SuperDeluxe wrote:Interesting thing that the government of Quebec posted on their website:
Vaccination for people who have had COVID-19
For people who have had COVID-19, a single dose of the vaccine is required. The infection triggers the immune system's response the same way a 1st dose of the vaccine does. The dose of vaccine given to someone who has had COVID-19 has a booster effect the same way a 2nd dose of the vaccine does.
Note that giving two doses of vaccine to someone who has had COVID-19 is not dangerous, but the risk of having adverse reactions is higher. In addition, the 2nd dose does not provide any additional protection for these people.
For people with a weakened immune system or who had COVID-19 when they were given the 1st dose or in the days after they were vaccinated, two doses are required.
https://www.quebec.ca/en/health/advice-and-prevention/vaccination/covid-19-vaccine#c88272No idea if this is accurate or if it applies to all the vaccines available worldwide. (For reference, here in Quebec we're getting the Pfizer, Moderna and AstraZeneca vaccines.)
More & more data is accumulating suggesting that natural infection affords excellent immunity.
Cleveland Clinic 6/5/2021
Pfizer & Moderna
medRxiv preprint doi:
https://doi.org/10.1101/2021.06.01.21258176; this version posted June 5, 2021.
DISCUSSION
This study shows that subjects previously infected with SARS-CoV-2 are unlikely to get COVID-19 reinfection whether or not they receive the vaccine. This finding calls into question the necessity to vaccinate those who have already had SARS-CoV-2 infection.
It is reasonable to expect that immunity acquired by natural infection provides effective protection against future infection with SARS-CoV-2. Observational studies have indeed found very low rates of reinfection over the following months among survivors of COVID-19 [6–8]. Reports of true reinfections are extremely rare in the absence of emergence of new variants. When such reinfections occur, it would be purely speculative to suggest that a vaccine might have prevented them. Duration of protective immunity from natural infection is not known. However, the same also can be said about duration of protective immunity from vaccination. Uncertainty about the duration of protective immunity afforded by natural infection is not by itself a valid argument for vaccinating previously infected individuals. This study provides direct evidence that vaccination with the best available vaccines does not provide additional protection in previously infected individuals.
A prior study concluded that natural infection cannot be relied on to protect against COVID-19 [9]. That study was based on comparison of PCR-positivity rates during a second COVID-19 surge in Denmark between those who tested positive and negative during the first COVID-19 surge, and indirectly calculated that prior infection provided 80.5% protection against repeat infection, and that protection against those older than 65 years was only 47.1%. The study did not compare vaccinated and unvaccinated people, and it is therefore an assumption to consider that a vaccine would have provided better protection in that particular population. Furthermore, there was a gap of only seven weeks between the end of the first surge and the beginning of the second in that study. It is now well-known that a small number of people can continue to have positive PCR test results for several weeks to a few months after infection, one study finding that 5.3% remained positive at 90 days [15]. It is possible that some of the positives picked up in the early part of the second surge were not necessarily new infections but residual virus from the tail end of the first surge. Since the actual number of infections was small, a few such misclassifications could change the rates substantially.
Our study examined rates of SARS-CoV-2 infection in vaccinated and unvaccinated individuals and showed that those previously infected who did not receive the vaccine did not have higher rates of SARS-CoV-2 infection than those previously infected who did, thereby providing direct evidence that vaccination does not add protection to those who were previously infected.There are several strengths to our study. Its large sample size and follow-up of up to 5 months provide us with an ample degree of confidence in its findings. A major strength of our study is that we adjusted the analyses for the phase of the epidemic at all time points. The risk of acquisition of infection is strongly influenced by the phase of the epidemic at any given time, and it is important to adjust for this for accurate risk analyses. Given that was this a study among employees of a health system, and that the health system had policies and procedures in recognition of the critical importance of keeping track of the pandemic among its employees, we had an accurate accounting of who had COVID-19, when they were diagnosed with COVID-19, who received a COVID-19 vaccine, and when they received it.
The study has its limitations. Because we did not have a policy of asymptomatic employee screening, previously infected subjects who remained asymptomatic might have been misclassified as previously uninfected. Given this limitation, one should be cautious about drawing conclusions about the protective effect of prior asymptomatic SARS-CoV-2 infection. It should be noted though, that 12% of the subjects classified as previously infected did not have a symptom onset date recorded, suggesting that at least some of those classified as previously infected might have been asymptomatic infections. It is reassuring that none of these possibly asymptomatically infected individuals developed COVID-19 during the duration of the study. The study follow-up duration was short, being only five months, but this was longer than published mRNA vaccine efficacy studies [1,2], and longer than the follow-up duration of the largest published vaccine effectiveness studies to date [3,4]. Median freedom from reinfection (time from initial infection until end of follow-up) in this study, for those previously infected, of almost 10 months, is consistent with findings in an earlier study that immunoglobulin G (IgG) to the spike protein remained stable over more than six months after an episode of infection [16]. Our study included no children and few elderly subjects, and the majority would not have been immunosuppressed. Data governance policies in our institution precluded us from obtaining detailed clinical information on employees. While one cannot generalize this study’s findings to assume that prior infection would provide adequate immunity in these groups, there is also no reason to expect a vaccine to provide additional protection in these same groups. Lastly, it is necessary to emphasize that these findings are based on the prevailing assortment of virus variants in the community during the study. It is not known how well these results will hold if or when some of the newer variants of concern become prominent. However, if prior infection does not afford protection against some of the newer variants of concern, there is little reason to suppose that the currently available vaccines would either. Vaccine breakthrough infections with variants have indeed been reported [17].
Our study’s findings have important implications. Worldwide, COVID-19 vaccines are still in short supply. As of March 9, 2021, dozens of countries had not been able to administer a single dose of the vaccine [18]. As of May 17, 2021, only 17 countries had been able to reach ten percent or more of their populations with at least the first dose of vaccine [19]. Given such a scarcity of the vaccine, and the knowledge that vaccine does not provide additional protection to those previously infected, it would make most sense to limit vaccine administration to those who have not previously had the infection. In addition to profession, age, and comorbid conditions, previous infection should be an important consideration in deciding whom to prioritize to receive the vaccine. A practical and useful message would be to consider symptomatic COVID-19 to be as good as having received a vaccine, and that people who have had COVID-19 confirmed by a reliable laboratory test do not need the vaccine.
In conclusion, individuals who have laboratory-confirmed symptomatic SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination, and vaccines can be safely prioritized to those who have not been infected before.