Vaccine experts: Covid-19 booster shots aren't needed now | Hacker News Reader

Vaccine experts: Covid-19 booster shots aren't needed now

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234 pointsKoftaBob522 comments

I think this reporting is dancing around the issue, that the vaccine supply is most concentrated in countries that have essentially reached their maximum vaccination percentage. By not providing access to those developing or smaller countries, larger countries are shooting themselves in the proverbial global foot. I don’t think countries like the US and Canada aren’t trying to do that, I just think these experts would like more of a conscious effort.

I also think this advice feels like a slap to healthcare workers like myself who desperately want to continue taking care of patients as safely as possible. When your coworkers can spread virus more easily due to less immunity, being unvaccinated, etc, it would be more reassuring to continue to have stronger immunity to continue seeing patients. I don’t have the luxury of waiting for a patient to test negative before seeing them in the emergency room or clinic.

If you are continually exposed to COVID-19, wouldn’t you effectively be “re-upping” your immune system every time there is additional exposure?

No, exposure to the virus is like exposure to combat. You may not die, but the likelihood goes up the more time you spend exposed to it and the more of it you get exposed to. To keep with that metaphor a vaccine is like a war game, it won't kill you but it's not the real thing either. But if you've done it you're better off than if you hadn't.

This doesn't make sense. Do you have a source that says repeated exposure increases your odds of serious disease?

Repeated exposure increases your chances of disease not serious disease. Increased Viral load increases chances of serious disease. Apologies if that didn't come across clearly.

sounds like another policy/politicized blanket statement not based on science. Have they tested levels of anti-bodies? Why is Israel with its early high vaccinations levels doing third shots?

> Why is Israel with its early high vaccinations levels doing third shots?

Desperation. This is a case of politicians overpromising on something they could not deliver. Science will have to take a back seat.

Efficacy of Pfizer Biontech wears down after 6 months. So because they were early, they are the first to need boosters.

>sounds like another policy/politicized blanket statement not based on science.

Or, it is public health advice based on science, looking at what they believe would be the most effective policy globally. They aren’t saying it does or doesn’t affect the level of antibodies. They aren’t arguing that it is effective or ineffective at boosting an individual’s immunity. You seem to be fundamentally confused about what they are talking about.

>“Even if boosting were eventually shown to decrease the medium-term risk of serious disease, current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations”

I’m just not sure what it means to say that global policy is based on science. They didn’t run an observational study a sample of other globes to see which decisions correlated with better performance; they used their scientifically-informed expertise to a degree, but they also made a series of judgment calls about what policy goals we should have and the likely consequences of various actions on geopolitics. Why are vaccine experts the right people to make those calls?

>they used their scientifically-informed expertise to a degree, but they also made a series of judgment calls about what policy goals we should have and the likely consequences of various actions on geopolitics.

Yes, that is exactly what they did, specifically because we don’t have other globes lying around that we can run randomized controlled trials on global events. Just because we don’t have perfect data on something, doesn’t mean that expert opinion based on detailed information is no more valid or valuable than any other opinion.

>Why are vaccine experts the right people to make those calls?

They aren’t making a call. They are providing their expert opinion in vaccines and vaccinations, on a topic related to vaccines and vaccinations, to inform policy makers that do make those calls. It is for policy makers to consult various data sources and experts in related fields to make an evidence based and evidence informed decision.

https://www.nytimes.com/interactive/2021/world/covid-cases.h... looking at the map above tells me people in rich western countries are dying from covid at 2-8x rates of people in the developing countries with some exceptions(Brazil, Peru, Mexico). How on earth do you make any morality based policy calls based on this data?

>How on earth do you make any morality based policy calls based on this data?

Well, you make those calls by looking more deeply into data than a country level map. In the US, the majority of states are at or near the point where vaccine supply is higher than demand. [1] The people that wanted vaccines got vaccines and the majority of the unvaccinated are that way by choice. We also know that over 98% of covid hospitalizations are those very same unvaccinated [2], showing that even with breakthrough infections, the vaccine is still very effective at preventing “serious” cases of covid. At The same time, we have a 25% reduction in the estimated available vaccines worldwide through the end of the year and poor countries that are reliant on vaccine aid delivered by rich nations have received a fraction of what was pledged. [3]

Giving boosters to people in rich countries that are already highly protected and not at risk of significant illness and death while failing to send aid to provide any protection at all to the most vulnerable population is not exactly a morality based policy. Using vaccination rates of people that have access to vaccines and choose not to get them (and are dying based off that choice) as justification for this is ignorant at best, immoral in itself at worst.

[1] https://www.kff.org/policy-watch/supply-vs-demand-which-stat... [2] https://www.healthsystemtracker.org/brief/unvaccinated-covid... [3] https://www.bloomberg.com/news/articles/2021-09-08/global-va...

Why would you assume that vaccine hesitancy is uniquely American and immutable phenomena? Why would you assume 2 shots of vaccine is enough for life when a new variant pops up every month? As an official, how would you pick a country to send vaccines to when most of the world has lower infections and death rates? How would you ration your vaccines when FDA may authorize them for younger kids any day? What about vaccine mandates? Those are supposed to up the demand, right?

Seems more an acknowledgement that zero-Covid is never ever going to happen. At which point not sure if vaccinating outside of risk populations or to control hospitalizations if they are too high makes any sense.

> not sure if vaccinating outside of risk populations or to control hospitalizations if they are too high makes any sense

Based on this logic, flu shots are useless. As is any treatment without guaranteed success, i.e. most medicine.

(Note: prioritising vaccinating when hospitals fill up is programmatically, repeatedly peaking the healthcare system. It will do to it what repeatedly flooring the gas and hard braking will to a car.)

> flu shots are useless

(I've been struggling with the following sentence for several minutes but here goes): flu vaccines aren't widely distributed - never mind recommended - for healthy young people.

Countries appear to prioritise flu vaccine for older and/or more vulnerable people.[0]

[0] https://www.nhs.uk/conditions/vaccinations/flu-influenza-vac...

On that page NHS seem to make a cost tradeoff for free flu vaccine since they have to pay the costs.

From the CDC

>Who should get a flu vaccine this season?

>Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. A full listing of people at Higher Risk of Developing Flu-Related Complications is available.

>Flu vaccination has important benefits. It can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations and deaths.

>Different flu vaccines are approved for use in different groups of people.

>There are flu shots approved for use in children as young as 6 months old and flu shots approved for use in adults 65 years and older.

> From the CDC > > Everyone 6 months and older should get a flu vaccine every season with rare exceptions

According to the Nuffield Trust[0], international flu vaccination coverage varies widely.

It appears from the chart the US is only reaching 65% - 70% of their over-65s with annual flu vaccine.

How much does it cost to get the annual flu vaccine in the US?

[0] https://www.nuffieldtrust.org.uk/resource/adult-flu-vaccinat...

Around here it's free and the pharmacy gives you a $5 coupon for getting it. They definitely see it as an easy way to get people through their doors.

Well, I assume it's covered by insurance but probably not actually free if you don't have insurance.

No insurance required. It's a loss leader to get people into the store.

> How much does it cost to get the annual flu vaccine in the US?

As with all things in the US healthcare system, nobody knows how much anything costs.

That said, annual flu vaccine is included under mandatory no direct user cost vaccinations in insurance plans covered by the Affordable Care Act (although your insurer can pick and choose what locations they'll cover).

> As with all things in the US healthcare system, nobody knows how much anything costs

Once things are opaque one has to start wondering about motivations, financial incentives and <groan> the underlying politics.

Getting the vaccine into another wealthy & healthy child "for free" vs getting the vaccine into one poor & elderly adult ("but who will pay?") would appear to have very different outcomes, at least based on what we thought we knew about seasonal flu. The wealthy & healthy child might end up being off school for half a day less (maybe). It's almost certainly a bigger deal for the poor & elderly adult.

Perhaps it's just a lot easier to convince the healthy & wealthy family to take their kids to the pharmacy and have the insurer (cough) foot the bill?

Side note: the EU doesn't seem to be that keen on vaccinating healthy youngsters against seasonal flu[0]

"The immunity that is elicited by influenza vaccines is not as long lived as the immunity following natural influenza infection. This is especially so for individuals in the so-called risk groups, hence people have to be vaccinated annually [..]

The main strategy of immunisation programmes in Europe is to directly or indirectly protect the more vulnerable individuals"

[0] https://www.ecdc.europa.eu/en/seasonal-influenza/prevention-...

They are easy o get, readily available and reasonably well distributed (nowhere near Covid-numbers so). I only took them when I was working at a retirement home years ago, more for the residents then for myself. I was, as not being in constant contact with residents, not required to take the shot (if memory serves well, nit that it would have made a difference anyway), care personal and those being in regular contact with residents were obliged so. One of the reasons I don't get the discussion about obligatory Covid shots for health care professionals...

I don't see how that follows from his statement. Maybe something more like "based on this logic, flu shots should be targetted at high risk populations or to control hospitalizations". Doesn't France already do something like that with the flu vaccine?

Given the risk variability with coronavirus, I'm not sure that it would make sense to approach it the same way, but targeting highest risk populations still seems very different from "prioritising vaccinating when hospitals fill up".

> Based on this logic, flu shots are useless

If you believe the reports stating that the flu has basically been eliminated since the start of Covid-19, it seems the shots are indeed pretty useless! All it took was some half-assed masking and social distancing measures, that half the country swears the other half isn't doing. Who knew?

That's like saying back in the 70s and 80s that we cannot eliminate deaths and injuries from car accidents so it's useless to have seatbelt and air bag campaigns and laws.

>outside of risk populations

Depends on how you define risk, 59 children have died just in Texas from Covid so far. Risk goes up with age.

Every single additional vaccination helps the situation.

> 59 children have died just in Texas from Covid so far

Obviously you realize this is a controversial, at best, assertion.

What's your reasoning for why John's Hopkins wasn't able to find a single pediatric death _from_ COVID-19?

Because the study you reference only looked at data from early-ish in the pandemic, doesn't cover delta-variant or anything else that happened in the past year? (It's also not that difficult to find claims from John Hopkins that deaths in children have happened, so you obviously realize that the "wasn't able to find a single pediatric death" is a controversial, at best, assertion?)

Is there evidence of a massive uptick in pediatric deaths? So much so that we'd believe that, even as transmission patterns increasingly resemble endemic equilibrium, the results of this report (which, to my knowledge, is still, sadly, the only one of its kind) are completely reversed?

I think it's fair to say that the authors don't think so.

More like saying we should only wear seatbelts when we are in the fucking cars!

Interestingly, seat belts and air bags are still controversial among some (few?) folks.

That would only be an analogy if car accidents mutated to overcome seatbelts. Also car accidents can kill everybody, Covid not so much if you are young, have healthy lungs and are not overweight.

If zero-covid doesn't work (it won't IMHO), necessary immunisation levels can be reached either by

a) have enough people vaccinated

or b) have enough people infected

Not sure why people come to the conclussion option b) would be a good idea...

If zero-covid doesn't work, then necessary immunization levels can't be reached. It's endemic. Everyone will get it at one point or another.

It's now just a risk management question for individuals

The US has not met their maximum vaccination percentage. According to the graph I get in Google the US is stuck on around 50% fully vaccinated. Considering the head start they had on most of the world and the vaccine supplies this can't be described as anything other than a complete and utter failure on all levels.

> Considering the head start they had on most of the world and the vaccine supplies this can't be described as anything other than a complete and utter failure on all levels.

That's probably why the GP comment described it as "their"(our) maximum vaccination percentage. The vaccine and virus have both been politicized too much, and too many people are obstinately refusing it as a result.

It feels like more and more people whom I would consider very partisan (either side) simply act out of spite nowadays. Whatever the other side wants, well, we're just going to unconditionally fight it. You saw this accelerate after Trump won with "Resist", an ethos that literally means to defy regardless of circumstances. And now you see the right's version of "Resist" by avoiding vaccinations. Why? Because screw them, that's why. This is just more the feeling I get about society. It's very frustrating.

I also think places like the CDC made enormous tactical errors by doing things like celebrating certain political protests, or changing language from "mothers" to "birthing people", etc. They tried to score cheap political points while sowing seeds of total distrust in the process. Just a massive mistake, all downside no upside.

It's pretty insane to read "both sides" at this point.

The idea that democrats and republicans are equal in this way is absurd.

It isn't "both sides" to point out failures in leadership.

Say what you will about Republicans but their core messaging has been remarkably consistent and effective. The Democrats won a hard-fought chance to turn things around from a pandemic-leadership perspective, and then those leaders get caught up in ineffective lies (Fauci saying masks were likely ineffective to try and save supplies, which was a fool's errand) and unrelated culture wars.

Are they better than the Trump administration? Absolutely. Have they made some egregious and completely avoidable errors? Also yes.

Yeah, and it didn't help when during the BLM protests, when social distancing was being trumpeted in all contexts, a number of doctors (can't remember if the CDC endorsed it or not) came out and said the massive crowds at the protests were acceptable because "race issues are health issues too" or something to that effect. That's obviously hypocritical to anyone with half a brain.

If there's a kernel of truth to the right's message it's that there is an elite class in DC that is woefully out of touch and seemingly incapable of actual leadership. They just spout what they think, however asinine or poorly phrased, and we're supposed to listen because they're certified "experts". I know enough people in government agencies personally/have the scientific education necessary to filter the signal from the noise, but I can understand someone who doesn't have those advantages just refusing to trust anything they say. They sound like arrogant nerds, and a lot of them actually are.

Someone needs to remind anyone who releases a public statement that they are first and foremost in the business of public persuasion, not absolute truth telling down to the smallest detail for its own sake. That means clear, consistent messaging that a high school dropout who failed 9th grade Biology can understand. Broad strokes. Simple actions. Leave the nuance in the footnotes for the professionals who can handle it. For example, the messaging should have been some variety of "wear a mask as often as you can until we get a vaccine, then you can take off the mask if you get vaccinated" combined with support of mandates to enforce that path. Are there problems with that? Sure, but it gives people a simple path to follow, a light at the end of the tunnel, would have a positive impact on average, and doesn't get bogged down in ultimately irrelevant details about the tactical effectiveness of masks/vaccines and provides an incentive to get the vaccine. And consistency alone can be powerful messaging if there's even a little truth behind it. Much as I wish we were, we are not a nation of scientists and cannot be addressed as such.

And yeah I'm sure there are a million "it's different behind the curtain" excuses for why things were done the way they were. Same way when things are designed by committee at a large company everyone involved is conveniently not individually responsible when things go wrong. I'm not sure what the precise solution is, I'm certainly not in a position to influence anything related to Fauci's/The CDC's messaging, but someone has to start taking actual personal responsibility for the outcomes, and be in a position to relieve those who have proven ineffective. Granted it may already be too late for that, people are entrenched hard.

>Yeah, and it didn't help when during the BLM protests, when social distancing was being trumpeted in all contexts, a number of doctors (can't remember if the CDC endorsed it or not) came out and said the massive crowds at the protests were acceptable because "race issues are health issues too" or something to that effect. That's obviously hypocritical to anyone with half a brain

Here's the letter https://drive.google.com/file/d/1Jyfn4Wd2i6bRi12ePghMHtX3ys1... This quote is mind boggling "Even so, we continue to support demonstrators who are tackling the paramount public health problem of pervasive racism."

From what I remember, it started with saying you'd be stupid to take "the trump vaccine". (In less pleasant language)

To me, it seems to have been politicized by the left first. This in combination with the RAPID flip of the coverage/opinion from the left after Biden took the presidency seems like a pretty good explanation for a good part of the rights defiance.

>And now you see the right's version of "Resist" by avoiding vaccinations

"I love our people, so I want our people to take the vaccines." - Trump

"As a boy, I fought polio. Today, America’s been polio-free for 40 years — thanks to vaccinations. We’ll beat Covid-19 with vaccines, too. Protect yourself and your family. Get vaccinated." - McConnell

"Democrats and the media scoffed when @realDonaldTrump said we’d have a safe and effective vaccine this year, but he kept his promise!" - Kevin McCarthy, House minority leader

All of Republican leadership is urging people to get the vaccine. Anti-vaxxers think they're on the side of Republicans but, come midterms in 14 months, they're going to figure out that they're not on anyone's side.

Edit: I would love to hear from anyone old enough to remember what happened during a time in history when a large coalition of people thought they had representation in one party or the other but actually had no representation in either party. What happened during the subsequent election?

The one that made me the most upset was how large gatherings were bad, unless one was protesting about racial injustice. In which case, don't worry, those protestors had masks on.

Well, if merely having a mask on in a thousands large march is okay, why not just allow all sized gatherings provided one is wearing a face covering?

An outdoor, fully-masked gathering is meaningfully different, and the people pushing against COVID restrictions were also pushing back against mask guidance. In reality, indoor masked gatherings were fairly safe, but the practical distinction was between outdoor masked or indoor unmasked.

Funny, how everyone complained about sow start of vaccination campaigns. Only to forget that reaching roughly 70% fast was the goal, not being the first at 10%.

> complete and utter failure on all levels

Is the < 100% number due to lack of availability of vaccine, inability of people to get to a location to receive the vaccine, or people simply not wanting to be vaccinated?

There's an immense machine at work spreading FUD about the vaccine, and whole swaths of (mostly red) states where people refuse to get vaccinated.

So at least some of the reason for the low vaccination rate is due to no fault of the system, but rather the parties with an interest in working against the system.

I live in NL, and people here were anxiously waiting their turn (by age ranges) to get vaccinated. Meanwhile, one quick trip home to the US in May and I easily walked up to a Walgreens prescription counter, filled out a form, and got my free vaccination. It couldn't have been any easier. No appointments, no limitations, and no cost. That seems pretty successful to me.

I live in another European country and people here were also patiently waiting there turn... and then those people got vaccinated and nobody else wants to. This week the government has put into effect new regulations that effectively ban unvaccinated people from going into many shops and restaurants, as a way of trying to encourage more people to take up vaccines. They are also selling excess vaccines to African countries.

And I live in another European country and we have reached 90% with first dose and 80% fully vaccinated, of the population over 18. Currently vaccinating 16-17 years old and will probably start with 12-15 years old in not too long. Younger children will not be vaccinated for now.

>According to the graph I get in Google the US is stuck on around 50% fully vaccinated.

...still seems like an upward trend at:

https://www.mayoclinic.org/coronavirus-covid-19/vaccine-trac...

...according to the CDC % of Population ≥ 18 Years of Age who have had at least one dose is 75.7%.

https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-...

Thanks. Maybe the data in Google is lagging or is showing percentage out of full population?

I mostly agree, but these experts need to calculate how many shots this really is (~150Mil) and then look at how many shots are still needed in the rest of the world (~10Bil). So if everyone who had a single shot also got a booster, it would increase this time by 1.5 (or less since distribution and production rates increase with time)?

Prioritizing the elderly in developing nations (rather than the wealthy and politically connected) and speeding vaccine production (likely Adenovirus rather than MRNA due to encapsulation and cold-chain bottlenecks) would have order of magnitude larger effects on deaths than preventing booster shots. The number of wasted shots is closing in on the number likely to be administered.

