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

by peteradio • 5 years ago

227 347 5 years ago

sciencemag.org

AndrewBissell10• 5 years ago

There's really nothing surprising about this conclusion. Before Covid came along and the focus inexplicably shifted to antibodies-only, it was well understood that infection with a pathogen was always likely to result in better immunity than vaccination.

uchiga• 5 years ago

The drawback of an infection on weak/strong immune systems can be death.

KaiserPro• 5 years ago

kinda.

its more complex and nuanced than this. I had thought that the chickenpox vaccine gave you a higher chance of shingles in later life. However that appears to be the opposite of what actually happens.

The crucial thing is that its dependent on the vaccine and the thing infecting you.

For example the BCG jab which protects against TB is wild. Its a live vaccine that has been evolving, got lost once, and its kinda black magic. In older people it has a ~33% efficacy. its much more effective in babies and children though.

However we've got to the point that TB is so rare in the UK that targeted vaccination is more than enough to keep it under control.

With covid, we need to make sure that when people get it, they don't get seriously ill. Ideally they wont get it at all, but alas thats not the case, the vaccines are not effective enough for that against this variant.

I assume that altering the mrna vaccines would have a similar speed as the annual flu vaccine, so changes for new variants would require less development time.

But as someone pointed out, if you have a vaccine, and you get covid, te seems reasonable to assume that you will have a better immunity.

Also with just 8 cases out 32k, it seems a small dataset to draw conclusions on.

whoooooo123• 5 years ago

Not that I doubt you, but where can I read more about this? I know nothing about epidemiology or immunology and reading threads like this makes me realise I need to get more informed.

macksd2• 5 years ago

Except it was widely reported that natural immunity lasted 3 to 6 months and that the vaccines would last 2 years (at least Moderna), and the nuances there I think would be lost on a lay person. I even had an immunologist explain to me in detail why the immunity from the vaccine would be way stronger than acquired immunity. It doesn't really build confidence in science if, while we're finding new things, everyone pretends that the conclusion du jour was always obvious.

AndrewBissell10• 5 years ago

I think we're in agreement here -- I did not mean to imply that a lay person following the claims bandied about in the mass media this year would have been under this impression. In fact, six months ago a claim like this would have been likely to be labeled misinformation on Twitter. I'm just saying that for the Covid vaccines to have provided better immunity than recovery from infection would have been very divergent from what is observed for the vast majority of other pathogens.

eplanit2• 5 years ago

One can observe how this topic has become political, and is no longer scientific. Our focus and concerns are now all about existing and forthcoming restrictions and mandates for vaccinations and masks -- so much that information like this is no longer even interesting to most people. Not only uninteresting, but vulnerable to censors.

aabaker99• 5 years ago

For those who haven't observed this, what are your observations? Does this apply to the article we are discussing, too, or is it more of a general concern about mandates?

nogridbag• 5 years ago

Comments like these about censorship keep coming up, yet this is the third straight day this topic is being discussed on the front page of HN.

I see the same thing on Facebook. Half of my family is still complaining about censorship and how everything is politicized while they continue to post political memes about Hilary Clinton, false or misleading information about vaccines, etc. The other half quit facebook or occasionally post family pictures.

CodeWriter234• 5 years ago

Censorship is happening. A friend of mine (who happens to be a former Congressman) was silenced by Facebook for 30 days for merely citing Pfizer’s profit on the vaccine as reported in a WSJ Article.

Don’t be fooled by the narratives Facebook permits.

eplanit2• 5 years ago

Earlier this month Rand Paul, a U.S. Senator and a former physician, was banned from YouTube for a week for simply saying that cloth masks are ineffective.

YouTube et al. could just as easily decide that discussion of natural immunity from prior infection is also "dangerous" (it might discourage vaccination) and ban it.

abnorxiouster2• 5 years ago

Nobody censored anything in this case on this platform -> therefore there is no censorship on the subject of covid

Logic

capableweb• 5 years ago

Uuuh, you're writing a comment about how COVID has become political on a scientific article about COVID that doesn't mention any politics.

One could believe you are actively working against your best interests here by leaving this type of comment. You'd be better at making things scientific again by behaving the one you'd like others to behave.

SketchySeaBeast7• 5 years ago

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.

AndrewBissell10• 5 years ago

What is the realistic marginal increase in protection from the vaccine for someone who has recovered and is in a very low risk age/comorbidities cohort? Is reducing their absolute risk of a really bad Covid outcome by 0.00001% really worth the risks attendant in the vaccine?

Also, at least one study has hinted that the second dose may reduce humoral immunity.

SketchySeaBeast7• 5 years ago

I'm not sure, but we'd need to be dealing with something like your 0.000001% number before the risks started to outweigh the benefits, wouldn't we? Even a half or a tenth or a hundredth of a percent increase would be far beyond any sort of vaccination risk.

Also, at least one study has hinted that the second dose may reduce humoral immunity.

I don't think we can base current best choices upon things which are merely hinted, especially when they are so counter intuitive, and as far as I'm aware, outside of our experience with other vaccinations.

It also highlights that we still don't know everything, and I'd definitely make decisions based upon an abundance of caution, leaning towards more protection.

sleavey3• 5 years ago

Meta-reply: at time of writing your comment is grey enough to be on -2, yet nothing you say is trolling or unhelpful. In fact, your comment contains merely two questions and a supposition. I've seen this on HN particularly for COVID related topics and I don't think it's at all helpful. I reckon very few on here are outright anti-vaxxers in the traditional sense of the term (e.g. given to those implying a link between MMR and autism, etc.) yet these days anyone asking questions that may portray, perhaps merely indirectly, some SARS-CoV-2 prophylactics/treatments in a bad light are downvoted. It's not good for curiosity and doesn't help us collectively get to the truth on matters and I think we can do better as a community.

mc323• 5 years ago

I think people in high risk groups should get it, i.e., the elderly and people with weak immune systems or other health issues. Those who are strong health wise ok, they stand a good chance.

That said, I am totally against this blanket insistence on passports. There may be some situations which warrant vaccinations where the subject has no acquired immunity, health workers, etc. But being denied access to govt services because you lack the papers is not a good thing.

