The fallout continues from the CDC’s ‘bombshell’ report on natural immunity this week. The report set off a wave of confusion among natural immunity deniers, who believed that ‘vaccines‘ were the only way for people to get protection to Covid-19.
The CDC report nonetheless showed that prior infections were potent protection during the Delta variant wave in 2021.
“During America’s last surge of the coronavirus driven by the Delta variant, people who were unvaccinated but survived Covid were better protected than those who were vaccinated and not previously infected,” AFP reported on the new study.
While new networks like CNN spun itself into retractions after reporting false takeaways from the CDC report, medical professionals dissected the data and evidence. The following are 7 medical professionals’ conclusions.
Dr. Marty Makary, a Harvard-educated member of the National Academy of Medicine and resident at John Hopkins, responded that the results were in line with what he had been saying all along.
The data are now abundantly clear. Natural imm is more effective than vax imm.
Sadly, tens of thousands Americans lost their job & livelihood because the Ab circulating in their blood are Ab the govt does not recognize. Sci group think ruined their careers. Agree to Re-instate👇🏼 https://t.co/k0twDp3VMx
— Marty Makary MD, MPH (@MartyMakary) January 20, 2022
“The data are now abundantly clear,” Makary said. “Natural imm[unity] is more effective than vax imm[unity]. Sadly, tens of thousands Americans lost their job & livelihood because the Ab [antibodies] circulating in their blood are Ab [antibodies] the govt does not recognize. Sci group think ruined their careers.”
“Agree to Re-instate,” he added, referring to those who lost their jobs over the ‘vaccine’ mandates.
Dr. Makary has been undertaking his own studies on natural immunity. One of the reasons for doing the research was to pressure the NIH and CDC into doing it.
My Johns Hopkins research team is leading a long-term study of natural immunity because the NIH and CDC are not doing it. They have $50 billion and 30,000 employees and yet can't seen to conduct one of the most important studies we need done to inform the public.
— Marty Makary MD, MPH (@MartyMakary) October 27, 2021
“My Johns Hopkins research team is leading a long-term study of natural immunity because the NIH and CDC are not doing it,” he said. “They have $50 billion and 30,000 employees and yet can’t seen to conduct one of the most important studies we need done to inform the public.”
Dr. Makary appears to be vindicated by the CDC’s results.
CDC epidemiologist Benjamin Silk reacted to the report on a call shortly before its public release.
“Before the Delta variant, COVID-19 vaccination resulted in better protection against a subsequent infection than surviving a previous infection,” Silk said, before adding, “Surviving a previous infection now provided greater protection against a subsequent infection than vaccination.”
Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, also weighed in on the findings.
“LARGEST STUDY COMPARING VACCINATION TO “RECOVERY IMMUNITY” FOR COVID-19 IN US: Study conducted in NY and CA (18% of US population) from May-Nov 2021 so through delta surge. Compared cases and hospitalizations in 4 groups (cdc.gov/mmwr/volumes/7…),” she tweeted.
“How much were COVID cases lowered compared to group 1?”
1) Unvax’d, no prior infection
2) Vax’d (2 mRNA/1 J&J), no prior infection: 6.2 fold CA & 4.5-fold NY lower
3) Unvax’d, prior infection: 29-fold CA & 14.7 fold NY lower
4) Vax’d prior infection: 32.5-fold & 19.8 fold lower NY
“How much were COVID hospitalizations decreased compared to group 1 (unvax’d, no prior infection) during delta?”
1) Vax’d, no prior infection: 19.8-fold lower
2) Unvax’d prior infection: 55.3-fold lower
3) Vax’d prior infection: 57.5-fold lower
“Agree w/ CDC vaccine safest way to get protection,” she added. “However, this large US analysis shows immunity from prior infection >> vaccine-induced immunity to protect against re-infection/hospitalization with Delta. In U.S. recovery should count as “fully immune” (or “fully vaccinated”).”
