The Vaccine Thread

[ktgrok]

19 minutes ago, Plum said:

That's what I was saying...or trying to say. lol 

Now I have posted an NIH study that basically says antibody tests are only as good as the antibodies and proteins they are looking for, so YMMV. But there does need to be an honest look at natural immunity. Maybe people who have had it within a certain number of months can go about as if they were vaccinated for X number of months at the very least. 

 

https://www.wsj.com/articles/the-power-of-natural-immunity-11623171303

Right. We have said that in vet medicine for a long time - titers only tell us about the antibody we are testing for, not actual immunity. 

But given what we are seeing in real life regarding covid infection and immunity, even very super cautious still sprays her groceries with peroxide little old me feels that a card could be issued with proof of infection and a date. As we learn more about how long that immunity lasts, we can extend or change how long an "infection card" is good for. Or test for antibodies every say, 6 months or 1 yr or whatever. 

Wouldn't be perfect - some people would maybe have antibodies that wear off a bit sooner than their card is good for, and some will not show antibodies when retested even though they are immune and get a vaccine thy don't actually need, but those would be the outliers. From a public health standpoint it would work, and would make freaking sense. Which, likely, is why it won't happen, lol. 

But seriously, it wouldn't be THAT hard to have tables set up at vaccine clinics where you can bring proof of a positive test or antibodies and get your card, just like the vaccine card. And then we could collect real data on how many unvaccinated people are immune, which would let us make better policy decisions. Hell, it would let me make better parenting decisions. 

[ktgrok]

1 minute ago, FuzzyCatz said:

To be fair, we also haven't seen data until pretty recently that those who are immune aren't generally spreading it and it wasn't (and still isn't) exactly clear how long immunity can and will last.  Policies have evolved as we've learned more.  I was surprised how fast mandates went for masks.  But when the data was solid, they were gone.  

 

At this point though, we should be hearing something about "immune via infection" type programs - cards, or even just wording saying, "proof of vaccine or proof of infection within the last year OR proof of antibodies within the last 6 months"

There is, at this point, more evidence to support that idea than a heck of a lot of other policies. 

There are people who are immune and have no way to prove it, and I would LIKE to know they can prove it. And it would have the side benefit of encouraging all hose people that "swear they had it" to actually get an antibody test, so if they don't have antibodies they can make a more informed decision on vaccination. AND it would encourage those with minor symptoms going forward to bother getting tested, since although a positive test will mean inconvenience now, it will also mean more freedom later. 

Although I guess the fear is people will try to get infected on purpose to get the card?

[catz]

18 minutes ago, ktgrok said:

At this point though, we should be hearing something about "immune via infection" type programs - cards, or even just wording saying, "proof of vaccine or proof of infection within the last year OR proof of antibodies within the last 6 months"

There is, at this point, more evidence to support that idea than a heck of a lot of other policies. 

There are people who are immune and have no way to prove it, and I would LIKE to know they can prove it. And it would have the side benefit of encouraging all hose people that "swear they had it" to actually get an antibody test, so if they don't have antibodies they can make a more informed decision on vaccination. AND it would encourage those with minor symptoms going forward to bother getting tested, since although a positive test will mean inconvenience now, it will also mean more freedom later. 

Although I guess the fear is people will try to get infected on purpose to get the card?

A card for what though?  I haven't needed to show proof of vaccination anywhere at this point.  If you want to travel overseas, those countries set their own policies.  Spain is actually saying proof of vaccine or medical certificate of proof of recovery is accepted for Americans for proof of entry.  So this is actually happening.  

 https://www.usatoday.com/story/travel/news/2021/06/09/europe-travel-france-reopens-vaccinated-americans/7615814002/

Some states still have pretty pathetic positivity/infection rates IMO and should be holding back a bit yet, but whatever.  

I think we'll continue to see things change pretty rapidly.  Like my mom this week had eye surgery.  She has been fully vaccinated since March and our infection rate is like .6/positivity around 1.5%.  She has been laying low the last month so she wouldn't get anything before this surgery.  They still made her go get a PCR test in testing location.  I hope they drop that kind of thing soon for the vaccinated and recovered. 

Edited June 9, 2021 by FuzzyCatz

[Dmmetler]

11 minutes ago, FuzzyCatz said:

A card for what though?  I haven't needed to show proof of vaccination anywhere at this point.  If you want to travel overseas, those countries set their own policies.  Spain is actually saying proof of vaccine or medical certificate of proof of recovery is accepted for Americans for proof of entry.  So this is actually happening.  

 https://www.usatoday.com/story/travel/news/2021/06/09/europe-travel-france-reopens-vaccinated-americans/7615814002/

Some states still have pretty pathetic positivity/infection rates IMO and should be holding back a bit yet, but whatever.  

I think we'll continue to see things change pretty rapidly.  Like my mom this week had eye surgery.  She has been fully vaccinated since March and our infection rate is like .6/positivity around 1.5%.  She has been laying low the last month so she wouldn't get anything before this surgery.  They still made her go get a PCR test in testing location.  I hope they drop that kind of thing soon for the vaccinated and recovered. 

My college student's school requires vaccination or a medical waiver. It would be nice for them to accept proof of recovery from infection since being vaccinated isn't recommended for at least a few months after recovery. There is a difference between the precautions needed by someone who cannot be vaccinated at all and someone who is almost certainly immune due to having been infected. 

