> The main conclusion is that they should be prioritized to people who have not had prior infection
You're leaving out the primary finding, here is the actual conclusion from the study I previously cited [1]:
- "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."
> this study in particular predates the significant spread of the delta variant, and there is particular concern about reinfection from that variant
I agree on the general point. Relevant to the discussion is the fact that the OP paper addresses this, here are relevant excerpts:
- "Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells."
- "The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved."
- "Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains."
These findings hint that naturally acquired immunity may actually be more robust to variants of concern in comparison to the immune response induced by vaccination. But admittedly this has not been proven yet.
See my top level post on this thread for more details and citations.