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Comment by kleene_op | Hacker News Reader

It is not very difficult to imagine that antivaxxers would use this article as proof that vaccination was a mistake and that we should not go further. However, this bit:

> Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.

Actually makes a convincing case for anyone who did not get the vaccine to get it.

Anyway, that won't convince hardcore antivaxxers, so we shall see in the upcoming months/years whether this article actually transposes to our situation. Just a shame this may be happening at the expense of gullible yet still good at heart people.

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Interestingly, antivaxxers have been told their actions put others at risk, but they believe personal liberties are more important.

If that sentence you quoted comes to pass and a vaccine protects those who receive it, yet makes the disease more dangerous for everyone else, it will be the exact opposite situation. How many antivaxxers will cling to their ideals of personal liberties when they are on the losing end of the situation?

Of course, it works the opposite, how many have thought it irresponsible of antivaxxers to put others at risk, but then would ourselves put others at risk with such a vaccine?

Human interactions are interesting and complicated.

Yep. For the record I will literally die on this hill - if from COVID-19, or whatever variant, so be it. Freedom is much more important than safety right now.

The rub is that there are a lot of people on Earth. And, early evidence _might_ suggest that the vaccines that are available lose effectiveness sooner than originally thought. For example, [1] shows evidence of diminished effectiveness after 146 days.

Back to "Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts." and whether that implies that "for anyone who did not get the vaccine to get it." This sounds like a strategy that hinges on everyone on Earth getting vaccines and frequent-enough booster shots. What if that's unachievable though? The logistics for that would be unprecedented. What are the consequences of trying but failing to do it?

[1] https://www.medrxiv.org/content/10.1101/2021.08.03.21261496v...

> lose effectiveness sooner than originally thought

To be precise, have partially reduced effectiveness against transmission of a variant of the virus evolved after the creation of the vaccine, while still preventing almost all severe illness/death.

Possible ways forward: (1) give people additional booster shots of the existing vaccine; (2) develop a modified vaccine booster targeted more precisely to the variant virus; (3) keep public health measures in place (e.g. requiring everyone to wear face masks indoors) so long as Re > 1.

> What if that's unachievable though?

It has been more or less achievable for past vaccinations. It is a logistical challenge to be sure, but modern society is certainly capable of it if it is prioritized.

The consequence would be vaccine makers are now gods on earth with the power of life and death.

"Can create conditions" in the sense that any actions that perturbs a system can have that effect.

With, for example, antibiotics, resitance is quickly lost in their absence. Why? Because it's a costly adaptation to a need that no longer exists.

By the same mechanism, adaptation to the vaccine–if it happens–will by definition tend to be net-negative for the virus' fitness in unvaccinated people. Otherwise, that adaption would also happen without the virus.

All that's entirely theoretical, of course. Because the vaccine, despite the breakthoughs, still prevents the vast majority of infections. And that effect swamps everything, including hypothetical Quergedankenexperimente.

But, of course, they'll run with it, seeing how it's eaten up here as well. Personally, I'm no longer losing sleep over it since everyone I care about has been vaccinated, and most of my future attempts to explain evolutionary biology will be on the theme of "Darwin Awards".

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