SPECIAL REPORT: Natural COVID antibodies compared to the vaccine antibodies; doctors weigh in

Published: Jul. 28, 2021 at 4:25 PM EDT|Updated: Jul. 28, 2021 at 6:31 PM EDT
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HORRY COUNTY, S.C. (WMBF) - Vaccine hesitancy. It’s two words we often hear as vaccination numbers are dropping compared to where they were in the months following vaccines becoming available to the public. But, why?

Everyone who is vaccinated or unvaccinated against COVID-19 has their reasons, but some unvaccinated people may cite the possibility they have coronavirus antibodies already in their system from a previous infection.

But are they strong enough to fight re-infection without vaccination? Doctors are weighing in.

What are antibodies? They are little fighters in all of us.

They keep illnesses at bay, fight off disease and do their best to keep us healthy. But some of us do, in fact, have specific antibodies we’ve built from fighting off COVID-19. Or, are some people born with antibodies that can fight off COVID?

Conway Medical Center’s Dr. Paul Richardson said antibodies, in general, are proteins produced by our body’s immune system in response to a foreign invader.

These antibodies bind to those invaders to keep them from latching on to other places in our bodies that could make us sick.

In the case of COVID, after we’ve been either infected or vaccinated, we produce an antibody to fight the ‘spike protein’ that comes into our bodies with COVID-19. COVID uses the spike protein to get into our cells. But, if you have the natural COVID antibody or vaccinated COVID antibody, that specific antibody binds to the invading spike protein. Therefore, the idea is it can’t attach to you and is unable to make you sick.

Doctors say it’s still unknown why some people are asymptomatic to COVID or show very few symptoms, while others get extremely ill or die from it. But what we do know people with underlying health conditions are at greater risk. We do know COVID is a serious illness and vaccines are making an impact on infection numbers.

“It’s a very, very well-proven vaccine. This thing is incredible technology,” Dr. Gerald Harmon of Tidelands Health said.

Harmon is also the new president of the American Medical Association.

“We do have some clinical studies that say even if your antibody levels are low and you get re-infected, you don’t get nearly as sick. They don’t get hospitalized. They don’t have a fatal event. These are very good studies that show there’s a certain level of actual immunity once you get the disease. Also, apparently the sicker you get, the more antibodies you form, which is kind of expected, because your body had to respond to a really bad illness. Shortness of breath, ICU, ventilator stuff. You survive that, you have a pile of antibodies,” Harmon said of what’s being seen from people who are infected with COVID twice, or after they’ve recovered.

However, Harmon and Richardson agree the issue is that no one knows what the differing levels of COVID antibodies between people mean.

There are two tests that measure antibody levels in unvaccinated people: a qualitative test and a quantitative test. Both are taken by drawing blood.

A qualitative test tells you only if you are positive or negative for COVID antibodies. A quantitative test shows you the ‘quantity’ of your COVID antibodies in number form.

If you are over a .7, you are positive for COVID antibodies. Those numbers vary from person to person.

“Nonetheless, since we don’t know if this antibody level itself is a true measurement of immunity and resistance to the disease, we do recommend at some point after you’ve been sick with a documented infection, even if you have antibodies in your blood, still get the vaccines,” Harmon said.

Richardson echoed that statement.

“Here’s the issue with the number, though. I don’t know that we have normal range numbers. So, if I got a 20 and you have a ten (on the quantitative antibody test), we’re probably too early to know if I’m more protected than you. That may be nothing, or that may mean something. I think it’s too early to tell that.”

The doctors agree studies are showing unvaccinated people holding on to natural COVID antibodies longer than expected.

Richardson said the original estimate of antibodies staying up to only 30 or 90 days is not accurate. Both doctors know of and have seen studies of people holding on to native COVID antibodies for up to six months at least. WMBF News anchor Meredith Helline’s mother is an example of that.

Never knowingly infected with COVID or showing symptoms, she’s now had the COVID antibodies since August 2020. The COVID antibody number for her quantitative test is measuring at over a 378 as of July. She registered in the 390s in May. She only needed a .7 to qualify as positive for COVID antibodies. She’s had both the quantitative and qualitative tests done. All have been positive for COVID antibodies.

Richardson reiterated people who are vaccinated will test differently for antibodies than those who are unvaccinated. He said it’s unknown how many antibodies the vaccine will give you, as it’s unknown why unvaccinated people who test positive for COVID antibodies have varying levels.

