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Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by criticaltinker on Friday August 27, 2021 @11:03PM (#28335261)
The biggest flaw with this study is that it does not account for prior natural infection. It has been thoroughly demonstrated that individuals who acquire immunity through natural infection have a robust and durable immune response [1][2][3]. Recent vaccination on top of this immunity is likely to further prime and improve immune responses to subsequent infection [4][5].

Not accounting for this fact is a significant confounding factor in the study, and I'm disappointed the authors made no distinction between unvaccinated and immunologically naive. This is a distinction that every sensible scientific discussion needs to acknowledge.

EDIT: please leave a comment down voters, I’m starting to think there’s some sort of targeted campaign against this type of information

> Vaccine breakthrough infections exhibited similar proliferation dynamics as infections in unvaccinated individuals (mean peak Ct: 20.5, 95% credible interval [19.0, 21.0] vs. 20.7 [19.8, 20.2], and mean proliferation time 3.2 days[2.5, 4.0] vs. 3.5 days [3.0, 4.0]); however, vaccinated individuals exhibited faster clearance (mean clearance time: 5.5 days [4.6, 6.6] vs. 7.5 days [6.8, 8.2]).

> If the Ct values in vaccinated and unvaccinated infected individuals reflect the same amounts of infectious virus, then this implies that individuals with breakthrough infections may be as infectious as unvaccinated individuals in the early stage of the infection, but remain infectious for a shorter time, reducing the total degree of onward transmission. These findings are in keeping with the hypothesis that vaccination protects against the severe manifestations of disease but offers less protection against infection in the upper airway. Precautions are therefore necessary to prevent onward transmission even from vaccinated individuals.

[1] Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells https://www.cell.com/cell-reports-medicine/fulltext/S2666-37...

[2] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/

[3] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[4] Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection https://www.nature.com/articles/s41586-021-03696-9

[5] Initial report of decreased SARS-CoV-2 viral load after inoculation with the BNT162b2 vaccine https://www.nature.com/articles/s41591-021-01316-7

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by walterbell on Friday August 27, 2021 @11:07PM (#28335284)
> authors made no distinction between unvaccinated and immunologically naive. This is a distinction that every sensible scientific discussion needs to acknowledge.

Ideally, everyone would be tested for antibodies before receiving a vaccine, then we would have data to differentiate naive+vaccine from survivor+vaccine. This would be helpful for both science and public policy.

CDC needs to stop labelling people who are 13 days after their 2nd vaccine dose as "unvaccinated". A more accurate label would be "partly vaccinated".

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by criticaltinker on Friday August 27, 2021 @11:16PM (#28335331)
> Ideally, everyone would be tested for antibodies before receiving a vaccine

I agree that would help make optimal decisions with regards to distributing a limited supply of vaccine doses.

However it's worth noting that even when antibodies drop below levels detectable by standard tests, individuals are likely to retain robust immune responses that provide sufficient protection from severe outcomes [1][2].

[1] SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans https://www.nature.com/articles/s41586-021-03647-4.pdf

[2] Prior COVID-19 protects against reinfection, even in the absence of detectable antibodies https://www.journalofinfection.com/article/S0163-4453(21)002...

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by walterbell on Friday August 27, 2021 @11:22PM (#28335364)
Does this mean there's a narrow testing window for people to be able to "prove" their natural immunity?
Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by criticaltinker on Saturday August 28, 2021 @12:08AM (#28335566)
The window for SARS-CoV-2 antibody tests would be at least 8 months to a year for many individuals.

More expensive tests can detect immunity based on T cells for example, which would provide an even longer window.

And of course really expensive and invasive bone marrow aspirate tests could provide a window approaching a lifetime - but the tradeoffs involved there would likely be unfavorable for practical “proof”. Who knows what technology we’ll come up with in the future though.

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by thebruce87m on Saturday August 28, 2021 @07:02AM (#28337143)
It might be that you alluded to the term “natural immunity” which now comes with extra baggage.

There seems to be a recent talking point for “natural immunity”, and two of my [uk based!] friends who seem to end up on the wrong side of every issue are parroting this. They are somehow both tuned in to US YouTube talking heads, Tucker etc despite being in the UK.

The message that is being pushed as I understand it is “let the virus rip” since if(!) you come through unscathed you will end up with better immunity? Maybe I misunderstand it but they both in a “anti covid vaxx” stance so I think that’s their reasoning - it is somehow better to take your chances with the virus than get the vaccine.

Note that they are both engineers.

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by cies on Saturday August 28, 2021 @09:00AM (#28337673)
> it is somehow better to take your chances with the virus than get the vaccine.

As i understand it that statement is more true when the age (and presence of comorbidities) of the subject goes down.

<10y: why on earth would we vaccinate these people?

>70y: why on earth not?

Many of us are in the middle, and that means things are not that clear cut. I believe everyone should choose for themselves, as herd-immunity is off the table and outbreaks amoung the young do not cause much strain on the health care system.

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by thebruce87m on Saturday August 28, 2021 @10:04AM (#28338159)
I think it’s true age is a big factor, but I’m not sure if we can rule out young people from straining the healthcare system (depending on your definition of young or course).

In Scotland this week we had 14 people under 10 admitted to hospital and 78 who were 70+. A big difference but not as big as you’d think. The distribution is also not concentrated around older age groups at the moment, it’s got significant numbers in all age groups:

https://www.travellingtabby.com/scotland-coronavirus-tracker...

Check “Hospital Admissions by Age Group”

Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by totony on Saturday August 28, 2021 @01:01PM (#28339553)
Hospital admission is not a good metric to go by, because they may be discharged/not occupy it for long. If you check death by age you see no one young died, suggesting the disease is more easy on them ajd they won't need to be 2 weeks in ICU.
Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by thebruce87m on Saturday August 28, 2021 @03:05PM (#28340575)
What would you suggest as a better metric?
Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by totony on Saturday August 28, 2021 @11:22PM (#28343810)
Hospital bed usage per cause would be a better one
Re:Viral dynamics of SARS-CoV-2 variants in vaccinated and u... by Jeema101 on Saturday August 28, 2021 @02:25PM (#28340299)
You could try the 'scared straight' approach and direct them to this thread on the /r/nursing subreddit about what other ICU nurses are seeing right now regarding unvaccinated Covid patients in the ICUs:

https://www.reddit.com/r/nursing/comments/pbvcdu/uhh_are_any...

Some interesting quotes that stood out to me:

"They’re dropping like flies in our ICU. 20- and 30-year-olds on vent and 99% of them unvaccinated."

"There are really only 2 options we are seeing for patients here. -you die -you become permanently disabled. And they are sent to Rehab or Long Term Care"

"Dialysis here. All my new patients in the past six months have had their kidneys damaged due to covid. All of them."