JN.1 continues to be the only variant causing COVID cases now. A new study confirmed that the XBB.1.5 vaccine is effective against JN.1. It turns out that responses to COVID vaccines are better than previously thought. Antibody formation after vaccination shows two phases: an initial rapid decrease (waning) in SARS-CoV-2 spike IgG antibodies, followed by stabilization of antibody levels for at least 7 to 9 months. This is consistent with typical B cell physiology.
Thank you so much for sharing your absolutely excellent resources, and doing that in near lay language.
I would encourage you to look more at the immunity issues and the fading of immunity over time. This is an area where you far exceed many of your colleagues.
Many RNA viruses mutate, hybridize or re-assort so rapidly that mammalian physiology has learned in some way that we do not yet understand to recognize that and to then change immune response.
For SARS-CoV-2, our bodies recognize that building last immunity is not beneficial. Doing so is an energy and resource burden. But, the virus will soon mutate and hybridize to defeat that built immunity. As a result, our immune systems mount a two stage adaptive defense.
First is the production of antibodies tailored to attack the invader (infection or vaccine derived materials). This builds quickly and then fades slowly at a constant rate plotted logarithmically. The strength of the response is to a degree dose (or insult) dependent. That plateaus at some point. So vaccines can be highly effective on a par with immunity built from infection. However, as we saw in the bivalent vaccine, if the dose of vaccine is lower, the strength and durability of the response can be lower as well.
For most of the vaccines, they were well targeted to circulating strains. And they produced strong immunity that started at about 95% against any disease or transmission. This fades relatively rapidly to drop below about 50% by 4-5 months after vaccination.
Simmilarly, immunity from infection lasts about as long.
Second though, the body then also produces B and T memory cells to the insult. These serve as a reminder of the infection allowing rapid reproduction of that immunity to those strains. This immunity also fades in much the same way and it too is essentially gone at 6-9 months.
In both cases there is no firm cutoff. The response becomes less and less as time passes.
After these, the virus has mutated sufficiently that the old immune response is insufficient to fight the new strains. And then the body mounts a new defense and builds new immunity. That too then fades as before. Rinse and repeat.
The mainstream for reasons I cannot fathom seems unwilling or unable to believe or accept this. It seems that they may be caught in simpler ideas, despite knowing better. These ideas seem rooted in experience of DNA virus immunity that often lasts a lifetime, or nearly so. And too of the flu, an RNA virus that has a lower reproduction number and that as a result is limited to epidemic phases when people move indoors and aggregate in the winter.
The immune memory for flu virus does seem to last longer. And so immunity to past versions similar to the current versions tend to trigger some degree of protection. However, this is still viewed as being caused not by immunity fading, but instead by the virus re-assorting and mutating away sufficiently that the old immunity is not effective. This holds at its core the mistake of believing that the immunity is long term or permanent and not recognizing the strategies employed by the body to conserve precious resources and intentionally forgetting the old invaders - since they are unlikely to come around again.
With SARS-CoV-2, in early 2020 when the virus first arrived in Washington State (and elsewhere), it showed growth rates in the population (which was taking few or no precautions) such that the growth was about 35% per day. It had an R0 of about 15. In China at the same time, huge efforts there to contain the virus had begun and the reported R (not R0 as incorrectly assessed) was about 3-7.
The case fatality rate varied a lot based mostly on differences in age distributions. The CFR on average was about 4.5%. In Italy where it rampaged through communities of elderly folks, the CFR was around 18%. The CFR for the Wu-1 strain showed a straight linear relation to age plotted logarithmically, meaning that people over about age 55 was at risk with exponentially increasing risk of death with increasing age. Those under 55 were also at risk, but statistically at a lower rate.
What this actually showed was the shift from primary reliance on adaptive (antibody based) immunity in the young to primary reliance on innate (cytokine derived) immunity in the old, as the adaptive immune response fades with age.
That continued through the AY (Delta strains).
Then came Omicron (rodent - likely mouse derived) strains, when the pandemic in some unidentified animal reservoir (most likely mice) jumped to humans in at least five variations (BA.1, BA.2, BA.3, BA.4, and BA.5). In passing through mice (or whichever species it was) and adapting to them, the virus seems to have shifted its attack to rely more on TMPRSS2 and less on ACE2.
The practical result was that the virus became better at attacking the sinuses and upper respiratory tract, and less on the lungs. Though both still occur. The virus is now known to leverage attack on at least 15 cell surface receptors. In doing this, the lethality dropped by at least a factor of 10. Though that did not change the other impacts through complimentary immune system damage and clotting, spike protein toxicity to the cardiovascular system, heart, brain stem and organs, or to immune system damage leading to an AIDS like decline in CD8, long COVID, and hyper accelerated aging through methylation of the DNA, truncation of the telomeres, and the afore mentioned organ and brain damage.
