Most readers here recognize that one of the major reasons for the superiority of NI>vax is the presence of IgA antibodies. Good illustration here of the inferior level of IgA abs production provided by vaccines and rapid decay. journals.plos.org/plosone/articl…
https://twitter.com/jacquesenboit/status/1469275304539557891
For non-technical readers, basic idea is IgA antibodies are produced by in the nose and respiratory passages and are the first line of defense against respiratory viruses. Current gen vax is intramuscular injection and as Figure 2 shows here, produces minimal IgA protection.
This is why vaxxed get infected. But more than that, vaxxed can get infected and carry virus in their nose and mouth for days before immune system activates. So vaxxed (1) produce same viral load as unimmune, unvaxxed and (2) can superspread without knowing it for days.
Good accessible summary for those who aren't familiar with the importance of muscosal immunity: wsj.com/articles/covid…
Mucosal immunity is also a major reason why (rare) Ni breakthrough infections are almost invariably (1) asymptomatic or very, very mild and (2) far less infectious than vax breakthrough (which are similar to unimmune-unvaxxed. medrxiv.org/content/10.110…
This is likely one reason why it has been so difficult to document cases of (1) reinfection PLUS (2) transmission to others. Moreover, while vax to vax transmission is common (including superspreader all-vax events) are there any cases of NI to NI transmission in the world?
To sum up, there are 4 basic reasons why NI>vax: (1) mucosal immunity (IgA), (2) durability (15+ months), (3) protection against variants, and (4) much lower infectiousness on breakthrough. The first 3 provide superior protection against infection (1) and (4) reduce transmission.
Here's a case study that illustrates the dynamic. frontiersin.org/articles/10.33… "We present a case of SARS-CoV-2 infection in a healthcare worker despite the presence of highly neutralizing, multivariant-specific antibodies 7 weeks after full vaccination with the mRNA vaccine BNT162b2.
"We show that the virus replicated to high levels in the upper respiratory tract over the course of several days in the presence of strong antibody responses. The virus was readily propagatable in vitro, demonstrating the potential to transmit to others...
"bolstered by the fact that several household members were equally infected.... He developed high levels of viral load detectable in the pharyngeal swabs, and was likely to infect others."
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