Edit: asking for a mask is okay. I don’t think that’s too much to ask. It’s when they require proof of vaccination that I have problem (mind you, I’m vaccinated).

lowercased• 5 years ago

But being denied access to govt services because you lack the papers is not a good thing.

What gov services are people being denied? legit question - I hear this, but unsure what is being referred to.

How about "vaccine proof or wear a mask" to get/access govt services/buildings/etc?

giantg22• 5 years ago

At least places like Isreal issue you a green pass for naturally acquired immunity. In the US, people with natural antibodies who are refusing the vaccine are being fired. Basically measuring output rather than outcomes (for all you PMs out there).

kiba4• 5 years ago

Wearing a mask is a mild annoyance. With vaccine, you might suffer side effects, but even that is short term.

It's basically no-brainer, since getting infected with the virus is more likely to kill you than getting the vaccine.

The only reason people are not getting the vaccine is for various reasons they don't trust that the vaccine is going to help them. Everything else is justification.

Tenoke• 5 years ago

In Europe you can show a recent test or your Vax passport anywhere (e.g. you need one or the other to travel or go to the gym) and I really don't see the issue.

I'm glad there's a way to ensure only low risk people are in the places I go to and the privacy risks are comparable or smaller than for things with lesser benefits.

vibrato25• 5 years ago

Consider the realistic uncertainty and probability from previous study of antibody dependent enhancement. It’s not proven that the mRNA therapy won’t worsen covid reaction in the long run.

SketchySeaBeast7• 5 years ago

It’s not proven that the mRNA therapy won’t worsen covid reaction in the long run.

What are you defining by "long run"? We're quickly moving into a year with mRNA therapies. I'm not aware of any instance of this occurring with previous vaccines, and we can't just say "well mRNA could be different" because if we do that all the possible "what-ifs" we quickly swing into the absurd.

alsetmusic• 5 years ago

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.

hungnv• 5 years ago

Great point, the research should also investigate more about this case, since its get published it will create more negative effect to people who dont believe in vaccine but believe in themselves they will never die because of Covid

giantg22• 5 years ago

And does that affect the timing or need for booster shots?

programmarchy• 5 years ago

Wouldn’t the Hoskins effect [1], or “original antigenic sin”, apply in this case?

the propensity of the body's immune system to preferentially utilize immunological memory based on a previous infection when a second slightly different version of that foreign pathogen (e.g. a virus or bacterium) is encountered. This leaves the immune system "trapped" by the first response it has made to each antigen, and unable to mount potentially more effective responses during subsequent infections.

[1] https://en.m.wikipedia.org/wiki/Original_antigenic_sin

anonuser123456• 5 years ago

Probably not. B cells can return to germinal centers and undergo further affinity maturation.

Hoskins effect does not block this process, but may slow it down. If the original antibody is still effective, no problem.

Now, if the virus mutates to completely escape existing antibodies, we might have a different story. But in that story, the vaccinated are probably better off than the natural infection crowd.

The vaccine targets a highly conserved region of the RBD; it is largely essential to bind to ACE2. Mutation there is likely to reduce binding affinity and thus become less infectious / virulent.

Natural immunity however suffers from the problem that the body builds antibodies against other regions that are more prone to mutation. Some of those mutations have been shown to enhance infectiousness. So you could end up with a scenario where non RBD targeted antibodies enhance infectiousness while simultaneously you have slowed affinity maturation.

criticaltinker6• 5 years ago

Individuals who were naturally infected and then vaccinated, or vice-versa, should be well protected. It is unclear if a combination of the two provides better immunity especially when challenged by variants of concern. However, preliminary in vitro evidence (cited in OP) suggests that yes, a combination of the two may confer better short-term protection than either one alone [1].

The data suggest that immunity in convalescent individuals will be very long lasting and that convalescent individuals who receive available mRNA vaccines will produce antibodies and memory B cells that should be protective against circulating SARS-CoV-2 variants. [1]

[1] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9

tacomonstrous• 5 years ago

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.

cestith2• 5 years ago

Are you saying 32,000 people isn't a large enough study to be meaningful?

epistasis• 5 years ago

For low-prevalence events the number of events that happened is just as important for statistical power as the big 32,000.

Especially when doing relative risk, the confidence interval on that "27 times" could be extremely large.

Hinrik• 5 years ago

It's more about the small effect sizes of 8 people vs 1. Still a lot of room for noise in the result.

AndrewBissell10• 5 years ago

Have you ever looked at the numbers on the vaccine trials? Especially the ones in children under 18?

kiba4• 5 years ago

To develop natural immunity, you would need to get infected with the virus, no? That's considerably more risky than getting the vaccine.

If you do get infected with the virus after vaccination, wouldn't you also develop natural immunity?

foobar2021• 5 years ago

I think the worry with natural infection is if the timing is such to provide durable immunity. But it’s not like the vaccines have had 5 years of trials to determine the best wait between the 2 and 3 doses so kind of a moot point.

GDC7• 5 years ago

That's right, vaccine doesn't prevent you from getting the virus so if you get it you'd then amount an immune response of some sort which is on top of the one provided by the vaccine.

Or that goes to "fill up" again the immunity lost due to the time which went by since the vaccination.

newsclues2• 5 years ago

If you got Covid before vaccines were available that risk assessment is irrelevant.

If you get COVID after vaccination, your immune system may not learn how to fight COVID-19 as well, because the vaccine is present and doing something.

mikem1704• 5 years ago

There are also inactivated-virus covid-19 vaccines [0] in trials that one could expect to impart more broad-based immunity than the mrna vaccines which are designed to target only one part of the virus.

[0] https://en.wikipedia.org/wiki/Sinovac#COVID-19_vaccine_devel...

scythe• 5 years ago

The bigger problem is that the risk of hospitalization post-vaccine appears to be lower than the risk of death pre-vaccine. If seven of those eight hospitalized post-vaccine would have died when naively infected, then the difference disappears. Seven out of 32000 is 0.02%, while the risk of death from COVID-19 is 0.4%.

