IS NATURAL IMMUNITY BETTER PROTECTION THAN GETTING THE COVID SHOT?

Natural immunity poses an extreme risk, illness, and even death. Immunity wears off and each reinfection poses additional risks and mutations. Please get your vaccinations. Please stop spreading diseases, hurting, harming killing people (and maybe yourself).

Is natural immunity better protection than getting the Covid shot?

Dr Jo, Just another physician

Answered Wed

I made a mistake.

I searched for ‘natural immunity covid’ on Quora, and read some of the responses. I think I need a little lie-down…

Whew! I’m feeling slightly better now. (Image of “A Little Lie Down” is by Amanda Popham). Okay, let’s explore this.

Is there ‘natural immunity against the new coronavirus?

Our planet has 7.9 billion people. As far as we know, not one of them was born with natural resistance to the virus that causes COVID-19 — SARS-CoV-2. It seems that unchecked, it will get us all.

It’s possible that out there somewhere is someone with a really weird ACE2 receptor or an immune quirk that makes them unable to get the disease. We haven’t identified such people yet, so they are likely really rare, if they exist at all.

Bats are naturally resistant to such viruses. They do have weird immune systems, and their viruses mainly just lurk, without causing too much trouble—for them. We are naturally susceptible to many of those viruses. People are not bats.

So there are just two ways we know of to get immunity to the virus. Both involve ‘natural’ immunity. A better name for this ‘natural’ immunity is the term “acquired immunity”, and this is the term we’ll use from now on, just to dispel some of the confusion.

What has acquired immunity then?

Acquired immunity to a virus works as follows:

1. You get exposed to:
   1. the virus; or
   2. even just parts of a virus.
2. The body’s immune system hits the panic button—the details are quite spectacular, often involving sensors such as “toll like receptors”, all sorts of alarms and trip wires inside cells, and the production of virus-crippling proteins like interferon. Ultimately other responses kick in (B cells make antibodies, T cells do a variety of things, including helping B cells).
   1. This can go horribly wrong too. Part of the complex shitstorm that happens in some people—immunity losing the plot and making you very sick—is shown in the diagram above. Yes, SARS-CoV-2 + your own immune system can kill you.
3. With luck (or sometimes, a bit of help) you don’t die, and develop a degree of longer-lasting immunity to the virus. The next time the same virus comes by, your body is ready for it, and (at least sometimes) the virus might be eliminated quickly.
   1. A vaccine induces acquired immunity by presenting bits of the virus in various ways (or a whole killed virus, or a weaker form of the virus) that goad the immune system into doing the right, ‘natural’ thing. Even this can go wrong, but with vaccines against SARS-CoV-2 severe issues like myocarditis and clotting problems are far, far rarer than with infection, in the order of 1:100,000 people. They are damn safe vaccines. (Yes, I know your granny has a friend who told you otherwise).

“But vaccines are unnatural”

One of the reasons why I had my little lie-down above was all of the silliness that has been written about so-called ‘natural immunity vs vaccines’.

Vaccines prod the immune system into doing the right, natural thing without all the inconvenience of having a near-death experience, and those common complications of actual infection.

Infections vary as to how often they cause short and long-term complications. Ebola kills about 50% of those who get it. The most serious form of smallpox (variola major) had a death rate of about 30%. Polio was mostly asymptomatic, and under one percent developed paralysis; even fewer developed total paralysis of the nerves that control breathing, and needed someone (or a machine) to breathe for them, sometimes for months or longer. But a rate of under 1% doesn’t make polio ‘mild’.

Even in the long term, polio is not kind. Some 15–40 years after you’ve recovered as best you can, progressive weakness can set in: post-polio syndrome.[1] Measles is another bugger here—rarely, about 2–10 years down the line, the virus re-activates and progressively eats up your brain (subacute sclerosing pan-encephalitis).[2] And chickenpox lies latent in your nerve cells for many decades, eventually re-activating and causing the hell of shingles, pictured above.[3] About 30% of adults who have had chickenpox will get shingles in their lifetime. Ask someone who has had it about the experience.

