propaganda, not news. It reminded me that I need better sources for covid information, like statnews.com, to get away from such things.
I'd rather see more facts and less adjectives in the news. I'd rather that politicians justify their actions based on numbers, not vague statements. It doesn't seem like the general public is trusted with the facts, but are rather fed a lot of alarmist information.
I imagine the parent poster's assumption is that it would be front page if this study said that natural immunity expires quickly, but we won't see this good news about long lasting immunity on the front page.
If having COVID imparts as much future protection as the J&J vaccine, there is an ethical argument that one could make:
help vaccinate the poor who want it instead of adding to the asymptotic protection of the rich. Else, people might argue we should all have n- booster shots to get even better protection, when we still don’t have enough for the entire world. Vaccines are currently zero sum.
Immunity persists for a while but doesn’t seem to stop the new variants. Another study shows that re-infection with Covid is a lot more likely in unvaccinated people than in vaccinated.
> More than 7,700 new cases of the virus have been detected during the most recent wave starting in May, but just 72 of the confirmed cases were reported in people who were known to have been infected previously – that is, less than 1% of the new cases.
> Roughly 40% of new cases – or more than 3,000 patients – involved people who had been infected despite being vaccinated.
Optimistically both vaccine and natural immunity are good, but the numbers above seem to indicate that natural immunity is significantly better.
Do you have a moderately credible source on this? The linked is pushing a radical right-wing hard-line anti-vaccine agenda too hard to be considered remotely credible or trustworthy. It also does not link to primary sources.
> Now, a new NIH-supported study shows that the answer to this question will vary based on how an individual’s antibodies against SARS-CoV-2 were generated: over the course of a naturally acquired infection or from a COVID-19 vaccine. The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.
I could see a case to vaccinate people even if they have natural, durable, and long-lasting immunity to Covid-19 after infection if it makes their immunity even stronger.
If twenty percent of the population has had covid, and fifty percent has been vaccinated, say we assume half of the twenty percent isn’t an overlap. Wouldn’t that put us much closer to the herd immunity number of seventy percent than we’ve been thinking? And that if infections continue at a high pace, shouldn’t we reach that level very soon?
The idea of being at or near herd immunity has been pushed so many times since the start of this pandemic, and each time those hopes have been dashed.
The threshold needed for herd immunity has been revised upward since the 70% figure was widely discussed. First, the R0 for the delta variant is almost certainly higher than for earlier variants. I am personally skeptical of claims in the 8 range, but they are widespread, especially by public health professionals, in contrast to, say, virologists, who tend to point to antigenic drift as a mechanism that could explain the rise in delta prevalence.
Also, vaccine effectiveness is a factor in the herd immunity threshold, and that is also reduced a bit off earlier high estimates, partly because of variants and partly because of antibody waning.
So my best guess is that herd immunity is now permanently out of reach. I'd love to be proved wrong on that, though.
Can any of the findings from the properties of how natural immunity works be guided in to future COVID 19 vaccines?
Given how the pharma companies are examining anti-body half life, exploring booster shots, and considering vaccinations against variants (like lambda), can any of the learnings go into a more durable, more broad vaccine?
Vaccine immunity IS "natural" immunity. It works the same way, by exposing the body's immune system to virus components such that they product a response. The only difference is that with a vaccine those components don't add up to a viable organism.
But yes: expect newer vaccines tailored to currently-circulating strains to appear; the existing mRNA vaccines produce copies of the spike protein sequenced more than a year ago. That's what we've done for influenza for decades, though not with the same kind of precision.
The Red Cross disagrees[1]: “One of the Red Cross requirements for plasma from routine blood and platelet donations that test positive for high-levels of antibodies to be used as convalescent plasma is that it must be from a donor that has not received a COVID-19 vaccine. This is to ensure that antibodies collected from donors have sufficient antibodies directly related to their immune response to a COVID-19 infection and not just the vaccine, as antibodies from an infection and antibodies from a vaccine are not the same.”
Interestingly this means if you have natural immunity and are a regular blood donor you shouldn’t get the vaccine since it deprives the healthcare system of a lifesaving treatment.
