Immunity to Covid 19 involves more than just antibodies. Antibodies are more easily measured than other aspects of immunity. There are no commercially available blood tests that will let you know if you have immunity to Covid 19. That’s one of the reasons that measuring antibodies is not recommended. You can’t make good decisions with bad information. In particular, one should not latch on to the news summaries of scientific publications. Studies that show that one vaccine produces higher levels of antibodies after administration require thorough vetting done by experts. Antibody levels drop after administration of any vaccine, but that doesn’t mean that immunity goes away. Since Covid 19 is a novel virus, we don’t have all the answers as far as how long the effect of vaccines last. Many people don’t think we all need boosters and that third vaccines should be reserved for those with compromised immunity who likely haven’t responded to the first two doses. Here is an interesting article which gives a pretty good explanation of the complexities of cellular and humoral immunity form this mornings TPR.
Immunity To COVID-19 Could Last Longer Than You’d Think
All around the world, there seem to be signs that immunity to SARS-CoV-2, the coronavirus that causes the disease COVID-19, doesn’t last very long after you’re vaccinated.
Israel is now having one of the world’s worst COVID-19 surges about five months after vaccinating a majority of its population. And in the U.S., health officials are recommending a booster shot eight months after the original vaccine course.
So, how long does immunity last after two doses of the vaccine? Six months or so? And at that point, how much protection is left over?
It all depends on which type of immunity you’re talking about, says immunologist Ali Ellebedy at Washington University in St. Louis. Six months after your vaccine, your body may be more ready to fight off the coronavirus than you might think.
“If you were vaccinated six months ago, your immune system has been training for six months — you are better ready to fight a COVID-19 infection,” says Ellebedy.
A series of new studies, including two led by Ellebedy, suggests that mRNA vaccines like those from Pfizer-BioNTech and Moderna trigger the immune system to establish long-term protection against severe COVID-19 — protection that likely will last several years or even longer, Ellebedy says.
To understand what he’s talking about, let’s say you received the second Moderna or Pfizer vaccine six months ago. Right away, your immune system got to work and began making antibodies.
These antibodies are a bit like archers outside the moat of a castle. They set up in the lining of your nose and throat, ready to shoot down (aka neutralize) any SARS-CoV-2 particles that try to enter the moat (aka your nasal tissue).
These antibodies can prevent an infection, says bioimmunologist Deepta Bhattacharya at the University of Arizona. They stop the virus from entering cells and setting up shop. They are the body’s front-line defense.
But right after vaccination, this initial round of antibodies has a few problems. The antibodies are a bit wimpy. They’re not that well trained at killing SARS-CoV-2, and they’re not very durable, Bhattacharya says.
About a month after the second mRNA shot, the number of antibodies in the blood reaches its peak level and then starts to decline. The antibodies themselves degrade and the cells that make them die, a study published in the journal Nature reported in June.
This happens with every vaccine, whether it’s for COVID-19, the flu or measles, Bhattacharya says. “In every single immune response, there is a sharp rise in antibodies, a period of sharp decline, and then it starts to settle into a more stable nadir.”
The media has largely focused on this decline of antibodies as the cause of “waning immunity.” And it’s true, Bhattacharya says, that this decline in antibodies, combined with the high potency of the delta variant, which began dominating many countries this year, is likely increasing the rate of infection in fully vaccinated people.
“If you get a big dose of delta, as the variant often gives, the virus can slip past the initial wall of antibodies,” he says. “So I think we may be seeing some signs of that. But the [level of breakthrough infections] is probably not as dramatic as I think it’s being made out to be.”
Why? Because the media has largely overlooked several key facts about the antibodies present eight months after the vaccine. For starters, they’re more powerful than the original ones triggered by the vaccine, Bhattacharya says.
While the first round of archers (antibodies) was out guarding the moat of your castle (respiratory tract), the immune system wasn’t just sitting around idly, hoping those soldiers would be enough. Instead, it was busy training better archers — and a whole bunch of foot soldiers too.
After your second shot, the immune system sets up a training center in the lymph nodes to teach special cells how to make more powerful antibodies, the Nature paper from June reported.
“The quality of the antibody improves over time. It takes far fewer of those new antibodies to protect you,” Bhattacharya says. “So I think that worrying about antibody decline is not something that’s productive,” he adds.
At the same time, the cells that make these souped-up antibodies become souped up themselves, he adds. In the training center, they learn how to make a huge amount of the highly powerful antibodies.
“These cells are remarkable,” Bhattacharya says. “They’re estimated to spit out something like 10,000 antibody molecules per second.” So you don’t need many of these cells to protect you against a future infection.
“We’ve done some back-of-the-envelope calculations to figure out how many of these cells are needed to protect a mouse from a lethal infection. It’s three,” Bhattacharya says. “Of course, we’re bigger than mice. But you get the sense that it doesn’t take many to offer good protection.”
On top of that, these cells learn something remarkable in the training center: how to persist. “They’re essentially given the gift of eternity,” says immunologist Ellebedy.
He and his colleagues have found that by about six months after vaccination, these antibody-producing cells go into the bone marrow, where they can live for decades, perhaps even a lifetime, studies have found, and continue to produce antibodies the entire time. In one 2008 study, researchers identified antibodies that could neutralize the 1918 flu in the blood of people who were exposed to the virus 90 years earlier.
