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Matt

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  • Birthday 10/21/1984

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  1. Worth a read! Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US? BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2101 (Published 13 September 2021)Cite this as: BMJ 2021;374:n2101 he US CDC estimates that SARS-CoV-2 has infected more than 100 million Americans, and evidence is mounting that natural immunity is at least as protective as vaccination. Yet public health leadership says everyone needs the vaccine. Jennifer Block investigates
  2. Not peer reviewed, but a new study from Israel: Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections Model 1: "During the follow-up period, 257 cases of SARS-CoV-2 infection were recorded, of which 238 occurred in the vaccinated group (breakthrough infections) and 19 in the previously infected group (reinfections). After adjusting for comorbidities, we found a statistically significant 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection as opposed to reinfection (P<0.001)." - Vaccinated-only people had 13-fold more infections than previously infected in early 2021, who were not vaccinated. - Also, after adjusting for comorbidities, vaccinated people had a 27x higher number of symptomatic infections compared to previously infected. "As for symptomatic SARS-COV-2 infections during the follow-up period, 199 cases were recorded, 191 of which were in the vaccinated group and 8 in the previously infected group" "Nine cases of COVID-19-related hospitalizations were recorded, 8 of which were in the vaccinated group and 1 in the previously infected group (Table S1). No COVID19-related deaths were recorded in our cohorts." - If they broadened the time to 2020, they saw waning immunity but still better protection for people who were previously infected vs vaccinated individuals: "748 cases of SARS-CoV-2 infection were recorded, 640 of which were in the vaccinated group (breakthrough infections) and 108 in the previously infected group (reinfections). "Overall, 552 symptomatic cases of SARS-CoV-2 were recorded, 484 in the vaccinated group and 68 in the previously infected group. There was a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic breakthrough infection than symptomatic reinfection (Table 3b)" The study found that there was some additional protection for people who were previously infected and had 1 dose of vaccine. PDF: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1.full.pdf
  3. Matt

    What is your daily calorie target?

    I eat around 1500 K/cal per day. I eat the same thing almost all of the time as well πŸ™‚ However, I'm only 5ft 7"... I think 1200 is way too low, especially for your height and also just starting CR.
  4. I got my COVID-19 antibody test back. My antibodies are still good. I was infected sometime late October to early November 2020. Also included a slide from a study that shows the evolution of antibody response over time after infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816882/
  5. New data on coronavirus vaccine effectiveness may be "a wakeup call" - Overall, it found that the Moderna vaccine was 86% effective against infection over the study period, and Pfizer's was 76%. Moderna's vaccine was 92% effective - against hospitalization and Pfizer's was 85%. - But the vaccines' effectiveness against infection dropped sharply in July, when the Delta variant's prevalence in Minnesota had risen to over 70%. - Moderna was 76% effective against infection, and Pfizer was only 42% effective. - The study found similar results in other states. For example, in Florida, the risk of infection in July for people fully vaccinated with Moderna was about 60% lower than for people fully vaccinated with Pfizer. https://www.axios.com/coronavirus-vaccines-pfizer-moderna-delta-biden-e9be4bb0-3d10-4f56-8054-5410be357070.html
  6. From 2016. "Vaccines alter the immune landscape experienced by pathogens, and hence their evolution, by targeting subsets of strains in a population, reducing the number of fully susceptible individuals, and creating or expanding classes of semi-immune hosts. The great success of vaccination against the acute childhood occurred without being undermined by pathogen evolution, but those diseases were easy targets: natural immunity was evolution-proof; all vaccination needed to do was to induce something very similar. Pathogens now under assault by vaccination are different: their natural infections induce leaky, often strain-specific immunity that usually wanes. Vaccines against these diseases will induce immunity to which natural selection has already found solutions. Evolutionary analysis is particularly warranted where vaccines are leaky, target subsets of strains or virulence determinants, involve novel technologies, or relax selection against virulence. Vaccination has been a great benefit. Continuing past successes requires evolutionary considerations at all stages of vaccine design and implementation. Andrew Read, Alumni Professor in the Biological Sciences, Director, Center for Infectious Disease Dynamics, Evan Pugh Professor, Pennsylvania State University Pathogen evolution in a vaccinated world. Andrew Read, Alumni Professor in the Biological Sciences, Director, Center for Infectious Disease Dynamics, Evan Pugh Professor, Pennsylvania State University Pathogen evolution in a vaccinated world Andrew Read, Alumni Professor in the Biological Sciences & Director, Center for Infectious Disease Dynamics at Pennsylvania State University, visits the ASU Center of Evolution, Medicine and Public Health, to lecture on the subject of Pathogen evolution in a vaccinated World.
  7. I just ordered an antibody test kit and it'll be here in 2 days. I think it was October or November that I had COVID last year... so we'll see how that goes and it'll help me make a decision about the vaccine.
