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I don't understand this attitude. Yes vaccines aren't 100% perfct but they are a whole lot better than nothing. Same as masks.

It's not "pointless" at all, it's a government taking totally reasonable measures to ensure the greatest good for the greatest number. Nothing is ever going to be 100% safe, but to not take obvious measures to increase safety is negligent.

I just have no sympathy for the anti-vaccine crowd and their wilful ignorance and bad faith arguments. Fine, it's your right to not get vaccinated. It's everyone else's right to prevent your recalcitrant ass from affecting others with your ridiculous theories and bad decision-making.




Having survived Covid is better than some vaccines; forcing people to then pay Pharma companies is kind of a funny response, especially when there are still many people in the world that are under lockdown that want vaccines, you can easily argue it is not ethical.


I think it was a reasonable question, which I read as:

If I am vaccinated, and you are not, what do I gain from forcing you to get vaccinated? I am equally highly protected either way, right?


No you aren’t. A vaccine isn’t 100% effective. So say it prevents 9/10 COVID infections. If you are in an area where your normal probability of encountering an infectious level of virus is say 1/100, then your chances are 1/1000 of catching COVID. But if your local level of transmission is higher, so that your chance of contracting COVID over some time horizon is say 1/10, then your chances of getting ill is now 1/100.

And this all assumes that the vaccination works equally well for everyone. The effectiveness rates are and average. There will be people for whom it is highly effective, and others who get the vaccine who don’t get much protection at all.

It also ignores the reality of mutation rates. Mutations will happen no matter what, but the rate at which they occur is dependent on how many people are getting sick. So even if a vaccine offers protection now, if half the population is not vaccinated, and the virus is raging amongst them, then the chances of the virus developing a mutation that increases severity, or evades existing vaccine immunity, is much higher.

So the reality is that no, being protected is not a simple matter of an individual choosing to or not to get vaccinated. It’s community based. This isn’t unique for COVID either. It’s been true for every disease we’ve ever vaccinated against.


It's disturbing to me that depending on what argument is being made, the vaccines are both highly effective and simultaneously not effective enough. It doesn't get to be both when it's convenient.


Both those things are true, though. In fact, both are true of most vaccines that are actually in use; perfect vaccines are rare.


Please explain how something "is X" and "is not X" at the same time, without changing the definition of X between assertions, and without referring to quantum superposition.


It seems obvious that many medical treatments/pre-treatments clearly lead to generally good outcomes (or are at least better than the untreated case) while many of them are still less effective or have more side effects than we would like.

We can say the same thing in many domains. Modern car safety has improved a lot and makes cars from a few decades ago look like deathtraps in comparison. But way too many people still die on roads so we're constantly trying to make improvements.


That's a long way of saying that you're changing the definition of X between assertions. "Effective" doesn't mean the same thing in both contexts.


Vaccines are highly, but not perfectly, effective. The definition is the same, it's the adjective that's changing.

For true immunity without anyone else needing to be vaccinated they'd need to be perfectly effective. Since they're not, more of the community needs to be vaccinated. The less effective they are (or the more widespread or infectious the virus is) the larger the proportion of the population that needs to be vaccinated becomes.


If you have the polio vaccine, you basically cannot get polio and have lifelong immunity. That's an effective vaccine. It doesn't require everyone else to get frequent booster shots. The current covid vaccine does not measure up to the polio vaccine.


Why is it disturbing? Can both not be true?


Vaccine effectiveness goes up the more people have them. So let’s say a vaccine confers 60% immunity (not what the actual vaccines provide, whose numbers are much more complicated), that is basically friction that slows the virus’s spread around. Now, if almost everyone is vaccinated, that friction is enough for the virus to fizzle out and the pandemic to end. If only a few people are vaccinated, then the virus still has a lot of friction free hosts to infect, and because it is thriving, it can even mutate faster to get around the vaccine’s friction.

Think of the vaccine as a collective attempt to stop the virus, not as a personal attempt. The more people are vaccinated, the higher chance this pandemic will end and we can get back to normal. Anti vaxxers are extremely annoying here. Also, hopefully the vaccine is approved for children soon.