“Consistent with prior studies compiled by [Dr. K Lausner] in this nice systematic review in Lancet ID but largest one from CDC & with Delta variant,” she concluded.
Dr. Andrew Bostom, an academic internist and epidemiologist, also broke down the results.
Even CDC now acknowledges what we are seeing via @RIHEALTH “When looking at the summer & fall of 2021, when delta became dominant in this country surviving a previous infection now provided greater protection against subsequent infection than vaccination” https://t.co/04Fr5JSIob https://t.co/BJTwiqWCG9
— Andrew Bostom, MD, MS (@andrewbostom) January 19, 2022
“Even CDC now acknowledges what we are seeing via RIHEALTH ‘When looking at the summer & fall of 2021, when delta became dominant in this country surviving a previous infection now provided greater protection against subsequent infection than vaccination’,” he remarked, then pointed to his own breakdown of Rhode Island’s numbers.
Dr. Nan Hayworth, the first female M.D. to go to Congress and a board-certified ophthalmologist, had a straightforward reaction to the CDC report.
I'd rather have a vaccination than an infection, but natural immunity should be accepted at least as much as vaccination as proof of protection against COVID.
CDC: Prior Covid-19 infection provided greater protection than vaccination during Delta wave https://t.co/Gv3CP7YxGN
— Nan Hayworth, M.D. (@NanHayworth) January 20, 2022
“I’d rather have a vaccination than an infection, but natural immunity should be accepted at least as much as vaccination as proof of protection against COVID,” she said.
Dr. Jay Bhattacharya, who is Professor at the Stanford School of Medicine, specializes in health policy, including infectious diseases, COVID, and health economics.
The CDC starts to acknowledge reality, one piece at a time. What excuse is there now to not consider prior infection in vaccine mandates? https://t.co/kiTEOwY6dT
— Jay Bhattacharya (@DrJBhattacharya) January 19, 2022
“The CDC starts to acknowledge reality, one piece at a time. What excuse is there now to not consider prior infection in vaccine mandates?” Dr. Bhattacharya asked.
When the doctor was pressed by a commenter who opposed all mandates, he agreed on the matter.
“Agree entirely,” he said. “The mandates are now and have been throughout a terrible policy. So much social dislocation and harm caused to people, so much distrust for public health induced, for so little gain.”
But the most detailed and interesting analysis may have come from a data analyst and board-certified and fellowship-trained neurosurgeon.
🚩🚨🚩 Surprising paper in MMWR: C19 Cases and Hospitalizations in vaxed AND previous infected. Explicitly concludes “By early October, persons who survived a previous infection had LOWER case rates than persons who were vaccinated alone!” Finally! 🧵👇 (cdc.gov/mmwr/volumes/7…)
2a/ Paper reports on populations in California and NY, in 1.1 M total cases. They divided the population into four groups:
No prior infection/Unvaxed (NPI/UV)
No prior infection/Vaxed (NPI/V)
Prior infection/Unvaxed (PI/UV)
Prior infection/Vaxed (PI/V)
2b/ This is a longitudinal cohort study. The “prior” C19 infxn had to take place prior to 3/1/21, and vaccination prior to 5/16/21. They then measured new C19 cases, hospitalizations weekly from May30-Nov 20. They then performed adjustments and calculated hazard ratios. 2c/ Unlike some of the prior MMWR studies, this is a straightforward methodology, that is easy to follow. 2d/ The estimated hazard ratios (HR) ranged from 1.5-18 NPI/UV group, and correlated with the Delta wave, BUT Vaxxed and PI cohorts remained dramatically low!
3a/ Crudely and across entire study period, infection incidences in Cali (per 1k):
3b/ And in NY, infection incidences (per 1k) with a similar trend:
3c/ Thus, overall, PI/UV protection >> NPI/V protection.
Absolute benefit of vax is small in PI. You need to vaccinate (NNV) ~750 to save 1 infection.
For those without prior infection, NNV is 10.
