Pfizer 91% effective in updated data, protective against South African variant | Hacker News Reader

Pfizer 91% effective in updated data, protective against South African variant

reuters.com

419 pointsreddotX459 comments

Does anyone expect covid to be a significant cause of death in the US past, say, May 15? I guess if we get another wave very soon, maybe it could persist. But it just seems like this is on its way out between organic immunity and vaccine immunity (especially because the latter was focused on the vulnerable).

I'm not an expert, so don't take this as advice to go coughing on everyone. But we all have to make some decisions based on imperfect information and it seems like covid is nearly knocked out.

There is some concern over another wave, but it might just be minor cases from unvaccinated young people. That hopefully won't lead to a lot more deaths.

We are already seeing the beginning of a new wave in Michigan.

> But she said the most significant increase in hospitalizations in the state is in people in their 50s, a group still at risk of becoming severely ill or dying from Covid-19. Younger people have driven the rapid increase in cases recently, she said, including high school students who participate in sports and have contracted the virus through those activities.

> “I do think this could be the beginning of a third surge,” Dr. Khaldun said, after an initial rush of cases in Michigan last March and April, followed by a surge in October and November. “I am concerned. But I also think there are things that we can do today that will start to turn that curve down.”

https://www.nytimes.com/2021/04/01/us/michigan-covid-outbrea...

Sure, a new wave of cases, but will it translate to deaths? My understanding is that most deaths come from 20% of population and we have vaccinated over 30%.

>most deaths come from 20% of population and we have vaccinated over 30%.

In the US, most (59%) deaths come from people aged 75+ according to CDC. People aged 75+ make up roughly 12% of the population.

"we have vaccinated over 30%"

Some places are at much lower percentages. "Fully vaccinated" varies from ~12% in Utah to ~24% in New Mexico. 17% overall for the US.

New Mexico is currently at 48.4% of the eligible population with at least one dose, which recent research indicates is at least 80% effective. Research also indicates that the non-eligible population - children - are not as likely to spread or contract the disease. By mid-May I expect many more states to lift mask mandates, for venues to open at near 100% capacity, etc. People will still be dying from COVID, 80-90% effective still leaves a lot of people vulnerable. But that has not stopped us so far!

The 80-90% numbers are for symptomatic Covid. The protection against hospitalization/death seems to be close to 100%, which is fantastic news.

Yeah, people are reading the effective number wrong. It is very close to 100% in protecting against hospitalization/death, which is what we really care about. If we could vaccinate 100% (perhaps at some time interval), this would be over.

I think it's likely that the real-world protection against death is actually lower than 100%- immune compromised people exist, and are liable to be comparatively poorly protected. And they're not part of the big efficacy trials.

Ideally you can protect them by suppressing the virus by herd immunity, which I think is actually a viable prospect with these vaccines.

Yes, this was seen in the Israel Pfizer data that death protection was around 93%. There are a number of public data points from Israel with sample sizes that dwarf anything done in trials. Shame it’s not mentioned more as it’s incredibly robust (positive) evidence

CDC study from this week showed 90% effectiveness when doing proactive weekly testing regardless of if presenting symptoms. That is the best data I’ve seen as evidence it prevents even a symptomatic cases as a very high efficacy. Israel data claimed it was highly effective on a symptomatic but their methodology was off (for how they defined a symptomatic)

https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm?s_cid=mm...

You can quibble about the date, but there's every reason to believe that as the US eases into summer, restrictions/mandates will largely fade away and it will be the Roaring 20s all over again. I fully expect that not everyone is going to be happy about that but it seems inevitable. International travel without restrictions will almost certainly take longer.

Point being, we've focused vaccination on the most susceptible groups. Vaccinating even 15% of the total population means we've probably vaccinated ~90% of people aged 75+ (with that number being limited by health conditions that contraindicate vaccination).

Utah is saying they're at 22% fully vaccinated according to their site: https://coronavirus.utah.gov/vaccine

Interesting. I got my number from google (google for coronavirus immunization stats), which says it gets its data from "ourworldindata"[1].

[1] https://github.com/owid/covid-19-data/blob/master/public/dat...

Google screenshot: https://imgur.com/a/OMu5EcY

We don't really have enough contact tracing data to reliably conclude that that many younger people contracted the virus through participating in sports activities, as opposed to other activities. That seems like unscientific and irresponsible speculation.

Do you know that to be true, or is this speculation on your part? Just because you don't have the data doesn't mean it doesn't exist (unless you're saying that you're an epidemiologist in Michigan?)

The null hypothesis is that we don't know why/how they contracted the virus. Parent doesn't have to know it's true, or be an expert in anything.

Humans have been dealing with respiratory diseases since well before the dawn of recorded history. An article on nytimes.com proves nothing, but the null hypothesis (for a trained and educated medical professional) is not going to be "I dunno". The null hypothesis is "this will behave like [most similar virus I know about] and humans action will be causing spread in a manner following the epidemiological studies I have read".

COVID shouldn't be so much of a mystery any more, it has been 12 months of the most focused study the world medical profession has ever done. The only thing holding our knowledge back of the short term behaviour of COVID is ourselves at this point. We've had time to watch the disease play out multiple times.

Their exact statement was: "We don't really have enough contact tracing data to reliably conclude"

Your argument, then, is that one can make a confident affirmative argument about the null hypothesis absent any evidence and be correct in so doing...?

I don't see how that makes May 15 and beyond look any worse. A wave now means more organic immunity as well as more tranmission in the short term. But with so many vulnerable people already vaccinated, and so much organic immunity already, do you really think it will be a six-week-long wave?

Probably not. And in 6 weeks, that just means millions more will be vaccinated and younger people will have even more organic immunity.

In other words, there may be another surge, but it will probably be the last one, and probably over by May 15.

Again, non expert, don't cough on people, etc.

My friend's mom was just admitted to a hospital on the East side of Michigan with really, really bad Covid. Opening day for baseball is today, cases are surging like crazy and everyone is just pretending like it's over. I hope that things improve in 6 weeks, but I'm really pessimistic at the moment.

Michigan is at 30% vaccinated with at least one dose according to https://data.lansingstatejournal.com/covid-19-vaccine-tracke...

So things are better than in most places and will continually get better.

Yeah, it will eventually get better, but I have family who are physicians who are swamped again and friends with relatives in ERs and ICUs.. Hard to be too optimistic at the moment. NYTimes' latest concurs;

https://www.nytimes.com/2021/04/01/us/michigan-covid-outbrea...

> Michigan has more recent cases per capita than any other state, and has seen them soar in recent weeks, to more than 5,600 cases a day from about 1,000 on Feb. 21. The nation’s top five metro areas in recent cases per capita are all in Michigan: Jackson, Detroit, Flint, Lansing and Monroe.

...

> Health officials partly attributed the rapid rise in cases to the B.1.1.7 variant that was originally identified in Britain and is widespread in Michigan. But they have also observed a broader return to prepandemic life seen in a relaxing of mask wearing, social distancing and other strategies meant to slow the spread of the virus — many weeks before a substantial portion of the population is vaccinated. On Thursday, Michigan officials announced that they had identified their first case of the P.1 variant, which has spread widely in Brazil and has now been found in more than 20 U.S. states.

...

> Dr. Joneigh S. Khaldun, the state’s chief medical executive, said on Tuesday that 50 percent of state residents over 65 were fully vaccinated, a sign of progress that the most vulnerable population is closer to protection from Covid-19.

More people getting covid means more chances of a mutation that makes it spread easier or is resistant to current vaccines. A surge now is a bad thing.

What is the likelihood that any given mutation increases vs. decreases contagiousness or resistance?

That's probably random, but the mutations that increase contagiousness will be the ones surviving natural selection.

I recall a general principle in virology that given a virus found in the wild, the more contagious it is, the less harm or death it causes. (If it killed every host it would have no long-term survivability)

It doesn’t matter how likely any individual mutation is to increase transmissibility or resistance. We won’t ever see the ones that decrease transmissibility or resistance, because they’ll be outcompeted by the Brand X virus, as well as any nastier mutants.

Then why has it taken this long to see a global pandemic? Surely it must matter to some extent how likely any given mutation is to increase transmissibility or resistance.

Most mutations probably just render the thing unable to replicate and it "dies," much the same way flipping a random bit is more likely to cause a program crash than do anything useful at all.

The relative rate doesn't matter, the absolute rate does (how often does it mutate at all and survive to infect another host).

> A surge now is a bad thing.

It's always been a bad thing and will continue to be a bad thing.

It’s a little worse now in terms of selective pressures, but, at least hospitals aren’t overflowing currently.

I'd argue that it's worse now. Where I live we have over 20% vaccinated right now and that number increases every day. This adds a bias for mutations that are vaccine resistant. A mutation that gives a slight disadvantage, but means the vaccine won't stop it, would have gone nowhere a year ago. Now that same mutation has a large population where it can easily outcompete the current virus.

That's a good point. I guess the worst situation would be almost herd immunity, with the majority being vaccinated but a minority of unvaccinated people constantly circulating the virus. The vaccinated population then represents verdant fields:

https://www.youtube.com/watch?v=yybsSqcB7mE

I you look at Israels numbers, it seems like the vaccination herd immunity is slow but powerful. They're at early 2020 numbers now.

The biggest worry would be a new vaccine-resistant variant at this point, right? From my limited understanding, the big biotech companies involved can respond relatively quickly, but it may become a game of whack-a-mole.

This is how the flu shot works. I don't see how this would be that big of a deal, we get shots for previous pandemic strains every year.

> we get shots for previous pandemic strains every year.

That's not exactly how the flu shot works. They make an educated guess as to which strain will become most widespread, then develop the corresponding vaccine. Years that the flu shot isn't as effective is when they guess the wrong strain.

Yep, and next year is going to be a total shot in the dark for people formulating flu vaccines. Nobody's getting flu because COVID precautions are effective against flu, too. But, pigs and birds are, and their flu viruses jump over to us pretty readily.

My guess is that next year's flu season is going to be a lot worse than more recent ones because of this.

On the bright side, the practice we've (hopefully) had with masks, hand washing, and personal space should hopefully carry over to flu seasons in the future. If it does get severe, then we know what to do.

Whether we do it, though, is another question altogether.

Yeah, I wouldn't count on people actually doing it, either. Especially when a large segment of the population is convinced that mask mandates are a form of tyranny.

For obvious reasons, you're not going to see mask mandates for flu season. It's simply not contagious enough. I think there will be more social pressure to wear masks when you're not feeling well and an increased acceptance of staying home when sick though.

Sure, but do you really think people who won't wear a mask when it's literally against the law not to will wear one voluntarily?

I think it'll be more a matter of "I don't want to get sick and I'm your manager, so {put on a mask,stay at home until you're no longer sick} or stay at home forever".

This is indeed how it works for the healthcare industry; when I was doing hospital IT, my choices during flu season were either 1) vaccinate, 2) wear a mask, or 3) find a new line of work. I picked the first one.

My guess is that next year's flu season is cancelled too. It doesn't take much to push the R from slightly above 1 to slightly below 1.

Just putting a mask on half the symptomatic infected people (or even better, getting them to stay at home) would probably do the trick.

Also, the flu has to start from a very low level. Might miss this flu season completely.

Hmmm, my understanding is that the flu vaccines are basically built on the seasonality of the flu -- the southern & northern hemisphere's flu seasons run six months opposite each other, so you basically take the strains that were biggest in the southern hemisphere during its season and vaccinate the northern against them, and vice-versa six months later.

Do we have any sign yet on whether the COVID-season would be expected to run on a similar schedule?

Not really, no. The vaccines developed a year ago are mostly effective enough against the strains circulating now though, so it may work out for the better.

(the "spike" that the vaccines target is important to the virus, so changes to it often make it much less infectious or whatever, and we don't really know how much room is has to both escape the vaccine triggered immunity and stay highly infectious)

It is a bit different now because mRNA vaccines are much quicker to develop. It is somewhat realistic we can keep having up to date vaccines.

Having to pay a tax to a private company to get a mandatory yearly medical procedure is not my idea of fun. So now you get the flu and covid shot every year. Next 5 years, new bug, new vaccine, you do three ? And of course we have no long term data on cumulative shots effects, or interractions between various shots together, with other medicines, etc.

Doing anything like this systematically should be though out carefully.

Doing my first 10 vaccines felt like buying software licence in the 90'. I fear that the new ones will be like those sucky Saas subscriptions.

Can someone enlighten me on the logic of this sort of thinking?

The mRNA vaccines have a turnaround of only a few weeks to produce a variant booster, so this is less of a concern than with older vaccine technologies. Moderna and Pfizer are currently trialing their SA strain booster that was formulated and produced in under a month [1][2].

[1] https://www.cnbc.com/2021/02/24/moderna-covid-vaccine-booste... [2] https://www.statnews.com/2021/02/25/is-more-simply-better-wh...

Big pharma has deep pockets and believe me, this is part of their plan. Vaccine passports are the big pharma wet dream come to life. For a disease that 99.85% recover from.

For something that they're selling at cost? Your conspiracy detector is a bit off there.

99+%* recover when there's available medical care. There wasn't nearly enough for the entire population if it were allowed to spread unchecked. That's why most countries are going to vaccinate as much as they can until there's enough herd immunity.

* The 0.15% number is absurd when larger percentages of the US and UK population have died from Corona. Even if 100% were infected, IFR would have to be larger.

Lies and hate is all I read in your comment. Your numbers are made up entirely.

You seem to be subdividing into "lived therefore recovered" and "died therefore did not recover". You're ignoring both long-COVID which people can recover from after months and long term organ damage seen even in outwardly asymptomatic people.

It takes months to manufacture and distribute though.

It won't help if the virus mutates to a form that can escape the immune system.

The more people get vaccinated, the fewer the infections.

The fewer the infections, the fewer the mutations.

The fewer the mutations, the fewer the vaccine resistant variants.

The fewer the vaccine resistant variants, the fewer the need for new vaccines.

The fewer the need for new vaccines, the fewer the need for people to get vaccinated.

Repeat.

It's hard to predict when it will happen, but infections will collapse the same way they spread, but only if people get vaccinated and retain some discipline until the collapse.

> The fewer the mutations, the fewer the vaccine resistant variants. > The fewer the vaccine resistant variants, the fewer the need for new vaccines

Aren’t you committing a logical error here? There will need to be new vaccines as long as there is at least one escape variant. The “fewer the need” is really a binary 0 or 1, and you haven’t done anything to show that your “getting vaccinated and retaining some discipline until the collapse” gets us from a 1 to a 0. There’s a time component as well.

But yeah, it’s a neat story that gets shots in arms.

> The “fewer the need” is really a binary 0 or 1

I can see several ways in which this is not true.

For one, several different variants might need to be handled with several different vaccines. Vaccines might also not work perfectly on a variant, but they might confer some protection, leading to overall less total viral particles produced, reducing the probability of an effective mutation.

Mutations are happening all the time anyway, but the rate of mutation matters. This is all one big game of statistics.

Plagues end quickly all the time once conditions are no longer able to support it. Take a look at the current mouse plague in eastern Australia right now for a real world example. It's happened before but each time it collapsed as quickly as it came.

Statistically we will cross the threshold where the ecosystem is no longer favorable for the spread of covid and the plague will collapse. It will move back into the background noise just like the millions of other potential diseases that aren't currently causing a global pandemic.

The real danger are holdouts who can't or refuse to get vaccinated for whatever reason. If there's enough of them and they live close enough together to support a viable ecosystem that very well could provide a reservoir for covid to continue thriving and causing problems until they achieve herd immunity.

The problem with your logic is that all it took is a handful of infections in China to trigger a global pandemic. Even a "few" infections of a deadly resistant strain could prove to be problematic. That said, we do not have a full understanding of this disease yet. Its better to err on the side of caution - but not paranoia :)

Those infections in China were a problem because there was no sufficient partial immunity in the world's population. New mutations will have to overcome that partial immunity (through vaccination or prior infection), or mutate very far, which is very rare.

> New mutations will have to overcome that partial immunity (through vaccination or prior infection), or mutate very far, which is very rare.

We don't know whether it is rare or not. And we don't know how long immunity lasts. The Flu hits us every year.