No, you are not. If I am not vaccinated I am far more likely to carry the virus to you, and your vaccine, while good, is not 100% protection. So you have a significant decrease in your risk by forcing me to be vaccinated.


Do we apply this thinking to any other public health threats? Smoking for example, particularly for those forced to be around smokers like their children? I'm curious to hear the arguments for why this virus needs to be treated differently to all others that have come before, and to other public health issues.

Not trying to start a fight here. I just haven't been convinced yet why our old behaviour towards threats like CoV-2 doesn't apply to it itself.


We do apply the same logic. You can choose to be a smoker, but you can’t choose to be one in certain public spaces, including airplanes and trains. This type of mandate is no different. You can still choose to be a non-vaccinated individual, but not in particular areas.


I did mention in my comment above that children of smokers don't have a choice being around second hand smoke. Yet most governments consider the harm to the health of the child to be less critical than the smoker's individual freedom to smoke.

I'm not some freedom loving libertarian, I'm normally quite left leaning, but the dual standards I see applied by governments here really bother me. I can't help but think their response was driven more by fear than sense.


> I did mention in my comment above that children of smokers don't have a choice being around second hand smoke. Yet most governments consider the harm to the health of the child to be less critical than the smoker's individual freedom to smoke.

I don't think most people are suggesting mandatory vaccination of parents; the rules actually being imposed in developed countries are much more similar to indoor smoking bans (ie. you are allowed put yourself and your children in danger, but you're not allowed put the general public in danger.)


No one is taking away the children of anti-vaxxers, they are saying you can’t use public transportation. The same principle is at play: you can live you life in a way that negatively impacts the health of your children, because you have authority over your children. But when it becomes a threat to others that aren’t in your stewardship, you no longer have that freedom.

What is the double standard here? You aren’t even comparing the same situations.


> You aren’t even comparing the same situations.

We've gotten quite far from the original point; I'll reply once more but probably not again on this branch because we seem to have a fundamental disagreement over whether governments should have the right to mandate (either de-jour or de-facto) medical interventions on people in return for the ability to take part in society.

Governments can't mandate for every eventuality, they have to make policies covering broad areas. We're discussing public health policy here, i.e. the ways in which governments can reduce harmful effects on the health of the populace through rules and regulations. My point was that if governments truly cared about public health, they would have already for example banned smoking universally (or at least in situations where there is another person within X meters of the smoker), since second hand smoke is a demonstrable cause of premature death. The justification would be one of public health. And if anything, such a policy would be even less controversial than mandating vaccines because a smoker can simply stop smoking temporarily to be around other people whereas people cannot stop breathing and therefore potentially spreading viruses. Yet it seems governments have skipped over all of these easier public health issues, and gone straight to mandating that people get vaccinated to enter publicly funded places from a public health justification. To me, regardless of how effective or not these mandates have been and are, I smell bullshit when I hear governments justifying such rules with public health arguments because they have not from their previous actions demonstrated that they are merely following through with their public health manifesto. I rather fear they're mandating vaccines to enter public spaces because the public demanded something be done. Governments in representative democracies aren't doing their job if they do merely that which the public want; they are supposed to lead even if the majority of the public disagree.


> My point was that if governments truly cared about public health, they would have already for example banned smoking universally (or at least in situations where there is another person within X meters of the smoker), since second hand smoke is a demonstrable cause of premature death.

You keep failing to see the logic in this argument you are making. The point is that the government will allow the individual to make whatever medical decisions they want to to the extent it only affects themselves and the people legally in their care, like children. You are not allowed to make those choices when they harm the health and well-being of those that fall outside that purview. You can smoke all you want, and harn your kids with second hand smoke, the same way you can choose not to get vaccinated and harm your children by refusing to let them get vaccinated. But once your choice affects the people around you, your freedom is restricted. You can’t smoke in public areas. And now some governments are making it so you can’t be unvaccinated in public areas. There is no hypocrisy here, if anything it’s the only logically consistent stance. The only difference is that you can “turn off” smoking when you go into public, and can’t do the same for being unvaccinated. But that is an issue for the unvaccinated individual to deal with.

