Natural vs vaccine induced immunity🧵
This preprint study from 🇮🇱 does NOT prove that natural immunity 'confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant'.…
It has a major selection bias.
The sample of participants doesn't seem to be representative of the 🇮🇱 pop. The event rate in the study is much lower than that of the baseline pop in 🇮🇱  where > 1,200 infections per 100K were reported among the unvaxxed at the time.
Participants in this study doesn’t appear to be randomly selected. There was little adjustment and confidence intervals are too large. ➡️ we can’t rely on the results.
Besides it’s a RETROSPECTIVE observational study ➡️ a lot of infections can be missed
Participants didn't get PCR tests on a regular basis.
Besides, in this type of study, behavioral impact (seeking testing but also mask wearing, social distancing, limiting the number of contacts…) is a major bias because these behaviors may differ between the 3 arms.
All study’s outcomes - confirmed case, symptomatic disease, hospitalization, death - are rare (very small numbers), especially in the ‘prior infection’ arm. All conclusions are based on a total of 8 symptomatic infections (and 1 requiring hospitalization).
Survivorship bias
-'prior inf' group only includes infected ppl who recovered from🦠& excludes all those who died. It doesn’t represent the pop who’d become infected
-'fully 💉' group includes more participants w/underlying conditions who wouldn’t survive Covid w/out the 💉
Always keep in mind that studies on immunity conferred by infection vs vaccination are conducted to spur the design of future vaccines, not to promote immunity through infection that has no public health benefit… You have to get infected to have that protection !
The risk of getting Covid and all long term consequences that come with that (#longcovid, chronic complications...) are far from negligible, even in ‘low risk’ people.
Immunity through infection also means risking the safety of everyone, including the most vulnerable
Vulnerable populations include immune compromised ppl at high risk for vaccine failure even after 3 or 4 doses.
Letting 🦠 spread also gives it the opportunity to replicate & mutate. In contrast, vaccination slows the spread & suppresses mutations…
Also let’s not forget that the level of protection from infection can vary a lot, and ONE outlying study w/ lots of caveats CANNOT negate all other data we have so far and conclude the exact opposite (vaccination >> prior infection when it comes to immunity) !
There are well conducted studies that demonstrated the exact opposite. Most notably a recent prospective study from the UK.…
Again A huge 🙏 to @VirusesImmunity @sailorrooscout @angie_rasmussen @unbiasedscipod @doctor_love87 @niniandthebrain for sharing your insight and for your invaluable help (if I forgot to credit someone, please let me know !)

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More from @MerylSwanLake

13 Sep
@ashishkjha I wouldn’t be so optimistic. Immune compromised patients may not be protected even after 3 doses, especially those who can’t carry a memory of the vaccine. They have no choice but to rely on OTHERS. That’s why boosters should actually be given to those who CAN make antibodies…
@ashishkjha Circulating antibodies of the general public have to be high, they are our first line of response. It’s what will restore high levels of protection against infection/transmission, the only thing that can protect the most vulnerable from exposure. Antibodies are waning, and…
@ashishkjha … while low levels could have been sufficient to prevent infection from older variants (and onwards transmission), with Delta we are exposed to a lot more virus.
As for memory cells, they play a major role in individual protection against severe disease, but it takes a few…
Read 5 tweets
2 Sep
I see a lot of misinformation about immunity conferred by prior infection vs vaccination, most notably because of a recent preprint study from Israel. But this study does NOT prove that natural immunity 'confers longer lasting & stronger protection’ against Delta
The level of protection from infection can vary a lot. Besides, ONE outlying study with lots of caveats CANNOT negate all other data we have so far! There are well conducted studies that demonstrated the exact opposite, including this one 👇
First of all, immunity through infection - also referred to as natural immunity - means you have to get infected to have that protection !
Letting people get infected has no public health benefit 🤷‍♀️
Read 12 tweets

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