Is catching Covid now better than more vaccine?(bbc.co.uk)
bbc.co.uk
Is catching Covid now better than more vaccine?
https://www.bbc.co.uk/news/health-58270098
152 comments
>"do children need vaccinating at all, or does a lifetime of encountering build a good immune defence?"
>"However, he said the argument in children had "already been won" as "40-50% have already been infected and most weren't ill or particularly ill"."
This sounds like a pretty different conclusion than CDC guidelines to have children wear masks in school. I understand it might just be to slow the spread but it seems inevitable that the virus has to move through the population and those who aren't vaccinated right now aren't going to get vaccinated in the future.
Another question no one is asking in a lot of these is should people who have had covid get one dose or two? (Pfizer / Moderna) Every study on the subject seems to point to higher immunity after one shot than people who haven't had covid getting 2. This would have greatly increased the supply and rate we could immunize others.
>"However, he said the argument in children had "already been won" as "40-50% have already been infected and most weren't ill or particularly ill"."
This sounds like a pretty different conclusion than CDC guidelines to have children wear masks in school. I understand it might just be to slow the spread but it seems inevitable that the virus has to move through the population and those who aren't vaccinated right now aren't going to get vaccinated in the future.
Another question no one is asking in a lot of these is should people who have had covid get one dose or two? (Pfizer / Moderna) Every study on the subject seems to point to higher immunity after one shot than people who haven't had covid getting 2. This would have greatly increased the supply and rate we could immunize others.
Mostly I agree, but vaccination rates in the U.S. have picked up a little in the last few weeks, so there are at least some unvaccinated adults who are persuadable.
>Getting a booster shot every few months for the next 10 years is always going to be the best option — Every Vaccine CEO
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There's a legit conspiracy with this very narrative. We have a handful of companies who have just been showered in public funds in the hopes that they produce something to make themselves irrelevant. It's not hard to believe that they'll lobby for the boosters regardless of the data.
That's a really bad characterization though, the vaccine studies were designed with the participation of government scientists (for sure with Moderna, which was developed in partnership with NIH).
The idea that the corporate scientists are all utterly corrupt and also so much better at science that they can undermine the effectiveness of the vaccines without ruining them completely is nonsensical.
The idea that the corporate scientists are all utterly corrupt and also so much better at science that they can undermine the effectiveness of the vaccines without ruining them completely is nonsensical.
Whether the vaccine works perfectly or not is actually completely irrelevant to the simple question of whether the government is inviting corruption by allowing what are effectively lobbyist scientists to apply suasion with "participating" in the studies, and aside from whether "participation" now adds the veneer of respectability that you cite.
Yeah, the scientists at the NIH aren't 'lobbyist scientists' (I think that's who you mean?), so if you think they are that, well, there's no real point in trying to discuss it.
The idea that the government overseeing efficacy study design invites corruption is also sort of tedious. Just deciding to regulate something reaches that same low bar of inviting corruption, but that would not be a good reason to not have regulation.
The idea that the government overseeing efficacy study design invites corruption is also sort of tedious. Just deciding to regulate something reaches that same low bar of inviting corruption, but that would not be a good reason to not have regulation.
> Yeah, the scientists at the NIH aren't 'lobbyist scientists' (I think that's who you mean?)
No, that's not what I mean. The scientists at Moderna are effectively lobbying for the effectiveness of their product and "inviting" NIH to apply a thin veneer of respectability by "participating" in their studies. It's no different from getting scientists at a large research university from "participating" in a large, well-funded corporate study; merely the association of the well-known brand gives the study a certain gravitas, but, and perhaps more importantly, bathes it in an aura of independence.
If I invent a new vitamin supplement and claim to have clinical studies that it does anything at all, fine. If I invite the FDA to "participate" in the studies, and they accept, then that instantly changes everything.
And if those seemingly independent FDA scientists then actively shill (or even demand) that my product be widely deployed, even better.
And NIH is doing a lot more beyond "regulating". If that was all they were doing, we'd have no argument, but NIH is actually issuing "public health" decrees that are becoming de facto mandates for hundreds of millions of people, and keeping secret any data that might go against their preferred narrative.
"Pfizer, Moderna seen reaping billions from COVID-19 vaccine booster market"
https://www.reuters.com/business/healthcare-pharmaceuticals/...
No, that's not what I mean. The scientists at Moderna are effectively lobbying for the effectiveness of their product and "inviting" NIH to apply a thin veneer of respectability by "participating" in their studies. It's no different from getting scientists at a large research university from "participating" in a large, well-funded corporate study; merely the association of the well-known brand gives the study a certain gravitas, but, and perhaps more importantly, bathes it in an aura of independence.
