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by jaywalk 1814 days ago
It's time for the naturally immune to be treated the same as those who've been vaccinated. There is absolutely zero scientific evidence to the contrary, and plenty of evidence to support it.
6 comments

Vaccination is more comprehensive than natural immunity though. We've already see that the BNT vaccine offers a higher degree of protection against variants than natural immunity, or indeed other vaccines.

Reinfection studies from a few months ago demonstrated that natural immunity is roughly 50% effective for people aged 65 or over. And that's the age group most likely to experience negative outcomes from covid-19, it's seems prudent to go ahead and recommend vaccinations for this age group, regardless of previous infection.

Then there's the elephant in the room: so few people have been tested that it really difficult to know who has had it. Anyone who has had a cold in the past 18 months is going to claim they had covid, regardless of whether they tested positive or not. It would be easier to vaccinate this group than it would be to perform a test for covid antibodies.

If covid hadn't become a political shit-show, I'd agree with you. But at this point, I think it's a little irresponsible to society to give anyone an out on getting vaccinated.

> Vaccination is more comprehensive than natural immunity though. We've already see that the BNT vaccine offers a higher degree of protection against variants than natural immunity, or indeed other vaccines.

I have seen no evidence for either of these claims, other than assertions. If you have some, please provide citations.

It's quite irresponsible to try and coerce people who don't need treatment to accept it as well
No it isn't - it's providing unified and clear guidance on vaccination. I'm up in Canada where vaccine hesitancy has been almost unheard of[1] and those who refuse to get vaccinated, excepting those that can't for medical reasons, are ostracized for their overtly selfish actions. The US, though, has a real problem with disinformation being accepted more readily than fact. I am fine with the theory of having a nuanced and technical discussion of vaccine efficacy but I think it's pretty clear that that discussion can't happen in the public forum due to continued calls that hydroxychloroquine is an equally valid solution.

1. https://ourworldindata.org/explorers/coronavirus-data-explor...

As a Canadian who emigrated to the US, the attitude you so proudly display--ostracizing people who aren't convinced of a novel vaccine with zero long-term safety information--makes me so happy I live here.
It's not novel, this technology has been trialed and used for a decade, 3 years in vaccines.

We do already have long-term data. You would see side effects for a vaccine within six months, and we have been administering it for much longer than that.

The vaccines are safe.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956899/

This is incredibly misleading.

I used to be a close follower of the pharma industry, and you're making it seem like FDA trials happen on molecules and formulations somewhat related to the proposed formulation and then are, like, transitively approved on that hand-wavey basis. This is totally wrong.

For reasons that should be obvious to any engineer that's worked on any kind of even moderately complex system, the molecule that is tested and trialed is the molecule that goes to production.

You don't test "the technology" and then some unrelated other vaccine and then say, there we go, this one's safe.

You test the actual formulation that will go to production. This can't have happened for this yet. The trials are still underway. Unknown risk.

I dunno if you're misinformed or a troll, but that's dangerous stuff to be putting out there.

Vaccines are amazing life-saving tech, and they're safe because of our cultural technologies (FDA trials for e.g.) that make them safe. You can't take all the safety gear out and still get the same safety rating. Doesn't make sense, lol.

> You would see side effects for a vaccine within six months, and we have been administering it for much longer than that.

We have now had two separate rare-but-serious side effects of different Covid vaccines: the CVT issue with J&J, and the myocarditis issue with the mRNA vaccines in children. It's disingenuous to suggest that the vaccines are "safe" merely because they've been widely administered; even the question of what "safe" means is a far more nuanced question than you're presenting. For children, in particular, two-dose vaccination with the mRNA vaccines is probably a poor risk/benefit profile. We didn't know that until we started dosing enough kids to see the rare side effects.

The phase 3 trials were not powered to detect rare side effects, which is part of the reason that they're still classified as emergency use, and not fully approved.

I am an advocate for vaccination, but it's not right to ignore these issues.

> The vaccines are safe.

This is true by medicinal standards, but it's also a sleight-of-hand. The AstraZeneca vaccine had a rare side-effect that was right on track to kill more young women in Europe than the virus itself. That's why it was banned. By that standard, I could argue the viral infection is also safe - for young women at least.

