What a difference actual science makes, eh? “This is really good news,” says Dr. Christopher Murray, the senior study author of the meta-analysis of 65 studies in 19 countries. It’s also long-overdue news — and a rebuke to those who kept trying to shut down questions about naturally acquired immunity in a deluge of vaccination mandates.
Because, at least arguably, most people may not have needed vaccination at all, at least in the post-Delta phase:
Immunity acquired from a Covid infection provides strong, lasting protection against the most severe outcomes of the illness, according to research published Thursday in The Lancet — protection, experts say, that’s on par with what’s provided through two doses of an mRNA vaccine.
Infection-acquired immunity cut the risk of hospitalization and death from a Covid reinfection by 88% for at least 10 months, the study found. …
The findings may be a small silver lining to the explosive omicron outbreak of last winter. With so many people infected, many most likely still benefit from that protection against severe disease, Murray said.
The robust nature of this meta-analysis makes this difficult to ignore. What readers may not recall is that earlier published studies reached the same conclusion, as far back as September 2021. Ron DeSantis drew a fact-check from the Tampa Bay Times for citing an Israeli study that concluded the same thing — and in fact found naturally acquired immunity to be stronger and longer-lasting than vaccination. The TB Times rated DeSantis’ argument “accurate but needs more context” at that time:
Israeli researchers looked at thousands of medical records. In one part of the study, they compared over 16,000 patients who were previously infected and never vaccinated against another 16,000 who had only received the Pfizer vaccine. They factored in age, gender, health and when they were infected or vaccinated.
They found that the vaccinated group that did not report any prior infection was much more at risk of catching COVID-19 later on than those who had already been infected but not vaccinated. There was a 13-fold higher risk of a breakthrough infection compared with reinfection.
“This study demonstrated that natural immunity confers longer-lasting and stronger protection against infection,” the Aug. 25 study said.
They noted that the period they examined included the time when the delta variant was dominant in Israel. This study was released immediately, and still needs to be peer reviewed. Several factors might have shaped the results. Researchers might have missed a number of asymptomatic infections because those people would have less reason to be tested. And there was no control for social distancing and mask-wearing habits that would affect the risk of infection.
New work out of Rockefeller University adds weight to the Israeli findings. It focuses on the body’s molecular level defenses against the virus, especially the memory B cell. Long after the initial antibody response fades, these cells hold on to the blueprint of the virus and when they see it in the body months later, they crank up the antibodies to crush it.
Both vaccinations and natural exposure build memory B cells. But the Rockefeller team found that the memory B cells produced through natural infection are more robust. They continue to evolve over the months, while the vaccination-driven memory B cells stopped changing after about two months. When facing variants, the naturally occurring memory B cells delivered better protection.
That was September 2021, and it involved the Delta variant, a point to which I’ll return in a moment. Even then, the data supported a strategy for healthy adults under age 50 to eschew the vaccine. And yet the suggestion seventeen months ago that the choice was at least supported by actual data and science caused people to call DeSantis a “denier,” etc etc (although the TB Times was more careful).
Both NBC News and Murray anticipate the argument against vaccination and attempt to forestall it:
Still, experts stress that vaccination is the preferable route to immunity, given the risks of Covid, particularly in unvaccinated people.
“The problem of saying ‘I’m gonna get infected to get immunity’ is you might be one of those people that end up in the hospital or die,” Murray said. “Why would you take the risk when you can get immunity through vaccination quite safely?”
This argument has three large holes in it, however. In the first place, the mortality rate from COVID-19 had been estimated in the beginning of the pandemic — under the original viral profile — at somewhere around 0.3% to 0.5%. That means that over 99% of the people exposed didn’t die even in the initial phase of the pandemic, and only a relatively small percentage had a severely acute case. That’s significantly higher than the flu and clearly more dangerous (especially when we lacked therapeutics and resources early in the pandemic), but fatalities were almost entirely limited to the elderly and those with significant morbidities. Those people had much higher risk and a controlled exposure through vaccination would arguably have been the safer path, both in the Alpha and Delta variants, which were clearly more dangerous than later variants.
Two: The vaccines came out in between that initial variant shift. When the virus continued to mutate, it followed the typical viral mutation path toward more transmissibility and lower danger. NBC News cites Omicron and its rapid transmission across the US as “good news” now, but a number of people raised that point at the time too and questioned whether those exposed really needed to be vaccinated at all. The rapid spread likely meant nearly everyone has been exposed, they argued, and that everyone had already adapted with naturally acquired immunity from the exposure. Those who asked such questions got labeled as cranks or worse and found themselves gagged on social media and the public debate.
That brings us to the third point, which is that Murray appears to think that the vaccines themselves carry no risk. Put simply, we don’t know that yet, but we’re starting to find out that risks do exist. All of the vaccines have been granted emergency-use authorization that bypassed significant long-term testing and cataloguing of risks and later complications. Studies now have shown some complications arising from their use, and it will take a few more years to work that out.
We are now dealing with COVID variants that keep getting less dangerous in a population that has been overwhelmingly exposed to the virus. We also have more resources and experience in handling the complications that do arise. Murray asks the wrong question in this context. The correct question is this: Does your risk of severely acute COVID outweigh the potential risks of vaccination? If you have significant co-morbidities or if your immune system is compromised, the answer could be yes and the vaccine a good choice. For the rest of us, who have already either been vaccinated or exposed to COVID-19 — and almost certainly both — the still-unknown risks of continued vaccination would outweigh the small-to-nearly-zero risk of letting our existing immunity deal with subsequent exposures. Even for the small number of people who have neither been exposed nor vaccinated, the risk question remains the same.
That would be an actual application of science and risk management to the question of COVID. The disease has changed, the risks have changed, and our bodies have changed to adapt to it. That puts us in a much different risk profile than three years ago, and we should stop pretending that it’s March 2020 rather than February 2023. And that includes the CDC, which keeps using outmoded data collection to count deaths and hospitalizations correlated with a COVID diagnosis as causative COVID deaths and admissions. We’ve known the difference since Delta, and it’s been obvious since Omicron. When will the CDC actually do science to develop accurate data?
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