We do know that "far" mutations are more rare just by simple mathematics. The higher the number of mutated genes, the lower the probability for that mutation.

Wait, are you basing your argument in immunology or mathematics?

The number of mutations in each subsequent generation is not strictly linked with the ability to evade the host immune system. Most mutations are either neutral or harmful to the virus itself. All you need is a single mutation that is beneficial - which is what happened in one variant of Covid - 20I/501Y.V1, most notably a mutation in the spike - S:N501Y.

Secondly, we do know that rates of spontaneous mutations are very high in RNA viruses, or more specifically, because of the way RNA polymerase functions.

Lastly, as a nitpick, a gene is a region of DNA - which is not at play here. But I got the gist of what you wanted to say.

Source: works in biotech

I think people are very worried since only richer countries are getting significant amounts of vaccine currently, poorer countries are in the backlog for vaccines, so we most likely see some kind of mutation from those countries by the end of the year and maybe at least a couple more years of lockdowns and new booster vaccines around the globe. I think this is far from over.

'Another wave' is hitting right now in Canada.

50% of Republicans are wary of taking the vaccine. (Edit: that was Sep. 20' data. The partisan imbalance is now less with 56% of Republicans more or less opting in, notably, African Americans, theoretically 'most at risk' (we don' know exactly why) have the most hesitancy by race with only 61% planning to take it. [1])

Surprising number of elderly are not taking the vaccine, for a variety of reasons - access to information, travel, knowledge, language.

(Edit: more than 25% of age >80 in Ontario have been eligible and have not taken the vaccine. That's a 'very high number' for those most at risk. Toronto is now having mobile vans go door to door, esp. where there are high concentrations of elderly) [2]

For the same reason not everyone votes - a lot of people won't end up taking it.

I think the risk is that if there are 'no protocols' in place and we have the new more aggressive versions and lower rates of vaccination than we think ...

And we could definitely have another wave during the summer.

I believe the next few months will be fickle we should keep our guard up until 'done is done'.

[1] https://www.pewresearch.org/science/2021/03/05/growing-share...

[2] https://www.cbc.ca/news/canada/toronto/covid-19-vaccine-onta...

I think that is going to depend on your definition of "significant". I think at best we would have similar numbers to Israel right now by then. That would still represent >250 deaths per day.

(EDIT: If there is some reason that our rates will fall more quickly, I'd love to hear it.)

Seems about right. Israel appears to have twice the percentage of their population vaccinated and half the death rate compared to US. Current deaths in US is ~900/d, so half that is ~450.

http://91-divoc.com/pages/covid-visualization/?chart=countri...

That's on the order of a bad flu season, right? So not enough that it should affect our behavior in major ways.

The argument for our lifestyle changes was always to "slow the spread" or "bend the curve". It seems we've done that about as well as we can.

I think that would still that would still be 40% or more higher than our worst flu season?

Its definitely getting into the same order of magnitude at that point, though. It'd be hard to argue for stringent lockdowns, IMO.

That's the with-lockdowns rate, is it not? The without-lockdowns rate would be much higher.

Current Israeli death rates are with some social distancing measures, but nowhere near lockdown. They're having concerts and (vaccinated-people-only) indoor dining.

Wait until you hear about Florida and Texas.

But with much higher infection and fatality rates, because that is not a good idea without mass vaccination.

Texas and Florida deaths per day are under 100

Note that deaths are a very lagging indicator. Here in Ireland we have a massive spike at Christmas, and some of the people infected then are still dying.

Florida schools have been open since August.

Yeah, it does appear that relative to other activities, schools are less risky. France appear to be having issues though, and apparently that's related to schools.

The UK numbers have stopped decreasing since they re-opened schools, but that could be due to the B.1.7 variant.

By May, not really. Assuming by mid-May 50% of people are vaccinated and some more have had natural immunity the total immunity rate is likely to be around 70%, and much of the remainder is children and young teens. At that point you could do nothing and not worry much. Especially when the only excuse for being old or at risk and not being immune is your own anti-vax tendencies, not a realistic supply limitation.

There are entirely too many assumptions in that statement, especially with the complete lack of evidence cited. There is a lot of concern right now amongst scientists that our uneven rollouts could cause new variants to spread, and that this could turn into more of a yearly flu vaccine with a constant fight to stay in front of it.

The problem is that those 70% numbers assume even distribution, but that isn't turning out to be the case. Not only are different countries going at very different rates, but even inside of the US you can see a huge spread. This isn't just about where the vaccine is being delivered but we're it's being ignored. It's not hard to imagine that LA County might not ever get up to the 60% to 70% threshold needed for herd immunity due to a large community of antivaxxers who can support and spread new variants that spread further out.

This very article we're reading briefly mentions this, as pfizer is already working on boosters. Covid is not going to just disappear in the next six weeks.

I'm actually more optimistic than that.

I read an interesting article arguing that "the people who deserve the vaccine the least, should be the ones getting it first". As in, the kid who irresponsibly goes to Miami on spring break, should be the person getting the vaccine first- because vaccinating super spreaders would save more lives than vaccinating someone who stays home anyways. So arguably, the people who are most likely to transmit the disease should get vaccinated first.

The flip side of the coin is people who are most likely to catch the disease- probably already did. I can name a handful of people who I'm facebook friends with, who gave no shits about staying at home and caught covid already a few months ago.

So now, 1 year into the lockdown, the people who are most likely superspreaders- already got infected and are mostly immune. On the other hand, we're going to have 1/3 or 1/4 of the population still stay at home regardless of what the govt says.

So a significant percent of the population isn't contributing to spread anymore, even if they're not vaccinated.

Covid won't disappear but the risk of mass casualty events from the virus certainly will, and that should be enough to remove the pandemic restrictions. We've lived with endemic infectious disease for a long time, and we will continue to live with them for the rest of our lives.

dont forget that flu deaths are _after_ vaccinations, of which there are now billions annually.

The CDC estimates the flu vaccine prevents 6,500 deaths per year in the US. https://www.cdc.gov/flu/prevent/keyfacts.htm#effectiveness

Given that flu vaccine is needed annually, we don’t have nearly the coverage we are trying for with COVID. Hopefully, COVID vaccines (and natural immunity for those who recovered) hold for much longer than flu vaccines, so that we can actually get closer to true herd immunity.

I’m not optimistic we can rid ourselves of COVID completely, but pushing it to the fringes would be great.

Flu vaccines are less effective than what we're seeing with the covid vaccines as well as they're more of a guess as to what will become the biggest flu variant vs after the fact of the covid vaccines. Not really comparable.

Once every adult has had the chance to get vaccinated, there is no reasonable argument for lockdowns.

Sure there is, there could be new variants that the vaccines don't protect against. The criteria for the various levels of reopening were set at the beginning. Those are what should determine the reopening according to public health experts.

Surely you understand there are more considerations than just what public health experts say right? They are a part of the answer, not the whole.

The vaccines have proven highly effective at protecting against COVID and its highly transmissible variants, and it's unlikely that we'll see a new variant arise that exhibits sufficient immune escape to result in severe infections in vaccinated people.

The criteria for the various levels of reopening at the beginning were due the need to protect vulnerable people who did not have the opportunity to magically protect themselves by getting vaccinated.

The other aspect is that negative side effects are much more prevalent with COVID. So keeping cases down is still important

But how widespread are the negative side effects, do you have data on this ?

There have been a bunch of studies that have come out, with a range of quality in case selection methodology eg. biased sampling, so its still early days. I've seen estimates ranging from 2% - 33% for effects up to 7 months after infection for mild-moderate symptomatic cases. But generally, it seems quite a serious issue.

This is a good review on whats out there: https://www.nature.com/articles/s41591-021-01283-z

There is absolutely no way we will get vaccine update like Israel, there are far too many antivaxxers in the states for that to happen. They will just catch it sometime between now and year's end I will guess.

Israel had a fair number of antivaxxers, as well as people who aren't quite antivaxxers but are very wary of vaccination. The "green passport" (proof of vaccination that is required to take part in much of normal life there currently) has been doing a decent job of fixing that... Although I'm skeptical that the US will follow suit to the same degree.

I think Israel is kind of plateuing at around ~55% of the population vaccinated? I'm sure it will continue to increase, but the rate of increase seems to be slowing. I'm not seeing much evidence that the US will stay lower than that.

I don't expect COVID to ever go away, so I expect COVID deaths to be a thing forever. My guess is we all move on regardless and accept a slightly deadlier flu season each year.

No, COVID as a disease probably won’t go away entirely for longer than a human lifetime, I would guess. And, even then, it would probably either end up as a much milder disease.

But, we can probably reduce the number of cases per year to near 0 in the US, if all eligible people get vaccinated. Wiki told me there were under 500 confirmed cases in the US in 2018, and Google told me that r_0 for measles is between 12 and 18. COVID is nowhere near that transmissible.

> if all eligible people get vaccinated.

I don't see that ever happening, at least for another generation or two.

Neither do I, considering how politicized the whole COVID situation got.

Doesn't have to be all eligible people.

There's also natural immunity for the ones who'd rather have that than the scary scientist-designed shot. The most irresponsible ones have the best chance of getting nature's vaccine. Depending on how long immunity lasts, that might drive it very low.

And as far as I know, the vaccines are highly effective and very few people are actually medically unable to get this vaccine. Honestly, if only people who chose not to be protected from it die... too bad for them.

The public health authorities won't be honest about any of this. Anytime the choice is between controlling the behavior of stupid people vs. telling the public the truth, they choose the former every time.

"Organic immunity"? You mean that thing that the public health authorities are pretending doesn't exist, therefore requiring me, a person who caught, tested positive, and recovered from COVID in February to get vaccinated? Yeah, let me know when they stop pretending. I'm willing to get a vaccine, but annoyed because it has no benefit for me and only risk (albeit low).

Edit:

Downvote all you want, but I was a teen in the 90s when the public health authorities pretended like heterosexuals engaging in standard sexual activities were at equal risk of catching HIV compared to IV drug users and gay men. They weren't remotely at the same risk, by orders of magnitude. They wanted to promote safe sex and abstinence in teens and young people, which is a good thing, but they didn't hesitate to use the fear of HIV as a tool to (dishonestly) achieve that goal.

I have two friends who got covid twice. One had it first in July and then in January. Second one was brutal, maybe b/c it was likely the Brazilian strand, or maybe because the second time your lungs are still recovering. Who knows.

But I would advise you to take it.

Statistically, they likely had a false positive the first test. Columbia University commissioned a study on 50k people in Qatar (covid spread was rampant there) who were confirmed positive, and after 7 months, catching and recovering from it provided immunity at a threshold exceeding the Pfizer vaccine.

Yes, there are people who have caught it twice. They are rare, and the paper highlighted that a likely explanation was false positives in the original testing.

I'll take the vaccine, but shouldn't be required to.

It was not a rapid test; he got two positive PCR tests paid by his employer.

Mind you, this is in Perú (he works at a mining firm) which was hit really hard in July and then now (one of the hardest per capita deaths).

Also, the Qatar study might not say much about the newer strands

People with long COVID symptoms have recovered after taking the vaccine. This is hypothesized to be due to persistent viral reservoirs, viral fragments, or an autoimmune response.

We don't know how the vaccine would improve things for people without visible long covid symptoms, but it is likely to help.

Also immune response improves after a vaccine just as it improves after a second shot.

There are risks, there might not be benefits for you, but there are definitely benefits to taking the vaccine for people who recovered.

Good to know. That helps me knowing that there are benefits rather than having it essentially being a placebo.

Can you provide links to any peer reviewed scientific literature on the benefits of the vaccine for recovered individuals? I don't trust any of the journalism on this, considering that they are universally scientifically and statistically illiterate clickbait producers these days.

You're also getting immunity to variants that you haven't caught. Vaccines have been proven to confer some immunity, and less dire infections to those who do get it. Having previously caught it doesn't seem to, especially the Brazillian variant.

This seems like the most logical argument to me. His body may have deteremine and locked on to some other protein in whatever variant infected him rather than the one targeted by the vaccines that I believe all 3 currently approved vaccines go after.

You can find some preliminary work on this thread: https://mobile.twitter.com/VirusesImmunity/status/1371226482... and you can follow the professor for the latest updates.

One added note on "long covid":

I think a lot of sufferers of it are psychosomatic. The demographic for long covid doesn't match the demographic of those who are most at risk of the virus or get the worst symptoms. Instead, it matches the demographic most likely to complain about symptoms from other diseases that have attracted large numbers of sufferers, only to have most of them disappear when the disease became less trendy: Fibromyalgia and gluten intolerance, who had massive spikes in patients claiming to have the diseases, and suddenly big drop offs, for lifelong illnesses that don't go away. These patients tended to be affluent, white, middle-age women, who are not remotely the most at risk from covid, but are disproportionate in claiming long covid.

The vaccine probably has a placebo effect on these kinds of folks. Underestimating the full power of psychosomatic driven symptoms is a big problem. The mind can really make the body sick, and there's a lot of science backing this up.

I should specify that i don't think this is voluntary, or humans wanting attention. I think it's induced by excessive fear-based media and the subconscious, combined with the huge evolutionary advantage of the mind having the ability to induce vomiting if other tribe members who have eaten contaminated food begin getting sick.

https://www.newscientist.com/article/dn23851-what-if-your-gl...

If their symptoms are psychosomatic, but the vaccine cures those symptoms through the placebo effect, then what's the problem? They were genuinely suffering, and now they're not: the vaccine cured their long covid.

Probably better to give them a placebo vaccine so we don't waste the good stuff ;)

Given that lung scans of people with long-COVID show scar tissue, I doubt it's entirely psychosomatic. Given that lung damage has appeared even in outwardly asymptomatic carriers, it seems likely that that damage shows up more in people who, knowing they are less likely to die, take more risks.

That’s not the case in general. The CBC in Canada has run multiple article about long Covid and state again and again “doctors have said all the tests come back negative, nothing is wrong with them”.

I mean, you're looking at Canada. Look at the BBC and Oxford's xenon based scans that are in fact detecting the damage.

That’s experimental and has been done on a pretty small group of patients. It would still need to validated before it can be used as a diagnostic.

A very valid point. There have been quite a few conflicting reports, especially on long term lung damage. It may be too early to make definitive statements. Certainly it seems likely enough that some long term consequences exist, enough that it worries me.

No one is expecting you to get a vaccine, just don't expect to be able to fly in a couple of months if you don't have a vaccine card or be allowed in certain establishments. It's your body, your choice, but you also have to live with the ramifications of your choice.

There are benefits for recovering patients to get a single shot.

First, it seems that natural immunity is a bit inferior to the mRNA vaccines ('only' 80% protection for people at your age[0]). Second, a single shot offers better protection against the SA variant which can apparently escape the immune reaction of some people who were previously ill[1]. A second shot is apparently unnecessary[2].

Local guideline is to wait a few months following recovery (there are concerns a too early vaccination will lead to immune overreaction) and then get a single shot.

[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

[1] https://www.iol.co.za/lifestyle/health/new-sa-covid-19-varia...

[2] https://www.businessinsider.com/people-who-had-covid-19-need...

Hard to tell, as it depends on personal choices. If everyone in a high risk group gets immunized, sure.

Anecdotal but for my 2 appointments, the immunization centers clearly had a lot more capacity than customers. Lots of unused space and not-busy workers. I would guess because people that should be in line chose not to be.

Did they also have lots of unused vaccine? Given the cost of every additional day until back to normal it would be foolish to set up for anything less than best case supply, and then some.

No idea. I would guess so, because of all the various types of workers that were doing nothing. And this wasn't a walk-up thing, you had to have an appointment.

Buddy of mine got the vaccine because someone from the pharmacy was walking around the store asking if anyone wanted a spare dose so it would not go to waste.

Or they had more needles, more staff, than vaccine. If there is extra, send it to canada. Their shortage us getting less funny by the day.

Maybe, but wouldn't they send excess workers home?

To be clear, these were places where an appointment was needed, so they should have had a clear picture of demand.

In this economy you don't send people home unless you have to.

So if high risk people choose not to vaccinate, then we don't need to modify our lifestyle any more. They've accepted the risks.

