Getting a Vaccination vs Having Recovered from Covid -- Are they equivalent?

[Phil Core]

TL;DR Summary

Is getting vaccinated vs actually having had the Covid virus with symptoms considered to be better in preventing future infections?

There is a bias in the medical community toward getting vaccinated even if you have had Covid with symptoms. Example - https://health.clevelandclinic.org/when-should-you-get-vaccinated-if-youve-had-covid-19/

I am unaware of any hard science - incremental analysis - that would conclude that getting vaccinated is better than having Covid with symptoms for the prevention of near term infection.

I would think that antibodies produced by actual initial Covid infection would be more robust than antibodies induced by vaccines that only address a fraction of the structure of the Covid virus.

Many people who had Covid and then got vaccinated reported increased side effects.

I find the medical communities response to getting vaccinated after already having Covid caviler.

"The next time you encounter the pathogen, these responses will kick in faster and stronger, because your immune system is already primed to recognise and respond to it. This is why people who have already recovered from COVID-19 may experience more of these mild reactions. They are nothing to be alarmed by, and merely show that the body remembers the virus and is mounting an effective response to it. This is similar to receiving a second dose of the vaccine; in both cases, your body was already primed to recognise the antigen either by prior infection or the first dose.Indeed, two small studies recently suggested that people who’ve previously been infected with SARS-CoV-2 MIGHT only need a single dose of an mRNA vaccine, as they begin producing large amounts of antibodies against the virus following their first dose – although follow-up studies are needed to confirm that these immune responses were maintained over time." https://www.gavi.org/vaccineswork/w...more-common-people-whove-already-had-covid-19

 

[jedishrfu]

The difference you haven’t considered is that people who contract COVID may have long lasting after effects that vaccinated people don’t have.

In some documented cases COVID people have had their post COVID symptoms disappear after getting vaccinated. However, the jury is out as to why people suffer post COVID symptoms whether it’s due to the virus still lingering in the body or from some other reason.

 

[atyy]

Indeed, two small studies recently suggested that people who’ve previously been infected with SARS-CoV-2 MIGHT only need a single dose of an mRNA vaccine, as they begin producing large amounts of antibodies against the virus following their first dose – although follow-up studies are needed to confirm that these immune responses were maintained over time." https://www.gavi.org/vaccineswork/w...more-common-people-whove-already-had-covid-19

In Singapore, the current recommendation is for people who have had COVID to receive only a single dose of vaccine.
https://www.moh.gov.sg/covid-19/vaccination
"Can persons with prior COVID-19 infection be vaccinated?
Recovered persons who have not completed COVID-19 vaccination may receive a single dose of vaccine. This applies to recovered persons who are unvaccinated and recovered persons who had received one dose of vaccine before being infected. There is evidence shown that a single dose of vaccine can further boost the immunity against COVID-19 in persons who have recovered from a COVID-19 infection.
Recovered persons should discuss with their doctors on when to receive the vaccine. The general recommendation is to wait at least 6 months from the date of infection before receiving the vaccine dose.
No routine testing by PCR or serology is required before getting COVID-19 vaccination to determine eligibility for vaccination."

However, the current recommendation in other places (eg. the USA) for the usual vaccination is also consistent with evidence.
https://www.fda.gov/emergency-prepa...h-covid-19-vaccine-frequently-asked-questions
"Q: Can people who have already had COVID-19 get the Pfizer-BioNTech COVID-19 Vaccine?
A: Among all study participants, 3% had evidence of infection prior to vaccination, and among participants with evidence of infection prior to vaccination, more confirmed COVID-19 cases occurred in the placebo group compared with the vaccine group. While relatively few confirmed COVID-19 cases occurred overall among participants with evidence of infection prior to vaccination, available data suggest that previously infected individuals can be at risk of COVID-19 (i.e., reinfection) and could benefit from vaccination."

 

[Phil Core]

Covid infection - elicits antibody response - Antibody I
Vaccination - elicits antibody response - Antibody V

What is the difference Antibody I vs Antibody V ?

With respect to

1. virility - speed and effectiveness of response
2. duration - how long are the Antibodies "effective".
3. flexibility - ability to address mutations

 

[jim mcnamara]

@Phil Core
Hi - where did those terms come from in the post above? Please post a link. Thanks.
For:
2. And you presuppose that after antibodies wane, then there is no protection. Think T-cells, memory B-cells, for example.

Plus I'm not sure what Antibody I is supposed to be, same with antibody V. So I can't answer your question. Or maybe they are hypothetical...

