Biden to mandate coronavirus vaccine for federal workers | Hacker News Reader

Biden to mandate coronavirus vaccine for federal workers

npr.org

99 pointszerobias409 comments

As a part-time libertarian, one of the frustrating parts of the pandemic has been discovering how many people need the nanny state to step to stop them punching themselves in the face.

Near the start of the pandemic, I thought the most intrusive state powers would barely be needed. Why would you ever need to make a vaccine mandatory? What rational person would refuse a lifesaving medicine offered to them for free?

Well, I've got my answer.

> What rational person would refuse a lifesaving medicine offered to them for free?

Somebody who has already had covid. They've already taken on risk - why expose themselves to more?

Your argument of people acting rational breaks down in a lot of cases. Plenty of people have self destructive behaviors (many with externalities that affect others) that we are ok with.

If you've had COVID, a vaccine can help with Long COVID symptoms, and it can reduce the risk of reinfection, so it's still better to be vaccinated than to catch COVID a second time.

The vaccine reportedly can also trigger a more severe immune response in people who already have naturally-acquired antibodies.

Try to find good statistics on the rates and severity of adverse reactions for people who have already have COVID. I've had very little success.

This. And generally the possibility of more severe immune responses after vaxing. (Like with dengue for example) It is obvious these are a problem, and it's obvious we do not talk a out that right now.

Saying the vaccine is a perfect solution that will solve all our issues is just dellusional

There is no evidence of that with this vaccine, and with the number of people who have received it we would have collected that evidence by now, so stop spreading hypotheticals.

This is not something you usually notice until years into using it. Even the heart inflammation thing did not show in studies and only months after vaxing, and instead of more severe immune responses on infection this is something that happens immediately and not years later.

This is all just loud thinking at this point. But it's something you regularly find new studies too because it seems to be a concern.

The reason the heart inflammation think didn't show up is because of how rare it is, not the amount of time passed. If the issue you are talking about is that rare, than my argument still stands.

As to something appearing years later, that seems extremely rare and could happen without getting the vaccine, just being exposed again to the virus. Oh, and neither of us are the people that should be evaluating that because we aren't medical researchers who have closely studied the incidents of vaccines causing reactions years later. I will trust the people who have extensively studied the problem.

By now, the COVID vaccines have been given to an extremely large sample size so even very rare side-effects would be known by now.

Similarly, because vaccines train your own immune system without staying in your body, it’s extremely unlikely for a side-effect to be delayed in time for more than weeks. Note the timeframes on the relevant historical examples:

https://www.cdc.gov/vaccinesafety/concerns/concerns-history....

https://logfall.wordpress.com/absence-of-evidence-fallacy/

The questions to ask are -- how do we define rare? how do we define time to elapse before results show up?

When that rare or time-lapsed event occurs, what is its severity?

Most importantly, what is the severity of the original event (covid infection) to the particular individual?

This risk varies widely between individuals, and parts of it are very much subjective.

For an external entity to make an objective judgement without even considering all the factors is the sign of tyranny.

All evidence is that it still is a greater risk to not get vaccinated if you've had COVID than to get vaccinated. A lot of bullshit "reportedly" happens. That's why the CDC sets guidelines based on the based scientific evidence available and says you should get the vaccine whether or not you had COVID. Stop spreading disinformation.

To be a bit blunt - I made an unsupported assumption, which I called out explicitly by the use of scare quotes. You have responded with an unsupported dismissal.

I am most assuredly not spreading disinformation.

> All evidence is that it still is a greater risk to not get vaccinated if you've had COVID than to get vaccinated.

Source for the above?

The additional risk is nearly-zero and vaccination provides additional protection even in cases of prior infection.

I feel exactly the same

Punching yourself in the face, or nanny state discussions, is more akin to something like a seat belt law. We have seat belt laws to stop the individual from hurting themselves, not because we're afraid they're going to launch out as a projectile and hurt others.

But vaccination is a community thing more than an individual thing. If it were just about hurting yourself, then I'd agree that the discussion should be framed as paternal.

You're absolutely right - getting vaccinated protects your family, your community, and your country.

What I mean by punching yourself in the face is: Even if you don't have any family and you hate your neighbours, getting vaccinated is still in your own interests, because it stops you dying.

I encourage everyone to get vaccinated if they can, but it's unclear what community protection that provides. Vaccinated people can still get infected and spread the virus. They may be contagious for a shorter period on average but the magnitude is still unknown.

https://www.nature.com/articles/d41586-021-02187-1

Since the Delta variant is so contagious there will be no significant herd immunity effect to protect the unvaccinated. The virus is now endemic and can't be eradicated so all of us can expect to be exposed multiple times throughout our lives.

https://www.businessinsider.com/delta-variant-made-herd-immu...

Vaccination almost certainly reduces transmission.

https://www.timesofisrael.com/80-of-vaccinated-covid-carrier...

RNA levels spike to the same levels on PCR, but they decline faster, and culturable amounts of virus are lower in breakthrough infections, indicating a higher proportion of viral debris in breakthrough infections rather than virus:

https://www.medrxiv.org/content/10.1101/2021.08.20.21262158v...

Even if you take the worst numbers out there vaccines still eliminate 50% of infections. And symptomology, viral load and transmissibility are correlated -- which means the vaccines is likely to be effictatious against transmissibility just like it is against disease.

The worst-case idea that breakthrough infections, even though they're much less severe, produce identical risk of transmission does not make any sense at all.

I would bet money that if everyone was vaccinated that the R0 of delta would be less than 1.0 and we would not have epidemic spread and that breakthrough superspreaders are incredibly rare.

What is your scientific basis for betting that Prof. Pollard is incorrect? Even though vaccination likely reduces the risk of transmission, we have no evidence that even a very high level of vaccination would be sufficient to reduce R0 below 1.0. It's impossible to reach 100% coverage and even countries with high vaccination levels are still experiencing uncontrolled community spread. We can flatten the curve to an extent (useful for reducing impact on the healthcare system), but it's unlikely that we can significantly reduce the area under the curve.

What evidence does he have of actual transmission? I want to see actual studies with humans with breakthrough infections giving infections to other humans. I'd like to see one contact tracing case where a breakthrough infection was the index patient that spread it to multiple people at a given venue.

I've already posted studies which contradicts the idea that breakthrough infections are equivalent to unvaccinated infections in terms of actual live viral load, which should show up as reduced transmissibility. And the reduction in severity of symptoms with vaccination is highly unlikely to come without a corresponding reduction in transmissibility. What is his scientific data showing that viral loads, symptoms and transmissibility have somehow become completely decoupled?

And we seem to have forgotten that most of the spread of this disease is caused by individual superspreaders. Only 20% of the infections are responsible for 80% of the forward transmission. If vaccines reduce severe transmission the same way they reduce severe disease then they could very well have a disproportional impact on r0.

> It's impossible to reach 100% coverage

The fact that we can't hit 100% coverage doesn't imply that vaccines in the population that we can vaccinate aren't highly effective at reducing transmission.

Also if you're just making an argument by authority, then go watch all the recent TWiV episodes. I don't necessarily agree with Herr Professor Doktor Racaniello about everything (delta really is a lot more transmissible/virulent), but the whole crew there would tend to agree with me, and wants to see the real transmissibility studies with real humans infecting real humans.

This is not an argument by authority. There is strong evidence of significant Delta variant transmission by vaccinated people.

https://www.nature.com/articles/d41586-021-02187-1

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effective...

https://doi.org/10.1101/2021.07.31.21261387

The point is; Is it more (/less/no change) transmittive vaccinated vs unvaccinated? If it lowers transmittion only a tiny bit it's still net positive.

That nature article is still repeating arguments which conflate studies of Ct values of RNA with infectious virus and don't address the fact that vaccines reduce symptoms and that Ct values drop faster in vaccinated individuals.

The CDC article doesn't say anything other than "People who get vaccine breakthrough infections can be contagious" without any citation.

The actual study you cite only tests for viral RNA not infectious virus, they only cultured a single sample from a breakthrough infection to show that it could happen.

Other studies have found that viral RNA drops faster in vaccinated individuals, and that levels of culturable virus are lower at peak in vaccinated individuals indicating the presence of more viral debris than infectious virus:

https://www.medrxiv.org/content/10.1101/2021.07.28.21261295v...

https://www.medrxiv.org/content/10.1101/2021.08.20.21262158v...

We also know that viral loads are correlated with transmissibility and symptoms, and that vaccines reduce severe symptoms. We know there's less infectious virus in breakthrough infections and that they're less severe. It is rational to expect a reduction in transmissibility.

I'm afraid you're probably correct. I fully support vaccination, am vaccinated and support vaccine mandates. Still, the fact is here in Britain high vaccination rates are not stopping the propagation of the virus. Maybe if we also had a full lockdown as well that combined with vaccination might stop it spreading, but that's not a reasonable policy given the low risk of the virus to the vaccinated population and young people.

A full lockdown is not practical, nor would it be effective. SARS-CoV-2 has multiple animal reservoirs. So even if we could somehow eliminate it from all humans simultaneously (we can't), someone would just catch it from an animal again and the whole pandemic would restart. The bats which presumably transmitted it to humans in 2019 are still out there somewhere.

You still don't have high enough vaccination rates.

All the kids under 16 have a vaccination rate of 0% and they still count and they commingle and provide a reservoir. The vaccination rate in 16-25 year olds is also probably not high enough to achieve herd immunity with delta. It isn't a particular mystery why its still spreading unless you assume kids don't exist.

A single number for vaccination status and herd immunity would only be meaningful if the population was randomly well-mixed. In reality kids are much more likely to see other kids every day than hang out with the elderly.

Estimates for case rates among under 16s are up to 50%, half of them may well have had it already. They also fight it off fairly quickly and the vaccine doesn't stop you getting it. Add all that together and there rally doesn't look like a compelling case for vaccing kinds, at least in the UK.

We are rolling it out to 16-17 year olds, which happens to be the ages of my kids and both had their first shots about a week ago. There may be some marginal benefit for youngsters, but those dose are better deployed elsewhere. Over 17s are already well vaccinated here.

I'm not at all anti-vaccine, they've transformed the UK, but there's just no point vaccing under 16s. We're deep into diminishing returns with that, and those doses are sorely needed in many other countries.

> it's unclear what community protection that provides

Maybe against community spread of infection.

The protection vaccines provide against overloaded hospitals, tragic avoidable deaths and paralysing additional lockdowns and mask policies is clear, though.

The Yale/Harvard/Stanford team at https://covidestim.org estimates that R has receded under 1 for most states / counties. Much better than a month ago. This is a good indication we are past peak delta. The medical system was stretched in places, but held. While the vaccines help keep the pandemic under control and the human cost bearable, it doesn't follow that we need 100% vaccination rate for community protection.

Not only that, but there seems to be a campaign against the press actually informing people about the limited effectiveness of the vaccine at preventing infection and spread. The stat that actually matters is the relative reduction in risk of vaccinated people catching Covid-19 compared to unvaccinated - it's what dictates things like whether it's possible to get herd immunity via vaccination, and whether events that would turn into superspreading incidents without vaccination still will now. But there's this narrative being pushed that it's wrong and misleading based on nonsense stats like the total percentage of cases which were unvaccinated over a time period that includes a major wave which ended before widespread vaccinations were available, or the absolute risk of someone who's vaccinated catching it (which is worthless as it depends mostly on the prevalence of the virus, and Covid spreads exponentially).

This all seems to be done in order to blame unvaccinated people - and more specifically unvaccinated Republican voters - for the fact that Covid is still spreading and causing deaths and economic damage. (Vaccination rates are also dangerously low amongst black Democrat voters, but of course it'd be politically unacceptable to blame them in the same way). The press keeps pushing the narrative that we could end Covid and all the damage it's doing if not for those evil unvaxxed people, even though this doesn't seem to be borne out by the experience of countries with higher vaccination rates or the scientific evidence.

Humans are not rational creatures. Our beliefs can override rationality & that's true regardless of how smart you think you are. That's why you have Christian Scientists being convicted for child abuse/neglect for not providing a reasonable standard of medical care ("reasonable" being defined as "commonly accepted behaviors in our society"). Similar issues around beliefs would apply around vaccines, especially with extremely high levels of mistrust of the opposite party AND a historic amount of anti vaxxers generally. Would Democrats be accepting the vaccine so quickly if the bulk of the rollout happened under Trump? I don't know but I certainly had misgivings that the Trump government was playing politics fast-tracking the vaccine that evaporated when Biden came to power for some reason. I probably would have still taken the vaccine, but is that because I'm being rational or because I'm anti anti-vaxxers?

There is some just skepticism of anything that happens under Trump. The dude talked about injecting bleach into your veins. Come on.

He never talked about putting bleach in your veins. He spoke about putting UV light and disinfectants inside the body. Both are obscure, but real treatments.

Edit: https://youtu.be/zicGxU5MfwE

This is Trump minutes before the infamous quotes:

https://ichef.bbci.co.uk/news/976/cpsprodpb/AA47/production/...

In a society in which if you do something stupid that causes massive but not immediately fatal injuries to yourself you will be taken to an emergency room and likely given expensive treatment even if you do not have adequate insurance or enough money of your own to pay for that treatment, thereby passing the cost on to the rest of us in terms of either higher medical costs or higher taxes, it is a lot harder for it to be just about hurting yourself.

See e.g. obesity crisis. Or medicalized end-of-life costs. Sadly, we pay for expensive stuff people do to their health all the time.

Obesity is in itself a sickness in many cases. I think the implication that people "do it to themselves" really ignores the large pile of evidence that shows that it's really difficult to treat it effectively. Similarly other examples such as alcoholism or other substance addiction suffer from the same issue.

When it comes to vaccine hesitation I am not sure where to draw the line. It's a very emotional topic apparently and it seems rational arguments only go so far.

That said, I think if a society only treats those medical emergencies deemed to have a "non-egoistical" cause Pandora's box will come to haunt us sooner or later. We should save humans whenever we can. That's just the cost of doing business so to speak.

> But vaccination is a community thing more than an individual thing.

Right. It's more like running red lights in an absolutely massive armored vehicle. Little risk to self, potentially fatal consequences for others.

