MEDICAL: Does it make sense to vaccinate those who have had covid-19?

vaccination –  13 July 2021- by Sebastian Rushworth, M.D.

One of the strangest things about the last few months on planet Earth has been the relentless drive to vaccinate everyone, regardless of what their individual risk from the virus is, and whether or not they’ve already had the disease. It was well known long before covid came along that people who have had an infection are usually at least as well protected as those who get vaccinated.           

The whole point of vaccination is, after all, to mimic infection so as to stimulate immunity. If you’ve had measles, you don’t need to take the measles vaccine. If you’ve had hepatitis A, you don’t need to take the hepatitis A vaccine. If you’ve had chickenpox, you don’t need to take the chickenpox vaccine. Yet if you’ve had covid, you should supposedly still take the covid vaccine. Strange.

The obsession with vaccinating everyone is particularly odd in a situation where access to vaccines is limited and the stated goal is to reach herd immunity as quickly as possible, since wasting time vaccinating people who have already had the infection will inevitably delay the time it takes for a population to reach herd immunity.

Yet many people who should know better have been happy to play along with the “everyone needs to be vaccinated” mantra, in spite of the fact that it runs counter to the stated goal of governments and public health agencies. Many doctors had covid during 2020, yet they were more than happy to stand at the front of the line and take the vaccine in late 2020 and early 2021, even though they knew (or should have known) that they were almost certainly already maximally protected from the virus, and that taking the vaccine would inevitably mean a delay in vaccination of those who had not yet had the infection.

A few months back I wrote about a study, published in The Lancet in April, that showed a 93% decreased risk of re-infection in people who had already had covid. That would make prior infection equivalent to the most effective vaccines, in terms of its ability to protect against covid (which is as we would expect).

For those who remain unconvinced that prior infection is at least equivalent to vaccination, however, a very interesting study was recently posted on MedRxiv. This was a retrospective cohort study of the 52,238 employees of the Cleveland Clinic, who were followed from December 16th 2020 (when the Cleveland Clinic started vaccinating its staff) until May 15th 2021. The objective of the study was to compare the relative rates of infection between four groups of employees: Those who had had covid and been vaccinated, those who had had covid but not yet been vaccinated, those who had not had covid but had been vaccinated, and those who had neither had covid nor been vaccinated.

A PCR test was used to diagnose covid in the study. The Cleveland Clinic was not engaging in any screening of asymptomatic staff during the study period, so tests were in almost all cases carried out when participants developed symptoms suggestive of covid. In other words, the method used to diagnose covid in this study was equivalent to the method used in most other studies, and also the method that is used in the real world.

So, what were the results?

There were 2,139 new covid infections among the 52,238 participants. In other words, 4.1% of the participants in the study developed covid during the five month period. 99.3% of these infections were among participants who had neither had covid nor been vaccinated. The remaining 0,7% were among participants who hadn’t had covid but had been vaccinated.

2,579 participants had already had covid at the start of the study. Not a single one of them developed covid during the five month period. This includes both the 1,229 with prior infection who were vaccinated, and the 1,359 who weren’t. What that means is that prior infection was associated with a 100% reduction in the relative risk of infection. That was true regardless of whether the person with prior infection was vaccinated or not. Vaccination did not provide any additional benefit to those who had already had covid.

What can we conclude?

Prior infection is highly effective at protecting against covid. There is thus no need for people who have already had covid to get vaccinated. When governments do vaccinate people who have already had covid, they are wasting taxpayers money and putting people at risk of side effects for no good reason.

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Comments

  • Ollie  On 07/15/2021 at 4:09 am

    Good article, totally agree with it. I’ve not had vaccination and recently had Covid (Delta). My symptoms were fairly mild, same for my wife, really no worse than flu. Also same for a few friends that have had it and we’re all 55+ yrs old. I appreciate it’s not the same for everyone, and lethal for the vulnerable, elderly etc but I think when the global authorities look back on this pandemic they may consider that lockdowns, face masks, distancing and so on, actually cause more risks to health and wellbeing, and economic meltdown, and there may be more appropriate action to take. Of course, hindsight is a wonderful thing!

