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Comment by HarryHirsch | Hacker News Reader

It's been established that vaccinated people can get Covid and that they can infect others. Just yesterday - an outbreak on a cruise ship: https://www.houstonchronicle.com/news/houston-texas/galvesto...

This is a pointless exercise, people must get vaccinated to reduce the load on the healthcare system, but widespread vaccination on its own won't make enclosed spaces safe.

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Just stop twisting the truth. Yes vaccinated people can get covid, but at a much lower rate, and when they do, they spread it less. In fact in Ontario (largest province in Canada), you are 30x more likely to get COVID if you are unvaccinated (and 50x more likely to get in the ICU).

Source https://twitter.com/EdTubb/status/1426182876383612931

and

https://data.ontario.ca/dataset/covid-19-vaccine-data-in-ont...

And everyone vaccinated that got COVID on that cruise had low or no symptoms, which is a pretty good outcome if you compare to all those unvaccinated people in hospitals in Florida right now.

I'm not an expert in this field but I am a scientist and have been looking at the various data released on this point, because it's foundational to the reasoning behind the push for universal vaccination using unapproved drugs. I think that which you say is being twisted, the "truth", doesn't yet exist on this topic. We simply don't have scientific consensus yet on whether the current vaccines are fully neutralising. Lots of conflicting data for experts to untangle. I would not start calling people truth twisters until we know more. As an example of scientific studies with opposite conclusions to those you linked, see e.g. the links in the fourth paragraph here [1]. The fifth paragraph also provides a hypothesis as to why the vaccines aren't fully neutralising.

[1] https://www.hartgroup.org/vaccination-prevents-transmission-...

We have clear scientific consensus on the fact that vaccines reduce the negative effects of getting COVID, and reduce the likelihood of getting COVID in the first place.

So declaring that vaccine mandates won't affect populations 'because you can still get it' is effectively twisting the truth. Or at least applying some really bad logic.

The link you provided is unfortunately not helpful. Again, there is overwhelming evidence that actions taken by governments were successful in most ways in preventing spread during the pre-vaccination era. Huge spike is case rates were immediately neutralized by lockdowns etc.. The moral and legal case is ambiguous, but not the overall effect of the policies was clear. In my area, we had two huge spikes, after which there were lock-downs declared, and immediately the case rates dropped dramatically. I'm wary of the civil issues, but the results were clear.

The article provides no evidence that vaccines don't work, other than to indicate that protections against Delta variants is weaker, which we already knew.

This statement: "The principle defence against a respiratory virus actually takes place in the mucosal membranes of the respiratory tract, and the high proportion of those with some degree of natural immunity fight off SARS-CoV-2 there, preventing it replicating significantly in the bloodstream. Therefore, it is not actually surprising that a vaccine which works mainly in the circulatory system has little effect on stopping what starts as a respiratory infection. If that is the case, it is illogical to expect any reduction in transmission."

Is hugely speculative, not Scientific.

The author of this piece failed to play their own devil's advocate because there's tons of data to debunk most of what he is trying to say, in a nutshell, the author is cherry picking.

I don't doubt the vaccines are effective at reducing negative effects on the vaccinated individual. Nothing in my comment above was intended to imply that.

The specific point I was trying to make is that there is conflicting evidence that the vaccines reduce transmission. Since governments around the world pushed vaccines for everyone partly on the hypothesis that it should reduce spread, this is a big problem. The truth about transmission reduction from vaccination is therefore in my mind critical. And so far from what I've read, there is not yet a clear scientific consensus on whether vaccines do indeed significantly reduce transmission.

And for the record, in case anyone is wondering, I'm not a tunnel-visioned troll. I welcome being shown studies that do (or don't!) demonstrate reduction in transmission, which I will read and digest before the next HN debate on this topic. It's only by scientific inquiry and debate that we will get to the truth here.

The consensus has shifted to the point wherein the preponderance of evidence points to reduced transmission.

Here is Nature in Feb [1]

Here is Nature now [2]

[1] https://www.nature.com/articles/d41586-021-00450-z

[2] https://www.nature.com/articles/d41586-021-02054-z

Thanks, [2] is interesting. Sadly lacking much information on the transmissibility of the delta variant, which is the dominant strain in most (?) western countries. Such information would tell us whether achieving herd immunity without direct infection from SARS-CoV-2 requires continual application of boosters forever (i.e. for each seasonal variant). I say this because there is evidence from other respiratory viruses that, after having transitioned from animal to human, they typically mutate to become more transmissible but less deadly, which we normally deal with by letting sweep through the country without mass vaccination (only for the vulnerable).

Did you actually look at the data? Deaths in Israel went from over a 1400 in the month of January to 20 in July, with a vaccination rate of [0] 67%. I would say that that's a pretty darn good result, wouldn't you?

