Having SARS-CoV-2 once confers much greater immunity than a vaccine(sciencemag.org)
sciencemag.org
Having SARS-CoV-2 once confers much greater immunity than a vaccine
https://www.sciencemag.org/news/2021/08/having-sars-cov-2-once-confers-much-greater-immunity-vaccine-no-infection-parties
351 comments
This feels like an irresponsible title on behalf of the author. People don’t get the vaccine strictly on the strength of the vaccine. It’s considering the risk of getting COVID, understanding the long term side effects, and minimizing risk for those around you. It’s also about avoiding mutations of the virus as the higher availability of the virus only provides more opportunities for it to mutate into something more resistant or possessing other less desirable traits.
I understand that the post goes into these types of details but with the proliferation of “I read the title so I read the article” types a much less clickbait title should have been chosen. This only vindicates people looking to confirm their biases and leaves out the nuance that is so important to science.
>the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher
This sounds convincing, but then in the next graf:
>For instance, the higher hospitalization rate in the 32,000-person analysis was based on just eight hospitalizations in a vaccinated group and one in a previously infected group. And the 13-fold increased risk of infection in the same analysis was based on just 238 infections in the vaccinated population, less than 1.5% of the more than 16,000 people, versus 19 reinfections among a similar number of people who once had SARS-CoV-2.
This sounds convincing, but then in the next graf:
>For instance, the higher hospitalization rate in the 32,000-person analysis was based on just eight hospitalizations in a vaccinated group and one in a previously infected group. And the 13-fold increased risk of infection in the same analysis was based on just 238 infections in the vaccinated population, less than 1.5% of the more than 16,000 people, versus 19 reinfections among a similar number of people who once had SARS-CoV-2.
The term ”survivor bias” is usually used metaphorically, but in this case it applies literally.
Putting in some caveats about the risks associated with infection is not enough. This is a garbage analysis that should never have been accepted for publication.
Putting in some caveats about the risks associated with infection is not enough. This is a garbage analysis that should never have been accepted for publication.
I got downvoted for saying this here a while back. Anyone with good immunology experience would guess this to be accurate no matter what some half baked study says (which was what a bunch of people were telling in that earlier thread). Again doesn’t mean you should go get Covid or avoid the vaccine. The vaccine only helps. If you got Covid and then also got the vaccine it only helps more.
Why is "natural infections and recovery produce a better immune response than a vaccine" so controversial? Has it been this controversial for any other disease?
What about a person who is vaccinated and then has an asymptotic case? Do they still build up even better immunity? If so, that’s still a great reason to vaccinate.
It would be great if the people who had covid and developed immunity will finally become recognized by governments on par with vaccinated. Currently, they virtually don't exist for governments and media in many countries who prefer to divide everybody into just two groups: vaccinated and anti-vaxxers. A third group does exist and deserves to be heard.
But don’t you risk long hauler symptoms or worse? Meaning, it’s an interesting datapoint but not a viable strategy.
Would getting infected _after_ being vaccinated, which doesn't seem totally unheard of, confer an additional boost to one's immunity?
The Lancet just published a study yesterday on natural infection still causing symptoms one year later (“long Covid”) for 49% of unvaccinated people.
I’ll stick to the vaccine.
I’ll stick to the vaccine.
I can only consider this a positive for those who are vaccine hesitant, as they will probably be getting it, but I can't see how, considering the realistic dangers of a vaccine, a rational individual wouldn't want both forms of protection even if they were previously infected.
What the study says is out of 20k people that had the vaccine or previous infection only 200 got reinfected and nobody died. Yes in the 200 there were more vaccinated but imaging how many people died from the first round of infections. How the people who were sick are much more cautious and wear masks than vaccinated. None of this is adjusted for (ie they don’t ask a sample of the groups a question how often do you wear mask, all they needed to do was ask from 300 people from both groups and you could adjust for risky behaviors and I bet the effect would be much smaller). In any case both vaccine and previous infection provides plenty of protection.
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Are there credible papers which estimate the percentage of Covid survivors in one or more countries, i.e. those with natural immunity? During the first half of 2020, there were several attempts to estimate these numbers in the USA. Are some regions or countries doing statistical population sampling, e.g. blood tests for antibodies?
One of the biggest issues with this discussion is that we call these current round of therapeutics, "vaccines". They aren't. They don't prevent infection. They don't prevent transmission. At best, they reduce symptoms.
