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Comment by JamisonM | Hacker News Reader

"COVID will spread until everyone gets it at least once"

Unfortunately evidence seems to indicate that everyone getting once is also not very effective, the reinfection protection of past infection seems to be sub-20% from Omicron. You can find lots of studies with different numbers but none of them are good.

China's behaviour with respect to vaccines is very strange, they could mandate vaccination very easily, they could also relent and import mRNA vaccines but they don't. It seems like even mandating their very poor vaccines would be helping their situation a lot if it had been done months ago - availability has not been enough.

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> the reinfection protection of past infection seems to be sub-20% from Omicron

So then what? Lockdowns forever? Vaccines are even worse than natural immunity.

But the truth is your numbers aren't accurate. Someone who had covid and is reinfected is unlikely to go to the hospital - and that's the only thing that matters.

Yes, they will get Omicron, but that doesn't matter. Vaccine or natural immunity (and get both if you can, in that order) prevent hospitalizations and death.

Do you have a citation for that? The data I'be seen suggests no reduction in severity due to previous infection.

"Reinfections had 90% lower odds of resulting in hospitalization or death than primary infections. Four reinfections were severe enough to lead to acute care hospitalization. None led to hospitalization in an ICU, and none ended in death."

https://www.nejm.org/doi/full/10.1056/nejmc2108120

It was literally the first hit on google. And it's well known that infection is much more protective than vaccination (although riskier).

Who you're replying to specifically cited Omicron. The study you posted is older than Omicron. There is evidence Omicron and Delta are much better at reinfection.

According to https://www.nejm.org/doi/full/10.1056/NEJMc2200133 Omicron has 56.0% protection but: "Among the patients with reinfection, progression to severe Covid-19 occurred in one patient with the alpha variant, in two patients with the beta variant, in no patients with the delta variant, and in two patients with the omicron variant. None of the reinfections progressed to critical or fatal Covid-19. The effectiveness with respect to severe, critical, or fatal Covid-19 was estimated to be 69.4% (95% CI, −143.6 to 96.2) against the alpha variant, 88.0% (95% CI, 50.7 to 97.1) against the beta variant, 100% (95% CI, 43.3 to 100) against the delta variant, and 87.8% (95% CI, 47.5 to 97.1) against the omicron variant."

So for the metric that matters (deaths), Omicron is no different.

Deaths is not the metric that matters. Transmission is. It doesn't matter if the chance of death or severe illness is divided by 5, if you end up being reinfected 10 times over a few years.

No, infection is not more protective than vaccination. Vaccination is much more consistent than infection - not least because the vaccine is not packaged with immune suppressing elements.

Consistency refers to the spread not the mean. For instance, you could have a vaccine performing uniformly poorly relative to a prior infection and that sure would be consistent.

I was implying consistently good. As in, the ~ 90% protection was relatively uniform

Sources? Are you sure you are not conflating consistently higher specific antibody titers with uniformly better clinical outcomes?

That's not true: "Naturally infected populations were less likely to be reinfected by SARS-CoV-2 than the infection-naïve and vaccinated individuals."

https://www.nature.com/articles/s41598-022-05325-5

There are other studies that say the same thing - natural immunity is far superior to vaccination. (But also more risky since acquiring that immunity can cause people to end up in the hospital.)

The best is both:

"Two doses of BNT162b2 vaccine were associated with high short-term protection against SARS-CoV-2 infection; this protection waned considerably after 6 months. Infection-acquired immunity boosted with vaccination remained high more than 1 year after infection." https://www.nejm.org/doi/full/10.1056/NEJMoa2118691

Agree the best is both. Your source pertains to Bangladesh, not sure the results necessarily carry more generally, due to the different society/demographics/etc.

Please provide sources for your other studies - "far superior" is quite a strong claim

So the first study is a population that is mostly using the Chinese vaccine that is not very good and the second study just validates that getting vaccinated before getting infected is very good (and the reinfection population was only 210 subjects!). The unvaccinated participants data is pre-delta infections:

"A total of 6169 participants in the previously infected cohort were followed in the unvaccinated follow-up period and up to 1 year after a primary infection. These participants were predominantly infected in the spring of 2020 and were followed in the period before emergence of the delta (B.1.617.2) variant."

C'mon buddy, do better!

Here are the two recent studies I've seen that suggest reinfections are not rare and have similar severity to the first. Qatar's reports have been good so I wouldn't discount their results, and it's possible that the 81 study meta-review and the VA system data don't accurately capture what's really happening, but still they are the strongest cases I've seen in the area.

I haven't seen any case that protection from infection is better than at least the mRNA vaccines, only that it's inconsistent and wanes relatively rapidly. Where'd you find that?

Burden of PCR-Confirmed SARS-CoV-2 Reinfection in the U.S. Veterans Administration, March 2020 – January 2022 https://www.medrxiv.org/content/10.1101/2022.03.20.22272571v...

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis https://pubmed.ncbi.nlm.nih.gov/34900250/

"It needs to be determined whether such protection against severe disease at reinfection lasts for a longer period, analogous to the immunity that develops against other seasonal “common-cold” coronaviruses,4 which elicit short-term immunity against mild reinfection but longer-term immunity against more severe illness with reinfection. If this were the case with SARS-CoV-2, the virus (or at least the variants studied to date) could adopt a more benign pattern of infection when it becomes endemic."

You gotta do better than this, the source your cite doesn't support your point at all.. this study completely excludes vaccinated people and you are using it to say "infection is much more protective than vaccination". What are you doing here?

So far I heard the other way around: A natural infection also always means an attack on the immune system by the virus. Also if you have a very light infection your body often doesn't create as many anti-bodies as with a vaccine.

Vaccines are clearly better than natural immunity I don't know why you think the opposite, the data is public and available for you to view. We agree that vaccines plus natural immunity are better still.

Lockdowns forever are not required, inducements to reach 100% vaccination do seem to be required, and "availability" has not been enough to achieve that in most jurisdictions, unfortunately.

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