Is the Tide Turning For Natural Immunity?
Updated: 4 days ago
Since the pandemic erupted more than 18 months ago, COVID-19 has confounded doctors, scientists, and public health officials. But the virus has been especially puzzling to lay people, because unlike every other pathogen we've ever encountered, natural immunity seemed to offer surprisingly little protection. As the world breathlessly awaited a vaccine that would get us back to "normal," those of us who were old enough to have survived chicken pox and measles couldn't help but wonder: "Why do I need to get vaccinated for something I've already been infected with?"
Experts, of course, had the answer. They explained that while antibodies to viruses like measles may last a lifetime, the jury was still out on COVID-19; no one knew how long they would last in the blood or whether they would even give us immunity. There was just so much uncertainty — and faced with a virus that expresses mild symptoms in 99.4% of the people it infects, it simply wasn't a risk worth taking.
As a result, those who advocated for the power of natural immunity were often ridiculed. Rogue government advisers who argued that younger, healthier people should be exposed to the virus were accused of endangering the lives of millions of Americans. The idea of allowing the most robust Americans to roam free — while encouraging those most at-risk to quarantine and/or mask until herd immunity was achieved — simply wasn't an option. Sweden, the only country in the world that chose to follow this route, was demonized and widely regarded as a tragic failure.
Throughout this pandemic, natural immunity has been so maligned that the FDA even advised against COVID-19 antibody testing. In May 2021, it issued shocking this guidance: "Antibody tests can play an important role in identifying individuals who may have been exposed to the SARS-CoV-2 virus and may have developed an adaptive immune response. However, antibody tests should not be used at this time to determine immunity or protection against COVID-19 at any time."
If anyone had natural immunity, we didn't want to know about it.
Instead, scientists, doctors, public health officials, and desperate-for-normal Americans focused on the holy grail: vaccination. As recently as early August, the CDC's position was that vaccines offered even greater protection than natural immunity — so much so that employers refused to allow prior infection as a possible exemption from vaccination mandates. Because whatever Mother Nature could gin up couldn't hold a candle to what our best and brightest could produce in a lab.
In the past month, however, that narrative has started to change.
It began with an August 25th Israeli study that found natural infection to be considerably more of a shield against the Delta variant than two doses of the Pfizer-BioNTech vaccine. In a country that's been wracked by a record number of "breakthrough" infections since July, this was big news. But it was even bigger news in the U.S., where President Biden's mandate requiring vaccination for employees and companies receiving federal funds has sparked a firestorm of litigation, push back from governors, and a looming labor shortage from ultra-hesitant workers.
It's the kind of news that even prompted doctors like Sanjay Gupta, CNN's go-to health expert, to ask questions. In a recent interview with Dr. Anthony Fauci, Gupta confessed to not knowing how to field inquiries from people who have already had COVID-19 and are wondering why they need to get vaccinated if natural immunity affords them greater protection. So Dr. Gupta turned to Dr. Fauci for a "firm answer." This is what he got:
"I don't have a really firm answer for you on that," Fauci told him. "That's something that we're going to have to discuss regarding the durability of the response. The one thing that paper from Israel didn't tell you is whether or not as high as the protection is with natural infection, what's the durability compared to the durability of a vaccine? So it is conceivable that you got infected, you're protected, but you may not be protected for an indefinite period of time."
Hmm. Protection for an an indefinite period of time? Would that be a more indefinite period of time than vaccinations that now appear to require boosters within 6 months? Inquiring minds want to know.
In the meantime, at least one U.S. hospital has decided to roll the dice with natural immunity, and it's not hard to see why. Recent surveys have shown that one-third of all nurses refuse to get vaccinated, and most have given every indication that they intend to quit if forced to vaccinate. Rather than face a shortage of frontline workers going into cold and flu season, Spectrum Health has decided to grant an exemption to employees who have had a COVID-19 positive PCR or antigen test, plus a positive antibody test, within the past three months.
It's not clear whether Spectrum is relying on the Israel study or Dr. Fauci's lack of a "firm answer." Regardless, PCR and antibody testing seem like a common sense compromise that strikes a balance between placating nurses wary of a novel vaccine and protecting the health and safety of other employees and patients. And in these crazy times, it's awfully refreshing to see anyone use common sense.
I don't know who's making executive decisions at Spectrum Health, but they deserve a round of applause. Huzzah!
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