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Fauci can't give a 'really firm answer' on why Americans with natural immunity need vaccines

J. Scott Applewhite-Pool/Getty Images

Dr. Anthony Fauci, the White House's top adviser for the COVID-19 pandemic, told CNN on Thursday that he doesn't have "a really firm answer" on the accuracy of a study that found natural immunity provides better protection against the virus than vaccines alone.

During an interview on "Anderson Cooper 360," CNN chief medical correspondent Dr. Sanjay Gupta asked Fauci about a study done in Israel that found natural immunity from previous COVID-19 infection conferred longer-lasting protection against the Delta variant of coronavirus than two shots of the Pfizer vaccine.

"So, as we talk about vaccine mandates, I get calls all the time, people say, I've already had COVID, I'm protected. And now the study says maybe even more protected than the vaccine alone. Should they also get the vaccine? How do you make the case to them?" Gupta asked.

"You know, that's a really good point, Sanjay. I don't have a really firm answer for you on that," Fauci replied.

"That's something that we're going to have to discuss regarding the durability of the response," he continued. "The one thing that paper from Israel didn't tell you is whether or not — as high as the protection is with natural infection — what's the durability compared to the durability of a vaccine?"

Fauci explained that it is possible that natural immunity from previous COVID-19 infection only provides temporary protection from viral infection.

"So, I think that is something that we need to sit down and discuss seriously, because you very appropriately pointed out, it is an issue, and there could be an argument for saying what you said," Fauci said.

This answer is misleading. The Israeli researchers specifically addressed the durability of natural immunity compared to vaccine immunity, writing that their study demonstrated "natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant" than does the two-dose Pfizer vaccine.

Previously, Fauci expressed great confidence that the mRNA vaccines from Pfizer and Moderna provide greater immune protection against all variants of COVID-19 than does natural immunity.

"Vaccines, actually, at least with regard to SARS-CoV-2 [the coronavirus] can do better than nature," Fauci said in May during a White House COVID-19 briefing. "Vaccination in people previously infected significantly boosts the immune response."

At the time, Fauci pointed to two peer-reviewed studies that supported his assertion.

Health experts have stated that while natural immunity is good for individuals, it is a poor strategy for controlling a pandemic because it varies from person to person depending on several factors including age, health, and the strength of a person's immune system.

"What we're learning is that the immunity that is generated for many people after recovering from COVID-19 is stronger than we thought. And that's great news," said Dr. Brandon Webb, an infectious diseases physician with Intermountain Healthcare who spoke to KTVX-TV about the Israeli study.

"That natural immunity, it does appear to be stronger than the immunity that the vaccines are able to elicit in patients who have never had COVID," Dr. Webb explained. But, he added, relying on natural immunity to offer widespread protection against COVID-19 is a "non-viable strategy."

"It would be catastrophic in terms of life loss, in terms of overwhelming healthcare systems, in terms of economic impact. There's no question that just pulling off the brakes and allowing the virus to run its course through a community to generate natural immunity would be devastating," he said.

Webb pointed out that the Israeli study found that "patients who have natural immunity and are then vaccinated are in the best possible situation."

"For you out there who are making that personal decision, it's actually a risk, personal risk versus personal benefit question," he said. "I, as a physician, every medication that I prescribe has some risk and some benefit. And the vaccines are no different. I think it's really important for those of you who are making those decisions to understand accurately what the risks are, and understand what the benefits are both to you and to the community."

"Like any other medication that I prescribed, there are some risks," he explained. "For example, if you've had a Z-Pak, you may not know that the risk of having a fatal cardiac arrhythmia with a Z-Pak is very rare. But it's two times higher than having temporary inflammation of the heart after having one of the mRNA vaccines. We don't think about that, we take Z-Paks all the time. The risks of the vaccines are very real, we have excellent data from Israel, and from the vaccine safety data that the CDC is collecting. And I can say right now that after millions of doses administered, we have a good sense of what the adverse event rates are. And they're very, very low."

President Joe Biden on Thursday announced a sweeping executive order that requires private businesses with more than 100 employees to require their workers to get vaccinated or submit to regular COVID-19 testing. Any employer who does not follow the order will be subject to fines as high as $14,000 per violation, White House officials said earlier this week.

While Biden's vaccine mandate does not account for natural protection at all, some employers have taken steps to consider natural immunity exceptions to their vaccine mandates. A hospital system in western Michigan, Spectrum Health, for example, will grant temporary exemptions from its employee vaccine mandate to any individual who has a positive PCR or antigen test for COVID-19 plus a positive antibody test from within the past three months, the Detroit News reported.

Fauci told CNN he fully supports the president's order and said that were he in charge, he actually would have gone farther than Biden by removing the testing option for workers.

"I think the president is, you know, being somewhat moderate in his demand, if you want to call it that. And that there are some people who really don't want to get vaccinated, but they don't want to lose their job, you've got to give them an off lane. And the off lane is if you get tested frequently enough, and find out you're positive, you won't come to work, and you won't infect other people. So, it really is somewhat of a compromise there," Fauci said.

"Myself, I would make it just vaccinate or not. But he was trying to be moderate in what his pronouncement was," he added.

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