This sounds conflicting I read somewhere else earlier today, that the immunity you get from the actual disease is tailored towards the specific variant/strain.
Whereas the vaccines (at least the mRNA ones) confer immunity against multiple strains.
Whereas the vaccines (at least the mRNA ones) confer immunity against multiple strains.
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Survivorship bias comes to mind
https://en.wikipedia.org/wiki/Survivorship_bias
Tasteless/careless, IMO, especially living (in Texas) where “covid parties” have happened and people lost their lives right around the block last year. Although, it may be of relevance to my younger unvaccinated nephew that survived a rough case last December and is worried about being in school over in Tennessee without masks.
Is it still possible to detect whether you had COVID in the past, after already getting the vaccine?
Except for the people who died of it, presumably? A perfectly self-reinforcing thesis; whoever didn't die clearly developed strong enough immunity, and those that did, well we don't count them here.
In other news:
Having a $3 million mansion at the beach confers much greater happiness than an affordable house in the suburbs!
Having a new top-of-the-line Mercedes SUV confers much greater status than a used Honda minivan!
Having a beautiful face and 6-pack abs confers much greater attractiveness than looking like Shrek!
There are two mutually exclusive questions at play here... and I'm totally convinced the population at large has ability to discern the difference and not conflate one with the other.
1. What is the best/strongest/longest lasting type of immunity, natural or vaccine?
2. What is the safest type of immunity, natural or vaccine?
Is natural immunity better? There's some data to show it is. Should you risk your life to get? Probably not.
Having a $3 million mansion at the beach confers much greater happiness than an affordable house in the suburbs!
Having a new top-of-the-line Mercedes SUV confers much greater status than a used Honda minivan!
Having a beautiful face and 6-pack abs confers much greater attractiveness than looking like Shrek!
There are two mutually exclusive questions at play here... and I'm totally convinced the population at large has ability to discern the difference and not conflate one with the other.
1. What is the best/strongest/longest lasting type of immunity, natural or vaccine?
2. What is the safest type of immunity, natural or vaccine?
Is natural immunity better? There's some data to show it is. Should you risk your life to get? Probably not.
There is a simple solution to the conundrum: a standardised vaccine passport plus a separate, standardised proof of prior infection.
Then let each business and jurisdiction choose whom to admit. Part of the problem with the prior-infection claim is it’s harder to verify than vaccination. Solving that would go a long way towards letting those individuals participate in normal life without compromising public health or the right to choose with whom one assembles.
Broadly, the Israeli data seem to favour natural immunity while the British data, very slightly, vaccination. We need more data. In the meantime, let people make their own choices.
Then let each business and jurisdiction choose whom to admit. Part of the problem with the prior-infection claim is it’s harder to verify than vaccination. Solving that would go a long way towards letting those individuals participate in normal life without compromising public health or the right to choose with whom one assembles.
Broadly, the Israeli data seem to favour natural immunity while the British data, very slightly, vaccination. We need more data. In the meantime, let people make their own choices.
Vaccinating everyone was always about protecting the immunocompromised, for those who can’t defend themselves.
The way the study is presented is extremely disingenuous in my opinion.
The way the study is presented is extremely disingenuous in my opinion.
Isn't there some selection bias going on here? Having covid once protects against getting it again - if the first one didn't kill you that is.
It's important to be aware of the tremendous amount of evidence from a wide body of peer-reviewed literature which supports the fact that immunity acquired through natural infection provides protection against reinfection that is at least equally effective as vaccination. This fact has been repeatedly demonstrated in multiple large scale and long term serological studies [1][2][3][4][5].
It's still an open question whether natural infection confers better protection than vaccine-induced immunity, or if some combination of the two is even better. That's why the primary pre-print cited in OP is so important [6]. It is one of the first and largest scale studies to evaluate the risk of reinfection - in the context of the delta variant which is currently dominant in many countries around the world - by directly comparing naturally acquired immunity to vaccine-induced immunity.
The other cited papers in OP give some reasoning why natural infection might confer more robust protection, particularly when challenged by variants of concern [7][8][9]. The gist is that the immune response acquired through natural infection evolves in such a way that broader and more diverse antibodies can be developed. Another major difference is that natural infection induces antibodies against the nucleocapsid (N) protein, whereas vaccination with the current mRNA based spike protein focused formulations do not [10][11].
