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Comment by 0goel0 | Hacker News Reader

The analogy I like to use is shoes. We wear shoes and walk in muddy patches. Your feet are fine. But wherever you go, you shed the mud.

Now imagine the mud is the virus. Shoes are antibodies (vaccine).

Not an exact comparison, but helps explain.

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If the vaccine is only useful for reducing COVID severity and doesn't help prevent spread, then I see no reason why it should be required for anyone for whom an infection is unlikely to result in hospitalization, i.e. anyone outside the well known high risk groups.

Not sure why this is being downvoted. I think your logic is sound. Typically vaccinations don't work this way though. AFAIK contagion is proportional to viral load which is inversely proportional to immune response (via some complex function over time from initial infection).

I certainly agree that vaccinations typically don't work this way, which is why I find it very odd that there seems to be an effort to quickly handwave away these uncertainties with "well all vaccines are like this."

Does the time during which you are contagious change if you are vaccinated?

The short answer: we don't know.

The longer answer: contagion is caused by the emission of viral particles, which have been mass-produced by infected cells in your body. The question is if your immune system will suppress the viral infection before there is enough viral matter produced to cause further infection. Whether or not this happen is heavily influenced by specific details of how your immune system has kicked into gear, and immune systems are unfortunately one of the biological systems that varies most from individual to individual.

Shortening is a likely outcome. But in theory it's even possible that the immune response prepared by the vaccine only prevents virus spread to organs where we notice symptoms but does not clear out those places that the virus colonizes during the pre-symptomatic infectivity phase that seems to be the super-power of this particular virus. And that this success prevents another immune response that would otherwise clear out those spreading springboards. Of course this perfect storm of what could be called "vaccine enhanced infectivity" is an extremely unlikely scenario, but at least weak forms of it that cause longer infectivity, but not much longer or even permanent infectivity could remain undetected for years.

The reason for all this uncertainty is simple: testing for infectivity doesn't scale, definitely not enough to continuously observe test groups large enough to experience cases.

But Ithink there is hope: chances are someone is designing a study that recruits a number vaccinated that live together with someone unvaccinated. Then in case their unvaccinated peer falls ill you can observe the vaccinated one, that should be well in the test scaling envelope. We know the attack rate in unvaccinated households and can compare.

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