Director of the National Institutes of Health grossly misstates the science on vaccination vs. natural immunity

On the August 12, 2021 Special Report, Bret Baier asked NIH director Francis Collins: "Can you definitely say to somebody that the vaccine provides better protection than the antibodies you get from actually having had COVID-19?"

Dr. Collins replied to Bret and the almost 2 million viewers of Special Report:

Yes, Bret, I can say that.  There was a study published by CDC just ten days ago in Kentucky, and they looked specifically at people who had had natural infection and people who had been vaccinated and then ended up getting infection again.  So what was the protection level?  It was more than two-fold better for the people who had had the vaccine in terms of protection than people who had had natural infection.  That's very clear in that Kentucky study.  You know that surprises people.  Kind of surprised me that the vaccine would actually be better than natural infection.  But if you think about it, it kinda makes sense[.] ... That's a settled issue.

You can watch and listen to the actual exchange beginning at the 3:00 minute mark in this video.

I was one of those who did find this quite surprising, given my familiarity with studies such as this one from the Cleveland Clinic and my basic understanding of how immunity is conferred by mRNA vaccines versus the natural immunity arising from prior infection.

However, based on the unequivocal statement on national TV by Dr. Collins, a highly respected scientist leading one of our nation's pre-eminent public health agencies, that the issue is settled, I adjusted my thinking about vaccine immunity versus natural immunity from prior infection.

Fast-forward to the following night's Special Report to watch and listen to Admiral Brett Giroir, former assistant secretary for health during the Trump administration while concurrently serving in several other public health positions.  Dr. Giroir responded to a question about the confusion that arose from Dr. Collins's conversation on Special Report the night before.  He pointed out that Dr. Collins's statement the previous night about the superiority of vaccine immunity over natural immunity and his citation of the Kentucky/CDC study as evidence were "factually incorrect."

It is worth watching the whole conversation, but key points made by Dr. Giroir include the following:

It has not been shown that natural immunity, the immunity you have after infection, is any inferior to the immunity you have after vaccination.  And, in fact, there is growing evidence that natural immunity lasts a long time and is highly protective against infection and hospitalization[.] ... The study that Dr. Collins quoted did not have anything to do with people who had been vaccinated or who had natural immunity.  What it proved [is] that if you were previously infected, your chance of getting COVID in the middle of Delta in Kentucky was about 1 in a thousand to get COVID again.  If you got vaccinated that dropped it to 1 in 2500 so that's a reduction but still your risks were very, very low[.] ... This does not deal with people who were naturally immune vs. vaccinated. That's a whole different question and it begs the question about whether you have antibodies, is that as good as being vaccinated?  And the data right now pretty much say it is.

To clarify, the CDC published a report on a Kentucky study of people who had previously been infected with COVID-19.  The study addressed the question of whether being vaccinated after already being infected provides additional protection; and the findings suggest that vaccination does provide additional protection when added to immunity provided by previous natural infection.  But Dr. Collins relied on this study to make a definitive statement in response to an entirely different question: whether vaccination of people who were not previously infected provides better protection than does immunity obtained from previous infection.  This study sheds absolutely no light on that question.

Given the factually incorrect statements made by the head of the NIH on national TV, we are left to wonder how much we can trust about what our highest-level public health officials tell us.  And when they do mislead us, is it intentional, is it carelessness in communications, or is it because they are mistaken in their understanding of the science?  In the case of Dr. Collins's statement on Special Report, all but the most cynical have to conclude it is the third. 

This then raises the question as to how such an eminent scientist can get it so wrong.  This is a much tougher question to answer without discussing the issue directly with Dr. Collins.  I would speculate that we have a case of confirmation bias, the tendency to interpret new evidence as confirmation of one's existing beliefs or theories.  What might the source of this bias be? 

The Biden administration has made vaccination numbers a key measure of its progress in leading the fight against COVID-19, as it should.  However, in order to keep the public focused on vaccination as a universal necessity, and in its apparent approval of vaccine mandates, the public health bureaucracy has been quite conspicuous in minimizing any mention of the role, effectiveness, and extent of natural immunity arising from previous infection.  

According to a number of outside experts such as Marty Makary, "[r]equiring the vaccine in people who are already immune with natural immunity has no scientific support."  So as part of the public health bureaucracy which is invested in President Biden's objective of universal vaccination, Dr. Collins might easily have misread the Kentucky/CDC study as strong evidence that natural immunity is not nearly as effective as vaccination.  

In this regard, I don't hold the CDC blameless.  For example, I'm not sure if the CDC has even acknowledged studies like the one at the Cleveland Clinic showing strong protection due to natural immunity arising from previous infection.  And particularly after Dr. Collins's misreading, it would behoove the CDC to add a statement in the Summary or Discussion sections of its report on the Kentucky study making it clear that it does not address the question of the relative effectiveness of vaccination vs. natural immunity.

Photo credit: Fox News screen grab.

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