the cleveland clinic performed a study on vaccination of its 52,238 employees.

STORY , STUDY

surprising absolutely no one, it showed that prior covid infection works as well or better than vaccination in generating resistance to future covid infection.

i cannot over-emphasize that this is and always has been the base case scenario. vaccines are just a way to (hopefully more safely) train your immune system to recognize and respond effectively to a pathogen. that’s what resistance is.

• there is no reason (nor has there ever been) to presume that a vaccine would do a better job of training your immune system.

• there is, in fact, reason to generally assume that the pathogen itself would provide better training.

• we do not vaccinate people because it’s more effective than natural immunity.

• we do it because vaccines are lower risk and medicine is always and everywhere a matter of assessing and balancing risk and reward.

so let’s look at the data:

obviously, the first striking outcome here is that not a single previously infected yet unvaccinated person contracted covid.

• 0 of 1,359 prev infected and unvaccinated got covid. tough to beat 100% efficacy. those previously infected were younger (39 y/o vs 42) than those not infected and had a much higher incidence of patient facing jobs (65% vs 51%)

• incidence of covid infection among the vaccinated was 15 out of 26,882 among those who were covid naïve. (0.056% infection rate)

• incidence of covid infection was 2,139 of 22,777 among those who had not had covid and were not vaccinated. (9.39%)

so, vaccines look to have had strong ability to prevent further infection, but actually having had covid and recovering provided even stronger protection. this is in line with the results of the israeli study which also showed high efficacy for both, but higher efficacy for natural immunity.

i really wish that the study had tracked covid severity, symptomatic vs asymptomatic, and hospitalizations and or deaths as well as vaccine AE’s. this could have provided us with the tools to assess another really important outcome because there was one other striking piece of data here:

41% of cleveland clinic employees who has not previously been infected with covid chose not to get vaccinated.

this is quite a high number, below even the targets most states are using for vaccination. these are the employees of one of the top medical systems on earth. they had ready, free, and early access to vaccines. presumably, they are as well or better informed about vaccine benefits and risks as just about any meaningful group you could pick.

so why did they do this?

probably because, as i said above, medicine is ALWAYS about risk and reward. these vaccines are, by vaccine standards, very high risk. rates of complications are on the order of 100X those of other vaccines in common use. that’s quite high in relative terms, but this is not necessarily germane as the safety on most common vaccines is so high that you’re getting into “10X your risk of being struck by lightning” sort of territory. but it’s certainly non-zero.

so, for the young and healthy, for whom covid has always posed low risks, often at or below those of flu, it may make sense not to vaccinate. it’s simply less risky to get the disease, especially iterated probabilistically across a population.

it looks like 41% of the staff at cleveland clinics chose to go that route. this would seem to throw some quite cold water on the breathless moralizers trying to tar anyone refusing to get an experimental jab as an anti-vaxxer or some sort of luddite. these are the employees of on the best medical systems to ever exist in the history of the human race. you really want to play the credentialism and “i’m on the side of science” game with them?

before making such claims, perhaps consider if this is a product you might benefit from:

the idea that these young and healthy people somehow owe it to you or to society to take on costs in excess of benefit to “protect you” or “protect others” falls similarly flat.

once you are vaccinated, you are already so safe (less than 1/20th the death risk of flu) that nothing anyone else does can possibly make a meaningful difference to you. there is no difference left to make.

demand that they vaccinate to protect you is not science, it’s medical malpractice. so, again, see product offering above.

conclusions:

resistant population = recovered + vaccinated

using vaccinated alone as a standard is anti-science and anti-social. period.

there is literally no argument there.

vaxx passports and political policy that does not take the recovered into account is pseudoscientific twaddle rooted either in staggering ignorance or outright cupidity in pursuit of authoritarian aims or medical profiteering.

if you have had covid, getting the vaccine offers no incremental benefit, only incremental risk. that is the literal definition of medical malpractice.

among those who have not had covid, getting the vaccine is a matter of weighing cost and benefit:

• for the high risk, vaccination may be a very sensible policy.

• for the low risk, young, and healthy, it may be a bad choice with risks > reward.

make your own call, consult your trusted expert, etc. but do so knowing that that this is a benefit analysis, not some moral edict.

many quite smart and well informed people have chosen not to get the vaccine and it is not their moral obligation to take undue risks to protect you, especially when you have the ready option to vaccinate and reduce your own risk to negligible levels.

make the choice that’s right for you and respect the choices of others.

seriously, is that so fricking hard?