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Added a disclaimer on page 662. Many need to post better. |
On October 10 2021 21:24 Liquid`Drone wrote:Show nested quote +On October 10 2021 21:09 FreakyDroid wrote:
I'm having a hard time understanding this discussion. In order to get natural immunity you have to be infected first. So ultimately the question boils down to this: is there a study that says if you get a vaccine and then get infected, your natural immunity will be less than not being vaccinated at all? If there is no such a study that confirms this, then getting a vaccine is literally a no brainer. There's basically no discussion (here) about whether getting a vaccine is smart or not, no matter whether you've been infected or not. The question is more about booster shots. And while for people from the US, the big question is 'how do we get more people to vaccinate', for people from many European countries, the question is 'who should get the third shot first', and for people from development countries, it's 'how do we get enough vaccines to vaccinate our population'. From what data people have presented so far, I have the impression that if someone has had 1 shot of pfizer/moderna and they have also been previously infected, then their second shot can be better used elsewhere. (I know that the logistics don't work like 'you can just send the vaccine shot you didn't need to an african country' - but if 1 infection equals 1 less shot needed, then that can be part of the calculation when we purchase vaccines, and then, a country like Norway can purchase 190k fewer booster shots than if being infected does not contribute to immunity meaning those 190k vaccines can be made available for other countries.) Thus, the discussion about whether and to what degree being previously infected contributes to immunity is entirely relevant, and the discussion is not 'disguised anti-vaxxery'.
I think that would depend on the effect it would have on the immune system. Unless the 2nd or 3rd vaccine provide no significant effect on the immune system, then yeah it would make sense to skip 2nd and/or 3rd vaccine.
As for your last answer perhaps I didn't phrase the question well, I think previous infections and the degree of which that contributes to overall immunity of a person is important, so I agree with that part, but I think the more important question is, whether getting a vaccine first and then being infected gives you less immunity than not getting a vaccine but relying solely on natural immunity. In other words does getting a vaccine first, somehow impairs the ability of your natural immunity to develop a fighting mechanism against the virus when you're exposed to it. Hopefully that makes more sense now.
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I think the whole discussion of natural immunity is a moot point, given the fact that not all COVID infections actually result in protective antibodies, in other words natural immunity is not a given even if you survive. People therefore should not be assuming they're safe just because they've already been infected, and they should still take their full vaccination course. Thus I still don't agree with all the argument that has been taking place over how we should handle it. We should be assuming that natural immunity is not a thing, because it's dangerous to take it for granted and be wrong.
Plus the logistics of the shot being what they are, no, distribution of the vaccine is not ideal, but it is what it is unfortunately. The shots are only live for a short time, and they need to be used or thrown out. If second shots or booster shots are available, you should take them because if you don't then nobody does. There is no saving a shot to redistribute to another more needy community.
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On October 10 2021 21:29 Liquid`Drone wrote:Show nested quote +On October 10 2021 21:24 DarkPlasmaBall wrote:On October 10 2021 20:17 Liquid`Drone wrote:
maybenexttime, nobody (here) is arguing for using natural immunity as a strategy as opposed to vaccines. The question is, should people who have already been infected be required to / implored to vaccinate at the same rate / amount of times as people who have not been infected. Nearly 240 million people have been confirmed to have caught covid by now - if those 240 million do not need an extra booster shot or whatever, that's 240 million extra vaccination doses to give to others. In locations with vaccine scarcity (and there are plenty of such places), of course it makes sense to give the vaccines to those with higher risks (whether that's people who are old or immunocompromised or don't have a natural immunity, etc.). Yes, figuring out who needs the vaccine the most/soonest is important, and everyone here recognizes that natural immunity provides more protection *from a second infection* than no immunity *from a first infection*. I think it's probably reasonable to think about moving covid survivors out of the waiting line for a few months, if we're really low on vaccines, since they have some temporary immunity and others may have none. That might be one of many factors to consider when deciding how at-risk a person is against covid. This is not, however, the conversation we've been having with BJ over the past few pages. The way I read the thread, that is the discussion BJ was trying to have, but you and others kept insisting on having a different discussion. I've stated this before, I think you're overwhelmingly a reasonable guy, but BJ being misinterpreted really wasn't on him. I'm fairly confident that his opinions on this particular aspect are pretty close to mirroring my own opinions.