You still have to care about the immuno-compromised people they might infect.

And the people for whom the vaccine was not effective.

As a countering anecdote, the pharmacy where I got my shot had two pharmacists trying to deal with the normal work of distributing prescriptions while also juggling incoming vaccine appointments from multiple systems with a list printed that morning and people coming to the counter to request any "extras" they had. The main guy was keeping a cool head, but it looked like it had been a long day.

Took a lot of work to get a vaccine appointment at CVS pharmacy chain in MA. Friend who works in IT there told me over the weekend, they get 10-100X the hits every morning that they have doses for. So apparent lack of activity may just be lack of doses.

But he also said shipments are improving and I also got a message from one of the mass vaccination sites.

Many (most?) vaccination centers are still supply constrained, and will use up most of their supply early in the day, just serving stragglers later. This is good news, in that it means that it's pretty easy to scale up distribution as supply increases. The one I worked at was doing something like 6000 doses a day, and most of them before noon. If you came by at 4pm, you'd think we were doing nothing at all.

Depends if you can distinguish between dead because of Corona and dead with Corona, i.e. the Coronavirus was not the actual cause of death.

In Europe each country has their own definition of the above, making it nearly impossible to compare.

But judging from how things are going in Texas and Mississippi right now, there is a high chance of things being normal there on the May 15.

Mind you it does require around 25-30% vaccinated before you can say that.

Texas is getting ready to spike again. There are counties where people are actively refusing to get vaccines because Trump told them not to. City folks are actually driving an extra hour or two to those areas to get vaccinated because they believe in science and that the vaccine can help while the locals scoff at them. I think texas will see a huge surge in the rural areas where they don't believe in science within the next month-ish.

i live in Texas, i expect to see a rise just because new cases have fallen so far so fast and the broad re-opening of the economy. Today, there was the slightest little tick up in average new cases but I do not expect to see a surge like we did over the holidays. Further, i'm 100% onboard reopening the state. There's not a lot of difference between states that locked down hard and states that did not. If there isn't a very large and measurable advantage to crushing the livelihoods of the population then don't do it.

https://apps.texastribune.org/features/2020/texas-coronaviru...

I got dose 1 of Moderna yesterday (first day i was eligible).

You comments come across as much lower quality when you keep slipping in the politics.

I’d be surprised if the anti vax sentiment has really flipped that much, as in: remember when then vice presidential candidate Kamala Harris said on tv that she doesn’t trust the vaccine? Or when the governor of California said he wouldn’t take it unless it was independently reviewed by California? Or when the governor of New York said he doesn’t trust the vaccine? ~40% of black people currently are wary of taking the vaccine because of statements like that, are those the antivaxxers you’re referring to?

Your statements are inaccurate. In Michigan things are worse than ever thanks to the UK variant, and the Brazilian variant was just detected here also. There are multiple pages of data, links on the bottom to change page (it's a weird layout): https://www.accesskent.com/Health/covid-19-data.htm

Daily cases are trending up, but still below where they were for much of November and December, and many more people are immune than were during those months.

There is clearly a surge, but it's not yet worse than the previous one, and hopefully vaccination reduces the impact.

(I'm looking at the daily cases tab on https://www.michigan.gov/coronavirus/0,9753,7-406-98163_9817... )

Anecdotes about the variants spreading much more rapidly are going around though.

Michigan 0.24 deaths per 100k.

Cases up, but hospitalizations and deaths down. Giant nothingburger.

Did you actually look at the graph? It's quite disconcerting.

It will become endemic like HIV, which kills about a million per year over the past few decades.

I do.

I expect the emergence of new variants that spread in the unvaccinated either in places without masks (and resistant to vaccinations) like the US south, or (more probably) in the 96% of human beings that aren't Americans (and have much less access to covid vaccines), and the vaccine pressure selecting for the spread of variants that are different enough for the current set of vaccines to be less effective.

I am not an expert, this is just an educated guess by a layperson.

I also anticipate a major backlash against those who would refuse vaccines, as well as an impending necessary overhaul of the process and timeline for bringing slightly modified vaccines to market (as a clear need to quickly protect against new variants or even new strains emerges).

I think it's possible that in some communities with high proportions of anti-vaxxers, Rt could remain at 1 and continue to cause deaths a little past May 15th before organic herd immunity is achieved.

The wave has already started, there are plenty antivaxxers out there who would rather die than take it. US uptake of the vaccine will be 70% max because of the nonbelievers and antiscience people that form the core of Trump's cadre. There's still plenty people left to kill and I bet we will hit at least 600,000 (aka another 50000) by the end of the year. There absolutely will be a 4th wave.

The positive note is that we are already at 74% of over 65 w/ one dose, so hopefully we can push that to 85% and drastically lower deaths. Vaccine acceptance in 65+ is very high

Yes.

I think the answer to your question depends on the conclusion that may come after it.

Like if it's "therefore, past May 15 we should all just act as we did pre-COVID", that's different than "therefore, that's overall very good news for society".

There's a quantitative/qualitative thing going on here. We could be mostly "back to normal" in a broad numbers sense, while immuno-compromised people are left with a much more dangerous reality than they faced pre-COVID. They're left hoping for test/trace/eradication.

Personally, I'll feel pretty safe hanging out, even in closed-in areas, with other vaccinated people. But out and about, the decision to wear a mask will be more predicated on the actual disease prevalence numbers in that area. And we'll all continue to wait on data of how long the vaccines last.

I think May 15 is a bit early, but if you say for example 4th of July I think you are correct. At least by that date everyone who wants a vaccine in the US should be able to get it. And they do work incredibly well, enough to lift all restrictions and even start traveling again. I fully expect to be able to go home to Europe to visit family and have some vacation by the end of the summer.

For me, beginning of July is probably the relevant date, I usually go up to Maine then. So I'll have my vaccinations but probably won't change behavior all that much through late May/June and will (rightly or wrongly) expect more or less back to "normal" (doing heavy lifting) in July.

Don't travel plans, to Europe in your case, also depend on vaccinations and organic immunity (from infections) at your destination? Specifically, I'm not aware of studies demonstrating viral load carrying capacity of immunized individuals. In other words, how would you, as an immunized individual know that you're not a virus carrier?

By that time (4th of July) most people in Europe will be vaccinated as well.

I hope so, but the way things are going, I doubt I'll be able to get it this year at all.

Europe has been slower on the rollout than USA. I'd give them 3 extra months compared to USA, maybe October or so.

Once the USA is largely vaccinated, all of the supply the USA was buying up can pour into other countries.

Vaccine supply is still increasing. I think by end of summer it will be fine, but hard to tell right now.

Supply is increasing. Europe will actually be on par with US by end of summer.

I’m not buying tickets yet, this is my belief and hope about what is going to happen.

It’s great to see the light at the end of the tunnel. Perhaps it will be a bit later but I strongly believe this will be possible.

Will only do it once scientists recommend and countries are welcoming me. I could travel today as a Norwegian citizen and green card holder, but that would not be very smart and nice so I’ll wait for answers similar to your questions.

I re-read my comment, and I realized how impersonal it was. Of course, there is a science-first way of thinking of things and then there are practicalities of being with family. I just traveled from the US to Eastern Europe and back for a family emergency. I spent two weeks with my elderly mother deciding it was OK to potentially expose her based on on a three-day-old COVID test. (There really was no other choice, and luckily all turned out well.) Maybe, even with vaccines, it's all about managing risk to the best of our abilities and dealing with the unknowns.

I think your comment was fine :-)

I don’t have a source to link because I’m feeling lazy, but I do recall hearing today from the CDC director that there’s some preliminary evidence that vaccinated people don’t transmit the virus basically at all

It is already not a significant cause of death. Highest death rate in any state is 0.54 per 100k people.

I’m seeing a lot of similar concerns in the comments so I just want to post this video from Vox. They did a great job explaining this issue.

Effectiveness doesn’t really mean much between approved vaccines in the US. Please watch this video: https://youtu.be/K3odScka55A

From what we know so far, any of the approved vaccines are excellent and no one knows for sure if one is better than the other. The only logical thing to do is get what is offered to you as soon as possible.

That being said, this is excellent news that Pfizer is protective against the SA Variant. Not trying to minimize that news, just point out that it still is better to just get whatever approved vaccine you can.

I'm not sure I really buy that video - don't control groups account for differences in the general population at the time it was done?

This Pfizer data, plus the results in Israel suggest that the mRNA vaccines really are just objectively better.

They all prevent death and hospitalizations though so get the one you can get, but it seems likely the mRNA shots are better.

The main thing I'm wondering is if the people that got covid post J&J had really mild disease (like a tiny cold or something) or "mild" disease like absolutely miserable but just didn't have to go to ICU. Is that information known?

Basically the video confuses some of what the control group actually does and then says "well they all prevent death anyway" - no shit. The question is if one is better than the other and the answer seems like yes. The main counter would be the presence of variants, but the Israeli population faced variants and the mRNA efficacy rate held. This new Pfizer data suggests mRNA is just better.

> The main thing I'm wondering is if the people that got covid post J&J had really mild disease (like a tiny cold or something) or "mild" disease like absolutely miserable but just didn't have to go to ICU. Is that information known?

Of course. It's right there in the FDA report, starting on page 51:

https://www.fda.gov/media/146219/download

7.1.1.5.3 Case Definition for Mild COVID-19

• A SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (eg, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample;

AND at any time during the course of observation:

• One of the following symptoms: fever (≥38.0°C or ≥100.4°F), sore throat, malaise (loss of appetite, generally unwell, fatigue, physical weakness), headache, muscle pain (myalgia), gastrointestinal symptoms, cough, chest congestion, runny nose, wheezing, skin rash, eye irritation or discharge, chills, new or changing olfactory or taste disorders, red or bruised looking feet or toes, or shaking chills or rigors.

You will find equivalently precise definitions of moderate and severe disease, as well. And if you care to look, you can find the same thing for all of the other FDA-approved vaccines. They're similar, but not identical. In general, "mild disease" is what most reasonable people would consider to be mild disease, but there are minor differences in terms of which specific symptoms/thresholds are used. For this vaccine specifically, you can see that having two or more of the above symptoms will bump you into the "moderate disease" category. So they're pretty strict.

> The question is if one is better than the other and the answer seems like yes.

Given that you clearly haven't read the data, I don't know how you can possibly make such a speculation.

I don't mean to pick on you specifically, but this entire affair has been defined by people who are way too willing to speculate after reading a few news articles.

Thanks - that makes me feel better about how they define mild, and thanks for the direct reference. Earlier in the pandemic mild was being used to mean only not hospitalized.

> “I don't know how you can possibly make such a speculation.”

I don’t mean to come across as overconfident, is my understanding of efficacy wrong? Or the purpose of control groups? I’m happy to be wrong or corrected.

The speculation comes from the efficacy numbers and the results in Israel - is there a reason to dismiss those?

Edit: Reading the Pfizer results from here (https://www.fda.gov/media/144245/download) it seems like fewer moderate/severe cases of covid in the vaccinated population when compared to J&J (taking into account both of their placebo groups)? I’m not sure if I’m reading these correctly, but the docs don’t seem to contradict my impression that the mRNA vaccines are better.

I am not sure that it's a good explanation. Just the opposite.

J&J's excuse for 66% effectiveness is that they were tested when there was more Covid going around? That's exactly when the vaccine is supposed to protect you. Not when there isn't an opportunity to catch the disease.

And if we then take this claim on its face, then Pfizer and Moderna vaccine stated effectiveness is pointless, since it wasn't tested during the worst times.

Finally, the claim that no one in the study group that did catch the virus ended up in the hospital is also based on self-selective bias. I am assuming people in the study were younger people who needed the money and not older folks who are at a higher risk. I am not saying that it's not true - just that the biases need to be taken into account in any study.

> That's exactly when the vaccine is supposed to protect you. Not when there isn't an opportunity to catch the disease.

Are they saying the other vaccines were tested when you had lower chance of multiple exposures, and they were tested when there was higher chance, and it isn't controlled for in coming up with that number?

Correct. That’s what the video states.

> I am assuming people in the study were younger people who needed the money and not older folks who are at a higher risk.

That may be true in the earlier phases, when you are just trying to show that the vaccine isn't too harmful and works in at least some cases.

It's not true for the large phase 3 trials. For those you try for a study group that matches the demographics of the people who will be getting the vaccine in the wild.

For the J&J phase 3 trial, 34% of the participants were over 60. 41% had comorbidities associated with an increased risk for progression to severe COVID. Race was 74% white, 13% black, 6% Asian, and 1% Native American. Ethnicity was 15% Hispanic.

Pfizer was 45% age 56-85, Moderna was 16% over 65. Race for both was about 80% white, 10% black, 4-5% Asian, 1% Native. Ethnicity was 26% Hispanic for Pfizer, 20% for Moderna. I don't know what percent had comorbidities.

> I am assuming people in the study were younger people who needed the money and not older folks who are at a higher risk.

I'm a participant in one of the J&J Ensemble trials. There is no payment associated with my participation.

Thanks. Good to know. Might I find out why you signed up?

I would have signed up myself for free - a 50% chance to get a promising vaccine now instead of waiting? They weren't doing studies in my area, so I had to wait until after the study for a vaccine to be offered to me.

I'm pretty young and fairly healthy, so a licensed vaccine was a long way off (and still is) for me personally. The 50% chance of possible protection from Covid-19 was something of a selfish motivator, but more generally it seemed like a good thing to do to try and help society return to some sort of normality (I work in a sector which has been hit quite badly) - of course, there was probably no shortage of volunteers so my space likely would've been filled without my participation.

It also seemed like a kinda fun thing to do, though - I find medical sciences pretty interesting and had read through and familiarised myself with the phase 1 & phase 2 trial results for Ad26.COV2.S. I thought it'd be an interesting experience and the risks seemed acceptable to me.

The only downsides so far have been the distance I have to travel to get to the clinical research facility and the fact that I don't really like the sight of blood. I've had so many blood tests (in this study and outside) that I'm fine with the process, but I prefer not to watch.

No payment? You're getting ripped off! In my area, it's $150 per appointment.

There are 2 reasons for JNJ’s lower top line numbers.

1) There were more of the variants going around, not more of the original strain going around when JNJ was tested and all the vaccines are less effective against the variants. PFE and MRNA were tested when only the original strain was going around. All the vaccines were designed to combat the original strain.

2) JNJ doesn’t protect as well against mild Covid. But the symptoms from this mild Covid are comparable to the side effects from the second dose of PFE/MRNA which affect 30-40% of people and based on anecdata from people I know nearly everyone.

1 is false - this article's 91% includes data from before, during, and after the J&J trial. So it covers times when the variants were more active as well.

My original comment referred to the 95% effectiveness in PFE top line numbers from when we got the clinical trial readout rather than the 91% in the article. I was responding to the parent comment.

Further, the JNJ clinical trial data was from a population where the Brazilian variant, the most serious of the variants, was likely more widespread than this PFE data which seems to focus more on the relatively less dangerous South African variant.

A mild reaction to the vaccine is way different than actually having a viral infection. Potential long term persistent symptoms can occur with viral diseases and particularly COVID. Not sure that comparison makes sense.

Additionally JNJ has side effects as well.

A recent "real-world" study done in the US between mid-December to mid-March found that people vaccinated with either Pfizer or Moderna's vaccine show 90% protection against SARS-CoV-2 . Here you can read more about it. https://www.statnews.com/2021/03/29/real-world-study-by-cdc-...

This is same thing that happened with CDC and "masks aren't needed". A white lie with good intent but nevertheless just false info.

I'm sure if we polled all the bio-phd's with option between the vaccines, they will all choose mRNA based ones because they have higher protection %'s, and significantly lower side effect risks.

Most countries don't have the luxury of giving their citizens the choice, so they resort to making up a lie to calm people from "bank run" on mRNA vaccines.

https://old.reddit.com/r/COVID19/comments/mh7wtw/astrazeneca...

"It was mentioned by Emer Cooke during the press conference.

