4 ms·

First, you skipped the fact that this is about the Delta variant. Those folks have been refusing vaccines since much earlier than when Delta became prevalent.

First, you skipped the fact that this is about the Delta variant. Those folks have been refusing vaccines since much earlier than when Delta became prevalent. > Our study has several limitations. First, as the Delta variant was the dominant strain in Israel during the outcome period, the decreased long-term protection of the vaccine compared to that afforded by previous infection cannot be ascertained against other strains. Second... how do you reconcile your position with [1]? > Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated. Third, note that they describe another limitation: > Additionally, as this is an observational real-world study, where PCR screening was not performed by protocol, we might be underestimating asymptomatic infections, as these individuals often do not get tested. This is particularly important given that vaccines appeared to reduce viral loads (and thus transmission) for strains preceding the Delta variant, but they don't seem to have this effect for Delta anymore. One huge reason the CDC kept telling people to get vaccinated was to reduce transmission rates. It's not just about your personal health here. Yet people didn't listen, and now we have a strain whose transmission appears to be far less affected by vaccination. So if people are refusing it on that basis for Delta, that doesn't make it a "good point", but rather a self-fulfilling prophecy (and one that quite possibly sabotaged a public health campaign). [1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

BuGGeH 5y ago
From your same paper. >These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection What "2.34 times" is referencing is two groups had COVID-19 but one of them got the vaccine as well. In which case the COVID-19 + Vaccine group has less chance of reinfection compared to those who only had COVID-19. The original article does mention that COVID-19 + infection does provide more protection as well I believe.
- dataflow 5y ago
  You're only looking at "protection". It's not just about that individual. That's only half the story. Transmissibility is the other half. Think about it this way: if we could tell already-vaccinated people to get COVID for extra reduction of transmissions (!), we would do that too. For obvious reasons, we don't do that. But this clearly doesn't apply in the reverse direction!
tjbiddle 5y ago
> Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated. Simple. Not vaccinated != infected previously Those who are both not vaccinated, and not previously infected, will raise that number significantly.
- criticaltinker 5y ago
  The cited study explicitly compares previously infected (not vaccinated) individuals to vaccinated individuals, so your claim is wrong. However I will say, in a lot of the CDC literature they inconsistently refer to "unvaccinated" individuals in a manner that often does not distinguish between those with prior infection and those who are immunologically naive. I think this has been a major point of confusion for the general public who are trying to interpret the results of such studies.
criticaltinker 5y ago
> how do you reconcile your position with [1]? The CDC publication you cited has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature has contradicted their findings. Multiple large scale and long term serological studies have demonstrated that immunity acquired through previous infection has been at least equally durable and effective as vaccination in preventing reinfection. - 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) - In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494) - The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075) - 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) > One huge reason the CDC kept telling people to get vaccinated was to reduce transmission rates It's important to note that transmission is also equally well reduced by immunity acquired through natural infection. > It's not just about your personal health here. Yet people didn't listen, and now we have a strain whose transmission appears to be far less affected by vaccination. You seem to be implying that if everyone had been vaccinated the virus wouldn't have mutated into a variant with increased transmission/virulence. That fact is that the current vaccines do not provide sterilizing immunity. Therefore transmission, mutation, and selective pressure would have continued at a rate that would still be extremely likely to evolve into VOCs [6]. Moreover, analogous to antibiotic resistance, evolution of vaccine resistance is a non-trivial risk associated with mass vaccination strategies [7][8]. This brings us back to OP which is strong evidence suggesting that natural infection may induce an immune response that is more robust to variants of concern such as delta. Considering all of these facts, the optimal public health strategy will likely involve a mix of vaccination, naturally acquired immunity, and other viral elimination strategies such as early treatment using multi-drug therapies based on existing and widely available medications which have been proven to be effective at reducing hospitalization and death [9][10][11][12][13][14]. [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/ 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/ciab495/6287116 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/fullarticle/2780557 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/S2589537021001413 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/fullarticle/2776810 https://jamanetwork.com/journals/jamainternalmedicine/fullar... [6] The total number and mass of SARS-CoV-2 virions https://www.pnas.org/content/118/25/e2024815118 https://www.pnas.org/content/118/25/e2024815118 [7] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/ [8] Can we predict the limits of SARS-CoV-2 variants and their phenotypic consequences? https://www.gov.uk/government/publications/long-term-evolution-of-sars-cov-2-26-july-2021 https://www.gov.uk/government/publications/long-term-evoluti... [9] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?article=1139&context=infectiousdiseases_articles https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a... [10] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.12543 https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1... [11] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?attachType=PDF&id=5074 https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a... [12] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S0306987721001419 https://www.sciencedirect.com/science/article/abs/pii/S03069... [13] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/ https://pubmed.ncbi.nlm.nih.gov/33983065/ [14] Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19 https://www.frontiersin.org/articles/10.3389/fphar.2021.652688/full https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...