Delaying immunization school children for the school year (barring much higher than expected immune side effects in unpublished data) is likely going to be another own-goal for the FDA/CDC.

> I don’t have the luxury of waiting for a patient to test negative before seeing them in the emergency room or clinic.

Agreed that it makes total sense for HCWs to get a booster, but also why are you seeing patients before they test negative? Every patient could be getting a $5 antigen test as they walk in the door. The fact that this is not being done is just one more missed opportunity.

There is not strong evidence supporting a 3rd booster dose in immunocompetent people. We have partly seen a misinterpretation of the Israeli data [1] and specifically the single low effectiveness value that appears to be the result of Simpson's Paradox [2]. Dr. Fauci reported this single value decline from the high nineties to the high seventies on Andy Slavitt's podcast [3]. Pfizer's CEO has promoted this same data, Israel's 3rd dose campaign is well under way, and Fauci's public statements are a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that the Canadian numbers do not yet support a general 3rd dose booster but, like the UK, a longer 2nd dose interval due to a First Doses First (FDF) strategy may be a factor.

The 3rd dose is safe and will probably provide a small benefit to the recipient as Shane Crotty described in TWiV 802 [5]. The downside is that these doses are in short supply globally where they could make a significant difference.

[1] https://www.covid-datascience.com/post/israeli-data-how-can-...

[2] https://en.wikipedia.org/wiki/Simpson%27s_paradox

[3] https://lemonadamedia.com/podcast/dr-fauci-answers-your-bigg...

[4] (YouTube ~3.5min @36m45s) https://youtu.be/93Rnjmr7iCk?t=36m45s

[5] https://www.microbe.tv/twiv/twiv-802/

> a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that

...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

Link?

https://thehill.com/opinion/healthcare/571022-to-boost-or-no...

https://www.politico.com/news/2021/08/31/biden-booster-plan-...

https://endpts.com/breaking-in-a-major-blow-to-vaccine-effor...

These are authors of this report.

You said

> Biden administration seems to have asked

Nowhere is that reported, or even suggested, in the links you posted.

Two researchers resigning in disagreement is seriously, seriously different from the administration forcing people out.

One is researchers protesting decisions by their own senior leadership. The other is the administration censoring scientific disagreement.

> ...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

What you stated did not occur.

What did happen was that the FDA and CDC got into a procedural slap-fight, and because the CDC gave advice first and the White House signaled public acceptance of that advice before the FDA's panel had a chance to finish two people resigned in protest.

Let's break down why the post above is erroneous:

- "Biden administration seems to have asked" no factual basis.

- "authoring this report" they never authorized a report, that's what they were protesting.

- "report saying that the evidence didn't support the widespread use of boosters" since the FDA's Office of Vaccines Research and Review hasn't published a report you cannot state what is in the report.

What did occur is that the two resigning panelists published a review in The Lancet[0] where they essentially said they felt more data was needed to approve boosters and that the WH approval on the CDC's recommendation was premature (although they also said their view may not match the FDA's view as a whole so YMMV what the final FDA report says).

By the way I actually agree with the two FDA panelists on this one, and think the WH jumped the gun. But regardless of my feelings the "Biden had vaccine experts resign to push through the booster" comment above is problematic.

[0] https://www.nytimes.com/2021/09/13/health/fda-coronavirus-bo...

> - "authoring this report" they never authorized a report, that's what they were protesting.

You are commenting on a HN story which is literally linking directly to the document they authored.

I hope you will delete your misguided and grossly uncivil comment in the time that the site lets you do so, and consider offering another response when you've actually read the article that you're commenting on!

> the FDA and CDC got into a procedural slap-fight, and because the CDC gave advice first

The CDC statement is here: https://www.cdc.gov/media/releases/2021/s0818-covid-19-boost... you can see that it is unambiguously conditional on FDA approval: "We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines".

> "Biden had vaccine experts resign to push through the booster" comment above is problematic.

This is a false and fabricated quotation, which I did not say at any point. Your inclusion of it makes it extremely hard to see your comment as a good faith attempt to communicate.

> You are commenting on a HN story which is literally linking directly to the document they authored.

You're conflating the timeline and facts a lot. Here is what you stated happened above:

- FDA panelist published a report -> Biden admin asked them to resign -> they resigned.

Here is what actually happened:

- CDC published a report -> WH accepted the CDC's report -> WH signaled moving forward with boosters -> FDA panelists who never got to publish resign -> FDA panelists author review paper in The Lancet critical of boosters (what this article is about) -> [Future] FDA publish their official recommendation

The timelines are completely different (e.g. resign before Vs. after publication), what we're talking about being published is different (e.g. FDA official report Vs. Lancet review), and the whole "asked to resign" is nowhere to be seen.

> This is a false and fabricated quotation, which I did not say at any point.

You said this verbatim:

> Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign

You haven't defended or sourced that. Want to go ahead and do that rather than acting offended by my shorthand characterization of it?

I'm fairly convinced that the pharmaceutical companies want Uncle Sam to buy and mandate 350 million shots per year and that's why the boosters are being pushed and combined with flu shots, while Dear Leader figures out the best way to dictate the health choices of his subjects without so much as first having Congress vote on it.

Is this a parody account? Because you've nailed it

I don't know how the Israel data is being misinterpreted.

https://pbs.twimg.com/media/E_F6vV0XoAMbaNO?format=jpg&name=...

https://imgur.com/a/fzMdPFE

I guess ignoring data to push an agenda can be defined as "misinterpretation", fair enough. Carry on.

It's telling that linking to factual hard data is being downvoted.

It’s not hard data. It’s nonsense. There are so many confounding factors that comparing Israel and Sweden is non-sensical.

Hard data is easily available directly from the horse’s mouth [1].

As of today, in Israel, for age 60+, per 100K population. Unvaxxed are 4.5X more likely to be seriously ill compared to 2 shot vaccinated and 40X compared to 3 shot.

For under 60. The same ratios per 100K are 3x and 10x.

1. https://datadashboard.health.gov.il/COVID-19/general

with regards to misinterpretation of israeli data, it's more like miscalculation of israeli data:

1) his calculated efficiency for different age groups is up to 40%+ higher compared to numbers that released by israeli ministry of health in official presentations. when asked about it, he said that he doesn't know how they calculate it and this is his numbers

2) his calculations from the beginning included people that got booster shot. Kinda hard to base statistics about efficiency of two doses when you get inside it data about people who got three

I think the misinterpretation is mainly by the media and the general public. When most of your population is vaccinated and most of the serious disease is in the unvaccinated, you need to report by rate and vaccination status as the Ontario Science Table [1] now does (rather than absolute case numbers).

Simpson's Paradox is more of a data artifact that you have to be aware of. I didn't know about this statistical anomaly before but the takeaway is that if you see a effectiveness percentage decrease from 97% to 77% then you should also check that the value in each age cohort because each individual cohort may surprisingly be above 90%. The Israeli data might be fine but I want to see the "age corrected" range rather than a single effectiveness number.

The bottom line is that we will get good data moving forward from the Israeli 3rd dose program with other quality data sets soon to follow from the U.S., UK, Canada, Singapore, etc.

What we have not yet seen is any good evidence that the vaccinated are contributing to spread, though in the Fauci interview he indicated that the R(t) in the unvaccinated was non-zero. This is an important question, IMO.

[1] https://covid19-sciencetable.ca/ontario-dashboard/#riskbyvac...

i know. as i said he miscalculated efficiency for age cohorts. israeli data for most age ranges is 45 to 25 percent lower than his calculated 95%-99%+ efficiency. So maybe, as paradox it's nice, but as calculation go, they suck. and now everybody running around with this site as proof that there is no need in booster because efficiency is still 95%

Do you have a link to the full age cohort effectiveness numbers? I didn't think these numbers were published yet, if they are or don't exhibit Simpson's Paradox then the question is what accounts for the discrepancy with the UK and Canadian data and the immunological lab research done by Shane Crotty and Rockefeller [1].

[1] https://www.microbe.tv/twiv/twiv-717/

There were presentation with numbers stratified by age, but I can't find it now. Unfortunately I still can't figure out how to track down everything that ministry of health releases over there. Closet one that I found is this one https://www.gov.il/BlobFolder/reports/vpb-12082021/he/files_... . Look at slide 7.

Also, if you we are talking about Simpson's Paradox, we need to go deeper. As you can see at same slide, vaccine efficiency going down, the further you get away from second shot. Hence, age cohort effectiveness is useless. You need age/vaccination time frames to judge real efficiency

The whole booster conversation seems like a political game.

If you have a vaccine, then your risk of death is far below that of the flu (statistically).

If you don't have a vaccine by now, you want covid instead and this booster conversation is irrelevant.

Kids are banned from taking anything.

So I expect booster or no booster, frankly it just won't matter much at the population scale.

I also don't understand the mask/booster thing now.

Is it to protect kids? If so, then all that effort is better directed at the FDA who has banned them from getting the vaccine. I think this is the area where people should have the most anger and Biden should frankly push legislation to replace or reform the FDA. Their behavior has been atrocious.

Is it to protect the unvaccinated? COVID is not going away, so IMO here we just want everyone in this population to get the disease as fast as possible to get it over with. Spreading is basically "good" for this group.

Is it to protect the vaccinated? This makes no sense, as the risk to the vaccinated well below the range we have accepted for decades.

> Is it to protect the unvaccinated? COVID is not going away, so IMO here we just want everyone in this population to get the disease as fast as possible to get it over with.

No we definitely do not want that. There are large deaths of the country where vaccinated people are dying of unrelated conditions simply because hospitals are too full of dying unvaccinated COVID patients. The only way this works is if hospitals deny admittance to unvaccinated patients entirely, to reserve capacity for all the normal reasons that people need hospitals. No one is seriously suggesting this level of care rationing though.

it's really simple: you ration care according to the urgency of need. it's no different than any other event that would bring more people to the hospital than usual.

i've heard stories like what you're talking about. they don't make much sense. hospitals running out of oxygen? get more oxygen. that's why we have roads and trucks. not enough beds in the icu? build more. i think often about the start of the pandemic, before it got over here. i saw a story on the news that china had put up several hospitals practically overnight to handle the influx of patients. but here there's nothing but lame excuses. when i hear that kind of stuff it feels like i'm talking to someone that owes me money but doesn't have it.

Serious questions:

1. Where do you get the extra oxygen? There are places asking residents to reduce water usage because they are running out of liquid oxygen (used for water treatment in those places) do to medical uses. Do we have an enough manufacturing capabilities to produce enough oxygen to satisfy demand? Can this easily be increased?

2. "Beds" is not accurate. Often hospitals at 100%+ capacity still have physical space (i.e. "beds"), but who staffs the beds? You need doctors, nurses, and custodial staff. Where do those come from? Traveling nurses are a thing and places like Florida and Texas are hiring hundreds (thousands?). What is they supply of these nurses? What about doctors?

3. Where do the dead go and how do you deal with it? At the beginning of the pandemic NYC has to use refrigerated trucks. Now Texas and Florida (and presumably other out of control places) are also using refrigerated trucks to store the dead. This is probably one of the easier logistical issues because presumably we could just freeze the thousands of dead people every day until morgues and other resources could catch up.

I don't think this is so simple as "get more oxygen" and "add beds".

> i've heard stories like what you're talking about. they don't make much sense. hospitals running out of oxygen? get more oxygen. that's why we have roads and trucks. not enough beds in the icu? build more.

Poor? Just get more money! If only every problem had such a facile answer!

None of this is remotely as easy as you seem to think it is. If it were that easy, they'd already be doing it. They're not morons. And as someone else pointed out, "not enough beds" is shorthand for "not enough doctors and nurses". It'll take years to increase the supply there.

Where are people dying because the hospitals are too full of unvaccinated patients dying of COVID-19?

On the twitter!

In Southern Oregon, people with cancer or who are at risk of heart attack or stroke are being made to wait for care, because the hospitals are filled with unvaccinated COVID-19 patients:

https://www.oregonlive.com/coronavirus/2021/09/absolutely-he...

In another rural region (Idaho, maybe?) there was just that, someone who had some treatable condition who was unable to be seen for all the unvaccinated COVID patients, and who died from the condition. I couldn't find the article, but it was just published on some authoritative news service a few days ago, in case you'd like to look for it.

I mean the government and these private hospitals had a year and a half to build capacity. Last I checked building capacity was supposed to be the rationale for the whole “flatten the curve” thing back in March of 2020.

Why are hospitals “full” when they had all this time? Why is society supposed to be punished for a failure of leadership to do what they said?

Doctors and nurses don't get built in a year.

That seems like such an excuse. A year and a half is plenty of time to get creative. Pull people out of retirement. Let nursing students do more. Pay truckloads of money to all of them. I dunno. Figure it out. These folks are supposed to be the “experts”… what have they been doing this whole time?

Saying “no it cannot be done” is just not a valid excuse.

> Pull people out of retirement, Pay truckloads of money

So take the most vulnerable age group (old people) - and stick them on the front lines, looking after fat lazy middle aged people who are too lazy to get a 50cc jab.

They are retired doctors, they are not retards.

> what have they been doing this whole time?

Working on the most cost-effective, life-saving way to manage the pandemic: encouraging everyone who is able to to get vaccinated. Unfortunately, they had to work against an absurd scenario where an equal-opportunity virus has been politicized.

I am not a doctor so I cannot judge if “no it cannot be done” is valid or not.

But I think experts are allowed and expected to say “no it cannot be done” when something truly cannot be done. Experts are not superheroes and unlike superhero movies (just as example) there are matters that we cannot solve in a timely matter no matter how many experts we throw in the ring.

Alabama, for one: https://www.cnn.com/2021/09/13/us/alabama-heart-patient-icu-...

There is a finite healthcare capacity (largely based on the number of doctors and nurses). Once it's exceeded, people start dying who otherwise could've been saved had the full amount of healthcare resources been available.

I believe a serious issue with your “protect the unvaccinated” statement is it overlooks the amount of pressure they exert on our shared medical system. If your hospital beds are overrun with unvaccinated Covid patients, there is less room for others.

We could address the hospitalization issue by doing a better job of deciding when to hospitalize. It seems that more than half of the cases of those who are taking spaces in hospitals are asymptomstic, mild, or incidental.

https://news.yahoo.com/57-percent-vaccinated-covid-19-203448...

They're in the hospital for other reasons.

That study is based on VA data and not reflective of the general population. It seems very problematic to talk as if that's true for all hospitals.

> hospital beds are overrun with unvaccinated Covid patients, there is less room for others

Was in Jackson Hole for Labor Day weekend. They border Idaho, whose voluntarily unvaccinated have filled its hospitals. In four days I met as many nurses and one doctor who quit out of frustration. They could no longer empathise with their patients, each describing a visceral anger at tending to ICUs of COVID patients, all unvaccinated.

I was there too. I was also in Boise, and Twin Falls, ID.

I went to no less than 20 doctors or nurses in the space of 2 weeks

Not one doctor mentioned anything about quitting or being short-staffed.

20 doctors/nurses in 2 weeks? I hope you were taking a survey or selling medical equipment, and you were not ill.

It did seem crazy at the time.

But not ill. Thanks for your concern.

One of the doctors was an ophthalmologist. Did the full vision test while at it. I was not driving - mostly doing uber to get around.

Made the mistake accepting the eye drops they often do for vision testing.

My phone was a complete blur after the drops.

Yes...I had a few more appts that day.

Trying to get around or even something as basic as calling was hard. Now imagine having to fill out online forms on mobile. Nightmare

In quiet desperation, i tried to turn on the accessibility settings on my android.

The phone suddenly started parroting loudly YOU ARE NOW USING ACCESSIBILITY SETTINGS PLEASE CONFIRM in the middle of a quiet waiting room.

The 3 hours that followed where the most vulnerable and humbling of my life.

> Not one doctor mentioned anything about quitting or being short-staffed

This likely comes down to self selection. You were in Idaho, I in Jackson. Also, relatively-rural Driggs versus denser Boise having different rates of spare hospital capacity as well as vaccination. (Or seeing a doctor at their office versus off duty.) Given Idaho was flirting with crisis standards of care, I think it’s objective to say they have a problem.

This is definitely one of the reasons I bailed after Medical school. Unvaccinated COVID patients are new, but that kind of decision making is not. Once I realized medicine was as much begging people to make good decisions as it was actually helping people, I just didn't think I could spend a lifetime doing that. Anecdotally, the few physician contacts I've kept are regularly posting about how much they are working. Which is impressive, because to them working 60+ hours a week is not considered too much.

>They could no longer empathise with their patients, each describing a visceral anger at tending to ICUs of COVID patients, all unvaccinated.

Did you ask them if they treat obese people the same way?

If obesity could be prevented with a simple shot, and was otherwise overwhelming our healthcare system, that might be a useful question.

I mean you could get Osha to start banning foods or do whatever with the jurisdiction they have now. Tax sugar out of existence. Then government subsidize all healthier foods. I mean the amount of money we spent no Covid we could have done all this....

But wait are you saying people should be able to make their on decisions? Obesity effects only a single person. Nope obesity is transmissible. I've seen too many couples where 1 is skinny and the other is obese or overweight. They both become overweight.

No one in the history of the world has died from obesity two weeks after simply spending time with another obese person.

Yes but if we sent everyone a Peloton in March 2020 and required use of it how many people would we have saved by now? Just pay people to use it which seems more ethical than paying people to take the vaccine.

Pandemics come and go. We might as well use fear to pass policies now like we did after 9/11

It IS overwhelming our health system. The 1,3, and 9th causes of death can all be attributed to in whole or at least in part to obesity. And guess what it has a super simple treatment called exercise and healthy diet. You can add it to reasons for dying from COVID as well.

https://www.who.int/news-room/fact-sheets/detail/the-top-10-...

While we're at it since you seem to be really into some weird sort of eugenics mindset why don't you let us all know whether drug addicts should get treated? You might wanna tread carefully on this authoritarian attitude you've got going. You're treading a very fine line deciding who's worthy of treatment and who's not.

I do not want a medical system that gets to pass judgement on who they're going to administer treatment to. That's absolutely horrifying. These nurses can vent all they want but the moment they suggest they're not going to do everything they can to save people they should be relieved of their jobs.

> While we're at it since you seem to be really into some weird sort of eugenics mindset

I’m morbidly curious what leads you to say that.

I don't understand their frustration.

There's not much they can do for a patient once that patient is admitted to the ICU.

Hospitals should have been setting up Covid wards, or tents. The hospital had enough time. Other than intubation there's not much. I guess if you are important enough you get those coveted antibodies that were donated, or blood thinning drugs if you have blood clots in your lungs.

I've never met a doctor who quit over ethics. I've seen many who quit over ego disutes, or pay.

In medicine there's something called Professional Deniability. American doctors gave it in spades.

I'm all for getting the idiots vaccinated, but don't buy the caring doctor quitting because he/she has a moral dilemma.

(I think American doctors are good, but caring no. Ethical just enough to keep them out of a Malpractise suit.)

> Hospitals should have been setting up Covid wards, or tents.