Similar to drunk driving laws.

No. Seat belt laws are put in place by car insurance industries. The states that do not have them have the insurance industry lean heavily on the legislature on how much money it will save each user. Then the commercials are run about how you do not want to see a person launched from their car and impaled on the power pole.

The populace is increasingly being treated as children and pretend adults in leadership. We will force you to wear a seat belt or else. Force you to take a vaccine, circumstances be damned. The ACLU prior to their destruction pre power grab warned us all about what is about to happen… more things will be forced upon us “for our own good.” We are about to have a purge of the government and never has a purge of a government gone well.

further to this, a car manufactured can be liable if the seat belt does not work. You can sue the car manufacture company. You cannot sure Pzifer for example for vaccine side effects.

I disagree with people using or referencing to the seat belt law. A seatbelt can be removed and adjusted to a person. A vaccine cannot. Each individual human being is unique and they will react very differently. I agree that the demographic that are hit the hardest exponentially by covid should protect themselves (60+, obese, other underlying conditions) but everyone else should use discretion and if you don't plan on getting it, there should be alternate measures in place.

That a seat belt can be adjusted does not change the discussion, even a little bit, as to whether seat belt laws are paternal, or whether COVID vaccinations are of communal consideration.

> Each individual human being is unique and they will react very differently.

Even if society had an extraordinary scientific revolution where medicine was conducted on the basis of a special science just for your body, it would still not change the framing of whether vaccination is of communal concern.

Can you imagine ICUs already overwhelmed by covid in a world without seatbelts and airbags? Or ever-increasing safety standards in general. Times like this emphasize how what seems like individual choices can have major social consequences.

'But vaccination is a community thing...'

A vaccine goes into an individual body, so it is a personal thing subject to medical privacy.

You can choose to wear a seatbelt. You can’t un-inject a substance from my body.

...that is why I could never be a libertarian. People have repeatedly proved themselves unwilling or unable to live up to the libertarian ideal of behaving "rationally."

Even rational actors can ruin things deeply. E.g. government intervention is necessary to have network-neutrality.

There's nothing inherently inconsistent between right-libertarian values and a vaccine mandate.

Libertarians believe that force should be applied to person A to protect person B from person A in certain circumstances.

If person A wants to punch person B in the face, restricting person A by force is perfectly consistent with libertarian values.

If person A threatens to infect person B with a deadly disease due to refusing a vaccine, then a vaccine mandate has some justification under the same ideals. The devil will be in the details (e.g., how deadly is the disease, etc).

It's also why a carbon tax and many other measures are not inherently inconsistent with libertarian values on a first principles examination.

But for some reason, libertarians in practice tend to dislike these policy proposals, even though they can follow in principle from the founding axioms. I attribute that to group-think and a general disbelief in the existence of negative externalities, not to a problem inherent in libertarianism.

People are libertarian for different reasons. Some of them just hate government and look for an ideological framework to justify it. I would say that driving licenses are a similar case.

Except that you don't need a driving license to drive, only to do so on public roads. These mandates are similar, you can be as un-vaccinated as you like as long as you stay at home.

The similarity I’m drawing is that being out and about unvaccinated and driving without proper training both put others at risk, which violates NAP. Therefore both can (arguably) be mandated inside of a libertarian framework.

Exactly! Not getting a vaccine violates the all-important "NAP". Of course most self-professed libertarians likely would think of a short rest and not aggression when they hear NAP, as its become a generic anti-government term rather than the nuanced political ideology it once was.

Wait…what? You think forcing a person to accept a substance into their body under force isn’t inconsistent with libertarian values? As a classical liberal, I can’t think of something more offensive to my values and I am a fully vaccinated person and wished everyone else was too. This is absolutely f’ing horrifying and will ultimately be used against everyone at some point in the future.

The body is the absolute individual. Having maximum control over the individual is probably the most basal libertarian value there is. This is not some external restraint to prevent the commission of a crime. It’s not even punishment for a commission of a crime. It’s the mandated forcing of a substance internally into an individual’s body against their will with a sketchy societal benefit behind its justification. Sketchy because now with Delta there is apparently no scientific basis to believe that the vaccines eliminate the risk of spread of the virus but at this point it only seems to prevent serious illness.

BTW, watch as the GOP uses this mandate to justify the individual state prohibition of abortion. They will be able to too, because this is going to pretty much kill the DNC’s ability to win anything for at least 8-10 years.

We are not talking about forced vaccination. I'm referring to the workplace mandates where people are still free to not vaccinate if they wish, just as their employer is free under at-will employment to kick them out.

But even if we consider literal forced vaccinations, I still don't see that as necessarily inconsistent with libertarianism, due to the reasons I outlined, specifically the non aggression principle.

Suppose that a new disease emerged that had a mortality rate of Ebola and a transmissibility of COVID. Suppose we had a vaccine that was capable of stopping transmission. In such a rare and extreme set of circumstances, forced vaccination (not even mere mandates in workplaces) would be a must under the NAP. The right to choose not to vaccinate is effectively the same as the right to kill people with a disease that you may carry.

Luckily COVID isn't as deadly as that, and the vaccines aren't as effective at preventing transmission, so we don't need to consider such measures. But in the right context, I very much see forced vaccinations as following from libertarian axioms. Just like you would see jailing a serial murderer and depriving them of their liberty to be justified under those same axioms.

For the record, I'm one of the most anti-collectivist people you'll meet. I just pay significant credence to the reality of negative externalities. You can swing your fist all you want, but you can't punch my nose with that fist. In the same vein, you can't cough your deadly virus into my face and not expect to justly have force applied to you.

I think your NAP argument doesn’t really work for a very specific reason. Every punch in the face results in a punch to the face. Every homicide results in a death. Those actions always have an aggressive consequence, so most libertarians can justify prevention and incarceration and removal of liberties as a consequence of the aggression. However, every cough, even from a Covid-19 positive person, does not result in a death…or even an illness. Further, even a vaccinated person could cough and infect someone if they had COVID-19, including another vaccinated person. So is it truly aggression if there is a possibility of no negative consequence and a possibility of a negative consequence no matter which direction was chosen? I think you could maybe make a NAP case if the vaccines were a 100% effective and the unvaccinated ALWAYS caught and passed on Covid-19 causing severe illness. We aren’t at that stage, so this fails the NAP test in my opinion.

No, because I am also rightly not allowed to throw a brick out of my apartment window without looking below, because that might plausibly hit someone in the head. Most bricks that I could throw out my window won't hit someone in the head, but that doesn't mean that it should be legal for me to do it, because it is recklessly endangering people.

Same situation if I put a single bullet into a revolver, spun it, and pulled the trigger while aiming at someone's head. There's only a one in six chance that I'd murder that person, but that action should definitely be illegal and force should be applied to anyone who would pull that trigger.

This is why we have drunk driving laws. Some non-drunk drivers do kill people, and most drunk drivers don't kill people, but the probability is highly elevated for drunk drivers, and it is therefore illegal to do it. Drunk driving laws aren't authoritarian, they aren't a result of a nanny state. This is the state fulfilling its duty of protecting person B from aggression by person A, whether that aggression happens with absolute certainty (punching me in the face) or with an elevated probability (drunk driving)

Now, I don't think vaccines should be forced on people for COVID. I just think that it's a valid thing to do in the right circumstances (e.g Ebola with an R0 of 3).

Drunk driving laws are punitive. They allow the individual freedom of choice. The equivalent in this scenario is locking someone up because they own a car and a liquor cabinet and could drive drunk and kill someone. Then also giving them the keys to the prison bus to drive around the prison yard while providing an unlimited supply of pruno.

You are right that there's a big distinction there. But at the same time, I was attempting to point out that it's not only certainty of outcome where the NAP applies. We all accept that the NAP can validly apply in some situations where an aggression is probabilistic rather than guaranteed.

Let me outline an alternative situation where an individual would have no freedom of choice, but where you might agree with the measures imposed. Suppose we identify the first case of Ebola in the US next year. Do you support forcibly quarantining that person? Such an action is eminently necessary in my opinion. But at the same time, such an action violates the two things you've laid out: (1) it doesn't allow the individual any freedom of choice, (2) it is not guaranteed that they'll spread it and is therefore restricting their freedoms merely on the probability of aggression.

But—they have Ebola. The problem with a mandate of an imperfect vaccine on a person presently without Covid is they don’t have Covid. Frankly, I’d be ok quarantines imposed on Covid patients just like your Ebola scenario.

My problem is the whole “Minority Report pre-crimesque” aspect of it all. It’s an unnecessary aggression imposed on an individual to maybe or maybe not prevent a something that maybe or maybe not would have happened anyway.

A vaccine that was 100% effective and was 100% safe is probably the only way you can make an argument work. But if it was a 100% effective and a 100% it’s likely you wouldn’t need to mandate it anyway.

That appears to be a distinction without a difference. Even though they already have Ebola, they may not infect someone else.

P(infect another) = P(get the disease)*P(transmit after getting it)

With the Ebola example, that's P_Ebola = 1.0*P(transmit after getting it).

With the COVID example, that's P_COVID = 0.3*P(transmit after getting it).

Both of these are sub-1 and not guaranteed to happen. In fact, P_COVID may actually be larger than P_Ebola depending on the relative R0 and assumptions we plug into the above calculations. So I don't see why the distinction you raised has relevance.

Detaining someone with Ebola, which we both agree is a good idea, is also a pre-crime measure, because they haven't infected anyone yet and they may never have infected anyone even without detention.

And I will also point out once more (due to your second sentence) that I do not support forced vaccinations for COVID. The COVID disease just isn't deadly enough and the vaccines aren't effective enough at preventing transmission for me to support that. I am merely saying I do support it in the abstract if a sufficiently deadly contagious disease comes about in the future.

One is a known effective reaction to a danger. The other is an ineffective proaction to a possible danger. If you are going to violate someone’s liberty, you better have a damn good reason to do it.

They're both possible dangers, even though you're trying to frame the Ebola example as a certain danger, which it just isn't, since there's a very decent chance that they won't infect anyone even without detention. It's not valid to label one as "reaction" and another as "proaction". They're both pre-crime measures for possible dangers. Neither of them is a certain danger.

It is also not "ineffective" in the hypothetical I was discussing. You seem to insist on the point that I wish to hoist forced vaccinations for COVID, which I don't. I'm strictly speaking in the abstract given a hypothetical where there's a vaccine capable of preventing transmission of a disease that is much more deadly than COVID.

But I agree with your main point that the circumstances should be very extreme before such measures are considered. If there's a contagious disease that is killing 10-50 percent of infected people and early quarantine measures have failed and we have a vaccine that seems effective at preventing transmission, then I'm probably in support of forced vaccinations, although I suspect it might not be necessary since everyone will be desperate to get it.

Actually, I really don’t think we are really that far off from each other, as we are both making the distinction that an effective measure coupled with an extreme situation would be needed.

I’m more concerned with the existing proposed mandate, because it is not hypothetical and I don’t think it satisfies either test (an extreme situation with an effective prevention).

A hypothetical Ebola situation would be different animal just because of the mortality rate being around 20+ times the average Covid rate. The other factor being who it kills. Ebola is pretty indiscriminate. Covid danger is significantly higher among elderly and folks with pre-existing conditions and it looks like many of those folks heeded the vaccination call (85%+ have at least a single dose in the US).

agreed

I think it is less about the concern that others will be infected with severe disease and more about the potential cost and stress that the unvaccinated place on the healthcare system.

The vaccine costs $20 per dose while COVID treatment in the hospital is $23K (in Canada - likely similar in the US).

Perhaps a less draconian approach would be to allow the unvaccinated to purchase additional insurance to cover these costs in the scenario where hospitalization is required.

[1] https://www.cbc.ca/news/health/cihi-covid19-canada-hospital-...

Behaving rationally isn't a particularly libertarian ideal. All political ideologies aspire to behave rationally.

Nobody stands up and starts with "Lets approach this irrationally and ..."

Where your comment went wrong was in conflating rational decisions made at the time the rules are made or enforced with routine rational choices made constantly by the population. It’s much easier to have a rule which says “always wash your hands when preparing food” than to have every single restaurant worker have to reason about the level of risk posed by what they’ve done since the last time they washed their hands. In particular, think about how many bad calls are made by people who believe they’re acting rationally but are acting on incomplete or bad information.

Libertarianism involves a state as weak as possible so it critically depends on people to individually make good choices for a society to be an appealing place to live. You can sue your neighbor if he burns old tires upwind but you’re really hoping he’s smart enough not to because that’s tedious, slow, and risks retaliation. If you don’t have the equivalent of Social Security forcing people to save for retirement, you have to make your peace with having destitute old people on the streets, etc.

Libertarianism doesn't rely on all people making individually good choices. It relys on power being extremely spread out so the blast radius of bad choices is contained and the law of averages comes into play because the median person makes ok to good decisions.

And people keep proposing systems that do worse than that and refusing to critically assess how their ideas work out in practice vs a free market.

Note the rest of the sentence where I specified to be a desirable place to live. Outliers matter: if you live on a block with 10 houses, you care more about the one which is falling apart and full of rats than the ones which are mostly okay.

> And people keep proposing systems that do worse than that and refusing to critically assess how their ideas work out in practice vs a free market.

Can you provide examples of the baseline you’re using to say that other systems do worse? Successful implementations, not idealized imaginings.

> Outliers matter: if you live on a block with 10 houses, you care more about the one which is falling apart and full of rats than the ones which are mostly okay.

What is the plan? Imprison the person living in the ratty house? Fine them into oblivion? I've never heard of a case of a town council taking over someone's house to repair it - I'm sure it happened somewhere once but that is quite the outlier.

I've seen plenty of dilapidated houses, and lived near some quite large rats. There is no reason to think it would be worse in a more liberal society.

> Can you provide examples of the baseline you’re using to say that other systems do worse? Successful implementations, not idealized imaginings.

goes to https://en.wikipedia.org/wiki/Human_Development_Index and scans down the list

Hong Kong, jewel of Asia? Switzerland is probably pretty decentralised too, they certainly have the most democratic government I know of. And the highest-ranked superpower on the list, everyone's favourite USA, is famous for having some of the strongest constraints on their government in the world.

