Vaccine Hesitancy – Did the Bubble of Fear Burst?

November 18, 2022

Natural Immunity Provides Far Better Protection than Was Previously Thought and Creates Vaccine Hesitancy

By specialist in general medicine (GP) Claus Hancke, MD, FACAM, physiotherapist Michael Schultz, PT, and statistician Max Schmeling.

Are you afraid of viruses? Of another shot? Need a booster? Are you in doubt?

Decades of studies now show that there may be no reason to be so afraid of viruses.

In 2008, researchers made an astonishing observation in human blood 196. It was investigated whether 32 elderly people, born in or before 1915, had been infected with the 1918 Flu, the “Spanish Flu”.

What was found in the blood? Well, all of them had remnants of the virus from 1918, and 7 even had memory cells that could still activate antibodies against the virus. This is a sign of lifelong immunity.

These findings conflict with the narrative we have been given that natural immunity after infection is short-lived.

During the first wave of Covid-19, the concept of natural infection immunity was downplayed, and artificial vaccine immunity was in focus 134.

In terms of health policy, vaccine immunity was even attributed a longer duration than the natural infection immunity, even though it’s actually the other way around.

Those in power wanted to create fear in the population in order to motivate us to comply with restrictions and vaccination.

Officially, the repetitive message was that “we are only protected for 5 months after infection” 220 and “unvaccinated people live a dangerous life” 1.

However, this goes against solid scientific data! Therefore, we have found it necessary to document the effect of infection immunity based on the largest collection of literature on the subject known to us, over 200 recognized studies.

A Danish state funded fact-checking media1 has also, unsuccessfully, tried to get the Danish Health Authorities to document their claim about “the dangerous unvaccinated life”.

It has always been possible to find virus residues in humans, because we are constantly exposed to viruses without getting sick. This is nothing new. What’s new is that we have started to “name” variants and now suddenly have to fear something that has always happened.

But is this really justified?

In this article, we will demystify the horror stories we were told, hoping that we will never again experience such a disproportionate, unreasonable, expensive, and socially harmful 55, 218 panic reaction that we’ve had to endure.

The Studies
3 decades of studies show that natural infection immunity is long-lasting 2, 19, 25, 47, 54, 64, 72, 74, 102, 103, 109, 113, 143, 151, 155, 170, 178, 179, 190, 248, often lifelong 151, 196, stronger 2, 4, 16, 19, 23, 29, 41, 53, 62, 63, 64, 75, 81, 97, 109, 112, 127, 135, 154, 155, 185, 218, 233, 235, 240, 243, and broader 30, 53, 59, 59, 84, 94, 121, 154, 156, 162, 168, 171, 192, 218, 219 than artificial vaccine immunity 245, 249. This means that we are also protected against severe symptoms, in case of infection with variants or related viruses 197, 246. Some studies show at least 15 – 22 months of immunity 3, 15, 50, 19, 112, 241, 247 from the first Covid cases. Others show immunity 17 years after infection with SARS-CoV-1 6, 53, 139, 170, 178.

A study in 12 million subjects showed a “small risk” of new infection after the first infection11 due to natural immunity. Studies falsely consider positive PCR tests in healthy people as “disease cases” 42. This is nonsense when they are not sick. Eighty percent of those infected with SARS-CoV-2 do not develop disease 213.

Immunity is the body’s response to infection and ensures none or mild symptoms the next time we encounter the same or a similar virus 231, 232. When you are immune, you can be infected, but you do not get ill 9, 78, 118, and you rarely infect others 34, 122, 137, 141. A positive test does not mean that you are sick or can infect other people, and vaccines do not prevent infection either, despite what the authorities claim.

Studies show that previously infected people are better protected when they encounter the virus again than vaccinated people who encounter it the first time 4, 6, 41, 71, 77, 81, 119, 127, 135. Infection provides effective 118, 127, 130, 153, 154 and longer-lasting protection against both primary strains and variants than vaccines do, potentially lifelong protection and long enough to ensure mild or symptom-free infection the following year.

It should be remembered that infection does not only occur from contact and droplets (from a distance of 7-8 meters / 23-26 feet) from coughing or sneezing. The virus particles are so small that they are airborne, so-called aerosols, and float around the air indoors for hours199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, e.g. in a supermarket. They have a size of only approx. 0.002 mm in diameter 200, 205 and therefore masking or distancing doesn’t stop them from entering your body. As such, we are exposed to viruses whether we want to or not.

The common cold provides non-specific protection (cross-immunity) against Covid symptoms 13, 20, 25, 36, 52, 86, 87, 89, 91, 99, 102, 103, 120, 141, 159, 166, 167, 170, 175, 177, 179, 180, 184, 187, 189, 194, 197.

Eighty to ninety percent 87, 116 of the general population are fully or partially immune without previous SARS-CoV-2 infection, even if testing negative for antibodies 86, 107, 139, 144, 151, 170, 189, 192. Studies show that vaccination can impact the immune system negatively 6, 8, 53, 111, 221, 222, 223, 224, 230.

Overall, the studies show that natural infection immunity is broader, stronger, and longer-lasting than artificial vaccine immunity, because the memory cells mature correctly and optimally during and after infection 22, 36, 47, 62, 105, 130, 192, and therefore activate antibodies better and faster 84, 238 than after vaccination 120, 130, 150, 161, 192, 197.

We are constantly infected and immunized, the virus mutates, we are then infected with the variant and get no or only mild symptoms, depending on the individual nutritional health 215, 217, 244 and the degree of mutation of the virus. It is important for the physical resilience of the population that the healthy individuals are immunized naturally, whereby the weak individuals are automatically protected as well.

If we interrupt the continuous exposure to infection by distancing, we will be at risk when society reopens, because we will suddenly and abruptly encounter many new variants, to which we have no immunity.

The Elderly
Studies show a greater risk of variant infection for one month after vaccination in those vaccinated, especially in nursing home residents and addicts with lifestyle diseases17.

Instead of a one-sided focus on vaccines, prevention should also include prevention of immune weakening, which can often be solved easily and at a low cost.

A study found that immunity in the elderly against recognized viruses is good, but worse against new ones 90. This suggests that the elderly should be in mutual contact for as long as possible throughout their lives, as a wide range of viruses continuously stimulate their immune system. It also speaks against physical distancing, since avoiding the virus in one season will result in it hitting harder the following year. This was clearly seen in the mortality trajectory in Denmark and Sweden in 2020-2021 and in Australia this year.

The chief epidemiologist of Sweden, A. Tegnell, assessed the danger of Covid to be low, and his advice to the politicians to not shut down Sweden ensured rapid infection immunity in the population.

Sweden coped well with the pandemic. This despite having 15% more >80-year-olds229 and twice as many dark-skinned immigrants 225, 226 (with a reduced ability to produce enough vitamin D in our latitudes) as in Denmark.

Sweden’s relative number of deaths with Covid-19 in 2020-21 matches, without lockdowns, that of Denmark 227.

Vitamin D
It is well-documented that vitamin D is necessary for normal infection processes. It is easy and cheap to remedy the deficiency and thus immune weakening of the elderly and dark-skinned people. This was demonstrated through 60 years of international research. In a 2016 public television documentary it was estimated that vitamin D deficiency costs Denmark 30 billion DKK annually 228 (= 4 billion USD)

Antiviral vitamins and minerals do not cure or prevent Covid, but they can normalize, relieve, and shorten the illness 244, 250. Deficiencies are potentially dangerous and should be eliminated as they are widespread, even in Denmark.

A new large meta-analysis 215 shows that a 3-fold increase in vitamin D in the blood compared to Danish recommendations will lower the already low Covid mortality to, theoretically, zero.

A Superweapon?
Instead of blindly trusting vaccines as “superweapons”, we should remember that we have an effective, natural immune defense when the body is otherwise functioning normally 217. In future epidemics, immunodeficiency due to vitamin deficiency should be minimized. Immunity is more than infection and vaccines 61, 250. Our nutritional health and lifestyle also affect our resilience.

Simple cheap prevention works not only on immunity but is broadly preventative against a number of diseases and must be promoted with campaigns.

Furthermore, people’s own possibilities for natural prevention should never again 134, 236 be neglected or obstructed.

Finally, socially harmful distancing policies and lockdowns should be avoided, unless a pandemic of an extremely dangerous disease occurs, which neither Covid nor Influenza is.

*     *     *     *     *

Conflicts of interest: None.

Literature- and source overview:

1) Lever uvaccinerede unge livet farligt? Det mener Søren Brostrøm, men forskere maner til besindighed
(Do unvaccinated young people lead dangerous lives? Søren Brostrøm thinks so, but researchers urge caution.)

2) Pilz et al: SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity. Environmental Research, 2022, Feb. 2022 Jun; 209: 112911.
”Risk of hospitalizations and deaths was also reduced in SARS-CoV-2 reinfections versus primary infections. Observational studies indicate that natural immunity may offer equal or greater protection against SARS-CoV-2 infections compared to individuals receiving two doses of an mRNA vaccine, but data are not fully consistent. The combination of a previous SARS-CoV-2 infection and a respective vaccination, termed hybrid immunity, seems to confer the greatest protection against SARS-CoV-2 infections, but several knowledge gaps remain regarding this issue. Natural immunity should be considered for public health policy regarding SARS-CoV-2”.

3) Alejo et al: Prevalence and Durability of SARS-CoV-2 Antibodies Among Unvaccinated US Adults by History of COVID-19. JAMA, 2022, March, 15;327(11):1085-1087.
“Although evidence of natural immunity in unvaccinated healthy US adults up to 20 months after confirmed COVID-19 infection is encouraging, it is unclear how these antibody levels correlate with protection against future SARS-CoV-2 infections”.

4) Cohen et al: Long-term humoral immunity of COVID-19 recovered and BNT162b2 vaccinated individuals: a prospective comparative study. European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2022, Lisbon, 23-26 April)
“While the quantity of antibodies decrease with time in both COVID-19 recovered patients and vaccinated individuals, the quality of antibodies increases following infection but not after vaccination. Obese individuals have a significantly higher and sustained humoral response following infection. These results provide specific characteristics of the immune response that may explain the differential protection against COVID-19 in previously infected and vaccinated individuals”.

5) Willyard et al: What the Omicron wave is revealing about human immunity. Nature, 602, 22-25 (2022)
”A drop in antibody levels after infection is normal. What immunologists really want to know is where – or whether – the decline will stop. In April 2020, Ahmed and his team began studying people who had recovered from COVID-19. The scientists found that those people’s antibody levels dropped quickly for the first two or three months after infection. But then, after about four months, the researchers saw the curve start to flatten. They have published results on the first eight months, but now have data up to 450 days, and Ahmed is encouraged by what they see. So far, “looking at the shape of the curve, it looks pretty damn good”, he says. “It is really quite stable”.

6) Kojima et al: Protective immunity after recovery from SARS-CoV-2 infection. The Lancet Infectious Disesases, 2022 Jan; 22(1): 12–14.
“Some people who have recovered from COVID-19 might not benefit from COVID-19 vaccination. In fact, one study found that previous COVID-19 was associated with increased adverse events following vaccination with the Comirnaty BNT162b2 mRNA vaccine (Pfizer–BioNTech). In addition, there are rare reports of serious adverse events following COVID-19 vaccination. In Switzerland, residents who can prove they have recovered from a SARS-CoV-2 infection through a positive PCR or other test in the past 12 months are considered equally protected as those who have been fully vaccinated.
Although longer follow-up studies are needed, clinicians should remain optimistic regarding the protective effect of recovery from previous infection. Community immunity to control the SARS-CoV-2 epidemic can be reached with the acquired immunity due to either previous infection or vaccination… Given the evidence of immunity from previous SARS-CoV-2 infection, however, policy makers should consider recovery from previous SARS-CoV-2 infection equal to immunity from vaccination for purposes related to entry to public events, businesses, and the workplace, or travel requirements.
Researchers have also found that people who recovered from SARS-CoV infection in 2002–03 continue to have memory T cells that are reactive to SARS-CoV proteins 17 years after that outbreak. Additionally, a memory B-cell response to SARS-CoV-2 evolves between 1·3 and 6·2 months after infection, which is consistent with longer-term protection.
We reviewed studies published in PubMed from inception to September 28, 2021 and found well-conducted biological studies that demonstrated protective immunity after infection. Furthermore, multiple epidemiological and clinical studies, including studies during the recent period of predominantly delta (B.1.617.2) variant transmission, found that the risk of repeat SARS-CoV-2 infection decreased by 80·5–100% among those who had had COVID-19 previously (panel). The reported studies were large and conducted throughout the world. Another laboratory-based study that analysed the test results of 9119 people with previous COVID-19 from Dec 1, 2019, to Nov 13, 2020, found that only 0·7% became reinfected”.

7) Qureshi et al.: Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Patients Undergoing Serial Laboratory Testing. Clinical Infectious Diseases, 2022 Jan 15; 74(2): 294–300.
“We identified a low rate of reinfection confirmed by laboratory tests in a large cohort of patients with SARS-CoV-2 infection. Although reinfection appeared to be milder than primary infection, there was associated mortality… Reinfection was identified in 0.7% (n = 63, 95% CI: .5%–.9%) of the patients…
Due to concerns for reinfection, the Centers for Disease Control and Prevention [54] currently recommends vaccination for patients who had SARS-CoV-2 infection after 90 days but acknowledges that limited data available to support the recommendation”.

8) Seneff and McColluch et al.: Innate Immune Suppression by SARS-CoV-2 mRNA Vaccinations: The role of G-quadruplexes, exosomes and microRNAs. Food and Chemical Toxicology, 2022 Jun;164:113008.
“The mRNA SARS-CoV-2 vaccines were brought to market in response to the widely perceived public health crises of Covid-19. The utilization of mRNA vaccines in the context of infectious disease had no precedent, but desperate times seemed to call for desperate measures. The mRNA vaccines utilize genetically modified mRNA encoding spike proteins. These alterations hide the mRNA from cellular defenses, promote a longer biological half-life for the proteins, and provoke higher overall spike protein production. However, both experimental and observational evidence reveals a very different immune response to the vaccines compared to the response to infection with SARS-CoV-2. As we will show, the genetic modifications introduced by the vaccine are likely the source of these differential responses. In this paper, we present the evidence that vaccination, unlike natural infection, induces a profound impairment in type I interferon signaling, which has diverse adverse consequences to human health. We explain the mechanism by which immune cells release into the circulation large quantities of exosomes containing spike protein along with critical microRNAs that induce a signaling response in recipient cells at distant sites. We also identify potential profound disturbances in regulatory control of protein synthesis and cancer surveillance. These disturbances are shown to have a potentially direct causal link to neurodegenerative disease, myocarditis, immune thrombocytopenia, Bell’s palsy, liver disease, impaired adaptive immunity, increased tumorigenesis, and DNA damage. We show evidence from adverse event reports in the VAERS database supporting our hypothesis. We believe a comprehensive risk/benefit assessment of the mRNA vaccines excludes them as positive contributors to public health, even in the context of the Covid-19 pandemic”.

9) Hancke et al.: Analyse af Covid-19 situationen (Analysis of the Covid-19 situation), Vitalrådet, 2022 Jan.
”In terms of danger compared to flu, there is not much difference. The Delta variant seems to be like a severe flu for a few percent where it settles in the lower respiratory tract. It does not infect a large part of the population, but has roughly the same mortality rate as influenza.
The Omikron variant spreads significantly faster than the delta variant and influenza with a doubling time of 1.2 days. On the other hand, it is significantly milder, settles mainly only in the upper respiratory tract and has meant a large decrease in the need for hospitalization and intensive treatment, just as mortality is very low, almost insignificant.
There seems to be a fundamental biological misconception behind the development of vaccines if the idea was that they should be “a superweapon” to stop an epidemic, let alone a pandemic.
The vaccines do not protect against infection or re-infection, but provide a declining protection against serious illness and death for just over 3 months.

But after 3-4 months, the vaccine effect is directly negative for Omikron, so that the risk of becoming infected is 76% greater than if you have not been vaccinated at all. In terms of infection, the vaccines have no effect on the Omikron variant, which removes any argument for vaccinating children. Furthermore, the available data show that reinfection occurs mainly in vaccinated and not in persons with natural immunity after Covid-19”.

10) Altarawneh et al.: Protection afforded by prior infection against SARS-CoV-2 reinfection with the Omicron variant. New England Journal of Medicine, 2022 March 2022; 386:1288-1290.
“PES (prior infection in preventing reinfection) against symptomatic reinfection was estimated at 90.2% (95% CI: 60.2-97.6) for Alpha, 84.8% (95% CI: 74.5-91.0) for Beta, 92.0% (95% CI: 87.9-94.7) for Delta, and 56.0% (95% CI: 50.6-60.9) for Omicron. None progressed to critical or fatal COVID-19. Protection afforded by prior infection in preventing symptomatic reinfection with Alpha, Beta, or Delta is robust, at about 90%. While such protection against reinfection with Omicron is lower, it is still considerable at nearly 60%. Prior-infection protection against hospitalization or death at reinfection appears robust, regardless of variant”.
New England Journal of Medicine:
“Overall, in a national database study in Qatar, we found that the effectiveness of previous infection in preventing reinfection with the alpha, beta, and delta variants of SARS-CoV-2 was robust (at approximately 90%), findings that confirmed earlier estimates. Such protection against reinfection with the omicron variant was lower (approximately 60%) but still considerable. In addition, the protection of previous infection against hospitalization or death caused by reinfection appeared to be robust, regardless of variant.

11) Chivese et al.: The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis, Pathogens and Global Health, 2022 Jul;116(5):269-281
“Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection”.

12) A. Sigal: Milder disease with Omicron: is it the virus or the pre-existing immunity? Nature reviews Immunology, 2022 Jan, pages 69–71 (2022)
”Is Omicron infection really milder than Delta, or have the populations that Omicron is infecting built up enough immunity so that the disease course will be milder with any variant of SARS-CoV-2? There is support for both scenarios”.

13) Kundu et al.: Cross-reactive memory T cells associate with protection against SARS-CoV-2 infection in COVID-19 contacts, Nature Communications, 2022 Jan, 2022; 13: 80.
“We observe higher frequencies of cross-reactive (p = 0.0139), and nucleocapsid-specific (p = 0.0355) IL-2-secreting memory T cells in contacts who remained PCR-negative despite exposure…
Our results are thus consistent with pre-existing non-spike cross-reactive memory T cells protecting SARS-CoV-2-naïve contacts from infection…”

14) Rahman et al.: COVID-19 reinfections among naturally infected and vaccinated individuals, Scientific Reports volume 12, 2022 Jan, Article number: 1438
“Naturally infected populations were less likely to be reinfected by SARS-CoV-2 than the infection-naïve and vaccinated individuals. Although, reinfected individuals did not suffer severe disease, a remarkable proportion of naturally infected or vaccinated individuals were (re)-infected by the emerging variants”.
(”Naturligt inficerede populationer var mindre tilbøjelige til at blive reinficeret med SARS-CoV-2 end de uden tidligere infektion og vaccinerede individer. Selvom reinficerede individer ikke led af alvorlig sygdom, blev en bemærkelsesværdig andel af naturligt inficerede eller vaccinerede individer (re)inficeret af de nye varianter”.)

15) Rivelli et al,: Incidence of COVID-19 reinfection among Midwestern healthcare employees, PLOS ONE, 2022 Jan., doi: 10.1371/journal.pone.0262164

“This study supports the consensus that COVID-19 reinfection, defined as subsequent infection ≥ 90 days after prior infection, is rare, even among a sample of healthcare workers with frequent exposure”.

16) León et al.: COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status and Previous COVID-19 Diagnosis – California and New York, May-November 2021.  Morbidity and Mortality Weekly Report (MMWR), 2022 Jan 28;71(4):125-131.
“Importantly, infection-derived protection was higher after the Delta variant became predominant, a time when vaccine-induced immunity for many persons declined because of immune evasion and immunologic waning”.

17) Hollinghurst et al.:COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021. Age and Ageing, 2022 Jan; 51(1): afab223.
”COVID-19 infection risk amongst 14,104 vaccinated care home residents… Increased risk of infection after 21 days was associated with frailty. We found most infections occurred within 28 days of vaccination, suggesting extra precautions to reduce transmission risk should be taken in this time frame”.

18) Spizer et al.: Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Corona-virus-2 (SARS-CoV-2) – Kentucky, USA, 2020. International Journal of Infectious Diseases, 2022 Jan; 114: 21–28.
“Natural infection provides substantial and persistent immunologic protection for a period of several months for most individuals”.

19) Mobaraki et al.: Long-Term Persistence of IgG Antibodies in recovered COVID-19 individuals at 18 months and the impact of two-dose BNT162b2 (Pfizer-BioNTech) mRNA vaccination on the antibody response. MedRxiv, 2022.01.18.22269349 (pre-print)
“At 18 months, 97% participants tested positive for anti-NCP (anti-nucleocapsid protein) hinting towards the persistence of infection-induced immunity even for the vaccinated individuals. Our study findings demonstrate that while double dose vaccination boosted the IgG titers in recovered individuals 161 times, this “boost” was relatively short-lived. The unvaccinated recovered individuals, in contrast, continued to show a steady decline but detectable antibody levels”.

20) Wang et al.: Exposure to SARS-CoV-2 generates T-cell memory in the absence of a detectable viral infection. Nature Communications, 2021 Mar; 12: 1724
“In summary, by examining a substantial number of clinical samples, we determined the SARS-CoV-2-specific memory T-cell immunity in COVID-19 patients with various clinical symptoms. Despite some subtle differences, most patients developed measurable amounts of SARS-CoV-2-specific CD4+ and CD8+ memory T cells which were stably maintained between 48–86 days after convalescence. Importantly, our discovery of the presence of significant levels of SARS-CoV-2-specific memory T-cell immunity in a group of individuals (close contacts) who were exposed to but not infected by the virus highlights some unique characteristics in the dynamic interactions between SARS-CoV-2 and its human host. Although cross-reactive memory T cells were present in healthy donors who had never been exposed to SARS-CoV-2, their role in host protection needs to be thoroughly investigated as they were hardly able to proliferate”.

21) Laidlaw et al.: The germinal centre B cell response to SARS-CoV-2. Nature Reviews Immunology, 2022; 22(1): 7–18
“One central question is whether additional ‘booster’ vaccines expressing mRNA from variant strains will be necessary to induce a B cell response with sufficient breadth and affinity to neutralize future SARS-CoV-2 variants. While the administration of a third vaccine dose of the same formulation will likely result in an increase in antibody titres, it is unlikely to profoundly alter the specificity of the memory B cell response…

SARS-CoV-2 vaccines are administered intramuscularly and therefore are unlikely to induce sufficient levels of antigen expression or inflammation in mucosal tissues to support a local GC response. In the absence of a mucosal B cell response, protection from reinfection will be reliant on maintaining a high enough titre of circulating antibodies to neutralize viruses that infect the airways…

Relatedly, understanding how the SARS-CoV-2-specific IgA response differs between vaccinated and infected individuals will be important going forwards. The serum IgA response rapidly declines following both SARS-CoV-2 vaccination and SARS-CoV-2 infection and is less potent at neutralizing SARS-CoV-2 than IgG…

However, SARS-CoV-2 infection also elicits a virus-specific IgG, IgA and IgE antibody response in the saliva and bronchoalveolar fluid. Dimeric SARS-CoV-2-specific IgA, the primary form of IgA present in the nasopharynx, has an enhanced ability to neutralize the virus compared with IgG and may have an important role in preventing reinfection. While it is not known whether SARS-CoV-2 vaccination induces a mucosal IgA response in humans, intramuscular vaccination of mice drove a minimal mucosal IgA response and was not as good at mediating viral clearance at mucosal sites as intranasal vaccination”.

22) Lindsley et al.: Understanding memory B cell selection. Journal of Theoretical Biology. 2021 Dec 21; 531:110905
“A core aspect of the adaptive immune system’s humoral response is training two types of B cells through a process called affinity maturation (AM): plasma B cells which generate antibodies to identify the current antigen, and memory B cells which are used in subsequent immune responses to identify similar antigens in the future. The AM process is highly unusual, in that a specific region of DNA within participating B cells is mutated to generate offspring which are selected to have higher affinity to the antigen in question. The preservation of DNA sequences is usually of utmost importance in most cells, but the region of the genome which defines the shape of the B cell receptor must be rapidly modified for the B cell receptor to have a chance of becoming better at recognizing the antigen of interest (Meyer-Hermann et al., 2012). These mutations are responsible for the B cells’ incredible ability to recognize practically any antigen that they are presented, making the mammalian adaptive immune system one of the most effective learned identification systems in the natural world”.

23) Goldberg et al.: Protection and waning of natural and hybrid COVID-19 immunity. The New England Journal of Medicine, 2022 Jun 9;386(23):2201-2212.
“Protection from reinfection decreases with time since previous infection, but is, nevertheless, higher than that conferred by vaccination with two doses at a similar time since the last immunity-conferring event.”

24) Dowell et al.:Children develop robust and sustained cross-reactive spike-specific immune responses to SARS-CoV-2 infection. Nature Immunology, 2021 Dec., Nature Immunology; 23(1): 40–49.
“Importantly, children retained antibody and cellular responses 6 months after infection, whereas relative waning occurred in adults. Spike-specific responses were also broadly stable beyond 12 months. Therefore, children generate robust, cross-reactive and sustained immune responses to SARS-CoV-2 with focused specificity for the spike protein. These findings provide insight into the relative clinical protection that occurs in most children and might help to guide the design of pediatric vaccination regimens”.

25) Milne et al.: Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity? The Lancet Respiratory Medicine, 2021 Dec; 9(12): 1450–1466
“SARS-CoV-2 infection elicits an adaptive immune response against a large breadth of viral epitopes, although the duration of the response varies with age and disease severity… Current evidence from case studies and large observational studies suggests that, consistent with research on other common respiratory viruses, a protective immunological response lasts for approximately 5–12 months from primary infection”.

26) Adamo et al.: Signature of long-lived memory CD8+ T cells in acute SARS-CoV-2 infection. Nature, 2022; 602(7895): 148–155.
“Here, using spectral flow cytometry combined with cellular indexing of transcriptomes and T cell receptor sequencing, we longitudinally characterized individual SARS-CoV-2-specific CD8+ T cells of patients with COVID-19 from acute infection to 1 year into recovery and found a distinct signature identifying long-lived memory CD8+ T cells… Collectively, we describe a transcriptional signature that marks long-lived, circulating human memory CD8+ T cells following an acute viral infection”.

27) Saade et al.: Live virus neutralization testing in convalescent patients and subjects vaccinated against 19A, 20B, 20I/501Y.V1 and 20H/501Y.V2 isolates of SARS-CoV-2. Emerging Microbes & Infections, 2021; 10(1): 1499–1502.
“However, a significant decrease in neutralization ability was found for 20I/501Y.V1 in comparison with 19A isolate for critical patients and HCWs 6-months post infection. Concerning 20H/501Y.V2, all populations had a significant reduction in neutralizing antibody titers in comparison with the 19A isolate. Interestingly, a significant difference in neutralization capacity was observed for vaccinated HCWs between the two variants but not in the convalescent groups”.

28) A. Israel et al.: Large-Scale Study of Antibody Titer Decay following BNT162b2 mRNA Vaccine or SARS-CoV-2 Infection. Vaccines (Basel), 2022 Jan; 10(1): 64.
“This study demonstrates individuals who received the Pfizer-BioNTech mRNA vaccine have different kinetics of antibody levels compared to patients who had been infected with the SARS-CoV-2 virus, with higher initial levels but a much faster exponential decrease in the first group”.

29) Almendro-Vázquez et al.: Longitudinal dynamics of SARS-CoV-2-specific cellular and humoral immunity after natural infection or BNT162b2 vaccination. PLOS Pathogens, 2021 Dec; 17(12): e1010211
”Three months post-vaccination, the cellular response was comparable, while the humoral response was consistently stronger, to that measured in COVID-19 recovered patients. Thus, measurement of both humoral and cellular responses provides information on prognosis and protection from infection, which may add value for individual and public health recommendations”.

30) S. Sureshchandra et al.: Single-cell profiling of T and B cell repertoires following SARS-CoV-2 mRNA vaccine. JCI Insight, 2021 Dec 22; 6(24): e153201
”Natural infection induced expansion of larger CD8 T cell clones occupied distinct clusters, likely due to the recognition of a broader set of viral epitopes presented by the virus not seen in the mRNA vaccine. Our study highlights a coordinated adaptive immune response where early CD4 T cell responses facilitate the development of the B cell response and substantial expansion of effector CD8 T cells, together capable of contributing to future recall responses”.

31) A. Haveri et al.: Persistence of neutralizing antibodies a year after SARS‐CoV‐2 infection in humans. European Journal of Immunology, 2021 Dec; 51(12): 3202–3213.
“We found that NAb (Neutralizing Anti bodies, red.) against the WT (Wild Type) virus persisted in 89% and S-IgG in 97% of subjects for at least 13 months after infection”.

32) Keeton et al.: SARS-CoV-2 spike T cell responses induced upon vaccination or infection remain robust against Omicron. Nature, 2022; 604(7907): E25.
“These results demonstrate that despite Omicron’s extensive mutations and reduced susceptibility to neutralizing antibodies, the majority of T cell response, induced by vaccination or natural infection, cross-recognises the variant. Well-preserved T cell immunity to Omicron is likely to contribute to protection from severe COVID-19, supporting early clinical observations from South Africa.”
“Overall, our data show that unlike neutralizing antibodies, the SARS-CoV-2 T cell responses generated upon vaccination or previous infection are highly cross-reactive with Omicron”.

33) Chemaitelly et al.: Efficacy of Natural Immunity against SARS-CoV-2 Reinfection with the Beta Variant. New England journal of Medicine, 2021 Dec 15 : NEJMc2110300.
”Protection by previous SARS-CoV-2 infection against reinfection with the beta variant was observed, even 1 year after the primary infection, but protection was slightly lower than that against the alpha variant and wild-type virus circulating in Qatar.3-5 These findings give some insights into the hypothesis that natural immunity may provide protection against known variants of concern”.

34) Z. Lyski et al.: SARS-CoV-2 specific memory B-cells from individuals with diverse disease severities recognize SARS-CoV-2 variants of concern. Journal of Infectious Diseases, 2022 Mar 15;225(6):947-956.
“This finding, that VoC-RBD-reactive MBCs are present in the peripheral blood of all subjects including those that experienced asymptomatic or mild disease, provides a reason for optimism regarding the capacity of vaccination, prior infection, and/or both, to limit disease severity and transmission of variants of concern as they continue to arise and circulate”.

35) N. Kojima et al.: A Systematic Review of the Protective Effect of Prior SARS-CoV-2 Infection on Repeat Infection. Evaluation and The Health Professions, 2021 Dec; 44(4): 327–332.
“The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination”.

36) Ortega et al.: Seven-month kinetics of SARS-CoV-2 antibodies and role of pre-existing antibodies to human coronaviruses. Nature Communications, 2021 Aug.; 12: 4740.
“Impact of pre-existing antibodies to human coronaviruses causing common cold (HCoVs), is essential to understand protective immunity to COVID-19… after the peak response, anti-spike antibody levels increase from ~150 days post-symptom onset in all individuals (73% for IgG), in the absence of any evidence of re-exp
Thus, pre-existing cross-reactive HCoVs antibodies could have a protective effect against SARS-CoV-2 infection and COVID-19 disease.,, Strong correlations were found between antibody neutralization capacity and the days PSO, as identified in the previous literature…, in accordance with the antibody affinity increase after the maturation of the immune response”.

37) S. Mahajan et al.: Immunodominant T-cell epitopes from the SARS-CoV-2 spike antigen reveal robust pre-existing T-cell immunity in unexposed individuals. Scientific Reports, 2021 June; 11: 13164.
“Our findings suggest that SARS-CoV-2 reactive T-cells are likely to be present in many individuals because of prior exposure to flu and CMV viruses (Cytomegalovirus, red.)”.

38) B. Mizrahi et al.: Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine. Nature Communications, 2021 Nov; 12: 6379.
“After controlling for potential confounders as age and comorbidities, we found a significant 1.51 fold (95% CI, 1.38–1.66) increased risk for infection for early vaccinees compared to those vaccinated later that was similar across all ages groups. The increased risk reached 2.26- fold (95% CI, 1.80–3.01) when comparing those who were vaccinated in January to those vaccinated in April. This preliminary finding of vaccine waning as a factor of time from vaccine should prompt further investigations into long-term protection against different strains”.

