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Comment by stri8ed | Hacker News Reader

Given the relative weakness of the (current) vaccines vs Omnicron, do these mandates make any sense, or is it largely security theatre at this point?

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In this kind of context (residential university) where you’ll have a concentrated group of people living and working together and where the consequences of an outbreak would be extremely disruptive, I think it makes perfect sense.

The question is if/to what extent does the booster prevent transmission of Omicron. We already know its transmissibility is significant greater than prior variants. If the effect on transmissibility is small, this argument would not hold much weight.

There seems to be little relationship between percentage vaccinated and case-counts. Open to being proven wrong on this.

E.g. given total new cases today, California (30k new cases) has a higher number of cases per capita, vs Texas (15.5k), despite CA having 10% higher vaccination rate. Granted there are other variables at play, but its hard to make the case that vaccination has a large impact on transmission, currently.

there is pretty good evidence that a booster provides relatively strong protection at least in the short term

Of 288,072 people aged 16-39, only 6 people who had only 2 doses were hospitalized, compared to 1 person who had 3 doses [1]. This study was published before Omicron in October, for which the vaccine is even less effective and the disease is less severe.

I'm not yet aware of any other study that indicates the booster is useful for people in this age group.

I thought that a spike in antibodies might be useful in the short term, but a recent CDC presentation [2] said of an Omicron case study:

> 79% fully vaccinated; 32% with booster dose; Five of the 14 persons received additional dose <14 days before symptom onset

which doesn't give me any confidence.

> security theatre

Since mandates don't exclude people that were previously infected, to me, they seem punitive.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

[2] https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

From the lancet study:

"Vaccine effectiveness evaluated at least 7 days after receipt of the third dose, compared with receiving only two doses at least 5 months ago".

Literally no control for recency. Newer research (admittedly, not yet peer-reviewed) seems to show that efficacy of the vaccines dwindles over time. As little as 90 days. [1]

The results from the booster may have more to do with having received a vaccine more recently than they do with the overall efficacy of any of the vaccines.

https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...

Wow, that's not an encouraging paper!

It doesn't just say that "efficacy of the vaccines dwindles over time," but that the 2-dose vaccine effectiveness against omicron is significantly negative in the 91-150 day bucket.

Yes they do. The data still show pretty good protection against severe consequences from Omicron for boosted people, even despite the vaccines not being as amazingly effective against Omicron as they were against earlier variants. This is especially true for largely young and healthy populations such as the Stanford student body.

Some of them may still catch and spread Omicron, true. But overall far fewer will than without the three doses of vaccination, and those that do catch it will tend to have far briefer and milder symptoms than otherwise. It's still a big help to both the vaccinated/boosted students and all of their close contacts in the dense community that is a university.

Data from who? Because the population data from South Africa and Denmark with hugely different levels of vaccination point to omicron being mild regardless of vaccine protection. And frankly, unless we started RCTing the hell of it, population wide data is the only thing that allow us to infer any conclusions right now.

For example, in Canada and the US, the unvaccinated are hugely overrepresented in ICUs now, including in areas where Omicron is dominant. Most of the initial reports I think you're citing were preliminary when Omicron was new and hospitalization data (which is a lagging indicator) hadn't yet caught up.

Protection is not super relevant for young students who are not at risk. It also seems unlikely that the booster will slow down the spread all that much if even two doses of the vaccine have low efficacy.

Put yourself in the shoes of the school leadership. They need to weigh the negative publicity from this mandate against the potential negative publicity of an unvaccinated outbreak at their school (or god forbid, death(s)). It's really a no-brainer without even plugging the numbers in.

If the motivation is to avoid bad publicity, isn't that security theater?

Quite a few indications the booster is important.

https://www.cnbc.com/2021/12/14/covid-booster-dose-is-crucia...

> The U.K.’s Health Security Agency published a report last Friday, citing initial findings from a real-world study, that said a two-dose course of Covid vaccines were significantly less effective against the omicron variant than the delta strain. However, it found that a “moderate to high vaccine effectiveness of 70 to 75% is seen in the early period after a booster dose.”

> More research emerged from Israel on Saturday, with researchers also finding that a three-shot course of the Pfizer-BioNTech vaccine provided significant protection against omicron.

All of the current data shows that the vaccines being used in the US provide strong protection against severe illness.

That's completely useless. Vaccines are only useful if they stop or slow the spread. There are plenty of other treatments that are successful at preventing severe illness.

So what does forcing people to get a third vaccine really accomplish? In my opinion two things, further erosion of our freedoms, and huge profits for big pharma.

As I said elsewhere in this thread, the slogan of standford is literally "The wind of freedom blows". This policy does absolutely nothing to further anyone's freedom.

https://abcnews.go.com/Health/breakthrough-covid-19-infectio...

“Breakthrough infections are not evidence that vaccines don’t work anymore than the fact that car crashes [that] are still sometimes fatal is evidence that seatbelts don’t work. We use prevention tools because they help reduce our risk of serious disease or death, not because they are guaranteed to 100% always keep us safe,” Murray [, an assistant professor of epidemiology at Boston University School of Public Health] said.

Why would a vaccine only be useful if it stops the spread? It's a medical treatment like any other, and we universally recognize the importance of medical treatments that reduce severe illnesses to manageable levels even when they are not themselves cures.

(And moreover, this has been true for all vaccines ever made: no vaccine guarantees 100% protection from its illness, but nearly all significantly reduce the severity of breakthrough cases.)

Edit: to emphasize: there are other ways to prevent severe illness from COVID, like monoclonal antibodies (at least, the ones that still work against Omicron). But none of them counter what you've posited (making pharma companies money), and none have as mature, reliable, and freely available of a supply as do vaccines.

Because as I said, there are other treatments that are effective at treating covid. We can simply use those instead without need for mandates.

Could you elaborate on which treatments you think those are? I'm aware of monoclonal antibodies and other antiviral treatments, which are generally more difficult and expensive to distribute compared to vaccines, and are more susceptive to variant changes.

To reiterate: that doesn't mean that people shouldn't get antibody treatments, only that we should continue to practice "needs based" care: vaccinate everyone, and use the more drastic (expensive, logistically complex) treatments on those who need it the most.

I believe there is data that fully vaccinated individuals on average have less severe symptoms and significantly fewer hospitalizations. Feel free to refute (I don't have time at the moment to look it up) but I feel confident saying that.

There's a lot of room between 95% effective and useless. From everything I've read the vaccines are still a significant help, especially for preventing severe cases, even if they are less effective than against previous waves.

Would be interesting to know if/to what extent it prevents transmission. Assuming the booster reduced severity, but not transmission, it would make little sense to require it, since there is little/no negative externalities by someone not getting it.

One of the potential negative externalities is overwhelming hospitals, pushing out others in need of help.

This line of thinking could be extended to banning junk food, motorcycles, cars, etc.. Where do you draw the line?

Being in the hospital is a negative externality in a world where health care is delivered by humans with a lot of long training.

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