The long-term complications of even mild COVID-19 may also be as high as 30%—unless you don’t mind a continual ‘brain fog’ and the inability to do more than light exercise.[4] In some studies, Long Covid has been even more common[5]; others report rates that are a bit lower.[6]

With the initial infection, death is not rare. It’s unlikely that the death rate from infection with SARS-CoV-2 is lower than 0.5% overall, and in many circumstances, it’s a lot higher. Chubby people of all ages, for example, seem more prone, as are those with diabetes, lung disease, heart disease, and people on immune suppression. Older age is a huge risk factor, but even those under 30 years old can cope with it.

This summer in the USA, 20% of COVID-19 cases were under this age, and in one study of 3000 people in the age range of 18–34 who ended up in the hospital, one fifth ended up in intensive care and 10% were put on a breathing machine—one-quarter of them then died.[7]

Recent events have shown us that unvaccinated, right-wing radio hosts are a finite and diminishing resource. Perhaps SARS-CoV-2 regards them as ‘unnatural.

The image of polio patients in Sierra Leone is from CBS news.

Is immunity stronger after infection?

A common idea still punted by those resistant to vaccines is that immunity in those surviving infection (Only this do they call ‘natural’) is somehow stronger.

Initial data suggested low rates of re-infection[8][9][10]. These were enthusiastically greeted as ‘evidence of strong natural immunity, e.g.[11] Unfortunately many of these studies are proxy studies (antibody responses and not diligent surveillance studies), are short-term, or don’t adequately take Delta into account; some are just rubbish.[12]

Recently, we’ve acquired more solid data. The results don’t look good for longer-term immunity following infection:

1. If you’ve been infected and not vaccinated, on average you’ll get another infection in about 16 months time.[13] We’ve known for some time that re-infection is not necessarily milder.[14] [15] [16] [17]
2. If your initial infection was mild (with lower shedding), you’re more likely to get re-infected.[18]
3. In a Danish study of a first surge in late 2020 and a second surge between March and May, 2021, over the period of 3–6 months, initial infection provided about 80% protection against re-infection.[19] This sounds impressive until you realise that after just a few months, there were 20% who were not protected. Similarly, a six-month pre-Delta study in England showed “84% protection” (i.e. 16% non-protection).[20]
4. A Brazilian study found that 13.6% of all Gamma variant infections were re-infections[21] (preprint).
5. In a recent, detailed analysis of breakthrough infections and re-infections from Oklahoma,[22] the rate of breakthrough infections after vaccination was about 1% for the J&J vaccine (1077 per 100,000 people), and about half this for Moderna and Pfizer. Almost all of these avoided hospitalisation and death. In contrast, the ratio of re-infection rates to breakthrough case rates was consistently greater than one, even with re-infection defined as “after 3 months”. (As an interesting aside, in this analysis, half of those who died did not have even one ‘co-morbidity’.)

Why should SARS-Cov-2 infection not confer long-term protection?

Actually, this was expected from the start. To understand why you need to understand its relatives. Reference [13] above provides a detailed, cutting-edge analysis. The bottom line—without help, our immune system is not very good at developing long-term immunity after infection with coronaviruses.

The vaccines were specifically engineered to work better than just getting infected. As we’ve already found, immunity after infection is a bit hit-and-miss. This is likely because your immune system will sometimes mainly attack vital parts of the virus, especially the spike protein. Others will be less lucky and attack other more boring parts of the virus that don’t confer strong immunity. And in all, the immune response will tend to weaken over time—even more rapidly than for other coronaviruses.

The vaccines concentrate on the spike protein and direct all of the efforts of the natural immune system to fighting just this protein. This not only minimizes collateral damage but also cripples the virus, as it needs the spike protein to get access to cells (The spike binds that ACE2 receptor I mentioned above). Even variants are generally covered well enough to protect you against severe consequences.

So what should I do?

Get the vaccine. It will strongly protect you against hospitalization and death. It will also limit the spread of the virus (combined with other sensible measures like masking) and prevent new, even nastier mutants from arising (Image is from Johns Hopkins).[23]

Pretty much all the data also agree that if you’ve already had COVID-19 and then get the jab, this provides very solid immunity against further infection.[24] Unlike ‘natural’ immunity after infection.

Just abandon the conspiracy theorists (those who are still alive) and get the jab.