To be honest, I'd be happy if we all just did what Switzerland does. I'll take extreme democracy over any specific ideology if pushed. We can argue the details later.

> What is the plan? Imprison the person living in the ratty house? Fine them into oblivion? I've never heard of a case of a town council taking over someone's house to repair it - I'm sure it happened somewhere once but that is quite the outlier.

If you have this little information about how societies work, maybe it would be a good idea to do some reading before making bold pronouncements about how hypothetical systems are better. Cities have various approaches and degrees of success so there are plenty of real world examples you can compare with details rather than treating it like a dorm room hypothetical.

> Hong Kong, jewel of Asia? Switzerland is probably pretty decentralised too, they certainly have the most democratic government I know of. And the highest-ranked superpower on the list, everyone's favourite USA, is famous for having some of the strongest constraints on their government in the world.

None of those are commonly considered libertarian states and they all have many examples of rules which most libertarians oppose (e.g. the Swiss gun control laws) so it would again be better to talk about specific real policies rather than hypotheticals which are too vague to evaluate.

> If you have this little information about how societies work, maybe it would be a good idea to do some reading before making bold pronouncements about how hypothetical systems are better. Cities have various approaches and degrees of success so there are plenty of real world examples you can compare with details rather than treating it like a dorm room hypothetical.

I've seen a lot of derelict properties in my time. It would appear nothing was being done.

What various approaches are you thinking here? I think it is more likely that you aren't paying attention to derelict properties and rats than that I've missed something. If a homeowner doesn't want to maintain their home then there isn't a whole lot that gets done about it.

> they all have many examples of rules which most libertarians oppose (e.g. the Swiss gun control laws)

Switzerland does have one of the highest guns/capita in the world though. Nowhere is ideologically pure, it isn't like you can point to an example of any state that is only driven by one ideology. China has capitalists, the US has socialists, the Europeans have literal Nazis, etc etc. Everyone has a mix of policies based on who is pushing what agenda. There is evidence that if the liberty-authority dial is pushed towards liberty then there are some shining examples of success.

But that is all beside the point I wanted to make - libertarianism just doesn't assume that everyone is making great rational decisions. That isn't how groups of people work. Libertarianism is just noting that the evidence government makes things better on average is questionable. Governments are routinely behind the worst massacres - which is certainly cause for a raised eyebrow and asking some questions. And given the regularity with which the financial system collapses it really isn't obvious the government is helping there either. Then regulation is either making us do things that would happen anyway, or blocking quick responses when the situation is changing radically (eg, the lockdowns were official enforcement of stuff I was largely going to be doing anyway).

> specific real policies rather than hypothetical which are too vague to evaluate.

Korea got the first coronavirus tests, and reliable ones, because they let private enterprise develop them. The US tried a government-led response and badly fumbled the first few months. The regulator was the source of the problems. More libertarian policies in the medical field would have prevented that.

Maybe we should give it a try? I mean it's not like our current approach is wildly successful...

I'm a libertarian and I think choices should be up to the individual, because it's never ok to have a political group decide for you what is good or bad. It's antithetical to western liberalism.

My rant aside, I think there are better and worse ways to infringe on people's liberty when needed. And given the way the winds are blowing, it would be much better to enforce vaccination at the federal level, i.e. compel people by law to get it. There can be exemption of course, but the point is it becomes between you and the state. The current patchwork creates all kinds of disparity, invades privacy be repeatedly making you tell others about your health and identify yourself, and burdens businesses and others with enforcement. It also lets the government avoid the ire of people who don't want a mandate, by moving the front lines of enforcement elsewhere.

I think business and local level mandates are more popular because they play on people's desire to punish the unvaccinated, instead of working positively to tackle covid.

I think part of the difficulty with the libertarian point of view regarding the COVID vaccine is that not all parties are given a free choice either. For example, if someone refuses a vaccine, should an emergency room be free to refuse care? Currently, they can not due to EMTALA.

That's not to say that it's unreasonable to question and philosophize the implications of a mandate. At the same time, barring a more effective plan, the implications of not having a mandate seem particularly horrific.

All the same, I do agree with you that if there is to be a mandate, that it's best to come from the federal government to create a uniform set of guidelines. I also agree that the patchwork of rules has been a mess.

> should an emergency room be free to refuse care?

Let’s say instead of “unvaccinated” that they’re actually wildly radioactive and suffering radiation poisoning. Should we treat that person, or turn them away because they could irradiate the ER?

"For example, if someone refuses a vaccine, should an emergency room be free to refuse care?"

No we shouldn't, we don't turn people away who drove drunken with 200km/h and crashed.

those drunk drivers may have caused collateral injury/death in their crash, but once taken to an ER they can't infect those around them with crushed limbs and twisted metal.

We treat children and adults with pneumonia (among other things) in the ER, and they can infect others. Some illnesses simply make folks sick enough for the ER.

I'd not mind a way to put folks further down the list if they choose to be unvaccinated or have folks have a special waiting room - but the ER is no time to figure out if someone chose to be unvaccinated or not. It would take up even more time and resources from an already strained system.

> For example, if someone refuses a vaccine, should an emergency room be free to refuse care? Currently, they can not due to EMTALA.

Should not refuse care. A lot of people have unhealthy lifestyles (eating lots of processed foods, sugary soda drinks, don’t exercise, smoke, …). We also don’t refuse healthcare to these people even if they make poor life choices.

Since many people on this site live and work in the USA, I would guess more likely than not plenty of people are obese here. You don’t magically become obese. Yet you deserve healthcare, since you pay taxes, pay for a health insurance, etc…

Also that leads to questions like should we refuse care for healthy but dangerous activities like swimming and drowning. Or breaking a leg or arm during sports? Or concussions? These clearly could have been avoided by choosing safer options or ways. Thus should be refused care?

When the ICU is past capacity, these questions must be asked regardless. Who gets treated first and why? Unvaccinated covid patients are the ones pushing ICUs past capacity, not drivers or swimmers or soccer players or obese people. This is not a hypothetical thought experiment. Doctors are having to make these decisions right now.

Actually most people with COVID needing extra healthcare are obese: https://www.radboudumc.nl/en/news-items/2021/patients-who-ar...

Also from March 2020: https://www.dutchnews.nl/news/2020/03/coronavirus-death-toll...

> Meanwhile, Diederik Gommers, chairman of the Dutch intensive care association, told television talk show Jinek on Friday evening that 66% to 80% of corona patients on intensive care wards that he had seen are overweight.

> A specialist on the programme gave a similar picture. ‘Almost all the patients on an IC ward are overweight,’ Peter van der Voort of Groningen University’s teaching hospital said.

Let's word this more sharply.

Hospital capacity being limited, should ill vaccine refusers be getting priority as they are getting right now?

What if you get super unlucky, and you get contaminated and severely ill despite vaccination? Will they kick an unvaccinated covid patient from the one respirator?

Even more sharply, should the willfully unvaccinated take priority over lower priority but less life threatening diseases? If someone has the flu, and it looks like they'll make it, but the doctor wants them in the hospital just in case, should they get the bed over the unvaccinated person who is going to die without it?

That sounds like something different where the answer is not so clear-cut.

I've tried to rephrase the wording of the ethical dilemma I came up with to make it more neutral:

Imagine there's two covid patients coming into hospital at the same time: one vaccinated, one not. Both are in need of the same care, with the same urgency. Only one hospital bed is available. Which, if any, of these patients should receive priority in treatment?

> For example, if someone refuses a vaccine, should an emergency room be free to refuse care?

This argument doesn't hold up. First, tying availability of medical care to the "right" behavior unconscionable at so many levels. In a developed country, do we really want to create a tier of disabled or unhealthy people that we've denied care to because we don't like their behavior (maybe dont answer that)

More practically, should you get interviewed at the ER intake and moved down in priority based on factors in your control that make you a higher risk? Smokers, sedentary people, the obese, lifestyle induced diabetics, people who don't go to the doctor regularly, you could probably compile a big list. What is so special about vaccines?

I think that refusing the get vaccinated is unconscionable at so many levels.

In many ways, I do agree with you. I don't want there to be multiple tiers of healthcare based on someone's lifestyle. I believe strongly that if someone is sick, then they deserve help.

At the same time, there are several implications of that ideal that affect us very personally right now. At the moment, a large portion of the hospitals are full. By now, I'm sure we've read the news reports, but in case someone doesn't understand what that practically means, I'll offer the following. Full means a combination of no physical space and no staff to provide care. Now, the hospitals have done a good job of creating physical space to treat patients out of tents, portable buildings, conference areas, and cafeterias, but many of them really don't have anywhere else to go. Of course, those rooms don't mean a lot if there's not enough staffing of which there is not. Certainly, you can ask the existing staff to do more and they have. A normal ICU staffing ratio would be one nurse to either one or two patients depending on the level of care. The reason that the nursing ratio exists this way is that the care they provide requires that kind of attention. For example, they're required to titrate multiple medications, which means adjust the rate of the drips to achieve some kind of affect such as blood pressure. This can be fiddly given how sick the patients are and, to be clear, this is only one of the many tasks they provide. Current staffing ratios are something like three or four to one in the ICU, which is not standard of care, but where we're at.

As a result of this staffing and space conundrum, we're now at the point where the physicians are essentially being forced to choose who gets to die. My wife is an ICU physician. This week she's working days and is on night call. Last night, about every two hours, they called her because they need hospital beds and none are to be had. They had a heart attack come in who needed a stent. Normally, that would go to the ICU afterwards, but, again, no beds. When that went poorly, her job was to go through the charts and figure out who they were going to bump from the ICU to a step down unit. All of the patients there needed ICU level care. If the rare cases when this happened pre-COVID, they would transfer to another hospital. All of the hospitals for hundreds of miles are in the same situation, full, and we're in a very large metropolitan area. A good portion of these patients will likely die from this reduced level of care when they would normally live.

Now, my point in mentioning this is not to appeal to emotion and perhaps persuade someone to get the vaccine. We're well beyond that. It's more to help understand the consequences of our collective action.

At the moment, the hospitals are filled with with COVID patients. Around 99% of them are unvaccinated. Now, if we are going to treat everyone equally, which both you and I agree with, they get to go to the hospital to be treated. As a result, the hospitals are full. Since the hospitals are full, reduced care is given. Since reduced care is given, more people get to die of ailments unrelated to COVID. That is precisely why COVID differs from something like smoking or obesity. Hospitals are not full due to smokers nor obese people. They are full due to unvaccinated COVID.

Beyond that, I can assure you that the medical staff providing this kind of care are tired and they all want to quit. It's not just the sustained, long hours, it's the complete and utter unwillingness of the general public to take a very simple, preventative step. Further, they're frustrated that the public comes to them to save their life after they get sick, but derides, abuses, and slurs them prior to that point when they tell them precisely how not to be in that situation. Again, this is not to appeal to emotion. We're past that. Another consequence of the pandemic going on like this is that they can and will quit. This will exacerbate the existing hospital staffing shortages and they are not easy to replace because it takes about ten years of training to become an ICU physician.

Really, truly, I do not like medication mandates. I understand; if a vaccine now, what later? That's fine. However, then we're left with a crappy choice. Either get people vaccinated as quickly as possible or be left with a partially collapsed hospital system.

> Hospitals are not full due to smokers nor obese people. They are full due to unvaccinated COVID.

thank you for sharing the anecdote of your wife's work scenario.

But you differentiate between vaccinated and unvaccinated in Covid.

Do you do the same for the heart attack victim that did not get the ICU bed? Did he smoke? eat junk food?

Should we categorize this victim as well, and likewise give them different levels of treatment.

taking it further, should'nt we ban cigarettes and junk food -- can't think of anything good coming out of them - except that the timelines for its effects are a little longer than covid?

It seems that smokers largely pay their way [1] since it is relatively easy to price the delta into the product and insurance premiums. Perhaps the unvaccinated could be treated a bit like smokers.

[1] https://pubmed.ncbi.nlm.nih.gov/2918654/

This is compelling people by law to get it. Biden is using a law that is on the books to compel people to get it. I don't see the problem here. Any law that would be passed would be just as patch work and also require people to give up medical information. Truthfully, at this point this just sounds like an excuse not to do it.

> Biden is using a law that is on the books to compel people to get it.

Do you just make things up? What law is it? Does he get to write it up? There will be legal challenges for it, no doubt.

It is one thing to debate where mandating is right or wrong under the circumstances, and yet another, claiming legitimacy for the action.

My takeaway is the opposite: I'm pleasantly surprised with how many people are vaccinated, and how quickly. It's hard to get 2/3rds of Americans to agree on just about anything.

When you look at the hold-outs, it's largely young people who are at very low risk of serious illness. (85% of 65 and older are vaccinated, but just 57% of people 18-29.) So it makes sense to me that they are more hesitant.

No, it's only been hard to get 2/3 of Americans to go along quite recently. Everyone lined up for vaccines in the 1950s and 1960s, numbers well over 90%.

Consider that in 1955 one of the companies producing the Salk Vaccine shipped 120,000 doses with live virus which sickened 40,000 children and sparked a polio epidemic.

https://en.wikipedia.org/wiki/Cutter_Laboratories#Cutter_inc...

And yet numbers were still 90%+, so what does that say about their views on vaccine usefulness?

Or does it just tell the story of a time without easily accessible open media?

Fair, although I could look at that open media as propaganda/brainwashing and reach a conclusion on media's effectiveness.

I can also look at the past and ask if vaccines eradicated the diseases it was meant for... and for that it was incredibly effective.

But is that even true? Have you seen this graphic for example https://postimg.cc/CBJQF4dZ

Edit:// I don't know how truthful it is. But vaccines seem not always the resolving factor. Source of the image: https://learntherisk.org/vaccines/diseases/

objectively, polio was eradicated via vaccine.

objectively, US had a fighting chance in its independence war due to George Washington's forced immunization of armies.

What you are sharing is proof that propaganda works. You are sharing non-scholarly articles from untrustworthy websites..

It's absurd because anyone can set up a website at anytime with charts/data saying anything we might want and reach any conclusion we want.

