As other commenters have noted, this case study further supports the widespread observations that COVID-19 vaccines reduce the chance of severe (symptomatic) illness but do not necessarily prevent infection and transmission.
The authors of this study conjecture that the unvaccinated asymptomatic “patient 40” may have been the source of the infections seen in the other fully vaccinated patients - however this was a minor point as limited rational and evidence was provided.
That being said, IMO there seems to be a growing public opinion that unvaccinated individuals are to blame for the increasing dominance of variants of concern (delta, gamma, etc).
One counterpoint that I’ve come across during my own review of the literature, is the idea that imperfect vaccines can cause selective pressure which enhances the fitness of highly virulent pathogens. For example see this peer reviewed publication from 2015: “Imperfect Vaccination Can Enhance the Transmission of Highly Virulent Pathogens” (https://journals.plos.org/plosbiology/article?id=10.1371/jou...).
My understanding is that this is a relatively new and perhaps highly understudied phenomenon. I wanted to share the idea here because it seems conspicuously missing from many of these discussions. Furthermore, I’d love to hear feedback from someone with more expertise - or just trade relevant links with others who are diving into primary sources as a way to form an educated and well rounded opinion.
> One counterpoint that I’ve come across during my own review of the literature, is the idea that imperfect vaccines can cause selective pressure which enhances the fitness of highly virulent pathogens.
This is what happened with "Marek's disease", a virus-caused disease in chickens. The vaccine was "leaky" and ended up selecting for a more deadly form, such that now all chickens worldwide have to be vaccinated for it or they'll die if they get infected - which didn't used to be the case.
1) All current variations of concern come from mostly unvaccinated countries. Apparently there's a serious issue with immunocompromised individuals and the vaccines may help prevent that:
2) We can see with SARS and MERS that a more deadly form may actually reduce overall mortality, since the virus can't spread as effectively. However, we haven't had this effect so far.
> All current variations of concern come from mostly unvaccinated countries.
Isn't it more significant not where they emerge (which is by random mutation) but where they do well? And don't they seem to do well in countries that have vaccinated more people?
Is it even particularly easy to say where a variant originated? Could the mutations happen multiple times independently?
>Isn't it more significant not where they emerge (which is by random mutation) but where they do well?
Random mutation happens more when we give it more chances, by letting it infect more unprotected people. We'd rather avoid that, so it's also important.
>Is it even particularly easy to say where a variant originated?
No, but we have gene sampling to help.
>Could the mutations happen multiple times independently?
The Delta variant is a humanitarian crisis in less vaccinated India and a moderate public health concern in countries with higher rates of vaccination.
> Analysis of samples from the patient showed that the virus evolved rapidly after the plasma therapy, developing mutations that changed how it could infect cells and resist antibodies.
Seems to be that the plasma therapy (injecting antibodies) is responsible here.
> We can see with SARS and MERS that a more deadly form may actually reduce overall mortality, since the virus can't spread as effectively. However, we haven't had this effect so far.
As GP pointed out, when the unvaccinated are at risk and vaccinated ones are carriers, the dynamics don't remain the same as in the case of Ebola / Nipah / MERS / J. Encephalitis, because the infection retains its virulence while evolutionary pressure selects for a fatal variant, a deadly combination.
Marek's disease in chicken is what the PLOS article is about: MDV = Marek's disease virus.
> The vaccine was "leaky" and ended up selecting for a more deadly form
The researchers of the PLOS article do not claim to know that for certain:
"Our data do not demonstrate that vaccination was responsible for the evolution of hyperpathogenic strains of MDV, and we may never know for sure why they evolved in the first place."
But this they claim:
"But whatever was responsible for the evolution of more virulent strains in the first place (and there may be many causes), our data show that vaccination is sufficient to maintain hyperpathogenic strains in poultry flocks today."
1) the most contagious variants have emerged from countries with little to no vaccination: UK before vaccination and with very little protective measures (pubs, etc.), Brazil with Bolsonaro, India with a very high population density who are mostly unvaccinated, etc. These variants appear thanks to the high number of contaminations. Vaccination means fewer contaminations, and thus the less likely arising of mutations and a new variant.
2) Current vaccines are very effective against the current variants. This observation is inconsistent with the assumption that one of the variants could have been naturally selected to resist to vaccination. This is also expected as the percentage of vaccinated people is low in most parts of the world, thus there is little pressure to select a vaccine-resistant variant for now.
If we had made the variants "worse" because of imperfect vaccination, we would have seen a vaccine-resistant variant emerge from one of the vaccinated (>50%) countries.
It's looking extremely iffy right now as to whether it's even possible to achieve herd immunity against the current variants through vaccination, which will set up basically the perfect environment to select for vaccine escape globally: enough people vaccinated that it's a strong advantage, but the virus can still spread and infect more people in order to get a chance to adapt.
By "very little protective measures (pubs etc)" you mean the pubs were all closed? The UK has had some of the most restrictive lockdowns in the western world.
I agree that the idea that vaccines are leading to new variants seems extremely dubious though. Like everything else in epidemiology, when you go looking for the underlying rational basis for it, there's just nothing robust there.
No. First off, we still haven't had the level of death that we had in 1918, and almost certainly won't. Second, the narrative of vaccinated individuals being major spreaders of this disease is false. The virus is evolving due to mutations occurring while hopping from one unvaccinated person to another, full stop.
The UK now has a similar test positivity rate to what it had in November 2020 yet a hugely vaccinated population.
If the vaccinated aren't spreading it then you're suggesting that the unvaccinated have become drastically more infectious for no apparent reason and in ways that don't show up in contract tracing data. I think the alternative explanations are more likely to be correct: the vaccine is actually not a vaccine in the traditional sense, it's more like a prophylactic. Vaccinated people aren't getting an immune response in the normal areas where it would usually enter and exit, like the nose and lungs, instead it's being injected into the arm.
Also, COVID tests don't actually detect COVID or even SARS-CoV-2, they detect RNA debris from destroyed SARS-CoV-2. Thus it's expected that if someone's body fights off the virus immediately if they're exposed to it, they will still test positive.
The unvaccinated population is not uniformly distributed though. The vaccines is not rated for the age younger than 12 yet, and it will still take a while to roll it out in the younger age groups. Also, I wouldn't be surprised if most vaccine refusers are part of groups who collectively refuse to vaccinate. We know from measles outbreaks that this is often the case. Finally, most vaccines achieve their maximum effect only if both doses are given. If only one is given, all bets are off.
> Also, COVID tests don't actually detect COVID or even SARS-CoV-2, they detect RNA debris from destroyed SARS-CoV-2. Thus it's expected that if someone's body fights off the virus immediately if they're exposed to it, they will still test positive.
Slightly untrue. The particles gathered from infected and spreading persons are fully functional, by definition. To distinguish these cares from immune people, one would have to determine the percentage of viable virus particles. Hard to tell whether that's even feasible at scale. It's not too bad though. At worst this causes a higher than expected false-positive rate.
It's not rated for children because they appear to be immune to COVID and thus basically no safety results can possibly make the risk/reward tradeoff make sense in that age group.
"one would have to determine the percentage of viable virus particles. Hard to tell whether that's even feasible at scale ... It's not too bad though. At worst this causes a higher than expected false-positive rate."
I'm not sure you're aware of the scale of the problem. There have been studies that correlated PCR test results with ability to do viral culturing and concluded about 60% of all positive test results did not imply infectiousness. For example, this one:
> There have been studies that correlated PCR test results with ability to do viral culturing and concluded about 60% of all positive test results did not imply infectiousness.
My point was that the viral culturing might not be feasible for large-scale testing. In that case, we might have to stick to PCR.
Yes, governments use PCR because it's fast and mechanical.
The correct response to the PCR not detecting what people actually need to know is to shut down mass testing entirely. There is no point in mass testing if it creates chaos and doesn't help, which is what's happening (there is no correlation between testing levels and incidence levels, killing the theory that test test test = better results).
> you're suggesting that the unvaccinated have become drastically more infectious for no apparent reason
Isn't that the point of concern about the variants? Alpha is vastly more infectious than the original and delta is even more infectious than Alpha, which is the reason why they're able to become the dominant strain in unvaccinated populations (england in early 2021 & india with delta). Both have some immune escape but less than e.g. the gamma variant which hasn't become dominant in most countries with high vaccination rates.
(now, since the covid vaccines don't mean complete sterile immunity, just like all others, increased infectiousness also leads to problems)
The PCR tests do detect the virus if the body fought of the virus immediately, but can also measure the amount remaining (the cycle count) which has a cutoff point. Thus it often doesn't get counted as "infectious".
The antigen tests (the fast, cheap ones) don't trigger on small amounts, also leading to issues and that results in them being more-or-less useless to detect infected vaccinated people.
It's not clear they're actually more infectious. Claims that they are come from invalid methodologies like comparing the growth rate of one variant when it's new against the decline rate of another when it's old, or making assumptions like the one you just made above. Generally, it's good to treat any claim made by the field of epidemiology as suspect. They aren't incentivised to use statistics correctly.
In light of our findings that more than half of individuals with positive PCR test results are unlikely to have been infectious, RT-PCR test positivity should not be taken as an accurate measure of infectious SARS-CoV-2 incidence. Our results confirm the findings of others that the routine use of “positive” RT-PCR test results as the gold standard for assessing and controlling infectiousness fails to reflect the fact “that 50-75% of the time an individual is PCR positive, they are likely to be post-infectious”
There's two major metrics to measure the severeness: the mortality rate and the infection rate. I think that "we haven't had the level of death we had in 1918 so the pandemic is less severe" ignores the fact that COVID-19 is far more infectious and therefore in a sense more severe since it will be awfully hard to get rid of for that reason (if we can indeed never get rid of it the number of deaths will keep growing, so might eventually catch up)
Varicella is more infectious than SARS-CoV-2 and it's under control with vaccines, same pattern: spread through the air, R0 chickenpox > R0 COVID-19, vaccines help with immunity and even when infected developing a mild version of the disease.
There is hope, we might not get rid off it but if we could control chickenpox that is quite more infectious, we can have a little hope. Even more with more modern medicine.
