“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.
Not one of the 1359 previously infected subjects who remained unvaccinated had a SARS-CoV-2 infection over the duration of the study.”
I know that seems like a large number but in the vaccine arm there were 20x more subjects and only 15 cases. So with the 1359 previously infected subjects, assuming identical behavior to vaccinated subjects, we would expect around 0.9 cases if vaccines were approximately equal to infection.
So this study doesn't have enough statistical power to say how vaccines compare to previous infection. Could be better, could be up to 3 times worse within a high confidence interval.
(disclamer: back-of-the-napkin math, did not double check everything)
Previously infected: 2579, of whom 1220 vaccinated, 1359 not vaccinated. No subsequent infections in either of these groups.
Not previously infected: 49659, of whom 29461 vaccinated (15 subsequent infections), 20198 not vaccinated (2139 subsequent infections).
Comparing previous infection with vaccination, we have 0/1359 infections in the previously infected and 15/29461 infections otherwise. According to Fisher's exact test, the two-tailed P-value for this is 1.0, which is very much not significant. You're correct to say that the study doesn't show how vaccines compare to previous infection. The study is way underpowered to show that.
For the unvaccinated, it gets more interesting. We have 0/1359 infections versus 2139/20198. According to Fisher, that has a P-value of 2 * 10^-64, which is most definitely significant. The study is not underpowered to show this at all. A previous infection is definitely protective.
With the caveat that the participants didn't have asymptomatic screening, so there is quite possibly bias due to people with a previous infection getting a second milder case and not being tested.
Using the exact method, 95% confidence intervals for infection rate are:
Previously infected, not vaccinated: 0% to 0.3%
Previously infected, vaccinated: 0% to 0.3%
Not previously infected, not vaccinated: 10.1% to 11.0%
Not previously infected, vaccinated: 0.03% to 0.08%
Thanks for this! Yes there is no doubt that there is an effect, of course, but it doesn't rule out the booster shot being possibly very helpful in strenghtening immunity
>> So this study doesn't have enough statistical power to say how vaccines compare to previous infection. Could be better, could be up to 3 times worse within a high confidence interval.
Could be. But it would be great if they'd just say having had a confirmed case is equivalent to getting the vaccine because several studies have now shown that to be roughly the case. It's also conventional medical wisdom although it varies by virus.
>> You'll notice they say - we don't have enough data. Then data is incomplete. Then we can't really say because study was X / Y / Z.
This is a weird trend these days. Medical science refuses to take an engineering approach to anything and only accepts statements based on controlled studies. That includes rejecting previous understanding of how immunity works in general. Early on when claims were made about HCQ, Zinc, or whatever, they were shot down as "not approved treatment" even though there were no approved treatments! The utter failure to recommend vitamin D supplements is another failure - we know deficiency weakens immune response, we know most (Americans) are deficient in the winter, it's a no-brainer but in their mind it was not "proven" so not even mentioned or recommended for anyone.
The only pattern I see considering all cases like that is the underlying notion that people must not do anything for themselves.
According to this study it could be a long time before we know that - I think cov-19 in the presence of a non overwhelmed medical system armed with steroids and oxygen kills less than 2/100 infected folk so getting enough incidents in either of those arms of a trial is going to be hard work.
The death rate for certain demographics (especially say over 70s) is far higher than 2-in-100. While some countries have high levels of vaccination - especially in those demographics - most don't.
The UK is enterring a third wave, and has a high number of elderly people having been fully (2 shot, mainly AZ) vaccinated. Early indications are that those enterring hospitals now on the whole have not been fully vaccinated.
The infection fatality rate varies exponentially with age. A good rule-of-thumb is that for a given age group, the IFR of catching Covid is about the same as the all-cause mortality risk over one year of life. It just so happens that these two numbers are about the same, when looking at age groups.
It does suggest that people with 2 shots are unlikely to end up in hospital. I haven't seen enough data about the hospitalisations when adjusted for age+vaccines to draw any more conclusions.
There are still many over 70s who haven't had any shots though. My (estranged) uncle and his mother-in-law haven't left the house for 18 months, he disinfects his food deliveries and leaves the post in a box for 3 days. He refuses to get the vaccine because he's worried about catching it. Chances are he won't end up in hospital either, but people like that could skew the cases as more data comes out to allow spurious claims from anti-vaxers (They might claim that 'before 2 in every 100 over 80s were going into hospital) , now it's only 1 in every 100 unvaccinated over 80s going in to hospital), because the chance of catching covid from the population still unvaccinated dwindles because of continued isolation
Yes, this and "long COVID" are quite underreported, and it's the much bigger risk. However, there is some evidence that getting vaccinated improves/cures long COVID.
The rough consensus is that an infection is equivalent to a single dose of vaccine. Some countries do not give the second dose to previously infected people.
Unfortunately, we have reason to believe that over time, the immune defenses from COVID-19 infection seem to decline, particularly in older folks. It'd be great if we had some definitive data on secondary infection rates, but until a lot more people get infected, we just won't have it.
I think this is another case where improved surveillance is turning up things that, while they look bad, happen with other vaccines and never turn out to be a problem.
The same goes for variants, which a lot of people expect to break through vaccines because that's how the flu works, but it doesn't actually seem like they will.
A couple recent studies indicate that previously infected and then vaccinated individuals may have longer term immunity than those who are vaccinated but weren't previously infected or those who were infected but haven't been vaccinated:
> Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.
> Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.
Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature. The other study, posted online at BioRxiv, a site for biology research, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.
> “The papers are consistent with the growing body of literature that suggests that immunity elicited by infection and vaccination for SARS-CoV-2 appears to be long-lived,” said Scott Hensley, an immunologist at the University of Pennsylvania who was not involved in the research.
That’s interesting. Maybe the duration of the trial was too short or sample size too small, because I know two people personally who were re-infected pre vaccination.
Maybe too short, but also Covid-19 isn't really just one disease anymore, but rather a family of strains.
Just yesterday the news had an article about how a national level soccer player for Sweden who had been infected previously in the past managed to get infected again and infect parts of the team.
The player in question had been infected about a year ago initially (before the British strain was found) and with the British strain now being the main one in Sweden I don't think it's a far fetch to say that re-infections of a different strain is actually quite likely once a certain amount of time has passed.
Recently greek letters were introduced to remove the geographic stigma [1] , so that would read as "the Alpha strain now being the main one in Sweden"
Besides risking moral overtones ("the British strain? Typical - when they aren't being Hollywood baddies they're busy incubating viruses") it only tagged where a strain was first isolated, not necessarily its geographic origin (not that it actually matters whether the Kent variant actually came from that Home County)
It's quite amusing that there was such a push at the start of the pandemic to not call it Chinese Flu or Wuhan Flu, but the British, South Africa, India and Brazil strains all caught on quickly in the media.
The "Kent variant" (later "English", now "Alpha") was first described in Sept 2020, widely publicised as having become the dominant strain in the UK in late Nov 2020.
So a geographic label was widely used before Biden without apparently causing ructions. It was adopted because the released name for the variant, lineage B.1.1.7, was less convenient or distinctively memorable for the public. If it had been repeatedly referred to as the "Kentish virus" by senior politicians then a similarly hostile reaction might have been seen as was for "Chinese virus".
The thing that stikes me about the naming of variants, is that to your standard person on the street, referring to the variants by the place they were first identified is going to be considerably more meaningful than calling them a greek letter, especially with the less common letters. It's also easier to mentally track the variant's progress if you know where it "originated".
> Coronavirus variants get Greek names — but will scientists use them?
From Alpha to Omega, the labelling system aims to avoid confusion and stigmatization.
I'm living in Sweden and my girlfriend has been infected twice about a year apart. So yeah it seems like the passage of a year and the combination of new strains is enough for this to happen. Also unfortunately her second case was definitely worse than the first (which wasn't exactly fun either). It's a shitty disease.
You don’t actually know that for sure though. The following paper found PCR positives months after being infected, with a slowly decreasing odds ratio, which is in their words consistent with shedding: https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Unless someone gets a PCR positive, has the virus sequenced, and then gets a separate positive later, has the virus sequenced again and can confirm they were actually infected again with live virus (perhaps using live viral culture) they can’t really be sure.
Hey I'm curious, if you don't mind sharing, how do you think you got it? Throughout this whole pandemic, I'm still kind of amazed how people are getting it
I've avoided infection, but some friends of mine didn't, a couple who got infected by an acquaintance who "forgot" to tell people he was infected.
They then went on to unwittingly spread the infection at a small gathering of friends, even though their rapid tests were negative. A subsequent rapid test showed negative for one, positive for the other. PCR tests nailed it down, and they went through the whole contact tracing malarkey to get everyone tested.
It may be as simple as someone not taking it completely seriously, or someone 100% unwittingly becoming a carrier, even with negative tests.
Had avoided Covid all 2020, but in February I needed to go to hospital for unrelated reasons -- needed urgent treatment, otherwise potentially life-threatening, had to stay several days. Had three negative Covid tests during the stay, but the fourth came back positive, just a day before my discharge. So I'm pretty sure I caught it inside the hospital. :(
My dad stayed isolated throughout 2020. He had the AZ vaccine in January. About 10 days later a blood clot to the brain caused a seizure and he went into hospital. He was tested when he went in and was not infected, he was kept fairly isolated in hospital for a couple of weeks, obviously no visitors.
