[HN Gopher] Is one vaccine dose enough if you've had Covid? What...
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       Is one vaccine dose enough if you've had Covid? What the science
       says
        
       Author : dsr12
       Score  : 29 points
       Date   : 2021-06-27 17:31 UTC (5 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | macinjosh wrote:
       | Natural immunity is way better than any vaccine. You don't need a
       | vaccine if you already have antibodies.
        
       | Scoundreller wrote:
       | > France, Germany and Italy, among other countries, now advise
       | only one dose of vaccine for people with a healthy immune system
       | and a confirmed previous diagnosis. Many scientists who have
       | studied immune responses to vaccination say such policies are a
       | sensible way to make the most of limited supplies in countries
       | that are racing to inoculate their populations.
       | 
       | At least for France, their Infectious Disease professionals go
       | further. They're of the opinion that a second dose in someone
       | that's been infected (within a certain range of time) is
       | subjecting them to unnecessary treatment, wasted time and side
       | effects for no/limited benefit.
       | 
       | It's not to make the most of limited supplies.
       | 
       | Auto-translation (with some readability tweaks):
       | 
       | > If the second dose of vaccine has already been administered to
       | people with a history of infection with SARS-Cov-2, the data
       | available to date do not show any difference in the safety
       | profile apart from the occurrence of more common systemic
       | reactions.
       | 
       | https://www.has-sante.fr/jcms/p_3237271/en/strategie-de-vacc...
       | 
       | But questioning the value of a vaccine under any circumstances is
       | ban-worthy in a lot of places.
        
       | kriskrunch wrote:
       | The study used 26 participants? Did I read that right?
       | 
       | What is the preferred sample size to back these sorts of claims?
        
         | Scoundreller wrote:
         | Not sure why they'd focus on a study out this week, there have
         | been several others, e.g. the first 5 references in this Letter
         | published a month ago:
         | https://www.thelancet.com/journals/ebiom/article/PIIS2352-39...
        
       | 123pie123 wrote:
       | Why doesn't getting Covid and then allowing your body to produce
       | your own immunity not protect you from getting it again?
       | 
       | As I understand the variants are not like the flu or the cold
       | (yet!)
        
         | crazygringo wrote:
         | It probably does.
         | 
         | We just haven't had enough time to prove it yet, or to
         | investigate the differences between variants.
        
           | raarts wrote:
           | According to this (preprint) paper(n=52000), recovering from
           | covid-19 protects just as well (or even slightly better) than
           | getting vaccinated.
           | 
           | Also note that vaccines focus on the Spike protein only, and
           | you're immunesystem takes the entire virus into account,
           | which might offer better protection against variants.
           | 
           | https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v.
           | ..
        
             | thedrbrian wrote:
             | PHE are doing one too:-
             | 
             | https://www.gov.uk/government/news/past-
             | covid-19-infection-p...
             | 
             | >>PHE scientists working on the study have concluded
             | naturally acquired immunity as a result of past infections
             | provide 83% protection against reinfection, compared to
             | people who have not had the disease before. This appears to
             | last at least for 5 months from first becoming sick.
        
         | uryga wrote:
         | iirc for some reason the amount of antibodies you have falls
         | sharply after 1-3 months and you're vulnerable again.
         | anecdotally, a friend of a friend (EMT) had covid like 4 times
         | before vaccines were available.
        
           | furgooswft13 wrote:
           | Can someone explain why this would not be the case for
           | vaccines?
           | 
           | If antibodies fall off quickly from an actual infection, why
           | would this not also happen for the antibodies produced
           | because of taking the vaccine?
        
           | strogonoff wrote:
           | Antibody count falls at first, but relevant antibody-
           | producing cells were found[0] to remain in the bone marrow. I
           | suppose it is not the only determining factor in
           | susceptibility to symptomatic infection, though.
           | 
           | I'd be curious if currently available vaccines stimulate such
           | preexisting antibody-producing bone marrow cells of past
           | COVID patients (which sounds more optimal on the face of it),
           | or they trigger yet another variety of antibodies to be
           | produced in addition to the "native" one.
           | 
           | [0] https://www.nature.com/articles/d41586-021-01442-9#ref-
           | CR1 "Had COVID? You'll probably make antibodies for a
           | lifetime"
        
           | mfkdkslsn wrote:
           | Bullshit. SARS 1 produces immunity against COVID and every
           | other coronavirus has natural immunity. Your friend had some
           | colds, the flu, maybe COVID once, and potentially false
           | positive tests.
           | 
           | Antibodies do drop but they're not the only part of the
           | immune system. T cells have memory and will remember the
           | antigen
        