This is very likely. And has already been said by various critics already months ago. But these people were silenced or ridiculed, because it apparently was already decided the vaccines need to be sold.
This has indeed been predicted by various experts but almost completely ignored. As seen in the comment below the strategy now is to blame those who are critical of our single minded vaccination strategy.
Completely untrue. The reservoir of selfish unvaccinated individuals is what is providing a place for Covid to hide and mutate. Vax critics were silenced and ridiculed because they are dangerous deceivers who need to be called out and held to account for the consequences of their lies.
So far, the "reservoir of selfish unvaccinated individuals" that the virus has mutated in is people who literally could not get vaccinated because there weren't enough vaccines available. The most important variants so far have showed up in the UK before any vaccines were approved, South Africa during their vaccine clinical trials (rendering the vaccine they were planning on using effectively useless), and India which is just too big to vaccinate quickly at current production levels.
You obviously need to check the database again then, because there are remarkably few cases where the person had a adverse reaction to the mRNA-based vaccine. Furthermore in the majority of those cases (of which were already slim to begin with), they are usually something like anaphylactic shock a.k.a. an allergic reaction which they can deal with at the time that the vaccine is administered.
It infuriates me that "armchair experts" who likely lack even a bachelors degree in STEM much less epidemiology think that they know better than the majority of medical professionals.
They are more likely to follow their advice of the mechanic who tells them that their catalytic converter needs to be replaced than a medical professional who has nearly a decade of specialized training.
That's not something that's ever been a problem with vaccines before.
Even if you have unshakeable faith in this evidence-free perversion of biological theory, nobody was claiming the vaccines will fail without 100% adoption last year when they launched. Their reception would have been rather different if that had been claimed, wouldn't it? So you can either believe this is true, in which case governments and pharma firms deceived people about the nature of the 'vaccine', or you can believe it's false and they didn't. But you can't believe it's true and it's the other people who are deceivers. That makes no logical sense.
It's a general issue with every vaccine against an illness that has a reservoir. The reservoir can be other species (birds and various other animals in case of influenza) or it can be human populations that for various reasons have not eliminated the spread of the illness yet (measles in countries that refuse or make it difficult to vaccinate, polio if not completely eradicated yet). In this reservoir the agent has opportunity to mutate, and it can never be excluded that at some point it makes inroads into populations again where it was eradicated before.
Global eradication of diseases has been achieved with smallpox and bovine rinderpest precisely because they had no natural reservoir and all vulnerable populations could be vaccinated. With Coronaviruses the situation is not so simple, but it should at least be possible to eradicate the currently relevant variant.
> [...] vaccines reduce the chance of severe (symptomatic) illness but do not necessarily prevent infection and transmission.
My understanding is that at least the RNA vaccines are sterilizing when titers peak, i.e. in the first weeks (months?) after full vaccination. This is due to the presence of a certain type of antibody in the mucosa of the respiratory tract. We also know that levels decrease over 6-12 months, at which point you can get infected, but illness will be mild due to T cell activity. (assuming the immune system of a young, healthy person).
> My understanding is that this is a relatively new and perhaps highly understudied phenomenon.
I don't have the impression it's understudied. With the widespread prevalence of genetic sequencing we have a pretty good understanding of the mutation activity. Once a variant has an evolutional advantage it is studied quite closely whether it is a fitness escape, an immune escape or both. E.g. Delta is mostly a fitness escape but fortunately only a slight immune escape.
> or just trade relevant links with others who are diving into primary sources as a way to form an educated and well rounded opinion.
The best resource I can give you is a German podcast with two of Germany's leading virologists [1]. Personally listening to experts in their field in a long form interview has been orders of magnitude more insightful. It's one thing to read an article in Vanity Fair whether the virus has escaped from a lab, it's a totally different thing to listen to an expert that actually knows how to do gain of function research.
> imperfect vaccines can cause selective pressure which enhances the fitness of highly virulent pathogens
The number of ways in which we undertaking a natural experiment in viral evolution has been top-of-mind for me as well. But the greater issue in my view is not that the vaccines are imperfect. All vaccines are somewhat imperfect. On its own, I the mRNA vaccines were probably entirely adequate.
The problem is that the human population, as a result of policy decisions, will continue to have an immediately-adjacent reservoir of infection [0] with whom we are constantly in contact. I speak, of course, of the large numbers of unvaccinated among us. With vaccinated-to-vaccinated chains of transmission, there's a greater chance that a chain of vaccine-resistant variant will die out because the vaccine both reduces the risk of becoming infected [1] and the risk of transmitting infection [2].
But in a heterogeneous population, with large numbers of unvaccinated individuals, those chains of transmission can go on indefinitely, hopping back-and-forth between the two populations. That's a far greater risk here than the issue of a "leaky" vaccine. A vaccine might "leak" a little bit, yet the probabilities of infection and subsequent infection remain so low that all chains of transmission quickly terminate. Instead, we have a situation where the virus can slip into a separate (reservoir) population where it continues unchecked.
That, in my view, is the real risk to furthering infection.
Becoming infected also doesn't completely protect you from becoming infected again, 1% of patients who had severe covid get infected again in just 3.5 months. [0]
So even if vaccines don't prevent the transmission or protect from infection worse than being severely infected then you might treat them just as a way of making you survive your first infection so that first infection can protect you better from further infections. If we didn't have or use vaccines we'd eventually end up in the same place with nearly all people eventually contracting covid at least once, just with a little more damage.
Research on covid is not done. We need therapies for acute covid. We need a way to treat and prevent long covid.
Some of the reinfected people died. You don't die from false positive result on two tests. It's not stated in the article buy you can safely assume that some of the reinfected had symptoms other than death as well.
They presumably didn’t die from their first detected infection which may be a false positive. And I guess by “some” you mean a small subset. Other sources are saying around 30 confirmed reinfections worldwide. Which is correct?
In addition, the vaccines currently in use -- at least in the West -- are either mRNA or vector vaccines containing only parts of the virus (as far as I know only the spike protein from the virus's surface). I would expect them to result in a more specific immunity which is easier for the virus to circumvent, my mutating only its spike protein. Conventional vaccines however, which are more prevalent in the developing world, as well as having gone through COVID, should provide a broader immunity - at least in my half-educated view.
My guess is that nobody really knows the answer to that question. It's also entirely plausible that the only way to have true sterilizing immunity to COVID is to have antibodies to the spike protein. shrugs
> I would expect them to result in a more specific immunity which is easier for the virus to circumvent, my mutating only its spike protein.
This is not clear at all - actually the opposite might be the case.
Natural immunity focuses on a number of 'markers' that are more likely to change than the spike protein.
As far as I know we don't know yet. Here is a comparison with other vaccines [1].
The mRNA vaccines are not "adequate": they are being treated by governments as if they aren't working whilst also being significantly more dangerous than every other vaccine programme out there by a long way, even according to the CDC's own rather unreliable VAERS data. Look at the graph here and repeat that these vaccines are adequate:
"the human population, as a result of policy decisions, will continue to have ... large numbers of unvaccinated among us"
You need to rethink this for several reasons:
1. It's logistically impossible for everyone to be vaccinated simultaneously. This is not the result of policy decisions, it's a simple matter of distribution and manufacturing. There will therefore always be large numbers of unvaccinated living alongside the vaccinated for any vaccine. If they don't work given that fact then they are useless and should be abandoned.
2. Prior vaccination campaigns have worked or even wiped out whole diseases, even when there are lots of people who weren't vaccinated. If the new "vaccines" cannot do this then they aren't actually vaccines at all.
3. The idea that vaccines only work if everyone has taken them is entirely unsupported by any evidence or sound biological theory, quite clearly would not meet the definition of a vaccine, and leads inevitably to evil totalitarianism in which people are forced to take an endless parade of injections regardless of whether they're at risk, regardless of the severity of the disease which is being treated and regardless of how many safety protocols were skipped.
native_samples You've been misinformed. We have pre launch studies with 40k+ participants showing no meaningful risk. And post launch when there were exceedingly rare ("This adverse event is rare, occurring at a rate of about 7 per 1 million vaccinated women between 18 and 49 years old. For women 50 years and older and men of all ages, this adverse event is even more rare.") and not unexpected clotting issues vaccine administration was paused so the issue could be analyzed more thoroughly and quantified specifying to defeat this kind of FUD. "As to safety The Pfizer trial reported serious adverse reactions in 0.6% of vaccine recipients and 0.5% of placebo recipients." https://www.sciencemediacentre.org/expert-reaction-to-phase-...https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/sa...https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer...
Unfortunately, there is evidence that trials under-state risks. Evidence for this is:
1. Safety notices for the vaccines have been edited post launch to start talking about risks of heart inflammation and other problems, which were not detected by the trials but are now common enough to justify people being warned about them.
Additionally, the trials never formally completed, cannot now complete because the control groups have been vaccinated, and some of them excluded whole groups of people e.g. pregnant women, children and in some cases the elderly!
This leads to an absurd situation in which the US CDC is saying that the vaccine is safe for pregnant women simultaneous with Moderna starting trials in pregnant women (who were previously excluded).
And finally, putting all those problems to one side, the issue is actually relative risks. Even if the risk of a vaccine is low, even if similar to or higher than the risks of the thing it's trying to vaccinate you against, it may not make sense to take it. That is just basic cost/benefit analysis.
Why do you think smallpox wasn't eliminated by vaccines?
mRNA vaccine is not particularly more dangerous than any other type
I don't understand how that is consistent with the data from the various vaccine surveillance systems which show clearly that it's drastically more dangerous. It's also inconsistent with anecdotes that I've been hearing from people around me, of whom a disturbingly large number say that the vaccines made them very sick (i.e. they describe symptoms similar to that of COVID itself).
Of course the vaccine made them feel sick, that's how immune responses tend to, much of the time, work. I felt like shit for about 12 hours, with fever and muscle soreness all over my body. Then it abated, as expected, and I went about my life knowing in two weeks I'd be at peak protection and could start participating in society again with a flipped risk profile.
I read a lot of your other comments so far and I had a suspicion, but this lone comment of yours confirmed it for me. You have some basic internal fear of the vaccine so you've done a bunch of rationalizing to make it seem worse and confirm your own bias.