BJ's entrance into the conversation started at the top of p.489, where he began with "So what's your source for saying vaccine immunity > natural immunity? Because your link doesn't say that. Your link says natural immunity + vaccine immunity is better than natural immunity alone." Everything was built off a comparison between natural and vaccinated immunity (what's better, what's worse, how do we define better/worse, what evidence is there, what prerequisites are there for each, etc.). Neither he nor I nor anyone else proposed the interesting topic of "How do survivors of covid (and their natural immunity) play a role in the overall order and decision of who gets vaccinated next, given a limited supply of vaccines." You just introduced that now. And I think that's a really cool, thought-provoking question, but that's not what the past few pages were about, and it's definitely not how BJ was presenting arguments/questions.
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On October 10 2021 22:11 NewSunshine wrote:
I think the whole discussion of natural immunity is a moot point, given the fact that not all COVID infections actually result in protective antibodies, in other words natural immunity is not a given even if you survive. People therefore should not be assuming they're safe just because they've already been infected, and they should still take their full vaccination course. Thus I still don't agree with all the argument that has been taking place over how we should handle it. We should be assuming that natural immunity is not a thing, because it's dangerous to take it for granted and be wrong.
Plus the logistics of the shot being what they are, no, distribution of the vaccine is not ideal, but it is what it is unfortunately. The shots are only live for a short time, and they need to be used or thrown out. If second shots or booster shots are available, you should take them because if you don't then nobody does. There is no saving a shot to redistribute to another more needy community.
That is interesting, that is true, and I agree. In fact, the first article that I posted in response to BJ said this:
"A third of infections don't get any protective antibodies
Some people who get COVID-19 receive no protection from reinfection – their natural immunity is nonexistent. A recent study found that 36% of COVID-19 cases didn't result in development of SARS-CoV-2 antibodies. The people had different levels of illness – most had moderate disease, but some were asymptomatic and some experienced severe COVID-19.
"Vaccine-induced immunity is more predictable than natural immunity," says Dr. Rupp. The COVID-19 vaccines provide great protection from severe disease, hospitalization and death."
https://www.nebraskamed.com/COVID/covid-19-studies-natural-immunity-versus-vaccination
For the purposes of making progress with a discussion about natural immunity and how it affects who gets vaccinated next, we can certainly assume that some sort of test has preemptively verified that a covid survivor actually has natural immunity (as ~2/3 of them should), but of course, any covid survivors who don't actually have reasonable protection from covid wouldn't be particularly applicable to a proposal of, say, moving them out of line because they're temporarily safer from covid.
In other words, it's basically acknowledging the difference between "I've had covid, and therefore I'm temporarily protected against reinfection" (which doesn't necessarily follow) and "I've had covid and doctors have medically confirmed that the fight against the infection has left behind a natural immunity of relevant antibodies, and therefore I'm temporarily protected against reinfection" (which is a more reasonable conclusion, given the immunity confirmation, and only happens 2/3 of the time).
