Immunity from vaccination vs prior COVID infection? (spin out from lockdown thread)

[Pam in CT]

Since there seems to be interest in this subject, feel free to offer up personal experiences, other anecdata, and studies here; or ideas about how "proof of natural immunity" vs "proof of vaccination" could work in contexts like employment / air travel / frequenting business that wish to protect employees & other patrons etc.

 

[Spy Car]

In conjunction with a Federal Vaccine Passport program that would track things, I would accept proof of naturally acquired immunity, if the evidence of protection meets the standards set by public health authorities in the prevailing conditions.

Follow the science all the way.

Bill

 

[Dmmetler]

It is accepted at my child's college as equivalent to having been vaccinated for move in, for 90 days OR with a titer showing equivalent Immunity. I think it's mostly used by international students who didn't have access to the vaccine at home or had access to a different vaccine. 

[ktgrok]

2 minutes ago, Spy Car said:

In conjunction with a Federal Vaccine Passport program that would track things, I would accept proof of naturally acquired immunity, if the evidence of protection meets the standards set by public health authorities in the prevailing conditions.

Follow the science all the way.

Bill

 

Agreed. Proof of a positive test within a certain amount of time, or antibody test - also with a certain amount of time. That time frame would change as we know more, same with how long vaccines will be good for. 

[prairiewindmomma]

I honestly question the relevance of this given that vaccinated persons can spread delta. Is it better than nothing? Yes. Do I want an unmasked vaccinated person near my unvaccinated child right now? No.

 

[regentrude]

At my college, proof of having recovered from Covid infection in the prior 90 days is accepted for move-in, as would be proof of vaccination.
My home country Germany accepts proof of recovery for entry into the country.

Edited August 10, 2021 by regentrude

[Terabith]

1 minute ago, prairiewindmomma said:

I honestly question the relevance of this given that vaccinated persons can spread delta. Is it better than nothing? Yes. Do I want an unmasked vaccinated person near my unvaccinated child right now? No.

 

This is a fair point, but since vaccinated people are less likely to get covid, I definitely am prioritizing interactions with vaccinated people or people who I know have had recent recoveries from covid, over interactions with unvaccinated people.  So doing things like asking if driver's ed instructors are vaccinated.  I'm desperate for some trigger point massage therapy for a very painful thing, but I'm leaving messages asking massage therapists if they are vaccinated.  I expect everyone to also be masked, too, but I don't think vaccination is useless.

[Dmmetler]

2 minutes ago, prairiewindmomma said:

I honestly question the relevance of this given that vaccinated persons can spread delta. Is it better than nothing? Yes. Do I want an unmasked vaccinated person near my unvaccinated child right now? No.

 

And I don't want to be near an unvaccinated child without a mask now, as a vaccinated teacher, either. The risk is too high on both sides. 

 

But, I am very, very glad my teen's college is requiring vaccination, demonstrated immunity, or a medical waiver for all students, faculty and staff, as well as requiring masking in classes and indoor public areas, and that masking is required off campus indoors. Because the difference between universal vaccination plus masking is quite a bit better than masking without universal vaccination, even with Delta. Because vaccination DOES reduce the likelihood of infection and limiting infection limits spread.

[Pam in CT]

Transplanting from the other thread:

Studies looking at immunity from prior infection vs vaccination:

 

Logic for allowing prior infection as evidence of immunity for entry / travel / employment etc:

 

Implementation issues:

 

[Sdel]

And once the 90 days is up then what, your forced to get the vaccine or attend a plague party? 
 

From the point of view of someone who isn’t into a vaccine because they’ve already had it and trust their immune system….I can’t see how this is any different than just flat out ignoring natural immunity.

[happi duck]

Wouldn't they just test natural immunity again?  I don't think any immunity is holding forever so any sort of passport would need to be reissued frequently.

No one should be issued anything based on their word for it that they had covid.

[Spy Car]

I'd support proof of natural immunity by antibody titers, rather than by arbitrary number of days.

Re-tests should follow the best evidence.