I've looked at the VAERS data this morning for the US and you have a much higher chance of getting hit by a car and dying, or as is the very prescient case, getting COVID and having more adverse affects from that than an adverse vaccination, but I'm not going to convince you of anything because of that basic fear you have.
No, you're mis-understanding cause and effect. I've had vaccines before and have no fear of vaccines in general. This round in particular does concern me, but that concern arose due to the data and anecdotes that I already mentioned. Concern follows reason for concern. You're asserting it's the other way around, which is:
Your claims are pretty extraordinary and demand extraordinary evidence. How exactly are they not adequate? How are they being treated as if they aren't working? How are they dangerous?
The one source you provide is embarrassingly poorly founded. It takes garbage input sources, obscures even the meager data in them and then decreases the quality of the claims even further with misleading representations. Here's just one example to show explicitly what I'm taking about with my claim. "A recent analysis by researchers at Queen Mary University in London found that even in senior citizens, about 85% of deaths reported to VAERS were definitively, likely or possibly caused by the vaccine." That language implies heavily "85% scary!" when in fact that the claim by the paper is "15% were confirmed to have nothing to do with the vaccine" and as you read further their results show even less than that. I'm just going to go in order through my notes from a critical read of the paper for more background, these are not prioritized or meant to be hard exclusion criteria on their own but rather straws on the camels back. The project this paper was published under is not specialized in this area, making me suspicious that they are qualified for this analysis at all. "PAMBAYESIAN is a 3-year EPSRC funded project to develop a new generation of intelligent medical decision support systems based on Bayesian networks. The project focuses on home-based and wearable real-time monitoring systems for chronic conditions including rheumatoid arthritis, diabetes in pregnancy and atrial fibrillation. The project has the potential to improve the well-being of millions of people." Looking through through the credentials and publication history of all the authors seems to confirm that they may not have the relavant foundation for this work. There is absolutely no statistical analysis anywhere in the paper and the authors acknowledge their data set is what I would call almost but not quite entirely useless "This process is ongoing, as there are 1644 deaths in the dataset that have been reported in patients who had recently received their first or second COVID-19 vaccination, and over 28,000 serious adverse events that did not result in death. This interim results paper presents information on the first 250 reported deaths that have been reviewed and coded by our team. Obviously, these results cannot be generalised as the sample is heavily biased - these were all people vaccinated very early in the programme when only the elderly, those with significant or chronic health conditions and frontline health service staff were being vaccinated." And finally the actual claim that is attempted to be made by the paper authors is "But there are some important findings. that the only patients where a vaccine allergic reaction be ruled out as contributing to death were 34 (14%) who were all either already bedridden, at end of life, and expected to die anyway from a serious comorbid like lung cancer or were on palliative hospice care. We also found that for at least 13 of the 250 deaths (5%), a vaccine allergic reaction was indisputably the most likely direct cause for the symptoms and patient outcomes described." They found 13 very ill people whose deaths, in a third party's interpretation of case notes, were contributed to by an allergic reaction to receipt of the vaccine. 5% of the most delicate people had a normal reaction to receiving any vaccine and because of their extreme poor health or their quality of care were not able to be helped with standard intervention for such a reaction. Shocking stuff that.
I think you should take a serious critical look at this data source swprs.org and how much of things you think you know have been influenced by it.
Paragraphs would help me work through your questions.
Firstly, the claims aren't extraordinary. There is a long history of vaccines being suspended for being more dangerous than is worth it, for example here's a CNN archival story about that:
"ATLANTA, Georgia (CNN) -- The man who led the response to the 1976 swine flu outbreak is defending the vaccination campaign that led to more deaths than the disease, but says he's sorry for the people killed or sickened ... the program was suspended after at least 25 people died from vaccine reactions"
In 2010 there was another Swine Flu scare but not much was learned: Pandemrix was authorized and sold in Europe but turned out to occasionally create narcolepsy in teenagers. Although rare, swine flu was sufficiently mild that this was much worse for the affected people than actually getting the disease would have been. There was a coverup and the true nature of what happened only came out 5 years later thanks to lawsuits.
So there's nothing odd about the idea that a vaccine may yield more injuries or deaths than it can save. It's happened before.
Now, I've already cited the evidence you require: the data from national vaccine reporting systems. That's the graph at the top of the page I linked. You appear to have simply ignored the graph and then gone off on some other link to a paper you found there, which isn't what I was referring to, and at any rate seems to actually support my point. Multiply the Y axis of the graph by 0.85 if you want - the numbers are still radically higher than the normal expected rate of vaccine side effects. Or don't. But actual government data cannot be handwaved away with an argument of the form, "some random paper looking at the data has some limitations that it openly admits to" because I wasn't basing my point on that paper to begin with.
Sorry on a limited device where I can't do much formatting.
You made a pretty explicit claim earlier in this thread "The mRNA vaccines are not "adequate": they are being treated by governments as if they aren't working whilst also being significantly more dangerous than every other vaccine programme out there by a long way". Talking about historic or generalized vaccine ROI is different and is a new claim that isn't really on topic. I have no interest in arguing that all vaccines have always been perfect or that you can't have a generalized concern. Your claim that current mRNA vaccines for an ongoing pandemic are not adequate and are dangerous is an extraordinary claim and do need evidence.
Which brings us back to the point. I went into the analysis of the VAERS data because it needs analysis. It is a fairly raw data set meant for usage and analysis by professionals. We pumped millions of data points in to it this year, seeing a spike doesn't mean anything without analysis. How many people out of the population who were vaccinated were expected to be dying of strokes and heart attacks in the same time period? Here's a great write-up that goes into the details: https://medium.com/microbial-instincts/underreporting-and-po...
Alright. Let's break down the question of adequacy; as it's a vague word that we may be using differently.
1. Does it work? In the UK even people who have completed both rounds of vaccination are having restrictions imposed on them. Contact tracing has not been ended there and is now triggering a full blown "pingdemic" that is causing a generalized economic crisis in which supermarket shelves are emptying, port authorities are warning of further supply chain disruptions and TV shows have been knocked off the air. This is incompatible with the idea that vaccines work and very incompatible with the narrative that was previously being sold, that vaccines were a way out and would mark the end of the restrictions.
Hence, governments are acting as if the vaccines are not adequate solutions to the crisis.
2. Are they dangerous? You raise good questions. Unfortunately the article you link to is paywalled. However, I've also read deeper analyses of VAERS data + similar databases from other countries that look at this and conclude:
2a. Background reporting rates for other vaccines are similar to what would be expected normally. There is no evidence that current events are inflating the reporting rate (or decreasing it).
Fundamentally although the Y axis may not be accurate, the trend is hard to ignore. The data has gone vertical in 2021. Once massively increased awareness is excluded as a possibility, I don't see how other conclusions are possible.
Thank you. The article is very reasonable. It makes limited and tight claims, mostly similar points to ones I make elsewhere in this thread: that risk is relative, under-reporting is real and so on.
At one point it claims the only vaccine to be withdrawn post-approval is for rotavirus. Perhaps he means, in the USA and only after VAERS was set up. There were other vaccines withdrawn post-rollout than that one. The CNN article I cited already is one American example but there are others. Note that "withdrawn" is a slightly vague standard, for example, in the Pandemrix case, German doctors refused to use it in Germany even though it had been approved elsewhere, which in hindsight turned out to be the right call. Does that count as withdrawn: hard to say.
My own views aren't exclusively based on VAERs. I am convinced there must be very widespread under-reporting because of how ideological vaccination has become. The reason I think this is that I keep encountering anecdotes in my daily life from people who had extremely severe reactions to the vaccine but are blowing it off as no big deal. I'm not seeking these anecdotes out. I don't ask people about their vaccines. Yet, I keep hearing about these problems anyway. For example:
Two neighbours of the parents of my partner, who both died after taking the vaccine.
A scientist I know was trying to convince me the vaccines are perfectly safe, then almost in the same breath admitted that it knocked him flat for days and made him so sick he could hardly move. That does not meet my definition of "safe".
A friend told me he'd been walking down the street when he overheard a conversation by a guy on a phone behind him. The guy was saying that someone in his close family had died days after taking the vaccine.
I had a similar experience: I overheard a conversation when people who knew each other bumped into each other near where I was sitting in a park. One of the women had clearly not been seen for a while because of severe reactions to her first dose. She described having high fever, difficulty breathing and being unable to leave her bed for a week. She also said she "thought she was dying".
Outside of daily life, I read a news story a few days ago about a guy whose wife died just days after taking the vaccine. She was perfectly healthy before, early 60s, no signs of any problems.
All this is really quite disturbing. I've never heard such a constant flow of stories about any other vaccine. Also, the symptoms people describe are very similar to actually having COVID itself, which is not a big surprise when you look at how the vaccines work. Actually the most disturbing thing is people's reactions to it. The guy whose wife died stressed in the news story that he's a big supporter of the vaccines, and just wanted people to know that some families are "affected" by it. The women who got so sick she thought she was dying went back for her second shot anyway. The scientist was telling me how perfectly, totally, undoubtably fine mRNA Tech is and how it also made him so sick he couldn't work. The point of the vaccines is to stop people getting sick! But, they've been presented as a moral issue, one of collectivist responsibility, and governments have all committed themselves to vaccines-or-bust. I quite simply do not believe we have anything approaching valid data on how dangerous these things are.
> In 2010 there was another Swine Flu scare but not much was learned: Pandemrix was authorized and sold in Europe but turned out to occasionally create narcolepsy in teenagers.
A protein in the Swine Fly virus triggered narcolepsy in some people. You can get exposed to this protein both from the Pandemrix vaccine, and from getting sick from Swine Flu. China didn't vaccinate, but there was a spike in narcolepsy cases in China, from people who were infected by the virus.
Yes ... which leads where? Those teenagers probably wouldn't have got Swine Flu if they'd just done nothing. So it probably leads to the conclusion that if the vaccines have similar effects to being exposed to the virus itself, that's not obviously a win?
