The following very understated, self-explanatory comment is from a CDC document entitled, “Questions & Answers: Vaccine Against 2009 H1N1 Influenza Virus”:
“If you have had 2009 H1N1 flu, as confirmed by an RT-PCR test, you should have some immunity against 2009 H1N1 flu and CAN CHOOSE NOT (emphasis added) to get the 2009 H1N1 vaccine.” [1]
Fast forward just over a decade later, and after intensive investigation for the past 16-months, both laboratory and real world clinical data demonstrate convalescent, unvaccinated covid-19 immunity is just as robust as vaccine-acquired covid-19 immunity. Indeed multiple laboratory studies conducted by highly respected U.S. and European academic research groups have reported that convalescent mildly or severely infected SARS-CoV-2 (covid-19) patients, who are unvaccinated, can have greater virus neutralizing immunity—especially more versatile, long-enduring T-cell immunity—relative to vaccinated individuals who were never infected [2,3,4,5,6,7]. An enormous real world Israeli national follow-up study of ~6.4 million individuals, demonstrated clearly that naturally-acquired covid-19 convalescence immunity was equivalent to vaccine-acquired immunity in preventing covid-19 infection, morbidity, and mortality. Faring at least as well as those vaccinated, 187,549 unvaccinated covid-19 positive persons who tested positive between June 1, 2020 to September 30, 2020, and were followed through March 20, 2021, revealed 894 (0.48%) were reinfected; 38 (0.02%) were hospitalized, a mere 16 (0.008%) hospitalized with severe disease, and only 1 (one)/187,549 died—an individual over 80 years old. [8]. The Israeli investigators concluded, “Our results question the need to vaccinate previously infected individuals” [8].
Pooled with vaccine-acquired immunity, i.e., unvaccinated with natural immunity, plus vaccinated, Rhode Island has achieved de facto herd immunity [9] in terms of clinical covid-19 disease: covid-19 hospitalizations and deaths are at low background rates [10] consistent with a very manageable endemic disease, like seasonal influenza. [11,12] Moreover, and concordant with these reassuring data, while ~90% of Rhode Island’s covid-19 mortality has accrued among those 65+ years old, as of Friday, May 14. 2021, 92.4% of that age group had been partially vaccinated, and 86.1% fully vaccinated, against covid-19 [10]
Epidemic spread of covid-19, like all other respiratory viruses, again notably influenza [13], is driven by symptomatic persons; asymptomatic spread is trivial, and inconsequential: a meta-analysis of contact tracing studies published in The Journal of the American Medical Association showed asymptomatic covid-19 spread was 0.7% [14]. Accordingly, a rational, ethical true prevention model alternative to “vaccine passports” would be simple notifications, as part of formal policies, by public agencies and businesses that persons with active symptomatic, febrile (feverish) respiratory illnesses stay home from work, and refrain from patronizing businesses.
References
[1] “Questions & Answers: Vaccine Against 2009 H1N1 Influenza Virus” https://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm
[2] “Highly functional Cellular Immunity in SARS-CoV-2 Non-Seroconvertors is associated with immune protection” bioRxiv 2021.05.04.438781; doi: https://doi.org/10.1101/2021.05.04.438781
[3] “Protracted yet coordinated differentiation of long-lived SARS-CoV-2-specific CD8+ T cells during COVID-19 convalescence” https://doi.org/10.1101/2021.04.28.441880
*[4] “Live virus neutralisation testing in convalescent patients and subjects vaccinated against 19A, 20B, 20I/501Y.V1 and 20H/501Y.V2 isolates of SARS-CoV-2” https://www.medrxiv.org/content/10.1101/2021.05.11.21256578v1
[5] “Differential effects of the second SARS-CoV-2 mRNA vaccine dose on T cell immunity in naïve and COVID-19 recovered individuals” https://www.biorxiv.org/content/10.1101/2021.03.22.436441v1
[6] “Discrete Immune Response Signature to SARS-CoV-2 mRNA Vaccination Versus Infection” https://ssrn.com/abstract=3838993
[7] “Prior SARS-CoV-2 infection rescues B and T cell responses to variants after first vaccine dose” https://science.sciencemag.org/content/sci/early/2021/04/29/science.abh1282.full.pdf
*[8] “Protection of previous SARS-CoV-2 infection is similar to that of BNT162b2 vaccine protection: A three-month nationwide experience from Israel” https://www.medrxiv.org/content/10.1101/2021.04.20.21255670v1
[9] “Human Adaptation to the Parasitic Environment” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2102678/pdf/procrsmed01176-0006.pdf
[10] “Rhode Island Covid-19 Response Data” https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/
[11] “Impact of Influenza Vaccination on Seasonal Mortality in the US Elderly Population” https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486407
[12] “Infection fatality rate of COVID-19 inferred from seroprevalence data” https://pubmed.ncbi.nlm.nih.gov/33716331/
[13] “Does Influenza Transmission Occur from Asymptomatic Infection or Prior to Symptom Onset?” https://pubmed.ncbi.nlm.nih.gov/19320359/
[14] “Household Transmission of SARS-CoV-2A Systematic Review and Meta-analysis” https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774102