They are following the FDA guidance for the convalescent plasma EUA, which does allow people that were sick prior to vaccination to donate plasma...it seems the Red Cross isn't interested in trying to communicate that to potential donors.
If you expand the boxes on your link, you'll also see that they aren't specifically collecting convalescent plasma, as demand has decreased. Perhaps that is changing with the recent uptick (but given the demographics of blood donation, they'll probably have to change their rules if they need a lot of it; most people donate ~1 time).
Yes I read the link I myself posted, and yes I see the above since that's why I specifically said "regular blood donor." Obviously casual donors should just get vaccinated.
Sure, but there is a real difference in response between vaccine/virus.
I think, given the difference in response, the term natural immunity makes sense. You have to choose something and I don’t think ‘natural immunity’ says anything about vaccine immunity being unnatural.
Your body might accidentally create an immunity to a portion of the virus that mutates. Perhaps the protein produced by vaccine mRNA forces your body to create an immunity against a portion of the virus that is less likely to mutate.
I don't know if this is the case, but I offer this as an example of how our biological systems may be complicated beyond intuition.
The spike protein is part of COVID-19's infection mechanism.
The thinking (if I understand correctly) in targeting the spike protein was that mutations to the spike protein may render the vaccine less effective, but would also render COVID-19 less infectious.
It's a clever hack to rely not on whether the spike is mutation-prone, but instead on the odds that a mutation would result in a less effective virus that the vaccine wouldn't be necessary for.
I think GP is referring to the fact that boosters are being pushed, which implies vaccine immunity is not persistent. It has certainly been pushed since when that study was published.
we still need the primary antibody count up high, because we’re still in a pandemic, thus the desire for boosters.
in both vaccine induced and survivor induced immune responses, long term immune systems come online to store a memory of the disease so that on future challenge, more of those antibodies will be produced by people fairly rapidly after future exposure, even when your blood stream isn’t full of covid antibodies anymore.
When there are this many cases floating around, though, you can't afford to wait for the spin-up time.
If i'm asking for the same image every 500ms from your webserver, do you want to go to disk every damn time, or are you gonna cache it? Same deal, kinda.
You and I aren't walking around with bloodstreams full of anti-measles antibodies, despite being vaccinated in infancy: but you can bet that you will be if you encounter a bunch of measles in the wild, in relatively short order.
The question is: are the covid vaccines like tetanus vaccines or like measles vaccines? So far, the evidence points to the latter, but the desire for a booster anyway is driven by the fact that SARS-CoV-2 is a pandemic; neither tetanus nor measles are.
This paper further supports the fact that naturally acquired immunity to SARS-CoV-2 is 1) robust and 2) durable.
1) Robust means the immune response recognizes many different parts of the virus.
2) Durable means the immune response remains detectable - and likely effective at protecting the individual - for a long period of time.
A robust immune response is important because it provides a certain degree of protection against variants of the virus.
This robustness is why some people hypothesize that natural immunity provides better protection than vaccination - however this hypothesis has not been conclusively proven in the literature yet. If you're aware of primary sources that say otherwise please share them.
For now, all available evidence strongly suggests that individuals with naturally acquired immunity are at least equally well protected as individuals who have been vaccinated. Here are a couple more supporting references [1][2].
As a final point - in the literature there is some evidence & concern that the current mRNA vaccines induce an immune response which is highly targeted toward the spike protein [3]. When combined with mass vaccination campaigns, this creates tremendous selective pressure that can further enhance the fitness of the virus, and lead to increasingly infectious or virulent variants [3][4][5][6].
It's clear that vaccination poses little additional risk - but also little benefit - to previously infected individuals, and consequently our vaccination campaigns should be highly targeted toward vulnerable demographics to reap the most benefits and minimize the risks to public health.
Reference [1] is applicable to how our body handles an immune response to the viral infection in general: i.e. whether naturally acquired, or through controlled vaccination. Natural infections were, naturally focused upon, in order to understand the baseline dynamics of viral infection.
Reference [2] is...it says just as much about the efficacy of vaccination as the efficacy of natural immunity:
> The cumulative
incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated
subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vaccinated, compared with a steady increase in cumulative incidence among previously uninfected
subjects who remained unvaccinated.