The whole point of vaccines is that they are much better than getting the virus itself, and for the classical vaccines that established the reputation of the technique, that's definitely the case. For cases like swine flu and now it seems maybe COVID, it's not at all clear that the vaccines are universally preferable to the disease, especially for the young. For one, COVID is mostly not dangerous to people under the age of 65 or so. For another, the symptoms are often mild. And the symptoms of the vaccine are often quite intense. mRNA vaccines create the same kind of cell death as the disease itself, they aren't just presenting the immune system with inactivated virus and letting it target practice on the vaccine particles: they turn the bodies own cells into target practice. That's a fundamental difference in approach.
When it gets into these sorts of grey zones of a vaccine with strong side effects and a not very deadly virus (for certain risk groups), a repeat of the Pandemrix disaster is not out of the realm of possibility.
Many young people have still a low chance of severe course of the disease but they are pushed to get vaccinated. My issue with the disease is not the severe course, which some people are pretty well protected from, but the lasting tissue and organ damage going thru the infection with or without a vaccine. I yet have to see a study showing that vaccines prevent such damage. We will have huge epidemics of CVDs after this is over as nobody really pays now close attention to people who pass thru the disease with or without symptoms.
They surely prevent damage by reducing infection rates in fully vaccinated, but not sure if they can save you from damage, same way they are saving you from death if you contract the virus anyways.
My point is that many restrictions are removed for fully-vaccinated people, i.e. the exposure of these people will increase, i.e. the chance of getting the infection, even if it doesn't take you to the hospital, greatly increases. Even if it's a small percentage, this means many people will get lasting damage. To me, vaccination status should not mean you can take your face mask off - first, you can still get stick, and, second, you can still bridge two sick people even better as you're less likely to show symptoms when you still carry the virus and exhale it without the mask.
It's of course not ideal that restrictions are unduly waived. But it is also recognized that many won't consider taking the vaccine because they don't see how doing so contributes to end the pandemy. Luring them with incentives like entry to bars without testing, or positive monetary rewards, changes the decision making process though. But many places maintain restrictions like mask wearing or mandatory testing for a reason.
Vaccination is too slow anyway. You need to vaccinate the entire world at once otherwise the reservoirs outside of the first world will keep the variant roulette spinning and more dangerous variants will nullify the first generation of vaccines and we'll back to where we started. Just today here on HN was a post about gamma variant escaping fully-vaccinated with Pfizer. And this is not even considering that we're about to see immunization protection starting to expire for some people - I doubt it's for life unless you're constantly exposed to the virus, which probably makes sense to stop wearing a mask... unless getting multiple infections to relaunch the antibodies is not doing unforeseen damage.
This sumbission is actually about just that article ;-) But yeah, it's too slow. The only saving grace is that there are multiple vaccines. Unless they all work exactly the same way, new mutations are unlikely to be immune to all of them.
We indeed don't know that much about the virus itself, what happens when one gets infected multiple times and when multiple vaccines are combined. We are going to find out either way. The goal of the vaccines and the other containment measures is to keep our health systems from collapsing. Whether or not we manage to eradicate Covid or to just force it into low-level virulence is not so important. It is probably not feasible to convince the public to hunt down Covid to extinction as with Smallpox.
I am disappointed by health authorities across the globe. If I was responsible, I would have the following:
1. Provide vitamin D3, zinc, and some zinc ionophore to the masses and advertise the benefits. Also, advise people to take a baby aspirin daily (slows viral replication and prevents blood clots).
2. Just like with cigarettes, have highly visual ads presenting the data that about a third of men have ED problems after surviving COVID-19. I think this would work better than anything else!
3. Have a ongoing campaign in prime time showing how to properly wear a face masks, what's the difference between a cloth one, a surgical one, and N95 - people still can't wear masks properly and have no idea what's the difference between a cloth one, a surgical one, and an N95/KN95/KF94/FFP2/FFP3.
>the widespread observations that COVID-19 vaccines reduce the chance of severe (symptomatic) illness but do not necessarily prevent infection and transmission.
that puts worksplace/etc. mandates into spotlight as their main rationale is to prevent the spread, ie. supposedly "it is not for you, it is for the others".
So, it sounds like as a result of such mandates we may end up in a situation where the only people spreading virus at work/hospitals/government offices/etc. would be the ones with a highly virulent variety less susceptible to vaccines.
This is just a specific version of the Red Queen of evolution and in no way unexpected. But the virus will keep mutating as much as it spreads, so our best bet is still to vaccinate as widely as possible to contain the spread, thereby reducing chance of mutations. Vaccinated people get still sick but are less likely to infect others, reducing overall spread.
> imperfect vaccines can cause selective pressure which enhances the fitness of highly virulent pathogens
I've wondered this ever since the UK changed it's approach and now that we've got to a state where there is pretty much no restrictions. I think scientists around the world also have this concern with the UK's approach
I think their approach is mirroring the one from the start of the pandemic. They intend let the corona run through the population, but hope that population being vaccinated will reduce the damage. And when most people will get infected with the corona at least once they'll have even better reduction of transmission even when compared to perfect vaccination rates.
Why would I want to vaccinate if I'm still going to get restricted?
I mean the whole deal here was that if we got vaccinated we'd be back to normal life. If that wasn't the case they should've been sincere up front and most of us wouldn't have gotten vaccinated.
Same reason I want to wear a seatbelt even though I’m still restricted by the speed limit: demonstrably lower chances of not merely death but also sub-fatal harm.
Even if all of the VAERS reports were both causal (they’re not) and fatal (not even remotely) the vaccine would still be seven times better than the illness.
As the reports are overwhelming not about surprise deaths and not causal, the vaccines are somewhere between 170 times better and infinitely better than the disease.
> Not a day goes by where I don't hear about somebody dying shortly after getting the vaccine, often in novel ways like described here
And how many do you expect by coincidence in an ideal case where there are exactly zero side effects? Because it isn’t going to be zero coincidental deaths when there are 3.79 billion vaccination events. Not even zero per day.
Would you want to wear a seatbelt if it also injected you with a novel gene therapy vaccine, which is basically a russian-roulette with rare harmful health effects and your family can't sue the state nor the pharma?
Would you rather play Russian roulette with one live round somewhere in 200,000 chambers, or one round in 100 chambers?
You don’t get to opt out and attempting to do so gets you the 100 chambers. Neither you nor your family get to sue anyone in either case. If you opt for 100 either directly or by failing to make a choice fast enough, anyone around you who hasn’t faced the 200,000 yet — even if they wanted to — faces the 100 a few days later.
You can't compare getting vaccinated with getting bad COVID in this way. Getting vaccine is like a Russian roulette, because you do not know whether you are in the group of poor people who get maimed or killed by it. But not getting a vaccine is not like going to meet all people in town and hoping for the best. There are alternative strategies that reduce your risk of getting COVID and risk of severe health results from COVID immensely, for some people even below that of vaccine.
In other words, I have lots of information to help me efficiently avoid bad COVID impact; but I have no information to help me efficiently prevent bad vaccine impact.
> But not getting a vaccine is not like going to meet all people in town and hoping for the best.
Absent vaccines the disease only goes away when too many people have caught the illness; that means you can only avoid catching it with your approach (regardless of what it is!) if you are an unusual and exceptional case.
> There are alternative strategies that reduce your risk of getting COVID and risk of severe health results from COVID immensely
The best way to reduce the of risk of severe health results from COVID is literally take one of the twenty different vaccines with a variety of different operating principles behind them.
> The best way to reduce the of risk of severe health results from COVID is literally take one of the twenty different vaccines
I don't disagree with that, although I am not sure either, it's too early to tell regarding unknown long-term efficacy and side-effects.
The point is, many people don't need to risk the (hypothetical) best way (TM) when there are proven different ways of reducing COVID impact of similar efficacy (those who care know about them, often posted for discussion here on HN). Especially given the censorship, one-sided expertology and disinformation about vaccines and available treatments from the governments, institutions and media.
These groups really f-d up the vaccination program with their despicable tactics and large masses of people are not going to vaccinate precisely because of that - the main vaccine pushers quickly became completely untrustworthy.
To prevent yourself and others from getting (the severe form of) the virus. I can assure you that most people would still have gotten vaccinated.
Personally what I would like is roughly what we've had in the UK for the previous few months. The ability to do mostly normal life, but with restrictions on large events and mandated precautions such as masks. Along with vaccinations that would probably have been a sustainable state. Unfortunately I strongly suspect that the complete opening up that we're currently seeing will only lead to further lockdowns in a few month's time. I would love to be proved wrong on this, but that's what it's looking like to me at the moment.
"what I would like is roughly ... the ability to do mostly normal life, but with restrictions on large events and mandated precautions such as masks. Along with vaccinations that would probably have been a sustainable state."
To be clear, are you stating you would like all large events to be permanently banned forever.
A lot of people (mostly older people in my experience) seem to think that people who work in the events industry should just curl up in an alleyway and die at this point. According to the more authoritarian-inclined, COVID means we can never ever have festivals, clubs, or anything like that again in the name of biosecurity. Personally I'd rather chew on razor wire than inhabit the mind-numbingly beige world of dull conventionality these people so clearly have never left in their lives.
I really don't like this new orthodoxy of "safetyism" which to me is a slavish adherence to the precautionary principle, a general approach of authoritarianism, and excessive influence of technocratic institutions which aren't subject to the usual political processes. This kind of ideology existed long before COVID but the pandemic has massively increased its influence. If people like authoritarianism and technocracy I'd rather they argued for them openly and in good faith than trying to use the pandemic as a smokescreen. There's nothing wrong with arguing for these things but I cannot stand people who dress their political opinions in lab coats and try to pass them off as science. There's no one true approach here, and pretending there is has caused a lot of avoidable strife in my opinion.
Politics is so much more than "follow the science", I think we'll regret in the future that we only gave seats at the table to epidemiologists and bureaucrats when it came to this pandemic rather than including a far wider range of scientific disciplines, experts in philosophy (especially ethics), and broader industry representation. The events industry has been done dirty in my opinion for example.
Okay, I agree with everything you said, BUT we were lied to when we were promised that we'd be back to normal life if we got vaccinated.