 

[Ygggdrasil]

Summary:: Is getting vaccinated vs actually having had the Covid virus with symptoms considered to be better in preventing future infections?

There is a bias in the medical community toward getting vaccinated even if you have had Covid with symptoms. Example - https://health.clevelandclinic.org/when-should-you-get-vaccinated-if-youve-had-covid-19/

I am unaware of any hard science - incremental analysis - that would conclude that getting vaccinated is better than having Covid with symptoms for the prevention of near term infection.

I would think that antibodies produced by actual initial Covid infection would be more robust than antibodies induced by vaccines that only address a fraction of the structure of the Covid virus.

Many people who had Covid and then got vaccinated reported increased side effects.

I find the medical communities response to getting vaccinated after already having Covid caviler.

There are reasons to think that vaccines would elicit a stronger and more durable immune response than viral infection. For example, viruses have evolved to try to minimize the host's immune response to itself while vaccines are designed to stimulate robust immune responses. You are correct that vaccines elicit antibodies only to the spike protein while natural infection induces antibodies against other proteins, though it is mainly antibodies against the spike protein that are responsible for neutralizing viruses (Huang et al. 2020).

A study in the UK estimated the risk of re-infection after an initial COVID-19 infection, and found that prior infection confers ~ 84% protection against any re-infection, and a 93% protection against symptomatic infections (Hall et al. 2021). A study in Denmark similarly found an 80% protection against re-infection, though this protection was less effective in those aged >65 (47%) (Hansen et al. 2021). These levels of protection are somewhat lower than the ~90% protection observed for the mRNA vaccines (Pfizer-BioNTech and Moderna), though they are comparable or higher than the protection observed with the adenoviral vectored vaccines (Johnson & Johnson and Oxford-AstraZeneca) (see data compiled at https://alsnhll.github.io/covid19_vaccine_comparison.html). Notably, the clinical trial data for the Pfizer mRNA vaccine showed no drop in efficiency in older individuals (95% effective in age >65 vs 95% overall) (Polack et al. 2020) and the Moderna vaccine showed only a small drop in efficacy (86% effective in age >65 vs 94% overall) (Baden et al. 2021).

We do know that immunity to other coronaviruses is fairly short lived (~ 1 year) (Edrige et al. 2020). One might hypothesize that vaccinating those previously exposed to the Coronavirus would help stimulate the production of memory B and T cells that would make the immune response much more durable and longer lasting. In my opinion (as not a medical professional), it's likely that a second dose of the vaccine would not be necessary for those who were previously exposed. However, administering the second dose would not cause harm whereas skipping the second dose for someone who thought they were previously exposed (but was not) could potentially cause greater harm.

 

[Astronuc]

Summary:: Is getting vaccinated vs actually having had the Covid virus with symptoms considered to be better in preventing future infections?

I am unaware of any hard science - incremental analysis - that would conclude that getting vaccinated is better than having Covid with symptoms for the prevention of near term infection.

Did one look for studies/evidence?

As of about the end of April, there were at least 1,108,960 hospitalizations (Carlson, 37 states) and 579,634 deaths (NY Times) from COVID-19. There were 32,632,099 positive cases of COVID-19 (NY Times).
Today the numbers are: 32,880,674 positive cases, 583,990 deaths. 1,119,219 (Carlson)
Hospitalizations are difficult to count since some states do not report hospitalizations due to COVID-19.
Carlson = https://carlsonschool.umn.edu/mili-misrc-covid19-tracking-project
NY Times = https://www.nytimes.com/interactive/2021/us/covid-cases.html

I would think that antibodies produced by actual initial Covid infection would be more robust than antibodies induced by vaccines that only address a fraction of the structure of the Covid virus.

Evidence?

Many people who had Covid and then got vaccinated reported increased side effects.

Please substantiate this claim.

I find the medical communities response to getting vaccinated after already having Covid caviler.

On what basis?

I have heard reports that those with lingering symptoms of a COVID-19 infection are benefitting from the vaccine. Scientists are currently studying the population of long-haul COVID-19 patients (long haulers).

https://www.yalemedicine.org/news/vaccines-long-covid
How is the vaccine helping some long-haulers?

As many as 30 to 40% of those who get the vaccine have reported improvements to their symptoms. “I’ve heard from people who say they no longer have ‘brain fog,’ their gastrointestinal problems have gone away, or they stopped suffering from the shortness of breath they’ve been living with since being diagnosed with COVID-19,” says Iwasaki.

