[HN Gopher] Antibody levels highly predictive of immune protecti...
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       Antibody levels highly predictive of immune protection from
       symptomatic Covid
        
       Author : georgecmu
       Score  : 65 points
       Date   : 2021-05-22 17:11 UTC (5 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | mikem170 wrote:
       | From the article, a section called "Prediction of the potential
       | for long term protection" at the bottom of the Results:
       | 
       | > The estimated neutralization level for protection from severe
       | infection is approximately sixfold lower than the level required
       | to protect from any symptomatic infection. Thus, a higher level
       | of protection against severe infection is expected for any given
       | level of vaccine efficacy against mild SARS-CoV-2 infection.
       | Assuming that this relationship remains constant over time, it
       | appears probable that immunity to severe infection may be much
       | more durable than overall immunity to any infection. Long-term
       | studies of antibody responses to vaccinia, measles, mumps or
       | rubella suggest that these responses generally stabilize with
       | half-lives of >10 years. We therefore projected beyond the
       | reported decay of SARS-CoV-2 responses (out to 8 months after
       | infection5), assuming that after 8 months following the infection
       | the decay rate will slow down. We modeled the decay rate of the
       | neutralization titer, assuming that it slowed linearly to a
       | 10-year half-life over 1, 1.5 or 2 years (details in Methods).
       | This analysis predicts that even without immune boosting, a
       | significant proportion of individuals may maintain long-term
       | protection from severe infection by an antigenically similar
       | strain, even though they may become susceptible to mild infection
       | (Fig. 3b,c).
       | 
       | Sounds like good news. This study appears to be saying that the
       | vaccines do a 6x better job of preventing severe covid infection
       | than the known 94% efficacy preventing even mild symptoms from
       | appearing, and that long term immunity [0] might be expected to
       | last decades, similar to other vaccines.
       | 
       | [0], EDIT: "long term protection against severe sickness", as
       | opposed to "immunity", as pointed out by PeterHolzwarth in
       | comment below
        
         | PeterHolzwarth wrote:
         | I believe the paper indicates otherwise, in regards to
         | immunity. To help make sense of the paper, I read this Science
         | Daily article that reviews it, and contains some comments from
         | the paper's authors.
         | 
         | https://www.sciencedaily.com/releases/2021/05/210517105727.h...
         | 
         | Here, one of the people associated with the paper mentions:
         | 
         |  _" Vaccination works very well to prevent both symptoms and
         | severe disease in the short to medium term, but efficacy is
         | predicted to decline over the first few months for most of
         | these vaccines,"_
         | 
         |  _" However, it is very important to understand the difference
         | between immunity against infection and protection from
         | developing severe disease. Our study found that a 6-fold lower
         | level of antibodies is required to protect against severe
         | disease. So even though our analysis predicts that we will
         | start losing immunity to mild infection in the first year after
         | vaccination, protection from severe infection should be longer
         | lived," says Dr Khoury._
         | 
         | Key is that distinction between immunity and protection against
         | severe sickness.
        
           | BurningFrog wrote:
           | Does _" 6-fold lower level"_ mean "a sixth of the level"?
        
             | Out_of_Characte wrote:
             | Yes
        
           | [deleted]
        
           | mikem170 wrote:
           | I added a clarifying edit to my comment above.
        
           | christkv wrote:
           | So it will become endemic and be one of the common colds ?
        
             | ed_balls wrote:
             | pretty much. This what happened with 7 cold viruses and 2*
             | flu viruses. I don't think it's realistic to destroy the
             | virus reservoirs.
             | 
             | *not sure if these are the exact number I remember from the
             | lecture.
        
             | PeterHolzwarth wrote:
             | I feel this depends on what we mean when we say "common
             | cold."
             | 
             | I perceive the topic as characterized by answers to the
             | questions of:
             | 
             | 1. How easily can I catch the virus?
             | 
             | 2. How likely am I to experience severe symptoms when
             | infected?
             | 
             | 3. Are there treatments that will significantly help me if
             | I experience severe symptoms?
             | 
             | My readings indicate covid appears to be more infectious
             | than influenza, but I do not know the comparison between
             | the common cold viruses and covid on this front.
             | 
             | I am uncertain if covid is more or less likely to cause
             | severe symptoms vs influenza. I believe, however, that the
             | viruses that represent the common cold (rhinoviruses) can
             | be definitely characterized as being much more benign in
             | regards to symptoms.
             | 
             | I feel a key issue is #3 - there are few known compounds
             | that can reliably aid in treatment of someone who is
             | experiencing severe symptoms for covid. This is an area of
             | rapidly expanding research now, of course.
        