"For the AZ vaccine based on spontaneous reporting in the EEA it's 4.8 cases per million, for the Biontech vaccine, based on the same criteria it was 0.2 cases per million and for the Moderna vaccine, based on the same criteria, 0 cases per million"

So ~25 fold compared to the BioNTech/Pfizer vaccine. 0.2 cases per million is in line with the expected number of cases in the general population. The Moderna vaccine probably hasn't been used enough in the EEA for such rare events to occur.

It's also worth keeping in mind that these numbers are based on older data. It is based on 62 reported cases (of which 44 are in the EEA). Germany alone has reported 31 cases and they aren't all included here. So expect these numbers for the AZ vaccine to go up a bit when they announce their updated recommendations at the plenary meeting next week."

You're mixing statistics from different testing protocols. Apples and oranges.

Of course citizen. All of them are excellent and equal, but some are more excellent and equal than the others.

Genuinely asking: What happens if you are vaccinated but then exposed to a variant of COVID your vaccine doesn't support? Is it the same as having no vaccine at all?

> The only logical thing to do is get what is offered to you as soon as possible.

Is there any reason to be skeptical of the vaccine? Long term effects, etc. I don't normally get a flu shot or go to the doctor or anything like that. I'm pretty nervous. I used to date an anti-vaxxer who swore some kind of shot gave her brother autism... Obviously that's material to get downvoted and laughed at here on HackerNews but... just thought I'd bring my "atypical" perspective to the table.

All evidence points to the your symptoms being much lower if you have the vaccine even if it's a different mutation. If the vaccine really did nothing for a certain mutation it would be front page news all over the world.

I'm always confused about "effectiveness" numbers. Are these "effective at preventing severe disease" or "effective at preventing symptomatic disease" or against transmission period? The article seems to suggest it's the latter, but it seems somewhat ambiguous. Does this term have a specific definition in epidemiology that journalists and pharma marketers assume everyone understands what kind of "effectiveness" they're talking about?

It's "effective at preventing symptomatic disease".

All the vaccines so far are 100% effective against "preventing severe disease"

The last one (non-symptomatic), we don't really know, I don't think any studies have been done which regularly test everyone, at scale. Someone correct me if I'm wrong.

There's some studies that have done regular testing, the vaccinations prevent infection.

https://www.nejm.org/doi/full/10.1056/NEJMc2102153

https://www.nejm.org/doi/full/10.1056/NEJMc2101927

2 weeks after the second Pfizer dose, one of the medical centers had a positive test rate of 0.05% (not a typo, 0.05 percent).

Those are great, though they are pretty early results. I think in both cases, they finished giving the 2nd dose around February, so we've only had around 1 month of data.

I'm a little confused by the percentage though. Looking at the 2nd study, and ignoring 1-7 days after the second dose, there's still 8+7 people who got infected a week after the 2nd dose, out of ~5000 tested. How do they get to the 0.05% number? Also, if I understand correctly, the table says there's around 16,000 eligible, but only 4000-5000 were tested? Am I missing something?

I misinterpreted them is what it is. The 0.05% is 7/14990, so it's the infections identified in the vaccinated group and isn't about regular testing, it's just that the result may include cases that were identified by testing rather than being symptomatic.

This is the key point that needs to be conveyed when the J&J 1-shot starts to be distributed. It has a 66-75% efficacy at preventing symptomatic disease, but 100% efficacy at preventing hospitalization. In situations where the 1-shot is ideal, patients being scared off by the lower efficacy rate could be an issue.

Not only that, J&J is also doing a trial for 2nd shot, as well as some places such as UK ended up doing Pfizer/Moderna with one shot only with delayed 2nd shot (3-4 months later). So we'll see how that works out, there may be the possibility of getting a 2nd shot of J&J later down the line to increase your immunity.

I believe Pfizer has even started doing 3rd shot boosters for very early phase 1-2 people from last year.

the 100% number probably doesn't include the P1,SA variants, no data on them. There is good probability that they become dominant so I'm waiting for the results on those.

This is a good question that was picked up by a blog I read. IIRC it refers to the ratio of infections in the control group vs. the vaccinated group. Hence an effectiveness of 90% means 90% of cases occurred in the non-vaccinated group.

It does not mean 10% of people end up with no protection at all, as was my first thought.

Minor nit. The ratio you refer to is called efficacy, not effectiveness. Effectiveness is the number you would get by observing people in the real world rather than the phase 3 trial. It's worth noting the difference because we're also starting to get data on effectiveness, like the CDC study that tracked healthcare workers and found the vaccine also prevented asymptomatic infection.

Its a technical & medical term, rather than one that is meant to be useful for broader discussion.

Efficacy in vaccines == people who were prevented from being confirmed COVID positive (symptoms sufficient to prompt a test, leading to a positive result)

Therefore, a 91% effective metric for vaccines means that 91% of those who receive that vaccine are expected to NOT contract COVID 'at all'. Thing is though, many vaccines broadly do not prevent disease but shift the severity upon contraction.

The metric that is actually useful for informing the public and policy is the answer to the question of 'does this prevent hospitalization, severe disease and death?'. Broadly speaking most approved vaccines globally have near 100% effectiveness in this.

The primary endpoint is symptomatic infection, not any infection per se. And it's a bit of a kludge, as all the Phase III protocols I've read define symptomatic infection as X no. of symptoms for Y+ no. of days i.e. there are people with fewer symptoms who aren't counted (or even tested to check for infection).

The efficacy is the 1-relative risk of the primary endpoint.

> Therefore, a 91% effective metric for vaccines means that 91% of those who receive that vaccine are expected to NOT contract COVID 'at all'. Thing is though, many vaccines broadly do not prevent disease but shift the severity upon contraction.

But I was just reading about another study of medical personnel who were taking periodic COVID tests so as to catch asymptomatic transmission, and I believe this study (or maybe merely the media about it) also used "effectiveness".

They're all 100% effective at stopping hospitalization/death (at least in phase 3, not necessarily out in the field). So 9% chance for any infection, but all those that test positive have mild to no symptoms.

They basically split people at a certain area into two groups, give one the real thing, another one placebo, track infections, compare the results.

Comparing vaccines by effectiveness is meaningless because they're not all tested at the same place at the same time. So J&J has lower effectiveness, but it was calculated at the peak of the outbreak, when each participant interacted with Covid more frequently in their everyday lives.

For the comparisons to become meaningful, it'd need to be re-done at the same place at the same urban area, with 10s of thousands of participants for each vaccine. You'd also need to have approximately similar age spread, plus similar population distribution within an urban area. Since it's all volunteer-based, this kind of study won't happen.

In conclusion: take any that's available to you.

I really don't know why this term is thrown around in the news so much without explanation. What I thought at first (and I think is the obvious interpretation) is that with an effectiveness of 90%, 10% of vaccinated people have no protection at all.

The companies have every incentive to publish the good results and the media doesn't care about explaining things clearly.

I'm not sure I can envision a reasonable way to embargo the numbers.

Yeah, J&J especially got the shit end of the stick on that. 72% effective, in the US, at no symptoms, but 100% effective at preventing death but every talks like it's a worthless vaccine.

Moreover, it's only one shot. J&J is currently enrolling for a 2-shot trial (https://clinicaltrials.gov/ct2/show/NCT04614948), unfortunately, the control arm .. is no vaccination. I can imagine how this may hinder recruitment.

I wonder if us legacy J&J users will be able to get a second dose at some point.

That is the plan if it is helpful, but it depends on a lot of factors. First, of course how much better is a second shot vs one - if the difference is minimal it probably isn't worth it. I'm guessing that we will forever say the difference is too minimal - it works well enough with one shot, so why not give the second shot as a first shot to someone else? Of course this gets mixed in those who might be more vulnerable (and thus more helped with a second shot) if we can figure that out. And there is the possibility of buy a second shot for you (at double price but that isn't stated), and we send a free shot to some poor person in [pick a poor country]. There is also the question of do we reach herd immunity - if Covid isn't spreading in your country and you are not traveling to a different country where it is why make your arm sore?

Probably more considerations, but the above should get you started thinking of them.

My interest is purely from avoiding further unpleasantness from catching COVID19. I took the J&J vaccine and ended up around 103F fever for a few hours so I have an inkling if I end up in the 28% who still has symptoms when catching COVID19, would I go through another bout of fevers and chills. Of course I could ride it out, but if I had the opportunity to avoid, I would!

First dose of Russian Sputnik V vaccine uses the same adenovirus as J&J vaccine, both of virus vector type. Second dose of Sputnik V is using different adenovirus. I would think J&J second dose would have to use different adenovirus also.

There has been a lot of speculation on that. It isn't an unreasonable idea. However we don't know if it is true or not. We will have to wait for the 2 dose trials to see how they turn out.

I guess we hang out in different strata of society since all my friends want the J&J virus if they get a choice because it's one and done.

Well, it seems like it's 66%, not 72%, at dealing with the variants. And, yes it prevents death at 100%. But you're ignoring the middle category - serious and long term symptoms. This is where there's a significant difference between the mRNA vaccines and J&J. A lot of people are worried about long-COVID and permanent damage.

It was 72% in the US as I pointed out in my comment.

https://www.reuters.com/article/health-coronavirus-vaccines-...

J&J was 85% effective at preventing severe reactions and hospitalizations and 100% effective at preventing death. The 72%, in the US, was for mild symptoms.

Yes, and the mRNA vaccines were 100% effective at preventing severe reactions and hospitalizations as well as 100% effective at preventing death. That's a significant difference. Would I take the J&J over nothing, of course. If they offered me a choice I would take an mRNA vaccine.

There's nothing wrong with saying X is much better than Y, Y is much better than nothing.

I get from a public health standpoint you may want to blur the difference so people take the first available dose because there is a huge value to herd immunity, and a society with 100% J&J shots is going to be safer - probably even for the vaccinated given herd immunity - than 20% with mRNA shots. But I won't pretend they are equal while doing so.

Meanwhile, the 72% vs. 66% was when the world had variants not seen in the US. They're here now. I think it more likely that the vaccine has less efficacy against the variants than the vaccines have special "efficacy +" modes that are geoblocked.

The claim that they prevent death is not significantly significant. https://dalewharrison.substack.com/p/vaccine-boosterism

This is conflating P(death|vaccinated) with P(death|infected while vaccinated).

Yeah I don't know how people miss that but I guess a lot of people read to support their opinions rather than for the truth.

The J&J vaccine having lower effectiveness makes sense. Unlike the mRNA vaccines which use lipid nanoparticles as their delivery mechanism, the J&J vaccine uses an adenovirus. Some fraction of the population has immunity to this adenovirus due previous exposure to similar viruses. That means the delivery mechanism won't be nearly as effective for those people. It also means that booster shots won't be nearly as effective since everyone who gets the J&J vaccine will be immune to the adenovirus. For higher booster effectiveness, they'll probably have to choose a different adenovirus.

Obviously if you can get any vaccine, do so! But to claim that we can't possibly compare vaccines is silly. Yes the trials have differences, but they're not so different as to make us totally ignorant. We can use the trial data plus knowledge of the mechanism of action to make solid bets on relative effectiveness.

My wife and I decided to take different vaccines. I got Moderna and J&J for her, primarily as a hedge if they have different efficacy against different variants.

Especially important since we have kids.

How does rate of community spread impact efficacy calculations? The placebo and treatment group should be operating in similar areas w/ similar case rates. If there were 10,000 cases in placebo and 1,000 in vaccine, how is that different from 1,000 in placebo vs 100 in vaccine? Not read out to the same efficacy.

My layman's understanding was that "91%" "effective at preventing disease" (from the TFA) goes something like this:

  - Take two identical[1] populations of people
  - Wait for some people (100 for easy math here) in the unvaccinated group to get the disease. Probably measured by a PCR test indicating presence of the virus and ignoring symptoms since they say "preventing disease" and not severe symptoms, hospitalization, death etc. 
  - Count how many folks have the disease in the vaccinated group[2]. In the "91%" case we would expect 9 people to test positive, meaning 91 of 100 people we would expected to get the disease did not.

I like to think of it as I am ~1/10th as likely to get the disease as I would be if i had not been vaccinated.

Is this what they mean in this?

  [1] Doing your best to create identical groups by controlling for population differences such as gender, age, and other known risk factors, 
  [2] We need also to control for time in the study etc.

[Lots of editing for formatting etc]

> I like to think of it as I am ~1/10th as likely to get the disease as I would be if i had not been vaccinated.

Same, and it gets less likely if you are in a group of vaccinated people since the chances of being exposed to someone who is sick goes down. Herd immunity at that point.

This short video[1] explains it quite well imo. They also make the interesting point that efficacy rates are not comparable because the studies were done at different times/locations with different spread of the virus in the population.

[1]https://youtu.be/K3odScka55A

Reading the more technically detailed comments I think really reinforces throwaway894345's point. I understood what "91%" means (much better than non-techies in my circle) but assumed a lot incorrectly about the controls and the actual "end point" they are measuring. It seems lots of folks are saying the different studies use different sets of symptoms etc and not routine testing at intervals to identify those who have the disease.

I suspect most of the public doesn't even know what 91% means. Combine that with being bad at evaluating risk in general. It mostly represents a 10x improvement in cases per capita per time, but I think telling folks that their risk went from 1 in 10,000 to 1 in 100,000 (or whatever) probably doesn't mean a lot. Folks just want "safe" or "not-safe" :(

> I like to think of it as I am ~1/10th as likely to get the disease as I would be if i had not been vaccinated.

> Is this what they mean in this?

Yes, that's what they mean. And even for the vaccines that are ~60-70% effective, all of them have so far been 100% effective in preventing hospitalization and death. It's not binary, the vaccines don't make you completely immune to this virus but greatly reduce the impact it has.

I thought this video explained it well: https://www.youtube.com/watch?v=K3odScka55A

As I understand it, it turns out that none of the vaccines are 100% effective in preventing hospitalization and death, it's just really hard to measure this accurately in the kind of studies used for vaccine approval because there aren't enough people in them, especially people at high risk. The actual figure from the various large-scale rollouts is closer to 80% I think?

Yeah, the language I've seen is usually something like "...there were 0 deaths in the test group..." Which most people will read as "100% effective in preventing deaths" but technically there's no specific claim at preventing deaths - the "0 deaths" is effectively an anecdote.

I would assume that even a claim about being 100% effective has some asterisks like “has a strong enough immune system” where “strong enough” means “unless you’ve already been diagnosed with having a weak immune system you’re fine.”

It's quite possible that some people will eventually contract COVID-19 and die from it, even several weeks after getting their last immunization shot (supposedly at a point when they're fully protected). It just didn't happen in any of the trials.

If anyone wants to look at the raw phase 3 numbers:

Pfizer numbers: 43,448 participants received injections (21,720 the vaccine and 21,728 the placebo); 8 cases of COVID-19 in the vaccinated group and 162 in the placebo group, 9 were severe (8 of those in the placebo group).

Pfizer study: https://www.nejm.org/doi/full/10.1056/NEJMoa2034577?query=fe...

Moderna numbers: 30,420 participants, evenly split with 15,210 in each group, over 96% got both injections. There were 185 symptomatic cases in the placebo group and 11 in the vaccinated group. 30 participants had severe cases including one causing death: all were in the placebo group.

Moderna study: https://www.nejm.org/doi/full/10.1056/nejmoa2035389

Israel has much more robust data than the trials for pfizer (monster study group size of 600k per group). They have seen hospitalizations and death in fully immunized individuals. There’s more papers out there but here’s one.

https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

Most (possibly all?) of the headline figures for how effective Covid vaccines are at preventing disease are based on the number of symptomatic cases, including mild symptoms. So it's not purely measured based on number of positive tests regardless of symptoms, but it's not just severe symptoms either.

Two weeks past second dose, I’m taking a lot fewer precautions, as I expect is the case for the vaccinated trial groups (based on an N of 1 where I know they started taking fewer precautions while in the J&J trial). This is, of course, the entire point of getting vaccinated.

That might make the vaccine even more effective than the study shows if the stats don’t back out risk adjustment (which they probably cannot do).

The CDC recommendations do substantially reduce the precautions you have to take once you're fully vaccinated.

But note that wearing a mask is still required. At a technical level, you may still be able to spread the disease, even if you're fully vaccinated. And the vaccines aren't 100% effective, so even the minimal self protection you get from a mask is better than nothing.

