Does Prior Infection Convey More Immunity Than a COVID Vaccine?

A CDC study suggesting as much was pre-omicron and didn’t account for boosters.

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Recent viral social media posts from popular right-wing figures and websites have suggested that a recent Centers for Disease Control and Prevention study determined previous coronavirus infections offered greater protection against coronavirus than vaccination.

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  1. Avatar photo
    Jon Holmlund

    The argument for vaccination for most people is strong but it is deeply regrettable that NO attempt to account for natural immunity is included in policy making. Natural immunity matters, and the point is not to "go have a COVID party," but to pose questions about a mandate to get vaccinated on top of a prior infection.

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    Ben Connelly

    Omicron definitely threw a wrench in that. Lots of second-timers getting Omicron.

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  3. Philip Howard

    why does so much effort go into comparing vaccine and acquired immunity? It seems from the CDC graph that they are roughly similar and both much better than unvaccinated/unexposed. To me was a big “we’re almost out of the woods!” moment.

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    Ian Fillmore

    Complex and nuanced scientific questions like this do not lend themselves to fact checks. Let's keep the fact checks focused on things that are actually fact-checkable.

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    ScottFromStChasIL

    I'm looking over the actual study write-up on the CDC website and it appears from Table 1 that they have absolutely no data for New York hospitalizations during this period (unless they're trying to say there were no hospitalizations due to Covid in New York over this period). With regard to the CA data, the problem I see is with the relative sample sizes for each cohort.
    There were 10,737 hospitalizations among the 15,484,235 subjects who were vaccinated and had no previous diagnosis (0.07% or 0.7 per 1000 ppl). There were just 378 hospitalizations among the 1,370,782 subjects who were unvaccinated and had a previous diagnosis (0.03% or 0.3 per 1000 ppl). The problem here is two-fold:

    1. The vaccinated/no diagnosis cohort is over 11 times larger than the unvaccinated/prior diagnosis cohort. To make meaningful comparisons between these cohorts, one has to assume a linear project, i.e., that enlarging the second cohort by a factor of 11 would yield 11 times as many hospitalizations, and this is a dubious assumption.

    2. There's a significant "chunk" of people missing from that second cohort, namely, the number of people who were unvaccinated and had a previous diagnosis of Covid-19 but could not "participate" in this epidemiological study - because they had died from Covid!

    So, sure, maybe you have a slightly better chance of not being hospitalized with Covid if you're unvaccinated and have had a previous infection but studies have already shown that this immunity wanes over time (which is why we have boosters) and it's clear that the risk of severe infection - and death - is far higher for the unvaccinated.

    It should also be noted (as mentioned in the fact-check) that conducting a study over such a relatively short time period is not likely to produce conclusive results.

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    Chany Ockert

    To more accurately explain this fact check, I think you need to add from the CDC study, prior COVID + vaccine had the best/highest protection from hospitalization, et al.

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    Frank Lee

    Boy… the left and the left administrative state is working overtime to deny what the rest of the world has already confirmed. Not only is natural infection many times better at providing immunity than are the mRNA sticks, it is now clear that the mRNA sticks are cause people to be more contagious for Omicron. Time to dig deep on Fauci’s family ownership of big Pharma stock.

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      PaulH

      There is no evidence that mRNA makes people more contagious. Indeed the evidence is that vaccinated people are less likely to get infected and are contagious for a shorter period of time -- particularly if they are boosted. Those are the facts and "the rest of the world" has not confirmed anything different.

      As for natural immunity, remember the goal here is NOT to get COVID. If you have natural immunity, you have failed to achieve that goal. By definition, natural immunity is less effective than vaccines. Because if you have natural immunity, there is a 100% chance that you got infected with COVID. This should be blindingly obvious, yet you and others continue to make statements like "natural immunity is many times better" (demonstrably false, btw) without realizing just how meaningless that argument is.

      Look, I understand from your comments that you are not well-informed and nothing I say will change your mind. But I do think it is important for misinformation to be directly countered.