Read reference [3] to understand why natural immunity doesn't cut it. Note that widespread natural immunity causes the same positive selection pressure as widespread vaccine deployment, and:
> Finally, our work suggests that immune evasion requiring one to two mutations occurs within months, raising the prospect that this phenomenon will further shorten the duration of natural immunity...
The paper goes on to provide (under Discussion) a series of strategies for developing a vaccination system that takes into account modelled viral evolution. Can't come up with strategies like that for natural immunity, apart from: "periodically re-infect individual"...which is exactly what vaccines do, in a controlled manner.
Reference [4] and [5] are research tabulating mutations the virus is undergoing to counter both natural acquired and vaccine-mediated immune responses. It is not an indictment against vaccines, but just like paper [3], provide strategies on how to update vaccines. That updates will be required is not a surprise to anyone. Viral evolution has long been known of, and no one expected the emergency COVID-19 vaccines to be effective until the end of time.
Reference [6]...did you read it? It's about vaccines which protect the host(keep them alive), but still keep them infectious (capable of transmission). None of the COVID-19 vaccines do that...
Are you trying to refute the claim that natural infection confers immunity that is at least equally as protective as vaccination?
It's not clear to me that you've presented any counter evidence. I will try to outline my thoughts on your comment to help the discussion.
[1] is another primary source beyond the OP that demonstrates the durability of the immune response from natural infection. We are in agreement that in principle the immune response from vaccination should also be durable due to relying on the same underlying mechanisms of the immune system - in fact I am unaware of any literature which demonstrates otherwise. So your point about [1] doesn't seem particularly relevant to me.
> Reference [2] is...it says just as much about the efficacy of vaccination as the efficacy of natural immunity
Yes you're right, and that is a relevant quote you pulled from the abstract. Again, I think we're actually in agreement here - the findings support my original claims.
> Read reference [3] to understand why natural immunity doesn't cut it. Note that widespread natural immunity causes the same positive selection pressure as widespread vaccine deployment
You seem to be missing the central thesis of [3], here are the relevant excerpts:
- "The spike protein receptor-binding domain (RBD) of SARS-CoV-2 is the molecular target for many vaccines and antibody-based prophylactics aimed at bringing COVID-19 under control."
- "Such a narrow molecular focus raises the specter of viral immune evasion as a potential failure mode for these biomedical interventions. With the emergence of new strains of SARS-CoV-2 with altered transmissibility and immune evasion potential, a critical question is this: how easily can the virus escape neutralizing antibodies (nAbs) targeting the spike RBD?"
- "Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection."
- "The speed at which nAb resistance develops in the population increases substantially as the number of infected individuals increases, suggesting that complementary strategies to prevent SARS-CoV-2 transmission that exert specific pressure on other proteins (e.g., antiviral prophylactics) or that do not exert a specific selective pressure on the virus (e.g., high-efficiency air filtration, masking, ultraviolet air purification) are key to reducing the risk of immune escape"
- "Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities"
We are in agreement [4] and [5] are not an indictment against vaccines - but again you seem to be missing the most important and highly relevant findings which support my claims.
For example from [4]:
- "The acquisition of the L452R substitution by multiple lineages across multiple continents, including the B.1.617.1 and B.1.617.2 lineages emerging in India (54), is suggestive of positive selection, which might result from the selective pressure of RBD-specific neutralizing Abs"
- "Our data support that the SARS-CoV-2 NTD evolved a compensatory mechanism to form an alternative disulfide bond and that mutations of the S signal peptide occur in vivo in a clinical setting to promote immune evasion."
- "Understanding the newly found mechanism of immune evasion in emerging SARS-CoV-2 variants, such as the signal peptide modification described herein, is as important as sequence surveillance itself to successfully counter the ongoing pandemic."
For example from [5]:
- "different individuals immunized with the Moderna (mRNA-1273) or Pfizer–BioNTech (BNT162b2) vaccines produce closely related, and nearly identical, antibodies."
- "To avert selection and escape, antibody therapies should be composed of combinations of antibodies that target non-overlapping or highly conserved epitopes"
- "We speculate that these mutations emerged in response to immune selection in individuals with nonsterilizing immunity."