And if you remove hospitalization as an endpoint, you're basically dependent on self-reports. That's not to say I don't believe the conclusions -- they should survive this critique -- but there is reason to expect a little inflation of the ORs.

refurb• 5 years ago

But that seems intuitive? If you survive the first Covid infection, you’re biased towards less severe symptoms for the 2nd infection (ignoring even any immune response).

Basically all the folks who died from Covid are excluded from this population.

pacbard• 5 years ago

the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher

The denominator in those odds ratios seem to fishy to me. Comparing people who were previously infected with COVID and vaccine recipients does some weird conditioning on getting COVID, so it should hide risks of developing symptomatic COVID and hospitalization for people who got COVID previously. It seems to me that the risks should be "cumulative" for people who were previously infected (i.e., the denominator should include symptomatic infections and hospitalizations for previous COVID variants and not just delta) rather than "zeroing" those risks for this group and just focus on delta re-infection. The decision to only focus on delta infections will bias up the OR estimates for vaccine (in)effectiveness, so we should read the results of this paper as the possible upper bound of the ORs.

Also, the study compares the risk of delta infection, meaning that people cannot really just say "I won't get vaccinated because natural immunity is better" as the variants that provided that natural immunity are not "dominant" anymore, meaning that the opportunity to acquire natural immunity against delta is probably close to zero at this time.

Also also, isn't it something that is known that natural immunity is better than vaccine-acquired immunity? The trade-off is that natural immunity has the "side effect" of actually having to fight off and survive the illness?

AndrewBissell10• 5 years ago

Also also, isn't it something that is known that natural immunity is better than vaccine-acquired immunity?

Yes, I pointed this out elsewhere in the thread, but it has somehow been verboten until very recently to state it in regards to Covid. My brother-in-law was even told by the people administering his vaccine that having had a prior Covid case put him at more risk and made it even more essential that he get vaccinated.

criticaltinker6• 5 years ago

You raise a good point that it would be useful to report the "cumulative" risk for people previously infected.

However the goal of this research is specifically evaluating risk of reinfection, not the cumulative risk of SARS-COV-2 infection. The fact is that a vast majority of people survive initial SARS-COV-2 infection, so the pure risks associated with reinfection are also equally useful to know.

The decision to focus on delta infections does impact the OR estimates for vaccine effectiveness as you mention. But again this was one of the primary research goals of the paper - to evaluate the risk of reinfection by comparing natural immunity to vaccine-induced immunity in the context of a variant with mutations conferring immune escape.

the variants that provided that natural immunity are not "dominant" anymore

This was controlled for in the study by censoring data based on the date of previous infection.

The trade-off is that natural immunity has the "side effect" of actually having to fight off and survive the illness?

Yes, and people need to stop interpreting the title and cited paper as a manifesto against vaccination. Rather, the study provides valuable data on the efficacy of natural and vaccine induced immunity in the context of evolving variants, which will be useful in guiding public health policy and also formulating next generation vaccines that improve upon the current formulations.

blablablub• 5 years ago

Survivorship bias comes to mind https://en.wikipedia.org/wiki/Survivorship_bias

AndrewBissell10• 5 years ago

Not sure how that's really relevant when over 99% of people in both the vaccinated and unvaccinated cohorts do not die from Covid.

ukj• 5 years ago

The entire point of vaccintation is to enable a road to immunity which kills less people than simply getting infected.

If we were OK with the death rate of naturally-attained immunity we didn't need a vaccine.

actually_a_dog8• 5 years ago

There are other bad outcomes besides death.

IonizedOp2• 5 years ago

From the point of view that there is some risk involved from the first covid infection in order to get the immunity, so people will be less likely to correctly assess the risk of getting natural immunity vs getting vaccine in order to end up to the study's cohorts.

zzleeper2• 5 years ago

It's relevant because of the 1%. The numbers in the study are so low (8 people hospitalized in one, 1 person in the other group) that 1% makes a difference.

jmull• 5 years ago

The people infected by covid who died do not appear in this study.

SamBam5• 5 years ago

32,000 people in the study, of which 16,000 had previously had Covid.

They found a total of 238 re-infections.

Assuming 1% mortality from Covid, that group of 16,000 would have previously been 16,162, before being culled down to the study size by deaths.

You don't think an additional 162 would make a difference to the results?

(Obviously it doesn't make a difference if you read this study as "given someone survived Covid, what are the odds..." but lots of people are reading this study as "It's safer to catch Covid than get vaccinated." Given that, the deaths absolutely matter.)

bigmattystyles• 5 years ago

But don’t you risk long hauler symptoms or worse? Meaning, it’s an interesting datapoint but not a viable strategy.

AndrewBissell10• 5 years ago

Long haul Covid is generally associated with severe cases. The question then becomes, how much does getting the vaccine reduce a recovered individual's probability of having a severe case? Given that it's pretty rare for reinfections to be serious, and the vaccine does not prevent infection or even serious breakthrough cases, the answer would seem to be "not much."

vibrato25• 5 years ago

Working very viably for myself.

sokoloff• 5 years ago

Well, we should just scale your experience/anecdote up by 8 billion and we’re good then.

jjuel3• 5 years ago

Are you saying you didn't get vaccinated and have yet to get COVID so your strategy is working? Or you already got COVID but it wasn't serious so it is working? Either way it seems like saying "I've been smoking all my life and never got cancer. Not sure why everyone is so worried about smoking."

SV_BubbleTime5• 5 years ago

We know as much about “long Covid, as we know about “long covid vaccine“.

That’s not pro or con anything, it’s just the truth that some are having a hard time admitting.

I’m not sure at what point in the last year “we don’t know” became taboo. Maybe when we wrapped unknowns in policy decisions?

EDIT: yes, we have data for that long Covid symptoms especially in severe cases, and suspected in mild cases, my point was that we do not have enough data to make policy decisions based on this. Currently hard to quantify, as the CDC has anxiety and depression listed as long Covid symptoms.

JumpCrisscross4• 5 years ago

We know as much about “long Covid, as we know about “long covid vaccine“

As in we have proof one exists and none of the other?

peteradio12• 5 years ago

Its not about vaccine vs natural immunity. Its about immunity vs mandates.

