Is Rand Paul confusing the vaccine’s message for Covid survivors?


Last week, Senator Rand Paul (R-Ky.) Released a Twitter feed claiming that people who survived covid-19 infection were unlikely to be reinfected and have better immunity to the variants than those who were vaccinated against – but not infected with – SARS-CoV -2, the virus that causes covid.

The social media communication was its latest round in the ongoing debate over whether natural immunity is equivalent or even better than vaccination.

As the science on the subject still evolves, a look at the evidence behind Paul’s series of tweets seemed in order. After all, although nearly 65% ​​of Americans have received at least one dose of a covid vaccine, some people who have recovered from covid may not feel the need to be vaccinated. Paul, who was the first senator to be diagnosed with the virus, is one of them. Here’s a closer look at what Paul said on Twitter, the studies he cited, and how researchers characterized his comments.

Break the Twitter thread

In his first tweet, Paul referred to a recent Cleveland Clinic study revealing that among those unvaccinated but who had previously had covid-19, there had been no re-infections during a period of five-month observation: “Great news! Cleveland Clinic study of 52,238 employees shows unvaccinated people who have had COVID 19 have no difference in reinfection rates compared to people who have had COVID 19 and have taken the vaccine . “

In subsequent tweets, the senator said: “The immune response to natural infection is very likely to provide protective immunity even against variants of SARS-CoV-2. … Thus, recovered COVID-19 patients are likely to defend themselves better against the variants than people who were not infected but who were immunized only with vaccines containing spikes. The three vaccines authorized for emergency use in the United States (Pfizer-BioNTech, Moderna and Johnson & Johnson) contain genetic instructions that tell our cells how to make a spike protein associated with the coronavirus. The presence of this spike protein then causes our body to make antibodies to protect against covid.

At the end of his last tweet, Rand then linked to a second study led by scientists at the Fred Hutchinson Cancer Research Center in Seattle to back up his claims.

Digest scientific articles

Paul referred to two scientific papers in his discussion thread – both of which are preprints, meaning they have not yet been published in scientific journals or peer reviewed.

One was a Cleveland Clinic study the following four categories of health workers: unvaccinated but previously infected; not vaccinated but not previously infected; vaccinated and already infected; and vaccinated but not previously infected. The workers were followed for five months.

The researchers found that no unvaccinated person who had previously been infected with covid was re-infected during the five-month study period. Infections were almost nil among those who were vaccinated, while there was a steady increase in infections among those who were not vaccinated and had not been infected before.

When asked if he believed Paul’s tweet correctly interpreted the results of his study, the study’s lead author, Dr Nabin Shrestha, an infectious disease specialist at the Cleveland Clinic, said “this was an accurate interpretation of the study results.”

however, Dr George Rutherford, an epidemiologist at the University of California-San Francisco, wrote in an email that he would add a caveat to the wording of Paul’s tweet: “Note that in his tweet, Senator Paul seems to suggest that the denominator of the previously infected health workers at the Cleveland Clinic was 52,238 – that was the total number across the study. There were 1,359 who were previously infected and never vaccinated, and no reinfection was noted during a median follow-up of 143 days. So the tweet itself is accurate if read literally, but the denominator is actually 1,359. “

Regarding the other study Paul mentioned that the researchers analyzed immunity to covid-19 in those who had been infected with the covid virus and those who had not and found that the infection activated a range of immune cells and that the immunity lasted at least eight months.

In his last two tweets in the thread, Paul directly quotes from the “discussion” section of the study: “The immune response to natural infection is very likely to provide protective immunity even against the SARS-CoV-2 variants. … Thus, recovered COVID-19 patients are likely to defend themselves better against the variants than people who were not infected but who were immunized only with vaccines containing spikes. “

The main author of the study, Kristen cohen, a senior scientist in the division of vaccines and infectious diseases at the Fred Hutchinson Cancer Research Center in Seattle, admitted that Paul’s tweet was a direct quote from the study. Yet, she said, in her opinion, the quote was taken out of context and presented to meet Paul’s purpose – but does not accurately reflect the overall take-home message of the study’s findings.

This is because, she said, Paul was quoting the discussion section of the document. The discussion is the last section of a scientific paper, and Cohen said his goal here was to project what the study results might imply for broader scientific significance.

“We wrote that recovering covid patients are ‘likely’ to defend themselves better against the variants than those who have just been immunized, but that doesn’t mean they do,” Cohen said. “It doesn’t mean they’re famous. It’s making a guess or saying that it might be.

In fact, Cohen’s study did not include any vaccinated subjects. The researchers were only reasoning in the sentence Paul quoted that, based on data showing the immune system’s broad natural response, those who recover from covid-19 and then receive a vaccine may be better protected against the variants. covid than those who had only one vaccine. induced immunity.

“We didn’t intend to pretend that infected people don’t need to be vaccinated or that their immune responses are superior,” Cohen wrote in an email.

However, Cohen acknowledged that the phrase was confusing when taken out of context and said she would remove it from the document when submitted for publication.

Cohen gave us another Study led by Fred Hutchinson with which she was involved. This showed that people who previously had covid-19 also benefited from the vaccination, as there was a significant increase in the immune response, especially against the variants.

Conventional wisdom on natural immunity

So what is known from these two studies is that surviving a covid infection confers a significant amount of immunity against the virus. Other studies also support this claim.

“The existing literature shows that natural immunity offers protection against COVID-19,” said Shane Crotty, a professor at the Center for Infectious Diseases and Vaccines at the La Jolla Institute of Immunology who has published numerous peer-reviewed studies on natural immunity to covid-19. He said such immunity especially protects against hospitalizations and serious illness.

In Crotty’s recent study, the largest to date to measure the molecules and cells involved in immune protection, his team found that natural immunity to covid lasted for at least eight months. According to projections, this could last up to a few years.

While this is good news, Crotty said, there are three points of caution.

First, although natural immunity appears to be very effective against current dominant American variant (called alpha), it also appears to be weaker than vaccine immunity against some of the circulating variants, such as the delta variant, first detected in India. This means that if these variants end up becoming dominant in the United States, people who depend on natural immunity would be less protected than those who are vaccinated.

Second, there is a lack of data on whether natural immunity prevents asymptomatic transmission and infection. Several other studies, however, show that vaccines do.

Third, Crotty said his studies have shown that levels of natural immunity can vary widely in individuals. His team even found a hundredfold difference in the number of immune cells in people.

“If you think of the immune system like a basketball game and think of it as one team scoring 1 point and another team scoring 100 points, that’s a big difference,” Crotty said. “We are not so confident that people with low immunity levels would also be protected against covid-19.”

But those who get an injection of the vaccine have a much more consistent number of immune cells, since everyone gets the same dose, Crotty said.

With all of this in mind, the Centers for Disease Control and Prevention recommended that those who had previously had covid-19 should get vaccinated and receive both doses of a vaccine, be it the Pfizer-BioNTech or Moderna vaccine. Fauci, the country’s leading infectious disease expert, reiterated this message during a White House briefing on covid-19 last month.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Together with Policy Analysis and Polling, KHN is one of the three main operational programs of KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on health issues to the nation.


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