[KSera]

1 hour ago, Not_a_Number said:

I think the reason this is hard is because it's actually hard to access that information -- you have to use T-cells or something. I actually would guess there's plenty of monetary motivation for it: everyone would love to know. 

There actually is one approved by the FDA, but once I actually read about it, it didn’t sound as helpful as I had hoped. I don’t have time to read about it again right now, but I seem to recall it hadn’t been tested very far out from the participants infection, so it’s hard to know how long it actually is reliable for. If there was one that was accurate, I would want to take it.

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-adaptive-biotechnologies-t-detect-covid-test

[catz]

1 minute ago, Dmmetler said:

My college student's school requires vaccination or a medical waiver. It would be nice for them to accept proof of recovery from infection since being vaccinated isn't recommended for at least a few months after recovery. There is a difference between the precautions needed by someone who cannot be vaccinated at all and someone who is almost certainly immune due to having been infected. 

I wonder if some of the colleges will evolve their policies by fall as this data becomes more clear and used?  At my kid's college, they were ALL testing twice a week spring semester.  I think those who had positive covid tests were given a 90 day reprieve after recovery on testing.  And then once they started vaccinating at the University hospital, those people didn't need to test either.  

[ktgrok]

19 minutes ago, Dmmetler said:

My college student's school requires vaccination or a medical waiver. It would be nice for them to accept proof of recovery from infection since being vaccinated isn't recommended for at least a few months after recovery. There is a difference between the precautions needed by someone who cannot be vaccinated at all and someone who is almost certainly immune due to having been infected. 

Oh...you know..in practicality maybe a doctor would give a medical waiver if someone has proof of a positive test?

[ktgrok]

48 minutes ago, FuzzyCatz said:

A card for what though?  I haven't needed to show proof of vaccination anywhere at this point.  If you want to travel overseas, those countries set their own policies.  Spain is actually saying proof of vaccine or medical certificate of proof of recovery is accepted for Americans for proof of entry.  So this is actually happening.  

 https://www.usatoday.com/story/travel/news/2021/06/09/europe-travel-france-reopens-vaccinated-americans/7615814002/

Some states still have pretty pathetic positivity/infection rates IMO and should be holding back a bit yet, but whatever.  

I think we'll continue to see things change pretty rapidly.  Like my mom this week had eye surgery.  She has been fully vaccinated since March and our infection rate is like .6/positivity around 1.5%.  She has been laying low the last month so she wouldn't get anything before this surgery.  They still made her go get a PCR test in testing location.  I hope they drop that kind of thing soon for the vaccinated and recovered. 

I WISH proof was required though, to go unmasked. At least here where we are still over 4% positivity, and that rate (well, rolling 7 day average) did not go down this past week. 

 

[Dmmetler]

13 minutes ago, ktgrok said:

Oh...you know..in practicality maybe a doctor would give a medical waiver if someone has proof of a positive test?

I believe students with waivers have to have private rooms, and have to quarantine if exposed. I also think there are restrictions on internships, etc. The focus is on protecting such students from exposure, but It is likely overkill for those students who are immune due to having had COVID. 

[TCB]

4 hours ago, Penelope said:

+1000. Why should a young male, for example, take any small risk of vaccination to fulfill a college requirement if they already are protected from previous infection? It makes no sense and is unethical.

This is fairly new information though right? Some decisions were made prior to this information being available. Maybe the guidelines need to be adjusted but it doesn’t seem fair to accuse people of making nonsensical and unethical decisions when they were making them with the knowledge available at the time. 

[Lucy the Valiant]

52 minutes ago, TCB said:

This is fairly new information though right? Some decisions were made prior to this information being available. Maybe the guidelines need to be adjusted but it doesn’t seem fair to accuse people of making nonsensical and unethical decisions when they were making them with the knowledge available at the time. 

Several sources have been saying for over a year now that natural infection confers immunity. NIH understood it well in January.

And for all those recovered from covid who have had positive antibody tests ever since (aka the convalescent plasma donors & most of their families) - the data has been there, ya know? 

I do hope we continue to see organizations and states and universities try to catch up.

(Edited to add: Sources = medical doctors, immunologists, and researchers, not just "average joes." They were routinely questioned, mocked, derided, and castigated by the media. Hoping that era is over, too, and that we can move forward with actual science as it continues to confirm.)

Edited June 9, 2021 by Lucy the Valiant

[TCB]

2 hours ago, Lucy the Valiant said:

Several sources have been saying for over a year now that natural infection confers immunity. NIH understood it well in January.

And for all those recovered from covid who have had positive antibody tests ever since (aka the convalescent plasma donors & most of their families) - the data has been there, ya know? 

I do hope we continue to see organizations and states and universities try to catch up.

(Edited to add: Sources = medical doctors, immunologists, and researchers, not just "average joes." They were routinely questioned, mocked, derided, and castigated by the media. Hoping that era is over, too, and that we can move forward with actual science as it continues to confirm.)

I realize that as time has gone on they’ve been more confident that immunity lasted more and more months.  Then you get the situation in Manaus, Brazil, where it seemed that reinfection might be happening. I’m always amazed to hear that some people knew all along about these things, despite it being a novel virus. I can understand making educated assumptions, but being absolutely sure way before everyone else not so much, and also not making policy decisions based on educated assumptions.
We feel like we are still continuously learning, looking after Covid patients, where I work. 

