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A quarter of Americans are hesitant about a coronavirus vaccine (reuters.com)
12 points by nabla9 11 days ago | hide | past | web | favorite | 12 comments

Despite all the water cooler conversations about "immunity passports," their usefulness is hard to envision for several reasons. It's a lot easier to imagine institutions requiring employees to provide proof of immunization instead.

what's wrong with the other 3/4? Unless I was at major risk from Covid, I'd never do it unless it was tested for many years. No, I'm not anti-vaccine

I personally perceive vaccination as a moral duty. For many vaccines nowadays (polio, chickenpox, diphtheria, rubella,etc), the chance to get the disease is lower than the chance to have a severe allergic reaction. For example, according to the CDC, the US has been polio free starting in 1979, but the chance of a severe allergic reaction to the polio vaccine is about 1 in 1 million. Why would you take a 10^(-6) risk to counter a zero risk? Because if you don't, and nobody else does, we lose the herd immunity and polio makes a comeback, and we are all worse off. Classic prisoner dilemma. Nature's way of solving prisoner's dilemma is morality. If something feels immoral to you, it's an underlying evolutionary solution to a prisoner's dilemma problem.

So here we are. I will personally take the Covid19 vaccine when it becomes available, knowing that I trade a smaller risk for a larger one, but also knowing that if everyone does the same we are all better off.

Just commenting so people scanning don't miss the logical error.

You're comparing established vaccines with an untested one, so your argument doesn't make any sense.

> Why would you take a 10^(-6) risk to counter a zero risk?

Nobody knows the risk of a new vaccine in advance.

We're more likely to reach herd immunity before a vaccine is approved, sooner the better.

> with an untested one

Not sure where you got the idea that the Covid19 vaccines will not be tested. On the contrary, they will be the most tested and scrutinized vaccines in history. Even now you can find countless articles/blog posts explaining every little detail of the progress of the testing so far. In a few months there will be even more. Then the FDA will give the Emergency Use Authorization, and millions of people will be vaccinated under that. By the time the FDA provides the actual approval, there will hundreds of times more testing data than for other vaccines. There will be enough data to have statistical power to identify side effects with a prevalence rate of 1 in 100k or 1 in 1 million.

>We're more likely to reach herd immunity before a vaccine is approved, sooner the better.

That's possible. That doesn't mean we won't need a vaccine. Herd immunity diminishes in time, and then you have new bouts of the disease. This virus will not simply go away. The only way for it to be wiped out, like the smallpox virus was, is to have a very determined vaccination campaign.

Tests take time. You don’t know what side effects may present themselves one year, two years, five years down the line until you’ve monitored the vaccine for one, two, five years. This is one reason vaccines take a long time to test and is why people familiar with vaccines are hesitant to inject themselves with something that hasn’t been tested over a normal period.

credit_guy: you're either a shill, or overly trusting.

There have been several medications in US history that turned out very badly, like thalidomide.

And Emergency Use Authorization implies less testing, not more.

> The only way for it to be wiped out, like the smallpox virus was, is to have a very determined vaccination campaign.

I disagree. Around 5% of the population has had corona and survived. They seem to be doing fine.

Sounds like you're one of those guys who believes everything you read, and thinks hope is a strategy, and a short-term one at that. That's the second epidemic - hope is not a strategy.

> either a shill, or overly trusting

Not a shill. A company that makes a successful Covid19 vaccine will make many billions in profits. They don't need shills on Hacker News.

Overly trusting I may be. I am certainly an idealistic guy, who believes in benefit of doubt, innocent until proven guilty, life, liberty, happiness and all that.

> Emergency Use Authorization implies less testing, not more.

That's correct, I never said it implies more testing.

However, all vaccine companies will move to secure full approval after the EUA phase. At that point, there will be tons of testing data available to the FDA, data that's not normally available for other vaccines, for the simple thing that the EUA concept exists only during emergencies like this one.

I don't think anyone should feel obligated to do the vaccine during the EUA period, when the risk will arguably be higher. However, once the full approval is granted, then the vaccine will be, if anything, safer than your annual flu shot, for example.

Did you know that among the flu shots offered for the current season (2019-20), one was approved as recently as 2017 [1]? For all I know in 2017 I may have taken this then brand new vaccine. I didn't care to ask, and I won't care to ask in the future. In my mind, if the CDC recommends the population to get a vaccine, and the vaccine is available at my local pharmacy, then I'll go ahead and just do it.

> thinks hope is a strategy.

This is a head-scratcher. What exactly made you believe I consider hope to be a strategy? Advocating for a vaccination campaign is the opposite of "hope as a strategy", wont' you think?

[1] https://www.cdc.gov/flu/prevent/qa_flublok-vaccine.htm

> We're more likely to reach herd immunity before a vaccine is approved, sooner the better

Herd immunity only really works if it's a disease we build a long term immunity to after being infected or vaccinated. So far we don't know how long we build an immunity to COVID-19.

It is unknown (as of April 2020) if past infection provides effective and long-term immunity in people who recover from the disease.Some of the infected have been reported to develop protective antibodies, so acquired immunity is presumed likely, based on the behaviour of other coronaviruses. Cases in which recovery from COVID‑19 was followed by positive tests for coronavirus at a later date have been reported. However, these cases are believed to be lingering infection rather than reinfection, or false positives due to remaining RNA fragments. Some other coronaviruses circulating in people are capable of reinfection after roughly a year.


Plus there's also the risk that COVID-19 mutates like influenza and norovirus:

Herd immunity itself acts as an evolutionary pressure on certain viruses, influencing viral evolution by encouraging the production of novel strains, in this case referred to as escape mutants, that are able to "escape" from herd immunity and spread more easily. At the molecular level, viruses escape from herd immunity through antigenic drift, which is when mutations accumulate in the portion of the viral genome that encodes for the virus's surface antigen, typically a protein of the virus capsid, producing a change in the viral epitope. Alternatively, the reassortment of separate viral genome segments, or antigenic shift, which is more common when there are more strains in circulation, can also produce new serotypes. When either of these occur, memory T cells no longer recognize the virus, so people are not immune to the dominant circulating strain. For both influenza and norovirus, epidemics temporarily induce herd immunity until a new dominant strain emerges, causing successive waves of epidemics. As this evolution poses a challenge to herd immunity, broadly neutralizing antibodies and "universal" vaccines that can provide protection beyond a specific serotype are in development.


I am in the same boat. For some reason I feel anxious about getting vaccinated for COVID knowing the development of the vaccine has likely taken short cuts to get to people. I am also not anti-vaccine.

that doesn't yet exist? lol.

Amusingly if Trump says it’s safe, less people are willing to take it.

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