Vaccine Megathread No 2 - Read OP before posting

There is at least another 20/25% in that cohort that are currently waiting for their second doses. They've been able to get it only since a couple of weeks in the best case.

Apparently the current high number are due to proximity to NI and wider UK where rates are higher than here and there is a significant amount of travel between us and them; a population in Ireland that has a higher percentage of young people than in other countries and younger people have not yet reached the point where they are fully vaccinated (2 doses + 7 or 14 days); the fact that a high proportion of workers in Ireland were not born here and there is a lot of international travel because of that. Also, Ireland is a small country so a large outbreak in Border regions or in Dublin will spread quickly round the country in a way that would not happen elsewhere- a large outbreak in Paris would not necessarily spread to Bordeaux.

That's what I can remember from what was said today at NPHET briefing

Lack of widespread antigen testing

I got the one shot J&J so I'd take a second shot all day long if I could.....don't think I'll ever have that option though as it'll be Pfizer or Moderna only going forward.

https://edition.cnn.com/2021/08/25/health/johnson-vaccine-booster-data/index.html

It's all opinion. For the CEO of a pharmaceutical company, talking up the skill of his company and their products is part and parcel of his job. "We don't think one will emerge so we're not paying any attention to it", doesn't sound as good as, "We think one will emerge and we'll be able to annihilate it quickly".

The actual research experts have no real skin in the game, and by a far larger proportion seem to believe that a completely resistant variant is an impossibility.

It's most likely that Bourla is referring to their ability to respond to a variant that is slightly more resistant than Delta, not one that is fully resistant. Kholin is talking about the claim a variant could bring us back to square one by being able to completely evade the immune system. The former is a possibility. The latter is not.

Some news from J&J on a second shot "booster". One shot reckoned to be good for 8 months. 230,603 doses have been delivered here.

I think this is expected and part of the high efficacy values in the first few months, the antibody count produced by the mRNA vaccines is very high, and even after waning, is still relatively high, but the waning is expected and a natural part of the immune system. If we could vaccinate everyone in the same 2-3 months, we'd see the virus die out quickly, as it is, those vulnerable may need yearly boosters for the next few years, healthcare workers as well (particuarly those who work in nursing homes). For the average person, the initial vaccination may be all that's ever needed.

It's not a time to work in healthcare and not take your vaccines.

If the decay in vaccine-induced antibodies continues past the end point of the study, then it will mean boosters may be required for those vaccinated - but natural immunity may last much, much longer.

The study showing antibody titers for convalescent vs vaccinated patients was posted above. The idea that natural immunity persists longer is simply based on extrapolating those trendlines for antibody decay.

There are new studies coming out that show risk of reinfection is higher for naive vaccinated individuals compared with convalescent only also:

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1

@timmyntc that's very interesting (and new!). I wonder whether there's some survivor bias in there, because the recovered cohort excludes those who will die from their first infection.

Regardless, it obviously makes no sense to acquire protection from infection by getting infected (by avoiding vaccination or seeking infection), but if herd immunity doesn't happen then eventually everyone will end up infected unless they die from something else beforehand, or lead an incredibly careful existence.

So from an individual perspective, whether you've been previously infected or not, the question is whether you're better protected by being vaccinated or not at your next exposure. The answer is fairly obviously that you're better protected with a vaccine.

It does strengthen the case for adding recovered people to the discriminatory indoor access regulations though. This is AFAIK planned anyway and I've no idea why it hasn't been introduced already.

@timmyntc wrote

I'm not sure that makes sense. I think you (or others) have posted that the post-infection immunity appears to be proportionate to severity of disease. If that's true, a lower disease burden from either post-vaccine infection or reinfection could be the same or less efficacious (and less safe) than a booster. I don't know. We'd need a study that evaluates that.

(I understand the argument that boosters are unethical in a vaccine-short world, but that's a mostly separate issue from efficacy in a world where there is no herd immunity anywhere.)

It's important to note that the antibody levels after the vaccine are still at a higher level than those who were infected and survived (i.e. most people), the fact that the vaccines start off with such a high antibody count makes the fact that the antibodies wane faster kind of expected (and would only be an issue if that velocity continued, which even within 6 months it doesn't and starts levelling off to a steadier decline).

The question then is what the eventual antibody count is after a longer period of time and if the T-Cell memory to be able to produce antibodies is sufficient at this stage even if antibody counts reduce to zero (which hasn't been seen yet).

I also wonder now how many diseases older people and immuno-compromised people are dying of (besides COVID) that they assumed they were immune to, but age reduced their lifelong immunity making them vulnerable.

There's a good read here from various experts, ranging from "this is expected and protection against severe disease is what matters" to "We need new vaccines for each mutant, it will be like the flu".

expert reaction to press release from the ZOE app on vaccine effectiveness over time | Science Media Centre

edit:

There is also no study or expectation that "naturally derived antibodies from the virus" are lasting longer than vaccine antibodies, luckily we have numerous studies last year, pre-vaccine to compare to, that show the 6 month drop off in antibodies for those who recovered from SARS-COV2.

You are correct on the B-Cells creating the antibodies. Your conclusion essentially marks the antibody count reports as useless and waiting on real world data, however, the reason the antibody counts are being studied so much is that it is a good indicator of what the real world results will be. It will be interesting to see what the final outcome of the study will be and what the vaccine then infection long term protection looks like.