Sure, let's critically evaluate the guidance put forward by our public health institutions, but quoting a statement from Norway's equivalent institution without the backing evidence doesn't make the US "wrong". If the evidence available on the efficacy of vaccines for kids is so ridiculously wide that it goes from -99% to +370% risk of infection, then surely Norway is _also_ drastically overstating its case when it says (about kids) "previous infection offers as good of protection as the vaccine against reinfection" esp since it _also_ seems like the protective effect of prior infection is both uncertain and changing.
How about flatly declaring that guidance was "wrong" about school closures because minority and poor kids did markedly worse at math? Obviously these decisions are complex trade-offs, and one can't conclude that the choice was "wrong" simply by pointing out one of the costs.
How about quoting a CDC scientist, who cannot possibly have strong evidence when making the prediction "CDC guidance worsened racial equity for generations to come. It failed this generation of children." Generations to come? Show us the data that lets this scientist predict the far future with such confidence.
I get that it's deeply unnerving when these institutions make sweeping recommendations based on less firm data than we would normally demand. But not recommending anything, or not taking decisive action because of the limited data would _also_ have been irresponsible. When schools first closed, we didn't know a lot of things, but it would have been pretty reckless if agencies said "well this is putting a lot of people in the hospital and spreading fast, but we don't have the data to give definitive guidance yet, so you're on your own. Depending on the range of things your communities choose, maybe in a few months we'll have the evidence to say something."
The protective effect of prior infection is not uncertain, nor is it changing. There have been dozens of papers now, all saying the same thing: natural infection is at least as protective (if not more so) than even 3 doses of the current vaccines. If you are hearing otherwise, you are being misinformed. Full stop.
Here's the latest paper in a long line of consistent evidence, last week in the NEJM:
https://www.nejm.org/doi/full/10.1056/NEJMoa2203965
> No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection.
Norway is saying what it is, because we know that most people -- vaccinated or previously infected -- will eventually get re-infected. But even if you are re-infected, you will be well-protected against severe illness.
The paper you linked shows effectiveness of previous infection alone at 46%, 3 vaccine doses at 52% (and slightly above the upper end of the confidence interval for infection only), and previous infection and 3 doses at 77%. When I looked for earlier studies, the first one that popped up was this one from Sept 2021, which finds that previous infection gives a 90% reduced risk re-infection.
This seems to be consistent with what has been reported more popularly; in 2020-2021 it seemed that the immune benefit from a previous infection could last several months, and that this informed the timing on when boosters were recommended. Whereas now it seems it's significantly easier to be re-infected with an omicron variant relatively soon after a previous infection.
The finding of 90% in late 2021 vs <50% now does sound like the protective effect of prior infection _is_ changing.
Look a Figures 1, 2 and 4, and you'll see clearly that protection against severe disease remains quite robust. Protection against severe, critical or fatal Covid-19 due to any Omicron infection is shown at 91% (95% CI 60-100) after prior infection (Figure 2D).
> You are going to get Covid multiple times in your life, regardless of your vaccination or infection status.
Yeah but whether you expect to get it once every couple years or multiple times a year is meaningful to what living in a post-covid world looks like.
Earlier your very firm statement did not qualify the unchanged protective effect as being limited to severe, critical or fatal disease, and I think you're moving goalposts.
> The protective effect of prior infection is not uncertain, nor is it changing.
> The protective effect of prior infection is not uncertain, nor is it changing. There have been dozens of papers now, all saying the same thing: natural infection is at least as protective (if not more so) than even 3 doses of the current vaccines.
I was saying that natural infection is equivalent to vaccination -- if not better. Then, in the same comment, I explicitly said that none of this will prevent re-infection:
> Norway is saying what it is, because we know that most people -- vaccinated or previously infected -- will eventually get re-infected. But even if you are re-infected, you will be well-protected against severe illness.
Did people originally overstate the claim that vaccination would prevent infection? Absolutely. Do we now know this to be untrue? Again, absolutely. You're going to be re-infected multiple times in your life. Cannot be helped.
But it's still true that infection and vaccination offer at least equivalent levels of protection. So if you're concerned about the protection of "natural immunity" -- by whatever standard -- then I have bad news for you: the vaccines are no better.