In major shift, EU says vaccine boosters should be considered for all adults
reuters.com
reuters.com
So, I’ll admit I don’t understand the physiological mechanisms at play (is it just waning antibody concentration?) but what is the long term strategy here? Is there going to be annual boosters with vaccine passports? The governments are not exactly being transparent and I think it is time now that things are under relative control to start having adult discussions and public policy debates once more.
Two notable mechanisms:
* The booster shot does increase antibody concentrations and recruits more memory B cells to make antibodies.
* Each booster also significantly increases the diversity of the immune response. You get more antibodies against the antigen, and you also get many more antibodies against things kind of like the antigen.
> but what is the long term strategy here? Is there going to be annual boosters
That's a really good question.
I personally believe (based on little evidence at this time) that each dose provides some small permanent increase in protection against infection, and a somewhat larger permanent increase in protection against severe illness.
So as we go through this whole exercise, a greater proportion of the population is protected and people are less likely to be carriers. In turn, it becomes easier to leave things up to individual choice, as the overall baseline risk reduces and people's choice mostly affects their own health.
> and I think it is time now that things are under relative control to start having adult discussions and public policy debates once more.
Yes. Look, I don't want to wear masks forever indoors. I think it'd be great to normalize it for when we're feeling under the weather or it's flu season, but I also want to be able to see other peoples' faces and carry on normal conversations.
I suspect we should also be vaccinating the wider world in order to minimize mutations which might nerf our vaccine and natural immunity. I’m of the impression that most of the world doesn’t hasn’t had even a single dose.
That said, last I checked, the US had donated more vaccine than all other countries combined and committed itself to many times more donations than it had already delivered. Further still, it was committed to building out the logistics infrastructure to make sure those vaccines get delivered and in such a way that other polities (e.g., Europe) can donate via that same infrastructure. Now we just need other polities to step up their donations.
It's very unevenly distributed, but it looks like we're at ~55% with a single dose and ~43% fully vaccinated: https://www.nytimes.com/interactive/2021/world/covid-vaccina...
Basically they negotiated to be Pfizer’s testbed / data partner for full rollout of the vaccine.
They also have a very integrated very high tech medical data system, with complete info on each person, medical history, doses, everything in one file.
We all also have a very integrated high tech medical data systems with complete info on each person, medical history, doses, everything in one file (and works anywhere in the country.)
So there must be a difference in policy.
Sometimes understanding long term effects requires long term observation.
So do we give up fantastic results while we wait to see if they'll find something with better longevity?
Now, I suppose that whether large scale booster programs, vaccine passports, etc will continue will simply depend on how widespread and serious the virus remains. So no-one knows for sure.
We might end up with combined flu/covid vaccines recommended annually for the vulnerable.
Yes, currently it is. But that may change at any time.
So we already have thousands of mutations. But changes we call variants happen much slower.
Still, the vaccins are based on the 2019 variant.
This might mean accepting we have a new endemic disease that's going to be around for the foreseeable future, but that might be inevitable given the global distribution and all the new variants.
Incidentally, this is why I'm strongly opposed to gain-of-function research involving taking wild-type animal viruses and modifying them to include sequences that bind human cell receptors. It's likely possible to transform a wide variety of animal viruses into human pathogens with these approaches, and it doesn't add much value to the medical knowledge base. Yes we have learned how to create new diseases - oops - so let's stop doing it already.
Recombinant monoclonal antibodies seem like an interesting approach, these would speed up production by shortening the critical chain.
It is important to remember that initially we meant to protect the vulnerable. I still remember when several government ministers in their late 50s and people even in their 80s contracted COVID-19 and the majority of those were saying in TV interviews that they had luckily only mild symptoms. I remember when the chief medical officer was stressing that even though the virus can be deadly that the vast majority of people will experience no or very mild symptoms.
That was at the beginning of the pandemic. I contracted the virus like at the very start and I had indeed only mild symptoms. Almost a year later I received my very first shot as soon as I was eligible. I was very happy because people were saying that I could get COVID again and I simply didn't want to be unwell for a week again even if it was a mild illness to me. Then I got my second shot as well as soon as I could get it. I was convinced that after my natural infection that I had a very strong immune response, because I was knowingly exposed to COVID many times before I got my first vaccine jab and never felt ill again.
Now I have had: - Natural infection before vaccine: I had a very mild illness - 1st shot - 2nd shot - Many natural exposures to COVID which might have boosted my immune response.
I honestly don't feel very keen anymore on yet another jab. Mainly because when I got my first two jabs I had quite noticeable heart palpitations for a few days after and now I'm thinking why do I still need to keep getting more jabs if even when I didn't have a jab at all I was already strong enough to shake off the virus.