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Norway28736 Posts
On October 10 2021 22:15 DarkPlasmaBall wrote:Show nested quote +On October 10 2021 21:29 Liquid`Drone wrote:On October 10 2021 21:24 DarkPlasmaBall wrote:On October 10 2021 20:17 Liquid`Drone wrote:
maybenexttime, nobody (here) is arguing for using natural immunity as a strategy as opposed to vaccines. The question is, should people who have already been infected be required to / implored to vaccinate at the same rate / amount of times as people who have not been infected. Nearly 240 million people have been confirmed to have caught covid by now - if those 240 million do not need an extra booster shot or whatever, that's 240 million extra vaccination doses to give to others. In locations with vaccine scarcity (and there are plenty of such places), of course it makes sense to give the vaccines to those with higher risks (whether that's people who are old or immunocompromised or don't have a natural immunity, etc.). Yes, figuring out who needs the vaccine the most/soonest is important, and everyone here recognizes that natural immunity provides more protection *from a second infection* than no immunity *from a first infection*. I think it's probably reasonable to think about moving covid survivors out of the waiting line for a few months, if we're really low on vaccines, since they have some temporary immunity and others may have none. That might be one of many factors to consider when deciding how at-risk a person is against covid. This is not, however, the conversation we've been having with BJ over the past few pages. The way I read the thread, that is the discussion BJ was trying to have, but you and others kept insisting on having a different discussion. I've stated this before, I think you're overwhelmingly a reasonable guy, but BJ being misinterpreted really wasn't on him. I'm fairly confident that his opinions on this particular aspect are pretty close to mirroring my own opinions. BJ's entrance into the conversation started at the top of p.489, where he began with "So what's your source for saying vaccine immunity > natural immunity? Because your link doesn't say that. Your link says natural immunity + vaccine immunity is better than natural immunity alone." Everything was built off a comparison between natural and vaccinated immunity (what's better, what's worse, how do we define better/worse, what evidence is there, what prerequisites are there for each, etc.). Neither he nor I nor anyone else proposed the interesting topic of "How do survivors of covid (and their natural immunity) play a role in the overall order and decision of who gets vaccinated next, given a limited supply of vaccines." You just introduced that now. And I think that's a really cool, thought-provoking question, but that's not what the past few pages were about, and it's definitely not how BJ was presenting arguments/questions.
I'll agree that him asking for a source does not constitute asking the more interesting question we've now moved on to - but it was even further from constituting making the statements he was then asked to justify or defend. I had the same reaction to Gorsameth's post that BJ had, because I have also read studies indicating that comparing just vaccine immunity with just post-infection immunity (not a combination of the two, which BJ wrote nothing about) seemed to favor just post-infection immunity. (And again, it's very possible that this isn't the case - but the Israeli study BJ referenced seemed to indicate that based on my cursory glance at it, at least from how I remember it. Thus, if there's information to the contrary - that only being vaccinated gives better protection than only having been previously infected, that's interesting, and reasonable to ask for a source for. ) Nothing about that statement is indicating that getting infected is preferable to being vaccinated.
Anyway, the discussion of BJ's contribution also isn't really all that interesting. I would, however, like to see more people read him in good faith, and not argue against him based on what they assume is the extension of what he said. There's an element to it where he could do a better job clarifying his point of view from the get-go, but honestly, he shouldn't have to, because the communication breakdown happens at the point where people argue against what they assume he said. Myself, I've posted here for 20 years, and I tend to make these addendums to my post (in this post, I do that inside the parenthesis of the first paragraph) before I press post, precisely because I am so used to people misinterpreting and reading stuff in bad faith, but I think this is an extra hoop that I jump through that I shouldn't have to jump through.
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On October 10 2021 22:27 DarkPlasmaBall wrote:Show nested quote +On October 10 2021 22:11 NewSunshine wrote:
I think the whole discussion of natural immunity is a moot point, given the fact that not all COVID infections actually result in protective antibodies, in other words natural immunity is not a given even if you survive. People therefore should not be assuming they're safe just because they've already been infected, and they should still take their full vaccination course. Thus I still don't agree with all the argument that has been taking place over how we should handle it. We should be assuming that natural immunity is not a thing, because it's dangerous to take it for granted and be wrong.
Plus the logistics of the shot being what they are, no, distribution of the vaccine is not ideal, but it is what it is unfortunately. The shots are only live for a short time, and they need to be used or thrown out. If second shots or booster shots are available, you should take them because if you don't then nobody does. There is no saving a shot to redistribute to another more needy community. That is interesting, that is true, and I agree. In fact, the first article that I posted in response to BJ said this: "A third of infections don't get any protective antibodies Some people who get COVID-19 receive no protection from reinfection – their natural immunity is nonexistent. A recent study found that 36% of COVID-19 cases didn't result in development of SARS-CoV-2 antibodies. The people had different levels of illness – most had moderate disease, but some were asymptomatic and some experienced severe COVID-19. "Vaccine-induced immunity is more predictable than natural immunity," says Dr. Rupp. The COVID-19 vaccines provide great protection from severe disease, hospitalization and death." https://www.nebraskamed.com/COVID/covid-19-studies-natural-immunity-versus-vaccination For the purposes of making progress with a discussion about natural immunity and how it affects who gets vaccinated next, we can certainly assume that some sort of test has preemptively verified that a covid survivor actually has natural immunity (as ~2/3 of them should), but of course, any covid survivors who don't actually have reasonable protection from covid wouldn't be particularly applicable to a proposal of, say, moving them out of line because they're temporarily safer from covid. In other words, it's basically acknowledging the difference between "I've had covid, and therefore I'm temporarily protected against reinfection" (which doesn't necessarily follow) and "I've had covid and doctors have medically confirmed that the fight against the infection has left behind a natural immunity of relevant antibodies, and therefore I'm temporarily protected against reinfection" (which is a more reasonable conclusion, given the immunity confirmation, and only happens 2/3 of the time).