39) S. Andeweg et al.: Increased risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variant compared to Alpha variant in vaccinated individuals. Science Translational Medicine, 2022 Jul 21; eabn4338
”I modsætning til vaccine-induceret immunitet blev der ikke fundet nogen øget risiko for reinfektion med Beta-, Gamma- eller Delta-varianter i forhold til Alpha-varianten hos individer med infektionsinduceret immunitet”.

40) L. Abu-Raddad et al.: Severity of SARS-CoV-2 Reinfections as Compared with Primary Infections. New England Journal of Medicine, 2021 Nov 24: NEJMc2108120.
“Reinfections had 90% lower odds of resulting in hospitalization or death than primary infections. Four reinfections were severe enough to lead to acute care hospitalization. None led to hospitalization in an ICU, and none ended in death. Reinfections were rare and were generally mild, perhaps because of the primed immune system after primary infection”.

41) R. Satwik et al.: ChAdOx1 nCoV-19 effectiveness during an unprecedented surge in SARS COV-2 infections.
European Journal of Internal Medicine, 2021 Nov; 93: 112–113.
“The third key finding is that previous infections with SARS-CoV-2 were significantly protective against all studied outcomes, with an effectiveness of 93% (87 to 96%) seen against symptomatic infections, 89% (57 to 97%) against moderate to severe disease and 85% (-9 to 98%) against supplemental oxygen therapy. All deaths occurred in previously uninfected individuals. This was higher protection than that offered by single or double dose vaccine”.

42) B. Sciscent et al.: COVID-19 reinfection: the role of natural immunity, vaccines, and variants. Journal of Community Hospital Internal Medicine Perspectives, 2021; 11(6): 733–739.
“The definition of reinfection has been interpreted differently across many studies. The Centers for Disease Control defined reinfection as an infection in the same individual across a different time period with evidence of genotypic variance, i.e., infection in an individual with two different viral strains within ≥45 days in highly suspicious cases of COVID-19 or ≥90 days in asymptomatic cases or in cases with low suspicion[3].
The above model also takes into consideration cycle threshold values less than or equal to 35[9]. Many other studies define reinfection as two positive SARS-CoV-2 RT-PCR tests with negative tests in between without taking the genotypic variation into account.
Hall et al. reported that the prior history of SARS-CoV-2 is associated with an 83% lower risk of reinfection and that the protective effect may last for 5 months[10]. In a large population study done in Denmark by Hansen et al., protection against repeat infection was deemed to be 80.5% in the general population and 47.1% in patients 65 years or older[11].
However, this study defined reinfection differently. Here, the authors included people who were tested with COVID-19 RT-PCR during the first surge before June 2020 and followed the cohort from September to December 2020 to analyze SARS-CoV-2 contraction[11].
Abu-Raddad et al. studied the efficacy of natural infection against reinfection, which was accounted for by a change in viral genome sequencing. This study found that the rate of reinfection was estimated to be 95.2%”.

43) A. Jeffrey-Smith et al.: SARS-CoV-2–specific memory B cells can persist in the elderly who have lost detectable neutralizing antibodies. The Journal of Clinical Investigation, 2022 Jan 18;132(2):e152042
“Our findings demonstrate that a reserve of SARS-CoV-2–specific MBCs persists beyond the loss of nAbs…
In conclusion, by focusing on an elderly cohort with a high proportion of nAb loss, we demonstrated that this waning in the first line of humoral defense could be compensated by the presence of a reserve of adaptive B cell memory in the majority of cases. Our findings highlight the importance of including measures of B cell memory in larger studies of natural infection and vaccination to determine their role as additional correlates of protection.

Our data underscore the idea that identifying antigen-specific B cells by tetramer antigen staining is useful for quantitation and thorough ex vivo characterization, but may not necessarily equate with the preservation of a functional response, in line with discrepancies between the frequency and function of MBCs described in chronic viral infection).
The relative preservation of IgA antigen–specific MBCs in those with waned serum nAb raises the possibility that mucosal sequestered immunity may outlast that which is detectable in the circulation. Increased expansion of activated MBCs in the elderly highlights the need to investigate whether these cells are more prone to prolonged stimulation from persistent reservoirs of SARS-CoV-2 antigen.”

44) Kojima et al.: A Systematic Review of the Protective Effect of Prior SARS-CoV-2 Infection on Repeat Infection. Evaluation and The Health Professions 2021 Dec; 44(4): 327–332.
“We identified 1,392 reports. Of those, 10 studies were eligible for our systematic review. The weighted average risk reduction against reinfection was 90.4% with a standard deviation of 7.7% (p-value: <0.01). Protection against SARS-CoV-2 reinfection was observed for up to 10 months. Studies had potential information, selection, and analysis biases. The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination”.

45) Sarraf et al.: Immunity to COVID-19 in India through vaccination and natural infection. MedRxiv (pre-print),
“We compared the vaccination induced immune response profile with that of natural infection, evaluating thereby if individuals infected during the first wave retained virus specific immunity…
The overall immune response resulting from natural infection in and around Kolkata is not only to a certain degree better than that generated by vaccination, especially in the case of the Delta variant, but cell mediated immunity to SARS-CoV-2 also lasts for at least ten months after the viral infection”.

46) Abu-Raddah et al.: Assessment of the Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection in an Intense Reexposure Setting. Clinical Infectious Diseases, 2021 Oct 1; 73(7): e1830–e1840.
“SARS-CoV-2 reinfection can occur but is a rare phenomenon suggestive of protective immunity against reinfection that lasts for at least a few months post primary infection”.

47) L. de Campos‐Mata et al.: SARS‐CoV‐2 sculpts the immune system to induce sustained virus‐specific naïve‐like and memory B‐cell responses. Clinical & Translational Immunology, 2021; 10(9): e1339.
”SARS‐CoV‐2 sculpts the immune system to induce sustained virus‐specific naïve‐like and memory B‐cell responses. In summary, our in‐depth characterisation of SARS‐CoV‐2‐specific B‐cell responses revealed a previously unappreciated expansion of virus‐specific naïve‐like B cells over time, perhaps through the continuous mobilisation of mature B‐cell precursors to the periphery. Moreover, our results consolidated previous findings on the immune response dynamics occurring in COVID‐19 patients, showing both transient and long‐lasting changes associated with disease severity and development of immune memory”.

48) Y. Mao et al.: Reinfection rates among patients previously infected by SARS-CoV-2: systematic review and meta-analysis. Chinese Medical Journal, 2022 Jan 20; 135(2): 145–152
“The rate of reinfection with SARS-CoV-2 is relatively low. The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy”.

49) Vimvara Vacharathit et al.: CoronaVac induces lower neutralising activity against variants of concern than natural infection. Lancet, Infectious diseases, 2021 Oct; 21(10): 1352–1354.
CoronaVac induces lower neutralising activity against variants of concern than natural infection
“Overall, the percentage of participants with quantifiable NAb titres (≥20 units) was highest against the WT strain, followed by much lower titres against the alpha, beta, and delta variants (appendix p 5). This pattern was consistently observed in all cohorts, and notably, the percentages of individuals with detectable NAbs were lower in CoronaVac recipients than in the naturally infected cohorts “.

50) J. Wei et al.: Anti-spike antibody response to natural SARS-CoV-2 infection in the general population. Nature Communications, 2021; 12: 6250.
“We estimated antibody levels associated with protection against reinfection likely last 1.5-2 years on average, with levels associated with protection from severe infection present for several years”.

51) J. Vitale et al.: Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy. JAMA Internal Medicine, 2021 Oct; 181(10): 1407–1408
“The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year”.

52) L. Loyal, Drosten et al.:
 Cross-reactive CD4+ T cells enhance SARS-CoV-2 immune responses upon infection and vaccination, Science, 2021 Oct 8;374(6564):eabh1823
”There is mounting evidence that immunological memory after infection with seasonal human coronaviruses (hCoVs) contributes to cross-protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)… Preexisting cross-reactive immunity may be responsible for the unexpectedly rapid induction of protective immunity after primary SARS-CoV-2 immunization and the high rate of asymptomatic and mild COVID-19 disease courses”.

53) H. Banoun: Covid-19: Natural immunity versus vaccine immunity. Qeios, Oct 1, 2021
“Survivors of the 2003 SARS-CoV have cellular immune memory more than 17 years after infection.
Numerous studies have explored humoral (antibody) and cellular immunity to SARS-CoV-2 after Covid-19 infection: it persists for at least one year (and even 14 months) in a robust manner in convalescents and would be of better quality than vaccine immunity: natural antibodies are more potent, have a broader spectrum, and are able to evolve against variants more efficiently than vaccine antibodies.

These in vitro studies are confirmed by the protection against reinfections conferred by a primary infection, particularly in early and highly vaccinated countries such as Israel and the United Kingdom.
Vaccination of a primo-infected person could also decrease the effectiveness of his natural immunity against future reinfections…

These in vitro observations of antibody and memory cell levels are well confirmed by looking for reinfections in convalescents: these are very rare.
Numerous publications (see for bibliography the recent BMJ article16 ) show that the rate of reinfection is very low (less than 1%) following a first infection with SARS-CoV-2. The vast majority of these reinfections are not reinfections as such since they are asymptomatic: they are simply nasal carriage of virus without systemic infection. This is not surprising for a cold virus; the nose is an immune sanctuary where blood antibodies do not circulate.

Natural immunity to Covid-19 (i.e., obtained after natural infection with the virus) is therefore certainly robust and durable.
Work on post-vaccination immunity is mainly concerned with so-called “neutralizing” antibodies in vitro. The levels of these antibodies may not be a good correlate of protection because studies often find higher levels of antibodies after vaccination than after infection. However, reinfections are much more frequent in vaccinated patients than in convalescents. Protection against Covid-19 could rather depend on immune memory (due to memory T and B cells that persist long after infection) and seems to be of better quality than that conferred by vaccines.
In addition, vaccination of convalescent subjects could be risky: more systemic adverse events are observed in convalescent subjects than in naïve subjects after the first dose of vaccine.

Vaccination may decrease the ability to respond to future variants. It could also have a non- specific effect of remodeling the innate immune response by decreasing the potential response to other viruses or to cancers and by modifying the course of inflammatory and autoimmune diseases”.

54) H. Marcotte et al.: Immunity to SARS-CoV-2 up to 15 months after infection. Iscience, 2022 Feb 18; 25(2): 103743.
“SARS-CoV-2-specific memory B and T cells persisted in the majority of patients up to 15 months although a significant decrease in specific T cells, but not B cells, was observed between 6 and 15 months. Antiviral specific immunity, especially memory B cells in COVID-19 convalescent patients, is long-lasting, but some variants of concern may at least partially escape the neutralizing activity of plasma antibodies”.

55) Shenai et al.: Equivalency of Protection From Natural Immunity in COVID-19 Recovered Versus Fully Vaccinated Persons: A Systematic Review and Pooled Analysis. Cureus, 2021 Oct; 13(10): e19102.
“… our review demonstrates that natural immunity in COVID-recovered individuals is, at least, equivalent to the protection afforded by complete vaccination of COVID-naïve populations. There is a modest and incremental relative benefit to vaccination in COVID-recovered individuals; however, the net benefit is marginal on an absolute basis. Therefore, vaccination of COVID-recovered individuals should be subject to clinical equipoise and individual preference”.

56) Giorgi et al.: Naturally Acquired SARS-CoV-2 Immunity Persists for Up to 11 Months Following Infection. Journal of Infectious Diseases, 2021 Oct 15; 224(8): 1294–1304
“Our data suggest that immunological memory is acquired in most individuals infected with SARS-CoV-2 and is sustained in a majority of patients for up to 11 months after recovery”.

57) Zhang et al.: One-year sustained cellular and humoral immunities of COVID-19 convalescents. Clinical infectious Diseases, 2021 Oct 5 : ciab884.
“SARS-CoV-2-specific cellular and humoral immunities are durable at least until one year after disease onset”.

58) E. Callaway: COVID super-immunity: one of the pandemic’s great puzzles. Nature, 2021 Oct;598(7881):393-394.
“Natural infection triggered antibodies that continued to grow in potency and their breadth against variants for a year after infection, whereas most of those elicited by vaccination seemed to stop changing in the weeks after a second dose. Memory B cells that evolved after infection were also more likely than those from vaccination to make antibodies that block immune-evading variants such as Beta and Delta.”

59) A. Cho et al.: Anti-SARS-CoV-2 receptor-binding domain antibody evolution after mRNA vaccination, Nature, 2021; 600(7889): 517–522.
”Coronavirus 2 (SARS-CoV-2) infection produces B cell responses that continue to evolve for at least a year. During that time, memory B cells express increasingly broad and potent antibodies that are resistant to mutations found in variants of concern…While individual memory antibodies selected over time by natural infection have greater potency and breadth than antibodies elicited by vaccination, the overall neutralizing potency of plasma is greater following vaccination. These results suggest that boosting (previously uninfected, red.) vaccinated individuals with currently available mRNA vaccines will increase plasma neutralizing activity but may not produce antibodies with equivalent breadth to those obtained by vaccinating convalescent individuals.

60) R. Reyes et al.: 
SARS-CoV-2 spike-specific memory B cells express markers of durable immunity after non-severe COVID-19 but not after severe disease. BioRxiv, Preprint. 2021 Sep 27.
”SARS-CoV-2 infection elicits a robust B cell response, resulting in the generation of long-lived plasma cells and memory B cells… Collectively, our results suggest that the memory B cell response elicited during non-severe COVID-19 may be of higher quality than the response after severe disease”.

61) J. Boechat et al: The immune response to SARS-CoV-2 and COVID-19 immunopathology – Current perspectives. Pulmonology, 2021 September-October; 27(5): 423–437.
“Severe COVID-19 appears to be due not only to viral infection but also to a dysregulated immune and inflammatory response. In this paper, the authors review the most recent publications on the immunobiology of SARS-CoV-2, virus interactions with target cells, and host immune responses, and highlight possible associations between deficient innate and acquired immune responses and disease progression and mortality… Much of the data from these first 12 months indicate that actions aimed at controlling the inflammatory response and immune dysregulation will be as important as those targeting the virus and its replication mechanisms”.

62) Pape et al: High-affinity memory B cells induced by SARS-CoV-2 infection produce more plasmablasts and atypical memory B cells than those primed by mRNA vaccines. Celle Reports, 2021 Oct 12; 37(2): 109823.
“Infection-induced primary MBCs have better antigen-binding capacity and generate more plasmablasts and secondary MBCs of the classical and atypical subsets than do vaccine-induced primary MBCs. Our results suggest that infection-induced primary MBCs have undergone more affinity maturation than vaccine-induced primary MBCs and produce more robust secondary responses”.

63) Eyran et al: The longitudinal kinetics of antibodies in COVID-19 recovered patients over 14 months. PLOS Pathogens, June 3, 2022.
“We found a significantly faster decay in naïve vaccinees compared to recovered patients suggesting that the serological memory following natural infection is more robust compared to vaccination. Our data highlights the differences between serological memory induced by natural infection vs. vaccination, facilitating the decision making in Israel regarding the 3rd dose vaccination”.
An exploration of the differences in the longitudinal kinetics between recovered patients and naïve vaccinees who had received two doses of the BNT162b2 vaccine showed a significantly faster decay in the naïve vaccinees, indi-cating that serological memory following natural infection is more robust than that following to vaccination”. (b)

64) Chen et al: Differential antibody dynamics to SARS-CoV-2 infection and vaccination. BioRxiv, (pre-print)
“Optimal immune responses furnish long-lasting (durable) antibodies protective across dynamically mutating viral variants (broad). To assess robustness of mRNA vaccine-induced immunity…compared antibody durability and breadth after SARS-CoV-2 infection and vaccination…While vaccination delivered robust initial virus-specific antibodies with some cross-variant coverage, pre-variant SARS-CoV-2 infection-induced antibodies, while modest in magnitude, showed highly stable long-term antibody dynamics…Differential antibody durability trajectories favored COVID-19-recovered subjects with dual memory B cell features of greater early antibody somatic mutation and cross-coronavirus reactivity…illuminating an infection-mediated antibody breadth advantage and an anti-SARS-CoV-2 antibody durability-enhancing function conferred by recalled immunity.”

65) F. Maghsood et al.: Differential Antibody Response to SARS-CoV-2 Antigens in Recovered and Deceased Iranian COVID-19 Patients. Viral immunology, 2021 Dec;34(10):708-713
“The levels of IgM and IgG specific to N and RBD proteins were detected by ELISA. N- and RBD-specific IgM was higher in deceased patients in comparison with recovered patients, while there was no significant difference in N- and RBD-specific IgG between the two groups. A significant correlation was observed between IgG and IgM titers against RBD and N, in both groups of patients. These results argue against impaired antibody response in deceased COVID-19 patients”.

66) T. Ma et al.: Protracted yet Coordinated Differentiation of Long-Lived SARS-CoV-2-Specific CD8 + T Cells during Convalescence. Journal of immunology, 2021 Sep 1;207(5):1344-1356
“Over the approximately six month period of convalescence monitored, we observed a slow and progressive decrease in the activation state and polyfunctionality of Nuc322-331-specific CD8+ T cells, accompanied by an increase in their lymph node-homing and homeostatic proliferation potential. These results suggest that following a typical case of mild COVID-19, SARS-CoV-2-specific CD8+ T cells not only persist but continuously differentiate in a coordinated fashion well into convalescence into a state characteristic of long-lived, self-renewing memory”.

67) Garrido et al.: Asymptomatic or mild symptomatic SARS-CoV-2 infection elicits durable neutralizing antibody responses in children and adolescents. JCI Insight, 2021 Sep 8; 6(17): e150909
“We evaluated humoral immune responses in 69 children and adolescents with asymptomatic or mild symptomatic SARS-CoV-2 infection. We detected robust IgM, IgG, and IgA antibody responses to a broad array of SARS-CoV-2 antigens at the time of acute infection and 2 and 4 months after acute infection in all participants. Notably, these antibody responses were associated with virus-neutralizing activity that was still detectable 4 months after acute infection in 94% of children. Moreover, antibody responses and neutralizing activity in sera from children and adolescents were comparable or superior to those observed in sera from 24 adults with mild symptomatic infection. Taken together, these findings indicate that children and adolescents with mild or asymptomatic SARS-CoV-2 infection generate robust and durable humoral immune responses that can likely contribute to protection from reinfection”.

68) Schiffner et al.: Long-Term Course of Humoral and Cellular Immune Responses in Outpatients After SARS-CoV-2 Infection. Frontiers In Public Health, 2021 Sept.; 9: 732787.
“Our data suggest that immunological reaction is acquired in most individuals after natural infection with SARS-CoV-2 and is sustained in the majority of patients for at least 10 months after infection after a mild or moderate disease course”.

69) Dehgani-Mobaraki et al.: Longitudinal observation of antibody responses for 14 months after SARS-CoV-2 infection. Clinical immunology, 2021 Sep; 230: 108814.
“Patients reporting loss of smell and taste during the clinical course of the disease developed significantly higher
antibody titers. In conclusion, our study findings are consistent with recent studies reporting antibody persistency suggesting that induced SARS-CoV-2 immunity through natural infection, might be very efficacious against re-infection (>90%) and could persist for more than six months. Our study followed up patients up to 14 months demonstrating the presence of anti-S-RBD IgG in 96.8% of recovered COVID-19 subjects”.

70) Gazit et al.: Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections. MedRxiv, (pre-print)
”Denne undersøgelse viste, at naturlig immunitet giver længerevarende og stærkere beskyttelse mod infektion, symptomatisk sygdom og hospitalsindlæggelse forårsaget af Delta-varianten af ​​SARS-CoV-2 sammenlignet med den BNT162b2-vaccineinducerede immunitet med to doser”.

71) Wang et al.: Ultrapotent antibodies against diverse and highly transmissible SARS-CoV-2 variants. Science, 2021 Aug 13; 373(6556).
“Our study demonstrates that convalescent subjects previously infected with ancestral variant SARS-CoV-2 produce antibodies that cross-neutralize emerging VOCs with high potency…
We identified four receptor binding domain-targeting antibodies from three early-outbreak convalescent donors with potent neutralizing activity against 23 variants, including the B.1.1.7, B.1.351, P.1, B.1.429, B.1.526, and B.1.617 VOCs”.

72) Rank et al.: One Year after Mild COVID-19: The Majority of Patients Maintain Specific Immunity, But One in Four Still Suffer from Long-Term Symptoms. Journal of Clinical Medicine, 2021 Aug; 10(15): 3305
“Activation-induced marker assays identified specific T-helper cells and central memory T-cells in 80% of participants at a 12-month follow-up. In correlative analyses, older age and a longer duration of the acute phase of COVID-19 were associated with higher humoral and T-cell responses. A weak correlation between long-term loss of taste/smell and low IgA levels was found at early time points. These data indicate a long-lasting immunological memory against SARS-CoV-2 after mild COVID-19”.

73) Dopico et al.: Immunity to SARS‐CoV‐2 induced by infection or vaccination. Journal of Internal Medicine, 2022 Jan; 291(1): 32–50
“Evidence suggests that Ab immunity to endemic seasonal CoVs and SARS‐CoV wanes within a 2‐ to 3‐year period in the majority of those previously infected… Several case studies of SARS‐CoV‐2 reinfection have been documented in the literature…., although it is not known at present whether these were caused by infection with a different strain, waning immunity or unique clinical features explained the occurrence”.

74) Petersen et al.: SARS-CoV-2 Natural Antibody Response Persists for at Least 12 Months in a Nationwide Study From the Faroe Islands. Open Forum Infectious Diseases, 2021 Aug; 8(8): ofab378
”Although the protective role of antibodies is currently unknown, our results show that SARS-CoV-2 antibodies persisted at least 12 months after symptom onset and maybe even longer, indicating that COVID-19-convalescent individuals may be protected from reinfection. Our results represent SARS-CoV-2 antibody immunity in nationwide cohorts in a setting with few undetected cases [7], and we believe that our results add to the understanding of natural immunity”.

75) Sariol et al.: Function is more reliable than quantity to follow up the humoral response to the Receptor Binding Domain of SARS- CoV-2 Spike protein after natural infection or COVID-19 vaccination. Viruses, 2021 Oct; 13(10): 1972
“No differences were observed between naturally infected and vaccinated individuals when total anti-S antibodies and IgG titers were measured…This work is an important contribution to understanding the natural immune response to the novel coronavirus in a population severely impacted by SARS-CoV-2. Furthermore, by comparing the dynamics of the immune response after the natural infection vs. the vaccination, these findings suggest that a functional neutralizing antibody tests are more relevant indicators than the presence or absence of binding antibodies…
Furthermore, our data indicates that—compared with mRNA vaccination—natural infection induces a more robust humoral immune response in unexposed subjects. (pre-print-version)

76) Molodtsov et al.: SARS-CoV-2 specific T cells and antibodies in COVID-19 protection: a prospective study. Clinical infectious Diseases, 2022 Jul 1; 75(1): e1–e9.
“Explore the impact of T cells and to quantify the protective levels of the immune responses…5,340 Moscow residents were evaluated for the antibody and cellular immune responses to SARS-CoV-2 and monitored for COVID-19 up to 300 days. The antibody and cellular responses were tightly interconnected, their magnitude inversely correlated with infection probability. Similar maximal level of protection was reached by individuals positive for both types of responses and by individuals with antibodies alone…T cells in the absence of antibodies provided an intermediate level of protection.”

77) A. Redd et al.: CD8+ T-Cell Responses in COVID-19 Convalescent Individuals Target Conserved Epitopes From Multiple Prominent SARS-CoV-2 Circulating Variants. Open Forum Infectious Diseases, 2021 Jul; 8(7): ofab143.
“This study examined whether CD8+ T-cell responses from coronavirus disease 2019 convalescent individuals (n = 30) potentially maintain recognition of the major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants (alpha, beta, gamma; n = 45 mutations assessed). Only 1 mutation found in Beta variant-spike overlapped with a previously identified epitope (1/52), suggesting that virtually all anti-SARS-CoV-2 CD8+ T-cell responses should recognize these newly described variants”.

78) Mishra et al.: Natural immunity against COVID-19 significantly reduces the risk of reinfection: findings from a cohort of sero-survey participant. MedRxiv, (pre-print)
”Out of the 2238 participants, 1170 were sero-positive and 1068 were sero-negative for antibody against COVID-19. Our survey found that only 3 individuals in the sero-positive group got infected with COVID-19 whereas 127 individuals reported contracting the infection the sero-negative group. Interestingly, from the 127 sero-negative individuals who later contracted COVID-19 infection, 30 needed hospitalization, out of which 12 were on oxygen therapy, four in ICU and one was on ventilator. At the other hand, from the 3 sero-positives re-infected with COVID-19, one had hospitalization, but did not require oxygen support or critical care. These findings reinforce the strong plausibility that development of antibody following natural infection not only protects against re-infection by the virus to a great extent, but also safeguards against progression to severe COVID-19 disease”.

79) Letizia et al.: SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. Lancet Respiratory Medicine, 2021 Jul; 9(7): 712–720.
”Seropositive young adults had about one-fifth the risk of subsequent infection compared with seronegative individuals. Although antibodies induced by initial infection are largely protective, they do not guarantee effective SARS-CoV-2 neutralisation activity or immunity against subsequent infection”.

80) Hoehl et al.: A new group at increased risk of a SARS-CoV-2 infection emerges: The recently vaccinated. Vaccine, 2021 Jul 5; 39(30): 4025–4026.
“ the days following the start of the vaccination campaign, a new development became evident: Several of the recently vaccinated HCWs developed symptoms of Covid-19, and an infection with SARS-CoV-2 was confirmed by PCR… The recently vaccinated made up 35% of the total number of the 20 employees of the University Hospital who tested positive in that time period, meaning the recently vaccinated were overrepresented among those with a symptomatic infection”.

81) D. Rosenberg: Natural infection vs vaccination: Which gives more protection? Nearly 40% of new COVID patients were vaccinated – compared to just 1% who had been infected previously. Israel National News, Article, Jul 13, 2021, 9:24 AM (GMT+3)
“With a total of 835,792 Israelis known to have recovered from the virus, the 72 instances of reinfection amount to 0.0086% of people who were already infected with COVID…By contrast, Israelis who were vaccinated were 6.72 times more likely to get infected after the shot than after natural infection, with over 3,000 of the 5,193,499, or 0.0578%, of Israelis who were vaccinated getting infected in the latest wave.”

82) D. Kwon: This ‘super antibody’ for COVID fights off multiple coronaviruses. Nature, 2021 Jul 14. doi: 10.1038/d41586-021-01917-9
“Scientists have uncovered an antibody that can fight off not only a wide range of SARS-CoV-2 variants, but also closely related coronaviruses… The researchers examined 12 antibodies that Vir Biotechnology, a company based in San Francisco, California, that was involved in the study, isolated from people who had been infected with either SARS-CoV-2 or its close relative SARS-CoV… The other 11 antibodies could target a variety of viruses, but the more effectively an antibody blocked the entry of the earliest known SARS-CoV-2 strain into a cell, the smaller the range of viruses it could bind. The team also found that antibodies that could disable a wide variety of viruses targeted sections of the binding domain that tended not to change as the virus evolved… It’s good news that the team has identified antibodies that can bind to a range of sarbecoviruses”.

83) Bertolini et al.: Associations of Vaccination and of Prior Infection With Positive PCR Test Results for SARS-CoV-2 in Airline Passengers Arriving in Qatar. JAMA, 2021 Jul 13; 326(2): 185–188
“Vaccination and prior infection were associated with reduced risk for SARS-CoV-2 PCR test positivity in residents of Qatar returning on international flights”.

84) Fraley et al.: Cross-reactive antibody immunity against SARS-CoV-2 in children and adults. Celluar and Molecular immunity, 2021 Jul; 18(7): 1826–1828.
”We determined that children and adults without SARS-CoV-2 infection history had preexisting cross-reactive humoral immunity that may contribute to disease pathogenesis. However, cross-reactive humoral immunity to SARS-CoV-2 is only one aspect of the immune system that may play a protective role in preventing severe COVID-19. Indeed, it has also been demonstrated that high frequencies of uninfected individuals mount preexisting cross-reactive T cell immune responses to SARS-CoV-2.. The identification of these broad B and T cell epitopes with protective efficacy might serve as future targets for pancoronavirus vaccines and also predict disease severity after coronavirus infection”.

85) N. Kojima et al.: Incidence of Severe Acute Respiratory Syndrome Coronavirus-2 infection among previously infected or vaccinated employees. MedRxiv, doi: (pre-print)
”Previous SARS-CoV-2 infection and vaccination for SARS-CoV-2 were associated with decreased risk for infection or re-infection with SARS-CoV-2 in a routinely screened workforce. The was no difference in the infection incidence between vaccinated individuals and individuals with previous infection”.

86) Greany et al.: Antibodies elicited by mRNA-1273 vaccination bind more broadly to the receptor binding domain than do those from SARS-CoV-2 infection. Science Translational Medicine, 2021 Jun 30; 13(600): eabi9915.
”The neutralizing activity of vaccine-elicited antibodies was more targeted to the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein compared to antibodies elicited by natural infection. However, within the RBD, binding of vaccine-elicited antibodies was more broadly distributed across epitopes compared to infection-elicited antibodies. This greater binding breadth means that single RBD mutations have less impact on neutralization by vaccine sera compared to convalescent sera. Therefore, antibody immunity acquired by natural infection or different modes of vaccination may have a differing susceptibility to erosion by SARS-CoV-2 evolution…  recent study suggests that mRNA vaccination elicits a different distribution of isotypes and fewer antibodies that cross-react to common-cold coronaviruses as compared to infection”

87) Karl Friston: Up to 80% not even susceptible to Covid-19. Unherd, F. Sayers, June 4, 2020
“Results have just been published of a study suggesting that 40%-60% of people who have not been exposed to coronavirus have resistance at the T-cell level from other similar coronaviruses like the common cold…the true portion of people who are not even susceptible to Covid-19 may be as high as 80%.”

88) Lafon et al.:
 Potent SARS-CoV-2-Specific T Cell Immunity and Low Anaphylatoxin Levels Correlate With Mild Disease Progression in COVID-19 Patients. Frontiers in Immunology, 2021; 12: 684014.
“Our data clearly demonstrates a significantly stronger induction of SARS-CoV-2 specific CD8+ T lymphocytes and higher IFNγ production in patients with mild compared to patients with severe or critical COVID-19. In all patients SARS-CoV-2-specific antibodies with similar neutralizing activity were detected, but highest titers of total IgGs were observed in critical patients. Finally, elevated anaphylatoxin C3a and C5a levels were identified in severe and critical COVID-19 patients probably caused by aberrant immune complex formation due to elevated antibody titers in these patients. Crucially, we provide a full picture of cellular and humoral immune responses of COVID-19 patients and prove that robust polyfunctional CD8+ T cell responses concomitant with low anaphylatoxin levels correlate with mild infections. In addition, our data indicates that high SARS-CoV-2 antibody titers are associated with severe disease progression”.

89) Nelde et al.: SARS-CoV-2 T-cell epitopes define heterologous and COVID-19-induced T-cell recognition. Nature Immunology, 2020 Sept., 22, pages74–85 (2021)
“The first work identifying and characterizing SARS-CoV-2-specific and cross-reactive HLA class I and HLA-DR T-cell epitopes in SARS-CoV-2 convalescents (n = 180) as well as unexposed individuals (n = 185) and confirming their relevance for immunity and COVID-19 disease course…cross-reactive SARS-CoV-2 T-cell epitopes revealed pre-existing T-cell responses in 81% of unexposed individuals, and validation of similarity to common cold human coronaviruses provided a functional basis for postulated heterologous immunity in SARS-CoV-2 infection…intensity of T-cell responses and recognition rate of T-cell epitopes was significantly higher in the convalescent donors compared to unexposed individuals, suggesting that not only expansion, but also diversity spread of SARS-CoV-2 T-cell responses occur upon active infection.”