We had a late night call saying he was unlikely to last the night, so we were allowed in to see him.
The next morning we were waiting for the phone call. And we had one. From Test and Fucking Trace, who wanted to speak to him. They were insistent he wasn't in hospital so we hung up on them with a rather non-polite scream.
His swab (which was from before we saw him) came back and he was positive, so we had to isolate. He did last the night, and then was moved to a covid ward.
So he clearly caught it in hospital on a non-covid ward. While I was holding his hand a nurse came along to give him an injection. She had a mask on, over her mouth - not her nose. Clearly lots of unconcious people who had frequent negative tests and weren't moving around a ward aren't going to be spreading covid, the only close contacts were the medical staff.
As it happens he lasted another 3 weeks before he came home for palative care. The vaccine presumably helped with fighting covid, but the damage caused by the siezures meant he couldn't even swallow.
He died 29 days after the positive test, so didn't go on the T+28 day stats.
My wife and I think we got it from movers in NYC. We had become too comfortable around others and overly confident that we wouldn’t get it. I was diagnosed two weeks before my vaccine appointment, it was so frustrating to fail so close to the finish line!
It's even worse than that, my dad got it in an indoor space (office) while both he and the carrier were wearing masks. Then I got it from him in the house, even though I avoided him and kept my distance.
He wouldn't wear a mask in the house (because "I'm fine") and kept coughing up the place, though.
The outlier being Austria where everyone is required to wear FFP2 (N95 equivalent) masks when indoors (shopping, public transport, etc). And the government mandated the price of masks to be less than 1 Euro each. Not to say they are handling things great, but that was at least one step in the right direction.
- Friend 1: had son in school, son's classmate's father got it and by the time they knew, the kids had met. This was during a wave and contacts weren't tested, only symptomatic people.
- Friend 2: stupid, stupid colleague came to work to pick up laptop when she got quarantined.
Almost certainly[1], my grandad caught it in hospital, then infected most of the rest of the family (6/7 people) when he was discharged.
He was admitted with suspected sepsis, and tested negative on admission. He had a new cough when he was discharged, but we didn't think much of it as he had COPD so periods of coughing weren't unusual. A few days later, he was readmitted with a recurrence of his original symptoms, but this time his admission test was positive. Six of the other family members tested positive the next day, and developed symptoms over the following days.
[1] The only other person in the house who hadn't been isolating subsequently tested negative. Everyone else had been nowhere but home for at least the proceeding two weeks, so the chance of another vector seems remote.
My wife got it either at the grocery store or Home Depot early in. She’s a nurse and worked with covid patients but hadn’t been to work for over two weeks. Those were the only places we had gone otherwise. I got it from her a few days after she showed symptoms.
I caught it in September when numbers here in the UK were quite low.
I'm not sure how I caught it. I had left my car into the garage a few days before I showed symptoms and had to get an Uber home, then back to the garage to pick it up, so my strongest suspicion is one of the Uber drivers or previous passengers had it or potentially a mechanic had it and it remained in the car.
The strangest thing is my girlfriend and I had spent the day before I showed symptoms together and she slept over that night but she didn't seem to catch it off me. She even had an antibody test about a month after which was negative suggesting she hadn't already had asymptomatic Covid.
I think it is possible to be exposed to the virus and never need to build antibodies. Innate immune response, if robust, can fight off (or block) infection quickly enough that the adaptive immune response, never kicks in. Adaptive response takes time, and antibodies don't show up until a few days in, IIRC .
For those fortunate to be able to work from home during this pandemic, as I'll guess most on HN can & do, I'm very curious how they're getting it assuming they:
a) Just go to the store and back wearing a mask while indoors
b) Spend most of their leisure time outdoors - because what else can you do?
I haven't been holed up this whole time. I'm outside multiple times every day (dog walks, kids playground etc.) and I don't know anyone who works in a factory, meat processing plant, hospital etc. hence my curiosity how people think they're getting it.
i wouldnot call it unstoppable, but i would expect excellent protection, that extends horizontally to provide an unspecified degree of protection across variants.
In that case it seems like the headline reads wrong based on a colloquial and imprecise but often correct heuristic. Should read more like "non-necessity of C19 vaccination for previously infected..."
It says (at least, it does now, as I write) 'evaluating necessity'.
[EDIT: I read further down this page, dang commented that he'd edited in the 'evaluating' just 1m before parent's comment: https://news.ycombinator.com/item?id=27453952 So, yes, fair enough, 'necessity of' is ambiguous, as I went on to say in my original comment continuing below.]
Necessity is the concept as well as describing one possible state of it.
Another example: when 'my hunger is sated', I do not 'have a hunger', I am 'not hungry'.
I don’t see it in the abstract, but what was the infection rate for the unvaccinated? That’s your comparison.
They also mentioned 0 infections in fully vaccinated which is odd as other countries are seeing a number of infections in their vaccinated front line workers.
>> They also mentioned 0 infections in fully vaccinated which is odd as other countries are seeing a number of infections in their vaccinated front line workers.
No, they had infections in the vaccinated. They had 0 infections in the previously infected, although another poster pointed out that the vaccinated (but never infected) group is much larger than the unvaccinated but previously exposed.
Frankly since the vaccine trains the immune system on the spike proteins I would think they're roughly equivalent and either both will offer similar duration of protection. If that turns out to be only a year I'm going for the vaccine next time, as the infection kinda sucked.
Immunity from infection does more than the spike protein, so it ought to be more robust against variants, even if one does show up that changes the spike protein enough to escape vaccines.
That was my thought as well. Natural immune response should have more vectors of attack since all of the virus proteins are available to make antibodies for.
As another comment mentioned though, the spike protein is unlikely to change much, and if it did, the virus would loose a major weapon in infecting people. So the vaccine is probably as effective as natural immunity in practice.
(1) A friend of mine who works as a doctor in one of the vaccination centers in South Germany told me that re-infection rates with problematic outcome after full vaccinations are ~5%. This is what they tell their patients in the information talk before the shot. Note that my friend could not give me a higher resolution of the data (age, etc).
(2) I think I wrote that in one of my prior comments ~ 9 month or so ago -
Another medical doctor aquaintance of mine that was working in the local health department Corona group told me that in the town of Tuttlingen (pop ~ 100K) there habe been 9 re-infections with the SARS-CoV2. At the time there were only 7 known cases in literature.
Reinfection rate differing between different studies and populations could partly or entirely be the result of differing error rates in lab processes. Just a 0.1% contamination rate between samples in the lab or hospital would more than explain most of the results.
Is that with AZ or an mRNA vaccine? Also by "problematic", do you know if they meant WHO's "mild" or "severe"? "Mild" is still quite bad, just not enough to hospitalize you.
sorry for the late reply. Had to get back to my contacts re your questions. I did not check or ask for reference / primary data sources, but I was talking to medical doctor directly involved in the German SARS-CoV2 vaccination program on a local level.
> Is that with AZ or an mRNA vaccine?
It seems to be unclear by now which combination of vaccination dosages (and their timing) gives the best results. When it comes to double shots, I was told that
- AZ: 1 in 5 get infected
- Biontech: 1 in 20 get infected
> Also by "problematic", do you know if they meant WHO's "mild" or "severe"? "Mild" is still quite bad, just not enough to hospitalize you.
Unfortunately, I did not ask regarding these specifics, but I believe that the wording was according to WHO standards.
According to my source, after two shots:
- AZ: 90% less severe cases, 85% less infections
- Biontech: 85% less severe cases, 95% less infections.
So, statistically speaking, AZ is better to avoid bad cases, while Biontech is better for spread.
In southern Germany, it seems that there is increased activity in administration a combination of both vaccines. This is done because there seems to be an indication that a combination might be better than a mono-vaccine, and/or because of the supply situation / available vaccines.
There is a meta study coming out in the UK regarding AZ/Biontech/Moderna vaccine combination and vaccination timing effects.
I’m convinced I had Covid twice, in March 2020 and again in December 2020. So in my case, “natural” immunity did not last 9 months. (Although there were presumably different Covid variants at play here. I’m in London where the “Kent” variant was dominant in the December peak)
Only the second time was confirmed by PCR test (no testing available in March 2020), but symptoms and progression were nearly identical both times.
A lot of people were convinced they had COVID in Jan-March 2020. You're not the only one. Without a test though, it's impossible to say because the symptoms of mild COVID, which it sounds like you had, overlap a very large number of other diseases. There was also a very bad flu going around in early 2020 that a lot of people had caught so you probably had that.
I think if you've had Covid, you'd disagree that its symptoms are similar to other common diseases. It feels quite different from any cold/flu I've ever had - unlike most flus I've experienced, there was no bronchitis, no throat pain, no sinus congestion, only a mild intermittent cough, little snot/phlem, etc.
But it has some distinct features: high fever/temperature which lasts < 24 hours, changes in taste (foods which I normally enjoy tasting bitter and disgusting, toothpaste tasting like bitter chemicals, etc), severe fatigue, mild-to-moderate nausea, shortness of breath, and muscle and joint pains. Some of these symptoms lingered for quite a few weeks.
I know some people who got COVID and said they felt fine, except for a stuffy nose. Almost everyone I know that had COVID said that the flu was worse. All the symptoms that you mentioned apply to the flu as well. There might have been one day where they felt really worn out, but that was it. I felt the same way after taking the vaccine. Change in taste can be attributed to blocked nose which radiacally changes the taste of food. This has happened to me with bad colds and bad allergy attacks too.