Getting covid intentionally is stupid. If you feel up to it, get the vaccine. Any encounter with covid will be milder.

However, some people have already had it and are frankly being unjustly discriminated in some states and institutions.

I'm not against vaccines but the treatment of previously infected people as second tier has got to stop.

shmatt• 5 years ago

there is a point to be made here. in Israel for example, a verified blood test with high antibody levels gets you a "vaccine passport", without the need of a vaccine

it only lasts a limited time though, and these measured antibodies fade within months. so people that have been sick are still encouraged to get at least 1 shot of Pfizer

It's important to add antibody levels for people that have been sick are very different. I know many sick people who got under 150 (the stated minimum to get the passport) a few weeks after being sick. With 2 shots of Pfizer I got over 12,000 units. So it's not even the same ballpark. At least for the measurable antibody tests we currently have

I suspect, if the government offered a monitored blood test to prove antibodies, the "but muh mandates" crowd will still be just as angry

travisporter• 5 years ago

I would equate it to hiring for a job: saying you have a college degree (history of infection) < showing the degree (proof of vaccination) < showing your GPA (antibody levels). This is because my colleagues say of covid: "oh, just sniffles" versus "worst sore throat and muscle aches of my life". Unlikely both these immune systems are similarly trained to fight covid

throwaway7432• 5 years ago

Is there any information on how both or either current means of gaining some level of immunity measure up to lesser known "newer" variants such as b.1.621 (Colombian variant), lambda, iota, eta, etc?

throwaway7432• 5 years ago

It was a legit question. Not sure why I'm being downvoted.

gkfasdfasdf• 5 years ago

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.

peteradio12• 5 years ago

Its relevant to survivors.

IonizedOp2• 5 years ago

By survivors you include the vaccine survivors?

CyanLite4• 5 years ago

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.

jlmorton2• 5 years ago

* among patients hospitalized with severe illness in one Wuhan hospital between Jan and Feb 2020, self-reporting at least one symptom from a long list, such as fatigue, joint pain, etc, vs 33% of a control group without Covid infection reporting the same.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

criticaltinker6• 5 years ago

Yes thank you. GPs comment is completely inaccurate, and the referenced study does not make any claims about natural infection, only about patients hospitalized with severe illness.

Multiple recent large scale studies have estimated an asymptomatic proportion lower bound of at least ~33% [1], and an upper bound of 65% (and even higher for young adults) [2]. This implies a significant proportion of people infected by SARS-COV-2 will not experience any noticeable symptoms.

Furthermore, there is strong evidence that infections and cases are massively under-reported (by 10x to 100x) [3][4], so it's exceedingly likely that such estimates are underestimates of the true asymptomatic rate.

[1] The Proportion of SARS-CoV-2 Infections That Are Asymptomatic https://www.acpjournals.org/doi/full/10.7326/M20-6976

[2] Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands https://link.springer.com/article/10.1007/s10654-021-00768-y

[3] Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters https://www.sciencedirect.com/science/article/pii/S253104372...

[4] Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States https://stm.sciencemag.org/content/13/601/eabh3826

ynfnehf• 5 years ago

49% of infected having symptoms a year later is ridiculous and obviously not true. Unless you define symptoms extremely broadly.

I have not read the study you are referring to. Are you sure it is not specifically about hospitalized patients? Even then it sounds extreme.

But you are right that vaccines are clearly better when given a choice.

ymck• 5 years ago

If you have a disease that causes organ damage, it's not that ridiculous. Look at the referenced studies. Multiple studies by different organizations performed 6-12 months out showing persistent fatigue, body aches, headaches, cognitive issues, loss of taste/smell, kidney function. Seems to be a real phenomenon.

sacado2• 5 years ago

The study you're probably talking about focuses on hospital survivors, not on the broad group of "naturally infected people".

nradov4• 5 years ago

I assume you're referring to this study.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

They studied hospitalized patients, who by definition had severe symptoms. We would expect more severe symptoms to take longer to resolve. I don't know the exact numbers in China but in the US 95% of cases were never hospitalized.

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

The study also counted anxiety and depression as "long COVID" symptoms which doesn't make much sense; they haven't proposed a biological mechanism of action for SARS-CoV-2 to directly cause such psychiatric symptoms.

I would still encourage everyone to get vaccinated if they can because the data shows it cuts the risk of death to virtually zero.

jinder• 5 years ago

Studies have already linked the inflammatory response in acute COVID to disruptions of the gut microbiome. This is a plausible route for long term, post-COVID neurological complications (anxiety, depression, neurosensory disturbances, insomnia etc).

pow_pp_-1_v• 5 years ago

Isn't age a factor? I don't understand if the study considered the age of the participants. So, could it be that the people who were vaccinated tended to be older and thus more vulnerable?

thom2• 5 years ago

Would getting infected _after_ being vaccinated, which doesn't seem totally unheard of, confer an additional boost to one's immunity?

stanpinte• 5 years ago

and vice versa?

thom2• 5 years ago

I'd specifically prefer to be infected after if I had to choose, on the assumption it'd be milder.

myko9• 5 years ago

Absolutely it would. Which is why it's a good idea to get vaccinated even if you have been infected or think you may have been.

The article backs this position up as well, though the headline belies that:

"The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated."

jaywalk5• 5 years ago

It's a good idea why, exactly? Because previously-infected people tend to experience worse vaccine side-effects for little to no additional benefit?

criticaltinker6• 5 years ago

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...

stefan_• 5 years ago

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.

h2odragon2• 5 years ago

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?

zzleeper2• 5 years ago

I think it's because people draw the wrong conclusions. Sure, if your body was stuck fighting COVID19 for two weeks and you then survived (i.e. excluding those pesky 700k Americans who didn't make it), then you are better prepared than if your body was stuck "fighting" COVID19 vaccine for half a day (of sleepiness or at most mild fever).

The PROBLEM is that people then say "oh well then to protect myself better against COVID19 what I should do is get infected with COVID19, rather than get vaccinated". I have NO IDEA why so many people are jumping to that conclusion.. but oh well..