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        Frank Lee

        Omicron, aka “Imacold” is a low risk infection to provide effective final COVID immunity for all future variants.

        There IS evidence that vaccinated people are more likely to be infected by Omincron. There is evidence that the mRNA sticks do not prevent infection, do not prevent passing on the virus to others… including others that have been vaccinated and boosted. There is evidence that being vaccinated reduces systems and risk of death; however, in the UK the death rate for vaccinated people has been significantly higher than for unvaccinated people for over 6 months. That is why the UK and other countries are saying no mas. No more masks, no more social distancing, no more vaccines. They are done because they are not cult of COVID sufferers… addicted to the pandemic and unwilling to let it go.

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          BWG

          Frank, I'd love to see your evidence, please provide a reference or link.
          The real truth is that you're being lied to. You are much better off getting vaccinated, you are way more likely to be hospitalized or die if you're unvaccinated:
          https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/data-tables/421-010-CasesInNotFullyVaccinated.pdf
          If you don't believe that I can relate a personal experience. My unvax'd brother-in-law and his wife came down with it. He was in the hospital for 12 days, and was on the maximum amount of oxygen they give you before putting you on a ventilator. He remained on oxygen for 2.5 mo after going home. I think it's permanently damaged his health. His wife never did go to the hospital, but they eventually had to put her on oxygen too, and it looks like she may have permanent lung damage.
          I got vax'd in Spring '21, and boosted in early Dec when I realized that in about 2 weeks I was going to be celebrating Christmas with lots of unvaccinated extended family. This past Sat I came down with a head cold. I got tested Monday morning and guess what? It's covid. I'm almost over it. Maybe there's a link between getting vax'd and boosted and having mild symptoms? I must say I feel a bit covid-bullet-proof now that I'm vax'd, boosted, and have had omicron. But only until the next variant emerges- there's no guarantee that having omicron will provide immunity for all future variants. The flu doesn't work that way, and thousands of people die of the flu every year.
          And omicron is still killing people. Last week 12 people died of covid in my community, including people in their 30's, 40's, 50's and 60's in addition to "older" people (70's and over - I'm 60, and "old" is always at least 10 yr older than me.)
          The percentage of covid patients in our local hospitals is approaching 25%, primarily the unvaccinated. https://covid19.bfhd.wa.gov/cases-and-roadmap-to-recovery/
          The UK is relaxing restrictions because they are over the omicron spike. Some places in the US are over the peak and declining, some are still rising, like my area.
          Kind of a stream of conscious response, but the bottom line is that you are being lied to, the best way to steer clear of hospitalization or death from covid is to get vax'd and boosted.

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            Frank Lee

            You need to start paying attention to the data being reported from other countries and inject a bit more understanding that what the US government is pushing is not science-based, but a combination of bureaucratic power porn, political nonsense, Wall Street big pharma wealth generation and corporate media money making. Seems like they have been successful and feeding your head with the COVID collective narrative.

            The ONLY point being made here is you and others irrational addiction to these mRNA novel drugs that are NOT vaccines (the CDC had to change the definition of "vaccine" and "vaccination" when it became clear").

            I know quite a bit about immune response as someone with related health maladies. The spike proteins in the mRNA drugs do not match those of Omicron. Also, the vaccines are being pushed on people already infected with COVID. So the cult of COVID vaccines are being pushed without need and at great potential harm. I have two healthy male friends in their 40s that have pacemakers installed after getting their second shot after they had already been infected. The shot caused them an immune response that attacked healthy tissue. That is likely happening in varying degrees to many people and they will not know it until later. That is what kills people when infected... their immune response reaction... not the virus itself. All flooding immune responses as a result of an infection or a vaccination do harm to other cells in the body depending on the individual. The novel mRNA drugs are causing a flooding immune response and causing harm to many. Yes, they provide a benefit too... that is hyped. But the harm is ignored and that is not scientific.

