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 > 2019–2022 CORONAVIRUS PANDEMIC POSTINGS

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dturm

Lake County, IN

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Posted: 09/22/21 06:53am Link  |  Quote  |  Print  |  Notify Moderator

Moderator is correct. Your premise is incorrect!!

Natural antibodies from infection are NOT equivalent to the protection from vaccination.


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BCSnob

Middletown, MD

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Posted: 09/22/21 07:09am Link  |  Quote  |  Print  |  Notify Moderator

Which antibody test? Not all antibody tests measure antibodies against the RBD or the spike. Should the test be for antibodies against any portion of the spike of just the RBD. And antibodies against which variant of the spike (wuhan, alpha, beta, etc) should be used for assessing if a vaccine is needed?

Where is the clinical data which shows any of the antibody tests values correlate to reduced risk of infection; isn’t this the data the fda would require to use an antibody test as you describe?

BCSnob

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Posted: 09/22/21 07:32am Link  |  Quote  |  Print  |  Notify Moderator

way2roll wrote:

And both wane in efficacy at some point anyway rendering either almost moot.
Where did you get the idea that the protection goes to almost nothing; and moot against what (infection, hospitalization, death)?

Quote:

Vaccine effectiveness and duration of pr........ainst mild and severe COVID-19 in the UK

Vaccine effectiveness against symptomatic disease peaked in the early weeks after the second dose and then fell to 47.3 (95% CI 45 to 49.6) and 69.7 (95% CI 68.7 to 70.5) by 20+ weeks against the Delta variant for Vaxzevria and Comirnaty, respectively. Waning of vaccine effectiveness was greater for 65+ year-olds compared to 40-64 year-olds. Vaccine effectiveness fell less against hospitalisations to 77.0 (70.3 to 82.3) and 92.7 (90.3 to 94.6) beyond 20 weeks post-vaccination and 78.7 (95% CI 52.7 to 90.4) and 90.4 (95% CI 85.1 to 93.8) against death for Vaxzevria and Comirnaty, respectively. Greater waning was observed among 65+ year-olds in a clinically extremely vulnerable group and 40-64-year olds with underlying medical conditions compared to healthy adults. Conclusions We observed limited waning in vaccine effectiveness against hospitalisation and death more than 20 weeks post-vaccination with Vaxzevria or Comirnaty. Waning was greater in older adults and those in a clinical risk group, suggesting that these individuals should be prioritised for booster doses.


Quote:

An Analysis of SARS-CoV-2 Vaccine Breakthrough Infections and Associated Clinical Outcomes
MedRxiv preprint https://doi.org/10.1101/2021.09.09.21262448

Understanding the rate and clinical features associated with vaccine breakthrough infections (VBT) is of critical public health importance. Recent evidence on VBT in Barnstable County, Massachusetts, has prompted guidance on masking for vaccinated individuals in areas of high community-level transmission. Additional data is needed to better understand the prevalence and rate of VBT infections. Using detailed disease investigation data from Washoe County, Nevada we sought to assess the rate of symptomatic infection and serious illness among VBT cases compared to non-vaccinated individuals with COVID-19. From February 12 - July 29, 2021, the Washoe County Health District identified and traced 6,128 out of 6,399 reported cases across the sample period. 338 (5.5%) of all cases were identified as breakthrough infections, and 289 (86%) vaccinated individuals had symptomatic infections. Severe clinical outcomes were infrequent with 17 hospitalizations (5% of VBT) and no deaths. Cycle threshold values were not statistically different between vaccinated and unvaccinated individuals.


BCSnob

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Posted: 09/22/21 07:33am Link  |  Quote  |  Print  |  Notify Moderator

Incidence of COVID-19 reinfection among Midwestern healthcare employees
medRxiv Preprint 12 Sept 2021

Quote:

Of 2,625 participants who experienced at least one COVID-19 infection during the 10-month study period, 156 (5.94%) experienced reinfection and 540 (20.57%) experienced recurrence after prior infection.


