4 ms·

I agree completely with this comment. The numbers in this paper are a casually spectacular defense of the vaccines. You would be hard pressed to find 100k unvac

I agree completely with this comment. The numbers in this paper are a casually spectacular defense of the vaccines. You would be hard pressed to find 100k unvaccinated people anywhere in the world with outcomes like that. Nonetheless, the interrogation of natural immunity (+1 dose of pfizer) against naive with 2 doses of pfizer is incredibly valuable and I am intrigued by the outcomes here. What this suggests to me is the vaccines are good, but we can do even better with careful applications of science. I look forward to what scientists and drug companies produce over the next few years.

criticaltinker 5y ago
> The numbers in this paper are a casually spectacular defense of the vaccines Yes the paper is certainly not an attack on vaccines. The crucial implications of the findings in OP are especially relevant to public health policy: 1) There are diminishing returns to vaccinating individuals who have already acquired immunity through natural infection. The benefits are borderline insignificant. Therefore when faced with a limited supply of vaccines, vaccination strategies should be highly focused on immunologically naive or vulnerable individuals. 2) Compulsory mass vaccination mandates need to accommodate naturally immune individuals. If they do not, such mandates are not only wasteful, but are also effectively ordering unnecessary medical procedures which is a violation of medical ethics and likely a violation of constitutional rights to bodily integrity and informed consent. 3) If vaccine effectiveness at preventing infections continues to be undermined by viral evolution, new formulations will need to be tested and deployed. The mRNA delivery mechanism supports rapid iteration in that respect, but those efforts will still take months at minimum. Consequently it will likely be necessary to supplement mass vaccination with other viral elimination strategies, such as early treatment with multi-drug therapy based on existing and widely available medicines [1][2][3][4][5]. [1] 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... [2] 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... 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... [3] 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... [4] 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/ [5] 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...
- bart__ 5y ago
  On your second point: The paper shows, when comparing recovered to recovered with single dose, that there are about half as many re-infections. And yes we're talking about 0.3% vs 0.15% reinfection (that's why there is not enough power for significance), but halving the chances may still be important. I'm opposed to compulsory vaccination either way though.
sfteus 5y ago
W/R/T your second point, one of the things I touched on was whether or not those with natural immunity are more likely to experience repeated exposure after acquiring immunity. For instance, is a healthcare worker more likely to experience "micro-doses" of virus exposure that helps consistently refresh antibody levels? This is a potential reason as some sources have stated that the third booster shot is generating 5-10x the antibody levels as observed than after the second shot, and a higher number of free antibodies should be associated with a smaller chance of re-infection. The other potential that jumps out to me is that only targeting the spike protein is causing the drop in protection, as in theory that should be the only type of antibody a only-vaccinated person would have. The potential conclusion to draw there is that antibodies developed for other antigens on the virus may not be as effective as the spike protein, but when combined help retain that higher level of effectiveness when the spike protein mutates. If that's the case, I wonder if having a inactivated/attenuated vaccine as the "third-dose" may end up being more effective, or if the immune system would ignore the additional antigens in favor of the one it already has. [1]: https://www.wsj.com/articles/covid-19-third-shot-booster-11623421703 https://www.wsj.com/articles/covid-19-third-shot-booster-116...

criticaltinker 5y ago

> The numbers in this paper are a casually spectacular defense of the vaccines Yes the paper is certainly not an attack on vaccines. The crucial implications of the findings in OP are especially relevant to public health policy: 1) There are diminishing returns to vaccinating individuals who have already acquired immunity through natural infection. The benefits are borderline insignificant. Therefore when faced with a limited supply of vaccines, vaccination strategies should be highly focused on immunologically naive or vulnerable individuals. 2) Compulsory mass vaccination mandates need to accommodate naturally immune individuals. If they do not, such mandates are not only wasteful, but are also effectively ordering unnecessary medical procedures which is a violation of medical ethics and likely a violation of constitutional rights to bodily integrity and informed consent. 3) If vaccine effectiveness at preventing infections continues to be undermined by viral evolution, new formulations will need to be tested and deployed. The mRNA delivery mechanism supports rapid iteration in that respect, but those efforts will still take months at minimum. Consequently it will likely be necessary to supplement mass vaccination with other viral elimination strategies, such as early treatment with multi-drug therapy based on existing and widely available medicines [1][2][3][4][5]. [1] 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... [2] 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... 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... [3] 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... [4] 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/ [5] 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...

bart__ 5y ago
On your second point: The paper shows, when comparing recovered to recovered with single dose, that there are about half as many re-infections. And yes we're talking about 0.3% vs 0.15% reinfection (that's why there is not enough power for significance), but halving the chances may still be important. I'm opposed to compulsory vaccination either way though.

sfteus 5y ago

W/R/T your second point, one of the things I touched on was whether or not those with natural immunity are more likely to experience repeated exposure after acquiring immunity. For instance, is a healthcare worker more likely to experience "micro-doses" of virus exposure that helps consistently refresh antibody levels? This is a potential reason as some sources have stated that the third booster shot is generating 5-10x the antibody levels as observed than after the second shot, and a higher number of free antibodies should be associated with a smaller chance of re-infection. The other potential that jumps out to me is that only targeting the spike protein is causing the drop in protection, as in theory that should be the only type of antibody a only-vaccinated person would have. The potential conclusion to draw there is that antibodies developed for other antigens on the virus may not be as effective as the spike protein, but when combined help retain that higher level of effectiveness when the spike protein mutates. If that's the case, I wonder if having a inactivated/attenuated vaccine as the "third-dose" may end up being more effective, or if the immune system would ignore the additional antigens in favor of the one it already has. [1]: https://www.wsj.com/articles/covid-19-third-shot-booster-11623421703 https://www.wsj.com/articles/covid-19-third-shot-booster-116...