Relatedly, an often overlooked benefit of vaccination (and its less common companion in medical confirmation of a successful immunity response to infection) is the creation of a record that serves a number of purposes, from providing important details in an individual's medical history to providing public health officials with concrete data that can be used to inform recommendations and policies.
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Some people who get COVID-19 receive no protection from reinfection – their natural immunity is nonexistent. A recent study found that 36% of COVID-19 cases didn't result in development of SARS-CoV-2 antibodies. The people had different levels of illness – most had moderate disease, but some were asymptomatic and some experienced severe COVID-19. that's a shit take on the actual study.
from the study:Conclusions
In summary, we show that patients with low SARS-CoV-2 viral loads in their respiratory tract are less likely to mount a systemic antibody response. Although we cannot formally exclude false-positive RT-PCR results in some participants, PCR contamination is highly unlikely as an explanation for our findings (Appendix). We also show that clinical illness does not guarantee seroconversion and that laboratories with highly sensitive RT-PCR assays are more likely to detect serologic nonresponders. These results provide an explanation for the puzzling variability of seroconversion in different cohorts. low viral load at nasopharyngeal level is assumed to be the cause for no detectable antibody levels; but, since the patient recognized the virus at mucosal level and killed it, he's mostly fine.
a body's reaction is proportional to the threat. producing 234985745345 antibodies is not free.
Edit: also, they say that even after vaccination some patients do not show seropositivity.
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On October 10 2021 20:03 BlackJack wrote:There's a myriad of other sources and scientists that agree that the 2nd shot provides little benefit for those previously infected and 1 shot of pfizer or moderna is sufficient for a previously infected person to have better immunity than someone that has had only the 2 shots with no previous infection. Show nested quote +Similarly to findings from a smaller study that directly measured antibody neutralizing capacity in 59 volunteers8, we found, in our large cohort, that a second vaccine dose did not offer previously infected individuals a substantially greater benefit over a single dose in antibody neutralizing potential. Thus, our data suggest that a single dose of the Pfizer–BioNTech vaccine is sufficient for individuals with prior SARS-CoV-2 infection, Study out of Cedars-Sinai Medical Center Los Angeles https://www.nature.com/articles/s41591-021-01325-6Show nested quote +"Our data suggest that a person who previously had COVID-19 has a huge response after the first mRNA vaccination and has little or no benefit from the second dose," said senior author Dr. Otto Yang, a professor of infectious diseases and of microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA. https://www.uclahealth.org/news/people-who-have-had-covid19-may-require-only-single-dose-of-twodose-vaccinesShow nested quote +In fact, "we observed higher SARS-CoV-2 antibody levels in previously infected individuals after 1 dose of [the Pfizer vaccine], compared with infection-naive individuals after 2 doses," concluded a team led by Dr. James Moy, of the division of allergy and immunology at Rush University Medical Center in Chicago.
What's more, giving previously infected people a second dose of the Pfizer vaccine did little to boost their antibody levels further, "suggesting that 1 dose may be acceptable in this group," the researchers added. https://www.usnews.com/news/health-news/articles/2021-08-06/one-dose-of-pfizer-vaccine-may-be-enough-for-folks-whove-had-covid
The first study you linked (https://www.nature.com/articles/s41591-021-01325-6) confirms that one dose of vaccination after a prior case of infection does significantly boost immunity. The benefit was only found to be low from another, second dose. The first dose shows a significant benefit.