I only know 1 person who almost died from it, my friend's mother who had to be put on a ventilator, but she survived.
I’m fit and 33. I run, cycle and do adventure races. I got COVID and bronchopneumonia concurrently a month ago. I was lucky enough to not have to go to hospital, but I can honestly say I have never felt so sick in my life. Never has a flu even come close to that for me. Ofc it hits everyone differently, but this wasn’t “just flu” for me.
Yes, same here. My housemate was convinced she must have been infected, but her only symptom was losing her sense of smell & taste. Positive PCR test.
> "Almost everyone I know that had COVID said that the flu was worse."
I'm inclined to agree. I've had a few severe flus in my lifetime that felt worse and more intense, but again, in my experience the symptoms of flu feel quite different to Covid.
That said, I certainly don't recommend getting Covid!
> "Change in taste can be attributed to blocked nose which radiacally changes the taste of food."
This. If someone just thinks or suspects they Covid, it almost certainly was normal flu. Trust me, with actual Covid you’ll know quite clearly something foreign and new is attacking. You feel it in your cells and bones. Then the symptoms hit.
I didn't have any burning sensation. More like a sort of tingling discomfort, and the "shortness of breath" feeling where I'm breathing normally but it doesn't feel like you're getting the normal amount of oxygen from each breath?
Also I never really had that much of a cough. Just a mild, intermittent dry cough.
> This study was not specifically designed to determine the duration of protection afforded by natural infection, but for the previously infected subjects the median duration since prior infection was 143 days (IQR 76 – 179 days), and no one had SARS-CoV-2 infection over the following five months, suggesting that SARS-CoV-2 infection may provide protection against reinfection for 10 months or longer.
This comment is right - and the study began shortly after Ohio's peak of infections.
As such, most infected participants would have been recently infected in a situation with low and decreasing virus circulation. Nobody thinks there's any risk of reinfection at that point.
why the downvotes on this comment? iirc the vaccine response was shown to diminish over time and health experts discussed the potential need for covid vaccine booster shots. a limited timeframe for reinfection poses an issue considering we may never be truly done with this disease as it could recirculate and require frequent shots like the flu
It’s really, really problematic this study used a hospital database of PCR test results, instead of self-reporting. This study will go viral and every yokel who was on the fence but had flu symptoms back in July will decide they don’t need the vaccine.
However there already exist real people in the world who have had Covid twice, and who reportedly have had a much tougher time the second time around.
This study helps us put some bounds on how many people this might happen to (assuming there are no mutations to the virus) but it doesn't rule it out completely, because of the prior existence proofs
The early Nevada case involved a relatively younger person who caught it once. Then they caught it again while caring for a parent who also had it and was hospitalized. The case was confirmed by PCR analysis of the samples that were taken combined with validating that the samples had the subjects DNA in them.
But they likely had a very mild initial infection and being young they fought it off with mostly an innate immune system response and didn't generate a lot of antibodies or adaptive response.
Then when their parent got sick (in the same household) I would bet money the cared for that parent taking little to no precautions believing that their prior infection granted them survivor-island-style invincible immunity to disease (which is how most people think the immune system works). They likely got a whopping large viral dose which (probably combined with a bit of bad luck) is what caused the second infection to be severe and require hospitalization.
And due to selection effects that unusual case bubbled up to the top early because it was someone in the hospital with covid who had positive evidence that they'd caught it 3 months earlier. A lot of people with mild covid both times would never have landed into a study and the clinicians wouldn't have bothered with genetic sequencing.
If this is rare enough, it could fall into the false positive rate of the COVID test they've previously done (i.e. while the test said they had COVID, they didn't)
The tests are designed to have high false positives because they have to bias toward few false negatives and there are no perfect tests. What gets me is that the negative result is the one bearing meaningful information but not the positive result, yet everyone mistakenly talks about positives as if they are far more informative than they actually are.
I'm not sure what test you have in mind, and I'm guessing that such tests with high false positive bias might exist, for example the antibody tests. It's very difficult to get a genuine false positive with a PCR-based test: whatever you're reading out should have the same sequence as the part of the virus you're sequencing. The only reasonable way to get a false positive is that you contaminate the sample, but I don't think that the possibility of contamination is part of the design in any of the commercially available tests.
Certainly the case with the PCR test, because it is so sensitive. It can detect Covid fragments at such a low level that no symptoms would show and no adaptive immune response would arise. That's not enough Covid to generate memory and immunity.
You could be PCR tested positive, while experiencing a cold or flu (which you would now understandably think were Covid symptoms), but would not have immunity for a future, larger infection from Covid.
Though statistically unlikely, it's bound to happen sometimes.
Could be - but the case I remember reading about involved hospitalisation.
Remember that immunisation makes antibodies but only provides something like 50-95% protection (depending on the vaccine) - it's not surprising that actually catching it does the same thing
From a family member who works with Covid response (in India, where you have a large enough sample size), repeat infections are less likely and tend to be mild. But they are neither rare nor limited to people with exotic conditions.
Why is it that so many people seem to be biased against evidence that our immune systems do a pretty good job? It's as if they want the vaccine to be the only thing that helps stop COVID.
But really, I think many people are laser focused on not just minimizing risk of COVID, but now trying to zero out COVID risk, that having any reason to delay receipt of a vaccine isn't a pre-existing medical condition is considered a form of aggression.
At some point we transitioned from "bend the curve" to "eradicate the virus", and this seems like a byproduct of that mental shift.
Why do you not want to eradicate hunger, inequality, mental health problems, and general suffering?
I ask such an absurd question in response to your equally absurd question because of course everyone wants to eradicate these issues! But it is not possible to fully eliminate being monetarily poor (by somehow making everyone wealthy), or hunger (by overproducing food and creating distribution), etc.... and so a realization that tradeoffs must be made given our finite resources will better frame our collective decisions as a society.
Good science tests assumptions. Even if the result often ends up unsurprising it is important to test assumptions as else we never find out which ones are wrong.
There were a number of cases of individuals being infected a second time after covid recovery. This article corroborates the evidence that individuals that had covid might have a low chance of reinfection and therefore might not need a vaccine. If you look at some other comments here you will see that still the evidence is not 100% clear cut, so good that data analysis continues in the future, e.g. to see if there are differences in how long the effect lasts between different kinds of vaccines and natural infection (there is also more than one way to have covid).
When you say "our", who do you mean? 30yo with no underlying health conditions? A leukemia patient? An HIV-positive person? A 50yo diabetic? 40% of the adult obese Americans?
Yes, healthy immune system can be effective at fighting covid. But vaccination is a matter of public health. You aim to eradicate the disease so that everyone is safe.
> It's as if they want the vaccine to be the only thing that helps stop COVID
Our immune system didn't evolve to cope with living in incredibly tight spaces surrounded by millions of people. Our immune system also isn't good at dealing with infections as we age: it's simply unnatural to survive past 70. We need to keep vaccinating, to create a collective immunity that protects the vulnerable.
How does that relate to my point? I said that the vaccination is a matter of public health. Instead of letting everyone get sick, we aim to eradicate the virus by vaccinating as many people as possible. This helps reduce the death toll.
They do a pretty good job, that's why we don't have a pandemic every year. But the fact that we have a pandemic now is clear evidence that it's not doing a good enough job.
Similarly, if you get a rabies infection you're going to die, even though you have an immune system.
Anecdotally: I know a number of people who say they "had COVID" but when you poke a little bit deeper it turns out they never had a formal diagnosis or test result -- they just self-diagnosed based on some symptoms. I have no data about the numbers here, but I suspect that these people make up a non-trivial percentage of the "already had COVID" crowd. Vaccination seems like a pretty good precaution for these folks.
I assumed that the fear was that lots of people who think they got covid but were never tested (or people who falsely tested negative) would use this as an excuse to not get the vaccine
I think many of us are so exhausted from fighting to get people to just sort of follow the rules. I’d rather just tell everyone to get the vaccine and leave no room for error here
This seems to be a US thing at least at the moment.
Here is Switzerland the government specifically says if you have had a positive Corona test you should not vaccinate for at least 6 month and if you do after that only 1 shot not 2.
Then again we had a vaccine shortage so that may also have something to do with it.
Because the issue has turned into a political and morality issue now.
In the US, over 40% of Democrats think that hospitalization rates for COVID are 50% or higher, and 28% of Democrats tink that hospitalization from COVID is 20-49%. It's really 1-5%.So the vast majority of Democrats think that COVID is over an order of magnitude worse than it actually is. So people who don't want to take the vaccine because they are concerned about taking a new medication or they already have been infected and don't need it, are now "immoral right wing Trumpists".
I read on the Bay Area subreddit how someone was called a 'Republican' for not wearing a mask outside, even though the mandate now is that you don't need to wear a mask outside if you're vaccinated and not in a large group of people.
Most authorities are downplaying natural immunity, despite evidence like this. The more widely this spreads, the more people will realize it's ok to rely on natural immunity, and to not blanket demonize those who are unvaccinated.
> to not blanket demonize those who are unvaccinated.
Well, I'm currently in quarantine from my 4 month old and wife because an acquaintance refused to get vaccinated. "young people don't die from COVID" type mentality.
