Andy Slavitt, former Biden White House Senior Advisor for the COVID Response and the past head of Medicare/Medicaid for Barack Obama, put his Harvard MBA to good use today and explained how vaccines and natural immunity to Dr. Roger Marshall, the Republican U.S. Senator in Kansas:
COVID Update: At a time when most scientists are concluding an additional mRNA vaccines is needed, a Republican senator wants to go the other direction.
His idea? Prior infection should count as immunity. 1/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
What would a medical doctor know about vaccines or natural immunity anyway?
Roger Marshall from Kansas thinks the country should officially recognize prior COVID infection as the equivalent of being vaccinated when considering a vaccine requirement.
He’s not alone but he’s wrong in so many ways. 2/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Narrator: Dr. Marshall is right, by the way:
Roger also recently said this:
“The people that have thus far not gotten the vaccine are not going to do it until this White House acknowledges natural immunity.”
He’s calling for a sort of protest? Wut? 3/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Good. More Republicans should acknowledge this:
Several Republican states have in fact passed or are passing laws allowing prior infection with COVID to count the same as a vaccination as @JoanneKenen from @politico has pointed out. 4/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Slavitt didn’t get around to mentioning Dr. Marshall’s credentials until the 5th tweet in his thread:
I will grant that Kansas Senator Roger Marshall is an OB/Gyn.
Another description of an OB/Gyn is “still not an infectious disease expert.” And it’s the confusion between illness & infection that leads Roger astray.
5/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
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And then he goes into all the reasons why Dr. Marshall is correct in asking for the White House to acknowledge that natural immunity does go a long way to providing protection from severe Covid infections:
Let’s look at his claims. There are 10s of millions of unvaxxed Americans with prior infection. Prior infection provides them some protection in 2 ways.
-a shorter term & targeted antibody response
-a T cell response to protect against more serious illness 6/— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Let’s look at those both with a little more rigor than Roger has.
First, the short term targeted antibody response, while real, is, well, short term.
And it’s also targeted. Meaning Delta infection doesn’t create enough antibodies against Omicron. 7/https://t.co/cU2HqSKnp7 pic.twitter.com/zoIKo5w4b9
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
The second benefit is a T cell or memory B cell response that initiates later & aims to prevent an upper respiratory infection from traveling to the lungs.
While this is a great feature of the immune system, it is 100% irrelevant here. 8/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
But. . .
The CDC says vaccinated people can still spread it. That’s why they want us to wear masks:
Vaccine requirements aren’t concerned with unvaccinated people’s illness from spreading to their lungs. They are concerned with the virus spreading to OTHER PEOPLE.
Roger, that’s why people care— because it’s an INFECTIOUS disease. 9/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
This is an ongoing misconception among people who don’t support vaccine or mask requirements in any situation.
If someone were able to get COVID & not spread it, nobody would care whether you took care of yourself. It’s because you can make us sick. 10/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
And Dr. Marshall isn’t even saying *no* vaccine requirements. He’s saying that if there’s a vaccine requirement, a prior infection should be treated like a vaccination in an uninfected person. This isn’t nearly as awful as he thinks it is:
This is an ongoing misconception among people who don’t support vaccine or mask requirements in any situation.
If someone were able to get COVID & not spread it, nobody would care whether you took care of yourself. It’s because you can make us sick. 10/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
We regret to inform Mr. Slavitt that it’s not just Republican Senators pointing out the science behind natural immunity. Here’s epidemiologist Michale Mina:
This study is important
For unscientific reasons we in scientific/academic community downplayed impact of Covid infections in effort to get more ppl vax’d
We publicly project that infections don’t offer much immunity -stating only Vax does -> but this goes against evolution
— Michael Mina (@michaelmina_lab) December 12, 2021
And he’s begging people just to focus on the science and let the chips fall where they may:
My goal is to say simply –
Focus on the science and the data and what we know of biology. Then message and create policy off that.Yes we want everyone vax’d. But really we want everyone protected. With >50% of Americans exposed/infected… we should at least consider this…
2:
— Michael Mina (@michaelmina_lab) December 12, 2021
We absolutely do not want ppl to intentionally go out and get infected. But we also can’t reverse time. We know a majority of Americans have been infected. Given that protection is derived from infection – assuming you do OK through it – we should leverage that, not ignore it
3:
— Michael Mina (@michaelmina_lab) December 12, 2021
If infections are helping us to reduce onward transmission, this is crucially important information to know and recognize.
But alas we have a@regulatory agency in the FDA that states to not look at pre-existing immunity as a market of past infection. This is a mistake
4:
— Michael Mina (@michaelmina_lab) December 12, 2021
I want to emphasize that I am not advocating to not get vaccinated. I advocate quite the opposite based on all that we know of the benefits of vaccines. But being pro-vaccine does not and should not mean being anti-reality. We should leverage the infections that have occurred 5/
— Michael Mina (@michaelmina_lab) December 12, 2021
And to all those who will call this thread “anti-vax” – I’m just trying to stick to the data. Give ppl good data. Gain trust. And public health can prevail.
— Michael Mina (@michaelmina_lab) December 12, 2021
Also just to clarify -the study is showing that protection from transmission is best among people who have previously been infected and then got vaccinated
However protection from disease and hospitalization is good from vaccination alone. Though of course it diminishes in time
— Michael Mina (@michaelmina_lab) December 12, 2021
More from Slavitt here, ending with a claim that Dr. Marshall’s pro-science position is actually “anti-science propaganda”:
Your illness, your business.
You spreading your illness to the rest of us including kids, older people & sick people, that’s everyone’s business. 11/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
And if you haven’t heard, COVID (Delta and Omicron both) are very contagious. According to @larrybrilliant, accounting for the quick incubation period, they make COVID the fastest spreading respiratory illness ever recorded. 12/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
But, some say, it’s getting less lethal, more like the flu. Why make a big deal over spreading it?
First, what kind of person is OK spreading the flu?
Second, there’s no evidence that Omicron will be less lethal. And even if it turns out to be, it won’t be for everybody.13/— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
So prior infection may for help the individual but it doesn’t do much to help the rest of us.
And I haven’t heard how Roger thinks we will verify whether someone has had a prior infection. Because he really doesn’t think we should. He’s just mucking up the gears. 14/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
So what is Roger really saying? He’s saying to unvaccinated people that they should be able tell everyone else to just fuck off.
And part of that brave stance is to be OK getting COVID. And not afraid to give the infection to someone else. 15/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
A more responsible person would let the health authorities parse this complex topic for people.
But Roger’s aim isn’t better public health understanding. His comments were made prior to his vote to strip OSHA of its authorities to require workplaces protect against COVID. 16/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Aren’t vaccines subject to similar properties? Waning and some level of reinfection?
Less so but yes— particularly against Omicron. So we will need to consider what the science is likely to tell us about Omicron. 17/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Particularly once Omicron hits US shores in earnest, the CDC & local public health authorities must revisit their definition of vaccinated— likely to require an mRNA booster.
And if the science later tells us we will need a different shot, we need to look at that too. 18/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Many will come out and say— see if the science changes, don’t trust it.
Others will say that the science evolving as the virus changes is why we trust it. 19/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
Around the globe this could also mean that shots of Sinopharm or Sputnik or AZ, could also be insufficient.
This will mean higher cases & losses around the world. It could also mean proof of vax requirements to travel will need to evolve. 20/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
We have the tools today to minimize the virus’s impact if we use them.
At this point in the pandemic we should be preparing to take on tomorrow’s challenges not fighting anti-science propaganda. /end
— Andy Slavitt 🇺🇸💉 (@ASlavitt) December 12, 2021
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