This is what you are sharing: https://en.wikipedia.org/wiki/Learn_The_Risk but I guess you did not do your own research on what you are consuming... Their arguments are disputed in the wikipedia links if you want to inform yourself.

> Arguments against vaccination are contradicted by overwhelming scientific consensus about the safety and effectiveness of vaccines.[7][8][9][10]

It's also a non profit set up by an antivaxer that has no research/investigative capabilities, all they do is gather donations and spread fake data to gather more donations.

It says they had their trust badly abused by the sort of people who push for universal vaccination, and learned from it.

Why should we consider it? Billions of people have been vaccinated without a vaccine-caused epidemic.

We do however have a virus-caused epidemic, currently.

It's just stark the difference between adults back then and the overly coddled people passing for adults today.

What are we supposed to learn from that example? Companies developed safer techniques, government testing plans improved, it sounds like the system was improved in response to the kind of thing which happens with new technology.

More importantly, however, it happened in an era where everyone agreed that polio was worth avoiding. The modern antivax movement was founded on Andrew Wakefield’s fraudulent attempts to cash in on test kits and lawsuits brought against vaccine manufacturers but it also critically depended on people who had grown up in a world of ubiquitous vaccination and preventative medicine, where vague claims sounded dire because the imagined baseline was “life is basically okay” rather than “I know multiple kids who died or were scarred for life” as their parents had known. Finally, there wasn’t a major political movement putting a billion-dollar propaganda machine to work spreading false claims and downplaying the real impact of a disease.

I have extended family--aunts, uncles, cousins--who all decided not to get vaccinated. There are young people who can't be bothered to do a damn thing, but hesitancy among a particular political persuasion is rampant.

People of that "particular political persuasion" have lost trust in most institutions. Unfortunately they're discarding some good things (like the vaccine) along with the bad.

It’s not just “that particular political persuasion”. It’s wide spectrum of folks. We love to single out that “political persuasion” but I think you will find that this mandate will frustrate and potentially financially hurt a lot of folks that are not of that “political persuasion”. This will of course make more people of that “political persuasion”.

But some of us see it differently.

You are telling me that I am not allowed to disagree with you.

There are vaccines. Everyone that wants a vaccine already got it or can easily get it. People say they are extremely good at eliminate severe covid, that's what I got one myself. But at this point taking a vaccine or not is a personal decision.

People are punching themselves in the face all the time, see obesity crisis for example. Should we ban hamburgers & fries next?

yes, if obesity were contagious.

If only vaccines were to prevent covid spread. 'CDC: COVID-19 Vaccines 66% Effective Against Delta Variant'.

https://www.webmd.com/vaccines/covid-19-vaccine/news/2021082...

What point are you trying to make? And why do you think a link to a single study without explanation would prove any point whatsoever?

That according to CDC data 1/3 of vax people are going to develop an infection. There is no way to purge covid infections from the population, not even with 100% vax rate. In a population 67% vaccinated or higher, there are going to be more vax infections than unvax infections. At which point choosing to vax oneself or not is not going to keep covid from spreading and becomes a personal choice.

If you are an adult, would do you good to get vaxed. But seems strange that the OP claimed to be 'libertarian' and yet in favour of forced vax. There is a big difference between 'this is what I think would do you good, but I'm going to respect your decision regardless' and 'get vaxed or else' position so many have embraced of late.

Vaccines can bring the R number below 1 from above 1, which means that it really doesn't spread out of control anymore, and becomes much less common in the population.

Thanks for mentioning R. For a bit of good news, current estimates are that most states/counties currently have R < 1, https://covidestim.org. Hopefully we've passed the worst of Delta. I have no doubt vaccines helped, though I'm unsure how much. Obviously we didn't needed 100% vax rate to get to this point. Comparing with the situation a month ago obviously something else other than vax (and/or masks) has had a big hand in the R reduction (hint, natural immunity).

What I am pointing at is that there is a population vaccination level beyond which further vaccination has diminishing returns. There are fundamental principles like bodily autonomy and human dignity that we shouldn't throw away just to chase a slightly lower R number, cumulative deaths with covid, or any hyperfocused metric we use to track the pandemic evolution.

PS. I hold the underlying assumption that covid is endemic and over the next decade we'll keep having outbreaks until everybody builds up sufficient natural immunity.

That claim is an article of faith in some circles but there is actually no reliable scientific evidence that even a high level of vaccination can drive R0 below 1. Transmission will slow down as more people gain some level of immunity one way or another but the virus is now endemic and all of us can expect to get exposed occasionally. Fortunately the vaccines are still very effective at preventing deaths.

https://www.businessinsider.com/delta-variant-made-herd-immu...

From https://www.nature.com/articles/srep37961 :

> In a social network, many phenomena have been found to spread interpersonally, such as biological games4, indirect reciprocity5, misinformation or rumors6,7, and infectious diseases8,9. Obesity is one of them10 and is often seen as a contagious epidemic1

> Everyone that wants a vaccine already got it or can easily get it.

Assuming you have luck and live in a rich country that offers one of the actually working vaccines.

Everyone is still a very far stretch

Everyone under the purview of Biden's decree.

People aren't allowed to drive drunk not because it's a risk to themselves, but because it's a risk to other people. This is the same with the vaccine. You are putting at risk children, the immunocompromised, or people who have legitimate medical reasons they can't get the vaccine, do your logic falls apart. Not to mention the risks and costs associated with an overburdened healthcare system.

Actually, refusing the vaccine isnt the same as driving drunk. To be in a situation where you're endangering others by driving drunk requires an action: drinking alcohol recklessly (action) Refusing the vaccine requires no action on the person's part, but somehow are still considered to be endangering others (even if they're healthy and without COVID).

If something is free, you are the product.

Air is free.

Lots of stuff is free without someone being a product.

I can make art for free if I really put my mind to it, and leave it in the forest for others to possibly enjoy.

Air isn’t manufactured by a corporation.

(1) It is population level rational to have diversity. Sometimes acting irrationally has payoffs because something wildly unexpected happens.

(2) There is an almost endless list of things people do that are to their detriment. A core part of libertarianism is that people have to be free to make their own mistakes. We don't mandate exercise, prudent spending, safe sex practices or sensible family planning. The reasons to mandate vaccination are not robust enough to justify mandating that either.

Although I think it is humourous that the "my body my choice" slogan is being studiously avoided by both wings of politics at the moment.

avoiding exercise doesn't cause people around you to get fatter though.

And everyone is going to get coronavirus sooner or later, regardless of how vaccinated the population is. Because if the virus was stopped dead by vaccination then it wouldn't matter what other people did, and if it isn't then ... vaccines aren't going to stop you catching it eventually.

Besides, there have been crazy ideas floated like making an issue out of vaccinating people who have already had & recovered from COVID. They're less likely to spread the coronavirus around than any other demographic.

> Because if the virus was stopped dead by vaccination then it wouldn't matter what other people did, and if it isn't then ... vaccines aren't going to stop you catching it eventually.

I'm not sure if you chose this binary line of thinking or if it was by accident, but you present the outcomes based on a 0 or 100% efficacy when it's not the case.

It matters/ed what other people do, and if more people got vaccinated (or could do so earlier) it might've stopped covid. Whether it could now is a crap-shoot, but more protection is always better than less.

> but more protection is always better than less

It isn't, immune systems are quite complicated:

"White House immunologist Dr Anthony Fauci offered the warning while giving an update on efforts to develop vaccines at an online US Senate hearing on Tuesday. He said: ‘I must warn that there’s also the possibility of negative consequences, where certain vaccines can actually enhance the negative effect of the infection.’ Dr Fauci later explained that in rare cases people vaccinated against a condition could end up contracting the virus they thought they’d been protected against, and falling more seriously-ill with that disease as a result" [0]

We should be letting people make their own choices.

[0] https://metro.co.uk/2020/05/12/americas-top-coronavirus-doct...

You're quoting something from May last year, before there was vaccine, where he was expressing a general disclaimer about the (very) small potentional for enhanced pathogenesis when creating vaccines.

This is not the case with the covid-19 vaccines. So yes, regarding covid, more protection is always better than less. The rest of my points were also specifically about covid, as is apparent if you were to quote its entirety.

> We should be letting people make their own choices.

Should people make "their own" decisions on how much diesel exhaust their cars produce, or whether they can carry around airborne nerve gas?

It could still happen. There are going to be more waves of coronavirus that are better adjusted to work around the current crop of vaccines. Nobody has a crystal ball for this stuff. That is why the scientific bodies keep talking about "evidence" and "no evidence" instead of making blanket claims.

Plus if I recall correctly there is some evidence that people who get COVID after being vaccinated (ie, breakthrough cases) get worse cases. We haven't had time for the Phase IV trials yet, so it is entirely possible that there are some interactions that haven't come to light yet.

> Should people make "their own" decisions on how much diesel exhaust their cars produce, or whether they can carry around airborne nerve gas?

Yes to the diesel. And no to the nerve gas.

But I'll point out that coronavirus is quite different to nerve gas - you're going to be exposed to it anyway regardless of vaccination rate. And statistically speaking, the person who exposes you is likely to be vaccinated.

> Plus if I recall correctly there is some evidence that people who get COVID after being vaccinated (ie, breakthrough cases) get worse cases.

Please find the source, otherwise I assume this is from misinformation around Israel statistics, which doesn't say that at all.

> Yes to the diesel.

"The excess emissions of harmful nitrogen oxide (NOx) exhaust gases can be linked to 38,000 premature deaths worldwide, according to the new research." [0]

[0] https://www.newscientist.com/article/2131067-diesel-fumes-le...

> But I'll point out that coronavirus is quite different to nerve gas - you're going to be exposed to it anyway regardless of vaccination rate.

[citation needed]

> And statistically speaking, the person who exposes you is likely to be vaccinated.

Misleading. Please tell me adjusted to group size which group (vaccinated/unvaccinated) is more likely to expose me.

> Please find the source

On reflection, it didn't make any sense. Obviously the worst case scenario for covid is death and so it isn't possible for a vaccine to make breakthrough cases worse.

Regardless, you're still wrong. It isn't the case that more protection is always better. We know that there are circumstances where a vaccine can make a disease worse. And we don't know what future variants of the coronavirus will do.

On the diesel; yeah, it causes deaths from air pollution. Lots of things do. Life is not without risk.

> [citation needed] ... Misleading.

I mean; it is kinda obvious that COVID isn't going away. And you can tell from the case numbers that it is mostly vaccinated people getting it, because there aren't enough deaths for it to be raging through an unvaccinated population [0].

It isn't misleading, it is just facts.

[0] EDIT - Eg, New York is at around 33 deaths v. 4,400 cases in the last 7 days. CFR of 0.7%, let alone IFR. Compared to a batting average of around 55k / 2 million cases overall which is >2%. Suggests around 66% of cases are among vaccinated people minimum, maybe higher.

> Regardless, you're still wrong. It isn't the case that more protection is always better. We know that there are circumstances where a vaccine can make a disease worse. And we don't know what future variants of the coronavirus will do.

I'm still wrong because I point out based on facts that I'm correct? The covid vaccines are much better than no vaccines.

I'll throw in another point:

"For every 10 million people who receive the first dose of AstraZeneca, about 66 more will suffer from a blood-clotting syndrome than during normal circumstances, according to the study published in the British Medical Journal. This figure compares with 12,614 more incidences recorded in 10 million people who have tested positive for Covid-19." [0]

> On the diesel; yeah, it causes deaths from air pollution. Lots of things do. Life is not without risk.

Is your freedom not impeding on other peoples freedoms (to live)?

> I mean; it is kinda obvious that COVID isn't going away. And you can tell from the case numbers that it is mostly vaccinated people getting it, because there aren't enough deaths for it to be raging through an unvaccinated population.

> It isn't misleading, it is just facts.

"Prevalence in those aged 5-49 was 2.5 times higher at 0.20% (0.16%, 0.26%) compared with those aged 50 years and above at 0.08% (0.06%, 0.11%)." [1]

It would've been nicer with more exact data, but older were vaccinated earlier, and ages 5-12 have 0 vaccinations yet.

Your "facts" seem based on simple reasoning that I can't reconcile with what I consider facts to be, nor do I agree with the reasoning to begin with.

[0] https://www.bloomberg.com/news/articles/2021-08-26/blood-clo...

[1] https://spiral.imperial.ac.uk/handle/10044/1/89629

> I'm still wrong because I point out based on facts that I'm correct?

No, you're wrong because you said "more protection is always better". That isn't true - sometimes the protection turns out to be worse than nothing.

> Is your freedom not impeding on other peoples freedoms (to live)?

There isn't a freedom "to live", it doesn't mean anything. Everybody dies in the end no matter what. Nobody has ever had a "freedom" not to catch diseases, if I had that one I'd have exercised it a few times in the past; I don't like throwing up.

> "Prevalence in those aged 5-49 was 2.5 times higher at 0.20% (0.16%, 0.26%) compared with those aged 50 years and above at 0.08% (0.06%, 0.11%)." [1]

They only opened up vaccinations to people aged under 40 in May, and it takes a few months to get both doses of the vaccine and that paper was issued in mid June. I'm not sure that tells us anything. Obviously if the majority of a population is vaccinated then unvaccinated people will be the majority of cases, that isn't in question.

> Your "facts" seem based on simple reasoning that I can't reconcile with what I consider facts to be, nor do I agree with the reasoning to begin with.

We're not disagreeing on any numbers here. I doubt you consider your reasoning to be superior due to excessive complexity.

> No, you're wrong because you said "more protection is always better". That isn't true - sometimes the protection turns out to be worse than nothing.

You're arguing the semantics of "always" while ignoring the context provided. You're trying to win an argument, regardless if it's relevant to the topic.

The protection against covid (the vaccine/s) isn't worse than nothing. That is a fact, and what I'm arguing. You're stating I'm wrong, by carefully navigating around that into something entirely pointless.

> There isn't a freedom "to live", it doesn't mean anything. Everybody dies in the end no matter what. Nobody has ever had a "freedom" not to catch diseases, if I had that one I'd have exercised it a few times in the past; I don't like throwing up.