How sure are you about the long term effects of COVID?
Oh, not very sure at all. However, I may have already have it, so that cat's out of the bag (and invalidates any reason to get the vaccine anyways). Or I may never get it. Taking the vaccine, which includes three brand new medical technologies and has not completed phase3 trial, guarantees me taking that risk.

I am extremely healthy, have a great diet, and as a farmer, I get plenty of time soaking up vitamin D, a potent inhibitor of covid. The vaccine doesn't make any sense for me to take.

Normal disclaimer, I am a huge, huge believer in vaccines, and am probably more vaccinated (due to travel and other circumstances) than nearly everyone reading this comment. I believe bar none vaccines are the medical technology that has saved the most lives in our history as a species. Big fan of vaccines.

But, vaccines are made safe via clinical trials and long-term studies. These vaccines are wholly new in type, were rushed to market, have liability waivers for those pushing them, and to make things even worse, the manufacturers aren't collecting followup data about adverse events in any kind of systematic way (as they would during a normal phase4). So it seems to me the playbook that gave us generations of safe vaccines that saved billions of lives has been thrown out the window.

No thanks!

Did I miss the long term safety information of the corona virus?
Hear hear. That will never be the norm in the United States of America, no matter what some cliques and bubbles online seem to think.
This has nothing to do with what I said. You are reacting to anti-vaccine views other people have that are not expressed in my comment. I said that _if_ Covid-19 infection confers equal levels of protection to vaccination then it is irresponsible to try and coerce people who have been infected to get vaccinations they don't need. I have said nothing about anything else. If you have issues with what those people have said you should take it up with them
To be fair, your comment was rather nebulous. If you're going to comment on a topic that tends to polarize people, then it's wise to be slightly more explicit in one's statements.
> are ostracized

That sounds like hell.

> hell

My Canadian friends seem to think that's what their country has turned into, and on just about every front, not just vaccines.

Yea, I unfortunately have a lot of friends and family still there, and almost all of them are not gonna take the vaccine and find the social environment very taxing.

But, they are still OK, because they know we're never given any challenge to great for our spirits to overcome.

> I'm up in Canada where vaccine hesitancy has been almost unheard of[1] and those who refuse to get vaccinated, excepting those that can't for medical reasons, are ostracized for their overtly selfish actions.

In other words, those who value individual freedom might want to avoid Canada for its over-boarding groupthink and overtly collectivist mentality.

I actually strongly disagree with this point. America has a very precise definition of individual freedom that I disagree with - it's a big part of why I emigrated. In the US you're absolutely free to die as you wish - in Canada you're free to live a healthy life and do with that life what you may.

Socialism and socialized healthcare frequently gets painted as being anti-freedom but I think that the lack of socialized healthcare infringes more effectively on individual freedoms than the presence of it. In the case of vaccinations - encouraging widespread vaccination (and there is currently and probably will never be a mandate) allows more of the population to act freely. Canada is only behind on vaccinations (and, in total doses administered we're now actually tied) due to the fact that we don't have domestic production facilities which resulted on our dose orders being delayed until America dealt with their domestic population. I don't think that's unfair and I've been pretty critical of the LPC that failed to build out domestic production facilities early into the pandemic but - eh, we work with what we've got.

I think you are projecting what you view as two options in America - either communism or individual freedoms - onto the rest of the world. That is a myopic approach to take when considering all the cultures and governments in the world.

> In the US you're absolutely free to die as you wish - in Canada you're free to live a healthy life and do with that life what you may.

...while ostracized for defending your self-interest?

I'm not saying one is strictly better than the other. It's a tradeoff. As they say in New York: "If you can make it here, you can make it anywhere". The corollary of that might be: "If you can't make it here, move to Canada".

Lack of socialized healthcare? The USA has at least 3 times as many people on government healthcare than the entire population of Canada (Medicare, Medicaid, the VA). The USA has the second- third-largest government-run healthcare system in the world.

As a person who lived 20 years in Canada and 14 in the USA, I'll take the USA every day of the week--and for the past year I've paid for my own health insurance directly.

Canada's healthcare system is run by bureaucrats who prioritize many items ahead of citizen health.

Here's one example: A family member is a police officer. While I was visiting home, in Ontario, he was hit with some insane shoulder-related pain. This is one tough guy and he was reduced to tears--some kind of nerve damage or something.

The hospital in Canada told him he needed an MRI. And that it would take between 4 and 6 months til there was an available slot. They gave him a prescription for strong opiates to manage the pain during his wait.