I attended my brother's bachelor party - of which we all thought everyone was vaccinated. Turns out this person, not only refused to get vaccinated - but had COVID exposure and still decided to attend. He told us the day after being in close contact for 3 days, that he tested positive and had symptoms during our contact with him.
Of the unvaccinated people I know, this mentality is the large majority of them. They refuse to get vaccinated because they refuse to consider how their actions might actually impact someone else.
> "young people don't die from COVID" type mentality.
What mentality is this? It is well known that young people are at extremely low risk of dying, even more so than the average person.
> He told us the day after being in close contact for 3 days, that he tested positive and had symptoms during our contact with him.
The problem wasn't that your acquaintance refused the vaccine. The problem is that he didn't stay home. You could say the same thing about the flu. If you have it, don't go to parties. Who goes to a party with a flu? A cold even?
I hardly think this guy is representative. There's also evidence that asymptomatic people don't spread COVID. This would mean that if they don't have symptoms, you won't get it, and if they do and they're like most people, they'll stay home which means no transmission.
> Of the unvaccinated [sic] people I know, this mentality is the large majority of them. They refuse to get vaccinated because they refuse to consider how their actions might actually impact someone else.
This seems unnecessarily hostile. Plenty of people don't want to be vaccinated either because they've had COVID and don't need it (this study isn't the first; Peter McCullough for example has spoken about other studies), they don't want to risk the potential side effects, including long term, of an experimental vaccine that is not technically approved by the FDA, ethical/religious reasons (the use of stem cell lines derived from aborted children during vaccine research, etc), and because the virus is not a serious threat to most people.
It is disturbing how the media is lumping those wary of the COVID vaccine in with antivaxers (~2% of the population; 98% of Americans get all common immunizations), COVID deniers, or "grandma killers". Let's not do that, as the OP recommends.
> There's also evidence that asymptomatic people don't spread COVID. This would mean that if they don't have symptoms, you won't get it, and if they do and they're like most people, they'll stay home which means no transmission.
We wouldn’t be in the middle of a pandemic if this were true.
It's been a pretty mild pandemic. What has been newsworthy about was the removal of freedom, not the number of dead people.
It's flu-like transmission - which is mostly through droplets.
If you're not sneezing in the face of people you don't have high chances of passing it around
Why so? Or are you mixing up asymptomatic with presymptomatic, as many do? It is clear that latter do indeed play a big role in spreading infection, but the science is not so clear on the former. Likely that asymptomatic do not spread it.
One of the unfortunate things about SARS2 is that there is reasonable evidence of some asymptomatic spread. Particularly the recent Japanese study[0]
"When taken together, I think these two studies show that people with asymptomatic covid-19 can and do spread the disease, and the best estimate from both studies is that those with symptomatic disease are about three to four times more infectious than those with asymptomatic disease. That is not a huge difference. Even though people with symptoms are a couple of times more infectious than people without symptoms, those without symptoms could still be causing more infections overall."
The measles vaccine is less effective than the COVID vaccine, and for mumps is less than 90% effective. Are you going to quarantine yourself over those lowered percentages? Most vaccines are less effective than the COVID vaccine.
Data indicates actual effectiveness as about 91.5%.
However, that's across the population. Factors like extended contact period increase viral load intake, could further decrease the effectiveness. Since my 4 month old can't get vaccinated against COVID yet, we decided it wasn't worth taking the risk.
Infants almost have a 0% chance of encountering any issues with COVID. 8 out of 100,000 children need to be hospitalized. You're talking about a 0.08% chance of hospitalization and for infants it's actually even lower.
Most vaccines have an efficacy lower than the COVID vaccines. Basically you are feeding off of your own fear, and you don't trust science. That's your right, but don't blame anyone for your self-imposed quarantine but yourself at this point.
The unvaccinated are still vectors for the infection of those who cannot be vaccinated, such as the immunocompromised. I personally don't think in terms of "blanked demonizing" people, but neither am I going to blanket-absolve all the unvaccinated — especially willful anti-vaxxers.
Regardless, this study is good news — because it means that every person who is infected and then recovers contributes towards herd immunity, regardless of their outlook on vaccines.
> The unvaccinated are still vectors for the infection of those who cannot be vaccinated, such as the immunocompromised
Is it actually the case that immunocompromised people cannot be vaccinated? The ones that I know have been; as far as I know, the mRNA vaccines by virtue of not being based on live virus are not dangerous to those with weakened immune systems.
Immunocompromised people can safely get the vaccine, but it might not work, leaving them still vulnerable to the virus.
In recent studies something like half of organ transplant recipients did not produce antibodies after being vaccinated, and there have been a few cases where a group of vaccinated transplant recipients caught Covid (e.g. from a vaccinated nurse who had an asymptomatic infection) and had severe symptoms including some deaths.
Re-infection is very rare, so the chance that it happened to two people in the same household is extremely rare. Are you certain you were infected with covid both times?
Not certain, but the second time we had a positive PCR test to confirm. The first time, there were no tests in NYC but close contacts had it and we had the same exact symptoms (which are not similar no any other flu/disease we have had).
I know it is, my point is that two spouses getting re-infected isn't two independent things.
It's not like bringing your bomb onto a plane decreases the odds of an attack, because what are the odds of two bombs.
The devil is in the details here. If natural immunity wears off after 6-9 months (as some studies suggest), and one spouse got infected again after that period, then the odds of the other one of getting re-infected too are pretty high.
While I agree reinfections are likely to exist in small numbers, the tests we're using are often not great so it's hard to say whether those were covid or something else.
This year I've been heavily sick several times (and the flu almost never caused me all this pain before in my life) and it was never covid.
If one of the test returned a false positive I would have been convinced it was covid. If I actually got covid again I would have believed I was one of the rare reinfections.
The second time we had a positive PCR test to confirm. The first time, there were no tests in NYC but people I worked with had it confirmed and we had the same exact symptoms (which are not similar no any other flu/disease we have had).
You really shouldn't be saying this on public forums without proof. You have no proof that the first infection wasn't the flu or a bad cold. The odds of reinfection are very small, and the odds of both of you getting reinfected is vanishingly so. Without proof this is potentially fear mongering.
I can imagine it being downplayed out of fear that it could slow down the vaccination program by pushing people over the edge that were hesitant to get vaccinated and possibly questioning covid-19 in the first place.
It's fine if those previously infected don't get the vaccine. I don't see why information on how natural immunity is effective would make people who haven't gotten Covid even less likely to get the vaccine.
There are many people who are convinced their respiratory infection earlier in the pandemic was Covid despite never having been tested. While some of those may plausibly have been Covid, many were surely flu or some other disease.
It would be a shame if such people avoided the vaccine under a disinformation-driven impression that the vaccines are risky, and ended up catching/spreading Covid later on.
I can only imagine it's because it might convince people that don't take Covid-19 seriously to not get the vaccine because even if they didn't get it, they'd be immune once infected going forward, missing the point about hospitalization, protecting the vulnerable, etc.
> Most authorities are downplaying natural immunity, despite evidence like this.
OK, I think I can agree with this, I've seen lots of "getting the vaccine provides much better immunity than getting Covid"-type statements that seemed more like conjecture.
> The more widely this spreads, the more people will realize it's ok to rely on natural immunity, and to not blanket demonize those who are unvaccinated.
Is this a serious statement? The problem isn't that natural immunity doesn't keep make you immune, the problem is that "acquiring natural immunity" often results in death, especially for vulnerable populations.
> > The more widely this spreads, the more people will realize it's ok to rely on natural immunity, and to not blanket demonize those who are unvaccinated.
> Is this a serious statement? The problem isn't that natural immunity doesn't keep make you immune, the problem is that "acquiring natural immunity" often results in death, especially for vulnerable populations.
It's a real policy question: how much to worry about vaccinating people who already had COVID. The confusion (or propaganda?) downplaying natural immunity means that many people would needlessly get the vaccine while already possessing immunity from prior infection.
In the US, this no longer matters, as we already have more vaccine supply than we have people willing to receive it. Elsewhere, though, where supplies remain scarce, we absolutely should be focusing efforts around vaccinating people who have not yet gotten the disease.
> the problem is that "acquiring natural immunity" often results in death, especially for vulnerable populations
You're reading beyond what I'm saying. My point is that there is no need to push those who have already gotten Covid to also get the vaccine. I'm not saying anything about getting sick as an alternative to getting the vaccine.
It rarely results in death. Even men 65-75 have a only a 3% chance of dying if they get covid. To put that into perspective, according to the mortality tables, those people have a 1.5-3.5% chance of dying in a given year even under normal circumstances.
Because it's not public health policy anywhere that I'm aware of? But vaccine rollout would be way quicker, and 'positive test or vaccinated' proportion of populations would be way higher, and that would influence discussion of other aspects, like 'herd immunity' for example.
I'm incredibly skeptical that it would do much at all to hasten rollout, at least in the US and other countries in a similar place. There are more than enough vaccines to go around at this point[1], and adding any kind of question mark to "should I get it?" just creates unnecessary complexity.
Just get it in everyone's arms as fast as possible, all this dicking around with rules around who can or should get it now that it's plentiful is just slowing everything down.
[1] to the point that 'we' should be doing a lot more to get our excess to countries that are still struggling.
Well I'm not really necessarily saying it should change now, but I was responding to 'this has always been obvious, why interesting' - you'd think policy would've been different from the start if it were so obvious.
