NIH Director's Blog

This is why making vaccines virtually compulsory (eg. France) is a horrible idea. They should be 100% optional. It's very far from obvious taking one now is a good idea. It helps with delta, but new variants that evolve in response to pro-ADE selective pressure may be extremely dangerous to the vaccinated.

Infected vaccinated people are variant factories, because they have same [1] [2] viral loads as unvaccinated, but less severe symptoms (for the delta strain) - meaning infected unvaccinated are much more likely to self-isolate fast, while vaccinated may not even know they have covid. We already know current vaccines are borderline worthless [3] in preventing delta infections - Pfizer is only 39% effective.

In addition to that, selective pressure for new variants with more severe ADE doesn't exist inside people without antibodies because newly mutated strain has no competitive advantage. This means a new variant with severe ADE is almost certainly going to originate from a vaccinated person.

Immunity from a past infection is more selective [4] which is very good as far as ADE risk is concerned, so the main risk is from current vaccines.

Last but not least, policies that encourage 100% vaccinated environments (covid passes) create a perfect environment for a new ADE variant to preferentially spread - also because people there feel safe so they don't care about masks and social distancing.

Trading a negligible risk from current covid strains for a potential risk of a…

This is an argument that first appeared in July 2020.[1][2] That led to comments such as, in October 2020, "If we add t-cell immunity (greater than 50%) to antibody immunity (around 20%) we have over 60% immunity in the general population which qualifies as population immunity (herd immunity). This is why we have not seen exponential growth of the disease anywhere in the world and why we will not see a second wave…".

That was not a successful prediction.

There's an experimental skin test being developed for COVID-19 T-cell immunity.[3] It's from a startup which announced the test, three new vaccines, and a share offering at the same time, which raises some questions. But at least people are working on this.

[1] https://directorsblog.nih.gov/2020/07/28/immune-t-cells-may-offer-lasting-protection-against-covid-19/

[2] https://blogs.sciencemag.org/pipeline/archives/2020/07/15/new-data-on-t-cells-and-the-coronavirus

[3] https://www.bioworld.com/articles/503586-tonix-looks-to-the-past-for-the-future-of-covid-19-vaccines-and-testing

> Natural immunity should be better because you are exposed to all the same proteins in the vaccine plus more

This directly contradicts what immunologists seem to be finding as in the "Antibodies elicited by mRNA-1273 vaccination bind more broadly to the receptor binding domain than do those from SARS-CoV-2 infection" [1] study.

Summarized by the director of the NIH [2]:

> antibodies elicited by the mRNA vaccine were more focused to the RBD compared to antibodies elicited by an infection, which more often targeted other portions of the spike protein. Importantly, the vaccine-elicited antibodies targeted a broader range of places on the RBD than those elicited by natural infection.

If there's one thing we should learn from this pandemic it seems like the complexity and non-intuitiveness of the immune system is amongst them.

1: https://pubmed.ncbi.nlm.nih.gov/34103407/

2: https://directorsblog.nih.gov/2021/06/22/how-immunity-generated-from-covid-19-vaccines-differs-from-an-infection/

The funny thing about India is that at the beginning of 2021, Covid was considered a thing of the past. Cases flat lined. The government was so confident it was trying to export vaccines to curry diplomatic favour.

Then delta came. Turns out being infected with one variant doesn’t offer as much protection against another variant as being vaccinated. (https://directorsblog.nih.gov/2021/06/22/how-immunity-generated-from-covid-19-vaccines-differs-from-an-infection/)

> The new evidence shows that protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from an infection.

So yeah, life is back to normal in India. Until the next variant.

Also interesting:

“Is One Vaccine Dose Enough After COVID-19 Infection?”

> A small, NIH-supported study, published as a pre-print on medRxiv, offers some early data on this important question [1]. The findings show that immune response to the first vaccine dose in a person who’s already had COVID-19 is equal to, or in some cases better, than the response to the second dose in a person who hasn’t had COVID-19. While much more research is needed—and I am definitely not suggesting a change in the current recommendations right now—the results raise the possibility that one dose might be enough for someone who’s been infected with SARS-CoV-2 and already generated antibodies against the virus.

https://directorsblog.nih.gov/2021/02/23/is-one-dose-of-covid-19-vaccine-enough-after-covid-19-infection/

An article written by an expert in biology and disease and the director of the National Institutes of Health, which summarizes an a article that was published in a peer-reviewed medical journal and written by another accomplished medical doctor, isn't scientific enough for you.

Why? Because Sweden didn't mandate masks. First, Sweden had more deaths per capital than most countries. Second, even if it had very good numbers, that would not mean that masks aren't effective.

Masks save lives (1) (2) (3) (4)

(1) https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent

(2) https://www.nature.com/articles/d41586-020-02801-8

(3) https://www.nature.com/articles/s41598-020-72798-7

(4) https://directorsblog.nih.gov/author/collinsfs/