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Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2101 (Published 13 September 2021) Cite this as: BMJ 2021;374:n2101

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Re: Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?

Dear Editor, allow me to comment for I agree fully that this vaccine induced spike-specific immunity cannot compare to the broad, robust, durable, long-lasting natural exposure immunity from prior infection. Immunology 101.

It is a simple question: when you were a child, and you got measles or your classmate, did your mother then after you recovered, take you to get a shot for measles? This is after you recovered from your measles bout. You will recall your mom did not then vaccinate you and this is for a reason. She knew you were now immune. Back then. The doctor would have told her no need if she took you for a shot.

So why is it different for COVID?

Additionally, Hellerstein (1) writes “Although most vaccine candidates are focusing on spike protein as antigen, natural infection by SARS-CoV-2 induces broad epitope coverage, cross-reactive with other beta-coronaviruses”. Furthermore, Lineburg et al. (2) adds to this debate on long-lasting protective immunity by reporting that their findings indicate “the basis of selective T cell cross-reactivity for an immunodominant SARS-CoV-2 epitope and its homologs from seasonal coronaviruses”. We also have two tantalizing studies (3, 4) by Stamatatos and Reynolds showing that prior infected persons receive elevated post-infection serum-neutralizing capacity with one vaccine dose. Shrestha’s study (6) is also critical for it shows that “Individuals who have had SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination”.

References

1.https://www.sciencedirect.com/science/article/pii/S2590136220300231

2. https://www.cell.com/immunity/fulltext/S1074-7613(21)00168-0

3. https://www.science.org/lookup/doi/10.1126/science.abg9175

4. https://www.science.org/lookup/doi/10.1126/science.abh1282

5. https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v3

Additional research that shows the superiority of natural exposure immunity over vaccine immunity:

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3838993
https://www.nature.com/articles/s41586-021-03647-4
https://www.medrxiv.org/content/10.1101/2021.04.19.21255739v1
https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v3
https://www.medrxiv.org/content/10.1101/2021.07.03.21259976v2
https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00203-2#%20
https://www.biorxiv.org/content/10.1101/2021.07.14.452381v1
https://www.biorxiv.org/content/10.1101/2021.05.12.443888v1
https://www.medrxiv.org/content/10.1101/2021.07.13.21260426v1
https://www.medrxiv.org/content/10.1101/2021.08.19.21262111v1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209951/pdf/RMV-9999-e2260.pdf
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00141-3/fulltext#%20
https://www.medrxiv.org/content/10.1101/2021.07.19.21260302v1
https://www.medrxiv.org/content/10.1101/2021.04.20.21255670v1
https://www.medrxiv.org/content/10.1101/2021.04.20.21255670v1
https://www.medrxiv.org/content/10.1101/2021.07.02.21259897v1
https://pubmed.ncbi.nlm.nih.gov/33777028/
https://www.medrxiv.org/content/10.1101/2021.05.11.21256578v1
https://rupress.org/jem/article/218/5/e20202617/211835/Highly-functional...
https://www.medrxiv.org/content/10.1101/2021.07.19.21260302v1
https://www.nature.com/articles/s41467-021-24377-1?utm_source=other&utm_...

Competing interests: No competing interests

14 September 2021
Paul Alexander
Evidence based medicine researcher, clinical epidemiologist, former assistant Professor McMaster
Washington DC