[kokotg]

1 hour ago, TCB said:

I realize that as time has gone on they’ve been more confident that immunity lasted more and more months.  Then you get the situation in Manaus, Brazil, where it seemed that reinfection might be happening. I’m always amazed to hear that some people knew all along about these things, despite it being a novel virus. I can understand making educated assumptions, but being absolutely sure way before everyone else not so much, and also not making policy decisions based on educated assumptions.
We feel like we are still continuously learning, looking after Covid patients, where I work. 

Manaus is definitely concerning and a good reason not to get cocky just because numbers are down right in the US right now (or to be too confident about natural immunity): https://www.thelancet.com/article/S0140-6736(21)00183-5/fulltext

[wathe]

thanks, deleted.

Edited June 12, 2021 by wathe

[Not_a_Number]

1 hour ago, TCB said:

I’m always amazed to hear that some people knew all along about these things, despite it being a novel virus. I can understand making educated assumptions, but being absolutely sure way before everyone else not so much, and also not making policy decisions based on educated assumptions.

I definitely haven't known all along and I hope I haven't sounded like I did. It's just looked like it for the last few months. The jury was out before then. 

And I'm not at all clear on what happens with variants, but then same goes for vaccines, so it seems unfair to ding natural immunity for that... 

[mommyoffive]

wathe,

I would  go with the first dose you can get.  I am in the states and haven't heard of mixing doses here at all so I don't know anything about the science of that.   

Delta becoming the main strain there this month is so scary.  Ugh.  

[rebcoola]

6 hours ago, FuzzyCatz said:

A card for what though?  I haven't needed to show proof of vaccination anywhere at this point.  If you want to travel overseas, those countries set their own policies.  Spain is actually saying proof of vaccine or medical certificate of proof of recovery is accepted for Americans for proof of entry.  So this is actually happening.  

 https://www.usatoday.com/story/travel/news/2021/06/09/europe-travel-france-reopens-vaccinated-americans/7615814002/

Some states still have pretty pathetic positivity/infection rates IMO and should be holding back a bit yet, but whatever.  

I think we'll continue to see things change pretty rapidly.  Like my mom this week had eye surgery.  She has been fully vaccinated since March and our infection rate is like .6/positivity around 1.5%.  She has been laying low the last month so she wouldn't get anything before this surgery.  They still made her go get a PCR test in testing location.  I hope they drop that kind of thing soon for the vaccinated and recovered. 

We have quite a few activities that are selling vaxxed sections of tickets and to get those oyu have to show proof.  Including things like graduations.  It allows venues to get more people in since their aren't distancing requirements.   It would make sense to say you could show your vax card or results from antibody test within x time.

[wathe]

Just now, mommyoffive said:

wathe,

I would  go with the first dose you can get.  I am in the states and haven't heard of mixing doses here at all so I don't know anything about the science of that.   

Delta becoming the main strain there this month is so scary.  Ugh.  

I think so too.  I will feel terrible if he gets VITT though.  But I will also feel terrible if he gets covid while waiting......

[Penelope]

6 hours ago, TCB said:

This is fairly new information though right? Some decisions were made prior to this information being available. Maybe the guidelines need to be adjusted but it doesn’t seem fair to accuse people of making nonsensical and unethical decisions when they were making them with the knowledge available at the time. 

I don’t think it’s new information.
I can’t fault colleges or businesses; I expect that they go by what public health agencies say. A lot of people, rightly or wrongly, have been saying that public health is extremely slow on this issue. But it is unethical to require an unnecessary medical treatment, so public health needs to act like this is also an emergency, to acknowledge natural immunity as protective in guidance to other organizations. 
 

Yes it’s a novel virus, but it’s not a new family of virus, and reading and listening to various scientists from the beginning, there was never any reason to think that getting infected would confer zero immunity, that you would get reinfected every couple of months, and most especially, that you would get very sick each time. That was IMO a fear-based narrative drummed up by rumor and a scientifically illiterate press.
 

What I primarily heard even over a year ago is that we seem to get reinfected with common cold Coronaviruses every few years, so that maybe that would happen with this one, maybe as little as every 1-2 years, or maybe it would be longer. But that generally, it would be milder after the first exposure, for most people. 
 

There is still the idea that many of us will get reinfected with very mild or asymptomatic infections over the years, boosting the immunity gained from vaccination or previous infection. This could be expected as we won’t all continue to have super high neutralizing antibody titers over time. 
 

I don’t know if the Manaus story has been fully resolved, but I thought the concern about huge numbers of reinfections with a variant is based on one problematic antibody survey that was not confirmed in other studies. There is a lot more on that than the January article someone else just linked. 

[TCB]

7 hours ago, Penelope said: 

I don’t know if the Manaus story has been fully resolved, but I thought the concern about huge numbers of reinfections with a variant is based on one problematic antibody survey that was not confirmed in other studies. There is a lot more on that than the January article someone else just linked. 

I think I read that they questioned some of the findings of the survey. Hopefully we will be able to get a clearer picture of that. We have many friends in the Manaus area and according to their experiences there were many, many people sick during the 2 big waves. It was extremely chaotic there though, because of lack of resources, so it may be difficult to figure out exactly what happened. I can’t remember if the studies linked above, showing prolonged immunity after infection, addressed the variants predominant in Brazil and India, sorry I know the latter is Delta but can’t remember the new name of the former.