Bill

[TarynB]

This author is an epidemiologist, known online as "Your Local Epidemiologist". (bio below). She links to data and several studies in this article that she just published today: “Natural” immunity protection and variants

Quote

If you’ve recovered from COVID19, you still need to get the vaccine. Back in May, I gave four reasons why but this is particularly important with Delta and future variants of concern. Here’s why.

Quote

Bottom Line: The immune system is incredibly complex but we are slowly getting more and more evidence that natural immunity is not as effective as vaccine immunity. If you’ve recovered from COVID-19, you still need to get vaccinated to continue to fight against the ever changing virus.

Quote

https://yourlocalepidemiologist.substack.com/about

My name is Dr. Katelyn Jetelina. I have a Masters in Public Health and PhD in Epidemiology and Biostatistics.

During the day, I’m an Assistant Professor at a School of Public Health where my research lab resides and where I teach. I have a secondary appointment at a medical school too.

. . . 

 

Edited August 10, 2021 by TarynB

[Pam in CT]

re how to assess & manage possibility that immunity wanes over time

19 minutes ago, Sdel said:

And once the 90 days is up then what, your forced to get the vaccine or attend a plague party? 
 

From the point of view of someone who isn’t into a vaccine because they’ve already had it and trust their immune system….I can’t see how this is any different than just flat out ignoring natural immunity.

This is a genuine difficulty with implementation.

It's a new disease, and new variants are actively mutating and spreading, and so it just is not known whether / how quickly / to what extent immunity from EITHER the vaccine OR prior infection sustains over time, or withstands new variants like Delta.

This issues are being tested and studies at yuge scale for the vaccines. They are not, for prior infections.

What that means to your concern is that there is not verifiable data on the ongoing protection from a prior infection (without pretty regular re-testing for titres/ antibodies for each individual who's been infected in the past), whereas there IS verifiable data about the vaccines.

[Not saying it isn't possible, just that there's an additional layer of implementation complexity to manage. ]

[prairiewindmomma]

1 hour ago, Dmmetler said:

 

 

But, I am very, very glad my teen's college is requiring vaccination, demonstrated immunity, or a medical waiver for all students, faculty and staff, as well as requiring masking in classes and indoor public areas, and that masking is required off campus indoors. Because the difference between universal vaccination plus masking is quite a bit better than masking without universal vaccination, even with Delta. Because vaccination DOES reduce the likelihood of infection and limiting infection limits spread.

Oldest's college proclaimed that it was requiring vaccination also.

He filled out the paperwork yesterday.

It was a single attestation that he has been vaccinated, no proof required.

 

I had to show up to jury duty today. Supposedly the court has a mask mandate.  When we showed up for voir dire, the judge and attorneys were unmasked. An order from the state Supreme Court allows them to be unmasked. The judge then said that anyone who has been vaccinated could unmask.

I frankly don't trust people to be honest about that.

And I'm really sick of a mismatch between what we're lead to believe versus what is actually carried out.

I do believe that vaccination reduces the likelihood of infection, limits spread, etc. and that universal vaccination is better than just universal masking.....I would just like the AND statement to be carried out.....vaccination AND masking.

[bibiche]

1 hour ago, regentrude said:

At my college, proof of having recovered from Covid infection in the prior 90 days is accepted for move-in, as would be proof of vaccination.

They’re requiring vax (or recovery from Covid) now?! That’s great news!

[regentrude]

2 minutes ago, bibiche said:

They’re requiring vax (or recovery from Covid) now?! That’s great news!

Sadly no, they are not. You can also move in with a negative tests. But a previous Covid recovery or vaccine exempts you from the testing.

And as far as I know, no regular testing is planned. This is just for the move-in to the dorms. Not for attending school. But that topic belongs in another thread.

Edited August 10, 2021 by regentrude

[KSera]

1 hour ago, Dmmetler said:

But, I am very, very glad my teen's college is requiring vaccination, demonstrated immunity, or a medical waiver for all students, faculty and staff, as well as requiring masking in classes and indoor public areas, and that masking is required off campus indoors. Because the difference between universal vaccination plus masking is quite a bit better than masking without universal vaccination, even with Delta. Because vaccination DOES reduce the likelihood of infection and limiting infection limits spread.

