5 ms·

Not to disagree with the effectiveness of immunity gained by getting Covid-19, but also: "The evidence shows that protective antibodies generated in response t

Not to disagree with the effectiveness of immunity gained by getting Covid-19, but also: "The evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants ... compared to antibodies acquired from an infection." https://directorsblog.nih.gov/2021/06/22/how-immunity-generated-from-covid-19-vaccines-differs-from-an-infection/ https://directorsblog.nih.gov/2021/06/22/how-immunity-genera... "Vaccination offers longer, stronger immunity" https://www.jhsph.edu/covid-19/articles/why-covid-19-vaccines-offer-better-protection-than-infection.html https://www.jhsph.edu/covid-19/articles/why-covid-19-vaccine... "Why a vaccine can provide better immunity than an actual infection" https://theconversation.com/why-a-vaccine-can-provide-better-immunity-than-an-actual-infection-145476 https://theconversation.com/why-a-vaccine-can-provide-better... "Why You Need to Get Vaccinated Even If You’ve Already Had COVID-19" https://www.healthline.com/health-news/why-you-need-to-get-vaccinated-even-if-youve-already-had-covid-19 https://www.healthline.com/health-news/why-you-need-to-get-v... And also, vaccination is a much, much safer way to get antibodies, than via getting sick with Covid-19.

eightysixfour 5y ago
To add to the list: "Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.58–3.47). These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection." https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm7032e1_w https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...
- rubatuga 5y ago
  Observational evidence of course, meaning plenty of confounders.
  - timr 5y ago
    Also a very small study of N=246, which is why the confidence interval on the OR is so large.
- criticaltinker 5y ago
  Here is a paper (not yet peer-reviewed) which presents statistically strong evidence (N = 52,238) that vaccinating previously infected individuals provides practically no benefit [1]. Quote from [1]: - "The cumulative incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vaccinated, compared with a steady increase in cumulative incidence among previously uninfected subjects who remained unvaccinated." Right now there is no scientific consensus that full vaccination of previously infected individuals provides any additional protection that is meaningfully beneficial. In fact there is a lot of evidence pointing the other way - supporting the idea that vaccination strategies should be highly targeted at only the most vulnerable populations. [1] Necessity of COVID-19 vaccination in previously infected individuals https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v3.full.pdf https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v...
  - raphlinus 5y ago
    Thanks for bringing this paper, it's relevant to the conversation. A couple of points of context. First, this study is quite early on in the vaccination campaign, when supplies were very short. The main conclusion is that they should be prioritized to people who have not had prior infection. That advice was not followed, largely because determining prior infection status complicates the protocols for vaccination quite a bit, and simpler is better. Now, at least in the US, we're in a situation where we are literally throwing vaccine down the drain[1, 2]. Second, this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant[3]. Vaccine effectiveness appears to be somewhat reduced compared with the original variant, but still pretty good. This is definitely an area where more science is needed. [1]: https://www.statnews.com/2021/07/20/states-are-sitting-on-millions-of-surplus-covid-19-vaccine-doses-as-expiration-dates-approach/ https://www.statnews.com/2021/07/20/states-are-sitting-on-mi... [2]: https://www.al.com/coronavirus/2021/08/alabama-threw-out-65000-expired-covid-vaccines-state-health-officer.html https://www.al.com/coronavirus/2021/08/alabama-threw-out-650... [3]: https://www.nature.com/articles/s41586-021-03777-9 https://www.nature.com/articles/s41586-021-03777-9
briefcomment 5y ago
Probably not as clear cut as that. The OP study suggests that vaccines can be improved from learnings from natural immunity. > "Overcoming the challenges to end the pandemic is accentuated by the recognition that SARS-CoV-2 can undergo rapid antigenic variation that may lower vaccine effectiveness in preventing new cases and progression to severe disease. Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells. The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved. Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains."
timr 5y ago
I am a believer in vaccines, but you're mischaracterizing the first link by selective omission. You've cut out the critical words of the sentence (emphasized): > The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection. The paper shows that vaccines produce a more diverse antibody response to the RBD, which is one portion of the spike protein. They admit that natural infection produces antibodies targeted to other portions of the spike protein (also, presumably, to other parts of the virus, though that isn't discussed in this press release): > Specifically, antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein. Is this evidence that vaccines are "better" than natural infection? No. It can't be. The paper shows that there's a difference between the antibody responses, but beyond that, it's impossible to know what the practical impacts of that difference might be from this paper. This is a perfect example of the political weaponization of pre-prints that has happened throughout the pandemic. People read these things, don't fully understand what they're reading or what questions they answer, and immediately jump to social media to start waving them around like team flags (and worse, people who should know better -- like Francis Collins -- seem to encourage the behavior. This PR seems to be trying very hard to mislead, without actually stepping over the line.) This is an interesting paper, but it is in no way a definitive statement about the relative benefits of vaccination vs. natural immunity.
- SideburnsOfDoom 5y ago
  Thank you for adding nuance. This topic is indeed in sore need of more nuance.
- raphlinus 5y ago
  Thanks for trying to bring more precision to the discussion. I also cited that blog post elsethread, and, having reviewed it, agree it's not the single best piece of evidence. It establishes a narrow result which suggests a generally better immune response from vaccines, but does not prove it. If I had to cite a single preprint to support the assertion, it would probably be this one: https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4 https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4 Obviously this study also has limitations: it speaks only to Ab levels, while obviously the overall immune response is a lot more complicated. I agree with the "waving of preprints" claim. Unfortunately, hyperskepticism, rejecting drawing conclusions because of the inevitable limitations of any study, is also a politicized position, and unfortunately I see a fair amount of that as well.
phkahler 5y ago
We can cherry pick papers all day long to support or refute the idea that having had Covid19 is equivalent/better/worse than getting the vaccine. Anyone being honest can see that the jury is still out on the issue. But I can state 2 things with certainty. 1) having had it does offer some degree of immunization. 2) there is a lot of evidence that those spike proteins do damage. Given that, I dont know why some people lump previously infected folks in with anti-vaxxers. It's not even close to the same thinking.
- mmcnl 5y ago
  > there is a lot of evidence that those spike proteins do damage Citation needed.
nickthemagicman 5y ago
I love how the top comment is links to 4 opinion piece articles two of which are from healthline.com and theconversation.com. "Citations" My high school English teacher would be disappointed in this site. I'm sure there's a bunch of actual scientific articles below that are flagged because they are going against the narrative. Don't ever change HN.
arein3 5y ago
you can look at jewish data for a highly vaccinated population 50% newly infected are unvaccinated, 50% are vaccinated and only 1% are getting the virus the second time
- amanaplanacanal 5y ago
  I assume you mean Israeli data?