[Acadie]

Anecdotally I have a friend clinically diagnosed with probable Covid last April when it was first going around here. She was unable to access testing, but had typical moderate symptoms, including losing her sense of taste and smell for almost 3 months. 

She recently got sick again, and tested positive for Covid. Similar symptoms, like the worst flu ever, but she did not need to be hospitalized.

How could the Cleveland Clinic research tell us what will happen when people encounter variants, especially Delta variant? It's only 6% of cases in the US now, and would have been somewhere between less than that and zero during data collection.

[Not_a_Number]

7 hours ago, Penelope said:

What I primarily heard even over a year ago is that we seem to get reinfected with common cold Coronaviruses every few years, so that maybe that would happen with this one, maybe as little as every 1-2 years, or maybe it would be longer. But that generally, it would be milder after the first exposure, for most people. 

I think people did think this, yes, but there was also concern about generalizing from common cold coronaviruses? Like, it's a little dangerous to make the assumption that it's the same.  

[Not_a_Number]

4 minutes ago, Acadie said:

Anecdotally I have a friend clinically diagnosed with probable Covid last April when it was first going around here. She was unable to access testing, but had typical moderate symptoms, including losing her sense of taste and smell for almost 3 months. 

She recently got sick again, and tested positive for Covid. Similar symptoms, like the worst flu ever, but she did not need to be hospitalized.

How could the Cleveland Clinic research tell us what will happen when people encounter variants, especially Delta variant? It's only 6% of cases in the US now, and would have been somewhere between less than that and zero during data collection.

The problem is that the vaccine research has similar issues, right? We never know how it responds to each new thing until we try. 

[ieta_cassiopeia]

The UK accepts two doses of approved vaccines as full vaccination, including mixed doses (trials, plus some people who were allergic to OxfordAstrazeneca/mRNA on dose #1 and given the opposite type to avoid allergies on dose #2), and other countries that accept proof of vaccination are accepting NHS-backed mixed doses as proof of full vaccination. Provided you can get both doses recorded, I do not think mixed doses will be a barrier to travel. At this point, the larger issue is that many countries don't take vaccination into account for their travel policies at all.

 

Can't comment on the effectiveness situation yet because the research is ongoing, but I've not heard any safety-related horror stories from mixed vaccination.

Edited June 10, 2021 by ieta_cassiopeia

[vonfirmath]

Evidently more than just organ transplant patients are finding the RNA vaccines are not working well for them. 

 

https://www.cnn.com/2021/06/04/health/covid-19-vaccine-immunosuppressants/index.html?fbclid=IwAR2bYlvtTLjVxFST7N1xD9SSqOBukS5zLViIDhO9XcdOkl1Xn3xNPGACn0g

[Penelope]

Germany approves Pfizer for 12-17 but only for those with pre-existing conditions. https://news.yahoo.com/german-panel-gives-limited-approval-145104409.html

Quote

Germany's vaccine advisory committee, known as STIKO, recommended on Thursday that only children and adolescents with pre-existing conditions should be given the coronavirus vaccine produced by Pfizer and partner BioNTech.

STIKO said in a statement that it recommends a vaccination only for those youngsters with an illness that raises their risk of a serious case of coronavirus.

It said it was not currently recommending the use of the vaccine for those aged 12-17 without pre-existing conditions, although noted doctors were allowed to give the shot if the individual accepts the risk.

Germany has said it plans to offer shots to children as young as 12 from June after the European health regulator authorised the vaccine for use in adolescents last month.

STIKO committee member Ruediger von Kriess, a paediatrics professor, said previously it might be preferable to endorse the vaccine for use in children only if they have risk factors given the lack of data on long-term effects.

There is an FDA vaccine advisory meeting today about what is appropriate re testing and approving Covid vaccines for children. 
Slides from myocarditis presentation are here. Info from 12-15 year olds largely still unavailable. 

[TCB]

On TWIV last week Dr Daniel Griffin was talking about the possible myocarditis vaccine link. He said that the incidence was the same as (or ? less than) the usual incidence in the population, however the incidence of myocarditis in the general population has actually been lower than usual in recent times. Thought that was very interesting. He said usually it is a quite short illness and treated with ibuprofen for the inflammation. I’m getting a bit fuzzy about where I’ve heard different things, but I think he also said that a case he was personally aware of was after the young man had had the J&J vaccine.

[vonfirmath]

45 minutes ago, TCB said:

On TWIV last week Dr Daniel Griffin was talking about the possible myocarditis vaccine link. He said that the incidence was the same as (or ? less than) the usual incidence in the population, however the incidence of myocarditis in the general population has actually been lower than usual in recent times. Thought that was very interesting. He said usually it is a quite short illness and treated with ibuprofen for the inflammation. I’m getting a bit fuzzy about where I’ve heard different things, but I think he also said that a case he was personally aware of was after the young man had had the J&J vaccine.