“We looked in the bone marrow and have seen these cells in people previously infected with SARS-CoV-2,” Ellebedy says. “Now we are finishing research that shows these cells appear in the bone marrow after vaccination as well.”
Called long-lived plasma cells, these cells will likely pump out antibodies into the blood for decades, Ellebedy says, giving people some sustained, long-term protection against SARS-CoV-2. (There is a caveat: If the virus changes too much, these antibodies won’t be as effective.)
“The antibodies are maintained at very low levels, but they’re the first line of defense against an infection,” Ellebedy says. “If you’re taken by surprise by SARS-CoV-2, these antibodies will slow down the replication of the virus” — until reinforcements come along.
And reinforcements will likely come!
On top of training up better archers (antibodies) and factories to create them (plasma cells), the immune system has also been training up the equivalent of foot soldiers, several studies have found. These foot soldiers are called memory B cells and memory T cells, and they largely serve as a surveillance system, looking for other cells infected with SARS-CoV-2.
“They’re patrolling all over,” Ellebedy says, checking to see if a cell has SARS-CoV-2 hiding in it. “It’s almost like going through the neighborhood, house by house, and just making sure it’s clean.”
These foot soldiers can’t prevent an infection from initially occurring, but they can quickly stop one once it occurs, says immunologist Jennifer Gommerman at the University of Toronto. “Because of the vaccine-generated ‘memory’ of the SARS-CoV-2 spike protein, you get a very brisk cellular immune response.”
OK. So now we’ve got all the information to understand what’s going on with the COVID-19 vaccine and immune durability.
About six months after the shots, the antibodies in the blood have fallen — as expected. They’re also a bit less effective against the delta variant. “Together, that means there are more symptomatic infections as we go further out from the vaccination rollout,” Gommerman says.
But in vaccinated people, these infections will most likely be mild or moderate because the immune system isn’t starting from scratch. In fact, it’s the opposite. It has been training cells and antibodies for months.
“You still have all this immunity inside of your body that will then say, ‘OK, we’ve had a breach, and it’s time to bring in the cellular immunity and respond to this threat,’ ” Gommerman says. “And because of vaccination, you have cells that can do that really quickly.”
And so, overall, you’ll be less sick than if you weren’t vaccinated and be much less likely to end up in the hospital, she says.
“That’s really what the vaccines were designed to do — to teach the immune system to deal with this invader if an infection does occur,” Gommerman says. “And the vaccines do that remarkably well.”
UPDATE ON BOOSTERS
This is the press release from several weeks ago touting the availability of Booster doses this fall. Be sure to read the bolded areas. The FDA and CDC have not signed off on the plan to immunize people with booster doses 8 months after your last dose and after September 20th. There is no approved plan to carry this out and currently you have to sign a statement that you are immunocompromised. Even if you are a healthcare worker immuninized 8 months ago, there is no approved plan in place to offer you a booster.
Joint Statement from HHS Public Health and Medical Experts on COVID-19 Booster Shots
For Immediate Release: Wednesday, August 18, 2021
Contact: Media Relations
(404) 639-3286
Today, public health and medical experts from the U.S. Department of Health and Human Services (HHS) released the following statement on the Administration’s plan for COVID-19 booster shots for the American people.
The statement is attributable to Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC); Dr. Janet Woodcock, Acting Commissioner, Food and Drug Administration (FDA); Dr. Vivek Murthy, U.S. Surgeon General; Dr. Francis Collins, Director of the National Institutes of Health (NIH); Dr. Anthony Fauci, Chief Medical Advisor to President Joe Biden and Director of the National Institute of Allergy and Infectious Diseases (NIAID); Dr. Rachel Levine, Assistant Secretary for Health; Dr. David Kessler, Chief Science Officer for the COVID-19 Response; and Dr. Marcella Nunez-Smith, Chair of the COVID-19 Health Equity Task Force:
“The COVID-19 vaccines authorized in the United States continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. Recognizing that many vaccines are associated with a reduction in protection over time, and acknowledging that additional vaccine doses could be needed to provide long lasting protection, we have been analyzing the scientific data closely from the United States and around the world to understand how long this protection will last and how we might maximize this protection. The available data make very clear that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination, and in association with the dominance of the Delta variant, we are starting to see evidence of reduced protection against mild and moderate disease. Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout. For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.
“We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence. We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose. At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster. We would also begin efforts to deliver booster shots directly to residents of long-term care facilities at that time, given the distribution of vaccines to this population early in the vaccine rollout and the continued increased risk that COVID-19 poses to them.
“We also anticipate booster shots will likely be needed for people who received the Johnson & Johnson (J&J) vaccine. Administration of the J&J vaccine did not begin in the U.S. until March 2021, and we expect more data on J&J in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.
“Our top priority remains staying ahead of the virus and protecting the American people from COVID-19 with safe, effective, and long-lasting vaccines especially in the context of a constantly changing virus and epidemiologic landscape. We will continue to follow the science on a daily basis, and we are prepared to modify this plan should new data emerge that requires it.
“We also want to emphasize the ongoing urgency of vaccinating the unvaccinated in the U.S. and around the world. Nearly all the cases of severe disease, hospitalization, and death continue to occur among those not yet vaccinated at all. We will continue to ramp up efforts to increase vaccinations here at home and to ensure people have accurate information about vaccines from trusted sources. We will also continue to expand our efforts to increase the supply of vaccines for other countries, building further on the more than 600 million doses we have already committed to donate globally.”
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