    • Dennis Albert  On 07/16/2021 at 6:28 pm

      No worse than flu but Guyanese of Asian and Indian, and African heritage are dying from it. Lemme guess…You’re white or Portuguese?

      • Ollie  On 07/17/2021 at 5:55 am

        Harsh words indeed. I was simply relaying my own experience, sorry if it offended you. Your reply has undertones of resentment that I didn’t suffer more severely. That’s what if feels like. Covid has killed millions throughout the world, all races, nationalities, religions etc. ALL losses are equally tragic. I see from your other posts that you have a specific narrative.
        Please think about your comments before posting.

      • Dennis Albert  On 07/17/2021 at 8:54 pm

        You didn’t answer my question.

        “No worse than the flu” is the same repetitive arguments like the “All lives matter” coming from the same group of people.

  • wally n  On 07/16/2021 at 1:11 pm

    “When governments do vaccinate people who have already had covid, they are wasting taxpayers money and putting people at risk of side effects for no good reason”
    Maybe… there is $$$$ to be made in dem damn hills???????

    Among the biggest winners will be Moderna and Pfizer – two very different US pharma firms which are both charging more than $30 per person for the protection of their two-dose vaccines. While Moderna was founded just 11 years ago, has never made a profit and employed just 830 staff pre-pandemic, Pfizer traces its roots back to 1849, made a net profit of $9.6bn last year and employs nearly 80,000 staff.?????

    • Dennis Albert  On 07/16/2021 at 6:32 pm

      So we should cut costs by giving tax breaks to Jeff Bezos and stop inoculating against polio, tetanus and small pox, because some rich white anti-COVID masker told you so?

  • Clyde Duncan  On 07/17/2021 at 9:49 am

    The Republican Anti-Vax Delusion

    America’s vaccination programme is stalling. Populist conservatives are to blame

    The Economist

    In early May, with the Food and Drug Administration expected to approve the first COVID-19 vaccine for teens any day, Michelle Fiscus found herself fielding questions from Tennessee vaccine dispensers on what this would mean in practice.

    Could 12- to-15-year-olds be vaccinated without parental consent, for example? Dr Fiscus, the state official in charge of immunisations, sent back the official legal advice on that. Referring to a 34-year-old ruling of the Tennessean Supreme Court, it noted that any sensible 14-year-old could request a vaccine of their own accord. What happened next, according to Dr Fiscus, “can only be described as bizarre”.

    Her memo was shared on social media, seized on by angry conservatives and the Tennessee Department of Health duly accused of machinating to destroy families and subvert children. Scenting an opportunity, Tennessee’s Republican legislature summoned the state’s public-health officials to explain why they were “targeting” the young and innocent in this “reprehensible” way. ONE LAWMAKER DEMANDED THE HEALTH DEPARTMENT BE DISBANDED.

    The department vowed to try less hard to vaccinate Tennesseans against COVID-19 and other diseases. According to reports and internal emails shown to Lexington by Dr Fiscus, this has involved ending all vaccine outreach to teens.

    Any Tennessean adolescent who has received a first COVID jab is no longer being sent a reminder to show up for the second; the department has stopped sending information about immunisations — against measles and meningitis as well as COVID-19 — to schools.

    THIS WEEK DR FISCUS WAS ASKED TO RESIGN. WHEN THE VETERAN PAEDIATRICIAN REFUSED, SHE WAS FIRED.

    AMERICA HAS A LONG HISTORY OF ANTI-VAX CONSPIRACY THEORIES. But the vaccine denialism that has gripped the Republican Party in Tennessee and everywhere is unprecedented. Past anti-vax movements have been disparate, fringe and, at least on an individual basis, responsive to patient dissuasion. Their adherents have included rich Californian suburban moms, gulled by misinformation about the risks of immunising babies, and poor African-Americans, with a part-justified suspicion of the medical profession. The results, by and large, have been small measles outbreaks and a marginal contribution to black Americans’ poor health.

