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Comment by caslon | Hacker News Reader

This is a very low quality article and the arguments seem to be very poor and don't really align with the data.

Maybe I'm just old enough to remember there was a period of time when people actually thought stigmatizing unintelligence was the only way to have a healthy society and a second and third industrial revolution happened; this paper seems ridiculous.

It's worth noting, also, that The Lancet contributed much to global vaccine hesitancy with its historical lack of quality control. We might not be in the present situation if not for this:

https://en.wikipedia.org/wiki/The_Lancet#Andrew_Wakefield_an...

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It screams cherry-picked data. Look at how oddly specific each citation is:

> In Massachusetts, USA, a total of 469 new COVID-19 cases were detected during various events in July, 2021

> In the USA, a total of 10 262 COVID-19 cases were reported in vaccinated people by April 30, 2021

> In Germany, 55·4% of symptomatic COVID-19 cases in patients aged 60 years or older were in fully vaccinated individuals

> In Münster, Germany, new cases of COVID-19 occurred in at least 85 (22%) of 380 people who were fully vaccinated or who had recovered from COVID-19 and who attended a nightclub

If the author has a strong argument, why not present more than disjointed months of data in specific cities, states and populations?

Because he would have to revert his whole point. 10262 cases among vaccinated people is actually lower than any 7-day moving average and he points out on a data (check the source ref) from 1 Jan 2021 - a day with over 100k cases per day.

Full story laughs at its author.

While vaccine hesistancy is at crazy levels, the so called scientists that get invited to news are regularly underreporting the seriousness of possible side effects of COVID vaccines, which can add to the hesistancy. Of course it's still much better than getting the virus itself, but it's usually not explained honestly in the media.

Every single person I know has gotten the vaccine at least twice, some three times, and not a single person has had any persistent side effects.

I think the problem with saying the vaccine has all these side effects is that in placebo controlled trials a lot of people also get “side effects” from the placebo, either by random chance or they make it up. There really isn’t any evidence these vaccines (mRNA at least) have any serious level of side effects above background noise.

They might just not be telling you about it.

Of the people I know who have taken the vaccine, a lot have had persistent side effects. But I didn't start hearing about this for a couple of months, and even then, well, it's personal medical situations and scary ones at that. I think a lot of people are being told by doctors to just ignore it and hope it'll get better. As the months go by and things don't improve, people become more willing to speak up to friends. Of course, it's also possible me and my gf hear these stories because these people know we haven't taken it yet. If we were rah-rah pro vaccine I bet nobody would mention it because they wouldn't want to be criticized or start an argument.

Side effect reports heard about so far:

- Several menstrual problems, including completely stopped periods and suddenly near-daily bleeding, that lasts for (so far) months.

- Major fatigue including inability to perform sexually, again, months after the shot.

- Sickness for a day or so that's serious enough that the recipient can't work (heard this 4x now).

These are mostly "young" people (under 50). The virus is by itself not a serious illness for these people, some of them had it and it was a few days of feeling ill - nothing special and nothing they haven't experienced before. Given that being bedridden is a commonly reported side effect, and it seems to happen on each shot, and that COVID itself usually only lasts a few days for them, it only takes 3 shots before the vaccines have made them as sick as COVID itself. Which doesn't seem like a smart tradeoff. The goal is to not get sick.

Just because it's not persistent and not categorized as serious it doesn't mean that it's not unusual for young people and it's not a side effect.

As you get older you accept that sickness and pain is a sad part of life, but young people aren't used to even small amount of sickness.

Your thinking just emphasises not having empathy to people being afraid of even small amount of pain.

Also again you write mRNA and not emphatize with people who get AstraZeneca vaccine which has higher side effects. We have to acknowledge these things and be more open about having a tradeoff.

And what is the alternate reality where they don’t get the vaccine and also don’t ever get covid?

Some sickness and pain is going to happen, is a choice between minor, temporary side effects or gambling with a covid infection. The virus is not going anywhere.

There are more people vaccinated than infected generally, so what they see around them are young people in pain for maybe weeks from the vaccine, and the media not being transparent about those side effects, while the alternative media blowing up the side effects and negledging the real problems that COVID causes.

I had a side effect that lasted 5 months - persistent pain in the arm and is confirmed by doctors as caused by the vaccine.

This is much better than the ilness but is not something I would like to repeat.

I suggest you visit your doctor. It could have been Guillain Barre Syndrome a known rare, but possible, effect of COVID-19 vaccines.

https://www.shutterstock.com/search/guillain+barre+syndrome

"Although the cause is unknown, the underlying mechanism involves an autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves and damages their myelin insulation.[2] Sometimes this immune dysfunction is triggered by an infection or, less commonly, by surgery, and rarely, by vaccination."

https://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_sy...

It is currently criminally under investigated by the CDC, who just "noticed" the 258 cases in the US reported in the VARS system. You can also get it after after different types of infections including getting Covid. So not related to the vaccine.

It happened after the second dose of the vacinne (started 3 days after and it is not related to the virus). It is completely gone now so not sure what doctors will find.

