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Evidence that Natural Immunity is Better: Odds of of Severe, Critical and Fatal COVID-19 in Reinfection Greater in the Vaccinated than in the Naturally Immune
These data show show that the vaccinated are 10.29 more likely to suffer from severe or critical COVID-19 or death upon reinfection than those with natural immunity.
In a Letter to the Editor (NEJM), a team from Qatar report the results of their study of over 353,000 people who had been given a diagnosis of COVID-19 between Feb. 28, 2020, and April 28, 2021.
Among those with natural immunity, 1,304 reinfections occurred (0.4%, or 0.004). Only 4 cases of severe COVID-19 were found among those with reinfections.
In the vaccinated, 193 cases of severe, critical or fatal COVID-19 were seen.
There were zero critical cases or fatal cases among those with natural immunity.
Looking at their numbers, the odds of severe disease in reinfection of the vaccinated compared to the
unvaccinated naturally immune was as follows:
Severe disease: (158/6095)/(4/1300) = 8.43
Critical disease (28/6095)/(0/1300) = NAN (division by zero, no critical disease in the naturally immune.
Fatal disease (7/6095)/(0/1300) = NAN (no fatal disease in the naturally immune).
Severe, Critical or Fatal Disease (193/6095)/(4/1300) = 10.29.
These data show show that the vaccinated are 10.29 mores likely to suffer from severe or critical COVID-19 or death upon reinfection than those with natural immunity.
This result is reassuring to individuals who have had prior SARS-CoV-2 infection.
The data also show that the risk of severe, critical or fatal disease in the vaccinated is 3.16% [(193/6095) x 100]. That’s about ten times lower than than some estimates of the number of American at risk of serious COVID-19 (see KFF article). However, the virus has now evolved and is thought to have escaped the vaccine and the current efficacy of vaccines is likely well below 50%.
The superiority of natural immunity is no surprise given that we know that there are only five immunogenic epitopes in the spike protein, and at least 55 immunogenic epitopes considering all of the SARS-CoV-2 virus proteins (see Lyons-Weiler, 2020).
A valid concern is that unhealthy people - those at higher risk of severe COVID-19 - may have been the first to vaccinate, to follow through with both doses, or may have higher comorbidity rates for severe COVID-19.
The medicine community needs to start using indicators to inform their patients of the risk of severe COVID-19 and quell the fear among those with natural immunity, and those without all of the following risk factors for serious COVID-19: immunocompromise, obesity, autoimmunity, Th-2 skew, family members who had severe COVID-19 during infection, diabetes. People with these risk factors should do all they can do to reverse their conditions. CDC’s list of comorbidities contains diagnostic categories that are too broad to be useful for personalized medicine.
In March, 2021, the accumulation of mutations in the spike protein were used to predict that the virus would eventually escape the vaccine (Link) That has now happened Given that the virus has now escaped the vaccine, e.g.,
it’s time for the medical community to start taking prophylaxis via supplements and antivirals seriously. It’s actually long overdue; their failure to provide care to ambulatory care to PCR+ patients while they sit at home waiting to get sick is unacceptable, and has made viral incubators out of hundreds of millions of people around the world.
And it’s time to start counting the naturally immune as “immune” - why throw a vaccine against extinct variants into their immunological mix?
It’s the holidays. Give a physician you love the gift of logic & reason. All you need is their email address and method of payment for your generous gift.
Data Source: Severity of SARS-CoV-2 Reinfections as Compared with Primary Infections https://www.nejm.org/doi/10.1056/NEJMc2108120?url_ver=Z39.88-2003
PS Consider signing up for The Biology of the Immune System, a 15-week lecture and discussion series course to be taught by yours truly at IPAK-EDU online starting in January, 2022 (Click on the IPAK-EDU image below to register). I will be working all of December collecting studies and creating my slides for an extremely applied syllabus. If you have interesting immunological studies to share, drop them in the comments.