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Covid: Prior infection vs vaccination - Which one provides a higher degree of immunity?
Dr. Sebastian Rushworth, M.D. ^ | 05/13/2021

Posted on 05/13/2021 8:18:04 PM PDT by SeekAndFind

Ever since the beginning of the covid pandemic, one of the big topics of discussion has been whether infection results in lasting immunity. Since the advent of the vaccines, that has expanded in to a discussion about whether prior infection or vaccination provides a higher degree of immunity.

Back in December, I wrote about a study that showed that 90% of people who get covid still have antibodies six months out from infection. This was encouraging news. However, all it really did was show that most people keep their antibodies for a decent period of time after infection. It didn’t actually tell us anything about the probability of being re-infected.

Antibodies are a “surrogate” marker. We think they might tell us something useful, but we can’t really be sure. It’s kind of like looking at the share of a population that have high blood pressure instead of looking at the proportion that are having strokes. We really don’t know whether the presence of antibodies after infection means that someone is immune, or whether the absence of antibodies means that someone has lost their immunity. In fact, we still don’t really know whether antibodies play a meaningful role in fighting covid or not. Correlation isn’t always causation. Antibodies appear to be a good marker for prior infection, but that doesn’t mean that they have a causal role in preventing a re-infection.

So, what we really need is a study that looks at the degree to which people actually get re-infected, not more studies that look at antibodies. Once we have that, we can do a comparison with the results of the vaccine trials, and then we will finally have a reasonably good estimate of whether prior infection or vaccination provides a higher level of immunity, or if they are equivalent. That is now exactly what we have, thanks to a study that was recently published in The Lancet.

This was a cohort study carried out in the UK that recruited 25,661 NHS hospital workers and then followed them for an average seven months. The study was funded by the UK government. Participants were divided in to two cohorts, a covid positive cohort and a covid negative cohort. The purpose of the study was to see what proportion of people in each cohort went on to develop covid-19. The data were collected during the second half of 2020.

Everyone who had or had previously had a positive antibody test or PCR test for covid-19 at the beginning of the study was placed in to the covid positive cohort, and everyone else was placed in to the covid negative cohort. The covid positive cohort contained 8,278 participants at the beginning of the study, while the covid negative cohort contained 17,383.

Since this was a study of healthcare workers, more than 80% were female, and since it was carried out in the UK, more than 80% were white. The median age was 46 years and 75% had no underlying health conditions. In other words, the results primarily apply to relatively young healthy white women. It’s actually a good thing that the participants were relatively young and healthy, because we want to compare the results we get here with the results from the vaccine trials, and the participants in those trials were also young and healthy. The fact that the study mainly consisted of white women shouldn’t be that much of a problem, since there is no evidence to suggest that non-whites or men are different in their ability to develop immunity after getting covid as compared to white women.

Questionnaires were sent out to participants every two weeks asking about whether they had recently had any possibly covid-related symptoms, and they were also tested at regular intervals with both PCR tests and antibody tests. The goal was to PCR test all participants every two weeks, and antibody test them once a month. In other words, the participants weren’t just tested if they had symptoms. They were continuously screened for covid.

This means that the risk of missing a case was very low. Rather the opposite, in fact. It means that they found a large number of asymptomatic cases, or as we normally call them in medicine, healthy people. This could have been a problem in terms of allowing us to compare the results of this study with the vaccine trials, since the vaccine trials only counted people as cases if they both had a positive PCR test and also had at least one symptom suggestive of covid-19. Luckily, it isn’t a problem, because this study has gathered and presented data on the proportion of those with a positive PCR test or antibody test that actually had symptoms, and the proportion that didn’t. So we have all the data we need to do an apples to apples comparison with the vaccine trials.

Ok, let’s get to the results.

Over the course of 2,047,113 days of follow-up in the covid positive group, there were 78 cases of symptomatic covid-19 (by which we mean a positive test + at least one symptom).

Over the course of 2,971,436 days of follow-up in the covid negative group, there were 1,369 cases of symptomatic covid-19.

This works out to a relative risk reduction 0f 92%. For comparison, the Pfizer vaccine trial reported a reduction of 95%, the Moderna trial reported an reduction of 94%, the Astra-Zeneca trial reported a reduction of 70%, and the Johnson&Johnson trial reported a reduction of 67%.

So, on the face of it, prior infection is equivalent to the Pfizer and Moderna vaccines in terms of the level of protection offered, and much better than the Astra-Zeneca vaccine and J&J vaccine. In light of this, it seems completely unnecessary for people who have had covid to get the vaccine. In fact, if the goal of governments is to get their populations to herd immunity as quickly as possible, it would make more sense to tell people who have had confirmed covid-19 that they don’t need to get vaccinated. Vaccinating people who have already had covid-19 means delaying vaccination of people who haven’t had it, which means delaying the onset of herd immunity.

