Before he was Kentucky’s junior senator, Rand Paul was a practicing ophthalmologist. So when the doctor turned Republican lawmaker recently announced that he would not be getting vaccinated for COVID-19 because he already has “natural immunity,” some Americans may have assumed he was following the science.
“Until they show me evidence that people who have already had the infection are dying in large numbers or being hospitalized or getting very sick,” Paul told radio host John Catsimatidis, “I just made my own personal decision that I’m not getting vaccinated because I’ve already had the disease and I have natural immunity.”
In March 2020, Paul was the first U.S. senator to test positive for the coronavirus. Yet the Centers for Disease Control and Prevention and the World Health Organization both say prior infection is no reason to refuse vaccination.
“It’s very important for people who have had COVID-19 in any form to get the COVID-19 vaccine shots,” explains Yahoo News Medical Contributor Dr. Kavita Patel, a primary care physician in Washington, D.C., who also serves as a health policy fellow at the Brookings Institution. “One, it protects them as individuals from getting reinfected or infected with a new variant, which we know can happen. Two, it also helps us as a society get closer to that population or herd level of immunity where we just don’t have any cases, or as close to zero as possible.”
Paul is hardly alone in thinking a prior infection makes vaccination redundant. According to a Yahoo News/YouGov poll conducted earlier this month, 7 percent of unvaccinated U.S. adults say the fact they “already had COVID-19” is the “most important reason” they haven’t gotten vaccinated yet. That’s the equivalent of more than 7 million people.
But 7 million Americans (and at least one physician-politician) can be mistaken — and so far, the science suggests they are.
The problem isn’t so much, as Paul put it, that “people who have already had the infection are dying in large numbers or being hospitalized or getting very sick” because they remain unvaccinated. It’s clear that prior infection confers some degree of immunity.
The problem is that experts don’t know exactly how much immunity prior infection confers, or how long that immunity lasts.
“In some cases, immunity [from a COVID infection] doesn’t even last six months,” says Patel, citing studies that suggest people who experienced asymptomatic infections (like Paul) go on to lose their SARS-CoV-2-specific antibodies more often and rapidly than symptomatic patients. Another recent study published in the Lancet, meanwhile, has suggested that age could be a factor as well, with prior infection giving those under the age of 65 years around 80 percent protection against reinfection versus just 47 percent for those over 65. Paul is 58.
Then there are virus variants to consider. “[Researchers] take people’s blood who have been infected, and they take their antibodies and try to test them against [newer] variants,” Patel continues. “Sometimes it doesn’t work, which means that even a previously infected person could still be susceptible to what we would call a second infection or a reinfection.”
In contrast, researchers already know that immunity from the approved COVID-19 vaccines lasts longer than six months — likely between a year and several years. Study after study has also shown that the vaccines remain very effective against every concerning variant worldwide.
Unlike prior infection, explains Patel, “these vaccines actually make your body produce antibodies that can attach to lots of different receptors on that [coronavirus] spike protein. That is important because as new variants that we don’t even know about crop up, being able to have antibodies that can attack those spike proteins on a new variant is incredibly valuable.”
Overall, more than 15 studies have shown that even a single dose of COVID-19 vaccine for people who already had the disease provides superior immune protection than natural immunity; some have even suggested that one dose for people with prior COVID offers stronger immunity than two doses for people who were never infected.
In other words, both infection and vaccination provide immunity. But right now researchers are certain that vaccination-induced immunity is both comprehensive and long-lasting for pretty much everyone who gets jabbed. They can’t say the same about natural immunity. As a result, it is safer for previously infected individuals to get vaccinated (which carries no real risk) than to rely on natural immunity for long-term protection from COVID-19.
The same is true beyond the individual level as well. The latest data suggests that the COVID-19 vaccines not only reduce symptoms and serious illness but infection itself — which in turn drastically reduces transmission of the virus. “If we had better tests to look at how much antibody I have [after] I had COVID-19, maybe we could” compare the effects of vaccination and prior infection on viral spread, says Patel. But we don’t. So again, getting vaccinated is a surer, safer way of “breaking the ability of the virus to infect [other] people” and ending the pandemic.
“Even if you were infected, getting a vaccine doesn’t just help you,” explains Patel. “It helps the people around you as well.”
Whether this argument carries weight with Americans such as Rand Paul remains to be seen. In March of last year, Paul continued to go to work at the U.S. Capitol for six days after testing positive, potentially exposing his colleagues to the virus. And last week he justified his refusal to get vaccinated by mischaracterizing CDC recommendations as Orwellian diktats and trumpeting the same notions of personal freedom that inform his libertarian politics.
“In a free country, you would think people would honor the idea that each individual would get to make the medical decision, that it wouldn’t be a Big Brother coming to tell me what I have to do,” Paul said. “Are they also going to tell me I can’t have a cheeseburger for lunch? Are they going to tell me that I have to eat carrots only and cut my calories? All that would probably be good for me, but I don’t think Big Brother ought to tell me to do it.”
The difference, of course, is that cheeseburgers aren’t contagious.
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