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Please don't take HN threads into flamewar. It's tedious and evokes worse from others. We're trying for the opposite here.

Especially please don't take HN threads on generic flamewar tangents like "Vaccination is a moral obligation". They're highly repetitive and don't lead any place interesting.

https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor...

https://news.ycombinator.com/newsguidelines.html

I posted what I thought was a very uncontroversial idea - "vaccination is a moral obligation for me", since Covid is surging again and vaccination rates have flatlined because vaccine hesitancy et.al.

I don't know why this evoked such a negative response. I will just cool off posting comments on HN for a while.

Informed consent, a cornerstone of medical ethics, has very little to do with the fact that we can't prove treatment will not be detrimental in all cases.

Or perhaps you prioritise the group above the individual in all cases and think e.g. the Nuremberg Code is worthless historical artifact?

Just an interesting question here, if you are saying vaccination is a moral obligation does this mean you are a moral realist [0]? My guess is not.

You may mean to say for you vaccination is a moral obligation which if this is the case you are a moral relativist [1] and therefore your moral obligation does not necessarily apply to others.

[0] https://plato.stanford.edu/entries/moral-realism/

[1] https://plato.stanford.edu/entries/moral-relativism/

Of course, my moral obligation only applies to me. But I can advocate for others to follow my line of reasoning through persuasion.

Many moons ago, when I lived in a community where most residents were of the all-organic-no-vax types, I convinced the powers that be that vaccination was a moral obligation for the (mostly young) community due to the effects of infecting young and old and the resulting deaths.

Everyone got a flu vaccine that year. I was not very popular after that ;(

> moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you.

When people are not on stable scientific ground, they invoke morality. That's what priests and politicians do, not scientists.

(edited)

For someone who doesn't work in the field, deciding to take the vaccine is an act of faith.

By that logic, doing anything you aren't expert in is an act of faith. It's pretty reductive.

I'm not reducing it to entirely faith, but faith takes part in it.

That logic seems sound to me.

You’re more correct than you realize.

If I get on a Boeing aircraft, I am indeed engaging in an act of faith: that it was built properly, maintained well, and all the rest.

When that faith is violated, say by the control systems having the RANDOMLY_FALL_OUT_OF_THE_SKY flag set to “true”, then society engages in faith-restoring rituals: grounds the aircraft, leads an inquiry, does a recall, that sort of thing.

What you are seeing here is what happens when a large chunk of the population has lost faith in, and thus no longer trusts, its institutions.

Yes it's the human element that makes it a faith act. I have no doubts about the physics. The airplane must fly, it's not a matter of faith. But was it built properly, by qualified workers, has it been maintained properly with no shortcuts taken, are there any design flaws not yet discovered, and is it being operated by qualified, sober, healthy pilots?

Is it.. not? Or rather, what would you prefer to call it?

I've long had that opinion - it is faith, in my mind. It's very logical faith, but faith nonetheless. Not in science exactly, but in the morals, honesty and competency in the results of those performing the science. It's faith that if i was to become an expert in the field, i'd be able to recreate their exact results and deem them correct.

Is this unsound in your mind? I'm fairly anti-religious but i have no problem describing my belief in science based outcomes as faith. It doesn't feel reductive, it feels honest - to me. It takes a leap of.. something, if not faith, to trust the results of results of humans. Some science is bad, some is good, but often you lack the expertise to determine which is which. So you logically go with the common assertions and proceed from there. I do think it's logical, but i don't think that precludes it from also being faith.

How would you phrase / reason through it?

Thanks for accurately summarizing my thoughts better than I did above.

Sometimes people seem to use the word "reductive" when they mean "obviously and uninterestingly true."

I would say and act of responsibility, not faith, but we definitely need some answers.

Don't mix religious and political beliefs with health and science

No? Newton? Pascal? Lemaitre? Wheeler?

If ethics is confined to politics and religion, humanity is in big trouble...

This had me nodding my head:

However, we have to weigh the residual risks against the risk of death from Covid

But then this made me wonder if there was a paragraph I missed:

Vaccination is a moral obligation

I think it's a mistake to think the weighing process you endorse in the first quote will land everyone with the moral obligation you endorse in the second.

> Vaccination is a moral obligation

Only if the mechanism of its action contributes to herd immunity. If it provides symptom abatement without lowering infection and transmission, then vaccination of those not at risk can prove counterproductive due to asymptomatic spread.

Death isn't the only negative outcome of covid. We're seeing a relatively high rate of long-term damage caused by low-level symptoms. If we can reduce those symptoms with a (perhaps annual) shot, then covid turns into the "just a cold" that we were all hoping it would be

>We're seeing a relatively high rate of long-term damage caused by low-level symptoms.

