Quit.

[1] A glaring counterexample to your hypothesis is Brazil (Manuas) where prior infections (as high as 60%) didn't stop the P1 variant from ripping through.

The prior infection estimates for Manaus were simply wrong. They were based on a paper that "adjusted" the observed seroprevalence rates upward by a factor of ~3x. The parsimonious conclusion is that these corrections were too aggressive and ended up over-estimating infections. See Figure 2a in the paper, here:

https://pubmed.ncbi.nlm.nih.gov/33293339/#&gid=article-figur...

It is a "glaring" example only of how the low editorial standards of major journals during this pandemic has led to a wave of confusion amongst the public.

Apparently they're using 40% Astra Zeneca, 60% Sinopharm; hopefully the issue is simply the latter being ineffective. But as all the success stories with vaccination have also had very significant numbers of deaths with covid, we may need significant levels of natural immunity in conjunction with vaccine immunity to actually get cases to decline.

New Zealand had zero community cases without vaccination, during 2021 its vaccination programme has only covered some front line workers and very high risk people, and it still has zero community cases. Is that "success"? Is it "not success" ? How would you tell?

Whereas in my own country about two thirds of adults have had at least one jab, but still people are dying every single day from COVID-19, just much fewer than an the height of the pandemic here. Is that a success? Not a success?

One of the reasons New Zealand was so slow? With zero cases they had no reason to do Emergency Authorization. So they didn't. The Pfizer vaccine they picked got the full (albeit accelerated) approval process that any other medicine would get. This behaviour would be crazy in a country like the US with thousands dying, but it made sense in a country where most citizens have negligible risk day-to-day.

I think you're reading my comment incorrectly. I'm not promoting a criteria. I'm just stating the facts: we may find out that vaccines alone simply can't stop covid from infecting - and maybe even killing - large numbers of people.

Obviously, if that is true to a sufficient degree, lockdown may prove to have been pointless.

> How would you tell?

New Zealand will most likely find out how successful their vaccination program was when they open their borders to the rest of the world.

The Seychelles is still 40% unvaccinated. Even people who are vaccinated have some chance of getting infected, though if they get infected, their chance of showing symptoms is lower, and their chance of ending up in the hospital is much lower. It looks like the people testing positive in the Seychelles are mostly unvaccinated, and that the people ending up in the hospital are even more likely to be unvaccinated. But there's not enough information in the BBC article to judge just how effective the vaccines have been in the Seychelles.

The BBC article does contain one falsehood:

> In April, China's top disease control official said the efficacy of the country's Covid vaccines was low, although he later insisted his comments had been misinterpreted.

George Gao did not say this. He gave a talk at a conference on vaccines which was blatantly misconstrued by a "researcher" at an American think tank, the Council on Foreign Relations. That misrepresentation then got spread by the media. All George Gao actually said was that researchers should consider ways of increasing the efficacy of vaccines that have lower efficacy. He didn't name any specific vaccine or any specific country. He proposed the same sorts of measures that are being considered for other vaccines, such as the AstraZeneca shot: delaying the second dose, mixing vaccine doses, etc. This got twisted into an "admission" that Chinese vaccines have low efficacy. It's too bad to see that the BBC is still repeating this false claim, weeks later.

Seychelles just reported 1800 cases for the last week or 1.8% of its total population. This equates to 6 million cases in the US or more than 800k per day, a number never approached.

> It looks like the people testing positive in the Seychelles are mostly unvaccinated

It stated that 1/3 were in fully vaccinated and the rest were in partially vaccinated or unvaccinated. There are now 60k that are fully vaccinated, leaving just 8.5k first-dose only. The article was written before the 1800 cases dropped a couple days ago.

More data is needed for hospitalizations and deaths, but as it stands now, it does not look convincing for the vaccine. It's likely more cases will continue to come over the next few weeks, even more than the record breaking prior week.

Seychelles and other island nations that had no major covid outbreaks before vaccine launch (only 500 cases prior and 7.5k since) are the best real life settings we have for vaccine efficacy. For much of the rest of the world, a huge number of people were already infected before vaccine launch, making it difficult to separate out the effectiveness of the vaccine.

I see 67% effectiveness of preventing symptomatic cases for Sinovac. I'm not sure where the 80% comes from, they could be talking about AstraZeneca.

> A large multi-country Phase 3 trial has shown that 2 doses, administered at an interval of 21 days, have an efficacy of 79% against symptomatic SARS-CoV-2 infection 14 or more days after the second dose.

There are two different Sinopharm vaccines, but I think that BIBP is the one being used in the Seychelles. And yes, as you note, the Phase III studies were conducted outside of China. In order to conduct a Phase III study, there has to be community transmission of the virus, meaning that Phase III trials are impossible in China right now. You would get the same result for the vaccine and placebo arms of the trial: no infections.

1. https://www.who.int/news-room/feature-stories/detail/the-sin...

> The rest had either had a single dose or were unvaccinated.

So ~66% of the cases were from partially or unvaccinated people.

Do you have a source for that?