CodeWriter234• 5 years ago

The PROBLEM is that people then say "oh well then to protect myself better against COVID19 what I should do is get infected

Both approaches carry risk, yet your statement presents as if the risk of vaccination is 0. And also excludes the idea that opting not to be vaccinated is a legitimate choice for the millions and millions of “cases” that have already been infected.

jaywalk5• 5 years ago

Sure, if your body was stuck fighting COVID19 for two weeks and you then survived ... then you are better prepared than if your body was stuck "fighting" COVID19 vaccine for half a day

From what I've read, it's less about severity of infection and more about the fact that the vaccine only introduces one specific aspect of the virus (the spike protein) to the immune system, while the actual virus introduces... all of itself to the immune system. So natural immunity ends up being more comprehensive and resistant to variants than the vaccines.

kaibee• 5 years ago

It makes it very easy for people to lie about. Both to themselves, ("well i was a little sick around month X, so that was probably covid, so i don't need a vaccine") and to others.

jaywalk5• 5 years ago

It's no easier than lying about vaccination status. Antibody tests are widely available, yet none of the pro-vaxers are willing to accept them as evidence of immunity. Why do you think that is?

CodeWriter234• 5 years ago

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?

Confirmation bias

dabbledash• 5 years ago

As you can see from some previous replies, it’s because people are less concerned with what’s true than with how (they believe) information will influence the behavior of others.

The apparent prevalence of this attitude in media and public health is eroding the credibility of those institutions, imo.

nickandre2• 5 years ago

Sort of like when the FDA insinuates that Ivermectin is unsafe because it has also been used by veterinarians in addition to its human indications.

thehappypm4• 5 years ago

Agreed, it's very much an attempted form of manipulation by hardcore pro-vaccine people. There's a line of logic among anti-vaxxers of "I'll take my chances", and studies like these -- which show that taking your chances with COVID, surviving (which might be overwhelmingly likely), and then going on your merry way gives you equal or greater protection than the vaccine. Hardcore pro-vaxxers would much rather the narrative be "the vaccine, and only the vaccine, will protect you."

londons_explore2• 5 years ago

There are some diseases it is not true for. Mostly ones that attack parts of the immune system (eg. Measles). Probably wouldn't be true for HIV either.

Aachen3• 5 years ago

I remember reports of the first reinfections as well as early talk of asymptomatic cases, where the news then tentatively concluded: and thus we hope a vaccine will be able to get good immunity where the having of covid does not. A few days ago was the first time I heard that knowledge challenged.

So it's not so much that it's unbelievable, more that it was established knowledge for more than a year and only now we're finding out these people were fine the whole time? Why then do we give them a booster dose that could be going to Africa?

(I don't mean to have those questions answered by the way since it's off topic; the questions this information conjures up are in answer to why it, at first glance, sounds controversial.)

sk2020• 5 years ago

It’s controversial because nobody can package and sell “natural” immunity. Given that there are about 7.5B people in the world, RNA injections are, apparently, only good for 90 days, and that Pfizer (or someone) gets $20/injection, the market is about $600B a year.

Do you remember 20 years ago when the people on TV said that terrorism was an existential and imminent threat and the result was defense and surveillance companies made massive fortunes? The more things change…

Just kidding. Public opinion shaping campaigns are a dangerous conspiracy theory and nobody of any public office or Fortune 500 company ever lied for money and nobody ever tried RNA injections for humans until, like, just now.

aww_dang7• 5 years ago

Please also consider the incentives for vaccine passports and "verified digital identities".

archagon• 5 years ago

RNA injections are, apparently, only good for 90 days

Er, what?

wankerrific• 5 years ago

Just like encouraging people to run around unvaccinated and mask free keeps your donors who make a $2000 per treatment Regeneron very happy.

kiba4• 5 years ago

You can only get natural immunity by getting the virus and hoping you don't die.

Sure Pfizer makes lot of money from the living, but I guess they will make less money since some of us are no longer among the living.

I guess the funeral industry will be very happy, indeed. The welfare state saves money on not having to care for a sick elderly person...

SideburnsOfDoom• 5 years ago

Why is "natural infections and recovery produce a better immune response than a vaccine" so controversial?

Why would that be your default assumption? Is it because ""natural infections" are natural and natural "should" be better? That is straight-up https://en.wikipedia.org/wiki/Naturalistic_fallacy

Have you considered the counternarrative that "vaccines are engineered to produce a strongest possible response" and you should therefore expect them to perform as designed, unlike haphazard nature.

Or perhaps consider that either might be true, and discard any prior assumptions about "natural = better".

Has it been this controversial for any other disease

It's "controversial" because politics this time. It's not the default assumption in this or previous diseases, because it's often not true.

The last time this was raised: https://news.ycombinator.com/item?id=28107854

Not to claim now that those links are the whole story, but they do represent a whole lot of prior knowledge.

So it seems that there is some debate and nuance on this topic. My (simplistic) understanding is that vaccines produce a different and in some ways stronger response than the disease that they mimic, as they are literally designed to do. The COVID vaccines mostly contain Spike protein and therefor produce a very strong response ... but only to spike protein. recovery from infection produces response to that and other parts of the virus.

peterbonney6• 5 years ago

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.

peteradio12• 5 years ago

I don't see survivor bias here at all. This is simply a study that caters to a rather significant population who justifiably want to know what they stand to gain from this vaccine.

What this study has done is identified a sub population who stand to gain such minuscule benefit from vaccination that it would be unethical to include them in a study (most studies DO exclude previously infected individuals, huh wonder why?) Furthermore it is unscientific discrimination to penalize people when they could prove prior infection and/or immunity.

amluto• 5 years ago

The study appears to be reporting at least a further 50% reduction in risk for previously infected people who get a vaccine.

One might debate whether the probabilities involved are so low as to be irrelevant, but the study absolutely supports the existence of a benefit.

siilats3• 5 years ago

Nobody died from vaccine but all the weak ones died from first infection so the surviving infected have survivorship bias.

