Trading 1,000 Headaches for a Single Symptomatic COVID Case

Vaccinating 2,000 people with natural immunity will prevent a single case of COVID over a two-month period based on numbers from a recent study. Is it worth it?

Stalin famously said that a single death is a tragedy, and a million deaths is a statistic. In times of COVID, and vaccine mandates for the naturally immune, this translates loosely to “a single symptomatic infection matters, and a thousand headaches don’t”.

So much of what we hear about COVID is in the abstract, and fueled by perception and bias. I think the general public and particularly policymakers would benefit from seeing how raw numbers translate into relevant populations, like a college campus, or a corporation, or the military. If you’re mandating the vaccination of thousands of people who already have natural immunity to COVID by virtue of previous infection, what are the expected health outcomes?

I’m going to focus on the one large study conducted to date which has systematically compared vaccination vs. natural immunity by matching the date of onset of immunity (noting that numerous other studies conducted in a handful of nations including the US, Israel, Denmark, Qatar, and the UK have also demonstrated that natural immunity appears to be as good or better than vaccine-derived immunity). Gazit et al. conducted a retrospective study on over 750,000 people in Israel. The authors concluded that natural immunity was substantially better than the Pfizer-BioNtech vaccine against the Delta variant, specifically finding that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant. Drilling into the numbers, we find that when the time of initial immunization was matched, natural immunity provided 13 times better protection against subsequent COVID infection than being vaccinated with the Pfizer COVID vaccine. This was not close; it was a blowout (if you're wondering how the relative difference could have been so high, consider that the Pfizer vaccine might have roughly 50% effectiveness against the Delta variant of COVID, suggesting 96% effectiveness for natural immunity in this selected population against this variant).

The reason I’m focusing on this study is that other studies which have compared natural immunity with vaccine immunity generally compared people who were vaccinated perhaps a few months previously against people who had been infected (and thus obtained natural immunity) many months previously, which is clearly not a fair comparison given the fact that immunity declines over time.

It’s worth looking at the raw numbers from this Israeli study. Only about one out of every 2,000 people who developed COVID during January or February of 2021 subsequently developed a symptomatic COVID infection during the summer when the study was conducted.

This same study also compared people with natural immunity against a group of people with natural immunity that had been boosted by supplemental vaccination with a single dose of the Pfizer vaccine. The supplemental vaccination reduced the chance of infection by roughly 2x. In other words, natural immunity was far superior to the vaccine, but being vaccinated on top of natural immunity provided additional protection.

More specifically, two groups of 14,029 people with natural immunity as a result of prior Covid infection were compared. As previously stated, vaccination did indeed reduce the chance of infection by nearly a factor of two, but it’s worth looking at the raw numbers. The difference in symptomatic infections was seven out of 14,000 people. Again, that’s one in 2,000. In other words, vaccinate 2,000 people with natural immunity, and according to the numbers in this Israeli study, you’ll prevent a single symptomatic COVID case (over the 2.5 month duration of the study).

So if you’re running a university, or a corporation, let’s say you have 2,000 students or employees or soldiers in your organization who have documented natural immunity. By mandating their vaccinations against their will, you might expect your actions to prevent one symptomatic COVID case over the next few months according to this study. Note as well that there will be many breakthrough COVID cases among your vaccinated students or employees.

Let’s pull out the ledger. On the minus side, you have: (i) forced the vaccination of 2,000 people against their will, violating the sanctity of their bodies; (ii) subjected them to known and unknown side effects, especially considering that side effects of COVID vaccines on people with natural immunity tend to be more severe on average, and (iii) subjected them to psychological stress. Speaking of which, college students are roughly ten times more likely to commit suicide than die from COVID. Think about the psychological trauma of having to choose between (i) getting a vaccine you desperately don’t want and (ii) having to drop out of college, or move cities, or quit a job that you like and perhaps have spent many years building towards a pension.

What do you have on the plus side to balance all these negatives? Congratulations - you have prevented one symptomatic case of COVID. If you’re dealing with a university or many employee groups, this one COVID case would be in a young person who probably won’t get very sick anyway, particularly as that person has already had and recovered from COVID.

