the misleading thing about this misleading thing is that "lingering immunity" is of no use whatsoever when the variant to which we have "lingering immunity" is extinct.
new variants replace those to which we had immunity REALLY FAST (see covariants.org for realtime illustrations). this is because we are breeding *so much* covid, and immune escape is a heavy evolutionary pressure on the virus. if it can't find hosts, it goes away. the immune-escaping ones are the ones in circulation; i.e. the ones that go right on infecting people.
so "lingering immunity" is kind of a lab curiosity? it's not stopping people getting sick. it is driving viral evolution more than stemming the pandemic. people are still getting sick, including with covid's particularly nasty and unpredictable long-term consequences, every day.
1 in 72 americans has covid RIGHT NOW: "lingering immunity" isn't doing much to help us.
It's still important to understand immune kinetics, because among other things: 1) populations are not 100% susceptible at the start of every variant wave, and understanding how persistent responses can cross-protect is important - because they are currently stopping many people getting ill compared to susceptibility in early 2020 (even if some still do get ill); 2) we need to distinguish between waning immunity (which would influence vaccine timing and frequency, independent of which specific variants are circulating) and virus evolution (which will influence vaccine selection and understanding how well current responses cross-protect).
As the virus evolves, annual vaccines will be useful, particular among those at higher risk. But over time it won’t be so much a ‘booster’ as a vaccine against new circulating variants (like the seasonal flu shot).
I sure appreciate these types of analysis and discussion. My degree was in hazardous materials management and health and safety, so I am no expert in viruses. I would appreciate every writer start with some definition of basic terms like ‘infection’ and ‘immunity’. Or maybe point to some standard definitions. I know there is plenty of confusion on those terms in the general public.
I've learned there is no clear definition. Everyone thinks they know, but it depends on who you talk to - whether it's when an infectious agent enters the body, when it multiplies, or when it causes disease, right? After that, Is it an infection after symptoms resolve and it is below detection levels? Or, if it's dormant for 20 years?
Only thing I'm sure of is: It's not an infection if we are properly protected from it and never catch it.
5 years now, masked and happy 😷 😃
I also think it’s important to set the stage with some reminder that the decision was made from the top to get everyone infected in April 2020 and that a boatload of propaganda, misinformation and disinformation was employed to make that happen.
So might this imply if you’ve had whatever vaccine is as closely targeted to currently circulating variants as possible , as imperfect as that may be, that you wouldn’t necessarily need more than one until a new variant specific vaccine formulation is released? Currently because of various risk factors in our family, including age, but also just our understanding of the science was that it’s best to get a vaccine or booster every six month to maintain antibody levels and vaccine effectiveness.
As you say, it depends on the variants circulating, current vaccine composition (which can lag behind what's actually circulating, as for flu) and individual risk factors. At some points in time the additional benefit of the vaccine will be more limited than at others, but it's hard to predict ahead of time given the challenges of anticipating variant waves.
Anyone thinking of taking the vaccines in the future would be well advised to read the analyses of the EWG considerations provided by Profs Heneghan and Treasure in their substack Trust the Evidence (I think most may be behind a paywall). The were massive gaps in the knowledge before authorisation that were brushed over and ignored by the EWG. The failure of the MHRA to act as a protector of the public is astonishing.
Just to point out something relevant to this article, the relationship of antibody levels and field protection is unknown. Antibody levels are taken as surrogate measures of field protection, and therefore efficacy, in nearly all anti virus vaccine studies. The graphs of antibody levels with time give reassurance that may be completely spurious.The EWG note this problem in their minutes, and regulators have been aware of this problem for decades, but done nothing to address it.
I'm afraid 'Heneghan made a claim behind a paywall' is pretty far down on the evidence pyramid for me... We're looking a lot at antibodies vs protection currently (building on existing work, e.g. https://www.nature.com/articles/s41467-023-37176-7) – stay tuned for more...
Heneghan made no claim! It is picking over the failures of the MHRA EWG deliberations on the vaccines.
I note you make no response to the problem i noted of the use of antibody levels as surrogate measures of vaccine efficacy.
Let us hope you look a bit more carefully at the correlation of antibodies vs protection than the reference you cite, which is a joke. The paper aims to prove antibodies strongly correlate with protection against severe covid infection. Fine, except that there is no data to do this. There is no data on the antibody levels to compare, so the authors use PREDICTED antibody levels for this, ie essentially they concoct the data for the comparison. It is exactly this sort of bad science that pollutes the knowledge base.
Like I said, there’s more to be done in this area. But fundamentally, if you want to relate antibodies to infection or outcome risk, you have to either solve an inference problem or make very strong assumptions (I wrote more about this: https://kucharski.substack.com/p/we-cant-avoid-models). The only way to get an answer directly from ‘the data’ would be to run a very large cohort study set up to bleed and swab participants every single day for several months, which is not realistic.