It’s also nice to see how increasingly those crazy posts about ‘natural’ immunity are being down-voted out of existence. You can do this too—it will make everyone just that little bit happier.

My 2c, Dr Jo.

Jim Yarrow, B.A. English and Linguistics & Psychology, California State University, Fullerton (2011)Answered Thu

Here is something from our local paper, just this week. A man, age 30, got the Delta variant of COVID-19 and experienced symptoms. He recovered, being generally in good health. Three weeks later he started showing symptoms. He was tested again, and this time he had a mutation of the Delta variant. The thinking has been that natural immunity can last 4–6 months, but as this case shows, that is not especially true when different variants and mutations are showing up.

That having been said, if you get a bad case of COVID-19, your immune system is not going to do you much good. Why? One of the first things that a coronavirus does is infect the white blood cells (neutrophils). On a good day, white blood cells are good for the body because they identify pathogens and kill them. However, if the same defenses that are supposed to be protecting the body go “rogue” and the immune system goes into overdrive, this can have very bad results for the body.

Here’s why. One of the defenses that white blood cells (neutrophils) use is called a neutrophil extracellular trap (NET). Basically, the white blood cell has a controlled explosion, expelling a web-like structure that can entrap pathogens in the bloodstream. The NET contains materials like DNA and fibrin. Fibrin is the substance that is involved in blood clotting. If too many NETs are deployed and there is a buildup of fibrin in the bloodstream, thrombosis (a blockage of the vein) can happen. This can kill the lungs, heart, kidneys, and other body systems, which is what we are seeing with COVID-19 right now in severe cases – multiple organ systems shutting down.

When you receive a COVID-19 vaccination, the body is exposed to one single aspect of the COVID-19 virus, information about the spike protein that is outside of the pathogen. The body sees, this, and while it is not otherwise under attack can create antigens to respond to it so if it sees the same culprit again in the body, it will be prepared with hardened weapons to deal specifically with COVID-19 and can take it out before it can do too much damage. Obviously, if someone has an immune system that is already compromised by other illnesses, a COVID-19 infection can still happen, and while it happens very rarely, a person can die. However, right now over 99% of the cases that are being seen in hospitals are in people who are not vaccinated. Every one of those deaths was potentially preventable.

So to answer your question, no, it is not better to let the immune system just deal with COVID-19. COVID-19 attacks the immune system, and the likelihood that the body will be able to mount a successful defense, especially if one already has co-existing conditions, is much lower.

COVID-19 Hyperinflammation: What about Neutrophils? | mSphereCOVID-19 is often related to hyperinflammation that drives lung or multiorgan injury. The immunopathological mechanisms that cause excessive inflammation are under investigation and constantly updated. Here, a gene network approach was used on recently …https://journals.asm.org/doi/full/10.1128/mSphere.00367-20

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Footnotes[1] Post-Polio Syndrome Fact Sheet [2] Subacute Sclerosing Panencephalitis – NORD (National Organization for Rare Disorders)[3] Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia[4] Post-acute COVID-19 syndrome – Nature Medicine[5] Frequency and Variety of Persistent Symptoms Among Patients With COVID-19[6] Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK[7] Coronavirus and COVID-19: Younger Adults Are at Risk, Too[8] Mild SARS-CoV-2 Illness Is Not Associated with Reinfections and Provides Persistent Spike, Nucleocapsid, and Virus-Neutralizing Antibodies | Microbiology Spectrum[9] Rate and severity of suspected SARS-Cov-2 reinfection in a cohort of PCR-positive COVID-19 patients[10] Low risk of reinfections and relation with serological response after recovery from the first wave of COVID-19 – European Journal of Clinical Microbiology & Infectious Diseases[11] Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?[12] Dr Jo’s answer to A recent Israeli study claims immunity following COVID-19 is stronger than vaccine-induced immunity. How solid is this conclusion?[13] The durability of immunity against reinfection by SARS-CoV-2: a comparative evolutionary study[14] COVID-19 reinfection: a rapid systematic review of case reports and case series[15] Severe reinfection with severe acute respiratory syndrome coronavirus 2 in a nursing home resident: a case report – Journal of Medical Case Reports[16] Reinfection in COVID-19: A scoping review[17] SARS-CoV-2 Reinfection among Healthcare Workers in Mexico: Case Report and Literature Review – PubMed[18] Coronavirus (COVID-19) Infection Survey, characteristics of people testing positive for COVID-19, UK[19] Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study[20] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN)[21] Reinfection by the SARS-CoV-2 Gamma variant in blood donors in Manaus, Brazil[22] https://oklahoma.gov/content/dam/ok/en/covid19/documents/weekly-epi-report/2021.10.13%20Weekly%20Epi%20Report.pdf[23] COVID-19 Vaccines: Myth Versus Fact[24] COVID super-immunity: one of the pandemic’s great puzzles29K viewsView 1,920 upvotesView shares

