This is a super exciting finding, other discussion here: https://news.ycombinator.com/item?id=29999807

I find the final paragraph amazing of the mmwr:

> Among the two cohorts with a previous COVID-19 diagnosis, no consistent incidence gradient by time since the previous diagnosis was observed (Supplementary Figure 3, https://stacks.cdc.gov/view/cdc/113253). When the vaccinated cohorts were stratified by the vaccine product received, among vaccinated persons without a previous COVID-19 diagnosis, the highest incidences were observed among persons receiving the Janssen (Johnson & Johnson), followed by Pfizer-BioNTech, then Moderna vaccines (Supplementary Figure 4, https://stacks.cdc.gov/view/cdc/113253). No pattern by product was observed among vaccinated persons with a previous COVID-19 diagnosis.

1) Natural immunity did not appear to wane over the study interval. (No difference in Hazard Ratio when stratifying by time since infection)

2) Vaccine only immunity showed major differences stratified across brands and time but if the person also had prior exposure then all differences disappear. Seems to indicate natural immunity is the heavy lifter here.

Of course they go on to blanket recommend vaccines but of course that was going to be the conclusion somehow.

Are you surprised that they recommend vaccines though? Even if natural immunity gave absolutely perfect immunity, it would make sense to recommend vaccines to the uninfected population.

I believe they go further than that, recommending vaccine to anyone unvaccinated (not just uninfected+unvaccinated). I may have misread, I don't think the study they present really justifies that reach as the difference between vaccinated and not vaccinated is not statistically significant when someone has already recovered. That is per their own evaluation as I've read it.

For one I am glad the CDC has finely ditched their two year long quest in undermining natural immunity. Sadly it may be too late, and I am certain that once this crisis peter out there will be a massive re-organizing (specially if the GOP takes back both Houses).

Too late for what?

One-year sustained cellular and humoral immunities of COVID-19 convalescents http://doi.org/10.1093/cid/ciab884

A link to the actual study https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

>During May–November 2021, case and hospitalization rates were highest among persons who were unvaccinated without a previous diagnosis. Before Delta became the predominant variant in June, case rates were higher among persons who survived a previous infection than persons who were vaccinated alone. By early October, persons who survived a previous infection had lower case rates than persons who were vaccinated alone.

And

>What are the implications for public health practice? Although the epidemiology of COVID-19 might change as new variants emerge, vaccination remains the safest strategy for averting future SARS-CoV-2 infections, hospitalizations, long-term sequelae, and death. Primary vaccination, additional doses, and booster doses are recommended for all eligible persons. Additional future recommendations for vaccine doses might be warranted as the virus and immunity levels change.

Interesting that they only admitted this after omicron came along and a special omicron formulation of the vaccine is getting ready to be rolled out.

I wonder if an ideal vaccine would mimic natural infection. A natural infection grows and grows and grows until the immune system finally gets going and snuffs if out, over the course of days or weeks.

Perhaps a slow-release vaccine would work better than a multi dose regimen? Two or three huge doses doesn’t really mimic anything like what an infection actually looks like.

There's always a balancing act between vaccine safety and efficacy. The smallpox vaccine mimics a natural infection, but it's extremely dangerous because people who get vaccinated can actually spread real smallpox to others for a period of time, so they have to stay isolated.

Pre-Covid coronavirus vaccines tested in animals induced antibody-dependent enhancement and were thus deemed unsafe for human trials. A safe, effective Covid vaccine was always a long shot. Maybe one day we'll get one, but maybe we won't. Thankfully, there are multiple other drugs that are effective at preventing and treating Covid.

> A natural infection grows and grows and grows until the immune system finally gets going and snuffs if out, over the course of days or weeks.

Or you grow progressively weaker, miserable, and slowly suffocate until your body gives out—all without your family at your side.

(There's a reason we do not strive for even approximate mimicry of actual disease if we can help it.)