I do understand that we need to have a lot of immunity and I do believe that I have a lot of immunity without any further boosters. I'm certain that my natural immunity has given me the best protection from the beginning with the jabs acting as long lasting boosters.
Can someone explain to me why I should even entertain the idea of yet another booster. I feel like I'm ok to get infected with COVID-19 once every so often like with a cold or flu. We all have a baseline protection which we didn't have before. Now our illness should be mild for everyone, even the older and more vulnerable people.
It honestly sounds like this is a conversation for your doctor, considering the possible heart thing. Regardless of public policy (which will be to protect the most people and reduce hospital burden), individual health concerns will always be the final answer to your question. One reason for the healthy to get vaccinated is to reduce the risk for someone who can’t be vaccinated for some complication or another.
It’s also worth noting that both flu and COVID are dangerous and severe enough to not want to get them. (Way more so than the common cold, which doesn’t take long to get over.) Hence the yearly flu booster that some folks opt for.
Honestly, the political side of this will optimize towards reducing the burden COVID takes on the health system. If there are too many people with severe cases in the hospital, the rest of us can’t get treated for other ailments. That sort of thing just doesn’t happen with the flu regularly, and it’s the sort of thing public policy is supposed to solve.
Yes, if I must get a third jab in order to be allowed to roam freely then I will probably ask my GP if I could get a different vaccine the next time. I had Moderna as my first two jabs and perhaps having the Johnson or Oxford is something to consider.
Well, data shows it sadly isn't, that's why we talk about booster shots, because data looks like they help with that.
Myself, I am refusing a third booster shot. We were promised a return to normalcy after getting vaccinated (with the % required ever increasing, and communities with almost 100% seeing no improvement) and after falling ill with the second shot I'm not participating in this charade anymore.
“Falling ill” means your body had a strong, visible immune response to the vaccine. The whole point of the vaccine is to trigger your body into an immune response which creates antibodies against the vaccine, thereby giving you protection against the real thing.
> communities with almost 100% seeing no improvement
You’re just wrong about this. In cities like Seattle and Portland, life is pretty much “back to normal.” As a result, people are interacting with each other and “spreading germs” around like they used to be. Without a vaccine, this kind of behavior would have caused a huge spike in severe cases. And while changed behavior has caused an uptick in cases, the number of severe cases has not. Unvaccinated people in King county near Seattle, for example, are 38x more likely to be hospitalized with covid.
The better explanation to your comment is that an imperfect world is hard to predict and that there are reasonable explanations to most things, rather than some sort of superstitious reference to it being a “charade.”
Less than 4000 are people under 60 and still my government tries to vaccinate kids. Why? It is entirely possible that it can have a negative effect on building real immunity against Covid. The very low death count in lower age brackets would very well warrant to build a control group here.
Well, one assumes children often have contact with older people, and can spread it to them. Plus we don't know that Covid does not have long term impacts in young children. Plus if we ever want to eliminate this disease, it means doing it in children as well.
At some point people will have to build immunity and I think there are some people that made good cases that vaccine immunity is reductive because vaccines only include a specific component of the virus towards which immunity is build. We simply don't know enough here, not even how our immune system reacts exactly, it is not a system we completely understand.
I don't really think the long covid examples are very convincing as a potential for danger (I also don't think vaccines have long term effects either).
Yes, kids could infect elderly people and they should be protected as best as we can. But I don't really see vaccinating kids as feasible. It should only be done when there is a measurable benefit.
Oh, I've heard of so many cities/communities like these. Tell me in a few months.
Where exactly is the charade? Being ill for a few days after a vaccine is normal, it even happens with flu.
No one has long term experience with them, so understandably no one knows how long they protect you for. That's life.
Yes, there are some (minor) risks associated with the vaccines. I too spent a day in bed. Twice. So what? Both you and I knew there's a risk of that when we got it. Still, the vaccine does what it says on the tin. So again, where's the charade?
We live in a time and place that allowed us to get a vaccine with 90%+ efficiency just a year after an incredibly infections, never before seen virus has been spotted and begun taking (many) lives. It even proved to be effective against the even more infectious variants that appeared later. And after millions around the world were literally suffocated to death by covid, both you and I got the vaccine for free (or at an affordable cost, depending on where you live). And the only side effect of the vaccine that either of us experienced is feeling sick for less than a day.
The word I'd use to describe this situation is definitely not charade.
If my body reacted to the vaccine like that, I dread to think how it would have dealt with the real thing.
10 hours in bed is a minor inconvenience.
I don't think boosters are part of a sensible solution to be honest.
