Natural immunity, vaccine mandates, and “following the science”
In October 2020, three public health academics published the Great Barrington Declaration, which argued that policymakers should focus on protecting those most vulnerable to covid, while encouraging those at low risk of death or serious disease to resume normal activities. This would result in a rapid spread of natural immunity through the population, hastening an end of the epidemic.
I will discuss the Great Barrington Declaration – both its substance and what it teaches us about libertarianism – eventually. But for now let’s catch up with Martin Kulldorff, one of the authors of the Great Barrington Declaration, and a professor at Harvard Medical School:
How can hospitals best protect their patients from Covid disease? It is an enormously important question, also relevant for nursing homes. There are some obvious standard solutions, such as separating Covid patients from other patients, minimizing staff rotation, and providing generous sick leave for staff with Covid-like symptoms.
Absolutely.
Another goal should be to employ staff with the strongest possible immunity against Covid, as they are less likely to catch it and spread it to their patients. This means that hospitals and nursing homes should actively seek to hire staff that have natural immunity from prior Covid disease and use such staff for their most vulnerable patients.
Eh. This might well have made sense early in the epidemic, before vaccines, but with vaccines now widely available it seems like a lot of effort testing, hiring and training new employees, and reassigning or firing existing folks for possibly not much benefit. Maybe we should concentrate on getting everyone vaccinated.
Hence, we are now seeing a fierce competition where hospitals and nursing homes are desperately trying to hire people with natural immunity. Well, actually, not.
Instead, hospitals are firing nurses and other staff with superior natural immunity while retaining those with weaker vaccine-induced immunity. By doing so, they are betraying their patients, increasing their risk for hospital-acquired infections.
By pushing vaccine mandates, White House chief medical advisor Dr. Anthony Fauci is questioning the existence of natural immunity after Covid disease. In doing so, he is following the lead of CDC director Rochelle Walensky, who questioned natural immunity in a 2020 Memorandum published by The Lancet. By instituting vaccine mandates, university hospitals are now also questioning the existence of natural immunity after Covid disease.
This is astonishing. . . .
This is astonishing . . .
No one is questioning the existence of natural immunity. Here is what the 2020 Memorandum cited by Kulldorff said about natural immunity: “It is unclear how long protective immunity lasts, and, like other seasonal coronaviruses, SARS-CoV-2 is capable of re-infecting people who have already had the disease, but the frequency of re-infection is unknown.” And remember, this Lancet Memorandum is from 2020. Kulldorff is using a memo from 2020 that does not question the existence of natural immunity to suggest that people today are questioning the existence of natural immunity.
Of course, people may not believe in natural immunity even if they do not say this out loud. Kulldorff seems to think that it only makes sense to support a vaccine mandate without an exception for people with natural immunity if natural immunity does not exist. He then infers that mandate supporters do not believe in natural immunity.
But, in fact, it might make sense to have a vaccine mandate that applies to all health care workers, even those with natural immunity. There are two reasons for this. First, it is administratively simpler to require everyone to get vaccinated then to set up a system with exemptions for people with prior infections. Second, it seems reasonable to believe that people with natural and vaccine-induced immunity will be less likely to become infected than people with natural immunity alone. This will protect patients directly, by keeping their caretakers from getting sick if they are exposed to covid, and indirectly by bringing down overall disease prevalence.
Of course, it is possible to argue that we should offer exemptions to vaccination requirements to people with natural immunity, to respect the wishes of those who are vaccine hesitant, to avoid having to fire people for noncompliance (although, contra Kulldorf, it does not seem like this will be a serious problem), to tamp down political polarization, or to free up vaccine supplies for people in poorer countries.
We could have a reasonable discussion about this. A reasonable discussion would ask questions like these: How would exemptions be administered? Do we have the capacity to do mass testing for antibodies? If not, do we delay vaccine mandates until we ramp up anti-body testing? Are positive PCR tests sufficient to establish natural immunity? What about other tests? How will we check to see if natural immunity is waning over time? How many additional breakthrough infections will there be if we expand exemptions to cover natural immunity? How many people will in fact quit their jobs without an exemption? Etc. In other words, we would do policy analysis. But this is not what how Kulldorff rolls.
Finally, there’s this:
If university hospitals cannot get the medical evidence right on the basic science of immunity, how can we trust them with any other aspects of our health?
