Even though it wasn't a conclusion of the study, if someone wants to make the point that they already had Covid, and therefore have at least the same immunity as a vaccinated person, that's a very reasonable position. They should not be restricted from anything a vaccinated person can do.

No, because covid tests are not 100% conclusive, so from a statistical point of view it will always be better to get a vaccine shot anyway.

You are trying to not trigger autoimmune disorders. Someone recovered from covid with potentially three additional shots is at greater risk for autoimmune reactions.

We really need to be careful making claims like that. There is no evidence this is true and there is evidence that getting a vaccine gives additional protections even if you already had COVID.

https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...

Considering the sars-1 and mers vaccine attempts had over-stimulated immune response problems, it absolutely should be a concern.

Vaccination induced immunity levels were sufficient, but now that natural immunity levels are higher, that's not good enough?

Since I've been told over and over that the vaccine reduces the severity of breakthrough infections, shouldn't we also demand vaccinated people intentionally catch covid and quarantine, since that will also boost their immunity and prevent public spread?

Where's the study that shows breakthrough cases are any greater of a risk than vaccine side-effects?

And if the risks are comparable, why wouldn't it be reasonable to demand vaccinated individuals intentionally catch the virus to also boost their immunity?

Due care is called for in both directions. My daughter's immune system took 13 years to decide that she didn't need insulin any more.

If anything comes from this particular pandemic I'm hoping that one of them is that we need to be honest and transparent about risk/benefit and knowns/unknowns rather that try to brush the long tails under the rug as if they don't exist.

How do you weigh that against the long tail of a COVID infection having long term effects? We already have evidence of that, and zero evidence of that with the vaccine.

You would weight them based on individual risk factors.

If you have a risk of autoimmune disorders because of genes or other factors you would weight it against other factors.

Maybe you have left the house 4 times in the last year and you have an autoimmune worries perhaps avoiding the vaccine makes sense. Your risk rises wheb even going to the place to get the vaccine.

Everyone wants one piece of advice to fit everyone. Everyone is different.

If you get the vaccine and go out three times to every one time an unvaccinated person goes out you both have the same risk profile. If you go out 4 times you are more likely to catch it.

If you really want to stop this, stay at home unless you must go out. The vaccine adds 3x the protection.. not 10x or 100x

I don’t think there’s a great answer to your question.

One has to weigh the guaranteed exposure to risks of the vaccine, which currently appear to be extremely low but not zero, versus the less certain exposure to the demonstrably greater short term and long-term risks of a covid infection.

Ultimately that wasn’t my point, my main point is that transparency and humility in communication will likely create less of a backlash than what we are seeing today.

There is evidence of possible "long COVID" symptoms in breakthrough infections.

https://www.nejm.org/doi/full/10.1056/NEJMoa2109072

In breakthrough cases where the individual has a high viral load and typical COVID symptoms (shortness of breath, fatigue, etc.) it's not unreasonable to assume that the person might suffer from the same course of illness as an unvaccinated person. While the vaccines clearly reduce the incidence of hospitalization and death, there are people whose breakthrough cases aren't exactly what the average person would call "mild".

The FDA has asked Pfizer to perform 5-year studies for known adverse side effects of vaccines, like myocarditis.

As of 2021, we do not have long term (e.g. five years) data on either vaccines or Covid.

This week, the FDA approval required Pfizer to perform multi-year studies to assess risks of adverse events, https://www.fda.gov/media/151710/download

> ... to evaluate the occurrence of myocarditis and pericarditis following administration of COMIRNATY ... substudy to describe the natural history of myocarditis and pericarditis following administration of COMIRNATY ... prospective cohort study with at least 5 years of follow-up for potential long-term sequelae of myocarditis after vaccination

Vaccine injuries are rare but nonzero. A German pathologist has been performing autopsies, https://translate.google.com/translate?sl=auto&tl=en&u=https...