               | guscost wrote:
               | > I believe, however, that the viruses that represent the
               | common cold (rhinoviruses) can be definitely
               | characterized as being much more benign in regards to
               | symptoms.
               | 
               | There are at least four endemic cold-coronaviruses, plus
               | the adenovirus family, plus a bunch more. The severity of
               | most of these respiratory infections depend a lot on
               | patient comorbidities, and immune history.
        
               | timr wrote:
               | The OP asked a simple question that requires no
               | definitional equivocation. You are complicating the
               | question unnecessarily.
               | 
               | The question is: will the virus become endemic. The
               | simple answer is "yes", because it is _already endemic_ :
               | it has multiple mammalian reservoirs, is found in every
               | country on earth, and is ubiquitous in the human
               | population. It is endemic.
               | 
               | Theories about severity, treatment, etc., are completely
               | irrelevant.
        
               | jacobmischka wrote:
               | How is it irrelevant? It seems like some of the most
               | relevant considerations when explicitly asking about
               | something compared to the common cold, which is exactly
               | what they did.
               | 
               | This was a super weird reaction to someone's detailed yet
               | brief and thoughtful response.
        
               | anamexis wrote:
               | And the second half of the question is "and be one of the
               | common colds," which is exactly what GP was responding
               | to..
        
             | belltaco wrote:
             | Not if a significant fraction refuses to get vaccinated.
        
       | AlexCoventry wrote:
       | I'm a little surprised this is in nature... Isn't that exactly
       | what you'd expect?
        
         | dEnigma wrote:
         | But not everything turns out as you'd expect, so it's important
         | to actually test and provide evidence.
        
           | AlexCoventry wrote:
           | Yeah, it just seems unusual for Nature to publish such a
           | confirmatory outcome.
        
         | noodlenotes wrote:
         | The headline might be what you expect, but the article contains
         | mathematical details about the relationship between antibody
         | levels from the vaccines and neutralization. It also models
         | antibody levels over time to see what immune protection we'll
         | have in the future. Did we know the expected efficacy of the
         | vaccine against severe Covid 750 days post-vaccine before?
        
       | The_rationalist wrote:
       | I wonder whether bromantane can help with the covid response
        
       | xiphias2 wrote:
       | My father tested negative for spike specific antibodies 2 weeks
       | after the 2nd Pfizer vaccine (he's not the only one), and as I
       | didn't find any data on people who test negative (and I know that
       | the vaccine has 94% efficiency preventing COVID), he's still
       | mostly not leaving his apartment.
       | 
       | He'll have a test against the viruses themselves next week, but
       | he'll need to wait 2 weeks for the result for that test.
        
         | yosito wrote:
         | I wonder if an expert could chime in on this. If someone tests
         | negative for antibodies a few weeks after a vaccine, should
         | that person get vaccinated again? Maybe with a different
         | vaccine?
        
         | tdeck wrote:
         | How did he happen to get that antibody test?
        
           | xiphias2 wrote:
           | A nurse came to his apartment to take the test (I payed for
           | it)
        
             | tdeck wrote:
             | That's cool! I had no idea those were available to the
             | general public.
        
         | rgbbtc4life wrote:
         | If the vaccine is truly 95% effective in preventing infection,
         | how did 9 fully vaccinated Yankees players all contract the
         | virus?
        
           | [deleted]
        
           | BurningFrog wrote:
           | Part of it is probably that these people get tested very
           | often.
           | 
           | The "95% protection rate" doesn't really mean people don't
           | get infected. Vaccinated people get in contact with as much
           | virus as others.
           | 
           | What it means is their immune system defeats 95% of the
           | infections before you notice you're sick.
           | 
           | But if you get a test while your body is in the middle of
           | crushing such a small infection, you'll test positive.
        
           | neither_color wrote:
           | 5% of one hundred million people is 5 million people.
        