More importantly, I believe, is sociological: once there are a lot of people in public without masks, even if it were safe, a lot of people would take it as an excuse not to wear one. That leaves both them and others open to getting sick. The mask is a minimal inconvenience, and should be continued.

If you want want to skip the mask among people you know to be vaccinated, in private, that's about as safe as anything ever gets in life. Even small, private gatherings with a cluster of unvaccinated people (i.e. people who all live together) are reasonably safe without masks for those who are vaccinated.

I fully believe the CDC is optimizing for the sociological aspects rather than biological aspects with respect to mask-wearing.

I'll do it for many more months, because the sociology aspect is valid.

Yep. Plus, it's about as easy as it gets, and I get to conceal myself from facial recognition cameras. Win-win-win.

I'm not sure which sociological aspect you mean, but we have a hard enough time getting people to wear their masks without the ability to lie and claim to have gotten the vaccine.

That’s exactly the sociology we’re talking about.

Be *very skeptical* of any future articles on the long run effectiveness of these vaccines.

I was paid to work specifically on COVID, so was monitoring the vaccine data very closely. It was *very* promising, but there were a few things that puzzled me in where comparing results in placebo/control group vs vaccine groups, for both Pfizer and Moderna.

So I would check near daily for new results.

And then after Christmas break, when I went to check, found out both control groups had been effectively destroyed. (https://www.wsj.com/livecoverage/covid-2020-12-17/card/Pc6LV...)

I'm not kidding, there are no longer any control/placebo groups for these vaccines. These were studies that were approved to run for 2 years!

I had to sit through hours of boring mandatory training from NIH on importance of control groups. In these cases they just threw that away.

It reaks to high heaven to me.

(Note: I've seen nothing to indicate these vaccines are dangerous. Effective? Looks very likely, at least in the short run. Long run effective? HIGHLY skeptical. Total contribution to ending the pandemic from the vaccines? I'm highly skeptical that it will actually be high, when an honest accounting comes out). Would I personally take the vaccine had I not had COVID already? Yes. Though not if I were a kid or teenager (very little risk from COVID).

If you are in medical research, please don't look to these people as role models. Please do things openly, on git, and don't sweep uncomfortable truths under the rug.

Can you say more about what you think the implications of offering the control group vaccinations are? My prior assumption would be that protecting the control group would cause the study to underestimate the effectiveness of the vaccine since it now looks comparatively more similar to the control.

We've lost any type of objective long term way to get to the truth on how dangerous COVID really was/is, and how long term effective the vaccines are.

The numbers do not come close to supporting any ethical reason for doing this.

There was never going to be a two year control group. The moment somebody in a trial could get vaccinated via some other channel, they'd drop out and get unblinded. Anything else would make it much harder to get people to participate in the study.

For Covid, there's an additional problem with antibody tests being relatively abundant, and would allow the participants to unblind themselves anyway.

> There was never going to be a two year control group.

    Actual Study Start Date: July 27, 2020
    Estimated Primary Completion Date: October 27, 2022

[0] https://clinicaltrials.gov/ct2/show/NCT04470427

I thought there was going to be a two year control group because that was the plan published on ClinicalTrials.gov run by NIH.

> The moment somebody in a trial could get vaccinated via some other channel, they'd drop out and get unblinded

If this is such obvious common knowledge why wasn't it in the plan? Why isn't it in the training?

I am 100% open to fundamentally and drastically changing the way we test medicines and vaccines et cetera, but that's very different than just making decisions willy nilly that just so happen to align 100% with shareholder interests.

The trial protocol allows for a participant to leave at any time for any reason. It does not require the participants to not get another vaccine if one becomes available. They'd obviously do that if possible, because there was a 50/50 chance they had gotten the Placebo. Both the treatment and control groups would start to disintegrate the moment a vaccine gets approved for an EUA.

(But fair enough; in the case that no vaccine got an EUA, the control group would have lasted for two years.)

All that the protocol change to give the control group the Moderna vaccine at that point did was to let them at least continue with the observational open-label phase B of the study.

Your suggestion that this a sinister plot to hide the long-term inefficacy of their vaccines is absurd. A Covid vaccine that was highly effective for only a couple of years would be a goldmine in the long term, and would sell just as well right now.

> The trial protocol allows for a participant to leave at any time for any reason.

Exactly. And some would. But most would not. Just like every other randomized control study. It boggles the mind to say "let's tell everyone they got the placebo, because some people might leave". That does not follow logic.

> plot to hide the long-term inefficacy of their vaccines is absurd.

What part of that is absurd?

At the time the control groups were destroyed, there was no evidence that the vaccines were saving lives (https://www.fda.gov/media/144434/download — 7 deaths in placebo group; 7 in control group). Now, if you got tens of billions of dollars based on those early results, wouldn't you have *strong* incentives to shut things down, and not wait for the long-term verdict? What would you have to gain if 2 years in, the placebo group continued to have just as few deaths as the vaccine group?

Are you saying that the idea that humans respond to incentives is absurd?

> But most would not.

How could that possibly be true? Basically everyone who isn't a rabid anti-vaxxer is trying to get a Covid shot as soon as possible. And pretty obviously none of the participants in a vaccination study is going to be an anti-vaxxer.

> 7 deaths in placebo group; 7 in control group

That's not true. Why in the world would you fib about something that is this easy to verify? There were 3 deaths in the treatment group, 4 in the control. But more to the point, there were no deaths from Covid in either group. It's not that "7 people died of Covid in the treatment group" which you were clearly trying to imply.

Now, why were there no deaths from Covid? Because the size of the trial was set such that they could reasonably expect to find an effect for preventing symptomatic disease. That's why it was the primary endpoint.

Why couldn't they run a trial where Covid deaths were the endpoint? Because the IFR of Covid is "only" 1%. To run a trial that could reliably show an effect on the number of deaths, you'd be looking at 100x the participants. I'm sure you're not seriously suggesting running a trial of 3M people.

> Are you saying that the idea that humans respond to incentives is absurd?

No. I think your suggestions on what Moderna's incentives are absurd.

Think about it for a bit: the early results showed no change in the number of deaths. You're suggesting that if they waited and... ummm.. showed no change in the number of deaths, it'd somehow lose them tens of billions. I can't help but notice that the before and after are the same there: "not showing a change in the number of deaths".

But also, that's 1.5 years from now. There's a lot of vaccines to be sold right now, and that's what their incentives would be focused on. Not on hypothetical effects that their trial was not designed to surface in the first place.

And again, the foundation for this theory is that the trial participants would have agreed to not get a working vaccination for two years, even if on placebo. You've not presented any proof for this except claims about "NIH training".

> Why in the world would you fib about something that is this easy to verify?

Sorry, that was a typo from memory: not 7 and 7 but 4 and 4. Conclusion is unchanged. From the FDA link I provided, Table 19. Here's a screenshot with the relevant line https://twitter.com/breckyunits/status/1348080756921303041/p...

> which you were clearly trying to imply.

I absolutely was not trying to imply these were COVID deaths. I'm trying to imply that the wholistic expected value of the COVID vaccine needs to be considered. In my personal circle of ~2,000 family and friends, I have lost 4 people in the past ~12 months from Non-Covid (35, 50, 65, 62), for a total of about ~100 healthspan years lost, versus 1 person from COVID (with a healthspan left of ~1). I know >100 people confirmed COVID. One cannot make decisions in isolation.

> Now, why were there no deaths from Covid?...that their trial was not designed to surface in the first place.

Because they cut the study short! In the clinical study protocol (https://www.modernatx.com/sites/default/files/mRNA-1273-P301...) they specifically state "To evaluate [Vaccine efficacy] to prevent death caused by COVID-19" as an objective!

"The study is designed to primarily evaluate the clinical efficacy and safety of mRNA-1273 to prevent COVID-19 for up to 2 years after the second dose of mRNA-1273...Participants are considered to have completed the study if they complete the final visit at Day 759 (Month 25), 24 months following the last dose of IP."

> the foundation for this theory is that the trial participants would have agreed to not get a working vaccination for two years, even if on placebo.

I can't speak to what the experience of people in this trial was like, as I was not a participant, but I have never been involved with a control group where they have told you that they would tell your your placebo status not even halfway into the study.

> I think your suggestions on what Moderna's incentives are absurd.

Moderna the corporation has no incentive to keep the control group going because they've already closed the sale so if the long run efficacy turned out to be not as strong, they potentially could be exposed to downside risk. I am not against the vaccine or the rollout. I'm against the destruction of the control group.

It would be unethical to hold back vaccinations from a control group for 2 years after it already proved efficacy. It would also get very hard to find study volunteers because why would people join a vaccine study if there is a 50-50 chance it means they can't be protected for 2 full years?

> It would be unethical to hold back vaccinations from a control group for 2 years after it already proved efficacy.

Is it? I don't remember reading about that in NIH training on control groups. I'm pretty sure when your plan is to distribute 1 billion vaccines, holding out 0.000015 for a placebo control group is a sensible "ethical" tradeoff. Especially if, I don't know, everyone *volunteered* and agreed to those terms when signing up! And especially if, I don't know, all the data they had to date showed no increase in death rate?

breck, just FYI, you have been downvoted to the point of being flagged I think. ( I actually upvoted you so that your post does not disappear).

Also HN may shadow ban you.

Haha thanks!

I don't think HN shadow bans me. My goal on these sites is high variance. High upvotes or high downvotes. In my experience that's the goal—either create a lot of value for people or learn something.

I also have accounts on not my real names for more pleasant, positive, uplifting content, but I save the controversial stuff for my real name accounts.

There is no standard definition. The clinical trial would have a set of predefined outcomes ("endpoints") that are used for the efficacy analysis. The endpoints will not necessarily be the same ones for each vaccine, even for the same disease.

You'll need to read the actual trial protocol for a specific vaccine to find out just what they were measuring, and how they defined e.g. "serious" vs. "non-serious" cases.

Most of the responses to your question that I have read are factually incorrect in some way. Efficacy/effectiveness is up to each study to define.

Generally you should assume they are measuring symptoms of infections that go beyond the upper respiratory tract. This is because the vaccines provide little protection against an upper respiratory tract infection but instead are very effective at preventing it from progressing further into a more severe infection. This is referred to as non-sterilizing immunity: it is probably the most important concept for everyone to understand about the vaccines.

I am seeing a lot of comments here claim that vaccines are 100% effective at preventing death or severe infection where severe is generally defined as hospitalization. Nothing is 100% effective, and particularly not vaccines for those whose immune system does not respond properly. Death in particular is generally not an endpoint that can be compared in a statistically significant way in these studies. [1]

I will still be getting the first imperfect vaccine I am allowed to at the first chance I get. When I needed to get an appointment for my Mom I started writing a user script to help with that. [2]

[1] https://dalewharrison.substack.com/p/vaccine-boosterism

[2] https://gist.github.com/gregwebs/265e0ef6b1a3051377cfc4d66ac...

> the vaccines provide little protection against an upper respiratory tract infection

They prevent symptomatic covid infection which includes respiratory symptoms.

I don't think "against transmission period" is really possible, no?

The whole point of a vaccine is to prime your immune system, it does not provide a magical shield to your body. If you get exposed to COVID-19 after being vaxxed, you will still have COVID-19 in your system for some amount of time. It will just (hopefully) get killed very quickly when the memory B/T cells (that were created by your body when you had an immune response to the vaccine) ramp up production.

It’s a percentage reduction in risk. If a random unvaccinated person has a 10% chance of infection and a vaccinated person has a 1% chance of infection, the vaccine is 90% effective.

I wish it was easier to tell which vaccine was the better one to take. I know the "correct" answer is "whichever one is available to you", but let's pretend we're free-agent adults here and put the infantile answers aside for a moment.

There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves.

Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions? For example, if someone has a history of reacting to vaccines (GBS), is the attenuated adenovirus from J&J a better choice compared to the mRNA alternatives?

I think that's what the challenge study was supposed to do, but it didn't go ahead.

I'm not sure there's enough data at the moment to give an answer. Each of the approved vaccines had a double-blind placebo-controlled study run, but on different timelines and in different locations, so it's hard to conclude much from small differences between the reported numbers.

Right, unless you do a full trial with all vaccines side by side with similar sample/timeline, it's not really possible to tell. Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%.

The dosage also matters. J&J for example decided to study one dose first, but are now doing a phase trial to see how good the immunity is for a 2-dose program. So potentially if you get a second dose (maybe down the line), you will also get a stronger immunity closer to the other 2 dose vaccines.

> Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%.

But we're talking 91% vs. 76%.

You can't compare the 91% vs 76% numbers because the 91% test was performed in the late summer last year between virus waves and in a location with an less-contagious form of the virus.

Whereas the JJ virus was tested during the fall 2nd-wave in South Africa when there was a lot of cases and more cases of a higher infection strain.

The only fair comparison would be if all of the testing was done at the same time in the same geographic location.

source: https://www.youtube.com/watch?v=K3odScka55A&feature=youtu.be

There was a new, recent study that showed that the mRNA vaccines were still 90% effective among healthcare workers during the big surge in December/January period when the variants were certainly present.[1] This doesn't mean the J&J vaccine is bad by any means, but it does show how incredible the new mRNA vaccines have performed.

[1] https://www.statnews.com/2021/03/29/real-world-study-by-cdc-...

From that same study:

> The study suggested that even the first dose of vaccine was 80% effective at preventing infection

Which is within the error bar of J&J's one dose result in the US (75%). We will have to see the results of the 2-dose J&J trial coming out soon, but I expect that to be around 90% too.

It's also worth noting that some places in the world (UK, Canada), have been using 1-dose pfizer regimen to get the most out of their short supply, with possible 2nd shot 3-4 months down the line. Similarly, we could see a delayed J&J booster being given to increase immunity to matching 90%.

No, the 91% from Pfizer is just announced and covers roughtly 6 months, including up until at least the middle of march, at which time the variants were circulating. Notably this covers the entire time of the J&J trials.

Of course they used somewhat different geographical regions so you can't compare them, but still the 91% does include variants.

Right, but as the comment above was pointing out, there are many other factors.

Pfizer/Moderena both did their trial from July-November, whereas J&J did their phase 3 from Sept-January. Looking at the COVID case graph [0], you can see J&J was tested at the peak. Not only that, J&J was party tested in the UK and South Africa, when the two new variants were starting to take over.

[0] https://media.npr.org/assets/img/2021/02/15/seamus-coronavir...

Just this week we also saw data from Pfizer & Moderna mRNA vaccine rollouts to frontline healthcare workers in December (at a time of peak infection and emerging variants) that touted 80% effectiveness after a single dose, 90% after two doses. I'm struggling to find a reason not to interpret that as further evidence that the mRNA vaccines are in fact more effective than the J&J shot.

Medical workers take precautions better than the general public, maybe? But they're also far more exposed.

80% with one dose seems right in line with 75% with one dose of J&J (in the US). For what it's worth, J&J is also now doing a phase trial of two doses, and I expect that to be around 90% too.

So yes, once you take into account the +/- 5% error, they seem to be pretty much equal.

"whichever one is available to you" is not an infantile answer.

It's a rational answer.

Humans are notoriously irrational in their decision making, and focusing on which is better in order to make the best health decision may lead to making a decision that is far worse.

Not the OP, but let's rephrase: if you go to the clinic to get the shot and they tell you they have so many doses of all vaccines available that it's up to you to choose which one to take, and either way, you are going to get the shot today, which one should you choose? And how much does this choice matter in your expected health outcomes?

I would ask the doctor and not trust my ignorance (as a non-medical professional) to provide me the answer. Everything being equal? I'm taking the shot that doesn't require me to come back for a second.

And what would the doctor say? And please don't reply "whatever the correct answer is", because then I will have to ask "what is the correct answer" and we end up in an infinite loop.

The guidance provided so far is that all three shots are equally effective. That's likely what the doctor would say.

From my own, semi-informed research:

* The effectiveness of J&J is likely under-reported because it was tested during a significant outbreak.

* Moderna seems to have slightly higher reports of side effects compared to Pfizer, though unlikely to be statistically significant.

* I am a young, healthy person.