> Reference [6]...did you read it? It's about vaccines which protect the host(keep them alive), but still keep them infectious (capable of transmission). None of the COVID-19 vaccines do that...
You are incorrect - the current spike protein focused mRNA based vaccines do not guarantee sterilizing immunity - that means you can be vaccinated yet still get infected and transmit the virus to others. Please cite your sources if you're going to make such claims.
I don't see how I'm missing the central thesis of [3]. If a strategy X develops for eliminating a virus Y, Y will undergo positive selection to escape targeting by X. X can be whatever target scheme our immune systems first fixate on, or a narrow targeting emergency vaccine. It really doesn't matter. The researchers focus on the defense mechanism kickstarted by the vaccine, because their point is we cannot be complacent. Point well taken, to be sure, but no one was being complacent anyway (I've seen a fair number of presentations on vaccine design at this point, and no one is touting anything as the silver bullet). Where I'm living, other mechanisms for managing the infection have not disappeared just because vaccination is now in play. The emergency vaccine is first and foremost, a way to generate herd immunity quickly. It will need to be supplemented with other strategies, both in the short term, and in the long term. The researchers have done valuable work in helping us better quantify the timespan over which we can expect escape, and thus allow us to better estimate the time by which we'll need the next wave of solutions in play. THE RESEARCHERS DO NOT ARGUE THAT THE EMERGENCY VACCINE IS USELESS.
I said it the first time, and I'll repeat it again: that a more comprehensive vaccine design will need to supplement the emergency vaccine was a given from day 1. For that same reason, design of "upgrades" to the vaccination program began a long time ago. The papers you're citing are collecting data which help such designs. None of them advocated that the emergency vaccination is useless.
> You are incorrect - the current spike protein focused mRNA based vaccines do not guarantee sterilizing immunity - that means you can be vaccinated yet still get infected and transmit the virus to others. Please cite your sources if you're going to make such claims.
Do you realize that the extent to which vaccinations stop transmission is on a continuum? It is not "on", or "off" in exact terms. The current COVID-19 vaccines immunize to an extent that the re-transmission rate is negligible. A leaky vaccine (the kind studied in the paper) barely makes a dent to the transmission rate, and if it does, only mildly. COVID-19 vaccinations are far from leaky, even if they are not 100% water-tight.
I'm not sure why you're using that paper either, to be honest. There are better ones, but they don't suit your point as well, probably? Here's one that directly talks about COVID-19, and openly acknowledges the risk that exists due to the ACTUAL leakiness of the COVID-19 vaccine, but also shows why this does not prevent herd immunity from emerging, and why it in fact poses a greater risk to those who choose to stubbornly remain unvaccinated, or (and more seriously) those who lack the resources to be vaccinated:
I'm not going to continue on this conversation, as I went through your other posts, and I have a fair grasp on what your position is. Continuing on trying to talk to you would be extremely stupid on my part. Have fun doing whatever it is you want to, and good luck.
> THE RESEARCHERS DO NOT ARGUE THAT THE EMERGENCY VACCINE IS USELESS
We are in agreement on these points, and to be fair I never made such a broad claim, nor did I intend to insinuate such.
You seem to be concerned with defending vaccination which is understandable, but I believe you're interpreting my statements as completely disregarding the utility and benefits of vaccines, which is not a position I support or attempt to argue.
> Do you realize that the extent to which vaccinations stop transmission is on a continuum? It is not "on", or "off" in exact terms.
We are in agreement on this point as well.
> The current COVID-19 vaccines immunize to an extent that the re-transmission rate is negligible.
A citation on this claim would be greatly appreciated - "negligible" is strongly worded there. FWIW I'm aware of the literature showing that vaccination reduces transmission, but I've never seen it dismissed as negligible.
Thanks for the citation you did share, it's indeed very relevant.
> why it in fact poses a greater risk to those who choose to stubbornly remain unvaccinated
We are in agreement that viral immune escape also poses a risk to the unvaccinated population, especially those who have not acquired natural immunity.
> I'm not going to continue on this conversation
> trying to talk to you would be extremely stupid on my part
I'm sorry I've put you off - my position is not set in stone and I do my best to keep an open mind when presented with conflicting evidence.
