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Comment by AndrewBissell | Hacker News Reader

Well none of the push for mandates or vaccine passports or other such nonsense makes much sense if the vaccines don't prevent spread and only provide an individual benefit of reduced risk. I mean, although many people are able to hold a blatant contradiction like this in their heads without experiencing cognitive dissonance, you can't really sell "we need to protect the vaccinated from the unvaccinated" without inherently casting doubt on the vaccines' efficacy against severe disease.

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While I personally have reservations about mandates/passports for being able to travel domestically, eat at restaurants, etc., in terms of things like international travel, which is a privilege, there is a valid argument for treating people with no immunity differently as they are at a higher risk of severe illness, hospitalization and death. Those can cause high costs that are borne by others.

But yes, statements like the one about protecting the vaccinated from the unvaccinated have been head-scratching, which goes back to my point about how the CDC and other authority figures continue to bungle the messaging and shoot themselves in the foot.

I'm fully vaccinated but am not sold on getting a booster because I'm not in a high-risk group and understand the current science to indicate that the initial series I received continues to significantly reduce my risk of illness, hospitalization and death. Of the friends and family I've discussed boosters with, most say they have similar thinking. I find it hard to believe that somebody who has not yet been vaccinated will see Walensky's comment about the "fully vaccinated" definition possibly changing and suddenly feel eager to get the initial series.

Just as another data point, I probably will get a booster shot if they're available for my demographic (and it's just the same Pfizer shot I've already had two of).

But it would only be under real duress that I'd prove to someone other than my doctor that I'd had it. The point to me is individual choice, and limits on what kind of information the state can compel from you. Generally I think the vaccines (even if they don't work to well) are not a big deal.

For international travel I would accept mandatory testing and quarantine. It is entirely sensible solution to problem, also I don't think vaccination status should make difference until we have sterilizing vaccine.

> people with no immunity

So immunocompromised people? The rest of us have immunity.

Does natural immunity (from a past instance of catching COVID), or demonstrated from a Test, count as “people with no immunity”?

People with natural immunity should be considered to have immunity. The science clearly shows that their immunity is not inferior and is perhaps superior to those with vaccine-based immunity. It's crazy to me that we're even having a debate about whether natural immunity should count as immunity.

> I'm fully vaccinated but am not sold on getting a booster because I'm not in a high-risk group and understand the current science to indicate that the initial series I received continues to significantly reduce my risk of illness, hospitalization and death.

One thing that I think is getting lost in all of these discussions is that it's okay for there to be a range of comfort levels. But a range implies there are boundaries, somewhere.

I got a booster shot of Moderna a little over a month ago, by lying to the clinic and telling them it was actually my first dose. (This is why I'm on a throwaway account, btw.) I'm aware this was kind of risky, because third doses haven't been well studied in my age cohort. And I also got really ill for a day!

I wouldn't recommend that anyone else jump ahead of the FDA guidelines like this—but it was something I wanted to do. I'm being very bad about masking and social distancing right now, and I'm in close contact with a lot of children, so I really wanted to do something extra to protect them.

At the other end of the spectrum, I think it's totally okay for anyone who is vaccine-skeptical, for whatever reason, to take a wait and see approach. But there eventually comes a point when a majority of the public has actually gone ahead and been guinea pigs for you, and you're just needlessly endangering people.

> One thing that I think is getting lost in all of these discussions

What's really being lost in all of these discussions is science. Looking at your case:

1. You decided to lie to get a booster even though it has apparently not been approved for your use.

2. The vaccines do not provide sterilizing immunity and it is possible to become infected even when vaccinated. While the data does suggest that vaccination reduces transmission, it also indicates that infected vaccinated individuals are still capable of spreading the virus.

3. Despite the fact that you have no idea how much additional protection your booster will give you, and for how long, or if and how much it might reduce your ability to transmit the virus to others, you're choosing to be "very bad about masking and social distancing right now" which will increase your potential exposure, especially if you live in an area with a higher positivity rate. More exposure, even while vaccinated, increases your risk of infection.

4. You say you're doing this to protect the children you are in close contact with, but according to the CDC, only 542 children under the age of 18 have died in the US during the entire pandemic.