My one anti-vax friend (who I make fun of constantly for not getting it) is constantly bombarded with people telling him that his previous infection doesn't give him any immunity. I already knew that was false - and I think he knew that too. It probably fed into his (motivated) reasoning to hold out this long if people are telling him so much information they know to be untrue.
Still, I don't see how public health would benefit from not recommending shots to everyone as there is no downside.
The only reason I got the vaccine is because of the chance idiotic unscientific governments won't bother me with tests I need to pay for when travelling.
I'm not a "anti-vaxxer" "conspiracy theorist" "racist" "sexist" "nazi" but the risk is just too low for me to care. If you think covid can affect you, take the vaccine and don't bother me.
I self isolated weeks before the government told me so because we didn't know what the risk involved was. By the time the government approved a 2 weeks lockdown which turned into 1 year and a half, it was already evident the risks were minimal. This is all a political play and I shudder when I think about what's coming next. Shall we do a climate change lockdown next? Or shall we try some more covid variants first?
I also don't think vaccines are likely to be dangerous (minus the platelets / blood clots issue - hopefully no long term issues pop up in 10 years).
Also, the downside is that everyone is paying for these shots, they're not free and they come out of the taxes the government steals from me every month - and they accomplish very little. Same as the flu shots.
We don’t know that there is no downside which is why these vaccines were approved via Emergency Use Authorization. At the very least I and several people I know were absolutely flattened by the vaccines for a day or two. One guy I know had very low blood sugar for weeks afterwards and needed medical intervention.
The vaccines are important in establishing herd immunity, but I don’t understand the desire to jab people who already have established immunity.
Feeling symptoms of COVID after receiving the vaccine is a normal and expected result that makes common sense: your immune system is doing its job. The only possible long term side effect here is partial or total immunity from COVID. On the other hand you don’t know the long term effects of COVID either, but I would bet dollars to donuts that they are worse than from the vaccine, based on what we know as of today.
> The only possible long term side effect here is partial or total immunity from COVID.
You don’t need to convince me to get vaccinated, but this is a profoundly unscientific statement. The mRNA vaccines are a brand new technology that would not have been approved without several years of human trials if there was not a pandemic justifying rushing through the normal process.
So far so good, but the immune system is a complex system and we can’t rule out some unexpected side effects for some people some of the time.
one of the other long term effects of covid transmission, is the opportunities given for variation and selection according to viral efficiency, in effect each infection is a crap shoot toward generation of recombinants, or molecular variants
> I don't see how public health would benefit from not recommending shots to everyone as there is no downside.
You'd get all the never infected people vaccinated sooner; so 'everyone' (except anti-vax not infected prior to effective 'herd immunity') would be immune sooner.
That's my thing. Plenty of people who know they almost certainly had Covid weren't tested, some were tested with tests that were experimental, etc.
And while trying to predict second-order behavior effects is tricky either way it is pretty clear that saying "don't get the vaccine if you already had Covid" would scare some people away.
> Plenty of people who know they almost certainly had Covid weren't tested
I had quite the opposite experience ; plenty of people told me they had (mild) flu symptoms - a lot of TMI, to be honest - and assumed they had had COVID already. It later turned out, with no exception, that they absolutely did not.
Scaring those people away would probably hurt a lot, at least in my anecdotal experience.
"Plenty of people who know they almost certainly had Covid weren't tested..."
Do you mean tested for antibodies with finger prick blood test, or PCR random number generator (see elon musk wild PCR results).
I was sick, had test that showed antibodies, and a confirmation letter from my Dr.
Since the EUA to rush out the vaccines does not include those who had it and recovered, it needs more testing and study before it is approved for those who have antibodies.
The jab is not risk-free.
That was true when the EUA was issued, but by now, we have vaccinated major segments of the population without seeing issues (e.g. hospitalizations are decreasing even as the rate of exposed population is much higher).
I was in a similar position as you: possible early COVID exposure (though no symptoms), several positive antibody tests, but absolutely zero side effects from either Pfizer shot. Annoyed not a few people though by my lack of any reaction to the shots, so that was kinda fun.
It's certainly arguable that there is downside for some people. Some vaccine side effects are worse for some people who have already been infected. [1]
How do you know your anti-vax friend was actually infected? I think a very real risk is that people decide they don't need the vaccine based on false-positive tests or otherwise mis-diagnosed illness.
This study appears to be based on following up with a single hospital's own database of people who tested positive. But I imagine you would get different results if you just found a bunch of people and asked them to self-report their prior infection status before enrolling them in the study.
He was tested twice and came back positive both times - many people in his workplace had it. He 100% had it.
Agree on the self-reporting, but I guess my larger point is he already doesn't want to get the vax and people telling him that his natural immunity is not sufficient makes him even more distrustful since he does know enough about science/statistics to see that natural immunity is about equal with a vaccine as far as we can tell.
This is a dubious claim, and is a frequent anti-vaxx/vaccine-hesitancy talking point.
VAERS data needs to be interpreted with special care. It's not equivalent to a safety study with a proper experimental design. It has a whole lot of legal and administrative context to account for.
And until the studies happen there is no danger? The studies create the danger? Or may we behave like rational individuals and realize that "zero danger" is a political talking point which is fully debunked by the VAERS data?
VAERS is user-generated content. I can go in there and file a report that I grew a third arm after vaccination and it'll go in.
Dying or having an adverse event after vaccination also isn't the same as dying from vaccination; even the genuine VAERS reports don't permit teasing this wrinkle out on their own.
> I can go in there and file a report that I grew a third arm after vaccination and it'll go in.
And you'd be committing a felony. I see this idea tossed around all the time that tons of the reports coming in are fake, but so far have seen scant evidence that that's the case.
> Dying or having an adverse event after vaccination also isn't the same as dying from vaccination; even the genuine VAERS reports don't permit teasing this wrinkle out on their own.
Okay, but then why are so many more people reporting dying after Covid-19 vaccination than have reported dying after flu shots which have been administered to millions of people for decades?
> In a July 2005 web post, Dr. James R. Laidler wrote: "The chief problem with the VAERS data is that reports can be entered by anyone and are not routinely verified. To demonstrate this, a few years ago I entered a report that an influenza vaccine had turned me into The Hulk. The report was accepted and entered into the database.
> "Because the reported adverse event was so… unusual," Laidler wrote, "a representative of VAERS contacted me. After a discussion of the VAERS database and its limitations, they asked for my permission to delete the record, which I granted. If I had not agreed, the record would be there still, showing that any claim can become part of the database, no matter how outrageous or improbable."
> Moss explained one way VAERS can amplify fears about the COVID-19 vaccine in particular. Most vaccinations are given to a small segment of the population: young, healthy children, who are generally less likely to have health problems afterward. But the COVID-19 vaccine is given to a much larger group — all Americans 16 and older are eligible now. And the earliest recipients included a large number of elderly patients and adults with preexisting health problems.
Do you look at anything other than factchecks? Taken right from the VAERS website (in bold font, no less): "Knowingly filing a false VAERS report is a violation of Federal law (18 U.S. Code § 1001) punishable by fine and imprisonment." A single case of a doctor submitting a goofy report in 2005 (and even having the CDC follow up with him!) doesn't establish a widespread pattern. Has even a single such incident been reported with the Covid VAERS submissions? I have to imagine the media would be keen to trumpet it, given their evident interest in putting out the word that there's "nothing to see here" in the VAERS numbers.
> Moss explained one way VAERS can amplify fears about the COVID-19 vaccine in particular. Most vaccinations are given to a small segment of the population: young, healthy children, who are generally less likely to have health problems afterward. But the COVID-19 vaccine is given to a much larger group — all Americans 16 and older are eligible now. And the earliest recipients included a large number of elderly patients and adults with preexisting health problems.
This is trivially accounted for by comparing Covid and influenza vaccines. If I limit to ages 18-59 I get ~73,000 total adverse events for influenza vaccines across their entire history, and 173,000 adverse events for Covid vaccines since they started to be administered at the beginning of the year.
It really is not "trivially accounted for" in this manner. The flu is an annual thing that most people are coping well with mentally. Can't quite say the same about the latest pandemic, and people's attitudes and beliefs are going to significantly colour the amount and nature of the self-reporting system.
Those are separate concerns from the age/demographic ones I was addressing. I could see what you raise driving some difference in the rates of reporting to VAERS. I could not see it driving a difference of, say, zero "Death + Life Threatening" reports for influenza vaccines in 2020 versus 2,857 "Death + Life Threatening" reports for Covid vaccines in 2021 for the 18-59 age group.
You need to apply some Bayesian thinking. No reasonable person (expert or not) believes in such a thing as zero danger.
- The vast majority of new drugs that undergo safety trials are found to have serious side effects.
- The near totality of new vaccines that undergo safety trials are found to have a formidably beneficial risk profile.
Don't make the mistake of applying the same risk heuristic in your mind for both things. Risk assessments in science have absolutely nothing to do with politics.
I don't think this is incompatible with public health policy even if public health policy treats previously-infected people the same way as never-infected people.
Owing to the dramatic risk asymmetry between vaccine and disease, it's probably better to implement a policy that optimizes more for expediency, simplicity (fewer rules and fewer exceptions) and, in this case, minimizing the number of false assumptions made about the status of individuals. ie.: in the context of vaccination it's sometimes better to not assume that everyone who claims to have been previously infected was actually infected, even if we have lab data to back up this assumption.
