Thread by @michaelmina_lab

@phil_luttazi The global exit strategy from this pandemic is/always has been the building up of immunity

This virus will never disappear and herd immunity to eliminate is not a thing for a virus like this

So we are stuck with effectively one option (with multiple paths to get there)

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@phil_luttazi We must build up a sufficiently robust and diverse immune response so that the importance that this virus has in our lives falls lower and lower.

As adults we are on the same steep learning curve that babies are on in early life. But doing this as adults is risky business

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@phil_luttazi However, we have no choice. The virus is with us and just like the other viruses we contend with as babies, it’s not going away.

So it would be foolish to assume that vaccination is our only approach to building immunity when we have a virus that will cycle for our lifetimes

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@phil_luttazi We have to build up foundational layers of immunity safely - through vaccination. But virus keeps circulating.

As vaccinated ppl become unintentionally exposed, they will ideally not get severe disease, but they will, with an exposure, gain new immune knowledge

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@phil_luttazi We can’t deny infections occur and shouldn’t deny that it helps as long as we get through it

Our immune memory works just like any other memory in our body. It requires repetition. But also benefits to see the broader context to do even better.

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@phil_luttazi As we consider our long term efforts to deal with this virus, if we assume that only the vaccine can provide us w immunity (untrue) we find ourselves planning for vaccine purgatory. But simply put that’s not how this is happening.

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@phil_luttazi We know that people who have been vaccinated and infected have a more broad immune response than ppl who have been only vaccinated.

T cells don’t care about spike protein any more than all the other proteins not in the vaccine

They work w a fundamentally different process

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@phil_luttazi This added breadth of immune memory is beneficial in the long term.

our mitigation strategies exist to keep things ideally better controlled but not to eliminate the virus

In fact, the whole point of getting a vax is to protect us when we get exposed/infected.

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@phil_luttazi So as we plan our off ramp, it is absolutely ridiculous to not consider that billions will be infected - repeatedly, and as such we incorporate this into our epidemiological models and planning - in vaccine rich and vaccine poor countries.

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@phil_luttazi Burying our head in the sand and pretending infections aren’t happening when we likely have >billion infections would be remarkably shortsighted

We can use measured immunity from both infections and vaccines to better allocate resources, including vaccine doses, globally

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@phil_luttazi We can make smart policy that if a child has had two vaccines and gets an infection w Omicron and it causes their antibodies to drive high, then that child probably won’t benefit sufficiently from a 3rd dose to warrant it at that moment.

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@phil_luttazi We can learn to measure immune protection & incorporate into mathematical models & in our on the ground decision making

We can gain info on relationships and timing between vaccine and infection to better understand how to consider risk post breakthrough & resources needed

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@phil_luttazi So, there are a million reasons we should make sure to consider immune memory from both vaccination and infection as we plan as a nation and as a globe what the next years will look like for us.
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@phil_luttazi If you made it this far, I should note this thread was in response to concerns that I shouldn't discuss immunity from infection b/c it's perceived as anti-vax.

I disagree.

But as we get to broad immunity:
• Vax
• Test
• Mask
• Ventilate
• Be respectful

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