You upvoted this1.9K37218

Amy ChaiThu

I am literally losing my mind over dealing with anti-vaxxers. Help me! Be kind, calm, kind, calm, repeat.Upvote·70Reply

Cary McdonaldThu

Ami, the issue isn’t ‘anti-vaxxer here; it’s the FORCED vaccination of those that DO NOT NEED to be stabbed.

Do you get the difference? According to studies of N=60k patients in Israel, ‘acquired immunity is 8 to 16 times MORE protective than a vaccine and LASTS much much much longer. Please sort it o… (more)Upvote·14ReplyDr JoHi Cary Mcdonald I agree with you that forcing anyone (in the sense of mandatory vaccination) is evil and wrong. We may however diverge on other points. If you read the more recent literature then, as I’ve already suggested in my main post, the Israeli data are grossly flawed.

For a detailed analysis of one of the most cited but worst preprints of all, see my reference [12], with the link here for your convenience: Dr. Jo’s answer to A recent Israeli study claims immunity following COVID-19 is stronger than vaccine-induced immunity. How solid is this conclusion? There is no absolute certainty in science—and it evolves—but Cary, you’re almost certainly incorrect if you’re basing your decision-making on studies like this. As I’ve also mentioned in my post, there are multiple confounders here, an important one being the rise of Delta.

But read my Israeli analysis anyway, as it’s a lot of fun. There’s even a built-in detective story 🙂 Of the rational critics of ‘Big Pharma’ I know of, I think I might be the third most vigorous, but there is a fine dividing line between calling out their devious excesses when they occur and throwing a whole bunch of valuable therapeutic choices in the bin because you have a bee in your bonnet. You may wish to tread with more circumspection and moderate your discourse appropriately. Just a thought 🙂 Regards, Dr. Jo.

Mo RiddifordThu

You’re losing your mind because of cognitive dissonance. You can look it up. Either get used to it, or you WILL be getting much harder slaps from reality.Upvote·6ReplyView more replies

Rick HamiltonThu

Thanks, Dr. Jo! Your answers are always clear, concise, and directly on-point. I hope the anti-vaxxers take time to read them.Upvote·55Reply

Tim ColeThu

Unfortunately, the anti-vax lunatics can’t be bothered to learn anything. We can see this from comments here that directly contradict Dr. Jo’s discussion about immunity produced by infections. Either the commenters didn’t bother to read the post, or simply blocked out anything that didn’t conform… (more)Upvote·42Reply

Neil BowenThu

Alas, the vaccination rate in the UK is about to slow as the UK antivaxxers now have a shining new hope in the news that the UK has, yesterday, bought half a million antiviral Molnupiravir pills. So, of course, denied Ivermectin, they can now pin all of their hopes on a drug whose mode of action is to cr… (more)Upvote·19Reply

Dr JoThu

You may have seen my thoughts on molnupiravir: 

Dr Jo’s answer to Would you be willing to try Merck’s anti-Covid pill, Molnupiravir, if it is deemed safe by the FDA?Upvote·16Reply

Neil BowenAbsolutely I read your post. When the drug first appeared in the media over here, I checked on the mechanism as it was being compared to anti-flu drugs and as they all target the flu virus neuraminidase, I thought it pretty unlikely. If it works as stated, then it’s something I have fewer problems with. But what worries me is that the targeting of the drug has to be absolutely precise. Mutagenesis in DNA, our own mRNA, mitochondrial DNA and RNA, all have to be effectively zero. It is, this morning, being gently promoted will be getting my booster jab. Soon, hopefully.