90) Ciocca et al.: Evolution of Human Memory B Cells From Childhood to Old Age. Frontiers in Immunology, 2021; 12: 690534.
“After in vitro stimulation with CpG, B cells from older individuals produced significantly fewer IgM and IgA antibodies compared to younger individuals. Aging is a complex process characterized by a functional decline in multiple physiological systems. The immune system of older people is well equipped to react to often encountered antigens but has a low ability to respond to new pathogens”.

91) R. Sealy et al.:
 Cross-Reactive Immune Responses toward the Common Cold Human Coronaviruses and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Mini-Review and a Murine Study. Microorganisms, 2021 Jul 31;9(8):1643.
”Når mennesker blev naturligt inficeret med SARS-CoV-2, steg krydsreaktive antistoffer, der genkendte almindelig forkølelses-HCoV-antigener, i betydeligt omfang. Krydsreaktive T-celler, ligesom antistoffer, var til stede i mennesker før SARS-CoV-2-eksponeringer og steg efter SARS-CoV-2-infektioner. Nogle undersøgelser antydede, at humane infektioner med almindelige forkølelses-HCoV’er gav beskyttelse mod sygdom forårsaget af efterfølgende eksponeringer for SARS-CoV-2”.

92) H. Abo-Leyah et al.: The protective effect of SARS-CoV-2 antibodies in Scottish healthcare workers. ERJ Open Research,2021 Apr; 7(2): 00080-2021
“HCWs were three times more likely to test positive for SARS-CoV-2 than the general population. Almost all infected individuals developed an antibody response, which was 85% effective in protecting against re-infection with SARS-CoV-2”.

93) Björkström et al.: 
Natural killer cells in antiviral immunity. Nature Reviews Immunology, 2022; 22(2): 112–123.
“Importantly, NK cells can also eliminate virus-infected cells via CD16-mediated antibody-dependent cellular cytotoxicity (ADCC)16. Finally, NK cell activity is modulated by cytokines, including, but not limited to, the activating cytokines IL-2, IL-12, IL-15, IL-18 and type I interferons, which can be produced by virally infected cells or activated antigen-presenting cells17. Many of these cytokines, alone or in combination, promote NK cell survival, proliferation, cytotoxicity and cytokine production, including interferon-γ (IFNγ) production18. Through these mechanisms, NK cells are uniquely equipped to sense and quickly respond to viral infections7. In this respect, they often act in concert with other host immune responses in mediating antiviral immunity”.

94) Cohen et al.: Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells. Cell Reports Medicine, 2021 Jul 20; 2(7): 100354.

“Here, we evaluate 254 COVID-19 patients longitudinally up to 8 months and find durable broad-based immune responses. SARS-CoV-2 spike binding and neutralizing antibodies exhibit a bi-phasic decay with an extended half-life of >200 days suggesting the generation of longer-lived plasma cells. SARS-CoV-2 infection also boosts antibody titers to SARS-CoV-1 and common betacoronaviruses. In addition, spike-specific IgG+ memory B cells persist, which bodes well for a rapid antibody response upon virus re-exposure or vaccination. Virus-specific CD4+ and CD8+ T cells are polyfunctional and maintained with an estimated half-life of 200 days. Interestingly, CD4+ T cell responses equally target several SARS-CoV-2 proteins, whereas the CD8+ T cell responses preferentially target the nucleoprotein, highlighting the potential importance of including the nucleoprotein in future vaccines. Taken together, these results suggest that broad and effective immunity may persist long-term in recovered COVID-19 patients”.

The study is based on the studyLongitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells (preprint)

95) Jung et al.: SARS-CoV-2-specific T cell memory is sustained in COVID-19 convalescent patients for 10 months with successful development of stem cell-like memory T cells. Nature Communications, 2021; 12: 4043.
”In the present study, we report SARS-CoV-2-specific CD4+ and CD8+ T cell responses in peripheral blood mononuclear cells (PBMCs) from individuals infected with SARS-CoV-2 over 10 months post-infection. Using diverse T cell assays, we show that SARS-CoV-2-specific memory T cell responses are maintained 10 months after the infection. In addition, we report the differentiation of SARS-CoV-2-specific memory T cells during the study period and the successful generation of TSCM cells. 
We demonstrated that PD-1 and TIGIT are rarely expressed in SARS-CoV-2-specific TSCM cells, indicating that SARS-CoV-2-specific TSCM cells are not exhausted-like progenitors, but bona fide stem-like memory cells.
We also demonstrate the effector functions and the proliferation capacity of long-term memory CD4+ and CD8+ T cells. Our findings provide insights for understanding long-term SARS-CoV-2-specific T cell immunity”.

96) Shrestha et al.:
 Necessity of COVID-19 Vaccination in Persons Who Have Already Had COVID-19. Clinical Infectous Diseases, 2022 Aug 24;75(1):e662-e671
”Individuals who have had SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination, and vaccines can be safely prioritized to those who have not been infected before.
Cumulative incidence of COVID-19 was examined among 52238 employees in an American healthcare system. COVID-19 did not occur in anyone over the five months of the study among 2579 individuals previously infected with COVID-19, including 1359 who did not take the vaccine”.

97) S. Nielsen et al.: SARS-CoV-2 elicits robust adaptive immune responses regardless of disease severity, Ebiomedicine. 2021 Jun; 68: 103410.
“We included 203 recovered SARS-CoV-2 infected patients in Denmark between April 3rd and July 9th 2020, at least 14 days after COVID-19 symptom recovery. The participants had experienced a range of disease severities from asymptomatic to severe…
Overall, the majority of patients had robust adaptive immune responses, regardless of their disease severity”.

98) Lumley et al.: An observational cohort study on the incidence of SARS-CoV-2 infection and B.1.1.7 variant infection in healthcare workers by antibody and vaccination status. Clinical Infectious Diseases, 2022 Apr 9;74(7):1208-1219
”Compared to unvaccinated seronegative HCWs, natural immunity and 2 vaccination doses provided similar protection against symptomatic infection… There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7”.

99) S. Jordan: Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses. Clinical and Experimental Immunology, 2021 Jun; 204(3): 310–320.
“In addition, long-term assessment of SARS-CoV-2 memory B and T cell-mediated immune responses in patients recovering from an infection or those with cross-reactive immunological memory will help to define risk for future SARS-CoV infections. Finally, patients recovering from SARS-CoV-2 infection may experience prolonged immune activation probably due to T cell exhaustion”.

100) J. Turner et al.: SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans. Nature, 2021 Jul;595(7867):421-425
”Consistently, circulating resting memory B cells directed against SARS-CoV-2 S were detected in the convalescent individuals. Overall, our results indicate that mild infection with SARS-CoV-2 induces robust antigen-specific, long-lived humoral immune memory in humans”.

101) L. Yao et al.: Persistence of Antibody and Cellular Immune Responses in COVID-19 patients over Nine Months after Infection. Journal of Infectious Diseases, 2021 May 12 : jiab255
”SARS-CoV-2-specific immune memory response persists in most patients nearly one year after infection, which provides a promising sign for prevention from reinfection and vaccination strategy”.

102) P. Ahluwalia et a.: Infection and Immune Memory: Variables in Robust Protection by Vaccines Against SARS-CoV-2. Frontiers Immunology, 2021; 12: 660019
“Virus-specific CD8+ T cells have been shown to persist for 6-11 years (102, 103). In another study, memory T cells against SARS-CoV-1 were detected even 17 years after the previous pandemic, hinting at the long-term immune response against the pathogens (17). In a recent study, almost half of donor blood samples between 2015 and 2018 showed reactivity to SARS-CoV-2, well before the emergence of this pathogen in the human population. It is speculated that this might be due to the cross-reactivity of other common cold coronaviruses with SARS-CoV-2”.

103) Lineburg et al.: CD8+ T cells specific for an immunodominant SARS-CoV-2 nucleocapsid epitope cross-react with selective seasonal coronaviruses. Immunity, 2021 May 11; 54(5): 1055–1065.e5.
“Screening of SARS-CoV-2 peptide pools revealed that the nucleocapsid (N) protein induced an immunodominant response in HLA-B7+ COVID-19-recovered individuals that was also detectable in unexposed donors. Our findings demonstrate the basis of selective T cell cross-reactivity for an immunodominant SARS-CoV-2 epitope and its homologs from seasonal coronaviruses, suggesting long-lasting protective immunity”.

104) E. Murchu et al.: Quantifying the risk of SARS‐CoV‐2 reinfection over time. Reviews in Medical Virology, 2022 Jan; 32(1): e2260.
”Reinfection was an uncommon event (absolute rate 0%–1.1%), with no study reporting an increase in the risk of reinfection over time. Only one study estimated the population‐level risk of reinfection based on whole genome sequencing in a subset of patients; the estimated risk was low (0.1% [95% CI: 0.08–0.11%]) with no evidence of waning immunity for up to 7 months following primary infection. These data suggest that naturally acquired SARS‐CoV‐2 immunity does not wane for at least 10 months post‐infection”.

105) Ivanova et al.: Discrete Immune Response Signature to SARS-CoV-2 mRNA Vaccination Versus Infection. Sneak Peak/MedRxiv/Pubmed pre-print, 3 May 2021
“In COVID-19 patients, immune responses were characterized by a highly augmented interferon response which was largely absent in vaccine recipients. Increased interferon signaling likely contributed to the observed dramatic upregulation of cytotoxic genes in the peripheral T cells and innate-like lymphocytes in patients but not in immunized subjects.
Analysis of B and T cell receptor repertoires revealed that while the majority of clonal B and T cells in COVID-19 patients were effector cells, in vaccine recipients clonally expanded cells were primarily circulating memory cells. Importantly, the divergence in immune subsets engaged, the transcriptional differences in key immune populations, and the differences in maturation of adaptive immune cells revealed by our analysis have far-ranging implications for immunity to this novel pathogen”.

106) Bert et al.: Highly functional virus-specific cellular immune response in asymptomatic SARS-CoV-2 infection. Journal of Experimental Medicine, 2021 May 3; 218(5): e20202617.
”Thus, asymptomatic SARS-CoV-2–infected individuals are not characterized by weak antiviral immunity; on the contrary, they mount a highly functional virus-specific cellular immune response”.

107) A. Breathnach et al.: Prior COVID-19 protects against reinfection, even in the absence of detectable antibodies. Journal of Infection, May 27, 2021DOI:
“Studies did not address whether prior infection is protective in the absence of a detectable humoral immune response. Patients with primary or secondary antibody deficiency syndrome and reduced or absent B cells can recover from COVID-19…Although there have been few mechanistic studies, preliminary data show that such individuals generate striking T-cell immune responses against SARS-CoV-2 peptide pools…SARS-CoV-2 specific T cell immune responses but not neutralizing antibodies are associated with reduced disease severity suggesting the immune system may have considerable redundancy or compensation following COVID-19…our results add to the emerging evidence that detectable serum antibody may be an incomplete marker of protection against reinfection. This could have implications for public health and policy-making, for example if using seroprevalence data to assess population immunity, or if serum antibody levels were to be taken as official evidence of immunity – a minority of truly immune patients have no detectable antibody and could be disadvantaged as a result. Our findings highlight the need for further studies of immune correlates of protection from infection with SARS-CoV-2, which may in turn enhance development of effective vaccines and treatments.”

108) Abu-Raddad et al.: SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy. EClinicalmedicine, 2021 May;35:100861. doi: 10.1016/j.eclinm.2021.100861. Epub 2021 Apr 28
”Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months”.

109) P. Ahluwalia et al.: Infection and Immune Memory: Variables in Robust Protection by Vaccines Against SARS-CoV-2. Frontiers in Immunology, 2021; 12: 660019.
“Although neutralizing antibodies can wane over time, long-lasting B and T memory cells can persist in recovered individuals. The natural immunological memory captures the diverse repertoire of SARS-CoV-2 epitopes after natural infection whereas, currently approved vaccines are based on a single epitope, spike protein”.

110) J. Vitale et al.: Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy. JAMA Internal Medicine, 2021 Oct; 181(10): 1407–1408.
”The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies”.

111) Föhse et al.: The BNT162b2 mRNA vaccine against SARS-CoV-2 reprograms both adaptive and innate immune response. MedRxiv, May 06, 2021, doi: (Pre-print)

“ The response of innate immune cells to TLR4 and TLR7/8 ligands was lower after BNT162b2 vaccination, while fungi-induced cytokine responses were stronger. In conclusion, the mRNA BNT162b2 vaccine induces complex functional reprogramming of innate immune responses, which should be considered in the development and use of this new class of vaccines”.

112) WHO: COVID-19 natural immunity, Scientific brief. World Health Organization, 10 May 2021
”Available scientific data suggests that in most people immune responses remain robust and protective against reinfection for at least 6-8 months after infection (the longest follow up with strong scientific evidence is currently approximately 8 months). Some variant SARS-CoV-2 viruses with key changes in the spike protein have a reduced susceptibility to neutralization by antibodies in the blood. While neutralizing antibodies mainly target the spike protein, cellular immunity elicited by natural infection also target other viral proteins, which tend to be more conserved across variants than the spike protein”.

Current evidence points to most individuals developing strong protective immune responses following natural infection with SARSCoV-2. However, inaccurate immunodiagnostic tests may falsely indicate infected individuals as naïve to the virus (not previously infected) or may falsely label non-infected people as positive for immune markers of recent infection”.

113) E. Callaway: Had COVID? You’ll probably make antibodies for a lifetime. Nature, 2021 May 26. doi: 10.1038/d41586-021-01442-9.
“People who recover from mild COVID-19 have bone-marrow cells that can churn out antibodies for decades…the study provides evidence that immunity triggered by SARS-CoV-2 infection will be extraordinarily long-lasting.”

114) Goldberg et al.: Protection of previous SARS-CoV-2 infection is similar to that of BNT162b2 vaccine protection: A three-month nationwide experience from Israel. American Journal of Epidemiology, 2022 Mar 30: kwac060
“Our results should be considered by policymakers when deciding whether or not to prioritize vaccination of previously-infected adults”.

115) Alfego et al.: A population-based analysis of the longevity of SARS-CoV-2 antibody seropositivity in the United States. EClinicalmedicine, 2021 Jun;36:100902
“To track population-based SARS-CoV-2 antibody seropositivity duration across the United States using observational data from a national clinical laboratory registry of patients tested by nucleic acid amplification (NAAT) and serologic assays… specimens from 39,086 individuals with confirmed positive COVID-19…both S and N SARS-CoV-2 antibody results offer an encouraging view of how long humans may have protective antibodies against COVID-19, with curve smoothing showing population seropositivity reaching 90% within three weeks, regardless of whether the assay detects N or S-antibodies. Observational data from a national clinical laboratory, though limited by an epidemiological view of the U.S. population, offer an encouraging timeline for the development and sustainability of antibodies up to ten months from natural infection and could inform post-pandemic planning”.

116) Majdoubi et al.: A majority of uninfected adults show preexisting antibody reactivity against SARS-CoV-2. JCI Insight. 2021 Apr 22; 6(8): e146316.
“Preexisting cross-reactivity to SARS-CoV-2 occurs in the absence of prior viral exposure…. we determined that more than 90% of uninfected adults showed antibody reactivity against the spike protein, receptor-binding domain (RBD), N-terminal domain (NTD), or the nucleocapsid (N) protein from SARS-CoV-2…
The common occurrence of circulating coronaviruses year after year and their structural similarity with SARS-CoV-2 raises the possibility that the former may stimulate cross-reactive responses toward SARS-CoV-2 and that this heterotopic immunity may impact clinical susceptibility to COVID-19…
We conclude that most adults display preexisting antibody cross-reactivity against SARS-CoV-2, which further supports investigation of how this may impact the clinical severity of COVID-19”.

117) C. Ogega et al.: Durable SARS-CoV-2 B cell immunity after mild or severe disease. The Journal of Clinical Investigation, 2021 Apr 1; 131(7): e145516.
“Multiple studies have shown loss of severe acute respiratory syndrome coronavirus 2–specific (SARS-CoV-2–specific) antibodies over time after infection, raising concern that humoral immunity against the virus is not durable.  If immunity wanes quickly, millions of people may be at risk for reinfection after recovery from coronavirus disease 2019 (COVID-19). However, memory B cells (MBCs) could provide durable humoral immunity even if serum neutralizing antibody titers decline…. Resting MBCs (rMBCs) made up the largest proportion of S-RBD–specific MBCs in both cohorts. FCRL5, a marker of functional memory on rMBCs, was more dramatically upregulated on S-RBD–specific rMBCs after mild infection than after severe infection. These data indicate that most SARS-CoV-2-infected individuals develop S-RBD–specific, class-switched rMBCs that resemble germinal center–derived B cells induced by effective vaccination against other pathogens, providing evidence for durable B cell–mediated immunity against SARS-CoV-2 after mild or severe disease”.

118) V. Hall et al.: SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN). The Lancet, 021 17-23 April; 397(10283): 1459–1469.
“A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals”.

119) G. Anichini et al.: SARS-CoV-2 Antibody Response in Persons with Past Natural Infection. New England Journal of Medicine, 2021 Apr 14 : NEJMc2103825.
”The most remarkable finding of this study was the significantly lower neutralizing antibody titer after administration of a second dose of vaccine in previously uninfected patients than the titer after only a single dose of vaccine in previously infected participants. It is unclear how the neutralizing antibody titers influence the ability of the host to transmit the virus. These findings provide evidence that after the administration of a single dose of vaccine, the humoral response against SARS-CoV-2 in persons with a history of SARS-CoV-2 infection is greater than the response in previously uninfected participants who have received a second dose”.

120) Saini et al.: SARS-CoV-2 genome-wide T cell epitope mapping reveals immunodominance and substantial CD8+ T cell activation in COVID-19 patients. Science Immunology, 2021 Apr 14; 6(58): eabf7550
“Most vaccine development efforts are currently focusing on mounting antibody responses to the spike protein, with limited focus on T cell immunity…
Taken together, COVID-19 disease drives substantial T cell activation, with T cell recognition of a large number of SARS-CoV-2-derived peptides. There is also considerable T cell recognition of such peptides in healthy donors, arguing for cross-recognition, potentially from T cells raised against other coronaviruses… Data suggest a lower TCR avidity to the probed pMHC in healthy individuals compared to COVID-19 patients, which could represent potential cross-reactivity from existing T cell populations potentially raised against other coronaviruses (such as common cold viruses HCoV-HKU1, HCoV-229E, HCoV-NL63, and HCoV-OC43) that share some level of sequence homology with SARS-CoV-2, as suggested in recent reports… Importantly the phenotype of the SARS-CoV-2-specific CD8+ T cells, revealed a strong T cell activation in COVID-19 patients, while minimal T cell activation was seen in healthy individuals. We found that patients with severe disease displayed significantly larger SARS-CoV-2-specific T cell populations compared to patients with mild diseases and these T cells displayed a robust activation profile. These results further our understanding of T cell immunity to SARS-CoV-2 infection and hypothesize that strong antigen-specific T cell responses are associated with different disease outcomes”.

121) B. Laidlaw et al.: Transcriptional regulation of memory B cell differentiation. Nature Rewies Immunology, 2021 Apr;21(4):209-220
””Memory B cells (MBCs) are critical for the rapid development of protective immunity following re-infection. MBCs capable of neutralizing distinct subclasses of pathogens, such as influenza and HIV, have been identified in humans. However, efforts to develop vaccines that induce broadly protective MBCs to rapidly mutating pathogens have not yet been successful”.

122) Cromer et al.: Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection. Nature Rewievs Immunology, 2021 Jun;21(6):395-404
“The waning of neutralizing antibody responses over the first year after infection suggests that reinfections may become more frequent in the coming months and/or years. However, the robust B cell and T cell memory responses induced by primary infection suggest that reinfection severity, and potentially transmission, may be mitigated over the longer term”.

123) L. Atlani-Duault et al.: Immune evasion means we need a new COVID-19 social contract. The Lancet Public Health, 2021 Apr; 6(4): e199–e200.
”This virological game changer has numerous consequences, not only for vaccines and treatment, but also for prevention and control strategies. The fervently awaited end of this global health crisis might be continually postponed, as new variants emerge and immune evasion reduces vaccination effectiveness in the short and medium term.
Hence, it is time to abandon fear-based approaches based on seemingly haphazard stop-start generalised confinement as the main response to the pandemic; approaches which expect citizens to wait patiently until intensive care units are re-enforced, full vaccination is achieved, and herd immunity is reached…
We scientists working against COVID-19 must have the courage to address those in power, who bear ultimate responsibility for the policies chosen and their consequences. If this responsibility is shirked or delayed, the inevitable day of reckoning might be terrible.
We are members of the French COVID-19 Scientific Council”.

124) R. Goel et al.: Distinct antibody and memory B cell responses in SARS-CoV-2 naïve and recovered individuals following mRNA vaccination. Science Immunology, 2021 Apr 15; 6(58): eabi6950.
“In SARS-CoV-2 recovered individuals, antibody and memory B cell responses were significantly boosted after the first vaccine dose; however, there was no increase in circulating antibodies, neutralizing titers, or antigen-specific memory B cells after the second dose. This robust boosting after the first vaccine dose strongly correlated with levels of pre-existing memory B cells in recovered individuals, identifying a key role for memory B cells in mounting recall responses to SARS-CoV-2 antigens”.

125) J. Wu et al.: SARS-CoV-2 infection induces sustained humoral immune responses in convalescent patients following symptomatic COVID-19. Nature Communications,
2021; 12: 1813.
“…data indicate sustained humoral immunity in recovered patients who had symptomatic COVID-19, suggesting prolonged immunity”.

126) Perez et al.: A 1 to 1000 SARS-CoV-2 reinfection proportion in members of a large healthcare provider in Israel: a preliminary report. MedRxiv, doi: (pre-print)
Israel: “Out of 149,735 individuals with a documented positive PCR test between March 2020 and January 2021, 154 had two positive PCR tests at least 100 days apart, reflecting a reinfection proportion of 1 per 1000.”

127) Sheehan et al.: Reinfection Rates among Patients who Previously Tested Positive for COVID-19: a Retrospective Cohort Study. Clinical Infectious Diseases, 2021 Mar 15: ciab234.
“This retrospective cohort study of one multi-hospital health system included 150,325 patients tested for COVID-19 infection via PCR from March 12, 2020 to August 30, 2020.
Prior infection in patients with COVID-19 was highly protective against reinfection and symptomatic disease. This protection increased over time, suggesting that viral shedding or ongoing immune response may persist beyond 90 days and may not represent true reinfection”.

128) J. Klausner et al.: Op-Ed: Quit Ignoring Natural COVID Immunity – Antibody testing and proof of prior infection can allow more people to return to normal. Medpagetoday, May 28, 2021
”So why are we so focused on vaccine-induced immunity – in our goals to reach herd immunity, our gatekeeping on travel, public or private events, or mask use – while ignoring natural immunity? Shouldn’t those who have natural immunity also be able to return to “normal” activities”?

129) Ansari et al.: Immune Memory in Mild COVID-19 Patients and Unexposed Donors Reveals Persistent T Cell Responses After SARS-CoV-2 Infection. Frontiers in immunology, 2021; 12: 636768
”We found detectable immune memory in mild COVID-19 patients several months after recovery in the crucial arms of protective adaptive immunity; CD4+ T cells and B cells, with a minimal contribution from CD8+ T cells. Interestingly, the persistent immune memory in COVID-19 patients is predominantly targeted towards the Spike glycoprotein of the SARS-CoV-2. This study provides the evidence of both high magnitude pre-existing and persistent immune memory in Indian population”.

130) Sokal et al.: Maturation and persistence of the anti-SARS-CoV-2 memory B cell response. Cell, 2021 Mar 4; 184(5): 1201–1213.e14
“Memory B cells play a fundamental role in host defenses against viruses, but to date, their role has been relatively unsettled in the context of SARS-CoV-2. We report here a longitudinal single-cell and repertoire profiling of the B cell response up to 6 months in mild and severe COVID-19 patients. Overall, these findings demonstrate that an antigen-driven activation persisted and matured up to 6 months after SARS-CoV-2 infection and may provide long-term protection”.

131) Harvey et al.: Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection. JAMA Internal Medicine, 2021 May; 181(5): 672–679.
“The cohort included 3 257 478 unique patients. In this cohort study, patients with positive antibody test results were initially more likely to have positive NAAT results, consistent with prolonged RNA shedding, but became markedly less likely to have positive NAAT results over time, suggesting that seropositivity is associated with protection from infection. The duration of protection is unknown, and protection may wane over time”.

132) J. Zuo et al.: Robust SARS-CoV-2-specific T-cell immunity is maintained at 6 months following primary infection. Nature Immunology, 2021 May 1; 22(5): 620–626.
“Median T-cell responses were 50% higher in donors who had experienced a symptomatic infection indicating that the severity of primary infection establishes a ‘setpoint’ for cellular immunity. T-cell responses to spike and nucleoprotein/membrane proteins were correlated with peak antibody levels. In conclusion, our data are reassuring that functional SARS-CoV-2-specific T-cell responses are retained at six months following infection”.

133) Tong et al.: Memory B cell repertoire for recognition of evolving SARS-CoV-2 spike. Cell, 2021 Sep 16; 184(19): 4969–4980.e15.
“Memory B cell reserves can generate protective antibodies against repeated SARS-CoV-2 infections, but with unknown reach from original infection to antigenically drifted variants. We charted memory B cell receptor-encoded antibodies from 19 COVID-19 convalescent subjects against SARS-CoV-2 spike (S) and found seven major antibody competition groups against epitopes recurrently targeted across individuals… Inclusion of published and newly determined structures of antibody-S complexes identified corresponding epitopic regions.. Group assignment correlated with cross-CoV-reactivity breadth, neutralization potency, and convergent antibody signatures…
Although emerging SARS-CoV-2 variants of concern escaped binding by many members of the groups associated with the most potent neutralizing activity, some antibodies in each of those groups retained affinity—suggesting that otherwise redundant components of a primary immune response are important for durable protection from evolving pathogens.
Our results furnish a global atlas of S-specific memory B cell repertoires and illustrate properties driving viral escape and conferring robustness against emerging variants”.
(”Our results provide a global atlas of S-specific memory B cell repertoires and illustrate properties that drive virus escape and confer robustness against new variants”)

134) K. Mølbak et al.: Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. The Lancet, 2021 27 March-2 April; 397(10280): 1204–1212.
“Protection against repeat infection was 80·5%. We found no difference in estimated protection against repeat infection by sex (male 78·4% [72·1–83·2] vs female 79·1% [73·9–83·3]) or evidence of waning protection over time (3–6 months of follow-up 79·3% [74·4–83·3] vs ≥7 months of follow-up 77·7% [70·9–82·9]).
Interpretation: Our findings could inform decisions on which groups should be vaccinated and advocate for vaccination of previously infected individuals because natural protection, especially among older people, cannot be relied on”.

135) Lozano-Ojalvo et al.: Differential effects of the second SARS-CoV-2 mRNA vaccine dose on T cell immunity in naive and COVID-19 recovered individuals. Cell Reports, 2021 Aug 24; 36(8): 109570.
”Overall, our data support the vaccination scheme determined in clinical trials with prompt administration of the second dose in individuals without previous SARS-CoV-2 exposure (Kadire et al., 2021), but they suggest that in individuals with pre-existing immunity against SARS-CoV-2 the second dose of the vaccine may not be necessary.
Our results demonstrate that, while the second dose increases both the humoral and cellular immunity in naive individuals, COVID-19 recovered individuals reach their peak of immunity after the first dose. These results suggest that a second dose, according to the current standard regimen of vaccination, may be not necessary in individuals previously infected with SARS-CoV-2”.
“In naive subjects, the T cell response is boosted in conjunction with spike-specific IgG levels after the second dose. On the contrary, the second vaccine dose not increase the spike-specific T cell response in individuals with a pre-existing immunity against SARS-CoV-2 and further evidences that a single-dose vaccine is sufficient to induce protective immunity in Covid-19 recovered individuals

136) H. Kared et al.: SARS-CoV-2–specific CD8+ T cell responses in convalescent COVID-19 individuals. Journal of Clinical Investigation, 2021 Mar 1; 131(5): e145476.
“A multiplexed peptide-MHC tetramer approach was used to screen 408 SARS-CoV-2 candidate epitopes for CD8+ T cell recognition in a cross-sectional sample of 30 coronavirus disease 2019 convalescent individuals…Modelling demonstrated a coordinated and dynamic immune response characterized by a decrease in inflammation, increase in neutralizing antibody titer, and differentiation of a specific CD8+ T cell response. Overall, T cells exhibited distinct differentiation into stem cell and transitional memory states (subsets), which may be key to developing durable protection.”

137) Brolin et al.: Risk of SARS-CoV-2 transmission from newly infected individuals with documented previous infection or vaccination. European Centre for Disease Prevention and Control, 2021 March 29.
“The review of evidence on natural immunity and possibilities for transmission from previously infected to susceptible contacts found that
– There is evidence that reinfection remains a rare event…
Results from cohort studies confirm that the protective effect of previous SARS-CoV-2 infection ranges from 81% to 100% from Day 14 following initial infection, for a follow-up period of five to seven months. Protection against reinfection is lower in individuals aged 65 years and older…
These studies were carried out before the emergence of SARS-CoV-2 variants of concern (VOCs) and therefore there is limited preliminary evidence that immunity induced against previously circulating SARS-CoV-2 variants may not have the same potency or duration against the VOCs identified to date (in particular the B.1.351 and P.1 variants.) • As the number of individuals acquiring natural immunity increases, the total number of infections is expected to decrease significantly, leading to decreased transmission overall, unless the genetic changes in the circulating variants induce significant immune escape”.

138) Pilz et al.: SARS‐CoV‐2 re‐infection risk in Austria. European Journal of Clinical investigation, 
2021 Apr; 51(4): e13520
“We observed a relatively low re-infection rate of SARS-CoV-2 in Austria. Protection against SARS-CoV-2 after natural infection is comparable with the highest available estimates on vaccine efficacies. Further well-designed research on this issue is urgently needed for improving evidence-based decisions on public health measures and vaccination strategies”.

139) Bertoletti et al.: The T cell response to SARS-CoV-2: kinetic and quantitative aspects and the case for their protective role. Oxford Open immunology,
2021 Feb 23: iqab006
“SARS-CoV-specific T cells (CD4 and CD8 T cells) can be detected at 11 and 17 years after SARS-CoV infection [17, 76] in the absence of detectable antibodies… Early appearance, multi-specificity and functionality of SARS-CoV-2-specific T cells are associated with accelerated viral clearance and with protection from severe COVID-19”.

140) Sette et al.: Adaptive immunity to SARS-CoV-2 and COVID-19. Cell, 2021 Feb 18; 184(4): 861–880.
“The adaptive immune system is important for control of most viral infections. The three fundamental components of the adaptive immune system are B cells (the source of antibodies), CD4+ T cells, and CD8+ T cells…a picture has begun to emerge that reveals that CD4+ T cells, CD8+ T cells, and neutralizing antibodies all contribute to control of SARS-CoV-2 in both non-hospitalized and hospitalized cases of COVID-19.”

141) Sage et al.: Pre-existing heterosubtypic immunity provides a barrier to airborne transmission of influenza viruses. PLOS Pathogens, 2021 Feb; 17(2): e1009273.
“We found that pre-existing H3N2 immunity did not significantly block transmission of the 2009 H1N1pandemic (H1N1pdm09) virus to immune animals. Surprisingly, airborne transmission of seasonal H3N2 influenza strains was abrogated in recipient animals with H1N1pdm09 pre-existing immunity. This protection from natural infection with H3N2 virus was independent of neutralizing antibodies. Pre-existing immunity with influenza B virus did not block H3N2 virus transmission, indicating that the protection was likely driven by the adaptive immune response. We demonstrate that pre-existing immunity can impact susceptibility to heterologous influenza virus strains, and implicate a novel correlate of protection that can limit the spread of respiratory pathogens through the air”.

142) Tarke et al.: Negligible impact of SARS-CoV-2 variants on CD4+ and CD8+ T cell reactivity in COVID-19 exposed donors and vaccines. Cell Reports Medicine, 2021 Jul 20; 2(7): 100355.
“Performed a comprehensive analysis of SARS-CoV-2-specific CD4+ and CD8+ T cell responses from COVID-19 convalescent subjects recognizing the ancestral strain, compared to variant lineages B.1.1.7, B.1.351, P.1, and CAL.20C as well as recipients of the Moderna (mRNA-1273) or Pfizer/BioNTech (BNT162b2) COVID-19 vaccines…
the sequences of the vast majority of SARS-CoV-2 T cell epitopes are not affected by the mutations found in the variants analyzed. Overall, the results demonstrate that CD4+ and CD8+ T cell responses in convalescent COVID-19 subjects or COVID-19 mRNA vaccinees are not substantially affected by mutations”.