SamBam5• 5 years ago

You haven't read the replied upthread where people use research like this to suggest "Corona parties" (like chickenpox parties) and how many people think it's safer to catch the virus than get the vaccine?

This article will absolutely not just be used by already-infected people trying to make a decision.

shadowgovt2• 5 years ago

peterbonney's right for exactly the reasons that the public trying to reason its way through interpreting studies like this unaided is dangerous to public health.

This is an observational study. It's not possible for it to control for (among other things) the possibility that those who were infected and survived already possessed enhanced natural immunity due to some other cause. All we know is that people who get COVID-19 and don't die from it are less likely to become symptomatic with the delta variant than people who are inoculated, not whether or not they were always less likely to become symptomatic with the delta variant.

People who interpret this study to mean "I don't need the vaccine" are really rolling the dice on the possibility that there's an X-factor here to COVID-19 survival... And they don't have it.

tootie8• 5 years ago

I'm fully vaccinated as is my whole family but you're the one showing bias here. The data is the data. Obviously the data set is only recovered patients. That has no bearing on the analysis. It's not a recommendation to go get infected or anything ridiculous like that. It's not a recommendation of anything. It's just data.

peterbonney6• 5 years ago

It’s math for the sake of math with no actual scientific value.

Here, let me help:

“Car crash survivors show greater seat belt compliance than people who watch a seat belt PSA.” Useless analysis.

JumpCrisscross4• 5 years ago

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.

peteradio12• 5 years ago

It may be in their rights to bar immune people who refuse vaccination but its plainly unscientific discrimination.

JumpCrisscross4• 5 years ago

may be in their rights to bar immune people who refuse vaccination but its plainly unscientific discrimination

We don’t have strong evidence either way. Neither choice—vaccinated only or both—is unscientific. (It is understandable that, without reliable proof, the unvaccinated would be barred.)

In any case, this is a problem we need to solve soon. The mRNA platform looks promising. We don’t want to back into a future where a diseased minority is barred from our urban cores. Particularly if they pose little risk to others.

nabla9• 5 years ago

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.

ramraj07• 5 years ago

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.

Aachen3• 5 years ago

Not sure if it was you but I might have been one of the skeptics (don't think it was with this user though). Many of the comments I saw sounded like conspiracy fuel. I didn't downvote anything that sounded substantial (for example if it had references, or at least the disclaimer that this doesn't mean you shouldn't get vaccinated). Makes me wonder how to tell cherry picking science for conspiracy (I saw that heavily with 5G for example) from reality, especially when official outlets are not agreeing with the latest research yet.

calvinmorrison• 5 years ago

But the risk of dying of COVID for most age groups is basically zero.

smileypete• 5 years ago

The opposite view was a mainstream media narrative last year, in that a suggestion as such was very widely reported:

'The rapid waning of antibodies did not necessarily have implications for the efficacy of vaccine candidates currently in clinical trials, Imperial’s [Wendy] Barclay said.'

“A good vaccine may well be better than natural immunity,” she said.

https://www.reuters.com/article/uk-health-coronavirus-britai...

https://www.google.com/search?q=“A+good+vaccine+may+well+be+...

ProjectBarks2• 5 years ago

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.

jlmorton2• 5 years ago

What is the harm?

"I'm very worried about getting Covid, but I'm also worried about the vaccine, so I'll get Covid to protect me against Covid?"

This is an important public health topic to model how the pandemic proceeds as more and more are naturally infected.

CyanLite2• 5 years ago

Some folks are looking for any excuse to not get the vaccine.

Buttons840• 5 years ago

The heart of the issue, and the one we seem most unable to talk about productively is "I'm worried about the vaccine".

deelowe• 5 years ago

That's exactly it. Almost everyone in my immediate family is more concerned about getting the vaccine than they are covid. And this is AFTER someone in the family has died from it. It is extremely concerning how bad this has gotten. My own mother literally had a panic attack after getting her first shot. My kids' school administrators are making decisions based on these illogical conclusions. I have had school staff tell me that it's best that they all go ahead and get covid. They compared it to chicken pox parties from the 80s. When I mentioned shingles, they told me that was a different disease. I have an at risk child at home. My tolerance for stupidity is waning.

I'm afraid the general publicly is woefully underequipped to engage in nuanced discussions around this topic. They need simple and clear instructions.

raffraffraff2• 5 years ago

Yeah. Should be "If you survive covid 19, you will have greater immunity to covid that you would get from a vaccine"

seoaeu2• 5 years ago

Pedantically, dying from covid makes it even less likely you'll catch it again... Really this is all just confusing what the actual goal is: to end the pandemic while minimizing death and suffering

koheripbal7• 5 years ago

This assumes the audience for this title are people that have not yet been infected.

It could also apply, for example, to the hundreds of millions of people world wide who have already been infected.

I don't think a fact should assume an audience.

roenxi• 5 years ago

Based on the number of deaths, a very large percentage of people have already had COVID.

Given that there is a non-0% chance of death or harm from taking the vaccine, why should they then get vaccinated? They are already less of a risk to themselves and others than someone who has been vaccinated.

gammarator• 5 years ago

Serological tests have consistently shown that far fewer people have had COVID than have been vaccinated, for instance.

andybak3• 5 years ago

why should they then get vaccinated?

I haven't done the sums but I suspect the risk of harm from the vaccine is less than the benefits the vaccine gives (especially when you factor in the duration of protecection depending when you had Covid vs when you had the vaccine).

I know people who've recovered from serious Covid and still got vaccinated. I would.

tootie8• 5 years ago

RTFA

The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated.

polote2• 5 years ago

a much less clickbait title should have been chosen

It is not clickbait, (if true) this is just a fact.

andybak3• 5 years ago

Clickbait and truth are not mutually exclusive. In fact I would suggest that most clickbait is true.

koheripbal7• 5 years ago

The volume of criticism for posting verifiable facts that might be misused in illogical arguments, is really frustrating.

It's as if we need to post a disclaimer in advance that we agree with the consensus first in order to post a fact like OP.

