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Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

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Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#141

Earlier quoted context omitted.

https://theconversation.com/covid-vaccines-focus-on-the-spik... is probably relevant to your question. The short answer (this was also discussed recently on TWiV) is that spike is the earliest interaction with cells, so focusing on it hopefully causes the immune response to mount earlier as well. But, as described in the link, other proteins may be viable targets as well.

Another issue is, other targets may not provide neutralizing immunity and may facilitate ADE. I don't think we've seen ADE in natural infection yet, so it may just be a theoretical issue, but I also don't know if we've really looked for ADE in natural infection either. We do know that other similar coronavirus vaccine candidates (a candidate for SARS-COV-1) exhibited ADE in primate studies. So since the spike protein…

For people curious about ADE (a fascinating topic that so far doesn't seem to have caused problems with SARS-CoV-2), here is some excellent background reading that covers many of the points made in the above comment, with citations and deeper discussion:

https://blogs.sciencemag.org/pipeline/archives/2021/02/12/an...

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#142
post #106

Earlier quoted context omitted.

Interestingly, we're putting unnatural selection pressure on the viruses by leveraging vaccines that are leaky, this has in at least one example been shown to produce a deadlier pathogen for unvaccinated. So, maybe you had ought to be a little more skeptical about your risk assessments when the data isn't yet in and may never be until it is. And as for the philosophical conundrum, I'd posit that it's far safer to mai…

This is a pretty bad take. No vaccine has 100% coverage. Most of the time we're talking about 85-90% protection rate, with some low possibility of mild infectious contagion. The particularly ignorant take on your part is ignoring 1918 to 1919 change in that flu. It 'naturally' became far more deadly with no vaccine needed.

Right. Abstractly viruses find a sweet spot between transmission rate and lethality to host. Too lethal and it won’t spread very far. However, in practical terms there is a lot more room for something like COVID to be far more damaging and still spread just like it has been or more. All of the immunity we now have and the particular nature and quality of it will certainly impact what the virus does when mutating. If it really can breakthrough vaccinated populations it’s going to change how it evolves. That is a lot of ifs, buts and maybes. The real world data just is t backing up a lot of these weak claims folks are making. In practical terms the vaccines work and do their job. There is a lot of interesting observations to make and we are in the middle of a great experiment of sorts, so we should be very data driven in my opinion.

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#144

Earlier quoted context omitted.

We know based on past corornaviruses that natural infection can lead to durable immunity up to 20 years, and like you mentioned with T-cells and more. We also have data showing the current ones so far last as long as we’ve tested them, while vaccines have waned once near a year out. The consensus hasn’t been reached, by my current beliefs strongly tend towards (based on many past similar viruses and all current studi…

Antibodies wane, but B-cell and T-cell response is important for longer term protection. Fortunately, we have results (including [B] and [T]) that vaccines also induce these memory cell responses. Also, the durability of immunity from coronavirus probably depends on the exact coronavirus. It does seem to be true for SARS, but possibly less so for the seasonal coronaviruses that cause a respectable fraction of common…

While they may stimulate some B and T, they aren’t close to the levels from infection.

From what I’ve seen many coronavirus have durable immunity from infection, you’d need to cite that they vary. Also, from what I’ve seen the T and B cell response is not nearly the same effect, nor as durable.

Further, like the Israeli report, there are a handful more reports of previously infected not getting reinfected at nearly the same rates. The Israeli report has hard numbers in the article you ignored.

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#145
post #19

Its important to keep studies like this in mind when talking with people who refuse to take the vaccine because they "already had COVID". In a very real sense, if natural antibodies are durable, persistent, and effective; the vaccine is an unnecessary medical procedure. Doctors would not cut off your legs for no reason; that would be unethical. The vaccine is a medical procedure like any other; if the benefit is ques…

I know this thread is catnip for the antivax contingent that reliably appears, but this argument has several problems. First, our vaccines provide a stronger immune response than infection, as has been well documented by now[1]. Vaccination on top of prior infection boosts the response[2]. Second, the harm from the vaccine is minimal, and comparing it with an amputation is ridiculous (in spite of the large number of…

Maybe the comparison with amputation is a little over-the-top but let me illustrate with a few other real-world examples why this kind of concern is not completely illegitimate.

The health policy in some countries e.g. in France (and maybe large parts of Europe?) actually allow you to have an "health passport" just because you recovered from Covid recently enough.

It would actually be illegal in France to privately require proof of vaccination if not exceptionally allowed by a narrow law (as a general principle, medical information are very protected here).

Some Covid vaccines have been forbidden for people under a specific age limit, although they were allowed for a while, but the risk has eventually been reassessed after a few suspects side effects (very very rare, but considered a risk important enough to change the policy, esp since the risk of covid itself decrease greatly the younger you are, and there are arguably safer alternatives in other models of vaccines).

Of course it is still probably "on average" better to get vaccinated on top of recovering from Covid, and of course the comparison with amputation was probably over-the-top (at the very least it should have been stated as a risk of "amputation" with a very very low proba); but overly constraining people is debatable -- especially when tons of factor are hard to be synthetized to "everybody should just get vaccinated right now, unconditionally, -- and accept to be privately controlled by anybody -- or they are horrible antivax people and people will die because of them"; not everybody has the same amount of social contacts with the same categories of people and/or live in the same kind of city and accommodations, public health is not something that appears in empty social contexts just because of raw numbers and models, etc.

Yes it probably would be better if "everybody" was vaccinated. Willingly. And if we had decades of feedback to convince people. And if they were vaccinated against other diseases too. Now welcome to the real world and think of how to navigate efficiently with imperfect knowledge, including how to avoid entirely dismissing concerns.