"Natural exposure induces a dominant Ab response against the nucleocapsid protein (NP), but since NP is not in the vaccine, there is no vaccine induced response against it. In this way vaccinated people who had a prior natural exposure can be classified because they have Abs to NP."

Simply looking at one aspect of immunity - detectable antibodies in the blood - is a very incomplete way of looking at the overall level of protection. For example, it's well known that mucosal immunity is important, and injected vaccines have a hard time inducing that kind of immunity: https://theprint.in/opinion/why-a-mucosal-covid-vaccine-has-...

It's also concerning that there is evidence that while people who have been vaccinated are much less likely to be infected. If they do get infected, they are more likely to be infected with one of the variants than unvaccinated: https://www.ncbi.nlm.nih.gov/bioproject/PRJNA728463

The immune response developed to our vaccines is quite specific - they only generate the spike protein - which leads to a much less diverse response than a natural infection.

Finally, the study you quoted can't really compare apples to apples anyway, as it's defining prior infection as simply having some level of antibody response, without considering how mild or severe those infections actually were.

I'm nowhere near as concerned about a variant infecting my upper respiratory tract as I am with being unvaccinated and having any of the variants attack my heart, kidneys, lungs and blood.

The use of spike was also not a mistake. Attempts to produce vaccines against NP for SARS-CoV-1 produced signs of ADE, so that is why everyone is using spike-only (other than the few inactivated virus vaccines).

I have not seen an actual credible claim that injectable vaccines can’t produce mucosal immunity. IIRC the HPV vaccines seem to generate strongly protective mucosal immunity. The opinion piece you linked seems off, too: the mRNA vaccines and (possibly to a lesser extent) the viral vector vaccines do seem to prevent most infections.

But it’s definitely true that antibodies in the blood are an incomplete picture. There are also memory B cell and all kinds of T cells.

That's not "concerning"...it's a truism. You've made those people immune to the wild-type strain. If they're going to get infected, it's going to be to a variant. You're still missing the denominator (i.e. how often does it happen?) and the most important question: how serious is it when they do get infected?

So far, the answers are "not often", and "not serious", respectively.

>Simply looking at one aspect of immunity - detectable antibodies in the blood - is a very incomplete way of looking at the overall level of protection

You seem to have no idea what you are reading. Of course vaccines aren't going to have antibodies against the nucleocapsid -- they only generate antibodies against the spike! The vaccines only ask the human body to develop immunity to the spike!

And you know what actually neutralizes the virus? Mostly antibodies against the spike because that is where all the important parts of infecting a cell originate from.

>For example, it's well known that mucosal immunity is important

You are right about mucosal antibodies -- but your statement is also proving to be false as more research comes out. The latest research shows IgG antibodies from vaccination in the mucosal regions too. Apparently our nose is not just waiting for IgA from a natural infection (https://www.medrxiv.org/content/10.1101/2021.05.06.21256403v...)

>It's also concerning that there is evidence that while people who have been vaccinated are much less likely to be infected. If they do get infected, they are more likely to be infected with one of the variants than unvaccinated

You also completely misrepresented this (and frankly, it's disappointing you couldn't even link to the actual publication -- it's https://www.medrxiv.org/content/10.1101/2021.04.06.21254882v...). The framing of this is disingenuous. Vaccines provide nearly complete protection against the non-variant form of COVID-19. They provide a little less protection against variant COVID-19s. Your non-protected human body is the same way -- it's more likely to get a variant too. It isn't that if you get infected after vaccination, it's because you were more susceptible to variants, it's that everyone is more likely to get one of the variants. Your risk is still minimized way more than than if you weren't vaccinated!

This says nothing about the strength of a previous infection. It very plausibly just says that R > 1.7, ie it is infecting the remaining 40%.

Now, of course the excellent chance of becoming immune to a respiratory infection that's killing loads of people is a much better offer than a Coke. So I agree people should take up this offer, get yourself vaccinated - but we shouldn't claim "literally no downside".

to be fair, you could have scheduled your shot at a different time so the kebab shops would have been open amirite

I honestly hoped I had more side effects! You know you’re not getting sick, so a mild fever? Kind of a perverse pleasure.

Unlike the mRNA platforms, these vaccines use an existing virus to make the spike proteins. Specifically, an Adenovirus (so the sort of thing that might be implicated in some colds) but which ordinarily thrives in Chimpanzees instead of Humans, so they can have confidence you aren't immune to it already. The virus is altered to tell human cells to make the protein chosen by the engineers (for COVID-19 this was the spike protein from the SARS-CoV-2 virus); and not more copies of itself, once the copies in the vaccine injection are cleaned up (typically a few hours to a few days) the virus is gone, so you can't "catch" the virus.

But of course your immune system has no particular reason not to destroy this (harmless) Chimp virus meanwhile, it shouldn't be in your body, so it's every bit as much a target as the spike proteins we want immunity against.

Thus, it's certainly possible any fever one particular patient suffers is a side effect from their immune defence against this poor harmless chimp adenovirus, and nothing to do with SARS-nCOV-2 or its spike protein. No way to tell for sure I believe.