> The doctor now wants to get to the bottom of rare, serious side effects of the vaccination - such as cerebral vein thrombosis or autoimmune diseases. The problem from his point of view: Vaccinated people usually do not die under clinical observation ... More than 40 people have already been autopsied who died within two weeks of being vaccinated. Schirmacher estimates that 30 to 40 percent of them died from the vaccination. In his opinion, the frequency of fatal consequences of vaccinations is underestimated

Self-reported VAERS lists 5,000+ US deaths after [does not imply causality] Covid vaccination, but such reports are much less informative than tissue samples from an expensive autopsy. Note that if someone develops Covid or dies within two weeks of being vaccinated, CDC statistics categorize that person as unvaccinated. It would be more accurate to create a new U.S. reporting category for those who are partly vaccinated.

"Note that if someone develops Covid or dies within two weeks of being vaccinated, CDC statistics categorize that person as unvaccinated." This is concerning and shows how much care is taken to sweep negative outcomes under the rug.

We need CDC to provide more granular data on partially vaccinated people, instead of bundling them with unvaccinated people, https://www.cdc.gov/vaccines/covid-19/health-departments/bre...

> For the purpose of this surveillance, a vaccine breakthrough infection is defined as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S. Food and Drug Administration (FDA)-authorized COVID-19 vaccine.

Redline changes were made in April 2021, https://www.cms.gov/files/document/qso-20-38-nh.pdf

> Fully vaccinated” refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine. “Unvaccinated” refers to a person who does not fit the definition of “fully vaccinated,” including people whose vaccination status is not known, for the purposes of this guidance

Restrictions being placed on unvaccinated individuals with natural immunity is based on the premise that it's not as effective or long-lasting as the vaccine.

That might not be an excuse to not get vaccinated, but it's absolutely a reason that individuals with natural immunity should not be treated any worse or differently than vaccinated individuals.

Regardless of whether vaccination improves on extant natural immunity.

And based on what we know about sars-1 and mers, that's not necessarily a safe assumption. For cases of repeated exposure and vaccination over time, the problems with those vaccine attempts were primarily over-stimulating an immune response.

regarding reduction of observed antibody titre == evidence of waning natural immunity.

this is not evidence of waning immunity this is evidence of efficiency and conservation of function

the presence of antibodies has been used as an indicator that vaccination produces an immune response, unfortunately far too many people have conflated reduction of this antibody titre over time as a reduction of immunity, when it is a modality of immunity.

antibody titre is a better indicator of prophylactic efficacy than immune status.

unfortunately it is very inconveinient to work with T cells and B cells as a measure of intensity of immune response.

this however can be inferred by observation of changes in antibody titre following infections/challenges subsequent to reduction of post innocual antibody titre

The FDA recently approved the T-Detect COVID test to check memory T cell response.

https://www.fda.gov/news-events/press-announcements/coronavi...

I did a T-Detect test. Their website states "A recent study demonstrated 95% of patients tested positive for T cells up to five months after a confirmed positive PCR test.1 Clinically validated data for T-Detect COVID performance beyond five months is not available yet." but it has stated this for months now.

I assume they are tracking how long their test detects T cells in subjects who had confirmed infections and hope they will provide public updates on this more frequently because "up to 5 months" is of limited value to people like me who were interested in knowing if they had the virus back in the earliest days of the pandemic.

Presumably the 5-month duration was based on the date of their 2020 submission for FDA EUA approval, relative to the earliest date of infection of their test subjects. If those early test subjects are participating in the ongoing trial of T-Detect, it's now probably a year since their infection & recovery. Hopefully we'll see a longer duration in their next FDA submission.

yes this is a good thing, the virus[sars2] has a feww features that allow partial stealth, and has accumulated variations that contribute to possible immune evasion.

this should not be taken casually, and perturberance of memory immunity should it occur would be a variant profile of high concern.

Sorry I’m not quite sure I follow. You’re saying antibodies are the “quick and easy” way to measure whether a person’s body is (correctly) reacting to the vaccine. So when someone has antibodies soon after vaccination it’s a sign it’s worked, but the antibodies dissipating isn’t necessarily a sign a person no longer has immunity? But since testing for antibodies is the only feasible test available to measure immune response in response to the vaccine it’s become conflated with actual immunity?