Note that the reinfection rate here is similar to the breakthrough infection rate above.

* This post was edited 09/22/21 07:59am by BCSnob *

Deb and Ed M

SW MI & Space Coast, FL USA

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Posted: 09/22/21 08:35am Link  |  Quote  |  Print  |  Notify Moderator

way2roll wrote:


Interesting. So back to my point, with natural antibodies equivalent to the protection of a vaccination, shouldn't the mandate be - Vaccination OR a recent antibody test?


If my experience is the "norm" - it doesn't matter. I went to my Dr for my annual "Wellness visit" (which finds me "well", for which I am grateful) and while checking in, the young lady asked for my ID and Health Insurance card, and I said "I'll bet you'd like my vaccination card, too?" since we had been vaccinated in FL and my Michigan Dr would not have that info.

She said "no - those cards are too easy to fake".

Later, during the Dr's visit, she (my Dr) entered the dates. I guess my questions about when I could get a 3rd Moderna shot were more convincing than my card :-(

BCSnob

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Posted: 09/22/21 09:06am Link  |  Quote  |  Print  |  Notify Moderator

Here is another recent preprint that relates to the current discussion.

Quote:

Prior Covid-19 and high RBD-IgG levels correlate with protection against VOC-delta SARS-CoV-2 infection in vaccinated Nursing Home Residents
MedRxiv preprint https://doi.org/10.1101/2021.09.21.21263880

Among the 140 analyzed residents (58 to 101 years; 94 females, 46 men, mean age (SD): 84.6 yr (9.5 yr), one resident among the 44 with prior Covid-19 before vaccination developed a VOC-delta infection during the outbreak (1.3%) vs 55 of the 96 without Covid-19 prior to vaccination (57.3 %)(p<0.0001). The median value for RBD-IgG after the vaccine and during the outbreak was higher in residents with prior Covid-19 (31553 AU/mL and 22880 AU/mL) than in those without (1050 AU/mL and 260 AU/mL)(p<0.0001). In residents without Covid-19 prior to vaccination, post-vaccination RDB-IgG levels did not predict protection against VOC-delta infection. Conclusions In contrary to residents with prior SARS-CoV-2 infection, those without a history of Covid-19 before two BNT162b2 doses are not protected against VOC-delta infection and their RBD-Ig-G levels are low 3 to 5 months after vaccination. This suggests that a booster vaccine dose should be considered in this group of residents for a better protection against VOC-delta infection.


Previous infection plus vaccination provided better protection against the delta variant than just vaccination. This particular antibody test yielded antibody titer values (SARS-CoV-2 IgG II Quant assay, Abbott Diagnostics) for RBD IgG which correlated to protection in these 140 patients. There were no patients evaluated that were not vaccinated (likely due to mandatory vaccination for all residents with or without previous infection).

* This post was edited 09/22/21 09:13am by BCSnob *

BCSnob

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Posted: 09/22/21 09:28am Link  |  Quote  |  Print  |  Notify Moderator

The Delta Variant Had Negligible Impact on COVID-19 Vaccine Effectiveness in the USA
MedRxiv preprint https://doi.org/10.1101/2021.09.18.21263783

Quote:

The SARS-CoV-2 Delta variant (B.1.617.2) was initially identified in India in December 2020. Due to its high transmissibility, its prevalence in the U.S.A. grew from a near-zero baseline in early May 2021 to nearly 100% by late August 2021, according to CDC tracking. We accessed openly available data sources from the public health authorities of seven U.S. states, five U.S. counties, and the District of Columbia on RT-PCR COVID-19 tests split by the COVID-19 vaccination status of individuals tested during this period. Together, these time series enable estimation and tracking of COVID-19 vaccine effectiveness (VE*) (against RT-PCR diagnosed infection) concurrently with the growth of Delta variant prevalence in those locations. Our analyses reveal that in each locality the VE* for the combined set of all three US vaccines remained relatively stable and quite well-performing, despite the dramatic concurrent rise of Delta variant prevalence. We conclude that the Delta variant does not significantly evade vaccine-induced immunity. The variations in our measured VE* appear to be driven by demographic factors affecting the composition of the vaccinated cohorts, particularly as pertains to age distribution. We report that the measured VE*, aggregated across the collected sites, began at a value of about 0.9 in mid-May, declined to about 0.76 by mid-July, and recovered to about 0.9 by mid-September.