We should have had all the information when we made the choice of getting vaccinated or not. You say most people would've gotten vaccinated, I say they wouldn't have. We'll never know, since we were lied to.
> As other commenters have noted, this case study further supports the widespread observations that COVID-19 vaccines reduce the chance of severe (symptomatic) illness but do not necessarily prevent infection and transmission.
Your argument that the vaccine stops only symptoms and not the infection is false.
If that was true, we would not see countries that practically eradicated the virus instantly after vaccination (like Israel). The virus would still be spreading and infecting people, and those unvaccinated would still be getting seriously ill.
> That being said, IMO there seems to be a growing public opinion that unvaccinated individuals are to blame for the increasing dominance of variants of concern (delta, gamma, etc).
The vaccines have proved to be effective preventing infection from the original strains.
If people have vaccinated then, it is likely we would have been done with the virus.
Now, there were not enough vaccine doses to vaccinate everybody in the world in time, so a strain developing in a poor country could still reach western world. So it may not have been possible to prevent delta completely.
Coparing Jordan and Israel, their new cases and death graphs look very similar. Israel has a 60% vaccination rate and Jordan has 20%. Where did you get this "instantly eradicated" idea from?
The sentence before that switched to Poland. It's fair to think the last sentence applied to Poland. After all, you were claiming eradication in Israel.
The MRNA vaccine was developed fast, it's the testing that took a long time. There should be sampling and a new variant of the vaccine created fast to prevent this variant of the virus from spreading.
> My understanding is that this is a relatively new and perhaps highly understudied phenomenon
It is neither relatively new or understudied. Everyone's favourite "anti-vaxxer", the Godfather of the "Anti-Vaxx Movement", Andrew Wakefield has been saying so for some time.
My understanding is that there is very little evidence of vaccinated individuals actually transmitting the original ("wild-type") virus, or even the Alpha variant (obviously, Delta/Gamma are potentially different beasts). This was why we in the United States dropped mask mandates for vaccinated individuals. I don't know why the narrative always reverts to "oh, the vaccines just decrease symptoms", a statement unsupported by evidence.
EDIT: Before I get downvoted completely into oblivion, take a look at the 90% reduction in infections, both symptomatic and asymptomatic, seen in vaccinated individuals in Israel. https://pubmed.ncbi.nlm.nih.gov/33964222/
I think we can all agree that you can't transmit the virus if you yourself don't get infected.
This is not an RCT. The work itself makes this very clear, it's observational, based on what we'll call "pseudo-voluntary" testing. Just provide the RCT for your claims-- this is necessary since the vaccine is known to be effective on a symptomatic level.
Please provide the RCT that shows that vaccinated individuals have similar levels of infection to unvaccinated individuals.
What the RCTs for Pfizer and Moderna showed was that the vaccines reduced the symptomatic infection rate by 95%. But you are misconstruing the language being used if you extend that to say "the vaccine is known to be effective on a symptomatic level". The statement about symptomatic infection just means that it was impractical to have 42,000 people take a COVID nasal swab every day, and therefore they can make no professional scientific statements about the actual rate of infection.
But if you are aware of an RCT that actually established the vaccine as being ineffective at preventing infection, I would love to see it.
EDIT: And yes, I linked to observational data from Israel (TWICE) that showed real-world effectiveness in preventing both symptomatic and asymptomatic infections.
I don't have an RCT which establishes this. But I'm not the one who asserted that the Pfizer or Moderna vaccines prevented transmission. You have the burden of proof in this situation. Hence my reference to the astounding amount of certainty in your comment.
I think it is completely clear from the statement that you made that: the vaccines are effective at treating symptoms of covid and that they will reduce the symptomatic infection rates.
However, symptomatic infection rate and infection rate are decidedly not the same and we've know from the beginning that asymptomatic spread occurs substantially with covid.
The only way you establish the effect on transmission is with a large-scale RCT using a well-designed testing protocol. This may be hard but this is the standard.
> That being said, IMO there seems to be a growing public opinion that unvaccinated individuals are to blame for the increasing dominance of variants of concern (delta, gamma, etc).
This is no coincidence. The media has been directed to _not_ blame vaccines for ANYTHING, as doing so would negatively impact their narrative. It's well known that people vaccinated with leaky vaccines are the breeding ground for super-bugs, especially between they get their 1st and 2nd dose.
The problem? Since their immune system has been trained for only the spike protein, they will be at an immune disadvantage once the variant learns how to completely circumvent the vaccine-induced immune response (and trust me, that's where we're going with all these variants, it's no coincidence Pfizer is prepping the 3rd shot).
Once SARS-COV-2 has mutated enough to evade the current vaccine, we're going to have a resurgence of hospitalization and severe covid cases all around the world, but this time in VACCINATED people. Since their immune system has been primed by an incomplete vaccine, it will not generate multi-epitope antibodies any longer as it'll think "it got this handled" due to previous (incomplete) antibodies.
Of course, the media will blame the "unvaxxed", just as they started doing right now. More lockdowns will commence, more vaccines every few months (with compounding risks). Oh, did I mention that subsequent vaccines will be less effective the more you get vaccinated, because your body is already primed and it'll produce the antibodies from the 1st vaccines? Look into "Original Antigenic Sin" or OAS.
'It's well known that people vaccinated with leaky vaccines are the breeding ground for super-bugs, especially between they get their 1st and 2nd dose.'
It's well known immunocompromised people are breeding grounds. One way to avoid that is vaccinating them early.
'it will not generate multi-epitope antibodies any longer as it'll think "it got this handled" due to previous (incomplete) antibodies.'
The immune system knows to benchmark existing antidotes. If the spike antibody isn't enough it will stop producing it.
It doesn't usually work like that. Media is directed via money and preferential treatment from the ruling class. For example, in some countries state has bought air time and ads in media. Media welcomes the gravy-train and makes sure no dissent is aired.
"No clinically severe COVID-19 (1) was observed, and no patient was hospitalized"
In other words, this case study is a relatively ordinary result in line with what we know: that the major COVID-19 vaccines greatly reduce the chance of severe illness but leave nontrivial chance of infection and transmission.
It’s worth noting that the bar for severe illness is set incredibly high. [1]
All of the major symptoms including high fever, cough, severe fatigue, loss of taste/smell, and shortness of breath still count as mild under their definition. This is very much a disease you don’t want to get, even the so called mild version that happens in vaccinated people.
> Severe Illness: Individuals who have SpO2 <94% on room air at sea level, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mm Hg, respiratory frequency >30 breaths/min, or lung infiltrates >50%.
Isn't the point that levels below severe are not generally fatal and don't require hospitalization. Nobody thinks it's good to get sick, but it generally ceases to be a threat to public health with vaccination.
- Long COVID post-vaccine. >10% of people have brain damage visible on MRIs, including mild cases.
- Future mutations. People have been overly optimistic for 15 months now, and believed bad things couldn't happen. They do. There's no reason to believe Delta or Gamma are the end, or anywhere close.
This one scared me since it was a large, relatively unbiased sample, with before-and-after imaging. It also showed brain damage even in mild cases of COVID19 in >10% of cases.
There are a lot of supporting smaller-scale studies too, replicating the same general result. E.g.
> This one scared me since it was a large, relatively unbiased sample, with before-and-after imaging. It also showed brain damage even in mild cases of COVID19 in >10% of cases.
It shows no such thing. It's an analysis of MRIs where the authors infer loss of gray matter in specific regions of the brain. This is in no way "brain damage", and representing it this way is leaping to wild conclusions.
Lest you not believe me, here is a randomized controlled trial, showing that "excessive online video gaming" reduces orbitofrontal gray matter:
(...so your Mom was right: gaming is turning your brain to mush!)
Here is a review that shows that similar losses in gray matter are associated with anxiety and sleep loss (two problems that I'm sure didn't affect anyone in 2020):
Just for fun: here's a paper that shows that "tooth loss was a causal factor for volume reduction in brain areas related to memory, learning and cognition"
(bonus points: can you spot the missing correlate?)
The fact is, you can find research literature associating "loss of gray matter" with pretty much anything. And if a reliable trend does exist across this literature, it seems to be that gray matter changes are often seen in...wait for it: depressed people and the aged.
But I'm sure that Covid has done nothing to depress people or affect the aged, so we can probably safely ignore that little detail.
I think a lot of this comes down to replication, effect size, and sample size.
Yes, there are studies which show virtually everything, but in this case, we have:
- >10% of mild cases reporting long COVID brain fog (without MRIs)
- Visible correlations on MRIs with large n (cited study)
- Lots of small-scale studies / looking at specific cases
- Some understanding of a relevant mechanism-of-action (see: olfactory loss)
Together, that's about as strong evidence as you'd expect after 15 months. We have effect, we have correlation, we have case studies, and we understand why it's plausible.
The big question is whether it strikes vaccinated mild / asymptomatic cases. We don't know. There are a lot of cases like this.
> >10% of mild cases reporting long COVID brain fog (without MRIs)
"Brain fog" is not a diagnosis. It has no definition. It has no test. Literally anyone could say they have it, and not be wrong.
It also overlaps substantially with "fatigue"...which we all know comes along with a lot of other common issues. Such as depression.
> Visible correlations on MRIs with large n (cited study)
The size of n doesn't matter if the thing you're reporting is not a meaningful metric. Here, we have a paper that has gone on a fishing expedition for a quasi-subjective metric with unknown levels of noise, which is widely "shown" to be associated with many common and uncommon issues across the research literature.
This is a low-quality data set. But yes, it is a larger low-quality data set.
> Lots of small-scale studies / looking at specific cases
Collections of anecdotes are not data.
> Some understanding of a relevant mechanism-of-action (see: olfactory loss)
...for a single symptom (loss of smell). But no, we don't know why that happens, and to the extent we do, the current best hypothesis has nothing to do with neurons, but rather, the scaffolding around those neurons.
> Together, that's about as strong evidence as you'd expect after 15 months.
Nonsense. We've been debating this "long covid" for more than a year now. There are apparently many sufferers. We could have easily conducted randomized, longitudinal, controlled trials. We have not.