There is one potential problem with taking the 92% number at face value, especially in relation to the results from the vaccine trials, and that is that this is an observational study, not a randomized trial, so there is significant scope for confounding. For example, it could easily be the case that the people who had already had covid at the beginning of the study were the people who were at highest risk of exposure. Maybe they were disproportionately front-line workers, caring for covid patients. In that case, they would be disproportionately more like to get exposed to covid again over the course of the study than the people in the covid negative group. If that was the case, it would make the risk reduction seem smaller than it really is.

Conversely, it might be the case that those who were covid positive at the start of the study were disproportionately working in areas that were hard hit during the first wave, and that therefore had already built up a high level of population immunity by the time the second wave came around. These areas would then be only mildly hit during the second wave. That would mean that those participants who were negative at the start of the study would disproportionately be working in areas that hadn’t been hit very hard in the first wave, and that would therefore likely be hit harder in the second wave. If that was the case, then the covid negative group would end up being more exposed to covid during the study than the covid positive group, which would make the risk reduction seem bigger than it is.

The researchers attempted to correct for confounders to the extent that they were able, and came up with a modified risk reduction of 93%. But correcting for confounding is really a kind of guessing game. It isn’t a very reliable technique. And for all the confounders that are known and that can be corrected for, there are plenty more that aren’t known and can’t be corrected for.

That being said, a 92% or 93% risk reduction is a huge reduction, not far off the difference in lung cancer rates seen between smokers and non-smokers, so even with unknown confounders pushing the results up or down, it is clear that prior infection provides a high degree of immunity.


TOPICS: Health/Medicine; Science; Society
KEYWORDS: covid19; immunity; infection; vaccination
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ABOUT THE AUTHOR AND HIS BLOG:

I work as a physician in Stockholm, Sweden. I studied medicine at the Karolinska Institute and graduated in January 2020.

I am a proponent of evidence based medicine. In other words, I think that medical diagnosis and treatment should be guided by the scientific evidence, not by expert opinion or personal anecdote, and certainly not by salespeople working for pharmaceutical companies.

Unfortunately, much of what is written on the topic of health and medicine on the internet is just plain wrong. That applies even to much of what is written on supposedly serious medical web sites. That’s why I started this web site, to improve (however modestly) the information-to-misinformation ratio on the internet.

If you find value in the content I produce, then please support my writing by becoming a patron. Patrons gain access to a private discussion forum, and are also able to have private one-on-one communication with me through Patreon.

1 posted on 05/13/2021 8:18:04 PM PDT by SeekAndFind
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To: SeekAndFind

The masks are off


2 posted on 05/13/2021 8:26:26 PM PDT by frogjerk (I will not do business with fascists)
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To: SeekAndFind

Interesting.


3 posted on 05/13/2021 8:26:39 PM PDT by TChad (The MSM, having nuked its own credibility, is now bombing the rubble.)
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To: SeekAndFind

Very interesting. So because I have had Covid, I am just as least likely to get Covid again as someone who has been vaccinated.

So why should I get vaccinated and take the risk, very very small risk, of having any adverse reactions or consequences from these vaccines?


4 posted on 05/13/2021 8:28:13 PM PDT by Responsibility2nd (Actual FR Quote: “I ain’t getting no Covid Vaccine. I’d rather get Covid and DIE before I get a jab.)
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To: SeekAndFind

Summary:

92-93% risk reduction for having a prior infection, statistically the same as the faux ‘vaccines’.

I’ll go further:

As I stated months ago, we’d have reached a theoretical herd immunity by September of last year if they’d just put kids in school over the summer, the safest months of the year. I also stand behind prior statements that the total deaths would have remained unchanged, if anything reduced under other such ‘sane’ measures.

But without their artificial ‘crisis’ they couldn’t stage multiple multi-trillion dollar bills or coerce the population into compliance, now could they?


5 posted on 05/13/2021 8:31:00 PM PDT by logi_cal869 (-cynicus the "concern troll" a/o 10/03/2018 /!i!! &@$%&*(@ -)
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To: Responsibility2nd

To make someone else feel better


6 posted on 05/13/2021 8:31:34 PM PDT by frogjerk (I will not do business with fascists)
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To: Whenifhow; null and void; aragorn; EnigmaticAnomaly; kalee; Kale; AZ .44 MAG; Baynative; bgill; ...

p


7 posted on 05/13/2021 8:31:41 PM PDT by bitt (People who wonder if the glass is half empty or half full miss the point. The glass is refillable.)
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To: logi_cal869

RE: As I stated months ago, we’d have reached a theoretical herd immunity by September of last year

The question is herd immunity to what variant of the Coronavirus? Maybe the original, but we have variants from the UK, Brazil, South Africa and double variants from India and who knows how many more?


8 posted on 05/13/2021 8:34:44 PM PDT by SeekAndFind
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To: Responsibility2nd

You are likely even MORE protected, if you’ve had china flu, naturally....

