Professors at internationally respected institutions mislead on vaccines versus reinfection protection.

I was scheduled for a vaccination on Tuesday, 10 August. For someone my age, 31, in this country, that took some initiative. I was vaccine-keen. On 9 August, however, I tested positive for Covid-19, ruining my vaccine plans and the next ten days.

Bedridden, my heart rate and blood oxygen slumped, I was prescribed steroids and much else, my family was worried, and I felt kaput. I was also frustrated, being one of the relatively few “youth” in this country with a job, that I could not perform my duties for so long. I was especially miffed to drop out in the middle of legal briefings on our ConCourt submission to Save The Vote.

Trying to cheer me up, a friend said: “At least you will have more protection than if you had just been vaccinated”.

I wasn’t sure if my friend was right (he’s a gardener without matric), so I asked Google. First up came a professorial mini-lecture called “Common myths about Covid – debunked” in the UK Guardian. This is the kind of piece that is supposed to teach me and my friend a lesson.

“Having had Covid does give you reasonable protection from being infected again” the Guardian concedes, “but it’s not as good as the protection you get from being vaccinated”. Ok, should the journalist and the gardener just stick to digging up dirt?

The Guardian piece is written by Christina Pagel, (PhD, MA, double MSc) director of the Clinical Operational Research Unit at University College London (UCL). Her Wikipedia bio explains that Pagel’s father was a Reuters senior manager, that she is the “first female” clinical research director at UCL, and that she has appeared as a Covid-authority on BBC News Night, Sky, ITV, and Channel 4.

(Christina Pagel: image source wiki)

Maybe that is why Pagel offered no quantification of her claim that “immunity from vaccination lasts longer and is more robust to new variants”, nor did she provide any links to any studies as evidence for her claim. Pagel might think that with all those qualifications humble folk like us should just trust her. Before the pandemic I probably would have done exactly that.

Now things are a different, so I clicked the pertinent hyperlink on protection duration, which took me to Johns Hopkins Bloomberg School of Public Health’s webpage, specifically to an interview called “Why COVID-19 Vaccines Offer Better Protection Than Infection”. That headline smacks me and the gardener into place, right?

Hopkins is one of the top medical institutions in the US; its “Vaccines Offer Better Protection” interview was conducted by the Hopkins Public Health editor-in-chief, Brian W. Simpson (Master of Public Health) and the introduction refers to a Virologist, Molecular Microbiology and Immunology professor, Sabra Klein (PhD, MS, MA), who will “explain the nitty gritty” of why vaccination offers better protection than convalescence.

Ok, I told my friend that we should get ready to eat humble pie together.

But there was nothing to learn from the Hopkins interview with Klein. No numbers, not one reference to a study there either. Once again following “the science” means following someone with lots of qualifications and talk in metaphors.

That is not an exaggeration. The Hopkins Public Health introduction says, “Spoiler alert: Klein is a big vaccine fan” and that is literally as serious as it gets. Vaccines are now like the Springboks, and PhDs go “yay!”

(Sabra Klein: image John Hopkins Bloomberg School of Health)

Check the state of play for yourself. Klein is asked, “How long does immunity last from being infected? From vaccination?” She answers, “Immunity from natural infection starts to decline after 6 to 8 months. We know that fully vaccinated people still have good immunity after a year – and probably longer”. That is the whole answer. This is meant to justify the subtitle which says that vaccine protection lasts “longer” than convalescent protection.

First, on a strict reading of the language, her answer does not justify that headline conclusion. 

Second, this massive peer-reviewed study published in the Lancet, found that “Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months” and to be clear the longitudinal in vivo study “did not show any evidence of waning immunity for over seven months”.

Where is the evidence that immunity declines after that? I don’t know: the study just ends there and doesn’t say what comes next, because that would shift from “study” to “speculation”. Klein did not bother to say what her source is, if she even has one. Nor did she bother to mention that unlike natural immunity, immunity from vaccination starts to decline long before six months, making it “shorter” not “longer”, as the subtitle claims.

The Pfizer-BioNTech vaccination declines every two months for the first six months. After Astrazeneca’s vaccination “geometric mean antibody levels” drop by half in six months and decline 70% by day 320 after the first dose. Because there is another drop 28 days after the second jab the paper, co-funded by Astrazeneca, recommends a third jab of Astrazeneca at a later point.