eightysixfour 5y ago

To add to the list: "Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.58–3.47). These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection." https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm7032e1_w https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...

rubatuga 5y ago
Observational evidence of course, meaning plenty of confounders.
- timr 5y ago
  Also a very small study of N=246, which is why the confidence interval on the OR is so large.
criticaltinker 5y ago
Here is a paper (not yet peer-reviewed) which presents statistically strong evidence (N = 52,238) that vaccinating previously infected individuals provides practically no benefit [1]. Quote from [1]: - "The cumulative incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vaccinated, compared with a steady increase in cumulative incidence among previously uninfected subjects who remained unvaccinated." Right now there is no scientific consensus that full vaccination of previously infected individuals provides any additional protection that is meaningfully beneficial. In fact there is a lot of evidence pointing the other way - supporting the idea that vaccination strategies should be highly targeted at only the most vulnerable populations. [1] Necessity of COVID-19 vaccination in previously infected individuals https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v3.full.pdf https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v...
- raphlinus 5y ago
  Thanks for bringing this paper, it's relevant to the conversation. A couple of points of context. First, this study is quite early on in the vaccination campaign, when supplies were very short. The main conclusion is that they should be prioritized to people who have not had prior infection. That advice was not followed, largely because determining prior infection status complicates the protocols for vaccination quite a bit, and simpler is better. Now, at least in the US, we're in a situation where we are literally throwing vaccine down the drain[1, 2]. Second, this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant[3]. Vaccine effectiveness appears to be somewhat reduced compared with the original variant, but still pretty good. This is definitely an area where more science is needed. [1]: https://www.statnews.com/2021/07/20/states-are-sitting-on-millions-of-surplus-covid-19-vaccine-doses-as-expiration-dates-approach/ https://www.statnews.com/2021/07/20/states-are-sitting-on-mi... [2]: https://www.al.com/coronavirus/2021/08/alabama-threw-out-65000-expired-covid-vaccines-state-health-officer.html https://www.al.com/coronavirus/2021/08/alabama-threw-out-650... [3]: https://www.nature.com/articles/s41586-021-03777-9 https://www.nature.com/articles/s41586-021-03777-9