Big difference! 3d/ For hospitalizations, NPI/UV rate was 11.5/1000k, but PI/UV was only 0.3 !! Vaccination had virtually NO EFFECT on preventing hospitalization in previously infected !!
4a/ So what about the evolution of C19 hazard ratio over time? In Cali, when comparing NPI/V to PI/UV, HR went from 0.4 (adv vax) in May, to 3.5 (adv PI) in November.
4b/ Similarly in NY, HR went from 0.6 in May to 4.7 in Nov, in strong favor of PI by November.
So while vaccination protection waned, natural immunity remained durable and effective with Delta.
4c/ Is there any value to vaccination in the prior infected? Overall, NNVs are high (see 3c,3d). There seemed to be some benefit to it in mid summer, but it seemed to wane by November to parity with PI/UV.
4d/ Similarly with hospitalizations, vax had a strong advantage in May, but by November, PI/UV had a 3.1x fold lower hospitalization rate! 5a/ The analysis in this paper is a stunning reversal to the conclusions of prior MMWR paper. Cavanagh et. al reported ~2.3x protection with vax in PI, and Bozio reported an ~5x advantage for vax of PI in hospitalization. 5b/ Those studies were “pre delta”. But there were also many methodological concerns. 5c/ This study concludes that vaccination protection rapidly waned with Delta, but C19 rates in previously infected (vaxed or unvaxed) remained low and steady.
5d/ Again, put succinctly by authors:
“Vaccination protected against COVID-19 and related hospitalization, and surviving a previous infection protected against a reinfection and related hospitalization [during alpha and delta]”
5e/ Of course this is all prior to Omicron, and the authors discuss that. There is notable viral escape to both vax and PI immunity. But, from other studies, it appears that PI is roughly equivalent to 3-doses of vax.
5f/ The authors are also careful in their wording. The continue to maintain that vaccines are effective – and they are compared to the unvaccinated without prior infection. 5g/ Authors also are careful to caveat prior infection with “those who survive”, out of the obvious sensitivity to persons purposefully trying to get C19 as an alternative to vax. But, this is the FIRST evidence that the CDC has provided of the effectiveness of natural immunity in protection against C19. This is a remarkable admission !
There has been a growing body of independent evidence, however. 7a/ The equivalency (at least) of natural immunity to vaccination was reported in our metaanalysis:
In this analysis, we also saw early signs of PI outperforming Vax in the Delta phase. (cureus.com/articles/72074…) 7b/ Here is another review that comprehensively reviews real-world data to date, and also finds natural immunity “may offer equal or greater protection … [than] receiving two does of an mRNA vaccine” (papers.ssrn.com/sol3/papers.cf…)
8a/ Prior infection and natural immunity must be considered in vaccination policy. Over 60 million Americans have now had confirmed infection, and possibly 145 million may have been exposed.
8b/ A one size fits all vaccination policy does not make sense when people have different baseline protections to C19 based on prior infection history. Each person should consult their own doctor!
8c/ Given this new light, it is stunning that the CDC still recommends vaccination (and boosters) in ALL persons over the age of 5. Hopefully, this study is the start of a pivot towards more flexible policy!
8d/ Especially in children who have had prior infection, and many recently with Omicron! These children have a unique risk/benefit calculus — mandates for kids are senseless.
8d/ Universities and employers, who generally depend on CDC guidance, should also consider flexibility in their policies. The evidence supporting NI is robust. Focus on immunity, not only vaccination!
8e/ Universities and employers, who generally depend on CDC guidance, should also consider flexibility in their policies. The evidence supporting NI is robust. Focus on immunity, not only vaccination!
Thus concludes Dr. Shenai’s thread.
It should be noted that it was hoped that there would be more doctors and medical experts reacting to the CDC’s report on natural immunity. Unfortunately, they are either too afraid to speak up about it publicly, or are hesitant to admit that perhaps they were wrong all along.
OPINION: This article contains commentary which reflects the author's opinion.