            The benefits of these drugs, at this point in the pandemic, are over-hyped, and the potential risks are ignored by the corporate media and the government.

            In Denmark 95% are fully vaccinated and case rates are through the roof. Case rates have the same trajectory in almost all countries no matter their vaccine rates. It is time to stop this insane attempt to force everyone to get injected with more of these novel drugs. It is insane to keep requiring masks. It is insane to keep businesses shut down and impaired. It is insane to keep demanding social distancing. If you keep pushing these things now, you are insane and not at all basing your opinions on facts and science.

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          PaulH

          Well you are just wrong about MRNa vaccines; apparently you have difficulty grasping the difference between "prevent" and "lower the risk of".

          And you persist in the argument that the best way to shield yourself from getting a disease is to catch the disease. You don't realize how stupendously stupid that argument is.

          Of course, you are detached enough from reality to think that a disease that has killed hundreds of thousands of people is just a cold, so it is not surprising that you don't understand basic scientific facts.

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    Pat Riot

    Republican values:

    "In October, 25 out of every 100,000 residents of heavily Trump counties died from Covid, more than three times higher than the rate in heavily Biden counties (7.8 per 100,000). October was the fifth consecutive month that the percentage gap between the death rates in Trump counties and Biden counties widened."

    https://www.nytimes.com/2021/11/08/briefing/covid-death-toll-red-america.html

    "Sen. Johnson holds another forum for vaccine skeptics; Wisconsin doctors, hospitals reject claims"

    https://www.wkow.com/coronavirus/sen-johnson-holds-another-forum-for-vaccine-skeptics-wisconsin-doctors-hospitals-reject-claims/article_e8c85956-7d79-11ec-82fd-abdc49311ff6.html


    "The GOP’s anti-vaccine mandate push is seeping into other vaccines — and schools"

    https://www.washingtonpost.com/politics/2022/01/25/gops-anti-vaccine-mandate-push-is-seeping-into-other-vaccines-schools/

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      BWG

      Democrat values, Fall 2021:
      We must acquiesce to teacher's union demands to not conduct in-person schooling, despite multiple studies that show that schools do not show high rates of transmission, and multiple studies that also show that students are harmed, some to the point of suicide, by not meeting in person.

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        Tyler

        I'm with Nate Silver on this: the school closings are going to be the Democrats' Iraq War. Wait a year, and somehow nobody will admit to having supported it. And for those unlucky few who have screenshotted tweets or op-eds proving otherwise, they will claim to have been misled by [select any combination: teachers' unions/the CDC/the FDA/the CIA/the FBI/the NSA/WHO/the Koch Brothers/George Soros/Facebook/the Internet/Vox/NYT/Twitter/etc.].

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          Pat Riot

          Vax denial will be the Republican's Siberian death camps.

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            Tyler

            Well, it's not like Stalin tricked his citizens into going to the death camp; he arrested them at gunpoint and forcibly put them there. If Stalin were a Republican, by your analogy he'd just talk about how delightful and wonderful the "cornucopian fields of Siberia" were while every newspaper in the Soviet Union reported that they were labor camps marred by starvation and death that you should very much avoid. Oh, and you'd be able to leave at any time once you saw how crappy the camps were.

            Republican politicians' dalliance with the anti-vax nonsense may be morally abhorrent, but they're not forcing anyone to die. Ultimately, it is one's choice as to whether to believe Tucker about the vaccines. Lying about a lifesaving vaccine is bad, but it's on a different moral plane from using force.

            The school closings were in fact forced on families. Those with wealth simply could move their children to private schools, but those without means were deprived of education by the state and had nowhere to turn. For the party that claims to care about "equity" it was a staggering betrayal.

            We had pandemic plans written before COVID, and in every single one of them, schools were the last to close and first to open. Democrats threw out those plans wholesale, kowtowing to unions whose goal it seems was not to negotiate for higher pay or better working conditions but rather to negotiate over having to work at all. And instead of pushing back---instead of even considering for a moment the costs of depriving the poorest among us of their one tool for moving up in our society---Biden censured his own CDC director for pushing to open schools that should never have been closed to begin with.

