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Having already had an infection before you were able to get vaccinated. A recent CDC study [0] joins plenty of others from last year in showing that these peop

Having already had an infection before you were able to get vaccinated. A recent CDC study [0] joins plenty of others from last year in showing that these people were at least as protected from infections and severe outcomes during delta as those who were vaccinated without a prior infection. Avoiding getting something that offers little benefit and offers even small risks makes sense to me. You've probably spent the last year being told these people are trying to murder your family though, so it also makes sense to me if you don't agree with this. [0]: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm7104e1_w https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

acdha 5y ago
> Avoiding getting something that offers little benefit and offers even small risks makes sense to me. It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else. Getting boosted, even after having been infected, is a cheap and easy way to reliably keep your immune response high without unpredictable timing. It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”.
- ifyoubuildit 5y ago
  > It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else. I encourage you to read the linked study, particularly the parts about the included cohorts. The recovered cohort didn't have any kind of stipulation that their infection was recent. The text does call out waning efficacy in the vaccines, but it does not mention the same for infection. > It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”. Does this have something do with what I said?
  - acdha 5y ago
    I did read, when it came out. I’m quoting Dr. Benjamin Silk, one of the authors: "The evidence in this report does not change our vaccination recommendations. We know that vaccination is still the safest way to protect yourself against COVID-19.” The reasoning is easy: many more people do not develop as strong a response from infection as they do from vaccination, and vaccination happens on a known schedule. This is especially of interest since the relationship here was reversed with Alpha, and is still unclear with Omicron - the figures I’ve seen have relatively recent infection somewhere between 2 doses and 3 in terms of efficacy, and infected plus vaccinated being the strongest. Now, if you think from a public health perspective that makes the call very easy: vaccines are cheap and effective, and more reliably produce an immune response. Waiting for people to get infected means that the schedule is unpredictable (overloads happen), and the timing being variable means that you might have people thinking they’re protected but they were part of the group who never mounted a strong response, or who have waned over time. Rather than having people get infected randomly or hoping that they had a strong response, it’s much easier to spend a few seconds vaccinating them so you have a higher confidence that they’re protected.
    - ifyoubuildit 5y ago
      Maybe you can help me understand this: if what you keep saying about reliability and timing are a thing, why doesn't this data support that? The study shows a cohort of people who had infections sometime between the advent of testing and march of 2021, and that cohort had better outcomes than the vaccinated but uninfected cohort. How can that be? What does it mean for immunity solely from vaccination to be "stronger" and "more reliable" if the outcomes are worse? What am I missing here? For the alpha vs delta point, what does it matter if the relationship flipped? They're basically equivalent either way. The important part is that they're both much better than seronaive. I think you might have lost track of my original response to the question that started this thread (what is a reason to not get vaccinated) where I said: > Having already had an infection before you were able to get vaccinated. How are pox parties and "waiting for people to get infected" and "having people get infected randomly" relevant to the scenario that I mentioned, where people don't have the choice of getting vaccinated before they get infected, since its already happened? There's no waiting, there's no parties, there is just dealing with the cards you've been dealt. By now there should be far more of these people than straight up seronaive folks. Similarly, "We know that vaccination is still the safest way to protect yourself against COVID-19", sounds like the same thing: if you need to gain protection from covid, we recommend getting it via vaccine rather than illness. That doesn't apply in this scenario, since protection has (as it seems to me we see empirically here) already been attained.

acdha 5y ago

> Avoiding getting something that offers little benefit and offers even small risks makes sense to me. It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else. Getting boosted, even after having been infected, is a cheap and easy way to reliably keep your immune response high without unpredictable timing. It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”.

ifyoubuildit 5y ago
> It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else. I encourage you to read the linked study, particularly the parts about the included cohorts. The recovered cohort didn't have any kind of stipulation that their infection was recent. The text does call out waning efficacy in the vaccines, but it does not mention the same for infection. > It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”. Does this have something do with what I said?
- acdha 5y ago
  I did read, when it came out. I’m quoting Dr. Benjamin Silk, one of the authors: "The evidence in this report does not change our vaccination recommendations. We know that vaccination is still the safest way to protect yourself against COVID-19.” The reasoning is easy: many more people do not develop as strong a response from infection as they do from vaccination, and vaccination happens on a known schedule. This is especially of interest since the relationship here was reversed with Alpha, and is still unclear with Omicron - the figures I’ve seen have relatively recent infection somewhere between 2 doses and 3 in terms of efficacy, and infected plus vaccinated being the strongest. Now, if you think from a public health perspective that makes the call very easy: vaccines are cheap and effective, and more reliably produce an immune response. Waiting for people to get infected means that the schedule is unpredictable (overloads happen), and the timing being variable means that you might have people thinking they’re protected but they were part of the group who never mounted a strong response, or who have waned over time. Rather than having people get infected randomly or hoping that they had a strong response, it’s much easier to spend a few seconds vaccinating them so you have a higher confidence that they’re protected.
  - ifyoubuildit 5y ago
    Maybe you can help me understand this: if what you keep saying about reliability and timing are a thing, why doesn't this data support that? The study shows a cohort of people who had infections sometime between the advent of testing and march of 2021, and that cohort had better outcomes than the vaccinated but uninfected cohort. How can that be? What does it mean for immunity solely from vaccination to be "stronger" and "more reliable" if the outcomes are worse? What am I missing here? For the alpha vs delta point, what does it matter if the relationship flipped? They're basically equivalent either way. The important part is that they're both much better than seronaive. I think you might have lost track of my original response to the question that started this thread (what is a reason to not get vaccinated) where I said: > Having already had an infection before you were able to get vaccinated. How are pox parties and "waiting for people to get infected" and "having people get infected randomly" relevant to the scenario that I mentioned, where people don't have the choice of getting vaccinated before they get infected, since its already happened? There's no waiting, there's no parties, there is just dealing with the cards you've been dealt. By now there should be far more of these people than straight up seronaive folks. Similarly, "We know that vaccination is still the safest way to protect yourself against COVID-19", sounds like the same thing: if you need to gain protection from covid, we recommend getting it via vaccine rather than illness. That doesn't apply in this scenario, since protection has (as it seems to me we see empirically here) already been attained.