They have, at least where I am. As demand goes up, they've even shut down whole clinics to reserve them for COVID patients.

> The hospital had enough time.

They definitely did not have enough time to train and hire new nurses and doctors.

They are not quitting out of ethics, ego or pay. They are quitting because they are overworked (more patients per doctor), and putting their own lives at risk because people made a choice not to get vaccinated.

> Hospitals should have been setting up Covid wards, or tents.

didn't this happen basically everywhere already, and most if not all of ended up being unneeded at the time? our local civic center converted into a temporary emergency covid care facility months ago and it was never used, so they shut it down. now the local healthcare corporation CEO is claiming the ICUs are full again. well if that's truly the case, we could easily set up the emergency care facility again, our mayor and governor have shown they're more than willing to help when the situation arises. so, at least here in my neck of the woods, something doesn't add up.

Percentage of 65+ people in Idaho with at least one covid vaccine dose: 93.2%

Percentage of 65+ people in Wyoming with at least one covid vaccine dose: 89.2%.

https://www.mayoclinic.org/coronavirus-covid-19/vaccine-trac...

As I mentioned on another thread, I just spent a few days in the hospital with an appendicitis. The hospital was swamped with COVID patients. It took 16 hours for me to be admitted to the hospital, which I was told was quite long for this hospital. My hospital roommate waited nearly 30 hours. The non-covid floor that I was on was severely understaffed, with nurses caring for 2.5x as many patients as normal. The nursing staff was run ragged.

I'm not sure exactly what we should do. We can't just refuse to treat the unvaccinated (I half suggested this before, which I regret), but we need to maintain our ability to care for other people. I didn't make a conscious decision that landed me in the hospital. My roommate didn't decide to let a spider bite his foot. The stage 4 cancer patient whose "elective" surgery was postponed didn't decide to get cancer. The heart patient who can't get an ICU bed didn't decide to have a heart attack.

I could imagine having regional FEMA/national guard run COVID hospitals. But where would the staff come from? There are a limited supply of trained medical staff.

I'm just not sure what we can do that's humane and fair to everyone besides just provide incentives to get vaccinated. We probably need WWII level propaganda to convince the unvaccinated.

So your assumption is that all the covid patients were unvaccinated?

Not an assumption. Just the data showing this to be true almost universally across the US. Statistically, breakthrough cases also skew older. Locally where I live >95% of patients in the hospital with COVID are unvaccinated.

It's a safe assumption that MOST are unvaccinated based on all available data. But of course not ALL (statistically speaking).

> If you don't have a vaccine by now, you want covid instead and this booster conversation is irrelevant

Friend’s mother visiting from Jamaica. People in her country are dying while they wait for first shots. The voluntarily unvaccinated in America are idiots. The author’s point is there are billions of unvoluntarily unvaccinated around the world to whom these doses could go.

Yikes. Idiots? All this condescension all the time.

Maybe some people won’t get the vaccine because they already had Covid. Israeli study showed that people who had Covid are more protected than the vaccinated.

Doesn’t hurt to get vaccinated anyway. In fact that should offer the most protection overall.

And that’s besides the point as the recovered may as well be vaccinated in the context of this discussion.

somebody's gotta be the control group in all of this, I'll take one for the team, in the name of Science

Not with the delta variant.

It's highly ignorant to call unvaccinated Americans idiots. Over 100 million Americans have already caught and recovered from Covid. I imagine many in that group don't see any value in getting the vaccine (rightfully so).

Most of those people don't actually know they had COVID. They make up stories that "they've already had it". Remember that vaccinated still get COVID, those numbers include them.

What evidence do you have for your claim? An anecdote or two from your own life? How is that any more scientific than what you claim to be decrying?

In the U.S. at least, there is a mass testing regime that many must submit to for work, school, etc. Are you suggesting those who have tested positive in these situations are "making up stories"?

Anecdotally, there are people who say it only based upon symptoms. I'd even argue that they are probably right, but its fair to say that they have any way of validating or proving that knowledge.

I agree that if someone is doing this, they do not have definitive proof.

The comment I was responding to claimed "most" people are making claims without proof. Despite the hundreds of millions (billions?) of covid tests that have been administered throughout the pandemic in the U.S.

There were a few stories that called into question the effectiveness of these tests ranging from PCR, antibody, antigen, etc.

Overwhelmingly people did not have to test for COVID, and never did. They had a few "symptoms" and claimed they got COVID and it "was no big deal". When in reality they have no proof of it. Humans overwhelmingly make up stories so reinforce their opinions. And no, most work did not require testing, even government work. Even federal government work.

"Humans overwhelmingly make up stories so reinforce their opinions."

At least we can agree on that. You're doing it right now.

Funny that you put "a few symptoms" in scare quotes, given that loss of taste and smell is highly indicative of covid and not any other widely circulating illness.

There is some value in fitting in with society and showing those who are skeptical that there's nothing to be afraid of with a vaccine. And with more mandates going into place it's easier to just get vaccinated.

I've said from the beginning of this year that I'll get vaccinated as soon as the government gets out of it. At this point, the mandates are specifically why I refuse to get vaccinated. I caught covid in August so I'm immune for the next year at least. So there's no reason for me to get vaccinated and every reason not to.

> I've said from the beginning of this year that I'll get vaccinated as soon as the government gets out of it. At this point, the mandates are specifically why I refuse to get vaccinated.

Do you find any irony in your decision being controlled by the government's policy?

I agree with arcbyte, and I got my second shot in March. The amount of government interference as it relates to COVID and vaccines is complete bullshit. I hope we look back on this in 20 years and feel a deep sense of embarrassment for how COVID and the vaccine has been managed and used to emotionally manipulate and divide people.

When 9/11 happened it united the country. COVID should have done the same thing, but it has been used as a political tool instead, bringing out the worst in people. It makes me quite depressed when I think about it for too long.

> When 9/11 happened it united the country. COVID should have done the same thing, but it has been used as a political tool instead, bringing out the worst in people. It makes me quite depressed when I think about it for too long.

I've felt this way too. People have made this so incredibly, incredibly divisive. I'm not sure what blend of fear and tribalism is driving this either. When you talk to some people about covid, what comes out of their mouth is almost word salad--they are so incredibly fearful and panicked that almost none of what they say makes sense. The idea that society should completely alter everything for this one specific illness (aka "new normal") is pretty absurd, yet people will stop just short of spitting on your face when you express any skepticism at all.

Societies reaction to this is all just so freaking bizarre. None of what we are doing adds up or makes much sense when you really start asking questions.

After 9/11 a significant portion of the US was staunchly anti-war, organized some of the largest protests in US history, and yet they were ignored by the media and demonized as anti-patriotic. On top of that, muslim americans have had to endure years of racist attacks, not only from individuals but also from the state, in borders and airports, ongoing to this day.

If you think it "united the country" then you either have rose-tinted glasses on, or you had your opinion validated by the pro-war media and never looked elsewhere. The difference is that now the media disagrees with you.

That isn't accurate. The media doesn't disagree with me, the country is ripped in two over COVID and vaccines, there is no denying that.

Why do you say they disagree?

Edit: capitalization

Second edit: I didn't say the WAR united the country. You're twisting my comment.

The war was a direct response to 9/11, they're directly related, just like vaccines and mandates are a direct response to COVID. The country was ripped in two back then two, you just didn't hear about it as much.

I was wrong when I said the media disagrees with you though. Maybe the difference is that the anti-vax side has managed to organize through the internet and has gotten a lot more coverage, so they look bigger than they actually are?

> The war was a direct response to 9/11, they're directly related, just like vaccines and mandates are a direct response to COVID. The country was ripped in two back then two, you just didn't hear about it as much.

I understand the point you’re trying to make, but I still disagree. I was in high school when 9/11 happened, I remember it well. There was a period of time, I will admit it was on the order of 48-96 hours, where this country was as united as I’ve ever experienced. COVID could have had that same effect, us as country(wo)men against the world. It didn’t. From the jump it was politics. I’m sure you remember Harris and Biden saying they wouldn’t get a vaccine when Trump was president. It’s political all the way down.

You talk about an event that occurred over 12 hours uniting the country for a business week, and wonder why a disease that had been politicized and downplayed in contradiction to the science and what we were seeing in other countries for months before we saw significant numbers of infections in the US did not generate the same effect?

Of course it didn't. I don't understand why you think it ever had the chance to.

>I’m sure you remember Harris and Biden saying they wouldn’t get a vaccine when Trump was president. It’s political all the way down.

I remember their comments. I also remember the rest of the statements they made and the context around them. And neither of them said they wouldn't get a vaccine while Trump was president - they said that they wouldn't get a vaccine if Trump was the only one saying to get it, and experts like Fauci weren't.

https://www.politifact.com/factchecks/2021/jul/23/tiktok-pos...

> I remember their comments. I also remember the rest of the statements they made and the context around them. And neither of them said they wouldn't get a vaccine while Trump was president - they said that they wouldn't get a vaccine if Trump was the only one saying to get it, and experts like Fauci weren't.

that is another shining example of how COVID and the vaccine were used for political manipulation. Biden and Harris should have not made the vaccine about donald fucking trump.

Their stance was bullshit and you know it. In what world are global pharma companies going to develop a brand new vaccine using relatively new technology to try and stop a global pandemic, and the only fucking person to talk about them is Trump? Nobody else will say anything until Trump does? Trump would be the first and only authority on these vaccines? That's such a crock of shit.

> I caught covid in August so I'm immune for the next year at least.

Yeah and if you got vaccinated you probably wouldn't have caught it in August. Great hill to (hopefully metaphorically) die on.

Choosing to risk catching a disease with a 1-2% case fatality rate, while refusing an overwhelmingly safe and effective vaccine is the definition of idiocy.

IFR is a better metric than CFR:

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s...

The overall IFR is misleading, given how age-stratified the risk is:

https://www.nature.com/articles/s41586-020-2918-0

I absolutely adore when publicly available data sourced from government agencies gets downvoted.

Since March of 2020 any kind of statement suggesting covid isn’t as bad as some make it out to be is met with fierce vitriol. The number of times I’ve been called “dangerous” for posting well sourced data that clearly shows the IFR of covid is not 1-2%…

It’s as if people believe that any good news will result in others “not taking this serious”. They must feel that everybody needs to be scared stiff of this thing all the time… the result is the average person thinks if they catch covid they have a 10% chance of dying, which for most age groups is like 1000x off[0].

It’s super evil, really. If people were better informed about the risk profiles of covid, how many would have sacrificed a year and a half of their short life? Wouldn’t that imply that forcing this “new normal” crap by scaring the daylights out of people is a tad misguided and perhaps very unethical and immoral? If the only way you can get people to comply with your draconian interventions is lying to society about the risks of covid… well that is pretty fucked up.

Worse, by the way, is peoples risk assessment for covid is so completely wrong it makes debating public policy impossible. If the average adult thinks they have a 10% of dying if they got covid, of course they will want to mask little kids at school, of course they’ll cheer vaccine passports, of course they’ll rat each other out for sitting on a park bench. If they knew kids were at almost zero risk of covid, and their age bracket had minimal risks, would they have agreed to any of that?

[0] a fascinating data set: https://covid19pulse.usc.edu/

I remember when I first saw that USC dataset, it was mind blowing. Any public health official worth their salt should be absolutely horror struck that the public's perception of the risk profile of a disease is off by multiple orders of magnitude. Their entire job is to accurately inform the public about public health risks, and that dataset is proof that they've failed more spectacularly than I would have thought possible. They should be working around the clock to try to amend their failure, and earn back the trust they've thrown away.

Strangely, despite all the pearl clutching about "misinformation", this data-backed and quantifiable instance of covid misinformation never gets brought up. As a result, I now consider government / public health institution claims to be politically calculated fearmongering or propaganda until proven otherwise, and likely not worth my time to pay attention to. I'll update my opinion about them if their stance toward "correcting misinformation" starts to include misinformation like the above as well.

I'm not holding my breath.

You expressed my exact thoughts better than I ever could hope to. Thanks!

Mmmm - I thought the problem was that the risk profile is it's not linear? So like, if enough people have it, they swamp emergency rooms, and suddenly, a lot more people are dying than would be dying at a lower incidence rate. So from a public health perspective, you're not really looking at 'how likely is this to kill people' but rather, 'how likely is this to crash an already fragile medical system' and thereby cause a lot of people to die.

I think the point about COVID is that if everybody just ignored it, this is absolutely what would happen, and case fatality rates could get pretty high.

If they've already had and recovered from Covid, as in the case of this 100 MM, their case fatality rate is nothing near that, and may well be lower than that for vaccinated-but-never-infected people.

Their choice is this, if they are otherwise healthy and young: With protection as good or better than the vaccinated, should I get a shot that might lower my already minuscule chance of dying or serious disease by a further tiny amount.

I could see rational people coming down on both sides of that.

Let us assume person x already got covid? The rationale for refusing the vaccine is either (a) they believe they do not need it or (b) they do so on ideological belief.

If it is (a), evidence shows that covid + vaccine is better than either alone and hence no reason to refuse the vaccine.

If it is (b), there is perfect justification for calling that stancy as an idiotic stance.

It is true that evidence suggests past infection + vaccine is best. But the evidence also shows that antibodies from past infection are superior to two shots of Pfizer which the majority of people were rolling with maskless just fine.

So regarding option a, it’s moreso the case that there’s no legitimate reason TO bother with the vaccine if you have those antibodies already. A marginal improvement at best over what is already better than two shots of Pfizer, is not worth the long-term unknowns to me.

Source:

https://www.science.org/content/article/having-sars-cov-2-on...

There is also new evidence that it may be safer for boys to just get covid rather than vaccination.

Source:

https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...

Knowing this, will you still say there’s no reason to refuse it? Why would you elevate yourself into a position where you believe yourself to be an arbiter of this? The evidence is clear that the antibodies tens of millions already have from past infection are excellent. So stop coming up with false dilemmas.

> It's highly ignorant to call unvaccinated Americans idiots.

Agreed. The correct term for them is "immoral". The only world in which it makes sense to forgo the vaccine is one in which your life is only one that matters. So a healthy unvaccinated person is making a perfectly rational decision, just a morally bankrupt one.

How is it morally bankrupt to care about yourself more than people you don't know?

How does getting a vaccine affect a young healthy person negatively?

It is immoral for the same reason as refusing to help others survive at zero cost to you.

> How does getting a vaccine affect a young healthy person negatively?

Isn't that a reason people don't want the shot? Because they're not sure of the answer to that question.

I got my 2 shots. Had to drive 1.5 hours each way both times, find someone to watch my kids and burn up 2 Saturdays that I could have spent doing something I wanted to do that wasn't getting a shot.

To claim there is zero cost is insincere at best.

I am not sure which country you are in because I can walk into pharmacies and grocery stores and get a shot while shopping. Vaccine appointments were booked out early in the year in the United states. You could have just waited. The US government/pharma companies cant produce 600 million doses in a couple of weeks.

For me both shots were zero cost, as for every other person I know.

I was flying all over the country for the entire lockdown period. I didn’t want to wait to get the shot.

You had a peculiar outlier situation that simply isn't true for 99% of Americans. Glad to see that you judged that the vaccine was worth spending 2 entire days on.

If you answer my question I'll answer yours.

The vaccine does not come with 0 cost.

What was the cost to you? Sore arm? Feverish for a day?

It sucks to be surrounded by people who won't give a shit about senior Citizens, immunocompromised neighbors or older folks in their own families. It is indeed a lack of morality.

It would be very useful to know what percent of the unvaccinated population are not getting vaccinated because they already had COVID. What are their demographics, compared to the larger demographics of the unvaccinated population? And is it worth spending any effort (or White House budget paying TikTok influencers) trying to convince them to get a vaccine for an illness they have already had?

Anecdote to support your statement: A close friend that tested positive for COVID last year works at a hospital. They saw no value in getting vaccinated since they had already been infected and recovered. They were given an ultimatum last month of "get vaccinated or find a new job".

Reason has left the building.

How it would have hurt to get a vaccine?

Well for one it could go to desperate people in 3rd world countries? If you already provably had covid letting your now useless shot go to the ones in need is arguably the moral choice?

The doses in the countries they're at now aren't likely to go to a different country, and are more likely to expire before they could be shipped elsewhere, so people in those countries may as well get them. For other places, the problem is manufacturing and distribution, and lifting patent restrictions would help too.

>How it would have hurt to get a vaccine?

Notice how easy it is to conveniently jettison the science + data and just demand that people "tow the line or else.."

It's not only ignorant of the science, as you point out regarding prior immunity, but highly ignorant of history and social dynamics. Creating an underclass that is considered diseased and "dangerous to us" ends badly, to say the least.

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

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

In addition, minorities have reason to distrust the medical establishment.[0] For all the noise made about "voter ID is racist", almost no one has said that "vaccine passports are racist". Do we really want to create another two tiered system where minorities are the outgroup again?

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

Calling the unvaccinated idiots is about as effective as calling the obese, alcoholics, people who don’t take their medication, etc, idiots.

Apparently we have sympathy for people who fail to make good health choices except for the unvaccinated.

Not effective at all.

> obese

Requires lifestyle change

> alcoholics

Requires lifestyle change

> people who don’t take their medication

Requires lifestyle change

> Vaccine

Requires a choice and a half day off.

There is a BIG difference there.

What you call lifestyle changes I call “need to make a decision”. Patients make terrible healthcare choices all the time. If we’re going to hammer them on vaccines let’s go all in, huh?

Obesity causes massive costs and burden on our healthcare system yet I don’t see people calling them idiots.

A lifestyle change is something that you need to actively pursue forever. It's not just a one time decision and action. I can't tell if you're being intentionally obtuse, or you actually can't see the difference.

And yes, all the issues listed are ones that can (usually) be corrected by action of the person involved. But the _level_ of action is on a totally different scale.

>I can't tell if you're being intentionally obtuse

Given this guy's attitudes towards vaccines, I doubt it's intentional.

Then we agree - these are are healthcare choices where people fail to make the right one?

> What you call lifestyle changes I call “need to make a decision”.

Well I'd suggest not downplaying it that way. Going from a junk-food-and-soda diet to a healthy one is a huge shift in lifestyle. You don't just make a decision one day and that's that. You have to make that decision several times a day, every day, for the rest of your life.

Not getting enough exercise? You don't just sign up for a gym membership and consider it done. No, that's just the first step. Now you need to show up at the gym several times a week, and put the work in over and over again.

An alcoholic doesn't just decide to stop drinking one day, then poof they're cured. That decision is just the beginning. What follows is some mix of white knuckling in the beginning and an ever-present vigilance to maintain sobriety. It's not just "I don't drink anymore", but also "I need to come to terms with this issue or that relationship", and "I can't hang out at the bar every night anymore". It's a long-term project, not just a decision.

Getting a vaccination is not like that at all. It really is a single decision, once made, and never thought about again.

Obesity is also way more complex than taking a shot. Its not as simple as "eat as much as your neighbor". Minor systemic differences in metabolism can have huge long-term weight implications.