With that calculus:

1) I'd pick whichever was available to me the fastest. In my area immunizations are by appointment and segmented by vaccine. I'd rather have Moderna tomorrow than wait a week for an appointment for another to open up.

1.a) In the unlikely case that I had a choice between the shots, I'd select J&J, as it has been shown to be safe and effective with one shot. This simplifies my life.

In reality, scheduling a vaccine seems to be the hardest. No one of the ~10 or so I've talked to who have had their first shot between January and early March have had the ability to chose. When I received my first dose of Pfizer last month I didn't have a choice of options; I was on four or five call lists and took the one that offered me an appointment. My wife received Moderna because her work coordinated mass vaccinations and that's what they offered. A coworker received J&J because there were leftover doses that needed to be administered.

Perhaps that's changed, but as many states open up to 16+ I suspect it'll remain the biggest challenge.

Using the words equally effective is a lie though. An uncharitable take being government propaganda being repeated because bureaucrats/politicians see it as a noble lie. If these studies only produced a pass/fail then that would be acceptable, but we all know that's not how studies are done.

Which is a fair question, and a fair way to raise it.

Calling the standard answer infantile was where I took issue.

Assuming your question wasn't rhetorical--in the hypothetical scenario you described based on today's info, I would opt for J&J,

1) as a matter of convenience

2) The technology behind J&J is more mature

J&J, one and done. In any future scenario where the vaccinated have privilege over the non-vaccinated(as has been proposed with vaccine passports), then J&J is the better choice. 1.5 months to freedom vs 15 days. People can say out loud otherwise because it's not the right thing to say, but deep down J&J offers the best incentive for a non-vulnerable risk-group member. "Whichever one is available to you" is a platitude that assumes all our motivations for getting it are the same. You're doing it out of concern for X, I'm doing it because chances are I'll have to, etc.

Data from the study released this week (of frontline healthcare workers vaccinated in December) showed that the mRNA shots had a high efficacy just two weeks after the first dose, likely higher than the efficacy of the J&J shot.

Just a single data point from one study, but I raise it only to point out that it may in fact not be the case that the J&J shot provides better immunity vs two weeks after the first mRNA dose.

If your goal is just to get a vaccine passport then J&J will still be the better option until regulators acknowledge that one shot of mRNA is about as good

shrug

There is new data showing the efficacy for Pfizer is better for children age 12 and up.

The point being; it's way too early to know which is better and why, and to base a decision on that data.

That assumes that, at this point in time, having a "vaccine passport" confers some concrete benefit. It's also more like 2 weeks vs. 5 weeks. The other factor is if you end up getting a vaccine somewhere 2 hours away or something like that. Which is a reasonable consideration but fairly minor in the scheme of things.

If someone is asking for more information and is willing to learn the details, it's counter-productive to give them a canned answer like "whichever one is available to you". You're encouraging ignorance, not being "rational" as you put it. Lack of transparency is what sows the distrust in the first place. Acting like an elitist by withholding the information because "you're not smart enough to make this decision" is what makes the approach so infantile.

It's a difficult question. You don't want to infantilize people, and there does seem to be a trend towards manipulating the informational landscape in order to create better outcomes in people.

At the same time, this is a country where 45% of people believe ghosts are real and 35% have been in contact with someone after the've died. You absolutely do not want people at the margin holding out for a longer time to get the vaccine they think is best when they could have been vaccinated a month ago.

You make a valid statement, but it doesn't appear to valid in this case. I don't think the demographics of this platform fall under that umbrella. If someone on here is asking for more information and articulating their reasons for it well, there's no reason to hide it. There's also an equal risk that if people don't know enough about the vaccines, they won't get any of them at all let alone deciding which to get. Seldom is it that I believe withholding information will have a better effect than being adequately transparent; keyword here being adequate because you still need to explain and emphasize strongly in plain English why it would be detrimental to wait it out.

Treating people like idiots yields worse results than making them believe they're intelligent (be it true or not). You can look at our political landscape for evidence of that. That's just my opinion of course.

> I don't think the demographics of this platform fall under that umbrella. If someone on here is asking for more information and articulating their reasons for it well, there's no reason to hide it.

The data is available. No one is hiding it. No one is treating people like idiots. Those with expertise in pandemics may not consider every single internet comment made by every single internet random, but honestly, it would be ridiculous to think every internet random’s comment should have the same weight as those with expertise.

The data is not hidden, we’re all free to analyze it.

No one is encouraging ignorance. Public health officials are encouraging a policy that will best resolve the current situation.

All the vaccine information that is available is fully available, and the only decision that is available is:

Get the vaccine, or don't get the vaccine. Picking which vaccine is not an option at this time.

>Acting like an elitist by withholding the information because "you're not smart enough to make this decision" is what makes the approach so infantile.

counterpoint: if a person believes themselves to be "smart enough to make this decision", they should also be smart enough to read the research and make that conclusion for themselves which one is better for their specific situation, no?

AFAIK, the research is publically available, so it's not a problem of a lack of information, rather it's a lack of anyone with significant enough credentials willing to speak up and endorse a particular solution over the others.

>Humans are notoriously irrational in their decision making, and focusing on which is better in order to make the best health decision may lead to making a decision that is far worse.

This doesn’t matter on an individual level. There are public health reasons to try and get as many people as vaccinated as possible, no matter the vaccine. But aggregate math means little to the individual person. The difference between. 70% and 90% is fairly profound, profound enough to weigh against individual people making a decision on which vaccine to get.

It’s not irrational at all for an individual to prefer the vaccine with the highest efficacy. It’s hubris, or insanity, on the part of public health officials to expect an entire nation of people to put individualism aside for the sake of greater good.

> It’s hubris, or insanity, on the part of public health officials to expect an entire nation of people to put individualism aside for the sake of greater good.

It is absolutely not hubris to encourage people to take the vaccine available to them now, rather than wait a month for the one with 90%.

It's a prisoners dilemna and the government should encourage people to choose the cooperate approach by imposing incentives and manipulating the informational landscape.

It's the same reason why I support government recycling initiatives or the general idea of taxation.

> It is absolutely not hubris to encourage people to take the vaccine available to them now, rather than wait a month for the one with 90%.

Who is to say it’s a month wait? That’s the issue.

> It’s not irrational at all for an individual to prefer the vaccine with the highest efficacy.

Clearly I disagree with the rationality--you're comparing the efficacy rates of being vaccinated among Moderna, Pfizer, or J&J. That's irrational--instead a person should compare the efficacy rate of being vaccinated by any of the available vaccines vs the efficacy rate of not being vaccinated due to holding out for personal preference of a vaccine.

If you're eligible now, it will probably cost you 2-3 weeks at most to choose the one you want (it only cost me a day to pick pfizer though). It will likely be a long time before you're able to get a different shot, so picking one that has more evidence for covering mutations, lasting longer, and being more effective in real world scenarios may well be the rational choice.

You’re simplifying the calculation to suit your point.

It’s a decision of waiting 2-3 weeks for a 28% increase in efficacy. Am I more likely to get covid in those 2-3 weeks, or is the reduced effectiveness more likely to result in getting covid?

It does not seem irrational at all me, and clearly also not to others making these same decisions.

I think it's especially true because the most important aspect of vaccination is not really protection of the individual, even if it does accomplish that. It's getting as many people as possible vaccinated so that society as a whole has a good handle on the disease.

If the 90% effective one is supply constrained and has this complicated 2 dose thing, and the 60-some % is simple and available, you're still doing your part to make a serious dent in the spread of the disease overall. And if the death rate of covid is some low number x, making it 0.3x is a pretty good deal.

No, it's a non-answer. If someone asked the question, they deserve a real answer. That's a great PR answer for advertising the importance of the vaccine, it's not an answer to a pointed and specific question from an educated person with access to either vaccine.

> access to either vaccine.

Is this your situation? I hadn't heard of this happening for anyone.

Yes, I can get J&J from places like Costco or the County sites, I can get Moderna and Pfizer from the state sites.

And which did you choose and why?

Or did you ask, and were told who cares, just get it.

Indiana here, I can get Moderna at most sites nearby, Pfizer at Walgreens/CVS, or J&J by driving to Indy

In Florida you can book an appointment at Publix on Monday or Friday if you want Moderna or Wednesday if you want Johnson & Johnson:

https://www.publix.com/covid-vaccine/florida

I hate this toxic anti-thinking attitude.

You may think people should get whatever vaccine is available to them. That is fine. But to actively discourage discussion and information comparing the vaccines is downright Orwellian.

That clearly was not what my comment conveyed. The OP's desire to be able to more easily get information to compare was not under question.

It's Loserthink to believe every person has the medical background and qualified to weigh the medical information on vaccines to make an informed decision to wait for their choice of vaccines.

It seems a lot of people don't really want to discuss this, but I think the facts are relatively clear: The mRNA vaccines have an effectiveness above 90% and none of the others comes close to that. Biontech and Moderna are so close to each other that there's probably no argument for either of those.

I'd take any approved vaccine without hesitation if it'd be offered to me right now. But if I am free to choose: It'd be Biontech or Moderna.

I opted for pfizer just because they let you get the second shot a week earlier

I have been seeing legitimate concern with the response of "i want the better one" or "i want the quicker one" because these are being each obstacle to quick spread of vaccine. But attempting for to say only "just as good" or "no difference" is only creating more mistrust between public with agencies that already having great mistrust from public.

I received Pfizer, but I would also probably choose Moderna if I had the choice. IIRC a Pfizer shot has 30ml of mRNA and Moderna has 100ml of mRNA. I know that the amount of mRNA injected shouldn't make a difference so long as your body learns the proper immune response, but my monkey brain thinks "more = better".

Wouldn’t less of the same thing with an almost identical outcome be better? I mean, it’s a liquid being shot into your arm, not chocolate.

I chose to get Pfizer for the exact same reason. If it was able to get the same effectiveness as Moderna with lesser mRNA it seemed to be an efficient choice (as a programmer :))

I'd choose Pfizer because AFAIK this is the first vaccine Moderna has ever made. At least Pfizer has some history, even if both are using a new technology. Also, anecdotally, the Moderna shot seems to cause more side effects.

But I wasn't given a choice, and I'd happily get J&J if it was "this or nothin." So I ended up with Pfizer anyway.

Wait, I thought producing just a few grams of mRNA is very hard and requires huge amounts of resources. Surely there isn't that much mRNA in every vaccine? Does that include the nano lipids?

It's micrograms of mRNA per dose, not ml.

Effectiveness doesn’t really mean much between these vaccines. Please watch this video: https://youtu.be/K3odScka55A

That video is bullshit (and Vox is a publication that in Feb 2020 was pushing the "just a flu" narrative).

The effectiveness is measured as 1-(Nnotinfected / (Ninfected + Nnotinfected)).

The video claims that when the study was done during the surge or in "other countries", the effectiveness might be different because Ninfected is higher, which makes no sense at all, since the probability of the vaccine protecting you shouldn't change based on how the virus is spreading in the general population. For a set of 100 placebo and 100 vaccinated, even if all 100 are infected, the vaccinated segment should be as protected as possible. 95% efficacy means only 5 in the vaccinated are infected. 66% efficacy means 50 in the vaccinated are infected.

That's not what they are claiming. They are claiming that the chance that a vaccinated person will get the disease is higher if that person is subject to more exposure events. What they say about trials during surges then follows from that.

For the part about other countries, what they are saying is that there were more infectious strains circulating in those countries during the trial, so you can't compare to trials done before those strains were circulating.

bro, you are missing out the news and the point of this whole post, pfizer is 90% effective against all current strans overral, even the nasty ones

Unless you are claiming that right now there are less strains around, compared to october-novemeber (when the J&J data was compiled)

This news just solidifies the argument that the mRna vaccines are much better. Suggesting otherwise is just either ignorance, or willful lie (let other take it, so i have more for me)

> It seems a lot of people don't really want to discuss this, but I think the facts are relatively clear: The mRNA vaccines have an effectiveness above 90% and none of the others comes close to that. Biontech and Moderna are so close to each other that there's probably no argument for either of those.

There are error bars on those point estimates, and they're wide, because the trials didn't have a huge number of hospitalizations or deaths. You also can't compare them across trials, because they were tested on different populations, at different times, under different conditions (i.e. dominant variants, but also temperature, disease prevlance, etc.)

Based on everything I've seen so far, the approved vaccines are all essentially statistically indistinguishable, with the caveat that the J&J vaccine is one dose, the mRNA vaccines are two, and the AZ trial was kind of a mess. But the choice of dosing strategy was always somewhat arbitrary, based on the inherent sloppiness of a combined phase 1/2 trial. Had Pfizer and Moderna decided to go with a one-shot regimen, the trial would have reported a very similar effectiveness profile to J&J.

I strongly suspect we'll see better data on all three that will put them within a margin of error of each other, and suggest better dosing strategies.

> and the AZ trial was kind of a mess

Also AstraZeneca keeps getting suspended due to blood clots. I think we're up to 7 or 8 countries now? Canada was the most recent I remember, but I think most have resumed now.

https://www.sciencemag.org/news/2021/03/rare-clotting-disord...

The running theory appears to be that in rare cases, that vaccine results in antibodies that attack platelets, causing a weird reaction that results in clotting.

Maybe. It could also just be fear porn and bad luck.

I'm definitely not an expert in this area, but people who are tell me that the rate of this (very rare) clotting abnormality is higher in the general public than it is amongst the vaccinated. At least so far.

Certainly, the fact that governments choose to do something is not scientific evidence of much of anything. Governments have chosen to do a lot of objectively silly things during this pandemic.

I had a preference for the mRNA vaccines because the immunity appears to build faster.

It's not enough of a difference to wait for one of the others, but it would drive my choice if I had an option.

When I made my appointment, the clerk warned me that they only had 2 dose vaccines, apparently enough people wanted the 1 dose that it was worth mentioning it.

So it can be pretty situational which one is 'better'.

I've been trying to follow along and I'm not super confident in my answer, but Pfizer and Moderna both seem to be doing incredibly well, either one is a safe choice as "this is the best I can do for myself"

AstraZeneca seems to be lagging behind, and what little data I've seen on J&J seems to suggest that it's better than AstraZeneca but still not as effective as Pfizer or Moderna.

"whichever one is available to you" is still the right answer since as some other comments suggest there isn't enough data, yet. For sure one is likely better than the others. If we had the data we'd make the choice, but it seems it's not possible to know yet. The better one may be the one that protects against the variant that is forming via mutation right now in some person in Iowa. But yeah, we don't know yet. So you can wait until we know more, for sure eventually in retrospect we may see there is a clear vaccine winner. But really today just get one, or wait and see which one is the winner, with the risks associated with waiting. I think that's the free-agent adult pants decision.

Also, let's say you get vaccine A today. And in 6 months, it turns out you really wanted vaccine B since it's way more effective it turns out. Why can't you just get vaccine B in 6 months? I imagine if vaccine B is the clear winner, they are going to crank up production on that one as much as they can?

> I know the "correct" answer is "whichever one is available to you", but let's pretend we're free-agent adults here and put the infantile answers aside for a moment.

The way this sentence is worded negatively affects the way the rest of your comment is read. You would have created a better foundation for discussion (I believe/hope) if you had removed all the snark:

"I know the answer is 'whichever one is available to you', but lets put that aside for a moment."

I disagree. I think it's a good way to illustrate the bullshit that needs to be curated from some of the armchair expert answers here on a constant basis.

People can grow thicker skin and not let a slighly snarky argument undermine a valid discussion. This isn't reddit, there's no reason for the hivemind mentality here. I come here to see discussions around the substance of the content and not ridiculous semantic disputes or someone flexing their "iamverysmart" muscle

> Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions?

No. Because the trails were structured differently and measured different things and there is little interest in doing studies comparing the options rather than just administering them to as many people as possible.

The Pfizer and Moderna mRNA vaccines seem to have strong evidence of being more protective than other options. The AstraZeneca vaccine has some early evidence of not being protective against the South African variant and has some minor safety concerns around extremely rare blood clotting. As far as I have heard anecdotally, the mRNA vaccines seem to have stronger flu-like symptoms, especially for the second dose.