I think universal vaccination is the key. I think the difference in transmission dynamics is likely to be quite different in a completely vaccinated population vs one that is only partially vaccinated. In the universally vaccinated population, I think the decreased transmission rate is likely to make it hard for an outbreak to find enough hosts to be sustained.

 

I read an article on this topic this morning that I thought was interesting, suggesting that the vaccine provides better response to variants than disease:

What Is “Natural Immunity”? And Why Should You Get the Vaccine Even if You Already Had COVID?

Quote

Scientists have recently found that the immune response to the mRNA COVID vaccines is better prepared for the threat we face now—not just the threat from the original variant.

There’s one tiny but critical piece of the COVID spike protein (called the receptor binding domain) that is especially useful to have antibodies against in order to defeat variants like Delta because it works like a key to enter our cells and cause havoc. By just showing the immune system the spike protein, the vaccine gives it the chance to learn that receptor binding domain really, really well.

In the case of a full-blown infection, scientists found that the body had fewer antibodies against that critical piece. It’s like giving someone a study guide of the most important class material versus telling them to reread everything from the whole year for the final exam.

 

[ktgrok]

2 hours ago, prairiewindmomma said:

I honestly question the relevance of this given that vaccinated persons can spread delta. Is it better than nothing? Yes. Do I want an unmasked vaccinated person near my unvaccinated child right now? No.

 

No, but if I can choose between a masked, vaccinated hair dresser for my kid and a masked unvaccinated one, I'd choose the former over the latter. It's another layer. The more layers, the better. 

Also, if EVERYONE is vaccinated, they are not all going to have a breakthrough. It slows transmission in a BIG way. As an example, my son was living with 8 people on his trip - all sleeping in the same room most of the time, eating at the same table or next to each other, sharing bathrooms, etc. They went the same places. My son tested positive 24 hours after arriving home. All of the others have now tested negative. Out of 8 exposed only one was positive, and didn't spread it to the others. 

In a building of coworkers, if everyone is vaccinated, spread is much harder than if no one is. It's not just each person has less risk of being infected but the way that works in disease transmission. 

1 hour ago, Sdel said:

And once the 90 days is up then what, your forced to get the vaccine or attend a plague party? 
 

From the point of view of someone who isn’t into a vaccine because they’ve already had it and trust their immune system….I can’t see how this is any different than just flat out ignoring natural immunity.

In my perfect world you'd get a free antibody test to re-up. As we get more data we will have a better idea of how long is the right length of time. 

One reason I'd really like to see an "antibody card" or whatever, with free easy to access antibody tests, is that 1. we'd get way more data and 2. people who think maybe they had it but don't really know could find out for sure if they have antibodies. If they don't, that might sway them to get the vaccine. Better than thinking they had it, didn't have it, and accidentally put themselves at risk. 

[whitestavern]

My question is why the US seems to be the only country not accepting prior infection in a mandate.  Also, I realize it gets complex, but if we were to require antibody testing for those with prior infection, we should require the same for vaccinated as well because we know there are people who do not get immunity from the vaccine. 

[AbcdeDooDah]

25 minutes ago, whitestavern said:

My question is why the US seems to be the only country not accepting prior infection in a mandate.  Also, I realize it gets complex, but if we were to require antibody testing for those with prior infection, we should require the same for vaccinated as well because we know there are people who do not get immunity from the vaccine. 

They’re ignoring the science. 

Dh’s work(state of CA) is requiring vaccine or weekly testing. No tests of the vaccinated. Make it make sense. Doubt it will last long, they cant even keep office/restroom supplies stocked, let alone tests.

ETA: Dh’s office is first responders. The ones that chose to were fully vaccinated in February. Almost 7 months out. Again, make it make sense..

Edited August 10, 2021 by AbcdeDooDah

[SKL]

1 hour ago, KSera said:

I read an article on this topic this morning that I thought was interesting, suggesting that the vaccine provides better response to variants than disease:

What Is “Natural Immunity”? And Why Should You Get the Vaccine Even if You Already Had COVID?