There's a little bit of an unfair comparison here. You say the vaccine is a single choice, but what I see, continued boosters, masks, social distancing forever, "I'm willing to make a small change in my life to end this." And you might say "I'm not arguing for those things though" but if you stop at one shot, a year from now someone is going to be calling you an anti vaxxer or covid denier for not wanting to turn this one shot into a lifestyle change. And that's what is expected of us if we are being honest, not one quick shot, but a permanent lifestyle change. Some people don't even want to start down that road.

The lifestyle change is a choice that we make. For those people that HAVE made these choices, should also have a choice into taking a vaccine when they don't need it, just to satisfy those that have not taken the choice to do the same. Those who are obese, alcoholics or whatever can then take the choice to get vaccinated to better protect themselves

The problem is that, by not getting vaccinated, they're not _just_ impacting themselves. They're more likely to get, to pass it to others, to introduce a variant, etc. We're all much safer if everyone gets immunized. Or, at least, so the prevailing scientific theory and minds indicate... and you can either believe them or chose not to with no actual facts to back up your position... and be called an idiot ./shrug.

The unvaccinated are putting others at risk, including kids. I can't say the same about the obese or people who don't take their medication.

There is no significant risk to healthy kids.

https://www.nature.com/articles/d41586-021-02423-8

Obese people take up health care resources that could go to keeping kids healthier at lower cost or making those resources more available to kids in an emergency.

asides from obese people / poor lifestyle choice people taking up health care resources, not only from Covid but they're also taking up resources from all other ailments that comes up BECAUSE they're obese. As well the culture today encourages plus size, like it's asking to overwhelm the healthcare system

obesity spreads too https://www.nejm.org/doi/full/10.1056/NEJMsa066082 just not the way you think they do as a virus

If someone were struggling with alcoholism, and I offered them an FDA approved shot to remove their addiction to alcohol, I would consider them fairly stupid if they refused it. Handling diseases and addictions is a long term struggle, not similar to a one time choice at all. It is orders of magnitude easier to get a covid shot than to rid yourself of an addiction.

There are FDA approved medications which are effective in treating alcoholism.

https://www.webmd.com/mental-health/addiction/features/fight...

Those are all drugs which try to make curing addiction easier, but it's still hard and you're going to suffer withdrawal symptoms and take these drugs for months. Very different from this magical hypothetical. Probably taking something like one of these is, however, advisable if trying to get off alcohol?

I’m glad your not a doctor then?

First off, the vaccine does not eliminate the risk of Covid. If you went to an alcoholic and said “this shot has a 90% chance of curing you of alcoholism but had side effects and you might end up quitting anyways” would you still call them an idiot for hesitating?

Type 2 diabetics can prevent most of the complications if they adhere to a strict diet and medication regimen. When they end up getting a limb amputated do you call them idiots as well?

> If you went to an alcoholic and said “this shot has a 90% chance of curing you of alcoholism but had side effects and you might end up quitting anyways” would you still call them an idiot for hesitating?

Depends on the side effects obviously. If clinical trials revealed nothing but rare allergic reactions to shots themselves and priors based on established medical knowledge predicted a very low chance of anything unusual happening over the very very long term, it'd be a no brainer. Nobody just quits alcoholism. It's by definition a difficult process.

> Type 2 diabetics can prevent most of the complications if they adhere to a strict diet and medication regimen. When they end up getting a limb amputated do you call them idiots as well?

I would call them idiots if they were presented a single shot to cure them of type 2 diabetes and they decided not to, then lost their limbs.

It's not really fair to compare a healthy person to someone "struggling with alcoholism".

If you run into a bar shouting about the dangers of consuming alcohol while promising an injection that makes a person never want to drink again, I would consider you fairly stupid.

That's my point. Falling victim to alcoholism is not an apt analogy to getting a covid shot. People don't generally choose to become alcoholics. If you really want to make your contrived example fit, it would be something like a shot that prevents organ damage from alcohol, not desire to drink.

If such a thing were available, and people refused, and then got alcohol poisoning, then it is arguable that, on some level, their stupidity is to blame here.

Ok, but would you call them an idiot? That’s my point. Do you think calling them idiots makes them more or less likely to make the right choice?

>Calling the unvaccinated idiots is about as effective as calling the obese, alcoholics, people who don’t take their medication, etc, idiots.

I mean, we should. And I say that as someone who is overweight and drinks more than I should. (Hm. Are they connected?!)

I'm fully aware that one of the most significant changes I can make to reduce my risk profile for all cause mortality is dropping weight, and have at times done so, and at times slipped back into poor eating and exercise habits. I'm in the middle one of the trends to improve it, but who knows if it will stick this time.

And yep, I'm stupid for not sticking to it. Or lacking in willpower. Or some combination of things that you would be fully justified in ascribing some sort of negative label to.

But if I could take a shot that makes me significantly less likely to die from my love of craft beer and cooking delicious, delicious, high calorie meals full of carbs and fat and not enough veggies, I sure would. If I could take a shot that made my body recover from doing strength training now in my 30s like it did back when I was in my early 20s, and less likely to have minor injuries, or even more likely to get me to return to the habit after recuperating from those injuries instead of staring wistfully at my garage door and thinking "man I really should get back to lifting weights", I would definitely do that.

I know I'm an idiot for not taking enough control over my own life to take care of some of the single largest health concerns. But I'd be an even bigger idiot if there was something as simple as a two or three dose vaccine regimen available to take care of those risks that I ignored.

Anecdotally, I decided not to get the vaccine. Three weeks ago, my friend who had gotten the vaccine got Covid, and then gave it to me. (He also beat me in golf that day which says a lot more about my golf than his ability to play while sick). But anyway, we both lost our sense of taste and smell, had fevers, were achy, him up until about a week ago, me up until a couple of days ago. So, perhaps he would have had an even tougher go at it had he not been vaccinated, but to me it seems we both suffered just about identical outcomes.

I roll a six sided die. You roll a 20 sided die. We both get a 4. I guess they're the same.

Except the 6 and 20 numbers are ones you just made up to support your position and make yourself feel warm inside but this fact just makes your entire statement meaningless and at the center of your grin at your own wit is an empty, hollow nothing.

His point was that two processes can result in the same outcome when dependent on more factors than just the quality of the process. That doesn't mean that you shouldn't use the better process, just that it does not guarantee a better outcome. Only a better chance of a better outcome.

Though, based on the actual data we have, his numbers aren't bad for cases, and would need to be shifted to a dice with a lot more sides than a d20 for hospitalizations and deaths.

https://www.fastcompany.com/90675524/delta-variant-vaccinate...

Anecdotally, the CEO of my company just died of Covid.

Anecdotally, my uncle who was otherwise healthy died months after getting the jab. And my sister's husband came down with some major fatigue/fever issues recently after the jab. So again, I took my chances based on the facts I had, yet I will get downvoted because they aren't in lock step with most of HN.

Apparently my comment was also not in lock step as you say. I'm not questioning your decision but if we're providing anecdotal data points then we should provide as many as possible.

So, at first you claimed you didn't want to get the vaccine because a friend got it and still got sick. Now you claimed your uncle died from it and your sister's husband got serious sick from it. I wonder why you didn't mention that at first to make your point, instead of using the much less serious case about your friend. Make me skeptical about everything you said.

No, it wasn't that I didn't want to get the vaccine because my friend got sick. The fact was he had the vaccine, and got me sick and we both had as close to the exact same experience during the sickness. The second parts about my uncle and my sister's husband I can't really prove they are related to the vaccine, but were just in response to the previous commenters. Sorry if that wasn't clear.

Given the R0-value of Covid, the likelihood is fairly high that you spread the virus to other people. Your amazingly impressive immune system would have absolutely crushed the virus with the help of a vaccine, and perhaps you would have had 0 symptoms and been totally non-contagious. Someone could be in a hospital bed because of your decision. Food for thought.

Last I checked, it's unknown how much (if at all) the vaccine reduces spread.

please give '''my''' shot to a high risk person in jamaica or iran or brazil. i don't need it, they do.

Thankfully, the most high risk people in Brazil have gotten two shots by now; we're moving towards giving a first shot to every adult, and starting second shots for everyone. The vaccination campaign was botched by negligence and corruption from the Bolsonaro government, but by now the doses are finally arriving.

We're also having the same discussions about third dose... Currently, the order is to give a third dose for the elderly (70+) and immunocompromised.

> i don't need it

Yes. You do. Even if you're asymptomatic, the virus will still mutate with a small chance of becoming another variant, and if you're unvaccinated in such a case, that means you'll spread it to others.

By not being vaccinated, you run the risk of spreading a variant around that is a "breakthrough variant" - a mutation of the disease that is hardened against a particular vaccine brand.

Thus, you will be contributing to healthy people getting sick despite being properly vaccinated.

While I agree that the rational course for anybody who is able to get vaccinated is to get vaccinated, people may still have reasons—however irrational—that are not idiotic.

Lets say you are a person who has had substandard health care all your life. And justly see the medical system as something not catered for people like you. You know the history of inhumane medical experiments being conducted on your ancestors as early as a generation ago. You also know that the medical profession has had severely wrong and racist theories about health care for your ethnicity.

Now the medical profession asks you to trust them and accept the vaccine.

Now I am not that person, and where I’m from the health care system has proven it self to be extremely valuable for me personally and those who I love (and coincidentally has one of the highest vaccination rate in the world). But if I put my self in other’s shoes I can easily understand how vaccine hesitancy is only natural.

Now what to do about it: Respect peoples concerns, e.g. don’t call them idiots for these concerns. Try to understand and educate. If people still don’t want the vaccine, don’t panic. Keep giving vaccines out for free to those who want it (and please include poorer countries). Perhaps if enough people are vaccinated worldwide it will slow the spread and mutation rate of the virus enough that we won’t have more of the mass waves of new variants and the vaccination status of each individual becomes irrelevant.

>Is it to protect kids? If so, then all that effort is better directed at the FDA who has banned them from getting the vaccine. I think this is the area where people should have the most anger and Biden should frankly push legislation to replace or reform the FDA. Their behavior has been atrocious.

What specifically has been atrocious? The FDA has ALWAYS been extremely cautious in approving vaccinations for children. The vaccine was just officially approved for adults, they don't feel they have the data to do so for kids yet as far as I can tell.

The FDA initially wanted 2 months of data for under 12, just like adults. Then they changed their minds and wanted 6 months instead. I'm sure they had a reason, but in 70 years of vaccines, we've never had a side effect after 2 months. If they changed their minds once, they can damn well do it again and get this thing out there.

Then there's the objections (and resignations) to the booster. The specific reasons being:

> current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations

We all know this, but it's not the FDA's job to factor in global supply and distribution. Are boosters safe and effective? That's the FDA's job. Will denying boosters in the US increase first shots in other countries? That sure seems debatable to me. But regardless, it's not the concern of the FDA. I don't know what the hell they have been doing, but they've been going far beyond their scope lately.

How are they going to model efficacy if child mortality is very low already?

I think the first efficacy data is going to be about preventing infections. Data about preventing deaths will take longer to obtain.

Infections in a world where asymptotic spread is possible seems tough to measure. Are infections measured by symptoms such as cough, fever, etc, or by enough virus replication to shed or expel viral enough material to infect others?

Depends on the study design. Infections are detected by doing a PCR covid test. However, different studies might have different criteria for exactly who gets tested.

PCR doesn’t differentiate between live and dead virus molecules, which makes it less than diagnostic for active infection without symptoms, right?

That distinction isn't as important for evaluating vaccine efficacy. It wants to measure if the person was infected, not if the person is infectious.

If a trial subject is exposed to virus and the vaccine works to trigger an effective immune response, how does PCR know the difference between virus molecules neutralized by vaccine response and those neutralized otherwise?

In those cases the virus particles don't replicate enough to be detected.

How is a difference be determined between between vaccine enhanced immune response, normal immune response and not exposed?

The basic structure of a phase 3 vaccine efficacy trial is that you give the vaccine to half of the volunteers and placebo to the other half. Then you you wait for them to naturally be exposed to COVID. When a pre-determined number of infections is reached, the data is unblinded and they compare how many infections happened in the vaccine group vs the placebo group. If less people are infected in the vaccinated group then it shows that the vaccine is effective.

The initial comment wrote:

If child mortality and clinically significant infection are low, then would it not potentially take longer to see a statistically difference in a difference between vaccine and placebo subjects?

> I'm sure they had a reason, but in 70 years of vaccines, we've never had a side effect after 2 months.

Have we ever had mRNA vaccines?

no, but nothing about the mechanism of mRNA vaccines suggests they'd be an exception in that regard, since mRNA is very short-lived and thus if you'd get long-term effects, you'd have them from other delivery methods too.

As Vinay Prasad would say, It is often our mechanistic understanding that misaligns with study results. All we can do is test.

I believe part of the difficulty was the lull in infections before delta, plus the effectiveness of school closures. If nobody is getting sick, you cannot say anything about effectiveness.

I don’t know if they want proof of effectiveness again, or are specifically looking at risk (which would not be impacted by the above).

If guess the risk of death is so low among children, you need far more data to exclude a risk from vaccination at that (small) magnitude. Think of helmets, and how they are exactly as comfortable to wear in a car as they are on a motorcycle.

> Is it to protect the vaccinated? This makes no sense, as the risk to the vaccinated well below the range we have accepted for decades.

What is the acceptable range? Older people are still dying from Covid even after 2 shots. If a third shot can improve someone's protection from death due to Covid, say from 70% to 90% [1], that sounds like a good reason to take that shot.

The comparison between someone in Israel taking a booster shot and someone in a 3rd world country without access to vaccines is irrelevant - at least until there's a serious global initiative to provide vaccines to everyone around the world.

[1] Original stats talked about 90% protection, but that has gone down since then. One of the possible reasons is the need for a booster shot. But we still don't know what level of protection the booster shot will provide.

As long as they don't impose to me (40 y.o.) to catch a plane... fine with me

I am getting very wary of the whole situation.

"As soon as we get a vaccine we are good". Now we have the bloody thing, I got injected with it hoping to get back to normal: "We need a booster shot"

I was always pretty rational about it, but this is becoming a farce

There is a good chunk of society that absolutely refuses to move on.

Yea, They can easily end this by just getting the jab, but choose not to. I'm starting to think the anti-mask, anti-vax crowd actually loves COVID and stay-at-home and all these restrictions. With COVID, these people imagine themselves as powerful freedom fighters, knowers of The Truth, battling the authoritarian government, standing lone against evil, occasionally martyrs for the cause--just like Braveheart! Without this imagined COVID tyranny, they're just normal schmucks like the rest of us.

mhh you might be right

some people need a villain to justify the evil in the world

The reason for masks always has been to flatten the curve. The hospitals are too full for everyone just to get it and get it over with, so people without COVID can't get medical help. Right now, the CDC recommends everyone older than 2 years old should wear a mask indoors. This is not just to protect kids but prevent them spreading it.

Source: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si....

Accept the CDCs own study of 169 K–5 schools failed to find that masks for children in schools prevent the spread. Adult masks and ventilation were supported.

"The 21% lower incidence in schools that required mask use among students was not statistically significant compared with schools where mask use was optional."

https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e1.htm

Are there real statistics on just how many people are being turned away? Hasn't it always been the case that people sometimes have to be turned to another hospital? Wouldn't reform of the horrible mix of public/private hospitals make more sense? It seems to me the risk to the general population isn't really that high, it just makes news because it's a sad story when someone who had a heart attack can't get admitted because some anti-vax moron is taking up space.

There are tons of people coming into the hospitals in my part of the US who are completely asymptomatic but panicking. The solution to this isn't for everyone to wear masks, the solution is for the hospitals to redirect those people to their primary care physicians.

There’s a serious disconnect between public health experts and the general public, and the experts have continued to not learn that lesson over the last year plus. It’s mind-boggling.

Earlier in the summer, we lifted mask mandates “because the vaccines were preventing disease”, and regardless of the technical facts behind that decision, the perception was reality for the general public. Now they are trying to walk that back to “vaccines prevent serious disease” in the face of delta breakthroughs but the baseline had already been set.

Not to mention the fact that experts continue to pedantically stick to their definition of serious disease as “needed oxygen in the hospital”, once again out of touch with the layperson’s opinion that a week of debilitating sickness at home followed by a month of weakness until full recovery seems pretty “serious” and something people do not want. Boosters are appealing because laypeople don’t want any serious-by-their-definition disease and experts seemingly are incapable of acknowledging or understanding that, let alone their part in creating confusing messaging (partly to appease a 3rd set of people who ironically don’t really want to hear from them at all).

Public health officials need to understand that their primary job is managing public perception of a situation first and foremost. They can go push their glasses up and pedantically spout off technical corrections behind closed doors as much as they want, but in public they have to connect and empathize with normal humans.

Part of this probably comes from medicine’s continued promulgation of their air of expertise (read: superiority) that they’ve affected for a long while, but things like compassion and bedside-manner at lower importance. I worked in medicine and studied public health, and this status-over-all-else attitude was one of the reasons I left.

> Public health officials need to understand that their primary job is managing public perception of a situation first and foremost. They can go push their glasses up and pedantically spout off technical corrections behind closed doors as much as they want, but in public they have to connect and empathize with normal humans.

So what should they have said in the beginning? If they don't give technical reasons, they will be accused of talking down from their ivory tower, dictating policy with a 'just trust us' attitude, or of being biased/political.

But if they give technical reasons, people will nitpick those, especially if the data is incomplete or evolving.

There were lots of people being correct and nuanced, but they were drowned out (partly for political reasons I suspect).

> So what should they have said in the beginning?

Probably something like “Masks aren’t proven to help yet, but unless covid is unlike any other respiratory disease they probably won’t hurt.” Yes, this could’ve caused a rush on them (though maybe that would’ve alleviated some of the need in hospitals?) and we would’ve had to deal with that, but lying to people in the name “for their own good” is not empathizing with them.

Getting too deep into technical reasons in the middle of such an event is not understanding the definition of teachable moment. Most people aren’t open to learning deep knowledge when their fear or other emotions are up, but it can take real skill to avoid diving into details as an expert. And I have some sympathy for people getting metaphorical microphones shoved in their face, but that just goes back to my point about public health (and medical people in general) needing to know that their job is as much soft skill as hard.

you're somehow making a dissonant "people are too stupid for their own good" argument couched in a "don't talk down to the people" argument. but this dichotomy is wholly unnecessary.

the simpler reframing is to tell people the truth, and do it so it's not overwhelming to folks ("having empathy") who have many competing attention-grabbing issues in their lives (i.e., they're busy, not stupid).

and regarding masks, the simple truth is, they don't help in most common situations (i.e., out in public, where distancing does all the work), and it's extremely hard to get folks to use them in the one common situation where they can be effective: social/family gatherings. masks were never going to be an effective mitigation for this one reason alone, but because of their visible, performative value, became immediately politicized.

Agree 100% with your comment, there has been a breakdown when it comes to technical definitions. The medical professional's definition of "airborne spread" for example. By their textbook definition, "airborne spread" was impossible and it got into the definition of what a droplet is.

The CDC seems dangerously close to a no-win scenario.

Present truth and facts backing policy: Not managing public perception correctly.