The total evidence for "long covid" continues to be anecdotes and self-reported "symptoms", of indeterminate duration, amongst populations that are mostly self-selected for having "long covid". I believe that we'll eventually find out that some of these things are real, but right now, this is just hysteria.
My hypothesis is that COVID leads to a Gaussian distribution in reduction in general neurological function, and that we will see a bell curve distribution reduction in e.g. general IQ.
Can you please propose a "randomized, longitudinal, controlled trials" one might conduct to figure that out?
Preferably, one which would pass an IRB review. We can't randomly infect 10,000 ethnic minorities with COVID19 anymore, which I think what you're suggesting. The Tuskegee Syphilis Study and the Nuremberg Trials took care of that for us.
Short of something like that, we work from mixed methods evidence.
As a footnote, a year isn't a long time in the world of research. That's sometimes quite literally how long it takes from when you apply for a grant to when funding lands in your account. And you're asking about a phenomenon which often occurs months later.
> Can you please propose a "randomized, longitudinal, controlled trials" one might conduct to figure that out?
This is not a herculean problem. It's essentially the definition of any halfway decent medical study:
* pick a set of measurable endpoints from the pantheon of "long covid" symptoms that are likely to be real. Objectively measurable endpoints should be mixed in with subjective ones (e.g. "fatigue", "loss of smell", "reduced lung capacity", "heart inflammation").
* pre-register these endpoints, so that you can't go back on a fishing expedition later, when your first choices don't pan out.
* pick a set of participants at random (balancing for demographics of interest: age, co-morbidities, weight, gender, etc.)
* measure those endpoints at the start of the study so that you have a pre-trial baseline.
* follow those people over time for the endpoints of interest.
* some percentage will get infected with SARS-CoV2. verify this via testing.
* at the end of the study, compare the group that caught SARS-CoV2 with the ones who did not along the endpoints of interest. compare both groups with their own pre-trial baselines.
This is not the ONLY way of doing such a study, but it would be vastly better than any data currently reported. The biggest challenge is that it has to be done before the pandemic passes, and the number of cases drops too low to get a significant result in a reasonable period of time. The window on this is rapidly closing.
> As a footnote, a year isn't a long time in the world of research. That's sometimes quite literally how long it takes from when you apply for a grant to when funding lands in your account. And you're asking about a phenomenon which often occurs months later.
There have been multiple RCTs conducted during the pandemic, despite the bureaucratic inertia of the academy, and "long covid" is one of the biggest remaining controversies. There's no universe in which you couldn't get funding and approval for such a study in short order.
>> Can you please propose a "randomized, longitudinal, controlled trials" one might conduct to figure that out?
> This is not a herculean problem. It's essentially the definition of any halfway decent medical study:
You're running in circles. That's not a randomized control trial. You'll get biases since the set of people infected with COVID19 isn't random.
This is not much better than existing studies. They're not preregistered, but that's the only upside of your methodology.
> There have been multiple RCTs conducted during the pandemic, despite the bureaucratic inertia of the academy, and "long covid" is one of the biggest remaining controversies. There's no universe in which you couldn't get funding and approval for such a study in short order.
IRBs are set up to prevent subject harm. An RCT, in this case, would involve randomly infecting people with COVID19 to eliminate the bias above. That will never fly.
Denial is quite a river these days. Where else are you going to get a brain imaging study with before and after data on thousands of people? If that's not persuasive and concerning to you I don't think anything will be.
Why should a "study" in the abstract automatically be persuasive and concerning? Scientists get paid to publish studies, so the literature is full of nonsensical studies that show correlations between anything and everything. User timr just explained to you why this specific study cannot be used to conclude anything, but you're saying he's the one in denial?
A study in isolation should not be persuasive. There's a pipeline from idea to hypothesis the theory to fact, which includes many studies with many methodologies.
On the other hand, a handful of studies, one correlational with large n, a few causal, a good theoretical basis, etc. do move us up that pipeline quite a bit.
Mild and asymptomatic cases of COVID19 due seem to cause brain damage leading to brain fog.
- Reports of brain fog in isolation? Psychosomatic.
- Correlational studies? Correlation is not causation.
- Case studies? Anecdotal.
- Extrapolation from olfactory symptoms? Theoretical.
And so on.
Put together, though, it's a pretty strong case. It's not airtight, but it's well into the well-supported theory range.
Define "brain fog". Tell me what the diagnostic criteria are, and how one might make an objective measurement of its presence and magnitude.
Bonus question: tell me how your stated criteria differs from the pre-established diagnostic criteria for depression.
One can survey a random sample of the population, ask them if they have ever "felt the presence of God", and find a strong signal confirming this. It does not make God a diagnostic factor in a medical study.
> tell me how your stated criteria differs from the pre-established diagnostic criteria for depression.
If the person lacks dysphoria or anhedonia, would that satisfy the question? I understand your angle (I think), but for comparison, the last time I had a serious flu I found that even after I felt better, it was extremely difficult to focus at work. For about 3 days, gradually improving each. I suspect that is what people refer to as "brain fog", and I could distinguish it from depression by (among other things) a lack of dysphoria / anhedonia (and generally speaking, other depression signs).
I remember in medical school that when we were interviewing patients receiving chemo they would have us do a neuro exam, and very distinctly remember when one guy got angry at me when he couldn't answer some of my questions. He didn't seem to have depression and nobody told me I was doing it wrong when I said he had "chemo brain". So its certainly a real thing in the general sense, and can certainly be caused by a variety of medical conditions.
I guess a more constructive question would be -- assuming a long term cognitive impact, what (practical) research should these researchers be doing instead? Or what if when they asked about brain fog they _also_ asked about depressive symptoms?
> If the person lacks dysphoria or anhedonia, would that satisfy the question?
No. That is certainly more specific than ~all of what you hear in the media surrounding "brain fog", but you can't define something by what it isn't.
Example: I have the wiggles. I'm not itchy though, and my muscles don't hurt.
OK, great. What are the wiggles?
> the last time I had a serious flu I found that even after I felt better, it was extremely difficult to focus at work. For about 3 days, gradually improving each. I suspect that is what people refer to as "brain fog"
Could be! The problem is, until there's a definition (and ideally some kind of objective measure), all of these self-reports are blind people describing different parts of an elephant.
> I guess a more constructive question would be -- assuming a long term cognitive impact, what (practical) research should these researchers be doing instead? Or what if when they asked about brain fog they _also_ asked about depressive symptoms?
We could start by simply using established terminology and testing. What percentage of patients reporting "brain fog" show up as depressed using a standard screen?
It's literally the easiest thing in the world to do...why isn't it done?
> Where else are you going to get a brain imaging study with before and after data on thousands of people?
Why does the size of the study matter so much if the endpoint of the study is absurd, the gathering process was a fishing expedition, and the whole thing is subject to confirmation bias?
Even if you believe that these researchers are finding real signals in these MRI scans (which I don't automatically grant; even they admit that some of the "pathologies" they've identified aren't significant, and they didn't pre-declare the endpoints anyway, so you can't rely on conventional statistical significance thresholds), the fact that they know the outcome for each subject hopelessly poisons the data.
> Denial is quite a river these days.
People have a habit of inventing fictions they believe wholeheartedly in order to ignore a truth they cannot accept.
I was thinking of all of the lifestyle factors that might make one susceptible to tooth loss for >10 years prior to the study (this was a selection criteria for the participants): lack of education, nutrition, medical care, etc. The paper never controls for why these people lost their teeth.
(To be fair to the researchers of this paper, they do discuss some of this, but they focus on a causal relationship between tooth loss and the other factors. They never really consider that the relationship between these factors and tooth loss could be reversed.)
That was listed under "The million dollar questions include"
I'm now realizing formatting / phrasing was unclear.
1. >10% of mild / asymptomatic cases have brain damage.
2. The million dollar question is whether this includes vaccinated cases. Vaccines reduce hospitalizations and deaths by far more than they do mild and asymptomatic cases.
Ah, now I see what you mean. That is worrying. I hope that the rate of mild cases in vaccinated people is lower than the article would lead one to believe. I also hope the protection given is enough to avoid that kind of brain damage.
All I can say is I hope you're wrong on some of those points. It's inevitable that myself and my family will be exposed to covid19 at some point in the future. I think the same is true for most of us.
All I can say is that humanity, outside of Asia, has consistently had "all I can say" responses. It's a preventable slow-motion train wreck.
I could be wrong, but there's no reason to believe delta and gamma are the last mutations we'll see. COVID was astronomically cheaper to exterminate pre-mutation, and astronomically cheaper before it spread. At each point, people wished things weren't that bad, only they turned out to be worse.
That may be but it’s not a particularly useful definition on an individual level.
If I’m sick in bed for two weeks I can’t work or take care of my family so those mild symptoms very much would be a danger, not to mention the dangers from long COVID which hasn’t been ruled out in vaccinated folks and the dangers of exposing people who can’t be vaccinated.
> Sure if you don't think permanent social distancing and mask wearing is not a problem.
I'm confused by this comment. I do think they are a problem, that's why I am encouraged by a vaccine that reduces covid to something that is not life threatening and that we can stop freaking out about.
That's a terrible loss, practically a genocide, but to be fair the parent said "the vast majority of people" and there's 1.4 billion people in India. In India, 151,000 people die every year just from car accidents, and ~4 million die each year from heart disease.
I am relatively certain this is the reason they are banned from youtube... i have seen a (now removed) video from a crank on youtube who suggested saturation bombing of high incidence areas might be the solution...
Bret Weinstein has been citing studies he claims show that ivermectin reduces spread such that even close family members are unlikely to be infected from a person with covid.
edit: curious how hn readers feel they will be able to correct misguided beliefs if they don't even know what those beliefs are.
> permanent social distancing and mask wearing is not a problem.
It's a problem, but we can manage it better than overflowing morgues. Frequent tests, rapid antigen testing (let's say at the entrance of restaurants, clubs, festivals), encouraging people who feel ill to stay the fuck away from others, and so on.
Whoa, I sometimes get SpO2 around 91 - 94 and I chalk it up to calibration error on cheap SpO2 devices (The ones that clip on to the hand, cost about 20 USD). Have been tested twice per employer requirements and was never positive though.
