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Dr. Marc Siegel: I had measles and don’t need a vaccine to protect me. What if I’ve had COVID?

My office manager had COVID three months ago and has thus far refrained from taking the COVID vaccine. I continue to encourage it though I do believe she is still protected by natural immunity. The question is for how long?

I was born just before the measles shot became available, and I, like most children my age, suffered through a bout of measles. Luckily, I didn’t develop pneumonia or brain swelling, I did just fine. And science has determined that my immunity from measles now is lifelong, hence I don’t need a measles shot.

I also had chicken pox, which means I don’t need a varicella vaccine, though I am at greater risk for getting a severe case of shingles (recurrence of the virus that causes chicken pox which is harbored in my nerves) than if I had received the vaccine. 

The point is that natural immunity after infection isn’t perfect, but it is important. Similarly, no one should wish for COVID-19, but if you have it, it is clear that your immunity lasts for at least several months if not longer. In fact, a new study from Cleveland Clinic looking at over 50,000 workers there beginning in December found that the group that received the vaccine did no better at fending off COVID than the group that had already had it (5 percent of employees). (Both groups didn’t get sick with COVID). 

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And a recent study from Washington University in St. Louis revealed ample plasma cells in the bone marrow of those recovering from COVID, up to a year after, signaling immune memory. If these patients were faced with the virus again, chances are they would not get sick.  I spoke with the study’s lead author, Dr. Ali Ellebedy, who said the findings were significant and durable.

So why get the vaccine at all if you have had COVID-19? As a practicing physician I continue to recommend at least one dose of an MRNA vaccine for several reasons. 

First, studies have shown that one shot of the Pfizer vaccine augments the immune response several fold. This may end up being important as variants such as India’s delta variant emerge which are both somewhat resistant to the vaccines and also present a risk of re-infection to those who have had COVID. Two shots of the Pfizer vaccine has been shown so far to be over 80 percent effective against the delta B 1617.2 variant. 

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Another reason to be vaccinated with at least one MRNA vaccine if you have already had COVID is if you are in a group at higher risk of catching it or having complications, namely the obese, diabetics, immune-compromised, cancer patients, lung and heart disease patients, and the elderly. 

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Finally, the Cleveland Clinic study, yet to be peer reviewed or published, began in December, so it only covers data over four to five months. Dr. Peter Marks, head of the Center for Biologic Evaluation and Research at the FDA which looks over the new vaccines, told me that he believes that the falling blood antibodies three months after having had COVID is enough justification to get a vaccine, if only as a booster, rather than to rely entirely on memory cells for immunity without knowing the long term affects yet. 

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I agree with him. It may turn out you get long term natural immunity from COVID, but in the meantime it makes sense to cement this immunity, especially since we haven’t fully exited the pandemic yet.

But I think the main takeaway from the Cleveland Clinic study is to acknowledge the immunity of group who have had COVID (probably over 100 million people in the U.S. at this point). For them, vaccination (at least in the short term) is less pressing. 

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Why should so-called vaccine passports exclude them? I believe those who have had COVID should be able to present a positive antibody protein test (nuclear capsid) which is just as valid as showing immunity (spike antibody protein) from the vaccine.

Natural immunity to the SARS COV 2 virus has been ignored and marginalized for far too long. I am one of their advocates. They have suffered enough from the disease, but the fact is that they have been gifted with an immunity which not only protects them but also helps us all to slow this virus down.

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