The exception may be Moderna, which is the only vaccine I know of to get a headline like this: Moderna’s Coronavirus Vaccine Protection Does Not Decline After Six Months.

The trouble is that statement came from Moderna and was not vetted. That’s why the USNews story reads so cynically, ‘In a statement released in advance of its earnings call, the company, offering few scientific details, said its vaccine’s 93% efficacy “remains durable through six months after the second dose”.’ 

Here is a New England Journal of Medicine summary of data that shows steady in vitro decline in immunity a month after Moderna vaccination, and further declines after boosters.

According to Nature’s summary of what 1.7 billion doses of vaccine has taught us, two major studies to consider are the following: a UK study of 25,000 health care workers “found that a SARS-CoV-2 infection reduced the risk of catching the virus again by 84% for at least 7 months”.

But the study says 84% is actually a low-ball estimate since some of the ‘reinfections were probably residual RNA detection’, meaning false positives from dead broken bits of Covid lingering in the blood rather than ‘true reinfections’. Out of 25,000 people, the study only detected ‘two probable reinfections’, and 153 ‘possible reinfections’, so the authors take 93% protection against reinfection to be a better, but still very conservative, estimate.

Here is a paragraph extract where the UK study compares vaccine protection to convalescent protection, for the real “nitty gritty” kind of science that Klein did not get into.

“The ChAdOx1 [Astrazeneca vaccine] trial reported protection against symptomatic infection (COVID-19 typical symptoms) of between 62·1% and 90% over 2 months of follow-up, and the BNT162b2 [Pfizer-BioNTech] vaccine phase 3 results reported 95% protection over 3 months of follow-up. Another phase 3 trial of the mRNA-1273 [Moderna] vaccine showed 94·1% efficacy against symptomatic (COVID-19 typical symptoms) SARS-CoV-2 infection, including severe illness, over a median of 2 months of follow-up. In a separate analysis on the SIREN cohort, we showed that the BNT162b2 [Pfizer] vaccine offered 70% protection from both symptomatic and asymptomatic infection, 21 days after the first dose, which increased to 85% 7 days after the second dose. Our findings of a 93% lower risk of COVID-19 symptomatic infection, after a longer period of follow-up, show equal or higher protection from natural infection, both for symptomatic and asymptomatic infection’.[emphasis added].

This study flatly finds protection is equal or higher from natural infection and from a conservative estimate, over a longer period than vaccine protection. 

An earlier study, published in the New England Journal of Medicine of 12,000 UK health care workers, found that zero out of 1,265 who recovered from Covid got symptomatically reinfected. I don’t know any vaccines with a record that good.

The second research source Nature points to is this massive study of 43,000 Covid convalescents from Qatar which finds 95% protection against reinfection and ‘only one reinfection was severe, two were moderate, and none were critical or fatal’ out of the 43,000.

Nature added that the ongoing study further suggests, though this has not been peer-reviewed yet, that there is 90% protection against reinfection ‘as much as a year after a bout of SARS-CoV-2’. That certainly qualifies as ‘good immunity after a year’, although that is the phrase that Klein reserves for vaccine immunity, which is not as good by any quantifiable estimate. 

Methul Suthar, a viral immunologist at Emory University, is ‘concerned that vaccine-induced immunity will not be as durable as immunity from natural infection’. Suthar says that he and his collaborators have found that antibody levels declined faster in those who were vaccinated with the Moderna vaccine than in those who had been infected by SARS-CoV-2.

Things get worse for Klein and Pagel if you look at death figures. According to NYTimes data the death rate for fully vaccinated people is as high as 9 per 100,000, or 217 in absolute terms in Michigan (as of mid-July). According to this Dutch tracker (as of mid-July) there were only 3 confirmed deaths and only 299 suspected deaths from reinfection worldwide.

In other words, suspected deaths (deaths “with” Covid) after full vaccination just in Michigan are only slightly less than all suspected deaths upon reinfection on the planet. And confirmed deaths from reinfection are 3 out of 4.8 million. 