  8. Yes, especially if they kill their hosts quickly and the virus don't transmit well. However, COVID is fairly deadly to enough people to be a problem and it's very transmissible. Of course, there is random mutations that are always occurring but we've never (from my knowledge) engaged in a mass vaccination program in the middle of a pandemic -- which could in theory help select for or keep more virulent variants circulating in a population. In the study below, they demonstrate that non-sterilizing vaccines (the ones we have right now) lead to vaccine failure and spreading of more severe variants. The unvaccinated birds spread the least virulent variants. "Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts." Again, it's worth reading the whole study: https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002198 The issue is the narrowness of the vaccine and the ability of vaccinated people to also spread the virus just as easily even if they aren't seriously ill. This combined with a lot of infections among unvaccinated can lead to selective pressure to keep more virulent strains going around. Many of the previous vaccines we've used are sterilizing vaccines, the ones we have right now are NOT that. Another study which used a model to look at the problem of resistance: https://www.nature.com/articles/414751a "Vaccines rarely provide full protection from disease. Nevertheless, partially effective (imperfect) vaccines may be used to protect both individuals and whole populations1,2,3. We studied the potential impact of different types of imperfect vaccines on the evolution of pathogen virulence (induced host mortality) and the consequences for public health. Here we show that vaccines designed to reduce pathogen growth rate and/or toxicity diminish selection against virulent pathogens. The subsequent evolution leads to higher levels of intrinsic virulence and hence to more severe disease in unvaccinated individuals. This evolution can erode any population-wide benefits such that overall mortality rates are unaffected, or even increase, with the level of vaccination coverage. " Another more recent study: https://www.nature.com/articles/s41598-021-95025-3 "As expected, we found that a fast rate of vaccination decreases the probability of emergence of a resistant strain. Counterintuitively, when a relaxation of non-pharmaceutical interventions happened at a time when most individuals of the population have already been vaccinated the probability of emergence of a resistant strain was greatly increased. So if anything, as we have the virus suppressed somewhat with vaccines, we should be taking the chance to go even harder with masks and lockdowns to eradicate it. Counter to what is going on right now. It feels as if we're being backed into a corner here and we've not fully understood the consequences of mass vaccination during a pandemic like this. This is a pretty unique situation we're in, in many respects. What if a variant emerges and all the rich countries are vaccinated, provides selective pressure to make the virus worse, and now it inadvertently kills a lot more people in poor countries who have almost no access to these vaccines? All that being said, it doesn't feel like we have much of a choice but to vaccinate. And I'm glad my family and friends had them. I just worry that this is nowhere near over and it could get a lot worse and inconsistent public policy and uncoordinated efforts eradicate this thing will make things worse for some time to come.
  9. Interesting reading: https://www.quantamagazine.org/how-vaccines-can-drive-pathogens-to-evolve-20180510/
  10. Thanks, Dean! I read through it fairly quickly earlier today. It's basically confirming what was found in other studies showing that natural immunity + a vaccine dose raises antibody levels much higher and therefor likely better at protecting from reinfection. The study didn't look at vaccinated vs previously infected, though (other studies have like the Cleveland study, but it was before delta variant and they found previous infection was as good as vaccine). In the paper you linked to, they do mention 5 limitations of the study. And the numbers are fairly small with no mention of reinfected having any serious illness (vaccinated or non vaccinated). Here is the problem as I see it: whether you are getting 2 vaccine doses, previously infected, or infected and vaccinated, the level of antibodies are going to decrease rapidly in the first few months and you end up with the same issue over and over β€” decreasing protection over time. There is no silver bullet unless everyone is expected to be vaccinated every 6-12 months? A paper published in Nature shows that COVID-19 infection induces long-lived immunity and bone marrow plasma cells are persistent over time, so once you come into contact with the antigen again, you'll see a rapid increase in antibodies and therefore (hopefully) a reduction in symptoms and damage. So the vaccine after an infection is just doing what a booster shot would do or if you were to be exposed in the wild to the virus. Another recent study: "We also compared the affinities of pairs of antibodies obtained from conserved clones between 2 and 5 months after vaccination. Conserved clones obtained at 2 and 5 months from vaccinated individuals showed an average 1.9-fold increase in affinity (p=0.03, Fig. 4c). In contrast, a comparable group of conserved clonal antibodies obtained from convalescent individuals 1.3 and 6.2 months after infection showed an average 24-fold increase in affinity (p=0.002, Fig. 4c)." "We conclude that memory antibodies selected over time by natural infection have greater potency and breadth than antibodies elicited by vaccination." I could easily change my mind on this as more data comes in. And I'll probably end up getting vaccinated anyway (Novavax looks good) because of restrictions being put in place (which are a bit ridiculous in my mind given that people infected with delta can spread the virus just as easily as unvaccinated). We desperately need better vaccines that are sterilizing otherwise we may end up in a situation were enough selective pressure is put on the virus to escape vaccine induced immunity, especially now given that both vaccinated and unvaccinated are able to transmit the virus, we could end up in an even worse situation due to antigenic shift, drift; but also cause a problem with antigenic sin and make what we have useless and be in a much worse situation. I do think vaccination is completely necessary and we don't really have much of a choice right now. But the direction we're going in does worry me, especially with the relaxation of social distancing and masks (if anything we should be going hard on that now). I may be misunderstanding the research but one particular scenario is scary, and it's highlighted by this study: Imperfect Vaccination Can Enhance the Transmission of Highly Virulent Pathogens: "Anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts" Most of the world is still unvaccinated, and we might be in a situation where this virus will evolve and make vaccines ineffective and be more virulent because of selective pressure and therefor have an even higher mortality rate in unvaccinated. That's the disaster scenario I fear. If you're interested in doomsday scenarios, feel free to read a recently published UK government report. There's other variants out there besides Delta which are concerning but not yet widespread. See Gamma variant study on CDC website. It's only a small sample size but the attack rate: Attack rate of new variant: 15/25 (60.0%) fully vaccinated miners 6/15 (40.0%) partially vaccinated 0/6 (0%) persons with previous history of COVID-19 got reinfected 63.2% persons with no previous history --- So yeah, I'm not very optimistic and concerned about where this is going. Fortunately, my experience with COVID-19 last time was like a very mild flu and I recovered in less than 2 days with no symptoms after that.