If I invent a new vitamin supplement and claim to have clinical studies that it does anything at all, fine. If I invite the FDA to "participate" in the studies, and they accept, then that instantly changes everything.
And if those seemingly independent FDA scientists then actively shill (or even demand) that my product be widely deployed, even better.
And NIH is doing a lot more beyond "regulating". If that was all they were doing, we'd have no argument, but NIH is actually issuing "public health" decrees that are becoming de facto mandates for hundreds of millions of people, and keeping secret any data that might go against their preferred narrative.
"Pfizer, Moderna seen reaping billions from COVID-19 vaccine booster market"
https://www.reuters.com/business/healthcare-pharmaceuticals/...
You understand that the NIH did the basic research on the Moderna mRNA vaccine?
The proper rabid screaming is that public research was privatized for profit, not that a public research agency is giving a veneer of respectability to a scam vaccine.
And then there's also the option of not rabidly screaming.
The proper rabid screaming is that public research was privatized for profit, not that a public research agency is giving a veneer of respectability to a scam vaccine.
And then there's also the option of not rabidly screaming.
The research is funded by the government and the profits are kept by the companies. You don't need to get on your high horse with "really bad characterization" or "nonsensical". We were told two vaccines would be enough, and now it seems like we're getting a third. That nonsense you mentioned is happening. Whether it's happening because we didn't have the data for the Delta variant at the time of research, I can believe, but you won't convince me that the CEOs of those companies aren't joyful finding strains that resist their vaccines.
If you want examples of years of bad scientific advice take a look at the food pyramid. It literally consists of interest group representation. It’s not based solid on science.
> The idea that the corporate scientists are all utterly corrupt
I don't believe the scientists are corrupt, but there's been enough corrupt businessmen in America that I take everything they say with a bag of salt. Promoting boosters sooner than needed is par for the course
I don't believe the scientists are corrupt, but there's been enough corrupt businessmen in America that I take everything they say with a bag of salt. Promoting boosters sooner than needed is par for the course
[deleted]
Rather than a contentious article about how vaccines are harmful, it’s about how immunity differs between actual infection and vaccination, and whether with background immunity if a booster or catching covid is better. Worth a read.
This is the sort of valid point that one will tend to avoid discussing because it is likely to be misused by the ideological critics of vaccination.
As an alternative I haven’t heard much of, updating the vaccines would seem to be a good option, as well? The first round was developed fast enough to almost outrun variants, so it should work quite well second time around.
It’s important to avoid the naturalistic fallacy: infection is not necessarily better protection. That is why, for example, tetanus and rabies vaccines work even when given after infection.
As an alternative I haven’t heard much of, updating the vaccines would seem to be a good option, as well? The first round was developed fast enough to almost outrun variants, so it should work quite well second time around.
It’s important to avoid the naturalistic fallacy: infection is not necessarily better protection. That is why, for example, tetanus and rabies vaccines work even when given after infection.
Yes, but the actual results from Israel and elsewhere suggest that, in this case, infection is better protection. It's not the naturalistic fallacy, it's what we're actually seeing.
Of course, vaccination is far, far better than nothing. But for a 5-year old, or a 50 year old who's already vaccinated, it's not clear that more vaccination is better than just having your immune system learn from the real thing.
It's all a moot point, of course, since it seems like we're all getting exposed, regardless of what we want. Even white-tailed deer in Canada are getting covid-19, so it's not likely that humans living in cities are going to avoid it.
Of course, vaccination is far, far better than nothing. But for a 5-year old, or a 50 year old who's already vaccinated, it's not clear that more vaccination is better than just having your immune system learn from the real thing.
It's all a moot point, of course, since it seems like we're all getting exposed, regardless of what we want. Even white-tailed deer in Canada are getting covid-19, so it's not likely that humans living in cities are going to avoid it.
>Yes, but the actual results from Israel and elsewhere suggest that, in this case, infection is better protection. It's not the naturalistic fallacy, it's what we're actually seeing.
What is this in reference to? All evidence I've seen points to vaccine provided immunity being more protective.
What is this in reference to? All evidence I've seen points to vaccine provided immunity being more protective.
I find it unlikely that this would ever even be raised as a question in an American mainstream news source.
A better question, though, would be "who needs a vaccine more now, a 1st world 10-year old, a 1st world 50-year old who's already been vaccinated, or a 3rd world 65-year old?"
A better question, though, would be "who needs a vaccine more now, a 1st world 10-year old, a 1st world 50-year old who's already been vaccinated, or a 3rd world 65-year old?"
One thing left out of the article is whether we should be vaccinating people to discourage spread simply to keep the risk of a much worse variant from randomly occurring low.