For example, OP's fact correlates with the recent study that demonstrated that getting one shot of Moderna and one shot of Pfizer was more effective than getting two shots of either.

...and none of that is a surprise to virologists, because a diversity of antibodies is obviously going to be more effective at combating infection, and more importantly, provide broader protection against variants.

...but instead OP gets downvotes because of the fear that some imbecile is going to repost this all over Facebook in order to convince people to not get vaccinated.

Think about the consequences of this reflex. We cannot talk about the truth in-depth because less informed people might be mislead by misinterpreting it. This diminishes the quality of our conversations. It puts a cap on the intelligence of this community.

...and when you first identify this phenomenon - you begin to recognize it all over the place on social media. True verifiable facts being downvoted because they might maybe work against the "greater good" agenda in a less sophisticated forum. ...and that ultimately causes a dumbing down of the conversations - something very noticeable on Reddit and Twitter.

yodsanklai• 5 years ago

This feels like an irresponsible title on behalf of the author

The title describes the content of the article. I think people should be treated as adults (esp. on HN). We should be able to discuss Covid-19 science and data without always fearing misinterpretation from anti-vaxxers.

fncypants• 5 years ago

Sorry, no. This is why there are anti-vaxxers to begin with. Communication is key. Scientists and health professionals fail at it. Listing cold facts does not effectively communicate to the broad public, because they receive the message not by learning the new facts to change their word view, but by trying to fit it in their world view. Messaging is critical in public communication.

flowardnut• 5 years ago

go step into the world of "covid vaccines are bad!" for a second (/r/newnormal) and you'll rescind this statement. It's getting out of hand, between misinformation and politicizing how we treat an infectious virus.

tootie8• 5 years ago

You're right. Data is data. That being said there is a pretty irrational contingent on HN these days.

ProjectBarks2• 5 years ago

The original title of the paper was "Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections." It's important to point out that the paper isn't just one fact but a collection of facts that form nuance.

To me science mags title is much more sensationalistic and there is a reason they did not chose a title more closely aligned to what the authors of the original study chose.

vmception• 5 years ago

The research impresses Nussenzweig and other scientists who have reviewed a preprint of the results, posted yesterday on medRxiv

Its very irresponsible, look at this nonsense masquarading as peer review of a preprint 24 hours ago

Furthermore, getting a vaccine for last year’s ailment cannot be compared to this year’s ailment, although its obvious people dont really have a choice in the matter the study should at least lead with that. There will be delta specific vaccines soon, compare to natural immunity then.

switch007• 5 years ago

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.

Erm everyone I know under 40 got it because of a huge marketing campaign, wanting to travel with as few restrictions as possible and not wanting a vaccine passport to party.

tacobelllover99• 5 years ago

Yesterday NPR was shaming US Military memebers for spreading this information as COVID misinformation.

I'm so disqusted with the media right now.

del_operator• 5 years ago

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.

tomaszs• 5 years ago

The title is a fake news. The same goes for the article on sciencemag and conclusions of the research. Researchers did not prove that vaccines cause higher risk.

Pxtl• 5 years ago

Good news for survivors, but this is going to make battles about vaccine passports much worse as anti-vax covid survivors demand exemption from the program.

londons_explore2• 5 years ago

I think most health policy decisionmakers would happily accept a positive test result for covid in place of a vaccination as long as this science is replicated by other parties.

john_minsk• 5 years ago

Sorry? Not exemption. Inclusion! Why there is some process that treats some antibodies better compared to others is beyond my understanding.

But In my view it is unscientific and as a result I can’t trust that the rest of the program of passports is designed properly and based on facts.

BoxOfRain• 5 years ago

I don't think being against vaccine passports necessarily makes you an anti-vaxxer. I've had both shots of the vaccine and I strongly oppose any sort of mandatory government ID card health-related or not, to the point I'll avoid patronising domestic businesses that voluntarily (ie without strong government coercion) impose them.

I'm not a fan of any form of authoritarianism really, let alone the overtly authoritarian "papers please" brand of it. One of the key parts of a free country is that you can be anywhere within it without some nosy government inspector (in person or by proxy electronically) demanding that you justify your presence there.

swader999• 5 years ago

Exactly this. And all it takes is for this scanning system to be centralized and then they can turn you off and geo fence you in. You may trust the current government to not abuse it but do you trust the next ten?

tzs2• 5 years ago

Long term it seems pretty straightforward.

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.

abnorxiouster2• 5 years ago

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.

You get vaccinated against an extremely specific variant, that does not guarantee any immunity for other variants unlike immunity from infection. Did you get vaccinated every year for the seasonal flu pre 2020? If not, why do you sustain vaccination when it is clear that you will have to take boosters and variant specific vaccines every year? Why would you suggest anyone that is not in a risk group and is healthy to vaccinate when his body is better prepared to withstand and easily battle any sars-cov-19 variant?

xyzzyz• 5 years ago

The vaccine does not “guarantee” protection from other variants, but it does have some, more for some variants and apparently less for others (delta). But, the same can be said about prior infection: it does not “guarantee” protection from other variants either. The paper here provides evidence that even though neither of them “guarantee” immunity for other variants or reinfection, prior infection provides more protection from COVID-19 than currently used vaccines.

seoaeu2• 5 years ago

Vaccination guarantees some immunity for all existing variants. Just because it is impossible to say for all hypothetical future variants doesn't mean you need to spread misinformation like that

tzs2• 5 years ago

You get vaccinated against an extremely specific variant, that does not guarantee any immunity for other variants unlike immunity from infection.

The current vaccines in the US provide excellent protection against serious illness or death from all current variations. It is only protection against infection that has fallen off some with the variations.

Did you get vaccinated every year for the seasonal flu pre 2020?

Yes.

Why would you suggest anyone that is not in a risk group and is healthy to vaccinate when his body is better prepared to withstand and easily battle any sars-cov-19 variant?

Because P(serious illness or death from their first COVID infection|not vaccinated) is much greater than P(serious illness or death from vaccination) + (1 - P(serious illness or death from vaccination)) x P(serious illness or death from their first COVID infection|vaccinated).

wokwokwok• 5 years ago

Did you read the article?