What’s next? Universities questioning whether the earth is round or flat? That, at least, would do less harm.
Libertarians have been caterwauling about progressives and public health officials and political leaders who say they are “following the science” when in fact the science is not clear, or when policy choices are based not just on science, but on value judgments that can reasonably be questioned. Fair enough, people do sometimes invoke the authority of “science” to justify decisions where the science is not clear or where decisions depend on contestable value judgments as well as science. But here we see the opposite:
an academic with a libertarian ax to grind falsely claiming the mantle of “science” to justify a debatable policy (whether exemptions to vaccine mandates make sense is a complicated moral and policy question, not “the basic science of immunity”), misrepresenting the facts (no reasonable people deny that natural immunity exists), and using this misrepresentation to deliberately undermine trust in public officials.
That makes lots of sense, if you’re a libertarian and regard distrust in government as a good thing. Of course, distrust in government threatens to destroy American democracy, but whatever. At least no one with natural immunity will be forced to get vaccinated. Whew.
Oh, and guess what? Kulldorff’s essay was published at the Brownstone Institute, founded by Jeffrey Tucker, the libertarian pundit who sponsored the Great Barrington Declaration, spent a year ranting about lockdowns, and parlayed that “success” into funding for his new venture. We’ve seen Tucker’s work before. For libertarians, covid is the gift that keeps on giving.
Herd immunity for COVID-19
Lancet Respiratory Medicine – Nov 2020
(Walensky was appointed CDC director, effective Jan 20, 2021.)
@Eric,
Excellent post!
“Natural immunity” has acquired a brand status, like “organic” food. Natural immunity was all humanity had until vaccines, and the human cost was and is horrific. But there have been no controlled studies on the degree of protection conferred by so-called “natural immunity,” while all vaccines are held to strict standards. What is unnatural about an immune reaction to a vaccine, anyway?
As you allude to, everyone who mounts an immune reaction to a SARS-CoV-2 doesn’t necessarily achieve the same level of “natural immunity.” Nor is it clear how durable “natural immunity” is. The same can be said about vaccine-based immunity, but the data are getting better there. “Natural immunity,” not so much.
At the core of anti-vaxxism is solipsism. My decisions only affect me. Libertarianism is the apotheosis of solipsism. The reality is that pandemics only occur when the actions of one individual affect the well-being of others. Epidemiology 101. There is no place for anti-vaxxer libertarianism in civil society. Patriots reject anti-vaxxism and libertarianism. Full stop.
Is Jeffrey Tucker related to MFucker Carlson of Faux News?
Just asking the question.
If you read through the links to the studies and articles, you find there are reasons to believe that having had Covid confers protection which should be considered adequate as compared to the vaccine. You also find that the vaccine provides additional protection on top of natural immunity. I did not see that any evidence was provided that hospitals are firing anyone who has had the disease but refused the vaccine.
To the extent that I see anything in Kulldorff’s concerns, I see that Israel does accept proof of having recovered (and having natural immunity) as a substitute for vaccination in order to get the green card they need to be in public places. I have not seen anything like that in the US. (Is it not happening or is it getting no press?)
Although the Brownstone Institute uses Israeli outcomes to to justify their stance, I suspect they would go ballistic if someone in the US suggested we implemented green cards.
Arne and Dobbs
thanks for the additional facts.
I had some qustions about the post:
Does being a professor at Harvard Medical school trump being a professor at…. well, another less famous school?
Does being a professor at either make one an authority on what there is no place for in civil society? or who is a patriot?
Are we talking about “encouaging those with low risk to go about normal activities” or whether hospitals should fire those with “natural immunity” but no vaccination?
could people with “natual immunity” be responsible for proving their own lack of infectiousness, rather than asking “us” to have the capacity?
Who said, “Hence, we are now seeing a fierce competition where hospitals and nursing homes are desperately trying to hire people with natural immunity. Well, actually, not. “?
[actually, I would guess it was Kulldorf, but between the graying of quotation, the differnt type faces, the contrafactual, the separation of the quoted, contrafactual, it’s denial, and the rest of Kuldorf’s argument…by a break for the quoter’s…comment…from Kulldorf’s set up for the contrafactual….well, I just got lost I guess, not being used to intricate writing and modern punctuation.]