briefcomment 5y ago

Probably not as clear cut as that. The OP study suggests that vaccines can be improved from learnings from natural immunity. > "Overcoming the challenges to end the pandemic is accentuated by the recognition that SARS-CoV-2 can undergo rapid antigenic variation that may lower vaccine effectiveness in preventing new cases and progression to severe disease. Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells. The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved. Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains."

timr 5y ago

I am a believer in vaccines, but you're mischaracterizing the first link by selective omission. You've cut out the critical words of the sentence (emphasized): > The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection. The paper shows that vaccines produce a more diverse antibody response to the RBD, which is one portion of the spike protein. They admit that natural infection produces antibodies targeted to other portions of the spike protein (also, presumably, to other parts of the virus, though that isn't discussed in this press release): > Specifically, antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein. Is this evidence that vaccines are "better" than natural infection? No. It can't be. The paper shows that there's a difference between the antibody responses, but beyond that, it's impossible to know what the practical impacts of that difference might be from this paper. This is a perfect example of the political weaponization of pre-prints that has happened throughout the pandemic. People read these things, don't fully understand what they're reading or what questions they answer, and immediately jump to social media to start waving them around like team flags (and worse, people who should know better -- like Francis Collins -- seem to encourage the behavior. This PR seems to be trying very hard to mislead, without actually stepping over the line.) This is an interesting paper, but it is in no way a definitive statement about the relative benefits of vaccination vs. natural immunity.

SideburnsOfDoom 5y ago
Thank you for adding nuance. This topic is indeed in sore need of more nuance.
raphlinus 5y ago
Thanks for trying to bring more precision to the discussion. I also cited that blog post elsethread, and, having reviewed it, agree it's not the single best piece of evidence. It establishes a narrow result which suggests a generally better immune response from vaccines, but does not prove it. If I had to cite a single preprint to support the assertion, it would probably be this one: https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4 https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4 Obviously this study also has limitations: it speaks only to Ab levels, while obviously the overall immune response is a lot more complicated. I agree with the "waving of preprints" claim. Unfortunately, hyperskepticism, rejecting drawing conclusions because of the inevitable limitations of any study, is also a politicized position, and unfortunately I see a fair amount of that as well.

phkahler 5y ago

We can cherry pick papers all day long to support or refute the idea that having had Covid19 is equivalent/better/worse than getting the vaccine. Anyone being honest can see that the jury is still out on the issue. But I can state 2 things with certainty. 1) having had it does offer some degree of immunization. 2) there is a lot of evidence that those spike proteins do damage. Given that, I dont know why some people lump previously infected folks in with anti-vaxxers. It's not even close to the same thinking.

mmcnl 5y ago
> there is a lot of evidence that those spike proteins do damage Citation needed.

nickthemagicman 5y ago

I love how the top comment is links to 4 opinion piece articles two of which are from healthline.com and theconversation.com. "Citations" My high school English teacher would be disappointed in this site. I'm sure there's a bunch of actual scientific articles below that are flagged because they are going against the narrative. Don't ever change HN.

arein3 5y ago

you can look at jewish data for a highly vaccinated population 50% newly infected are unvaccinated, 50% are vaccinated and only 1% are getting the virus the second time

amanaplanacanal 5y ago
I assume you mean Israeli data?