Super Immunity vs Anti-Vaxxers

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Science-Based Meidicne

Steven Novella on January 26, 2022

Anti-vaxxers continue to spread demonstrable misinformation, while the evidence for the benefits of COVID vaccines grows.

In a recent march on DC antivaxxers were angry and spewing forth a firehose of misinformation. Among them were Robert F. Kennedy Jr, number 2 on the misinformation dozen list. Kennedy was a one-time environmental activist who descended into the world of anti-vaccine misinformation, in what appears to be a combination of confirmation bias and motivated reasoning. If you look hard enough for a conspiracy, you can find one. At the rally Kennedy claimed: “if you take the vaccine, you have a 21 percent increased chance of dying over the next six months.”

I could not source this claim with anything published, but Kennedy keeps touting VAERS (the voluntary open reporting system that anti-vaxxers love to troll), an unscientific source of information just made for confirmation bias. By comparison actual CDC data finds:

During October–November, unvaccinated persons had 13.9 and 53.2 times the risks for infection and COVID-19–associated death, respectively, compared with fully vaccinated persons who received booster doses, and 4.0 and 12.7 times the risks compared with fully vaccinated persons without booster doses.

An unvaccinated person was more than 50 times as likely to die from COVID as a fully boosted person during that time period.

While the pandemic has been long and difficult with many twists and turns including new variants just when we thought things were slowing down, it has actually played out pretty much like experts predicted (once we knew what we were dealing with). This is how major pandemics of highly contagious respiratory illnesses roll. They rip through the population, killing the old and sick first but also indiscriminately, then moving on to others and coming back around, spawning new variants as it goes. After a few years it slowly burns itself out, mainly through increasing immunity in the population, until it becomes a relatively mild background or seasonal infection, just another cold or flu.

Our modern world has been both a boon and a bane for the pandemic. Our global economy and massively interconnected populations allow the virus to spread quickly to every corner of the world. However, our modern medical technology gives us unprecedented tools to fight the pandemic, minimize its impact, and perhaps shorten its course. You know where this is headed – the COVID vaccines are the most critical tool for fighting the pandemic.

A recent study adds yet more weight to the body of evidence supporting the use of vaccines as a major strategy to fight the pandemic – “Vaccination before or after SARS-CoV-2 infection leads to robust humoral response and antibodies that effectively neutralize variants” published in Science Immunology. The researchers looked at three groups of people:

  • Those who were vaccinated but never infected
  • Those who were vaccinated after being infected
  • Those who had a breakthrough infection after being vaccinated

The results:

We find that human immune sera following breakthrough infection and vaccination following natural infection, broadly neutralize SARS-CoV-2 variants to a similar degree. While age negatively correlates with antibody response after vaccination alone, no correlation with age was found in breakthrough or hybrid immune groups. Together, our data suggest that the additional antigen exposure from natural infection substantially boosts the quantity, quality, and breadth of humoral immune response regardless of whether it occurs before or after vaccination.

That’s good news. Hybrid immunity is about 10 times that of vaccination or infection alone, and the antibody titers are high enough to combat the Omicron variant. Further, this robust hybrid response was not diminished with age, which might turn out to be critical for protecting the older and more vulnerable population.

Remember, however, the goal is to not get COVID. This is still a deadly virus, with potentially severe long-COVID symptoms. The ideal is to get vaccinated, be responsible in terms of exposure and pandemic protocol, and simply never get COVID. The second best scenario, however, is to get vaccinated and if you do get COVID the chances are high that the infection will be mild, and leave you with super hybrid immunity for extra protection against reinfection or new variants. Further, if you have been infected already, all the more reason to get vaccinated as another path toward hybrid immunity. Many people use past infection as an excuse not to get vaccinated, but the reality is the opposite.

Slowly we will more toward a more and more resistant population, and that will beat back the pandemic into just another endemic respiratory illness that we live with, but not something that disrupts society. And again, I want to emphasize, we want to get there mainly through vaccination, not through the spread of the virus. Vaccination also slows the emergence of new variants, while spreading infections increases that risk.

In addition, the CEO of Pfizer announced that they have an Omicron version of their vaccine ready for release in March. That is how we can stay ahead of the pandemic, by adjusting the available vaccines to optimally cover new variants as they emerge. Anti-vaxxers make a big deal about the fact that we need booster shots to maintain immunity, but this is misguided. We need an annual flu vaccine, which is also adjusted every year to track the variants that are spreading. The same will likely be true with SARS-CoV-2, we may need an annual vaccine which will be updated to track new variants. This is just part of modern life, and is far better than the alternative.

The reality is that COVID-19 is a severe pandemic, historically a once-a-century pandemic, although such pandemics may become more common given the human population and interconnectivity combined with our propinquity to wild animal populations increasing the risks of zoonotic cross-over infections. But also, vaccines work. They are safe and provide effective resistance to the virus, significantly reducing the severity of illness, taking it from something that may put you in the hospital and even result in death to just a bad cold.

As the anti-vaxxer rally in DC shows, that community is not based in reality. The rally was angry and seething with every sort of conspiracy theory. They do not have facts or even basic common sense on their side. Their anger is about something else entirely, but the spillover effect is that they are hampering our efforts to get the pandemic under control while minimizing the damage.

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking – also called The Skeptics Guide to the Universe.