143) S. Reynolds: Lasting immunity found after recovery from COVID-19. National Institutes of Health, January 26, 2021
“The researchers found durable immune responses in the majority of people studied. Antibodies against the spike protein of SARS-CoV-2, which the virus uses to get inside cells, were found in 98% of participants one month after symptom onset. As seen in previous studies, the number of antibodies ranged widely between individuals. But, 
promisingly, their levels remained fairly stable over time, declining only modestly at 6 to 8 months after infection… virus-specific B cells increased over time.
Several months ago, our studies showed that natural infection induced a strong response, and this study now shows that the responses last,” Weiskopf says. “We are hopeful that a similar pattern of responses lasting over time will also emerge for the vaccine-induced responses.”

144) M. Shrotri et al.: T cell response to SARS-CoV-2 infection in humans: A systematic review. PLOS One, 2021; 16(1): e0245532
“A complex pattern of T cell response to SARS-CoV-2 infection has been demonstrated, but inferences regarding population level immunity are hampered by significant methodological limitations and heterogeneity between studies, as well as a striking lack of research in asymptomatic or pauci-symptomatic individuals. In contrast to antibody responses, population-level surveillance of the T cell response is unlikely to be feasible in the near term. Focused evaluation in specific sub-groups, including vaccine recipients, should be prioritized.. Symptomatic adult COVID-19 cases consistently show peripheral T cell lymphopenia, which positively correlates with increased disease severity, duration of RNA positivity, and non-survival; while asymptomatic and paediatric cases display preserved counts. People with severe or critical disease generally develop more robust, virus-specific T cell responses. T cell memory and effector function has been demonstrated against multiple viral epitopes, and, cross-reactive T cell responses have been demonstrated in unexposed and uninfected adults, but the significance for protection and susceptibility, respectively, remains unclear”.

145) Galais et al.: Intrafamilial Exposure to SARS-CoV-2 Associated with Cellular Immune Response without Seroconversion, France. CDC, Emerging Infectious Diseases, Volume 27, Number 1 – January 2021.
”Overall, our results indicate that persons exposed to SARS-CoV-2 may develop virus-specific T-cell responses without detectable circulating antibodies. This aspect of the immune response against SARS-CoV-2 contributes substantially to the understanding of the natural history of COVID-19. Furthermore, our data indicate that epidemiologic data relying solely on the detection of SARS-CoV-2 antibodies may lead to a substantial underestimation of prior exposure to the virus”.

146) J. Dan et al.: Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science, 2021 Jan 6: eabf4063
”Individual case reports show that reinfections with SARS-CoV-2 are occurring (76, 77). However, a 2,800 person study found no symptomatic re-infections over a ~118 day window (78), and a 1,246 person study observed no symptomatic re-infections over 6 months (79). We observed heterogeneity in the magnitude of adaptive immune responses to SARS-CoV-2 persisting into the immune memory phase. It is therefore possible that a fraction of the SARS-CoV-2-infected population with low immune memory would become susceptible to re-infection relatively soon. While gender and disease severity both contribute some to the heterogeneity of immune memory reported here, the source of much of the heterogeneity in immune memory to SARS-CoV-2 is unknown and worth further examination. Perhaps heterogeneity derives from low cumulative viral load or a small initial inoculum in some individuals. Nevertheless, our data show immune memory in at least three immunological compartments was measurable in ~95% of subjects 5 to 8 months PSO, indicating that durable immunity against secondary COVID-19 disease is a possibility in most individuals”.

147) Tan et al.: Early induction of functional SARS-CoV-2-specific T cells associates with rapid viral clearance and mild disease in COVID-19 patients. Cell Reports, 2021 Feb 9; 34(6): 108728.
”These findings provide support for the prognostic value of early functional SARS-CoV-2-specific T cells with important implications in vaccine design and immune monitoring… Although rapid induction and quantity of humoral responses associate with an increase in disease severity, early induction of interferon (IFN)-γ-secreting
SARS-CoV-2-specific T cells is present in patients with mild disease and accelerated viral clearance”.

148) Gaebler et al.: Evolution of antibody immunity to SARS-CoV-2. Nature, 2021 Mar; 591(7851): 639–644.
“We conclude that the memory B cell response to SARS-CoV-2 evolves between 1.3 and 6.2 months after infection in a manner that is consistent with antigen persistence”.

149) DiPiazza et al.: T cell immunity to SARS-CoV-2 following natural infection and vaccination. Biochemical and Biophysical Research Communications, 2021 Jan 29; 538: 211–217
“Although T cell durability to SARS-CoV-2 remains to be determined, current data and past experience from human infection with other CoVs demonstrate the potential for persistence and the capacity to control viral replication and host disease”.

150) Newell et al.: Switched and unswitched memory B cells detected during SARS-CoV-2 convalescence correlate with limited symptom duration. PLOS One, 2021; 16(1): e0244855.
”We observed a significant negative correlation between the frequency of peripheral blood memory B cells and the duration of symptoms for convalescent subjects. Memory B cell subsets in convalescent subjects were composed of classical CD24+ class-switched memory B cells, but also activated CD24-negative and natural unswitched CD27+ IgD+ IgM+ subsets. Memory B cell frequency was significantly correlated with both IgG1 and IgM responses to the SARS-CoV-2 spike protein receptor binding domain (RBD) in most seropositive subjects. IgM+ memory, but not switched memory, directly correlated with virus-specific antibody responses, and remained stable over 3 months. Our findings suggest that the frequency of memory B cells is a critical indicator of disease resolution, and that IgM+ memory B cells may play an important role in SARS-CoV-2 immunity”.

151) J. Dan et al.: Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science, 2021 Jan 6: eabf4063.
“Substantial immune memory is generated after COVID-19, involving all four major types of immune memory. About 95% of subjects retained immune memory at ~6 months after infection. Circulating antibody titers were not predictive of T cell memory. Thus, simple serological tests for SARS-CoV-2 antibodies do not reflect the richness and durability of immune memory to SARS-CoV-2. This work expands our understanding of immune memory in humans. These results have implications for protective immunity against SARS-CoV-2 and recurrent COVID-19”.

Notably, memory B cells specific for the Spike protein or RBD were detected in almost all COVID-19 cases, with no apparent half-life at 5 to 8 months post-infection. Other studies of RBD memory B cells are reporting similar findings (50, 60). B cell memory to some other infections has been observed to be long-lived, including 60+ years after smallpox vaccination (61), or 90+ years after infection with influenza”.

152) Wajnberg et al.: Robust neutralizing antibodies to SARS-CoV-2 infection persist for months. Science, 2020 Dec 4; 370(6521): 1227–1230
“Wajnberg et al. used a cohort of more than 30,000 infected individuals with mild to moderate COVID-19 symptoms to determine the robustness and longevity of the anti–SARS-CoV-2 antibody response. They found that neutralizing antibody titers against the SARS-CoV-2 spike protein persisted for at least 5 months after infection. Although continued monitoring of this cohort will be needed to confirm the longevity and potency of this response, these preliminary results suggest that the chance of reinfection may be lower than is currently feared”.

153) Hanrath et al.: Prior SARS-CoV-2 infection is associated with protection against symptomatic reinfection. Journal of Infection, 2020 Dec 26.
“Immunity to seasonal coronaviruses is maintained for up to 12 months. Recent unpublished studies in HCWs reported no evidence of symptomatic reinfection, suggesting that immunity is maintained for at least 6 months. In these studies there was a relatively low event rate (123 and 20 symptomatic infections respectively). It is possible that the protective immunity observed may have been explained in part by the relatively low incidence of SARS-CoV-2 infection. Our data confirms and extends these findings. Despite 290 symptomatic infections in 10,137 non-immune HCWs, there were no symptomatic reinfections in over 1000 HCWs with past infection. We conclude that SARS-CoV-2 infection appears to result in protection against symptomatic infection in working age adults, at least in the short term. This is consistent with the low rates of reinfection reported in the literature”.

154) M. Hellerstein: What are the roles of antibodies versus a durable, high quality T-cell response in protective immunity against SARS-CoV-2? Vaccine: X, 2020 Dec 11; 6: 100076.
“Progress in laboratory markers for SARS-CoV2 has been made with identification of epitopes on CD4 and CD8 T-cells in convalescent blood. These are much less dominated by spike protein than in previous coronavirus infections. Although most vaccine candidates are focusing on spike protein as antigen, natural infection by SARS-CoV-2 induces broad epitope coverage, cross-reactive with other betacoronviruses”.

155) Hartley et al.:
 Rapid generation of durable B cell memory to SARS-CoV-2 spike and nucleocapsid proteins in COVID-19 and convalescence. ScienceImmunology, 2020 Dec 22; 5(54): eabf8891
“Rapid decline of anti-SARS-CoV-2 serum IgG levels beyond 20 days post-diagnosis and the transient presence of circulating plasmablasts have led to questions about the longevity of immunity (17–21). In contrast, antigen-specific memory T cells and memory B (Bmem) cells can be detected in convalescence (22–24).
As these memory cells are programmed to respond rapidly upon subsequent antigen encounter, it is reasonable to hypothesize that these long-lived memory cells provide durable long-term immunity (4, 25). However, detailed insight into the nature and longevity of the Bmem cell compartment specific to SARS-CoV-2 is currently still unresolved (26)…
COVID-19 patients rapidly generate B cell memory to both the spike and nucleocapsid antigens following SARS-CoV-2 infection…
The fact that nearly all RBD-specific IgG+ Bmem cells expressed CD27 and their numbers correlated with circulating TFH cells is indicative of long-lived immune memory…
Several studies have reported a decrease in B cell frequencies during COVID-19 infection which normalized in convalescence (31–34). As these studies report frequencies rather than absolute numbers, the reported decrease might have been confounded by an increase in other immune subsets such as NK cells (31, 33)….
Our results indicate that SARS-CoV-2 infection generates long-lasting B cell memory up to 8 months post-infection that could be protective against systemic disease upon reinfection.
In summary, RBD- and NCP-specific IgG and Bmem cells were detected in all 25 patients with a history of COVID-19. While specific IgG levels in serum declined with time post-symptom onset, SARS-CoV-2-specific Bmem cell numbers persisted, and RBD-specific Bmem cell numbers correlated with TFH cell numbers. This long-term presence of circulating Bmem cell subsets directed against both the major SARS-CoV-2 neutralization target (RBD) and a non-neutralizing target (NCP) is indicative of persisting immune memory following natural exposure and could provide a means to evaluate protection from severe COVID-19 following vaccination”.

156) Bernardes et al.: Longitudinal Multi-omics Analyses Identify Responses of Megakaryocytes, Erythroid Cells, and Plasmablasts as Hallmarks of Severe COVID-19. Immunity,
 2020 Dec 15; 53(6): 1296–1314.e9.
“The study demonstrates broad cellular effects of SARS-CoV-2 infection beyond adaptive immune cells…
In summary, we observed an increase in B cell clonality in COVID-19, and there was an increase of memory B cells and PBs, dominated by the IgA and IgG isotypes and a skewed use of the IGHV gene early during the disease course”.

157) Lumley et al.: Antibodies to SARS-CoV-2 are associated with protection against reinfection.
MedRxiv, doi: (pre-print)
“Critical to understand whether infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) protects from subsequent reinfection… 12219 HCWs participated…prior SARS-CoV-2 infection that generated antibody responses offered protection from reinfection for most people in the six months following infection.”

158) Ripperger et al.: Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity, 2020 Nov 17;53(5):925-933.e4
“We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles.
We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection”.

159) Beretta et al.: Is Cross-Reactive Immunity Triggering COVID-19 Immunopathogenesis? Frontiers in Immunology, 2020; 11: 567710.
”There is also evidence that pre-existing T cell immunity to common cold coronaviruses can prime the response to SARS-CoV-2”.

160) Faulkner et al.: Preexisting and de novo humoral immunity to SARS-CoV-2 in humans. Science, 
2020 Dec 11; 370(6522): 1339–1343.
“Our results from multiple independent assays demonstrate the presence of preexisting antibodies recognizing SARS-CoV-2 in uninfected individuals… SARS-CoV-2 spike glycoprotein (S)–reactive antibodies were detectable using a flow cytometry–based method in SARS-CoV-2–uninfected individuals and were particularly prevalent in children and adolescents”.

161) Yang et al.: Naturally activated adaptive immunity in COVID-19 patients. Journal of Cellular and Molecular Medicine,
2020 Nov;24(21):12457-12463
”We demonstrated that the T and B cells are activated naturally and are functional during SARS-CoV-2 infection. These data provide evidence that the adaptive immunity in most patients could be primed to induce a significant immune response against SARS-CoV-2 infection upon receiving standard medical care”.

162) Peng et al.: Broad and strong memory CD4+ and CD8+ T cells induced by SARS-CoV-2 in UK convalescent individuals following COVID-19. Nature Immunology, 2020 Nov 1; 21(11): 1336–1345.
“We studied T cell memory in 42 patients following recovery from COVID-19 (28 with mild disease and 14 with severe disease)…
The identification of T cell responses associated with milder disease will support an understanding of protective immunity.
The breadth and magnitude of T cell responses were significantly higher in severe compared with mild cases.
Broad, and frequently strong, SARS-CoV-2-specific CD4+ and CD8+ T cell responses were seen in the majority of convalescent patients, with significantly larger overall T cell responses in those who had severe compared with mild disease. However, there was a greater proportion of CD8+ T cell compared with CD4+ T cell responses in mild cases, with higher frequencies of multi-cytokine production by matrix (M)- and NP- specific CD8+ T cells”.

163) Rodda et al.: Functional SARS-CoV-2-Specific Immune Memory Persists after Mild COVID-19. Cell, 2021 Jan 7;184(1):169-183.e17
“Our data further reveal that SARS-CoV-2-specific IgG memory B cells increased over time. Additionally, SARS-CoV-2-specific memory lymphocytes exhibited characteristics associated with potent antiviral function: memory T cells secreted cytokines and expanded upon antigen re-encounter, whereas memory B cells expressed receptors capable of neutralizing virus when expressed as monoclonal antibodies. Therefore, mild COVID-19 elicits memory lymphocytes that persist and display functional hallmarks of antiviral immunity”.

164) Moderbacher et al.: Antigen-Specific Adaptive Immunity to SARS-CoV-2 in Acute COVID-19 and Associations with Age and Disease Severity. Cell, 2020 Nov 12; 183(4): 996–1012.e19.
“We completed a combined examination of all three branches of adaptive immunity at the level of SARS-CoV-2-specific CD4+ and CD8+ T cell and neutralizing antibody responses in acute and convalescent subjects. SARS-CoV-2-specific CD4+ and CD8+ T cells were each associated with milder disease. Coordinated SARS-CoV-2-specific adaptive immune responses were associated with milder disease, suggesting roles for both CD4+ and CD8+ T cells in protective immunity in COVID-19. Notably, coordination of SARS-CoV-2 antigen-specific responses was disrupted in individuals ≥ 65 years old. Scarcity of naive T cells was also associated with aging and poor disease outcomes. A parsimonious explanation is that coordinated CD4+ T cell, CD8+ T cell, and antibody responses are protective, but uncoordinated responses frequently fail to control disease, with a connection between aging and impaired adaptive immune responses to SARS-CoV-2”.

165) Saini et al.: SARS-CoV-2 genome-wide mapping of CD8 T cell recognition reveals strong immunodominance and substantial CD8 T cell activation in COVID-19 patients. SCIENCE IMMUNOLOGY, 2 Apr 2021, Vol 6, Issue 58.
“COVID-19 patients showed strong T cell responses, with up to 25% of all CD8+ lymphocytes specific to SARS-CoV-2-derived immunodominant epitopes, derived from ORF1 (open reading frame 1), ORF3, and Nucleocapsid (N) protein. A strong signature of T cell activation was observed in COVID-19 patients, while no T cell activation was seen in the ‘non-exposed’ and ‘high exposure risk’ healthy donors”.
”The phenotype of the SARS-CoV-2–specific CD8+ T cells revealed a strong T cell activation in patients with COVID-19, whereas minimal T cell activation was seen in healthy individuals. We found that patients with severe disease displayed significantly larger SARS-CoV-2–specific T cell populations compared with patients with mild diseases, and these T cells displayed a robust activation profile. These results further our understanding of T cell immunity to SARS-CoV-2 infection and hypothesize that strong antigen-specific T cell responses are associated with different disease outcomes”.

166) Mateus et al.: Selective and cross-reactive SARS-CoV-2 T cell epitopes in unexposed humans. Science, 2020 Oct 2; 370(6512): 89–94.
”Mateus et al. found that the preexisting reactivity against SARS-CoV-2 comes from memory T cells and that cross-reactive T cells can specifically recognize a SARS-CoV-2 epitope as well as the homologous epitope from a common cold coronavirus. These findings underline the importance of determining the impacts of preexisting immune memory in COVID-19 disease severity”.

167) P. Doshi.: Covid-19: Do many people have pre-existing immunity? British Medical Journal, 2020 Sep 17;370:m3563
“Six studies have reported T cell reactivity against SARS-CoV-2 in 20% to 50% of people with no known exposure to the virus… in a study of donor blood specimens obtained in the US between 2015 and 2018, 50% displayed various forms of T cell reactivity to SARS-CoV-2… Researchers are also confident that they have made solid inroads into ascertaining the origins of the immune responses. “Our hypothesis, of course, was that it’s so called ‘common cold’ coronaviruses, because they’re closely related…we have really shown that this is a true immune memory and it is derived in part from common cold viruses.”

168) Peng et al.: Broad and strong memory CD4+ and CD8+ T cells induced by SARS-CoV-2 in UK convalescent individuals following COVID-19. Nature immunology, 2020 Nov 1; 21(11): 1336–1345.
“Taken together, this study has demonstrated strong and broad SARS-CoV-2-specific CD4+ and CD8+ T cell responses in the majority of humans who had recovered from COVID-19”.

169) Jones et al.: Persistence and decay of human antibody responses to the receptor binding domain of SARS-CoV-2 spike protein in COVID-19 patients. Nature Immunology, 2020 Nov 1; 21(11): 1336–1345.
”We measured plasma and/or serum antibody responses to the receptor-binding domain (RBD) of the spike (S) protein of SARS-CoV-2 in 343 North American patients infected with SARS-CoV-2 (of which 93% required hospitalization) up to 122 days after symptom onset and compared them to responses in 1548 individuals whose blood samples were obtained prior to the pandemic..
IgG antibodies persisted at detectable levels in patients beyond 90 days after symptom onset, and seroreversion was only observed in a small percentage of individuals… The concentration of these anti-RBD IgG antibodies was also highly correlated with pseudovirus NAb titers, which also demonstrated minimal decay. The observation that IgG and neutralizing antibody responses persist is encouraging, and suggests the development of robust systemic immune memory in individuals with severe infection”.

170) Cox et al.: Not just antibodies: B cells and T cells mediate immunity to COVID-19. Nature Rewies Immunology, 2020; 20(10): 581–582.
“Recent reports that antibodies to SARS-CoV-2 are not maintained in the serum following recovery from the virus have caused alarm. However, the absence of specific antibodies in the serum does not necessarily mean an absence of immune memory”.
COVID-19 is caused by infection with SARS-CoV-2, which is a member of the coronavirus family. There are currently four human coronaviruses (HCoVs) that cause respiratory infections or the ‘common cold’ (namely, 229E, NL63, OC43 and HKU1), as well as three coronaviruses that have arisen through zoonosis and cause severe diseases in humans, namely, SARS-CoV, MERS-CoV and SARS-CoV-2, which emerged in 2003, 2012 and 2019, respectively…

A recent report suggesting that antibodies to the virus may only be maintained for 2 months has caused speculation that ‘immunity’ to the virus may not be long lived. Similarly, a rapid decline in antibodies was reported in mild cases. It is important to remember that memory B cells and T cells may be maintained even if there are not measurable levels of serum antibodies…
Although spike-specific CD4+ T cells are found in patients with COVID-19, 30–50% of healthy people with no detectable COVID-19 infection also had SARS-CoV-2-specific CD4+ T cells and 20% had CD8+ cytotoxic T cells. These T cells are probably cross-reactive with other HCoVs, but whether they can provide protection from COVID-19 disease remains to be determined.

Studies of patients who became infected with SARS-CoV in 2003 suggested that the infection induced durable T cell responses lasting for 6 years but no long-term memory B cells. Importantly, these T cells were shown to cross-react with the SARS-CoV-2 virus 17 years later”.

171) P. Nguyen-Contant et al.: S Protein-Reactive IgG and Memory B Cell Production after Human SARS-CoV-2 Infection Includes Broad Reactivity to the S2 Subunit. American Society for Microbiology ASM, 2020 Sep-Oct; 11(5): e01991-20
“Most importantly, we demonstrate that SARS-CoV-2 infection generates both IgG and IgG MBCs reactive to the novel RBD and the conserved S2 subunit of the S protein…. In conclusion, our analysis investigated Ab and MBC immunity to SARS-CoV-2 in unexposed subjects and individuals soon after recovery from SARS-CoV-2 infection. The findings emphasized the novelty of the SARS-CoV-2 S protein RBD in unexposed subjects. However, IgG reactive to the S2 was widespread in unexposed subjects and likely resulted from exposure to HCoVs. Although our approach was unable to directly identify S2-reactive MBCs in the unexposed subjects, we suggest that these cells were present and strongly contributed S2-reactive IgG early in the response to SARS-CoV-2 infection. The IgG response in convalescent SARS-CoV-2 subjects was also strong against the RBD and, less consistently, against the N protein. Importantly, the convalescent SARS-CoV-2 subjects had generated RBD-reactive and S2-reactive IgG MBCs. The RBD-reactive MBCs are likely to provide strong long-term protection if RBD-reactive neutralizing Ab levels wane and reinfection occurs”.

172) Gudbjartsson et al.: Humoral Immune Response to SARS-CoV-2 in Iceland. New England Journal of Medicine, 2020 Oct 29;383(18):1724-173
”Our results indicate that antiviral antibodies against SARS-CoV-2 did not decline within 4 months after diagnosis. We estimate that the risk of death from infection was 0.3%”.

173) Juno et al.: Humoral and circulating follicular helper T cell responses in recovered patients with COVID-19. Nature Medicine, 2020 Sep;26(9):1428-1434
”We found that S-specific antibodies, memory B cells and cTFH are consistently elicited after SARS-CoV-2 infection, demarking robust humoral immunity and positively associated with plasma neutralizing activity.

174) Isho et al.: Evidence for sustained mucosal and systemic antibody responses to SARS-CoV-2 antigens in COVID-19 patients.
MedRxiv, August 04, 2020,
doi: (pre-print)
“Whereas anti-CoV-2 IgA antibodies rapidly decayed, IgG antibodies remained relatively stable up to 115 days PSO in both biofluids. Importantly, IgG responses in saliva and serum were correlated, suggesting that antibodies in the saliva may serve as a surrogate measure of systemic immunity”.

175) T. Hicklin, Immune cells for common cold may recognize SARS-CoV-2. National Institute of Health NIH, August 18, 2020 (scientific article)
“Now a new study led by scientists at La Jolla Institute for Immunology (LJI) shows that memory helper T cells that recognize common cold coronaviruses also recognize matching sites on SARS-CoV-2, the virus that causes COVID-19. The research, published Aug. 4, 2020 in Science, may explain why some people have milder COVID-19 cases than others—though the researchers emphasize that this is speculation and much more data is needed.
“We have now proven that, in some people, pre-existing T cell memory against common cold coronaviruses can cross-recognize SARS-CoV-2, down to exact molecular structures,” says LJI Research Assistant Professor Daniela Weiskopf, Ph.D., who co-led the new study with LJI Professor Alessandro Sette, Dr. Biol. Sci. “This could help explain why some people show milder symptoms of disease while others get severely sick.”

176) Braun et al.: SARS-CoV-2-reactive T cells in healthy donors and patients with COVID-19. Nature, 2020 Nov;587(7833):270-274
“Spike-protein-reactive T cell lines generated from SARS-CoV-2-naive healthy donors responded similarly to the C-terminal region of the spike proteins of the human endemic coronaviruses 229E and OC43, as well as that of SARS-CoV-2. This results indicate that spike-protein cross-reactive T cells are present, which were probably generated during previous encounters with endemic coronaviruses… the presence of spike-protein cross-reactive T cells in a considerable fraction of the general population may affect the dynamics of the current pandemic”.

177) Sette et al.: Pre-existing immunity to SARS-CoV-2: the knowns and unknowns. Nature Rewies Immunology, 2020 Aug;20(8):457-458
“T cell reactivity against SARS-CoV-2 was observed in unexposed people… it is speculated that this reflects T cell memory to circulating ‘common cold’ coronaviruses”.

“In conclusion, it is now established that SARS-CoV-2 pre-existing immune reactivity exists to some degree in the general population. It is hypothesized, but not yet proven, that this might be due to immunity to CCCs. This might have implications for COVID-19 disease severity, herd immunity”.

178) Bert et al.: SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls. Nature, 2020 Aug;584(7821):457-462
“In all of these individuals, we found CD4 and CD8 T cells that recognized multiple regions of the N protein. Next, we showed that patients (n = 23) who recovered from SARS (the disease associated with SARS-CoV infection) possess long-lasting memory T cells that are reactive to the N protein of SARS-CoV 17 years after the outbreak of SARS in 2003; these T cells displayed robust cross-reactivity to the N protein of SARS-CoV-2. We also detected SARS-CoV-2-specific T cells in individuals with no history of SARS, COVID-19 or contact with individuals who had SARS and/or COVID-19 (n = 37).
Thus, infection with betacoronaviruses induces multi-specific and long-lasting T cell immunity against the structural N protein”.

179) F. Collins: Immune T Cells May Offer Lasting Protection Against COVID-19. National institute of Health, Blog, July 28th, 2020
“Much of the study on the immune response to SARS-CoV-2, the novel coronavirus that causes COVID-19, has focused on the production of antibodies. But, in fact, immune cells known as memory T cells also play an important role in the ability of our immune systems to protect us against many viral infections, including—it now appears—COVID-19. An intriguing new study of these memory T cells suggests they might protect some people newly infected with SARS-CoV-2 by remembering past encounters with other human coronaviruses. This might potentially explain why some people seem to fend off the virus and may be less susceptible to becoming severely ill with COVID-19.”

180) A. Grifoni et al.: Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals. 
Cell, 2020 Jun 25; 181(7): 1489–1501.e15.
”Using HLA class I and II predicted peptide “megapools,” circulating SARS-CoV-2-specific CD8+ and CD4+ T cells were identified in ∼70% and 100% of COVID-19 convalescent patients.
Importantly, we detected SARS-CoV-2-reactive CD4+ T cells in ∼40%–60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating “common cold” coronaviruses and SARS-CoV-2”.

181) Robiani et al.: Convergent Antibody Responses to SARS-CoV-2 in Convalescent Individuals. Nature. 2020 Aug; 584(7821): 437–442.
“Antibody sequencing revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titers, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50s) as low as single digit ng/mL. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested”.

182) Ling Ni et al.:
 Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals. Immunity, 2020 Jun 16; 52(6): 971–977.e3.
“Collected blood from COVID-19 patients who have recently become virus-free, and therefore were discharged, and detected SARS-CoV-2-specific humoral and cellular immunity in eight newly discharged patients. Follow-up analysis on another cohort of six patients 2 weeks post discharge also revealed high titers of immunoglobulin G (IgG) antibodies. In all 14 patients tested, 13 displayed serum-neutralizing activities in a pseudotype entry assay. Notably, there was a strong correlation between neutralization antibody titers and the numbers of virus-specific T cells. Our work provides a basis for further analysis of protective immunity to SARS-CoV-2, and understanding the pathogenesis of COVID-19, especially in the severe cases”.

183) Wang et al.: Neutralizing Antibodies Responses to SARS-CoV-2 in COVID-19 Inpatients and Convalescent Patients. Clinical infectious Diseases, 2020 Jun 4 : ciaa721.
”The neutralizing antibodies were detected even at the early stage of disease, and a significant response showed in convalescent patients”.

184) Weiskopf et al.: Phenotype of SARS-CoV-2-specific T-cells in COVID-19 patients with acute respiratory distress syndrome. SCIENCE IMMUNOLOGY, 26 Jun 2020 Vol 5, Issue 48
“We detected SARS-CoV-2-specific CD4+ and CD8+ T cells in 100% and 80% of COVID-19 patients, respectively. We also detected low levels of SARS-CoV-2-reactive T-cells in 20% of the healthy controls, not previously exposed to SARS-CoV-2 and indicative of cross-reactivity due to infection with ‘common cold’ coronaviruses”.

185) Smetana et al.: Decreasing Seroprevalence of Measles Antibodies after Vaccination – Possible Gap in Measles Protection in Adults in the Czech Republic.
 PLOS One, 2017 Jan 13;12(1): e0170257.
”A long term high rate of seropositivity persists after natural measles infection. By contrast, it decreases over time after vaccination”.

186) A. Chia et al.: Memory T cell responses targeting the SARS coronavirus persist up to 11 years post-infection. Vaccine, 2016 Apr 12; 34(17): 2008–2014.
“Severe acute respiratory syndrome (SARS) is a highly contagious infectious disease which first emerged in late 2002, caused by a then novel human coronavirus, SARS coronavirus… In this study, the screening for the presence of SARS-specific T cells in a cohort of three SARS-recovered individuals at 9 and 11 years post-infection was carried out, and all memory T cell responses detected target the SARS-CoV structural proteins. Two CD8+ T cell responses targeting the SARS-CoV membrane (M) and nucleocapsid (N) proteins were characterized by determining their HLA restriction and minimal T cell epitope regions. Furthermore, these responses were found to persist up to 11 years post-infection… The knowledge of the persistence of SARS-specific celullar immunity targeting the viral structural proteins in SARS-recovered individuals is important…”

187) Shridhar et al.: Cellular immune correlates of protection against symptomatic pandemic influenza. Nature Medicine, 2013 Oct;19(10):1305-12
“The 2009 H1N1 pandemic (pH1N1) provided a unique natural experiment to determine whether crossreactive cellular immunity limits symptomatic illness in antibody-naive individuals… Higher frequencies of pre-existing T cells to conserved CD8 epitopes were found in individuals who developed less severe illness, with total symptom score having the strongest inverse correlation with the frequency of interferon-γ (IFN-γ)(+) interleukin-2 (IL-2)(-) CD8(+) T cells (r = -0.6, P = 0.004)… CD8(+) T cells specific to conserved viral epitopes correlated with crossprotection against symptomatic influenza.”

188) Petrova et al.: Cross-Reactivity of T Cells and Its Role in the Immune System. Critical Reviews in Immunology. 2012; 32(4): 349–372.
“T-cell cross-reactivity based on recognition of more than one peptide by a TCR can be a very important facet of immune responses. Networks of cross-reactive T cells might generate a robust system that can deal with most novel pathogens in the absence of large-scale de novo production of naïve T cells, as is found in human post-thymic involution”.

189) Wilkinson et al.: Preexisting influenza-specific CD4+ T cells correlate with disease protection against influenza challenge in humans. Nature Medicine, 2012 Jan 29;18(2):274-80
“Protective immunity against influenza virus infection is mediated by neutralizing antibodies, but the precise role of T cells in human influenza immunity is uncertain. We conducted influenza infection studies in healthy volunteers with no detectable antibodies to the challenge viruses H3N2 or H1N1. We mapped T cell responses to influenza before and during infection. We found a large increase in influenza-specific T cell responses by day 7, when virus was completely cleared from nasal samples and serum antibodies were still undetectable. Preexisting CD4+, but not CD8+, T cells responding to influenza internal proteins were associated with lower virus shedding and less severe illness. These CD4+ cells also responded to pandemic H1N1 (A/CA/07/2009) peptides and showed evidence of cytotoxic activity. These cells are an important statistical correlate of homotypic and heterotypic response and may limit severity of influenza infection by new strains in the absence of specific antibody responses”.

