Comment by Uberphallus | Hacker News Reader

Comment by Uberphallus | Hacker News Reader

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> Shouldn't this kind of research have been carried out before billions of people were vaccinated?

It's unfeasible to carry out research on every little aspect of any medication, except for the very long term. That's why drugs get approved all the time, yet trials and studies continue for decades to account for long term and extremely rare side effects.

That said, literally anything can change the menstrual cycle (flu, stress, changes in nutrition or exercise levels), and especially given that menstrual symptoms correlate more with inflammatory markers than with actual hormone levels [0], it's to be expected that treatments that elicit an inflammatory response might have an effect in menstrual symptoms. It's good this research is done, but I doubt these changes come up as a surprise to any physician.

> Is it ethical to enforce vaccinations (via mandate) with these matters unresolved?

I think so, unless you consider to keep enforcing lockdowns, travel restrictions, or a Children-of-the-corn-light type of scenario to be ethically better.

[0] https://pubmed.ncbi.nlm.nih.gov/16403011/

> I think so, unless you consider to keep enforcing lockdowns, travel restrictions, or a Children-of-the-corn-light type of scenario to be ethically better.

Well, a lot of places that have high vaccination rates still have domestic restrictions, or are considering bringing them back as they deal with new surges in COVID cases. International travel restrictions are still significant, even for fully vaccinated travelers.

See: Israel, Singapore, UK, Belgium to name a few

The vaccines do appear to offer good protection against hospitalization and death, which is great, but let's be honest: they haven't been anywhere near the panacea hoped for, and a lot of the pseudo-promises made around a return to normalcy haven't been kept. Instead, the goal posts keep changing.

> let's be honest: they haven't been anywhere near the panacea hoped for, and a lot of the pseudo-promises made around a return to normalcy haven't been kept.

Isn't the latter caused in part by the former?

> Instead, the goal posts keep changing.

Have the goal posts moved or did the vaccines not make it to the goal line? You can't have it both ways.

I think the parent you're replying to and you are in agreement - the vaccines have turned out not to be magic exit to this, regardless of vaccination rate, so returning to normalcy isn't possible yet without overwhelming healthcare systems. So it's either start-stop for the near future again, or the ugly alternative where the systems get overwhelmed.

No good answers unfortunately, either way people suffer.

The vaccines appear to be providing very good protection against hospitalization and death. This was the original goal -- to keep people from getting super sick and dying. Then the focus shifted to preventing infection entirely. However once it became clear that the vaccines didn't provide sterilizing immunity, a lot of places remained focused on cases.

If you plot cases versus deaths in countries like the US and UK, it's clear that the vaccines are doing what we needed them to do most and as more and more people have some level of immunity (either through vaccines or prior infection) the virus is looking less and less menacing.

It's true that COVID continues to strain hospital systems, primarily because of unvaccinated patients and vaccinated patients who are high-risk to begin with (due to age, immunocompromisation and comorbidities), but getting out of the "overwhelmed hospitals" situation is going to be really, really difficult. Resource and staffing shortages didn't just begin when COVID started. According to Becker's Hospital Review, "For most level 1 trauma centers and tertiary care facilities, operating intensive care units at 80 percent to 90 percent capacity is standard — even before the COVID-19 pandemic hit."[1]

Between the large populations of vaccinated individuals and those with natural immunity, it's getting harder and harder to justify maintaining restrictions indefinitely on the basis that SARS-CoV-2 naive individuals in certain populations (namely the elderly, overweight/obese and diabetic) and high-risk vaccinated individuals are filling ICUs that were already routinely at 80-90% capacity before the pandemic.

At some point, learning to live with the virus also involves accepting that we can't shut all of society down when ICUs fill up.

[1] https://www.beckershospitalreview.com/patient-flow/2-healthc...

In your opinion, what should the punishment be for not complying?

There shouldn't be a punishment.

In the European countries I'm familiar with, those people are now on unemployment benefits and their contract temporarily suspended. As a tax payer, I'm fine with that. I don't want unvaccinated health workers to get in close contact with my elderly mother, thank you.

Why though? Aren't the viral loads similar between the unvaccinated and fully vaccinated, and so the only benefit to being fully vaccinated is a private one (you are less susceptible to severe illness, though not totally immune)?

Exactly. Plus if you are vaccinated you may not have (early) symptoms which means you can spread it before you realise that you are infected.

The opposite. Vaccination for any disease generally leads to shorter incubation periods in breakthrough cases, because your immune system reacts much more rapidly to the pathogen, and most early symptoms are your immune system doing its job.

No. The protection against severe illness is much better than the protection against transmission, but the latter is also not zero.

You may have seen something posted on HN recently, as I recall it was a Dutch study that compared transmission within families where the initial infectee was or was not vaccinated? And the result was basically a halving.

> Aren't the viral loads similar between the unvaccinated and fully vaccinated

The viral loads in respiratory mucous at the peak are similar, sure, so from that one-dimensional metric that antivaxxers seem fixated in, it doesn't matter.

But vaccinated people:

1. Have fewer chances of getting infected.

2. The incubation period is shorter so, if infected they go around spreading it for a shorter amount of time.

3. Their disease lasts for much shorter so, again, less time spreading it around.

4. The symptoms are milder, so the chances of contaminating via coughing/sneezing are lower.

And let's not forget infecting other health workers reduces the quality of healthcare access overall.

> Have fewer chances of getting infected.

I think more precise language is warranted here. If you're vaccinated, you have a reduced risk of becoming infected if exposed. The protection of the vaccines against infection, however, appears to decrease fairly rapidly, hence the discussion around boosters.

But if a vaccinated person (especially one who has lower neutralizing antibodies) puts themselves in environments where they inevitably have more exposures (think crowded, poorly-ventilated indoor spaces like bars) and they are not as vigilant about mask wearing, they might have a relatively higher risk of getting a breakthrough infection than even an unvaccinated person whose behavior leaves them with fewer exposures.

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