The cheap SPO2 devices are calibrated on fair skin. If you have a darker complexion there is a known measurement error. If you are at 91% and feeling fine you are probably fine. Your body has a better SPO2 sensor than anything man-made.
I got it, and it was annoying, sure, but I had influenza A in the past and boy, was that REALLY bad.
I would be totally fine if we get to a point where we consider Covid to be like an endemic seasonal flu for the vaccinated, because I can’t see many ways out otherwise
I think what a lot of people call the flu is actually "the sniffles" which desensitizes people to the danger. Influenza like you had is really, really bad. It takes weeks to recover and the first 1 or 2 weeks are hell.
Yes, that is correct. I believe the difference is that most of us were exposed to the flu when we were younger, building immunity to the strains that are seasonal.
This is not the case for new strains. There are reports from the 1918 influenza strain that it killed young people over night: Folks went to bed with fever and didn't wake up the next day.
If you had the flu or know somebody who had, it's no joke.
A virus with the flu's potential for damage and the SARS-2 level of infectivity even after a vaccine would be terrible for those getting sick, but even worse for healthcare.
I had COVID before the lockdowns. It wasn't apparent to me until I started hearing about the symptoms. The fatigue was awful, but on top of that, the night my fever broke I was laying down on my bed during February with a window open and no sheets covering me. All while hyperventilating. I kinda thought this was a weird flu but fortunately I didn't have to worry up front about potential death while having it. Worst case scenario I just wouldn't have woken up.
I traveled by bus all the way from Southern Italy to Sweden just before the virus hit the news, and fell sick with the same symptoms for about a week from the day I arrived.
The fever was nasty, but the one thing I remember most is lying there alone in the middle of the night feeling like I wasn't getting enough oxygen and wondering what the hell was going on.
I honestly was a little scared because it was so odd. I though it was just gonna be another flu. But of everything, the fatigue was the absolute worst. My spine, neck, and legs just felt like mush for a full week. Existing was effort. Could barely keep food down.
When my fever broke, I went about my life like normal. Still I'd hate to imagine what it would've been like in a not so vaccinated era like the early 1900s. I probably would've died.
I had the virus and it was slightly inconvenient, had a slight fever, cough and shortness of breath.
Strangly my wife had different symptoms to me, no fever and vomiting.
Lasted around 10 days with no lingering symptoms.
I think the fever is important because my wife got reinfected but I did not.
Glad you're ok, but I'm surprised you describe SOB as a slight inconvenience. In general, SOB is a pretty bad sign-- you're having trouble getting the one thing you'll die fastest without. Sure, you can put up with temporary mild SOB if you know it's going to stay mild, but not everyone can know that :/
> but I'm surprised you describe SOB as a slight inconvenience
Ever been to a high altitude city? I was short of breath for my first week in Mexico City, and my lungs hurt after exercise. It’s very disconcerting, but also just a slight inconvenience.
Yes, it's a minor inconvenience when it's expected and you have confidence in a good prognosis. It can be tortuous when you don't know whether it's about to get worse.
i.e., it's like the common cold +/- a bit. Also keep in mind that many people are mostly asymptomatic entirely, even the unvaccinated.
Sure, try not to get sick. Understand that there is some risk of symptoms. But getting COVID once you've had the vaccine shouldn't really be a concern worthy of altering any behaviors to avoid for healthy people.
What I wonder is the other symptoms like long covid. We’d hope the vaccines would diminish the incidence of that, but I’ve not heard it. Probably too early for the newer variants.
I suppose those miners are strong healthy men, wouldnt we expect the same results if they were exposed to the virus while being not-vaccinated?
> In other words, this case study is a relatively ordinary result in line with what we know: that the major COVID-19 vaccines greatly reduce the chance of severe illness but leave nontrivial chance of infection and transmission.
I dont think this particular case is a proof of your claim at all.
From the study: "Mine workers were mostly men (42/44); median age was 53.3 years. Eighteen of the workers had risk factors for severe COVID-19: high blood pressure (11/44), diabetes mellitus (4/44), or obesity (4/44)."
What is your point? You are not comparing against the general population to see if there is a difference.
Also from the study:
> Such a low vaccine efficiency against infection by the Gamma variant was not expected because in vitro studies have shown a similar reduction of neutralization for Beta or Gamma variants by BNT162b2-elicited antibodies (5) and a conserved CD4+ T-cell response against spike proteins from the Beta variant (6).
So, no, this was not "business as usual", in fact the results are so shocking that the investigators wrote:
> Given the surprisingly high attack rate, we hypothesized potential dysfunctions of conservation or administration of vaccines, but the absence of traceable cold-chain interruption and the use of different batches seemed to refute this hypothesis.
So the study so far suggests that the Pfizer vaccines may well have an actual low effectivenes rate against this virus variant.
Small nitpick but French Guiana isn’t its own country, it’s a part of France. That being said their population does seem to trend young when compared to the rest of France or other western countries.
From family experience it seems miners these days tend to be in the old, lifer side. Once you've adapted to the hardship, you mostly keep at it. Can be well paying jobs too, in an area with not a lot of jobs...
I think mining is exceptionally poor for your health, esp re respiratory disease, lack of vitamin D, and also usually highly correlated with near poverty (and the health issues that’s associated with)
The key point: The attack rate was 15/25 (60.0%) in fully vaccinated miners, 6/15 (40.0%) in those partially vaccinated or with a history of COVID-19, and 3/4 (75%) in those not vaccinated. Attack rate was 0/6 among persons with a previous history of COVID-19 versus 63.2% among those with no previous history (Table).
In other words, natural immunity from previous Covid case was the only protection and the vaccinated miners were not statistically different than the unvaccinated (sample size of 25 vaccinated at 60% attack rate vs sample size of 4 at 75% attack rate is inconclusive).
It is interesting that none of the infection-recovered were infected - though with only 6 individuals, that could be luck. There have been other hints natural immunity is stronger versus later variants.
But your other point doesn't follow. The vaxed still tested positive at a slightly lower rate than the unvaxed. With no severe cases, no one died & no burden on limited emergency facilities was created.
There's not enough info to know how much the vaxed spread it to others; they conjecture that their "patient 40", an unvaxed individual who had an asymptomatic case, was the "index case" that brought the infection in. Especially in the conditions of a mine – which might have limited ventiliation – perhaps that one unvaxed person shedded enough infectious material to create all the subsequent infections.
> The fact that vaccinated individuals don’t stop transmission means that there is no “public good” from getting vaccinated, it’s solely for personal benefit.
This is not true. Where did you hear this? What is your source?
Israel's Minister of Health came out yesterday and said theyre seeing only 39% effectiveness now (delta). Based on prior reporting, Israel's vaccination program seemed to be the best in the world.
That is effectiveness against infection. The efficacy against transmission will be higher.
When the virus infects someone that is vaccinated there are less symptoms, less viral load and less risk of further transmission.
And I don't think anyone has done a study on the efficacy of vaccination preventing superspreading, but I suspect that vaccinated individuals are rarely, if ever, superspreaders.
Also that is contradicted by the NEJM study today that finds that Pfizer is still 88% effective against Delta:
The point OP is making is it relieves pressure on the healthcare system, but the pressure was only there because of old people. Now that old people are vaccinated there’s no reason to mandate or require vaccines. Just look at UK or Israel and the case rates there for how effective vaccines are against transmission. This study just drives home the point.
> Just look at UK or Israel and the case rates there for how effective vaccines are against transmission.
It is not a reader's job to "just look at ...". Point us to a study if you want to persuade.
Furthermore, pointing at a data set or graph is not sufficient. Data in isolation (by this I mean a table full of numbers) does not prove causation. Only by understanding how the data is collected (i.e. the experimental design) can we start to reason about causation.
I'm saying this because I've seen people point to a graph and say "Don't you see X?" (where X is an inference) as if it were an obvious fact. On the contrary, a valid inference requires statistical thinking, which requires understanding how the data was collected and some kind of model.
This study shows an attack rate of 60% which means vaccinated individuals can both contract and spread the virus.
Previously infected individuals had an attack rate of 0%.
So no, mass vaccination of the younger population provides no “public good” and for younger individuals probably has a negative cost/benefit due to side effects.
> I just assumed most people weren’t living under a rock and were aware of the basic facts of COVID. Study from Italy shows almost 90% of hospitalizations are in the 65+ group:
https://academic.oup.com/biomedgerontology/article/75/9/1796...
> I just assumed most people weren’t living under a rock and were aware of the basic facts of COVID.
There is no need to indirectly insult me or other people on the thread.
I discussed with you in the hopes that I could learn something. You didn't reply to my specific comments in detail. If you were hoping to persuade or be kind, you missed an opportunity here.
Nope, globally we know that re-infection rarely occurs after being infected. This study shows a 60% attack rate for fully vaccinated miners, which is horrendous. The whole point of this study is that vaccination does not stop transmission of the virus. To quote the study:
In conclusion, we describe a VOC Gamma COVID-19 outbreak with a strikingly high attack rate among persons fully vaccinated with BNT162b2 vaccine.[…]Masking and social distancing —even among those fully vaccinated— may be necessary.
We also know that confirmed cases are mainly among the unvaccinated and serious outcomes are nearly all (99%) among unvaccinated, despite fully vaccinated and unvaccinated being roughly equal populations in the US at present.
The mine in question had 44 employees. The sample size is thus a bit small, the mine is probably not well-ventilated, and the working conditions are not good for health in general. Of course, it's bound to happen that eventually a COVID variant emerges against which a booster shot becomes required,so this might or might not hint at something greater.
In a mine -- constricted space of very small volume with forced ventilation -- the conditions would be ideal for getting infected with a very high initial viral load. Under these conditions, it is not unreasonable that immunity of any kind (from infection or vaccination) would not be sufficient to prevent symptomatic COVID19 infections.
We should keep in mind that working in mining operation is very bad for your lungs and mucous membranes in general. They may also be vitamin-D deficient among other issues.
If someone can check my math, this seems like a perfect opportunity to do a statistical test. Sample sizes are too small to say that there is a difference between previous infection and no previous infection.
