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Antibody levels highly predictive of immune protection from symptomatic Covid

101 points| georgecmu | 4 years ago |nature.com | reply

68 comments

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[+] mikem170|4 years ago|reply
From the article, a section called "Prediction of the potential for long term protection" at the bottom of the Results:

> The estimated neutralization level for protection from severe infection is approximately sixfold lower than the level required to protect from any symptomatic infection. Thus, a higher level of protection against severe infection is expected for any given level of vaccine efficacy against mild SARS-CoV-2 infection. Assuming that this relationship remains constant over time, it appears probable that immunity to severe infection may be much more durable than overall immunity to any infection. Long-term studies of antibody responses to vaccinia, measles, mumps or rubella suggest that these responses generally stabilize with half-lives of >10 years. We therefore projected beyond the reported decay of SARS-CoV-2 responses (out to 8 months after infection5), assuming that after 8 months following the infection the decay rate will slow down. We modeled the decay rate of the neutralization titer, assuming that it slowed linearly to a 10-year half-life over 1, 1.5 or 2 years (details in Methods). This analysis predicts that even without immune boosting, a significant proportion of individuals may maintain long-term protection from severe infection by an antigenically similar strain, even though they may become susceptible to mild infection (Fig. 3b,c).

Sounds like good news. This study appears to be saying that the vaccines do a 6x better job of preventing severe covid infection than the known 94% efficacy preventing even mild symptoms from appearing, and that long term immunity [0] might be expected to last decades, similar to other vaccines.

[0], EDIT: "long term protection against severe sickness", as opposed to "immunity", as pointed out by PeterHolzwarth in comment below

[+] PeterHolzwarth|4 years ago|reply
I believe the paper indicates otherwise, in regards to immunity. To help make sense of the paper, I read this Science Daily article that reviews it, and contains some comments from the paper's authors.

https://www.sciencedaily.com/releases/2021/05/210517105727.h...

Here, one of the people associated with the paper mentions:

"Vaccination works very well to prevent both symptoms and severe disease in the short to medium term, but efficacy is predicted to decline over the first few months for most of these vaccines,"

"However, it is very important to understand the difference between immunity against infection and protection from developing severe disease. Our study found that a 6-fold lower level of antibodies is required to protect against severe disease. So even though our analysis predicts that we will start losing immunity to mild infection in the first year after vaccination, protection from severe infection should be longer lived," says Dr Khoury.

Key is that distinction between immunity and protection against severe sickness.

[+] xiphias2|4 years ago|reply
My father tested negative for spike specific antibodies 2 weeks after the 2nd Pfizer vaccine (he's not the only one), and as I didn't find any data on people who test negative (and I know that the vaccine has 94% efficiency preventing COVID), he's still mostly not leaving his apartment.

He'll have a test against the viruses themselves next week, but he'll need to wait 2 weeks for the result for that test.

[+] azinman2|4 years ago|reply
That doesn’t mean he doesn’t have protection. The antibody tests only look For one thing, but the body has many mechanisms of protection from the vaccine. That is one of the reasons why they’re not suggested to be used for the general population.
[+] yosito|4 years ago|reply
I wonder if an expert could chime in on this. If someone tests negative for antibodies a few weeks after a vaccine, should that person get vaccinated again? Maybe with a different vaccine?
[+] inter_netuser|4 years ago|reply
Has he been tested for immune deficiencies? What is his age? Have a contact that's an NIH immunologist, want to get his opinion.

tia

[+] tdeck|4 years ago|reply
How did he happen to get that antibody test?
[+] rgbbtc4life|4 years ago|reply
If the vaccine is truly 95% effective in preventing infection, how did 9 fully vaccinated Yankees players all contract the virus?
[+] dunnevens|4 years ago|reply
My partner is the recipient of an organ transplant and is on anti-rejection meds. She's already had both shots of Pfizer. So we're following the research closely. Researchers are beginning to look at how the vaccine works in the immunosuppressed. The initial results aren't great. In one study[1], 46% didn't have any antibodies after both shots. 39% had antibodies only after the second shot. Only 15% received antibodies after the first shot.

I know this research is still in early stages and the initial sample size was relatively small. And T-cell responses were not measured. There's a decent chance the situation isn't as bad as it initially seems. But it's still discouraging.

[1] Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients

https://jamanetwork.com/journals/jama/fullarticle/2779852

[+] meepmorp|4 years ago|reply
I'm assuming the J&J/other viral vaccines are a no-go with the immunosupressants. Hopefully, additional mRNA boosters can improve the immune response.
[+] ralusek|4 years ago|reply
I hope a consequence of this is that we'll begin to treat antibody levels as an alternative proof of immunity to vaccine documentation. Vaccines are a means to an end, not an end themselves. If someone has the requisite antibody immunity from having had the virus, we shouldn't necessarily be vaccinating those people.