Source?

I've seen it reported that this may actually be dubious. [1]

[1] https://archive.ph/CConv

https://www.sciencedaily.com/releases/2021/03/210331204431.h...

I'm not saying COVID doesn't have long-term impacts in certain portions of the population, but this sentence is pretty important: "However, the findings are observational, and the authors cannot rule out the possibility that rates of diagnoses in general might have decreased indirectly because of the pandemic, particularly in people not admitted to hospital with covid-19."

It's really hard to draw meaningful conclusions when COVID has completely changed all kinds of factors in healthcare ranging from people being stuck at home and eating poorly to opting not to visit the doctor because of overburdened hospitals and fear of infection. I'd like to see some studies a year from now before forming a strong opinion.

Here's the problem: we don't have enough information on long term damage. It could be that there are none, it could be that we'll see them in decades (like shingles).

We do not know. Since we do not know, we need to play it safe. If we are wrong, nothing will happen. If we are right, we have avoided long term damage.

https://www.theinsight.org/p/long-covid-how-bungle-reporting...

> Comparison groups are also important to understand the scale of a problem. To put it bluntly: it’s not very informative to describe people as COVID “long-haulers” if, sixty days after being diagnosed with an illness that is sweeping the world in a devastating pandemic, they report anxiety, fatigue, insomnia, headache etc., without a comparison group!

My anecdotes are my Bayesian truth, and they include neighbors and coworkers with longterm anosmia that I've never had friends experience before COVID. The article you mentioned didn't even address this rather well known symptom... why not? It would seem to be rather measurable and comparable vs earlier baselines.

The replies here seem to be ignoring the point I was making, so I guess I was unclear. I'm going to try once more, hopefully this helps:

The effects of the virus at play are irrelevant... long term, short term, sniffles, death. None of that matters to the topic of moral obligation. Only contagion matters, so let's take two opposing mechanistic scenarios:

1 - Reduced infectiousness (what we expect)

Person A getting the vaccine reduces the chance they will spread it to Person B if exposed and/or infected.

2 - Reduced symptoms (counterintuitive)

Person A getting the vaccine still gets infected and can infect Person B, but no longer has symptoms such as fever. In this situation, Person A actually becomes problematic to the un-vaccinated Person B, since it's not obvious to either individual that Person A is infectious.

In the first scenario, your vaccination potentially helps others. In the second, your vaccination potentially hurts others. The mechanism of action can change altruism into unintended harm. This is why the mechanism of vaccination is so important from social perspective.

Huh, that's nonsense. Every vaccination also carries risks, so there can be no moral obligation if the risks outweigh the benefits. That said, I also disagree with the moral obligation. At the very least, there are also other scenarios to consider. For example if only a small group is at risk and can't be vaccinated (too risky), that small group could be isolated or choose to self isolate. Afaik it already happens with chemotherapy patients who are being isolated. There is no obligation for the rest of the world to disinfect everything and walk around in hazmat suits so that chemotherapy patients can walk freely in the outer world.

> effects of the virus at play are irrelevant... only contagion matters

No, I'm sorry, but hospital ICUs near me are 90+% full again and we're returning to a strict lockdown. Given a hypothetical vaccine which reduces symptoms but transmission, the vaccine still reduces the hospitalization rate, so your un-vaccinated person B will have a better chance at treatment. Your situation #2 presumes that people with mild symptoms will be inclined to stay home -- in my experience, this is not the case.

Herd immunity exists when enough people are incapable of re-transmitting a disease that the R number is below 1, even when we're back to a normal way of living.

It may be that the vaccines will be incapable of giving us herd immunity, but they may allow us to keep the R number below 1 with much less extreme social distancing and lockdown procedures.

Without the vaccines, the only way to get rid of this pandemic is through severe economy-damaging lockdowns and liberty-encroaching contact tracing and quarantining. If we can achieve the same thing with vaccines plus just having to wear a mask when near other people, then I would say that vaccination would still be a moral obligation, even though we haven't achieved herd immunity.

No, not at all. Lockdowns, quarantining and other human rights violations don't help us get rid of the pandemic, they prolong it. To end the pandemic faster, more people need to get exposed to the virus.

Please take this rhetoric elsewhere. No human rights are being violated. We are trying to protect people and buying time until all can be immunized (or, if vaccines didn't exist, allowing health care facilities to handle the load).

We KNOW containment measures work (Ebola, SARS).

If you expose more people to a virus, you risk making the pandemic much worse. Or deadly. Viruses mutate. Every new person exposed is a potential laboratory.

Mutating viruses tend to get less deadly, not more. Killing its host does not benefit it.

