Is Covid-19’s “innate immunity” better than a vaccine?

Following last month’s news about the amazing results from Pfizer and Moderna’s Covid-19 vaccine, Senator Rand Paul tweeted a provocative comparison.

Paul said the new vaccine was 90% and 94.5% effective. However, he claimed that the “naturally acquired” Covid-19 was even better, at 99.9982%.

Paul, Kentucky is one of many who were fed up with blockades and financial losses and admired the benefits of being infected with the coronavirus. Senators were diagnosed with the disease this year and argued that surviving a Covid-19 attack provides stronger protection and less risk than vaccination.

Jennifer Gommerman, an immunologist at the University of Toronto, said the problem with this logic is that it’s difficult to predict who will survive the infection unharmed. Given all the unknowns, such as the capacity of local hospitals and the strength of a person’s immune response, she said choosing a disease over a vaccine was a “very bad decision.”

The main advantage of the vaccine is that it is predictable and safe, she said. “It is optimally tuned to produce an effective immune response.”

But what do we know about how immunity from previous infections is compared to the protection provided by the new vaccine? And what if I’m already using Covid-19? Is it safe to get vaccinated? We asked an expert to review the latest evidence.

Which of the natural infections and the vaccine causes a stronger immune response?

Simple answer: I don’t know. However, experts say the Covid-19 vaccine prevents the disease as expected and is a much safer method.

Vaccines against some pathogens, such as Streptococcus pneumoniae, induce better immunity than natural infections. Early evidence suggests that the Covid-19 vaccine may fall into this category. Volunteers who received the Modana Shot had more antibodies (one of the markers of the immune response) in their blood than those infected with Covid-19.

However, in other cases, natural infections are more potent than vaccines. For example, mumps, which can cause infertility in men, provides lifelong immunity, but some people who have been vaccinated once or twice are still ill.

Paul’s point: Fortunately, the innate immunity from the coronavirus is very strong. The majority of infected people produce at least some antibodies and immune cells that can fight the infection. And previous evidence suggests that this protection will last for years and prevent serious illness, if not reinfection.

However, the immune response has a “large dynamic range”, with antibody levels that differ by a factor of 200.

In people with mild illness, the immune protection that can prevent a second infection can be diminished within a few months. “These people may benefit from the vaccine more than others,” said Bill Hanage, an epidemiologist at Harvard’s School of Public Health.

The diversity of immune responses from natural infections can be due to differences in the amount of virus exposed to a person.

With the vaccine, everyone gets the same dose. “We know the dose being administered and we know that it is effective in eliciting an immune response,” Gommerman said. “That makes it a variable that is removed from the table when vaccinated.”

I am young and healthy and have a low risk of Covid-19. Why not seize the opportunity instead of rushing to get the vaccine?

Experts were unanimous in their answer: Covid-19 is a much more dangerous option.

Marion Pepper, an immunologist at the University of Washington in Seattle, said: “It’s clear that one has less problems recovering than the other. There is an increased risk of natural infection.

People who are obese or have a disease such as diabetes are particularly vulnerable to severe cases of Covid-19. On average, the virus appears to be less risky for young people, and women tend to work better than men. But beyond these widespread generalizations, doctors do not know why some people are very ill and die, and others are asymptomatic.

For example, some studies have shown that people who have certain mutations in their immune genes are more susceptible to the disease. “So there are risk factors that have nothing to do with age,” Gommerman said.

In a study of more than 3,000 people aged 18 to 34 years admitted to Covid-19, 20% required intensive care and 3% died.

Dr. Yvonne Maldonado, who represents the American Academy of Pediatrics at the Federal Convention, said: Advisory Committee on Immunization Implementation.

But “no one is immune to serious illness,” she said. And even if people aren’t at high risk for Covid-19 itself, their friends and family can.

One in three people who recover from Covid-19 have chronic dissatisfaction, such as malaise and heartbeat, for the next few months. This includes people under the age of 35 who were previously unhealthy. Some Covid-19 survivors have symptoms similar to lupus and rheumatoid arthritis, but show annoying signs that their body has turned on on their own.

In contrast, the Covid-19 vaccine carries a little-known risk. They have been tested by tens of thousands of people, at least so far, without serious side effects. “When we start vaccination of millions of people, we can find very rare events,” Hanage said. “But you need to know that they are very rare and far more rare than the adverse events associated with natural infections.”

I had a Covid-19. Is it safe to get the vaccine? If so, when can I get it?

According to experts, vaccination at some point is safe and perhaps even beneficial for those who have Covid-19.

“There’s nothing harmful about boosting the immune response you had before,” Pepper said. “By boosting the immunity gained from the initial infection with the vaccine, you can actually get a better immune response.”

In fact, at a meeting on Wednesday, Dr. Monsef Slawi, Chief Advisor to Operation Warp Speed, said up to 10% of participants in vaccine clinical trials were unknowingly infected with the virus. He said their immune response to the vaccine has been analyzed.

If you already have Covid-19, you can afford to wait for the vaccine.

Pepper’s team and other studies have shown that the immune response evolves in the first few months after infection, but anyone who has used Covid-19 has some protection during that time. There is power.

“No one had a certain immune response,” she said. “I don’t think these people need to be vaccinated in a hurry, as very sensitive people actually do.”

ACIP, which advises the Centers for Disease Control and Prevention on vaccine distribution, said at a meeting Wednesday that uninfected individuals should be prioritized over those infected with the virus in the last 90 days.

“At some point, we need to determine if 90 days is a good number,” Maldonado said. But for now, “people with recent evidence of infection should probably not be vaccinated in a row at first, as there are so few vaccines available.”