190) Tang et al.: Lack of Peripheral Memory B Cell Responses in Recovered Patients with Severe Acute Respiratory Syndrome: A Six-Year Follow-Up Study, The Journal of immunology, June 15, 2011, 186 (12) 7264-7268;
“In conclusion, specific IgG Ab to SARS-CoV eventually vanish in most SARS patients. Peripheral memory B cell responses are undetectable in all the patients. However, quite a portion of the patients maintain T cell memory even 6 y postinfection. Whether the T cell anamnestic response is adequate to protect a person from reinfection requires further investigation”.

191) Vivier et al.: Innate or adaptive immunity? The example of natural killer cells. Science, 2011 Jan 7;331(6013):44-9
“More recently, a more nuanced view of NK cells has emerged. NK cells are now recognized to express a repertoire of activating and inhibitory receptors that is calibrated to ensure self-tolerance while allowing efficacy against assaults such as viral infection and tumor development. Moreover, NK cells do not react in an invariant manner but rather adapt to their environment. Finally, recent studies have unveiled that NK cells can also mount a form of antigen-specific immunologic memory. NK cells thus exert sophisticated biological functions that are attributes of both innate and adaptive immunity, blurring the functional borders between these two arms of the immune response”.

192) Wrammert et al.: Broadly cross-reactive antibodies dominate the human B cell response against 2009 pandemic H1N1 influenza virus infection. Journal of Experimental Medicine, 2011 Jan 17; 208(1): 181–193.
“The 2009 pandemic H1N1 influenza pandemic demonstrated the global health threat of reassortant influenza strains. Herein, we report a detailed analysis of plasmablast and monoclonal antibody responses induced by pandemic H1N1 infection in humans. Unlike antibodies elicited by annual influenza vaccinations, most neutralizing antibodies induced by pandemic H1N1 infection were broadly cross-reactive against epitopes in the hemagglutinin (HA) stalk and head domain of multiple influenza strains.
The antibodies were from cells that had undergone extensive affinity maturation. Based on these observations, we postulate that the plasmablasts producing these broadly neutralizing antibodies were predominantly derived from activated memory B cells specific for epitopes conserved in several influenza strains…
We propose that the expansion of these rare types of memory B cells may explain why most people did not become severely ill, even in the absence of preexisting protective antibody titers. Recent studies in mice strongly support the idea that consecutive immunizations with antigens from divergent influenza stains can indeed hone the antibody response to preferentially target broadly protective conserved epitopes…
In conclusion, analyses of the 46 mAbs induced by pandemic H1N1 infection indicated frequent activation of broadly reactive B cells. We propose that these cells had a memory cell origin caused by cross-reactivity to conserved and functionally important epitopes”.

193) Bodewes et al.: Yearly influenza vaccinations: a double-edged sword? Bodewes et al. The Lancet Infectious Diseases, Volume 9, Issue 12, December 2009, Pages 784-788
”However, it has been shown-mainly in animals-that infection with influenza A viruses can induce protective immunity to influenza A viruses of other unrelated subtypes. This so-called heterosubtypic immunity does not provide full protection, but can limit virus replication and reduce morbidity and mortality of the host. This type of immunity might be relevant to human beings when a new subtype of influenza A virus is introduced into the population, such as the new influenza A H1N1 virus responsible for the present influenza pandemic and the highly pathogenic avian influenza H5N1 viruses that are causing an ever increasing number of human infections with high mortality rates.
Preventing infection with seasonal influenza viruses by vaccination might prevent the induction of heterosubtypic immunity to pandemic strains, which might be a disadvantage to immunologically naive people-eg, infants”.

194) Greenbaum et al.: Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population. 2009 Dec 1; 106(48): 20365–20370
“A major concern about the ongoing swine-origin H1N1 influenza virus (S-OIV) outbreak is that the virus may be so
different from seasonal H1N1 that little immune protection exists in the human population. Memory T-cell immunity against S-OIV is present in the adult population and that such memory is of similar magnitude as the pre-existing memory against seasonal H1N1 influenza…the conservation of a large fraction of T-cell epitopes suggests that the severity of an S-OIV infection, as far as it is determined by susceptibility of the virus to immune attack, would not differ much from that of seasonal flu.”

195) Centers for Disease Control and Prevention (CDC): Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. Morbidity and Mortality weekly Report, 2009 May 22;58(19):521-4.
“No increase in cross-reactive antibody response to the novel influenza A (H1N1) virus was observed among adults aged >60 years. These data suggest that receipt of recent (2005–2009) seasonal influenza vaccines is unlikely to elicit a protective antibody response to the novel influenza A (H1N1) virus”.

196) X. Ju et al.: Neutralizing antibodies derived from the B cells of 1918 influenza pandemic survivors. Nature, 2008 Sep 25;455(7212):532-6
“Here we show that of the 32 individuals tested that were born in or before 1915, each showed seroreactivity with the 1918 virus, nearly 90 years after the pandemic. Seven of the eight donor samples tested had circulating B cells that secreted antibodies that bound the 1918 HA. Thus, these studies demonstrate that survivors of the 1918 influenza pandemic possess highly functional, virus-neutralizing antibodies to this uniquely virulent virus, and that humans can sustain circulating B memory cells to viruses for many decades after exposure—well into the tenth decade of life”.

197) Welsh et al.: No one is naive: the significance of heterologous T-cell immunity. Nature Reviewa Immunology, 2002 Jun;2(6):417-26.
”Memory T cells that are specific for one virus can become activated during infection with an unrelated heterologous virus, and might have roles in protective immunity and immunopathology. The course of each infection is influenced by the T-cell memory pool that has been laid down by a host’s history of previous infections, and with each successive infection, T-cell memory to previously encountered agents is modified”.

198) Berczi et al.: Neuroimmunoregulation and natural immunity. Domestic Animal Endocrinilogy, 1998 Sep;15(5):273-81
”Bone marrow activity and leukocyte function are high and the liver is converted to the rapid production of acute-phase proteins (APP). APP include LBP, CRP, fibrinogen, some complement components, enzyme inhibitors, and anti-inflammatory proteins, which may rise in the serum from several hundred to a thousand times within 24-48 hr. Therefore, natural immunity is a polyspecific response to homotopes, which functions as an instantaneous defense mechanism in health and which is rapidly boosted by cytokines and hormones during febrile illness. This is a highly successful defense reaction, as in the overwhelming majority of cases, febrile illness leads to recovery and the development of adaptive immunity in man and higher animals”.

199) Valk et al.: SARS-Cov-2: The Relevance and Prevention of Aerosol Transmission. Journal of Occupational and Environmeltal Medicine. 2021 Jun 1;63(6):e395-e401
“However, the large number of COVID-19 infections cannot be explained only by droplet deposition or contact contamination. It seems very plausible that aerosols are important in transmitting SARS-Cov-2. It has been demonstrated that SARS-CoV-2 remains viable in aerosols for hours, facilitating rapid distribution of the virus over great distances. Aerosols may, therefore, also be responsible for so-called super-spreader events.

200) Hawks et al.: Infectious SARS-CoV-2 Is Emitted in Aerosol Particles. American Society for Microbiology, 2021 Oct 26;12(5): e0252721
“Respiratory viruses such as SARS-CoV-2 are transmitted in respiratory droplets and aerosol particles, which are released during talking, breathing, coughing, and sneezing. Noncontact transmission of SARS-CoV-2 has been demonstrated, suggesting transmission via virus carried through the air…. The majority of virus was contained within particles <5 μm in size. Thus, we provide direct evidence that, in hamsters, SARS-CoV-2 is an airborne virus.

201) Setti et al.: Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough. International Journal of Environmental Research and Public Health, 2020 Apr 23;17(8):2932.
“Recently published studies support the hypothesis of virus transmission over a distance of 2 m from an infected person. Researchers have proved the higher aerosol and surface stability of SARS-COV-2 as compared with SARS-COV-1 (with the virus remaining viable and infectious in aerosol for hours) and that airborne transmission of SARS-CoV can occur besides close-distance contacts. Indeed, there is reasonable evidence about the possibility of SARS-COV-2 airborne transmission due to its persistence into aerosol droplets in a viable and infectious form. Based on the available knowledge and epidemiological observations, it is plausible that small particles containing the virus may diffuse in indoor environments covering distances up to 10 m from the emission sources, thus representing a kind of aerosol transmission”.

202) Gohli et al.: Dispersion of SARS-CoV-2 in air surrounding COVID-19-infected individuals with mild symptoms. Indoor Air, 2022 Feb;32(2): e13001.
“Accumulating evidence suggests that SARS-CoV-2 can be transmitted by aerosols, and not only via larger respiratory droplets”.

203) Bahl et al.: Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019? The Journal of Infectious Diseases, 2022 May 4;225(9):1561-1568
“Of 10 studies on horizontal droplet distance, 8 showed droplets travel more than 2 meters (≈6 feet), in some cases up to 8 meters. Available studies also show that SARS-CoV-2 can be detected in the air, and remain viable 3 hours after aerosolization”.

204) Port et al.: Increased small particle aerosol transmission of B.1.1.7 compared with SARS-CoV-2 lineage A in vivo. Nature Microbiology, 2022 Feb;7(2):213-223
“The major transmission route for SARS-CoV-2 is airborne. However, previous studies could not elucidate the contribution between large droplets and aerosol transmission of SARS-CoV-2 and its variants… Aerosol transmission of both variants was confirmed in all sentinels after 24 h of exposure as demonstrated by respiratory virus shedding and seroconversion. Productive transmission also occurred after 1 h of exposure, highlighting the efficiency of this transmission route… Interestingly, after donors were infected with a mix of both variants, the Alpha variant outcompeted the lineage A variant in an airborne transmission chain. Overall, these data indicate that a lower infectious dose of the Alpha variant, compared to lineage A, could be sufficient for successful transmission.

205) Mallach et al.: Aerosol SARS-CoV-2 in hospitals and long-term care homes during the COVID-19 pandemic. PLOS One, 2021 Sep 30;16(9):e0258151
“We deployed particulate air samplers in rooms with COVID-19 positive patients in hospital ward and ICU rooms, rooms in long-term care homes experiencing outbreaks, and a correctional facility experiencing an outbreak. Samplers were placed between 2 and 3 meters from the patient. Aerosol (small liquid particles suspended in air) samples were collected onto gelatin filters by Ultrasonic Personal Air Samplers… In total, 138 samples were collected from 99 rooms. RNA samples were positive in 9.1% (6/66) of samples obtained with the UPAS 2.5μm samplers, 13.5% (7/52) with the UPAS 10μm samplers, and 10.0% (2/20) samples obtained with the Coriolis samplers. Viral RNA was detected in 15.1% of the rooms sampled. There was no significant difference in viral RNA recovery between the different room locations or samplers. Method development experiments indicated minimal loss of SARS-CoV-2 viability via the personal air sampler operation”.

206) Tang et al.: Aerosol transmission of SARS-CoV-2? Evidence, prevention and control. Environmental International, 2020 Nov; 144: 106039
“We aimed to review the evidence of aerosol transmission of SARS-CoV-2. Several studies support that aerosol transmission of SARS-CoV-2 is plausible, and the plausibility score (weight of combined evidence) is 8 out of 9”.

207) Doremalen et al.: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The New England Journal of Medicine, 2020 Mar 17: NEJMc2004973.
“Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed)

208) Jayaweera et al.: Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environmental Research, 020 Sep; 188: 109819
“The case studies found worldwide indicate that the behavior of the SARS-CoV-2 virus has been unprecedentedly unique with more survival and viable rates in the air and believed to linger in the air for an extended period.

209) Chatterjee et al.: How coronavirus survives for hours in aerosols. Physics of Fluids, 2021 Aug;33(8):081708
“Recently published titer measurements of SARS-CoV-2 in aerosols have disclosed that the coronavirus can survive for hours”.

210) M C Jarvis: Aerosol Transmission of SARS-CoV-2: Physical Principles and Implications. Frontiers in Public Health, 2020 Nov 23;8:590041
“Evidence has emerged that SARS-CoV-2, the coronavirus that causes COVID-19, can be transmitted airborne in aerosol particles as well as in larger droplets or by surface deposits.
There are also opportunities to inactivate SARS-CoV-2 in aerosol form with sunlight or UV lamps”.

211) Finch et al.: SARS-CoV-2 antibodies protect against reinfection for at least 6 months in a multicentre seroepidemiological workplace cohort. PLOS Biology Collection – Antiviral innate Immunity, 2022 Feb 10;20(2):e3001531
“The presence of SARS-CoV-2 antibodies at baseline is associated with around 72% to 86% reduced odds of a subsequent PCR positive test based on our point estimates. This suggests that primary infection with SARS-CoV-2 provides protection against reinfection in the majority of individuals, at least over a 6-month time period”.

212) Flacco et al.: Rate of reinfections after SARS-CoV-2 primary infection in the population of an Italian province: a cohort study. Journal of Public Health, Oxford Academics, 2021 Sep 8 : fdab346.
This study confirms previous findings on a low risk of SARS-CoV-2 reinfection. If confirmed, these findings suggest that more targeted restriction policies can be applied to the subjects that recovered after a first infection. Overall, these findings are in line with the available literature,3–6,8 suggesting that the natural immunity confers substantial protection in the first months after the primary infection: all the published cohort studies reported reinfection rates lower than 1%,3–6 and the only Italian study, on a sample of 1579 positive subjects, reported a virtually identical reinfection rate (0.32%).6 However, this is the first study with a follow-up longer than 12 months, and the first to provide data separately for the minors: notably, no reinfections were recorded after 12 months of follow-up, and none of the 832 included minors experienced a reinfection.

213) Deadline, DR tv: Thea Kølsen Fischer, professor of public health, viral infections and epidemics at the University of Copenhagen, head of research at Nordsjællands Hospital, former head of the national virus surveillance at the Statens Serum Institut and trained disease detective at the Centers for Disease Control in the USA: ”80% get no or only mild symptoms with this virus”.
Source: DR tv, Deadline 23.11.2021.  22.50 minute. (Danish speak)

214) Andeweg et al. Elevated risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variant compared to Alpha variant in vaccinated individuals. Science Translational Medicine, 2022 Jul 21; eabn4338.
”We analyzed 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status obtained through national community testing in the Netherlands from March to August 2021. We found evidence of an increased risk of infection by the Beta (B.1.351), Gamma (P.1), or Delta (B.1.617.2) variants compared to the Alpha (B.1.1.7) variant after vaccination. No clear differences were found between vaccines. However, the effect was larger in the first 14-59 days after complete vaccination compared to ≥60 days.
In contrast to vaccine-induced immunity, there was no increased risk for re-infection with Beta, Gamma or Delta variants relative to Alpha variant in individuals with infection-induced immunity”.

215) Borsche et al.: COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis. Nutrients, 2021 Oct; 13(10): 3596.
”Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity”.

216) Cardozo et al.: Informed consent disclosure to vaccine trial subjects of risk of COVID-19 vaccines worsening clinical disease. International Journal of Clinical Practice, 2021 Mar;75(3):e13795.
“COVID-19 vaccines designed to elicit neutralising antibodies may sensitise vaccine recipients to more severe disease than if they were not vaccinated… these vaccines… may worsen COVID-19 disease via antibody-dependent enhancement (ADE)… The specific and significant COVID-19 risk of ADE should have been and should be prominently and independently disclosed to research subjects currently in vaccine trials, as well as those being recruited for the trials and future patients after vaccine approval, in order to meet the medical ethics standard of patient comprehension for informed consent”.

217) Shelley et al: Impact of Microbiota: A Paradigm for Evolving Herd Immunity against Viral Diseases. Viruses, 2020 Oct; 12(10): 1150.
“Here, we outline several factors that can directly or indirectly alter the acquisition of immunity. Among those factors, the gut microbiota is an essential element that contributes to shaping individual immunity and thereby mapping the population immunity. Gut microbiota, along with nutrients and environmental factors, play an indispensable and cumulative role in establishing herd immunity against any infectious disease. We propose that heterologous immunity is the most important factor contributing protection against SARS-CoV-2 infection in India… Imbalance of nutrients perturbs microbiota and abrogates immunity. Thus, a particular population can become vulnerable to the infection…  Intestinal dysbiosis leads to environmental enteropathy (EE). As a consequence, the generation of herd immunity can either be delayed or not start in a particular cohort”.

218) Sanders: Stronger, More Robust Natural Immunity Thwarts Any Case for “Vaccine Passports”. American Institute for Economic Research, September 9, 2021.
“A growing body of research is making it increasingly clear that natural immunity to Covid-19 owing to previous infection is stronger, more durable, and broader than vaccine-induced immunity. Apart from not being unusual among infectious diseases, this fact has significant implications for governmental, school, employer, and business plans to harass and restrict people who aren’t vaccinated”.

219) Sekine et al: Robust T Cell Immunity in Convalescent Individuals with Asymptomatic or Mild COVID-19. Cell, 2020 Oct 1;183(1):158-168.
“Our collective dataset shows that SARS-CoV-2 elicits broadly directed and functionally replete memory T cell responses, suggesting that natural exposure or infection may prevent recurrent episodes of severe COVID-19”.

220) Corona passport changes: Previous infection protects worse than vaccine. Berlingske, 11.11.2021 (text in Danish)

The Danish Health Authority recommends a shorter duration of the corona passport (text in Danish)

221) Trougakos et al: Adverse effects of COVID-19 mRNA vaccines: the spike hypothesis. Trends in Molecular Medicine, 2022 Jul; 28(7): 542–554.
“Adverse effects (AEs) following vaccination have been noted which may relate to a proinflammatory action of the lipid nanoparticles used or the delivered mRNA (i.e., the vaccine formulation), as well as to the unique nature, expression pattern, binding profile, and proinflammatory effects of the produced antigens – spike (S) protein and/or its subunits/peptide fragments – in human tissues or organs…
In mRNA vaccines, which are characterized by relatively rapid prototyping and manufacturing on a large scale, the S protein-encoding mRNA is delivered via lipid nanoparticles (LNPs) to human cells that produce the mature viral protein or related antigens…
Finally, as we essentially do not know for how long and at what concentration the LNPs and the antigen(s) remain in human tissues or the circulation of poor vaccine responders, the elderly, or children (see Outstanding questions), and given the fact that cellular immunity likely persists despite reduced in vitro neutralizing titers [28], boosting doses should be delivered only where the benefit–risk profile is clearly established”.

222) Ntouros et al: Effective DNA damage response after acute but not chronic immune challenge: SARS-CoV-2 vaccine versus Systemic Lupus Erythematosus. Clinical Immunology, 2021 Aug; 229: 108765.
“Whether and how an acute immune challenge may affect DNA Damage Response (DDR) is unknown. By studying vaccinations against Influenza and SARS-CoV-2 (mRNA-based) we found acute increases of type-I interferon-inducible gene expression, oxidative stress and DNA damage accumulation in blood mononuclear cells of 9 healthy controls, coupled with effective anti-SARS-CoV-2 neutralizing antibody production in all.

Increased DNA damage after SARS-CoV-2 vaccine, partly due to increased oxidative stress, was transient, whereas the inherent DNA repair capacity was found intact.

In contrast, in 26 patients with Systemic Lupus Erythematosus, who served as controls in the context of chronic immune activation, we validated increased DNA damage accumulation, increased type-I interferon-inducible gene expression and induction of oxidative stress, however aberrant DDR was associated with deficiencies in nucleotide excision repair pathways. These results indicate that acute immune challenge can indeed activate DDR pathways, whereas, contrary to chronic immune challenge, successful repair of DNA lesions occurs”.

223) Kowarz et al: Vaccine-induced COVID-19 mimicry syndrome. Elife, Cell Biology, Microbiology and infectious Disease, Jan 27, 2022.
”Meanwhile, scientists have proposed an immune-based pathomechanism and the condition has been coined vaccine-induced immune thrombotic thrombocytopenia (VITT)”.

224) Harvard researchers: COVID-19 vaccines could permanently alter human genomic DNA

225) Danmark har 8,8% ikke-vestlige indvandrere (2020) (Denmark has 8.8% non-Western immigrants (2020))

226) Sverige har 22% indvandrere (2020) (Sweden has 22% immigrants (2020)

227) Kanstrup og Petersen, København Universitet: Danmark og Sverige har »klaret sig fuldstændig ens – trods vidt forskellige strategier. (Denmark and Sweden have ‘done exactly the same – despite very different strategies)
Berlingske, den 08.7.2022.

228) Sundhedsmagasinet: Danmark kan spare 15-16% (30-32 mia. kr.) på de årlige sundhedsudgifter, ved at udrydde D-vitaminmangel, Dr tv, 2016.
(Sundhedsmagasinet: Denmark can save 15-16% (DKK 30-32 billion) on annual health costs by eradicating vitamin D deficiency, Dr tv, 2016).

229) 15% more elderly people over 80 in Sweden compared to Denmark. (15% flere ældre over 80 år i Sverige ift. Danmark). Nordic Counsil of Minister: State of the Nordic Region, 201815, figur 2.4, side 28.

230) EBMPHET Consortium: COVID-19 Severity in Europe and the USA: Could the Seasonal Influenza Vaccination Play a Role? EBMPHET Consortium, June 7, 2020 (pre-print)
”Our analysis indicates that receiving seasonal influenza vaccination(s) in the past might be an additional risk factor for the elderly in terms of enhanced susceptibility to infection with SARS-CoV-2 and higher likelihood of a lethal outcome in case of infection. More research about this possible risk factor is urgently needed”.

231) Kim et al: Duration of SARS-CoV-2 Natural Immunity and Protection against the Delta Variant: A Retrospective Cohort Study. Clinical Infectious Diseases, 2021 Dec 3 : ciab999.
”SARS-CoV-2 infection is highly protective against reinfection with Delta. Immunity from prior infection lasts at least 13 months. Countries facing vaccine shortages should consider delaying vaccinations for previously infected patients to increase access”.

232) Flacco et al: Risk of reinfection and disease after SARS-CoV-2 primary infection: Meta-analysis. European Journal of Clinical investigation, 2022 Oct;52(10):e13845
”A strong natural immunity follows the primary infection and may last for more than one year, suggesting that the risk and health care needs of recovered subjects might be limited. Although the reinfection rates considerably increased during the Omicron wave, the risk of a secondary severe or lethal disease remained very low. The risk-benefit profile of multiple vaccine doses for this subset of population needs to be carefully evaluated”.
(Meta-analysis, involving 15 million people)

233) Gazit et al: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Naturally Acquired Immunity versus Vaccine-induced Immunity, Reinfections versus Breakthrough Infections: A Retrospective Cohort Study. Clinical Infectious Diseases, 2022 Aug 24;75(1):e545-e551.
”Methods: A retrospective observational study of 124 500 persons, compared 2 groups: (1) SARS-CoV-2-naive individuals who received a 2-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, and (2) previously infected individuals who have not been vaccinated.
Results: SARS-CoV-2-naive vaccinees had a 13.06-fold (95% confidence interval [CI], 8.08-21.11) increased risk for breakthrough infection with the Delta variant compared to unvaccinated-previously-infected individuals, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant for symptomatic disease as well. When allowing the infection to occur at any time between March 2020 and February 2021, evidence of waning naturally acquired immunity was demonstrated, although SARS-CoV-2 naive vaccinees still had a 5.96-fold (95% CI: 4.85-7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI: 5.51-9.21) increased risk for symptomatic disease.
Conclusions: Naturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 2-dose vaccine-indued immunity”.

234) Ridgway et al: Rates of COVID-19 Among Unvaccinated Adults With Prior COVID-19. Jama Network, JAMA Netw Open. 2022;5(4):e227650
“Among 121 615 patients with more than 10 million days of follow-up, unvaccinated individuals with prior symptomatic COVID-19 had 85% lower risk of acquiring COVID-19 than unvaccinated individuals without prior COVID-19. Prior studies investigating protection against SARS-CoV-2 reinfection found similar results, with protection associated with natural immunity ranging from 80.5% to 100%”.

235) Verschoor et al: Natural immunity helps overcome the age-related decline of SARS-CoV-2 vaccine immunogenicity. The Lancet, July 2022
“Regarding SARS-CoV-2, most studies support this idea, with evidence of higher antibody responses in previously infected compared to uninfected vaccinees. In line with this, vaccine effectiveness against infection following second dose in previously uninfected adults declines from 85% after 1–2 months to 51% approximately 9 months later, whereas for those previously infected, effectiveness remains around 90% after 9 months”.

236) Pugh et al: The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity. British Medical Journal, Journal of Medical Ethics, Volume 48, Issue 6
”At the present time, however, it appears that requiring those with natural immunity to undergo vaccination is not clearly necessary to obtain a substantial public health benefit. If so, it is discriminatory to treat natural immunity differently to vaccine-mediated immunity, and this is something that ethical, evidence-based public health policy should reflect”.

237)Townsend et al: The durability of natural infection and vaccine-induced immunity against future infection by SARS-CoV-2. PNAS, 2022 Aug 2; 119(31):
”Vaccines typically go through several phases of clinical trials prior to deployment. However, during this time, viral antigens will continue to accrue new sequence variation that will gradually or abruptly shift them away from the target of the vaccine. Consequently, the immune response to a vaccine will, by necessity, target an earlier strain of the pathogen than would the immune response to a contemporaneous natural infection. This difference in strain targeting will mean that immune evasion by the virus will likely be more advanced against immunity conveyed by a vaccine than against immunity conveyed by natural infection. Indeed, neutralization efficacy of the ancestrally targeted SARS-CoV-2 vaccines against successive selected strains declined precipitously against the insurgent delta and omicron variants (57), and natural infection by a predominant strain has been shown to update vaccine-mediated immune targeting, increasing the antigenic breadth of neutralizing capacity”.

238) Margiotti et al: Natural immune response and protection from SARS-CoV-2 reinfection. Acta Virologica Vol.65, No.4, p.333-338, 2021
”Although more studies are needed, evidence suggests that virus-specific B cell response in people with SARS-CoV-2 infection is rapidly generated and seems to be more reliable marker of long-lasting humoral responses than serum antibodies”.

239) Chemaitelly et al: Duration of immune protection of SARS-CoV-2 natural infection against reinfection. Journal of Travel Medicine, 2022 Sep 30;taac109
”Protection of natural infection against reinfection wanes and may diminish within a few years. Viral immune evasion accelerates this waning. Protection against severe reinfection remains very strong, with no evidence for waning, irrespective of variant, for over 14 months after primary infection”.

240) Mischlmayr et al: Observed protection against SARS-CoV-2 reinfection following a primary infection: A Danish cohort study among unvaccinated using two years of nationwide PCR-test data. The Lancet Regional Health – Europe, 2022 Sep; 20: 100452
”SARS-CoV-2 infection offered a high level of sustained protection against reinfection, comparable with that offered by vaccines…
The level of estimated protection against serious disease was somewhat higher than that against infection and possibly longer lasting”.

241) Flacco et al: Risk of SARS-CoV-2 Reinfection 18 Months After Primary Infection: Population-Level Observational Study. Frontiers in Public Health, 2022 May 2;10:884121
“…the incidence of reinfection did not vary substantially over time: after 18-22 months from the primary infection, the reinfection rate was still 6.7‰, suggesting that protection conferred by natural immunity may last beyond 12 months. The risk of reinfection was significantly higher among females, unvaccinated subjects, and during the Omicron wave”.

242) Carazo et al: Estimated Protection of Prior SARS-CoV-2 Infection Against Reinfection With the Omicron Variant Among Messenger RNA–Vaccinated and Nonvaccinated Individuals in Quebec, Canada. Jama Network open, 2022 Oct; 5(10): e2236670.
“The findings of this study suggest that vaccination with 2 or 3 mRNA vaccine doses among individuals with prior heterologous SARS-CoV-2 infection provided the greatest protection against Omicron-associated hospitalization. In the context of program goals to prevent severe outcomes and preserve health care system capacity, a third mRNA vaccine dose may add limited protection in twice-vaccinated individuals with prior SARS-CoV-2 infection”.

243) Diani et al: SARS-CoV-2-The Role of Natural Immunity: A Narrative Review. Journal of Clinical Medicine, 2022 Oct 25;11(21):6272.
“This extensive narrative review regarding a vast number of articles highlighted the valuable protection induced by the natural immunity after COVID-19, which seems comparable or superior to the one induced by anti-SARS-CoV-2 vaccination”.

244) Chowdhury et al: Immune response in COVID-19: A review. Journal of infection and Public Health, 2020 Nov; 13(11): 1619–1629.
“According to the World Health Organization, healthy foods and hydration are vital. Individuals consuming a well-balanced diet are healthier with a strong immune system and have a reduced risk of chronic illness, infectious diseases. Vitamins and minerals are vital”.

245) Abu-Saleh et al: Neutralizing antibodies against SARS-CoV-2 are higher but decline faster in mRNA vaccinees compared to individuals with natural infection. Journal of Travel Medicine, 2022 Nov 7;taac130
“While double-dose mRNA vaccination boosted antibody levels, vaccinated individuals’ ‘boost’ was relatively short-lived”.

246) Chemaitelly: Efficacy of Natural Immunity against SARS-CoV-2 Reinfection with the Beta Variant. New England Journal of Medicine, 2021 Dec 15 : NEJMc2110300.
“Protection by previous SARS-CoV-2 infection against reinfection with the beta variant was observed, even 1 year after the primary infection, but protection was slightly lower than that against the alpha variant and wild-type virus circulating in Qatar.3-5 These findings give some insights into the hypothesis that natural immunity may provide protection against known variants of concern”.

247) Yan et al: Neutralizing Antibodies and Cellular Immune Responses Against SARS-CoV-2 Sustained One and a Half Years After Natural Infection. Frontiers in Microbiology, 2022 Mar 3;12:803031.
”We found that 91.9% (57/62) and 88.9% (40/45) of COVID-19 patients had NAbs against SARS-CoV-2 in a year (10-11 months) and one and a half years (17-18 months)… We concluded that SARS-CoV-2 infection elicited a robust and persistent neutralizing antibody and memory T-cell response in COVID-19 patients, indicating that these sustained immune responses, among most SARS-CoV-2-infected people, may play a crucial role in protection against reinfection”.

248) Peres-Aslos et al: Modeling of waning immunity after SARS-CoV-2 vaccination and influencing factors, Nature Communications, 2022; 13: 1614.
“Our results indicate that IgG levels will drop at different rates depending on prior infection, age, sex, T-cell response, and the interval between vaccine injections. Only natural infection mounted a significant and lasting IgA response”.

249) Addo et al: Duration of immunity following full vaccination against SARS-CoV-2: a systematic review. Archives of Public Health, 2022; 80: 200.
“Waning of immunity against SARS-CoV-2 begins as early as the first month after full vaccination and this decline continues till the sixth month when the level of immunity may not be able to provide adequate protection against SARS-CoV-2”.

250) Larenas-Linnemann et al: Enhancing innate immunity against virus in times of COVID-19: Trying to untangle facts from fictions. World Alliance Organization Journal, 2020 Nov; 13(11): 100476.
”Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we discuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections. Some of these interventions can also stimulate the adaptive T- and B-cell responses, but our main focus is on the innate part of immunity. We divide the reviewed interventions into: 1) lifestyle related (exercise, >7 h sleep, forest walking, meditation/mindfulness, vitamin supplementation); 2) Non-specific immune stimulants (letting fever advance, bacterial vaccines, probiotics, dialyzable leukocyte extract, pidotimod), and 3) specific vaccines with heterologous effect (BCG vaccine, mumps-measles-rubeola vaccine, etc).
For each of these interventions we briefly comment on their definition, possible mechanisms and evidence of clinical efficacy or lack of it, especially focusing on respiratory tract infections, viral infections, and eventually a reduced mortality in severe respiratory infections in the intensive care unit. At the end, a summary table demonstrates the best trials supporting (or not) clinical evidence.
Several interventions have some degree of evidence for enhancing the innate immune response and thus conveying possible benefit, but specific trials in COVID-19 should be conducted to support solid recommendations”.