This article seems to say that, among the young population (16-to-24 year olds) its actually twice the usual incidence.

https://www.cnbc.com/2021/06/10/covid-vaccine-cdc-says-heart-inflammation-cases-in-16-to-24-year-olds-higher-than-expected-after-second-shot.html?fbclid=IwAR2GT7qu_s-Gzu0flo3J7piCjiNameF3LtVPZDQJvTdfhtlaPN2qh-y-mrE

 

[TCB]

38 minutes ago, vonfirmath said:

This article seems to say that, among the young population (16-to-24 year olds) its actually twice the usual incidence.

https://www.cnbc.com/2021/06/10/covid-vaccine-cdc-says-heart-inflammation-cases-in-16-to-24-year-olds-higher-than-expected-after-second-shot.html?fbclid=IwAR2GT7qu_s-Gzu0flo3J7piCjiNameF3LtVPZDQJvTdfhtlaPN2qh-y-mrE

 

Interesting. I may have misunderstood him. He seemed to say that the incidence was more than background at the moment, because the background incidence is lower than usual, but the same as, and I thought he said maybe slightly lower, than the previous usual background incidence. But, as I say, I may have misunderstood. I’m pretty sure it was the TWIV clinical update #65 in case anyone wants to listen.

[whitestavern]

6 hours ago, TCB said:

On TWIV last week Dr Daniel Griffin was talking about the possible myocarditis vaccine link. He said that the incidence was the same as (or ? less than) the usual incidence in the population, however the incidence of myocarditis in the general population has actually been lower than usual in recent times. Thought that was very interesting. He said usually it is a quite short illness and treated with ibuprofen for the inflammation. I’m getting a bit fuzzy about where I’ve heard different things, but I think he also said that a case he was personally aware of was after the young man had had the J&J vaccine.

That is not accurate. They are finding higher than normal incidents.

https://www.msn.com/en-us/news/us/evidence-grows-stronger-for-covid-vaccine-link-to-heart-issue-cdc-says/ar-AAKV9eB?ocid=msedgntp

They are also following up on all of these in six months to make sure there are no lasting issues. The CDC is concerned enough that they are having an emergency meeting next week to discuss.

https://www.msn.com/en-us/news/us/evidence-grows-stronger-for-covid-vaccine-link-to-heart-issue-cdc-says/ar-AAKV9eB?ocid=msedgntp

 

[Terabith]

The situation in Brazil has made me very anxious about the potential for reinfection.  Also, frankly, Mrs. Tiggywinkle's experience, although I know that's anecdotal.  

I do think infection conveys protection, but I've been hesitant to say how much because of what happened in Brazil.  But maybe that was an issue with the variants?

[Not_a_Number]

4 minutes ago, Terabith said:

The situation in Brazil has made me very anxious about the potential for reinfection.  Also, frankly, Mrs. Tiggywinkle's experience, although I know that's anecdotal.  

I do think infection conveys protection, but I've been hesitant to say how much because of what happened in Brazil.  But maybe that was an issue with the variants?

It's so hard to get good data out of this all 😕 . A LOT of stuff is anecdotal. 

At the moment, it looks like people staying put mostly don't get reinfected within a small number of months. Butt no one's measured this for any lengths of time, either for the vaccines or for natural immunity. It wouldn't be surprising if a year in our current COVID-mutation-happy world would be enough for the virus to bypass both types of immunity 😕 . 

[Terabith]

9 minutes ago, Not_a_Number said:

It's so hard to get good data out of this all 😕 . A LOT of stuff is anecdotal. 

At the moment, it looks like people staying put mostly don't get reinfected within a small number of months. Butt no one's measured this for any lengths of time, either for the vaccines or for natural immunity. It wouldn't be surprising if a year in our current COVID-mutation-happy world would be enough for the virus to bypass both types of immunity 😕 . 

Didn't an awful lot of people in Brazil get re-infected in a pretty short period of time? 

[Not_a_Number]

1 minute ago, Terabith said:

Didn't an awful lot of people in Brazil get re-infected in a pretty short period of time? 

I have no idea. Did they? Last time I looked for any kind of reliable Brazilian data, I came far short. But if you have a link for that, I'd love to see. 

[Terabith]

I don't know about how reliable it was, but I remember reading about Manaus having such a huge epidemic early on and most experts thought they had reached herd immunity, and then the city got hammered again.  But I don't know how many of those people were officially tested or not.  

[Not_a_Number]

3 minutes ago, Terabith said:

I don't know about how reliable it was, but I remember reading about Manaus having such a huge epidemic early on and most experts thought they had reached herd immunity, and then the city got hammered again.  But I don't know how many of those people were officially tested or not.  

I remember the "herd immunity" stuff coming out of lots of places, though, and I never knew how reliable that was. People seem to have HUGE epidemics even when only 20 percent of the population gets sick, so it's quite possible one wouldn't be anywhere near herd immunity despite a giant spike, you know? And as you say, most people wouldn't even be recorded as cases, so you can't really count it properly. 

Remember how Sweden thought it was close to herd immunity, lol? You can get all sorts of weird results if you make IFR assumptions... 

[Terabith]

5 minutes ago, Not_a_Number said:

I remember the "herd immunity" stuff coming out of lots of places, though, and I never knew how reliable that was. People seem to have HUGE epidemics even when only 20 percent of the population gets sick, so it's quite possible one wouldn't be anywhere near herd immunity despite a giant spike, you know? And as you say, most people wouldn't even be recorded as cases, so you can't really count it properly. 

Remember how Sweden thought it was close to herd immunity, lol? You can get all sorts of weird results if you make IFR assumptions... 