Even I, as someone who fully accepts vaccines and sees the data illustrating that mRNA vaccines reduced death rates enough to make COVID "the new flu" were it not for the antivax population and their role in overwhelming hospitals, am quite tired of hearing about how the boosters were only going to be for old and sick, and then it was a sudden flip into "everyone should get them". I don't even know what data would suggest that I should get a booster shot, I do not see death rates climbing and I have fatigue from doing the research I wish the nation-state which sets my laws would simply have done correctly and before recommending my action.
There's some evidence of waning immunity and reduced antibody titers, and greater incidence of breakthrough infections for people who have been vaccinated a long time. There's also just a lot of evidence that 3 is better than 2 for likelihood of breakthrough infection.
Waning immunity isn't enough to make overall death rates increase: even at current slow incremental rates of vaccination the effect from increased vaccination "beats" waning immunity. But this can't hold up forever.
> I do not see death rates climbing
Waiting for death rates to climb is way too late. It'll take a long time to move them in the opposite direction. Also, a lot of this is preventative: more doses doesn't mean just "more immune response" but "broader immune response and better protection against future variants".
> and I have fatigue from doing the research I wish the nation-state which sets my laws would simply have done correctly and before recommending my action.
There's no way the dose schedule is ideal steady-state. Doses a few weeks apart isn't what will maximize response. The vaccine doses themselves are probably too high. But we had to do something while supplies were lacking, the pandemic raging, and with partial information.
I do not contest this. I am likely to receive a booster shot myself in January.
What I contest is that they make the original suggestion that "only weakened immune responses will receive the booster" with no implication the policy will change with new data. Now it is a "major shift", and not an "predicted outcome acted upon with sufficient data". This is a consistent problem in public messaging throughout the pandemic; people feel uncertain and like the government is as clueless as them.
> There's no way the dose schedule is ideal steady-state
Again, I am not in medicine, nor do I in general care for this style of research, yet I have been made to do it consistently because I do not understand the public messaging, and I am quite staunchly a believer that you cannot simply not act against a pandemic. This is my complaint. I do not argue the conclusions you put forth, simply the way the governments have been unable to outline scenarios in any meaningful way and thus give off the appearance of constant reactivity without foresight
I think it's really hard to give such a nuanced message. Here in the US, there was broad speculation about the requirements for boosters for all eventually-- including by policymakers -- but the boosters were initially only recommended for those with risk factors (either occupational or health).
In a few years, there's going to be a recommended coronavirus vaccine dose schedule, and it's going to look nothing like what we do now. It's all going to evolve. The public messaging is going to be focused, though, on what we want people to do now.
This is where I think you may be asking too much. I agree with you that we need to better normalize uncertainty in politicians, but asking politicians to interpret science to even make "predicted outcomes" is unlikely to work out at best, and likely part of why we got here in the first place. "We think we only need two shots, but we'll find out when more data arrives" turns into "Just two shots and we're done" because the politicians are trying to "predict outcomes" and in part are going to tell people what they want to hear rather than the uncertain part. If they are right they sound like heroes of the people and if they are wrong they apologize and move on, and we get exactly the whiplash a lot of people have felt in all this, because this has been a virus intent on breaking "predicted outcomes".
I think what we need to normalize is both simpler and a lot harder: "I don't know, I will ask the experts." and "We don't know yet." and "Let me get back to you on that." and "Right now, here's what we think based on the data that we have, but that could change."
It's simpler because those are arguably really easy answers to give. They don't take a lot of time. They don't make "predictions". They state pretty plainly that there are experts to trust, those experts need time, and those experts update their recommendations as real world facts come in.
It is a lot harder because it isn't "good" politics (in the current political climate, at least). "No one" wants to elect a politician that defers to experts, that admits when they don't know something, that doesn't make bold predictions their constituents want to hear. It sounds "weak" to ever state that you don't know something or don't have an opinion on something until you have more facts.
An interesting thing that I watched in the past couple of years was my own state's Governor attempt to put contemporary politics aside and very much take that stance of "We don't know yet" and "We want to find out" and "We have experts working on that", because he seemed to generally believe that an event like this was more important to get right than to treat as politics as usual. It has had some insane political blowback from the obvious stuff of opponents predicting he will take a beating in the next reelection attempt and may only be a one term Governor, to a dramatic hanging of an effigy on the Governor's Mansion lawn (where he and his wife and kids live), and many things in between subtle and not-so-subtle.
I absolutely wish there were more politicians like that out there in this crisis, because watching my governor do exactly this "We don't know yet" and "I don't know but I'll try to find out" to press question after press question was immensely satisfying and comforting to some of us here, and I would have wished more people to experience that. I don't know how we get there in the current general political climate (at least in the US) that is currently so deeply anti-expert and stuck in toxic machismo where "I don't know" is a "weak" and "unacceptable" answer.
