5 ms·

They've always had a good point. This is yet another paper in a line of good (and unsurprising) research going back to vaccine trials in 2020. The discourse ha

by wahern 5y ago

They've always had a good point. This is yet another paper in a line of good (and unsurprising) research going back to vaccine trials in 2020. The discourse has become politicized, unfortunately, and for whatever reasons the voices of the pro-vaccine faction in the U.S. have become dominated by people who reflexively discount the science. This doesn't seem to be the case in Europe, where the EU-wide immunity passport treats those with prior documented infection the same as the fully vaccinated. This was pointed out to me on HN a few weeks ago, when I opined that it would be logistically impractical to verify and issue immunity passports to the previously infected. Would it be better if those with a previous infection received a vaccine? Maybe. That's a more complex question. But at this juncture that's moving the goal posts; it's scientifically and politically unreasonable to make that demand.

foolinaround 5y ago
> it would be logistically impractical to verify and issue immunity passports to the previously infected. If one is donating blood etc, this information is available such as in the Red Cross donor app. The push by the pro-vaccine groups in the US without accounting for folks who have antibodies acquired naturally - reeks of ignorance from those who are supposedly 'of science'
tedunangst 5y ago
I imagine they're trying to discourage people from getting deliberately infected to avoid a shot.
- wahern 5y ago
  Except the CDC decided to hang their hat (https://www.cdc.gov/media/releases/2021/s0806-vaccination-protection.html https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...) on the one published article that claimed to show vaccination was dramatically more efficacious than previous infection, despite that study contradicting multiple, better studies, and despite the study itself admitting in a footnote that the data was exceptionally suspect. Also note how the CDC hedges their bets in the press release, saying that vaccination is better than prior infection alone, which only begs the question. Here's the rub: is previous infection as good as Moderna? Probably not, especially given the new variants. (Though last year studies were showing infection providing 90%+ immunity.) But nothing is as good as Moderna. (Except maybe Novavax?) Should we require J&J vaccine recipients to be re-vaccinated with Moderna? Nobody is demanding that, though very roughly speaking J&J-level immunity may be about where things stand now for the previously infected. This seems to be another unforced err by the CDC. Not as bad as some others, but unforced and very politically costly. It also complicates things going forward because it seems we're quickly approaching the point where we'll need to begin requiring a 2nd round of vaccinations. The CDC will need every last shred of credibility and good will left for that initiative. It could have been in a position where it could say, "hey, we tolerated the previously infected skipping vaccination before, but now the situation has changed." Instead, they'll have much less capital to work with.
  - spfzero 5y ago
    I'm curious why you think previous infection is not better than Moderna. If we grant that Moderna is better than the vaccine used in the study in the OP, can it possibly be a factor of 6 better? a factor of 12? Those are the kinds of numbers they're seeing in this study. Admittedly it's not yet peer-reviewed and maybe those factors get watered down or thrown out, but if they don't, it would look like the difference between vaccine efficacies are down in the noise compared to the difference between any vaccine and natural immunity.
    - wahern 5y ago
      > I'm curious why you think previous infection is not better than Moderna. I was trying to be conservative. I don't have any hard opinion on this one way or another. It seems like a degree of precision we'd be lucky to achieve in the best of times--i.e. when the virus and demographics aren't constantly evolving. And it's a degree of precision that is unnecessary to establish in this particular debate, even if we could. It feels like bike shedding. The question isn't which is better--infection or vaccination. The question is, do we demand that the infected be vaccinated even though the substantial and consistent weight of scientific evidence gives us little reason to believe the previously infected put the population at more risk than the vaccinated, especially relative to vaccines that we affirmatively accept as sufficiently efficacious? The only scientifically justified answer is an unqualified, "No". There are innumerable other questions people can debate, but from a pandemic policy perspective there's no need to venture there. And, frankly, it seems imprudent considering the level of uncertainty surrounding everything--not just the quality and relevance of data, but even if you're technically correct one moment, things can go sideways the next moment, necessitating a change in policy.
      - spfzero 5y ago
        Thanks, good points.
      - tedunangst 5y ago
        I think you're stuck on the word "previously" infected. If the government says you must be vaccinated or pass an antibody test by Sept 15 to keep your job, what are people going to do?
enkid 5y ago
"Pro-vaccine faction" sure sounds like a loaded term. Look, the CDC says if you were infected, you should still get the vaccine because it gives additional protections. This paper says the same. The vaccine is extremely safe from all of the data we have seen so far, much safer than getting COVID. So just get the vaccine. It's really not that hard unless you make it hard.
- zpeti 5y ago
  Many pro vaccine people basically attack people who have had the infection and don’t want the vaccine, and call them anti science and anti vaccine, and judging by your tone you have similar views. Yet from a science perspective they have a point, already having the disease matters.
  - maccam94 5y ago
    Still, many people don't have proof that they actually had covid-19, some have falsely identified the symptoms of other infections as covid-19, and getting the vaccine will still boost the immune response for an extended period of time. Just get the vaccine, it's not hard.
    - barcoder 5y ago
      Or better still give the vaccines to countries and people that actually want them. Or is that much harder?
      - mijamo 5y ago
        Actually it is in fact much harder.
    - higherup 5y ago
      >Just get the vaccine, it's not hard. Getting the Vaccine is easy. What is hard is to trust the what every biased, safety studies done on it and the fact the AEFI reporting system is not strictly mandated, indicating a bias from the authorities to not want to know about potential vaccine injuries. As usual, this comment will get flagged. If you see this comment check back a bit later to see the shilling on HN.
walterbell 5y ago
One issue is that an FDA advisory in May 2021 discouraged doctors from antibody testing of immunity, https://noorchashm.medium.com/fdas-advisory-discouraging-americans-from-determining-the-status-of-their-individual-immunity-to-1af4788805ef https://noorchashm.medium.com/fdas-advisory-discouraging-ame... & https://www.fda.gov/medical-devices/safety-communications/antibody-testing-not-currently-recommended-assess-immunity-after-covid-19-vaccination-fda-safety https://www.fda.gov/medical-devices/safety-communications/an... > [FDA] blocked Americans from finding out the status of their antibody immunity to SARS-CoV-2 ... prevents un-immune Americans from knowing that they are vulnerable ... exposes already immune Americans to the risk of an unnecessary or marginally beneficial vaccination ... prevents vaccinated Americans in whom the vaccine has not induced good immunity from knowing that they remain vulnerable ... discourages a vast majority of American physicians from providing the people with the necessary prescriptions to obtain COVID-19 antibody blood tests ... Every American deserves easy access to information about their personal immunity status in order to make a cogent decision to maximally protect themselves. Am I immune? Did my vaccine work for me? Am I still immune?
bigcorp-slave 5y ago
I mean, you know what’s happening here, I presume. The anti-vaccine faction will just lie about prior infection and keep spreading the plague. In exactly the same way as we have people forging vaccination cards now. There’s been a consistent anti-science and pro-disease stance on the right since pretty much day one. It’s breathtaking, no pun intended, to watch.
claudiusd 5y ago
Thank you for saying this. Despite taking all precautions, I was infected in Jan 2021 before becoming eligible for the vaccine. Once I recovered, I was comfortable venturing outside again and doing some traveling but there was practically zero information about natural immunity following infection. As states easing travel restrictions, these only applied to people who had been vaccinated. There was no exception for folks who were previously infected (at least for the states I researched). At a time when vaccine appointments were scarce and there were long waiting lists (my how times have changed), I still got the first appointment I could so I could get my vaccine card. The lack of guidance for those who were previously infected was strange. When I'd read about immunization rates and progress towards "herd immunity", previous infections also weren't included in these stats, which again was strange. I'm in Europe now, and here it seems like natural immunity is essentially as valid as vaccination, at least for travel. I can't explain why previous infections seem so widely discounted in the US. It feels like an intentional omission, which makes it hard for me to trust at face value what I hear and read about the pandemic.