Again, from the data in your link: 91.4% efficacy against severe Covid - IE: ventilators or death, 88% efficacy against hospitalization. I'll take those chances.

The kicker for the article is quoting an "epidemiologist" - Andrew Bostom - that is not one. His argument: Israel sees a high percentage of deaths due to Covid among the vaccinated, ergo the CDC data is wrong. Omitting that Israel deaths are less than 1/10th of what they were in January, while in the U.S. they are at 1/3. So - as you may guess - not really close.

You won't get scientific consensus if you reject the numbers that don't support your theory.

I have been fully vaccinated and I do still wear a mask in public - following CDC guidelines put into place because we know that the vaccine is not fully neutralizing.

Is the vaccine a silver bullet? No. Does it save lives? Yes - in 98% of the cases.

[0] https://ourworldindata.org/covid-vaccinations

I think if you re-read my comment you'll see that I was specifically making a point about reduction in transmission in vaccinated vs unvaccinated individuals, not efficacy. Re-reading it myself, I see that might not have been 100% clear, so apologies if that's the case. For the record I don't doubt the vaccines reduce risk of death.

I'm deeply uncomfortable with the picture all the anecdotes paint. Closer to home, a colleague reports that her sister-in-law brought Covid home from a conference and then have it to her husband. Both were vaccinated (Pfizer/J&J).

Yes, being vaccinated keeps out out of hospital and out of a coffin, that's enough reason to get the shot. But it doesn't prevent synptomatic infection as well as we've been told (latest numbers indicate 50 % efficacy against Delta), and there's still the risk of long Covid (~ 20 %). The older you are and the longer ago yhour shot was the greater the risk.

We need to limit large gatherings again and increase ventilation. I work at a university and am frankly sick of being asked to take risks to my health while others can hide out until there's the Delta/Lambda booster, all in the name of propping up the value of commercial real estate.

We can't limit large gathering forever. Since the virus can never be eradicated and will always be around the most likely scenario is that almost all of us will eventually get infected regardless of what infection control steps we take. Fortunately the vaccines are very effective at preventing bad outcomes.

Is getting COVID after having been jabbed twice within the last 6-months worse than the regular flu in terms of mortality risk or ICU risk?

Should be either comparable or much better for most age ranges. Most important, it becomes much harder to overload the healthcare system. If the vaccine prevents you from getting into ICU most of the time, it's "as if" you multiplied the number of ICU beds by 10-20.

The data shows you are 30x more likely to receive a positive COVID test result if you are unvaccinated, not that you are 30x more likely to “get COVID.” You need to give the distribution of tests between vaccinated/unvaccinated to draw the latter conclusion.

> You need to give the distribution of tests between vaccinated/unvaccinated to draw the latter conclusion.

That wouldn’t give you the information you want.

Behavior should be factored into those numbers - unvaccinated people are less likely to believe covid is serious (on average) ergo are more likely to be putting themselves in risky situations and/or less likely to wear masks. Studies are all over the place on vaccine effectiveness - clearly much better than zero, but not a reason to be complacent.

I don't understand this attitude. Yes vaccines aren't 100% perfct but they are a whole lot better than nothing. Same as masks.

It's not "pointless" at all, it's a government taking totally reasonable measures to ensure the greatest good for the greatest number. Nothing is ever going to be 100% safe, but to not take obvious measures to increase safety is negligent.

I just have no sympathy for the anti-vaccine crowd and their wilful ignorance and bad faith arguments. Fine, it's your right to not get vaccinated. It's everyone else's right to prevent your recalcitrant ass from affecting others with your ridiculous theories and bad decision-making.

I think it was a reasonable question, which I read as:

If I am vaccinated, and you are not, what do I gain from forcing you to get vaccinated? I am equally highly protected either way, right?

No, you are not. If I am not vaccinated I am far more likely to carry the virus to you, and your vaccine, while good, is not 100% protection. So you have a significant decrease in your risk by forcing me to be vaccinated.

Do we apply this thinking to any other public health threats? Smoking for example, particularly for those forced to be around smokers like their children? I'm curious to hear the arguments for why this virus needs to be treated differently to all others that have come before, and to other public health issues.

Not trying to start a fight here. I just haven't been convinced yet why our old behaviour towards threats like CoV-2 doesn't apply to it itself.

Can you give some examples?

We do apply the same logic. You can choose to be a smoker, but you can’t choose to be one in certain public spaces, including airplanes and trains. This type of mandate is no different. You can still choose to be a non-vaccinated individual, but not in particular areas.

I did mention in my comment above that children of smokers don't have a choice being around second hand smoke. Yet most governments consider the harm to the health of the child to be less critical than the smoker's individual freedom to smoke.