Tell public what needs to be done but omit details: Conserve N95's with "masks don't work" all over again.

This. Even here in Germany it's a "damned if you do, damned if you don't" scenario. It's entirely polarized.

You cant tell the truth because it will just be 'fuel for the anti-vaxers'. Not telling the truth being also fuel for the anti-vaxers.

vaccines are and always were effective, its just 90+ % of people would need to take them to kill covid once and for all. but people are dumb so its not happening

> Public health officials need to understand that their primary job is managing public perception of a situation first and foremost.

Actually, public health officials need to maintain the trust of the public, or no one will listen.

And you won't be trusted if everything coming out of your mouth is a lie, no matter what your intentions.

Actually, it's both. Parent is arguing a consequentialist ethical framework - public health experts have a primary duty of care to the population, and their actions should promote this goal.

Your position of "you won't be trusted if everything coming out of your mouth is a lie" is fully compatible with this framework.

Considering the other person's mental model and incorporating their terminology when communicating with them, even when they're a bit wrong, isn't "lying" - it's basic empathy.

fwiw, the US has been increasing its vaxxed % by about 3-4 points per month. Not great, but still improving.

> If you have a vaccine, then your risk of death is far below that of the flu (statistically).

That seems worth checking.

US flu deaths per year over the last 10 years ranged from 12000 to 61000, averaging 35900 [1]. That's 3.7 to 18.6 per 100k, averaging 10.9 per 100k.

Weekly COVID deaths among vaccinated people is 0.1 per 100k [2].

The flu season is typically about 8 months. A weekly death rate of 0.1 per 100k over 8 months would be 3.5 per 100k.

So...about 1/3 the risk of dying from from flu in an average flu year which arguably is indeed "far below".

[1] https://en.wikipedia.org/wiki/United_States_influenza_statis...

[2] https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e1.htm

> The flu season is typically about 8 months. A weekly death rate of 0.1 per 100k over 8 months would be 3.5 per 100k.

That's still depressingly high, and the 0.1 rate doesn't is before July 17th, so wouldn't really account for the Delta variant? COVID is no joke.

How is 1/3 of a number that the vast majority of people don't even blink at "depressingly high"?

Delta was the dominant variant only by end of July so the data set for the 0.1 number could have been based mostly on a virus which is 2.5x less deadly.

We're now facing an endemic virus which, even with vaccination, approaches (or could get as bad as) the deadliness of the flu.

Doesn't seem quite right to compare historical flu rates of the general population to mask mandated covid rates among vaccinated.

As it is today, it seems like flu deaths are far less frequent than covid deaths. Cherry picked link but it _is_ the cdc.

https://www.cdc.gov/flu/weekly/index.htm

>Among the 3,388 PIC deaths reported for this week, 2,785 had COVID-19 listed as an underlying or contributing cause of death on the death certificate, and three listed influenza, indicating that current PIC mortality is due primarily to COVID-19 and not influenza.

You just said it's not fair to compare mask mandated rates, but then compare against the flu, which obviously is affected by the mask mandates (also mask mandates right now in the US are a bit of a joke, have you seen a sports game recently?).

The point is that comparing un-masked flu rates to masked-covid rates isn't valid.

Comparing masked-flu to masked-covid is valid.

Of course, if you're doing that comparison, it may also be worth mentioning that the flu also has a vaccine and if you're vaccinated against the flu too, its less dangerous than covid.

both comparisons are useful to me. masked covid vs. masked flu shows how dangerous covid is in relative terms, masked covid vs. unmasked flu shows how dangerous covid is compared to the risks I used to take.

Flu is under-diagnosed compared to covid because it kills a lot of old people and their cause of death is frequently not listed as flu. With covid, every death that might be attributable to it is counted. So it’s probably actually a more extreme difference under a fair comparison.

Any kind of equivalence statement to the flu is a well-known conservative "dog whistle"

And therein lies the problem: to politicize a perfectly testable statement and put intent into it.

That is not true at all. I'm fairly progressive and I found the analysis done there credible and welcome the information.

that's exactly why you should rethink the concept of a 'dog whistle'.

1 ) painting an individual politically by extrapolating a single opinion across their entire persona is irresponsible and over-simple.

2 ) 'conservative' is over-generalized to the point of uselessness and ambiguity.

it's a concept (dog whistle) that is used strictly for generating rage and calling other individuals to arms so that the crowd picks up torches and pitchforks and follows your lede in attacking an individual's opinion with as little prompting or individual thought as possible.

the classification and announcement of a 'dog whistle' makes civil conversation near impossible afterwards, even if those who announce it are dead-wrong or working in poor faith against an individual.

In my experience the people who announce 'dog whistles' are rarely arguing in good faith.

>it's a concept (dog whistle) that is used strictly for generating rage and calling other individuals to arms so that the crowd picks up torches and pitchforks and follows your lede in attacking an individual's opinion with as little prompting or individual thought as possible.

It is not used strictly for that, indeed would be ineffective for that purpose were it not also a useful word. It means "warning, this seemingly innocent reference/argument/line of argument has historically been used by people with questionable motives, and warrants extra scrutiny".

Isn't the dog whistle comparing COVID without vaccination/masking/distancing/etc to the flu, to downplay the severity of the pandemic and hence the need to take any action against it?

A comparison of COVID risk in vaccinated people showing that vaccination apparently reduces the risk to less than that of the average seasonal flu is the opposite of what the usually dog whistling people are trying to convey.

Not only that, but it is part of the concerted campaign by the right to downplay Covid. They would very much prefer the poors to suffer and die quietly - without stopping work of course.

I get so frustrated by this stuff.

Here’s where you went wrong.

Your number is not based on efficacy last week. It’s cumulative!

The vaccine efficacy wanes. For those who get a vaccine 8 months ago, it’s almost worthless now.

The worst part of you logic, you lump all risk groups together! A 90 year old is not a 20 year old. Argh! People have been doing this, even public health people, since the beginning of the pandemic. Teenagers and children have never been at risk really. It’s not about you, it’s about high risk groups. Old people, obese people with diabetes over a certain age.

I get so very frustrated.

> For those who get a vaccine 8 months ago, it’s almost worthless now.

You need to back this claim up with data please.

Good point - another data point that is actually not one, but many. There are 13 different COVID-19 vaccines around the globe, which work in different ways.

"The overall age-adjusted vaccine effectiveness against infection for all New York adults declined from 91.7% to 79.8%." - https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm?s_cid=mm...

"Two doses of mRNA vaccines were 74.7% effective against infection among nursing home residents early in the vaccination program (March–May 2021). During June–July 2021, when B.1.617.2 (Delta) variant circulation predominated, effectiveness declined significantly to 53.1%." - https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e3.htm?s_cid=mm...

"The efficacy figure, which is based on an unspecified number of people between June 20 and July 17, is down from an earlier estimate of 64% two weeks ago and conflicts with data out of the U.K. that found the shot was 88% effective against symptomatic disease caused by the variant." - https://www.cnbc.com/2021/07/23/delta-variant-pfizer-covid-v...

"“As seen in real world data released from the Israel Ministry of Health, vaccine efficacy in preventing both infection and symptomatic disease has declined six months post-vaccination, although efficacy in preventing serious illnesses remains high,” the companies said in a written statement. “These findings are consistent with an ongoing analysis from the Companies’ Phase 3 study,” they said. “That is why we have said, and we continue to believe that it is likely, based on the totality of the data we have to date, that a third dose may be needed within 6 to 12 months after full vaccination.” ...... Executives from Pfizer and BioNtech have repeatedly said people will likely need a booster shot, or third dose, within 12 months of getting fully vaccinated because they expect vaccine-induced immunity to wane over time. They also said it’s likely people will need to get additional shots each year." - https://www.cnbc.com/2021/07/08/pfizer-says-it-is-developing...

So, while it's true that the effectiveness wanes, the same articles also point out that it is still effective at preventing severe hospitalization. If you're vaccinated, you're more likely after 6 months to get COVID anyway, but you are much less likely to be sent to the hospital or die.

It was a horrible marketing mistake to ever imply that a vaccine would eliminate COVID by reducing transmission / infection. In fact, it'll turn COVID into a manageable disease by eliminating the most severe symptoms.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e2.htm

77% efficacy against infection for Pfizer, 92% efficacy against infection for Moderna in the US.

Really wish people would stop saying vaccines have waned to uselessness. That just isn't even true for VE against infection. All the studies that I see at the lower level of ~50% VE against infection are highly problematic (there was a study of healthcare workers in San Diego where their unvaccinated control was only monitored via PCR for infection and only had a 3x increase of infections during the delta spike in Jul which suggests their unvaccinated controls had a significant amount of natural resistance or were taking many more precautions).

Pretty sure he thinks antibody count is the same as being protected. And since antibodies fade over time, he thinks the protection fades. But the immune system is immensely more complicated with memory cells and such.

We don’t have it past early midsummer yet but this[1] goes to the beginning of summer. You can extrapolate out from the trend lines. I prefer to take a conservative ie. maximally pessimistic view because of the potential for human suffering. Ymmv

[1] https://www.bmj.com/content/374/bmj.n2113

““In my opinion, a reasonable worst case scenario could see protection below 50% for elderly people and healthcare workers by winter,” he said. “If there are high levels of infection in the UK, driven by loosened social restrictions and a highly transmissible variant, this scenario could mean increased hospitalisations and deaths. We urgently need to make plans for vaccine boosters and decide if a strategy to vaccinate children is sensible.””

Nothing past 6 months or so yet, but again the original British report which is discussed in the bmj article shows trend lines and it’s easy to extrapolate if you are good with charts/data.

How are you going to get frustrated and then make wild claims with 0 evidence?

Er, so can you show any numbers to the effect that Covid is deadlier than the flu among some Covid-vaccinated subpopulation? Even if it's true that Covid "scales" (becomes deadlier) as a function of age more steeply than influenza does, it's not clear to me that Covid is deadlier in any single age group.

Good news: it may actually last several years not months: "A series of new studies, including two led by Ellebedy, suggests that mRNA vaccines like those from Pfizer-BioNTech and Moderna trigger the immune system to establish long-term protection against severe COVID-19 — protection that likely will last several years or even longer, Ellebedy says." https://www.npr.org/sections/goatsandsoda/2021/08/30/1032520...

Vaccine efficacy against infection wanes, but not severe disease and death. This is likely due to the difference in speed in which the B cells (faster) and T cells (slower) wane from the vaccine.

Your claim is frustrating because it is inaccurate and misleading.

As this thread seems to be confusing two concepts, maybe worthwhile to post again:

"Vaccine efficacy, effectiveness and protection"

https://www.who.int/news-room/feature-stories/detail/vaccine...

Vaccine efficacy is found in trials, vaccine effectiveness is dynamic depending WHEN you calculate it and its found after 'deployment in the field'

"A vaccine’s efficacy is measured in a controlled clinical trial and is based on how many people who got vaccinated developed the ‘outcome of interest’ (usually disease) compared with how many people who got the placebo (dummy vaccine) developed the same outcome. Once the study is complete, the numbers of sick people in each group are compared, in order to calculate the relative risk of getting sick depending on whether or not the subjects received the vaccine. From this we get the efficacy – a measure of how much the vaccine lowered the risk of getting sick. If a vaccine has high efficacy, a lot fewer people in the group who received the vaccine got sick than the people in the group who received the placebo."

"Vaccine effectiveness is a measure of how well vaccines work in the real world. Clinical trials include a wide range of people – a broad age range, both sexes, different ethnicities and those with known medical conditions – but they cannot be a perfect representation of the whole population. The efficacy seen in clinical trials applies to specific outcomes in a clinical trial . Effectiveness is measured by observing how well the vaccines work to protect communities as a whole. Effectiveness in the real world can differ from the efficacy measured in a trial, because we can’t predict exactly how effective vaccination will be for a much bigger and more variable population getting vaccinated in more real life conditions."

Your frustration could be lessened by being less wrong.

This very article is titled “experts say booster shots not needed”. Less frustrated people are statistically more likely to get that this means the essential benefits of vaccination have not (or not yet) deteriorated significantly.

As to with data from all age groups, they do so for both the value and the comparison. If you feel the need to split each population into subgroups, you would need continue doing so once you find, for example, what differs from the 20-year old that died vs the one that didn’t. In the end, each person would have their own group, because they all differ. But try doing any comparisons, then.

The table from the CDC is split into two parts, one covering April 4 - June 19 and one covering June 20 - July 17. I used the death rate from the latter.

As far as age groups go, isn't there a pretty high correlation between high risk age groups for flu and high risk age groups for COVID?

As far as vaccine efficacy goes, the comment I decided to try to check the data on was comparing deaths, not infections. The mRNA vaccines in the US have had only a slight drop in the effectiveness at preventing death.

You can’t discount COVID deaths by using yearly flu deaths, but then only extrapolating to 8 months. Think of the other four months as “low-activity flu-months” and should be obvious why. You are intuitively mixing an attempt to estimate risk per year and risk per infection, I believe.

I’m also not entirely sure how good surveillance is for the flu? I could imagine it being recorded as “pneumonia” or “respiratory arrest”, especially when it affects poorer people, or those not admitted to hospitals.

(please not that the two issues above would pull any conclusion into opposite directions, then reflect on the relative amounts of hate and love, respectively, before deciding that I must be wrong because disagree)

> Is it to protect the vaccinated?

Unfortunately, yes. The unvaccinated are a fertile ground for strains to develop. Protecting the unvaccinated is in your own best interest. We're going to need new vaccines when the the virus evolves in the unvaccinated, but the vaccinated can delay that eventuality.

Do you know about ADE?

People with a vaccine that doesn’t stop infection may have a higher chance and time to help develop mutations in order for it to survive.

It was extremely dangerous to push an imperfect vaccine, and because we know the current ones do not stop infection, transmission, or lower the viral load, that might be what has happened. IDK, not an epidemiologist.

https://www.chop.edu/centers-programs/vaccine-education-cent...

Your own link says that there is zero evidence of ADE being an issue with CV19 and our vaccines.

Luc Montagnier, a Nobel Prize winner, is quite concerned about ADE and these vaccines creating mutations. He’s also unvaccinated.

So what? There are many more Nobel Prize winners who are vaccinated. Brilliance doesn't make you immune to stupidity.

Regarding kids I think the approach to be more careful is granted: kids immune system does not work the same as in adults.

Also overall their health/body works different than adults thus lot of medication available for adults cannot be used for kids as it is dangerous.

Thus what is beneficial for adults might not be for children.

The risk to the vaccinated increases over time, as the protection wears off.

Not to mention, the original version of the virus is gone, it has been outcompeted by the variants. The booster should be updated to work against the latest dominant variants. Think of it as a software update.

> Not to mention, the original version of the virus is gone, it has been outcompeted by the variants.

No, that is not true. Also, for note, there are ZERO tests for variants so you know. It must be genetically sequenced. All the data we have is from sampling. Last report I saw put delta at 20% of Covid cases in the UK based on sampling sewage water which seems like it could have a high margin of error. But I’m open minded if you have a different source.

It's to flatten the curve. Approx 10% of vaccinated still require oxygen and other medical measures. And with hospitals currently at full capacity, boosters are a short-term way to keep the hospitalization numbers low until kids can get vaccinated and every one else has had their chance before we fully open everything up once and for all.

We’ve been flattening the curve for a year and a half. They had ample time to build capacity. Why is it not built?

>Biden should frankly push legislation to replace or reform the FDA

That's a very American-centric view. I'm not aware of any regulatory bodies (WHO included) which allow vaccination for kids under 12.

> I also don't understand the mask/booster thing now.

It’s to reduce strain on hospitals and healthcare in general, but ICU beds in particular. It’s one thing for someone to get severe covid when the healthcare system knows how to treat it and has the capacity. It’s another thing to get severe covid (or have a heart attack, or be in an auto accident) when hospitals are at full capacity. The goal of the US government has always been to flatten the curve and never to eradicate the disease.

Why are all your suggestions about protecting people? Don't you realise there is a huge profit opportunity?

If big pharma can get billions of people signed up for regular booster shots and new vaccines, they will become enormously powerful.

I think this is the correct analysis - the focus should be to provide vaccines to the rest of the worlds nations that have not yet gotten widespread access to vaccines. This is likely to cause the greatest benefit in the form of fewer global deaths, and reduced global spread of the disease.

And, for a selfish western pitch: reduce the chance that bad new variants develop.

How will these vaccines that don't produce immunity lead to less severe variants? If they mute severity of illness they will lead to more severe variants. This is basic.

They do provide immunity in 95% (conservative) of cases, so it massively reduces the population that mutations can happen in.

They reduce severity of illness, and don't produce sterilizing immunity and eliminate transmission. And that's the problem, if you pick up a nasty mutation but because of vaccine you are able to still function, you are more likely to be out and about spreading it.

And when your limited immunity wanes in a few months this mutinous bastard copy you pushed on the masses may come back to bite you in the ass.

Maybe not though if you got your booster in time and if they designed it to match. Better hope your country went with the gold subscription.

What data are you referencing to claim that the vaccines do not provide some immunity? But importantly, the vaccines do reduce transmission. See the below study along with others.

https://www.nejm.org/doi/full/10.1056/NEJMc2107717

Admittedly, one weakness of the above study is that it took place before Delta was widespread. There isn't a lot of data yet on how much the vaccines reduce transmission with Delta, but the likelihood is that they still do even if to a lesser degree.

Reducing transmission isn't good enough! If you have an R naught above one you're still in trouble. It's common knowledge that countries with highest vaccination rates have spikes in cases right now. Israel and Gibraltar for example. Herd immunity for this was always impossible.

Israel isn't among the countries with the highest vaccination rates anymore, quite a few other countries have overtaken it.

Ok well you can't beat Gibraltar at 99%. But you look at other countries. New Zealand is a good one. Their hospitals are getting swamped with kids right now with severe RSV. Why? They've had their immune systems degraded from some of the most severe lockdowns I the planet. And admittedly they aren't in a covid spike but the effective lockdown has created other problems.

This shouldn't be down voted. It appears to be correct and is a subject of active concern in NZ.

https://www.auckland.ac.nz/en/news/2021/08/02/fight-against-...

I down-voted because that has nothing to do with a "degraded immune systems". Many of the more common respiratory viruses also died out in New Zealand with the quarantine. Kids never got a chance to develop immunity to those particular diseases previously and now it's coming on in a wave as they are reintroduced. It's not that their response is special, in normal circumstances kids would have gotten sick and been hospitalized, that it's happening all at once is.

No, they would have stronger immune systems from repeated exposure without the extreme lockdowns NZ introduced and less hospitalizations.

Respiratory viruses don't die out, they can persist in animal populations indefinitely. Sars Cov2 antibodies detected in 40% of NE deer populations for instance. Not to mention cats and dogs...

I assume you have evidence of the claim that by being regularly sick your immune system is stronger? Sure, it's run into more things it has learned to fight, but just because it knows how to fight a catalogue of things it doesn't mean that it will be better with the next novel pandemic, right?

