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Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?

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  • Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?

    Source: https://www.bmj.com/content/374/bmj.n2101

    Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?
    BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2101 (Published 13 September 2021) Cite this as: BMJ 2021;374:n2101

    Jennifer Block, freelance journalist

    The US CDC estimates that SARS-CoV-2 has infected more than 100 million Americans, and evidence is mounting that natural immunity is at least as protective as vaccination. Yet public health leadership says everyone needs the vaccine. Jennifer Block investigates

    When the vaccine rollout began in mid-December 2020, more than one quarter of Americans—91 million—had been infected with SARS-CoV-2, according to a US Centers for Disease Control and Prevention (CDC) estimate.1 As of this May, that proportion had risen to more than a third of the population, including 44% of adults aged 18-59 (table 1).

    The substantial number of infections, coupled with the increasing scientific evidence that natural immunity was durable, led some medical observers to ask why natural immunity didn’t seem to be factored into decisions about prioritising vaccination.234

    “The CDC could say [to people who had recovered], very well grounded in excellent data, that you should wait 8 months,” Monica Gandhi, an infectious disease specialist at University of California San Francisco, told Medpage Today in January. She suggested authorities ask people to “please wait your turn.”4

    Others, such as Icahn School of Medicine virologist and researcher Florian Krammer, argued for one dose in those who had recovered. “This would also spare individuals from unnecessary pain when getting the second dose and it would free up additional vaccine doses,” he told the New York Times.5

    “Many of us were saying let’s use [the vaccine] to save lives, not to vaccinate people already immune,” says Marty Makary, a professor of health policy and management at Johns Hopkins University.

    Still, the CDC instructed everyone, regardless of previous infection, to get fully vaccinated as soon as they were eligible: natural immunity “varies from person to person” and “experts do not yet know how long someone is protected,” the agency stated on its website in January.6 By June, a Kaiser Family Foundation survey found that 57% of those previously infected got vaccinated.7

    As more US employers, local governments, and educational institutions issue vaccine mandates that make no exception for those who have had covid-19,8 questions remain about the science and ethics of treating this group of people as equally vulnerable to the virus—or as equally threatening to those vulnerable to covid-19—and to what extent politics has played a role.

    The evidence

    “Starting from back in November, we’ve had a lot of really important studies that showed us that memory B cells and memory T cells were forming in response to natural infection,” says Gandhi. Studies are also showing, she says, that these memory cells will respond by producing antibodies to the variants at hand.91011

    Gandhi included a list of some 20 references on natural immunity to covid in a long Twitter thread supporting the durability of both vaccine and infection induced immunity.12 “I stopped adding papers to it in December because it was getting so long,” she tells The BMJ....

  • #2
    Just my thoughts here: Covid-19 virus has mutated. So people who have been diagnosed with Covid-19 in the past, were not exposed to the Delta variant or any of the other current variants that have changed the original virus.

    The original vaccine was manufactured before these new mutations occurred.
    I am unsure whether the boosters included ingredients for the Delta virus.?
    Maybe someone could enlighten me on this. Thanks

    Comment


    • JJackson
      JJackson commented
      Editing a comment
      Vaccination post infection by a single dose seems to give better protection than just infection or double vaccination. In theory the vaccination should stimulate any Spike related B and T cells to reproduce and the previous infection should still give some protection, to all the other proteins produced during viral replication, as the B & T cells generated to them will also get boosted and help if re-challenged. In practice it gives excellent protection against disease from all the variants encountered to-date.

    • Mary Wilson
      Mary Wilson commented
      Editing a comment
      Well lets hope so. My brother was hospitalized with near severe Covid-19 affecting multiple organs. He received his J&J vaccine 7 months later. He had extremely bad reactions hours after the vaccine. Said his vaccination symptoms were almost as bad as when he had Covid, symptoms lasted for several weeks.
      Unsure whether this type of person would considered a booster shot (that is if J&J would offer one).

    • Emily
      Emily commented
      Editing a comment
      I'm sorry to hear that, Mary, and am wishing the best for him. Thank you for letting us know about his experience. I was hoping that waiting 6 months after infection would avoid the severe reaction he had to the vaccine, but it must vary by individual status and possibly the vaccine.

  • #3
    bump this

    Comment


    • #4
      Dr. Jay said that a new study showed you would be safer from catching COVID in a room full of unvaccinated people who were recovered from COVID than you would be in a room full of completely vaccinated people. He also said everyone on the face of the earth will get this disease sooner or later. He felt the vaccine still protects vulnerable people from serious illness even after the 3 month period they are more protected from infection.

