Pulmonary Artery Blood Clot Images Courtesy of the Vaccine Hesitant

[Gunnar]

What we are starting to see now with the pop-up outbreaks in preeminently red counties around the country is Darwinian evolution at work.

So is the appearance and proliferation of new COVID-19 variants, especially from areas that have the highest concentrations of cases.

[Jersey Girl]

I wouldn't be at all surprised if state or federal government were to offer cash payment for people to get vaccinated. Sports teams, etc., are already doing it. Listen, at this point I say do whatever it takes.

[DrW]

What we are starting to see now with the pop-up outbreaks in preeminently red counties around the country is Darwinian evolution at work.

So is the appearance and proliferation of new COVID-19 variants, especially from areas that have the highest concentrations of cases.

You bring up a very important twist to this whole twisted pandemic. Where data are available so far, the vaccines seem to be reasonably effective against the new variants. The longer this goes, however, the greater the chance that we will see an 'escape' - a variant against which the present vaccines are inadequate.

The unwillingness of a large proportion of the population to protect themselves because of the unfounded beliefs and contrarian lies of mainly religionists and Republicans makes me wonder if this country is headed to the status of society depicted in this not so funny now comedy from 2006 - Ideocracy.

Today's Example: Tucker Carlson May Be America’s Biggest Public Health Problem

https://www.thedailybeast.com/tucker-ca ... =DDMorning

[Some Schmo]

People in the GOP base complain that "leftists look down on them" for being dumb. I don't think they're really that concerned with looking stupid, for all their whining. They keep saying and doing stupid things. What do they expect?

It's like the sky whining that people keep saying it's blue.

[Gadianton]

Dr. W,

is there a reliable way to test antibodies? I recently completed my 2nd round, but I'd like to know 3 months down the road; 6 months down the road how i'm doing.

[DrW]

Dr. W,

is there a reliable way to test antibodies? I recently completed my 2nd round, but I'd like to know 3 months down the road; 6 months down the road how i'm doing.

Antibody tests of which I am aware detect antibodies produced by an infection, and do not cross-react much with antibodies raised against the vaccines.

In general, Covid-19 infections give rise to antibodies against the nucleocapsid protein of the corona virus, while the vaccines give raise to antibodies against the spike proteins.

Antibody titer may eventually fall below detectable levels in the absence of an active infection. However, that does not necessarily mean there is a lack of protection. So called 'memory cells' that form from the B-lymphocytes theoretically "remember" the antigen for long periods of time, and can cause antibodies to be raised quickly if the antigen (in this case the SARS-CoV-2 spike protein) is encountered in the future.

The potential problem is mutation. The spike protein that the memory cells recognize as that presented by the vaccine may not be the same as that on a highly mutated future strain. While there is likely to be some cross reaction, protection may be diminished for the mutant.

Long story short; to my knowledge, there is not a reliable lab test for checking whether or not your vaccination has been effective. Chances are better than 96% or so that it has been effective as initially determined in more than 45,000 people. That number has increased to millions over the last few months with post vaccination infections being exceedingly rare. To my knowledge, there have been no reported deaths from Covid-19 in fully vaccinated individuals. The issue of a test for individual vaccine effectiveness does not have a high priority in the diagnostic or pharma labs at this point.

Depending on future infection rates and severity of the resulting symptoms in those who have been vaccinated as the virus mutates, some hospitals have contingency plans for staff to get a booster shots, or the latest version of the vaccines, on an a near annual basis going forward. I would say this represents a worst case scenario. We just don't know yet.

In the meantime, those of a certain age (like you and me), should definitely continue to follow CDC guidelines for fully vaccinated individuals. For me that means continuing to wear a mask, maintaining social distance, and minimizing time spent in public buildings or in large crowds wherever possible. Outdoors I normally do not wear a mask, but avoid large crowds or close proximity (less than 6-8 feet) to strangers for more than a few minutes. Folks I encounter in public seem to reciprocate and appreciate the gesture.

[Gadianton]

thanks for the explanation, DrW.

[Gunnar]

I also thank you for your explanation, DrW. Your posts always leave us smarter and better informed after reading them. Among the many points of interest in your explanation was:

Antibody tests of which I am aware detect antibodies produced by an infection, and do not cross-react much with antibodies raised against the vaccines.

It never occurred to me before that the tests that detect antibodies produced by an infection might not also be usable to test whether someone might have been vaccinated or not, or whether or not one's vaccination was still protecting against the virus.

[Jersey Girl]

Wait a sec. I thought that antibody tests were being used to track how long immunity lasts from the vaccines? If not, how are they coming out with the (so far) 6 months of immunity determination? Is the Penn T cell study the same as an antibody test?

Now I am confused.

[DrW]

Wait a sec. I thought that antibody tests were being used to track how long immunity lasts from the vaccines? If not, how are they coming out with the (so far) 6 months of immunity determination? Is the Penn T cell study the same as an antibody test?

Now I am confused.

Jersey Girl,

Not sure which Penn study you are referring to. I could find no reference to a Penn T-cell study in the recent literature. If you have the reference, please post a link.

As opposed to concentrating on antibody titers, the latest Penn study I'm aware of regarding Covid-19 immunity (see URL below) underscored the importance of the 'memory B cells' (mentioned upthread) in long term immunity. If you haven't had a look at the report on this work (URL below) it's worth the time.

https://www.pennmedicine.org/news/news- ... ccine-dose

The report describes the immune response of recovered Covid-19 patients, compared to that Covid-19 naïve subjects, after receiving the first shot of an mRNA vaccine. It showed that Covid-19 patients had been immunologically "primed" by the presence of memory cells created by the earlier infection to have a robust response to the initial mRNA injection.

This is due to the similarities (or at least the spatial proximity) between the two types of protein antigens presented by the corona virus and the ability of antibodies to one of the antigens to recognize and react to some extent to the other. The fact that the memory cells created from the infection had at least some recognition of the spike protein fragments for which the mRNA coded meant that the memory cells were primed and ready to mount a vigorous immune response to the spike protein generated from the mRNA injection. This robust response to the vaccine likely resulted in a new population of more specific anti-spike antibodies as well as a new population of more targeted memory B cells.

To my knowledge, the lab methods used in this study to check for antibodies from the vaccine have not been implemented as test kits and are not available to the general practitioners or the public.