San Antonio Express-News (Sunday)
Paul touts being ill with virus over receiving vaccination
On the heels of last month’s news of stunning results from Pfizer’s and Moderna’s experimental COVID-19 vaccines, Sen. Rand Paul tweeted a provocative comparison.
The new vaccines were 90 percent and 94.5 percent effective, Paul said. But “naturally acquired” COVID-19 was even better, at 99.9982 percent, he claimed.
Paul, R-Ky., is one of many people who, weary of lockdowns and economic losses, have extolled the benefits of contracting the coronavirus. The senator was diagnosed with the disease this year and has argued that surviving a bout of COVID-19 confers greater protection, and poses fewer risks, than getting vaccinated.
The trouble with that logic is that it’s difficult to predict who will survive an infection unscathed, said Jennifer Gommer man, an immunologist at the University of Toronto. Given all of the unknowns — like a region’s hospital capacity, or the strength of a person’s immune response — choosing the disease over the vaccine is “a very bad decision,” she said.
The primary advantage of a vaccine is that it’s predictable and safe, she said. “It’s been optimally tailored to generate an effective immune response.”
Vaccines for some pathogens, like pneumococcal bacteria, induce better immunity than the natural infection does. Early evidence suggests that the COVID-19 vaccines may fall into this category. Volunteers who received the Moderna shot had more antibodies — one marker of immune response — in their blood than did people who had been sick with COVID-19.
In other cases, however, a natural infection is more powerful than a vaccine. For example, having mumps generates lifelong immunity, but some people who have received one or two doses of the vaccine still get the disease.
To Paul’s point: Natural immunity from the coronavirus is fortunately quite strong. A vast majority of people infected produce at least some antibodies and immune cells that can fight off the infection. Andthe evidence so far suggests that this protection will
persist for years, preventing serious illness, if not reinfection.
But there is a “massive dynamic range” in that immune response, with a 200-fold difference in antibody levels.
In people who are only mildly ill, the immune protection that can prevent a second infection may wane within a few months. “Those people might benefit more from the vaccine than others would,” said Bill Hanage, an epidemiologist at the Harvard
T.H. Chan School of Public
Health.
People who are obese, or who have diseases like diabetes, are particularly susceptible to severe cases of COVID-19. On average, the virus seems to be less risky for younger people, and women tend to fare better than men. But beyond those broad generalizations, doctors don’t know why some people get very sick and die while others have no symptoms.
For example, people who harbor certain mutations in immune genes are more susceptible to the disease, several studies have shown. “So there’s a risk factor that has nothing to do with age,” Gommerman said.
In a study of more than 3,000 people, ages 18 to 34, who were hospitalized for COVID-19, 20 percent required intensive care and 3 percent died.
Asmany as one in three people who recover from COVID-19 have chronic complaints, including exhaustion and a racing heart, for months afterward. This includes people under 35 with no previous health conditions. Some survivors of COVID-19 also show troubling signs that their body has turned on itself, with symptoms similar to those of lupus and rheumatoid arthritis.
COVID-19 vaccines, in contrast, carry little known risk. They have been tested in tens of thousands of people with no serious side effects — at least so far. “Once you start vaccinating millions, you might find very, very rare events,” Hanage said. “But we have to know that they are very, very rare and much more rare than the adverse events associated with natural infection.”