           | verdverm wrote:
           | 1. It was a single player, the rest were other staff
           | 
           | 2. Vaccines don't prevent infection, they reduce severity by
           | training the body's immune system. Natural exposure works the
           | same way. This it is not surprising that 8/9 Yankees which
           | tested positive were asymptomatic
        
             | atty wrote:
             | This is incorrect - from population studies, we now know
             | that both the mRNA vaccines reduce infection rates and
             | reduce severity of symptoms for those who do get infected.
             | In fact, they both show about 90% efficacy at preventing
             | infection at all. That number is probably trending down a
             | bit with all the new strains, but it is still very high.
        
               | _coveredInBees wrote:
               | The Yankee players all had J&J vaccines, so not the mRNA
               | variety.
        
               | verdverm wrote:
               | https://www.cnn.com/2021/05/20/health/yankees-
               | covid-19-break...
               | 
               | The Yankees are reported to be using the J&J vaccine,
               | which is a viral vector product.
        
               | verdverm wrote:
               | I suppose that depends on how infection is defined.
               | Nothing prevents the virus from entering the body and
               | triggering a positive test result, especially when the
               | tests are run with longer cycle times
        
             | standardUser wrote:
             | I don't know where this misinformation came form, but it is
             | absolutely false. COVID vaccines have been shown to prevent
             | infection...
             | 
             | https://www.cdc.gov/media/releases/2021/p0329-COVID-19-Vacc
             | i....
        
           | legobmw99 wrote:
           | I think most ball players got J&J, which has a decently lower
           | prevention number. The encouraging news was that they all
           | ended up asymptomatic, which is the next best thing
        
             | _coveredInBees wrote:
             | Yes, All of the Yankee players who were vaccinated had J&J.
             | Also, most were completely asymptomatic and no one had
             | serious symptoms. All-in-all, it was a success story for
             | vaccines.
        
         | inter_netuser wrote:
         | Has he been tested for immune deficiencies? What is his age?
         | Have a contact that's an NIH immunologist, want to get his
         | opinion.
         | 
         | tia
        
         | azinman2 wrote:
         | That doesn't mean he doesn't have protection. The antibody
         | tests only look For one thing, but the body has many mechanisms
         | of protection from the vaccine. That is one of the reasons why
         | they're not suggested to be used for the general population.
        
           | xiphias2 wrote:
           | I know that it doesn't mean that he isn't protected, but I
           | didn't find data on the protection against severe covid
           | disease with the conditional probability of spike specific
           | antibody test being negative after being properly vaccinated.
           | Instead of just guidance I would like to see data.
           | 
           | Anyways that's why there are specific, slower test that can
           | test his protection against specific virus mutations.
        
       | rgbbtc4life wrote:
       | The people achieving immunity through vaccination are at a huge
       | disadvantage compared to those with natural immunity. As shown in
       | research from the other day, natural antibodies target several
       | proteins and more of the spike protein than Pfizer immunity does.
       | Additionally, natural immunity stimulates both the innate immune
       | response and killer T cell response.
       | 
       | I wouldn't be surprised if we start seeing ADE among vaccinated
       | individuals - there's a good chance their antibodies will be non
       | neutralizing when challenged with live virus a year from now.
       | 
       | Also, it appears governments are motivated to hide information
       | about the vaccine. It's come out the CDC is performing PCR
       | testing for vaccinated individuals with a lower cycle count than
       | for the unvaccinated. There's no reason to trust anything coming
       | out of the CDC with regards to vaccination.
        
         | bandyaboot wrote:
         | Do you have a link to the research you're citing from the other
         | day? Also the basis for your implication that there's a known
         | difference in T cell response for natural immunity vs vaccine
         | immunity?
        
           | rgbbtc4life wrote:
           | Natural antibodies target several proteins:
           | https://directorsblog.nih.gov/2021/05/18/human-antibodies-
           | ta...
           | 
           | Natural immunity robust and long lasting:
           | https://www.nytimes.com/2020/11/17/health/coronavirus-
           | immuni...
           | 
           | Killer t cell importance:
           | https://www.nature.com/articles/d41586-021-00367-7
        
             | tzs wrote:
             | Both the Pfizer and Moderna vaccines cause production of
             | the full COVID spike protein. There is no reason to believe
             | or even suspect that antibodies produced in response to
             | that do not target the same regions of that spike protein
             | that they would if produced in response to spike protein
             | from the actual virus.
        