The risk is more around autoimmune conditions like asthma and allergies. If the immune system doesn't start fighting off a variety of pathogens from an early age then it might go haywire later.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841828/

We should be focusing on overall health rather than just individual infectious diseases.

I don't much care for the hygiene hypothesis for allergies. I grew up on an acreage with all sorts of animals. I'm allergic to all of them, so much so that my parents got my allergy shots for several years. I'm most allergic to horses, which we had a trio of. It just doesn't make a lot of sense to me. And if it were true I'd much prefer more allergies to COVID.

Of note in that paper they are suggesting therapeutic strategies that involve controlled exposure of particular items, and how those exposures are fraught with potential dangers as well.

Singapore has an 81% full vaccination rates but is experiencing a rise in symptomatic cases.

https://www.reuters.com/world/asia-pacific/seriously-ill-cov...

As a counterpoint, Portugal currently has 81.10% fully vaccinated and 86.85% vaccinated once (meaning they'll be vaccinated again in 4 weeks or earlier), and the new infections are going down slowly but continuously for a while now.

My point is not that you're wrong, but that you were cherry picking examples and there can be numerous other reasons for spikes in infections such as relaxed measures and mask mandates, holiday season, schools re-opening, etc. It requires a more careful analysis than yours.

Yes, lock down and social isolation does work to prevent transmission but it also weakens the healthy immune systems and makes the population more fragile going forward.

Better to inoculate the most vulnerable, not the entire population for a fast mutating respiratory virus.

Polio can't really mutate and it makes a lot of sense to inoculate everyone for this.

The original clinical trials didn’t measure immunity, and, in fact, the claim from day one has been that the vaccines were designed to reduce serious disease and death.

> They do provide immunity in 95% (conservative) of cases

So not conservative. Real world data has all of them at under 80% now.

https://www.yalemedicine.org/news/covid-19-vaccine-compariso...

I heard against the Delta variant, RNA vaccines help divide the chance of contaminating others by at least two, even if you're asymptomatic (because basically, the virus last half the tine in your body). And also, since you're contaminated for less time, there is fewer chance of a variant popping out of a vaccinated person.

Take it as someone who heard someone talk about it, did not research himself (because i don't really care) and isn't really sure of what the truth is. See this comment as a clue if this stuff interest you.

You are not protected againts new mutations just because they originate from another place in the world. You are not reducing the chances for new mutations.

Keeping the vaccine to yourself will not help you.

I think you're misunderstanding the intent of the parent post.

They are saying letting vaccines go to the rest of the world is still the right course of action even if your motives were purely selfish. By reducing the number of infections elsewhere, the virus has fewer chances to mutate and return to and endanger you.

While in principle that's clearly sound - fewer viral particles means fewer future variants appears to be the consensus opinion - I'm skeptical that the decision to recommend boosters after 8 months will have a measurable impact on that.

First of all, even under rosy vaccine acceptance trajectories that's not going to be many doses vs. the unvaccinated population; secondly, you need 1 dose for a booster, yet 2 for a full vaccination; thirdly, the data for hospitalisations may not be in, but for mere infections it is clearly showing a reduction in efficacy well before a that 8 month mininum so the opportunity cost of not vaccinating half a person will be offset in terms of transmission by the booster dose; fourthly not all vaccines are easily distributed, and as long as the US needs to have a readily available supply to entice the unvaccinated stragglers, you might as well use doses nearing expiration dates for boosters rather than throwing them away; fifth: we're not at 8 months yet for most people, and if the minimum delay is 8 months the average might be considerably more such that by the time this matters vaccine production should be higher and thus the loss relatively less impactful.

Some of those effects might be trivial or zero, but at the very least the small number of doses overall affected probably isn't. I'd be really surprised if the US reaches 100 million booster doses by next spring; and even if we did that's just not a huge number if your aim is to reduce transmission (as opposed to suffering).

I think he is stating the exact opposite: to actually give doses to those countries without, exactly for this reason

Was going to answer to say exactly this.

The more vaccinated, the merrier the world with less variants

What if it works the opposite though?

Simple evolutionary biology suggests resistance develops from roadblocks or mechanisms to stifle. We see it all the time in antibiotic resistance, resistance of insects to pesticides used in crops, all kinds of areas.

I don't see a reason this case would be different.

because you are giving the virus less chances to replicate and therefore less chances at mutation

I might be wrong, but it seems obvious to me that this should reduce variants

But developing countries pay less, so BionTech and Pfizer will have less profits. As cool as having a company like Biontech, run by immigrants, founded in Germany they always rubbed me the wrong way in terms of PR and business conduct since the start of the pandemic. With huge support from German media and politics. The continued dissing of Astrazeneca is just one example, the push for booster shots is another.

It's fascinating how the vaccine makers have come out of this smelling like roses to so many and I wonder how long it will last. Not long ago, the NYT could write "the turpitude of the pharmaceutical industry is so commonplace that it has become part of the cultural wallpaper.” [0] Now we all seem very happy to accept their products and believe their claims. Truly wonderful to behold.

I can recall books and arguments that made a good case that big pharma operates most like a mafia. I also recall hearing some tthatime ago that drug pharma execs themselves consider the vaccine guys to be like the mob, with a habit of aggressive shakedowns and pressure campaigns the norm in that industry, and thought they gave the industry a bad name.

Citation https://www.nytimes.com/2020/12/17/opinion/covid-vaccine-big...

Yeah, and the one company that did the right thing (TM), AZ, by selling the vaccine at cost is the one who's image suffered the most. Strange times we live in.

Well, I'm assuming people were more critical before covid because it's easy to thrown stones when there isn't an epidemic going on a millions dying?

Are you suggesting the criticism was/is unfounded?

No, I’m suggesting it’s easy to criticize when you aren’t immediately benefiting.

Fake news alert: Biontech/Pfizer never "dissed" AZ.

They never commented on AZ. You can not blame BT if everyone wants "the best" for themselves.

There is active and passive dissing. Like publicly confirming deliveries when your competition is announcing delays. Or re-publishing your vaccine efficiency numbers when those of the competition are in doubt. I guess we can agree that this is a form throwing shade, or dissing, your competition. Just doing it in a smarter way than saying "AZ sucks".

>Like publicly confirming deliveries when your competition is announcing delays.

Sorry but that is nonsense. When in spring 2021 AZ had big delays, everyone was nervous that the same might happen to BNT. So politics, the public and the press asked them about it. At this time we had almost daily reports on deliveries because it was THE news item in spring.

BNT deliveries were rock solid and mostly on time in the EU in spring 2021, while AZ had plenty of delays. And you are now holding this against BNT?

The US and other developed countries have purchased vaccine doses from the manufacturers at the negotiated price and then donated some of those to developing countries. So did those doses at least the profit was the same.

Hum, anyway they are making a lot of effort to sell doses around here (Brazil), even with an uncooperative government. And they indeed are asking for a smaller price than on the developed countries.

I guess the rich countries applying a 3rd dose is a net benefit for them, but they seem to be playing the "we will sell as much as we can" game, not the monopolizer "restricting supplies leads to more lucrative prices" one.

These strategies are not mutually exclusive, are they?

You either sell as much as you can or you restrict how much yo sell. You can't do both.

I'd agree in the ideal world that's exactly what should happen, however in reality there are a load of unadministered doses in the US (https://twitter.com/EricTopol/status/1437617018782449668?s=2...) which will go to waste if not used, so it would seem to make sense to use those for boosters where they're available.

By the time these are distributed the virus will have drifted and these legacy doses likely not as effective with the new strains.

Which is why we should use them as soon as possible.

What about sending the unused doses to developing countries? Then they wouldn't go to waste.

yeah ideally that should happen :) Just it hasn't so the choice isn't "use locally or send abroad" it's "use locally or let them go to waste"

TBF I guess this must be a really complex logistical challenge.

Not sure about logistics, so. Sure it i challenging, but there are well established vaccination programms run by expierenced NOGs in developing countries already. These folks would, I guess, be really happy to take those doses and set something up. They are also rather capable of doing so.

initially, that was part of the EUs over-ordering. Take those doses and give them to poorer countries. Good for public health, good PR and really good at gaining soft power in the world. No idea why that isn't happening. Russia and China are grateful for that I guess, so.

I read that it wasn’t the logistics of sending them out that’s challenging; rather it’s trying to collect them back from the 100k+ pharmacies, hospitals, distribution sites etc in the US, most with poor records. The us mounted such a large and effective campaign to get them out there, would take just almost as large an effort to bring them back

True, that is a a challenge, I didn't think of that... It's definitely easier to use those doses still sitting in central warehouses somewhere. Funny how demand can be off so much from estimations. I, and it seems I'm not alone with that, really did expect demand for the vaccine to be much higher than it turned out to be.

The US government, to secure the doses, committed to indemnify the suppliers if anything went wrong and not to transfer the doses to any country that would not (or in some cases, they had to commit to not transferring the doses at all). Most countries are refusing to indemnify the companies.

So the US government would be in breach of contract and could be sued for sending the doses overseas.

Oh I see, didn't know that. Thanks for explaining! That being said, the government could also give the doses back to the manufacturers for a small fee who could then sell it abroad themselves, because right now it seems to me that their production capacities are maxed out and they produce less than they could sell.

Oh yes. Or renegotiate the contracts. And, IIRC, Biden got around that in the case of Mexico by "loaning" them the doses against their preorder that Pfizer couldn't fill yet.

If they can keep the Moderna, and Pfizer vaccine, at below freeing?

I just picture America the "great" delivering vaccines, and there's no infrastructure on the other end.

On a selfish note, I wouldn't mind closing all ports of entry until this virus is truly under control.

I don’t understand what closing all ports of entry will do (in USA) at this point. The virus is already here and all travel to USA requires a negative covid test taken at most 72 hrs before flight.

Good luck closing the U.S. southern border.

That’s not really the concern. Foot travel is ridiculously slow. This virus travels by air, first class.

People board buses and planes once they cross the border.

Not likely planes. The most mobile people are the richest.

It's not expensive if you're not paying for it. Immigration administration flies people from the border to the interior for processing and release.[0]

"U.S. Customs and Border Protection, which turns over border crossers to ICE after arresting them, has begun flying migrants to other cities for processing and is releasing them directly into communities without going through ICE, saying their own facilities are at capacity." [1]

[0] https://www.expressnews.com/news/local/article/ICE-says-780-...

[1] https://apnews.com/article/us-news-ap-top-news-mi-state-wire...

But we do not have a limited number of vaccines. At this point there has been plenty of time supply chains to produce the necessary precursors so we are limited entirely by demand. If we are distributing extra vaccines to other countries it is because we don’t want to not because we can’t or because we’re fighting over a single scarce resource.

There is no evidence that we have to choose between boosters or sending vaccines to other countries.

This is the same flawed logic that officials made when they spread doubt about the effectiveness of masks early in the pandemic, hoping to “conserve” masks for healthcare workers.

The assumption of vaccine scarcity is actually a hidden assumption made outside the expertise of those who aren’t deeply knowledgeable about vaccine supply chains.

Source? Everything I’ve read talks about that decision being very real.

Source? Are you suggesting that Moderna and Pfizer have factories-worth of unused capacity sitting around idle?

They need to make the actual data based argument not just appeal to authority.

Booster shots have these benefits, these risks, and these tertiary effects.

The argument seems to be that boosters have small increases in immunity, very small difficult to quantify side effects likely similar, and because of limited global supply and large numbers of unvaccinated.

The optimal deployment might be a very few should have boosters, and the rest of supply should be directed towards people who want but can’t yet get vaccines.

Looking at Israel third dose boosters are pretty much the only thing that stopped their deaths from growing in lock step with their cases: https://www.medpagetoday.com/infectiousdisease/covid19vaccin...

Without them they were headed to the same daily death rate per million as the US. How they are at half the death rate.

I’m unconvinced.

The death rate in Israel is lower than the US for many reasons — including a far less obese population, a younger population, a higher vaccination rate, and (likely) more willingness to do things like mask up voluntarily. They don’t have an Arkansas.

The cases started falling around when the boosters started but it could just be the natural rise and fall. Timing is not enough proof for me.

>The death rate in Israel is lower than the US for many reasons — including a far less obese population, a younger population, a higher vaccination rate, and (likely) more willingness to do things like mask up voluntarily. They don’t have an Arkansas.

They have the Ultra Orthodox which make Mississippi look like NYC.

The US has lots of vaccines (tens of millions) already delivered to administration sites. Using those for boosters won't impact global equity (they will either get used in the US or thrown away).

So we could offer boosters to most older folks.

I just got an unsanctioned booster in NY (a 2nd J&J). I expect a 2nd J&J, though classified as a booster, to provide an immunogenic response comparable to a second dose of Moderna or Pfizer; the fact that J&J marketed itself as a 1-dose rather than 2-dose solution seems to have been motivated by a desire to get to market faster [0] rather than something intrinsic about the vaccine, and we already know that one dose of J&J ~= one dose of Moderna/Pfizer [1].

Now that many months have passed since our first dose, I think it makes sense for people who got Johnson & Johnson to get a second dose, and to treat it as a "full" dosage, equivalent to the Moderna/Pfizer/AZ shots.

I basically decided to go it alone, and diverge from our public health experts, when the CDC started recommending boosters for people who got Moderna and Pfizer shots and not for people who got J&J; as Alex Tabarrok pointed out at the time [2], that makes no sense. In light of that, I think we need to do our best to apply scientific reasoning to the issue, rather than deferring to people with scientific degrees and political authority.

[0] https://apnews.com/article/which-virus-vaccine-shot-is-best-...

[1] https://marginalrevolution.com/marginalrevolution/2021/02/si...

[2] https://marginalrevolution.com/marginalrevolution/2021/08/th...

> I basically decided to go it alone . . . apply scientific reasoning to the issue

Please be sure to publish the results of your study of one.

it's been two whole days since my booster and no covid yet :)

Ok, let’s put that on PLOS and roll up some sleeves!

I hope it goes ok. If n=1 or 100% of the participants in this study trips over and falls, or has anything else out of the ordinary happen, then it means bad things for the other 7.9billion people when we extrapolate it up.

You've convinced me to do the same. Thanks.

Tip for anyone following suit: If you're worried that they'll "catch" that they've already vaccinated you, by seeing your name and address in their database, just claim that your parent/child has the same name and lives with you.

You can search for a provider of your desired type of vaccine here: https://www.vaccines.gov/search/

You're welcome, I hope it goes well; of course I am not a doctor not a source of medical advice etc.

RE: addresses: they just grabbed my driver's license and asked if I was still in the same address; the actual answer was no and I gave my new address. so you can say whatever you'd like

Get a 2nd dose of what? J&J? I'm in the same boat as you (also got J&J). I thought it was temporarily pulled off the market by the FDA too?

yes J&J, and yes, it's back on the market; it got pulled off for like a week or two in April but returned shortly thereafter:

https://www.fda.gov/news-events/press-announcements/fda-and-...

I’m curious what happened to all of the other vaccines that were in development, which we heard about in 2020. Now it still only seems to be Moderna and Pfizer.

If supply is a major constraint we would benefit from expanding the number of options in the market and have more pharma production built in other countries.

Although the pharma cartel is a very small community with a few mega firms. Making vaccine development an even smaller subset.

Novavax is potentially even more efficacious, and should be widely available next year. [1]

It's also not mRNA based FWIW. [2]

[1] https://www.reuters.com/business/healthcare-pharmaceuticals/...

[2] https://www.nebraskamed.com/COVID/moths-and-tree-bark-how-th...

> All alone, the spike protein is harmless

(From your [2])

This is a lie. The spike protein has been shown to cause cardiovascular issues.

Water can also cause death, in high enough doses.

Sola dosis facit venenum.

> This is a lie. The spike protein has been shown to cause cardiovascular issues.

[Citation needed]

There was an article posted on HN a few days ago indicating such: https://news.ycombinator.com/item?id=28438315

Almost necessarily less harmful than the complete virus, but the spike protein isn’t entirely harmless it seems.

CureVac (mRNA based) didn't get good enough efficacy results, most likely due to the timing with the delta variant. They're working on a new version of the vaccine which targets that variant specifically and which will be available next year.

Sputnik V is alive and kicking, but not in the western world. Russia is giving licence to produce it, and there are already several other countries that produce that vaccine.

There are also two (maybe three) Chinese vaccines that are distributed around the world.

AstraZeneca didn't suddenly disappear, despite the bad press in some western countries. There's Johnson&Johnson too.

But you are right, Moderna & Biontech/Pfizer are the favourites of the media and regulators in the western world.

NYT has a very thorough overview of the vaccines in development:

https://www.nytimes.com/interactive/2020/science/coronavirus...

So one in 500 Americans have died of covid-19 at this point. If you get vaccinated, your chance of death from this stupid virus drops by a factor of 10. But apparently these are not good enough odds for those of us who consider ourselves armchair epidemiologists doing the research so to speak.

So let's rephrase this. I just gave you a free ticket to Disney world. But what will make this trip to Disney world unlike any other trip you will ever have to Disney world is that for every 60 visitors I'm going to give a sniper a bullet. And that sniper gets to shoot anyone the sniper wants to shoot. Are you going to accept my free visit to Disney World?

Because basically one in eight Americans have had covid-19 to the extent that their case was recorded. And 1:61 of those people then died of it.

And and before you think I'm some sort of weird tyrant enabler, I support your right not to get vaccinated if you support my right to require you to be tested whenever you want to mix among the vaccinated.

But what's funny is when anti-vaccine ideology was considered part of one political party that sort of viewpoint was just fine but now it's some sort of Nazi Germany outlook because reasons or something. What changed? For bonus points please explain how this is consistent with getting a cavity search every time you want to fly or you hate America.

The Lancet article referred to seems to be here:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

I can already see this backfiring later when that assessment changes due to more information or increased supply, like it did with the mask messaging.

ugh... can we please just get a medical expert to publish a report directly rather than having the media report it? I am so tried of the way the media twists things to suit their point of view or sensationalize things. I just want direct information... is that too hard to ask for?

This is the direct link to the medical journal that this article is reporting on: https://www.thelancet.com/pb-assets/Lancet/pdfs/S01406736210...

Thanks for the link to the source article. That URL might work for users who have an account with the Lancet but when I followed that link, I got a PDF containing the following text:

> For full text of this paper please go to https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

This URL (also posted earlier in another comment by dfawcus) contains the journal article.

This title is misleading. It isn't about them not being needed.

Instead, as per article, it is about how these shots will save more lives, if administered to people without access to first shots!

If vaccine doses were unlimited worldwide, 3rd shots (according to article logic) would by recommended for all.

Right. The problem is that those guys are pretty hard to convince with facts. I took my 3rd shot because otherwise this would go in the garbage. In that sense it does increase my protection and reduces the overall burden on the system so it does help.

"those guys are pretty hard to convince" about giving supply to unvaccinated populations is a fairly shitty take while sitting in one of the short list of countries that has had enough vaccine to supply everyone who wants one.