So does that mean that I have complete freedom to endanger others with my actions? I assume you don't think so, so there's obviously a line somewhere.

> They only opened up vaccinations to people aged under 40 in May, and it takes a few months to get both doses of the vaccine and that paper was issued in mid June. I'm not sure that tells us anything. Obviously if the majority of a population is vaccinated then unvaccinated people will be the majority of cases, that isn't in question.

That is exactly the point. The prevalence is 2.5 times higher in a group with much fewer vaccinations.

> You're trying to win an argument, regardless if it's relevant to the topic.

Are you not trying to make an argument? I would suggest you challenge yourself about why you are arguing so much if you don't want to. You have the option of stating your opinion then leaving it at that.

> The protection against covid (the vaccine/s) isn't worse than nothing. That is a fact, and what I'm arguing.

If you don't mean "always" then you should take the easy path and say "Well, you're right it isn't always better, but it is different words". Some people got vaccinated and then died from it - it is pretty clear that is worse than nothing. It is hard for the outcome of a vaccination to be worse than death. It is most certainly not an unalloyed good, there are risks even assuming the manufacturers don't stuff it up.

> So does that mean that I have complete freedom to endanger others with my actions? I assume you don't think so, so there's obviously a line somewhere.

Sure, but people being unvaccinated isn't the biggest risk, particularly since something like 30% of them have probably already had COVID and developed antibodies the natural way - and the diesease may well burn through the unvacced population before the authorities manage to strap them down and force-vaccinate them. If you go down the list of risks from biggest to smallest, the larger chance is getting COVID from someone who is vaccinated and never had the original disease.

I was talking to a doctor friend of mine who was emphatic that the vaccines didn't stop the spread at all, and I didn't understand why at the time but I've since learned it was probably because the vaccines didn't target the mucosal immune system. So it doesn't make sense to forcing people to do something they don't want to do, for a not-that-meaningful gain (everyone is still going to be exposed to coronavirus sooner or later, vaccines or no).

But it could weaken your immune system, making you a better vector for all kinds of diseases.

Why not let them? A lot of things can only be learned through hardship.

There are two things a vaccine can do - protect you, or protect society. Their greatest benefit is when they protect society by dampening the spread/severity of a pathogen to a level low enough that society can function essentially normally.

If a sizeable chunk of the population chooses not to participate in that collective action, they endanger themselves (which can be argued is their fair choice), but also those around them who are unable to take the vaccine. There is no individualist refusal to vaccinate, the effect is still collective, just in a negative direction.

The whole point of democracy and freedom is that you convince people with words and not with sticks. If people are refusing a vaccine, that means you (as the political class, media class, scientific class) have failed your job to educate a segment of your population.

It is easy to blame people for what could be your shortcomings. But this is not 5% or 10% of your population, it seems to be around 40-50%. This is more of a crisis of faith on both public and private institutions and it certainly doesn't get fixed with sticks and by removing more rights (and thus reinforcing the believes that made these people refuse the vaccine in the first place).

It doesn't help that major components of the "political class" are being the biggest babies and spreading straight up disinformation. Sure, we shouldn't have to have a mandate, but we are now at the point where it makes no sense not to have one and people can't see that because they are being routinely lied to by people that have the vaccine and by organizations that have the mandate.

> It doesn't help that major components of the "political class" are being the biggest babies and spreading straight up disinformation.

Again, this is your shortcoming. It doesn't get fixed by forcing people to have something injected inside of them and have their movement restricted by sanitary passports.

Where does personal responsibility come into the equation? You say it's someone else's fault they haven't educated someone, but that someone has to carry some responsibility on being receptive and to evaluate information, no?

Being persuaded and being informed are hopefully related, but demonstrably different.

This is not "my" shortcoming. This is a shortcoming of the system that we have to make up for in some way, like having a vaccine mandate.

"The whole point of democracy and freedom is that you convince people with words and not with sticks."

This is just false, though. The whole point of democracy is to allow folks to have a voice in their politics, not to avoid forcing folks to do things. We force folks to do things all of the time. This is what laws do: Sometimes they are easy to follow, but we also know that if we don't have, say, building codes and food safety laws that some folks will cut too many corners building or add weird things to bread (like in the 1800's).

Simply put, you aren't always going to be able to use words. And it seems vaccinations are similar.

The problem with free choice is that people often make the wrong choice. -The Chinese Communist Party and Michaelt the Libertarian.

> What rational person would refuse a lifesaving medicine offered to them for free?

Every rational person. If i gave you a free medicine (drugs for example) will you take it ?

The problem was that the political class undermined all trust in vaccination: promising more liberties to vaccinated people, contradicting the responsible state agencies ( this was the worse they could do), pouring money in Pharma companies and then buying their products ( looks like corruption), lying that the vaccines have been tested but in reality they had express approval, dismissing other vaccines ( Sputnik) for political reasons and forcing the people in a so called lockdown which (except in some countries) had no effect on the pandemic because the measures were pure propaganda (for example the child must stay in quarantine but the rest of the family, not)

Not to forget not standing to higher moral standard by going beyond and above in showing example.

For the same reason that, in a completely libertarian society, people will not buy police insurance and fire insurance and thus provide financial support for a police force and fire company. It's too idealistic and shows the limits of the invisible hand. Governments specialize in risk externalities and black swan events, and COVID-19 falls under both of these scenarios. What's clear from all this is that pandemics and wars show the weakness in the Libertarian philosophy and yes, giving government this kind of power is both dangerous and necessary. "If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary." - Federalist 51, Alexander Hamilton.

List of folks who refuse it:

1. Young, healthy and fit people who don't have any prior medical conditions. I checked the stats in Canada and I have a lot more chances of dying in a car accident than COVID in my age group.

2. Minorities who have had very bad treatment by the medical community in the past. Numerous examples of blacks, Latin Americans, indigenous being used for experiments.

3. Similar to point 2, anyone who's low income and therefore had poor treatment by the medical community.

4. Everyone who's already gotten natural infection immunity. There's numerous studies of this being much stronger and longer lasting. While they also say that an extra vaccine might boost the immunity slightly more too, there's very little benefit imo, especially if you are already young and healthy.

5. Many vaccinated folks also oppose vaccine mandates because that requires disclosing personal information. Quebec's vaccine passport app already got hacked including name, date of birth, IP address and which vaccines. And the Quebec government was very dismissive of this whole thing too which didn't instil any confidence in them.

Vaccine mandates are also opposed by many in the minority community as they know this is just another reason which will cause more law enforcement actions.

Here's Aba & Preach, 2 of the largest black YouTubers of Canada, explaining why they oppose such vaccine mandates even though they themselves are vaccinated. They explain how historical poor and unethical treatment explains why many minorities or those from poor families are skeptic of the health care institutions:

https://www.youtube.com/watch?v=k6yHSIqsT9g

https://youtu.be/Kt1FsXdrX5I

So there's many reasons of not getting the irreversible, non-long term tested, declining efficacy and short lasting vaccine. There's no guarantees of how many boosters and how often they will be required. Israel is already talking about the 4th booster shot.

Also this whole mandate thing just makes the public even more accepting of more surveillance.

I personally know several POC who chose not to get vaccinated because the CDC suggested at one point that for “social justice” reasons that POC should be vaccinated first.

A rapidly developed vaccine using new experimental tech, with an emergency use approval…and someone in our government suggests that the black folks should line up first. Talk about clueless.

Yep. Just a few days ago, even the NYTimes reported that only 27% of the blacks in NYC are vaccinated and the number one reason for hesitancy was lack of trust in the vaccine. Many people even mentioned how they got extra skeptical when they decides to vaccinating blacks first which was a pure optics failure.

The vaccines were as close to a literal miracle as I've ever seen in my life. We got several different vaccines that worked within a year of the pandemic hitting. There was no guarantee that we'd ever get working vaccines, let alone so many so fast.

Depressing that it wasn't enough.

Because it's not lifesaving medicine for them? Vaccines are lifesaving for old and obese, not so much for anyone else who is pretty much at zero risk from COVID, yet most of the people are harassed with restrictions and forced vaccination if they don't wanna be discriminated for being healthy and taking care of their health unlike obese filling hospitals.

This and the existence of commons are the primary issues with libertarianism.

If you want to build a system as large as 300,000,000 people, you need some way to control the dynamics of that system so that outliers don't cause catastrophes, and the larger the system, the more extreme the outliers you'll encounter.

Yes, that is a fantastic argument. Better have someone else come in that is many times stronger than you and punch you in the face. Great solution!

Gosh, disturbing comment section for disturbing times. When experimental medical treatments become mandatory for illnesses that have a 99%+ survival rate, and there is absolutely NO LONG TERM safety data, some red flags should be raised.

https://www.youtube.com/watch?v=Jktvh6k0qys

What about the long term safety data on catching / surviving COVID itself? Long COVID seems to affect between 10-30% of people who catch COVID. Why do I never hear anti-vaxxers being concerned about that?

Because its mostly undefined what long-covid even means. In the worst cases it means organ damage, but Ill bet you anything those are not anywhere near 10-30% of cases. More likely people randomly feel like shit for a while sometimes, like every other year in my adult life.

Which is exactly my point - we don't know what or how prevalent the long term effects of COVID are.

Agreed. But I guess I'm the odd-man out to err on the side of "not-fear".

> I'm the odd-man out to err on the side of "not-fear".

I'm not sure what this means. So you got the vaccine then because you're not afraid of it, right? Or you didn't get the vaccine because you're not afraid of COVID-19?

I am also not afraid really of COVID-19 but I got the vax because I'm also not afraid of that. Mostly I'm afraid I'd get it and then pass it to others where that could have been avoided by me just not being lazy for a second. I don't feel like an odd-man though.

Swine flu took me several months to fully recover. Nobody made this a topic back then but i know some other people who too had issues for months.

I put long COVID in the same bucket at long Lyme, which doesn't actually exist. It's a pretext for hypochondria, not a legitimate basis for public policy.

While I don't doubt that such psychosomatic disorders exist, there is simply not enough data yet to make such a strong statement. There are numerous reports of people not recovering their sense of taste / smell months after catching COVID, on top of all of the hospitalized people reporting symptoms long first catching it. It's not like there isn't legitimate evidence of this: https://time.com/6093164/long-covid-19-largest-study/. Obviously, it'll take a lot of time and care to sort out the effect that the lockdowns / hospitalization have vs. just the disease itself, and it's entirely possible that the mental effects of the lockdown play a large role in these prolonged recoveries.

But still, it's a novel, deadly disease which has a significant impact on the respiratory system (and perhaps the vascular system as well). The human body and our immune system are incredibly complex. It's far too reductive to categorize all of these collective experiences as just "hypochondria".

And it's not like post-lyme is a fiction either: https://www.hopkinsmedicine.org/news/newsroom/news-releases/...

Ah yes, Long COVID the self diagnosed symptoms that surprisingly coincide with those that you would expect if you told a society to lockdown for 18 months.

For a nuanced take on long COVID I recommend Scott's post: https://astralcodexten.substack.com/p/long-covid-much-more-t...

> Gosh, disturbing comment section for disturbing times. When experimental medical treatments become mandatory for illnesses that have a 99%+ survival rate, and there is absolutely NO LONG TERM safety data, some red flags should be raised.

The current case fatality rate is averaging around 2%, but that's with access to medical care.

The CFR at the early stages of the pandemic, and in countries without good medical systems, is much higher. See Italy during the first wave, which peaked at around 15%, or several Central and South American countries, which have averaged between 5% and 10%.

> The current case fatality rate is averaging around 2%, but that's with access to medical care.

This is an order of magnitude off from what the data actually say.

https://assets.publishing.service.gov.uk/government/uploads/...

See table 4.

Delta: total cases: 92,029 Deaths within 28 days: 117

100 * (117 / 92,029) = 0.127%

No, not anywhere close to 2%. 5%? 10%? It never got anywhere near that.

This disease just isn't that deadly and we need to recognize that.

Your pamphlet was published in June, at the start of the Delta-variant infection spike. On average, it takes eighteen days before someone infected with COVID-19 passes away from it.

The UK had 769 COVID-19 related deaths over the last week, which was up from 654 the week before. Source: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

The UK has had a total case fatality rate of 1.9%. Source: https://coronavirus.jhu.edu/data/mortality

> This disease just isn't that deadly

Vs. 4.6M dead worldwide, discounting 2nd order excess deaths.

How can you be so blithe?

The world has almost eight billion people.

Without vaccine/lockdowns and too many people in need of hospitalization would it still be 99%?

What's your definition of long term? mRNA vaccines are built on science started 30 years ago, are being made by companies founded to make mRNA vaccines 10+ years ago, and have been to numerous trials for many years now.

The current set of vaccines have been fielded for nearly 2 years. How long term do you want to get?

I find it interesting that full approval has not affected people calling the vaccines "experimental" in any way. Seems that this goalpost was never real in the first place.

I learned something very interesting the other day. Historically, virtually all cases of vaccine side effects occur in the first few months. I honestly can't believe I haven't seen this more widely discussed. It makes the concerns about "long-term safety data" mostly moot. By now, we have plenty of the relevant safety-critical data that we need for the covid vaccines.

Here is the director of the Alabama Vaccine Research Clinic discussing the issue [1]:

> “Vaccines are just designed to deliver a payload and then are quickly eliminated by the body,” Goepfert said. “This is particularly true of the mRNA vaccines. mRNA degrades incredibly rapidly. You wouldn’t expect any of these vaccines to have any long-term side effects. And in fact, this has never occurred with any vaccine.”

> “The side effects that we see occur early on, and that’s it,” Goepfert said. “In virtually all cases, vaccine side effects are seen within the first two months after rollout.”

[1] https://www.uab.edu/news/health/item/12143-three-things-to-k...

Regardless of where you stand with this policy, you gotta give it some Kudos:

It's a very efficient way to cleanse your entire bureaucracy of doubters.

I can't think of another example where a democratic republic, which by definition includes a spectrum of opinions, has its whole bureaucratic hierarchy re-aligned with the ruling party's platform.

Maybe this is due to the fact, that this is inherently undemocratic?

If the only difference between political opinion is whether you get vaccinated or not, you're already a monoculture.