Could we check for natural immunity waning over time the same way we check for vaccine-immunity waning over time?
Is there a difference between forcing people to submit to vaccination and just saying “no, you can’t work here if you won’t wash your hands before operating”. [i combined two issues into one to keep this short, no doubt the reader will undersand what i meant.]
Is “Full stop.” a scientific way to win a argument?
Disclaimer: I am not now, nor ever have been, a member of the Libertarian Party, or a party to any “libertarian thought.” don’t much like the authoritarian party either, even in a white coat.
Whatever the problems of accepting natural immunity in vaccination mandate situations, administrative burden is not one of them. Prior infection produces the reaction in the human body that these vaccines are designed to. No one proposes testing to see if the vaccine worked or not for the individual. A piece of paper from a vaccine clinic is all that is needed. A lab test return of positive or a doctor’s diagnosis is no harder for HR to look at.
Yeah, cause those two things are exactly the same, except for actual scientists that say they aren’t. People like you are killing people, and you do not seem to care.
And of course they are killing people.
https://i2.wp.com/jabberwocking.com/wp-content/uploads/2021/10/blog_covid_deaths_october_4_2021.jpg?resize=960%2C598&ssl=1
h/t Kevin Drum.
EMichael
they are not exactly the same. does that mean they are not enough the same that the same protocol for checking their continued effectiveness in preventing transmission would not be enough the same?
moreover, would it not work to put the burden of proof on the person desiring to use the “natural immunity” as a reason to waive the vaccination requirement for working in a particular place?
there is a difference between “forced vaccination” as in physical force..tied down and injected against his will, or threatened with jail for refusing… and vaccination as a requirement to be allowed close contact with people who object to having close contact with unvaccinated..or unmasked.. people. i know i would not care to be operated on in a hospital were doctors were allowed “free choice” as to whether or not they wore masks or washed their hands.
i didn’t want to get involved in this thread because the thinking is so shabby on both sides that all i would accomplish is make more enemies than i really need.
i am not a libertarian, nor am i an authoritarian..even when it wears a white coat.
speaking of which, is a professor at Harvard Medical School one of those experts I am obligated to trust?
Read some of Joel’s post in here and/or do the actual research. The vaccine is a much more effective prevention against Covid than natural immunity gained from having Covid previously.
Yes . . .
EMichael
I am not sure Joel’s posts count as authority.
Nor does “people like you are killing people, and you do not seem to care.”
Nor do I think you and I are in any position to “do the actual research.” That’s why I suggested the people who wish to waive the “vaccinated” requirement have the burden of proof. And the people who are being asked to admit them to their crowded rooms have the final say.
Coberly:
Joel is the only person here who has worked on mRNA technology over the years. He is the expert and teaches also.
Run
I don’t dispute what Joel knows about mRNA technology. I dispute what he knows about public policy, human psychology, manners and what I actually said when he calls me a liar.
I also have my doubts about what he knows about epidemiology and this virus in particular.
Coberly:
Joel is the only person here who has worked on mRNA technology over the years. He is the expert and teaches also.
This is from Politico Nightly, Oct 6. Hardly a Trumpist rag.
THE TWO-FRONT VAX WAR — The highly politicized national dialogue over the unvaccinated goes like this: The unvaccinated are Trump loyalists , disproportionately rural, less educated and white. Their recalcitrance and denial has fueled the deadly Delta surge, threatening us all and obstructing our path toward “something-like-normal” life.
It’s true. But it’s not the whole story.
These partisan anti-vaxxers represent about 12 percent of the American adult population . That hasn’t dropped much since last winter, according to the Kaiser Family Foundation’s Vaccine Monitor, which tracks immunization trends.
But there’s another large and important group of unvaccinated — the still-hesitant, or what Kaiser dubs “the wait and see.” This is now 7 percent of the adult population — a drop from the 17 percent back in March, but still millions of people.
The racial and ethnic gaps in this group have shrunk, according to data from KFF, Pew and the CDC. The new vaccine mandates, fear of the Delta variant and months of outreach, including among minorities, have helped boost immunization rates.