Damon KaswellThu

I simply do not understand why these lunatics are so excited about a pill they wouldn’t have to take at all if they vaccinated themselves against the virus.

Sometimes I think these people are incapable of hearing the word “vaccine” without some weird neurological effect kicking in and replacing it with th… (more)Upvote·28Reply

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Danielle FraserThu

So basically the solution is to do what we did with polio and smallpox and get the vaccination rate up to 90+% to get the transmission vector below 1. And the whiners are preventing this from occurring. Thus prolonging the whole damn thing.Upvote·30Reply

Richard CoxThu

I’ve been following your advice in downvoting answers regarding immunity (plus, anything else about vaccines). When those answers are false, I also take the step of reporting them. I don’t know if it does any good, but one can only hope….Upvote·12Reply

Sharon WilliamsThu

I’m trying to do the same thing. Maybe if more of us do this, it’ll stop some of the stupid bs. Thx!Upvote·2Reply

Karen Arianna KasperFri

My niece’s baby got Covid last spring when he was about six months old. He got better.

Now he’s almost a year old and he has Covid AGAIN.

So much for natural immunity.

Get vaccinated. Because babies like my great-nephew CAN’T.Upvote·8Reply

Jackie Howe JanssenThu

Bless you. I would happily give you more upvotes if that were legal. But… I don’t work the way the way the majority of Republicans seem to.Upvote·3Reply

Timothy Scott LittleFri

Those republicans would just move your voting booth, er, I mean, your upvote button, so far away you could never get to upvote.Upvote·1Reply

Chris O’LearyThu

Re: Downvoting – If an answer contains dis-information about COVID or the COVID vaccines, I also report it as “Factually Incorrect,” and in the report comment generally add something to the effect of “Anti-Vaxx horseshit.”Upvote·40Reply

Muralidhar Kamidi22h ago

If you downvote a good number of such answers, you will eventually stop seeing them; and lose the “privilege” of downvoting newer ones out of existence.

They (anti-vaccine answers) don’t appear in my feed anymore. But, I guess, not for lack of people (I m sure some anti-vaxx Quorans are still breathing wi… (more)Upvote·2Reply

Herb Fellows21h ago

Chris, I have taken to not using the term anti-vax anymore. I now use the term pro Covid. I think it’s time to call a spade a spade.Upvote·9Reply

View more repliesLee ThéThu

Did you ever imagine that one of America’s two major political parties would devote itself to helping a deadly pandemic spread as far and wide as possible because they think sabotaging President Biden’s efforts to control it will help them in the next election?Upvote·23Reply

Alex DhimitriThu

They aren’t a political party. They are a collective of likeminded terrorists.

They haven’t been a political party for at least the last 50 years.

The sooner we acknowledge that the better off we will be.

Upvote·18Reply

Timothy Scott Little

This is one of the most cogent and valuable comments I have seen, and one that is worth everyone’s attention. The bulk of the GOP has indeed become a collective of like-minded terrorists, as you so eloquently, if not bluntly, stated. We need to stop legitimizing them by continuing to give them status as a valid political party. They are not a valid political party. They do not support a democratic approach to government. They do not value our national institutions.

They certainly do not value non-violent ways to settle disputes. They place little importance on truth, comfortably manipulating information and creating misinformation as a way to maintain power. They demonstrate remarkably little understanding of our foundational documents. Every minute that we treat the Republican Party as a legitimate participant in our national conversation, we cede more of our potential and our future to an ugly stew of conspiracy theorists, know-nothings, xenophobic self-victimizers plus those wealthy autocrats who use those same groups to do their dirty work and subvert the will of the people. We must remove the scales from our eyes and confront this truly powerful threat to our way of governing and to our future.

Albina GriniuteThu

Latvia just entered into another quarantine, with all non-essential shops (everything except groceries and pharmacies) closed, all students except for primary students going back to studying from home, and everyone else working from home, too. There is a curfew of 8 pm to 5 am. Hospitals are overcrowded … (more)Upvote·20Reply

Sharon WilliamsThu

I would like to see criminal charges to the covidiot killers spreading their stupid lies! The pandemic should be completely over in the US for months if not for these morons.Upvote·6ReplyView more comments