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Comment by Mediterraneo10 | Hacker News Reader

Who knows what motivated the grandparent post to say that [EDIT: OK, now he explained and I definitely don’t endorse that, geez], but I can see some grounds for unease at aledalgrande's vision of a specifically annual vaccination mentioned above. The COVID epidemic has been accompanied by border closures, followed now by a slow and chaotic reopening of them as different countries recognize different vaccines and different certificates proving vaccination. A future where everyone must get an annual jab to prevent even the common cold, and then have to prove recent vaccination to cross borders, would only continue indefinitely what many people hoped was just a one-off thing in their lifetimes.

Incidentally, only half of people or less even in affluent countries get the annual flu shot. It is frequently believed to be relevant only for the elderly and at-risk demographics.

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You live already in that world. I have already lost track of the number of "jabs" I've needed to travel to several countries, and this was way before COVID.

No, the vaccinations required for travel were virtually never expected to be taken on an annual basis but rather were good for years. For example, not only was the UN yellow-fever vaccination certificate good for 10 years, but recently the WHO announced that the yellow-fever vaccine now appears to confer life-long immunity, so border officials should accept the certificate regardless of the date on it.

That's just the luck of the draw, though. Yellow Fever happens to be amenable to life-long immunity. COVID (may) not be.

Had the situation been reversed, you'd have had to get Yellow Fever vaccinations a lot more often if you were travelling into those regions, and the COVID situation would be one-and-done. It just happens that this is the way it worked out, instead. There's nothing dystopian about this.

You've lost track? The only 100% required vaccine for international travel I'm aware of is yellow fever, which poses an infection fatality risk hundreds or thousands of times higher than Covid.

Checked this - the yellow fever IFR only appears to be about 10× that of covid-19 overall.

The Wikipedia data for yellow fever IFR [0] claims that the data are based on "optimally treated patients". The problem in some of the countries where a vaccination certificate is mandatory to enter is that they do not have healthcare infrastructure to adequately treat patients. Somewhere in the past I have seen statistics that during some African yellow-fever outbreaks, 25–50% of those infected perished, which is why states were so insistent on this vaccination specifically.

[0] https://en.wikipedia.org/wiki/List_of_human_disease_case_fat...

That doesn't seem at odds with a single order-of-magnitude difference though. Covid IFR in the 0.5% range is also based on more or less optimally treated patients given a developed country's population demographics. There isn't really room for a fatality rate to be "hundreds or thousands of times higher", you run into the 100% fatal bound pretty quickly.

The Covid IFR is not in the 0.5% range, and a few exceptions notwithstanding, the fatality rate tends to be lower in developing countries than the developed world.

US covid deaths are 0.51% of the CDC’s estimated total number of covid cases. The highest (NPR) estimate of US covid deaths is 0.79% of the CDC’s estimated total number of covid cases (which is, itself, not the highest total case estimate). Many studies have estimates in the similar range.

I know the IFR is lower in developing countries, I never meant to imply otherwise.

> Incidentally, only half of people or less even in affluent countries get the annual flu shot. It is frequently believed to be relevant only for the elderly and at-risk demographics.

You are right as far as about half getting it, at least for the United States. Quite a few people who are not elderly or at risk get it. Here are the age breakdowns.

About 60% of the people under 18 get it [1]. Under 18 is about 25% of the population.

About 34% of 18-49 year olds get it. They make up about 42% of the population.

That makes under 18s who get flu vaccine about 15% of the population, and 18-49s who get flu vaccine about 14% of the population. If only 50% of the population get the flu vaccine, that would mean that 58% of the people getting flu vaccine are under 50.

[1] https://www.thenationshealth.org/content/47/9/E45

It might not even be a shot. Would it still be an issue if it was a nasal spray that you can buy at your pharmacy once a year?

The issue is really availability of the vaccine at all. It would suck if a person from country A traveling in developing country B needs to get vaccinated yet again in order to move on to country C, but developing country B has a poor healthcare system that travelers would reasonably want to avoid contract with. One would then be compelled to visit a private hospital for expats at great expense, but sometimes even that option is not available.

Even if nasal sprays bought from a corner pharmacy are on the horizon, they would probably only reach developing countries years from now – and merely buying a product from a pharmacy in most countries might not get you an internationally recognized certificate of vaccination.

Availability and inequality is a fair concern, but why should we stop working on something that would improve everyone's lives? Nobody said it's going to be mandatory for travel.

The entire point of such vaccinations would be to prevent another major shutdown from a new coronavirus outbreak, and thus avoid a much larger issue when trying to cross borders. The expectation is nobody is going to care much if people get the next shot anymore than they do about the annual flu vaccine because significant herd immunity will be in play.

The only way that changes is if some new and extremely deadly variant is out there, but again past vaccinations are likely still helpful. Thus, regular vaccination deployment would be a pure win for travelers.

> many people hoped was just a one-off thing.

This was never the case. If you didn't understand that COVID is here to stay indefinitely, like flu, after April 2020 I'm sorry but you aren't paying attention. Not to mention, if we follow perfect vaccination around the world, we can eradicate COVID like we eradicated smallpox etc, although this will be a lot harder.

So, I still don't see your point. Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.

As frequently reported in the last year, only a small niche of the scientific community is optimistic that COVID can be eradicated through vaccination. Smallpox had no animal reservoirs, while COVID does.

> Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.

No, it hasn’t. The only common annual vaccination is for influenza, it was introduced only in recent decades, and, as I mentioned, only half the population or less take it annually.

> No, it hasn’t. The only common annual vaccination is for influenza, it was introduced only in recent decades, and, as I mentioned, only half the population or less take it annually.

You only take flu annually but there are other vaccines you need to take periodically. E.g. tetanus booster every 10 years etc. For example, I'm supposed to take my last HPV vaccine this summer and this is the 3rd shot. I'm 25 and I took approx. one vaccine every year for the last few years. I'm not saying strictly one every 12 months, it's just that it doesn't make sense to be outraged about COVID vax since regular vax is already part of our lives.

Note that aledalgrande’s original post above was speaking specifically about annual vaccination. That is is a completely different league than the common vaccines that require a booster shot every decade or so, and are much easier for people moving around internationally to plan around.

All those vaccines were also tested much more extensively and use techniques which have been widely deployed for much longer than the Covid vaccines.

This is exactly the point. We have decades of evidence for most vaccines and you only need them infrequently. That's a world away from a 6m old vaccine that hasn't been through the normal approval process.

> Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.

This isn't even remotely true. There's a set of vaccines taken in childhood, a few later. And that's it generally.

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