If you are in the USA you should be able to easily choose between the three approved vaccines, so it is relevant to gather good information, just as you would with any medical decision.

Pfizer, Moderna, and J&J used a prefusion-stabilized version of the spike protein; AZ used the wild spike protein. The former should prove more effective against variants as a result.

https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behi...

Moderna and Pfizer seem to be nearly bit-for-bit identical at the mRNA level, though Moderna seems to have stabilized the mRNA better to be viable at higher temperatures.

J&J appears to be slightly less effective with its one dose, but would probably be just as effective as Moderna and Pfizer (if not more) if a second dose were given. J&J simply doesn't need the second dose because 75+% is still considered extremely good.

Even though J&J isn't considered one of the "mRNA vaccines", it still functions similarly to the mRNA vaccines. Their adenovirus carries the mRNA, allowing it to be remain stable in your body for longer, building strong immunity from 1 dose.

A single dose of Moderna or Pfizer is 80% effective:

https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-...

This appears to be a very new finding. I seem to remember earlier studies suggesting single doses of Moderna/Pfizer were between ~53-70% effective. The number 53 sticks out in my memory for some reason. Could be misremembering though.

Edit: Looks like the earlier results I was thinking of say 52% effectiveness from 1 dose, but that included people who were infected very shortly after the first dose.

> Using the data from the published study of the Pfizer vaccine, Public Health England determined that vaccine efficacy was 89% for 15-21 days after dose 1 – and before dose 2 on day 21. The range was between 52% and 97%.

Source: https://globalbiodefense.com/2021/03/20/how-effective-is-the...

It's unfortunate that you've been downvoted as this is a worthwhile discussion to have.

I think the short answer is that we simply don't know yet which one is "better", especially since there are so many dimensions for what can make one vaccine better than the others:

- dosing schedule

- logistical constraints like refrigeration, shelf life

- rate of severe side effects (like allergic reactions)

- rate of mild side effects (like the severe cold symptoms I got from the J&J shot)

- duration of immunity

- effectiveness against emerging variants

- effectiveness at preventing hospitalization vs severe disease vs transmission vs infection altogether

We just don't have data to fairly compare the vaccines on all these dimensions.

The answer from a public health perspective is to get as many shots in as many arms as fast as possible, as long as they have low rates of severe side effects and are reasonably effective. However I agree that it sows distrust to not be honest & upfront about the fact that it's highly unlikely that all vaccines are actually equal, and that we simply don't have the data to know exactly how they differ. That could easily be followed up with a "once we figure out which ones are actually better we'll give additional vaccines and/or booster shots to those that drew the short straw".

Pretending they are all equal is only going to further erode trust when we inevitably figure out how they're not actually equal.

I'm not going to go deep on this right now because I don't have the emotional will to type out the entire story but my in-laws have kinda fallen off the "trust healthcare professionals" boat over the last couple of years.

This pandemic has really shined a light on their lack of trust in institutions, and while they both got the J&J vax, they are proactively sending me and my partner literature about why mRNA is dangerous / should be avoided / how it's all a big plot to... X/Y/Z.

They're not crazy, I swear. In fact if you sat and had a conversation with either of them, you'd think they were some intelligent / kind people. But for some reason, I have to spend way more time than I care to combating misinformation they send us to the point where we had a harsh talk recently that we need them to stop bringing it up or we'll cut off communication for a bit.

If I had to take a guess... they got to retirement with too much free time on their hands, so they spend all day on their phones reading crap they see on the internet. They might have had their initial biases, but when they see a headline that strengthens the bias they can't get enough.

> They’re not crazy, I swear

> I have to spend way more time than I care to combating misinformation

I find these statements at odds with each other. FWIW, my in laws and my extended family all believe in various vaccine conspiracy theories and that makes them all literally, truly crazy.

Yeah, you're probably right, but it's like deep down I think they're just gullible. I think if I really pushed hard on correcting this thinking (I honestly don't have it in me right now), we'd probably get somewhere back to normal.

Anecdata but, I have not witnessed this happening or even heard of this ever happening. Once people accept a kernel of bullshit into their knowledge map, they’ve lost the ability to separate fact from fiction from uncomfortable truths, and then they start adding more and more bs to their knowledge base at an accelerating pace. It's quite a lot like cancer, really, and there are doctors that can help with this, but of course these people don't typically trust doctors. So don’t feel bad if you don’t have it in you, chances are it would make no difference except potentially destroying your relationship with them.

Bloomberg has really good analysis in their vaccine tracker. Especially all the data about vaccines not offered in the west (for all vaccines they have a timeline of testing, use, and also temperature, and a description of their type and the organizations involved instead of just “China” “Russia” while saying “Oxford” “Pzifer” for others).

Worth paying for a subscription during this pandemic.

For me, the list in order of preference is:

Pzifer

Moderna

Sputnik V

Sinopharm

JnJ (steep bell curve to get to this point)

I think its helped me, who was already sold on the mRNA ones. But most important to me is how it undermines most of the “plandemic” theories, not that they were ever convincing, only how they never factored in geopolitical realities.

This article has a chart you can refer to: https://www.businessinsider.com/covid-19-vaccines-efficacy-v...

It includes data on the variants and how the differing vaccines are impacted by those variants. Disclaimer: this is just preliminary data and obviously needs way more research.

I've also been following the Israeli studies for Pfizer and that's what lead me to choosing the Pfizer vaccine over the Moderna one.

One follow-up question I had is this: is it dangerous to have more than one type of vaccine? Provided it's spaced out long enough (2-6 weeks apart) and there's an abundance in supply of course.

For covid vaccines, there is currently a trial in the UK studying the outcomes on alternating doses of different vaccines. A positive outcome would be significantly increase flexibility in scheduling second shots.

From what I understand, mixing vaccines is not a new strategy for vaccinations in general (it's called heterologous prime-boost) and can provide enhanced immunity.

https://www.advisory.com/daily-briefing/2021/04/01/vaccine-m...

There is one real consideration that most of forgotten about: what is your personal allergy situation. For a few people the wrong vaccine is potentially much worse, but what vaccine is wrong is different for each person.

> There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves.

This is a bad analysis. Disease management is simply not a case where "best health choices for themselves" has any meaning whatsoever. The best choice, the UNAMBIGUOUSLY best choice, for everyone, everywhere, is to get the vaccine that is available first as soon as you possibly can. Period. That's the "best" choice.

Imagining that you can do better individually relies on an intuition that everyone else will be following the rules while you cheat. And that's why no one wants to give you answers as to which the "best" vaccine is.

(Note: this is from a US perspective, so I'm leaving AZ, and other vaccines that don't have EUA here out of it.)

Your questions would need to be answered by scientific medical research... which hasn't been done.

The "strong urge not to compare any of them" is good because there isn't a good basis for doing sound comparisons.

Also, even if you somehow knew, for example, that Pfizer was X% more effective or X% safer for you than J&J, but J&J was available now while Pfizer would be available in 4 weeks, you would still need to add the risk of four additional weeks of unprotected exposure to the equation for Pfizer to understand the relative risks.

Putting it together: (A) there isn't a sound way to compare the relative efficacy of J&J, Pfizer, and Moderna (especially on an individual basis) (B) waiting will increase your risk of serious problems from covid means "whichever one is available to you" is the right answer (not an "infantile" one -- careful there; you're throwing around a pejoritive, but I'm pretty sure you're the one who has a superficial grasp of the situation.)

As more data is collected it may be possible to break things down, e.g., by age group or region (if a particular variant is dominant in a region a particular vaccine is especially effective against that variant), but we'll have to see.

If I could choose I'd currently take Pfizer-Biontech. My second choices would be a tie between Moderna and Sputnik V, third choice J&J, last choice currently AstraZeneca because of the lower efficacy and elevated risk of trombosis (which according to the latest German data seems to be fairly high for a vaccine).

I cannot choose, though, and will probably get AstraZeneca once it's my turn.

Funny how US media write 'Pfizer' and EU media write 'Biontech'. Patriotism, probably. Or for Reuters, maybe Brexit!? What's it usually called in Asian, South American, or African media?

'Pfizer/Biontech' or 'Biontech/Pfizer' is just too long!

We could have called them the Boris, Merkel, and Trump vaccines ...

The Hong Kong government here usually uses its brand name “Comirnaty”. The news uses every variation “Pfizer-BioNTech”, “BioNTech”, “Pfizer”, or often just “the German made jab”.

So can you walk in and say "give it to me German style" ?

No, you have to book your appointment online.

Referring to "that" vaccine with Pfizer instead of Biontech is like saying that "Yellow Submarine" is from EMI instead of the Beatles because EMI produced the LPs.

That’s why both companies are equally sharing both the costs and the profits?

The vaccine was developed by BioNtech. Not by Pfizer. You also have an Apple AX in your iPhone. Not a TSMC chip, right?

Efficacious vaccine candidates are high in supply (moderna, Pfizer, j&j, AstraZeneca etc etc) - massive manufacturing capacity, testing and clinical trial ability however is not. If Pfizer hadn’t partnered with biontech they wouldn’t have idle manufacturing, they would have partnered with another lab to create something else.

Apple is a customer of TSMC - they pay for fab time to create a specific component they need for their devices. Pfizer and biontech however are splitting the development costs and sharing the profits. That is a very different relationship.

So if they're sharing everything, why is not BioNtech mentioned in the submission's title?

This America first thing is becoming really annoying for the rest of the world. Germany and the EU funded much of the vaccine's development. It's the EU who is supplying the world with vaccines. The US only stand out by blocking exports.

And the EU is being stupid. Look the disaster of a roll out.

I think the idea is that biontechs contribution is a dime a dozen at this point - the heavy lifting (ie where demand outstrips supply) is being done by Pfizer not biontech

If this were not the case why is it that the EU vaccine rollout has been dismal compared to the US and UK? It’s because they don’t have the negotiating power that comes with having what is actually in demand - production capacity.

> why is it that the EU vaccine rollout has been dismal compared to the US and UK?

Because both do not export any vaccine. And the EU does. So even Canada cannot get vaccines from the US and gets it from the EU which exported about half its production outside the EU. Some even went to the US.

Partnering with Pfizer was done because the BioNtech CEO knew people at Pfizer from before. If they would’ve chosen e.g. Bayer (which is what CureVac did) the story of would’ve been different.

> Because both do not export any vaccine. And the EU does. So even Canada cannot get vaccines from the US

Blatantly Untrue - the US has directly exported vaccine to both Canada and Mexico and it’s companies are producing huge amounts of vaccine worldwide for over 70 countries right now. The UK has fallen short of its export commitments but that is a far cry from ‘do not export any vaccine’.

Again though this just comes back to leverage, the EU and it’s properties generally lack what is in demand: production capacity. That is why we have the short end of the stick right now, blaming everyone but ourselves only fans flames unnecessarily.

Executive order 13962 is still in effect.

https://www.federalregister.gov/documents/2020/12/11/2020-27...

Sec. 2. Policy. It is the policy of the United States to ensure Americans have priority access to free, safe, and effective COVID-19 vaccines. After ensuring the ability to meet the vaccination needs of the American people, it is in the interest of the United States to facilitate international access to United States Government COVID-19 Vaccines.

Which in no way directly excludes the export of vaccine to other countries - as I have mentioned the US has directly exported to canada and mexico and its properties are creating vaccine for over 70 countries including every country in the EU.

Can you point to a source for your claim that the US has exported (present perfect) vaccines to anybody? All I can find is news articles from about 10 days ago about plans to export vaccines, not mentioning a date.

What's the label/musician split again?

It’s called the ‘Pfizer–BioNTech COVID-19 vaccine’ in virtually every language and country (see Wikipedia pages per language). Most people outside of Germany just say Pfizer vaccine because it’s a lot shorter and has some preexisting name recognition.

I haven’t even heard people discuss the ‘where’ when getting the vaccine they just want one of the more effective vaccines (be it Moderna or Pfizer- Johnson and Johnson and AstraZeneca are possibly just as effective but that’s hard to communicate and still being studied).

I think either way is probably fine, both companies are sharing the costs and profits equally.

In Turkey it’s BioNTech colloquially, probably because the inventors are Turkish immigrants in Germany.

Argentina, Pfizer

Credit where credit is due. It was developed by BioNtech and Pfizer helped with trial and distribution. Calling it Pfizer vaccine because it is American or just because it is bigger is such a shame. Give credit to the small company that developed it no matter what country it is from. If the company was from the US, there would’ve been hundreds of fluff pieces and heroism on display writing up the company and the name would be known long and wide.

I don't even know how to say BioNtech. Bio-inn-tech? Bion-tech? Bio-and-tech? It's a clumsy name, to be fair, compared to moderna or pfizer.

In the news media in the US, I've heard it Bio-en-tech, where en is the way you'd say the name of the letter "N".

I’d say most of the world’s population does not know how to pronounce “Pfizer” correctly.

And it’s Bion-tech.

Why? Anyone who would be investing in companies would know it's Biontech if they did 5 minutes of research. I think they'll do just fine after developing the vaccine. The people who matter to their future will know their name.

Don't underestimate the value of political support by having name recognition.

Imagine if instead of Solyndra, the money went to GE or something. The project still failed, the government still lost the money. But it's a lot easier to sell "We gave the money to this well known company, the project failed, it happens" even though the result is exactly the same.

Czechoslovakias were often referred to as "Czechs". Go figure.

I always wondered: after the Czechs and Slovaks split up, what ever happened to the O's?

It's a comparison between two control groups and the amount that were infected.

X - vaccine - 25 people get it Y - no vaccine - 250 people get it

That would mean it's 1 - 25/250 * 100 = 90% effective.

Reuters fixed the title and added BioNTech. Someone at HN should update the submission's title.

I just got my first dose but they have no appointment available for the second dose so I wonder how effective it is with only one dose.

Nothing that has been proven conclusively, but evidence suggests that in the near term you get over 90% effectiveness >12 days after the first dose. What isn't known is how long that phase lasts before fading. Personally, I wouldn't worry too much about delaying a bit, as long as it wasn't more than a month or so.

My state tells me that the best time-frame to get the 2nd dose is 21-42 days after 1st dose. But luckily some sloths because available (maybe they weren't scheduling that far out yet).

It's weird that it's even possible for someplace to be able to schedule the first dose and not the second. I noticed that with my local Smith's when I was vaccine hunting, too - I could pick a date for the first dose no problem, but nothing available for the second.

What gives? You'd think it'd be the other way around if anything.

My second dose was automatically scheduled after receiving my first.

Sorry but I don't believe it.

In the very beginning of the South African variant there was a report that it wouldn't protect against it and other variants. They're the most expensive vaccine and they want to keep selling their product.

I just lost faith in anything. When politicians make a profit from a prolonged emergency situation they have no reason to shorten the pandemic period. I'm talking about German politicians getting a commission on masks, and them being the ones who decide which kinds of masks are required. It's all so corrupt.

I'm waiting for the Russian and/or Chinese vaccine, maybe travel to Serbia to get my Sputnik V shots, since the EU is playing it political. About a month ago they were even suggesting that "Can we trust the Russian vaccine or is it a Trojan Horse" I mean, suggesting that the Russians would knowingly kill the population of the EU. How through and through Nazified is Germany?

Why would I pick the Sputnik V one over all others? Because they have prior knowledge and are doing 2 vectors (I'm not an expert but I read something about them doing ... well 2 vectors so the virus can't develop a resistence against the vaccine). I trust the Russian government more than my own, who has time and against lied and deceived me, even denounced what we were demonstrating against the new copyright laws and upload filters. The EU is corrupt through and through and they walk over dead bodies. Especially this new EU council lead by Ursula von der Leyen.

Who even elected her? No one that's who. She has a past where she was involved in a corruption scandal and the phone with evidence on it, a state owned phone, was magically erased just when the evidence was to be secured.

So yeah I don't trust anything that's developed in the EU and much less GB who voted pro those harmful "copyright" laws so they could have an advantage when they brexitted.

Astazenica kills people. A Vaccine that kills people. WTF. And politicians are debating that it should now be used on the elderly, because hey fuck the elderly right, they're old and almost dead anyway...

I can't eat how much I could puke.

> Sorry but I don't believe it.