We were arguing about vaccination after infection being beneficial, so if the second dose doesn't show additional benefit, then that's missing the point of the discussion.
"In a cohort of BNT162b2 (Pfizer–BioNTech) mRNA vaccine recipients (n = 1,090), we observed that spike-specific IgG antibody levels and ACE2 antibody binding inhibition responses elicited by a single vaccine dose in individuals with prior SARS-CoV-2 infection (n = 35) were similar to those seen after two doses of vaccine in individuals without prior infection (n = 228)."
The second link you posted also confirms this.
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Furthermore, I can't find any studies citing that previously infected individuals should never receive a second dose. The following study looks into this and it recommends maybe delaying the second dose until up to 10 months after infection. So in the context of that study it is not necessarily recommended that the second dose should be delayed beyond 10 months, and it is also not necessarily recommended that previously infected individuals wait a total of 10 months before their second dose in the first place.
"Delaying the second vaccination in individuals infected up to ten months prior may constitute a more efficient use of limited vaccine supplies."
"A second dose was administered 21 days after the first."
21 days is not a long time, so it cannot be said at this point that a second dose would (in every context) not have any effect at all, as immunity might be waning slower after either two doses or after infection + a single dose. Delaying the second dose beyond 21 days might show different results.
https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(21)00382-0/fulltext
Even in studies on two-dose vaccination (after no prior infection) the findings on the best timeframe are unclear, too. Since the arrival of the first covid vaccine this has been continuously debated, with some recommendations saying it's best to wait 7-8 weeks before giving a second dose due to findings of improved efficacy as compared to an earlier second dose. It would make perfect sense that such unclear results would also show for previously infected individuals.
To the point (tl;dr): there's no research showing conclusively that a second dose after a prior infection strictly doesn't add immunity in any capacity. It may simply be that the timeframe must be longer, which would make sense according to all other observations.
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On October 10 2021 22:15 DarkPlasmaBall wrote:
Neither he nor I nor anyone else proposed the interesting topic of "How do survivors of covid (and their natural immunity) play a role in the overall order and decision of who gets vaccinated next, given a limited supply of vaccines." You just introduced that now. And I think that's a really cool, thought-provoking question, but that's not what the past few pages were about, and it's definitely not how BJ was presenting arguments/questions.
I literally posted this twice in the last 2 days...
On October 09 2021 15:38 BlackJack wrote:
1) In a world with limited vaccines should we use vaccines on people that already have protection from natural immunity or give them to the next person
Thanks Eri, for just now bringing up that thought-provoking question. 
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400 is an insanely small sample size to be trying to draw conclusions like this. A number of people several orders of magnitude higher than that have died, and a yet bigger number represents the total number of infections, and thus behaviors in infected individuals. Maybe it's good and true? But there's every chance it doesn't end up meaning much.
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Asprins a really really werid medication. Microdoseing it for people with any kind of heart issues has some tangible benefits. They still give out "baby asprin" even though they don't give asprin to babies anymore.
the thing that people don't get about science is that his is good enough to start a larger study but in it of itself doesn't say anything more than that.
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On October 11 2021 10:22 NewSunshine wrote:
400 is an insanely small sample size to be trying to draw conclusions like this. A number of people several orders of magnitude higher than that have died, and a yet bigger number represents the total number of infections, and thus behaviors in infected individuals. Maybe it's good and true? But there's every chance it doesn't end up meaning much.
Fair call, I’m saying it warrants further investigation.The other study they mention in the article used 10,000 people as a sample size.That study mainly discussed possibility of reducing chance of infection in the first place though, 29% lower chance of getting covid if you take aspirin but they did also note quicker recovery.
https://m.jpost.com/health-science/coronavirus-aspirin-may-help-prevent-infection-israeli-study-shows-661682
The use of aspirin might help prevent becoming infected with corona and shorten the duration of the disease, a study conducted by a joint team from Leumit Health Care Services, Bar-Ilan University and Barzilai Medical Center has shown.
The study, whose findings were published in the FEBS Journal of the Federation of European Biochemical Societies, analyzed data from some 10,000 Israelis who were tested for COVID-19 between February 1 and June 30, 2020.