251) Gibbons et al: Association between vitamin D supplementation and COVID-19 infection and mortality. Scientific Reports, 2022 Nov 12;12(1):19397.
“Vitamin D deficiency has long been associated with reduced immune function that can lead to viral infection. Several studies have shown that Vitamin D deficiency is associated with increases the risk of infection with COVID-19. However, it is unknown if treatment with Vitamin D can reduce the associated risk of COVID-19 infection, which is the focus of this study. In the population of US veterans, we show that Vitamin D2 and D3 fills were associated with reductions in COVID-19 infection of 28% and 20%, respectively [(D3 Hazard Ratio (HR) = 0.80, [95% CI 0.77, 0.83]), D2 HR = 0.72, [95% CI 0.65, 0.79]]. Mortality within 30-days of COVID-19 infection was similarly 33% lower with Vitamin D3 and 25% lower with D2 (D3 HR = 0.67, [95% CI 0.59, 0.75]; D2 HR = 0.75, [95% CI 0.55, 1.04]). We also find that after controlling for vitamin D blood levels, veterans receiving higher dosages of Vitamin D obtained greater benefits from supplementation than veterans receiving lower dosages. Veterans with Vitamin D blood levels between 0 and 19 ng/ml exhibited the largest decrease in COVID-19 infection following supplementation. Black veterans received greater associated COVID-19 risk reductions with supplementation than White veterans. As a safe, widely available, and affordable treatment, Vitamin D may help to reduce the severity of the COVID-19 pandemic”.

The good, the bad, the ugly and Vaccine side effects can be treated

July 4, 2022

This newsletter from the Vitality Council is a double publication by
Max Schmeling, Statistician / Economist, MSc (log)
and Claus Hancke MD, Specialist in general medicine


The good, the bad, the ugly

The Covid-19 vaccine from Pfizer is in fact three different vaccines with very different risks of side effects.

Summary of an open letter (in Danish) to the Danish parliament dated 14/06-22 by Max Schmeling, Statistician / Economist, Cand.merc. (Log).
(Info in English:

A statistical analysis of reported side effects from the Danish Medicines Agency (LMST), as well as data on the number of vaccine doses per batch from Statens Serum Institut (SSI), concerning the Danish vaccine program against Covid-19, showing several completely unexpected and very disturbing findings.

Significant differences in side effects
Vaccines are produced in batches (series of numbers). The quality must be completely identical between all batches of vaccines. If a batch exhibits more side effects than usual there is a quality issue. For all vaccines in the Covid-19 vaccine program, statistically significant differences in adverse events are seen between batches of up to 33,480 times for Pfizer, 2440 for Moderna, 78 times for AstraZeneca and 34 times for Jansen. This precludes the vaccines from being manufactured in a uniform pharmaceutical grade (GMP – Good Manufacturing Practice).

The adverse reaction rate is between 0.006 and 185 adverse reactions per 1000 doses for Pfizer, between 0.25 and 244 for Moderna, between 8.3 and 651 for AstraZeneca and between 0.88 and 30 times for Jansen. For Influenza vaccinations in 2018-19, the side effect rate is by comparison 0.15 side effects per 1000 doses.

A demonstrable systematics
In the production of vaccines, the level of side effects per batch be randomly distributed around an average level. There must be no systematics in production. For both Comirnaty (Pfizer) and Spikevax (Moderna) a clear systematic is seen in relation to batch numbers and batch size. This shows that there is a reason for the variation in the side effect. The full cause is not yet known, but the systematics speaks very strongly against the fact that these are production quality problems.

Several types of vaccines
For Comirnaty (Pfizer) and partly Spikevax (Moderna), at least three different types / versions of the Covid-19 vaccine can be found, even though the EU has only authorized one vaccine per vaccine. Producer.
The three types can be roughly described as:

  • Type 1. Consists of both small and large batches, but regardless of the size of the batches gives almost no side effects. The level is roughly on par with previous flu vaccines
  • Type 2. Consists of both very small and very large batches. There is a moderate correlation between the size of batches and the number of side effects.
    The side effect is a factor of 29 greater than Type 1 for Pfizer and a factor of 218 for Moderna.
  • Type 3. Consists almost exclusively of small and very small batches, but which gives an extremely large number of side effects. The side effect is on average a factor of 1034 greater than Type 1 for Pfizer and a factor of 952 for Moderna.

Conclusion – Consequence
As there among the vaccines are: several different versions, very large and significant differences in side effects and for some vaccines a clear systematic in the differences it is impossible for the recipient of the vaccine to give informed consent, as the recipient can not be informed about the risk of side effects. If the recipient of the vaccine cannot give informed consent, all vaccinations against Covid-19 that have been carried out in Denmark, cf. The Health Act LBK no. 210 of 27/01/2022, §15, subsection 1 and 3 are necessarily illegal.


Vaccine side effects can be treated

A summary of clinical protocols from around the world.

The Vitality Council has for many months been encouraged to write about options for treating side effects from Covid-19 vaccines. Many people have been forced or coerced into covid-19 vaccination and many are now suffering from long term consequences after this. These persons have called for an easily accessible guide, which I will try my best to summarize here.

No knowledge of long-term side effects
The vaccines are only conditionally approved, as there is no knowledge of the long-term effect, which was not started until 2021, but without a control group.

As we have seen in the above article by Max Schmeling, in some vaccine series there is a very high risk of side effects, and in one of the series even serious side effects. Pfizer/BioNTech has even listed hundreds of different types of side effects, but this newsletter will mainly treat the most common ones namely fatigue and inflammation in the muscles, especially the heart muscles and blood clots.

In the last season, there have been numerous initiatives for treatment protocols, despite the fact that it has never been tried before to treat consequences after gene therapy, as the covid-19 vaccine actually is.

An mRNA code is injected, which triggers the body’s cells to produce the coronavirus’ spike protein, to which the immune system must then respond.

This process is then intended to cease as mRNA is destroyed. But that is not always the case. There are mechanisms (reverse transcriptase) that copy mRNA sequences into the cells’ DNA, and once reverse transcriptase has ensured that the mRNA sequence has been transferred to the cell’s DNA, then there seems to be no way back, as this can then proceed to produce this specific mRNA via RNA polymerase and thus continue the production of spike protein.

Symptom treatment
If this production of spike protein does not stop soon after the vaccination, because the mRNA code has been built into the cells’ DNA, then this production can continue as mentioned, and it can cause side effects from the vaccine long after, maybe several years. Nobody knows, because it has never been investigated.

If the production of spike protein continues, and continues to cause symptoms for the vaccinated, then the solution must necessarily be symptom treatment, until the pharmaceutical industry develops a method to “decode” the cells so that they no longer produce spike protein.

In case the production of spike protein continues, then the affected will go with a chronic inflammatory condition with continuous cytokine production and many of the side effects will be the same symptoms that Covid-19 disease gives. Therefore, the treatment of these is very parallel to the treatment of Covid-19.

Many treatment suggestions
Many more or less serious treatment proposals have flourished, and it can be argued that you are free to come up with you own treatment suggestions, as no one has ever tried it before.

So there is no long-term research on the treatments, nor on the vaccine.

This is the reason why the Vitality Council has been taking so long to make proposals for treating the side effects after the covid-19 vaccine. The many treatment proposals appear mainly as clinical experience in anecdotal form from many doctors and scientific societies around the world.

In reviewing a number of these, emphasis has primarily been placed on the treatments that had a theoretical evidence, and special emphasis has been placed on those that were repeated in the many treatment proposals.

As the spike protein is primarily responsible for both primary disease and side effects after vaccine, there is a large overlap between treatment of covid-19 disease and treatment of side effects after the vaccine.

Based on the treatments that target the spike protein in the primary disease, the following have been proposed: Ivermectin, Hydroxychloroquine, Zinc, Vitamin D3, Vitamin K2, Vitamin C, Quercetin, PQQ (Pyrroloquinoline Quinone), Curcumin, LDN (low dose) Naltrexone), Melatonin, NAC (N acetyl-cysteine) and even Zeolite, which is thought to cause the spike protein to break down.

However, the treatment must necessarily also be directed at the inflammation and cytokine storm that the spike protein causes, and many of the proposed measures are therefore exclusively anti-inflammatory, such as EPA.

In addition, a number of suggestions for anti-inflammatory diet, intermittent fasting, a good sleep and even sauna, which increase heat shock proteins and elimination of cells with spike protein and misfolded proteins (autophagy.)

Any treatment is always a balance between effect, documentation, side effects and price. It is best if the first two are high and the last two are low.
In addition, there is an individual weigh out, because not everyone can handle a comprehensive regime and not everyone has the opportunity to take the entire palette.
It may therefore be appropriate to define the objectives of the treatment first and foremost. What do we want to achieve:

  • If you could, you would have to stop the accident by stopping the continued production of spike protein. But once the DNA of the cells is affected, then one can not stop the process. This will probably have to wait for a new, specific gene therapy.
  • Next, the spike protein should be prevented as much as possible from binding to the ACE2 receptor and damaging the cell wall.
  • Then one must counteract the inflammation and cytokine storm that the spike protein promotes.
  • And finally counteract the oxidative stress that results from the inflammation.


Ivermectin is prescription medicine primarily intended for scabies and parasites, but also has potent antiviral properties. It is thought to bind to the spike protein so that this is neutralized without binding to the ACE2 receptor in the cell membrane.
It is usually taken in 0.3 mg / kg daily for 1-2 months. Has been known for decades and has a very high degree of safety. Do not take it with Quercetin as they counteract each other. Unfortunately, Ivermectin is extremely expensive in Denmark.

Hydroxychloroquine is a malaria prevention agent, but also shows that it can block the binding of the spike protein to the ACE2 receptor. Often dosed 200 mg 2 x daily for a week and then 200 mg daily for 3 weeks. An old, well-known and cheap medicine with high safety, which is available on prescription in Denmark.

Quercetin is a bioflavenoid from fruits and vegetables with powerful antioxidant properties, just as it also blocks the binding of the spike protein. In addition, it facilitates the uptake of zinc into the cells, thereby inhibiting virus replication enzymes.
Quercetin and Ivermectin compete for the same receptors, so concomitant treatment with these two will weaken the effect. Quercetin is often taken in a dosage of 100 mg daily.

Vitamin C is a powerful antiviral and antioxidant. It is tolerated in very large doses and can be given both intravenously and in tablet form. Depending on the condition, it can be taken as a powder, tablets, liposomal – or intravenously by a doctor. If you take it yourself, you start with 2-3 grams 2 x daily, and if necessary, you quietly increase the dose with a few grams a day until the stool begins to loosen. Then you can not achieve better effect that way.
In the case of a serious condition where larger doses are required, it must be given intravenously.

EPA / DHA are potent anti-inflammatory substances and is usually taken as fish oil capsules.
There are also algae-based products that are excellent. Take 2 grams morning and evening – typically equivalent to 4 capsules.

By default, the other recommendations should read as follows:

Vitamin D3 80-100 µg (3200 IU – 4000 IU) daily is immune-stimulating and suppresses a possible cytokine storm.

Zinc 50 mg daily inhibits virus replication.

Magnesium 300-500 mg daily (depending on whether it is Mg citrate or Mg carbonate) can if convenient be taken as oil. Necessary for the effect of vitamin D.

Vitamin K2 100 µg daily is i.a. anti-inflammatory.

Selenium 200 µg daily is antiviral and antioxidative. Selenium yeast is best absorbed.

N-acetyl cysteine 600 mg daily. Is an antioxidant.

Melatonin 3 mg before bedtime. Is anti-inflammatory and antioxidative.

If necessary, low dose Hydrocortisone 5 mg daily to reduce the inflammation.

If necessary, LDN (low dose Naltrexone) 4.5 mg daily, which is thought to be immunostimulatory.

In severe cases, it must be treated by a doctor, and here there may be good effect of Intravenous Vitamin C and Hyperbaric oxygen therapy.

In Denmark, when you experience side effects after a medical treatment, such as. vaccination, it must always be reported as a side effect to the Danish Medicines Agency.

This reporting obligation is further tightened by the Covid-19 vaccine because it is experimental and only conditionally approved (EMA: “Conditional marketing authorization“), and like all other medicines, the vaccine always requires informed consent before it is given, as mentioned in the previous article by Max Schmeling. (This means that before vaccination you must be informed of the possible effect and risk of side effects, after which you can give your consent on an informed basis).

All of the above dosage suggestions should therefore be discussed with a physician or other therapist who is familiar with orthomolecular therapies, just as some of the treatments require medical assistance.

The Vitality Council hopes to have covered the long-missing information on possible treatments for side effects after covid-19 vaccine.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

Analysis of the Covid-19 situation

The Vitality Council has in recent months received several calls to analyze the Covid-19 situation in Denmark in order to bring clarity to the overwhelming amount of information that seems to point in all directions.

This is illustrated very clearly with a current example from the Faroe Islands, where 2/3 of triple-vaccinated and thoroughly tested nurses were found to be infected with Covid-19’s Omicron variant a few days after their gathering.

  • 33 nurses held Christmas lunch on December 3rd.
  • All were fully vaccinated + booster (3rd jab).
  • All were tested negative, including a majority with PCR testing within the last 36 hours.
  • After 3 days, 21 of the 33 were infected with Omicron.

As an explanation for this, the authorities then say that the vaccines can prevent serious illness and death, but not infection and re-infection. And this is where the information goes in all directions and has led our readers to ask the Vitality Council to sort out the threads.

It is difficult to see the logic in the fact that we have to vaccinate our children when they do not get sick from Covid-19 themselves. But they must be vaccinated so as not to infect their grandparents – they say. But when the vaccine does not protect against infection and re-infection, then that argument is gone.

Another example where logic fails is the Corona Passport, which is solely to ensure that the holder does not infect others. But when the vaccine does not protect against infection and re-infection, then it should only be previously ill and recently tested who can get a green corona passport. The vaccinated can be contagious and should not have a corona passport without testing like everyone else.

Several of the restrictions that weigh on the Danish business community and the population are without any kind of logic, and the documentation on which these are based goes in all directions. Much of the information we receive from the authorities is directly contradictory. With this analysis, the Vitality Council will therefore seek to bring the reader clarity on three important questions in particular, when we look at Covid-19’s last 3 winter epidemics in the light of the usual influenza epidemics:

  1. How dangerous is the Delta variant?
  2. How dangerous is the Omicron variant?
  3. What is the cost / benefit of the vaccine?

We will also supplement with information about the immunological mechanisms, test methods as well as prevention and treatment options.

In terms of danger compared to the flu, there is not much difference. The Delta variant seems to be like a severe flu for a few percent where it settles in the lower respiratory tract. It does not infect such a large part of the population, but has roughly the same mortality rate as influenza.

The Omicron variant spreads significantly faster than the Delta variant and influenza with a doubling time of 1.2 days. On the other hand, it is significantly milder, settles mainly only in the upper respiratory tract and has brought about a large decrease in the need for hospitalization and intensive treatment, just as mortality is very low, almost insignificant.

There seems to be a fundamental biological misconception behind the development of vaccines if the idea was that they should be “a superweapon” to stop an epidemic, let alone a pandemic. The vaccines do not protect against infection or re-infection, but provide a declining protection against serious illness and death for just over 3 months. But after 3-4 months, the  effect of the vaccine is directly negative for Omicron, so that the risk of becoming infected is 76% greater than if you have not been vaccinated at all. In terms of infection, the vaccines have no effect on the Omicron variant, which removes any argument for vaccinating children.

Furthermore, the available data show that reinfection occurs mainly in vaccinated and not in persons with natural immunity after Covid-19.


The disease

There is a disease called Covid-19 (CV19). It is caused by a virus called SARS-CoV-2, which has a “spike protein” sitting on the surface of the virus particle. The spike protein mediates the virus’ passage across the cell membrane by linking to a receptor, ACE-2, which is widespread among the body’s cells. But the spike protein is also the pathogen that gives rise to symptoms, injuries and ultimate death.

SARS-CoV-2 is characterized in that, like influenza virus, it triggers a reaction with the release of a number of signaling molecules such as interleukins, interferons and lymphokines.

When this release is strong, it is called a “cytokine storm”. In Covid-19, it is so powerful that immune cells begin to damage the tissue where the process takes place, and here it is primarily the lung tissue that is damaged. The cytokine storm creates a violent inflammatory response and increased release of free oxygen radicals, which further damage the lung tissue due to the subsequent inflammatory microcoagulation seen in the pulmonary vessels. The lung tissue reacts by secreting a tough secretion that fills the lung alveoli, making it difficult to oxygenate the blood. Adding too much oxygen at this stage will only aggravate the situation, as several anesthesiologists have experienced when Covid-19 patients get their disease worsened if they are put on a respirator. The cytokine storm can then develop into a bradykinin storm with an effect on the renin-agiotensin ratio, so that the disease develops into a cardiovascular disease.

SARS-CoV-2 started as an alpha variant and has since been mutated several times, with the most widespread in 2021 being the Delta variant. It is now being supplanted by the Omicron variant. Most often, the virus mutates into a less pathogenic but more contagious type, which then becomes more or less endemic, which means that it joins the ranks of cold and flu viruses, which circulate in the population at intervals and which people therefore has an excellent defense against.

The vaccines

The new so-called mRNA vaccines program the body’s own cells to produce the spike protein, ie. doing exactly the same thing as the virus.

The AstraZeneca and JJ-Johnson vaccines provide the actual DNA code for the production of the spike protein. This is transported across the membrane by an empty adeno virus (in this case a modified chimpanzee virus). The DNA becomes part of the host cell’s DNA – presumably forever – and continues to produce spike protein according to the usual mechanism by which the code is transcribed into mRNA, which brings it from the nucleus to the ribosomes.

Pfizer / Moderna delivers the mRNA code directly – wrapped in synthetic liposomes (lipid nanoparticles). The plan was for the mRNA to go directly to the ribosomes and cause a modest, local production of spike protein and then (half a day) be neutralized by the nucleases present.

Two publications in the spring of 21 have changed this picture. First, the viral mRNA (introduced by SARS-CoV-2) can be reverse transcribed into the DNA of the host cell.1;2 As there is no qualitative difference in mRNA from the virus and from the vaccines, this implies that the mRNA code of the Pfizer / Moderna vaccine may also be latent in the DNA of the host cell and continue to produce spike protein. The injected person thus becomes a GMO. However, humans are excluded from the EU definition of GMOs and therefore also excluded from the 2001 environmental assessment assessment. 3

In July 2020, the EU also granted a temporary dispensation for the use of GMOs in medical treatment. 4 You could be tempted to assume that this was done to prepare for later authorizations for AstraZeneca’s and JJ ‑ Johnson’s vaccines that use a genetically modified adeno virus to bring the DNA across the host cell membrane. Furthermore, it was demonstrated in an animal model that the spike protein is pathogenic 5  and attacks cells with ACE-2 receptors. This, of course, is primarily the platelets and endothelium that are destroyed as the spike protein circulates in the bloodstream.

That the spike protein is the antigen that circulates throughout the body explains why home tests (antigen tests) can detect the spike protein in a nose scratch or in saliva.

In other words, you get Covid-19 from the injections, no matter what technology is used.

There is nothing speculative in this conclusion. It has been the official mechanism of action of vaccines since day one. In the near future, therefore, one can expect to see side effects from the vaccines, which are similar to the clinical symptoms now observed in the disease Covid-19. The long-term effects of the vaccines will be assessed below.

Composition of “today’s infection rates”

Today’s “infection rate” (positive RT-PCR test) can be composed of the following groupings:

  • Non-vaccinated, actually infected with resp. Delta or Omikron, registered with Ct <25 6 who are ill with symptoms. Should be treated early with hydroxychloroquine / zinc / azithromycin or ivermectin / azithromycin. 7
  • Non-vaccinated with positive PCR at Ct> 25 6 Weak or no symptoms. (Should have time to establish a T- and B-cell immune defense.)
  • Vaccinated who encounter Delta virus – and maybe even Omicron – for the first time. These individuals can have a violent, very unpleasant and ultimately fatal course. The explanation may lie in “Antibody Dependent Enhancement” (or “pathogenic priming”), which can end in a cytokine storm because the immune system overreacts in self-amplifying processes. This is especially true if they lack vitamin D, which moderates the cytokine storm.
  • Vaccinated who produce mRNA or encoded DNA fragments that are detected by PCR.
  • The conventional, dominant class of false positives, incl. common cases of influenza. WHO 8 and the CDC have publicly acknowledged that the RT-PCR test cannot differentiate between SARS-CoV-2 and influenza virus. As of January 1, 2022, the RT-PCR test can not be used to diagnose CV-19 in the United States! 9

Statens Seruminstituts (SSI) definitions

If the official announcements are already grinding in the logical sense, then it will not help to read the Serum Institute’s definitions 10(page 3):

  • “A post-vaccination infection is hereinafter defined as a positive PCR test for Covid-19.”
  • “A Covid-19 related hospitalization is defined as a hospitalization in which the patient was admitted within 14 days of the sampling date for the first positive SARS-CoV-2 PCR sample.”
  • “Covid-19-related death is defined as a Covid-19-confirmed case that has passed away within 30 days of being diagnosed with Covid-19 infection. Covid-19 is not necessarily the underlying cause of death. “

It is these numbers that the authorities have used to keep the population in fear. And if you take into account that the PCR test has also included cases of influenza 9, then that will be big numbers.
The reader may rightly ask whether this is politics or health facts.

The disease COVID-19

Autopsies in connection with CV-19 have been remarkably absent.

Only in Hamburg were all CV19 deaths autopsied at the beginning of the “pandemic”. A publication of the first 80 of these autopsies is available. 11

In support of the narrative of a pandemic, all individuals with a positive RT-PCR test, obtained both 4 weeks before and after death occurred, were classified as “Covid-19 deaths”.

The most important qualitative result of this work was that in only 2 (two) of the 80 autopsied were there no co-morbidities (other diseases) that could be the cause of death. The mean age was 79.2 years.

Comparison CV-19 with influenza

Such a comparison is important, as long as the Danish Minister of Health’s authoritarian powers are based on CV-19’s classification as “a generally dangerous disease” (text in Danish)

A Comparative Systematic Review of COVID-19 and Influenza 12

This study provides a comprehensive comparison of adult patients in SARS-CoV-2 and influenza infections in terms of comorbidities, clinical and paraclinical features and outcome. Clinical manifestations of COVID-19 and influenza appear to be similar with some differences. Thus, neurological symptoms and diarrhea were more frequently observed among CV19 cases, while vomiting, ocular and otorhinolaryngological symptoms were more frequently observed in influenza infection. Both viruses reduce lymphocytes. NE (neutrophilic leukocytes) were significantly more elevated in influenza than COVID-19 patients, whereas elevated transaminases were significantly more elevated in COVID-19 than in influenza patients. Radiological findings showed that GGO (Ground-glass opacity) is usually peripherally localized in COVID-19 compared to influenza, which also had central and random locations. All of these findings can help clinicians when dealing with cases of flu-like illnesses during a period when both flu and SARS-CoV-2 are circulating.


There are three factors to consider when reading this review 12:

  1. The overview ends on November 25, 2020, ie. before the emergence of “variants” and before vaccination began.
  2. At no time is a criterion provided – clinical or analytical – for diagnosing the patients with resp. influenza or CV-19. It is implied. One must assume that the differentiation is based solely on RT-PCR technology (which cannot distinguish).
  3. In this context, it should be remembered that American hospitals and doctors receive a hefty fee (USD 3,000) for enrolling a CV-19 patient in the hospital or subsequently classifying the patient as CV-19 and putting them on a respirator. In addition, the hospital receives $ 39,000 for each patient who dies from CV-19, which is not exactly an incentive to keep the patient alive.

A large number of clinical and technical parameters are listed and compared for the two patient categories.

COVID-19 Influenza Comment


Lung diseases
Circulatory diseases
Diabetes Obesity
Lung diseases
Autoimmune diseases
Age distribution Median 68 years Median 57
Dominates < 18 years
Relatively increased observation of clinical symptoms Neurological disorders, headaches, fatigue, loss of sense of taste, taste disorders. Gastrointestinal problems, diarrhea etc. Pregnancy problems Ear-nose-throat infections, cough, mucus, fever, vomiting, shortness of breath, snot, sore throat, Eye problems and visual disturbances. Pregnancy problems

Relatively higher laboratory analyzes

White blood cells elevated
Procalcitonin elevated
Indicates bacterial infection / inflammation,
Thrombocytopenia (lower platelet count) Platelets are attacked by spike protein
Transaminases elevated Included in the amino acid synthesis.
Liver effects.

X-ray of the lungs

GGO, shadows on the lungs
in CT scan (X-ray).
Interlobular septum thickening The walls of the small lung alveoli thicken
Peripheral distribution Shadows outside the lungs
Solid shadows in lungs
Linear opacities

Table 1. Summary of review Osman et al. 12

Comments on Table 1:

1) It must be remembered that the comorbidities are not a consequence of the disease. Rather, it is a selection of the patient categories that are most susceptible to infection.
Thus, when it is observed that comorbidities such as circulatory diseases, lung diseases, diabetes and obesity occur significantly more frequently among CV-19 patients, while lung diseases and weakened immune systems are more frequent among influenza patients, this could also be due to these patient categories’ different tendencies to give resp. positive or negative PCR test.

The discussion in this review12 offers a very interesting discussion about the mechanism and pathogenesis of the two infections, i.a. in relation to the ACE-2 receptors.

How dangerous is the Delta variant?

Morbidity (or morbidity) is the ratio between the number of disease cases and the size of the population in which they occur. Morbidity can be stated as incidence, ie. the occurrence of new cases within a given time period, usually one year, and as prevalence, ie. the total occurrence at a given time.

By mortality is in demographically respect meant the number of deaths per 1000 inhabitants in one year.

No children have died in Sweden of CV19.

There were 1,951,905 children (1-16 years) in Sweden per. January 1, 2020. Ludvigsson et al. 13 followed hospitalizations from this age group from March 1 to June 30 of the same year. There were no children who died from Covid-19 during this period, when there were neither shutdowns nor the use of masks in Sweden.

Similarly, statistics were kept on 13.7 million children in Germany. Among the 9.8 million children estimated not to have other diseases, 751,233 children, 5-17 years of age, had SARS-CoV-2 antibodies.

Of these, none but 3 of 305,044 infants (0.001%) died.

Tabel showing risk associated with SARS-CoV-2 and PIMS for children without comorbidity

Figure 1. Figures from Sorg et al. 14 on CV-19 treatments in Germany of children without other diseases.

Delta is less dangerous than the original SARS-CoV-2 variant Massachusetts.

According to this report, 15 published by the CDC, from a location in Massachusetts with several large public gatherings and events on July 30, 2021, there were subsequently 26% more vaccinated than non-vaccinated individuals who were diagnosed with COVID -19 (Delta).

1% of the Massachusetts outbreak was hospitalized. No deaths were reported among 469 “confirmed” COVID-19 patients.

Consequently, the mortality from the Delta variant is not particularly high. It is significantly less than the mortality rate (almost 6%) reported in May 2020 in the United States. Although the Delta variant is quite contagious, it does not appear to be particularly dangerous in the United States, where 1 in 9 people has already (summer 2021) had a confirmed COVID-19, while the death rate was 1.68% (August 19, 2021, ), and the majority of Americans had been infected at least once with SARS-CoV-2.

Figure 2. Data from Massachusetts show that the vaccinated are overrepresented.

Tabel showing SARS-CoV-2 infections associated with large public gatherings

Tabel showing SARS-CoV-2 real-time reverse transcription-polymerase chain reaction cycle threshold values

Figure 3. Data from Massachusetts. Expansion of Ct6 and mean values of the same for PCR-positive in resp. unvaccinated and vaccinated. Note the larger range for the vaccinated to Ct = 39.

Conclusions:                                                 The Delta variant is quite contagious, but is not very dangerous.
                                                                         It does not matter if you are vaccinated or not.


How dangerous is the Omicron variant?

The emergence of Omicron

South Africa

The first sequencing of the Omicron variant was reported in Botswana on November 11, 2021. 16 It was the fifth “Variant Of Concern” (VOC) after alpha, beta, gamma, delta, epsilon, zeta, eta, theta, iota, kappa, lambda and mu, as well as new sub-variants of these.

Figure showing SARS-CoV-2 cases in first, second, third, and fourth waves

Figure 4. The number of Omicron cases doubles every 1.2 days. 16

According to the sequencing, there are 30 mutations in the genome. Most mutations are located at the tip of the spike protein, and this makes it more difficult for them to attach to the ACE receptors in the lungs.

The world press

As early as the beginning of December, the horror scenario was projected onto the world opinion: the new variant could perhaps circumvent the immunity that the vaccines had provided.

But hospitalizations plunges in South Africa (Dec. 17, 2021)

South Africa’s Minister of Health: “Only 1,7 % of confirmed Covid-19 cases in the second week of the current fourth wave of the virus resulted in hospitalization. That’s compared with 19 % who were hospitalized in the same week of the third wave, which was driven by the Delta variant.”

Table showing Covid-19 in-hospital case fatality ratio in first 25 days of 2. 3. and 4. wave

Figure 5. Admissions in Tshwane, South Africa, where the Omicron variant was first registered.

Figure 5 shows that the fatality rate for the “fourth wave” (Omicron) in South Africa is far less than for the first variants in all age groups. But South Africans are not vaccinated to the same degree as Northern Europeans. So the course can be more dramatic at home latitudes when the omicron runs into the ADE wall.*1 Africans are younger and may have a better immune defence.

*1 Antibody Dependent Enhancement resp. pathogenic priming

The effectiveness of the injections

Statens Serum Institut (SSI) published a report on the occurrence of Delta / Omicron variant 22 / 11-15 / 12 – 202119.  17

In Figure 6, SSI gives the total number of Omicron cases. B.1.1.529 is the Omicron variant. Their data are based on variant PCR and whole genome sequencing.

Data fra Statens Serum Institut (SSI) der offentliggjorde en rapport om forekomst af Delta/Omikron variantFigure 6. Number of Omicron cases in DK weeks 47-49.5 according to SSI.

Figure 7 shows SSI’s statement of the effectiveness of the vaccine for all cases, incl. Omicron.

Tabel med SSI’s opgørelse af effektiviteten af vaccinen for alle tilfælde, inkl. Omikron.

Figure 7. Vaccination status for persons >12 years with Omicron infection compared to other variants. Weeks 47-49,5. Table 4 in Ref.19. Why column 3 does not match Figure 6 is not known.

The “revaccinated” have received 3 injections, the “completed” have received two. When calculating the total number of injections in all persons in Figure 7, it therefore becomes the following calculation:

7.657×3 + 60.326×2 + 3.019 + 1.884×3 + 14.053×2 + 313 = 180.719 injections.

The total number of vaccinated individuals among all PCR-positive are:

7.657 + 60.326 + 3.019 + 1.884 + 14.053 + 313 = 87.252 was vaccinated.
The average vaccination rate will therefore be =

180719/87252 = 2,07 injections / person.

The total number of PCR-positive persons (ie incl. Unvaccinated) is:

93.146 + 17.767 = 110.913 were PCR-positive

Percentage vaccinated of all 110,913 PCR-positive:

87.252 x 100/110.913 = 79 % of the PCR positive (infected) were vaccinated.

But they are very unevenly distributed between “other variants” and Omicron.

In the group “Other variants” it is 100 – 23,8 = 76,2 %, who have been vaccinated and tested positive.

In the Omicron group it is 100 – 8,5 = 91,5 %, who have been vaccinated and tested positive.

One must note that the vaccines largely do not protect against infection by the first variants of SARS-CoV-2 and not at all against the Omicron variant.

In the article discussed below from SSI, the same conclusion is reached (Figure 8).

SSI study of injection protection against Omicron infection.

21.12.23 SSI submitted a manuscript to JAMA entitled:

”Vaccine effectiveness against SARS-CoV-2 infection with the Omicron or Delta variants.” 18

Infected resistance to Omicron infection and Delta in relation to vaccination with Pfizer and Modern, as a person is described as vaccinated in the third week after the 2nd injection.

Infection is detected by specific PCR + sequencing of 5% of the cases. So it is not people who are sick. It is just a “cases of infection”.

The result is shown in Figure 8.

Data showing vaccine effectiveness against SARS-CiV-2 infection with the Delta and Omicron variants

Figure 8. From SSI preprint submitted to JAMA. Resistance to infection of Delta and Omicron, respectively, as a function of time after the 14th day after the 2nd injection.

The zero point corresponds to unvaccinated. It is seen that the effectiveness of the injections against infection decreases with time. Resistance to Delta decreases less than to Omicron. The ability to counteract infection with Omicron, on the other hand, is worse than catastrophic. It becomes negative. Three-and-a-half months after receiving the second injection of Pfizer, you are 76% more likely to be infected (tested positive) than if you were unvaccinated. It is obvious that the vaccine weakens the immune system and that this manifests itself just months after the vaccination.