I really don't understand the vaccines for all push:

A - The benefit for young people seems to be outweighed by the risk, for a given time period. The risk of mortality from vaccine induced clots in under 40s is twice the risk of death from Covid [0] (post relates to AZ but other vaccines has similar clot risks). The risk of hospitalisation from myocarditis is a multiple of the risk of hospitalisation from Corona, especially in young males [1] who have a four to six times risk. That alone would be enough to put serious doubt into the vaccines for all narrative, but there's also rarer and weirder confirmed side effects like Bell's Palsy and Guillain-Barre Syndrome.

B - The continued dramatic overlooking of natural immunity, which seems to be 6 or 7 times more effective than vaccines alone. Misinformation on this subject from vested interests and uncritical / complicit media has been rife [2].

C - Better, safer, more effective and more traditional vaccines are coming, ie, Novavax.

As a young male with no comorbidities and natural immunity, WHY in God's name would I risk taking an mRNA vaccine that has _far_ higher odds of sending me to hospital or killing me than it has of protecting me from the same by lowering Corona reinfection risk?

[0] - https://www.irishexaminer.com/news/arid-40328123.html [1] - https://www.theguardian.com/world/2021/sep/10/boys-more-at-r... [2] - https://www.bmj.com/content/374/bmj.n2101

Speaking as another young male with no comorbidities, I do tons of reckless shit that put myself at way higher risk for no other reason than to entertain myself and my friends. So I figured I might as well get vaccinated if it's a tiny societal positive with no non-negligible risk to myself.

> ...the vaccine on the entire adult population [in France] would avert 10 deaths from Covid among 18-39-year-olds, but would be associated with 21 deaths from blood clotting in the same age grouping over the same time period.

There are ~16 million 18-39 year olds in France. So both those risks seem vanishingly small.

I'm not saying that marketing of vaccines has been honest overall, but that's just my 2 cents about "WHY in God's name I would risk taking an mRNA vaccine".

No, other vaccines certainly do not have the same thrombosis risk as AZ. We easily have enough data here that we would have seen that by now. There is the myocarditis risk for the mRNA vaccines, but that is quite a different thing than the thrombosis risk for AZ. The myocarditis is not deadly.

The argument for vaccination of young boys is more complex, and different expert panels have come to different conclusions there. The UK is more of an outlier in this case. There is still enough uncertainty here, especially on the consequences of the infection itself that it's a really difficult decision.

As for point C, there is no reason to believe that Novavax would be safer than the mRNA vaccines. It could be, but there isn't anything inherently superior here that would automatically make it safer.

This is simply not true. The CDC has published a detailed analysis of the vaccine efficacy and known side effects [1]. This clearly shows that the benefit of being vaccinated vastly outweighs the risk due to side effects in all age groups >= 18 (only adults were considered in this analysis). Even in young males (18-29) they estimate that the risk of hospital admission due to COVID is an order of magnitude higher than the risk of myocarditis (which usually does not require hospital admission).

[1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e4.htm

I only skimmed this now, don't have the time to read it, but a few things to keep in mind:

1. Do they take into account the underreporting in VAERS? That could mean far higher adverse effects than those reported.

2. Are there any calculations regarding how the situation changes? As new variants emerge (like Delta), as immunity from vaccination wanes etc, how much will a vaccine prevent severe illness and death? Real world data seems to suggest vaccine efficacy isn't as great as previously thought.

3. Another point to keep in mind is that there are therapeutic solutions and as time goes on, hopefully better medications will be readily available, getting covid-19 will result in less severe illness and death.

I'm not against vaccination, I just think that these are all things we should consider.

Perhaps scientists have considered all this very carefully and have reached the conclusion that vaccination for all is better for the individual as well as for the society - I haven't looked deeply to find these answers. However, if all this has been carefully considered they & journalists/media really fail to communicate the science well.

Bullshit. The CDC reports ~3,500 people below 30 dying of covid, as opposed to a rate of 7 in 1 million developing a blood clot (which isn't implicitly fatal), or 2,800 if everyone were vaccinated.

Aside from that, vaccination helps everyone by helping to prevent the spread of the virus.

Except that it doesn't prevent spread. If you are less symptomatic because vaccine limited the severity, you will be more likely to be functioning socially and spreading it.

Also, a million doses to kids will likely result in one less ICU admission but create six myocarditus cases. What's the five year average outcome for those six kids?

Myocarditus tends to be brief and harmless, especially if induced by vaccine.

We don't have enough data and time to say that yet.

> Except that it doesn't prevent spread

That's right, it doesn't prevent it, it reduces it. Just like wearing a seat belt does not prevent dying in a car accident but reduces the risk.

You're just splitting hair.

Do we have any hard data on that or is it just something people say?

I'm not saying it doesn't reduce individual risk for a period of time. It does.

But vaccinating entire populations for a respiratory virus that mutates and stays infectious is a recipe for never ending boosters and has a strong possibility of creating more lethal variants because these will thrive in the vaccinated less severe masses when normally they'd be bed ridden, symptomatic and easily contained through contact tracing (See sars 1)

You better hope they dial the targeting for the boosters and the timing of them correctly because when you're short lived immunity wanes from the previous dose you may be facing a more tuned up lethal version that was kept circulating by all these vaccinated persons.

Vaccines for the most vulnerable are very appropriate here but not for the individuals that have very low risk. It would be better to unlock this population and let them develop stronger natural immunity while dealing with the edge cases with monoclonal antibodies and other promising viral therapies.

This is completely at odds with what the experts say. They could be all wrong, or you could be. What are your credentials in virology/immunology?

And do you have examples of vaccinations favoring the apparition of variants for other diseases? As far as I know, that's never happened. On the contrary, I've seen researchers point to immunocompromised patients as possible sources for variants, as the infection lingers in them. On the other hand, vaccines, even when they don't work to prevent the infection do shorten it, so by that logic they should reduce the apparition of variants.

Shortening it if it doesn't bring the R naught below 1 doesn't have much advantage.

Look at what happened with a vaccine that was applied to the poultry industry that didn't prevent transmission and had similar mutational characteristics to SarsCov2: https://www.pbs.org/newshour/science/tthis-chicken-vaccine-m...

> Shortening it if it doesn't bring the R naught below 1 doesn't have much advantage.

If it reduces R, other measures can help bring it down further. Further down the line, inhaled vaccines currently in development targeting the mucosal membrane are likely to enhance efficacy.

> Look at what happened with a vaccine that was applied to the poultry industry that didn't prevent transmission and had similar mutational characteristics to SarsCov2: https://www.pbs.org/newshour/science/tthis-chicken-vaccine-m...

So that vaccine, uniquely, precisely caused the infection to linger instead of quickly killing the host. That's not what's happening with Covid and current vaccines, the opposite in fact is.

The fact is that the majority of cases are still coming from unvaccinated people though, this hypothetical widespread infection of vaccinated people you're suggesting isn't happening.

Right now in my area 1 in 4 new cases are in fully vaccinated people. Why is Gibraltar experiencing a surge in cases with 99% of its population fully vaccinated? Its a leaky vaccine and this has huge implications for producing variants that are more deadly. See the article I posted on Marek's vaccine in chickens.

That's... still a minority? I'm not saying it's impossible, but here's a link saying that the risk here is minor: https://www.medrxiv.org/content/10.1101/2020.12.01.20241836v.... You can throw out all the theorhetical risks of a vaccine all you want but the harm of avoiding vaccination is readily apparent and obvious.

> Its a leaky vaccine and this has huge implications for producing variants that are more deadly.

The Covid vaccines reduce the duration of the infection (as well as reducing the likelihood of infection). The Marek vaccine caused it to last longer, by prolonging the life of the host. You're drawing the exact opposite conclusion to what your data shows.

> This title is misleading. It isn't about them not being needed.

It also implies a level of consensus that doesn't exist. "Vaccine experts", as a whole, don't hold this opinion. This is about two specific dissenters in the FDA.

It's not a completely cut and dry subject. There are tradeoffs with all such decisions, such as the value of a booster in one individual vs. a first injection to another in a different part of the world, etc... It's not an unreasonable position.

But it's not a consensus position either. The typical recommendation seems to be that boosters are valuable.

It's not just a couple of dissenters, the official position of WHO is the same - we need to vaccinate the whole world before booster shots and vaccinating children in the rich countries.

As I see it there _is_ a consensus among scientists and healthcare professionals, but not among politicians who see booster shots necessary to keep their national economies up.

>At 6 months post-vaccine, 70% of the infection-naive NH residents had neutralization titers at or below the lower limit of detection compared to 16% at 2 weeks after full vaccination. These data demonstrate a significant reduction in levels of antibody in all groups. In particular, those infection-naive NH residents had lower initial post-vaccination humoral immunity immediately and exhibited the greatest declines 6 months later. Healthcare workers, given their younger age and relative good-health, achieved higher initial antibody levels and better maintained them, yet also experienced significant declines in humoral immunity. Based on the rapid spread of the delta variant and reports of vaccine breakthrough in NH and among younger community populations, boosting NH residents may be warranted

https://www.medrxiv.org/content/10.1101/2021.08.15.21262067v...

That study suggests that 16% of the elderly have no immunity to covid 2 weeks after vaccination and 70% after 6 months.

Not to put too fine a point on it, but we might as well not vaccinate anyone over 60 if we're not going to be giving them boosters every 3 months or so.

Neutralizing antibodies are only part of the immune response. Not having a detectable level does not at all imply having "no immunity". Antibodies are expected to disappear over time, but cellular immunity is much more long-lasting.

Not needed and needed more somewhere else are different.

How do they propose to get Pfizer shots that have to be stored at -70 C, to areas in developing countries that need first doses?

As far as I can see, the vaccine that is actually suitable for developing countries is the AstraZeneca one, and this isn't often used in the west because of the blood clot issues.

They will use insulated containers with dry ice, same as everywhere else. This might not work in the middle of the jungle, but most developing contries actually have roads and trucks.

Roads and trucks are not a problem but most third world countries also have an abundance of corruption and general apathy towards rules, good luck running a cold chain to all corners of such a country.

The cooling requirements for Pfizer shots were loosened, it no longer needs -70°C. I don't know the new number, i think it's around -25°C.

The problem with this sort of analysis is that the logistical concerns of shipping vaccine doses are immense. For one thing, single "doses" don't exist - both Pfizer and Astrazeneca are distributed in multi-dose vials. If you as a patient are given a dose at the end of the day, and no one else is available right then and there to receive it, then that's anywhere from 1 to 5 doses which are literally thrown away.

As vaccination rates rise, the mere existence of vaccine stocks in countries with high vaccination rates means doses will be wasted - i.e. keeping the bare minimum on hand to vaccinate people as they need it means we have quite a lot of surplus doses which will otherwise definitely be wasted.

Hence the analysis of boosters: if there's any benefit at all to high risk groups (i.e. healthcare providers who overwhelmingly now were vaccinated about 8 months ago), then that's a productive use of local vaccine capacity which has to exist in some form (i.e. new people are hitting "vaccine recommended" age every day).

And this virus mutates which also limits the shelf life.

Yeah, the underlying take is that booster shots may not be the most effective use of the constrained vaccine supply if we wish to get the pandemic under some semblance of control. But someone just reading the headline could easily walk away with the impression that booster shots don't have any benefit.

I put myself out there as a frontline healthcare worker and was vaccinated prior to Christmas. My second dose fell before the 1/20 time frame by over a week.

It was a one-off thing for me - trying to help - did COVID testing and vaccination until late April... As one of the first groups of people to be vaccinated, I am concerned that my immune response is starting to lessen.

It's sad and ironic that if I were the type to lie at all about this, I'd even have my state paying me to get a first vaccination - no ID required...

It's a hard decision - and I suppose my actions may depend on how booster shots are or are not approved.

"It's easier to regret something you have done, than something you haven't done"

I so want to respond with Orbital lyrics... but this is a very good point.

are you still on the frontline? If so I'd personally be less worried about getting severely ill because you've probably had many small doses of exposure in your time there. Which is not precisely equivalent to a vaccine but is in the same ballpark.

I am not. I reported something and was fired the next day. I was also wearing a PAPR (N100 Powered Air Purifying Resperator) for the time I was doing testing. Though I was in close contact with many infected patients, I was also in pretty hardcore PPE. I'm doing much more photography for now and some music work as I find the right place in tech again.

I’ve been vaccinated.

I’ve had Covid.

I’m done, thank you.

I’m not subscribing to a lifetime of shots. If anyone else wants to do so please go ahead, but Im good.

And I expect this create even more pushback to the vaccine. The anti-vax crowd will say this is what the pharma gods want, to be paid subscription revenue in perpetuity by entire populations.

In the mid 70s I contracted measles. I was only 9 or 10 but I think I remember it was because there was a batch of vaccines that didn’t work, or maybe it was doctors learned we actually needed two doses. Whatever; I’d had the vaccination prescribed at the time, it didn’t work, I got measles.

Fast forward 25 years to when I applied to grad school. There was a measles outbreak happening and in order to attend I either needed to have a recent vaccination or a blood test proving immunity.

Even though I had natural immunity I just went ahead and got the additional vaccination. It was faster, cheaper, and I didn’t care.

The point is, medical knowledge changed. No one made a big deal about needing an extra vaccination. No one made a big deal about even needing certain vaccinations to do things like go to school. Why now?

> No one made a big deal about needing an extra vaccination

This is fine when there are plenty of vaccines to go around. The point is we should use the vaccines globally on unvaccinated people rather than giving existing vaccinated populations a booster.

the pfizer authorization is based on 4 months of data (https://blogs.bmj.com/bmj/2021/08/23/does-the-fda-think-thes...)

your 2nd measles vaccine had 25 years of data since your last one, they probably had enough time to know that it would be fine

The recent CDC study [1] suggests that vaccine efficacy against hospitalization for people 65+ is ~80% in the US. If we have reason to believe that a third vaccine dose would increase that efficacy, and the immunological data suggests that we do, then IMO it's clearly the right thing to do. Incontrovertible data will mean many seniors being hospitalized and dying in the interim.

There's so much we can do to increase the global supply of vaccines without sacrificing American citizens. Let's focus on those things to improve vaccine equity.

[1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e3.htm

This seems misleading. Saying that vaccines would be better spent on the unvaccinated isn't the same as saying that a booster is unnecessary.

Booster shots and vaccine mandates aren't about public safety or helping people, its politics, generating attention, and ultimately getting votes.

The paper is thoughtful. The reporting on it is reckless. An accurate headline would be: "Vaccine experts: Widespread booster mandates aren't needed now," or perhaps "recommendations"

There's a line between:

* Mandatory.

* Recommended.

* Allowed.

* Banned.

If I am flying to do humanitarian work in Vietnam tomorrow, I absolutely need a booster shoot. Right now, the only way to get that is to go to a state which doesn't require ids for vaccines, and get a shot.

The article discusses that boosters are clearly still appropriate in some circumstances:

"Boosting could be appropriate for some individuals in whom the primary vaccination, defined here as the original one-dose or two-dose series of each vaccine, might not have induced adequate protection—eg, recipients of vaccines with low efficacy or those who are immunocompromised2 (although people who did not respond robustly to the primary vaccination might also not respond well to a booster)."

Why do you "absolutely" need a booster shot? Are you immunocompromised? How do you know what your level of protection currently is?

Even if you did a test to look at your antibody titers, antibody titers aren't the end all and be all of immunity (think T-cells).

Well, I'm not flying to Vietnam tomorrow, so I'm not claiming I personally need a booster shot.

However:

- Vietnam is an epicenter right now, so my odds of catching COVID would be high.

- They are well beyond hospital capacity, so if I do have a serious case, it's uncertain I'll receive quality care (and if I do, I'm taking a bed from someone else)

We don't have full data, so the right way to think about this is with expected outcomes based on best available data. Best available data, in this scenario, places the likely reduction of risks of COVID19 as a much greater risk reduction than any potential risk of vaccines:

- We do have multiple studies about how immunity wanes over time from vaccination. Those provide better ground-truth data than theoretical arguments.

- We also have some estimates of breakthrough rates, and severity of infection

We don't have good data on long COVID post-vaccine, so that's a place we need to make an educated guess and rely on theoretical arguments.

You can plug whatever sane numbers you want, but in this scenario -- humanitarian work in an epicenter with limited hospital capacity -- a booster shot makes sense.

For other scenarios -- for example general population -- whether a booster makes sense is still often within the very large error bars of the limited data, and reasonable people can disagree, much as the authors of the Lancet article and the CDC currently do. Once more data rolls in, we'll know.

Mostly in agreement - I would note that the Lancet article gives a few arguments with citations as to why the vaccine efficacy decreases might be statistical artifacts, and so I think you may be a little over-confident on your bullet there. But I agree that there is data on both sides, and strongly agree with your general approach of accounting for the possibility that vaccine efficacy could be waning in your risk model and updating behavior accordingly.

> We do have multiple studies about how immunity wanes over time from vaccination. Those provide better ground-truth data than theoretical arguments.

I believe the studies you're referring to are those that address efficacy against symptomatic infection, not severe illness. Unless you're in a high-risk group because of age or comorbidities, with two doses of an mRNA vaccine within the past 8 months, to my knowledge all studies to date indicate that the average person's protection against severe illness and hospitalization is exceedingly high. This is probably related to the T and B cell immunity created by your body's response to the vaccines, which are more difficult to measure than antibody titers.

I traveled to/from a hotzone in Asia at the beginning of the pandemic and from Asia to the US and back to get vaccinated. My opinion as an expat and avid traveler is that if you have any concerns about your ability to receive adequate care in the case that you get sick, you should reconsider travel at this time. Since the vaccines clearly do not provide sterilizing immunity and everyone's immune response is different, there really are no guarantees, especially if you're going to be in environments where your exposure is high (both in terms of number of contacts and contacts that could lead to exposure of high viral loads).

This is my clear (amateur) conclusion as well. The exposure amount and dose varies, exposure in high-density hot zones is high risk and the cumulative dose does seem to pose some additional risk, as does the risk that you may not be able to receive a high level of clinical care in various areas.

I'm not necessarily talking about adventures in southeast asia there either.

Now we're getting into value systems.

- How much do you value your life?

- How much do you value the trip?

- How much do you worry about spending two weeks in a hospital?

- How much do you mind memory lapses and brain fog from long COVID?

From what you wrote, it's clear we have at least somewhat different value systems. Since you're an avid traveler, you should realize that's good, common, and healthy.

The subtle implication of your comment seems to be that I value my life and health less than you do? If so, I think that's unfair. But I'm happy to roll with it. If, in the face of substantial evidence that two doses of one of the mRNA vaccines remain highly effective at preventing hospitalization and death 8 months on, you still cannot tolerate the potential that you could end up in a hospital in a developing country, suffer from long COVID following infection and/or die, logic dictates that you should reconsider travel.

You might strongly believe or suspect that a booster will provide meaningful additional protection to you, but the ongoing booster debate reflects the fact that at the current time, there is no conclusive proof that a booster will definitely reduce risk in healthy already vaccinated individuals, nor has any potential risk reduction that booster proponents believe exists been conclusively quantified.

Put simply, just because one believes that they have meaningfully increased protection from a booster does not necessarily mean that they actually do. Science will eventually tell us but the data isn't in yet.

I don't think you've traveled so much if you think that's the implication, or at least not for long enough to soak in how values differ between cultures.