      A caller said he was infected in March-April of 2020 and his latest quantitative test for antibodies was still high. Dr. Jay wondered if his immunity might have been boosted naturally. That is why I don't fret over the vaccinated still transmitting the disease. It will keep boosting other people's immunity if they already have some. (I do.) There is a greater danger to vulnerable people with no immunity.

      https://relevantradio.com/2021/09/na...abortion-case/
      Hour 3 of The Drew Mariani Show on 9-22-21
      • Continuing the conversation from Hour 2 with Dr. Jay Bhattacharya on Natural Immunity
      _____________________________________________

      Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

      i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

      (My posts are not intended as advice or professional assessments of any kind.)
      Never forget Excalibur.

      Comment


      • #5
        Video interview at link.

        https://www.ntd.com/why-testing-your...hm_663430.html

        Why Testing Your Immunity to COVID-19 is as Important as Vaccination....
        Dr. Hooman Noorchashm
        Wide AngleBrendon Fallon Aug 19, 2021
        Antibody testing is the gold standard for determining immunity, says immunologist and physician Dr. Hooman Norchashm. Yet, the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) are actively deterring people from testing their immunity. Why?

        Additionally, the Delta variant of COVID-19 is currently being used by the government to explain the high occurrence of breakthrough infections.

        Dr. Noorchashm suggests vaccine spoilage could be the answer to both these issues.

        “It’s a medicine, just like any other medicine. It’s got a failure rate … and we should accept that.”

        “They’re worried that a substantial number of people are not going to find out that the vaccine didn’t work for them.”

        Hosted by NTD journalist Brendon Fallon, Wide Angle is following the latest political developments in the United States and abroad, and finding the connection between these and the larger global trends of our times.
        _____________________________________________

        Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

        i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

        (My posts are not intended as advice or professional assessments of any kind.)
        Never forget Excalibur.

        Comment


        • #6
          bump this

          Comment


          • #7
            https://www.bloomberg.com/news/artic...an-pfizer-shot
            prognosis
            Previous Covid Prevents Delta Infection Better Than Pfizer Shot

            By Michelle Fay Cortez
            August 27, 2021, 1:38 AM EDT
            • Early data from Israel shows natural immunity wanes with time
            • People who recovered from Covid may face lower risk from delta
            _____________________________________________

            Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

            i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

            (My posts are not intended as advice or professional assessments of any kind.)
            Never forget Excalibur.

            Comment


            • #8
              (I don't think vaccines should be forced under any circumstances, but ignoring natural immunity breed mistrust.)

              https://brownstone.org/articles/79-r...ed-and-quoted/
              91 Research Studies Affirm Naturally Acquired Immunity to Covid-19: Documented, Linked, and Quoted
              By Paul Elias Alexander October 17, 2021

              We should not force COVID vaccines on anyone when the evidence shows that naturally acquired immunity is equal to or more robust and superior to existing vaccines. Instead, we should respect the right of the bodily integrity of individuals to decide for themselves.

              Public health officials and the medical establishment with the help of the politicized media are misleading the public with assertions that the COVID-19 shots provide greater protection than natural immunity. CDC Director Rochelle Walensky, for example, was deceptive in her October 2020 published LANCET statement that “there is no evidence for lasting protective immunity to SARS-CoV-2 following natural infection” and that “the consequence of waning immunity would present a risk to vulnerable populations for the indefinite future.”

              Immunology and virology 101 have taught us over a century that natural immunity confers protection against a respiratory virus’s outer coat proteins, and not just one, e.g. the SARS-CoV-2 spike glycoprotein. There is even strong evidence for the persistence of antibodies. Even the CDC recognizes natural immunity for chicken-pox and measles, mumps, and rubella, but not for COVID-19.

              The vaccinated are showing viral loads (very high) similar to the unvaccinated (Acharya et al. and Riemersma et al.), and the vaccinated are as infectious. Riemersma et al. also report Wisconsin data that corroborate how the vaccinated individuals who get infected with the Delta variant can potentially (and are) transmit(ting) SARS-CoV-2 to others (potentially to the vaccinated and unvaccinated).

              This troubling situation of the vaccinated being infectious and transmitting the virus emerged in seminal nosocomial outbreak papers by Chau et al. (HCWs in Vietnam), the Finland hospital outbreak (spread among HCWs and patients), and the Israel hospital outbreak (spread among HCWs and patients). These studies also revealed that the PPE and masks were essentially ineffective in the healthcare setting. Again, the Marek’s disease in chickens and the vaccination situation explains what we are potentially facing with these leaky vaccines (increased transmission, faster transmission, and more ‘hotter’ variants).

              Moreover, existing immunity should be assessed before any vaccination, via an accurate, dependable, and reliable antibody test (or T cell immunity test) or be based on documentation of prior infection (a previous positive PCR or antigen test). Such would be evidence of immunity that is equal to that of vaccination and the immunity should be provided the same societal status as any vaccine-induced immunity. This will function to mitigate the societal anxiety with these forced vaccine mandates and societal upheaval due to job loss, denial of societal privileges etc. Tearing apart the vaccinated and the unvaccinated in a society, separating them, is not medically or scientifically supportable...
              _____________________________________________

              Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

              i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

              (My posts are not intended as advice or professional assessments of any kind.)
              Never forget Excalibur.