At the same time, a fiction circulated that viruses "aways get weaker". This is not true. But coinciding as it did with the decline in immediate lethality and the also competing idea of "herd immunity", it set the stage for governments to decide that it was both too hard to fight the virus, and too costly in its impacts on business. And so now we are caught in a "three monkeys syndrome" of denial.
What this conceals is ever increasing risks of hybridization with the virus circulating in pandemics in other species, wild type cousins in pandolins, camels, and bats (plus others) that are extremely lethal, or the on-going hybridization and mutation toward immune evasion.
It also conceals the immense impacts on health care both now, and the hidden impacts that are growing from long COVID, immune destruction, and aging that may collapse society in the near future as those impacts grow.
What is needed are changes in understanding by the experts to recognize the way the immune system chooses to forget this virus, and the impacts that have, which necessitate continual revision of vaccines on an at least twice annual basis, and allowing for vaccination not less than twice a year (to protect against severe disease and death), or better three times a year (to protect against infection and long COVID, immune damage and aging.
In many ways, the accumulated population level harm form 3 or more infections and recoveries is already sealed in. And that will have profound societal impacts over the next several years. However, the impacts are still growing, and we need to take action to protect those not yet destined to such difficulties.
We also need to recognize that it isn't just those who are immunodeficient that are at heightened risk. So too are those with hyperactive immune response (autoimmune disease). Every infection carries with it a 13-14% chance of developing a new autoimmune disease and an equally large risk or reactivating autoimmune diseases. And since people with long term autoimmune disease often have 6 or 7 different autoimmunities, the risk for them is near unity of some autoimmune problem developing with each infection. That is currently unrecognized.
Please do continue to do your incredibly good work. It is vital.
Oh - and back to the beginning, the 54% immunity that the vaccines provide against JN.1 is helpful. It is not lasting. Based on prior experience, that level of immunity provides at best 3 months of protection against disease and perhaps 4 against severe disease and death. Though it is better than nothing, it is NOT durable immunity. It is NOT success. It is instead a sign of a vaccine that is now all but ineffective against the current strains and the need for a new vaccine targeted at the JN.1.x derived strains - NOW. By the fall, JN.1.x will be a memory having been replaced by some new variant or hybrid and its progeny. Even newer vaccines will need to be in process then to target those in an unending cascade.
And that is another mark and indicator of the failed ideas that our leaders are using to guide their now nearly complete lack of response to the pandemic.
Another indicator is the loss of nearly all data and information about the pandemic. Though this aids in trying to get people back to work and shopping, and the near-term economic issues, in the longer intermediate term, these are catastrophic approaches.
Thank you!!
Dr Ruth,
Thank you so much for sharing your absolutely excellent resources, and doing that in near lay language.
I would encourage you to look more at the immunity issues and the fading of immunity over time. This is an area where you far exceed many of your colleagues.
Many RNA viruses mutate, hybridize or re-assort so rapidly that mammalian physiology has learned in some way that we do not yet understand to recognize that and to then change immune response.
For SARS-CoV-2, our bodies recognize that building last immunity is not beneficial. Doing so is an energy and resource burden. But, the virus will soon mutate and hybridize to defeat that built immunity. As a result, our immune systems mount a two stage adaptive defense.
First is the production of antibodies tailored to attack the invader (infection or vaccine derived materials). This builds quickly and then fades slowly at a constant rate plotted logarithmically. The strength of the response is to a degree dose (or insult) dependent. That plateaus at some point. So vaccines can be highly effective on a par with immunity built from infection. However, as we saw in the bivalent vaccine, if the dose of vaccine is lower, the strength and durability of the response can be lower as well.
For most of the vaccines, they were well targeted to circulating strains. And they produced strong immunity that started at about 95% against any disease or transmission. This fades relatively rapidly to drop below about 50% by 4-5 months after vaccination.
Simmilarly, immunity from infection lasts about as long.
Second though, the body then also produces B and T memory cells to the insult. These serve as a reminder of the infection allowing rapid reproduction of that immunity to those strains. This immunity also fades in much the same way and it too is essentially gone at 6-9 months.
In both cases there is no firm cutoff. The response becomes less and less as time passes.
After these, the virus has mutated sufficiently that the old immune response is insufficient to fight the new strains. And then the body mounts a new defense and builds new immunity. That too then fades as before. Rinse and repeat.
The mainstream for reasons I cannot fathom seems unwilling or unable to believe or accept this. It seems that they may be caught in simpler ideas, despite knowing better. These ideas seem rooted in experience of DNA virus immunity that often lasts a lifetime, or nearly so. And too of the flu, an RNA virus that has a lower reproduction number and that as a result is limited to epidemic phases when people move indoors and aggregate in the winter.