 

Again, regarding this article (as I mentioned in the other thread) - what that study was comparing was NOT natural immunity vs. vax.  It was natural immunity vs. natural immunity PLUS vax.  I see some people mistakenly citing it as if it is proof that the vax alone is way more effective than natural immunity alone.

I couldn't figure out from my first read how much protection natural immunity by itself gives.  Just for an example of the logic (fake numbers), suppose 1% of people got Covid a second time despite being vaxed after the first infection.  Then the study would mean 2-3% of people who were NOT vaxed would get Covid a second time, or 97-98% would NOT.  On the other hand, (more fake numbers) suppose 30% of people got Covid a second time despite being vaxed after the first infection.  Then the study would mean something like 70% of people who were NOT vaxed would get Covid a second time.  So without knowing more about the numbers, we can't know what the study is telling us about natural immunity.  When I have more time, I'll try digging deeper to see if the info is in there - I could not find it the first time through.

[KSera]

7 minutes ago, ktgrok said:

Also, if EVERYONE is vaccinated, they are not all going to have a breakthrough. It slows transmission in a BIG way. As an example, my son was living with 8 people on his trip - all sleeping in the same room most of the time, eating at the same table or next to each other, sharing bathrooms, etc. They went the same places. My son tested positive 24 hours after arriving home. All of the others have now tested negative. Out of 8 exposed only one was positive, and didn't spread it to the others. 

This reminds me I saw something yesterday out of Israel showing that 80% of vaccinated people with Delta breakthrough didn’t spread Covid to anyone in public. 10% infected one other person and 3% 2-3 people (7% it was unknown). We need comparison numbers to make sense of that, but given the Delta R0 of 8-9, that looks like a substantial decrease in transmission. I wonder what Re that translates to? 

 

[catz]

5 minutes ago, whitestavern said:

My question is why the US seems to be the only country not accepting prior infection in a mandate.  Also, I realize it gets complex, but if we were to require antibody testing for those with prior infection, we should require the same for vaccinated as well because we know there are people who do not get immunity from the vaccine. 

Part of this is lack of standardization and availability of the data.  Anything that might look like a "passport" has gotten tossed out, like what some European countries are doing.  Which is why it's harder to standardize titer testing and cards and why now we have people distributing fake vax cards.  So in the US, people get asked for what is available to be provided in a standardized form which right now are the vax cards.  It would be way easier if we had an app that could could standardize displaying a scan code that would cover medical excuse, vaccinated, recovery from infection etc.

I'd be all for easy and regular screening for antibodies.  That would give us a ton of data about how things are lasting in different populations.  It may be a young healthy person holds good immunity with a single infection and an elderly person needs a booster every 6-9 months.  Who knows.  Anyway, highly doubt any of this can happen with the current climate.

[Danae]

15 minutes ago, whitestavern said:

My question is why the US seems to be the only country not accepting prior infection in a mandate.  Also, I realize it gets complex, but if we were to require antibody testing for those with prior infection, we should require the same for vaccinated as well because we know there are people who do not get immunity from the vaccine. 

Because the people who don’t want to get vaccinated also don’t want to have any restrictions based on immunity so there’s no natural constituency for it.

[KSera]

2 minutes ago, SKL said:

Again, regarding this article (as I mentioned in the other thread) - what that study was comparing was NOT natural immunity vs. vax.  It was natural immunity vs. natural immunity PLUS vax.  I see some people mistakenly citing it as if it is proof that the vax alone is way more effective than natural immunity alone.

I couldn't figure out from my first read how much protection natural immunity by itself gives.  Just for an example of the logic (fake numbers), suppose 1% of people got Covid a second time despite being vaxed after the first infection.  Then the study would mean 2-3% of people who were NOT vaxed would get Covid a second time, or 97-98% would NOT.  On the other hand, (more fake numbers) suppose 30% of people got Covid a second time despite being vaxed after the first infection.  Then the study would mean something like 70% of people who were NOT vaxed would get Covid a second time.  So without knowing more about the numbers, we can't know what the study is telling us about natural immunity.  When I have more time, I'll try digging deeper to see if the info is in there - I could not find it the first time through.