I'm not saying current policies all make perfect sense or anything, but it doesn't particularly surprise me that everyone is being accounted for in the same way WRT the vaccine.
I wish. Here in Brazil it's effectively the official policy. Multiple times our president has shown that he'd rather give us chloroquine instead of vaccines.
Many EU countries will take either proof of prior infection, a vaccine cert, or PCR test for international arrivals. It's very much public policy for some.
There were stories of reinfection happening. Also variants. Also, every covid study of every kind is getting an enormous amount of attention and resources
Had the same symptoms both times (dry cough for 5 weeks, using inhalator, loss of smell, etc.). It could have been a very a flu very similar to COVID at the exact time NYC was locking down due to COVID?
> Because openly stating this obvious fact would get you downvoted on here a few months ago.
Attempting to discuss it here will still commonly get you downvoted. HN is not a particularly rational forum. People make the mistake of thinking it is because a lot of engineers hang out here. Engineers are not especially rational, that's a common myth derived from failing to understand the way people mentally compartmentalize; how they can frequently be rational about one subject and irrational about another.
Try this one for example: the numbers they've been reporting about Covid infections the past year are not the actual infection numbers, not even remotely close. Yet they're held up everywhere as being representative of how many infections there have been.
This is still the biggest comedy going about the pandemic. It's hilarious how batshit crazy people can be.
If the US were a sane nation, the people that have been trying to represent the supposedly official infection count as being fully representative of the number of infections that have occurred - those people would be publicly mocked and shamed for being anti-science, the equivalent of flat-earthers. Instead, the flat-earthers dominate the media and national discussion. That's why the lab-leak theory was buried under so much censorship and for so long, those same people have been holding that conversation back very aggressively.
Most people know on some level that the held-up official infection tally is not representative of the real number of infections. And yet the mainstream media, without exception, pretends those are the legitimate infection numbers. Any attempt to discuss how many infections have really occurred, will be shouted down. The shrieking emotionalism that pours out when you open this can of worms, is endlessly fascinating to me.
If you say: how many people in the US have had Covid, they'll point at the magic official number, which is not correct.
If we wanted to have a serious discussion nationally about herd immunity (for example), one of the most important steps is one they intentionally refuse to take: let's try to get a more serious estimate on how many people nationally have actually had Covid.
They won't have that conversation and the media goes out of its way to avoid it (and has done so for a year now). Why? Pick your poison on the why answer. Political psychopaths lusting for control, looking to prolong their ability to take advantage of a disaster (the 'ol never waste a good crisis mentality). Wildly irrational anti-science types in power that pretend they represent science, which is the wing that Fauci belongs to. Maybe a combination. Maybe it's just the fear that if the masses of people think we're anywhere near herd immunity, the vaccination rates will plunge even faster, so some people want to maintain the false illusion (on the actual infection counts) as long as possible.
Ok, essentially you’re saying the real number of cases is higher than the official numbers reported, because the official numbers only report ones confirmed by tests, and there are many people who got Covid and were never tested.
I think most on HN would agree with your assessment that the real number of cases are somewhat higher than the official count, although I haven’t seen any evidence indicating exactly how much higher or lower. The Dakota states did seem to taper off cases immensely before the vaccines were distributed, indicating a possible early herd immunity.
The most accurate approach would be to do repeated blood tests of a large nationwide study population looking at both antibodies and memory T cells. The CDC really should have been doing that nationwide for the past year.
The Red Cross Blood Donation centers perhaps come closest to doing this. From their emails, it sounded like they never saw widespread active antibodies (until a few months ago).
The Red Cross only did antibody testing which has a significant false negative rate, especially on patients who recovered from mild infections many months ago. That's why getting accurate numbers would require repeatedly testing the same subjects at regular intervals, and also assaying their memory T cells.
The point is that they should have been doing that since tests were first available, before anyone was vaccinated. Even now it would still be a useful study in the unvaccinated population.
My favorite was when they uncritically accepted China's claim of reducing infections to nearly zero within a span of a few weeks. (5,000 per day to 50 per day in four weeks).
That's so unlikely it's laughable, but it's widely reported and accepted.
No scientist ever believes any measurement to be perfectly accurate, and different types of random error, systematic errors, and statistical biases always need to be accounted for.
My brother-in-law who recovered from Covid was told that it actually put him at higher risk from a subsequent infection, and therefore taking the vaccine was even more important than if he had never had it. Every time someone with any prominence says, "I'm not getting vaccinated because I was already infected" there's a whole "well ackshually!" army that descends to insist that yes it's still SUPER IMPORTANT to get the shot. So I think your 99.99% number is overstating certainly the general public's level of knowledge on this question.
The person who told your brother this is either a non-expert, or some expert who for some reason is giving medical advice which is incompatible with the scientific consensus (this would really boggle my mind).
PS.: my 99.99% refers to the state of human knowledge and is more about what experts in the field know than what the general public knows.
I know there's always going to be PhDs who believe the earth is flat, because humans are like that... But it's just so hard to relate to super intelligent people believing crazy things. It really does boggle my mind!
> some expert who for some reason is giving medical advice which is incompatible with the scientific consensus (this would really boggle my mind)
Doesn't really seem that mind boggling to me. The clear public health impetus at this point is simply to get shots in as many arms as possible. We've already had Fauci openly admit that he gave guidance against masking and low-balled herd immunity threshold estimates because he presumed it would not lead to the behavior he desired from the public at the time. It's not hard to imagine that mentality has made its way into the rank-and-file somewhat.
I think what I was referring to, and the examples you're giving, are very different. The early advice against masks were the best advice public health could give, with the information that was available (even among experts) at the time. I would give the same advice as Fauci at the time. There are a bunch of factors to consider: behavioural (people having a false sense of security and taking greater exposure risks, or people not using masks properly and actually increasing their risk), medical (at the time, the benefits of non-N95 masks were not as clear as they are now) and system-level (supply chain issues were real, many countries had a really hard time getting procurement of basic PPE for hospitals... and you want to make sure you prioritize hospital workers over the general population)
I did have covid (not diagnosed while active but shown in antibody test), and I got vaccinated significantly later. This was not driven by belief in medical need, but by social/rules need. You get no "points" for being recovered like you do for a proof of vaccination.
For the EU certificate, proof of prior infection can be used, although I believe you need a positive PCR test for that, an antibody test is not sufficient.
> ... although I believe you need a positive PCR test for that, an antibody test is not sufficient.
Most countries in the EU just relaxed the requirements to travel before the summer vacations. You don't need a PCR test anymore to travel: just an antibody test (at least for Spain / France / Belgium but I take it many others are doing the same). And there's no requirement to be vaccinated.
They also raised the age at which you need a test from 6 to 12 years old.
Source: always living/traveling across France/Belgium/Spain.
Fun fact: when you travel by car in the EU they typically do not bother to check. You can cross several countries and they're not verifying anything. Another fun thing: test is supposed to be less than 72 hours old, so if you're traveling over more than 3 days, you need to get re-tested during your trip.
Antigen tests (the rapid test kit, results in ~15 minutes, sample taken from the nose or thread) are not the same as antibody tests (blood test for prior infection, has to go to the lab). You need the former for travel. Afaik, the latter is not accepted as proof of prior infection, you need a positive PCR test from at least 28-ish days ago.
The DGC doesn't have any such type of certificate, so there's that (which, obviously, doesn't mean countries cannot accept antibody tests). As for the traveling, that's weird, as I thought most countries exempt you from needing a test if you're just transiting.
Same. Covid in January, J&J a few weeks ago.
I don't really think it was necessary, but the risk of taking it balanced out the risk of reinfection, both of which seemed really low.
That outcome seems unlikely in the US in the near term, given how neatly people's opinions on COVID restrictions lined up with their existing politics. The lesson that seems to be sticking is that it feels great to have the full weight of public institutions on your side of the culture war, so win at all costs.
It is coercion. People have been coerced at every step of this crisis, by the threat of police violence, by the threat of reputation or job loss, by the the threat of fines and more.
Hopefully, like we see with the wuhan lab theory suppression, as time goes on, a lot of what people suffered will come to light, and be contrasted by the benefit of the elite and political class during all this.
I agree 100% - whatever reaction posts like yours get, it's important to realize that a lot of people think this way, quite possibly a majority if you could talk to them on their own, despite efforts to pretend anyone against whatever government / corporate orthodoxy is pushing this week is some kind of conspiracy nut
Thanks! That's why I posted a reply instead of just upvoting, I think its important to show people that they're not alone, and what they are thinking is normal.
There are a tremendous amount of people who have just been fed the same compounding stuff on YouTube or wherever based on their previous clicks. There's a difference between considering the nature of X with a way to validate or think about it, and simply having watched a netflix documentary while high on acid. The latter of which become conspiracy nuts, and they're really draining to listen to, probably as much as big L liberals droning on about whatever pet topic they have
I think I agree with what you're saying. The more recent challenge though is that calling someone a conspiracy theorist got a lot of traction for shutting down discussions, so it gets applied very liberally to any point of view that the mainstream disagrees with as a lazy way of avoiding debate.