Given the number of studies, it doesn't seem the medical community is acting in a cavalier manner, but rather from an informed understanding.

April 23, 2021, Study: Those Who Recovered From COVID-19 May Receive Maximal Immunity From One Vaccine Dose
https://www.pharmacytimes.com/view/...eceive-maximal-immunity-from-one-vaccine-dose

March 9, 2021, Patients Recovered from COVID-19 May Require Just One Dose of mRNA Vaccine
https://nyulangone.org/news/patients-recovered-covid-19-may-require-just-one-dose-mrna-vaccine

April 15, 2021, Penn Study Suggests Those Who Had COVID-19 May Only Need One Vaccine Dose
https://www.pennmedicine.org/news/n...ho-had-covid19-may-only-need-one-vaccine-dose

April 13, 2021, Immune response to vaccination after COVID-19
https://www.nih.gov/news-events/nih-research-matters/immune-response-vaccination-after-covid-19

15 Apr 2021, Distinct antibody and memory B cell responses in SARS-CoV-2 naïve and recovered individuals following mRNA vaccination
https://immunology.sciencemag.org/content/6/58/eabi6950

 

[Laroxe]

It is true that following natural infection the body will produce a wider range of antibodies that target various parts of the virus, the problem is that we don't know if many of these antibodies confer any additional protection. All the initial studies suggested it was antibodies to the spike proteins that conferred protection and as these are specifically targeted by the vaccines you should see higher levels of these antibodies without the risks of a broader range, increasing the potential for autoantibodies.
Ygggdrasil also makes a very important point in that this virus is capable of disrupting the normal immune response. There is an association between very serious illness and death in people that the virus has effectively destroyed the germinal centres in lymphatic tissue. It seems around 80% of patients with COVID-19 show evidence of a lymphopenia, particularly affecting the T cells and associated immune dysregulation. The ability of this virus to disrupt the immune response has been suggested to be associated with the fact that vaccines seem to be much more effective in generating a robust immune response. One of the main theories that attempt to explain Long Covid suggests that it reflects an ongoing immune dysregulation and autoimmunity.
There is a great deal of attention being given to the enduring immunity provided by the T and B cell responses, which again seem to be more reliably induced by vaccination.
Generally it does make sense to provide at least one dose of the vaccine in people who have had a prior infection, this does make it more likely that the person develops a good T & B cell response which induces an immune memory for the COVID-19 virus that is less variant sensitive.

https://www.frontiersin.org/articles/10.3389/fimmu.2020.596631/full

 

[artis]

However, the jury is out as to why people suffer post COVID symptoms whether it’s due to the virus still lingering in the body or from some other reason.

I don't have a reference for this now but being infected myself having spoken to doctors I would think the virus itself cannot just "linger" around in the body. The body once infected either fights off the virus at some rate so the number of infected cells decreases or if it's weak enough it cannot fight it off and the infection increases up until one or multiple organ failure like failure of lungs.

From what I know it seems that the long lasting effects are from secondary phenomena, like for example one can get scarred lungs because they were once infected and from all the inflammation etc.
I myself had rather lasting CNS effects. Surely the virus doesn't live in my nerves but something about it (not sure what exactly) causes these symptoms , I also hear from others. Symptoms like badly regulating hot/cold senses where even in hot weather one can feel sudden chills, happened to me, never before in my life only post Covid.
The same already mentioned brain fog etc.
I did many blood markers and tests and they all came back good or within the normal range yet these symptoms persisted for quite some time after, and the weird thing was that they tended to go away and then come back some days later for no apparent reason.
This was all while my tests were good and there was no left inflammation or any other physical damage within my body.From what I know the virus can either cause physical damage to organs while still in the active phase but for most it simply causes "mental" damage long afterwards , a period where the person is long free of the virus itself and even the secondary physical damage like bad blood markers etc but still experiences weakness or brain fog etc.

 

[pinball1970]

I don't have a reference for this now but being infected myself having spoken to doctors I would think the virus itself cannot just "linger" around in the body. The body once infected either fights off the virus at some rate so the number of infected cells decreases or if it's weak enough it cannot fight it off and the infection increases up until one or multiple organ failure like failure of lungs.

