Thread by @DrEricDing

⚠️NATURAL IMMUNITY versus VACCINES—Which is stronger? Let’s compare reinfection breakthroughs vs vaccine breakthroughs: ➡️Natural immunity is **MUCH weaker than vaccine** protection. By how much? HUGE—Vaccine is 📌9x stronger in May, 📌2x stronger during #DeltaVariant.🧵 #COVID19

2) Let’s walk through data together—look at the red circled column of reinfections - which is how often previously infected people with natural immunity got a breakthrough - 1000 reinfections per 100k… this is 9x higher in May & 2x higher in July-Sept than vaccine breakthroughs.

3) This data comes from Oklahoma health department. Ironically Oklahoma has good reinfection and breakthroughs tracking even though their vaccination rates low. Data also shows **COVID Reinfections Have Jumped 300% Since May**! So much for natural immunity
publicradiotulsa.org/post/covid-rei…

4) Also keep in mind that unvaccinated people have much much high infection rate than breakthroughs. Keep in mind many of these unvaccinated are those COVID immunity naive as well as many previously naturally infected too.

https://twitter.com/DrEricDing/status/1436347642804572173

5) And while vaccine breakthroughs happen - they are more rare with Moderna or Pfizer than with J&J. That’s why J&J folks need a 2nd shot. As does natural infection folks - they likely need at least 1 shot according to many vaccine experts.

https://twitter.com/DrEricDing/status/1436389153533464597

6) How do we know the Oklahoma breakthrough data is reliable? Well the Oklahoma data on breakthroughs confirms the larger CDC data on breakthrough rates. Thus, we would call this “external validation” that because the Oklahoma data holds up to scrutiny and comparison, it’s legit.

https://twitter.com/drericding/status/1436392644092039173

7) Furthermore, while we are seeing some breakthroughs— data from Israel clearly shows boosters have very high efficacy — 91% lower risk of infection compared to 2 doses after 6 months (not even compared to unvaccinated). That’s 10x further improvement in lowering risk!

https://twitter.com/drericding/status/1438301448383631362

8) Also the pro-mass-infection folks always ignore long term COVID damage—a new 🇬🇧 study finds 30% of #COVID19 patients experience #LongCovid—70% of #LongCovid sufferers develop damage to at least one vital organ like the heart or liver.

9) Furthermore, in addition to above data, vaccinologist @PeterHotez points out that recovering from COVID yields highly varied immune responses against reinfection—as in some have little protection, or none at all. This is also why convalescent plasma sometimes fails—some weak.

https://twitter.com/peterhotez/status/1442902945712906240

10) Furthermore, another Nature study found those who were infected but **then vaccinated** developed really robust responses, with even epitope broadening to make you resilient vs variants. Thus at very least ➡️ #vaccinate even if infected before!!! nature.com/articles/s4158…

11) Vaccines for PREGNANT🤰 & LACTATING🤱 moms—➡️New study sharply concludes “Vaccine-induced immune responses were statistically significantly greater than the response to natural infection.” 💥 BONUS: protection also transfers via placenta & breast milk. ajog.org/article/S0002-…

12) there’s debate whether the higher reinfection breakthrough rate it’s because natural immunity wanes & a lot of time has passed since many infected last year. Possibly—but isn’t that a strong argument to get a vaccine add-on and not play it risky with just natural immunity? 💡

13) “Vaccines beat natural immunity” say experts from Johns Hopkins… and says countless immunologists I know. hub.jhu.edu/2021/09/10/inf…

14) Furthermore, “Covid tricks your Immune cell memory to attack the body”. Don’t try to purposefully infect yourself with #COVID19.

Don’t be fooled by articles to beguile the public into forgoing precaution, says immunologist @fitterhappierAJ nature.com/articles/s4159…

15) This young man relied on his natural immunity. His mother begged him to vaccinate. He refused. @UNC_System should have mandated it for students. Unfortunately, his natural immunity was not enough. He was 20-years old…

https://twitter.com/drericding/status/1442828622616739843

16) 💡DON’T FORGET DEATH BIAS of natural infections—many people who have weaker natural immunity responses **have already died last year** (aka ‘dead men tell no tales’ as 🏴‍☠️say). Thus, among infection survivors—it’s selecting just strong survivors. But vaccines are for everyone!

17) In epidemiology, we call the above “survivor bias” or “selection bias” more formally. With vaccines you mass immunize everyone (especially many vulnerable high risk people)—and thus you see average immunity response of people with both stronger and weaker immune systems…

18) This above^ is agreed by virtually everyone. But many who tout natural infection focus on those who *survived*, plus often those with strong enough antibody response in antibody tests! Many weaker survivors who don’t mount antibodies are often excluded from their studies…

19) the effect of excluding weaker survivors & the survivor bias (aka “dead men tell no tales” in #16)—thus biases many studies comparing “natural immunity survivors” vs vaccinated. Don’t forget that! 👀

(I can get technical on “collider stratification bias”—but I’ll spare you”)

20) This is a complicated topic. I know there are studies out there that show higher immune responses among natural infection survivors—but remember they are SURVIVORS (and who could mount an antibody positive test, which not all survivors can). thanks for listening—watch this:👇

https://twitter.com/drericding/status/1440538409370468361

21) FWIW, natural immunity does work—but it’s more like a one shot (& #LongCovid risky). J&J is a one shot vaccine so far, but we know a second shot of J&J works really well… please get another shot if you had infection before or J&J before (hopefully formally approved soon).

https://twitter.com/drericding/status/1440265871398637568