I wasn’t actually sharing it for the study they include, but for all the other information about the immune process and especially the mechanism by which vaccination may provide broader immune response than disease. Still, as regards the study, I agree raw numbers would put it in context. It’s still meaningful that immunity from disease plus vax is better than disease alone. For those that want to be as protected as possible, this tells them that a shot is worthwhile even if they have had Covid. 

[Pam in CT]

re US policy vs other nations' policies

12 minutes ago, whitestavern said:

My question is why the US seems to be the only country not accepting prior infection in a mandate.  Also, I realize it gets complex, but if we were to require antibody testing for those with prior infection, we should require the same for vaccinated as well because we know there are people who do not get immunity from the vaccine. 

Thus far, neither the federal nor any state governments have done full mandates. The DoD policy announced yesterday was only for currently active service members; NYC has implemented Excelsior for participating concert/sports/entertainment venues; there have been a handful of university and other employers; and each of these is coming to its own assessment of what to do and how.

(which: for the record, I personally .think is sub-optimal from a public health standpoint, but in the absence of federal-wide or state-wide policies, the patchwork of measures will evolve... patchily).

 

But other than the one France example cited upthread, are you aware of how other nations are treating prior infection?  I'm quite curious about it.

[ieta_cassiopeia]

The UK allows anyone who's had a COVID positive result to be treated as if vaccinated for domestic purposes for 180 days following the initial positive test. However, they cannot begin to use it until they have completed their requisite period of isolation. There is no antibody test that can be taken to extend it past that point, or indeed to prove one is/isn't immune for the entire 180 days.

Vaccination is permanently valid and anyone who has neither recovered from the virus nor vaccinated against it can get a test and be treated as if vaccinated for 48 hours. None of these pathways allow exemption from masking in situations where it is demanded (although there are relatively few scenarios where masking is now required by the government), and indeed universities are not allowed to mandate any of these measures (though they can require a testing regime - weekly with two initial tests 3 days apart appears to be typical for students with face-to-face components to their teaching).
 

While anyone is allowed to go abroad, other countries do not recognise the NHS COVID App. Most countries have requisite testing procedures in their own countries, and the UK requires testing before leaving (for all countries, barring exceptional circumstances such as prisoners being extradited) and upon return (most countries - 38 countries or regions currently do not require post-return testing because their COVID rate is so low compared to the UK's.) These are generally purchased as "testing packs" appropriate to the country's perceived COVID risk level, and a test certificate (separate from the test results used for other purposes) must be shown as proof this requirement was met.

  

32 minutes ago, KSera said:

This reminds me I saw something yesterday out of Israel showing that 80% of vaccinated people with Delta breakthrough didn’t spread Covid to anyone in public. 10% infected one other person and 3% 2-3 people (7% it was unknown). We need comparison numbers to make sense of that, but given the Delta R0 of 8-9, that looks like a substantial decrease in transmission. I wonder what Re that translates to? 

 

80 * 0 = 0
10 * 1 = 10
7 * 2 = 14
3 * 3 = 9 (I'm assuming for the sake of this that the 7%  unknown averages 2 people and the 3% were all 3 people; this is likely a higher R than is actually the case)

Every 100 people infects 10 + 14 + 9 = 23 people

R = 23/100

R = 0.23

That's very good compared to an unvaccinated R of 8 (at least) for Delta.

Edited August 10, 2021 by ieta_cassiopeia

[KSera]

50 minutes ago, ieta_cassiopeia said:

80 * 0 = 0
10 * 1 = 10
7 * 2 = 14
3 * 3 = 9 (I'm assuming for the sake of this that the 7%  unknown averages 2 people and the 3% were all 3 people; this is likely a higher R than is actually the case)

Every 100 people infects 10 + 14 + 9 = 23 people

R = 23/100

R = 0.23

That's very good compared to an unvaccinated R of 8 (at least) for Delta.