So someone could (in theory) get the vaccine, have tons of antibodies 6 weeks later, then have greatly reduced antibodies and it doesn’t tell us anything about whether or how much immunity that person will have if they’re infected?

Someone will have tons of antibodies 4-6 weeks later and then experience a drop off. Especially if you’re measuring from the first vaccine dose.

This is literally how the Adaptive immune system works.

Initial adaptive response, production of IgM, Vdj recombination, class switching and global proliferation (especially in the face of a repeated antigen insult), followed by a tone down of B cells as the memory effect is preserved and the antibody titre falls back (antibodies have a half life of 3-4 weeks).

Because (at least currently) the antibody response in humans is non-sterilising (talk of boosters to generate IgA abound, along with a more specific Delta variant vaccine may change this) you can’t equate a titre in humans yet with a ‘level’ of immunity

you as well understand at a deeper level

More or less. There's cells that remember how to make the antibodies, speeding up the response to a second exposure even long after the initial exposure.

Having lots of antibodies when exposed can maybe prevent infection or lessen severity, so it isn't a complete non-concern that they fade.

you understand the concept in a practical form

you seem to understand it correctly, the level of >protection< may be inferred by observing titre of antibodies, the strength of immune response may be inferred by observing increase of titre after challenge by pathogen.

the durability of immunity may be inferred by observing the increased response to challenge over points in time.

Your right, but anybody else making this argument up until now in defense of natural immunity got ignored or ridiculed.

The study compared against 2-dose vaccinated. The three groups are as follows:

1. Two-dose vaccinated 2. Previously infected and not vaccinated 3. Previously infected and single-dose vaccinated

It would have been great to find out a fourth scenario: infected post double vaccination

I think they are working on that, and it will be important, but they just need time. Break through cases seem to be high recently, but folks need to recover, then they need to run around in the wild and get (or not get) COVID, and then they need to write the paper... Stay tuned, I can't wait to see, since I feel like this is where most people will end up.

But even though the protection waned, it was still a factor of 6 better than the vaccine at the same point in time. It waned to be "only" 6 times better.

Clearly, you want natural immunity if you can get it safely, which is a big question. It still makes sense to get vaccinated for most adults. You can always get your natural immunity through a break-through infection, which you'll ride out more easily having been vaccinated.

Where does the concept of diminishing marginal returns come in you think?

There’s got to be a point where we say, it’s “good enough” to not warrant exposure to 50 Billion copies of mRNA.

There is very little risk to the mRNA vaccine. So, what do you mean "warrant exposure to 50 Billion copies if mRNA." This is just trying to throw out a big number to sound scary, but in fact tells you nothing about the risks.

The 50Billon was a stat thrown at my feet by a phd arguing that the exposure to Covid is unknown in people with previous infections… they claim the more numerous the spike Protein exposure the better the immunity.

0. Less exposure to spike proteins the better: in all cases the less one is exposed to novel, man made stimuli into intimate bodily functions (read less than 1000 years of human existence) the better. And a counter point to the benefit of modern medicine… many still die in their sleep, if one is exceedingly lucky and very healthy, then they will have no need for the man made interventions.

1. Inadvertent intravenous injection: lack of properly aspirated needles can potentially send a majority of the mRNA into a vein, producing complications. This is my hypothesis for the wide range in side effects

2. Faulty Fatty Anchors: it is claimed that the lipid anchor keeps the spike protein in a safe state. Potentially this is not true and potentially when your body attacks the vaccine the protein is set free due to incomplete distraction

There are quite a few others, but these I’ve found to be the most compelling.

These and the others I will reserve unless anyone is curios.. these all require much more observation than a few years to complete.

I've had 5 shots so far (pfizerx2, AZx3) because of exactly this. Natural immunity (which I already have) doesn't confer complete protection, but in combination with the vaccines I believe I'm fully protected.

I guess when you make something free you can't cry fowl when people go back for seconds thirds fourths and fifths.

That's possibly a world record! Any reason for this?

Interestingly, it is not a world record. In July, I noticed that in VAERS, there are a few people with 4-5 shots. The reports made for interesting reading.