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Comment by angelzen | Hacker News Reader

There is a growing body of research indicating that VE declines over time. After 6 months the vaccines reduce the risk of getting covid by 2x, VEaI = 50%. Not sure where you picked the 10x number.

(OA) US, veterans, 3 months VEaI = 78%, 6 months VEaI = 50%, https://www.science.org/doi/10.1126/science.abm0620

US, 5 months VEaI = 47%, https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

UK, 3 months VEaI = 75%. https://www.nature.com/articles/s41591-021-01548-7

Qatar, 3 months VEaI = 70%, 6 months VEaI = 12.8%, https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

(preprint) Sweden, <50yo, 2-4 months VEaI = 83%, 4-6 months VEaI = 50%, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410

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We are talking about different things.

1. The probability of a BI is not the same as the relative probability of a vaccinated person infecting another person. I also refer to “vaccinated people“ to mean “a population of vaccinated people”, which is where the big gains are.

2. The day before they get their booster shot (6 months) is not the same as the probability overall, counting the best and moderate days of immunity too

1. Where do you pick your transmission data from? Are there credible studies? VE is the closest proxy for infecting other persons. Beyond that it is difficult to guess transmissibility, in particular because asymptomatic infections and differences in behavior.

2. I expect a vaccine to significantly (VE >90%) reduce infection probability for at least 10 years. These vaccines ain't that. While I'm vaccinated, I have not signed up for an endless stream of "boosters" every 6 months or so. Probably I'll be declared "unvaccinated" with a straight face and excluded from society in the not-so-far future.

> 2. I expect a vaccine to significantly (VE >90%) reduce infection probability for at least 10 years. These vaccines ain't that.

Why do you expect this, and do you think it's a reasonable expectation? Do you shrug off flu vaccines because they're only effective for a year or so? (I understand the difference between reduction in efficacy over time against a single strain vs against new variations)

> While I'm vaccinated, I have not signed up for an endless stream of "boosters" every 6 months or so. Probably I'll be declared "unvaccinated" with a straight face and excluded from society in the not-so-far future.

I don't understand this point of view at all. Do you only take the first pill in a course of antibiotics? Why wouldn't you follow the vaccine schedule that offers the best overall protection, and best reduction in total risk, that we're aware of and is available to you?

"Do you shrug off flu vaccines because they're only effective for a year" Yes, indeed, I don't go out of my way to get a flu vaccine. Flu vaccine effectiveness is underwhelming, 30-40% on average, see https://www.cdc.gov/flu/vaccines-work/past-seasons-estimates....

Suppose someone wants to minimise the total risk of injury and death to themselves and their community.

Is your position the rational position for them to take?

What is the motivation for your position?

A third of severe influenza cases develop bacterial pneumonia. Which, left untreated, is deadly. I know, because a few years back I developed pneumonia in the wake of a flu, collapsed a lung and almost died. They saved my life in an ICU with antibiotics. If the only metric of relevance is saving lives via medical intervention, prescribing an antibiotic course to everyone that develops cold symptoms is a no brainer. Statistically, such a public health measure will definitely save lives. Taking it a notch further, why don't we just mandate an antibiotic course twice a year for each person, sick or healthy. We'll never lose another life to bacterial pneumonia.

Yet we are very careful to not overuse antibiotics. Why?

https://www.pulmonologyadvisor.com/home/topics/pneumonia/bac...

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