All of these findings have major implications for public health policy. In particular, optimal vaccination strategy should likely be targeted towards immunologically naive individuals, or individuals more vulnerable due to age and poor health [12].
- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)
- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)
- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials. [5] (N=3,257,478)
> those vaccinated are still at a 5.96-fold increased risk for breakthrough infection and at a 7.13-fold increased risk for symptomatic disease compared to those previously infected. [6]
> SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalization compared to those who were previously infected. [6]
[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/
[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...
[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[6] Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...
[7] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9
[8] Affinity maturation of SARS-CoV-2 neutralizing antibodies confers potency, breadth, and resilience to viral escape mutations https://pubmed.ncbi.nlm.nih.gov/34331873/
[9] High genetic barrier to escape from human polyclonal SARS-CoV-2 neutralizing antibodies https://www.biorxiv.org/content/10.1101/2021.08.06.455491v1
[10] Combining spike- and nucleocapsid-based vaccines improves distal control of SARS-CoV-2 https://www.cell.com/cell-reports/pdf/S2211-1247(21)01108-6....
[11] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/
[12] Model-informed COVID-19 vaccine prioritization strategies by age and serostatus https://science.sciencemag.org/content/sci/371/6532/916.full...
It's still an open question whether natural infection confers better protection than vaccine-induced immunity, or if some combination of the two is even better. That's why the primary pre-print cited in OP is so important [6]. It is one of the first and largest scale studies to evaluate the risk of reinfection - in the context of the delta variant which is currently dominant in many countries around the world - by directly comparing naturally acquired immunity to vaccine-induced immunity.
The other cited papers in OP give some reasoning why natural infection might confer more robust protection, particularly when challenged by variants of concern [7][8][9]. The gist is that the immune response acquired through natural infection evolves in such a way that broader and more diverse antibodies can be developed. Another major difference is that natural infection induces antibodies against the nucleocapsid (N) protein, whereas vaccination with the current mRNA based spike protein focused formulations do not [10][11].
All of these findings have major implications for public health policy. In particular, optimal vaccination strategy should likely be targeted towards immunologically naive individuals, or individuals more vulnerable due to age and poor health [12].
- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)
- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)
- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials. [5] (N=3,257,478)
> those vaccinated are still at a 5.96-fold increased risk for breakthrough infection and at a 7.13-fold increased risk for symptomatic disease compared to those previously infected. [6]
> SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalization compared to those who were previously infected. [6]
[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/
[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...
[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[6] Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...
[7] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9
[8] Affinity maturation of SARS-CoV-2 neutralizing antibodies confers potency, breadth, and resilience to viral escape mutations https://pubmed.ncbi.nlm.nih.gov/34331873/
[9] High genetic barrier to escape from human polyclonal SARS-CoV-2 neutralizing antibodies https://www.biorxiv.org/content/10.1101/2021.08.06.455491v1
[10] Combining spike- and nucleocapsid-based vaccines improves distal control of SARS-CoV-2 https://www.cell.com/cell-reports/pdf/S2211-1247(21)01108-6....
[11] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/
[12] Model-informed COVID-19 vaccine prioritization strategies by age and serostatus https://science.sciencemag.org/content/sci/371/6532/916.full...
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Yeah, it also confers organ damage for life and/or death. lol. Get the vaccine, nerds.
Those who think this is supporting evidence for not getting vaccinated should think it again.
You must think in terms of risk of hospitalization and/or long covid with or without vaccination over the course of the whole path you choose.
ps. Moderna seems to be much more effective against Delta than Pfizer-BioNTech.
You must think in terms of risk of hospitalization and/or long covid with or without vaccination over the course of the whole path you choose.
ps. Moderna seems to be much more effective against Delta than Pfizer-BioNTech.
It is almost certain COVID will become endemic, and no known form of immunity whether from vaccination or prior infection confers sufficient permanent immunity against infection to stop re-infection but prior immunity (from vaccine or prior infection) does greatly reduce the chances that your infection will give you serious illness.
You assumption therefore should be that over the rest of your life you will get COVID multiple times.
The question then is whether you want your first infection to be with or without prior immunity. If you want that first time to be with prior immunity get vaccinated as that is the only known way to get immunity before your first infection.