The people being "cleansed" here are the crazies (of any political flavour).

The majority of black American population?

Maybe this is due to the fact, that this is inherently undemocratic?

SCOTUS ruled that mandatory vaccines are constitutional back in 1905. https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

The rationale in that case doesn't apply here: the COVID vaccines don't stop the spread of the virus. Because COVID vaccines can't actually stop the spread of the disease under any plausible level of vaccination (the R0 of the virus is too high), vaccines can serve only to safeguard the health of individuals, and we generally don't use heavy-handed nation-wide mandates to force people to do things that are merely good for them health-wise on an individual basis.

The same reasoning that justifies this mandate would justify a state-imposed limit on daily calorie consumption, a state-imposed exercise requirement, and all sorts of other coercive measures that, while good for people's health, are flagrant violations of principles of bodily autonomy and informed consent for medical treatment.

This isn't about the vaccine and it's not even about COVID. This is about one political tribe using the state to hurt the other political tribe.

We don’t need to eliminate transmission for the vaccines to be useful. My understanding is that they do meaningfully reduce transmission, even for Delta.

You are also missing another important factor. In addition to reducing transmission, the vaccines greatly reduce the chance of hospitalization, which together significantly reduces the peak load on the health system so that it continues to function well and serve non-COVID patients. In many areas, hospitals were nearing or at capacity due to the recent Delta surge.

I don't think reducing transmission matters that much as long as R_0 is above 1. If it's above 1, everyone is getting this thing.

There are 2 separate issues. Reduce transmission, which it only does marginally. Preventing hospitalization is a separate matter and not really worthy of a mandate. Banning alcohol and fast food will save far more lives, in that case.

> Reduce transmission, which it only does marginally.

91% is a huge reduction.

"COVID-19 vaccines ... reduce the risk of infection by 91 percent"

https://www.cdc.gov/media/releases/2021/p0607-mrna-reduce-ri...

Maybe so --- but places like Iceland still have big COVID waves despite very high vaccination rates, so clearly, the vaccine doesn't reduce the risk of infection enough to stop the spread, and that's what matters.

With the delta variant, experts believe we need 90% vaccinations to achieve herd immunity. Iceland is at 72.8%.

There is every reason to believe that the vaccine would stop the transmission once enough people had the vaccine.

Does that 90% include cats and deer? Believe what you want, though the fact is the animal virus reservoirs mutate and transmit to humans, so the 'rona will be with us for approximately forever.

Alcohol and fast food are not infectious diseases that can spread through entire populations in a matter of weeks.

Vaccines don't stop the spread. Look at Iceland. Any argument of the form you're making is invalid.

They significantly reduce spread.

Undemocratic does not mean unconstitutional. The Electoral College is undemocratic, yet constitutional by definition, for instance. SCOTUS itself is undemocratic yet constitutional.

> Undemocratic ...

The USA has always been a Representative Democracy. We elect leaders whom have the power to enact rules and laws. And this is what happened here.

Don't confuse what we have with "direct democracy".

Note all the "reasonable" and "great danger" in the decision. It's unclear (and to be determined) if covid fits that description

What do you mean, it is unclear? Do overfilled hospitals not create a great danger?

> It's unclear (and to be determined) if covid fits that description

700,000 people have died in the United States 18 months, 4.5 million world wide.

Like, what else needs to happen for this pandemic to meet that description?

Jacobson v. Massachusetts was a case about smallpox vaccination. For context, smallpox kills about 30% of those who are infected and the vaccine is so effective that the disease has been completely eradicated. Covid-19 is a lot less deadly than that and all indications are that the vaccine for it isn't remotely as effective at preventing infection and spread.

Vaccination is not a political position. Vaccines only work if a large majority of people are vaccinated and people who refuse to receive the shot are putting everyone else in danger. A basic function of a government is to protect public safety, and that is what a vaccine mandate does.

Your vaccine does not work unless someone or everyone else has one? Has this been observed with previous vaccine products?

Everyone getting vaccinated has clear benefits, and helps avoids breakouts. See mumps, measles, polio, etc.

Well, probably not the people with myocarditis or Bell’s palsy.

Yes:

https://en.wikipedia.org/wiki/Breakthrough_infection#By_dise...

https://en.wikipedia.org/wiki/Herd_immunity

Do not think in terms of "your vaccine," because vaccines are about preventing the spread of a disease within a population.

The Delta variant is so contagious that there will be no significant herd immunity effect. So I would encourage everyone to get vaccinated to protect themselves.

https://www.businessinsider.com/delta-variant-made-herd-immu...

Yes but here immunity is impossible :-/

https://www.businessinsider.com/delta-variant-made-herd-immu...

> Vaccines only work if a large majority of people are vaccinated and people who refuse to receive the shot are putting everyone else in danger.

I assume by "work" you mean herd immunity (I can't make sense of the statement otherwise), but even 99% vaccinated regions are seeing transmission because the Covid vaccines are not sterilizing and do little or nothing to reduce transmission. Herd immunity arguments don't apply here.

Citation needed, because that contradicts the CDC's guidance:

https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

"people fully vaccinated with an mRNA vaccine (Pfizer-BioNTech or Moderna) are less likely than unvaccinated persons to acquire SARS-CoV-2 or to transmit it to others"

emphasis mine

"less likely" is bureaucratic weasel language which could encompass a percentage reduction anywhere from 1 to 99 percent. But what the CDC specifically said in the Provincetown study is that "vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated." https://www.washingtonpost.com/health/2021/07/29/cdc-mask-gu...

Also from that article: > The breakthrough cases are to be expected, the CDC briefing states, and will probably rise as a proportion of all cases because there are so many more people vaccinated now. This echoes data seen from studies in other countries, including highly vaccinated Singapore, where 75 percent of new infections reportedly occur in people who are partially and fully vaccinated.

Clearly it has become a political position. A progressive way of thinking about this move is to depoliticize it by making it the enforced norm because it's a stupid thing to politicize. A cynical view is that it'll force non conformers out.

But its hardly novel to make government employees do politically slanted things. I'm sure a lot of government employees on the democrat or neutral side felt strong opposition to demands made of them during the trump admin.

I'm for this one.

COVID vaccination may have become a political position, but vaccination in general is not. Where are all the debates about MMR, hep-B, polio, etc.? We have required vaccinations in our children beginning in infancy for generations, and I am not hearing any governors or representatives saying that we must end the practice.

Each of these illnesses you state is multiple times more serious than covid. And each of their vaccines had the clear benefit of being an actual vaccine.

Covid was the third leading cause of death in the US in 2020. Just because it’s not a uniform risk profile across the population does not make it an unserious disease.

Hepatitis-B is more serious than Covid-19?

By what criteria?

Not only did you come forward with a political position while stating that it isn't, you are also wrong about what the vacines do and do not protect. If vacines didn't protect the person taking them, there wouldn't be any use to them at all.

For comparison the flu shot prevents infection in about 60% of people who receive it. The point is not to prevent infection in every single person who receives the shot, it is to prevent infection in or transmission from enough people that the virus will not spread from person to person.

Vaccination is not a political position in the US. We require children to receive numerous vaccines from infancy onward and that policy is broadly supported across the political spectrum, and has been for generations now. Where are all those political debates about the polio vaccine, or MMR, or hep B etc.? All I hear are crickets...

The flu shot is not mandatory, nor should it be. Partly becase low effectiveness, partly because it's sensitive to mutations, partly because the risk of complications, while not zero, is relatively low.

Polio vaccine is a bit of an outlier. 3 doses give 99% effectiveness.

MMR 2 doses is 97% effective against measles and 88% against mumps.

The jury is still out on how effective mRNA is against covid delta, studies are all over the place, 42% to 96% for Pfizer. A lot of people are concerned that mutations evading the vaccine are likely to occur, including Pfizer CEO.

https://www.cdc.gov/vaccines/vpd/polio/hcp/effectiveness-dur...

https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

https://www.healthline.com/health-news/heres-how-well-covid-...

>Vaccination is not a political position in the US.

Antivaxers aren't new, but it became a serious political question/fight when the covid vacine hit. As for right now there was multiple post about it on /r/politics.

Just because you do not think it should be a political issue does not mean it isn't.

By that argument you can sate your hunger by forcing me to eat a sandwich.

Vaccines only work if a large majority are vaccinated

Thats not true at all. If I get vaccinated it reduces my risk of serious disease - the vaccine works.

it's not about cleansing doubters, but rather political opposition. and it's never been about effective pandemic mitigation from either major party. it's entirely about flexing and coalescing power.

no matter what your political affiliation might be[0], we should always oppose such naked political power-grubbing.

[0]: note that i'd strongly argue against having one, not just as a matter of principle, but simply to make politicians really (rather than superficially, as it now is) work for our collective and individual support.

In Texas to be a public employee you must certify that you will not boycott Israel. This is an actual political position that’s disallowed.

Under Biden’s change (correct me if I’m wrong), I can believe whatever I want about vaccines and say anything (so: have a political position)… as long as I get vaccinated (this is not a political position).

Not to mention that both ruling parties at the top are urging all to get vaccinated.

> Not to mention that both ruling parties at the top are urging all to get vaccinated.

Ah good, the stuff they come together on is always really great.

Yep same with my primary care physician, my kids pediatrician, wife’s OBGYN, and the health authorities of… y’know what damn near everything.

On the other hand the dumbest people I’m related to are fiercely on your side. So maybe I need to do some more research.

Funny.

Certifying to not boycott something is hardly comparable to have something injected into your body.

While with the latter your livlyhood dangles on an administered injection of a substance into your body (and probably regular boosters) any pledge to not do something in private is virtually un-enforcable and thus just lipservice.

Are you not familiar with the concept of people getting fired for stuff they do outside of work? How on earth, with at-will employment, could this be unenforceable?

And no they’re not comparable, that was the point of my post. One is enforcing a particular political belief on your employees, the other is a routine public health measure, similar to other vaccine requirements I’ve been subjected to.

PS without this requirement I’m being implicitly required to inhale morons’ virus spray as a condition of my employment.

Most of the "doubters" on Fox News had their vaccinations already. Why wouldn't it be the same for doubters in government?

Isn't this an unnecessary medical procedure for people who have already recovered?

CDC says vaccines are still better: https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr... https://www.ncbi.nlm.nih.gov/search/research-news/12157/

This paper says natural immunity better: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

Unfortunately the science is evolving so fast and the variants are coming so fast, it's impossible to keep up!

because the science is evolving so we shouldn't have to mandate those who already have natural immunity. Will coercing someone who has natural immunity to take a shot or lose their job be truly that much more beneficial to justify? I don't think so and it's ethically wrong.

My antibody test was more painful than the pair of injections.

Vaccination doesn't harm people with existing antibodies (they just rebuff it faster) and going through the process serves as a good booster.

You don’t know this. We don’t know this.

We have to stop making these statements so casually about things that haven’t been studied.

What? They have been studied. For this and for other vaccinations. Kids get duplicate MMRs all the time because of lost paperwork.

Sometimes it feels like a new virus comes along and people forget we have 111 years experience with vaccinations.

It's not even the same technology.

But the method is identical. Get cells to present the proteins you want blasted. One uses direct mRNA deposition, the other hoodwinks denatured viruses into doing exactly the same thing.

mRNA isn't a scary new thing, it's a fundamental part of cell function. The clever new thing here is that we can bung it directly into cells to make proteins without having to mess around with carrier viruses.

Hundreds of millions of people have been exposed to covid and have also had a vaccine now, so even forgetting that there's no theoretical problem here, it has a physically tested track record.

What medieval test did you get?

I got the finger prick with a drop of blood. Quick and simple. Biting my tongue is much more painful.

The finger prick was more painful than the jabs.

Fingers are sensitive. Upper arm muscle isn't.

If you can't figure out whether natural immunity or vaccines are more effective based on the information we have available, the problem is with you, not the science.

The headline of that CDC article is misleading: the actual study compares the protection given by being previously infected with that given by being previously infected and then also vaccinated. There's no comparison against people who're relying only on vaccination to protect them. This is also a pretty weak justification, since if I remember rightly there's a comparable improvement by using one of the more effective vaccines rather than one of the less effective ones or possibly by increasing the number of shots required for a complete course of vaccination - but there's a huge taboo about noticing the difference in effectiveness between vaccines. (Also, I think this mandate kind of incentivises people to get the least effective of the US-approved vaccines, since it's a single shot and that makes it quicker and easier to meet the requirement.)

Plus, the article is old (before delta) and an opinionated piece by one of the most biased news outlets ever. yikes....

I don’t have the links, but studies from Israel and UK are showing 9x to 27x better protection by acquired immunity over vaccine.

Google around and you should find these.

It's a bit disingenuous to omit that they showed even higher protection in those who had previous infection and a vaccine.

The time wasted trying to confirm a previous infection would be better used just getting a jab.

Yes, mostly. Prior immunity needs to be considered.

Yes indeed. In fact vaccine studies generally exclude people who have already recovered so we are literally flying blind for these people. If there is no exemption then here are two middle fingers for whoever thinks this is a good idea.

Maybe. Vaccines generate a very predictable immune response. Natural recover results in a wide array of different immune responses, some of which are very weak and leave people susceptible to re-infection.

You can opt for regular testing instead.

IMHO the effective thing to do is to focus all our efforts on vaccinating 100% of those that will end up in the ICU (the elderly and those with co-morbidities).

These kinds of vaccine mandates get some of those at the greatest risk vaccinated but also ends up being a giant distraction in the US and makes it harder for the rest of the world to get the vaccines that they need as well. I think the blanket mandate approach is used because it is a lot easier for the leaders at the top to make these proclamations then to organize an outreach approach that actually reaches those most vulnerable.

That is not how vaccines or diseases work. Vaccines are never 100% effective at preventing infections or at preventing people from having to go to the ER. One vaccinated person surrounded by unvaccinated people will eventually contract the virus. A large unvaccinated population also breeds new variants, eventually resulting in vaccine-resistant variants that put those who are vaccinated in danger.

The fact is that a particularly vulnerable person is better off surrounded by vaccinated people even if they themselves are unvaccinated than if they are vaccinated but surrounded by unvaccinated people. This is a good and long overdue policy that should be widely replicated wherever vaccine supply permits.

