Yes, it seems likely that health care workers (and everyone over maybe 50) will be advised to get an annual booster. And it won’t be a big deal for the health care workers, who will be able to get it conveniently on-site, probably from the same syringe that holds their annual flu shot.
When there are studies showing that people who got covid in 2020 have better immunity than people who’ve recently gotten this year’s booster, I’ll certainly be willing to change my mind. But at the moment, all the studies show that someone who’s recently been boosted has better protection against omicron than someone with a prior infection. Someone with a prior infection may only need one booster, though, not all three shots of the series. But yeah, health care workers need to be vaccinated, based on the data available today.
Please provide a cite that someone who had COVID in 2020 has more antibodies than someone who recently got the booster. Because that’s what we’re talking about now, right? Healthcare workers who got it early on and don’t want to get vaccinated.
While there are no such studies, and that person should get a booster dose, i would support deferring the booster shot of a healthcare worker who caught covid last Christmas, Dec 2021.
You can’t “demonstrate immunity”. You can test yes/no for the presence of antibodies, which does not guarantee immunity. There exist quantitative tests of how many antibodies you have, which give a lot more information, but as best as I can tell, they aren’t used outside of clinical trials – I know my immune-compromised SIL has been trying to get a quantitative test and her doctors just looked at her funny, so she’s given up.
I’m late to this ‘vaccine party’ so to speak, but why on earth would you assume that full immunity would be conferred via having had the ‘natural’ virus?
I’m a pretty normal person, I got a bad dose of chicken-pox when I was 14 years old (first infection). GO ME, I would never get it again, right? WRONG.
I got another BAD dose when I was 21. Not subclinical, not just a few itches, a whole body (again) with pox lesions and other bad shit.
How are they going to demonstrate that? Stick COVID particles up their nose and see what happens? Because it’s well known now that immunity wanes with time, either vaccine or naturally induced. So, those healthcare workers who were infected before the vaccine are very likely to be vulnerable again, and more able to get infected and transmit COVID to their patients. Certainly more likely than someone who is fully vaccinated and recently boosted.
And i agree with your re the people who caught covid in the first wave. I was adding some nuance. Quite a lot of healthcare workers just caught covid recently. When i took my mom to the hospital for an antibody infusion in a vain attempt to treat her covid, the nurse who started her IV was a GI department nurse, because too many of the covid-clinic nurses were out with covid to keep the clinic open. The nurse who discharged her was a covid-clinic nurse, but he was only recently back, because he’d been out with covid over Christmas.
That hospital has had a vaccination requirement since the Pfizer vaccine won full FDA approval, so I’m sure he was vaccinated. (And the vaccine worked, he had obviously not been very sick with covid.) I didn’t ask him if he’d been boosted. But if not, i think he can wait several months to do that. So can all his co-workers.
I think @Magiver 's “just test for antibodies” is misguided, and displays a lack of understanding of our current toolset to fight covid. That strategy works for measles and German measles, fwiw. But no one uses it for viruses that we need boosters for. And covid will probably end up in the latter category. When we know more about it.
Perhaps you didn’t understand my post. It has everything to do with what you’re trying to say. You’re trying to claim that antibody levels of covid + vaccine is the same as those for covid alone. That is absolutely not true. There have been several studies and, I repeat, they show that vaccination following infection 1) increase antibody titers, 2) improve effectiveness of virus neutralization, and 3) reduce reinfection in the real-world.
@Magiver seems to believe that there’s a simple blood test that can determine immunity to covid, as there is for measles and rubella. But there isn’t.
There is a simple, cheap test for “do you have antibodies”, but it does not tell the whole story, and it’s unknown how well it correlates with actual immunity. Also, antibody levels are known to drop over time, so an antibody test today says little about your status in a couple of months.
There are expensive tests that seem to only be used in clinical studies that measure the quantity of neutralizing antibodies. The results of these are believed to correlate to immunity, but the precise relationship is unknown.
There are also a lot of clinical studies looking at both antibody levels and actual population immunity, as determined by the relative number of people who catch covid in various populations. And there are population studies that look at stuff like “how many people in this tracked population got covid recently, comparing those who had various combinations of prior infection and vaccination.”
The clinical studies find that a booster shot increases antibodies, including among those with prior infection.
The population studies show that having caught covid early in the pandemic provides little protection against catching covid now. And that a recent booster makes a huge difference in reducing the risk of covid.
OK, but that is a rare and exceptional event; in general people do not get chickenpox twice, and if people didn’t normally get some level of immunity after being infected with viruses, vaccination would never have been discovered in the first place. From what I understand, vaccine-induced immunity can be longer-lasting or more reliable, depending on the vaccine and the disease, and this may well be the case with COVID, but it wouldn’t exist at all if naturally-acquired immunity weren’t a thing.
We can track when you were vaccinated. We can track when you had a medically documented case of covid. In neither case do we know exactly how immune an individual is, what we know is that statistically speaking, people who recently recovered from covid or have appropriate vaccine history are much less likely to catch covid or to develop serious illness.
With the current state of knowledge, we need to track a date and and event. And we probably will need to keep those up-to-date (that is, yes, i expect we’ll need booster shots.) Maybe someday we’ll be able to track an appropriate antibody level that’s associated with immunity. But neither that test nor how to calibrate it (if it were cheap enough to routinely use) are currently options.
In addition to antibody titers for Covid-19 not reliably correlating with level of protection, such tests do not measure other components of the immune system that may be equally or more important, i.e. B and T-cells.
“For Paul Offit, MD, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, there’s another strong argument against using blood tests to assess whether individual patients are protected: circulating antibodies don’t give a complete picture of SARS-CoV-2 immunity.”
“The immunological component that is associated with protection against severe disease is immunological memory B cells,” Offit said in an interview. “These cells aren’t making antibodies, but they remember that they have seen this SARS-CoV-2 spike protein before.”
Since there aren’t “10 vaccinations” against SARS-CoV-2, statements like this are reminiscent of antivaxers claiming that children receive “69 vaccines”, in order to alarm people with scary-sounding numbers.
This seems like the ox before the cart. We know many of the vaccines aren’t effective with Omicron yet the solution is to continue to add boosters.
Immunity should be based on science.
If the current stock of vaccines aren’t working on Omicron but someone who had it and developed antibodies then why wouldn’t the person with the antibodies be considered unvaccinated?
Actually, we know that all of the vaccines authorized in the US, and the AstraZeneca vaccine that is widely used in Europe work extremely well to prevent serious illness and death from the omicron variant. We know that not from counting antibodies, but by counting people who were or were not vaccinated. They don’t work as incredibly well as they did against earlier variants, but we know they do work.
We also know that they don’t work very well against symptomatic disease, which means they also don’t work very well to prevent the spread of omicron. UNLESS the person has recently completed their vaccine series, or been boosted. And that with a booster (or a recent vaccination) there’s decent protection against symptomatic disease, although again, not as good as against original-style covid. But a booster works well enough that there’s serious debate in the medical community as to whether an omicron-specific vaccine is worth distributing.
We further know that previously having had covid provides little protection from symptomatic omicron, but that prior infection plus a recent booster provides pretty decent protection.
Immunity is based on biology, and is what it is. I think what you meant was not “immunity should be based on science” but rather that recommendations to track immunity should be based on science. And the science says that people with prior infection should get boosted. And also suggests that the covid vaccine should probably have been a 3 shot vaccine from the start, not a 2 shot vaccine. There are other 3-shot vaccines (polio, one of the hep B series, probably some others.) But it’s hard to do science in real-time. There’s no way to find out how long immunity lasts or how broad it is until people have been vaccinated for a while and until variants emerge.