Still, Thålin and other researchers stress that deliberate infection among unvaccinated people would put them at significant risk of severe disease and death, or the lingering, significant symptoms of what has been dubbed Long Covid.
The study shows the benefits of natural immunity, but “doesn’t take into account what this virus does to the body to get to that point,” says Marion Pepper, an immunologist at the University of Washington, Seattle.
COVID-19 has already killed more than 4 million people worldwide and there are concerns that Delta and other SARS-CoV-2 variants are deadlier than the original virus.

nradov4• 5 years ago

Exactly. The only reason that the other four endemic human coronaviruses don't kill many people today is that most of us get infected as children and build up natural immunity which protects us later. But they can still be deadly to people with weak immune systems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102597/

Obviously most people weren't infected with SARS-CoV-2 as children so the smart move is to get vaccinated and jump start your immune system. Non-pharmaceutical interventions like masks and social distancing are only marginally effective so everyone will eventually get exposed to the virus no matter what we do.

NhanH• 5 years ago

That paper did not age well.

koheripbal7• 5 years ago

The other influence is the evolution of the virus itself. A longer lasting less-than-lethal infection is, in the long term, is selected for by evolutionary pressure.

In the short term though the biggest selection pressure on the virus is vaccine evasion.

criticaltinker6• 5 years ago

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.

Not disagreeing with your general point, but this statement is not accurate. For example, cross-reactive antibodies from other common cold coronaviruses can provide immune protection [1], which may partially explain why a large fraction of people are completely asymptomatic after initial SARS-COV-2 infection.

COVID-19 patients elicit strong responses to the nucleocapsid (N) protein of SARS-CoV-2 but binding antibodies are also detected in prepandemic individuals, indicating potential crossreactivity with common cold human coronaviruses (HCoV) [1]
In our study, we speculate that preexisting OC43 HCoV IgGs to N protein could be protective and, as a result, incoming SARS-CoV-2 infections would be more controlled and thus fewer antibodies induced against them.
In conclusion, N protein is a primary target of SARS-CoV-2-specific and HCoV crossreactive antibodies, both of which may affect the acquisition of immunity to COVID-19. [1]

[1] 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/

siilats3• 5 years ago

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.

walterbell3• 5 years ago

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?

sct202• 5 years ago

The UK has been estimating their percentage of population with antibodies which includes both people who were infected and vaccinated. Scroll to Figure 1 for the charts, but before vaccination their levels in the different regions (England, Scotland, NI, Wales) were <20%.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

To me I think that it's kind of surprising how low the percentages are.

lawrenceyan• 5 years ago

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.

jaywalk5• 5 years ago

My natural antibodies "protect the immunocompromised" just as much if not more than any antibodies stemming from vaccination.

DavideNL3• 5 years ago

Is it still possible to detect whether you had COVID in the past, after already getting the vaccine?

mikem1704• 5 years ago

Yes, I believe the right test can differentiate between the different antibody responses, telling you if you reacted to the virus, reacted to the vaccine, or both. I looked into this at one time and think I found one that cost $220. Sorry I don not have the link handy.

DavideNL3• 5 years ago

If you or anyone could post more info i’d be grateful. Like what specifications to look for in a test.

Also i wonder (approximately) how long after infection it would still be possible to test.

dgudkov• 5 years ago

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.

angelzen12• 5 years ago

A fourth group: vaccinated with (potential) breakthrough infections. Non-trivial numbers, as the vaccine is only 66% effective in preventing covid infections. According to the manichean logic of the media, this group of people is an immediate public health danger, therefore must be subjected to the same draconian measures as the unvaccinated.

wesleywt• 5 years ago

The problem with these articles is that while it tries to inform. The people who don't understant the implications of getting covid will use it as support for their bias not to get vaccinated.

bobbytit• 5 years ago

Yeah, the sheeple can't handle the truth.

BFatts2• 5 years ago

Maybe if they dose with some hydroxycholorquine, ivermectin, and shoot some UV up their bum, they will get AMAZING protection??

jbirer• 5 years ago

If you survive it, that is.

fmax302• 5 years ago

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.

nickandre2• 5 years ago

Why? The vaccine is literally a carbon copy of one of the early variants. It just makes the protein without infection.

This whole idea that the vaccine has magical properties to substantially exceed natural immunity on basic dimensions is straightforward BS.

fmax302• 5 years ago

I meant the article said that the actual disease confers greater immunity than a vaccine.

While that might be true, that immunity would only be good for one particular strain of the virus as opposed to the vaccine which provides you protection against a wider variety of strains.

One can argue that the protection from the vaccine is better in the sense, that it protects you from a wider variety of Covid strains.

Also, just so you know, that while the (mRNA) vaccine replicates protein, it is still your body and immune system which reacts to this protein and creates the antibodies.

So even in case of the vaccine, strictly speaking the immunity is natural.

thehappypm4• 5 years ago

It's an interesting concept. When your body makes antibodies against an active infection, it targets more than just the spike protein. Against the vaccine, it targets the spike protein 100% because that's all it has. As variants come and go, you should expect that the spike protein will change -- but it can't change that much because changing too much will reduce its ability to infect cells -- so it's a good thing to have a wide variety of antibodies against. However, having antibodies against other parts of the virus is useful too, since those might be more conserved with variants, but also they could be conserved less -- we don't really know.

heavyarms• 5 years ago

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.

palisade• 5 years ago

Yeah, it also confers organ damage for life and/or death. lol. Get the vaccine, nerds.

tablespoon• 5 years ago

Here's the important bit:

The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated.

Get the vaccine.

moistrobot2• 5 years ago

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.

a0-prw• 5 years ago

I love these threads about the virus. Where else can you get the thrill of considering your own and your loved ones' mortality, and pump the illusion that what you say matters in the big picture?

Pokepokalypse2• 5 years ago

Vaccines are NOT a treatment for individuals.

Vaccines are for populations.

We seem so wrapped up in our own precious snowflake egos now that we seem to have lost the ability to think of ourselves as part of a group.

Having SARS-CoV-2 once confers much greater immunity than a vaccine

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