Of course containment measures work -- for keeping 80 year olds (and few other people) alive for a little bit longer at the expense of everyone else.

You can contract covid, have it mutate and also spread it to others even if you’ve been vaccinated. There’s supposedly less of a chance to do this if you’re vaccinated but with for profit corporations funding most of the science it should all be taken with a grain of salt.

While yes, that is one possible way to reach herd immunity. At what human cost?

Not low, but still lower than that of lockdowns and quarantines, closed schools, etc.

My fear with mRNA vaccine is that we place too much hope in this technology. Maybe it's much less efficient from what was expected.

My fear is that we still don’t fully understand genetic and epigenetic coding and there are probably latent dangers lurking with this class of vaccines that may not even be apparent until a new generation of posterity.

I suppose there's always a (very) small chance that we're making a civilization-ending mistake with this new vaccine :)

On the flip-side, while COVID can cause serious illness (and death), with a survival rate north of 99%, there's virtually no risk of societal collapse if we do nothing (OTOH, our response to it has been far more de-stabilizing).

I think we probably place too much hope in improving technology, in general.

It's a tremendous breakthrough, I'd say. But rather than focus on the tech, I'd rather see a rethinking of our governmental approach to issues concerning public health and how approval processes are set up. I'd rather focus on how we incentivize breakthroughs on issues that are most important, rather than developing another medicine that's 1% better at treating acne, for example. And I'd rather see cultural changes around adopting already existing technologies -- less than half of folks take flu shots!

I'd argue that getting flu shot numbers way up would be more of a breakthrough than any benefits from mRNA, as incredible as it is. Not that we have to choose one or the other. I'm just saying I'd like these other issues to get more prominence.

You keep saying we. There is no we in this CHOICE (your assumed moral obligation notwithstanding).

In the semi-rural area where I live we have 1/3 trumpsters who won't get it due to their political allegiances and 1/3 hippies who won't because woo woo reasons. I am assuming there will be a harsh reckoning in store for this and similar places.

The harsh reckoning will be for the urban areas who subsidize that stupidity, when variants will emerge from among these unvaccinated populations, and we are going to go through this song and dance all over again.

It's also why I'm incensed that vaccine production is ramping up both too slowly, and will top out at too low a number. It can't take six months to vaccinate the first world, and eighteen to vaccinate the developing world against a variant.

Or variants emerging from those vaccinated. It’s nonsense to assume “the unvaccinated are dirty Petri dishes where mutations come from!” Variants can come from vaccines themselves or mutating in the host and then spreading.

If anyone think that’s impossible, such a phenomenon is happening right now in Africa with Polio. Wild Polio is declared to be eradicated. A vaccine derived strain is keeping the outbreak alive.

https://www.npr.org/sections/goatsandsoda/2020/08/25/9058847...

Sure, it can happen, and viruses spread even through a vaccinated population, but quantity is a quality all of its own. Vaccinate everyone, and the number of opportunities for the virus to mutate and spread drops by orders of magnitude. Vaccinate half the population, and all that you'll do is create a great amount of evolutionary selection pressure for a mutation.

It's hard when people you don't like won't do what you want them to do isn't it?

This would require a degree of confidence in the benevolence of pharmaceutical companies that I do not currently have.

> benevolence of pharmaceutical companies

I get that sentiment. There's a question of alignment of incentives.

Covid19 vaccinations are likely to be a thing for many years to come, and there are a number of entities that will be able to produce those future vaccinations. If one of the big vaccine providers produces something that's demonstrably less safe than the others, then the odds of them getting more money for future vaccines goes down.

It's far from a perfect system, and there are a lot of holes, but in this case, things line up pretty well.

In short, you can be confident that these companies are primarily focused on long-term profit, which often aligns with good short and long term outcomes for its customers.

Regardless of your opinion of vaccination being a moral obligation, that does not sway my personal decision whether to take an experimental vaccine for an illness with a 99.5% survival rate.

Collectivist ideals like "vaccinate everyone for the greater good!" does not trump my personal sovereignty and never will. I do not consent.

There are people (not so much on HN, but definitely other places on the net) openly advocating for forced vaccinations and/or completely shunning the unvaccinated from society (to include employment).

Oh, I'm with you on this, but I think it's only a matter of time before things get very uncomfortable.

> Vaccination is a moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you.

Well put

By that logic, shouldn't you also through that same sense of decency and civic duty donate to prevent starvation? How is it morally decent to live in an expensive city while that money could prevent others from dying?

In fact, instead of taking that vaccine shouldn't you give it to a school teacher or hospital worker in a country that doesn't yet have the vaccine?

This 'moral obligation' nonsense sounds good at face value but really doesn't hold up in practice.