Second covid vaccine after covid?

[FiremedicMike]

*** I promise this isn’t seeking medical advice, I already have my answer from my doc.. I’m interested in the academic discussion..

So I’m in a cohort of folks who received the first dose of the vaccine and then became infected with corona. I’m pretty much back to normal and due to return to work this week..

I realize this isn't a common circumstance that probably hasn’t been studied, so I’d love to hear everyone’s thoughts on if/when/why a second dose should be given in these folks..

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[Crayola227]

I would do the second dose. You want to give your immune system every chance to see this virus and mount a strong immunity that you can (safely).

 

[DrMetal]

Why isn't it so common? Same happen to me!

I got the second dose, it was fine. Do it.

 

[FiremedicMike]

My knowledge of immunology is limited to the brief module I had during microbiology, but couldn’t infection after the first shot serve as the second shot?

Honestly I’ve never been much interested in infectious diseases and immunology before now..

 

[NotAProgDirector]

Not the academic answer, but the practical one:

Two doses of the vaccine will label you as immunized. Anything other than that will not. Viral titers are not standardized or useful (yet).

Somewhere in the near future, those whom are immunized will be allowed to travel without quarantine, and possibly allowed to stop wearing a mask.

 

[mszzeta]

*** I promise this isn’t seeking medical advice, I already have my answer from my doc.. I’m interested in the academic discussion..

So I’m in a cohort of folks who received the first dose of the vaccine and then became infected with corona. I’m pretty much back to normal and due to return to work this week..

I realize this isn't a common circumstance that probably hasn’t been studied, so I’d love to hear everyone’s thoughts on if/when/why a second dose should be given in these folks..

I think your argument makes sense. The infection should somewhat serve as a booster to the immune system

However, the immune response from a vaccine and an actual infection is different (I got this statement from the chief editor of NEJM in a lecture....). And as you can see the data from phase 2 trial, the antibody titer elicited by mRNA vaccine is actually HIGHER than convalescent plasma

 

[Lawpy]

Not the academic answer, but the practical one:

Two doses of the vaccine will label you as immunized. Anything other than that will not. Viral titers are not standardized or useful (yet).

Somewhere in the near future, those whom are immunized will be allowed to travel without quarantine, and possibly allowed to stop wearing a mask.

Thoughts on J&J vaccine?

 

[gutonc]

Thoughts on J&J vaccine?

Hasn't been approved yet. Only published data is on Ph1/2 immunogenicity/safety, which is cool scientifically, but not clinically meaningful. Looking forward to the Ph3 efficacy data. Interestingly (if you can believe science by press release, which you can't/shouldn't), looks like the single dose efficacy will be ~80%, which is essentially what the Pfizer vaccine has. Which means the J&J vaccine isn't any "better", just better marketed.

 

[zeloc]

Hasn't been approved yet. Only published data is on Ph1/2 immunogenicity/safety, which is cool scientifically, but not clinically meaningful. Looking forward to the Ph3 efficacy data. Interestingly (if you can believe science by press release, which you can't/shouldn't), looks like the single dose efficacy will be ~80%, which is essentially what the Pfizer vaccine has. Which means the J&J vaccine isn't any "better", just better marketed.

Pfizer vaccine is 50% after the first dose.

 

[gutonc]

Pfizer vaccine is 50% after the first dose.

Per the NEJM article (Fig 3), for people between doses 1 and 2, there were 357 cases in the control group and 89 in the vaccine group, which works out to ~75%.

 

[mszzeta]

Pfizer vaccine is 50% after the first dose.

the sample size for single dose in Pfizer trial is very small and estimation was with a wide CI. The sample size for single dose was larger in the Moderna trial, and the data looks pretty decent.

 

[zeloc]

Per the NEJM article (Fig 3), for people between doses 1 and 2, there were 357 cases in the control group and 89 in the vaccine group, which works out to ~75%.

No, if you look at Figure 3, the first number, after dose 1, is the total number, which includes persons after dose 2. It's 39 (intervention) vs. 82 (control) who got covid in-between the first and second doses, which is 52.4% effective, but the CI is wide: (29.5, 68.4).

 

[NotAProgDirector]

Looking at fig 3, to me it appears that in the vaccine arm, almost all of the COVID infections after dose 1 were before day 10 -- which isn't surprising, as I wouldn't expect any anibody response until then. once beyond day 12, there appeared to be very few infections. Hence, my sense is that one dose is actually much more effective than 52%. But what do I know? Not much, that's what.

 

[zeloc]

Looking at fig 3, to me it appears that in the vaccine arm, almost all of the COVID infections after dose 1 were before day 10 -- which isn't surprising, as I wouldn't expect any anibody response until then. once beyond day 12, there appeared to be very few infections. Hence, my sense is that one dose is actually much more effective than 52%. But what do I know? Not much, that's what.

Yes, but then you have to bump up the numbers for the other vaccines to express the same methodology.

 

[NotAProgDirector]

Yes, but then you have to bump up the numbers for the other vaccines to express the same methodology.

Totally agree. Happy to do the same with the Moderna vaccine data.

Interestingly, when the J&J data came out with the 58% effectiveness (or whatever it was, something close to that), since it was only one dose I was wondering whether they fell into the same trap. If so, then the J&J vaccine might look as good as the others.

But nope -- their efficacy measure was infection after 28 days. So they already excluded all of those early infections.

 

[Keep2r]

This happened to my friend, he went and got the second dose right after he came back from quarantine. I didn't bother to fact check him but he quoted me some study that said getting COVID is only 70-80% effective at preventing reinfection vs 95% getting fully vaccinated.