  11. I had COVID-19 towards the end of last year and that's why I haven't bothered getting the vaccine (this isn't listed on the survey). Previous COVID infection seems to be comparable (or better) than 2 vaccine doses. Although, perhaps there is some data showing that previous infection + vaccine might boost immunity in the short term.
  12. Another vegan here... I don't really have much to say here other than I think your body weight and calorie intake is way too low given your situation. And you're still early in your diagnoses, so it seems a bit extreme. I think an approach like Dr. Valter Longo would be better. Perhaps you'd fast for 2 days prior to chemotherapy and 24 hours after. Then return to normal (healthy) eating habits. This according to animal data can help prevent damage to healthy cells while making cancer cells more susceptible.
  13. Thank you for sharing! I'm really interested in watching back some of the old CR conference videos. Have they been put into a time capsule? πŸ˜„ They obviously exist out there in digital format somewhere that can easily be uploaded to the CR Society YouTube channel within a few hours. It's 2021, the information is quite old now, why not just upload them all? πŸ™‚
  14. Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy May 28, 2021 "The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. However, the observation ended before SARS-CoV-2 variants began to spread, and it is unknown how well natural immunity to the wild-type virus will protect against variants.https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2780557?guestAccessKey=5799e489-35eb-4fc7-8c11-67e793e3a89f&amp;
  15. A few studies you might be interested in. Personally, I think that almost all people should get vaccinated if they've not had an infection. However, I don't think people who have been infected and recovered should be stigmatized (as is currently the case it seems) for not having the vaccine - especially if young and healthy. I think I can understand why people are being this way... it could be people wanting to feel as if 'we're all in this together in getting the shot' and maybe if we say that natural immunity means strong protection, that may somehow encourage more vaccine hesitancy. However, we should be encouraged by all the studies coming out that show natural immunity does confer strong lasting immunity with reinfections being rare. SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans We demonstrate that S-binding BMPCs are quiescent, indicating that they are part of a long-lived compartment. Consistently, circulating resting memory B cells directed against the S protein were detected in the convalescent individuals. Overall, we show that SARS-CoV-2 infection induces a robust antigen-specific, long-lived humoral immune response in humans." https://www.nature.com/articles/s41586-021-03647-4 Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection Substantial immune memory is generated after COVID-19, involving all four major types of immune memory. About 95% of subjects retained immune memory at ~6 months after infection. Circulating antibody titers were not predictive of T cell memory. Thus, simple serological tests for SARS-CoV-2 antibodies do not reflect the richness and durability of immune memory to SARS-CoV-2. This work expands our understanding of immune memory in humans. These results have implications for protective immunity against SARS-CoV-2 and recurrent COVID-19." https://science.sciencemag.org/content/371/6529/eabf4063 SARS-CoV-2 Antibody Response in Persons with Past Natural Infection Whether or not persons who have already been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be vaccinated is unclear. Only a few studies have shown that vaccinees who were previously infected with SARS-CoV-2 had a significantly higher antibody response than previously uninfected vaccinees https://www.nejm.org/doi/full/10.1056/NEJMc2103825 mRNA vaccination compared to infection elicits an IgG-predominant response with greater SARS-CoV-2 specificity and similar decrease in variant spike recognition If I understand this study correctly, it's saying, in part, that vaccines generate a much more specific response whereas natural infection may protect against more variants. https://www.medrxiv.org/content/10.1101/2021.04.05.21254952v1
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