I also didn't have any paralysis at any moment, just pain.

There are two possible ways to diagnose it:

1) Blood tests. Some documented variants of Guillain-Barré are associated with an antibody called GQ1b. If it would be present, "could be" a diagnosis of the Miller- Fisher variant

2) Lumbar puncture. A special needle is placed into the area around the spinal cord in the lower back, and a small amount of fluid is removed. Naturally this second option is only chosen in more persistent cases.

Honestly just more transparency regarding them would be fine. Stigma and insults aren't very convincing, especially when the target has a strong community for support. Things like the refusal to shut down travel with China and the about-face on masks early on in the pandemic eroded a lot of people's trust in government. Politicizing the issue didn't help either. I recall reading a report during the early days of the pandemic where the volunteer being interviewed said they had much better receptivity to masks in conservative populations than others. This stopped about the time masks become mandated. Many members of my home community were also early adopters of the vaccine - their support dried up immediately following the series of mandates, with some of them participating in anti-mandate protests. At this point, further stigmatization of unvaxxed will only create more of a bunker mindset. Perhaps it's best for the future of the country we just accept a 100% acceptance rate is not going to happen.

Bringing up an interesting point. Not refuting anything you said :).

Conservatives in some countries like Germany, Scotland are the ones who want everyone to get vaccinated while the [harder?] left want vaccines to be a choice, etc.

This follows along my own hard left politics. Vaccination should be a choice.

However the hypocrisy or lack of self awareness of liberals and of the right has made all of this stuff so politicized and vitriolic now.

IE I would have an easier time taking the rights anti mask anti authority stuff seriously if pushing for Govt to stop abortions and CRT learning weren’t massively popular policies. So it’s not about principles then.

For liberals, the amount of authority seeking is problematic and goes against the apparent principles of caring about the disenfranchised and bullying authority.

This is not a paper, it's a letter to the journal. Space is very limited. The salient point is that governments are using shame and stigmatization to try and encourage vaccination, when in reality the unvaccinated are apparently only putting themselves at risk. The vaccines appear to help patients cope with and ward off the serious effects of Covid-19, but not significantly prevent infection or transmission (although a caveat is that this may go against the RCT data reported by Pharma to validate the vaccines -- but I haven't seen it myself). Stigmatizing the unvaccinated and even denying them medical care in some cases does nothing to help save lives, which should be the goal. Governments should be spending more efforts on proving that the vaccines are safe and well tested and developing treatments rather than bashing people who may become victims.

This isn't even really a "paper" -- it is "correspondence" -- a letter to the editor and as such is not peer reviewed and is basically the same as a similar letter to a newspaper. People (and web sites) need to recognize that journals publish such letters as well as opinion pieces, neither of which are required to go through the same scrutiny as an actual paper.

What is the benefit accrued from stigmatizing the unvaccinated?

From where I'm sitting in Montana, with no mandates, low vaccine uptake, and nobody giving a crap about the "OMG CASES THE CASES", the firmament remains.

It is a position that goes against all available data. We should absolutely stigmatize stupidity. People making crowd-harming decisions despite available evidence should be shamed.

People stopped dying because of (their own) stupidity a long time ago. Selection can still occur if we stigmatize bad behaviors enough.

On the other hand, if we don't stigmatize it, people who are innocent of the sin of stupidity will be harmed. That said, selection would also do its good work in this case, just less effectively and with a sadder outcome for all.

The only way to have an intelligent nation that's pushing forward in terms of technological progress is to have a nation that embraces intelligence and shuns nonsensical stupidity.

You haven't considered the most important part of this: is stigma good at changing behaviours?

If you stigmatise something and shame people for it, you tend to push people underground. At that point rational discourse can't exist because there are social pressures to not reveal the unpopular opinion, and thus discussion doesn't occur.

It's foolish to think that people have stopped dying from stupidity, it happens every day in every country on earth. And it's foolish to think you can cure "the sin" of stupidity by using shame. This doesn't mean we ignore people's bad decisions, but that we must be realistic about the utility of our response.

Right now in Australia, there is a huge gap between indigenous vs. non-indigenous vaccination rates.

Would your strategy be to stigmatize indigenous Australians as stupid, or to stigmatize them in other ways (which ones?) in order to convince them to get vaccinated?

Similar in the US, we have a “vaccine gap” for black and latinx caused by hesitancy/racism. They amazingly don’t trust a system the authorities have been spending a lot of effort telling them is a racist system.

But the media, despite the fact that the most hesitant groups are people of color, have painted a portrait of the vaccine hesitant as bad white people (rural, politically conservative, Christian). So shaming and ridicule have been embraced. The media and most elites, many posters here included, love to hate rural citizens, at least those who they presume to be privileged (ie white). They do not realize they are criticizing the uneducated poor, largely disadvantaged black people in urban areas.

>We should absolutely stigmatize stupidity.

Would that include stigmatizing people who insist on continuing a tactic that quite observably has flipped into being counterproductive?

Do you have some evidence that shaming people changes their behavior?