Primum non nocere certainly does not to be dropped and hopefully will not: the situation is shitty but will become clearer with time, and if we detect either more risks or more safety for various vaccines hopefully the policies will evolve accordingly, and individual opinions too. Note that they already are not completely binary and that it is still kind of hard to decide from which age we should allow / incite / require vaccination -- and the "optimal" solution probably depends on the coverage of the rest of the population too.

And that's because of that very principle. There is no exact obvious point where all-in starts to be required. It maybe would be useful to make regular-flu shots more or less mandatory (and now even the interest of flu-shots is debated by serious scientists because it may be counter productive for the state of the immune system latter in life; or that may depend on people -- maybe new strains of covid would yield to similar debates in a few years?). They are typically not.

That being said my current understanding make me wish more people go get vaccinated, but just do not pretend it is all black & white and that people should not have subtle/reserved opinions.

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#146

“Acquiring” natural immunity also has the following side effects at a much higher rate than the vaccine: - Death - Hospitalization - Chronic illness, which can include long-term neurological impairment I feel like it’s important to keep that in mind if you’re either advocating “natural immunity” as a public health strategy, or considering it a personal strategy.

Much of the death toll centers on those who are already sick, obese, and otherwise compromised. Age groups of children and young adults show remarkable resilience to infection. There is not one outcome.

So you would have us call to those who are already tired and add death to their burden?

I doubt it?

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#147

Earlier quoted context omitted.

I think other comments may have pointed this out already, but there are several problems with this line of reasoning. When deciding on whether or not to administer a procedure or treatment, one must consider the balance of potential harms and benefits, while accounting for uncertainty. In this particular case, the potential for harm from the vaccine is quite low (this is borne out by the data), and the benefits are m…

> In this particular case, the potential for harm from the vaccine is quite low (this is borne out by the data), Which is why a common anti-vax argument is sow doubt about the harmful effects. I noticed a few options: a) conspiratorial: "the government is lying about side harm" b) anecdotal: "I personally know at least 3 people who couldn't walk after the vaccine. Do you call me a liar?" c) hyper-skepticism: "how can…

It seems to me very reasonable to worry about long-term outcomes when we are talking about vaccinating every man woman child. Maybe its got precedence but damn if its not worrying, and honest skepticism ought to be treated with respect not derided.

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#148

Earlier quoted context omitted.

To add to the list: "Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.58–3.47). These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection." https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_c…

Here is a paper (not yet peer-reviewed) which presents statistically strong evidence (N = 52,238) that vaccinating previously infected individuals provides practically no benefit [1]. Quote from [1]: - "The cumulative incidence of SARS-CoV-2 infection remained almost zero among previously infected unvaccinated subjects, previously infected subjects who were vaccinated, and previously uninfected subjects who were vacc…

Thanks for bringing this paper, it's relevant to the conversation. A couple of points of context.

First, this study is quite early on in the vaccination campaign, when supplies were very short. The main conclusion is that they should be prioritized to people who have not had prior infection. That advice was not followed, largely because determining prior infection status complicates the protocols for vaccination quite a bit, and simpler is better. Now, at least in the US, we're in a situation where we are literally throwing vaccine down the drain[1, 2].

Second, this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant[3]. Vaccine effectiveness appears to be somewhat reduced compared with the original variant, but still pretty good.

This is definitely an area where more science is needed.

[1]: https://www.statnews.com/2021/07/20/states-are-sitting-on-mi...

[2]: https://www.al.com/coronavirus/2021/08/alabama-threw-out-650...

[3]: https://www.nature.com/articles/s41586-021-03777-9

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#149

“Acquiring” natural immunity also has the following side effects at a much higher rate than the vaccine: - Death - Hospitalization - Chronic illness, which can include long-term neurological impairment I feel like it’s important to keep that in mind if you’re either advocating “natural immunity” as a public health strategy, or considering it a personal strategy.

Much of the death toll centers on those who are already sick, obese, and otherwise compromised. Age groups of children and young adults show remarkable resilience to infection. There is not one outcome.

There is nevertheless a significantly lower incidence of negative effects from the vaccine than from a covid infection in all age groups.

Re: Longitudinal analysis shows durable immune memory after SARS-CoV-2 infection

#150

Earlier quoted context omitted.

> In this particular case, the potential for harm from the vaccine is quite low (this is borne out by the data), Which is why a common anti-vax argument is sow doubt about the harmful effects. I noticed a few options: a) conspiratorial: "the government is lying about side harm" b) anecdotal: "I personally know at least 3 people who couldn't walk after the vaccine. Do you call me a liar?" c) hyper-skepticism: "how can…

It seems to me very reasonable to worry about long-term outcomes when we are talking about vaccinating every man woman child. Maybe its got precedence but damn if its not worrying, and honest skepticism ought to be treated with respect not derided.

I'm not deriding the honest worry. Nobody can know with certainty anything about the future.

I'm worrying about the paralyzing effects of a meme that says that since it's technically possible for an adverse affect to happen at an arbitrary point in the future, we cannot consider an option to curb the effects of a known problem we have right now.

Often I'm accused of dismissing the possibility of adverse effects like if I knew with certainty that they can't happen. How could I? Nobody knows. That's not the point. The point is to make a guess and take balanced risks. We take risks all the time, about everything.

What's so special about vaccines that causes such widespread reaction? Is it because people feel forced to take them? Is it something about the way they work that triggers such a reaction in people that often (anecdotally) don't care about things like effects of second hand smoke?

(Genuine questions)

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