No. That's not the implication.

I don't know you well enough to tell you what the differences in our value systems are.

Since you do ask, if I were to speculate, I would guess you value your life and comfort more than I value mine. I was never fearful of dying of COVID, or of hospitalization, even pre-vax. Americans place an exceptionally high value on their own life and comfort relative to most cultures. I've also been in several hospitals in developing countries, and that's also not something which has really concerned me.

On the other hand, I suspect I am much more concerned about long COVID than you are.

And no, we don't know much for sure about COVID, but we have to work from best available evidence. If there's e.g. a 50% chance that a booster shot increases protection from 30% breakthroughs to 15%, and a 50% chance it does nothing, that means I've reduced my odds of breakthrough by (30-15)*50% = 7.5%.

Ha. So now you're questioning how much I've traveled. :eyeroll:

I don't know you so I won't pretend to know how much you value anything, how much you've traveled, etc. but you seem to be shifting your position for the sake of arguing. For example, you're now saying you're fine with hospitals in developing countries, but your original comment expressed concern about your ability to receive quality care in Vietnam:

> They are well beyond hospital capacity, so if I do have a serious case, it's uncertain I'll receive quality care

As for:

> And no, we don't know much for sure about COVID, but we have to work from best available evidence. If there's e.g. a 50% chance that a booster shot increases protection from 30% breakthroughs to 15%, and a 50% chance it does nothing, that means I've reduced my odds of breakthrough by (30-15)*50% = 7.5%.

In other words, your "absolute" need for a booster shot is based on numbers you've pulled out of a hat.

I think you are trying to overanalyse and overrule the experts here.

Experts are saying that with the regards to the whole population currently community wide booster shots are not needed. It may not apply to each individual case (such as immunocompromised etc., or people with very specific risk, like those going to Vietnam) but this was never to be meant an individual assessment. Many people are confusing these two things. Even though it does not apply for majority of readers, trying to imagine a different situation for a specific individual is not necessary.

That's unfair. I'm trying to overrule bad reporting, not experts. The experts made a nuanced point which seemed reasonable, and the reporters screwed it up.

> Vietnam is an epicenter right now, so my odds of catching COVID would be high.

ho chi minh is an "epicenter" according to Vietnamese authorities (who have always taken a much stricter, "zero-covid-adjacent" approach to managing covid). While there is always risk, the case-rate is roughly the same as Germany & France (neither of which are in lockdown) & much lower than other western states like the US & UK. The entire country is in lockdown because this is an all-time high by Vietnamese standards (Vietnam have fared similarly to NZ in terms of case-rates before now), despite case-rate in e.g. Ha Noi being low, further mitigating risk factors.

So no I don't think the odds of catching it would be significantly higher than wherever you currently reside, unless your humanitarian work is specifically treating covid patients, in which case of course you should get a booster but the destination country is completely irrelevant.

Points about hospital capacity are obviously still relevant, but that's not necessarily going to be impacted by boosters as much as vaccination in general: full vaccination rate in Vietnam is only ~5% due to supply issues that are only exacerbated by over-subscription to boosters in western states.

> “ recipients of vaccines with low efficacy or those who are immunocompromised2 (although people who did not respond robustly to the primary vaccination”

How do we measure it? Like is there a way to know through antibody tests?

If you want to know whether you need the booster or not, and you're in the US, the spike antibody test ("COVID-19 Blood Spike Protein AB") falls under Covid testing, so if you have insurance it's covered with no out of pocket expense. You can get it at most urgent care clinics, and then you can find out exactly what your antibody levels are.

I got my Moderna 2nd shot in February and my antibody levels are 1483 (out of 2500) so I am satisfied and not in any hurry to get the booster.

1. Determining how much real-world protection you have against infection, hospitalization and death is a lot more complex than antibody titers. Everybody is different, every infection is different and even in the healthy population, everyone's immune response to the vaccine will be somewhat different. My understanding is that it's entirely possible a person with antibody levels lower than yours might be at lower risk than you in the real world because of their health compared to yours, the strength of their immune system compared to yours, etc.

2. Antibodies are only one part of the immunity equation. In the long run, T and B cells are probably just as important if not more important than antibodies. This is another area where it's reasonable to expect that YMWV when you get vaccinated.

3. My understanding is that in the context of vaccines these tests are used primarily to assess whether an individual had an immune response to the vaccines, not to make a meaningful determination of how much protection they have (because there's no "formula" for this).

4. It appears from the Delta-related data that any relationship between antibody titers and risk is influenced by variants.

5. We shouldn't rule out environmental factors in the protection equation. For example, if you work in an environment where you're exposed to high viral loads on a regular basis, it seems possible that you could be at higher risk than somebody who isn't even if you have higher antibody titers.

There is more to immunity than antibody tests. Antibody levels typically drop after a while, but memory cells remain active.

Even if there is a good answer to "How do we measure it?" it might cost more to know than it does to administer a third shot.

There remains an argument (or a "rebuke," as the article puts it) that first world countries that are well placed to administer booster shots to the fully vaccinated should instead contribute to faster vaccination worldwide, even on a self-interested basis in order to reduce the cases where new variants can emerge.

But that is a tenuous argument. A simple first question unanswered in the article is: How much of the unvaccinated population lives where vaccines requiring ULT freezers can be distributed? It may be that every place well equipped to use those kinds of vaccines will do best to get their total vaccination rate as high as possible and administer booster shots to reduce breakthrough infections, so normal activity can resume. Supply chain disruption is not a trivial problem. Having safe workplaces is not a luxury.

Not all reporting there are good journalists out there.

Headline from RTL: Gezondheidsraad: derde prik alleen zinvol voor mensen met afweerstoornis

Listen to the experts, write down what they say. Basic journalism.

The most important trend (IMHO) they point out is that effectiveness vs. severe disease does not drop or barely drops. They claim: To date, none of these studies has provided credible evidence of substantially declining protection against severe disease, even when there appear to be declines over time in vaccine efficacy against symptomatic disease.

However, the graph they provide doesn't seem to be based on data that appears reasonably chosen (that could be my limitaiton, sure).

They refer to appendices (which are here: https://www.thelancet.com/cms/10.1016/S0140-6736(21)02046-8/...), and specifically table S4 appears to be the basis for their graph D. In it, they split same-paper sources into early vs. late effectiveness with respect to hospitalization. Four sources are relevant.

- #5: Health IM of. Two dose vaccination data. 2021. 2021 - I can't find this source.

- #41 https://pubmed.ncbi.nlm.nih.gov/34401884/ - ...but this paper has huge error bars and additionally the average effectiveness jumps up and down just to underline that the source not only claims to be noisy but appears to be so too. There's just not enough clean data here for any conclusion (wrt to a declining efficacy vs. severe disease).

- #42 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389393/ - this paper seems to have solid data, but it simply doesn't include data on when people were vaccinated, and it uses definitions like this: "Hospitalizations among persons with breakthrough infection were defined as new hospital admissions among persons fully vaccinated on the reporting day." - in other words, a mixture of people that are vaccine-protected, and those that have had the jab but not the time to become protected. And the paper does not track how long ago people were vaccinated - so how does the lancet article then try to split this into early vs. late groups? Presumably by calendar date, which I don't think is reasonable; at least not reasonable enough.

- #43 https://www.medrxiv.org/content/10.1101/2021.08.24.21262423v... - and I'm just going to believe they copied the results correctly, but notably that paper concludes: "The efficacy of the vaccine against severe disease for the 60+ age group also decreases; from 91% to 86% between those vaccinated four months to those vaccinated six months before the study. The corresponding efficacies for the 40-59 age group are 98% and 94%. Thus, the vaccine seems to be highly effective even after six months compared to the unvaccinated population, but its effectiveness is significantly lower than it was closer to the vaccination date."

So when they say this: "Given the data gaps, any wide deployment of boosters should be accompanied by a plan to gather reliable data about how well they are working and how safe they are. Their effectiveness and safety could, in some populations, be assessed most reliably during deployment via extremely large-scale randomisation,17 preferably of individuals rather than of groups." - that makes sense; I can understand that.

But this on the other hand: "To date, none of these studies has provided credible evidence of substantially declining protection against severe disease, even when there appear to be declines over time in vaccine efficacy against symptomatic disease." - seems to be contradicted by their own sources.

Given the data they themselves cite and in addition the many more sources demonstrating that protection from infection wanes (not just antibody levels), it seems implausible to assume that protection from severe disease won't wane significantly as well, even if they're right in saying we don't know for certain or by how much.

However, even the waning already demonstrated in the #43 data set represents approximately a 50% increase in the number of hospitalizations and an increase in transmissibility after less than 8 months. Saying it's "still very high" is surely true, but the way they paint boosters as somehow plausibly unnecessary smells like motivated reasoning to me.

They clearly make the case for greater third world vaccination; as an ethical argument that makes sense. But the claim that boosters likely won't be useful strikes me as being a little creative with their sources.

Furthermore, while the article goes to great lengths to question the utility of booster shots, it does not similarly make the case that avoiding booster shots will actually materially increase vaccinations elsewhere. And while that seems plausible at first glance, there are also reasons to think that's not really true: e.g. are the boosters going to be diverted from production or will they simply be usage of already distributed shots that weren't taken up by the vaccine hesitant (which could be logistically impossible to redistribute in time)? How many people will be both eligible and willing to take a booster, and how does that compare to the number of exported doses - it might not amount to much? Is the timing of the boosters early enough that there will still be a significant export crunch? Is there really a tradeoff here at all, or will by the time boosters are used in significant numbers (say 100 million) other production be ample too?

I don't think the article really makes a very thoughtful case, at all. It doesn't really support the notion that boosters will impact supply elsewhere by the time they're deployed, and it's claiming evidence supporting booster utility is slim, but it's not quite as slim as they make out, and again - by the time boosters are widely used, if the evidence we do have so far continues to build in that vein - there will be ample evidence then.

Sure, there is a plausible future in which boosters have unexpectedly low utility, yet high uptake, and are mostly doses from new production as opposed to older, already locally distributed doses, all while third-world vaccination remains highly supply constrained. That's a future to avoid. But the paper doesn't make the case it's a likely future, nor even that it'd be hard to see it coming and thus needs action today.

Not quite sure why you absolutely need the booster shot, could you explain more there? Is that personal preference. Having both almost entirely eliminates the risk of hospitalisation from the other strains.

People who got vaccinated five or six months ago are seeing their immunity rate drop to around eighty percent. That's double the risk compared to a fresh vaccination.

Studies have primarily observed a modest decline in effectiveness among older people and the immunocompromised, which is why some jurisdictions have recommended boosters for these people (Israel, California). There is a reason boosters have not been approved anywhere for the general population, and that is because so far the data does not indicate they are necessary.

Necessary and useful are two vastly different things. My state is throwing expired vaccine into the garbage. I'd take a booster even if it only made me five percent safer.

The meme of people sticking themselves with every needle they can get ahold of is real?

I think this is a bad idea, to make this booster decision on your own. Talk to your doctor first.

I never said I was making a booster decision on my own. I said I'd be willing to accept a booster shot even if it only somewhat increased my immunity.

This is the part I don't understand. There is an oversupply of vaccines, why not let me go get my 3rd shot if it's already here? I understand the desire to take those "extra" vaccines and ship them to other countries, but if the vaccine is already distributed out around the country, it would be more expensive and hazardous to collect them back up safely than to just administer boosters to those who want it.

The vaccines that are already distributed were distributed considering the original plan of only two doses per person. More vaccines would need to be ordered to get enough for a third dose.

Right, but if you order enough to give 100 people 2 doses (200 doses) and only 50 decide to get the vaccine, you have 100 doses left over.

The COVID vaccines have essentially a 6-month shelf life before they are considered expired [1]. So if the example doses above were delivered several months ago, the period for collecting and transporting them to another country is pretty small.

Instead of throwing away this unused vaccine, it could be given to people who are willing to participate in a booster study or would like to have it, without making the booster mandatory. Obviously a mandate wouldn't work for the excess supply sitting around.

[1]https://www.nbcdfw.com/news/national-international/unused-co...

Is that entirely true even for people who have a life outside their own home? I would assume being constantly bombarded by the viruses outside would keep their immunity higher than expected?

Do you have a citation for that 80% number?

The Pfizer vaccine loses 6% effectiveness every two months.

https://www.cnbc.com/2021/07/28/pfizers-ceo-says-covid-vacci...

That article indicates the Pfizer vaccine loses 6% effectiveness every two months within a six month period. It doesn't say anything about what happens after six months.

“Trust the science”

How can any healthcare professional, who has probably had multiple vaccines in the past, not take this Covid-19 vaccine? Isn't this akin to a tech worker using "password" as their PW?

How can any human, who has probably had multiple meals in the past, not eat McDonalds?

It is arguably unethical to provide a rich person a third or fourth shot before helping the poor with their first shot.

(it is also counterproductive, since the rich would benefit if the poor were immune. This applies to the current debate around natural immunity and mandates.)

By the same measure it is arguably far more unethical to provide a rich person ineffectual million-dollar cancer chemotherapy before helping the poor with malaria chemo-prevention that demonstrably saves a thousand lives...

Not necessarily more unethical, because in your example we know that this contributes to future advances which eventually reach more people including the poor.

With vaccines we know the end game, especially with an endemic virus.

Informed consent disclosure to vaccine trial subjects of risk of COVID‐19 vaccines worsening clinical disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645850/

That's really burying the lede - all they are saying is that there should be bigger, more explicit forms given stating that that there is possibly a chance of ADE. That article doesn't even attempt to prove that as possiblity. They even admit that "Current data on COVID‐19 vaccines is limited, but does not so far reveal evidence of ADE of disease."

Booster shots aren’t needed in the same way that masks weren’t recommended at the beginning of the pandemic. Not because they don’t help, but to save supplies for other people (health care workers for the masks, foreigners for the vaccine shots).

I still plan to get a booster ASAP though.

The CDC has a pdf (downloadable) presentation about the data being used to decide on COVID booster vaccines: https://stacks.cdc.gov/view/cdc/108332/cdc_108332_DS1.pdf

The UK government has data showing that about 2X more fully vaccinated people are dying from COVID than the unvaccinated (1,091 fully vaccinated vs. 536 vaccinated), even though the unvaccinated account for 3X more patients coming in for emergency care (6,492 fully vaccinated vs 14,319 unvaccinated) p.21: https://assets.publishing.service.gov.uk/government/uploads/...

https://www.gov.uk/government/publications/investigation-of-...

A summary and analysis of the data can be found here: https://notobiggov.medium.com/angry-about-anti-vaxxers-15a15...

But that would somewhat makes sense? Those at highest risk of Covid would be vaccinated, those at lowest risk unvaccinated.

Yes. Also this: “It isn’t the absolute number of deaths that should be compared as there are 20 times MORE people vaccinated over age 50 (where most deaths occur) than unvaccinated. The UK has a 95% vaccination rate for people over 50. The rate of deaths is much, much lower in the vaccinated population. The rate of death is the number who have died in a population (vaccinated or unvaccinated) relative to the size of the population, usually expressed as number per 100,000 people. With 20,000,000 vaccinated people over 50, the death rate is 3.2 (per 100,000 people), but for the 1,000,000 UNvaccinated people, the death rate is 32 (per 100,000 people) — ten times higher. In other words, the vaccine is 90% effective against death, consistent with what was found in the original clinical trials.”

This is the challenging part is that there are multiple factors which impact risk and benefit from the vaccine. And those are dependent up the population examined - the vaccinated (likely higher risk), hospitalized (likely higher risk), etc.

> The UK government has data showing that about 2X more fully vaccinated people are dying from COVID than the unvaccinated (1,091 fully vaccinated vs. 536 vaccinated), even though the unvaccinated account for 3X more patients coming in for emergency care

Because of the demographics of those 2 groups (old are more likely vaccinated, middle aged and below are less likely) and their risk profiles - it takes 150 people in their 40's to be vaccinated to have the same impact that 1 person in their 80's being vaccinated will.

I saw the same comment on a different thread today, so I decided to have a sceptical look at the summary and analysis link. From that link:

> Here is the pro-vaccine argument: “It isn’t the absolute number of deaths that should be compared as there are 20 times MORE people vaccinated over age 50 (where most deaths occur) than unvaccinated. The UK has a 95% vaccination rate for people over 50. The rate of deaths is much, much lower in the vaccinated population. The rate of death is the number who have died in a population (vaccinated or unvaccinated) relative to the size of the population, usually expressed as number per 100,000 people. With 20,000,000 vaccinated people over 50, the death rate is 3.2 (per 100,000 people), but for the 1,000,000 UNvaccinated people, the death rate is 32 (per 100,000 people) — ten times higher. In other words, the vaccine is 90% effective against death, consistent with what was found in the original clinical trials.” Of course, the chart also shows that people who are UNvaccinated are twice as likely to need overnight hospitalization than vaccinated people (4,033 vs 2,204), and thus this is one of the strongest justifications/reasons to get vaccinated.

I'm glad what appears to be an anti-vax article was actually showing both sides.

Good cause if they are anything like the 2nd dose shots they should find a way to compensate people for missing 2 days of work with headaches, fever, chills, body ache, etc.

The compensation is not missing weeks or years due to Covid... or in rarer cases, you know, dying.

Yes, not having a place to live is so much better than the 99.9% survival rate for someone in my age group.

How would getting covid be in any way preferable for someone in your age group than getting the vaccine?

You're guaranteed to get one or the other, likely both.

But think of the opportunity cost!

If you're under 40 and you spread the virus to your over 50 boss she has at least an order of magnitude more chance of dying than you. You could then move up the corporate ladder with her departure.

How about the reverse!

If you're a 8 year old male, you get the shot and die of myocarditis, but the 82 yr old overweight cancer patient gets an extra 4 months!!! YAY!

Myocarditis is about 8x more likely when getting COVID than when getting a covid vaccine, so nope, even an 8-yo should get shot out of pure self interest. (If their chance of catching COVID in the next few years is more than 1/8, which it certainly is.)

https://www.newscientist.com/article/mg25133462-800-myocardi...

>Post a study where totals are not separated by age / gender even though thats the claim.

Sloppy job.

https://nymag.com/intelligencer/2021/06/israel-detects-link-...

How about you introduce paid medical leave, like the rest of the developed world.

It's like an insurance - you pay with chills now to avoid bigger hit later (more serious sickness or death).

Or if you are young and healthy pay with a real infection for more robust immunity going forward

I don't know why the US is never serious about these things. We don't get a day off to vote, we don't get days off to get our mandatory vaccination.

But we get Juneteenth? I'm not from Texas, and where my family lived it didn't matter much that slavery was over until the 1950s. So an awkward, meaningless gesture towards black people for helping the DNC defeat Sanders is prioritized ahead of democracy and epidemic disease.

If you need a full day off work to vote you have other issues.

Sounds like you're assuming your situation applies to everyone.

I was referring to societal problems, not the individuals problems. Voting should be easy and accessible and not something you have to take the day off or several hours out of your day to get done. I literally spent 3 minutes voting this year on my way out of the vaccination center.

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