I drove him over the border to Buffalo, shelled out $500, and he had his MRI in less than half an hour. The drive was longer than the wait in the radiology clinic.

There are tradeoffs in every situation. I think Canada's healthcare system is better in one exact way: Nobody's bankrupted of their financial wealth due to healthcare. But many many many Canucks are bankrupted of their actual health, their time, their human wealth, due to healthcare.

What you are saying is contrary to the tack already taken towards the eradication of other endemic lethal diseases and pests such as River Blindness. That example has been eradicated through much of the Americas primarily by treating everyone in an affected community with ivermectin, which has the effect of slowing transmission from all of the infected individuals in the community (including those who don't know they are infected) and does not harm uninfected individuals. With attitudes like the one you are quoting, it would never work.
> Then there's the elephant in the room: so few people have been tested that it really difficult to know who has had it. Anyone who has had a cold in the past 18 months is going to claim they had covid, regardless of whether they tested positive or not.

There are many many people who have confirmed positive COVID tests. At least excuse those.

>I think it's a little irresponsible to society to give anyone an out on getting vaccinated.

I think it's irresponsible to require people who most science points to having better protection naturally, to also have to get a vaccine. From this point of view, 2 dose vaccine still have less protection than natural antibodies. Maybe we should require the vaccinated to keep getting more vaccine shots until science shows they're at par with natural antibodies, lowest hanging fruit and all...

> There are many many people who have confirmed positive COVID tests. At least excuse those.

The virus is a moving target and what was true of the alpha variant may not be true of delta or downstream. I guess it depends on what you mean by excuse. If you mean allow people to say go on a cruise with a positive covid test as opposed to a vaccination record that seems tentatively reasonable. If you mean allow workers at an old folks home to opt out based on a prior positive test that is unreasonable. If it makes you even possibly slightly less likely to kill the old folks you should get the jab.

The real problem is the grey area created by such a rule. There are probably multiple times as many people who think they have had covid compared to those that have actually had covid that have never been tested. I know people in the US who had an illness in 2019 who are sure they had covid. If you give them an opening they wont let it go. It will surely get ugly.

If folks can't produce a confirmed positive covid test or antibody test, then they can effectively be treated as unprotected because there's no evidence they have protection, that's fine.

> If you mean allow workers at an old folks home to opt out based on a prior positive test that is unreasonable. If it makes you even possibly slightly less likely to kill the old folks you should get the jab.

Where is the line drawn? Maybe it would be more effective for people with 2 doses to get a third? What science is there showing antibodies + 1 shot is more marginal protection than 3 shots?

It should be drawn where it's safe to draw it based on current knowledge.

I don't believe that it's firmly established that natural immunity is as good as 2 shots or natural immunity + 1 shot.

We bought more than enough doses to vaccinate everyone and downsides are small.

Consider a population of 10 million with natural immunity. Let us suppose that vaccination with Pfizer will kill between 0 and 1.

Suppose that 1% would fall ill and 1% of those die. That is 1000 preventable deaths.

It needn't be very much of a difference just 1/100th of 1% to vastly outweigh the risk of a very safe vaccine.

The vaccine also leads to natural antibodies. It only contains the spike protein so the immune system can safely develop the antibodies.
> Maybe we should require the vaccinated to keep getting more vaccine shots until science shows they're at par with natural antibodies, lowest hanging fruit and all...

Why would we do that when the vaccines are safer than the actual disease and effective enough to contain the spread?

There are repeated calls demanding people with antibodies should be required to get a vaccine shot. However most available science points towards natural immunity having slightly better protection. Is there any science whatsoever showing that antibodies + 1 more shot is better than 2 vaccine shots + 1 additional shot? If antibodies are still more protected than 2 shots, how do we know which option provides the most marginal protection? You could easily make the case that since the current science is showing natural antibodies have more comprehensive protection than 2 dose shots, that maybe our first priority should be giving 2 dosers a third shot?
I misinterpreted your post as some kind of “herd immunity” scheme where we all get infected and that is somehow better. That doesn’t seem to be the argument you were making so I am sorry.

It seems like we should be optimizing for vaccinating as much of the (non-antibody) population up to a level where the spread of the virus is contained rather than maximizing resistance in the population with antibodies. There must be a threshold at which the low hanging fruit becomes “people without antibodies” rather than “people with fewer antibodies”. I’m not sure it matters if the antibodies are from the vaccine or infection.