There's always someone to scapegoat. Instead of blaming politicians for being wrong, you're blaming the skeptics who knew that vaccines aren't going to change anything.
But they have, they've cut the death rate from Covid enourmously. Unless you have alternative figures that you can point me towards?
https://ourworldindata.org/covid-deaths-by-vaccination#unite...
These graphs are more or less useless to draw conclusions from.
Measuring COVID cases and outcomes in two unbiased population samples gives a statistically significant result. Please show me why this is false, I would love to know, but I don't see how what you list would introduce bias that would make that graph "more or less useless"
That's more than nothing.
The booster trials literally started as soon as the first EUV was issued, because they were expected to be more effective. They didn't invest in it because they thought it was unnecessary. The EUV was necessary because the disease is wide spread, communicable, and deadly enough to overwhelm ICUs, otherwise epidemiologists would prefer to have even more data. However, when the risk to your patient of actual illness is more than an order of magnitude higher without action... you take emergency action.
I hear similar stuff from engineers who now are looking for even more data on the effectiveness of masks, because they've read reports saying they aren't effective, or questioning studies saying that they are. The germ theory of disease hasn't been disproven. People don't wear masks well. Cloth masks aren't very effective protection (of the person wearing them) due to bypass flow. Viruses can enter through the eyes as well, so a mask can never be "perfect". Masks and glasses also protect (if you bother to wash your hands) from accidental surface contacts. At the same time there are doctors/nurses working in ICUs intubating COVID patients for months without getting exposed... that's an (uncontrolled) experiment running in thousands of places. It's not published, but it's known to be effective by people working there. The PPE is expensive and training along with diligence is required, because even if you're vaccinated you can spread it just not as likely and not as much and not as long (another long chain of but, but, buts... which add up to more than an order of magnitude).
Did you read the ECDC guidance, in September and now? Can you point out the passage that exemplifies your point? Or do you have another example of a government saying that young people will never get boosters? Since naturally you did not write your comment based solely on the tone implied by the words 'major shift' in the headline of the Reuters article...
There are certainly people, journalists, and government ministers guilty of what you say. But throwing a catchall accusation around is a bit cheap, in my opinion.
Even if the example you are putting was correct, and there was an insane amount of uncertainty, it may have still be the correct recommendation and the correct policy to first vaccinate "risk groups" and then later extend to the entire population, when/if shown necessary.
In other words: adding "unless conditions change" to every statement made by any organization is redundant, so they don't do it.
https://ourworldindata.org/explorers/coronavirus-data-explor...
and rising, which is what you said you didn't see
> and it doesn't discuss vaccination status
What is there to discuss? There are more vaccinated people in the EU now than at any earlier time, and yet the death rate has already climbed halfway back from to the November 2020 peak (which occurred when nobody had been vaccinated yet) and shows no sign of slowing down.
> Please read a bit more charitably, it makes no sense to post this graph as if it shows something relevant
However charitably I try to read this statement, I can make no sense of it.
> and rising, which is what you said you didn't see
"Death rates". How explicit do I have to be? "Death rate" is the total amount of deaths (which you linked) DIVIDED BY the total amount of COVID cases. Linking "total deaths" and implying it is "death rate" is absurd.
> There are more vaccinated people in the EU now than at any earlier time, and yet the death rate has already climbed halfway back from to the November 2020 peak
And this is even more absurd. You must be able to ARGUE IN NUMBERS if you will argue that numbers are increasing; using half-baked logic and ignoring the unvaccinated population who is probably fueling most of that death spike is like me making a performance benchmark for performance-per-core and then measuring how many instructions were executed without providing a time measurement and saying "the higher instruction count is better", which is to say if someone was to do it they would be laughed out of the room.
Perhaps this is your cue to exit.
> "Death rates". How explicit do I have to be? "Death rate" is the total amount of deaths (which you linked) DIVIDED BY the total amount of COVID cases.
By your personal definition, which you did not bother to specify until now. A (I think generally accepted) definition is deaths DIVIDED (to mirror your all-caps frenzy) by population, which is what I linked (no, it's not "total amount of deaths"; did you even look at the chart?).
What you are referring to as "death rate" is actually called "case fatality rate".
Now, once again, they've only wasted time and probably made the new wave worse, which in turn may force them into more stringent measures.
We have 80% two-dose and 90% single-dose people in the 12+ population (yes it includes children) and close to 30% third dose.
There are no lockdowns, hospitals not overloaded, people dying but not like crazy. Hospitals coping. The case numbers are high, but the logical implication is that most are mild and do not overload the system.
If vaccine mandates bother you, I strongly suggest moving to a rural area or to a region/country with less restrictions. Otherwise you will inevitably be forced to receive yearly boosters in order to participate in society.