> no downside to receiving the vaccine if you've already had COVID

So I assume that this means that there is no difference in potential unwanted effects between persons who have already had COVID and who have not.

On the other hand, there is some concern around the phenomenon known as "original antigenic sin". Its unknown if it is or will ever be an issue with Covid, but it essentially means that for some viruses (such as the flu), your immune system imprints on a virus the first time it encounters it, and more heavily relies on immunity for that particular virus than new antibodies for variants of that virus later on. This leads to the body mounting a sub-optimal defence against new strains of the virus (which is in part why we have yearly flu vaccines that don't offer amazing protection). There is some concern that there is a possibility that over time covid will continue to mutate and those whose initial infection was natural won't have as protective immunity as those who were vaccinated first, precisely because the vaccine only targets the spike protein and not the entire virus:

"Still, Hensley isn’t worried about imprinting — or at least not among people who have been vaccinated with mRNA vaccines. The very strong immune response generated by the Moderna and the Pfizer-BioNTech vaccines should override any imprinting impacts as SARS-2 mutates, he said. Hensley worries, though, that people whose immunity to the virus comes from infection, not vaccination, might have more difficulty handling variant viruses because of imprinting effects.

David Topham, an immunologist at the University of Rochester Medical Center and director of the New York Influenza Center of Excellence, also envisages that possibility.

He noted that, in the earliest stages of SARS-2 infection, the immune system mounts a response to a portion of the spike protein called S2. Later, the immune system focuses its attention on other parts of the spike, notably the part of the protein that attaches the virus to cells it invades, known as the receptor binding domain.

It’s not yet known if the early focus on S2 — which doesn’t change much from virus to virus — will blind the immune system to the changes elsewhere in the spike protein, the changes updated vaccines would be trying to teach the immune system to respond to, Topham said.

Topham doesn’t think this will be a problem in vaccinated people, because of the way the vaccines in use have been designed. The spike proteins they trigger production of appear to hide the S2 region, he said. The immune system can’t fixate on something it doesn’t see.

For people whose immunity comes from infection, Topham sees three possible scenarios. “It can be a problem, because the immune cells specific for S2 outcompete immune cells against other components of the spike protein that you really need in order to get protection. It can be inconsequential in that eventually the responses to the other parts of the protein catch up and it doesn’t matter. Or it could actually be a benefit because it gets the immune system revved up more quickly.”[0]

[0] https://www.statnews.com/2021/04/16/next-generation-covid-19...

The vaccine produces antibodies to a specific stretch of the spike protein. So everyone who has the Pfizer vaccine has a similar (but not identical) group of antibodies.

Those infected with Covid-19 have a more diverse set of antibodies that may or may not protect as well against varients.

https://theconversation.com/new-coronavirus-variant-what-is-...

Mutation causes random changes, the selection process eliminates those that render the mutated version less fit. The focus on the spike is because most random changes to the spike also make it useless, the virus becomes impotent. Such mutations won't thrive of course, and so we hardly see them at all, but they are happening.

In contrast, many random changes elsewhere might not prevent the virus from working. They might say, make it less able to survive outside a body, which would give it a disadvantage against variants that don't have that change, but if they also mean the immune system of a previous host doesn't recognise them, that's a big advantage to counteract that. We see lots of these variants because they "work", but since the spike is the same existing vaccines ought to be effective.

So this is why it made sense to focus on the spike, even though as this article shows it isn't a magical panacea.

Covid can wreck havoc on your body and leave it in a weaker state.

Let me change the perspective: when I get the flu because I stupidly did not get the flu shot that year, I don’t rush out and get the flu shot after the fact. I’m wondering why I would do the same with this vaccine when there are lots of evidence that first rounders are not likely to be infected even by variants (assuming low viral load)

The best answer I've heard is: it will give you "extra immunity".

Which begs the follow on question, if we're so concerned about topping off our immunity, why shouldn't people get vaccinated and revaccinated every month or two?

Maybe you could upgrade your car now for much less than you think, or maybe you only want the latest shiny parts. Either way you need to be honest with yourself, cars have evolved and stayed modern over the past 2 decades compared to any time in automobile history

Remember when cars of the 90s were so much better than cars of the 80s? Going over 100k mi/km in most cars wasn’t a concern anymore. Now a large majority of cars are going 200-300k without a sweat

Oh yes. Remote monitoring, tracking for advertising, contact list stealing through the USB charger port...

There was a time when people were worried about that as a privacy invasion. Even though, to access it, someone has to dig into the wreckage and retrieve the recorder. And all it yields is details of the last 30 seconds before the crash.

my partner could not give two trucks that i was sick. through the sleepless gasping nights where i was wondering if it was time to go to the hospital, my partner blamed it on anxiety. when i couldn't feel my feet, my partner thought it was due to me not eating (because food tasted like paper). this all culminated with my partner calling me lazy for sleeping all day. it really woke me up to their attitude and has reshaped the trajectory of our relationship. as of now it's pretty much just a show so our kids don't end up too messed up

And the incentives to push back on all this are super high!

People absolutely do not want to have to be bothered. Not all people, but the numbers are much higher than I expected.