Embrace the Naturally Immune: Hire Them – Don’t Fire Them

by Robert Nelson, MD

From the early months of the pandemic, many physicians, epidemiologists and scientists have been speaking out about the validity and benefits of naturally derived immunity to COVID19. Excluding natural immunity from the COVID19 conversation, regardless of the reason, is not a credible position based on the evidence. Moreover, focusing strictly on vaccine-induced immunity betrays a blind-spot in public health policy which is arguably slowing down the economic recovery as it relegates the unvaccinated, regardless of their immune status, to second-class citizens.

Jeffrey Klausner, MD, MPH, and Noah Kojima, MD make this point eloquently in their Op-Ed: Quit Ignoring Natural COVID Immunity | MedPage Today

“The range of reduction of re-infection from COVID-19 was between 82% to 95% among six studies that encompassed nearly 1 million people conducted in the U.S., the U.K.DenmarkAustriaQatar, and among U.S. Marines. The study in Austria also found that the frequency of re-infection from COVID-19 caused hospitalization in only five out of 14,840 (0.03%) people and death in one out of 14,840 (0.01%).

In a large cohort study from Israel, participants who were 16 years of age or older were selected from health plan enrollees. 637,676 virus-naïve fully vaccinated citizens (BioNTech/Pfizer mRNA BNT162b2 vaccine) were candidates for the study group. They compared 16,215 unvaccinated recoverees with an equal number of virus-naïve vaccinated, matched for age/sex/SES and geographic region. The study looked at rate of COVID positive tests, symptomatic COVID, COVID-related hospitalizations and deaths between the two groups.

“SARS-CoV-2-naïve [virus naïve] vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well. When allowing the infection to occur at any time before vaccination (from March 2020 to February 2021), evidence of waning natural immunity was demonstrated, though SARS-CoV-2 naïve vaccinees had a 5.96-fold (95% CI, 4.85 to 7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic disease. SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalizations compared to those that were previously infected.”

“This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.”

Harvard biostatistician, Martin Kulldorff, summarizes the findings of the Israeli study this way:

“Based on the solid evidence from the Israeli study, the COVID recovered have stronger and longer-lasting immunity against COVID disease than the vaccinated. Hence, there is no reason to prevent them from activities that are permitted to the vaccinated. In fact, it is discriminatory.”

An extensive review of the literature finds no compelling reason to suggest that those who have recovered from COVID-19 require or benefit long-term from the COVID vaccine. 

And from Emory University, a study published in Cell Reports Medicine, the authors state:

“The picture that emerges indicates that the body’s defense shield not only produces an array of neutralizing antibodies but activates certain T and B cells to establish immune memory, offering more sustained defenses against reinfection.”

“We saw that antibody responses, especially IgG antibodies, were not only durable in the vast majority of patients but decayed at a slower rate than previously estimated, which suggests that patients are generating longer-lived plasma cells that can neutralize the SARS-CoV-2 spike protein.”

“Ahmed says investigators were surprised to see that convalescent participants also displayed increased immunity against common human coronaviruses as well as SARS-CoV-1, a close relative of the current coronavirus. The study suggests that patients who survived COVID-19 are likely to also possess protective immunity even against some SARS-CoV-2 variants.”

The October 2021 MMWR study cited by the CDC as evidence of the superiority of vaccine-derived immunity has several design flaws which cause us to question the conclusions. Epidemiologist, Martin Kulldorf, who has worked as a biostatistician for nearly 20 years at Harvard sums up the CDC study this way:

“The problem is that the CDC study answers neither the direct question of whether vaccination or COVID recovery is better at decreasing the risk of subsequent COVID disease,…It answers whether vaccination or COVID recovery is more related to COVID hospitalization or if it is more related to other respiratory type hospitalizations.”

“Concerning the COVID recovered, there are two key public health issues. 1. Would the COVID recovered benefit from also being vaccinated? 2. Should there be vaccine passports and mandates that require them to be vaccinated in order to work and participate in society? 

The CDC study did not address the first question, while the Israeli study showed a small but not statistically significant benefit in reducing symptomatic COVID disease.”

The term unvaccinated does not differentiate between those who chose to remain unvaccinated after recovering from COVID infection vs those whose immune systems remain naïve to the virus. This is a critical distinction given the robust and durable immunity which follows in those who recover from natural infection.

The narrative fueling the vaccine mandate is the unsubstantiated notion that we are suffering a “pandemic of the unvaccinated.” Hidden in that phrase are two glaring omissions. When those omissions are examined and included in the discussion, it becomes clear that if we remove the unvaccinated from the equation, the pandemic still has plenty of momentum thanks to a vaccine that is inadequate to stop breakthrough infection and transmission. Based on the preponderance of the data, it appears likely that those with natural immunity may be doing most of the heavy lifting when it comes to herd immunity.

Based on well documented case studies we know that m-RNA vaccines cannot reliably stop the spread of SARS-CoV-2 virus; spread can occur rapidly in individuals after exposure, especially more than six months following vaccination. Therefore, we should all be wary of mandates which claim to make workplaces safe by requiring all employees to take a vaccine which does not prevent breakthrough infection or transmission.

“This communication … challenges the assumption that high universal vaccination rates will lead to herd immunity and prevent COVID-19 outbreaks … In the outbreak described here, 96.2% of the exposed population was vaccinated. Infection advanced rapidly (many cases became symptomatic within 2 days of exposure), and viral load was high.”

This from a study by the Norwegian Institute of Public Health:

“40 percent of those who needed to be admitted for care in Norway during the past week [first week of September 2021] have, for example, been fully vaccinated but have then an overwhelming majority belonged to risk groups.

Consider the Delaware County (Ohio) experience. Delaware county has one of the highest vaccination rates of any county in the U.S. and the highest in Ohio with upwards of 80% of eligible persons fully vaccinated. Despite this, they recently failed on 4 out of 5 pandemic score card metrics for COVID which meant they were in the red zone. Red Zone for cases per 100K, red zone for positivity rate of tested samples, red zone for ICU capacity, red zone for cases per 100K in schools. The only score card metric that was a passing grade was the vaccination rate!

For the three-month period ending July 31, 2021, Delaware county Health District published data for its fully vaccinated residents. The fully vaccinated accounted for 21% of all cases from May through July, 41% of hospitalizations and 20% of all deaths.

The justification for a mandate based on the collective good, without first considering individual welfare, violates the first principle of individual sovereignty regarding medical treatment. 

Certainly, no thoughtful person is suggesting that those at high-risk for complications or death from SARS-CoV-2 should take their chances with natural infection in the hope of obtaining more robust immunity. But the equally important caveat is that those who have recovered should be viewed as being naturally “vaccinated” and not treated as second-tier employees.

Unfortunately, this unjustified mandate will be implemented using the enforcement apparatus of OSHA and HHS/CMS to coerce businesses, nonprofits, and healthcare facilities into compliance; while the government cronies in media, corporate board rooms and C-suites use their bully pulpits to silence dissenters who have credible science-based objections.

We are long past the point in this pandemic where the general welfare or public safety is believable as a predicate for usurping individual choice, as if it ever should yield as an inviolable position. The evidence-poor vaccine mandate, while excluding naturally-derived immunity and other important risk-benefit assessments from the conversation, should be viewed as what it really is: Coercion at the hands of public policy technocrats who have lost their way.

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