Maybe you don’t trust the Dutch tracker, since it is not a peer-reviewed journal. So here is the British Medical Journal (BMJ) which published this rapid study which could only find 17 confirmed cases of reinfection worldwide up to October 12 last year. Of those only one person died, she was in her 80’s and on chemotherapy for blood, bone or lymphatic cancer.

If Klein or Pagel were serious they would distinguish between protection against death and protection against reinfection, and they would have to find that convalescent protection against death wins by orders of magnitude on the currently available data.

There are more nitty gritty points, like the difference between the protection offered from a heavy bout of Covid-19, like I had, and an asymptomatic encounter when you don’t even realise it happened. Klein’s laboratory work showed, amongst many others, that if you were more seriously infected you will have a stronger immune response. Klein’s excellent laboratory work also shows that she is way smart enough to know how manipulative she was being in her Hopkins interview.

One of the grittiest problems is that no one knows exactly how immune protection works, not even the people as smart as at Hopkins. There are antibodies that fly around in high numbers quickly and then start diluting a month later. But there are also longer-lasting defences, CD4+ T Cells, CD8+ T Cells, memory B cells, and analogues that appear in bone marrow, which work in concert, or not, with “kinetics” we don’t quite understand.

Here is some good news that Klein and Pagel don’t mention, because they don’t even mention the difference between ephemeral antibodies and lasting T and B cells. A Nature study into long-lived bone marrow plasma cells (BMPC’s) showed that while the superficial defences drop quickly, ‘our results indicate that mild infection with SARS-CoV-2 induces robust antigen-specific, long-lived humoral immune memory in humans.’

In five Covid convalescents on whom they did bone marrow tests over 11 months, the researchers found stable BMPC Covid-bashers in all five subjects. Other subjects dropped out along the way.

Even better news may be this study, published in Science, which found in 43 samples that ‘Memory B cells against SARS-CoV-2 spike actually increased between 1 month and 8 months after infection’.

What about “Variants of Concern”? Klein says ‘The good news is that the current vaccines recognize these variant viruses and induce excellent immunity against them. For people who were previously infected and have high immunity, they will have pretty good recognition of these variants, but you don’t really know your level of immunity against a specific variant or how degraded your immune response may be. You might actually be susceptible to reinfection with one of these variants. You just can’t predict it.’

So according to Klein vaccines produce ‘excellent’ immunity against variants, while natural immunity is only ‘pretty good’. Moreover, ‘you just can’t predict’ if natural immunity protects against a variant, but you implicitly can predict that a current vaccine will definitely offer ‘excellent’ immunity against a future variant. There is nothing to back this up, and in studies like the real-time Qatar one, a lot to contradict it.

This cutting-edge working paper (which created “polymutants” to investigate future-wave variants) discusses three studies that suggest “neutralizing antibodies in convalescent confers additional flexibility and affinity that may not be afforded by standard mRNA vaccine regimens”. In English that means the opposite of what Klein said, they predict natural immunity is more adaptable and robust to future variants, which is just what you would expect since any vaccine gives a more limited scope for immune response. To make matters worse the study generated a Covid “polymutant” and found the only way to beat it is if you have already had Covid and also been vaccinated.

To be sure, protection is stronger for some than others, and given enough viral load anyone becomes seriously at risk. But the simple point is that, as far as we can tell, if you recover from Covid illness you are probably in a better position than someone who just got vaccinated. Klein, Pagel and Simpson say the opposite, against all the evidence.

Why? I don’t know. They are definitely trying very hard to get you to take the vaccine, now, no matter what. The simple thing to say is that in order of ascendance the least protection is from a vaccine, then comes natural protection, and the best is to combine both. The other simple thing to say is that vaccine protection costs a hell of a lot less than the risks involved in getting natural protection. (Ask me, I still can’t smell and my back still aches). So natural protection is a consolation, but not something to aim for.

That is simple enough to say to my friend the gardener, without any links, to get a nod of approval. Now you have the links to support the factual claims too. If Klein, Pagel and Simpson just wanted to push vaccines, why not use the simple truth instead of talking manipulative rubbish?

My friend said ‘to them we are children. If somebody says our body can be more clever than those vaccines they think we will run away from the vaccine. They think we are too stupid for the up-down story.’ He winked at me and laughed ‘you are angry at them! They treat you like a child, so now you are angry, so what? Next time you must go to the sangoma, at least that way you know it’s magic!’