As can be seen from the last line in Figure 9, at the third injection (booster) you are back to start, ie. 55% immunity after 30 days.

Table showing estimated vaccine effectiveness for BNT162b2 and mRNA-1273 against infection with the SARS-CiV-2 Omicron and delta variants

Figure 9. Same data as Figure 8 in tabular form plus the effect of the third booster

SSI study: SARS-CoV-2 Omicron VOC Transmission in Danish Households

Danish study published December 23, 2021. 19

Here is the summary of the world press:

Omicron Spreads Faster Than Delta Within Vaccinated Individuals – Danish Study | 4 Jan 2022 |

A Danish study of nearly 12,000 households has discovered that Omicron spreads faster than Delta among those who are fully vaccinated, and even higher between those who have received booster shots, demonstrating strong evidence of the variant’s immune evasiveness. The Omicron variant was found to evade the immunity of vaccinated individuals at a much faster pace compared to Delta, and at a higher rate than the unvaccinated, according to the study conducted by researchers at the University of Copenhagen, Statistics Denmark, and Statens Serum Institut. “Comparing households infected with the Omicron to Delta VOC, we found an 1.17 times higher SAR (Secondary Attack Rate) for unvaccinated, 2.61 times higher for fully vaccinated and 3.66 times higher for booster-vaccinated individuals, demonstrating strong evidence of immune evasiveness of the Omicron VOC,” said the preprint of the study.”
The result is summarized in the article in this table:


Tabel der viser odds ratio estimater for effekten af at bo i husstande inficeret med Omikron sammen holdt med hussstande inficeret med Delta


Figure 10. Odds ratio (OR) is the relative probability of infection in one of the three categories of households where one person has tested positive with Omicron, compared to households infected with Delta, where OR is arbitrarily set to 1 (ref.). From Lyngse et al. 19

One may wonder about the authors’ conclusion in the abstract, namely that the result should “demonstrate strong evidence for the Omicron variant’s ability to evade the immune system.”

It would be correct to say that it shows the ability of the Omicron to evade vaccine immunity.

In other words, the vaccines do not work on the Omicron variant.

But not only that. SSI again proves directly that the vaccines weaken the immune system:

Omicron infects more than Delta. SAR2 is 31% in households with Omicron, 21% in households with Delta, regardless of age group. This can be due to several things.

However, if a vaccine does not work, there should be no difference between vaccinated and non-vaccinated, regardless of which pathogen the vaccine was aimed at.

But there is. We read horizontally:

Omicron infects 2.7 – 3.7 times more among the vaccinated than among the unvaccinated.

Assuming that the variant RT-PCR analysis method used is reliable, it must again be concluded that the vaccines weaken the immune system.

Other data from the SSI report
The authors are surprised that they do not find any difference in infection of resp. Delta and Omicron among the unvaccinated (Figures 10 and 12). This result is used to justify non-pharmaceutical interventions (masks, social distancing, etc.) among all categories (when it does not matter). And when the vaccines do not work, then you have to develop new vaccines… It must surprise the reader.


Kurver der viser antallet af dage fra sidste vaccination til forekomst af et sekundært tilfælde af de to virus-varianter

Figure 11. Shows how many days elapse from the last vaccination to the occurrence of a secondary case of the two variants. From appendix. 19

It can be seen that the delay in infection within the household is expected to be the same 3.5 months as SSI reports for the weakening of the Pfizer / Moderna vaccines (Figure 8).

The same is seen in Italy, where the Director of the Italian Institute of Infectious Diseases, Professor Anna Teresa Palamara says to Italian TV:

… “The reason is first and foremost that in Italy, as in other European countries, the variant infects primarily vaccinated people, and especially those who have been vaccinated with three doses.”

95% of new Omicron cases in Germany are vaccinated

The absence of certain tables in the weekly report from the Robert Koch Institute on 30 / 12-2021 20 is excused with the lack of data.

But on page 14 it says:

”Zu den im Meldesystem vorliegenden Omikronfällen sind zum Teil Zusatzinformationen bekannt. Für 6.788 Fällewurden Angabenzu den Symptomen übermittelt, es wurden überwiegend keine oder milde Symptome angegeben. Am häufigsten wurde von Patientinnen und Patienten mit Symptomen Schnupfen (54 %), Husten (57 %) und Halsschmerzen (39 %) genannt. 124 Patientinnen und Patienten wurden hospitalisiert, vier Person sind verstorben. Für 543 (5 %) Fälle wurde eine Exposition im Aus-land angegeben. 186 Patientinnen und Patienten waren ungeimpft, 4.020 waren vollständig geimpft, von diesen wurde für 1.137 eine Auffrischimpfung angegeben. Auf Basis der übermittelten Daten wurden unter allen übermittelten Omikron-Infektionen 148 Reinfektionen ermittelt, zukeiner der von Reinfektion betroffenen Person wurden Vorerkrankungen übermittelt. Abbildung 9 zeigt die Verteilung der bisher übermittelten Omikronfälle in Deutschland. In allen Bundesländern wurden Omikronfälle nachgewiesen.”

So for some of the Omikron cases, there is still additional information.

In 4,206 of the cases, information on vaccine status is available. Of these, 4,020 were vaccinated. 186 was not. If this subgroup was representative, it means that 95% of the registered Omicron cases are vaccinated.

From page 13: Between 21.11.21 and 21.12.27, 10,443 Omicron cases were registered in Germany. Of these, only 1,555 (15%) were sequenced. The rest was identified using a modified RT-PCR test.

When 95% are vaccinated and thus are protected against infection, one could imagine that the vaccine gives false positive PCR tests.

The increase in Covid-19 cases has no correlation with vaccine status in 68 countries and 2,947 US regions.

Study, 21 examining a possible correlation between the degree of vaccination and the incidence of CV19. Data are from September, 2021, so it is the “Delta variant.”

Graph showing relationship between cases per 1 million people (last 7 days) and percentage of population fully vaccinated across 68 countries as of Sep. 3, 2021

Caption: Relationship between cases per 1 million people (last 7 days) and percentage of population fully vaccinated across 68 countries as of September 3, 2021. (See table S1 for the underlying data).

Figure 12. Number of registered “cases” in a week at the beginning of September 2021 per. million in different countries as a function of the vaccination coverage.

Figure 12 shows that there is no clear relationship between the countries’ vaccination rate and new Covid-19 (Delta) cases within the observed week. There appears to be only a marginal positive correlation with higher cases of CV-19 among the fully vaccinated. Israel, for example, has the highest number of CV-19 cases with a vaccination rate of 70%.

It is also seen in other studies  that reinfection only occurs in vaccinated people, and not in people with natural immunity after CV-19.

Figur der viser antal ”tilfælde” i 2947 regioner i USA som funktion af vaccinationsgraden

Figure 13. Number of “cases” in 2947 regions in the United States as a function of the vaccination rate.

Among the nearly three thousand regions surveyed in the United States, there is also no clear trend (Figure 13). The 40-45% covered have e.g. just as many cases as the 0 – 5%. Also note that the spread in data varies completely unsystematically.

Tabel with percentage of 15 countries that experienced an increase of cases between 2 consecutive 7-day time periods

Figure 14. Percentages of regions within each of the different categories of vaccine coverage that experienced an increase. For example, among the group of regions that had 45-50% vaccine coverage, there were approx. 70% who experienced an increase in “cases”.

The rise – ie. not the nominal number – is also seen to vary quite unsystematically among the US regions (Figure 14) regardless of vaccination rate.

Figures from the UK Health Security Agency as of 21.11.05 also show a negative effect of the vaccines.

The figures in the table in Figure 15 are taken 22 from Table 5 in the UK Health Security Agency COVID-19 vaccine surveillance report Week 44.  23

Tabel fra UK Health Security Agency med data fra vaccinerede og uvaccinerede der viser negativ vaccine effektivitet

Figure 15. Table based on figures from UKHSA shows negative vaccine efficacy. 22; 23

The vaccine efficacy figures are calculated somewhat similarly to those used by Pfizer to announce a 95% efficacy (against non-specific symptoms) of their injection after the short phase 3 trial in autumn 2020. The point there was that they used the “infected” in the control group as a reference and calculated the reduction in “infection” from their absolute numbers.

Not quite the same here – and a little more correctly.

There is talk of “confirmed cases” 23, which means a positive PCR test.

In the article 22 it is assumed – not entirely unfair – that the number of “infected” among 100,000 of the unvaccinated would be the infection rate if the vaccines were completely ineffective.

Taking the 40-49-year-olds as an example, this means that 932.9 of the vaccinated who have been infected would have been infected anyway if they had not been vaccinated.

This means that (2,124.6 – 932.9) = 1191.7 have been infected BECAUSE they have been vaccinated.

That is (1,191.7 x 100) / 932.9 = 128% So 28% EXTRA of the 100% (932.9), which is the “normal” infection rate in this age group per. 100,000.

Adding up the numbers you get:

Total number of infected among the vaccinated: 7.588.8

Total number of infected among the non-vaccinated: 4,399.6

Over-representation among vaccinated: 3,189.2

Which is (3,189.2 x100) /4,399.6 = 72.5% MORE than there should be among the vaccinated, IF the vaccines were totally ineffective.

The vaccines are thus 72,5% worse than nothing.

Vaccine injury reports

Current figures from EudraVigilance Dec. 4, 2021

Figur fra European Medicine Agency der oplister antallet af bivirkninger og dødsfald fra Covid-19 vacciner frem til dec. 21.


Vaccine injuries in the EU are being reported to EudraVigilance. Figure 16 shows the figures per. December 4, 2021. We do not know what the reporting rate is in the EU. But it is known from a study conducted by Harvard University in 2011 ( ) that the reporting rate for the corresponding US surveillance system VAERS is only 1%.

So if we are really forthcoming and estimate that the reporting rate for EudraVigilance is ten times higher, ie. 10%, the above figures must be “only” multiplied by 10. Then you come to the conclusion that per. December 4, 21, 320,000 people had died from the vaccines in the EU. In addition, approx. 30 million injured. It is not about a slight nausea or sore shoulder. Approx. half of these persons required hospitalization and are lifetime-long.

Total mortality

If you look at the total mortality in Denmark in the years up to and including 2021 (see nf.), You can not help but stumble upon the remarkable excess mortality found in 2021 from May onwards. It is especially surprising that there is such a large excess mortality in the summer months, when there were no corona cases.

Although coincidence is not the same as causality the excess mortality coincides with the vaccine rollout, which from May covered 90% of the risk group and almost 80% of the entire population. A large proportion of these are probably the result of closures and restrictions the year before, so that many cancer patients and heart patients have arrived late for treatment, just as the many restrictions have had an effect on the psychological parameters.

We must expect that this excess mortality has the attention of the authorities and is being carefully investigated.

Graf over det samlede anta dødsfald per måned i Danmark 2007 - 21

The graph above shows the total number of deaths in Denmark per month. The excess mortality rate is 2936 persons. The brown line shows the average 2007-21.

If we go abroad, we also find remarkable data:

A study from the Netherlands shows how reinfection only occurs in vaccinated people, and not in people with natural immunity after Covid-19.

Excess mortality is seen in the most vaccinated states in Germany.

Minutes of report submitted to the Land Parliament in Thuringia on November 16, 2021

Figur der viser overdødelighed i forhold til gennemsnittet i Tyske delstater sammenholdt med vaccinationsgraden

Figure 17. Excess mortality compared to the average in German Länder compared to the vaccination rate.
Figure 17 shows a clear trend: The states (Saxony and Thuringia) with the lowest vaccination rate will have the lowest excess mortality in 2021.

(Prof. Dr. Rolf Steyer, Dr. Gregor Kappler, ”Jehöher die Impfquote, desto höher die Übersterblichkeit”, November 16, 2021, Analyse in Auftraggegeben von Dr. Ute Bergner und von Dr. Bergner am 17.11. vor dem Thüringer Landtag in einer Rede vorgestellt.)

What is the risk of the mRNA vaccine?

The increased risk of infection among the vaccinated may have several causes, which compromise the immune system. The spike protein is an aggressive antigen that promotes inflammatory response in general with what follows.

About myocarditis, the ACE-2 receptor and top athletes:

Children and young people have fewer ACE-2 receptors than old ones, which is why young people do not get CV-19, in contrast to the common flu, which children get much more frequently.

The ACE-2 receptor is located in many different tissues, primarily lungs, heart, endothelium, liver, kidneys, and gastrointestinal tract.

The Omicron variant can only poorly bind to the ACE-2 receptor because there are 25 amino acids in the S1 domain that have been replaced compared to Delta. And these amino acid changes have especially taken place at the top of the spike protein, where it binds to the ACE-2 receptor (Figure 21).

Picture of Delta and Omicron spike proteins showning their respective number of mutations

Figure 18. Models of the spike protein in the Delta and Omicron variants, respectively.
(copied from an article on

That’s why people do not get so sick from Omicron. But it is contagious because it replicates 20 x faster than Delta.

When the ACE-2 receptor is blocked by the spike protein, its normal function in angiotensin release is prevented, thereby compromising the normal vascular contraction and -dilation.

Via angiotensin production, the ACE-2 receptor is actually anti-inflammatory, and if it is blocked by the spike protein, the inflammation will gain extra momentum during the cytokine storm. This, too, will be less pronounced by infection with the Omicron variant, because this can not adhere so well to the ACE-2 receptor.

If, for example. you are an athlete with a high physics performance level  then you needs an effective ACE-2-angiotensin response, which could be compromised by spike proteins from the previous types or the vaccine-induced production by your body.

The number of top athletes getting heart problems has exploded. An updated (17/12-21) – but not exhaustive – list can be found here:

Graph showing increasing number of athlete collapses and deaths 2021-22.

326 medical histories are listed, incl. 183 deaths. It is based on voluntary, personal reports, not necessarily from doctors.

Second listing, Israel, per. Nov. 15: 183 top athletes. Most athletes are males (only 15 females). The vast majority are 17-40 years. Only 21 are older (5 aged 42-45, six aged 46-49, 7 aged 51-54, and 3 others aged 60-64). 23 are teenagers, aged 12-17, 16 died.

Letter from the Danish Medicines Agency to doctors and healthcare professionals dated July 19, 2021 warns of the risk of:

Myocarditis and pericarditis after vaccination with the mRNA vaccines Comirnaty and Spikevax against COVID-19. The cases mainly occurred within 14 days after the second vaccination and are most often seen in younger men. ”


Letter from the Danish Medicines Agency to doctors and healthcare professionals dated August 26, 2021 warns of:

“Possible risk of developing multisystem inflammatory syndrome in children (MIS-C) after vaccination with Comirnaty (Pfizer / BioNTech COVID-19 vaccine)”
Reference is made to Danish study: Multisystem inflammatory syndrome in children occurred in one of four thousand children with severe acute respiratory syndrome coronavirus 2 – Holm – 2021 Acta Paediatrica: It is from Covid-19, not the vaccine.

The Japanese Ministry of Health warns against myocarditis / pericarditis on the vaccines.

Pr. November 14, 2021, 160 cases had been registered in Japan of myocarditis respectively pericarditis among one million boys/men (10 – 30 years) vaccinated with Moderna / Pfizer.

Therefore, there is now a formal warning against “serious side effects” of myocarditis on the package leaflets/packaging, and the clinics in Japan are subject to stricter reporting obligations.

Here is a Japanese report with many important informations from Japan: (s.32-38)

Vaccines Pose 7 Times Higher Death Risk than COVID for Young People, Japanese Experts Warn

“The death risk of the jabs (injections) may even be as high as 40 times greater for young people.”

Note that in Japan vaccine injury is not recorded beyond 30 days after injection.

This figure can be understood immediately:

Figure showing comparison of cause of death: vaccinated and general population

Figure 19. From page 32 – 38. ”COVID-19 vaccine: Strong association with cardiovascular death, especially hemorrhagic stroke and venous thrombosis.” (p.32-38)

The reference group is from 2019, as no data can be collected from non-vaccinated in 2021.

Pages 38 – 41 ”Causal link between vaccination and subsequent death”.

Figure showing distribution of days to death after vaccination and incubation period of Covid-19

Figure 20. Number of days from injection to death, compared with the incubation period for COVID-19.

Figure 20 again supports the simple consideration that one gets COVID-19 from the injection when the mortality of persons <65 peaks on day 4 just like the incubation time for a viral infection.

“Therefore, the fact that the number of days to deaths after inoculation is similar to the incubation period of COVID-19 in the medical workers or people under the age of 65 is biologically plausible and this also supports the causality.”

It is also noted here that children and young people have far fewer ACE-2 receptors than old ones. Therefore, they do not get sick from CV-19.

Pages 41 – 43. Mortality risk of vaccination is 7 times higher than that of COVID-19 in 20s.

Figure showing mortality risk ratio of vaccinated medical workers to death from Covid-19

Figure 21. In the column to the right, age has been multiplied, which is why the spread between young and old is greater. There are no calculations for people under 20 for the simple reason that no one was killed by Covid-19. (You can not divide by zero.)

“Harm of vaccination in children may be enormous. There were no deaths due to COVID-19 infection under the age of 20 until September 1, 2021. If children in this age group are vaccinated, it may cause death. Mortality risk from vaccination may be lower in children than people in their 20s. Even so, the mortality risk ratio cannot be calculated because the number of death from COVID-19 is “0” in Japan by September 1, 2021.”

Norway August 21. More people than expected get myocarditis.

“We just give one injection.”

VAERS September 21. 6x increased likelihood of myocarditis in young men

Original article 26, preprint:

The figures are for Pfizer after the 2nd dose:

Boys 12– 15 years: 162 cases per. million. That equates to 1: 6,000
Boys 16 – 17 years: 94 cases per. million. That equates to 1: 10,000
The girls are not so badly affected.

It is estimated that 44 young people will be hospitalized per million with CV-19 over a 120-day period. That equates to 1: 23,000.

“Conclusion: According to a new pre-print study, boys between the ages of 12 and 15, with no underlying medical conditions, were four to six times more likely to be diagnosed with vaccine-related myocarditis than they were to be hospitalized with COVID.”


The various vaccine side effects and causal relationships have been difficult to understand as results from autopsies of the cases have been lacking. Professors Bhakdi and Burkhardt from the University of Gutenberg in Mainz have filled this gap with their histopathological study from December 2021, documenting why the vaccines do not work and how the vaccines can cause death: ( )

Cited from translation:

“A fundamental flaw behind the development of the Covid-19 vaccines was to neglect the functional distinction between the two main categories of antibodies that the body produces to protect itself against pathogenic microbes.

The first category (secretory IgA) is produced by immune cells (lymphocytes), which are located directly under the mucous membranes that line the airways and the intestinal tract. The antibodies produced by these lymphocytes are secreted through and to the surface of the mucous membranes. These antibodies are thus in place to meet airborne viruses.

The second category of antibodies (IgG and circulating IgA) occurs in the bloodstream. These antibodies protect the body’s internal organs against infectious substances trying to spread through the bloodstream.

Vaccines that are injected into the muscle – that is, the interior of the body – will only induce IgG and circulating IgA, not secretory IgA.

Such antibodies can not and will not effectively protect the mucous membranes from infection with SARS-CoV-2. Thus, the currently observed “breakthrough infections” among vaccinated individuals merely confirm this fundamental design flaw in the vaccines. Measurements of antibodies in the blood can never provide any information about the true status of immunity against infection in the respiratory tract.”

This is their explanation for why the vaccines do not prevent infection and re-infection.

But they have also analyzed the causes of death and they write:

“Histopathological findings of the same type were detected in organs from 14 of the 15 deceased. The most frequently affected were the heart (14 out of 15 cases) and the lungs (13 out of 15 cases).”

In addition, they find as dominant findings in all affected tissues in all the dead:

  • Increased inflammation in the small blood vessels, with an abundance of T lymphocytes and dead endothelial cells in the blood vessels.
  • Extensive accumulation of T lymphocytes around the blood vessels and in a variety of organs.

When infected via the respiratory tract with a coronavirus, the infection will primarily be localized to the mucous membranes of the respiratory tract.

However, when a drug is injected (into the body itself) that programs the cells to generate the viral spike protein, any cell that expresses this foreign antigen will be attacked by the immune system, involving both IgG antibodies and cytotoxic T lymphocytes. This can happen in all organs. For example, we now see how the heart of many young people is affected by pericarditis, myocarditis and even acute heart attack and death.

Whether these tragedies could be in a causal relationship with the vaccines has so far been unclear, as the crucial investigations based on autopsies have not been available until now.


Orthomolecular measures against Covid-19

The Vital Council has in newsletters available as articles on the Vital Council’s website since May 2020 written and documented the options available to prevent serious Covid-19 disease. So here we must confine ourselves to a quick summary:

The most important are daily exercise in fresh air, 7-8 hours of sleep and a good, varied diet without too much sugar. Next, supplement with extra Vitamin D, Selenium, Magnesium, Zinc and Vitamin C.

Vitamin D3: 75-100 mg, vitamin C: 2-3,000 mg, selenium: 100-200 mg, zinc: 20-30 mg and magnesium 2-300 mg. The small dose is for those weighing less than 70 Kg.
In addition, you can supplement with vitamin-A, -B6, -K2, and if you are a vegetarian, then also -B12.

And remember in the dark winter, when the flu is always raging: Vitamin D in the blood should rise to 100-150 nmol / l (40-60 ng/ml).

Right from the start of the pandemic, it was established that there was no treatment for Covid-19.

This statement has paved the way for the rollout of vaccines, and is not true either.

Often you see pseudo-science, where you use vitamins and minerals as treatment after disease outbreaks, and even often in relatively small doses. It is pointless and only suitable to show that it does not work. These nutrients are for prevention.

An exception, however, is Vitamin C in high doses given intravenously under medical supervision.

There are only sparse documentation here at the Covid-19 pandemic, but in the past there is ample evidence of an effect on viral infections.

Already early in the pandemic there have been numerous attempts with hydroxychloroquine, but with very varying results.

Hydrogen peroxide in ultra-weak solution has been tried as nasal or pulmonary inhalation with promising results. But a proper investigation is lacking.

Ivermectin is a remedy for scabies and certain parasites and has eventually got a well documented effect on Covid-19  ( ). Among others, the Indian health authorities have approved a treatment with Ivermectin, Doxycycline and zinc.

There are a number of other combined treatment regimens that also include IV Vitamin-C.

In addition, there are studies on several natural substances, such as. Melatonin, Quercetin, Glycyrrhizin as examples of some of the supplements that have potential as remedies against Covid-19.



(In the final addendum, reference is made to the Vitality Council’s articles, where further references can be found.)

(1) Thomas L. SARS-CoV-2 RNA can be reverse-transcribed to be part of chimeric viral-human genome. 2020.

(2) Zhang L, Richards A, Barrasa MI, Hughes SH, Young RA, Jaenisch R. Reverse-transcribed SARS-CoV-2 RNA can integrate into the genome of cultured human cells and can be expressed in patient-derived tissues. PNAS 2021; 118.

(3) EU. Directive 2001/18/EC of the European Parliament and of the Council. 2001.

(4) EU. Vaccine mod covid-19: Rådet vedtager foranstaltninger for at fremme hurtig udvikling. 2022.

(5) Lei Y, Zhang J, He M, Schiavon CR, Chen L, Shen H et al. SARS-CoV-2 Spike Protein Impairs Endothelial Function via Downregulation of ACE 2. Circulation Research 2021; 128:1323.

(6) Harrit N. Validiteten af RT-PCR testen vurderet på basis af dyrkningsdata. Newsvoice. 2022.

(7) American Association of Physicians and Surgeons. Physician List & Guide to Home-Based COVID Treatment. 2021.

(8) WHO. WHO Information Notice for IVD Users. Nucleic acid testing (NAT) technologies that use real-time polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2. 2020.

(9) CDC. 07/21/2021: Lab Alert: Changes to CDC RT-PCR for SARS-CoV-2 Testing. CDC . 2021.

(10) Statens Serum Institut. Covid-19 Gennembruds-infektioner og vaccineeffektivitet. 2021.

(11) Edler C, Sperhake P, Et al. Dying with SARS-CoV-2 infection – an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med 2020; 134:1275-1284.

(12) Osman M, Klopfenstein Te, Belfeki N, Gendrin V, Zayet S. A Comparative Systematic Review of COVID-19 and Influenza. Viruses 2021; 13(3):452.

(13) Ludvigsson JF, Engerström L, Nordenhäll C, Larsson E. Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden. N Engl J Med 2021; 2021/01/06(7):669-671.

(14) Sorg AL, Hufnagel M, Doenhardt M, Diffloth N, Schroten H, Kries R et al. Risk of Hospitalization, severe disease, and mortality due to COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany.medRxiv 2021;2021.

(15) Brown.C.M., Et al. Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings —
Barnstable County, Massachusetts, July 2021. Morbidity and Mortality Weekly Report 2021.

(16) Karim SSA, Karim QA. Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic. The Lancet 2021; 398(10317):2126-2128.

(17) Statens Serum Institut. Covid-19 Rapport om omikronvarianten. 2021.

(18) Hansen CH, Schelde AB, Moustsen-Helm IR, Emborg HD, Krause TG, Mølbak KÃ et al. Vaccine effectiveness against SARS-CoV-2 infection with the Omicron or Delta variants following a two-dose or booster BNT162b2 or mRNA-1273 vaccination series: A Danish cohort study. medRxiv 2021;2021.

(19) Lyngse FP, Mortensen LH, Denwood MJ, Christiansen LE, Møller CH, Skov RL et al. SARS-CoV-2 Omicron VOC Transmission in Danish Households.medRxiv 2021;2021.

(20) Robert Koch Institut Tyskland.Wöchentlicher Lagebericht des RKI zur Coronavirus-Krankhei-2019 (COVID-19). 2022.

(21) Subramanian SV, Kumar A. Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States. European Journal of Epidemiology 2021; 36(12):1237-1240.

(22) The Exposé. Latest UKHSA report shows the Covid-19 Vaccines have an average real world effectiveness of MINUS 73%. The Exposé . 2021.

(23) UK Health Security Agency. COVID 19 vaccine surveillance report Week 44. 2021.

(24) UK Health Security Agency. SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 31. 2022.

(25) Steyer R, Kappler G. Je höher die Impfquote, umso höher die Übersterblichkeit. 2021.

(26) Høeg TB, Krug A, Stevenson J, Mandrola J. SARS-CoV-2 mRNA Vaccination-Associated Myocarditis in Children Ages 12-17: A Stratified National Database Analysis. https://wwwmedrxiv org 2021.


Claus Hancke
Specialist in general medicine

Niels Harrit
Lecturer KU(retd.)

Sorgenfri January 20, 2022

How do we handle Covid-19?

December 15, 2021

Covid-19 virusThe other day, I heard the happy voice of a radio host on DR4 tell me that the Omicron infection is rising and rising, while the Delta variant has slowly begun to decline.

Then great concern about the rising infection makes the radio host say: “And what can we do then? -Yes, we can be vaccinated, for example. ”

I listened intently to hear if there were other examples since he said “for example”.

But there was no more.

It’s horrible to hear that we are only relying on vaccines, now that we have persistent messages that the current vaccine does not work very well on the Omicron variant, and that its effect even on the Delta variant is gone after 7 months .

Strangely enough, the vaccine’s short shelf life does not make the authorities seek other, more effective solutions, but on the contrary is used as an argument for more frequent booster vaccinations. It is as if you can not think in other directions at all, even if you are face to face with the vaccine’s limitations: it does not prevent you from becoming infected, it does not prevent you from passing on the infection, and it only lasts 7 months.

It is actually quite impressive that everyone, from the Danish Prime Minister to various experts, has been talking about vaccines alone for almost two years. Right from March 2020, the Prime Minister spoke about vaccines, as if she could already predict that such a vaccine would be developed in an unprecedented record time. -Well spotted.

Not a word about the prevention or treatment of the disease, as mentioned in the Lancet and in our newsletter of November 25, 2021.

As we are flooded with research results on both the prevention and treatment of covid-19, then this uncensored newsletter must of course pass on these results when the other media are not allowed to.

As early as May 6, 2020, the Vitality Council’s newsletter reviewed the first results of prevention with vitamin D. This has been described and documented numerous times since, also with good review articles, and in February 2021, 200 researchers and doctors wrote an open letter to all governments and health authorities appealing to be aware that vitamin D deficiency increases the risk of severe Covid-19 disease. In this letter, the researchers explain in detail the dosage needed to achieve the desired value in the blood, and as a curiosity, they also mention how much they themselves take. It is always a good sign when a doctor dares to take his own cure.

The vast majority of doctors take 100 µg (4000 IU) daily and aim for a recommended serum concentration of at least 75 nmol/L (30 ng/ml). This is far below the level in most Danes.

Another important piece of information in their letter is that a calculation error of factor 10 were made when calculating the RDA (Recommended Dietary Allowance) in the United States. This value of 1/10 of the ideal, was unfortunately adopted by other countries, and became ADT (Recommended Daily Supply) here in Denmark; – what is now called RI (Reference Intake). Regarding vitamin D, the Danish Veterinary and Food Administration still recommend RI to be 5 µg (200 IU) daily. In 2020, the National Board of Health has increased this recommendation to 10 µg daily, which is approx. 10% of what we really need.

What do we do then? First and foremost, we get our vitamin D content measured in the blood. If it is below 75 nmol/L, then we take vitamin D in double dose, which for a normal-weight, adult person is 200 µg daily, until the vitamin D level has exceeded 75 nmol/L, after which you continue with 100 µg daily.

If you are overweight, you need significantly more, because vitamin D will be stored in the fat layer, where it does not do much good.
When it is above the desired 75 nmol/L, there is a significantly lower risk of serious, hospital-requiring covid-19 disease.

Dear reader. You may be tired of us constantly returning to vitamin D. But when you are not allowed to get this information from the authorities who are suppose to take care of you, then do not think that the information does not exist.

In the same way, there is a lot of good research on vitamins A, -C and -K2 as well as the minerals Magnesium, Selenium and Zinc, all of which contribute to a well-functioning immune system and prevent severe Covid-19 disease.

But maybe it’s all just a storm in a teacup.
Indeed, much information suggests that the highly contagious Omicron-B.1.1.529 variant is no more dangerous than a mild flu.

Due to its high contagion, Omicron will just as quietly take over the epidemic, and then we’re back to a fairly ordinary winter season with a mild flu.
After this, society can open up and start functioning normally again.
A mild flu, we know how to prevent – and treat.

Have a Merry Christmas & a Happy New Year.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

Good news for the unvaccinated

November 25, 2021

What is happening in the Danish society?
Denmark is a wonderful country! One must look for a long time for a more tolerant, incorruptible and trusting people!
So far, most Danes can probably agree.

Therefore, we can not help but ask: What is happening in our country right now?
Are we talking about an A-team and a B-team? The vaccinated and the UN-vaccinated? Yes, according to the Danish Prime Minister, we are!
It is disrespectful, and we must go far back in history to see such state-run disgrace of a minority.
And is it at all true that the unvaccinated are a danger and “live life dangerously”? Let’s look at the facts.

We can ourselves
Every day in our lives where we are symptom-free (healthy), it is not due to the absence of viruses or bacteria, but to the presence of an active, balanced immune system that does exactly what it is designed for.
– And which no vaccine can replace.

When health professionalism became politics
Lack of knowledge and misinformation of the population has led to an unjustified fear of viruses and an equally unjustified one-sided focus on vaccines. But worse still, it has created a disunion in the population.

That politicians, agencies, government officials, health professionals, and the general public have been convinced that infection is the same as disease is spin and politics and not health science.

A high infection rate does not matter if there are no patients. When 1,000 persons are infected without anyone dying, it means that 1,000 persons gain natural, strong immunity.
So when the Danish National Board of Health now reduces the duration of natural immunity from 12 to 6 months in the corona passport, then that policy is contrary to science.

If we observe the total mortality in Denmark over the past 20 years, we can state that mortality had not increased in 2020, when we had an epidemic at full strength, but no vaccines.
Covid-19 has thus not increased mortality in Denmark.

Furthermore, we can state that mortality has not decreased in 2021 (January to October), where we have vaccinated 80% of the population and 90% of the risk groups.
The vaccines have thus not reduced mortality in Denmark.

