Natural versus vaccine immunity

a warm welcome to today's talk it's saturday the 2nd of october now i'm getting a lot of questions about the vaccine mandates in the united states and where the people that have had the infection naturally should still be mandated to be vaccine vaccinated because after all if you've had the infection do you need the additional immunity so basically i'm going to use the evidence to answer that question today that's that's kind of the the aim of today and then i'll leave you with a bit of a decision to make at the end probably more of an ethical decision to be quite honest than a scientific decision but let's look at the evidence here so um post vaccine and natural immunity is the question now we know we get immunity after infection of course and we know we get immunity after vaccination now let's start off by looking at some u.s data now this was of the 11th of december round about when the vaccination program started in the united states so us data as of the 11th of december now 11th of december it was estimated that 91 million people had had the infection therefore would develop some degree of immunity to the infection of course because they have had it 77 million estimated symptomatic illnesses in the united states and 3.4 million people had been hospitalized so that kind of gives you the rough percentages there doesn't it we can see about well over four percent of people are being hospitalized and um um three quarters of people uh or more uh have a symptomatic infection from that american data now moving on u.s natural infection february 2020 to may 2021 now this is the latest data i can find from the official um american sites up to the uh up to the uh end of may but of course that misses out a lot of the delta surge so these numbers are going to be lower than the actual figures now but we'll look at them anyway so not to 17 year olds 26.8 million had been infected out of 73 million in the entire demographic 18 to 14 nine year olds uh 60.5 percent have been infected 50 to 64 year olds 20.4 have been infected and 65 plus 12.3 percent have been infected and here we have the percentages of the population so this is the total number of people in the group demographic 73 million 138 million 62 million 54 million 65 plus and this is the total number over 120 million or the estimates there are actually about 103 million to about 140 million who had actually had the infection they settled on about 120 million out of a total population in the united states of 328 million based on the uh 2019 uh data that is the latest that's available so 37 of the population had already been infected at that point and of course now after the delta surge what can we add to that can we add five percent probably at least can we add 10 because of the delta surge we don't really know we don't have the latest data on that yet but it does show that there was a lot of natural infection uh in the united states as of the 11th of may end of may sorry 2021 now let's look at the first research paper that sheds light on this immunological memory to size coronavirus two assessed up to eight months after infection this is published in the journal science not a huge study they started off with 254 and they got long-term follow-up on only 51 but it's a peer-reviewed article so it's worth talking about anti-antibodies against coronavirus ii spikane receptor binding domain declined moderately over eight months so the antibodies did go down over the eight month period of this study but only only moderately but memory b cells now the memory b cells is the memory for the cells that actually make the antibodies so it's the b cells the b lymphocytes that actually produce these are the fractures for the antibodies or the immunoglobulins they actually produce the antibodies and if you have a cell that remembers exactly how to make the correct antibody this can duplicate very very quickly preventing future symptomatic infections very often so memory b cells against stars coronavirus 2 that make the antibodies make the antibodies for the spike protein at least increased between one month and eight months after infection so these actually carried on increasing interesting increasing uh proportion of subjects reports proportion of subjects positive for cd4 cells now these are the lymphocytes that are called the helper cells so these cd4 cells stimulate the b cells the cd4 t cells or the helper cells that stimulate the b cells to make the antibodies so this is the t cell here the the the cd4 cell with the cd4 receptor stimulates the b cells to make the antibodies and the proportion of subjects positive for cd4 cells t cells remain high at six to eight months after infection so again looking pretty good for the longer term immunity here and they say the different types of immuno memory each had distinct kinetics resulting in a complex interrelationship over time now what the kinetics means here is the kinetics means the way that the human body interacts with the immunity that it's being generated so in other words the saying b cells have one characteristic t cells have another characteristic of course another group of cells the the the t cd8 plus cells the the cytotoxic cells are also very important this infection because they kill whole infected cells so what did this study conclude well fairly fairly firm conclusions really substantial immune memory is generated after covered 19. so they're certainly going down in that camp aren't they about 95 of subjects retained immunity at about six months after infection but but for longer as well is it going to last for 18 months we don't know yet and this is important because people get so tied up on the antibodies and they say this circulating antibody teters that's the amount that you titrate you work out the amount of the antibodies we're not predictive of t memory cells so the antibodies really a bit of a red herring really just to focus on antibodies is is um is naive at best really but the centers for disease control are taking a different stance because they want everyone vaccinated whether they have had the infection or not and this is where the argument is originating and of course it's become politicized in the states we tend to get right-wing parties that are very strong advocates of um natural immunity and allowing people not to be vaccinated if they've had natural immunity sometimes the more left-wing advocates in the states are more for vaccinating everyone it's a pity it's become politicized but let's see what the the um the the centers for disease control is saying well they're still recommending full vaccination uh for all and especially with the official approval now of the fisa vaccine this is resulting in the mandates this is where the vaccine mandates have come from so basically um a lot of organizations in the states are mandating vaccines now with with government uh central government approval they're mandating vaccines whether someone's had the infection or not this is the crunch of the debate and we will come to a conclusion on this just just hang on a minute um the immune response for