[timr]

Yes, and?

The comment to which I'm responding said there's little evidence that natural immunity is better than vaccines. That's just not true. There's pretty strong evidence, actually.

That natural immunity plus a booster is better than either is interesting, but not responsive to the question.

[hcknwscommenter]

No there is not strong evidence. The Israeli study highlighted previous infection versus vaccinated but not (yet) infected. Note the "previously infected" category did not exclude the vaccinated, but the vaccinated category did exclude the previously infected. The only solid conclusion to make from that is: that even if you have been previously infected, get a vaccine.

[timr]

> The Israeli study highlighted previous infection versus vaccinated

Yes, they did this, and showed that natural infection was superior to vaccination alone.

> but not (yet) infected.

Incorrect.

> Note the "previously infected" category did not exclude the vaccinated, but the vaccinated category did exclude the previously infected.

No. You only have to read the link to see that your understanding of the study is entirely incorrect.

> The study...found in two analyses that never-infected people who were vaccinated in January and February were, in June, July, and the first half of August, six to 13 times more likely to get infected than unvaccinated people who were previously infected with the coronavirus. In one analysis, comparing more than 32,000 people in the health system, the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher.

> The researchers also found that people who had SARS-CoV-2 previously and 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.

[hcknwscommenter]

Okay. I admit that my characterization was sloppy/incorrect. Thank you for pointing that out. The paper is still not strong evidence though. To whit:

"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."

These numbers are very small for distinguishing between the effectiveness of two different and effective immunization methods (natural and vaccine). By now, we should have more data to support if the effect size is that strong. Do we?

[microtherion]

Even if the numbers scale up, they'd mean that you'd avoid roughly 1 hospitalization for every 2285 people who got immunity from being infected instead of from being vaccinated. Unfortunately, to obtain that immunity, about 1 in 30 had to be hospitalized, 1 in 250 died, and a significant number suffered serious complications.

Nobody in their right mind would choose such a tradeoff.

[timr]

Nobody here is making this argument. You're setting up a straw man.

The point is: people who have recovered from the illness are immune, and should be treated as such.

[logifail]

> people who have recovered from the illness

I'm not sure the guy on the street is actually interested in properly understanding the risks associated with Covid.

My neighbour is in his 70s, he had Covid in November 2020 and (in his words) he wasn't particularly poorly with it. He subsequently had his vaccinations.

He and a couple of friends have been having blood tests to check on antibody titres. His antibodies are still really high, his friends (who haven't had Covid) have antibodies which have dropped significantly since they were vaccinated. He told me he wasn't sure why.

We were talking out on the street, my kids were out and around on their bikes, he told me he thought it was really important that children (like mine) should get vaccinated in order to keep people like him "safe".

What do you say at that point? I'm honestly not sure where we go from here.

[timr]

> These numbers are very small for distinguishing between the effectiveness of two different and effective immunization methods (natural and vaccine). By now, we should have more data to support if the effect size is that strong. Do we?

You should check the number of deaths in the original trials used to approve the Pfizer and Moderna vaccines. You might be surprised. Even in big trials in immunologically naive populations, only a small number of people became seriously ill -- a total of 10 people became seriously ill across the entire Pfizer trial. No deaths occurred. [1]

Once you've vaccinated your population (or otherwise allowed them to become immune), you're talking about incredibly small effect sizes.

[1] https://www.nejm.org/doi/full/10.1056/nejmoa2034577