I can't find the statistics, because it was from so long ago now, but Sweden's evidence for herd immunity seemed a lot flimsier than Manaus's.  I mean, they had bodies stacked in the streets in the spring.  They had a LOT of deaths.  70% infected seemed pretty darn reasonable based on death rates there.  

[Not_a_Number]

6 minutes ago, Terabith said:

I can't find the statistics, because it was from so long ago now, but Sweden's evidence for herd immunity seemed a lot flimsier than Manaus's.  I mean, they had bodies stacked in the streets in the spring.  They had a LOT of deaths.  70% infected seemed pretty darn reasonable based on death rates there.  

Yeah, you're right -- I'm looking it up, and it looks like they did have good evidence that many people had been infected 😕 . On the other hand, the data is still not great and doesn't involve a random sample. 

Basically, I'd guess it's possible that they had something like 30% infected and then more people in the remaining group got sick the second round. NYC only had something like 20% of people infected and there was a true disaster here, with COVID being by far the most prevalent cause of death and too many bodies to bury and whatnot, as everyone knows. 

I'd need to know the stats for registered reinfections, I guess. I agree that lots of data out of Brazil does seem worrisome, though... just that it's hard to know exactly what to make of it. 

Honestly, I have a bit of an "eat, drink and be merry, for tomorrow you may die" feeling about this summer. It feels like FOR NOW, things are safe near where I am, and I'm going to darn well enjoy it. But my ability to predict what happens next (both with and without vaccines) is really low 😕 . 

Edited June 11, 2021 by Not_a_Number

[Penelope]

11 minutes ago, Terabith said:

I don't know about how reliable it was, but I remember reading about Manaus having such a huge epidemic early on and most experts thought they had reached herd immunity, and then the city got hammered again.  But I don't know how many of those people were officially tested or not.  

A lot of people even said India had herd immunity, and then look what happened. 

It does make you wonder sometimes when people say that about the US, but at least now with vaccines we have real studies that show they work and  documented numbers of people vaccinated. 
 

I think what we have now that we didn’t have when they were saying that about Manaus, is all the data showing that immunity seems to be at least protecting against severe disease with variants. So I guess there could have been a lot of reinfection due to variants, but if there is a wave that is also accompanied by large numbers of hospitalizations, it’s less likely that those severe cases are mostly reinfections. 

[Not_a_Number]

30 minutes ago, Penelope said:

A lot of people even said India had herd immunity, and then look what happened. 

To be fair, they at least actually measured antibody levels in Manaus and they were high. Although they used a convenience sample, which is always sketchy. I remember convenience samples yielding all sorts of nonsense in many places. 

[ieta_cassiopeia]

7 hours ago, Terabith said:

I can't find the statistics, because it was from so long ago now, but Sweden's evidence for herd immunity seemed a lot flimsier than Manaus's.  I mean, they had bodies stacked in the streets in the spring.  They had a LOT of deaths.  70% infected seemed pretty darn reasonable based on death rates there.  

There were three things going on there:

1) Brazil's vaccination rate was very low at that point due to low supply partly brought on by political issues and partly due to supply. This meant a bunch of people with no source whatsoever of immunity got the P.1 variant.

2) 25% of people that the sample showed to have had COVID earlier got it again. My understanding is that having COVID-19 gives immunity to that specific variant in most people, but that the effectiveness against other variants depends on the extent to which the immune system is able to adapt its behaviour to those variants - not something that can be relied upon. Vaccines, at least in theory, offer a better "teaching environment" and thus work more reliably against a broader range of variants for the average person than infection does - but good luck making a scientifically valid experiment testing that theory!

3) The total of 1) and 2) was sufficient to overload Manaus' not-especially-good hospital services. This led to a lot of people dying from complications brought on by lack of treatment, rather than the people in 1) and 2), who died from COVID-19 despite medical care. This is why flattening the curve matters - it's the difference between a relatively small number of people dying and a large number. There isn't really a situation where a moderate number of people die, because either the hospitals are overloaded or they're not.

[Penelope]

This article is from around the time many articles were highlighting the antibody study from Manaus showing a high prevalence of infection. It talks about the problems with the study (self-selected population of blood donors, offered paid rides to bring them in for testing, and then the 70+% publicized was actually derived from a model that they used to extrapolate to the total population).

It also mentions another study of households done over a similar time period that showed only 14% of the population had immunity. But that was pretty much ignored in the reporting, perhaps because it didn’t make for such a good headline. 

https://www.the-scientist.com/news-opinion/study-estimates-76-percent-of-brazilian-city-exposed-to-sars-cov-2-68272

 

[Penelope]

5 hours ago, ieta_cassiopeia said:

2) 25% of people that the sample showed to have had COVID earlier got it again. My understanding is that having COVID-19 gives immunity to that specific variant in most people, but that the effectiveness against other variants depends on the extent to which the immune system is able to adapt its behaviour to those variants - not something that can be relied upon. Vaccines, at least in theory, offer a better "teaching environment" and thus work more reliably against a broader range of variants for the average person than infection does - but good luck making a scientifically valid experiment testing that theory!
 

To point #1, I think the surge began even before they had any vaccines.

To #2, do you remember the publication where you saw this number? I didn’t think there was anything definitive on that. 
 