> At the other end of the spectrum, I think it's totally okay for anyone who is vaccine-skeptical, for whatever reason, to take a wait and see approach. But there eventually comes a point when a majority of the public has actually gone ahead and been guinea pigs for you, and you're just needlessly endangering people.

How long before the definition of "vaccine skeptical" changes? Will someone eventually be labeled "vaccine skeptical" because they refuse to get their 10th booster?

Well the problem is that this ship already sailed. You can be “not sold” on getting a booster all you want, but give it a few months and for employment/entertainment/etc venues you will be considered unvaccinated, period. This is what most “got vaccinated but not sure about passports” crowd don’t seem to understand, there is not gonna be a middle ground, you either have your nth (and go figure the value of n if they want to establish 1 or 2 a year…) booster or you might as well be Andrew Wakefield.

> You can be “not sold” on getting a booster all you want, but give it a few months and for employment/entertainment/etc venues you will be considered unvaccinated, period.

For what it's worth, in NYC right now indoor dining, gyms, government jobs, etc don't even require two vaccine doses, only one.

At my Bay Area employer you definitely need to be 14 days past your second shot (in the case of a 2 dose vaccine) to be considered. Wording on the internal emails about the topic makes it pretty clear that this status is subject to the changes by health authorities. So in this particular case I can assure you that the door for infinite boosters is not only open, but it has been clearly spell out that it will be used.

> , in terms of things like international travel

Data has shown that the HEPA filters in planes are working very well to prevent transmission between passengers already. If anything you are much less at risk in a plane than anywhere else. These restrictions make as much sense as throwing water bottles before taking a flight.

Cargo cult security theater.

I wasn't referring to transmission on the plane. I was referring to the fact that international travel for purposes of tourism, etc. is a privilege, not a right. No country is obligated to allow in foreign nationals who are at a higher risk of serious illness if they get infected. This especially makes sense for poorer countries that are already under pandemic strain.

Furthermore, border controls can be effective at limiting the introduction of variants.

When countries do choose to let foreign nationals in, at this stage of the pandemic, it's not unreasonable for them to limit arrivals to those with immunity, whether vaccine-based or natural, or apply different requirements (such as quarantine) for people with immunity versus without.

Planes and such are secondary. Main point should be borders themselves. Make entering to quarantine sufficiently efficient process and shoot on sight anyone who tries to pass it after all their goal is massmurder by spreading covid(at least many people think so). It won't be a problem if person catches covid on plane if after landing they spend a few weeks in quarantine.

> Well none of the push for mandates or vaccine passports or other such nonsense makes much sense if the vaccines don't prevent spread and only provide an individual benefit of reduced risk.

Perhaps you'd prefer overrun ICU units so people die of treatable diseases because nobody can find a bed?

Vaccines absolutely benefit everybody even if they just reduce severity but don't contain spread (and I don't concede that point).

The "overrun ICUs" thing is a canard, and to the extent it's true is mostly the fault of our having slashed the number of hospital beds over the past decades under the imperatives of for-profit healthcare. Prior to 2020 you can find all kinds of examples of hospitals being overwhelmed by bad flu outbreaks. It's been 20 months and hundreds of billions spent on pandemic response -- where is the added hospital capacity?

Not sure if this applies to you, but I also just can't take seriously anyone who professes great concern about ICU capacity while also supporting the mass termination of any nurses who won't take the vaccine.

> and to the extent it's true is mostly the fault of our having slashed the number of hospital beds over the past decades under the imperatives of for-profit healthcare.

I don't disagree with this.

Unfortunately, the anti-vax people are almost a 1:1 Venn diagram with the people who are all-in on for-profit healthcare.

So, you can complain about this, but you can't use it as justification for anti-vax accommodation since it is caused by the same group of people.

> but I also just can't take seriously anyone who professes great concern about ICU capacity while also supporting the mass termination of any nurses who won't take the vaccine.

Prophylaxis is an expected minimum thing for the sake of patients. Any nurse who will not wash her hands between operations should be fired even if there is a nursing shortage. If someone is not willing to follow medical prophylaxis, they shouldn't be in medicine.

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