    Anti-COVID vax sentiment on the right, by contrast, is fuelled by the country’s deepest divisions and the conservative entrepreneurs, in media and politics, who aggravate them. It explains why America’s vaccination rate has slowed in recent weeks, despite the availability of vaccines, an uptick in infections and deaths, and the fact that a third of adults have not received a first dose. Surveys suggest this large minority is overwhelmingly Republican. It represents half the party’s voters, predictably dominated by its most pessimistic and conspiracy-prone groups, white evangelicals and rural folk: THE TRUMP BASE.

    The problem looks even worse — politically, economically and health-wise — where such voters are concentrated. Vaccination rates are lowest wherever Donald Trump romped to victory last November. In Tennessee, where he won 61% of the vote, 43% have had a first dose. In Ohio, a more divided state with a pragmatic governor in Mike DeWine, it is a slightly more hopeful 48%. But in the most conservative Ohioan counties, the rate plummets.

    In Holmes County where the former president won 83% of the vote, 15% of people have had a first dose. The chances of succumbing to the virus in such places is correspondingly high; 99% of America’s recent COVID-19 fatalities had NOT been vaccinated.

    It is tempting to see this calamity as a predictable development in the politicisation of American identity, whether concerning race, sexuality or attitudes to health care. Yet it was not inevitable. The one thing Mr Trump got impressively right in his handling of the pandemic was his early investment in the vaccines his voters now consider to be unnecessary or part of a Democratic plot to spy on their innards. Poisoning the minds and jeopardising the bodies of so many Republican voters has taken a concerted campaign.

    Mr TRUMP IS CHIEFLY RESPONSIBLE FOR IT. Analysis by Shana Gadarian, a political scientist, suggests scepticism about COVID-19 vaccines is largely a consequence of his efforts to play down the virus and mitigation measures such as mask-wearing. As so often with Mr Trump, it was an approach that mingled conservative ideology with demagoguery and personal strangeness.

    Conservatives prize freedom of choice over the common good; demagogues rubbish expert advice in order to propagate their own reality; and Mr Trump, a conservative demogogue but also a lifelong conspiracy theorist, probably believed some of his own misinformation.

    JUST A SMALL PRICK

    He was once a noted anti-vaxxer — which may explain why he did not publicise his own COVID jab until weeks after it took place. By thus minimising his role in the vaccinations he made it easier for like-minded entrepreneurs, such as Tucker Carlson, to denigrate and blame the jabs — one of the biggest successes of Republican government in years — on Joe Biden. Fox News’s biggest star calls a Biden administration effort to step up local vaccination campaigns “the greatest scandal in my lifetime”.

    This extreme politicisation has encouraged vaccine-hesitant Republicans to dig in. To be conservative is now to a great degree to be against COVID-19 vaccination. And interviews with senior officials in Ohio and Tennessee (including Mr DeWine, who recently completed a statewide tour of vaccine centres) suggested there is little confidence that this can be reversed.

    Some public-health experts wondered whether the accelerating Delta variant might tip the balance. But it seems unlikely. Tennessee, like other states, has already seen so much death. “It is a mystery to me while watching your loved ones die of an infectious disease that we can easily prevent doesn’t move more people to reconsider,” said Dr Fiscus, revealing, yet again, the insidious pro-life sentiment that got her fired. ■

  • Kman  On 07/19/2021 at 10:44 am

    Clyde, l hope you have permission to post articles from the various sources, eg The Economist, Washington Post,

    • Brother Man  On 07/19/2021 at 1:03 pm

      Clyde Duncan, you are not only insulting the rest of us with your insatiable appetite to “cut-and-paste”, you are abusing your privilege to post in a public forum.

      What makes you think that we need you to endlessly cut and paste everything under the sun?

      For your information, I don’t read any of it, and I am sure most readers don’t either.

      We are more interested in what you have to say, not what can dig up by whomever impresses you. Originality matters! Enough!

      Please stop it!

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