Thanks for running the math! That’s actually super good news. It shows why, in a fully vaccinated setting, you wouldn’t expect to see any prolonged outbreaks. Someone might bring it into the community, but it should end pretty quick.  Also shows how theoretically, the entire population could have a measles type immunity if vaccination levels were high enough. I think some people forget that measles requires super high vaccination rates as well.

50 minutes ago, happysmileylady said:

Right, that is a super major problem.  Of course, the reason for that is dollars.  There are a lot of dollars to be made off of a vaccine being the answer, and there are no dollars to be made off of natural immunity.  Which is why I look at every study showing that vaccine immunity is better with a healthy grain of salt.  It's not that I outright disbelieve them or anything of the sort.  I just know that a whole lot of people benefit from the studies that say that. 

I would be worried about that if the studies were all coming from the manufactures and people who financially benefit, but they are not. Lots and lots of studies have been done by people who have nothing to gain financially from the vaccine, but are just looking for the best ways to save lives right now. I don’t know why so many people are so cynical that they don’t believe there are scientists and doctors who really truly do care about people and keeping them healthy and saving their lives. So many of them have been working tirelessly throughout this whole wretches ordeal, I expect it’s hurtful to them to hear people claim they are suggesting treatments that aren’t actually the most effective just because they want to somehow financially benefit from them. People also overlook the fact that there are lots of treatments being used for Covid that are cheap or free—dexamethasone and proning for example. Both of which were looked at in studies first in order to show that they helped and then became standard care when it was showing that they do. I feel quite confident that if something new comes along that is highly effective and cheap, it will become standard of care as well.

[Not_a_Number]

1 minute ago, happysmileylady said:

The studies don't have to be funded by manufacturers and other pharma entities specifically for there to be a lot of money involved.  Grant money, campaign money, charity money, etc etc etc.

I think there's plenty of interest in natural immunity being effective, too. 

[Not_a_Number]

1 minute ago, happysmileylady said:

I think there's a lot of interest.  But the financial benefit, not nearly as much.

That's an interesting question. Is that true? I bet if natural immunity gets accepted, there'll be big bucks in OTC antibody tests or something like that. 

[Not_a_Number]

Just now, happysmileylady said:

Anything OTC has to be really inexpensive for the general public.  There's a threshold which people are going to be willing to pay for something like that OOP............and it's not high.  In addition, that sort of benefit would be realized over the long term.....$30bn over 1 year vs $1bn per year for 30 yrs.....I am guessing that that the former is more enticing. 

Natural immunity or not, I think Pfizer has it made. Both kinds of immunity obviously wane, so I imagine people will be getting that vaccine every year, probably, unless some other vaccine outcompetes it. 

I tend to dig deep into data about that kind of thing, but I wouldn't assume anyone is fudging the immunity data. Not if there's more than one study from reputable places.

[Faith-manor]

If we reject vaccines because "follow the money", then why not reject a crap ton of other medical treatments and drugs? Seems inconsistent. Most of them should be " suspect" under this philosophy.

[Not_a_Number]

1 minute ago, happysmileylady said:

I am talking about studies being set up a certain way. 

This is where I like to actually see the numbers. I really prefer having the actual visualization and carefully broken down numbers as opposed to just some regressions... 

[Not_a_Number]

By the way, are there studies on efficacy of natural immunity? I understand that vaccine + natural immunity is more efficacious than just natural immunity, but that doesn't quite seem to be the right question! 

[Sdel]

55 minutes ago, Faith-manor said:

 

If we reject vaccines because "follow the money", then why not reject a crap ton of other medical treatments and drugs? Seems inconsistent. Most of them should be " suspect" under this philosophy.

 

There are some people who are against direct advertising of drugs to consumers for similar reasons as “follow the money”.  It’s kind of a circle….drug companies market on TV to drive up demand of name brand drugs and increase profits….which in turn drives the development of new drugs for when the patents run out and drugs go to cheaper generics.  

Edited August 11, 2021 by Sdel

[Sdel]

1 hour ago, Not_a_Number said:

I bet if natural immunity gets accepted, there'll be big bucks in OTC antibody tests or something like that. 

I expect they’ll be through the nose expensive in order to coerce people to just go get the vaccine.  Same with testing costs/procedures.  All the rhetoric I’ve heard usually implies that no exception to getting vaccinated is really acceptable.

