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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?


    Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?
    BMJ 2021; 374 doi: (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


    • 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