            Put yourself in the position of a lower-middle class parent. Who is a bigger threat to you? One party lies to idiots about vaccines, but you're not an idiot so you ignore them, get vaccinated, and COVID is now on par with the flu in its risk to you. The other party is forcing you to quit your job to stay home, devastating your child's ability to compete in the workforce, and increasing his or her odds of depression and suicide.

            Right now, the Democrats are the more morally abhorrent party. I was so disgusted by Trump that I voted for Joe Biden, and I regret it. I was stupid and gullible enough to believe that bullshit about his being a decent man who actually would try to do the right things and make good decisions, even though many of those decisions would go against my policy preference. But he is not. He is a stubborn, partisan, foolish poltroon whose bad judgment is matched only by his insecurity. The next generation will pay for his lack of leadership, and that of Democrats around the country.

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          BWG

          Agreed, except also Fauci - it's all his fault too.

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        Pat Riot

        Own them libs. And die doing it.

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          BWG

          Just mirroring you PR, although I realize that's a dubious "stragedy."

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      BWG

      Leftist values, ca. spring 2020:
      You must not go to church or any other social gathering because it's way too dangerous. Unless it's a social justice cause important to the left, then you can go and get covid and die, just as long as you protest loudly before dropping dead.

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    Tyler

    The natural immunity crowd really befuddles me. The who point of immunity---of any kind---is to avoid getting COVID. So the plan is what exactly? Go get COVID to avoid getting COVID?

    I get the argument insofar as it relates to people who got COVID in the pre-vaccine era. An intelligent public health apparatus (which we do not have) would have de-prioritized people who had natural immunity during the era of vaccine shortages, and it seems reasonable to me to consider such people's status in the context of vaccine passports and the like. But the argument that we're hearing on the right these days---that it's somehow _better_ to get natural immunity---is utterly nonsensical. It's like fireproofing your house by burning it down and then taking a victory lap because everything left over is guaranteed fireproof.

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      Aylene Wright

      Not that I agree with it, but I can understand people who think of COVID-19 like chickenpox, and believe it's basically impossible to get infected with COVID-19 more than once, thinking "since Omicron is the mild strain, might as well catch that one and get it over with".

      And even for those who don't think natural immunity lasts forever may assume "even if it eventually wears off, it has to last longer than these vaccines that we seem to need every 6 months indefinitely".

      There's also a general "natural is obviously superior to manmade" assumption that used to be more common on the Left among "crunchy" environmentalists, but seem to be gaining a foothold on the Right as well. As this is seen as Common Sense, no study will likely be enough to convince them otherwise.

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      George.Skinner

      The logic, as far as I can see it, is that they believe the vaccines pose real risks to their health. If they've already had COVID, they rationalize that they have no reason to intentionally expose themselves to the perceived risk of a vaccine when they feel they've acquired immunity already. People who haven't had COVID seem to be calculating that they're unlikely to get COVID, so again even if they accept the risks from a COVID infection they still think the risks of the vaccine are worse.

      The problem I see with all of this is that the data simply doesn't support their risk assessment. The vaccines are far safer and more effective than contracting COVID without benefit of vaccination. However, some people just can't get past a sense of revulsion to having a foreign substance injected into their bodies, and no amount of reasoning gets back the response of their hind brain.

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        Show Jay Janney the 🚪!

        Anecdotally, I've had several student-athletes in class, and several indicate they are worried about getting myocarditis from the vaccine, ending their playing careers. They are arguing since they are young and healthy, the vaccine is the worse risk for them. My youngest plays HS ball (vaccinated, will get boosted once the season is over). Why is he waiting? His 2nd shot made him feel sick for two days, so he doesn't want to miss practice or school (perfect attendance at school).

        I want to be clear I'm not agreeing with them, but I get the concern, and I am frustrated our athletic department didn't do a better job addressing the concern.