             | 123pie123 wrote:
             | this video is good simple(ish) explaination - note it says
             | bacteria, but the vid is for most things that are invasive
             | 
             | https://www.youtube.com/watch?v=zQGOcOUBi6s&list=PLsboZGJ1J
             | M...
             | 
             | It's from the Kurzgesagt - In a Nutshell channel
        
       | djrogers wrote:
       | > Research shows that a previous coronavirus infection plus one
       | dose of vaccine provides powerful protection -- but concerns
       | linger
       | 
       | This is one thing that's been incredibly frustrating throughout
       | this whole pandemic. Studies and research will show B, with no
       | sign of A, however inertia/politics/fear/ignorance will continue
       | to push A to the point of harm.
       | 
       | An example - a local store was insisting on wiping down the
       | entire checkout conveyor with alcohol between every single
       | customer until very recently, when we've know for a long time
       | that you won't get COVID from that.
        
         | avian wrote:
         | > a local store was insisting on wiping down the entire
         | checkout conveyor with alcohol between every single customer
         | until very recently, when we've know for a long time that you
         | won't get COVID from that.
         | 
         | As someone from a country where running orders are still to
         | disinfect often-touched surfaces (switches, door handles,
         | office desks, etc.) I was surprised by this.
         | 
         | I went to check what CDC from US recommends. It turns out it's
         | pretty much the same:
         | 
         | > Clean high touch surfaces daily. This includes tables,
         | doorknobs, light switches, countertops, handles, desks, phones,
         | keyboards, toilets, faucets, and sinks.
         | 
         | (from https://www.cdc.gov/coronavirus/2019-ncov/prevent-
         | getting-si...)
         | 
         | So maybe wiping down the belt between _every_ customer is a bit
         | excessive, but it seems my sources don 't agree with the "you
         | don't get COVID from that" part.
        
           | unpolloloco wrote:
           | https://www.nature.com/articles/d41586-021-00251-4
           | 
           | Cleaning for an airborne illness is just theater. Upgrading
           | air handlers, increasing airflow, and spacing people further
           | apart matter. Cleaning stuff randomly just makes people feel
           | better (but can make good business sense because of this!)
        
             | clairity wrote:
             | yes, cleaning surfaces regularly (but not excessively) is
             | good for a variety of reasons, but not for covid. the
             | airflow concern is also overblown though. you really just
             | need modest distancing indoors (or masks, absent modest
             | distancing). no need for fancy airflow handling. covid
             | isn't a robust virus that, as it's tiny water-bubble craft
             | rapidly evaporates, quickly falls apart outside the body
             | (similar to why surfaces aren't a concern).
        
         | konschubert wrote:
         | Security theatre.
         | 
         | It's about feeling safe, not about being safe.
        
       | the_laka wrote:
       | I wish there was an easier way to figure out if you had COVID.
       | 
       | As someone who's only got one dose so far, I would gladly skip
       | the second one if I knew for certain I had COVID before, so
       | someone else could get my second dose.
        
         | dataflow wrote:
         | [never mind]
        
           | taxicabjesus wrote:
           | The US is in desperate need of people who are willing to take
           | all the vaccines the government has purchased for us. What's
           | the shelf life on the mRNA products? Looks like Moderna's
           | lasts for six months in the freezer. Pfizer for 30 days on
           | dry ice, another 30 days in a regular freezer?
           | 
           | Lots of doses are going to get tossed. Most the people who
           | are going to get the shot have gotten it already.
        
           | sologoub wrote:
           | The article is not advocating doing anything unsafe or
           | otherwise endangering others. The scientific question is
           | quite valid - do we have to use our limited vaccine supply to
           | ensure all get two doses or can we save a dose on those who
           | already had COVID and give it to someone who needs it?
           | 
           | First paragraph of the article: "Many people who've been
           | infected with the coronavirus might be able to safely skip
           | the second jab of any two-dose vaccine regimen, a growing
           | number of studies suggest. These results could help to
           | stretch scarce vaccine supplies and are already influencing
           | vaccination policies in some countries."
           | 
           | US might have enough for everyone, and wouldn't it be also
           | great if we didn't need as many doses and could share with
           | hard hit places like India? I see this as a net positive if
           | true.
        
         | nikstar wrote:
         | A test for antibodies against N protein will tell you if you
         | had COVID or not.
        
