Considering a Vaccine Mandate? New Research says Consider Natural Immunity as Well

• In today’s Recommendations for Industry, we discuss natural immunity from the COVID-19 virus. Read more below.
• COVID-19 outbreak in California school traced to unvaccinated teacher. Half of the elementary school students in an unvaccinated teacher’s classroom developed COVID-19 after the teacher — infected and symptomatic — worked for 2 days and read to the students while not wearing a mask, according to researchers. The exposures led to a larger outbreak at the California school in May that was associated with the delta variant, with many cases occurring among children not eligible for vaccination, illustrating a continued need for nonpharmaceutical prevention strategies during the pandemic, the researchers wrote in MMWR. (Article includes illustration)
• Monoclonal antibody combination reduces COVID-19 hospitalizations, deaths by nearly 80%. Interim phase 3 data released by Brii Biosciences showed that the company’s monoclonal antibody combination therapy reduced the combined endpoint of COVID-19 hospitalizations and death by 78% in high-risk patients compared with placebo.
• The U.S. has now topped 100,000 daily COVID-19 hospital cases; the last time numbers were this high was winter of 2020 (pre-vaccinations). In states like Georgia, Mississippi, and Florida, intensive care units have reached their capacities (both in hospital bed shortages and also healthcare worker shortages).
• CIDRAP continues by reporting that the Delta variant poses double the hospital risk as the Alpha variant, in fact “[t]he chances of either hospitalization or emergency care within 14 days were 1.5 times higher in those infected with Delta.” Ultimately, the study, recently published in Lancet highlights, “outbreaks of the Delta variant in the unvaccinated could burden healthcare systems more than the Alpha strain.”
• In Asia, COVID-19 continues to surge to its highest numbers in the Philippines, Vietnam, and Japan.
• A new COVID-19 variant has been discovered in South Africa (since May 2021); thus far, it is the most mutated strain found. This strain is now considered a variant of interest. There have only been 100 sequences that have been reported globally since May, so sequencing has not provided as much of an insight into what’s going on. However, certain mutations it carries are linked to “increased transmissibility and reduced neutralization” as well as “mutations that could impact neutralization and replication fitness.” Read more from CIDRAP and The Jerusalem Post.
• The E.U. is proposing new travel restrictions for unvaccinated U.S. visitors. Other countries removed from the E.U.’s “safe list” include Israel, Kosovo, Lebanon, Montenegro, and North Macedonia. All countries have had an increase in cases in the last 2 weeks.
• Half of U.S. teens are partially vaccinated against COVID-19; while there has been a recent rise in COVID-19 cases, “the highest surges are in schools that have not followed the current guidelines and that data shows schools are more a reflection of the community landscape rather than propagator of more cases.”

Food Safety & Public Health

• With respect to the U.S. Department of Labor, this week is Labor Rights Week: “ All workers in the United States, regardless of where they’re from, have the same right to a safe and healthful workplace and full payment of wages earned under federal law.”
• The influenza vaccine for the 2021 – 2022 flu season has been released by the FDA and is available for distribution by manufacturers! It is time to consider encouraging your workers to be vaccinated for the flu!
• The FDA released the results from its first survey of PFAS in nationally distributed processed foods (including some processed baby foods). While 164 of 167 foods did not have detectable levels of PFAS, three food samples contained detectable levels, including fish sticks, canned tuna, and protein powder. However, based on current data and information, none of these foods have levels that would necessitate avoidance.

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Considering a Vaccine Mandate? New Research says Consider Natural Immunity as Well

As more studies are conducted, scientists are finding that naturally acquired immunity (i.e., having had the virus) can provide protection against COVID-19 and its variants, including Delta. A recent large Israeli study has demonstrated that the natural immunity provides strong protection against infection. The same study also finds that being vaccinated following natural infection provides even greater protection. The Israeli study is consistent with findings published by Cleveland Clinic earlier this year, which also has been recently supplemented with advice that all, including those who have been previously infected, be vaccinated.

A critical aspect of this, as also emphasized in a Science article on the Israeli study, is the focus on those who have been previously infected, in no way advocating intentional infection because of the associated risk, including that of death, from infection.

Additionally, the scientists from both studies advocate for vaccination for those previously infected, and additional studies (cited in Science) have shown that the immune systems of people who develop natural immunity then get vaccinated produce “exceptionally broad and potent antibodies against the coronavirus.”

​Given these study findings, as businesses consider vaccine mandates to reduce the risk of workplace transmission, it’s important to consider naturally conferred immunity as well. As the science continues to evolve, considering people who may be vaccine hesitant and already infected as having vaccine-comparable immunity is something to consider as companies calculate their overall vaccination or immunity rates. If an employer’s goal is to limit the risk of transmission in the workplace, considering both vaccine induced and naturally acquired immunity, especially in vaccine hesitant populations, may be useful. However, continuing to encourage, incentivize, or even facilitate vaccines for workers is still strongly recommended.  It’s also important to develop flexible policies that adapt to changing science as we’ve seen with the recent recommendations regarding vaccine boosters.  If new research shows waning protection from naturally acquired immunity, vaccines may be the safest way to provide ongoing protection against future infection.

• In last Thursday’s Recommendations for Industry, we discussed businesses continuing to follow COVID protocols into 2022 and looked at TAG’s weekly Risk Matrix. Read more here.
• Johnson & Johnson has released that a COVID-19 booster of its vaccine could lead to a ninefold increase in antibodies [Helio].
• The CDC, in a recent MMWR, has announced that unvaccinated individuals are five times more likely to get COVID-19 and 29 times more likely to be hospitalized for COVID-19.
• A recent study from the University of North Carolina’s Health Care further accentuates the ease by which COVID-19 spread amongst households (especially as close contacts). The majority of COVID-19 secondary infections (close contacts) occurred within the first week of the primary contact’s positive test!
• While hospitalizations have increased among those that are younger, much of U.S. COVID-19 deaths are driven by unvaccinated seniors having acquired the Delta variant.