             | bandyaboot wrote:
             | That antibody research doesn't seem to support your initial
             | assertion of vaccinated individuals being at a huge
             | disadvantage compared to those with natural immunity. Your
             | point about T cell response seems reasonable. A natural T
             | cell response may be able to target internal viral
             | proteins. But backing up a bit, I'm struggling to find the
             | overall "so what". If a person is worried about getting
             | covid and doesn't want to be at a "disadvantage" they
             | should...get covid?
        
         | tryonenow wrote:
         | The high cycle counts of the PCR tests in the US make all
         | official numbers suspect. Particularly in combination with
         | implicit political pressure against the previous
         | administration, and an overzealous press. The entire system -
         | academic, medical, news and entertainment - is rotten with bias
         | and society collectively is worse off for it, especially with
         | respect to handling this pandemic.
         | 
         | It's hard to find a source now but these PCR tests were being
         | run with cycle counts anywhere from 30-40; in this regime you
         | are extremely likely to amplify noise and generate a huge
         | percentage of false positives. The inventor of the PCR tests
         | made similar comments regarding abuse of the PCR process during
         | the HIV/aids pandemic - and wouldn't you know it, Dr. Fauci was
         | involved in [mis]managing that pandemic as well. His self
         | serving publication and premature press release created an
         | ultimately unfounded stigma around HIV positivity. There is
         | simply no reason to trust the guy now, regardless of his
         | overtly warm, anti-trump persona. And now he has repeatedly
         | denied before congress that he was affiliated with
         | funding/conducting gain of function research on bat
         | coronaviruses. But the publications, with authors publicly and
         | directly linked to Fauci and funds he managed, are freely
         | available online. This should be a far bigger story.
        
         | t-writescode wrote:
         | How does your argument here correspond with the numerous
         | articles discussing how the mRNA vaccines are effective against
         | the numerous variants?
         | 
         | There's a big scare every time there's a new variant, followed
         | by another article a couple weeks later about how the vaccine
         | is X > 50% effective against [ new variant ].
        
         | standardUser wrote:
         | "It's come out the CDC is performing PCR testing for vaccinated
         | individuals with a lower cycle count than for the
         | unvaccinated."
         | 
         | Do you have anything to back up this conspiracy theory? I'm
         | also wondering how many of the ~1 million tests per day are
         | being performed by the CDC itself?
        
         | [deleted]
        
         | grej wrote:
         | I don't believe this is clear at all. So far, it actually seems
         | the mRNA vaccines as well as the viral vector vaccines greatly
         | attenuate the severity of COVID among those who do catch a
         | variant.
        
           | rgbbtc4life wrote:
           | There is only one study to estimate the effectiveness of the
           | mrna vaccines. It was quite small, and performed only on
           | those who received pristine mrna injections.
           | 
           | It's come out that the mass produced vaccine has significant
           | mrna degradation. It's unclear how many people's vaccines
           | were even effective.
           | 
           | Additionally you have 9 Yankees players who were fully
           | vaccinated contracting the virus, so its not 95% effective in
           | preventing infection and there's a very real risk of Merek's
           | disease as a result.
           | 
           | Furthermore, Pfizer is on record as saying a 3rd dose will be
           | needed. Meanwhile, natural immunity has been shown to be
           | robust and long lasting.
        
             | truantbuick wrote:
             | AFAIK the only player to have tested positive for COVID in
             | that outbreak is Gleyber Torres (the rest were support
             | staff), who had an actual COVID infection before, which
             | undermines your idea that getting COVID is somehow superior
             | to getting vaccinated.
             | 
             | And as already mentioned, the Yankees received the J&J
             | vaccine, which is not an MRNA vaccine.
        
             | t-writescode wrote:
             | The Yankees were given the J&J vaccine, not an mRNA
             | vaccine. https://edition.cnn.com/2021/05/13/sport/yankees-
             | test-positi...
             | 
             | Are you scared? Or intentionally spreading misinformation?
        
             | [deleted]
        
         | rgbbtc4life wrote:
         | Naturally the hacker's echo chamber will downvote my wrongthink
         | into oblivion. I hate this community. Proceed to shadowban
         | everyone you disagree with. Bye.
        
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