[HN Gopher] Should individuals who already had a SARS-CoV-2 infe...
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       Should individuals who already had a SARS-CoV-2 infection receive 1
       or 2 shots? [pdf]
        
       Author : tosh
       Score  : 23 points
       Date   : 2021-02-01 18:59 UTC (4 hours ago)
        
 (HTM) web link (www.medrxiv.org)
 (TXT) w3m dump (www.medrxiv.org)
        
       | call_me_dana wrote:
       | None? Or are we supposed to believe synthetic gene therapy will
       | do a better job than, you know, nature.
       | 
       | I suspect we'll never know the actual answer because of a very
       | simple reason: a for profit medical system that incentivizes
       | medical interventions over outcome will naturally push what makes
       | them money whether it works or not. Hence the title of this
       | article, notice the lack of "0" or "should they get a shot at
       | all?"
       | 
       | For those that are saying "trust the science!", that sounds
       | really good on paper but lets be real, medical science was
       | compromised a long time ago. Why would a corporation with
       | shareholders publish studies that directly conflict with their
       | business model? They wouldn't.
       | 
       | And if that's not enough, any Covid-19 study that uses a PCR test
       | should include the number of RT cycles used. If that threshold is
       | not noted anywhere, the information can't be relied upon as
       | accurate and it's as good as useless.
       | 
       | For fun, go pick a few Covid-19 related studies and see if you
       | can find where the PCR test threshold is noted. I'll save you the
       | trouble, it's not there.
        
         | jhayward wrote:
         | The number of anti-science misinformation red flags in this are
         | remarkable.
         | 
         | Yes, there is strong evidence that vaccine-derived immunity is
         | quite a bit more protective (as evidenced by antibody titers)
         | than disease-acquired immunity.
         | 
         | The PCR cycle number misinformation is the current tinfoil
         | being used to try to claim that there is no "real" epidemic,
         | just false positive testing for some nefarious purpose. It's
         | nonsense. The case number (ie, positive tests) strongly
         | correlate to hospital admissions, which are strongly correlated
         | with deaths, which are not f*cking false positives.
         | 
         | So just stop this nonsense please.
        
           | beagle3 wrote:
           | I have verified that indeed case counts by PCR correlate with
           | hospitalizations and death. It's a good indicator.
           | 
           | I am, however, puzzled by the refusal of testing facilities
           | to actually disclose what cycle count they are using. It
           | could be too high, it could be too low, it's likely "just
           | right". But "trust me I am doing it right" is the wrong
           | answer to someone who hasn't yet made up their mind.
        
       | ynfnehf wrote:
       | It is certainly of scientific interest to know these things. But
       | I suspect the logistics of finding out who already have been
       | infected, and only giving them one/zero doses, is not going to be
       | worth it. And even then, only a small portion of the population
       | have a confirmed infection.
       | 
       | In the coming months a very large amount of vaccines is going to
       | arrive in most (western/rich) countries. It is then no longer
       | going to be important to optimize exactly who gets the vaccine,
       | but instead to increase the vaccination rate.
        
         | Animats wrote:
         | Yes. _" Using quantitative serological assays that measure
         | antibodies to the spike protein could be used to screen
         | individuals prior to vaccination if the infection history is
         | unknown."_ So it's possible, with enough testing, to see if
         | someone really needs a second shot of vaccine. Then, of course,
         | follow up after a month, and probably again later, to see how
         | it worked.
        
           | ynfnehf wrote:
           | That is the logistics I'm talking about. Testing was
           | incredibly slow to scale up last spring, and scaling up tests
           | for antibodies as well seems like unnecessary complication.
           | We need fewer moving parts, not more.
        
       | NkVczPkybiXICG wrote:
       | 0 shots... obviously?
        
         | zender12 wrote:
         | If the previous infection had only mild symptoms then probably
         | any vaccine would indeed be a waste. After all, the vaccine
         | manufacturers only claim to lower the severity of the disease
         | but not the infectiousness.
        
           | vkou wrote:
           | Vaccine manufacturers only claim this, because that is the
           | only claim that they have the data to make, beyond a
           | reasonable doubt.
           | 
           | It's entirely possible that the vaccine also lowers the
           | infectiousness. We don't know either way, though, because the
           | data from the studies isn't in yet.
        
         | scrollaway wrote:
         | There is nothing obvious about anything like that.
        
           | tomp wrote:
           | Why not?
           | 
           | Vaccines don't actually protect you against the virus, they
           | just activate your immune system (your body's natural
           | protection). Guess what else also activates the immune
           | system? The actual virus!
           | 
           | At the beginning of the pandemic, there was some talk that
           | anti-bodies might not last longer than 3 months, but that was
           | obviously just FUD (there was literally no data). I had
           | antibodies 6 months after being infected. Two additional
           | things I heard (but don't have the source), your body can
           | restart production of antibodies (B-cells remember), and
           | people had SARS(-CoV-1) antibodies years after infection.
           | 
           | Finally, this: https://www.ft.com/content/929ef3cd-8611-49b2-
           | 9f23-918dc3470... _Covid infection shown to provide as much
           | immunity as vaccines_ - I haven 't checked the source but FT
           | isn't really known for fake news.
           | 
           | Are there any credible studies that say that infection _doesn
           | 't_ confer immunity?
        
