In his continued sparring with Fauci, Senator Rand Paul oversimplified science


“I’m sorry, Dr. Fauci and other fear makers. New studies show that vaccines and naturally acquired immunity are effective in neutralizing COVID variants. Good news for everyone except bureaucrats and petty tyrants! “

– Sen. Rand Paul in a TweetMarch 21, 2021

That Senator Rand Paul of Kentucky told infectious disease expert Dr. Anthony Fauci, often disagreeing, is well known.

This story was produced in collaboration with PolitiFact. It can be republished for free.

The couple recently met at a Senate hearing when Republican Paul argued against mask recommendations for people who had Covid-19 or were vaccinated against it.

At the hearing, Fauci, President Joe Biden’s chief medical officer, pressed against Paul’s characterization of wearing masks as “theater”. Fauci said caution should continue as scientists study the new variants that are currently floating around in the US and other countries.

Paul, a trained ophthalmologist, continued the argument a few days later, calling up Fauci in a tweet. He pointed to a study in which he said that “vaccines and naturally acquired immunity are effective in neutralizing variants of COVID”.

The tweet is linked to a study published online on the JAMA Network, a family of medical journals.

We asked Paul’s office for additional sources for his tweet but received no response.

That is why we asked the experts: are Covid variants effectively neutralized by vaccines or natural immunity in people recovering from the disease?

In short, the research Paul cited shows good blood levels of neutralizing antibodies against at least some of the current variants after infection or vaccination. But they’re not the whole story.

Mehul S. Suthar, an author of the study Paul cited, said the results are encouraging but should not be taken as comprehensive: “Our interpretation is that our study examines one aspect of the immune response, antibodies.”

Small samples. Big questions.

Neutralizing antibodies are important because they can block the ability of a virus that causes Covid to infect cells. But the body also has other defenses. T cells can be spurred on, for example, by infection or vaccination, Suthar said, although the study wasn’t designed to look into those.

For the study, the researchers collected blood samples from 40 people who were hospitalized with Covid or who had recovered from it. The National Institutes of Health also gave them blood samples from 14 people who received both doses of the Moderna vaccine, said Suthar, an assistant professor at Emory University’s Vaccine Center.

They then ran tests on these samples against the original SARS-CoV-2 virus and three variants, including the one labeled B.1.1.7, which first appeared in the UK and is now widely used in the US

You wanted to know: Have antibodies generated by infection or vaccination neutralized B.1.1.7?

“We are lucky with B.1.1.7 that our antibodies against this virus seem to be working well,” said Suthar.

As with any study, however, there are caveats. For one, the results were based on a small number of samples. The analysis did not reveal any other worrying variations such as those seen in South Africa and Brazil, which limits the possibility of drawing broad conclusions.

After all, antibodies are only a measure of potential protection against disease. Laboratory tests to measure antibodies show that some immunity is produced by both disease and vaccination, but the strength and longevity of that protection – effectiveness in the real world – is a separate question. This is partly because the ideal level of neutralizing antibodies needed to protect is unknown and other immune protective measures such as T cells are not measured.

In the real world, other factors – such as the variant a person is exposed to and the presence of other mitigating factors, including masks and good ventilation – can also make a difference.

“One reason real world data is so important is to look at the bigger picture of immunity,” said Gigi Gronvall, a senior scientist at the Johns Hopkins Bloomberg School of Public Health. “Given the level of community disease transmission, I would be concerned that other varieties will emerge.”

Nuance Matters

Paul’s tweet, targeting what he believes to be an over-cautious approach by public health experts, fails to capture these types of nuances, nor does it refer to any studies on the other variants emerging.

“Blanket claims from non-scientific experts will not help,” Gronvall said.

Dr. Jesse Goodman, professor of medicine and an infectious disease specialist at Georgetown University, agreed.

“It is wrong to declare victory and say that there is no problem with variants and that anyone previously infected will be fine,” said Goodman, who served as chief scientist for the Food and Drug Administration under the Obama administration.

Viruses naturally mutate when they replicate. So it’s not surprising that the coronavirus did this. Several variants have emerged, including locals from California and New York.

Laboratory tests on blood samples from participants in the vaccine study in South Africa showed lower neutralizing antibody production, possibly related to the variant circulating there.

It is not yet known how big the difference is caused by the lower values ​​measured in these samples.

Levels are still high and could “effectively neutralize the virus,” Fauci wrote in an editorial published Feb. 11 in JAMA.

Even so, clinical trials testing covid vaccines before approving them for emergency use showed lower efficacy when tested in areas where the South African variant was in circulation.

“We expect vaccines and previous infections to provide significant protection against closely related variants,” Goodman said. “But if they become genetically more diverse – like the South African – this protection could decline.”

The main goal of the vaccines is to prevent hospitalizations and death. All vaccines used in the US appear to significantly reduce the risk of hospitalizations and deaths from Covid, according to research.

“While the current vaccines may not be perfect, they seem to prevent more serious results,” Goodman said.

Don’t assume, as Paul’s tweet suggests, recovering from Covid or getting vaccinated means no risk of infection.

For one thing, re-infection is rare, but it can occur.

Goodman pointed to a recent study in Denmark that found that a small percentage (0.65%) of people who tested positive for Covid in the spring got sick again.

“People shouldn’t assume that even if they had the vaccine or were previously infected, there is no future risk,” Goodman said.

While no vaccine is 100% effective, Hopkins’ Gronvall said he shouldn’t use this as an excuse to avoid vaccination.

“The vaccines seem great,” she said. “Get one if you can.”

Our decision

Paul is right that the JAMA study showed that vaccination or previous infection occurred on a small sample of people in an attempt to neutralize the virus. However, he left out important details that make his position an undue oversimplification of a complicated subject.

The study considered only one variant – the one that originated in the UK – and did not analyze any other types currently in circulation nor the potential for additional variants that might arise. In addition, the type of antibody tested is only one factor in protecting against disease, and it is not known what these levels of neutralizing antibodies, measured in a laboratory experiment, could mean in the real world.

For these reasons we rate the senator’s statement as half true.

Bibliography:

Telephone interview with Mehul S. Suthar, Assistant Professor at the Emory Vaccine Center, March 22, 2021

Telephone interview with Gigi Gronvall, Senior Scientist at the Johns Hopkins Center for Health Security and Associate Professor in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health, March 23, 2021

Telephone interview with Jesse Goodman, Professor of Medicine at Georgetown University and former Chief Scientist of the Food and Drug Administration, March 24, 2021

JAMA Network, “Neutralization of antibodies against SARS-CoV-2 variants after infection and vaccination”, March 19, 2021

CNN Politics, “Masks are no theater, says Fauci Sen. Rand Paul in a hearing exchange,” March 18, 2021

The New England Journal of Medicine, “Neutralizing Activity of BNT162b2-Induced Serum,” March 8, 2021

The New England Journal of Medicine, “Serum Neutralizing Activity Induced by mRNA-1273 Vaccine,” March 17, 2021

Yale Medicine, “Comparing COVID-19 Vaccines: How Are They Different?” Updated March 25, 2021

Fast Company: “Can I get Covid-19 twice? New ‘Lancet’ study provides insight into reinfection rates ”, March 22, 2021

JAMA Network, “SARS-CoV-2 Virus Variants – Combating a Moving Target,” editorial, February 11, 2021





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