I'm not some freedom loving libertarian, I'm normally quite left leaning, but the dual standards I see applied by governments here really bother me. I can't help but think their response was driven more by fear than sense.

No one is taking away the children of anti-vaxxers, they are saying you can’t use public transportation. The same principle is at play: you can live you life in a way that negatively impacts the health of your children, because you have authority over your children. But when it becomes a threat to others that aren’t in your stewardship, you no longer have that freedom.

What is the double standard here? You aren’t even comparing the same situations.

> You aren’t even comparing the same situations.

We've gotten quite far from the original point; I'll reply once more but probably not again on this branch because we seem to have a fundamental disagreement over whether governments should have the right to mandate (either de-jour or de-facto) medical interventions on people in return for the ability to take part in society.

Governments can't mandate for every eventuality, they have to make policies covering broad areas. We're discussing public health policy here, i.e. the ways in which governments can reduce harmful effects on the health of the populace through rules and regulations. My point was that if governments truly cared about public health, they would have already for example banned smoking universally (or at least in situations where there is another person within X meters of the smoker), since second hand smoke is a demonstrable cause of premature death. The justification would be one of public health. And if anything, such a policy would be even less controversial than mandating vaccines because a smoker can simply stop smoking temporarily to be around other people whereas people cannot stop breathing and therefore potentially spreading viruses. Yet it seems governments have skipped over all of these easier public health issues, and gone straight to mandating that people get vaccinated to enter publicly funded places from a public health justification. To me, regardless of how effective or not these mandates have been and are, I smell bullshit when I hear governments justifying such rules with public health arguments because they have not from their previous actions demonstrated that they are merely following through with their public health manifesto. I rather fear they're mandating vaccines to enter public spaces because the public demanded something be done. Governments in representative democracies aren't doing their job if they do merely that which the public want; they are supposed to lead even if the majority of the public disagree.

> My point was that if governments truly cared about public health, they would have already for example banned smoking universally (or at least in situations where there is another person within X meters of the smoker), since second hand smoke is a demonstrable cause of premature death.

You keep failing to see the logic in this argument you are making. The point is that the government will allow the individual to make whatever medical decisions they want to to the extent it only affects themselves and the people legally in their care, like children. You are not allowed to make those choices when they harm the health and well-being of those that fall outside that purview. You can smoke all you want, and harn your kids with second hand smoke, the same way you can choose not to get vaccinated and harm your children by refusing to let them get vaccinated. But once your choice affects the people around you, your freedom is restricted. You can’t smoke in public areas. And now some governments are making it so you can’t be unvaccinated in public areas. There is no hypocrisy here, if anything it’s the only logically consistent stance. The only difference is that you can “turn off” smoking when you go into public, and can’t do the same for being unvaccinated. But that is an issue for the unvaccinated individual to deal with.

This isn’t even restricted to medical interventions. If I own a private race track, I can drive however I want to, at whatever speed I want, in whatever kind of vehicle I want. But as soon as I want to use a public roadway, there are a litany of restrictions to those freedoms I am subject to, from the speed and the direction I can go, to the type of vehicle I can drive, because not doing so can negatively impact other people. Every society on the planet has had some form of restrictions of personal freedom when they start negatively impacting other members of society in a significant way. And refusing to be vaccinated in the midst of this pandemic harms society in a significant way.

To the children point specifically, the state rightly gives wide latitude for parental decisions and actions before it is considered child abuse. Mistakes certainly happen (in both directions) but for the most part society draws a reasonable line based on current norms.

> And refusing to be vaccinated in the midst of this pandemic harms society in a significant way.

Getting vaccinated can also harm oneself in a significant way:

Clot risk to 18-39s from AstraZeneca vaccine is twice as high as Covid death risk, Euro study finds https://www.irishexaminer.com/news/arid-40328123.html

Being forced to vaccinate in order to maintain one's livelihood is simply beyond the pale:

Covid-19: Mandatory vaccination violates fundamental right to livelihood, says Meghalaya High Court https://scroll.in/latest/998409/covid-19-mandatory-vaccinati...

"Vaccination by force or being made mandatory by adopting coercive methods, vitiates the very fundamental purpose of the welfare attached to it. It impinges on the fundamental right(s) as such, especially when it affects the right to means of livelihood which makes it possible for a person to live."

> I did mention in my comment above that children of smokers don't have a choice being around second hand smoke. Yet most governments consider the harm to the health of the child to be less critical than the smoker's individual freedom to smoke.

I don't think most people are suggesting mandatory vaccination of parents; the rules actually being imposed in developed countries are much more similar to indoor smoking bans (ie. you are allowed put yourself and your children in danger, but you're not allowed put the general public in danger.)

> Do we apply this thinking to any other public health threats? Smoking for example, particularly for those forced to be around smokers like their children?