             | unanswered wrote:
             | > Are there any credible studies that say that infection
             | doesn't confer immunity?
             | 
             | Of course! Economic studies said that vaccine manufacturers
             | might not make as much of their investment back if
             | infection confers immunity, so we can conclude that
             | infection doesn't confer immunity.
        
             | call_me_dana wrote:
             | Trying to figure out why a perfectly logical train of
             | thought like this is getting downvoted
        
             | scrollaway wrote:
             | > _Why not?_
             | 
             | Something can feel instinctively correct and not be
             | correct. For example, the sun going around the earth, or
             | the earth being flat, for that matter.
             | 
             | I'm not saying it should be 0, 1, 2 or 10 shots; I'm saying
             | the answer is absolutely not obvious, even if you
             | instinctively want to say zero.
             | 
             | In a world where we're lacking information, the default
             | _should_ probably be zero. But given that this is a
             | worldwide pandemic, we 're not going to be running out of
             | information any time soon, so it's good it's being studied.
        
             | [deleted]
        
         | anonuser123456 wrote:
         | The immune response from a vaccine can differ considerably from
         | an actual infection.
        
           | postalrat wrote:
           | At this point isn't the immune response from an infection
           | pretty well known? I'd say more well known than the response
           | from a vaccine.
           | 
           | I fail to any disadvantage of "0 shots" other than people not
           | getting the vaccine because they think they had covid but
           | didn't.
           | 
           | But then again the entire public policy around covid has been
           | to treat the entire population as morons that wouldn't make
           | the decisions thought to be correct on their own.
        
         | jlokier wrote:
         | Not obvious, and probably incorrect.
         | 
         | The immunity induced by the vaccines is said to be potentially
         | more effective and/or longer-lasting than the immunity obtained
         | from a prior infection.
         | 
         | There is also an open question about whether people who are
         | sufficiently immune from prior infection that they won't get
         | serious symptoms are still able to pass the virus to others
         | during a "fighting it off again successfully" phase.
         | 
         | Immunity is not a simple yes-no boolean. It's not even a single
         | variable, because there are different parts of the immune
         | system memory.
        
           | tomp wrote:
           | _> There is also an open question about whether people who
           | are sufficiently immune from prior infection that they won 't
           | get serious symptoms are still able to pass the virus to
           | others during a "fighting it off again successfully" phase._
           | 
           | Isn't this just as much an open question with vaccines? AFAIK
           | the main vaccine trials were only checking for _symptoms_ (so
           | you could still be asymptomatic  & transmitting the virus).
        
             | lsllc wrote:
             | FWIW, US Rep. Stephen Lynch (D-MA) tested positive on
             | Friday for COVID after being exposed to an infected
             | staffer. He had received the 2nd vaccine shot prior to the
             | inauguration:
             | 
             | https://www.cnn.com/2021/01/30/politics/stephen-lynch-
             | tests-...
        
               | worker767424 wrote:
               | > FWIW
               | 
               | It's worth basically nothing. We already know it's 95%
               | effective; someone has to be the 5%, and there's a
               | publication bias towards reporting on those.
        
           | worker767424 wrote:
           | Long-term, I agree, vaccines are generally (depends on the
           | vaccine) more effective, but when we're dealing with a
           | vaccine shortage, deprioritizing people who already have
           | antibodies isn't necessarily crazy. I had doubts about
           | prioritizing hospital staff who work with covid patients
           | because they might have already been exposed (I haven't seen
           | any data either way on this), but they also arguably "earned"
           | it by being on the front line, so I'm not complaining too
           | much, either.
        
       | tosh wrote:
       | the gist
       | 
       | > In this short report, we show that the antibody response to the
       | first vaccine dose in individuals with pre-existing immunity is
       | equal to or even exceeds the titers found in naive individuals
       | after the second dose. We also show that the reactogenicity is
       | significantly higher in individuals who have been infected with
       | SARS-CoV-2 in the past. Changing the policy to give these
       | individuals only one dose of vaccine would not negatively impact
       | on their antibody titers, spare them from unnecessary pain and
       | free up many urgently needed vaccine doses.
        
       | mensetmanusman wrote:
       | Your body throws the kitchen sink at SARS-CoV-2, it may generate
       | spike-based antibodies, but it also might generate core-shell-
       | based antibodies, which might mutate more (and therefore bypass
       | acquired immunity in the future).
       | 
       | That's one reason why spike-based mRNA vaccines are so
       | exciting...
        