Thanks Adam, probably also good to highlight that observations consistent with immune imprinting are likely due to selection bias :)
the misleading thing about this misleading thing is that "lingering immunity" is of no use whatsoever when the variant to which we have "lingering immunity" is extinct.
new variants replace those to which we had immunity REALLY FAST (see covariants.org for realtime illustrations). this is because we are breeding *so much* covid, and immune escape is a heavy evolutionary pressure on the virus. if it can't find hosts, it goes away. the immune-escaping ones are the ones in circulation; i.e. the ones that go right on infecting people.
so "lingering immunity" is kind of a lab curiosity? it's not stopping people getting sick. it is driving viral evolution more than stemming the pandemic. people are still getting sick, including with covid's particularly nasty and unpredictable long-term consequences, every day.
1 in 72 americans has covid RIGHT NOW: "lingering immunity" isn't doing much to help us.
It's still important to understand immune kinetics, because among other things: 1) populations are not 100% susceptible at the start of every variant wave, and understanding how persistent responses can cross-protect is important - because they are currently stopping many people getting ill compared to susceptibility in early 2020 (even if some still do get ill); 2) we need to distinguish between waning immunity (which would influence vaccine timing and frequency, independent of which specific variants are circulating) and virus evolution (which will influence vaccine selection and understanding how well current responses cross-protect).
So are you saying we need to continue getting yearly boosters or not?
As the virus evolves, annual vaccines will be useful, particular among those at higher risk. But over time it won’t be so much a ‘booster’ as a vaccine against new circulating variants (like the seasonal flu shot).
Thank you
I sure appreciate these types of analysis and discussion. My degree was in hazardous materials management and health and safety, so I am no expert in viruses. I would appreciate every writer start with some definition of basic terms like ‘infection’ and ‘immunity’. Or maybe point to some standard definitions. I know there is plenty of confusion on those terms in the general public.
I've learned there is no clear definition. Everyone thinks they know, but it depends on who you talk to - whether it's when an infectious agent enters the body, when it multiplies, or when it causes disease, right? After that, Is it an infection after symptoms resolve and it is below detection levels? Or, if it's dormant for 20 years?
Only thing I'm sure of is: It's not an infection if we are properly protected from it and never catch it.
5 years now, masked and happy 😷 😃
I also think it’s important to set the stage with some reminder that the decision was made from the top to get everyone infected in April 2020 and that a boatload of propaganda, misinformation and disinformation was employed to make that happen.
So might this imply if you’ve had whatever vaccine is as closely targeted to currently circulating variants as possible , as imperfect as that may be, that you wouldn’t necessarily need more than one until a new variant specific vaccine formulation is released? Currently because of various risk factors in our family, including age, but also just our understanding of the science was that it’s best to get a vaccine or booster every six month to maintain antibody levels and vaccine effectiveness.
As you say, it depends on the variants circulating, current vaccine composition (which can lag behind what's actually circulating, as for flu) and individual risk factors. At some points in time the additional benefit of the vaccine will be more limited than at others, but it's hard to predict ahead of time given the challenges of anticipating variant waves.
The MHRA Expert Working Group (EWG) on the Covid vaccines have published the minutes of their meetings when considering to authorise the vaccines. There were massive gaps in the evidence that were just passed over by the EWG.(https://www.gov.uk/government/collections/meeting-minutes-of-the-vaccine-benefit-risk-expert-working-group-from-the-covid-19-pandemic).
Anyone thinking of taking the vaccines in the future would be well advised to read the analyses of the EWG considerations provided by Profs Heneghan and Treasure in their substack Trust the Evidence (I think most may be behind a paywall). The were massive gaps in the knowledge before authorisation that were brushed over and ignored by the EWG. The failure of the MHRA to act as a protector of the public is astonishing.
Just to point out something relevant to this article, the relationship of antibody levels and field protection is unknown. Antibody levels are taken as surrogate measures of field protection, and therefore efficacy, in nearly all anti virus vaccine studies. The graphs of antibody levels with time give reassurance that may be completely spurious.The EWG note this problem in their minutes, and regulators have been aware of this problem for decades, but done nothing to address it.
I'm afraid 'Heneghan made a claim behind a paywall' is pretty far down on the evidence pyramid for me... We're looking a lot at antibodies vs protection currently (building on existing work, e.g. https://www.nature.com/articles/s41467-023-37176-7) – stay tuned for more...
Heneghan made no claim! It is picking over the failures of the MHRA EWG deliberations on the vaccines.
I note you make no response to the problem i noted of the use of antibody levels as surrogate measures of vaccine efficacy.
Let us hope you look a bit more carefully at the correlation of antibodies vs protection than the reference you cite, which is a joke. The paper aims to prove antibodies strongly correlate with protection against severe covid infection. Fine, except that there is no data to do this. There is no data on the antibody levels to compare, so the authors use PREDICTED antibody levels for this, ie essentially they concoct the data for the comparison. It is exactly this sort of bad science that pollutes the knowledge base.
Like I said, there’s more to be done in this area. But fundamentally, if you want to relate antibodies to infection or outcome risk, you have to either solve an inference problem or make very strong assumptions (I wrote more about this: https://kucharski.substack.com/p/we-cant-avoid-models). The only way to get an answer directly from ‘the data’ would be to run a very large cohort study set up to bleed and swab participants every single day for several months, which is not realistic.
Adam, thank you. This is very important to explore considering policy depends on this data.