By focusing our national dialogue on the hardcore ideological vax-refusers, we are doing a disservice to ourselves and to the vaccine hesitant, who remain vulnerable to the virus. In addition to getting hold-out adults protected, we need to get them to feel comfortable getting their c
END OF COPY/PASTE
if yu want to see i more I will try to copy/paste the rest. Maybe someone will figure out I have not been arguing with Joel about what he thinks I have been arguing with him about..before the argument descended into name calling by Joel.
here is the rest of the story from Politico:
By focusing our national dialogue on the hardcore ideological vax-refusers, we are doing a disservice to ourselves and to the vaccine hesitant, who remain vulnerable to the virus. In addition to getting hold-out adults protected, we need to get them to feel comfortable getting their children vaccinated, when those shots are authorized later this fall.
As we celebrate signs that Delta may — may — be abating, we still need to get more shots in arms. And unlike the partisan Never Vaxers, some of the wait-and-see crowd is persuadable.
On average, the members of the wait-and-see group are younger, lower-income and more urban than the people in the “definitely not” group. Both groups lean Republican, but the resistant group is more hard-core GOP.
The hesitant group is more worried about a family member getting sick, and less likely to believe the news media has exaggerated the pandemic, explained Liz Hamel, Kaiser’s vice president and director of public opinion and survey research.
This group’s vaccine skepticism is less intractable — but still a challenge to overcome, said Lisa Cooper, a Johns Hopkins physician/health equity researcher who was recently appointed to Biden’s Council of Advisers on Science and Technology.
The apprehension among the vax curious has many causes, ranging from fear of needles to religious beliefs to misplaced fears that the vaccines were dangerously “rushed” to market. Among people living in poverty and minorities, as Cooper points out, there are still large pools of distrust of the health care system. And some low income people are dealing with so many day to day crises and challenges — threats of eviction, joblessness, a family member with illness or addiction, to name just a few — that getting vaccinated just isn’t a priority.
Getting them protected will require “time, work and patience,” Cooper said. It also requires remembering that not everyone who is unvaccinated is seeing the coronavirus through a politicized lens.
Joanne Kenen, a former POLITICO health care editor and a contributing POLITICO writer, is the Commonwealth Fund Journalist in Residence at the Johns Hopkins Bloomberg School of Public Health.
Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight’s author on Twitter at @joannekenen.
Programming note: Nightly will not publish on Monday, Oct. 11. But don’t worry, we’ll be back and better than ever Tuesday, Oct. 12.
coberly:
By focusing our national dialogue on the hardcore ideological vax-refusers, we are doing a disservice to ourselves and to the vaccine hesitant, who remain vulnerable to the virus.
Asking for an inoculation is not hardcore or ideological? Your premise attempts to make it so. You are not being asked to sumit to a draft, go to war in Vietnam or Iraq, etc. You are being “asked” to sumit to two shots to prevent your death from Covid and to prevent others from being infected by Covid. Delta will never go away and it will always lurk like small pox, measles, polio. The shots are preventative for them and others limiting the impact of Covid.
Rather than the last phrase(s) give me the vaccine or I never thought it would kill me. Your demand to not be vaccinated such not infringe upon my rights to a safe environment. Piss in your water if you wish too but leave my water piss-free.
Stick to Social Security. And yes, Politico is a Rw rag if not Fox News.
EM
funny now that you mntion it, i have thought so myself at times. but the article i pasted here struck me as almost reasonable. probably because it almost agreed with me.
but you and run are still missing my point. not much reason to continue the shouting contest.
On February 20, 1905, the Supreme Court, by a 7-2 majority, said in Jacobson v. Massachusetts that the city of Cambridge, Massachusetts could fine residents who refused to receive smallpox injections.
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I see that I have repeated myself.. a comment I wrote earlier that did not appear immediately had been I thought deleted. But here it is. On the other hand, the comment I just wrote has not appeared. gets hard to keep up with.
Run
re yours of 12:28 a.m.
why is this addressed to me? I have never made any of the arguments you imply I made. In fact I have made exactly your closing argument, though in more elegant language.