Here's an obvious one:

As a society, we went from a period of it being socially acceptable to marry ridiculously young girls as an old man to the present day where it's unheard of. People will point to the law being the reason for this, but that's not actually the truth, really. The age of consent isn't really that high; in many states it's unrestricted at sixteen and much lower with loopholes. Also, in many cases, the raising of the age of consent is a historically-recent thing that followed the shaming.

We've managed to (largely) eradicate the case of "man finds a fourteen-to-sixteen year old girl and erases her future by making her responsible for children" in under a hundred years, and it came from shaming, not law.

Has the incidence of this kind of terribleness actually gotten lower, or do people just talk about how awful it is?

I hear a lot of horrible stories about sexual abuse and enslavement in the modern world, so I'm not sure this has actually changed materially. I would be glad to see evidence that it actually has changed.

> "It is a position that goes against all available data. We should absolutely stigmatize stupidity. People making crowd-harming decisions despite available evidence should be shamed."

Is then also stupidity not to force vaccinated people to be tested regularly? "all available data" shows they spread the virus, therefore also being "crowd-harming"?

"How do vaccinated people spread Delta? What the science says"

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

No it doesn't. All available data show that those with natural immunity are immune to covid far more than those with vaccine immunity.

Why should those with natural immunity be stigmatized?

Is this about immunity and getting out of a pandemic or is it about compliance and control or about something else entirely? Should be about the first, to me, and if so, natural immunity should not be stigmatized at all.

“So who is capable of mounting this ‘superhuman’ or ‘hybrid’ immune response?

People who have had a ‘hybrid’ exposure to the virus. Specifically, they were infected with the coronavirus in 2020 and then immunized with mRNA vaccines…” *

Natural immunity is not nearly enough. Everyone should get vaccinated. Those who have had covid should get vaccinated so that they can get a chance of super-human SARS-variants protection. Those who have not caught covid so that they avoid the very high risk of long covid, and of course to reduce their risk of hospitalization by an order of magnitude.

* https://www.npr.org/sections/goatsandsoda/2021/09/07/1033677...

You may be confused. At least here in Germany, we (mostly) implement 2G: "Geimpft oder genesen." -- vaccinated or recovered. (Depending on context, "getestet", meaning tested negatively, is also fine.)

So no, "natural immunity" is not treated any differently from "artificial immunity", and it absolutely is about getting out of a pandemic without too many people dying. By the way, there is no difference. Immunity is immunity.

I completely agree with you that shame works. I think people who pretend that shame changes nothing haven't been to Asia. But the world has already shamed these people as much as any group can be shamed in current year; there's not really any higher level of shame that can be given out at this point. The ones remaining are unaffected by shame.

So I'm not saying your plan is ineffective, I'm saying your plan was already executed and finished. That's why we're at 80-something percent instead of what it would have been.

Stupidity is in the eye of the beholder.

> From where I'm sitting in Montana, with no mandates, low vaccine uptake, and nobody giving a crap about the "OMG CASES THE CASES", the firmament remains.

You should check out places like Alaska, where the hospitals are (or were a couple weeks ago, anyway) overwhelmed. Even aside from the people directly affected by COVID, it affects anyone else who may have needed to use those hospitals for things like unrelated accidents, other diseases, complications from births, etc.

"It's not a problem right here, right now, so therefore it's not a problem at all anywhere." is not exactly a great argument.

No need for him to check out Alaska. That also happened recently in his state of Montana. If he finds that not to be a cause for concern I doubt he will find Alaska's mismanagement of COVID persuasive.

(And it was mostly not elderly people filling the ICUs. The average age of COVID patients in Montana ICUs was under 50. Before delta it was 80).

Of course, states like Montana will be hit the least by infectious diseases. The reason is population density. To spread a virus, you first need to meet another person. Montana is actually larger than Germany area-wise. But has less inhabitants than the city of Cologne. Overall the population density of Germany is 80x that of Montana. Equally the disease spread is worse and as are the consequences.

I'd say the USA is very specific because of so many places having such low population density. This is probably why Europe is most impacted by covid on paper: high population density, high urbanisation percentage and high levels of testing+reporting. Maybe it's worse in some high density poor countries but from what I understand they just pretend the problem does not exist

I believe the hope is, if being unvaccinated is stigmatised, people who are on the fence will become vaccinated, then we can finally beat this pandemic, saving tens of thousands of lives.

Of course, the fact being obese is stigmatised doesn't stop loads of people being obese, I doubt stigmatisation isn't a silver bullet for health issues.

Is there any actual indications that even if everyone was vaccinated this pandemic would go away?

Please, tell me, by what strategy do you propose we use these vaccines to end the pandemic? Please consider in your response that the pfizer vaccine wanes to 20% efficacy after 5 months [1] and the others are no better. As well consider those vaccinated still catch and spread the disease.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

From where I'm sitting it seems the vaccine maximalists believe the way we end the pandemic is a global 2-3x/year dosing regiment for all the earth's citizens.

That's a real comfort to the people I know in Montana who died of the virus.

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