That's true, and I don't necessarily think it's a good thing to shut down debate, but I don't think it's also perfectly valid to take whatever action you want to avoid argumentation if you choose. I don't want to go do something I enjoy, but feel less inclined to do so on the basis I might get into an argument with some jackass. Not everything requires me to debate in my daily life, and ignoring people I don't care to engage with changes nothing about the outcomes of the subject matter, most of the time.
That's the nature of the internet and decentralized information sources.
The vast majority of people are consuming propaganda or crazy shit (MSM and conspiracy theories) but don't know how to filter the info to find a narrative that most accurately represents reality.
Because of this, the mainstream media will ALWAYS be able to dismiss strawman arguments and label dissidents as conspiracy theorists. Conspiracy theorists will also ALWAYS be able to poke holes in the propaganda and spin convincing alternate narratives.
In any valid disagreement with the popular narrative, you WILL find conspiracy theorists.
One caveat to this situation is that IF the mainstream institutions were able to rebuild trust (by telling the truth), then you would have far less people poking holes in their narratives and therefore fewer conspiracy theories. So, I don't get angry at conspiracy theorists because I understand that they're created by a lying state and media - they're canaries not a cancer.
And then there’s guys who believed in the Wuhan lab theory from the start, and also think the vast majority of the so-called “vaccine hesitant” have absolutely nothing of value to say about Covid-19 and have no business arguing with public health authorities on the issue. They should put the donut down, forego the lunchtime cheeseburger and the evening beer, and stop worrying about incredibly small chance of something bad happening because they wore a seatbelt (got vaxxed).
What a sad way of looking at life. We used to have "if all your friends jumped off a bridge, would you too?", talk about people as sheep, and generally look down on people giving in to peer pressure.
Now it seems to be a badge of honor, or at least a popular opinion, amongst educated people, to lean in to being part of a herd.
Doing stuff because it makes sense is one thing, but praising the abstract act of being peer pressured is ridiculous.
There's all kinds of things we don't do because of social pressure and legal constraints (that are there, in general, because in aggregate they make sense).
I close my mouth when I chew because of social pressure.
Someone might choose not to pick their nose in public because of social pressure.
Someone else might put the toilet seat down because of social pressure.
The amount of time I spend changing lanes before a turn is because of social pressure.
And yet someone else may not take the last helping of a treat because of social pressure.
COVID restrictions have been coercion just like drunk driving laws are coercion: rules that prevent innocent people from being hurt by reckless people’s bad decisions. A fundamental part of any civilized system is that bad behavior that is likely to hurt others is punished in order to try to deter that bad behavior. Reckless behavior during a worldwide deadly pandemic is similar to reckless behavior on the road.
I see this comparison often and it is wrong.
Imagine if every driver is suddenly forced to take a breathalizer test every time before driving, even if they never had a DUI case.
What they might have meant is that many countries accept a positive PCR from >= 4 weeks ago as proof of prior infection (and therefore, presumed immunity), but not an antibody test. I'm not familiar with the error rates of the latter, but for the purposes of travel a positive antibody test is rather useless.
Where I live, you need to meet one of three conditions for things like indoor dining:
- proof of a full course of vaccination (2 weeks after the final shot)
- proof of prior infection - antibody test not accepted, only positive PCR between 1 and 6 months ago
- proof of an antigen test (rapid test) that's at most 24h old
This is really good news. Whenever I see people talking about if previously infected people should be vaccinated, they always mention how we don't know how long protection lasts for previously infected people. This study includes this section:
Duration of protection
This study was not specifically designed to determine the duration of protection afforded by natural infection, but for the previously infected subjects the median duration since prior infection was 143 days (IQR 76 – 179 days), and no one had SARS-CoV-2 infection over the following five months, suggesting that SARS-CoV-2 infection may provide protection against reinfection for 10 months or longer.
Most “previously infected” people were absolutely not infected at all. If this study involved self-reported previously infected and not confirmed PCR, the results would be very different.
Isn't there also a lot of people that self report as having had covid that actually didn't have it? Why do you assume the rate of false positive to be in one direction or the other?
One very important limitation is that this study does not take into account problematic variants such as P.1 and B.1.617
> Lastly, it is necessary to emphasize that these findings are based on the prevailing assortment of virus variants in the community during the study. It is not known how well these results will hold if or when some of the newer variants of concern become prominent.
Here in Brazil, I've heard news that the P.1 variant can cause reinfections but is still stopped by vaccines. This would point towards also vaccinating those who were already infected
How did the natural immunity path go for those 550k+ that died in the US? lol.
Obv everybody should've worn a mask. Everybody who hasn't had it should get vaccinated etc. Pretty much what the authorities have been saying the whole time.
Well, that's encouraging. Now we have data for about 5 months on that. About the same on vaccinated individuals. In a year, we'll know more about how long immunity lasts, and if and when booster shots will be needed.
What do you mean? Immunity of naturally infected individuals has been tracked far longer than five months, with both empirical evidence of lasting immunity along with obvious community evidence.
Do you know why the infection rate in San Francisco was so low? There was already a ton of natural immunity due to community spread. The majority of my office in downtown SF caught COVID in January 2020, which was confirmed by negative influenza A & B tests followed by positive antibody tests once they were made available.
What is particular disturbing to me is that, despite the fact that the CDC estimates total infections to be over a third of the U.S. population (and that estimate only accounts for February 2020 onward and doesn't include last two months), natural immunity is never, ever discussed by policy makers. Why? That's a massive amount of natural immunity that continues to be purposely ignored.
It's being measured, not ignored.[1] This data is obtained by re-using random samples of blood drawn by commercial labs for other medical blood tests. In Vermont, under 3% of the population has had COVID-19. In Puerto Rico, about 49%. Huge variance by state. This does not include people immunized; the test used can differentiate.
Like Panther34543, my wife and I were infected in December in Seattle 2019. My wife had to go to the hospital (Kaiser), where they told her they didn't know what it was.
After the symptoms were identified as "COVID", we knew what had happened. At this point, I assumed the infections were endemic and I had no idea if we could be re-infected. I went remote early on, as infections started to be tracked and we had stocked up on plastic gloves, toilet paper, masks etc. before many other people.
I suspect, a number of people know that this virus was always going to be around. I expect the situation was watched to see how to best manage the fact that every person on earth was going to get exposed, by community spread or vaccine.
I'm interested in the survival rate differences between the vaccinated and those infected through community spread. I suspect, it's not very different due to deaths in my family from the vaccinated who had access to every treatment (including plasma) through Kaiser, before passing. I also suspect it's more or less surviving the flu (tough for the elderly) + a particular genetic interaction, that makes you susceptible.
Here is one significant problem with this preprint:
"The health system never had a requirement for asymptomatic employee test screening. Most of the positive tests, therefore, would have been tests done to evaluate suspicious symptoms."
In other words, there could have been people who caught Covid-19, but because they had already had it, the symptoms were mild and they didn't get tested. It may be possible for these people to still be infectious (we don't really know this). For a proper study, they need to look at a decent population of people who have regular asymptomatic screening.
Maybe it's not necessary. It's my understanding there's different types of antibodies the body can create. I've already had Covid but I'm still taking the vaccine. My reasoning is that the vaccine offers a hack to ensure those specific antibodies are boosted that target the spike protein. I'm assuming it will further strengthen my immune system. Provide better protection against future variants.
the problem with live covid as the antigenic character is of course the mortality, and the morbidity risk.
there is also the instability of the spike protien in its natural form. when spike is cloven at it cleavage site it changes conformation, thus there are two faces available to the immune system; the default state, the cloven prefusion state. This makes a Naturally aquired immunity biased toward opsonizing antbodies.
the vaccine version of spike has been stabilized so as to remain in the default state resulting in a bias toward neutralizing antibodies.
so neutralizing antibodies bind to the viral spike at locations that interfere with receptor docking thus ideally preventing viral entry, while the immune system operates upon the many other viral epitopes, to produce a variant array of antibodies. This gives Tcell based [longterm] immunity.
the naturally aquired immunity involves Tcell activity upon infection, but that is the risk, as virus is capable of entering the cells before immune system begins to work against it.
this is why boosting is required beyond initial vaccine dose.
and this is why i believe it would be a good idea to take a vaccine along with naturally aquired immunity due to recovery, and you can have the best of both worlds, while not relying solely on naturally based immunity.
yes this is the case for the vaccines, and any synthetic protien based vaccine that is to come. there is a manner of inserting a couple of extra amino acids at a crucial location that will prevent the change of state when cleavage is activated. This leaves it "open" to binding at points required for cellular entry.
this took the better part of 12 years to understand the virus to the point that we knew how to stabilize tthe spike.
my theory is that the single dose vaccines and getting infected are about the same effectiveness as a single dose of the two dose vaccines.
If you are infected, you probably have about 85% resistance to infection. Getting an addition shot of moderna, pfizer, J&J is pretty much like getting a booster and gets you to 95%.
well pack it up boys, lets not make this go viral on social media and just hope the "peers" organically pick this study to review over the next 6 months instead of some other study that appears to be more in the public interest and has more popular people behind it
a while back I looked to see how long it actually took for the peer reviewed studies to come out for previous diseases and outbreaks, such as SARS 1. It was too long and we have to weigh inputs right now and react now.
This study backs up the claim that people who had it don't need to get vaccinated. If it gets widely reported, that probably means fewer people will get vaccinated.