This isn’t even restricted to medical interventions. If I own a private race track, I can drive however I want to, at whatever speed I want, in whatever kind of vehicle I want. But as soon as I want to use a public roadway, there are a litany of restrictions to those freedoms I am subject to, from the speed and the direction I can go, to the type of vehicle I can drive, because not doing so can negatively impact other people. Every society on the planet has had some form of restrictions of personal freedom when they start negatively impacting other members of society in a significant way. And refusing to be vaccinated in the midst of this pandemic harms society in a significant way.


> And refusing to be vaccinated in the midst of this pandemic harms society in a significant way.

Getting vaccinated can also harm oneself in a significant way:

Clot risk to 18-39s from AstraZeneca vaccine is twice as high as Covid death risk, Euro study finds https://www.irishexaminer.com/news/arid-40328123.html

Being forced to vaccinate in order to maintain one's livelihood is simply beyond the pale:

Covid-19: Mandatory vaccination violates fundamental right to livelihood, says Meghalaya High Court https://scroll.in/latest/998409/covid-19-mandatory-vaccinati...

"Vaccination by force or being made mandatory by adopting coercive methods, vitiates the very fundamental purpose of the welfare attached to it. It impinges on the fundamental right(s) as such, especially when it affects the right to means of livelihood which makes it possible for a person to live."


To the children point specifically, the state rightly gives wide latitude for parental decisions and actions before it is considered child abuse. Mistakes certainly happen (in both directions) but for the most part society draws a reasonable line based on current norms.


> Do we apply this thinking to any other public health threats? Smoking for example, particularly for those forced to be around smokers like their children?

Yes, of course. Most developed countries ban indoor smoking in most or all places outside the home.


Can you give some examples?


I think the slippery slope argument this creates is what is frightening a lot of people.


Yes, you can let the others do the work and often be just as well off. Society is a giant prisoner's dilemma (or more like 'grifers dilemma') like that.

That's why vaxxes are not like seatbelts, i.e. just affecting the user, they affect everyone.

We take vaccines to protect others as much as we do ourselves, because if we act responsibly then things will work out, but nearly everyone needs to participate.

In this case it's a little bit like 'positive responsibilities'. Normally, we could say 'don't steal' and that would be enough, but in this case it leans towards 'get your vax' i.e. an active action.

It's not as black and white, it's reasonable to have conscientious and other objectors. And of course I don't think 'requirements' are necessary unless specific health concerns. But on the whole, by and large, we need to get vaxxed here i.e. we need enough civic participants to move the situation forward so that the various kinds of objectors can survive so as to maintain their right to object, ironically.


> I don't understand this attitude. Yes vaccines aren't 100% perfct but they are a whole lot better than nothing. Same as masks.

This is only true for both if there are no side effects to doing either of them. If there are side effects, and there are, then it is not that simple.

I don't know why, but with COVID, people seem to have conveniently forgotten that in science, all factors matter. [1]

[1]: https://gavinhoward.com/2020/08/in-science-all-factors-matte...


[flagged]


If ADE happens with future strains, then it won’t matter if you are vaccinated or not, because unvaccinated individuals are absolutely guaranteed to get Covid eventually. Covid is never going away at this point, and it’s transmission levels are as high as just about any disease we’ve encountered. Short of completely retreating from society and building a survival bunker in the woods, you won’t escape ADE if it becomes an issue, so it’s not a valid argument against vaccination. If anything it is an argument for vaccination, since a highly vaccinated population will reduce the rate of mutation.


Natural immunity (which I already have) provides a much more generic defense because it targets all parts of the spike protein, and presumably other parts of the virus itself, many of which hardly mutate.

Vaccinal immunity targets only the receptor-binding domain of the spike protein. The RBD is, in fact, the most rapidly mutating part of the virus.

Therefore it is highly feasible that ADE will only affect the vaccinated and not those with natural immunity. So, yes, it is a valid argument against vaccination.

>If anything it is an argument for vaccination, since a highly vaccinated population will reduce the rate of mutation.

If the vaccine were known to be highly neutralizing, this would be a good point. Unfortunately that does not seem to be the case, though I admit it is still somewhat uncertain. If the vaccine is non-neutralizing, then, on the contrary, I expect a highly vaccinated population to increase the rate of immune-escaping mutation.


