COVID-19 vaccine mandates should not discriminate against natural immunity, The unnaturalistic fallacy
https://jme.bmj.com/content/48/6/371
COVID-19 vaccine requirements, debate,
policies should have recognised proof of natural immunity,
sufficient basis for exemption to vaccination requirements.
Arguments
Two implausible claims about natural immunity:
Natural immunity is superior to ‘artificial’ immunity
It is better to acquire immunity through natural infection
Naturalistic fallacy (many things are natural, but not good)
(A natural public health strategy, increased overall morbidity and mortality)
We lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity.
Vaccine requirements represent a substantial infringement of individual liberty, and other significant costs
Can only be justified if they are necessary for achieving a proportionate public health benefit.
Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity.
‘vaccine passports’ ‘health passes’
Rationale for vaccine mandates
Preventing healthcare systems becoming overwhelmed, (staff and patients)
Reducing community viral transmission
Acquired immunity naturally, potentially equivalent to vaccination immunity
This is the unnaturalistic fallacy as opposed to the naturalistic fallacy
Natural immunity and vaccine-induced immunity, evidence
Equivalency of Protection From Natural Immunity in COVID-19 Recovered Versus Fully Vaccinated Persons: A Systematic Review and Pooled Analysis
https://www.cureus.com/articles/72074-e
All of the included studies found at least statistical equivalence between the protection of full vaccination and natural immunity;
and, three studies found superiority of natural immunity.
NNT to prevent one annual case of infection in COVID-recovered patients 218
NNT COVID-naïve patients, 6.5
33.5-fold difference in benefit between the two populations
our review demonstrates that natural immunity in COVID-recovered individuals is, at least, equivalent to the protection afforded by complete vaccination of COVID-naïve populations
Vaccinations for recovered people, marginal on an absolute basis.
Omicron in adults aged 65 or over
minimal or no effect against mild disease with the Omicron variant from 20 weeks after the second dose of ChAdOx1-S or BNT162b2
data are beginning to emerge which suggest that the effect of the vaccines on transmission may diminish within a matter of months
Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection
https://www.science.org/doi/abs/10.1126/science.abf4063
Immunological memory is the basis for durable protective immunity after infections or vaccinations.
Substantial immune memory is generated after COVID-19, involving,
memory B cells, antibodies, memory CD4+Tcells, memoryCD8+T cells.
Circulating antibody titers were not predictive of T cell memory.
Do not reflect the richness and durability of immune memory to SARS-CoV-2.
Reinfection Rates Among Patients Who Previously Tested Positive for Coronavirus Disease 2019: A Retrospective Cohort Study
https://academic.oup.com/cid/article/73/10/1882/6170939?login=true
N = 150,325 patients
8,845 (5.9%)
141,480 (94.1%)
Protection against reinfection, 81.8%
Protection against symptomatic reinfection, 84.5%
Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden
https://www.sciencedirect.com/science/article/pii/S1473309922001438
Cohort one, 2,039,106
Cohort two, 962,318 one dose
Cohort three, 567,810 two doses
767 individuals with natural immunity needed to be vaccinated to prevent one reinfection
Protection against the Omicron Variant from Previous SARS-CoV-2 Infection
https://www.nejm.org/doi/full/10.1056/nejmc2200133
Protection from prior infection against severe outcomes from Omicron remained robust, 87.8%
Reinfection often occurs with negligible symptoms and high Ct values, indicating reduced epidemiologic significance
The case for natural immunity exemptions
Vaccine requirements have significant costs
Substantial infringement of individual liberty
There are non-trivial risks associated with vaccination
The Biopharmaceutical Industry Provides 75% Of The FDA’s Drug Review Budget. Is This A Problem?
https://www.forbes.com/sites/johnlamattina/2018/06/28/the-biopharmaceutical-industry-provides-75-of-the-fdas-drug-review-budget-is-this-a-problem/?sh=5dc27d7649ec