So let me ask you this, what's the worst case scenario if they're right but had waited 6 months to get it reviewed? Then consider, what's the worst case scenario if they're wrong?
not only that there is a comparison of vaccine generated Ab titre reacting with spike receptor domain
vs naturally generated Ab titre reacting with spike receptor domain, and with nucleocapsid features thus the naturall immunity is broader, and is long lasting based on opsonizing immunity.
Study doesn't seem to check for the B.1351 (SA) variant which has shown a limited ability to overcome natural immunity.
Arguably this variant isn't a big deal for now (compared to spreading out vaccine doses), but I suspect previously infected individuals will need to get a single shot eventually.
Note this is to inform public health / prioritization in the short term. (Which is less necessary places like the US where there is excess vaccine supply).
We know that past infection greatly reduces risk (and this helps quantify it). At the same time, vaccination is thought to cause a much broader and more durable immune response than natural infection. We'd like people who were previously infected to get vaccinated eventually for these benefits, but they're not who you'd want to vaccinate first.
Not that I have any knowledge on this subject, but why would a vaccine that stimulates the creation of a bit of spike protein create a "much broader and more durable immune response" than the actual virus which I presume creates a hell of a lot more of that exact same spike protein? Genuinely curious, because my simpleton assumption would be the opposite.
The rough theory - as I understand it - is that the virus is composed of other things as well as the spike protein e.g. the proteins in the viral shell. The immune system can learn to attack _whatever_ foreign materials it encounters. So a person that clears the infection might have a strong immune response to the spike protein, but the response could also be focused on some other part of the virus (or a mixture of different viral features).
Problem is, the "some other part" can mutate more easily into a form that the immune system no longer recognizes than the spike protein can, because the spike protein has to keep its form in order to react with the ACE2 receptors and enter a human cell. So the concern isn't that a real infection doesn't leave you immune to the virus you got sick with, but that the immunity might not apply or be as robust against a variant where the "some other part" has mutated into a different form.
The mRNA vaccines only cause your cells to make the (difficult to significantly mutate) spike protein, so the expectation is that vaccinated people would have a robust immune response against any variants which have that spike protein, regardless of whatever else changed, and a variant with an unrecognizable mutation of the spike protein would be less infectious anyway, as it could no longer successfully enter human cells either.
The results of the paper seem to indicate that this is not a problem in practice (so far - new variants are still evolving), but it's nice that someone checked.
A 2-dose vaccination regime (separated by 8-12 weeks) also gives our immune system time to build up the spike protein. An actual infection doesn't last as long and hence our immune system doesn't process it in the same way.
Odds are it does make things more effective rather than less, based on our experience with other vaccines. But IMO it's not wise, because it wasn't studied.
Still, 2 huge peaks separated by 3-4 weeks provokes really big immune responses.
> Odds are it does make things more effective rather than less, based on our experience with other vaccines. But IMO it's not wise, because it wasn't studied.
It has since been studied[1] (preprint) and that was exactly what was found -- delaying the second dose provoked a stronger response, similar to many other vaccines.
Sure, so far preliminary data looks OK. I still don't think it was a wonderful roll of the dice-- it didn't lower susceptibility so much in the short term (because a single dose's efficacy is limited, especially in the old) and it could have made things much worse.
Many reasons, that I don't fully understand. A few are: adjuvant properties of the vaccine, and the fact that there's a booster dose given, and that there's a whole ton of spike protein made and not many other targets.
But the reasons don't really matter -- studies like https://www.nejm.org/doi/full/10.1056/NEJMc2032195 have shown those vaccinated have significantly higher neutralizing antibody titers in their plasma than convalescent plasma, and slow decay of this response.
Of course, this isn't perfect evidence, as it is just the neutralizing antibody responses and the adaptive immune system response is much more complicated than this single measure.
Also no knowledge on the subject, but I can image a case where it is more durable:
If the spike protein is absolutely critical to the virus, but can't change too much without affecting function, an immune response that is specifically targetted against it would be better than an immune response against any other protein that could change without affecting the function.
It's not entirely the same. The Pfizer, Moderna and J&J (and Novavax) vaccines adjusted the protein to present a more consistent target than the viral spikes:
I think the key is that you get 2 shots. The second one might result in antibodies that bind the antigen better. This might happen because the immune cells undergo another round of mutation and selection after a second round of antigen exposure.
It's typically because of the adjuvants added to vaccines, and some other mutations done for stability.
The major covid vaccines have fewer adjuvants (to allow for boosters) and 2 shots because that's just how the trial was run, and it turned out to work, but later testing shows they're pretty effective just with one and some countries have been delaying the second one until everyone gets their first.
My mental model of this (and I'm not a medical expert) is that (a) for a given amount of spike protein, the immune response is similar, whether the protein originates from the vaccine or the actual virus, but (b) since the vaccine is lacking the actual health threatening properties of the virus, you can expose people to massive doses of it without incurring much risk.
My place employment had almost 280 people get vaccinated (myself included). On the second dose well over 50 percent came down with flu like symptoms about 12 hours later. I was sick for 3 days and my wife was sick for 2.
Would be curious on this forum on how many people got sick from Moderna.
No, they don't. The lipid nanoparticles they use seem to have an adjuvant effect, but they are also directly functional, and there's not anything else in the mRNA vaccines.
It's such a complicated semantic distinction, though. The formulation chemistries chosen for mRNA drug development efforts have a much smaller adjuvant effect (to allow people to better tolerate repeated administration of the agents). But here, using an (older, simpler) formulation chemistry that pisses off the immune system is useful. So is it an adjuvant or not?
So, it's otherwise functional but also chosen to have an adjuvant effect.
> vaccination is thought to cause a much broader and more durable immune response than natural infection
Why? Is there any data to support this assertion?
If anything, being ill (symptomatic) means the viral load was high in the body, so the immune system response should be as well, and in addition, infection should cause the immune system to produce antibodies to all parts of the virus, not just the spike protein, as with mRNA vaccines.
Shows a slow decay in neutralizing antibody titers, with a greater degree of viral inhibition months later than convalescent plasma at a month.
"At day 119, the binding and neutralizing GMTs exceeded the median GMTs in a panel of 41 controls who were convalescing from Covid-19, with a median of 34 days since diagnosis (range, 23 to 54)."
Note that antibodies to all parts of the virus aren't necessarily equally beneficial, because only a few functional areas are neutralizing.
neutralizing antibodies will give protection against cell entry to the degree they saturate the binding kinetics between receptor and ligand. non neutralizing does not mean ineffective, as ^any^ antibody is a lable that will provoke a complement based immune response, further leading to Tcell based production of antibodies that also include Ab that will bind to domains of spike that are essential to cell entry
Shows a slow decay in neutralizing antibody titers in those vaccinated, with a greater degree of viral inhibition months later than convalescent plasma at a month.
"At day 119, the binding and neutralizing GMTs exceeded the median GMTs in a panel of 41 controls who were convalescing from Covid-19, with a median of 34 days since diagnosis (range, 23 to 54)."
There's also data showing much higher neutralization titers against variants in those vaccinated vs. those naturally infected.
Of course, this is only one measure of immune response. Many other things are more difficult to measure, so we don't know too much about e.g. T cell responses from natural infection vs. vaccination. So it's hardly proven but there is some highly suggestive evidence.
What's up with all the antivaxxer/COVID hoaxer comments lately? Every COVID-related thread seems to be at least half-full of antivaxxer comments, and that's being optimistic.
I dislike when my own comments within a discussion are not considered in good faith, so I'll extend you the courtesy I often wish was extended to me:
Why do you believe that confirming suspected immunity response and subsequent protection, as is the case with so many other diseases, is in any way connected to the belief that COVID is a hoax?
That comment says "But that wouldn't contribute with the propaganda of the current mainstream narrative, would it?", where "that" appears to refer to "non-necessity of C19 vaccination for previously infected".
I agree with that comment—that there is a mainstream narrative that says those who've already recovered from COVID still need a vaccine as much as anyone else, and that this narrative is propaganda in terms of its truth value and in terms of how it originated and was spread around—and I also think COVID isn't a hoax and that vaccines are good.
It harms rational discussion and thinking, when you take one claim and attribute additional claims the author didn't make and denigrate the author for the latter. It pushes the discussion towards a "declare allegiance to one side, attack others who appear to be on the other side" fight, and away from exploration of any nuanced position other than the two extremes—when such exploration should be one of the attractions of a site like this.
A close friend of my family nearly died of what we presume was Covid-19 in February of 2020. All the right symptoms, but nobody had enough tests at the time. By the time they gave her a Covid-19 test, she was negative for Covid, but severely ill from the damage to her lungs.
She presumed she couldn't get it again. She did in May of 2021. Less serious, but tested positive this time with mild symptoms.
Perhaps the first infection wasn't covid-19, but something very similar. My guess is that immunity after infection doesn't last as long as we might all like. Which is why we all need to get vaccinated as quickly as possible.
I don't know much about naming viruses but if Covid-19 is from 2019, then we might be able say with some validity that we are now encountering Covid-20 and the delta strain is Covid-21.
That might explain some of the second infections. (?)
Since we are dealing with a corona virus and the common cold corona virus forms have been with us for many years I am not expecting that this will ever be completely gone, just managed.
“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.
Not one of the 1359 previously infected subjects who remained unvaccinated had a SARS-CoV-2 infection over the duration of the study.”