It's the vaccinated population that breeds vaccine-resistant variants. Just like it's the antibiotic half-course that breeds antibiotic resistant bacteria.

As the vaccines are failing harder and harder, convenient to blame those that weighted long term risk over short term protection.

No, the unvaccinated population, where the virus keeps being replicated, breeds variants of all kinds; the vaccinated population applies selection pressure that favors vaccine resistance. If the entire population is vaccinated variants would not emerge at all because the virus would not spread from person to person (and would eventually disappear from the population).

Sadly, the ZeroCovid ship has sailed. Vaccines do not prevent infection or transmission (1). All vaccines appear to do is to (hopefully) dull the severity of the infection once you've got it. Plus now we have animal reservoirs, and no way to vaccinate those.

Edit: (1) Obviously we should talk about the degree of infection and transmission reduced by vaccines, and not in black/white terms. I haven't seen conclusive data, just the Israel Delta charts that are not particularly encouraging.

Please stop spreading disinformation. Vaccines have been shown in many, many studies to reduce the spread of COVID-19.

[Fair enough, reformulated for better nuance.]

Sadly, the ZeroCovid ship has sailed.

* Covid vaccines only partially prevent infection or transmission. To the best of my understanding even 100% vaccination cannot prevent outbreaks.

* We live in an 8bn people world + God know how many animal reservoirs. It is logistically impossible to vaccinate every living being susceptible of covid infection. We've got to live with endemic covid.

* Fortunately the toll on children and teens is very small, and the vaccines do work best in preventing severe cases across the entire population, which makes living with endemic covid a whole lot more palatable.

At some point we have to face the unavoidable. There will be variants, there will be outbreaks, hopefully the impact will be bearable.

https://www.healthline.com/health-news/heres-how-well-covid-...

https://www.nature.com/articles/d41586-021-00396-2

https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi...

https://assets.publishing.service.gov.uk/government/uploads/...

My understanding is that the delta variant originated in India. I’m not convinced that achieving a 100% vaccination rate in the US would accomplish anything.

Your statement is reasonable for sterilizing vaccines, and maybe even for this vaccine before the Delta variant.

However, this vaccine is non-sterilizing, meaning that it does not stop people from getting infected in the nose but stops progression to the lower respiratory tract thus preventing hospitalization. Before the delta variant the vaccines also worked surprisingly well at reducing infections, but with the Delta variant this is much less clear (if you have any links to studies on this topic I am very interested to see them).

Now we are risking the opposite situation. Most people that I encounter say "I am fully vaccinated" (so I don't need to wear a mask, take precaustions, etc). But the studies on these COVID vaccines have always shown that with great enough exposure the vaccinated will get infected and transmit that infection to others.

Citation needed? A quick search turns up study after study from one country after another finding that COVID vaccines both reduce the rate of infection and reduce the rate of transmission even with the delta variant.

You are right that people are overstating what the vaccine does, and that is where politicians actually have a chance to do something useful. Unfortunately there is a major political party that is doing the opposite, spreading false information, and shouting about "freedom" while working to stop local leaders from taking action...

Here is an article last updated august 13 2021: https://www.nature.com/articles/d41586-021-02054-z

"But studies on Alpha and other variants cannot be easily generalized to Delta, says Steven Riley, an infectious-diseases researcher at Imperial College London. [...] So far, there are no published data on how vaccines affect infections and infectiousness with Delta, but a UK study5 published on 21 July shows that the Pfizer–BioNTech and Oxford–AstraZeneca vaccines both protect slightly less well against symptomatic disease caused by Delta than against that caused by Alpha. This could also mean a drop in how well they protect against transmission of Delta, but there is still a lot of uncertainty, says Dean.

[...] Even if vaccines are just as effective at preventing infections with Delta as with earlier variants, if Delta is more infectious, transmission in households could still increase, says Dean."

I think the danger is that often the vaccine is presented as THE solution, i.e. when you get it you don't have to worry about anything. I know far more people who are vaccinated and just stopped being careful (social distancing, masks, ...) than people who haven't vaccinated that aren't careful.

But looking at studies out of Israel and the UK/EU we are seeing 9 to 27 times the protection from acquired immunity.

Therefore this protective layer you describe would be most quickly and effectively formed by letting people at low risk all contract the disease.

Trump derangement syndrome has been cleanly replaced with Covid derangement syndrome.

Executive Order:

https://www.whitehouse.gov/briefing-room/presidential-action...

Whitehouse briefing:

https://youtu.be/RSFRFVIJqC4

COVID plan:

https://www.whitehouse.gov/covidplan/

A new vaccine. Rushed to market. Pushed upon us before it was even approved. Then rushed to approval.

That's strange.

I need to get this vaccine, not to protect myself, but to protect you.

That's strange.

That's 2 strange things in a row.

When you see 2 strange things in a row like that, it smells fishy.

> I need to get this vaccine, not to protect myself, but to protect you.

> That's strange.

Can you elaborate? Not sure I get it.

How does my vaccination safe you (given you'd be my neighbor)? I mean it is still quite possible that I get infected by the CoV and that would mean that I'd transmit it, even though I might not have / have mild symptoms.

It's strange if you don't know anything about the subject. For the several billion people vaccinated all over the world there's nothing strange.

Which point are you replying to? Are you objecting that the OP's opinion about those two points being strange is somehow wrong or misinformed?

Related discussion (can the comments be merged into this thread?): https://news.ycombinator.com/item?id=28474997

Except, it seems, USPS 600k+ employees

https://nypost.com/2021/09/09/usps-exempt-from-biden-vax-man...

thus proving this is not about science, but political, e.g. to stop talking about the Afghan fiasco.

Not sure if you read the article you linked to.

> The USPS exemption was initially believed to allow postal workers to duck the private-sector mandate, too. But nearly four hours after that understanding was reported, the White House issued a clarification saying that postal workers will have a choice between getting vaccinated and getting tested once a week, just like workers at large companies.

“USPS is not included in the executive order requiring vaccination of Federal employees. USPS has a separate statutory scheme and is traditionally independent of federal personnel actions like this,” a Biden administration official said.

He added: “That said, USPS is strongly encouraged to comply. Also, [the Labor Department’s Occupational Safety and Health Administration] will cover USPS through the [emergency temporary standards], meaning that postal workers will be subject to the vaccination or testing policy announced today”

You just need to raise the bar to see the difference between those who will/won't and where their will to resist expires. For most people it's a pretty low bar and when it comes to paying your mortgage then most folk won't jeopardize their job.

> For most people it's a pretty low bar and when it comes to paying your mortgage then most folk won't jeopardize their job.

Maybe so, but when you use naked force to make people do things, you make an enemy for life. Anyone forced to choose between his bodily integrity and feeding his family will never, ever, not a million years, forgive you, even, and he will hate you for the rest of your days.

I don’t think anybody cares whether they don’t forgive whoever. If your ain’t vaccinated then you are a problem that needs to be motivated to do the right thing.

> but vaccine hesitancy — particularly among white Republicans

This sort of quip really makes me distrust NPR.

White people are more vaccinated than blacks or Latinos, but the journalist couldn't help but try to throw in a dunk on their favorite bogeyman.

https://www.kff.org/other/state-indicator/percent-of-total-p...

You cited a page that doesn't split it out by White Republicans or White Democrats, which is a distinction that you quoted in your comment.

Wear protection when grinding axes.

When Joe Rogan said he had taken ivermectin as part of his Covid treatment, NPR put out a tweet saying he took "a deworming drug for cows that the FDA warns people should not ingest." It's a dishonest propaganda outfit funded by money from billionaire foundations.

The agenda won't push itself.

As a percent, you may be correct (your chart does not show a breakdown by party). In sheer volume, you're definitely incorrect, however.

"As you may know, an FDA-authorized vaccine for COVID-19 is now available for free to all adults in the U.S. Do you think you will...?"

# Definitely not get the vaccine | white: 65%, hispanic: 13%, black: 13%

# Wait and see | white: 50%, hispanic: 27%, black: 14%

# Unvaccinated adults | white: 57%, hispanic: 20%, black: 13%

"Partisanship also plays a major role with more than half (58%) of the “definitely not” group identifying as Republican or Republican-leaning. In addition, religious identity also plays a role as White Evangelical Christians make up nearly twice the share of the “definitely not” group (32%) as the “wait and see” group."

https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid...

Some more relevant data here: https://archive.is/RrzbZ

>Polling data from the Kaiser Family Foundation released [0] Wednesday morning (week of August 4th) makes obvious the disparity in the importance of each group. It estimates that Black Americans make up about 13 percent of the unvaccinated population and 13 percent of the group that says it will never receive a dose of the vaccine. Republicans, by contrast, make up more than half of each group, including nearly 6 in 10 of those who say they won’t get a vaccine.

[https://archive.is/NL5qA]

What is the usefulness of including race data in polls like this? I'm French and I have little if nothing in common with other "white" people.

Developing targeted campaigns to encourage vaccination. There is hesitancy in the US black population, especially in the South, to trust health government-based health institutions. There's also less access to healthcare resources. See: Tuskegee Syphilis Study as a case https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study

For Latinos, there's a language gap that needs to be overcome for large projects like this (other notable example is census hesitancy due to risk of deportation for family and friends). Anything that can get you or your household on a government record garners suspicion from the recently immigrated and those housing undocumented people (even if the current government says it's OK, who's the say the next one won't raid your home?). The television pundits definitely don't help.

In my city, Cambridge, there was a huge vaccination push for the black population. It included priority access, more accessible clinics + hours, door-to-door advocacy/pamphlets, and getting support from local black institutions and community centers. Our rates for black residents shot up after that.

The deeper you read into the historical of medical abuse and misinformation towards minorities and the poor in the US, the faster you realize why targeting and messaging matters.

I wasn't asking about minority groups, I was asking why the white population is being called out specifically when I have nothing to do with other white people. It feels incredibly dehumanizing at times.

> Definitely not get the vaccine white: 65% hispanic: 13% black: 13%

Given US demographics, this is exactly what one would expect.

> Unvaccinated adults white: 57% hispanic: 20% black: 13%

Again, this shows white people as more vaccinated than other groups when accounting for population.

It is shocking that this comment is downvoted by the supposedly math-loving pro-science HN crowd.

Click through to the specific graph mentioned - that's precisely what it shows - demographic breakdown of response groups, NOT percent responding per group.

I know this site leans heavily pro-vaccine, but we shouldn't be downvoting correct data analyses and upvoting grossly wrong interpretations because they confirm our biases.

As others have pointed out, those numbers sum to 100% per question. Given population distributions, whites are less likely to be vaccine hesitant.

The difference in vaccination rates among Democrats and Republicans is much, much larger than any racial gap. Numerically, they are calling out the largest group, which seems reasonable. What strikes me as unnecessary is adding "white". Removing that word doesn't change the factual implications of the statement.

Out of interest I went to their source. It is a Tennessee study of unvaccinated individuals and The primary distinction between conservative white and black/hispanic people is that the former are primarily in the "unwilling" category while the latter are in the "willing but not yet ready/waiting for an appointment".

I will say that the study is way too small and not rigorous enough to use as a source for that information.

Interestingly KFF's numbers and polling tell very different stories, so I wonder if kff has bad/outdated/unrepresentative data or if pretty much every demographic has a subset that is lying about their vaccination status: https://www.nbcnews.com/politics/meet-the-press/nbc-news-pol...

In that poll, white people are lower than both black and hispanic people, and the biggest predictors for low vaccination are rural, republican, and trump support. It's possible that those groups are more likely to tell the truth about vaccine hesitancy?

It's possible that the intersection of white people and Republicans is the least likely group to get vaccinated, according to some survey.

Even if that were true, it's still a cheap shot from NPR, since the group you'd want to reference in that context would be whoever the largest anti-vax group is, not the ones who are least likely to change their minds.

And in any case, the link they cite as support doesn't actually support the statement: it's about rural whites not getting vaccinated, and mentions Republicans (and Evangelicals) only speculatively and in passing. It might be that NPR sees all these groups as equivalent, and uses one as a shorthand for the other without the need for explanation or comment, which of course they are not.

Black people are 13% of the US population. If every adult black person in the US were unvaccinated it would still be less than the number of white Republicans who have not been vaccinated.

Good. There is no better use of state power than ensuring public health. Supreme Court resolved this in 1905 w/r/t smallpox.

It'll also indirectly purge the fed of people who think celebrities and YouTube are more trustworthy sources of health advice than actual doctors.

Exactly. I'd be tempted to do the same if i were an employer just to increase the average IQ and thinking skills of my workers...

It's not IQ at all. It's thinking skills and also emotional maturity. Many of the nuttiest conspiritards I've met have what seems to be a very high IQ. High native intelligence makes it easier to learn stuff but it also makes it easier to rationalize insanity and think yourself into corners.

I think emotional maturity factors into it because it enables you to see past plays to your ego like "take the red pill and now you are special and know secret knowledge THEY don't want you to know!" One of the drivers of this nonsense is the ego driven desire to be special and have secret knowledge.

And where does the line for public "health" get drawn? Who draws it, the ruling party in power? Everything is health based if you want it to be.

"Everything is health based if you want it to be."

What is the point of this comment? He is mandating a vaccine during a pandemic.

This argument is so tired. It applies to almost every single service provided by any government anywhere.

New traffic regulations? Everyone needs transportation to get somewhere. Controlling transport controls everything. This is a road to tyranny, etc, etc..

New worker's regulations? Everyone needs a job in our economy! Controlling wages controls people's lives! This is authoritarianism, etc...

New taxes? Everything you need to survive could be taxed! When does it end?? etc, etc..

The most minor policy change anywhere runs into this utterly inane argument. Updated food standards? Building codes? Public hearing to add a stop sign? When will this government overreach end???

It's tired, it's pointless, it's been said millions of times by the same libertarian/anarchists for a century. It adds nothing new to the conversation.

I mean he answered these questions. The line is drawn here.

Well, I'm not exactly sure what the line is. In the US, as with all things related to government power, it's decided jointly through the work of the three branches of government and the factors that influence them - democratic appeal, the constitution, jurisprudence, and so on.

