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Comment by disgruntledphd2 | Hacker News Reader

Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely.

Look, the risks are pretty low for younger people, but from a population level every extra bit of immunity helps to reduce the likelihood of health care system collapse (which has been the goal throughout the pandemic).

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> Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely.

Protection from Omikron quickly wanes. At what point does that "extra bit of immunity" justify heart injury? We're talking about roughly 1 in 10000 doses administered causing Myocarditis in a young male. We don't know if the risk increases after each dose, but preliminary data suggests that it may:

https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...

We're talking about ~1:10000 odds for one specific vaccine when vaccinating young males, which is why many countries are no longer using that vaccine for this demographic. Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19.

The study also shows that there was practically no increase in risk for the third shot (though with a fairly wide CI), so it's possible the risk may just depend on whether someone is immunonaive or not.

> Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19

The risk is given by the FDA as up to 1:14285 (males aged 12-17) for the second dose:

https://www.fda.gov/media/154869/download

However, a study from Hong Kong found an incidence of up to 1:2700 in the second dose (males aged 12-17):

https://pubmed.ncbi.nlm.nih.gov/34849657/

What we don't know is whether a vaccination would actually prevent Myocarditis in a breakthrough infection. These risks may well not be mutually exclusive. In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.

1:100000 was in reference to the "males < 40" age bucket in the UK study linked by OP. The myocarditis risk from infection for the 12-17 age group appears to be significantly higher according to this study[1] (1:1141), which gets us quite close to the Hong Kong study incidence if we assume two shots after the first dose.

> In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.

I do wonder how unrealistic it is with Omicron, but maybe we'll get lucky and Omicron's less likely to cause myocarditis.

[1]: https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v...

Maybe if the health care system had lots of staff, meaning lots of doctors, not just the trickle that comes from the tiny amount of medical schools, the system wouldn't collapse?

Has America tried addressing COVID that way, increasing the number of doctors?

Has America considered doubling the number of doctors, nurses, hospitals, and all other medical support, building and bootstrapping many more medical schools, and graduating an enormous cadre of recruits from a seven year program, all at a cost probably over a trillion dollars a year, so that we can care for a massive influx of Covid patients in preference to advocating booster shots?

That's not the real cost. They could double the number of doctors by cutting the amount of education required by half, and get better results. And they wouldn't need to expand medical school capacity at all.

The amount of education doctors get is harmful. It actually makes them worse at their job. It's effectively a form of hazing by AMA.

There's a combinatorial explosion of effects and side effects in the human body. It's important to learn and memorize, and memorization is undervalued, but not to that extent. It's like memorizing optimal solutions to traveling salesman instances. Other times it's like memorizing a times table of the three-digit numbers. That is a waste of time and will make you a much worse mathematician.

That's one of the dumbest things I heard in a long time

We need to do that anyway, but then the doctors that make those decisions wouldn’t get paid nearly as much. There is absolutely an artificial scarcity of MDs in the medical field that needs to be discussed.

You're getting a massive influx even if the booster shots have 100% uptake, so let's just stop restricting the number of residencies and let the doctors we already train... work as doctors!

Then all you need is bullet-proof evidence that transmission is significantly impacted by the vaccines. It ain't a guessing game, do the measurement. Do it all over the world and compare and contrast.

This seems to suggest viral loads are the same for everybody - vaxxed, unvaxxed, symptomatic or asymptotic.

https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...

Vaccinated individuals hit the same peak mRNA loads for the same symptom severity on average. Their time to recover is faster though, and at peak you recover less viable virus indicating they are producing more viral debris.

And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination.

All of those studies use PCR Ct values as proxies for viruses and compare vaccinated and unvaccinated individuals with similar symptom severity, and it turns out that correlates at peak because symptoms are on average due to antigen loading. Those studies aren't very good at showing how effective vaccination is at preventing transmission. They just show that its nonzero.

None of those old studies apply now that omicron is around. Omicron spread all throughout the world at record breaking pace via vaccinated people, so it doesn't seem like vaccines are doing much at all to prevent spread of omicron.

You may be correct, but it's too early to tell.

As I have stated elsewhere in this thread, the rate of vaccine escape has gone up by about 5x, (from 6% to 30%), but that's still much better than one would get from no vaccination.

But it spreads so fast that it doesn't seem like that matters. It spreads basically as fast as people are interacting, if it gets into the student body then everyone will be infected in a matter of days even if they are all vaccinated.

I can't see how it could spread any faster than it already does through vaccinated people. A few people there being unvaccinated wont make a difference.

> And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination.

This is the big one. Conditional on symptoms the viral load may be similar betwee vax/no vax, but if the vax have much less probability of getting symptoms then all is good.

Shouldn’t we be distinguishing between unvaxxed who had Covid, and unvaxxed who didn’t?

I haven't read the full paper, and it's pretty small data (maybe n=120 in total) but this would seem to suggest that there's about a 40% reduction in transmission associated with vaccination: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

I honestly don't understand how there wouldn't be protection from the vaccine. It's not a sterilising vaccine, but it does offer protection.

"SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15–35] for vaccinated vs 23% [15–31] for unvaccinated)."

In other words, once infected, there is no reduction. How effective are these boosters against Omikron infection, weeks and months down the line?

All the above applies for the flu as well, so why do we insist on inventing a new set of rules for Corona ?

With vaccine and booster shots, both require a similar amount of hospital resources.

The current way is simply not sustainable.

"every extra bit of immunity helps" - Agree. But this shouldn't be mandated. Rewarded, yes. But not mandated.

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