The researchers compared those who regularly take a low dose of aspirin as a medication to prevent and treat cardiovascular diseases with those who don’t.
They found that the former group was 29% less likely to become infected with the virus than the latter.
The researchers also observed that those who took aspirin and contracted the disease recovered on average two or three days faster than individuals who did not, depending on preexisting conditions. In addition, the time it took these patients to test negative for the virus after testing positive was significantly lower.
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I understand the hope for a quick discovery of a treatment, and I can't say whether or not aspirin helps in some capacity, but I can say that that study unfortunately should not be used as evidence, because there are too many confounding variables. It would need to be researched in a controlled setting.
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On October 11 2021 06:29 BlackJack wrote:Show nested quote +On October 10 2021 22:15 DarkPlasmaBall wrote:
Neither he nor I nor anyone else proposed the interesting topic of "How do survivors of covid (and their natural immunity) play a role in the overall order and decision of who gets vaccinated next, given a limited supply of vaccines." You just introduced that now. And I think that's a really cool, thought-provoking question, but that's not what the past few pages were about, and it's definitely not how BJ was presenting arguments/questions. I literally posted this twice in the last 2 days... Show nested quote +On October 09 2021 15:38 BlackJack wrote:
1) In a world with limited vaccines should we use vaccines on people that already have protection from natural immunity or give them to the next person
Thanks Eri, for just now bringing up that thought-provoking question.
When I'm in the middle of a conversation with someone, and we're having a back-and-forth about something in particular (e.g., whether or not certain conclusions can be validly drawn from multiple, posted articles about vaccine immunity and/or natural immunity, which then becomes substantive enough where analogies are offered as various ways to potentially perceive or reframe the arguments, and so on), that's my focus. If you ask an irrelevant question - and people are already in the middle of having a different conversation with you, so they're not biting because it appears like you're potentially derailing the current topic which hasn't had closure yet - then it does a disservice to what could otherwise be a good question, when asked at a better, less busy time. That question certainly was not the topic of our discussion.
I think your second question is also a good one, when not placed in the middle of a different conversation:
"2) Should people that already have protection from a previous COVID infection be exempt from vaccine passports/mandates?"
You've made it clear in this question that you're specifically referring to the subset of the roughly 2/3 of covid survivors that actually have the natural immunity, which I think is a good place to start. Obviously, there would need to be the prerequisite medical test for a covid survivor to make sure they actually have some semblance of the temporary natural immunity, or else they wouldn't be applicable for this hypothetical scenario.
In places where vaccines are in short supply (and there are many of these kinds of places, sadly), I'm all for looking at multiple factors when considering who needs the vaccine the most. Conventionally, we would put demographics like older people or medically at-risk people at the front of the line for receiving the vaccine, but I also think there's an argument to be made that generally healthy, younger covid survivors who have natural immunity could be placed towards the back of the line, since they have some protection already.
In places with limited amounts of vaccines, I could see an argument to allow people with natural immunity to be temporarily exempt from vaccine passports/mandates, although I think enforcing this effectively and accurately needs to be done. When I say that, I specifically mean that there needs to be medical documentation on when the person was infected and that the person does indeed have natural immunity (since it's not guaranteed, and it does fade). Kind of like the natural immunity equivalent of showing your covid vaccine card, if that makes sense.
In places where covid vaccines are not in short supply (e.g., the United States), I don't think exemptions should be made at all, regardless of whether or not you have natural immunity, because getting the vaccine is an available, free option and further reduces the risk to yourself and everyone.
Thoughts?
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Giving exemptions from vaccine passports / mandates to people with natural immunity is just adding more fuel to the idiotic fire of anti-vaxx fear mongering; and potentially, encouraging even those who would be okay with getting the shot to instead go out to try and get infected on purpose just so they can avoid having to wait for their turn to get vaccinated before they can start going to their football matches / pub crawls / whatever it is again.
It doesn't matter how reasonable or logical it is to make those with natural immunity exempt from whatever regulations. Giving any kind of a convenience / benefit to them will inevitably result in people catching / spreading the virus on purpose, and it will inevitably result in at least some people dying.
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EPT