It sounds like we're in agreement. Focusing on requirements for confirmed positive covid patients is of negligible benefit. Once the "people without antibodies" actual risk factor is curbed, then we hopefully have had the scientific research to determine what the next best lowest hanging fruit to address is.

> I’m not sure it matters if the antibodies are from the vaccine or infection.

I'm not entirely sure either. There is some research that since the vaccine is just the spike protein, while natural immune response was to the entire virus, that the natural immune response is more comprehensive.

Isn’t the number of antibodies after a COVID infection far lower than after receiving the vaccine? I thought that’s why a jab after an infection is actually still recommended, to boost the number to levels that vaccinated see?
https://www.nature.com/articles/d41586-021-01442-9

The study provides evidence that immunity triggered by SARS-CoV-2 infection will be extraordinarily long-lasting. Adding to the good news, “the implications are that vaccines will have the same durable effect”, says Menno van Zelm, an immunologist at Monash University in Melbourne, Australia.

> There are many many people who have confirmed positive COVID tests. At least excuse those.

Yes, but don't just take their word for it. Confirmed clinical test should be the bar. I fear if the "you don't need a vaccine if you've had it" narrative gains traction, even if it is undeniably true, it's going to result in the anti-vaxxers lying about having already had the virus, to manufacture another excuse for themselves. If we've learned anything in the last year, it's that any system that relies on people to pinky-swear they're telling the truth will be exploited by a small but significant minority of people.

Here is the thing (and that's something that people with kids might relate to) -- we already know that covid is not a danger to kids, and that there are potential side effects involved when vaccinating kids. There is no way in hell I would vaccinate my child because "it is good for the society as a whole".
> we already know that covid is not a danger to kids

We don't actually know this. We know it's less dangerous to them thus far. https://www.bbc.com/news/world-latin-america-56696907 https://www.statesman.com/story/news/politics/politifact/202...

"Thus far" is implied. We only ever know what we know thus far and we could always learn something new.
covid absolutely is a danger to kids, it's just less of a danger than to old people. the question is whether risk of vaccination is significantly less than risk of covid. we don't really know yet, but i'd surely vaccinate my kids if it meant they couldn't transmit the disease to their grandparents.
I agree entirely. My point is that there are a significant amount of people who aren't even there. There hasn't been acquiescing past demanding exception-less vaccine passports.
It's not your business to police this and that's not how it works in the United States. It is not anyone's business to demand a confirmed clinical test. Florida and other states have been open for a long time now and their covid numbers are declining same as wherever there are attempts at more mandates. What use is a confirmed clinical test there?

We are not a collective. We do not have these types of arbiters who will police and decide what is best for everyone. We are a nation of individuals and if you cannot trust people to "pinky-swear" on this matter then how can you trust them to do anything? Including vote on anything? Or reason? Who will make all the decisions for them?

Every system has some number of malicious actors. You should trust, but you must also verify. If a system designer assumes no bad actors exist, the system will be quickly exploited, which is why voluntary mask mandates and distancing rules didn't work. We have locks on doors, passwords for computers, seat belts in cars, and rules against drunk driving, precisely because of a small number of dishonest and reckless people.
Wear a mask and get vaccinated if you’re not and stay home if you’re scared.

Florida and other states have not had mandates and they’re doing fine per the data.

> zero scientific evidence to the contrary, and plenty of evidence to support it

We have evidence that vaccination continue to provide broad-spectrum immunity while those naturally immune are e.g. still vulnerable to the Delta variant [1].

[1] https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...

The Wall Street Journal reported Friday that about half of adults infected in an outbreak of the delta variant in Israel were fully vaccinated with the Pfizer-BioNTech vaccine

Source CNBC.

Is this intended as a counterpoint, or a point in support? People have been pretty loose with their "therefore" about this Israel snippet. After all, if 100% of Israel had been vaccinated with Pfizer, then 100% of adults infected with Delta would have been fully vaccinated. I'm sure the raw number of people infected with Delta is way down compared to what it would have been w/o vaccination though.
This is a frequent anti-vaxx talking point that well predates COVID-19. In most outbreaks in highly vaccinated populations, most of the cases will be in the vaccinated. We see this for measles and pertussis all the time. The rate will be much lower though.
Just googling, Israel vaccination rate is 57.0%
Cool. Note that among adults, that rate would be higher. (For the apples-to-apples comparison with above.) Saw one headline that said 80% as of June 1st. If that's true, the original stat is basically equivalent to saying that 50% of the infections are among the 20% of the (unvaccinated) adult population.
Can I see a link? I'm not finding the same report. Instead I'm finding these [1] which point to the vaccine being highly effective at keeping you out of the hospital.