I have also seen suggestion that vaccines could potentially do better with immunity to variants as opposed to natural infection. But there is another school of thought that says that natural infection may do better, because the resultant immunity is so much broader in scope. It could in fact be that those who received those inactivated virus vaccines made by the Chinese and those who were initially infected with the virus will have better long-term immunity, because they have more T-cell immunity to work with should the virus continue to mutate. While those of us who got spike protein vaccines will be chasing down any significant mutations with newer vaccines. There is talk that the next generation of vaccines would not focus only on one protein. There is a lot of talk about a lot of things, though, LOL, time will tell.

[mommyoffive]

German panel gives limited approval for COVID-19 shot for adolescents | Reuters

[Laura Corin]

https://inews.co.uk/news/health/most-brits-wary-vaccine-now-taken-up-jab-study-suggests-1048481

[Not_a_Number]

22 hours ago, Penelope said:

This article is from around the time many articles were highlighting the antibody study from Manaus showing a high prevalence of infection. It talks about the problems with the study (self-selected population of blood donors, offered paid rides to bring them in for testing, and then the 70+% publicized was actually derived from a model that they used to extrapolate to the total population).

It also mentions another study of households done over a similar time period that showed only 14% of the population had immunity. But that was pretty much ignored in the reporting, perhaps because it didn’t make for such a good headline. 

https://www.the-scientist.com/news-opinion/study-estimates-76-percent-of-brazilian-city-exposed-to-sars-cov-2-68272

Yep. That's kind of what my mind jumped to when I saw their methodology. I didn't even realize they paid for the rides, which skews it further! But having a convenience sample and then also bumping up the percentage they got from that... ugh. 

14% would be in line with what other places with serious disasters (like NY) had with decent sampling. 

[ieta_cassiopeia]

21 hours ago, Penelope said:

To point #1, I think the surge began even before they had any vaccines.

To #2, do you remember the publication where you saw this number? I didn’t think there was anything definitive on that. 
 

I have also seen suggestion that vaccines could potentially do better with immunity to variants as opposed to natural infection. But there is another school of thought that says that natural infection may do better, because the resultant immunity is so much broader in scope. It could in fact be that those who received those inactivated virus vaccines made by the Chinese and those who were initially infected with the virus will have better long-term immunity, because they have more T-cell immunity to work with should the virus continue to mutate. While those of us who got spike protein vaccines will be chasing down any significant mutations with newer vaccines. There is talk that the next generation of vaccines would not focus only on one protein. There is a lot of talk about a lot of things, though, LOL, time will tell.

Brazil had received some vaccines as part of various international vaccine creators' testing phases - notably OxfordAstraZeneca and SinoVac, as early as July 2020. During this phase, 14,000 Brazillians were due to be vaccinated with OxfordAstrazeneca , which was then increased to 19,000 later in the phase (14,000 other people had SinoVac, which failed its Phase III test phase due to only 50% effectiveness). Sputnik also did Phase III testing in September. While "production" vaccination had not begun, SinoVac turned out to be not much use, and proportional vaccination counts pre-second-surge will have been low, some people were test participants for OxfordAstrazeneca and therefore had been vaccinated.

The 25% is the lowest figure in the range used by The Guardian , which used this study from CADDE as its reference point that looked at serological (i.e. blood) samples from blood donors in Manaus. The samples themselves seem to be at the lower rate, but among other issues, all of the samples were from blood donors... ...and people with known COVID don't donate blood while still infected. Note the study has not been peer-reviewed, but is modifiable by anyone approved to edit files in that section of CADDE. Also note the researchers state that other forms of epidemiological testing need to be done to confirm the exact rate of reinfection, which is reasonable considering the potential range provided. For both these reasons, I'm inclined to believe the true figure is at/around the lower end of the provided range, rather than the 61% reinfection rate offered as an upper figure.

(Note that if natural immunity at 6-8 months is 75% and not lower, that still gives natural infection a better protection rate than either one-dose or two-dose Johnson & Johnson, though other vaccines approved in the USA have considerably better performance against COVID. This is a relative vilnerability, not an absolute one).

Other things I found out while checking that particular statistic: there has been a study in The Lancet from the collected Danish PCR data. 0.65% of people who had a positive test in the first surge later recorded a separate result in the second surge (compared with 3.27% of those who didn't have a positive test prior to the second surge). It was calculated from this in the Denmark cohort, infection gives just over 80% protection against reinfection (lower than the mRNA vaccines, either lower or higher than OxfordAstrazeneca depending on which dataset one uses, but higher than Johnson & Johnson single-dose).

My understanding was that the vaccines offered broader-scope protection than infections, because of the "improved training ground" hypothesis, and I've never previously seen the other school of thought expressed.

So far, none of the Chinese vaccines has passed Phase III testing in the UK, so I'm sceptical of the notion that those vaccines would be an improvement over the vaccines that have so far succeeded at that stage of testing (Pfizer, Moderna, OzfordAstrazeneca, both Johnson & Johnson versions - as well as Novovax, which is only awaiting approval due to delays in proving production consistency).

While looking for the information here, I discovered that The Gambia has had someone get reinfected with a similar strain of COVID-19 (B.1, then B.1.1.74) five months after the initial infection, without long COVID being involved. A Danish study has revealed that 95% of people who get infected do develop some sort of immune response after infection, which is well above herd immunity at the outset - but the protection from infection appears to fade faster than vaccine protection does. (The April 2020 OxfordAstrazeneca Phase I trial participants have thus far not needed a booster).

