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Comment by ReadEvalPost | Hacker News Reader

Yes, of course I think about others. I would never go in with symptoms of any infectious disease. Were I asked to work in a building away from people that are high-risk or are regularly in contact with high-risk people I would easily oblige. There are multiple possible solutions that do not violate my bodily autonomy.

I agree with your assessment that major adverse effects are unlikely, but ultimately unknowns are impossible to quantify. I know the risk of COVID, I do not if I am being prescribed thalidomide.

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Everything has unknown unknowns (u-u).

You do not know the u-u risk of covid for precisely the same reasons you do not know the u-u risk of the vaccine: they are both on the same timeline.

You also do not know the aggregate u-u risk to others: asymptomatic spread, modalities of spreading, etc.

The aggregate u-u compound the individual u-u of covid. Eg., suppose long-covid occurs at a higher rate than supposed, has a longer lasting impact, has a more severe neurological impact.... then this compounds the u-u risk on spreading (eg., suppose that asymptomatic spread is more severe...).

All you're saying by declining the vaccine is that you care more about the u-u risk to yourself.

> All you're saying by declining the vaccine is that you care more about the u-u risk to yourself.

which is fine, i think this is a valid position to take.

The invalid position is to prevent others from isolating you (who have this position) - for example, by mandating a vaccine passport for certain types of services or activities. You cannot take the position of wanting to protect yourself from u-u risk of vaccines, _and yet_ also continue consequence free life.

Pretty much every position has its own sort of moral defence.

My issue is the conceptual mistake of ignoring the "unknown unknown" risks you impart on others when you accept one set of "unknown unknowns" yourself. It is a sort of hypocrisy that allows you to dodge the shame of a private decision.

In the end, when rejecting this vaccine, you have to fully own the "shameful aspect":

Taking the vaccine is an act many are taking on behalf of others, and in doing so, accept a private risk for a public good. We ought rightly praise this.

Rejecting the vaccine is a rejection of the priority of this public good which many ought regard as shameful.

Personally, were I so inclined to reject it, I'd simply say: "I do not care about society so much" -- and it would be true -- "shame me all you like, who cares". But the latent hypocrisy here and doublethink makes me believe many are unwilling to say this -- because they dont believe it -- and hence my issue.

> Yes, of course I think about others. I would never go in with symptoms of any infectious disease.

Its not as simple as that. Most covid transmission occurs when the infecting person is asymptomatic. And approximately 30% of people who get covid have no significant symptoms at all.

You have a right to make decisions about your body and medical treatment. And, taken on its own, the decisions you make are very unlikely to make a significant difference to the outcomes for the society that you live in. But when large numbers of people decide, like you, to prioritise their own autonomy over the safety of their community, we end-up with a situation that is exploitable by the disease. The way to beat it is to act together. Sincerely, I'd urge you to consider this.

How are you so sure you know the risk of Covid, that has both an immediate and longitudinal risk, that will likely increase due to fitness escapes? Let's not forget there are still unknown unknowns regarding the longitudinal risk of Covid.

Evolutionary pressure selects for less deadly viruses over time. You're right though, there is still longitudinal risk as this does not preclude a vastly more deadly strain--but at that point the effectiveness of a vaccine is similarly unknown.

COVID spreads most in the few days before and after the appearance of symptoms. Organ failure, lethality, are largely due to the immune response to the virus.

The virus has little evolutionary pressure to be less lethal. COVID has already spread before the symptoms appear.

> Evolutionary pressure selects for less deadly viruses over time.

I'm hearing that for the first time, do you have a source?

> longitudinal risk

With longitudinal I meant the risk of what we have labelled 'long Covid' but really seems to be a conglomerate of different, sometimes chronic diseases in different people, that we still don't really know how to treat effectively (not very frequent in absolute terms, but orders of magnitude more frequent than any serious side effects we have observed due to the vaccines).

So if I understand you correctly, what you are fearing is that there is some unknown risk about the mRNA vaccine, that will only reveal itself over time, but that we have no idea about the mechanism of action nor any actual cases. Is that right?

>> Evolutionary pressure selects for less deadly viruses over time.

> I'm hearing that for the first time, do you have a source?

A virus that kills its host before it has a chance to infect others cannot reproduce.

I cannot remember which virus it was (might have been ebola) but it wiped whole communities so fast it died off because there were no new hosts to infect.

Not sure if that's what parent meant - these are extreme cases. In general (e.g. in the case of SARS-Cov2) evolutionary pressure will increase transmissibility but is indifferent to lethality (again up to the extreme point where lethality precludes transmission).

Won't any amount of lethality preclude some transmission?

In general no, as was remarked in a sibling comment in this thread: SARS-Cov-2 on average spreads within the first 1-4 days after infection (viral titers peak on day 2 I believe), so the virus is indifferent to what happens after.

I also want to remark that there is the opposite effect that transmissibility correlates strongly with viral load (amount of viral particles) and viral load correlates weakly with lethality.

The issue is that young people can die of covid, even if it's rare, also they can have some comorbidity that they do not want their employer to know about.

Also, you can transmit covid and be asymptomatic.

Finally, death is not the only "bad" outcome of covid. About 1/10 people have "long covid", ie symptoms that persist over time (lack of smell or taste, fatigue..). And this affects young people too.

So, as others have said many times, this vaccine is not a matter of individual choice. This is an infectious disease, so by being infectious, you may harm others, even young people. This is why governments or companies are making it mandatory.

What if you're asymptomatic?

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