Even the number of infections today is much higher than it was the same day a year ago, although fewer are being tested now.
Thus, the vaccines have not reduced the number of infections either.

Why do some people’s immune system fail?
A groundbreaking study from the University of Copenhagen (KU) showed that vitamin D is necessary for our ability to survive infections in the normal way. The findings of the study were evaluated by the University of Copenhagen and determined to be so important that “a number of immunology books must be rewritten“.

Vitamin D in sufficient amounts is crucial for activating the immune system in infections, and “switching it off” again afterwards, so that the immune response is normalized.
The study explains the mechanism that has been sought in 50-60 years of vitamin D research.
The informed reader of the previous newsletters is well aware that in the absence of certain micronutrients, the immune system will fail.

Such a deficiency can not be remedied by simply taking the doses that are currently recommended here in Denmark. These are often too low because they do not take into account poor diet, improper preparation of food, stress, smoking, medication, etc., which leads to a greater need for these nutrients.
With a healthy lifestyle and a sufficient intake of the vitamins and minerals that are crucial for the immune system to function as it should, virtually no virus will be generally dangerous to the population in countries with Danish living standards.

Is vaccine our only salvation?
As the vaccine does not prevent infection or transmission, but should only inhibit serious illness in the vaccinated person, it is inconceivable that one wants to vaccinate healthy children who do not risk serious illness. The risk of vaccine side effects and death will here be far greater than the risk of the disease that the vaccine should protect against. This is contrary to The Hippocratic Oath.

Vaccines and only vaccines have been heavily targeted. Not a word about natural, effective, inexpensive and side-effect-free prevention and treatment.
It is like a three-legged stool, where the two legs have been removed, namely prevention and treatment.
Such a one-legged stool will never be able to stand alone.

It therefore surprises us that information about the things that can actually prevent and treat serious illness is not disseminated to the population through the official channels, but on the contrary is censored in a fog of misinformation.

We find it responsibility incurring not to inform about this.

Natural immunity – our main defense
We hear again and again the same experts on TV and in other media repeating that our immunity decreases at the same rate as the amount of antibodies in the blood, both after vaccination and after natural immunity after a viral infection. But this is wrong. A scientifically incorrect assumption. And a misunderstanding. With natural immunity, the amount of antibodies decreases naturally, after a viral infection. It should actually drop.

The wise body
The body is energy efficient and does not use energy and space to maintain high levels of antibodies to a virus it has just fought or the thousands of virus types we are constantly exposed to.
Once the virus has been defeated, the body turns down the flame so that it can again use energy on other processes. And it can do so calmly, because with the infection the natural, strong and often lifelong immunity is built up.
If, after battling the infection, the body continues to maintain high levels of antibodies in the blood for months and years, it is equivalent to a boxer who has just knocked out his opponent in the boxing ring continuing to walk with the parades up for months. That does not make sense.

The important memory cells
In the event of a viral infection, there is an activation of e.g. memory cells, which are coded to be able to recognize the virus they have just been in contact with, so that they can reactivate antibodies again very quickly at later encounters with the virus.

Unlike vaccine immunity, natural immunity is longer lasting, more broad-spectrum and thus more effective against mutations.

The continuous updating of the cells’ memory by natural immunity after infection makes the immune system stronger after each update. This ongoing update does not occur to the same extent with vaccine immunity, where one instead has to revaccinate.

This has just been demonstrated in a new study from August 2021 from Rockefeller University that specifically examines Pfizer’s and Moderna’s mRNA vaccines against natural immunity and has been confirmed by previous studies.

Updated memory cells can quickly activate an immune response adapted to the inevitable re-infections.
The reaction is rapid and the virus is therefore killed before it has time to multiply in an amount that triggers disease symptoms.
This means that we do not detect these recurrent re-infections. In other words, we are symptom-free and healthy, even though from time to time there is a disease virus in the body, and if we are tested for re-infection, it will be possible to measure the virus, and we are thus “infected”, ie. have a positive test. But we are neither sick nor particularly contagious.
Infection rates as a disease indicator are therefore a wrong strategy.

If there was a pandemic with a generally dangerous disease with high mortality (such as Ebola), and there was an effective and proven safe vaccine, then we would all be vaccinated, right?
But something lags. For none of these things are the case.

And it does not increase confidence in authorities, experts and the health system that there can be no calm, open and uncensored debate on these things.

Take care of yourself and others.

Kim Varming, Chief Physician and Clinical Immunologist,
Claus Hancke,
Specialist in General Medicine and
Michael Schultz,
Physiotherapist and Business Lawyer

Note: This post has in a slightly different form been published as a column in media in the northern part of Jutland 15/11.


Basic prevention

July 28, 2021

In March 2020, politicians shut the world down on pandemic orders from the WHO.
It did not take many seconds from the shutdown before the talk went on that vaccines had to be developed that could free us from this covid-19 disease.
It was established from the outset that the disease could neither be prevented nor treated. There was only isolation until the saving vaccine came.
It was “The one-legged stool”, as mentioned in our newsletter feb. 21, 2021.

If anything was fake news, it was this.
But for inexplicable reasons it became the standing narrative, which was so sacred that one was shamed and censored if one doubted this worldview.

All over the world, doctors were prevented from rescuing their patients by early prevention and treatment of covid-19.
It sounds crazy that one has censored and prevented harmless methods of prevention and treatment before it goes so wrong that the patient has to be hospitalized.
Do the authorities really want people to get so ill that they have to be hospitalized?
Some of these harmless methods are even well documented, yet it is branded as “fake news” when it is publicly mentioned and the doctors in question are quarantined on Facebook and YouTube.

However, measures such as shutdowns and face masks are blindly accepted, even though there is very little documentation of the effect.
Health authorities as well as politicians from all over the world have loudly and sacredly emphasized that we must follow the science, and the world’s all-round experts have been shown on TV to give the authorities’ actions a tinge of science.

But when it comes to shutdowns, mink killings, face masks, PCR testing and the so-called vaccine, which is in fact a gene therapy, these highly praised scientific principles have failed.
We have even come so far that the population must be humiliated with testing or subjected to experimental gene therapy in order to preserve its civil rights.
Every thinking person must ask oneself: Tell me, what is going on?

If you want to try to get an overview of this madness, it is recommended to spend time watching:, which is a serious TV review of the conflict between science and the active deception of the authorities.

The Vitality Council is fortunately uncensored, and in the newsletter May 2020, there was a comprehensive overview of the supplements with which one could prevent a serious Covid-19 course.
The main thing is that the immune system must not lack these basic nutrients. On the other hand, a well-functioning immune system has the great advantage that it can quickly adapt to a new mutation of the virus and adjust its counter-attack to it.
A vaccine is specially designed for a specific type of virus, and must be reconstructed and adjusted if a new VOC (“virus of concern”, ie mutations that are viewed with concern) varies so much from the previous one that the vaccine does not work.
We see this at this time at home and abroad, where fully vaccinated people are admitted with severe covid-19.
This would not happen if the entire population had a well-functioning immune system that can quickly adjust the target to the new variant.
Then you only need to vaccinate the 2% who are in the absolute risk group.

But one thing is to prevent serious flu or Covid-19. Something else is the prevention of the major killer diseases like cancer and cardiovascular disease.
These disorders have been underdiagnosed during the Covid-19 pandemic, which must necessarily become a problem for the healthcare system in the coming years.
But then it is fortunate that many of the supplements that the Vitality Council recommended 1½ years ago also reduce the risk of these diseases.
This is not really so strange, for many diseases start with the process called inflammation. And it can be prevented to a great extent.
Regarding Covid-19, it starts with the immunological reaction to viral infection, the excessive reaction, the cytokine storm and then the whole inflammatory process.
In cardiovascular disease it starts with inflammation of the vessel wall and oxidation of LDL cholesterol, and in cancer it starts with inflammation of the cells in an oxygen-poor area, which then changes the metabolism in the mitochondria from aerobic and efficient energy production to anaerobic sugar fermentation and low energy production.
Therefore, if you focus on inhibiting the inflammatory processes that should not be in the body, then you are well on your way to preventing the large, life-threatening diseases, and at the same time you get to inhibit the development of viral diseases so that they do not develop in a fatal direction.
Therefore, if I have to come up with an all-round recommendation as a basis, then it will be:

  • A multivitamin-mineral product without iron
  • Plus extra Selenium, so the daily dose comes up to 150 µg
  • Plus extra vitamin D, so the daily dose is up to 100 µg (this is only the maintenance dose if you are not in deficit. Otherwise you need more.)
  • Plus extra vitamin C, so the daily dose comes up to 2,000 mg
  • Plus extra Magnesium, so the daily dose comes up to 500 mg
  • Fish oil (but not necessary if you eat fatty fish every day)
  • Lactic acid bacteria

This basic supplement can ensure that you do not run a deficit for the body’s performance of tits basic functions, including the processes of the immune system.

If, on top of this, you are exposed to infection, which we have all been at intervals in the last 1½ year, then you can for a period supplement with:

  • Vitamin A: 1 mg
  • Vitamin B6: 5 mg
  • Vitamin C: 3,000 mg
  • Vitamin D3: 100 µg
  • Selenium: 100 µg
  • Zinc: 30 mg.
  • Echinacea 20 drops 2 x dgl.

This ensures that the immune system is well-supplied, despite increasing consumption, and then inhibits the cytokine storm, which can be life-threatening for the elderly and weak.

And the very basics of a good immune system are of course:

  • A healthy diet
  • Daily exercise
  • 7-8 hours of sleep
  • Freedom from smoke
  • Moderation
  • A positive outlook on life

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

Don’t forget selenium

March 8, 2021

With the headline, we are entering the vital minerals, and selenium is one of the most important, because it is the gateway to 25 different selenoproteins, which control a wide range of processes in the body.

Selenium is a substance that we prefer not to lack, and numerous studies have over the years confirmed that selenium deficiency can lead to, among other things. heart failure, cancer, metabolic disorders, arthritis, infertility, atherosclerosis, increased inflammation, and a variety of immunological failures that are particularly relevant in this corona age.

Did you know, for example, that a vaccine will not work as intended if the vaccinated person lacks selenium and vitamin D. These two nutrients are necessary to activate the T cells, which must be able to recognize the infection the next time you encounter it (1,2,3). And they are also needed to moderate any vaccine-triggered cytokine storm.

There are thousands of articles cementing heavy research into selenium, and most recently, two months ago, an interesting study of selenium deficiency related to cardiovascular disease and inflammatory conditions was published (4). Since cardiovascular disease is also initiated by inflammation, it is natural to examine this collectively.

Previous studies have also shown that low selenium in the blood was the cause of increased inflammation, increased risk of cardiovascular disease and premature death (5,6).

Selenium dampens cytokine storms

The study included 858 healthy elderly and 606 cardiovascular patients of the same age.
The researchers examined the degree of inflammation by measuring the ratio of white blood cells (neutrophil / lymphocyte ratio), CRP and a wide range of cytokines, interleukins and chemokines.

They found a clear link between the lack of selenium and the incidence of cardiovascular disease as well as, not surprisingly, increased chronic, inflammatory load on the body, especially in the cardiovascular disease.

Selenium deficiency was associated with elevated values of circulating inflammation markers such as cytokines, interleukins and chemokines that are precisely characteristic of the scourge of our time, namely the risk of a cytokine storm at Covid-19.

Selenium is included as a moderator on an equal term with vitamin D, so that the formation and control of cytokines is formed and controlled, but to avoid the violent production called a cytokine storm, which triggers the damage that makes Covid-19 dangerous for individuals, weak people.

The researchers concluded that people with plasma selenium below 60 µg / l had almost twice the risk of cardiovascular disease compared to those who had a normal selenium content in the blood.

The result was convincing and statistically significant and corresponds very well to previous studies showing that the selenium-dependent glutathione peroxidase achieves its maximum activity in the blood when the concentration of selenium in plasma is between 70 and 90 µg / l (7).

In previous newsletters from May 2020, there are several references related to infections updated by Covid-19, and back in 2005 we wrote newsletters about cancer risk due to selenium deficiency. So selenium has been on the light board for many years, i.a. because there are so few who are aware that it is something we must not lack.

Daily intake (in Europe) should be around 100µg, and naturally it is found in fish, meat and certain nuts.
So remember selenium every day.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine


  1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet.
  2. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
  5. Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21.
  6. Caly L et al, 2020, Antiviral Research, 178, june 2020, 104787.

A stool with one leg

February 21, 2021

As previously quoted, they wrote in the Lancet (1) December 20th that in the future everything should be done to prevent and vaccinate and find methods for the treatment of Covid-19, and the Vitality Council can’t agree more that this stool should rest on three legs.

But the Danish government has not agreed to that. Since March 2020, it has focused on vaccines and only vaccines. – A one-legged stool.

Not only has the Government and the state media focused unilaterally on vaccines, but they have also actively censored information on both prevention and treatment. The government media has also been obediently accompanied by microphone holders from the major social and print media. It has been irrelevant to the censorship whether this information was sufficiently well documented.


In the previous many newsletters, the Vitality Council has primarily advised on prevention in terms of keeping the immune system intact.

In our modern way of life with easy and fast industrial food of poor quality, improper preparation and overeating of carbohydrates, there is a great risk that our immune system will run out of essential nutrients. I have reviewed this topic again and again and will not bore you with this at this time.

But I will try to give a simple model for understanding the functioning of the immune system. This is because it is absolutely essential in prevention against Covid-19 and all sorts of other infections.

The immune system has a myriad of different cells to work with, and it’s pretty complicated, but let’s try a Pixie model; -a mousetrap:
There are two main systems, a so-called “innate” (non-specific) immune system, which works all the time, and an “adaptive” (specialized) immune system, which is adjusted by infection. The innate system attacks just about everything when, for example, a virus penetrates the body, but first the adaptive needs to get familiar with the new virus, adjust and activate the so-called T cells for attack, and teach the memory cells to remember for the next time how these virus are best attacked (antibodies).

Back to the mousetrap.

In the loft with all the mice (virus in the environment) we put a box (the body), with a small hole in the side (the innate immune system), and inside the box we put a couple of mousetraps (the adaptive immune system).

If we lack proper nutrition, vitamin D, selenium, vitamin C and magnesium, then the hole in the box is very large (the innate immune system fails). Then many mice can enter the box at once, and the traps (the adaptive immune system) do not have the capacity to snatch many mice. – Especially not if there is a lack of vitamin D, which is necessary to activate the T cells (2).

If, on the other hand, we get enough of the above nutrients, then we only have a small hole in the box (a good innate immune system), and then only a few mice enter the box (the body) at a time, and the adaptive immune system (the traps) can snatch them one by one.
Remember the Danish Minister of Health showing a graph with red and green curves some time ago.
If too many come too fast, then the hospital system would collapse.
The same way with our immune system.

If it is intact, the innate immune system will make sure to moderate the load so that the adaptive defense can have time to get to know the enemy and calibrate its cannons accordingly. Hereby we avoid the overload that results in the so-called cytokine storm, which is the start of all the accidents.

That is why it is so important to provide proper nutrition and supplement with vitamin D, vitamin C, selenium and magnesium.
And remember in the dark winter: Vitamin D in the blood should rise to 30-50 ng/ml (75-125 nmol /L.)
If you can’t get the blood sample taken locally, there are several excellent options for home testing i Denmark (3,4).


Often you see pseudo-science, where vitamins and minerals are used as treatment after disease outbreaks, and even often in relatively small doses. It is pointless and only suitable to show that it does not work. These nutrients are for prevention.
An exception, however, is Vitamin C in high doses given intravenously under medical supervision.

There is only scant evidence here at the Covid-19 pandemic (5), but previously there is ample evidence of an effect on viral infections, as mentioned in the newsletter May 20th 2020.

There have been numerous experiments with hydroxychloroquine, which, however, have yielded quite varying results, and research into it is unfortunately largely discontinued.

Ivermectin is a remedy against scabies and certain parasites, and reportedly also has an effect on Covid-19 (6). The Indian health authorities have approved a treatment with Ivermectin, Doxycycline and zinc.
Ivermectin costs about 100 times as much as hydroxychloroquine, so it will probably never be the big success.
One week ago, Israeli researchers published (7) a preliminary result of treatment with inhalation of CD24 exosomes in 30 hospitalized moderately to severely ill Covid-19 patients. The 29 recovered in 3-5 days, the last one also recovered, but after more than 5 days. It should be a cheap method without side effects, so it sounds promising. CD24 exosomes are proteins that, like vitamin D, control T cell activation and can attenuate the cytokine storm.
We are anxiously awaiting news from the Israeli researchers.

What now?

After all, health authorities and the government are on thin ice right now, unless they manage to be saved by the globally declining infection rates and death rates.
You vaccinate and vaccinate, but to no avail on the closure of the society. The function of the vaccine is primarily to alleviate the disease in the vaccinated person.
Even though we have been vaccinated, we can still be infected and pass it on to others, because the virus is still there. Therefore, even the vaccinated must continue with face masks, despite the poor evidence of the effect of the hated face masks.
On top of this, there are still new mutations. Currently the English with increased infection of children, which we see in Kolding these days, but on the horizon lurks the South African and two different Brazilian varieties, which are even less sensitive to the antibodies we have received from previous infection and from vaccination.
Well, then the vaccine just has to be adjusted, and then the population just has to be vaccinated again.
Okay. -How many times? So far, in 2 months we have only vaccinated 3% of the population. So good luck with the task if it all has to start all over again.
It seems like a Sisyphean task if the Government will continue to focus only on the one-legged stool.
As a solution to this chaos, the Government is now proposing a wild testing strategy, where we will be tested twice a week next year. This will cost just as much as the overall healthcare system, and one does not have to be a nuclear physicist to figure out that this will massively affect all other diagnoses in the healthcare system.
And the virus will not disappear either due to this.
It’s a bit like setting up photo traps to detect an army of soldiers invading the country. No defense, just registration while the invasion rumbles towards the defenseless population.
When the hopelessness of this strategy eventually dawns on the Government, there is hope that the one-legged stool will be given two more legs, namely prevention and treatment.
Then every single person can be informed about the possibility of defending themselves against Covid-19.
Only then will the disease become so mild that it resembles a common flu, by which we can drop the hated face masks and the lockdown of society.

May we ask for the three-stringed strategy as soon as possible thank you.

A stool with one leg is doomed to tip over.
A stool with three legs does not tip over.
No matter how uneven the surface is, it will not even tilt.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine


  1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet.
  2. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
  5. Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21.
  6. Caly L et al, 2020, Antiviral Research, 178, june 2020, 104787.

Vaccine, treatment, prevention and censorship

February 4, 2021

Since the turn of the year, the big mantra on the part of the Danish government has been vaccines, vaccines, vaccines, and much of the news flow has revolved around approval, safety, supplies and groups of people that needed to be vaccinated. In addition, vaccine passports are now being introduced, which will be necessary if you want to go to the movies, to Mallorca, to concerts or to festivals. – That is coercion.

Immunological disability

Moreover, one mutation after another of the Covid-19 virus is being discovered, and currently it is the Brazilian P1 version that is lurking on the horizon. There are hundreds of thousands of virus types, and in addition, mutations of these.
RNA viruses are particularly prone to mutating, and the more the mutation changes the protein structures of viruses, the less immunity from previous infections or vaccines there will be. Well, then you have to make a new vaccine or adjust the old one, we hear in the media…. – And then we have to be vaccinated again.
How many immunizations must we have?
If the survival of mankind is made dependent upon new vaccines having to be made all the time, every time a virus mutates enough, will we then after 2-3 generations risk that increasing immunological disability occurs?
This is, of course, a hypothesis, but also a horror scenario where simple epidemics could require many deaths.
This race between viruses and vaccines is meaningless. It is a race we will never win.
Viruses will always be in the lead, and they will never be eradicated.
The only thing that is capable of lightning-fast adaptation and can keep up is a well-functioning immune system.
The question is whether we will ever get rid of the SARS-Cov-2 virus, or whether it will simply join the ranks of other corona, rhino and many other types of virus that exist among us and that appear from time to time with the symptoms of a cold or flu.


For years, orthodox medicine has researched the possibilities for treating colds and flu without much success. A few substances have been found such as oseltamivir (Tamiflu), which 20 years ago was thought to work against influenza, but where the results are highly questionable. And with such a product with many side effects, it is a mystery that it is still registered for the treatment of influenza here in Denmark. It is banned in Japan.
Another example is Remdesevir, which has been widely used against Covid-19 until WHO now has advised against it.(1)
Hospitalized patients are currently getting steroids to dampen down the exaggerated immunological response (cytokine storm) in Covid-19 disease. It makes good sense. In Danish hospitals, however, steroid treatment is still being combined with Remdesevir despite the WHO recommendation against its use. (1)
Far better results have been seen in orthomolecular medicine, where one uses substances already known by the body with minimal side effects.
The other day, for example, an RCT (randomized control study) was published from India using ozone therapy in conjunction with standard treatment versus standard treatment alone.(2) It is a small study with 60 patients, but the difference is massive and the authors conclude that ozone therapy is a safe and effective treatment for hospitalized covid-19 patients with mild and moderate disease.
A few months ago in the journal Science one could read an interesting article about a very solid research project by the Berger group at the Max Planck Bristol Center at the University of Bristol.(3)
Using “cryo-electron microscopy” they have mapped the spikes that make up the corona of the virus.
The spike protein is a so-called trimer (consisting of three proteins), and the authors have discovered a non-protein density in the SARS-CoV-2 S receptor binding position that has not been seen before.
In the binding pocket of the spike proteins was found a molecule that was examined by mass spectroscopy at the Max Planck Institute in Heidelberg and revealed something as simple as linoleic acid, which we know from the cheap corn oil or sunflower oil, but also in safflower oil.
Linoleic acid is an essential fatty acid. We cannot synthesize it ourselves, and so we must have it. -Just not too much, because it is an n-6 fatty acid, which in its synthesis pathway forms arachidonic acid and thus prostaglandin 2, which is pro-inflammatory. And that is not suitable. –
Especially not when we talk Covid-19, where the point is that we want to inhibit inflammation.
Therefore, it seems contradictory that linoleic acid nevertheless is not that crazy if you are faced with a Covid-19 disease. Actually the researchers showed that linoleic acid can inhibit virus replication by blocking the ACE-2 receptors, allowing the spike proteins to bind together by means of linoleic acid to a closed form that makes the virus non-infectious.
This is quite in line with the discovery that all severe Covid-19 patients had low levels of linoleic acid in their blood.
The research group is quite resigned to the inevitability of antiviral vaccination and mentions as an example that after 30 years of research into developing an HIV vaccine, we have ended up without a vaccine, but with a cocktail of antiviral small molecules that can keep the virus at bay.
The group is therefore now aiming to develop a small linoleic acid-like molecule that can be used in the treatment of Covid-19 disease. Again, an example of orthomolecular treatment.

Prevention and censorship

In the examples with ozone and linoleic acid, we got a few examples of orthomolecular treatment, as an option for covid-19 treatment.
But the orthomolecular methods are first and foremost supreme when we talk prevention.
In the recent many newsletters and in several interviews on radio and TV, as well as letters to the authorities, I have repeatedly pointed out the importance of ensuring that the immune system gets the nutrients it needs to function optimally, and the many scientific references to this can be found in the previous newsletters.
It is especially important that we get the blood content of vitamin D above 75 nmol/L (30 ng/ml), and preferably double that. Roughly estimated, a maximum of 10% of the Danish population is at this level.
That the blood content of vitamin D is only estimated and not factual data is because the regions oppose widespread testing of vitamin D because it costs money to test.
In a newsletter from University of Copenhagen 7/3 2010, Professor Carsten Geisler writes: “Vitamin D is absolutely crucial for the immune system”.
And further on, he states, the research group has discovered as something “completely new that vitamin D is crucial for the activation of the T cells, which play a central role in fighting particularly dangerous infections”.
Well, hello. Isn’t that just the knowledge we need when we have such widespread vitamin D deficiency?
This very important discovery is published in Nature (4), where the research group explains the activation of vitamin D by key T cells in the immune system. –In fact, exactly the cells that can fight the new virus mutations.
I came to mention this in an interview on a small TV station, which posted the interview on Youtube. From here, it was removed a few days later with the stamp “medical deception”. Almost the same day, the Danish National Board of Health went into the media with advice to the population about eating more vitamin D.
Section 77 of the Danish Constitution states: “Censorship and other preventive measures can never be reintroduced.”
This, of course, refers to state censorship. But Youtube, Google and Facebook are so massively widespread that they have something approaching monopoly-like conditions, and it is thought-provoking that here in Denmark we have a former prime minister to sit and administer such censorship.
When these tech giants get together in the medical-political complex, it costs lives.
This is best described in an editorial in the British Medical Journal from last year:(5)
“Politicization of science was enthusiastically introduced by some of history’s worst autocrats and dictators, but it has unfortunately become common in democracies. The medical-political complex tends to suppress science in order to adorn and enrich those in power.
And as the powerful become more successful, richer, and further intoxicated by power, the inconvenient truths of science are suppressed.
When good science is suppressed, people die”.
Therefore, the Vitality Council finds it necessary to spread the knowledge of the science that the population must not see.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine


  2. Shah M et al, 2021 Int Immunopharmacol. 2021 Feb;91:107301.
  3. Toelzer Christine, Gupta K et al. 2020, Free fatty acid binding pocket in the locked structure of SARS-CoV-2 spike protein. Science 06 nov 2020;370(6517):725-30.
  4. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
  5. BMJ 2020;371:m4425

Neglected opportunities

January 15, 2021

“The world is groping blindly for defences against the new virus variants” – according to a headline in the Danish newspaper Berlingske January 12th. The article then deals with gene sequencing and rapid diagnostics for infection control. But it is clear that panic spreads every time a new variant appears.

The fumbling in the dark began with clusters 1-5 found in Danish mink, which led to politician panic and the most drastic coercive intervention so far against any business in Denmark and the total closure of the region Vendsyssel.

The next time the panic screw was increased is now that the English variant B 1.1.7 is spreading. It is not more dangerous, but more contagious.

When the panic and anxiety from this variant begin to subside, then it’s time to introduce the South African variant and gravely tell us that this variant can now hit children, and then shut the country down. It is so deeply predictable that we absolutely must be pressed down into a state of chronic anxiety so that we conform to what is expected, and all of us line up for vaccination.

However, it is a good thing that the vaccines have arrived. The first vaccine was received by the media and politicians like a Messiah, and it was very nearly close to rose petals being sprinkled on the road in front of the trucks.

It is excellent that the health authorities quickly have launched vaccinating the elderly and seriously ill at risk. So far so good.

But my goodness, how they could have done so much good in the 10 months that have passed if they had listened to science.

When you consider that in order to shop in the supermarket Netto you have to look like a bank robber and wear a face mask whose effect is extremely poorly documented; -then it is striking that for months the authorities have turned a blind eye to well-documented opportunities that could have saved many lives and much suffering.

A study recently published in the Lancet (1) reviewed 89,000 hospitalizations with Covid-19 in March-April 2020 and Influenza Dec-Jan 2017-18.

It was found that Covid-19 caused significantly longer length of stay and greater mortality than the flu and it was concluded that in the future every effort should be made to prevent and vaccinate as well as find methods for treating Covid-19.

The Vital Council can only agree on this 3-string strategy: prevent, vaccinate, find ways to treat.

Unfortunately, this is not the strategy the government has chosen. Instead, they have chosen to put all their eggs in one basket.
Ever since the start of the pandemic, there has been hope and talk about the upcoming vaccine.
The authorities have been going all in, bone-hard, on the vaccine and only the vaccine and have not even wanted to squint at the other options in the three-stringed strategy mentioned above.

You can therefore understand the panic of the politicians until they were reassured that the mink variant was probably also sensitive to the upcoming vaccine. The same has now happened with B 1.1.7 from England, while we are still unsure of the South African variant.
That is to say the vaccines may in the future have difficulty keeping up with the constant changes in the highly mutated RNA virus, and one day they will fall short.

Yet all measures other than vaccines have been swept off the table despite massive documentation.
It is as if the authorities have overlooked that we humans actually have an immune system that is itself capable of adapting a new virus mutant.
Unlike a vaccine, a well-functioning immune system will be able to keep up every time a virus mutates.

Of course, it is necessary for the immune system to function optimally, and it ris necessary that we humans get a diet with the nutrients that the immune system needs.

This is so obvious that it hurts to say over and over again (see 5 previous newsletters from May 2020):
Decades of scientific evidence show that deficiency of especially vitamins A, C, D and K as well as deficiency of selenium, magnesium and zinc weakens the immune response and increases the incidence of infections, especially lung diseases. (2-10)

Specifically, in recent years there has been extensive writing about vitamin D, and the University of Copenhagen wrote almost prophetically on March 7, 2020, on its website in the News section: “Vitamin D is absolutely crucial for the immune system.”

Since then, several studies have been performed on vitamin D against Covid-19, which show significantly less infectivity, shorter hospital stays, milder illness, and lower mortality. (11-17) This documentation is further strengthened by the fact that the groups that are low in Vitamin D are those most affected by Covid-19, especially overweight persons, nursing home residents, immigrants, the chronically ill, and the elderly.

Traditionally, here in Denmark we have considered it sufficient, as long as the serum vitamin D (25-hydroxyvitamin D) level was 50 nmol/L (20 ng/ml) or more. This is not enough. All studies point to the need to have at least 75 nmol/L (30 ng/ml) in the blood and preferably 150 nmol/L (60 ng/ml.)
Far less than half of the Danish population are within these figures.
You cannot reach this preferred level, even if you then eat fatty fish every single day; you have to take supplements.
In turn, there is a major health benefit in eliminating the population’s deficiency of vitamin D. -Not only in the face of several of the major lifestyle diseases, but also of Covid-19.

Research shows, as mentioned, that sufficient vitamin D will shorten the duration of the disease, avoid hospitalizations, and reduce mortality from covid-19 disease. Those who become ill will simply have a mild course of the disease but will still build up immunological defenses until the next time they encounter it. If you also make sure that there is no shortage of the other above-mentioned vitamins and minerals, then the disease picture will look completely different in this country, and it could put a damper on the all-consuming anxiety and worry in the population.

Note: There is no talk of these vitamins and minerals being used to “treat” anything. They are used to correct deficiencies.

But it requires the authorities to think outside the box and show openness to the well-documented possibilities that exist here. Especially when these options are safe.
It is fine to think of collective infection control, but it does not preclude that one also thinks of the individual’s immune system and its well-being.

There has been an unfortunate streak of overlooked possibilities throughout the 10-month-long corona course. Opportunities that could have saved many lives and saved many sufferings.
-And these are, mind you, options that are significantly better documented than face masks.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine


1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet.

2. Arvinte C, Singh M, Marik PE (2020) Serum Levels of Vitamin C and Vitamin D in a Cohort of Critically Ill COVID-19 Patients of a North American Community Hospital Intensive Care Unit in May 2020: A Pilot Study. Med Drug Discov. 8:100064.

3. Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm, 2011; vol 86:23-62.

4. Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020 Jan 16;12(1).

5. Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011 Jan;55(1):96-108.

6. Dancer RC, Parekh D, Lax S, D’Souza V, Zheng S1, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015 Jul;70(7):617-24.

7. Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60.

8. Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010 Jun 14;5(6):e11088.

9. Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189.

10. Dofferhoff A et al, Reduced Vitamin K Status as a Potentially Modifiable Risk Factor of Severe Coronavirus Disease 2019, Clin Infect Diseases, 2021,

11. Kohlmeier M. Avoidance of vitamin D deficiency to slow the COVID-19 pandemic. BMJ Nutrition, Prevention & Health. 2020;3.

12. Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020; 12(4):988.

13. McCartney DM, Byrne DG. Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19. Ir Med J. 2020 Apr 3;113(4):58.

14. Aldridge RA, Lewer D, Beale S, et al. Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-0C43, and HCoV-229E): results from the Flu Watch cohort study 30 March 2020.

15. Ilie PC, Stefanescu S, Smith L. The role of Vitamin D in the prevention of coronavirus disease 2019, infection and mortality. Aging Clinical and Experimental research ( Springer Switzerland. 2020 May 6.

16. McCullough PJ, Lehrer DS, Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J Steroid Biochem Mol Biol. 2019 May;189:228-239.

17. Kaufman H et al, SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels PLOS ONE, sept.17,2020