At any rate, "vaccination for a highly infectious, potentially deadly virus" indisputably counts as "health". Everything might be health-based if you want it to be (maybe), but the nature of the American system hopefully and usually minimizes room for abuse of that power - and certainly there's no appearance of abuse of that power here, now.

That line would be drawn through elections, legislation, and court decisions. Decisions like the one OP was referring to [0] where the Supreme Court found that compulsory vaccination is within the state's power, and further that "[r]eal liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own [liberty], whether in respect of his person or his property, regardless of the injury that may be done to others."

0. https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

Slippery slope arguments are a way of avoiding discussing whether a particular proposal is good, by suggesting that they will lead to other, less positive developments. Better to evaluate each action on its own.

Vaccination requirements have been a standard practice for well over a hundred years now, and the case for mandating a vaccine for Covid-19 is much, much better than the case for mandating many other vaccines that are already required.

This is health-based, clearly, and not just "if you want it to be".

In Australia government now controls how much alcohol people can consume in their locked down homes. They are searching all bags and things coming into the building.

That is the line now. How far it will go we will see.

Also: In one of the most callous examples of exclusionary state politics in practice, last year the Queensland government denied a 14-year-old double-lung transplant patient from NSW access to his specialist doctor, declaring that Queensland hospitals were for Queenslanders.

The smallpox vaccine worked (works) much better than the covid vaccine. I don't think this is an honest comparison.

Fyi, the smallpox vaccine isn't as effective as the covid one...

The COVID vaccine is effective at preventing mass ICU occupancy. The smallpox vaccine is exceptionally effective when compared to other vaccines. Most other vaccines require 3-4 applications for reasonable immunity; same as COVID.

COVID mutates too fast and the covid vaccines do no provide sterilizing immunity. The smallpox vaccine provides sterilizing immunity, which enables eradication.

I agree the COVID vaccine is good at reducing severe cases and preventing death.

Don't pretend to be at all concerned about ICU capacity if you also support mass firings of nurses who won't take the vaccine, which is another of the "prongs" being rolled out by Biden today.

So you support having unvaccinated nurses in hospitals full of people with compromised immune systems? How does that work?

If this is a major concern testing daily is the only option. The covid vaccine's efficacy wanes over time.

Wouldn't the obvious solution be to combine both effective approaches? Both vaccination and regular testing should be employed.

The chance of false positives and false negatives is too high for this to be reliable in an environment with immunocompromised patients.

How else are you going to handle asymptomatic cases among vaccinated?

It works just fine because the net effect of the vaccines on transmission is not known, and may even be enhancing.

They've got only 21 days of funding until the debt ceiling is breached. So you may still lose your pay regardless.

Bad.

I prefer to have a choice.

The, "Trust the authority. It's for your own good." argument does not sway me.

You do have a choice. Take the vaccine if you want to work in the federal government or find another job. The government doesn't owe you or anyone else a job.

That's a really poisonous argument.

So is saying "Never trust an authority."

I did not say, "never trust an authority". You need to get your eyes checked.

I'd just like to point out the US has justified deadly experiments and acts of war only to later apologize saying they made a terrible mistake time and time again. I thinking questioning the authority here, especially one that has such a poor reputation, is a good idea.

A Hobson's choice is probably not what someone wanting a choice has in mind.

Absolutely. This also paved the way for Buck v. Bell. There is no better use of state power than forced sterilization (public health).

It's not comparable. Smallpox has a radically higher mortality rate, more contagious, worse side effects, and applies to both the young and old.

"The risk of death after contracting the disease was about 30%, with higher rates among babies. Often those who survived had extensive scarring of their skin, and some were left blind."

https://en.wikipedia.org/wiki/Smallpox

Explain this: https://nypost.com/2021/09/09/usps-exempt-from-biden-vax-man...

We've had tens of thousands of people pouring across our southern border for months illegally.

Where is the mandate to test / vaccinate these people?

Legal travelers and migrants are required to comply with covid restrictions, but these law breakers are not.

And then, on top of it, they are provided transportation all over the country and dropped off in jurisdictions without any coordination or notification.

How is this mandate supposed to help when the president and his people have been actively undermining the health and safety of this country for months, and have no plan to stop?

Got vaccinated but it looks like long covid was unavoidable all along thanks to my generation's willingness embrace and celebrate big govt.

The article doesn't say whether there's a medical exception. Not everyone can get the vaccine; having that cost your job is both heartless and (probably) illegal.

I would imagine that there will be medical exceptions. I gather from the article that either get the shot or show your exception. Showing a negative test is not an option.

I would imagine that, too. Or hope that. Expect that, even. But I would feel better if they actually said that. (Too much nonsense around Covid has made me a cynic...)

Just FYI, a cynic is someone who assumes people are selfish. A lot of people confuse it for pessimist.

But "pessimist" is more characters to type...

And, cynically, I see an amazing amount of selfishness around Covid.

One side won't wear masks because it impinges their freedom, and they'd rather have their freedom than not have vulnerable people die.

The other side wants to get everyone to do what they're supposed to do so that they (the ones demanding that others do what they should) can get back to living like they want, and never mind if they run over others' freedom or limitations on governmental authority or whatever. (Yes, I know, the second group is also concerned about the vulnerable. But it seems to me that at least some of the outrage comes from "Things should go the way I want them to, and it's unacceptable that the actions of others take that away from me.")

except a lot of doctors will be unwilling to give out medical exemptions because they are afraid to lose their license (even though they agree with the patient). It's happening here in Canada.

Happened to me.

Doctors gaslight me when I had an allergic reaction to Macrogol, claiming it was an anxiety attack while I could visibly feel myself suffocating to death. Did anyone bother to add it to my EHR? No.

Did anyone even add the allergies after I used the online portal to send a message to PAMF? No. Still in pending.

I keep on trying but somehow I keep getting doctors who don’t care or shift me from specialist to specialist since I’m apparently a case nobody wants to take.

I’m so tired of hearing ‘it’s safe and effective’ sometimes.

Should I go and get a shot that has a good chance of a giving me a life threatening reaction that may be fatal? (Oh and before you mention epinephrine, that’s also contraindicated; I have no faith that if it happens again, I’ll even end up alive considering I was left to just kind of suffer while nearly dying in the hospital ER not just once, but TWICE in the last few years).

I give up. I admit defeat.

And let's not forget that people with natural antibodies are being fired from their private sector jobs too.

We seem to be focused on measuring output rather than outcomes. Other countries are giving recovered people the same status as the vaccinated since they have the antibodies. But I guess that makes too much sense...

Natural antibodies + vaccination is basically a win-win for everyone, especially noting that the US is wasting vaccines rather than using them. You don't lose anything by getting the vaccine and there's a strong upside in resistance (around 10x more resistant than people who are simply vaccinated).

Like, between a 100-200$ blood test to prove natural immunity* vs. a free vaccine, it should make sense to get the vaccine.

* IMO, honor system should be de-emphasized for people claiming natural immunity. If they want to fight on this hill, they should be able to prove they have that immunity in the first place, otherwise it's simply inconsiderate.

Why would you risk side effects (which are really low, but do exist) if you already have antibodies? Is argue you do "lose something" if you get a vaccine after having recovered from covid.

"Like, between a 100-200$ blood test to prove natural immunity* vs. a free vaccine, it should make sense to get the vaccine."

The antibody test is about $45 from places like Labcorp. The vaccine is $40 per dose (so $80 total for most), with the government picking up the tab.

Yes, vaccination plus infection provides more antibodies. I'm not sure that it is correct to quantify that as "10x more resistance" as we would need to know where the threshold for resistance lies and all the factors involved (they don't know the min effective level of antibodies, and they are seeing protection in individuals before the antibodies are being produced).

"You don't lose anything by getting the vaccine..."

There are some people with valid concerns about the possiblity of autoimmune antibodies, which in theory, could be substantially higher if having already been infected. Sadly, I haven't been able to find any real research into this one way or the other.

"... they should be able to prove they have that immunity in the first place, ..."

Yes, other governments such as Isreal are issuing green passes for those confirmed to have recovered. I don't believe they are doing antibody testing, but we aren't testing vaccine recipients for antibodies either.

Your numbers are incorrect. Vaccination appears to boost immunity after infection by a factor of 2×, not 10×. The duration of additional resistance is unclear.

https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...

This is just a talking point coming from people who don't want to get the vaccination. Those people who don't want to get the vaccination largely exist because of misinformation, not because of any real risk (read: very very very very minimal risk) that comes with taking the Covid vaccine.

Everyone (who can) should take the covid vaccine, regardless of their antibody status.

Can you explain why a "talking point" immediately invalidates something?

>A talking point, often used in the plural, is a pre-established message or formula used in the field of political communication, sales and commercial or advertising communication.

https://en.wikipedia.org/wiki/Talking_point

Let me ask you this: is "Everyone (who can) should take the vaccine" a message that medical organizations are communicating with minimal variance?

If "talking point" is getting us tripped up here, maybe "convenient excuse spread mostly to help the vaccine hesitant continue to not get the vaccine" would be a better phrase.

I'm not an English major here. Just trying to get my point across.

Isn't the vaccination rate of healthcare worker only about 60%? If the reasons are strictly misinformation, then it seems you have an almost 40% chance of getting an incompetent healthcare professional. In my mind, that suggests there are rational and reasonable reasons, since I find that more likely than 40% being blatantly incompetent.

96% of practicing physicians are fully vaccinated [1]. That number goes way down as you look at nursing home aids, nurses, and home aids. If the argument is that healthcare workers not taking it makes it rational and reasonable, you need to contend with the fact that the more educated you are in medicine, the less hesitant you are.

It seems more likely that nurses and aids can't interprete dense medicalese or understand mRNA any better than the average person and are no less susceptible to misinformation than the average person. That doesn't make them incompetent at their jobs, which aren't about creating complex treatment plans using the latest and greatest medical research, but finding veins, delivering meds, scrubbing sores, changing bed pans etc.

[1] https://www.acpjournals.org/doi/10.7326/M21-3150

It could be that they are in higher risk demographics too. Only 7% were under 35, with the majority of the 300 or so being over 50. That greatly changes the risk/benefit equation. Although I think your generalization is probably accurate to some degree.

Most groups of people are susceptible to misinformation. I also wouldn't be surprised if there's a bias among nurses, who know enough to be in the medical field, but use that confidence to overestimate their ability to make medical decisions like getting the Covid vaccine.

96% of doctors have gotten the vaccine. Top medical researchers in the immunology recommend the vaccine. etc. etc. These people are less (but not completely) susceptible to misinformation because they are truly able to interpret research and findings.

We should be following doctors and immunology medical researchers. Not nurses.

(This isn't meant to be an inherent slight on nurses, by the way. I think it's just human nature.)

We also have to account for demographics and understand the risk/benefit analysis. That 96% number is from a WebMD survey of about 300 physicians. The ages are mostly over 50 with only 7% being under 35. So they are in the somewhat higher risk groups. They also work a job that runs a high risk of exposure. This means they might see their risk of infection and serious illness being high enough to justify it without feeling it is necessary to recommend it to everyone. For example, we don't all receive rabies vaccines yet many animal handlers do.

Another important thing to note is that there could be bias in that group. If you dedicate your life to medicine, you may be more likely to trust medicine without questioning it. Unless you've had an experience that was negative. Many physicians that have had negative personal experiences abide by the idea that new means unproven (which matches the reason that most unvaccinated doctors gave in the survey and the CDC lists - that the longterm risks are unknown).

Lastly, most doctors are to mechanics as medical researchers are engineers. Most doctors aren't looking up studies on PubMed or doing research. They mostly rely on what they've been taught in school and in continuing education. For the most part they are following established protocols. Hell, even the experts admit that there is a lot they don't know about the immune system. Take for example that researchers are seeing protection from the vaccine before antibodies are produced - which was unexpected.

So while most groups are susceptible to misinformation, that doesn't invalidate the position that one may avoid the vaccine due to the unkmown longterm affects. It's really a question of risk/benefit analysis in a sea of incomplete information.

I can't find exact distributions, but the average ago for nurses and the average age for doctors are the same. Around 51 years old. Seems like poor argument to use.

At the end of the day, doctors and medical researchers are producing the highest quality opinions on the subject. If you're not following their lead, then you are very likely in the wrong.

Are they sometimes wrong? Absolutely. But the key point: to think that you are more likely to be correct is absurd.

Natural antibodies are fun until you've waited a year and now you don't have them anymore.

Indeed, how might conflict with the Americans with Disability Act?

Federal agencies are still subject to the ADA, which Biden cannot waive without Congress. While the ADA appears to allow for vaccine requirements in general, it still requires reasonable accommodations for those who cannot get a vaccine.

I feel awful for the people with religious or medical reasons they can't be vaccinated. I can't imagen having to potentially pick between a truly held religious belief and proving for a family.

From NYT: "Ms. Psaki said that there would be some disability and religious exemptions for some"

Crazy to me religion and normal beliefs are not put in the same bucket. Why would a religious belief hold more weight than a normal belief?

1st Amendment still has a little power

The article didn’t really mention exemptions, are you assuming no exemptions for medical / religious reasons or are you saying this from a clearer source?

I can - I'd dump the voodoo.

And there are a vanishingly small number of medical reasons to skip it. Most of the people claiming this are making it up.

There's the wonderful SV attitude we all love...

Not me. But then again nobody cares about me anyway.

Apparently I learned that I’m allergic to my deodorant yesterday, it burned when I applied it to the skin and after a minute it became intolerable. Guess what it contained? PEG-8.

> Not me. But then again nobody cares about me anyway.

Nonsense, Your health system in America might be a steaming pile of garbage, but I'm gald I managed to find you here after I got worried once you deactivated one of your accounts.

So, a CDC study found 78% of people hospitalized for covid were obese or overweight.

https://www.cnbc.com/2021/03/08/covid-cdc-study-finds-roughl...

What's to stop the president from issuing another OSHA rule to fire people who are overweight and not actively addressing this risk factor?

Politics, obviously.

The checks on power for the president are politics (reelection), legality / constitutionality via court system, and removal from office via impeachment trial.

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