The vaccine prevents serious illness in many cases so I think this is a good argument in favour of vaccination. People can go around and catch covid, build up more natural immunity while not running all the risks from the start of the pandemic.


Even if vaccine prevents serious illness from the current strains, the ADE hypothesis is that the vaccine will enhance illness for future strains.

Also, once you get the vaccine, you don't build up more natural immunity. That's the point. The vaccinal immune response discourages the immune system from mounting a defense to the novel strain, instead it just pumps out antibodies for the Wuhan strain encoded in the vaccination. In the future, if these Wuhan antibodies cannot bind the new strains, the situation is obviously very dangerous, and much worse than not being vaccinated at all.


None of what you stated indicates any increased likelihood of ADE. In fact, there are concerns that natural immunity may be more susceptible to antigenic sin, precisely because the immunity is more generic and not focused to the spike protein. This would increase the odds of individuals with just natural immunity of developing a malformed immune response to future variants.

> Hensley worries, though, that people whose immunity to the virus comes from infection, not vaccination, might have more difficulty handling variant viruses because of imprinting effects.

> David Topham, an immunologist at the University of Rochester Medical Center and director of the New York Influenza Center of Excellence, also envisages that possibility.

> He noted that, in the earliest stages of SARS-2 infection, the immune system mounts a response to a portion of the spike protein called S2. Later, the immune system focuses its attention on other parts of the spike, notably the part of the protein that attaches the virus to cells it invades, known as the receptor binding domain.

> It’s not yet known if the early focus on S2 — which doesn’t change much from virus to virus — will blind the immune system to the changes elsewhere in the spike protein, the changes updated vaccines would be trying to teach the immune system to respond to, Topham said.

> Topham doesn’t think this will be a problem in vaccinated people, because of the way the vaccines in use have been designed. The spike proteins they trigger production of appear to hide the S2 region, he said. The immune system can’t fixate on something it doesn’t see. [0]

There’s also doubt as to if COVID even could cause ADE, both because it has yet to be seen across millions of cases, but also because the known mechanisms of ADE don’t apply to Covid [1][2].

Also recent studies have shown that the rate of mutation in a country is inversely correlated with vaccine coverage for Covid. [3]

[0] https://www.statnews.com/2021/04/16/next-generation-covid-19...

[1] https://mobile.twitter.com/macroliter/status/142157887960985...

[2] https://mobile.twitter.com/macroliter/status/142157887960985...

[3] https://mobile.twitter.com/sailorrooscout/status/14254499058...


It does though. None of what these people stated makes any sense. It appears to be some sort of propaganda for popular science media. In any case, the logics of the different individuals quoted are completely contradictory, so the only conclusion is a lack of consensus, which I don't deny.

No one knows what the next strains will be, but it is most likely that the generic natural immunity is more robust than the vaccinal immunity that targets only one rapidly mutating part of the spike protein. This is what makes the vaccinal immunity, and NOT the natural immunity, susceptible to antigenic original sin.

Also, Topham's whole argument seems to assume the existence of perpetual "updated" vaccines, which is entirely hypothetical, and which I do not wish to depend on.


>Also recent studies have shown that the rate of mutation in a country is inversely correlated with vaccine coverage for Covid. [3]

This is nothing. A single arbitrary estimator, applied to a few dozen countries (no explanation why they were chosen), shows a statistically insignificant correlation without controlling for any of the thousands of confounding variables.

Normally I would bring up the look-elsewhere effect here too, but it seems hardly dignified to discuss this tweet/paper at that level.

The authors' affiliation is a 5-employee startup addressed at an office-sharing facility.


Can you share some of the mounting evidence?


Mutations of the RBD that evade vaccinal immunity (which was long known):

https://doi.org/10.1016/j.cell.2021.04.006

https://doi.org/10.1016/j.cell.2021.03.013

Feasibility argument based on molecular modelling:

https://doi.org/10.1016/j.jinf.2021.08.010

Infection-enhancing antibody pathways exist:

https://doi.org/10.1016/j.cell.2021.06.021




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