BuGGeH 5y ago

From your same paper. >These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection What "2.34 times" is referencing is two groups had COVID-19 but one of them got the vaccine as well. In which case the COVID-19 + Vaccine group has less chance of reinfection compared to those who only had COVID-19. The original article does mention that COVID-19 + infection does provide more protection as well I believe.

dataflow 5y ago
You're only looking at "protection". It's not just about that individual. That's only half the story. Transmissibility is the other half. Think about it this way: if we could tell already-vaccinated people to get COVID for extra reduction of transmissions (!), we would do that too. For obvious reasons, we don't do that. But this clearly doesn't apply in the reverse direction!

tjbiddle 5y ago

> Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated. Simple. Not vaccinated != infected previously Those who are both not vaccinated, and not previously infected, will raise that number significantly.

criticaltinker 5y ago
The cited study explicitly compares previously infected (not vaccinated) individuals to vaccinated individuals, so your claim is wrong. However I will say, in a lot of the CDC literature they inconsistently refer to "unvaccinated" individuals in a manner that often does not distinguish between those with prior infection and those who are immunologically naive. I think this has been a major point of confusion for the general public who are trying to interpret the results of such studies.

criticaltinker 5y ago

> how do you reconcile your position with [1]? The CDC publication you cited has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature has contradicted their findings. Multiple large scale and long term serological studies have demonstrated that immunity acquired through previous infection has been at least equally durable and effective as vaccination in preventing reinfection. - 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) - In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494) - The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075) - 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) > One huge reason the CDC kept telling people to get vaccinated was to reduce transmission rates It's important to note that transmission is also equally well reduced by immunity acquired through natural infection. > It's not just about your personal health here. Yet people didn't listen, and now we have a strain whose transmission appears to be far less affected by vaccination. You seem to be implying that if everyone had been vaccinated the virus wouldn't have mutated into a variant with increased transmission/virulence. That fact is that the current vaccines do not provide sterilizing immunity. Therefore transmission, mutation, and selective pressure would have continued at a rate that would still be extremely likely to evolve into VOCs [6]. Moreover, analogous to antibiotic resistance, evolution of vaccine resistance is a non-trivial risk associated with mass vaccination strategies [7][8]. This brings us back to OP which is strong evidence suggesting that natural infection may induce an immune response that is more robust to variants of concern such as delta. Considering all of these facts, the optimal public health strategy will likely involve a mix of vaccination, naturally acquired immunity, and other viral elimination strategies such as early treatment using multi-drug therapies based on existing and widely available medications which have been proven to be effective at reducing hospitalization and death [9][10][11][12][13][14]. [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/ 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/ciab495/6287116 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/fullarticle/2780557 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/S2589537021001413 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/fullarticle/2776810 https://jamanetwork.com/journals/jamainternalmedicine/fullar... [6] The total number and mass of SARS-CoV-2 virions https://www.pnas.org/content/118/25/e2024815118 https://www.pnas.org/content/118/25/e2024815118 [7] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/ [8] Can we predict the limits of SARS-CoV-2 variants and their phenotypic consequences? https://www.gov.uk/government/publications/long-term-evolution-of-sars-cov-2-26-july-2021 https://www.gov.uk/government/publications/long-term-evoluti... [9] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?article=1139&context=infectiousdiseases_articles https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a... [10] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.12543 https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1... [11] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?attachType=PDF&id=5074 https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a... [12] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S0306987721001419 https://www.sciencedirect.com/science/article/abs/pii/S03069... [13] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/ https://pubmed.ncbi.nlm.nih.gov/33983065/ [14] Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19 https://www.frontiersin.org/articles/10.3389/fphar.2021.652688/full https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...