Even the Politico article is not making the argument you imply: they are making the argument that your intemperate language and false generalizations are counterproductive and assuring we will NOT get the vaccine hesitant vaccinated. It would be nice if you could understand this.
coberly:
I guess I know shit, heh? Then I guess they die, heh? More unused funding for SS.
run,
this is getting us nowhere.
coberly:
What is getting nowhere is your faux hurt feelings when response is made to your diatribe. There is no middle ground to this. You take the shot(s). You do not get to decide not to take a shot and then roam freely in public. You do not get to foment disagreement to being inoculated with muddied dialogue and expect everyone to nod our heads “oh, its Coberly again” in return.
As I have pointed out repeatedly to you, your f-ing liberty to not be inoculated “shall” not infringe upon my and other’s liberty to be safe from Covid and other things you wish to do. Your argument is a political stance along the lines of trump who muddies the water with unsupported BS, who claimed to have survived Covid, and doesn’t tell the rest of the story about how they pumped him full of everything on earth to save his fat ass. Think how different politics would have been if he passed on?
You cast doubt with your dialogue and people believe they may not need to do anything and still exist as they did pre-covid. 700,000 dead and probably just as many injured and existing with long-covid. How many more do you need?
Yours is not a discussion anymore, it is a stirring of the pot to which you thrive.
Run
this is not getting us anywhere. thank you for telling me what you think I have written.
Please allow me to say that is not what I think I wrote.
The issue I have tried to address is not my vaccination status, nor the desirability of vaccination. But the way we go about encouraging vaccination. I don’t believe it helps us to call the unvaccinated names or threaten to force them to get vaccinated. I have explicitly stated i support the right of people to deny the unvaccinated access to their “social space.”
I did expect people would at least read what I said, and not what they think I said.
My feelings, faux or not, are not hurt.
coberly:
Where in this post’s thread was “social space” said other than now? I will not expand on this as you did not say it in this thread relating to the entire post or three pages back in comments. I am not a librarian. You are not listed in Dewey’s system (although on SS, you should be).
I addressed your issue on the vaccination of others. If you wish to be in public, you get the shot because it works. The “you” addresses your beliefs and not whether you have been inoculated (you expanded it).
No one but a fool would challenge you on SS. You persist in challenging the science of mRNA technology and those who have played a part in bringing it to fruition as a vaccine. You promulgate the ignorance of others by your words which are very effective in creating doubt.
run
@2:11 Oct 6, this thread.
i don’t expect you to be a librarian, but this ‘thread’ is the most recent of a long string of related threads in which i have tried to make the same point over and over looking for the magic words that would enable understanding.
also @4″02 pm Oct 6, this thread.
“Nor do I think you and I are in any position to “do the actual research.” That’s why I suggested the people who wish to waive the “vaccinated” requirement have the burden of proof. And the people who are being asked to admit them to their crowded rooms have the final say.”
from the 2:11 Oct 6,…since it’s so hard to find:
“there is a difference between “forced vaccination” as in physical force..tied down and injected against his will, or threatened with jail for refusing… and vaccination as a requirement to be allowed close contact with people who object to having close contact with unvaccinated..or unmasked.. people. i know i would not care to be operated on in a hospital were doctors were allowed “free choice” as to whether or not they wore masks or washed their hands.”
i have never challenged the science of mRNA technology. I know nothing about mRNA technology. I have challenged the language of “force,” making clear my distinction between thrat of physical force, and “merely” denying access to work or other public space where people don’t want to be exposed to the unvaccinated, or unasked, or even people who don’t respect their persona; space.
i have seen no evidence that people pay any attention to what i say about anything, except when they get mad about something they think i said and call me names. i am learning to not respond to that. but it is a phylogentic response; people calling you (another person) nmes are engaging in a verbal attack which often precedes a physical attack, and the best defense as they say is a good offense. I would think that anyone who grew up in chicago would know that.
but you should also know that just as it provokes me, speaking “attack language” to or about the un-vaxed provokes them to opposition, exactly what we should not be doing. attacking the unvaccinated as if they were all Trumpist fools or Trumpist criminals is counterproductive.
as Joel would say, “full stop.”
what strikes me here is that if people who have known me for over ten years can get “Your argument is a political stance along the lines of trump …” out of what i say, I had best not say anything lest people who don’t know me at all believe I am encouraging people to inject bleach, go maskless, insist others go maskless in crowded places, and generally violate the reasonable rights of people who do not want them to spray covid into their faces.
of course, even with this i run the risk of “some people” concluding that i mean just the opposite of what i say.