If a vaccinated person acquires, and recovers from, a symptomatic SARS-CoV-2 variant infection (COVID), will this person now have "natural immunity" to the same degree as a recovered non-vaccinated person? Or will there still be some competition from the vaccinal antibodies? Many vaccinated people I know are becoming infected with moderate symptomatic disease and then recovering in 3-5 days.
This remains a difficult question. I am afraid, from an immunological viewpoint, breakthrough infections are a pain. As breakthrough infections accumulate, immune escape variants will only become more and more prevalent. This is because vaccines that cannot protect against mild or moderate disease allow vaccinees to shed virus while rapidly recalling and boosting their original vaccinal Abs (due to ‘antigenic sin’). The combination of mounting Ab titers and high viral load, within an increasing part of the vaccinated population experiencing breakthrough infections - only promotes further immune selection and dominant propagation of viral immune escape variants, which then, further improve on resisting vaccine-induced immune pressure of their infectiousness. It is, therefore, fair to assume that the recent emergence of Omicron resulted from large-scale breakthrough infections in a highly vaccinated population.
This is in sharp contrast to a situation where an unvaccinated individual contracts C19-disease. Unvaccinated individuals contract C-19 disease as a result of the virus breaking through their innate immune defense; in which case, viral transmission occurs well in advance of the appearance of a robust humoral response and, therefore, doesn’t cause immune pressure on viral infectiousness. De novo priming of anti-S Abs that are directed at the relevant circulating variant, prevents natural selection and adaptation of more infectious variants in the unvaccinated population.
Furthermore, vaccinal Abs continue to suppress innate immunity. This being said, it’s difficult to believe that recall of vaccinal Abs, in vaccinees who experience a breakthrough infection, would not accelerate the occurrence of viral resistance to the C-19 vaccines and not continue to further suppress the innate immunity of vaccinees. Recall of vaccinal Abs is inevitable given the dominant circulation of highly infectious strains. In other words, I fear that protection of vaccinees who recovered from C-19 disease and are re-exposed to the virus will be much less efficacious than the immune protection acquired by a nonvaccinated person who recovered from C-19 disease.
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Parallel question: Vaccinated memory B cells have been demonstrated to stop "improving" after 2 to 5 months, while memory B cells from natural immunity seem to continue to improve... Will this be an impediment for the vaccinated with a previous infection in the future?
Well, this is rather coincidental since I just asked Dr. Robert Malone almost the exact same question (https://rwmalonemd.substack.com/p/not-in-the-news-covid-epidemiology). I’ll share my question and his response below in case you’re interested in his take.
ME: Dr. Malone, when the vaccinated contract COVID after injection, do you know if they develop natural immunity in the same way the unvaccinated do, or is that process thwarted? (Granted, it may still be too early to make such a determination, and this article suggests it is still an unknown: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8402626/)
If they can still develop antibodies, do you think the highly-transmissible and apparently innocuous Omicron has the potential to achieve the natural herd immunity that we appeared to be on the precipice of a year ago, according to this December 2020 “Medical Hypotheses” article, “Is a COVID-19 Vaccine Developed by Nature Already at Work?”:
“The COVID-19 positive cases are increasing at an alarming rate across the world. On the contrary, the morbidity and mortality are showing decreasing trend as time progresses. The most intriguing part is the rise in asymptomatic Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) positive cases in the population, which made us speculate some kind of gradual development of immunity in the population.… Thus, we hypothesized the existence of SAMPPs mediated the development of immunity against SARS-CoV-2 infection, which has caused an increase in the incidence rate of asymptomatic cases and a decrease in mortality rate.” (https://pubmed.ncbi.nlm.nih.gov/33059225/)
DR. MALONE: If vaccinated with a genetic vaccine that only encodes for one protein (spike), the vaccinated do not develop the same protection as those who have caught the disease. There are 29 proteins in SARS-CoV-2 -which the body will mount an immune response with natural infection.