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Most agree that COVID will simmer in the population unless and until we reach herd immunity. And, yes, if SARS-COV-2 mutates “enough”, it will linger even longer, perhaps annually, because herd immunity will not have been achieved for the mutation in circulation.
Still, even if SARS-COV-2 mutates and circulates year after year, its impact on society should diminish as we likely would have some herd immunity. Some will get sick, really sick, and even die. But because we’d have some immunity, the morbidity and mortality should decrease. The influenza we experience annually is less deadly than the influenza experienced in 1918. (Except when the annual influenza in circulation substantively mutates.)
The two ways to achieve herd immunity are vaccination and contracting the disease.
There’s a push for employment to be conditioned on vaccination status. Some employers will allow the option of periodic and frequent testing.
I understand the impulse for pushing all employees to get vaccinated. Still, some employees are arguing that past infection with COVID-19 should give them a pass on vaccination. They argue they have antibodies and are currently as “protected” as someone who is vaccinated – perhaps even more protected if they developed an infection by (and antibodies to) a mutation that was not anticipated by the current vaccines in use.
I’m sympathetic to this argument.
If the goal is for the employee to have some protection against COVID, and the employee can demonstrate quantitative neutralizing antibody titers to the virus in circulation, hasn’t the public health goal been achieved? Arguably, demonstrating quantitative neutralizing antibody titers is a better metric for protection against serious illness compared to vaccination status. Colin Powell was vaccinated. He recently passed away because he was immunocompromised and then infected. It’s possible his quantitative neutralizing antibody titers were low or not even detectable. My point is not that employees should wait to get infected. Some who get infected will never live long enough to demonstrate quantitative neutralizing antibody titers. So, waiting on the sidelines entails risk.
But, for those who were infected, we should consider whether a blood test demonstrates adequate protection.
And, yes, I am aware of the call to also vaccinate those who had past infections because they will get even better protection. This blog post is not arguing against that paradigm.
I am making the case for employers not treating the unvaccinated past-infected the same as the unvaccinated never-infected.
What do you think?
Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation.
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Jeffrey Segal, MD, JD
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Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
The unvaccinated, never infected may have the strongest immunity of all. They may have been exposed and never sick but have the best immune systems to best handle the infection. I know of some who were never sick who are, and continue to be, antibody positive for over one year.
Ever think about why the NIH might have wanted gain of function work done? What motivation might there have been to do it? There are a lot of what ifs going around.
If you haven’t already watched the movie, Kingsmen, take a look. It’s a comedy, but it probably couldn’t be made today. And not because of political correctness.
What has been woefully lacking in the literature is actual evidence of antibody titers. Testing for antibody titers is not being done to any appreciable degree outside of some small research studies. If someone has antibody titers, then they are immune, they can show that to the vaccination police and should then be able to make them go away.
This is the first disease where the government came in and mandated a vaccine. The vaccine is new technology, rushed into service in 9 months, and we need to acknowledge that we do not have enough scientific evidence for long term outcomes from the adverse effects of the vaccine. It is pretty clear that any such evidence was suppressed.
This is the second disease that was politicized. The first was HIV. Contact tracing was denied back in the 1980s because of the “stigma” attached to the gay community. However, recently one of the members of that community indicated that they had been wrong to deny contact tracing, because many lives could have been saved had that tracing been done.
Politics mixing into healthcare is a disaster. Public policy setting regarding healthcare IS NOT something enumerated in our constitution. Healthcare is best left up to each patient and their physician as a private matter. Third party insurance including medicare, have intruded on this private relationship because of reimbursement. There are all kinds of negative consequences related to this. Just one aspect that was corrected with additional legislation was the right to try law. We need to get the government out of medicine. The country should not have been shut down. The economy would not have been impacted. The disease would have spread faster and ended up with herd natural immunity faster. Supply chains would not have been interrupted. Government would not have seen the need to spend trillions of dollars of stimulus and wound up introducing inflation, if it had not been for its attempt to “manage” the virus. The conflicting information presented by politicians and government employed or funded medical personnel, has created a slow rolling disaster, with the result that patients trust even less than they did before. I am pro vaccine. But I also recognize that that is an individual choice (to vaccinate or not) that is protected under the 4th amendment of the constitution. We as physicians should realize that paternalism in medicine was not appropriate. So why is paternalism on the part of government for healthcare appropriate, when it violated our constitutional rights?