For one, there are people all around the world waiting for vaccines. If the antibody levels can be used as a general stand in for immunity, there are people that need the vaccines more than those who have the requisite antibodies.

Secondly, intentionally triggering an immune response isn't exactly good for you. The assumption is that a vaccine arrives at an immune response in a less harmful way than getting the infection itself...but for those who have had the infection (and demonstrated a sufficiently high antibody count), retriggering an immune response is subjecting a person to a needless secondary immune response.

[+] Dma54rhs|4 years ago|reply
At least in EU that will be the case.
[+] timka|4 years ago|reply
In the 80s they achieved antibodies while working on a HIV vaccine. The vaccine still doesn't exist.
[+] dragonwriter|4 years ago|reply
> In the 80s they achieved antibodies while working on a HIV vaccine.

The I in HIV and the ID in the name of the associated disease mean something important here.

[+] AlexCoventry|4 years ago|reply
I'm a little surprised this is in nature... Isn't that exactly what you'd expect?
[+] noodlenotes|4 years ago|reply
The headline might be what you expect, but the article contains mathematical details about the relationship between antibody levels from the vaccines and neutralization. It also models antibody levels over time to see what immune protection we'll have in the future. Did we know the expected efficacy of the vaccine against severe Covid 750 days post-vaccine before?
[+] dEnigma|4 years ago|reply
But not everything turns out as you'd expect, so it's important to actually test and provide evidence.
[+] The_rationalist|4 years ago|reply
I wonder whether bromantane can help with the covid response
[+] rgbbtc4life|4 years ago|reply
The people achieving immunity through vaccination are at a huge disadvantage compared to those with natural immunity. As shown in research from the other day, natural antibodies target several proteins and more of the spike protein than Pfizer immunity does. Additionally, natural immunity stimulates both the innate immune response and killer T cell response.

I wouldn't be surprised if we start seeing ADE among vaccinated individuals - there's a good chance their antibodies will be non neutralizing when challenged with live virus a year from now.

Also, it appears governments are motivated to hide information about the vaccine. It's come out the CDC is performing PCR testing for vaccinated individuals with a lower cycle count than for the unvaccinated. There's no reason to trust anything coming out of the CDC with regards to vaccination.

[+] standardUser|4 years ago|reply
"It's come out the CDC is performing PCR testing for vaccinated individuals with a lower cycle count than for the unvaccinated."

Do you have anything to back up this conspiracy theory? I'm also wondering how many of the ~1 million tests per day are being performed by the CDC itself?

[+] t-writescode|4 years ago|reply
How does your argument here correspond with the numerous articles discussing how the mRNA vaccines are effective against the numerous variants?

There's a big scare every time there's a new variant, followed by another article a couple weeks later about how the vaccine is X > 50% effective against [ new variant ].

[+] grej|4 years ago|reply
I don’t believe this is clear at all. So far, it actually seems the mRNA vaccines as well as the viral vector vaccines greatly attenuate the severity of COVID among those who do catch a variant.
[+] lamontcg|4 years ago|reply
We would have seen evidence of ADE by now. From convalescent plasma to naturally re-exposed and reinfected to the individuals vaccinated almost a year ago now.

And the vaccines target spike because there were concerns about ADE with vaccines against the SARS-CoV-1 nucleocapsid protein, but not spike.

Pfizer stimulates both CD4+ and CD8+ T-cells responses:

https://www.fiercebiotech.com/biotech/pfizer-reports-strong-...

https://www.medrxiv.org/content/10.1101/2020.07.17.20140533v...

And the stuff in there about IL-4 and IL-5 and "the absence of a potentially deleterious TH2 immune response" is all about "no signs of ADE".

[+] bandyaboot|4 years ago|reply
Do you have a link to the research you’re citing from the other day? Also the basis for your implication that there’s a known difference in T cell response for natural immunity vs vaccine immunity?
[+] tryonenow|4 years ago|reply
The high cycle counts of the PCR tests in the US make all official numbers suspect. Particularly in combination with implicit political pressure against the previous administration, and an overzealous press. The entire system - academic, medical, news and entertainment - is rotten with bias and society collectively is worse off for it, especially with respect to handling this pandemic.

It's hard to find a source now but these PCR tests were being run with cycle counts anywhere from 30-40; in this regime you are extremely likely to amplify noise and generate a huge percentage of false positives. The inventor of the PCR tests made similar comments regarding abuse of the PCR process during the HIV/aids pandemic - and wouldn't you know it, Dr. Fauci was involved in [mis]managing that pandemic as well. His self serving publication and premature press release created an ultimately unfounded stigma around HIV positivity. There is simply no reason to trust the guy now, regardless of his overtly warm, anti-trump persona. And now he has repeatedly denied before congress that he was affiliated with funding/conducting gain of function research on bat coronaviruses. But the publications, with authors publicly and directly linked to Fauci and funds he managed, are freely available online. This should be a far bigger story.