         | johtso wrote:
         | T-cell tests are available in some places now.
         | 
         | https://www.tspotcovid.com/
        
         | crazygringo wrote:
         | Did you not get an antibody test at some point prior to the
         | vaccine? That would have given you an answer with 99% certainty
         | if you used a good one.
        
           | bpodgursky wrote:
           | Antibody tests were only widely available in July-August, so
           | people who got COVID in Feb or March often didn't have high
           | enough antibody counts by that point to flag positive on the
           | tests.
        
             | crazygringo wrote:
             | That's not true.
             | 
             | The half-life of antibody levels has been estimated at 73
             | days. The antibody tests are quite sensitive, time has not
             | been enough of a factor yet to produce false negatives. In
             | a year or two it might be.
             | 
             | The only time concern is that you need to wait 2-3 weeks
             | until _after_ you recover from COVID to ensure you test
             | positive.
        
           | briefcomment wrote:
           | I think they are relatively expensive, ~$200. Probably worth
           | it though.
           | 
           | We would need some form of official recognition of antibody
           | tests though. Pretty sure most places that require
           | vaccination don't accept antibody test results.
        
             | alkonaut wrote:
             | Antibody tests at the supermarket clinic here is $40.
             | Unsure if that's a crappy test or if any subsidy is
             | provided. $40 vs $200 does seem like the usual EU vs US
             | markup too I guess
        
               | briefcomment wrote:
               | Ah, not bad
        
             | colospoin wrote:
             | I believe the Red Cross tests for the antibody when you
             | give blood, as well.
        
             | crazygringo wrote:
             | Antibody tests have been widely made available for free
             | across the developed world.
             | 
             | In NYC, for example, they've been available for free at a
             | ton of different sites. It may always be as convenient or
             | quick, but it's free.
        
         | bootlooped wrote:
         | Don't some antibody tests do this? I think antibody tests that
         | detect antibodies to the nucleocapsid should be unaffected by
         | the vaccines, which only spur resistance to the spike protein.
         | 
         | See the section called "Binding Antibody Tests" here:
         | 
         | https://creakyjoints.org/living-with-arthritis/coronavirus/c...
        
           | DiogenesKynikos wrote:
           | This is true of some - but not all - of the vaccines. The
           | whole inactivated virus vaccines contain more than the spike,
           | but the mRNA and vector vaccines only contain the spike.
        
       | sigstoat wrote:
       | seems like there's some consensus on two "exposures" worth of
       | immunity being valuable.
       | 
       | any data on second shots for folks who took the J&J?
        
         | Scoundreller wrote:
         | The cynical part of me thinks that J&J is only 1 shot because
         | your body develops strong immunity to it adenovirus-26 vector,
         | so a 2nd shot would get immediately killed off before its spike
         | protein payload could take any action. Until your immunity to
         | it wanes anyway.
        
           | Throwawayaerlei wrote:
           | This is suspected to be a problem with the Oxford vaccine
           | which also uses one virus vector for both doses.
           | 
           | Like Sputnik V, J&J's Janssen unit's Ebola vaccine uses two
           | different virus vectors. And Janssen is doing an ENSEMBLE 2
           | Phase III clinical trial with two doses eight weeks apart
           | that lol768 mentions. But their primary objective stated from
           | the very beginning was to create the most effective single
           | dose vaccine possible, and vaccinated a billion people in
           | 2021.
           | 
           | They appear to have achieved the former, although Sputnik
           | Lite with the same Ad26 based vector could be a competitor,
           | the latter goal is failing due to inherent issues with using
           | cell culturing to make something, a strained supply chain for
           | that which is also required to make Oxford's Sputnik V, and
           | Novavax's vaccine (bug cell grown protein plus adjuvant), and
           | being forced to use the dangerously incompetent Emergent
           | BioSolutions as a subcontractor.
        
             | Scoundreller wrote:
             | Was J&J the most effective vaccine after 1 dose? Sure they
             | don't have much competition if you only compare against
             | 'approved' schedules, but mRNA vaccines seem better after 1
             | dose than J&J is. But yeah, there's just not a lot of trial
             | data out there for 1dose mRNA or Oxford vaccine since
             | they're (officially) pretty quick to get you to 2 doses.
             | 
             | Emergent BioSolutions was contamination between the J&J
             | side of production with the Oxford/AstraZeneca vaccine side
             | of production...
        
         | lol768 wrote:
         | I don't think they've published any data relating to ENSEMBLE 2
         | yet.
        
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