Who develops a better Immunity against SARS-CoV-2? The vaccinated or the previously infected?

This question was answered in a preprint study that is not yet peer-reveiwed. It was just published August 25, 2021, Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections 

In the study, Israel’s second-largest Health Maintenance Organization, the Maccabi HealthCcare Services. (MHS) was used. Israel is one of the first countries who have the highest rates of vaccinations in the world.

They compared three groups of people…

1. People who were never infected with the SARS-CoV-2 but were vaccinated twice with the Pfizer BNT162b2 vaccine (673,676 people)
2. Previously infected individuals who have not been vaccinated (62,883)
3. Previously infected and single-dose vaccinated individuals.   (42,099)

Results

1. People who are had two shots of the Pfizer vaccine and never had COVID-19 before had a 13.06-fold  increased risk for breakthrough infection with the Delta variant compared to those that were previously infected without vaccination.
2. The increased risk was significant for symptomatic disease as well.
3. People who had two shots of the Pfizer vaccine and never had covid-19 had a 5.96-fold increased risk for breakthrough infection and a 7.13-fold  increased risk for symptomatic disease
4. People who had 2 Pfizer vaccines and never had the COVID-19 disease before were also at a greater risk for COVID-19-related-hospitalizations compared to those that were that were previously infected. 
5. Individuals who were previously infected with SARS-CoV-2 seem to gain additional
   protection from a subsequent single-dose vaccine regimen.

Explanation of the Results

Natural Infection has a more elicits a more comphrehensive immune response. In the vaccine, only the mRNA of the spike protein is present.

Natural infection exposes the imune system including the T-cells, B-cells to the Spike protein, Membrane protein, Nucleocapsid- Protein and Envelope protein of the SARS-CoV-2.

Authors conclusions

This analysis demonstrated that natural immunity affords longer lasting and stronger protection against infection, symptomatic disease and hospitalization due to the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity.

Notably, individuals who were previously infected with SARS-CoV-2 and given a single dose of the BNT162b2 vaccine gained additional protection against the Delta variant. 

The long-term protection provided by a third dose, recently
administered in Israel, is still unknown.

Related:

1. Asymptomatic or mild symptomatic COVID-19 elicits effective and long-lasting antibody responses in children and adolescents
2. Immune escape: The reason the vaxxed get COVID-19
3. Concerning autopsy findings on a patient who had a COVID shot
4. Can coronaviruses elicit long-lasting immunity?
5. 60% may already have Immunity to COVID-19
6. High Levels of COVID-19 Antibodies is Bad News
7. CD4+ Cross-Reactivity between Seasonal Coronavirus Colds and COVID-19
8. Antibodies to COVID-19 can Exist in the Uninfected
9. The Rise and Fall of Antibodies in Mild and Asymptomatic COVID-19

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Image credite: By SPQR10 – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=88349537

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