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As the Biden administration’s vaccination mandate deadline approaches and many states and private employers continue to demand vaccination, many unvaccinated U.S. workers could soon lose their jobs if they don’t comply. not meet these vaccination requirements. This has already been the case for hundreds of healthcare workers and airlines across the country who have refused the vaccine.
Among some of the arguments against the COVID-19 vaccine mandates is that immunity against previous coronavirus infection should count as an alternative to vaccination. This topic has received a lot of attention lately, with NBA players and healthcare workers speaking out and citing “natural immunity” as what they believe is a valid reason for refusing to be vaccinated. .
Last week, NBA player Jonathan Isaac told a press conference that he was not getting the COVID-19 vaccine. His reasoning? Natural immunity.
“I would start with having had COVID in the past, and therefore our understanding of antibodies, of natural immunity, has changed a lot since the start of the pandemic and continues to evolve,” Isaac said.
The natural immunity argument also emerged as a potential legal challenge for states and federally mandated immunization policies.
In New York City, a warrant to vaccinate more than 650,000 hospital and nursing home workers has sparked a wave of statewide lawsuits by nurses and others seeking various exemptions, including one for people who have had COVID-19.
A judge on Thursday upheld the University of California’s COVID-19 vaccine requirement against a challenge from a professor who claimed he was immune to COVID-19 due to a previous coronavirus infection. The U.S. District Court judge handling the case said the university system had acted rationally to protect public health by making the vaccine mandatory and not granting exemptions to people with a certain level of natural immunity. The ruling appears to be the first on the issue, and it could influence future decisions on this issue.
But what does the scientific evidence say that offers better protection – natural immunity or vaccine immunity? The answer is, like almost everything around COVID, complicated.
Dr Monica Gandhi, an infectious disease specialist and professor of medicine at the University of California, San Francisco, says the available data is mixed, with some studies indicating that natural immunity is as effective as some of the vaccines, and other studies suggest otherwise.
“When the data is mixed up, we say we have the balance and we keep studying,” Gandhi tweeted.
However, the Centers for Disease Control and Prevention and most health care professionals in the United States widely recommend the COVID-19 vaccine for all eligible people, whether or not they have previously been infected with the coronavirus.
According to the CDC and health experts supporting this direction, one of the reasons for this recommendation is that research has yet to show how long protection against the virus lasts after recovering from COVID-19. In addition, the agency claims that one of its recent studies, which went through a “rigorous multi-level clearance process”, showed that vaccination offers higher protection than a previous coronavirus infection.
The peer-reviewed study of 246 Kentucky residents concluded that unvaccinated people who already had COVID-19 were more than 2 times more likely than fully vaccinated people to contract COVID-19 again.
Dr Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, told Yahoo News that another reason those who have had COVID-19 should get vaccinated is that not everyone develops immunity. solid after infection.
“If you look at some of these early studies, people who are infected and cured have widely varying heterogeneous responses to the virus,” Hotez said. “Some have quite strong and vigorous responses. Others have almost no virus, neutralizing antibodies or responses at all, and are very susceptible to reinfection, ”Hotez added.
Since it’s difficult to determine where someone might end up on this scale, Hotez says the best thing to do is recommend vaccination for those who have had the disease before.
But proponents of including natural immunity in the vaccine mandate equation also base their argument on scientific evidence. They point to some studies from the past year that have shown that natural immunity offers significant protection against reinfection. These include studies conducted at the Cleveland Clinic and the University of Washington, as well as in Israel.
The Israel study, however, was the one that received the most attention recently.
According to the study of 778,658 people, which has not yet been peer-reviewed, people who recovered from a previous infection and were not vaccinated were 27 times less likely to experience symptomatic reinfection. of the Delta variant compared to those who had not been infected and received two doses of the Pfizer mRNA vaccine. The study also found that a single dose of the vaccine in people with natural immunity enhanced protection against the Delta variant.
Responding to the Israeli study, Dr Anthony Fauci, chief medical adviser to the White House, said natural immunity was “something we need to sit down and seriously discuss.” He added that the study did not provide information on the durability of protection against a previous infection, and that there is much more that needs to be considered and studied further regarding this topic.
Other arguments put forward by opponents of vaccination warrants are that in other countries, for example Britain and Israel, evidence of a previous infection is taken into account, as people can receive a vaccination passport during six months. In the United States, however, this is not the case.
Even though opponents have argued that vaccination mandates should not be uniform, many health experts believe that vaccinating people who have already had COVID-19 is, ultimately, public health policy. most responsible today. “There is no doubt that natural infection confers significant immunity on many people, but we operate in an environment of imperfect information, and in that environment the precautionary principle applies – prevention is better than cure.” former CDC director Tom Frieden said. Medical journal.
Hotez says this universal vaccination strategy is also the best approach at this time because of the challenges that exist in testing people’s level of immunity or protection against COVID-19 on a large scale.
“We have tests to measure antibodies. In theory, you could even measure the virus, neutralize the antibodies in a specialized lab, but it’s not easy to do at high throughput, ”he said. “We don’t have what we call a true correlate of protection. We don’t have a blood test or even a series of blood tests that we can say for sure, you know, thumbs up, thumbs down, you are protected or not, ”he added.
Finally, health experts say vaccination is simply a more quantifiable, predictable, and reliable way to protect people right now, so Hotez stresses the importance of getting vaccinated, even if you’ve had COVID-19 before.
“The bottom line is that if you are infected and recovered, you are still susceptible to reinfection, especially from this Delta variant. … If you have not been vaccinated, get vaccinated; if you’ve been infected and recovered, get vaccinated, ”he said.
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