I get the impression that you think I'm incurably "anti-vax", so to clarify: my opinion is that vaccines are a powerful tool which must be carefully and strategically used.
vaccines also produce durable and persistent immune responses. Primary antibody titers wane, but the system itself remembers and can regenerate them when challenged.
Not really the anti-body count decays more quickly compared to that of a natural infection and does so dramatically especially for older people:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6....
This is the underlying reason that there is talk of boosters.
It is normal for antibodies to decline after an immune response, it doesn't mean the immunity is gone, the immune system remembers how to produce them when needed.
The paper you link actually says that the memory B-cell populations appear to be maintained after the waning of the antibodies. B-cells are the cells that remembers and creates antibodies in response to an antigen (like the spike protein on the surface of the virus).
No one is shilling vaccines. We use the "wonder of our natural immune system" effectively with the vaccine without being a public health risk to everyone around us by skipping it.
Interestingly, we're putting unnatural selection pressure on the viruses by leveraging vaccines that are leaky, this has in at least one example been shown to produce a deadlier pathogen for unvaccinated. So, maybe you had ought to be a little more skeptical about your risk assessments when the data isn't yet in and may never be until it is. And as for the philosophical conundrum, I'd posit that it's far safer to maintain the known function than it is the novel, keep the defaults. We've of course more or less crossed the Rubicon.
This is a pretty bad take. No vaccine has 100% coverage. Most of the time we're talking about 85-90% protection rate, with some low possibility of mild infectious contagion.
The particularly ignorant take on your part is ignoring 1918 to 1919 change in that flu. It 'naturally' became far more deadly with no vaccine needed.
Right. Abstractly viruses find a sweet spot between transmission rate and lethality to host. Too lethal and it won’t spread very far. However, in practical terms there is a lot more room for something like COVID to be far more damaging and still spread just like it has been or more. All of the immunity we now have and the particular nature and quality of it will certainly impact what the virus does when mutating. If it really can breakthrough vaccinated populations it’s going to change how it evolves. That is a lot of ifs, buts and maybes. The real world data just is t backing up a lot of these weak claims folks are making. In practical terms the vaccines work and do their job. There is a lot of interesting observations to make and we are in the middle of a great experiment of sorts, so we should be very data driven in my opinion.
Bit of an overreaction. Stating that the testing period of 15 weeks is, in your opinion, too short to determine long-term immunity would’ve sufficed as comment.
No need to be uncivil to eachother when you don’t agree.
The requirement for booster shots may be for increasing immunity to variants, not the original virus. If you survived the original virus and got an immunity out of it you are just as vulnerable to variants as anyone who got the vaccine.
The problem is that you think a high school biology class is sufficient to understand the broader implications.
What is the limitation of this study? For example, in the context of the paper, "immunity" means that your immune system mounts an immediate response. Do the antibodies created attack variants equally effectively relative to vaccines? Are they better? Worse?
This paper is one data point. Your high school biology class won't teach you how to understand the limitations of the paper. That's why we have people who study this for decades.
Don't mistake your "high school biology class" with expertise.
I suspect nobody commenting here is equipped to analyze critically the science being done either on the virus or the vaccine, yet everybody speaks with authority on what's relevant and what's bullhockey.
A high-school biology class will give you good general priors and instincts about how things generally work and is as good as you're gonna get trying to understand what's going on currently without a relevant degree or a few years of hindsight for the politicization to die down.
Infections generally leave antibodies behind therefore I'm going to assume people who have been infected have some immunity to this variant.
Masks reduce the spread of spit therefore I'm going to assume they are generally useful to combat the spread.
I'm sure this will strike some as being anti-science but having seen how the sausage gets made wrt science and medicine I don't trust myself or the journalists to interpret or qualify the new results we get every week.
I saw someone citing this a few days ago: having had the common cold recently can lessen your covid symptoms. He didn't source it, but on its face, it seems to make sense.
If you're going to comment, make sure you know the rules and stick to them: https://news.ycombinator.com/newsguidelines.html. That means making substantive points thoughtfully.
If you want to put down or yell at people on the other side of this $hot-topic, or any topic, please do that somewhere else. We're trying for a little better than internet default here.