> This waters down case rates in the unvaccinated group and ends up lowering the vaccine efficacy estimates.
Okay. Let's be clear on something.
Telling the truth is never a downside.
It is not a negative that the U.S. doesn't pretend that immunity due to prior infection is due to the vaccine. Suggesting that these cases should be counted in favor of vaccine efficacy is brazenly dishonest.
> Suggesting that these cases should be counted in favor of vaccine efficacy is brazenly dishonest. This article is flamebait.
This seems to be a complete misreading of what the article is saying. Nowhere does it claim that "immunity due to prior infection should be counted as due to the vaccine" merely that it makes the "unvaccinated" group look better than it actually is, as it should be further subdivided to "account for past infection" in a subgroup.
Drawing the conclusion that we should therefore ignore the article entirely is unwarranted. Let us not be brazenly dishonest.
1. This would require testing tons of people for antibody response all the time. That seems hard. We do at least have antibody tests that will test for infection vs vaccination.
2. If you are going to go this far, you'd also want the "vaccinated but had no effect" group.
The vaccine will not generate an immune response (or an effective one) in everyone, that's just how it works.
So the vaccinated group (and "breakthrough cases") include some percent of people who were vaccinated, but it didn't really do anything to them.
You'd want to know this number, because you want to know things like "how many breakthrough cases are people where the vaccine had no real effect vs people where the vaccine generated an effective antibody response, but not against this variant"
Especially because the "breakthrough" rate is small.
OK, but if doing this subdivision well is prohibitively hard, that does not not make the article dishonest about these groups. It does not "pretend that immunity due to prior infection is due to the vaccine".
The logic is bad. You need to compare 5 groups. Your group 3 lumps together people that were previously infected with those that were not previously infected. By doing that, it would artificially show the vaccine was more effective than it should be.
The 5 groups:
1a. Never vaccinated, No prior infection
1b. Never vaccinated, prior infection
2a. Vaccinated, No prior infection
2b. Vaccinated, prior infection (Infected then Vaccinated)
2c. Vaccinated, prior infection (Vaccinated then Infected)
Finer grained is better, yes. But I don't think that this supports the idea that anyone "pretends that immunity due to prior infection is due to the vaccine."
Yes it does. Just replace the vaccine with snake oil and follow it to its logical conclusions.
I'll use some BS numbers to make the point. Let's assume: study population of 100, 20% of the population had a prior infection, half are given the snake oil.
Starting conditions:
1. Never infected, Never Snaked: 40
2. Prior infected, Never Snaked:10
3. Never infected, Snaked: 40
4. Prior infected, Snaked: 10
Now let's assume wave 2 happens. 20% of the never infected gets infected, and 0% of the previously infected get reinfected.
Both groups 1+2 combined and 3+4 combined have an average infection rate of 16% for wave 2. The groups are equal because snake oil is bullshit.
What the Ars author was suggesting is to compare group 1 with group 3+4 combined. Now you have a 20% infection rate vs a 16% infection rate. The snake oil appears to have an (20-16)/20 = 25% effectiveness just by including previously acquired immunity.
I'm vaccinated, and I even volunteered to participate in phase 1 booster vaccine trials. Articles like this are flamebait. The title is likely wrong, for starters.
At a baseline, naturally generated antibodies/t-cell response almost always targets more than just the spike protein (ie nucleoprotein regions, etc). These often make them effective against a lot more variants, as those regions are much more preserved than the spike protein.
Duplicating this response is the whole goal of the 2nd generation vaccine programs NIAID and others are running - to generate the same kind of response as a backstop against variants (it has a secondary goal of needing less dosage to vaccinate people). We are trying to better mimic the response the human body gives naturally.
"Next, we showed that patients (n = 23) who recovered from SARS (the disease associated with SARS-CoV infection) possess long-lasting memory T cells that are reactive to the N protein of SARS-CoV 17 years after the outbreak of SARS in 2003".
17 years.
(Additionally, to the earlier point, lots of people infected with earlier SARS-COV variants appear to have an effective immune response to SARS-COV-2, because the natural generated response targeted preserved-between-viruses regions)
Now, this doesn't mean that you shouldn't get vaccinated if you were infected - in fact, the strongest immunity that is seen from people who were infected and then
vaccinated. This appears to generate a very strong, very effective response.
But this "hunting with a shotgun instead of a sniper rifle" stuff is just stupid. So is citing 2 studies that say different things and saying "therefore i've proven natural immunity is unreliable"
Any real discussion about vaccination vs natural immunity would have to go into CD4/CD8 response, what regions are targeted/preserved in mutations, etc.
IMHO These kinds of articles do a lot more harm than good, because the misinfo in them is easy to discover, and that convinces people even further of conspiracies. They take an area where science is actually trying to figure out the answers (we aren't all that good at understanding the immune response), and pretends we know.
That isn't going to help get people vaccinated.
I'd originally responded to the article's flamebait with flamebait, but forget that; let's focus on the actual science:
> Now, this doesn't mean that you shouldn't get vaccinated if you were infected - in fact, the strongest immunity that is seen from people who were infected and then vaccinated. This appears to generate a very strong, very effective response.
How does this relate to "Original Antigenic Sin", aka the Hoskins effect?
It must be that this effect isn't that strong, or else the subsequent vaccination wouldn't do anything? Or is it precisely because the vaccine doesn't have any of the other markers, that the immune system is now forced to learn a new, second response?
The effect can be strong, actually, for a number of possible reasons. Let me start by saying nobody is 100% positive quite yet, but the response is "much larger than expected".
The short version of mechanism is: When you are infected, your body preemptively guesses at what variants might occur and makes memory b-cells that can recognize them. When you later are vaccinated, it discovers which ones were "right" and generates an impressive response.
Beyond that, in some sense, it makes intrinsic sense - your body really does cost-benefit because of how many foreign bodies it has to deal with anyway - it initially treats it like any other infection, does the simplest, least energy thing it will take to get rid of it, and moves on. When it gets "reinfected" later, it tries a lot harder to not have it happen again because the threat seems higher.
Okay. Let's be clear on something.
Telling the truth is never a downside.
It is not a negative that the U.S. doesn't pretend that immunity due to prior infection is due to the vaccine. Suggesting that these cases should be counted in favor of vaccine efficacy is brazenly dishonest.
This article is flamebait.