[mathnerd]

I read a news report earlier pointing to a CDC study that said that unvaccinated people who had previously had Covid are more than twice as likely to be reinfected with the virus compared with people who were fully vaccinated after previously contracting Covid disease. I could not find that news link, but this is the CDC study that it was pointing to:

https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm7032e1_e&ACSTrackingID=USCDC_921-DM63289&ACSTrackingLabel=MMWR Early Release - Vol. 70%2C August 6%2C 2021&deliveryName=USCDC_921-DM63289#T1_down

 

[Not_a_Number]

9 minutes ago, happysmileylady said:

I did want to mention that this was the best breakdown of R naught that I have seen. 

How so?

[whitestavern]

3 hours ago, happysmileylady said:

I personally don't want to see any government mandates to require people to "show their papers" in order to eat in a restaurant, sign their kids up for gymnastics, or for heaven's sake get a job.  I would only support that sort of mandate in extreme situations such as people who work in nursing homes, people in prison, etc.   I don't care if a business wants to have their own sort of mandate, have at it.  I can choose not to frequent that business.

I do not want to see mandates either, but at least other countries are giving people a CHOICE. They can show proof of vaccination, a prior infection, or a negative Covid test. Unless I read incorrectly, the mandates in NYC do not provide choices, you are either vaxxed or not (unless you're under 12, which makes no sense if this is about keeping people safe/healthy). Most of the colleges are the same. Vaxxed or no vaxxed (unless you get a medical exemption or religious exemption, which many are not offering). Doesn't matter if you had Covid and have antibodies. Doesn't matter if you want to wear masks and get regular testing. 

[whitestavern]

4 hours ago, Danae said:

Because the people who don’t want to get vaccinated also don’t want to have any restrictions based on immunity so there’s no natural constituency for it.

Not sure I understand. What do you mean by restrictions based on immunity? As I noted earlier (though maybe on another thread) if by restrictions you mean antibody testing, then vaccinated people should have to be tested for antibodies as well. We have no idea how many vaxxed people might not have immunity or who have waning immunity. We know some do not have any or have decreased levels of immunity but no idea how many that might be. 

[Danae]

5 minutes ago, whitestavern said:

Not sure I understand. What do you mean by restrictions based on immunity? As I noted earlier (though maybe on another thread) if by restrictions you mean antibody testing, then vaccinated people should have to be tested for antibodies as well. We have no idea how many vaxxed people might not have immunity or who have waning immunity. We know some do not have any or have decreased levels of immunity but no idea how many that might be. 

No, by restriction I mean any checking of vaccination or antibodies or test results or current/prior infection status in order to participate in anything.

[SKL]

1 hour ago, mathnerd said:

I read a news report earlier pointing to a CDC study that said that unvaccinated people who had previously had Covid are more than twice as likely to be reinfected with the virus compared with people who were fully vaccinated after previously contracting Covid disease. I could not find that news link, but this is the CDC study that it was pointing to:

https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm7032e1_e&ACSTrackingID=USCDC_921-DM63289&ACSTrackingLabel=MMWR Early Release - Vol. 70%2C August 6%2C 2021&deliveryName=USCDC_921-DM63289#T1_down

 

Yeah, the question is, twice as likely means 2x what?  If it's 2x a small number, then that's still great natural immunity.  If it's 2x a bigger number, not so great.

[mathnerd]

28 minutes ago, SKL said:

Yeah, the question is, twice as likely means 2x what?  If it's 2x a small number, then that's still great natural immunity.  If it's 2x a bigger number, not so great.

The data is there in that linked CDC study. If you go through that linked document, you can see how many people were in that study.

To quote:

Overall, 246 case-patients met eligibility requirements and were successfully matched by age, sex, and date of initial infection with 492 controls. Among the population included in the analysis, 60.6% were female, and 204 (82.9%) case-patients were initially infected during October–December 2020 (Table 1). Among case-patients, 20.3% were fully vaccinated, compared with 34.3% of controls (Table 2). Kentucky residents with previous infections who were unvaccinated had 2.34 times the odds of reinfection (OR = 2.34; 95% CI = 1.58–3.47) compared with those who were fully vaccinated; partial vaccination was not significantly associated with reinfection (OR = 1.56; 95% CI = 0.81–3.01).