       | handoflixue wrote:
       | While "zero" obviously isn't the answer long term, I do think
       | it's a reasonable one in the short term: The re-infection rate is
       | clearly less than 1% given we only have a few anecdotal edge-
       | cases there, so "being infected" clearly establishes solid
       | protection. The first peak of the pandemic was 9 months ago, and
       | we're still not seeing re-infections rise, so there's no reason
       | to think this infection-based immunity is short-lived.
       | 
       | Obviously there might be long-term benefits to still vaccinating
       | such people, but right now we're dealing with a very limited
       | resource. Giving the vaccine to someone who hasn't been infected
       | is a huge gain (say, 0% to 60% protection), while the second shot
       | is a smaller gain (say, 60% to 90%), and someone who already has
       | natural immunity is probably even smaller yet (say, 90% to 99%)
       | 
       | (Numbers are off-the-top-of-my-head and meant to indicate
       | magnitude not an exact value)
        
         | lend000 wrote:
         | What is your source for reinfection rate less than 1%? It seems
         | much higher based on the recent second wave in Manaus [0].
         | 
         | [0] https://www.cidrap.umn.edu/news-
         | perspective/2021/01/variant-...
        
           | Exmoor wrote:
           | Here's a source for the reinfection rate. I've seen a few
           | studies that all came to the < 1% conclusion:
           | 
           | https://www.medrxiv.org/content/10.1101/2021.01.15.21249731v.
           | ..
           | 
           | The Manaus data is _interesting_. The basis for assuming
           | there 's reinfection happening seems to be a seroprevalence
           | survey done over the summer which estimated 76% of the
           | population had antibodies to the virus. The accuracy of that
           | survey has been called into question for a variety of
           | reasons. The survey was done through blood donors and
           | apparently they incentivized blood donation by offering
           | people the results of their antibodies test as part of
           | donation. Since testing capacity during peak infection was
           | limited, this would give people who thought they might have
           | had the virus (and likely did) incentive to donate blood and
           | made the sample not nearly as random as it was presented to
           | be.
        
             | timr wrote:
             | > The basis for assuming there's reinfection happening
             | seems to be a seroprevalence survey done over the summer
             | which estimated 76% of the population had antibodies to the
             | virus. The accuracy of that survey has been called into
             | question for a variety of reasons.
             | 
             | This is exactly correct. Extrapolating from the Manaus
             | seroprevalence paper is scientifically tenuous, at best.
             | They say so in the Lancet commentary cited in the CIDRAP
             | piece cited by OP:
             | 
             |  _" In the Lancet report, experts said four factors may be
             | at play, some possibly related. First, scientists might
             | have overestimated the attack rate for the first surge, and
             | infections might have been below the herd immunity
             | threshold"_
             | 
             | > The survey was done through blood donors and apparently
             | they incentivized blood donation by offering people the
             | results of their antibodies test as part of donation. Since
             | testing capacity during peak infection was limited, this
             | would give people who thought they might have had the virus
             | (and likely did) incentive to donate blood and made the
             | sample not nearly as random as it was presented to be.
             | 
             | Not just that, but if you read the paper carefully, you'll
             | see that they've applied a number of fairly arbitrary
             | "corrections" to the data, which pull the seroprevalence
             | from an observed 20% range up to the cited "76%" number
             | (Figure 2A in this link):
             | 
             | https://science.sciencemag.org/content/371/6526/288
             | 
             | While any of these adjustments might be individually
             | merited, when you see a >300% aggregate "adjustment" to the
             | raw data, it should make you _very_ skeptical about any
             | claims made with that data. Particularly when the raw data
             | is _below_ the likely herd-immunity threshold, and has been
             | "corrected" to be _above it_.
             | 
             | More simply: the most likely conclusion is that the
             | original paper was wrong.
             | 
             | This is perfect example of bad science being propagated by
             | journal title and headline. Whomever wrote that (IMHO,
             | terrible, editorialized) CIDRAP piece didn't bother to read
             | the original data, and just took the first paper's claim at
             | face value. Journalists have been (and continue to be)
             | insufficiently skeptical when it comes to Covid science --
             | except when it suits the narrative they're trying to
             | create. If a paper supports their desired narrative, any
             | half-baked, highly implausible claim is treated as worth
             | serious consideration. If a paper conflicts with their
             | claim, no counterargument is too implausible to be
             | considered.
        
           | LeoNatan25 wrote:
           | Isn't that an antibody-escaping variant? Existing vaccines
           | aren't very efficacious for that variant either.
        
             | LeoNatan25 wrote:
             | My comment is being downvoted by an emotional crowd, it
             | seems, but read this:
             | https://www.biorxiv.org/content/10.1101/2021.01.15.426911v1
             | 
             | "Our experiments indicate that these variants, and
             | potentially others that carry K417N/T, E484K and N501Y
             | mutations, can reduce the neutralization potency of
             | vaccinee plasma."
             | 
             | Preprint, not peer-reviewed, but still concerning.
        
       | andred14 wrote:
       | Stay away from these untested drugs. The satan1c ped0phile
       | eugenicists that made them are trying to kill you.
       | 
       | Please learn about these dangerous new vacc1nes:
       | 
       | https://www.bitchute.com/video/KAzUeDrgijM3/
        
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