I know the counterargument, that it’s not about the selfish unvaccinated person who got COVID, it’s everyone else they are infecting. Remember, on a time-matched basis, vaccinated people were 13 times more likely to be infected. Even if not matched for time, meaning natural immunity could be from 2020 while the vaccine was more recent, natural immunity still provided a six-fold reduction in risk. As most of the people in these population groups will be vaccinated, and they are six times likelier to be infected, the incremental transmission risk from the naturally immune population will be negligible. In other words, the domino theory isn’t convincing when domino redundancy means that removal of one domino does nothing to stop the chain.

Let’s contrast that with the risk of side effects, and we’ll assume that 2,000 people with natural immunity against COVID are administered a single shot of the Pfizer vaccine, and all are between the ages of 18 and 55.

Young men under the age of 25 who get vaccinated with the Moderna or Pfizer vaccines are at particularly high risk for myocarditis, pericarditis, and myopericarditis (unfortunately, as a father of a college-aged son, I've learned this the hard way). Finland, Denmark, Norway, and Sweden have all restricted use of the Moderna vaccine among young men for this reason. A study out of Canada reported that among men aged 18-24, there were 37.4 myocarditis cases per million doses after administration of the second dose of the Pfizer vaccine and 263.2 (1 in 3,800) myocarditis case per million people following second dose of the Moderna vaccine. Other studies have suggested a lower rate of incidence of these heart-related conditions.

Out of 2,000 people with natural immunity who are vaccinated against their will, especially if a significant percentage are young men (as you’d see on a college campus or in the military), there is a reasonable chance that at least one of them might develop myocarditis or pericarditis. Especially if they take the Moderna vaccine, which happens to be the vaccine that appears to be most effective. Note that this side effect typically occurred after a second dose, which also suggests that people who had already developed immunity to COVID would be more likely to develop the condition than others.

Obviously, these are not the only side effects associated with the COVID vaccines. Vaccinating 2,000 people who have natural immunity is going to cause a lot of flu-like sickness, especially given that the side effect profile tends to be worse in people with natural immunity (also not surprising given that the side effects of COVID vaccines typically are worse the second dose than the first). The side effect profile is also worse in younger people, who are more likely to be subject to these unwelcome vaccine mandates.

According to CDC, 51.7% of vaccine recipients reported headaches after the second dose with the Pfizer vaccine, 35.1% had the chills, and 15.8% reported a fever. Conservatively assuming that these numbers are fair representations of the side effects for young people with natural immunity, these 2,000 vaccine doses would produce over 1,000 headaches, 700 chills, and 315 fevers (subtracting out side effects from placebo shots still leaves over 500 headaches, 600 chills, and 300 fevers). Additionally, as mentioned above, there’s a reasonable chance of at least one case of a more serious side effect such as myocarditis. The bodily autonomy of 2,000 people will have been effectively violated, which will have induced significant psychological stress. Let’s hope no suicides, but let’s be realistic and recognize that kicking a 21-year-old marine with natural immunity to COVID out of the military because he refuses to get a vaccine might cause some issues. That’s all on the minus side of the ledger.

Again, on the other side, you’ve prevented a single symptomatic COVID case in someone who is at very little risk from COVID.

While the Hippocratic Oath is wrongly believed to be “do no harm”, what it actually says in Epidemics, Book 1 is: “Practice two things in your dealings with disease: either help or do not harm the patients”.

It’s all about proportionality. And any way you look at these numbers, vaccination provides almost no help, and a substantial accumulated dosage of harm, for people who have natural immunity, particularly younger people.

Note that taking a second dose of vaccine might further reduce the risk of infection (a CDC study in Kentucky found a 2.34x reduction in risk), perhaps saving one more COVID infection, but that second dose would also roughly double the side effect totals.

I’m not suggesting these absolute numbers would hold up on any given campus, or workplace, or military unit. Moreover, the duration of the study was only 2.5 months, and over a longer period, more COVID sicknesses would be prevented, with the caveat that the boost in immunity provided by vaccination will wane over time.

Nevertheless, based on the prevailing science, there is no medical case for requiring vaccinations for people with natural immunity, particularly previously infected young people who are at almost no risk from COVID. Even if they are re-infected with COVID, it is unlikely they will experience more than a few days of headaches and fever. For many, the vaccine would be worse than re-infection with COVID.

Saving a single symptomatic COVID case among people at low risk of developing serious COVID illness is not worth a thousand headaches, let alone everything else that comes with those headaches. Aren't we supposed to be following the science?