A Rolling Stone story this weekend highlighted the significant vaccine resistance in the NBA — one that often involves star players and conspiracy theories — and Isaac featured prominently. He responded by criticizing the report, saying it got facts about him wrong and expanding at length upon his decision not to get the shot.
There are significant problems with Isaac’s justification for remaining unvaccinated, even as his rationale is more thoughtful than most. Chief among them are the ideas — well-trodden in conservative circles — that this is basically just a personal-liberty issue and that being young and healthy means you don’t really need a vaccination.
“It should just be their decision,” he said of getting vaccinated. “And loving your neighbor is not just loving those that agree with you or look like you or move in the same way that you do. It’s loving those who don’t.”
So many arguments against vaccination devolve into this kind of thing, without accounting for the fact that unvaccinated people are more likely to serve as vectors for infecting others who might be less fortunate than an athletic 23-year-old. Loving one’s neighbor would seem to involve that, as well.
But let’s set that aside for a minute. While laying out his case, Isaac goes beyond simply saying he doesn’t want a shot; he also asserts that his natural immunity from a previous infection means he doesn’t need to be vaccinated.
“I would start with I’ve had covid in the past, and so our understanding of antibodies, of natural immunity, has changed a great deal from the onset of the pandemic and is still evolving,” Isaac said.
Isaac goes on to rightly acknowledge that even with natural immunity, vaccination still offers benefits — before just as quickly waving that off by citing his youth and fitness. But just as we shouldn’t wave that off, nor should we wave off the natural immunity debate, no matter how much the vaccine-skeptic community is rightly pilloried for its half-baked talking points and dodgy use of data.
Marty Makary of Johns Hopkins University School of Medicine made his case two weeks ago in The Washington Post.
“Unfortunately, many elected leaders and public health officials have held on far too long to the hypothesis that natural immunity offers unreliable protection against covid-19 — a contention that is being rapidly debunked by science,” Makary wrote.
Natural immunity has been popular for a long time among critics of the vaccination campaign, including Sen. Rand Paul (R-Ky.). Florida Gov. Ron DeSantis (R) has criticized President Biden’s vaccine-and-testing mandate for large companies, saying it does not take natural immunity into account. Some, like Makary, suggested focusing early vaccination efforts on those who hadn’t been infected because that’s where the vaccines would have done the most good.
When that pushback began, there was less actual evidence to back it. But as Makary notes, we’ve got more to work with now. The big piece is a study in Israel released a month ago that found natural immunity provides significantly better protection against infection than the Pfizer vaccine.
It’s also something other countries and even some U.S. vaccine mandates are accounting for. Germany, France and Italy administer one vaccine dose rather than two to those who have been previously infected. Israel’s “Green Pass” system allows entry to facilities for those who have been vaccinated or who have recovered from a coronavirus infection. The University of California system allows for a vaccination exemption of up to 90 days after an infection. Some hospitals requiring vaccines also allow exemptions for natural immunity.
And Ohio Republicans are fast-tracking a bill that would allow businesses and schools to mandate the vaccines but would provide for natural-immunity exemptions.
The U.S. government’s top infectious-disease expert, Anthony S. Fauci, also responded to the Israeli study two weeks ago by saying that natural immunity was “something that we need to sit down and discuss seriously.”
At the same time, Fauci emphasized there’s plenty we still need to account for and study further. Leading that list: Even if natural immunity allows for greater protection, how durable is it when compared with vaccine-induced immunity? Some research suggests it’s less long-lasting. If people who have been infected are exempted from the vaccine mandates or simply decide not to get the shots, what happens when they are outside the window of what the Israeli study suggests is superior protection?
Another problem with emphasizing natural immunity, as others have noted, is that it might encourage people to deliberately become infected — believing that it’s better or that it might exempt them from a vaccine they don’t want.
“It’s important to acknowledge that those promoting natural immunity aren’t entirely wrong,” George Washington University professor and Washington Post contributing columnist Leana S. Wen wrote in late August, after the Israeli study. She added: “They might even make a reasonable case that those who had the disease don’t need both doses of the vaccine. Where they go grievously wrong is when they encourage people to forgo vaccination and instead opt for infection.”
The last point brings us back to Isaac. As he rightly acknowledged, even those who have natural immunity still stand to benefit from vaccination. Wen notes a Centers for Disease Control and Prevention study that showed vaccinated people who previously contracted the virus have half the risk of reinfection as previously infected unvaccinated people. The same Israeli study agreed that vaccines offer “additional protection against the Delta variant.”
In other words, it’s still a significant benefit, and it’s one that is right there for the taking — particularly given that our vaccination problem is on the demand side and not the supply side.
But it’s also worth recognizing that there’s still much we have to learn and evaluate about how natural immunity works. Just because vaccine skeptics have pressed a version of that debate while botching the evidence (like pundit Clay Travis claiming Isaac “isn’t at risk at all from covid”) and disregarding the added benefits of vaccination (including for the broader societal fight against the virus) doesn’t mean it’s an illegitimate one.
That’s particularly the case as we move toward an increasing number of mandates, which take vaccination decisions out of people’s hands. And it can be done while reinforcing to people like Isaac that it’s still very good to get vaccinated if you truly want to demonstrate love for your neighbor.