[Not_a_Number]

1 hour ago, happysmileylady said:

Cause I have never seen any conceptualization of calculating that.  It's simple and concise and even if it's not completely accurate (I am sure it's not) it makes sense and gives a bit of a base on that. 

Ah I see. It's really just the average number of people a given person infects. 

[Pam in CT]

re potential that profit incentive does not align to public interest or good science when drug companies engage in direct marketing to consumers

3 hours ago, Sdel said:

There are some people who are against direct advertising of drugs to consumers for similar reasons as “follow the money”.  It’s kind of a circle….drug companies market on TV to drive up demand of name brand drugs and increase profits….which in turn drives the development of new drugs for when the patents run out and drugs go to cheaper generics.  

Many other countries prohibit such direct advertising.  At a minimum, it adds significant costs into the health care system; and as you say it may well drive corporate, physician and patient behavior in other ways that result in unintended or suboptimal ways.

[Sdel]

1 minute ago, Pam in CT said:

Many other countries prohibit such direct advertising.  At a minimum, it adds significant costs into the health care system; and as you say it may well drive corporate, physician and patient behavior in other ways that result in unintended or suboptimal ways.

Not to derail the thread…..but almost everything in “American” society can trace back to “the money”.  Food, healthcare, education, etc; even tax breaks.

[KSera]

5 hours ago, ieta_cassiopeia said:

80 * 0 = 0
10 * 1 = 10
7 * 2 = 14
3 * 3 = 9 (I'm assuming for the sake of this that the 7%  unknown averages 2 people and the 3% were all 3 people; this is likely a higher R than is actually the case)

Every 100 people infects 10 + 14 + 9 = 23 people

R = 23/100

R = 0.23

That's very good compared to an unvaccinated R of 8 (at least) for Delta.

I was looking at this again, and noticed a small error I didn't notice the first time. 10+14+9=33, for R=0.33.

 

Still, very low and would make outbreaks likely to die out each time they start.

[Not_a_Number]

1 minute ago, KSera said:

I was looking at this again, and noticed a small error I didn't notice the first time. 10+14+9=33, for R=0.33.

 

Still, very low and would make outbreaks likely to die out each time they start.

Good catch! 

Still, so much under 1 would really be great. 

[SKL]

3 hours ago, mathnerd said:

The data is there in that linked CDC study. If you go through that linked document, you can see how many people were in that study.

To quote:

Overall, 246 case-patients met eligibility requirements and were successfully matched by age, sex, and date of initial infection with 492 controls. Among the population included in the analysis, 60.6% were female, and 204 (82.9%) case-patients were initially infected during October–December 2020 (Table 1). Among case-patients, 20.3% were fully vaccinated, compared with 34.3% of controls (Table 2). Kentucky residents with previous infections who were unvaccinated had 2.34 times the odds of reinfection (OR = 2.34; 95% CI = 1.58–3.47) compared with those who were fully vaccinated; partial vaccination was not significantly associated with reinfection (OR = 1.56; 95% CI = 0.81–3.01).

I still don't see where this tells us what percent of people who have already had Covid, and who are not vaxed, have re-infections.  Or what percent of those who'd had both Covid and the vax went on to get re-infected.

(Also, I think it matters which vax they got, but since J&J seems unpopular, I'll assume it was usually one of the mRNA vaxes.)

But assuming the protection of BOTH the vax AND natural antibodies must be more than just the vax, then at least against the original Covid-19, the breakthrough cases must have been less than 5% of the infection rate among people who were NEITHER vaxed nor previously infected.  So let's say it was 3%.  Then the rate for people who'd had Covid but had not subsequently been vaxed would be around 7% times the rate experienced in unvaxed populations, i.e., the protection of natural immunity alone would be about 93%, which is higher than that of many vaccines.

Edited August 11, 2021 by SKL