From what I know it seems that the long lasting effects are from secondary phenomena, like for example one can get scarred lungs because they were once infected and from all the inflammation etc.
I myself had rather lasting CNS effects. Surely the virus doesn't live in my nerves but something about it (not sure what exactly) causes these symptoms , I also hear from others. Symptoms like badly regulating hot/cold senses where even in hot weather one can feel sudden chills, happened to me, never before in my life only post Covid.
The same already mentioned brain fog etc.
I did many blood markers and tests and they all came back good or within the normal range yet these symptoms persisted for quite some time after, and the weird thing was that they tended to go away and then come back some days later for no apparent reason.
This was all while my tests were good and there was no left inflammation or any other physical damage within my body.From what I know the virus can either cause physical damage to organs while still in the active phase but for most it simply causes "mental" damage long afterwards , a period where the person is long free of the virus itself and even the secondary physical damage like bad blood markers etc but still experiences weakness or brain fog etc.

Herpes virus reside in the nerves after infection, possibly other virus can do similar
https://www.frontiersin.org/articles/10.3389/fncel.2019.00046/full

 

[jedishrfu]

Typhoid Mary had a symbiotic relationship with the typhoid bacillus. She carried it everywhere but never got sick.

Hiv Aids is another where the body can fight it off at the same rate as new viral production giving the appearence of being in remission. However after a long battle the body eventually succumbs, gets really sick and the host dies.

 

[Ygggdrasil]

One theory regarding long COVID is that it could be related to autoantibodies (antibodies that attack the body's own immune defenses or other parts of the body), which are often associated with autoimmune diseases:
https://www.nature.com/articles/d41586-021-00149-1
https://news.yale.edu/2021/05/19/rogue-antibodies-wreak-havoc-severe-covid-19-cases

 

[artis]

@jedishrfu Well I agree there are viruses that indeed once inside stay inside until you die but in that case it should be possible to actually test and see the virus either in blood or other matter so I would suspect that Covid also being a physical virus should be seen if it is indeed inside still for someone should it not?

 

[jim mcnamara]

The sequelae (long hauler symptoms) in unvaccinated patients - a short and small case study shows that a percentage of everyone: hospitalized, ICU treated, and asymptomatic patients:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560
reported symptoms.

Respondents for the questionnaire, no matter the type of case, reported. Some problems that persisted or arose after 30 days were found. Overall, the majority of patients in this study reported no problems. On the flip side of this, some complaints were fairly common, circa 40% of respondents.

Reported symptoms ranged from myocarditis, to prolonged headache. Read the short paper.

The take away is, regardless of severity, there is a segment of the patient population, reporting a long term manifestation of continuing illness. An example:

I made up the 5% shown below, there are other reports, like this one with higher percentages, and some with lower percentages, so it is an example. Not hard fact.

The problem for the US is that as of today, 19-July 2021, Worldometer reports 34,964,110 confirmed Covid-19 infections in people. So if we assume 5% of the 34+ million report sequelae, we have a 1.7 million patient population on our hands. And we are just starting to address the problems.

More details:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941645/

 

[atyy]

I made up the 5% shown below, there are other reports, like this one with higher percentages, and some with lower percentages, so it is an example. Not hard fact.

The problem for the US is that as of today, 19-July 2021, Worldometer reports 34,964,110 confirmed Covid-19 infections in people. So if we assume 5% of the 34+ million report sequelae, we have a 1.7 million patient population on our hands. And we are just starting to address the problems.

More details:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941645/

Do we have any estimates of how common longer term effects are after a flu or a cold?

 

[jim mcnamara]

@atyy - some help.

I think you want to search for 'disease burden' which the CDC catalogs. Then summarizes by year and disease (really the pathogen) - WHO does the same. It is a LOT of data. Hundreds of reportable diseases. Have fun...

COVID-19 apparently is the worst viral pathogen in terms of DLY, YLL ( and other disease burden measures) that most humans now alive will encounter in their lifetimes. Influenza 2009 H1N1 and polio (in the 1950's) were in that category, if I recall correctly.

So try to limit your digging to 2009 H1N1. MERS CoV 2012 onward is the next most recent Coronavirus that became epidemic.

Try https://www.cdc.gov/flu/about/burden/past-seasons.html first.

 

[jedishrfu]

@jedishrfu Well I agree there are viruses that indeed once inside stay inside until you die but in that case it should be possible to actually test and see the virus either in blood or other matter so I would suspect that Covid also being a physical virus should be seen if it is indeed inside still for someone should it not?

Of course you can test but some virus lie dormant in tissue. It makes no sense to test every possible hiding place to determine if it there or not.