vaccine is more predictable that the cdc is saying that's a direct quote so basically the same natural immunity well you know you might get immunity you might not get immunity vaccines more predictable that's what they're saying we're going to consider if that's true or not antibody responses after infection vary widely by individuals well yeah the antibody responses do we'll accept that but does it matter does it matter um given that um circulating antibody teeters were not predictive of t memory cells we believe that to be true scientifically from analyzing the blood samples so um does does this matter um probably less so than that would intimate fda administration centre for biologics evaluation research um now um i've put the link here i'll show you in a minute you can watch the people actually saying this um we do know that that immunity after vaccine is better than immunity after natural infection well i mean that's on that youtube video there i'll show you the link in a minute i mean do watch it but that is a pretty bold statement they're actually saying that immunity after vaccination is better than immunity after natural infection now that is questionable that is questionable uh in fact we're going to conclude that it's probably wrong not to put too fine a point on it but that's what uh fda was saying just at the end of the end of june i think this was um generally the immunity after natural infection tends to wane after about 90 days well not really according to this paper here um that is not what this is really saying i'm afraid so again um really quite why they're uh coming out so strongly for this particular position is is rather difficult to justify as i understand the science uh heck that they they probably got better science than me but if they have i'm not quite sure what it is um it appears from the literature that natural infection provides immunity well they concede that point and we agree but that immunity is seemingly not as strong and may not be as long-lasting as that provided by the vaccines well pretty strong statements and i really don't i don't see that these are consistent with the science to be quite honest but that's what they're saying i mean just think of one theoretical point of science we know that the vaccines are going to produce an immune response against two antigens um in the spike protein and the receptor binding domain whereas natural infection will produce um an immune response in antibodies and memory b cells and memory t cells against 20 different epitopes 20 different antigens 20 different proteins that the immune system recognizes as being foreign so quite how they can justify that statement is rather difficult for me to see actually i don't quite get that i think um there you go i don't basically you can see i don't agree with that inconsistent with the uk as well the uk covered past guidelines for international travel and such like proof of natural immunity this is a direct quote from the government website a proof of natural immunity shown by a positive pcr test result for covered 19 lasting 180 days after the date of the positive test so they're saying you're good for six months basically they're saying you're considered to be fully immune for six months after natural infection so we see really clear blue water between the us position and the united kingdom position here next paper protection of previous size corona advice to infection is similar to that of uh fisa vaccine protection a three-month nationwide experience from israel so this is uh large-scale whole community data from uh israel not a study it's actually in this but it's okay it's in this peer review not peer reviewed sorry take that back it's not peer-reviewed it's it's a pre-print paper but it comes from israeli government data um direct from israeli government data which is a reliable source i believe um vaccination this is what that paper says vaccination was highly effective so preventing infection at that time ninety two point eight percent presented section against hospitalization 94.2 severe illness 94.4 and death's 93.7 so they're the levels of protection from the uh from the vaccine now we do know that this is declining now over time and we do know that these actually decline somewhat over time so this declines most over time this declines less this declines less and this declines less still but they are still declining over time we now know but let's look at the same time when this data was collected the the um protection from prior size coronavirus to uh infection so protection from prior infection now this is based on um quite a large sample size about half a million people who were infected but not vaccinated and they estimate that it was that the protection that they get against new infection is 94.8 so we see that's higher a little bit higher than that so how the cdc can say that um this number is higher than that number is inconsistent with the israeli that that number there is higher than that number is inconsistent with the israeli data we see that uh the protection against infection by the israeli data is slightly better if you've had the natural infection as opposed to the vaccine and that's before there was vaccine waning effects hospitalization um 94.1 as opposed to 94.2 are essentially the same okay the vaccine's point one ahead but it's basically the same severe illness protection after the vaccine 94.4 severe illness protection after the infection 96.4 so again we see that in these two instances at least uh the natural infection is providing more uh protection even in people that are unvaccinated compared to vaccination so um there we go that the israeli data seems inconsistent there with the uh the cdc thinking ministry of health uh again in israel during the summer surge fifth of july to the third of august is the delta surge of course over half a million people were infected but not vaccinated so again they had this good sample size so half a million people had had the infection but we run vaccinated so they can compare those and just one percent of wheatly new cases were in people who had who previously had covered 19. so that indicates really that the effectiveness of the vaccine is more like the effectiveness of the natural infection is more like 99 um to be fair that already said nearly 95 but it looks like it's even better than that and also and this is remarkably encouraging it shows that previous infection is protecting against the delta variant just one percent of weekly cases when people who previously had covered 19 who'd had the infection but were not vaccinated so we see a high level of protection with people who've had the infection but were not vaccinated now we believe that people that have had the infection and have had at least one dose of vaccine have even higher levels of protection than that but this is still showing those good levels of protection from natural good levels of protection from natural infection this is the guy who's been uh crunching the data for the israeli government israeli institute of technology these numbers look very low we agree the data suggests