by wahern 5y ago

foolinaround 5y ago

> it would be logistically impractical to verify and issue immunity passports to the previously infected. If one is donating blood etc, this information is available such as in the Red Cross donor app. The push by the pro-vaccine groups in the US without accounting for folks who have antibodies acquired naturally - reeks of ignorance from those who are supposedly 'of science'

tedunangst 5y ago

I imagine they're trying to discourage people from getting deliberately infected to avoid a shot.

wahern 5y ago
Except the CDC decided to hang their hat (https://www.cdc.gov/media/releases/2021/s0806-vaccination-protection.html https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...) on the one published article that claimed to show vaccination was dramatically more efficacious than previous infection, despite that study contradicting multiple, better studies, and despite the study itself admitting in a footnote that the data was exceptionally suspect. Also note how the CDC hedges their bets in the press release, saying that vaccination is better than prior infection alone, which only begs the question. Here's the rub: is previous infection as good as Moderna? Probably not, especially given the new variants. (Though last year studies were showing infection providing 90%+ immunity.) But nothing is as good as Moderna. (Except maybe Novavax?) Should we require J&J vaccine recipients to be re-vaccinated with Moderna? Nobody is demanding that, though very roughly speaking J&J-level immunity may be about where things stand now for the previously infected. This seems to be another unforced err by the CDC. Not as bad as some others, but unforced and very politically costly. It also complicates things going forward because it seems we're quickly approaching the point where we'll need to begin requiring a 2nd round of vaccinations. The CDC will need every last shred of credibility and good will left for that initiative. It could have been in a position where it could say, "hey, we tolerated the previously infected skipping vaccination before, but now the situation has changed." Instead, they'll have much less capital to work with.
- spfzero 5y ago
  I'm curious why you think previous infection is not better than Moderna. If we grant that Moderna is better than the vaccine used in the study in the OP, can it possibly be a factor of 6 better? a factor of 12? Those are the kinds of numbers they're seeing in this study. Admittedly it's not yet peer-reviewed and maybe those factors get watered down or thrown out, but if they don't, it would look like the difference between vaccine efficacies are down in the noise compared to the difference between any vaccine and natural immunity.
  - wahern 5y ago
    > I'm curious why you think previous infection is not better than Moderna. I was trying to be conservative. I don't have any hard opinion on this one way or another. It seems like a degree of precision we'd be lucky to achieve in the best of times--i.e. when the virus and demographics aren't constantly evolving. And it's a degree of precision that is unnecessary to establish in this particular debate, even if we could. It feels like bike shedding. The question isn't which is better--infection or vaccination. The question is, do we demand that the infected be vaccinated even though the substantial and consistent weight of scientific evidence gives us little reason to believe the previously infected put the population at more risk than the vaccinated, especially relative to vaccines that we affirmatively accept as sufficiently efficacious? The only scientifically justified answer is an unqualified, "No". There are innumerable other questions people can debate, but from a pandemic policy perspective there's no need to venture there. And, frankly, it seems imprudent considering the level of uncertainty surrounding everything--not just the quality and relevance of data, but even if you're technically correct one moment, things can go sideways the next moment, necessitating a change in policy.
    - spfzero 5y ago
      Thanks, good points.
    - tedunangst 5y ago
      I think you're stuck on the word "previously" infected. If the government says you must be vaccinated or pass an antibody test by Sept 15 to keep your job, what are people going to do?