The immune memory for flu virus does seem to last longer. And so immunity to past versions similar to the current versions tend to trigger some degree of protection. However, this is still viewed as being caused not by immunity fading, but instead by the virus re-assorting and mutating away sufficiently that the old immunity is not effective. This holds at its core the mistake of believing that the immunity is long term or permanent and not recognizing the strategies employed by the body to conserve precious resources and intentionally forgetting the old invaders - since they are unlikely to come around again.
With SARS-CoV-2, in early 2020 when the virus first arrived in Washington State (and elsewhere), it showed growth rates in the population (which was taking few or no precautions) such that the growth was about 35% per day. It had an R0 of about 15. In China at the same time, huge efforts there to contain the virus had begun and the reported R (not R0 as incorrectly assessed) was about 3-7.
The case fatality rate varied a lot based mostly on differences in age distributions. The CFR on average was about 4.5%. In Italy where it rampaged through communities of elderly folks, the CFR was around 18%. The CFR for the Wu-1 strain showed a straight linear relation to age plotted logarithmically, meaning that people over about age 55 was at risk with exponentially increasing risk of death with increasing age. Those under 55 were also at risk, but statistically at a lower rate.
What this actually showed was the shift from primary reliance on adaptive (antibody based) immunity in the young to primary reliance on innate (cytokine derived) immunity in the old, as the adaptive immune response fades with age.
That continued through the AY (Delta strains).
Then came Omicron (rodent - likely mouse derived) strains, when the pandemic in some unidentified animal reservoir (most likely mice) jumped to humans in at least five variations (BA.1, BA.2, BA.3, BA.4, and BA.5). In passing through mice (or whichever species it was) and adapting to them, the virus seems to have shifted its attack to rely more on TMPRSS2 and less on ACE2.
The practical result was that the virus became better at attacking the sinuses and upper respiratory tract, and less on the lungs. Though both still occur. The virus is now known to leverage attack on at least 15 cell surface receptors. In doing this, the lethality dropped by at least a factor of 10. Though that did not change the other impacts through complimentary immune system damage and clotting, spike protein toxicity to the cardiovascular system, heart, brain stem and organs, or to immune system damage leading to an AIDS like decline in CD8, long COVID, and hyper accelerated aging through methylation of the DNA, truncation of the telomeres, and the afore mentioned organ and brain damage.
At the same time, a fiction circulated that viruses "aways get weaker". This is not true. But coinciding as it did with the decline in immediate lethality and the also competing idea of "herd immunity", it set the stage for governments to decide that it was both too hard to fight the virus, and too costly in its impacts on business. And so now we are caught in a "three monkeys syndrome" of denial.
What this conceals is ever increasing risks of hybridization with the virus circulating in pandemics in other species, wild type cousins in pandolins, camels, and bats (plus others) that are extremely lethal, or the on-going hybridization and mutation toward immune evasion.
It also conceals the immense impacts on health care both now, and the hidden impacts that are growing from long COVID, immune destruction, and aging that may collapse society in the near future as those impacts grow.
What is needed are changes in understanding by the experts to recognize the way the immune system chooses to forget this virus, and the impacts that have, which necessitate continual revision of vaccines on an at least twice annual basis, and allowing for vaccination not less than twice a year (to protect against severe disease and death), or better three times a year (to protect against infection and long COVID, immune damage and aging.
In many ways, the accumulated population level harm form 3 or more infections and recoveries is already sealed in. And that will have profound societal impacts over the next several years. However, the impacts are still growing, and we need to take action to protect those not yet destined to such difficulties.
We also need to recognize that it isn't just those who are immunodeficient that are at heightened risk. So too are those with hyperactive immune response (autoimmune disease). Every infection carries with it a 13-14% chance of developing a new autoimmune disease and an equally large risk or reactivating autoimmune diseases. And since people with long term autoimmune disease often have 6 or 7 different autoimmunities, the risk for them is near unity of some autoimmune problem developing with each infection. That is currently unrecognized.
Please do continue to do your incredibly good work. It is vital.
Oh - and back to the beginning, the 54% immunity that the vaccines provide against JN.1 is helpful. It is not lasting. Based on prior experience, that level of immunity provides at best 3 months of protection against disease and perhaps 4 against severe disease and death. Though it is better than nothing, it is NOT durable immunity. It is NOT success. It is instead a sign of a vaccine that is now all but ineffective against the current strains and the need for a new vaccine targeted at the JN.1.x derived strains - NOW. By the fall, JN.1.x will be a memory having been replaced by some new variant or hybrid and its progeny. Even newer vaccines will need to be in process then to target those in an unending cascade.
And that is another mark and indicator of the failed ideas that our leaders are using to guide their now nearly complete lack of response to the pandemic.
Another indicator is the loss of nearly all data and information about the pandemic. Though this aids in trying to get people back to work and shopping, and the near-term economic issues, in the longer intermediate term, these are catastrophic approaches.