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How does natural COVID immunity compare to the vaccine?

Research is still being done but two infectious disease specialists in Colorado weigh in on what they know so far.

DENVER — We received questions about how natural immunity after having COVID compares to the protection from the vaccine. 

We spoke with Dr. Michelle Barron with UCHealth and Dr. Reggie Washington with HealthONE about what they know.

What do we know about natural immunity versus vaccine immunity?

Barron said doctors' understanding so far is that a person's natural immunity to COVID is a lot more tailored to what specifically happened to their body, while the vaccine is more encompassing, including protection against variants. 

"There have been studies that actually looked at people who had COVID at baseline and got the vaccine or got a placebo. We can see, compare groups, that got vaccine on top of having had immunity from COVID," said Barron. 

"We know at least with the vaccines that the variant piece of it, the changes have happened, your body still has the ability to recognize it. With natural immunity, it doesn't look like maybe it's going to be as consistent. That's why we still urge people, even if you had COVID, you may have had it a year ago, we just don't know where you are at. With the vaccine we can tell you with certainty you have that booster or prime to protect you," she added.

How does the severity of COVID impact immunity?

"Think about your immune system as a highly refined military operation. Sometimes when the threat is simple, they send out the frontline troops. If it is a severe attack on you, then your special forces and army are engaged in this. That's different. If you had cold-like systems as a manifestation of your COVID illness, your body probably didn't have to do a whole lot to protect you. Whereas if it got into your lungs and started to affect you more broadly, you know your body went full force and sent every arm of the immune system on attack. As part of that, your body remembers it because your special forces got trained, whereas mainly the frontline troopers were trained initially," Barron said.

She also said vaccines are fighting full force from the get-go. 

"They have the benefit of designing it exactly as you want," she said, "Knowing and understanding how the immune responses are normally dictated. We have that knowledge in our favor."

What about the variabilities? 

Barron gave some insight into the variabilities of natural immunity. 

"Being able to detect an immune response doesn't always mean it's the right immune response. That's where the variants come into play. OK, I have an antibody, I'm good right? We don't know. You have an antibody, we can detect a response, but is it the right response? Are the right troops ready and available for you? With the variants, we haven't really been able to assess that yet." 

Washington agreed. 

"The question that needs to be answered -- if you are exposed to a virus later on, how rigorous will your body's response be?"

While the vaccines available are showing protection against variants, both doctors talked about variabilities with the level of protection, including virus mutations and underlying health conditions. 

Washington said he will be keeping a close eye on mutations and vaccine effectiveness. 

What is their advice?

The advice from both doctors and the Colorado Department of Health and Environment (CDPHE) is to get vaccinated even if you have had COVID. 

CDPHE wrote: 

"We won't know how long immunity lasts until we have more data from over time. Experts are trying to learn more about both natural immunity and vaccine-induced immunity of COVID-19.

The state and CDC recommend that you get a vaccine even if you previously had COVID-19 and recovered. 

Anyone who is not fully vaccinated should continue to wear a mask, practice physical distancing, wash their hands frequently, and limit gatherings with people outside of their households. Anyone -- regardless of vaccination status -- who develops symptoms should get tested immediately and isolate. 

In order to get natural immunity, you would have to become infected with COVID-19, which can come with many serious risks and complications. We do know that the vast majority of hospitalizations involve individuals who have not yet been vaccinated. With the spread of the Delta variant, which we believe is more transmissible and can cause more serious illness, unvaccinated individuals are at a greater risk of serious illness. As more Coloradans get vaccinated, overall hospitalizations are likely to decrease accordingly, except in areas where vaccination rates are low and disease transmission is high. County level vaccination rates, two-week case incidence rates and hospitalization information is available on our website. The most recent modeling report also may be helpful."

What are the caveats? 

The reality is that there is a lot of research left to be done. 

"It's a situation that's in progress. We are learning more and more about this every day," said Washington. 

"The true question is how long will our immunity last if you had a vaccine or were naturally exposed? The short answer is nobody knows. It appears the immunity appears to be at least 12 months. That's as far as we know," he added.

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