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          Tyler

          Actually, this is a legitimate concern. Giving healthy teenage boys a booster shot is pretty questionable. We may actually be tilting into more-likely-to-harm territory. Myocarditis is an insanely rare side-effect, but also a serious case of COVID for a teenager after two mRNA shots is also vanishingly rare---possibly even _more_ rare than the rare side-effect.

          My point above, though, was really that "I prefer natural immunity" just doesn't make much sense. Saying "I'm not worried about COVID" is at least internally consistent. Saying "I'm more afraid of the vaccine than COVID" is also coherent even if I think that's a misreading of the data. But "I want to go get COVID so I'm immune to COVID" is pretty bonkers.

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      Show Jay Janney the 🚪!

      It all depends on if people are saying you should get it, or people are saying once you have it you're better off. Those are very two different arguments. Anecdotally, students at my college are very much in the latter group. They don't want to get it, but once they do they feel confident in their immune system. I don't think that is unreasonable, as long as they understand we don't know what new strains are emerging and if the natural immunity you have will withstand it.

      FWIW I am vaxxed/boosted, but still got Omicron. I'm pretty confident I won't get it again, but who knows about what comes after it?

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        BWG

        Just heard on the news tonight about the latest sub-variants that have emerged from Omicron (BA.2, BA.3). I'm just getting over an omicron case; nothing worse than a head cold, almost gone now after 4 days, but then I was vax'd and boosted. Let's hope that confers immunity, at least partial, to these variants and maybe the next one or two.
        We're reaching the endemic endgame. I'll wear a face covering to be polite but it seems pointless for me.

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          Show Jay Janney the 🚪!

          Let's see what they sub-variants do. My "mild case" was a month ago and I still feel the effects of it, and I am in good health, not too old, and was also vaxxed.

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        Tyler

        Yeah, I think that's fair. We absolutely should be recognizing natural immunity in the context of our vaccine passports and the like. It's just that these people are picking the most dangerous way possible to get immunity, and if you're comfortable with that path to immunity, then really, why care about having the immunity in the first place? In other words, you're really just saying "I don't worry about COVID." Which, honestly, for some people makes sense. If I were an eighteen-year-old, I think I'd be in the "I'm really not worried about this thing" camp, too.

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    4. Yisrael Gale

      I don't personally advocate it, but there is a certain amount of logic in getting a mild case of COVID while your vaccine booster is relatively fresh, in the hopes of being better protected after the vaccine protection fades.

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        Tyler

        I've actually thought about this. I got the booster (38-yo-male) in November. My antibodies are already waning, so getting Omicron now is probably better than getting it later. We're all going to encounter this virus eventually. Now, the right approach would be variant-specific boosters, but the FDA probably will get around to approving those sometime in 2025, and then the CDC will recommend it only for immocompromised people for three months, then cancer patients a month later, then people with mental health issues six weeks after that, people who have experienced homelessness at some point in the past sixty-seven months, and then eventually people who experience eye strain from computer screens around 2027, so that's a nonstarter.

        Given where we are, it's not entirely unreasonable for _vaccinated_ people to look to encounter Omicron intentionally. Personally, I'd rather wait until Paxlovid is widely available, but most boosted people will be completely fine anyway.

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      2. mle

        Except you can't predict how severe your specific infection will be. Yes, most boosted people have very mild disease, but some still end up in the hospital. Statistics are great at estimating things, but individual reality doesn't care about statistics.

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          Show Jay Janney the 🚪!

          It depends heavily on a person's individual health. Getting covid for the natural immunity would be, IMHO a bad idea for someone with health issues, including co-morbidities. For a very healthy person, it'd be less of a risk of a bad outcome.

          I myself do not advocate trying to get it (I had Omicron, blech!). But I also understand, from personal experience, how difficult it is to stop viral spread. My deceased wife caught a virus in a hospital ward for immuno-compromised people, where each room was designed to limit viral spread. Given how common viral spread was in there (about 30% of the patients), it's tough to stop spread.

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