[1] https://www.reuters.com/business/healthcare-pharmaceuticals/...

Moreover, half of the deaths from the delta variant in the UK occured in fully vaccinated individuals:

https://www.businessinsider.com/vaccinated-among-delta-death...

I would see two main reasons for this:

- vaccinations are far from "94% effective" in the age groups who need it the most (elderly with weakened immune systems)

- deaths are over-counted (death from any cause within 28 days is counted as COVID death)

Did you read the entire article?

Or even the bold points at the beginning?

No fully vaccinated people under 50 died, and the overall death rate was 0.13%.

One hundred and seventeen deaths from 92,029 cases is a death rate of about 0.13%.

you conveniently miss the fact that if more people were vaccinated, delta wouldn't have spread this fast and perhaps wouldn't even come to be or would die out before it could spread.
How is that relevant? The question is: How effective are these vaccines really against that variant? In the real world, not in the lab.

If half the cases are in vaccinated individuals and only half the people are vaccinated, how can the vaccine be 80%-90% effective? That's a mathematical impossibility.

In the case of the deaths, it might be possible because the vaccinated are far older on average and likely over-counted.

i disagree fundamentally about the question.

for me, the question is: how can we prevent the virus from mutating enough to escape vaccine- and covid-based immunity with another variant? the answer is to stop the virus from infecting a host in which it can mutate freely and from which it can escape. we don't know these people, so we should aim to vaccinate as many as possible before it finds another person who walks around with the virus for multiple months with no symptoms, accelerating natural selection thousandfold.

Just saw a quote from Gottlieb the other day saying that they think the vaccine is more protective against COVID generally than natural immunity... the variants also seem more likely to pierce prior immunity... and that what's really protective is if you get vaccinated after natural infection. (paraphrased, but pretty close.)

Also, generally speaking, people who caught COVID were contagious for a while, while vaccinated people aren't. So there's the social responsibility factor - if you have a lifestyle where you at all likely to be among people while contagious, getting vaccinated reduces risk for others.

> Just saw a quote from Gottlieb

Who is this? Why do we care what he says? Can you provide a source for the quote?

The Cleveland clinic disagrees with your “authoritative” quote (see comments above)

Dr. Scott Gottlieb, former commissioner of FDA, https://twitter.com/SquawkCNBC/status/1409465340292222986
Thanks, he doesn’t directly address this new study. And uses soft, non-definitive language that can be walked back if needed. Not saying I don’t appreciate you providing the source, but as far as what he says vs what you said he said… it’s a little different.

I’d also like to add, I don’t think many ppl are thinking they’d rather get the disease vs the vaccine, rather, if they already got the disease, is there a real benefit vs the risks of the vaccine (eg the heart stuff we’re seeing now). Personally I was careful and never got sick, so I got the vaxx ASAP, but I do think it’s a fair and legitimate concern.

Combination of previous infection and a vaccine dose gives you better coverage, the second is less needed. (And e.g. here in Germany proof of previous infection + one dose counts as fully vaccinated)
Vaccine induced immunity is natural too, it's the same mechanism, exposure to an antigen triggers a response in the body.

Really, "naturally immune" would imply a pre-existing immunity to the infection.

If someone opposes that common sense, I’d have to wonder what their agenda is tbh.
back in the day it was common sense surgeons washing hands is pointless.
And? That doesn't change that there are still things which are common sense and rooted in basic logic accessible to anyone. That Nature journal article is one of those things.
it was basic logic accessible to anyone that washing hands doesn't matter - it was, after all, just dirt and blood. it couldn't be proven that there was anything bad in dirt and blood.
So you think that Nature as a journal saying previous covid infection gives antibodies like the vaccines, is comparable to how primitive medical science once didn’t know you had to wash your hands before surgery?
yes, in that common sense is volatile and using basic logic in presence of unknown unknowns is a risky proposition. i don't particularly care about the paper because it doesn't apply to the variant which hasn't evolved yet.