enkid 5y ago

"Pro-vaccine faction" sure sounds like a loaded term. Look, the CDC says if you were infected, you should still get the vaccine because it gives additional protections. This paper says the same. The vaccine is extremely safe from all of the data we have seen so far, much safer than getting COVID. So just get the vaccine. It's really not that hard unless you make it hard.

zpeti 5y ago
Many pro vaccine people basically attack people who have had the infection and don’t want the vaccine, and call them anti science and anti vaccine, and judging by your tone you have similar views. Yet from a science perspective they have a point, already having the disease matters.
- maccam94 5y ago
  Still, many people don't have proof that they actually had covid-19, some have falsely identified the symptoms of other infections as covid-19, and getting the vaccine will still boost the immune response for an extended period of time. Just get the vaccine, it's not hard.
  - barcoder 5y ago
    Or better still give the vaccines to countries and people that actually want them. Or is that much harder?
    - mijamo 5y ago
      Actually it is in fact much harder.
  - higherup 5y ago
    >Just get the vaccine, it's not hard. Getting the Vaccine is easy. What is hard is to trust the what every biased, safety studies done on it and the fact the AEFI reporting system is not strictly mandated, indicating a bias from the authorities to not want to know about potential vaccine injuries. As usual, this comment will get flagged. If you see this comment check back a bit later to see the shilling on HN.

walterbell 5y ago

One issue is that an FDA advisory in May 2021 discouraged doctors from antibody testing of immunity, https://noorchashm.medium.com/fdas-advisory-discouraging-americans-from-determining-the-status-of-their-individual-immunity-to-1af4788805ef https://noorchashm.medium.com/fdas-advisory-discouraging-ame... & https://www.fda.gov/medical-devices/safety-communications/antibody-testing-not-currently-recommended-assess-immunity-after-covid-19-vaccination-fda-safety https://www.fda.gov/medical-devices/safety-communications/an... > [FDA] blocked Americans from finding out the status of their antibody immunity to SARS-CoV-2 ... prevents un-immune Americans from knowing that they are vulnerable ... exposes already immune Americans to the risk of an unnecessary or marginally beneficial vaccination ... prevents vaccinated Americans in whom the vaccine has not induced good immunity from knowing that they remain vulnerable ... discourages a vast majority of American physicians from providing the people with the necessary prescriptions to obtain COVID-19 antibody blood tests ... Every American deserves easy access to information about their personal immunity status in order to make a cogent decision to maximally protect themselves. Am I immune? Did my vaccine work for me? Am I still immune?

bigcorp-slave 5y ago

I mean, you know what’s happening here, I presume. The anti-vaccine faction will just lie about prior infection and keep spreading the plague. In exactly the same way as we have people forging vaccination cards now. There’s been a consistent anti-science and pro-disease stance on the right since pretty much day one. It’s breathtaking, no pun intended, to watch.

claudiusd 5y ago

Thank you for saying this. Despite taking all precautions, I was infected in Jan 2021 before becoming eligible for the vaccine. Once I recovered, I was comfortable venturing outside again and doing some traveling but there was practically zero information about natural immunity following infection. As states easing travel restrictions, these only applied to people who had been vaccinated. There was no exception for folks who were previously infected (at least for the states I researched). At a time when vaccine appointments were scarce and there were long waiting lists (my how times have changed), I still got the first appointment I could so I could get my vaccine card. The lack of guidance for those who were previously infected was strange. When I'd read about immunization rates and progress towards "herd immunity", previous infections also weren't included in these stats, which again was strange. I'm in Europe now, and here it seems like natural immunity is essentially as valid as vaccination, at least for travel. I can't explain why previous infections seem so widely discounted in the US. It feels like an intentional omission, which makes it hard for me to trust at face value what I hear and read about the pandemic.