11 Comments

I just wanted to thank you for your work! Your posts go a long way in helping me manage my COVID anxiety. Long COVID has been very much on my mind, so I am looking forward to your next post! I was hoping that you would also consider updating us on young men and booster shots. My family doctor has recommended that males under 29 get the Pfizer booster instead of Moderna "until we sort through the myocarditis issues" or something like that, but I can't find any corroborating data. My young adult son is in a risk category, was fully vaccinated in the beginning of April, and works in retail, so this, too, has been weighing heavily on me.

Expand full comment

Like all good info, I wish it could be made succinct enough to convince the ideologically anti-vax. I've tried to reach them by pointing out which of their anti-vax heroes have gotten their shots, but I'm not sure how much good it's doing yet.

I will say, I thought you noted in a previous post that natural immunity had an average length of 6 months, with up to 18 months protection. But this post says 5 years, and I'm wondering where 5 years comes from? I know mathematical models have been very useful on these things, but that still seems odd, given we've only seen this virus for two years.

Expand full comment

You cite the Kentucky CDC study comparing natural infection to vaccination. If I'm reading the study correctly, it's actually comparing natural immunity to hybrid (infection + vaccine) immunity, correct? I don't think it's designed to compare vaccine immunity in someone who never had Covid to natural immunity, though it does provide strong evidence that the previously infected do benefit from adding a vaccine on top.

Expand full comment

Yep. the CDC basically willed this into existence by using the misleading headline: "New CDC Study: Vaccination Offers Higher Protection than Previous COVID-19 Infection"

It should be "New CDC Study: Prior COVID-19 Infection Plus Vaccination Offers Higher Protection than Previous COVID-19 Infection Alone"

Expand full comment

There are several studies that highlight that immunity conferred by vaccination is superior to immunity derived solely from viral infection. and that those with solely naturally acquired immunity are more likely to become reinfected, and more likely to manifest serious disease. The CDC did confer "hybrid immunity to naturally conferred immunity but the title isn't misleading and the finding is correct.

Expand full comment

Thank you! Paid subscriber here. I’ll need to reread this often! I too am anxiously awaiting your long Covid portion. I’m very concerned for my 16 year old, who’s 8 months post vax & can’t get the booster yet (ditto both for me). Pre-dating Covid, I’m disabled with illnesses & symptoms that long Covid can cause, and don’t want that for anyone for any amount of time. I pray authorization for teen boosters come fast! Any idea on that?? Thank you again!

Expand full comment

Is there any updated information about this now that breakthrough infections have become so common?

Expand full comment

What about asymptomatic carriers? I haven't seen anything in any of the studies you or others have linked discussing that.

Expand full comment

If we ramp up humeral immunity (circulating antibodies) we likely reduce the available virus that would replicate and produce sufficient quantities to be transmitted by aerosols. If we were able to achieve sterilizing immunity, the vaccines would prevent anyone who received them from being infected by the virus. Sterilizing immunity isn't theoretically impossible but is highly unlikely and difficult to achieve. Instead, we're now trying to keep circulating antibodies up to reduce the threat of infection, or to more rapidly fight the virus if infected. Having antibodies in place after, say, an initial vaccination or booster is also indicative (generally) of the immune system already ramped up to produce antibodies and sensitized to this sort of foreign protein. It's then easier to produce more specific antibodies for the variant that is causing your infection.

IF you want to talk about asymptomatic persons, we now know that almost all who contract the virus are contagious within 2-3 days and will be until 2-3 days post symptom onset, or typically, for about 5-6 days. If they have an intact immune system they will be producing antibodies by ~3 days after symptom onset and likely will be quelling the virus. Unless they've contracted severe disease and their immune system isn't responding adequately (but then, those are not asymptomatic). Virtually everyone is contagious prior to symptoms; some peoples' symptoms are milder than others. As a personal anecdote, my symptoms were similar to a bad 5 days of allergies until my senses of taste and smell were modified, while my wife's symptoms were much more profound. Some people ascribe mild symptoms to something (in some cases, ANYTHING) besides COVID, and drive on.

What we're coming to learn is that there are super-spreader events, which most of us have heard of, and likely, super-spreader people, a concept with a bit less publicity. Some people will emit more virus than others. This is now believed to be the basis for workplace and other concentrated outbreaks. Not necessarily so much that the venue was to blame but that someone was producing a large... HUGE... aerosolized viral load within proximity of a large group and they, or a majority thereof, were subsequently infected. It's also possible that within those individuals, the virus saw random deletions and modifications ("new" variants) that increased the infectiousness. These are the people we need to see vaccinated.

Expand full comment

Katelyn, is there any information on this same topic but with omicron yet?

Expand full comment

Do you have any information about vaccinations for the 0-4 group? All of this data is fantastic in showing how these vaccines are safe and effective, so why are we withholding them from our youngest population, most of whom are too young to have even the protection of a mask?

Expand full comment