Yes, of course. Most developed countries ban indoor smoking in most or all places outside the home.

I think the slippery slope argument this creates is what is frightening a lot of people.

Yes, you can let the others do the work and often be just as well off. Society is a giant prisoner's dilemma (or more like 'grifers dilemma') like that.

That's why vaxxes are not like seatbelts, i.e. just affecting the user, they affect everyone.

We take vaccines to protect others as much as we do ourselves, because if we act responsibly then things will work out, but nearly everyone needs to participate.

In this case it's a little bit like 'positive responsibilities'. Normally, we could say 'don't steal' and that would be enough, but in this case it leans towards 'get your vax' i.e. an active action.

It's not as black and white, it's reasonable to have conscientious and other objectors. And of course I don't think 'requirements' are necessary unless specific health concerns. But on the whole, by and large, we need to get vaxxed here i.e. we need enough civic participants to move the situation forward so that the various kinds of objectors can survive so as to maintain their right to object, ironically.

No you aren’t. A vaccine isn’t 100% effective. So say it prevents 9/10 COVID infections. If you are in an area where your normal probability of encountering an infectious level of virus is say 1/100, then your chances are 1/1000 of catching COVID. But if your local level of transmission is higher, so that your chance of contracting COVID over some time horizon is say 1/10, then your chances of getting ill is now 1/100.

And this all assumes that the vaccination works equally well for everyone. The effectiveness rates are and average. There will be people for whom it is highly effective, and others who get the vaccine who don’t get much protection at all.

It also ignores the reality of mutation rates. Mutations will happen no matter what, but the rate at which they occur is dependent on how many people are getting sick. So even if a vaccine offers protection now, if half the population is not vaccinated, and the virus is raging amongst them, then the chances of the virus developing a mutation that increases severity, or evades existing vaccine immunity, is much higher.

So the reality is that no, being protected is not a simple matter of an individual choosing to or not to get vaccinated. It’s community based. This isn’t unique for COVID either. It’s been true for every disease we’ve ever vaccinated against.

It's disturbing to me that depending on what argument is being made, the vaccines are both highly effective and simultaneously not effective enough. It doesn't get to be both when it's convenient.

Why is it disturbing? Can both not be true?

Both those things are true, though. In fact, both are true of most vaccines that are actually in use; perfect vaccines are rare.

Please explain how something "is X" and "is not X" at the same time, without changing the definition of X between assertions, and without referring to quantum superposition.

It seems obvious that many medical treatments/pre-treatments clearly lead to generally good outcomes (or are at least better than the untreated case) while many of them are still less effective or have more side effects than we would like.

We can say the same thing in many domains. Modern car safety has improved a lot and makes cars from a few decades ago look like deathtraps in comparison. But way too many people still die on roads so we're constantly trying to make improvements.

That's a long way of saying that you're changing the definition of X between assertions. "Effective" doesn't mean the same thing in both contexts.

Vaccines are highly, but not perfectly, effective. The definition is the same, it's the adjective that's changing.

For true immunity without anyone else needing to be vaccinated they'd need to be perfectly effective. Since they're not, more of the community needs to be vaccinated. The less effective they are (or the more widespread or infectious the virus is) the larger the proportion of the population that needs to be vaccinated becomes.

If you have the polio vaccine, you basically cannot get polio and have lifelong immunity. That's an effective vaccine. It doesn't require everyone else to get frequent booster shots. The current covid vaccine does not measure up to the polio vaccine.

Vaccine effectiveness goes up the more people have them. So let’s say a vaccine confers 60% immunity (not what the actual vaccines provide, whose numbers are much more complicated), that is basically friction that slows the virus’s spread around. Now, if almost everyone is vaccinated, that friction is enough for the virus to fizzle out and the pandemic to end. If only a few people are vaccinated, then the virus still has a lot of friction free hosts to infect, and because it is thriving, it can even mutate faster to get around the vaccine’s friction.

Think of the vaccine as a collective attempt to stop the virus, not as a personal attempt. The more people are vaccinated, the higher chance this pandemic will end and we can get back to normal. Anti vaxxers are extremely annoying here. Also, hopefully the vaccine is approved for children soon.

Having survived Covid is better than some vaccines; forcing people to then pay Pharma companies is kind of a funny response, especially when there are still many people in the world that are under lockdown that want vaccines, you can easily argue it is not ethical.

> I don't understand this attitude. Yes vaccines aren't 100% perfct but they are a whole lot better than nothing. Same as masks.

This is only true for both if there are no side effects to doing either of them. If there are side effects, and there are, then it is not that simple.

I don't know why, but with COVID, people seem to have conveniently forgotten that in science, all factors matter. [1]

[1]: https://gavinhoward.com/2020/08/in-science-all-factors-matte...

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