              Comment


              • JJackson
                JJackson commented
                Editing a comment
                The problem with serology testing is we do not have a correlate of immunity for antibody levels so regardless of the results of the test we cannot say what it means regarding the level of either protection against infection or morbidity. Antibodies are important but are only one part of the equation. T cells are equally important as is the intra-cellular response but these are very much harder to measure. Then there is the problem of what antibodies you are testing for some are much more useful than others. Two areas on the Spike, one around the RBD and the other at the N terminal domain, are neutralising or at least can be depending on how well matched they are and the Spike only vaccines are going to produce more of these than natural infection - as all antibodies are spike specific. Natural infection will produce a much broader range of non-spike antibodies which will not be very useful in preventing infection but CD8 T cells to these antigens will be useful in clearing the infection.
                The vaccines produce a more consistent antibody response while some natural infections, in which the host clears the virus very rapidly due to an effective intra-cellular clearing of the virus, leave the host poorly protected against future infection. If the virus persists for longer there is more opportunity for dendrites and other APCs to sequester viral antigen (these can be held for months) giving much better maturation of the of the B cell affinity in the lymph nodes, assuming good matched Tfc production.
                In the long term it is not the level of antibodies that counts but the quantity and durability of the memory B cells and the affinity of the antibodies that they produce.

            • #9
              This is a large scale study looking at hospitalised patients who have had either a viral or vaccine challenge previously.
              The vaccinated did much better than the infected (OR 5) while this gap became much bigger in the high risk 65+ age group (OR 19).

              https://www.cdc.gov/mmwr/volumes/70/...mm7044e1-H.pdf

              Comment


              • #10
                Originally posted by JJackson View Post
                This is a large scale study looking at hospitalised patients who have had either a viral or vaccine challenge previously.
                The vaccinated did much better than the infected (OR 5) while this gap became much bigger in the high risk 65+ age group (OR 19).

                https://www.cdc.gov/mmwr/volumes/70/...mm7044e1-H.pdf
                CDC is under a lot of pressure right now from US reps and civil rights attorneys to come up with data that supports their anti-natural immunity stance. This may be behind this study. The study group, after they whittled through data from all those hospitals, is actually small. They only found about 1,000 previously infected patients and about 6,000 previously vaccinated patients who met their criteria. (Though that makes the vaccine look bad, I think the vaccinated group was older.)

                Their data machinations seem to give the vaccinated a leg up:
                "Then, previously infected patients were limited to those with more recent infections (i.e., 90–225 days before hospitalization [the lowest two tertiles of number of days since infection]), and fully vaccinated patients were limited to those with the longest interval since completion of vaccination (i.e., receipt of second mRNA vaccine dose 45–213 days before hospitalization"

                So there is a 45 day advantage to the vaccinated. More than one scientist has said, "There's lies, **** lies, and then there are statistics."

                The study is not peer reviewed, and the authors admit to these weaknesses:

                "The findings in this report are subject to at least seven limitations. First, although this analysis was designed to compare two groups with different sources of immunity, patients might have been misclassified. If SARS-CoV-2 testing occurred outside of network partners’ medical facilities or if vaccinated persons are less likely to seek testing, some positive SARS-CoV-2 test results might have been missed and thus some patients classified as vaccinated and previously uninfected might also have been infected. In addition, despite the high specificity of COVID-19 vaccination status from these data sources, misclassification is possible. Second, the aOR could not be further stratified by time since infection or vaccination because of sparse data and limited ability to control for residual confounding that could be magnified within shorter intervals. The aOR that did not adjust for time might also be subject to residual confounding, particularly related to waning of both types of immunity. Third, selection bias might be possible if vaccination status influences likelihood of testing and if previous infection influences the likelihood of vaccination. Previous work from the VISION net-work did not identify systematic bias in testing by vaccination status, based on data through May 2021 (1). Fourth, residual confounding might exist because the study did not measure or adjust for behavioral differences between the comparison groups that could modify the risk of the outcome. Fifth, these results might not be generalizable to nonhospitalized patients who have different access to medical care or different health care–seeking behaviors, particularly outside of the nine states covered. Sixth, the statistical model incorporated the use of a weighted propensity score method which is subject to biases in estimates or standard errors if the propensity score model is misspecified. Numerous techniques were used to reduce potential suboptimal specification of the model, including but not limited to including a large set of covariates for machine learning estimation of propensity scores, including covariates in both regression and propensity models, ensuring large sample sizes and checking stability of weights, and conducting second-ary analyses to assess robustness of results. Finally, the study assessed COVID-19 mRNA vaccines only; findings should not be generalized to the Janssen vaccine."

                My opinion - another nothing burger from the CDC.
                _____________________________________________

                Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

                i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

                (My posts are not intended as advice or professional assessments of any kind.)
                Never forget Excalibur.

                Comment

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