Should survivors get a Covid-19 vaccine shot?

covid-19 vaccines
Modi government must open up production, distribution and administration of Covid-19 vaccines.

The conspiracy theories and pseudoscience explanations about Covid-19 are almost as old as the disease itself. Most of them came from non-medical persons, but some were from senior politicians and doctors. The most dangerous group peddling false information and fake news is that of informed medical professionals holding political positions. They are the biggest source of conspiracy and pseudoscience theories related to Covid-19. Former Senator Dr Rand Paul (Kentucky, US) is one such. An ophthalmologist turned politician should have been much more sensible. One of those US politicians to get the infection early, Senator Paul started appearing in meetings without a mask (after recovery) and urged everyone who contracted the infection to throw away masks. He has been consistent in spreading misinformation to such a level that some media sources call him a “public health risk”.

When Pfizer and Moderna came up with 90% and 95% efficacy results after testing their vaccines, he said that he had 99.9982% immunity and didn’t need vaccination as he is protected for life from this nasty bug. But, is it that way? Is senator Paul right in glorifying natural immunity? Are vaccines always inferior to natural infection when it comes to immunogenicity? These are tough questions to answer. But let me give it a try.

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These are definitely not yes/no questions. Most of the time, a natural infection is better than a vaccine in giving long-lasting immunity. Mumps is in that league. The infection gives you lifelong immunity, but those who had a vaccine may get infected after a long period. Natural immunity wins over vaccine immunity in this scenario.

This is just one side of the story. There are many new vaccines that are better than natural infection in giving long-lasting immunity. The popular pneumococcal vaccines (prevents a bacterial infection from pneumococcus) win hands down against natural infection when it comes to preventing future infections.

What is the reason for this confusing scenario? Science is a bit complicated here, but one should know that the natural infection-based immunity is a wide range shot — one may get anywhere from virtually no antibodies to a place where one has 200 times higher a titre than the one with the lowest titre. So, one doesn’t know whether he/she is at 200X or at 0 — a big problem when it comes to planning for future immunity. And a lot of this “0 to 200x unpredictable business” happens predominantly due to variations in dose of the infectious agent, immune system characteristics, nutritional status and the age of the patient.

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The vaccine story is a lot different from the natural story. A vaccine induced immunity is as predictable as the tone of the old generation TV news readers. It’s a given. A definite dose given to the subject generates a decent immune response within “x to y” level and he/she is immune from “a to b” years. Most of the info is known if the vaccine has been in the shelf for long. So predictable, but as dependable as TV news of yesteryears.

So, one needs to tread carefully here. Where does this Covid-19 thing stand when it comes to the immunity question? One has no definite answer, but the early signs are that the natural immunity may be inferior to vaccine-induced immunity.

Studies done on Covid survivors have documented this zero to 200 plus range variation in antibodies. And the scientific community is yet to document the range for T cell mediated immunity, the other player in this game. The variations are here as well. So, it’s not definite yet, but medical researchers put their money in the “variable natural immunity” box for Covid-19.

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So, a natural infection may not be enough to protect one for the rest of his/her life. One needs to take a vaccine to be sure. It is prudent to take one even if one is a survivor, but better wait till others had the shot. Give the non-exposed a priority here.

And don’t throw away your mask like Senator Paul. I am not even bothered to talk about the infertility/sterility package of Covid vaccines. I have heard that bullshit with all vaccines from my early days in medical school till today morning. So, I am deaf ‘n’ dumb to such opinions.

(Dr Manu Raj is a paediatrician, clinical researcher and research methodologist based in Kochi.)