However, when asked, he said that if an unvaccinated person registers a strong positive antibody on a quantitative antibody test they are, ‘with an asterisk,’ “probably safe.” He said he doesn’t know for a fact, but clinically speaking. He reminded that the ‘jury is still out’ on what the strength of a positive COVID antibody test actually means as far as fighting off the COVID virus again.

Richardson said getting the vaccine will not bring down your natural COVID antibody response if you have the antibodies.

“No, it should not. If anything the opposite should be true. It should be a heightened response. We do know, I’ve seen patients who have had the native infection and then they got the vaccine, they may have a few more side effects, have a little more chills that kind of thing, a little more body ache after the vaccination. But other than that, they really have done very, very well. And we’ve got quite a number even amongst our own employees who had COVID, chose to get vaccinated and are doing very fine. Quite well,” he explained.

Harmon echoed that statement. He also added the vaccine will protect people better against COVID variants.

“Natural immunity probably does not protect you as well against the new strains,” Harmons said. “Since we don’t know if this (natural) antibody level itself is a true measurement of immunity and resistance to the disease, we do recommend at some point after you’ve been sick with a documented infection, even if you have antibodies in your blood, still get the vaccines.”

He said the vaccines give your body an additional layer of armor, especially if you know you have natural COVID antibodies.

“This technology has been around for quite some time. And actually, dates back to the first SARS outbreaks that occurred in the Middle East and in that area even 20 something years ago. So they were developing this technology even back then. So, this is not new tech. Yes, by definition, these are new vaccines, it’s not new technology that the platform is built on,” Richardson said.

Helline pointed out the vaccine has not been injected into millions of people until now. She asked him what does he tell those people who are hesitant about how it will affect them down the road.

“Again, I don’t know necessarily how to negate that sentiment. Other than to say, again, based on the way it works I just don’t see how that’s possible,” Richardson answered. “That’s going to cause an issue down the road. The way that it introduces the antibody to us, it basically uses our own cellular mechanisms and then it’s gone. And then it’s gone. So, I just don’t see how that’s particularly possible, but I do understand. Yeah, we haven’t had 10 years of experience with this particular vaccine. But, all of our vaccines started somewhere. You know, the measles, the mumps, polio...they all started somewhere.”

While Richardson said he’s seen no studies that would make him doubt the results of COVID antibody tests, Harmon said he’s not sold on the accuracy.

“So it’s interesting we have different tests out there. There’s no one test that’s recommended by the CDC, or for that matter, the FDA, that’s better than another because we still don’t really understand the antibody levels and the specificity or sensitivity to the test.”

When asked whether the vaccine antibody or natural antibody offers more protection, Richardson said more studies need to be done, but the natural antibody is being underappreciated.

“I don’t know that either one is going to be better than the other. I think the jury is still out on that. I don’t know. I do know that native infection antibodies should be real and I think that’s being sort of underappreciated for lack of a better term. There is some data around the vaccine that it gives a more vigorous antibody response than many patients who have had native infections, not all but many,” he said.

While it’s a fact there are still many unknowns about COVID, both doctors highly recommend everyone to get vaccinated, whether you’ve been previously infected with COVID or not.

Richardson calls the vaccines a ‘game-changer.” He urged young adults to get the shot to contribute toward herd immunity.

“That just makes common sense. So that’s why it is more helpful to have more people vaccinated to stop the spread and stop a potential for variants,” Richardson said. Looking to the future, Harmon said he could see one day combining the COVID-19 vaccine with a regular pneumonia shot.

The doctors said while vaccinated people can still get COVID, their infections are way less severe than unvaccinated people.

When these interviews were conducted at the end of June, Conway Medical Center’s Allyson Floyd said the hospital had only one COVID patient. She told WMBF News they were looking forward to zero COVID patients because of the vaccine. As of July 28, Floyd said they never got to zero COVID-19 patients. The hospital had 12 COVID-19 patients hospitalized July 28. All of them unvaccinated. Of that number, five were in the intensive care unit and three were on ventilators, she said. Floyd added the hospital has had at least one COVID patient a day since March 17, 2020. They do not test their patients for which COVID variant they have, she said. She said treatments are the same based on the patient.

Tidelands Health also provided updated hospital numbers on Wednesday, July 28. The hospital said it had 17 people in the hospital. Of those 17 patients, six were in the ICU and one was on a ventilator. 16 of those people were unvaccinated, one hospitalized patient was vaccinated.

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