BCSnob

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Posted: 09/22/21 10:14am Link  |  Quote  |  Print  |  Notify Moderator

Since antibody tests are not the gold standard for previous infections, the mandate could be changed to vaccination OR previous positive PCR test (which what the quoted review found was used to determine previous covid infection).


In defense of the others, new data continues to be published on reinfection, vaccine effectiveness, duration of immunity, etc.; the studies posted today were recently uploaded preprints to MedRxiv or BioRxiv. Unless you are reviewing the new preprints frequently you can fall behind the current state of understanding about this virus and the resulting pandemic.

* This post was edited 09/22/21 10:21am by BCSnob *

dturm

Lake County, IN

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Posted: 09/22/21 10:31am Link  |  Quote  |  Print  |  Notify Moderator

Previous NIH from Dr. Collins wrote:

These findings suggest that natural immunity and vaccine-generated immunity to SARS-CoV-2 will differ in how they recognize new viral variants. What’s more, antibodies acquired with the help of a vaccine may be more likely to target new SARS-CoV-2 variants potently, even when the variants carry new mutations in the RBD.

It’s not entirely clear why these differences in vaccine- and infection-elicited antibody responses exist. In both cases, RBD-directed antibodies are acquired from the immune system’s recognition and response to viral spike proteins. The Seattle team suggests these differences may arise because the vaccine presents the viral protein in slightly different conformations.


Actually, I don't agree that previous PCR positive test should be a valid opt out of vaccination or equivalent to vaccination. My understanding is that there is a tremendous variability in antibody level production in people who are infected with COVID, often dependent on severity of their disease. Those who believe that previous infection always protects from re-infection are probably taking unnecessary risks.

Also, evaluating immune competence in fighting a disease is more complex that measuring an antibody level. That's the easiest test we have right now, but evidence now is that vaccination after having COVID is appropriate.

* This post was edited 09/22/21 10:46am by dturm *

BCSnob

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Posted: 09/22/21 10:49am Link  |  Quote  |  Print  |  Notify Moderator

The study results indicated the range in vaccine effectiveness (protective vs breakthrough infection) was similar to the protection afforded by previous infection (protective vs reinfection). The quote from the nih was more about predicting what is best for an individual within that population (minimize the likelihood of infection); the approach needed for making public health recommendations.

I view previous infection similar to previous vaccination in terms of antibody production and developed immunity. Both can lead to strong immune responses (based upon an individual’s immune response) and both can lead to weak immune responses. IMO the public health recommendations should be vaccination of previously infected (prehaps just 1 shot, an immune booster) and boosters for previously vaccinated. Both will increase the nAbs which appear to be correlated to protection. Neither (previous infections or vaccinations) are >90-95% effective at preventing infections. Additionally I think the boosters (for previous infection and vaccination) should be against a spike with the greatest genetic difference from that if the wuhan variant.

However, until most of the world is vaccinated new variants will continue to evolve which likely will require additional boosters. With limited vaccine supplies and resistance to vaccination I’m not sure which is the better long term approach (boosters vs increasing vaccination rates).

IMO , as long as there are those who refuse vaccination (a proven preventative) insurance costs associated to treatments should go back to prepandemic calculations (the vaccinated should not bear the costs associated with treatment of the unvaccinated).
Mod can delete this as desired

* This post was edited 09/22/21 12:11pm by BCSnob *

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