Dr Peter McCullough....(note/transcription, of interview, by FRs ransomnote), scroll down....

https://freerepublic.com/focus/f-chat/3955998/posts

...But I think we should just recognize that it’s (Covid) is going to be here. [ransomnote: Stopping at the 20:22 minute mark in the video. There’s another 10 minutes to the video which I will transcribe later. He does say if you’ve had Covid, you have immunity for an average of 17 years and is against vaccinating those who have already had Covid]...


9 posted on 05/13/2021 8:34:55 PM PDT by Jane Long (America, Bless God....blessed be the Nation 🙏🏻🇺🇸)
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To: SeekAndFind

“Eric Topol
@EricTopol
Much on T-cell for vaccines & variants is unknown.
A @GladstoneInst preprint sheds light:
—Prior covid + vaccine -> very strong response w/ homing
—Supports: (1) need for vaccine w/ prior covid, (2) just 1-dose, and (3) marked protection vs variants”
https://biorxiv.org/content/10.1101/2021.05.12.443888v1

And a thread on natural immunity:
https://twitter.com/EricTopol/status/1390768515259408387

“Older immune systems have an increasing tendency to mistarget the virus, paying too much attention to its Nucleocapsid and Open Reading Frame 8 proteins, and not enough attention to the Spike protein”

Glad to see pre-prints about natural immunity! Interesting!


10 posted on 05/13/2021 8:38:50 PM PDT by mrsmith (US MEDIA: " Every 'White' cop is a criminal! And all the 'non-white' criminals saints!")
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To: mrsmith

RE: Older immune systems have an increasing tendency to mistarget the virus

So, mistargeting viruses increases with a person’s age?


11 posted on 05/13/2021 8:42:05 PM PDT by SeekAndFind
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To: Responsibility2nd

So why should I get vaccinated and take the risk, very very small risk, of having any adverse reactions or consequences from these vaccines?
~~~~~~~~~~~~~~

The risks with vaccination are largely unknown but we do know that the CDC/Fauci say that the vaccinated will have to continue to have additional ‘shots’ (e.g., ‘boosters) and that the CDC has declared those additional ‘shots’ will not have to undergo testing.


12 posted on 05/13/2021 8:47:44 PM PDT by ransomnote (IN GOD WE TRUST)
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To: SeekAndFind

Well, what they’re saying is that the immune system targets the whole virus instead of the spike.

The spike is like, to this layman, the armor attack of a Blitzkreig. Fighting against other parts of the opposing force is futile as the armor overruns the defense.

Hope my analogy is helpful.


13 posted on 05/13/2021 8:48:31 PM PDT by mrsmith (US MEDIA: " Every 'White' cop is a criminal! And all the 'non-white' criminals saints!")
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To: mrsmith

RE: Well, what they’re saying is that the immune system targets the whole virus instead of the spike.

I can understand this. But what does a person’s age have to do with it?


14 posted on 05/13/2021 8:52:10 PM PDT by SeekAndFind
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To: SeekAndFind

You’ll just have to click on the link. I’m a layman on the subject.


15 posted on 05/13/2021 8:59:17 PM PDT by mrsmith (US MEDIA: " Every 'White' cop is a criminal! And all the 'non-white' criminals saints!")
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To: SeekAndFind

“I work as a physician in Stockholm, Sweden. I studied medicine at the Karolinska Institute and graduated in January 2020.

I am a proponent of evidence based medicine. In other words, I think that medical diagnosis and treatment should be guided by the scientific evidence, not by expert opinion…”
****************************************************************
If the study of Medicine in Sweden is anything like in America, he’s just beginning his serious learning. He is, at most, a second year resident and still “wet behind his ears”. The article is right… natural immunity is definitely as good as mRNA vaccine prepared immunity.


16 posted on 05/13/2021 9:00:38 PM PDT by House Atreides
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To: House Atreides

“natural immunity is definitely as good as mRNA vaccine prepared immunity.”

Studies I’ve seen show that one shot of mRNA vaccine gives significantly better protection. than “wild” infection.
Of course there may be a bias there.


17 posted on 05/13/2021 9:05:51 PM PDT by mrsmith (US MEDIA: " Every 'White' cop is a criminal! And all the 'non-white' criminals saints!")
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To: mrsmith

Not according to the British study in the linked article. If conducted as described it would have provided statistically valid results.


18 posted on 05/13/2021 9:12:44 PM PDT by House Atreides
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To: House Atreides

What link please?


19 posted on 05/13/2021 9:14:30 PM PDT by mrsmith (US MEDIA: " Every 'White' cop is a criminal! And all the 'non-white' criminals saints!")
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To: SeekAndFind

OK, both my husband and I have had covid ... twice. We had different rates of recovery, but recover we did. We got covid for the second time at nearly 10 months to the day from the onset of the first bout. A friend of mine had a similar experience, only she went 11 months between bouts.

For what it’s worth.


20 posted on 05/13/2021 9:15:37 PM PDT by Ladysforest (Racism, misogyny, bigotry, xenophobia and vulgarity - with just a smattering of threats and violence)
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