> In the very beginning of the South African variant there was a report that it wouldn't protect against it and other variants. They're the most expensive vaccine and they want to keep selling their product.

> I just lost faith in anything. When politicians make a profit from a prolonged emergency situation they have no reason to shorten the pandemic period [. . .]

These two arguments you’re making contradict each other - the vaccine protection from the variant without an update shortens the pandemic period. An announcement that everyone needs to shelter in place while a new vaccine is developed is actually what would prolong it.

Also, you seem to be placing more trust in an early “news report” than a scientific study, which makes no sense.

Effective? You meant efficacy?

The vaccine was developed by BioNTech. Its name is Comirnaty. It's not the "Pfizer vaccine".

https://xkcd.com/2275/

US HN downvotes you.

If you told me that in 2021 there would be a global genetic engineering campaign I would have said you were crazy. But here we are. What an amazing time.

"Global genetic engineering campaign" suggests that the genes of humans are being edited, but it's just the genes of the vaccine.

The vaccine deliveries genetic material into the cells, and the cells create protein using this genetic material. How isn't this genetic engineering?

Unless I'm misunderstanding, the host's DNA is not changed during this process. When I think of genetic engineering, I think of "changing the host's genome". What does genetic engineering mean to you?

the deliberate modification of the characteristics of an organism by manipulating its genetic material.

By this definition, the mRNA vaccines aren't genetic engineering. They don't manipulate the organism's genetic material. They borrow the machinery that the organism uses (downstream) when doing stuff with its genetic material.

When I borrow your kitchen to cook my own recipe, I don't alter or even look at your cookbooks.

Isn't adding functional genetic material modifying?

Only in the same sense that navigating to https://news.ycombinator.com modifies your web browser's code.

That is: no, not at all.

An analogy about computer code isn't a valid counter point.

I'm trying to put it in terms this audience might better understand, since said audience doesn't seem to understand it when presented plainly (as has been done already, by various others). Though in hindsight, there's a better analogy:

So when you run a program on your computer, your computer doesn't directly execute that machine code right from the disk; rather, it loads a copy of it into memory first, and then executes that copy. If something changes that running copy (for example, by loading a DLL, or by using something like Cheat Engine to tweak the process memory), the original copy on the disk is untouched.

Likewise, when cells make proteins from your genetic code, they don't do so by "executing" the DNA directly. Rather, they make a copy of (a.k.a. transcribe) the DNA - this copy being "messenger" RNA or mRNA - and then that RNA gets tweaked and spliced and such before eventually making it to a ribosome to be "executed" - i.e. matched up to amino acids to make proteins.

An mRNA vaccine therefore works analogously to a DLL plugin: just like how loading a plugin doesn't change a program's binary as it exists on-disk, the vaccine's mRNA doesn't modify the DNA in your cells' nuclei - it instead goes directly to the ribosomes and gets matched up with amino acids to make proteins, leaving your DNA alone.

mRNA, like a running program, is short-lived; eventually it'll finish running, and then that's that. Since no actual DNA was modified, that's the end of it: the proteins that mRNA coded are all that remain. If more proteins are needed - e.g. for another round of training your immune system to attack SARS-CoV-2 spike proteins - then you'll need a second shot of mRNA, which will again go right to the ribosomes, get matched up with amino acids to make proteins, then that's that.

You're not addressing the point. You are just describing protein syntheses and comparing it to a computer program.

>the deliberate modification of the characteristics of an organism by manipulating its genetic material.

Is mRNA genetic material?

If yes, then is adding mRNA manipulating the organisms genetic material?

Is a process that puts foreign mRNA into people's cells deliberate modification of an organism?

> Is mRNA genetic material?

No, genes—well, in humans—are DNA. (RNA viruses and retroviruses have RNA genes.)

mRNA is, somewhat simplistically, a message format between genetic material and protein synthesis machinery. It has a short lifespan, so adding it has no lasting effect of the type that would come from genetic change.

> You're not addressing the point.

I feel like I've addressed it pretty thoroughly. Let's try again:

> Is mRNA genetic material?

As far as eukaryotes (like all animals, plants, etc. - including humans) and most prokaryotes are concerned: no, it is not. mRNA - per above - is a temporary copy of genetic material, not genetic material itself.

> If yes, then is adding mRNA manipulating the organisms genetic material?

No, because the organism's actual genetic material - i.e. the DNA in the cell nuclei - remains untouched.

> Is a process that puts foreign mRNA into people's cells deliberate modification of an organism?

Not in and of itself, no, because merely providing some arbitrary mRNA doesn't necessarily modify the organism itself - and especially not permanently - because (again) the underlying DNA is not modified.

Thank you, that clears the question for me.

It is genetic material but it doesn't get into your DNA and stay there. Those vaccines inject RNA into the cell. The RNA gets expressed into proteins, and then it breaks down. When people talk about genetic engineering, they are typically talking about permanently changing the genome of some host organism, and possibly that of its descendants.

>When people talk about genetic engineering, they are typically talking about permanently changing the genome of some host organism, and possibly that of its descendants.

Maybe I don't understand what is and isn't genetic engineering them. Still it is exciting and amazing thing that is happening.

Huh. Based on your original comment, I thought you were fear-mongering / being conspiratorial. Perhaps the grayed out text biased me to think that.

Whether or not the mRNA vaccine is considered "genetic engineering" (I think it's a confusing usage of the term, if not fully mistaken), I totally misread your intent. I stand corrected.

Do you know how long it takes for the RNA to break down? Is this why they need two shots? I find it very hard to find answers to these kind of questions using search engines.

It doesn't take very long for the mRNA to break down, a few hours.

It's perhaps overly simplified, but the first shot teaches the immune system what to look for and the second shot causes it to prepare a bunch of antibodies that will attack the virus (in some sense, the second shot is a reminder to keep defending against the virus, and the immune system does that by making antibodies).

Is that very fundamentally different from like... eating food?

‘The administration of beef to the stomach delivers genetic materials which are used to create energy to power the hemoglobin that carries oxygen in your blood.’

The main distinction is that saying genetic engineering doesn't convey a shared concept.

The point of language is to convey a shared concept and by saying genetic engineering nobody knows if you are a useful idiot for disinformation campaigns or just being unspecific in a way that nobody uses the term.

"Yes, some COVID vaccines use genetic engineering. Get over it." - Cornell Alliance for Science.

https://allianceforscience.cornell.edu/blog/2020/12/yes-some...

Interesting. Looks like they're talking about the Oxford/AstraZeneca vaccine which uses a reengineered virus as a delivery mechanism.

It also says the BioNTech/Pfizer and Moderna vaccines put mRNA into the cell. But I don't think it say how it's done.

I'm glad you found an article that matches an obscure academic use of the term, retroactively, as you started this thread with a question.

That's not what happened.

When I google "vaccine reprogram cells" it is on the first page. So, not sure how obscure it is.

I'm saying you started this thread with a question because you didn't already know the answer

and then you found an academic use of the term that matches your conclusion after being challenged about the obscurity of the use of the term. this is an obscure use of the term "genetic engineering" which would be limited to academic circles.

Going to be doing some genetic engineering later tonight then.

Giggity.

Ahh yes, arguing about semantics.

There are many businesses that have adapted to and prefer pandemic life. They, perhaps even more so than the hysterics, are our major blockers to returning to normalcy.

It's good day to announce this. People are taking all announcements today very seriously. https://www.youtube.com/watch?v=v53EUMNSdQs

Hilarious that they still label it as a country variant, as if the variant carries a genetic “country” code that determines the origin. Plain stupidity.

[Edit] To elaborate since there is so much negativity to my original comment. There is no absolute proof that the variant originated in South Africa, so calling it by a country’s name is an insult to human intelligence. We refer to the virus as the Coronavirus and not the Chinese virus. Why should the variant be any different? (This variant being actually called 501.V2)

And note that it's not racist to name a variant by where it is found, but it is racist and xenophobic to name the original form similarly.

This needs a citation or more detailed explanation for why it’s not problematic.

If I am refer to "British variant", no person is thinking I am racist against Englishmen. If I am refer to "Chinese virus", every person is thinking I am racist against Chinamen. But it is not "Asian coronavirus", that would be having more credible potential for racism. Persons who are using term in racist way are symptom, not problem: even while we are seeing use of alternate terms in all places, there still has been in past year increasing of hate crime against Asian. Neither terming has problem, British nor Chinese. It is a simple easy. Common man is not having any desire for to remember scientific names for any thing. And in last point, some persons are say that it create stigma against China: this is feature, not bug. China is deserving much fault for her failings in this manner.

Does that literally ever happen?

The citationable things come later because a student decided to write a paper for their race studies class, which is just as meta as us just telling you what our experience is.

These things aren't science, but maybe someone can articulate it better for you.

It's just convenient. What other naming scheme would you suggest?

Do you refer to SARS-CoV-2 as the Chinese virus?

The actual name for the variant in question is 501.V2.

Use the evolutionary lineage nomenclature. If people can memorize street addresses and telephone numbers they can learn to identify viruses by some other pattern.

The other problem with naming a variant after a country or state is what happens when the locale identifies a subsequent variant?

name after dinosaurs

Why humor them? Their "Plain stupidity" comment without offering anything resembling reason shows they will not respond to reason. Don't encourage the Twitterification of Hacker News.

The WHO generally recommends against naming diseases after countries or regions. Its why we say 'Covid-19' and not 'Wuhan Corona Virus'.

Yea, like is 20H/501Y.V2 or B.1.1.7 that hard to remember?

You can label it as a country variant unless that country is China.

Of course you have a point. There is hypocrisy. Unfortunately it is difficult to express this without flames. Political polarity also plays a role.

agree, do all the downmodders here find it interesting that "the Spanish Flu" originated in Kansas? The variants have alphanumeric names such as B.1.1.7.

As a layman who is generally skeptical of media promotions, 91% sounds wonderful. According to a recent study 100% of young teenagers found it effective. On face value the marketing sounds good.

However, I wouldn't be interested personally. If after long term use these vaccines prove to be everything they are promised to be _and_ coronvirus remains an issue, I would gladly take it. As it is I am relatively healthy and not at risk.

Reasonable people can disagree on the trustworthiness of media, government and technocrats.

Ultimately, trust is earned. It is up to the individual to decide for himself. Attempts to scare people into vaccination or mandate use don't help the sale. Trust has been lost. Until this has been addressed, the optics surrounding the promotion of these vaccines can appear as hard sell, urgency, "act now while supplies last" scare techniques.

I know many here are convinced. Hopefully this gives some insight into the skeptical view. Tinfoil or microchip implants don't play a role.

> However, I wouldn't be interested personally. If after long term use these vaccines prove to be everything they are promised to be _and_ coronvirus remains an issue, I would gladly take it. As it is I am relatively healthy and not at risk.

if you get the coronavirus you put other people at risk. Risk of death, in fact. shrugging off covid as not your problem is actually unethical.

>...you put other people at risk. Risk of death!

Without knowing anything about my situation, you jump to the furthest extreme. Please understand how this speaks exactly to my point.

I'd love to hear how this analysis does not apply to your situation.

Unless you withdraw from society, it will unfortunately remain an issue

> you jump to the furthest extreme

But that's exactly what not getting a vaccine for a very contagious disease does. In a population there will be people who can't take the vaccine for medical reasons or it was ineffective for some reason. But, if the whole population takes the vaccine that can, herd immunity is still achieved and those people end up protected. By not taking the vaccine when you medically can, you're putting others in the community at risk.

Much like prior to covid, we were seeing an uptick in measles outbreaks because of antivaxers. Not only did the antivaxers put their kids at risk, but also kids in the groups I mentioned earlier.

> https://www.cbsnews.com/news/measles-outbreak-anti-vaccinati...

Measles vaccines are established and effective. The objections to general vaccination are not analogous to concerns about a new, untested vaccine.

Sure, but if you get in a car you put other people at risk. And CO2 emissions mean that if you breathe you put other people at risk. The question then becomes how much risk is intolerable and it isn't clear that a single person vaccinating and free-riding is actually providing some appreciable level of risk.

Besides, there are ways of mitigating that risk. He could just prep at home and wait out the two weeks. It won't be the end of the world.

> Sure, but if you get in a car you put other people at risk.

Last I checked, car wrecks aren't self-replicating, mutating, exponential-growth deadly diseases.

And so? HIV/AIDS is a self-replicating, mutating, exponential-growth deadly disease and there is a non-zero probability that you carry the virus right now. But I'm not going to ask you to stop having sex.

It still boils down to total risk vs threshold. After all, breathing exposes us to atmospheric-CO2-driven climate change risk which has a small probability of being an extinction-level event.

You can't give AIDs to people by being in the same room with them.

Stop trying to reason using bad analogies. You keep coming to bad conclusions.

Ah, but it's not an analogy. Each time I comment I narrow the scope of your opposition. That is progress. Already you have shrunk it significantly, with each comment yielding more modifiers that diminish the space you cover. With sufficient effort, I could constrain it to the size of a pea, and then we will both be faced with the fact that situations that applying so many restrictive modifiers is akin to adding epicycles. Then it will be obvious that my original statement is correct: it is about aggregate risk.

But perhaps that is best left as an exercise for the reader.

If people collectively opt to take some risk, then ethically that's fine. Your car and CO2 emission examples both include reciprocation: everyone benefits and takes risk more or less equally. The problem comes when you participate in putting others at risk when they don't want to reciprocate.

For example, what if 90% of people on a flight would prefer for the 10% of unvaccinated-by-choice people not to be present on the flight at all? They would presumably be fine if the airline put on special "unvaccinated" flights for unvaccinated-by-choice people - except that probably wouldn't be viable as a business model. Since there isn't reciprocation, why should the vaccinated people be forced to be put at risk by you?

What if, instead of flights, we were talking about access to your local grocery store?

No, that's just tyranny of the majority. Just because you've decided to assume CO2 risk doesn't mean I have to consider it ethical (being carbon neutral). It's obviously ethically untenable that just because you guys have decided human extinction is okay, I have to accept that.

By not taking the vaccine if available, you are effectively offering up your body as another potential host within which for the virus to mutate.

Not only that, as a (likely asymptomatic) carrier to help that chain of infections keep going and spreading.

The advice provided suggests that vaccines may not prevent infection, only reduce the risk of death.

I'm pro-vaccine, and I got my first dose nine days ago, but the media drumbeat that those who already had the infection should get vaccinated anyway, and continue to wear masks, is definitely cause for suspicion.

It's a very strange position not predicated on the available science. People who are wary of the vaccine are likely reacting to the obvious anti-scientific message.

Expect to get vaccinated several times a year. No kidding.

https://www.reuters.com/article/us-health-coronavirus-eu-vac...

"The European Union aims to increase the region’s COVID-19 vaccine production capacity to 2-3 billion doses per year by the end of 2021"

Hint: The EU has about 400 Million people

Isn't that because a lot of their vaccines get shipped all over the world? We need doses for ~7B people in total. I don't see anything there that says they're planning on administering multiple vaccination rounds per person.

https://www.euractiv.com/section/coronavirus/news/eu-hopes-t...

3 bn PER year. Trust me. You may have to get vaccinated every year. Don't get me wrong, the strategy makes sense. Still not very encouraging.

Well, two shots a year, probably, maybe less.

The real reason the EU needs this kind of capacity is that the current EU vaccination campaign is going very poorly. Most of the population will only get vaccinated late in summer and autumn, so the yearly capacity needs to be appropriate to at least get it done this year and before the next flu season.

Oh, and the EU produces vaccines for a lot of others like UK, Israel and the US, as well as most third-world-countries. Imports into the EU are neglegible.

Hint: The world has more than 400 million people.

Ok. What are you trying to say?

Hint 2: ""Quite often vaccines are more effective than natural immunity but we might need to vaccinate everybody every year, or two or three, for quite some time and maybe forever."

https://news.sky.com/story/covid-19-will-we-need-an-annual-v...

Sorry to break the news to you but it is unlikely the world will be what it was.

It's an export market, and the vaccines they are using require 2 doses.

There’s a world of nearly eight billion people to vaccinate out there, and the manufacturing capacity may be useful when we start playing with mRNA vaccines for things like malaria.

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