that recovered that they recovered have better protection than people who were vaccinated so this data is suggesting the opposite of what the uh the cdc seems to be saying at the moment so that's the data from israel i'll leave you to decide which you uh think is the more reliable systemic side effects were more common in people that previously vaccinated so here we're on a kind of a risk benefit analysis aren't we there's your kind of seesaw and there's your plank on it so it's a risk benefit balance isn't it so um if there's more likely side effects that's kind of that's a bit of a downside isn't it against not vaccinating people quickly who've had the infection there's a large-scale uk study in fact this is about based on hundreds of tens of thousands of people this is the coverage symptom tracker the zoe data actually um so people have had the oxford vaccine 1.6 times more likely to get a reaction or systemic side effects after the first dose of the oxford vaccine but people that had the fisa vaccine nearly three times more likely to get nasty or systemic not necessar necessarily nasty but systemic side effects and people that have been previously infected and then vaccinated 50 more likely to experience severe side effects that require hospital care so this data would seem to indicate that giving people one or two doses of vaccine at least shortly after natural infection is associated with a greater risk so where does this leave us i think the debate here is public health strategy versus individualized medicine so i think the thinking of the uh fda and the cdc in the states is they want to the whole population to become as immune as possible and they want the kind of treating everyone the same whereas the traditional approach of medicine is to look at people individually so if you go and see a gp or physician they'll look at you as an individual whereas community health people tend to look at populations and this is the kind of tension we're seeing between that so ideally every individual would have a blood test every individual will have their antibody levels test to see if they had natural infection every individual have their b and t cell levels checked to see if they need to boost the dose of vaccine then if the b and t immune cells were relatively low they'd have a boosted dose of vaccine if the bnt immune cells were relatively high they could postpone having another dose of vaccine but practically that is simply not going to happen to over 300 million people in the united states it is just not going to happen it's not going to happen to the 64 million or whatever it is 66 million people who live in the united kingdom either it's simply not going to happen so pragmatically it seems that governments are saying well we need a one-size-fits-all and i can understand that argument so you can decide whether the argument is better it's kind of a utilitarian argument it's arguing the great is good for the greatest number whereas the individualized bespoke medicine approach would say well no what is right for this particular individual and let's tailor a bespoke vaccination program or non-vaccination program for that particular individual but given that that's not going to happen you have to decide which is most appropriate but the balance of evidence is that people that i've had my conclusion i've been looking at this most of today the balance of evidence is that people have had the natural infection have greater levels of immunity than people who have the vaccine uh the vaccine alone versus natural infection alone people that have had um natural infection followed by the vaccine have higher even higher levels and we don't know yet but i predict that people have had the vaccine followed by natural infection will also have even higher levels of immunity so there we are it's regardless of the the outcomes from this particular debate although scientifically i think the debate's probably pretty well over what we don't know of course is the longevity we do know that the immunity from vaccine-induced immunity is waning it's looking from provisional data that immunity from natural infection wanes more slowly but we don't know that yet but i suspect it will last for several years combining that immunity with the vaccine immunity it's looking good for herd immunity and community immunity which is partly why we're seeing numbers dropping in the united states for example at the moment at least in part although there is potential for a final kind of surge i believe in autumn so i think that's the conclusion do we want to take a public health strategy versus an interval individualized medicine strategy you decide that but the balance of evidence as i understand it at the moment is that natural infection causes a better grade of immunity than uh vaccination alone but if you've had both it's even better but there are slightly more risk well there is quite a bit more risk of systemic side effects if you've been vaccinated having had the natural infection and that's certainly consistent with nursing and medical colleagues i have who've had the vaccine after many were infected at work and they do seem to be pretty rough for some many are too well for a couple of days after that so um immunities vaccines are great for generating immunity but natural infection also great for generating immunity probably better the longevity remains to be seen if the longevity is good then i'm still hopeful and i'm in a minority of not many here but i'm still hopeful this that this um virus can be eradicated after a few seasons so quite a few seasons perhaps not straight away it's going to be some time but still hopefully it can be uh eradicated although we are certainly heading into an endemic face so i hope that helps resolve the debate it's not a political opinion it's just that the balance of the science i believe at the moment favors the natural immunity argument being superior but of course natural immunity and the vaccination is even better okay i hope that made sense and thank you for watching

Channel: Dr. John Campbell

Views: 1,304,419

Rating: 4.8400345 out of 5

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: 9bamaEMftg4

Length: 21min 54sec (1314 seconds)

Published: Sat Oct 02 2021

Reddit Comments

[u/Bourbon_neet]

A study of 2.5 million people shows natural immunity to be 13X more effective than the vaccines. Study is on the web.

[u/DingbattheGreat]

All of these discussions and studies suggests we are already at herd immunity.

This is why the only real case load is the variant.

Of course, with the vast majority of COVID patients having suffered not at all or a nasty cold, begs the question of why this is still such a dogged subject from the federal government.

Even the vast majority of those who died during COVID suffered from other ailments, with COVID being one of several comorbidities (average of 2-3 depending on age group) and thus was not actually a “COVID” death.

[u/CapNKirkland]

Please note that the covid 19 official subreddit bans this content because "YoUtUbE iS nOt A ReLiAbLe SoUrCe" regardless of the content within it lmao.