A Fisher Exact Test yields a p value of 0.1923. So there is not evidence that previously infected people are safe. Similarly, if we compare the attack rate in previous infections vs Pfizer, the p value is about 0.15, so there’s not evidence one is better than the other.
Fully vaccinated individuals getting infected shouldn't be all that surprising. The phase 3 trials of Pfizer and Moderna saw a 95% reduction in severe symptoms. No routine testing for infection was done, only testing if someone showed symptoms.
Singapore's gov't is tracking all of their infections and 80% of the population has had 1 shot, 50% fully vaccinated (Pfizer and Moderna).
They've had 1096 cases in the last 28 days, 484 are in fully vaccinated people [1]. The key difference is that 100% were asymptomatic/mild cases.[2]
I feel like a 60% attack rate among fully vaccinated people in one outbreak is pretty chilling, though. Like I'm glad they didn't have severe illness but this news is disappointing.
Delta seems to heavily dominate in Singapore [0], and they don't seem to have Gamma at all. The outbreak in this article was Gamma.
This study doesn't jive well with the in-vitro tests of vaccinated serum against gamma and the numbers we're seeing broadly though, so I'm still hopeful this is a fluke occurrence.
One thing to keep in mind is that they were miners at a mining camp. They were in close contact with each other much of the time.
Vaccination lowers your chances of getting COVID when you get exposed, but even a low probability per exposure can be significant if you are getting exposed over and over and over again.
At that point it’s probably best to move past talking about a vaccine as conveying a percentage of immunity in aggregate among the population and to discuss the biological processes more deeply. Ie it’s really making your immune system have some ability to abate an amount of viral load hopefully more than baseline prior to vaccination. But it seems clear that any biological system would have an upper limit to abatement. I wonder whether that’s much of a fleshed out area of study.
I wouldn't read too much into the 50% being fully vaccinated. Front-line workers (both medical and retail) are most likely to be exposed versus someone unvaccinated. In addition, as vaccination rates go up, you'd expect to see more fully vaccinated people test positive since there are so few unvaccinated people.
Not sure why I got downvoted - this is exactly what we expected - the vaccine protects against serious disease, not necessarily infection. We have some data showing that vaccinated people have a reduced risk of infection, but it's still a significant risk.
60% of the gold miners that were fully vaccinated at this jobsite got infected and became mild to moderately ill. that's why this is interesting - it's a case study of vaccine effectiveness among a bunch of people exposed to one variant in one place.
I got my wires crossed, I thought OP was talking about Singapore where ~50% of those infected were fully vaccinated.
Yes, you are correct that the miners are a defined population, all exposed to one variant in one place. It would suggest that the Singapore numbers aren't skewed that much by front-line workers being vaccinated at a higher rate.
But the US methodology of deciding whether you have COVID is much more strict if you've been vaccinated - this just fudges the numbers to make it look like vaccines work much better than they really do.
How are you measuring that? If it's using the CDC measure of whether you have COVID, then many of the hospitalised and dead who "didn't have COVID" were merely vaccinated and therefore didn't count.
The point is that the people naturally infected were not reinfected.
That stat isn't incompatible. The 99% in the US could easily be the people neither vaccinated nor previously-infected. It says nothing about the risk of reinfection.
Does anyone know if their is a correlation between how contagious a variant is and how lethal it is?
For example, MERS has a 35% CFR but wasn't a global health disaster because it wasn't highly contagious. Same goes for Ebola, which is even more fatal but even less contagious.
My point/question - the more contagious a Covid-19 variant = lower CFR?
There are no hard rules here. The UK variant is supposedly both more severe and more infectious ( https://www.bmj.com/content/372/bmj.n579 ). The common wisdom there is that something that kills you faster has less chance to transmit but there's nothing precluding something that kills you slowly and is very infectious while it does that.
Both are blood-to-blood, rather than respiratory. They are not at all contagious, compared to flus and colds. A lot more deadly, but they can be stopped much more easily.
Ebola spread is not stopped so much by it’s deadliness, but by the fact that you can’t get it by just being near someone who has it and is breathing.
Off topic but I wonder if one could build a "Covid Canary". A device that can alarm when there is a presence of Covid in the air in an enclosed room. Supposedly there are several companies working on a covid breathalizer.
Are the cold viruses impossible to vaccinate against? I always assumed they were the same as flu – possible, but you need new vaccines every year because the strains keep shifting – it's just that the severity of colds is low enough that we don't bother. Is that not the case?
Does French Guiana have the Pfizer vaccine for the general population? Or did the gold miners have Pfizer vaccines procured for them by the owner of the mine/government?
I'm not sure how you came to this conclusion. Even if vaccinated people could get COVID (which they can) and could get sick (which they currently do, to some extent) - the question is ultimately whether or not vaccinated people die at the same rate. As long as Rate of Death for Vaccinated < Rate of Death for Unvaccinated + Rate of Death for taking Vaccine; you should be vaccinated, regardless of age.
Age is a very important factor; high risk is heavily weighted towards the elderly for infection, and so far side-effects seem to hit all age groups for vaccination, possibly even weighted slightly towards the young due to an overreaction from a stronger immune system.
It's Rate of death for vaccinated * probability of catching covid < Rate of death of vaccinated * probability of catching covid-19 + probability of dying from vaccine.
As probability of catching covid-19 decreases, it makes less sense to vaccinate, and if the probability of catching covid-19 is 1%, the vaccine death rate needs to be 100 times smaller than the reduced covid-19 death rate. For young people I think the numbers are against the vaccine.
If it significantly stopped spread that would be different - but the new variants statistics make it pointless at 39% only efficacy.
At this point the numbers are just sadly against vaccines. I'm saying this as a disappointed vaccinated young person. I wouldn't have taken it with the currently known numbers.
I'm not sure how you came to this decision rule. There are plenty of things which strictly decrease my mortality rate, by some non-zero amount, which I do not do and are not recommended for me.
20-somethings are at a lower risk for mortality, that doesn't mean they won't suffer long COVID symptoms like arthritis and reduced lung function. And also infect more vulnerable age groups.
True. However, because viral fatigue and related complications are generally present among symptomatic people (and 20-somethings are less symptomatic than other age-cohorts) it might well be that your risk of these things is also lower-- even if, conditioned on being symptomatic, the risk of "long-COVID" in 20-somethings is higher. I think the jury is still out regarding risk ratios for long-COVID, however-- partly because the pathology is rather ill-defined and still developing.
The more important point is just that viral fatigue and respiratory complications are not new things. They are present for a range of viruses. The mere existence of these factors is not pertinent to the "public good" point that the original comment centered on.
But his point was on that of getting vaccinated as a "public good" - not on the vaccinations impact on your personal risk from covid. Excluding your personal risk, getting the vaccine does not prevent you spreading covid. Probably, it reduces your spread, as you have less symptoms, though.
Thanks, yeah. It is completely plausible, I think, that vaccination for any cohort of subjects could reduce their infectivity.
The decision rule, however, is never the existence of a non-zero number. It is always a question of magnitude and whether that magnitude has meaningful impact.
Just to clarify this point: if you experiment with some simple SIR or SIRS models (which are not useful in modern epidemiology, but I digress) you will observe threshold phenomenon. This means that there will be broad ranges where perturbations of parameters (for instance, R0) have little meaningful effect on the progression of the outputs (for instance, the number of infected). Then there will be very small intervals where slight perturbations of parameters have a very meaningful effect on the outputs. For instance, there's not that much difference between R0=5 and R0=6, but there's quite a lot of difference between R0=0.999 and R0=1.001.
This is just to say that: it's plausible that vaccination has little to no impact on actual spread of Covid variants in the global population. I'm not saying this statement is true, I'm just saying that this statement is far from being disproven. There's just not enough evidence to call covid vaccination a "public good" and care about whether the low-risk get it.
Except that Rate of Death for taking Vaccine is completely unknown and under-reported by authorities who have a vested interested in getting everyone vaccinated.
"Mine workers were mostly men (42/44); median age was 53.3 years. Eighteen of the workers had risk factors for severe COVID-19: high blood pressure (11/44), diabetes mellitus (4/44), or obesity (4/44)."
"The overall attack rate was 54.5% (24/44); 87% were symptomatic, 65% with fever, and 22.6% with dyspnea. No clinically severe COVID-19 (1) was observed, and no patient was hospitalized."
This make sense. If more severe variants are more damaging (i.e. more severe symptoms, death, etc.) they are less likely to persist. The less harmful variants are more likely to carry on.
At the extrene, for example, look at Ebola. It's quick and it's deadly. Consequently, it burns out. On the other hand, a longer asymptomatic incubation period - long enough to get on a plane - and Ebola is going to be big trouble.
All of this really depends on the specifics of the disease. For example, HIV is pretty much 100% fatal and it has remained so over the last 40 years. Syphilis and Leprosy also have high fatality rates and have been around for 2000+ years. If a fatal disease doesn't kill the host for a while then it can easily become more transmissible while still being very harmful.
Exactly. Long incubation period. Takes long to kill its host. The opposite of Ebola. If it were more like Ebola it would be must less likely to spread, if at all.
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The authors of this study conjecture that the unvaccinated asymptomatic “patient 40” may have been the source of the infections seen in the other fully vaccinated patients - however this was a minor point as limited rational and evidence was provided.
That being said, IMO there seems to be a growing public opinion that unvaccinated individuals are to blame for the increasing dominance of variants of concern (delta, gamma, etc).
One counterpoint that I’ve come across during my own review of the literature, is the idea that imperfect vaccines can cause selective pressure which enhances the fitness of highly virulent pathogens. For example see this peer reviewed publication from 2015: “Imperfect Vaccination Can Enhance the Transmission of Highly Virulent Pathogens” (https://journals.plos.org/plosbiology/article?id=10.1371/jou...).
My understanding is that this is a relatively new and perhaps highly understudied phenomenon. I wanted to share the idea here because it seems conspicuously missing from many of these discussions. Furthermore, I’d love to hear feedback from someone with more expertise - or just trade relevant links with others who are diving into primary sources as a way to form an educated and well rounded opinion.