[whitestavern]

27 minutes ago, ieta_cassiopeia said:

but the protection from infection appears to fade faster than vaccine protection does. (The April 2020 OxfordAstrazeneca Phase I trial participants have thus far not needed a booster).

Some recent articles on length of immunity after infection. Time will tell. 

https://www.nature.com/articles/s41586-020-2550-z

https://science.sciencemag.org/content/371/6529/eabf4063

[ieta_cassiopeia]

56 minutes ago, whitestavern said:

Some recent articles on length of immunity after infection. Time will tell. 

https://www.nature.com/articles/s41586-020-2550-z

https://science.sciencemag.org/content/371/6529/eabf4063

The first link is about original SARS, which is extinct. (The conclusions are rock-solid for people who got original SARS in 2003/2004; we just can't assume the same will happen with COVID-19).

The second link indicates that immunity from infection varies widely depending on which features changed (spike protein-based protection appears to last a lot longer than the CD4⁺ T and CD8⁺ T cells that respond to other elements of the protein). This may help explain why people's resistance to reinfection (from any source) varies.

Edited June 12, 2021 by ieta_cassiopeia

[Penelope]

2 hours ago, ieta_cassiopeia said:

Brazil had received some vaccines as part of various international vaccine creators' testing phases - notably OxfordAstraZeneca and SinoVac, as early as July 2020. During this phase, 14,000 Brazillians were due to be vaccinated with OxfordAstrazeneca , which was then increased to 19,000 later in the phase (14,000 other people had SinoVac, which failed its Phase III test phase due to only 50% effectiveness). Sputnik also did Phase III testing in September. While "production" vaccination had not begun, SinoVac turned out to be not much use, and proportional vaccination counts pre-second-surge will have been low, some people were test participants for OxfordAstrazeneca and therefore had been vaccinated.

The 25% is the lowest figure in the range used by The Guardian , which used this study from CADDE as its reference point that looked at serological (i.e. blood) samples from blood donors in Manaus. The samples themselves seem to be at the lower rate, but among other issues, all of the samples were from blood donors... ...and people with known COVID don't donate blood while still infected. Note the study has not been peer-reviewed, but is modifiable by anyone approved to edit files in that section of CADDE. Also note the researchers state that other forms of epidemiological testing need to be done to confirm the exact rate of reinfection, which is reasonable considering the potential range provided. For both these reasons, I'm inclined to believe the true figure is at/around the lower end of the provided range, rather than the 61% reinfection rate offered as an upper figure.

(Note that if natural immunity at 6-8 months is 75% and not lower, that still gives natural infection a better protection rate than either one-dose or two-dose Johnson & Johnson, though other vaccines approved in the USA have considerably better performance against COVID. This is a relative vilnerability, not an absolute one).

Other things I found out while checking that particular statistic: there has been a study in The Lancet from the collected Danish PCR data. 0.65% of people who had a positive test in the first surge later recorded a separate result in the second surge (compared with 3.27% of those who didn't have a positive test prior to the second surge). It was calculated from this in the Denmark cohort, infection gives just over 80% protection against reinfection (lower than the mRNA vaccines, either lower or higher than OxfordAstrazeneca depending on which dataset one uses, but higher than Johnson & Johnson single-dose).

My understanding was that the vaccines offered broader-scope protection than infections, because of the "improved training ground" hypothesis, and I've never previously seen the other school of thought expressed.

So far, none of the Chinese vaccines has passed Phase III testing in the UK, so I'm sceptical of the notion that those vaccines would be an improvement over the vaccines that have so far succeeded at that stage of testing (Pfizer, Moderna, OzfordAstrazeneca, both Johnson & Johnson versions - as well as Novovax, which is only awaiting approval due to delays in proving production consistency).

While looking for the information here, I discovered that The Gambia has had someone get reinfected with a similar strain of COVID-19 (B.1, then B.1.1.74) five months after the initial infection, without long COVID being involved. A Danish study has revealed that 95% of people who get infected do develop some sort of immune response after infection, which is well above herd immunity at the outset - but the protection from infection appears to fade faster than vaccine protection does. (The April 2020 OxfordAstrazeneca Phase I trial participants have thus far not needed a booster).

Thanks for clarifying. 

Those articles don’t show any evidence for reinfection in Brazil. Those numbers are a guesstimate based on the same antibody study from Manaus that we’ve been talking about here. They take the high seroprevalence and then assume that because it was so high, some must have been reinfections. But it seems just as likely that that was a faulty assumption.

Good evidence for reinfection due a particular variant would have to take a population with documented infection and show how many had documented reinfection, hopefully with some amount of sequencing involved. I don’t think that evidence exists.

And sure, they had a few thousand in vaccine trials in 2020, but so did the US and the UK and others. We still don’t think of these countries as having had vaccination available when surges began, since those are very tiny numbers. 
 

I think there are other papers looking at reinfections than those you have there. Reinfections happen and are expected  to happen, just as post-vaccine infections will also occur, but they seem to be infrequent and largely less severe in either case. Not to say that we haven’t or couldn’t see more immune evasion with a variant, but vaccination and previous infection both seem to be about equally good thus far.