Blood analysis makes it a more tractable problem where you can check for antibodies to the virus.

not knowing enough about this virus means we need to study it with open minds lest we miss some key dormant behavior.

 

[craig castanet]

Makes no sense to me. The CDC recommends the vaccine even if you had Covid, but that makes no immunologic sense. The CDC refers readers to another page that is supposed to provide the scientific rationale for their recommendation but going to that page simply restates their recommendation without any explanation.

 

[jim mcnamara]

Do you want the scientific papers that deal with the serology?

This is the rationale. I do not know what you saw on the CDC site.

Using serum from volunteers, all of whom had recovered from Covid, some vaccinated after infection , some not vaccinated after infection:
Vaccinated patient antibody response is up to 10 times greater against Covid-19 virus antigens (RBD -- receptor binding domain) than patients who did not receive vaccine.

That is the primary basis for the claim.

Plus the fact that some few Covid-19 recovered unvaccinated individuals in the test population showed an unexpected low antibody response compared to the population in general. Meaning that they were not fully immune to Covid.

I will dig out the links if you are going to read them. If you are not inclined, I can find the TWIV podcast on the subject.

 

[Nik_2213]

IIRC, based on antibody analysis, prior exposure to Covid gives a 'much narrower' immunity than even one (1) 'Western' vaccination. Which 'broadens' it to equivalent of two vaccinations.

IIRC, the vast majority of Covid Delta hospital admissions in US & UK are unvaccinated. I do not know what percentage have previously recovered from earlier Covid variants. As there's no clamour of "Not fair, I've had Covid !", must suppose any prior exposure was either forgettably mild or asymptomatic...

Globally, I've lost track of which Rus & Sino vacc types are considered 'efficacious', and to what extent. Sadly, the data is muddied by politics, lonnnng supply chains, some outright fraud, and vehement supplier denials that their stuff is anything less than wondrously efficacious, even against latest rampant variants...

 

[atyy]

IIRC, based on antibody analysis, prior exposure to Covid gives a 'much narrower' immunity than even one (1) 'Western' vaccination. Which 'broadens' it to equivalent of two vaccinations.

https://www.nature.com/articles/s41586-021-03696-9
Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection
Wang, Z., Muecksch, F., Schaefer-Babajew, D. et al.
Nature 595, 426–431 (2021).

 

[Nik_2213]

Does that support or counter my understanding ? Sorry, the depth of jargon defeated me...

 

[atyy]

Does that support or counter my understanding ? Sorry, the depth of jargon defeated me...

Supports.

Or at least that's what I understood them to be saying in: "Vaccination increases all components of the humoral response and, as expected, results in serum neutralizing activities against variants of concern similar to or greater than the neutralizing activity against the original Wuhan Hu-1 strain achieved by vaccination of naive individuals"

The "humoral response" is the antibody response.

Looking at papers they cite, here are other papers that reach a similar conclusion:

Stamatatos, L. et al. mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection. Science eabg9175 (2021).

Greaney, A. J. et al. The SARS-CoV-2 mRNA-1273 vaccine elicits more RBD-focused neutralization, but with broader antibody binding within the RBD.

 

[Nik_2213]

Thank you.

 

[craig castanet]

This comment is so rife with errors, that I will not respond to counter-commentary. It would be a waste of time/life.

 

[Nik_2213]

"among those affected by the recent Mass outbreak, 75% of infected individuals were fully vaccinated."

Please, please, make a distinction between 'infected' and dire disease. Remember, you'll probably get a mild infection before your vaccine-primed immune system ramps up to stomp it. Even if symptoms were so minimal, so brief that you did not notice...

With the exception of too many 'Non-Western' vaccines, due demonstrated diminished efficacy against recent variants, Covid vaccines keep you well, or 'well enough' to manage without hospitalisation. Or a stay in ICU...

UK experience is that hospitalisations for 'Covid Delta' are almost entirely among the un-vaccinated. And, looking at cases in US, the distinction is stark: Un-vaccinated ? TSB,NFC... {Expansion is brutal, NSFW.}

Delta is so much more infectious, so much more aggressive than earlier variants, and has now evolved to mostly side-step any immunity from survival of prior variant infection that, unless you have pressing medical reasons for not getting vaccinated, please, please, please get vaccinated as soon as you can.

Oh, and don't forget your decadal pneumonia vaccination, plus anything else that your MD / clinic recommends.

And the other thing ? Please seek counselling for your mega-glums...

 

[berkeman]

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