> we should be vaccinating people to discourage spread
Vaccinations with current vaccines don't stop infections/spread at all - it's very obvious now with the Delta variant in countries that are already massively vaccinated like Israel and Island.
In fact, vaccinated people can apparently carry just as high of a viral load as unvaccinated people (while vaccinated people will likely experience less symptoms). So the virus will happily keep infecting as many people as it can regardless of the vaccines.
Vaccinations with current vaccines don't stop infections/spread at all - it's very obvious now with the Delta variant in countries that are already massively vaccinated like Israel and Island.
In fact, vaccinated people can apparently carry just as high of a viral load as unvaccinated people (while vaccinated people will likely experience less symptoms). So the virus will happily keep infecting as many people as it can regardless of the vaccines.
cactus2093(8)
They sort of mention that in the breadth section. The idea is that natural immunity may target more than just the spike proteins the vaccine focuses on so may actually target more variants. One can imagine a scenario where continued (not initial) vaccination actually contributes to a longer spread with weaker immunity so more chance for variants to develop. Not saying this is 100% the case, but interesting article I’d like to see more data on.
But the spike is what is important, targeting the rest just makes the immune system make antibodies that don't do anything.
Are you a medical professional researcher? You are wrong though.
Just repeating what decades of SARS research has discovered. Maybe I'm wrong, but highly unlikely that something else would work when it hasn't in the past.
We are likely both wrong in some way, what a novel concept! ;)
Having parts of the spike protein targeted helps with existing variants, but not with new variants that might escape those markers. Delta is weakening the effects of vaccines already. Sure, booster shots might include new markers, but it's still a narrow moving target.
However, natural infection will provide broader immune response and antibodies. So if one could be sure to remain in good health, infection is much less terrible after two vaccine shots. That might provide additional protection that vaccines may not. It's more random though, but researchers are not foreign to the idea.
Nobody is able to predict future outcomes of it, but at some point society will need to accept widely spread of infections and deal with those outcomes. Hopefully, vaccine shots is enough to deal with the initial shock so the body can do the rest. It's not just about avoiding killing old people, but also avoiding degrading public health too much.
Having parts of the spike protein targeted helps with existing variants, but not with new variants that might escape those markers. Delta is weakening the effects of vaccines already. Sure, booster shots might include new markers, but it's still a narrow moving target.
However, natural infection will provide broader immune response and antibodies. So if one could be sure to remain in good health, infection is much less terrible after two vaccine shots. That might provide additional protection that vaccines may not. It's more random though, but researchers are not foreign to the idea.
Nobody is able to predict future outcomes of it, but at some point society will need to accept widely spread of infections and deal with those outcomes. Hopefully, vaccine shots is enough to deal with the initial shock so the body can do the rest. It's not just about avoiding killing old people, but also avoiding degrading public health too much.
There is a risk of creating variants by mass vaccination. If everyone has a uniform defense generated by a vaccine, this creates selection pressures for a variant that is able to maneuver around the vaccine induced immunity.
All the worst variants right now have developed in unvaccinated population.
So either you sacrifice 1-2% of the population and let variants continue while not vaccinating anyone. Or you get vaccinated and reduce your risks of going to the hospital by a ratio of 30:1.
So either you sacrifice 1-2% of the population and let variants continue while not vaccinating anyone. Or you get vaccinated and reduce your risks of going to the hospital by a ratio of 30:1.
Curious, how did/does one conclude or determine that the worst variants developed in unvaccinated populations?
Absolute nonsense though, as proven by looking at literally any of the diseases we have been vaccinating people for decades. Polio vaccine hasn't caused super polio to emerge, just like vaccines haven't caused super variants of hepatitis B, tetanus or whooping cough - all things that children are vaccinated against.
Even the flu vaccine doesn't cause new variants, and that has a spotty coverage at best.
Like, what you said sounds scienc-y enough that a lot of people seem to believe it, but it's literally not true and has never been true.
Even the flu vaccine doesn't cause new variants, and that has a spotty coverage at best.
Like, what you said sounds scienc-y enough that a lot of people seem to believe it, but it's literally not true and has never been true.
> it's literally not true and has never been true.
It’s widely regarded to be true for Marek’s disease.
It’s widely regarded to be true for Marek’s disease.
You are comparing apples and oranges. It is this reason there has never been a successful corona virus vaccine despite decades and billions of dollars of research.
Look up “leaky vaccines”
Look up “leaky vaccines”
Its not nonsense. Its possible and it has happened but in this case unlikely.
Though there is still concern due to the focus of these vaccines on the spike protein
Though there is still concern due to the focus of these vaccines on the spike protein
There are reasons to believe, and some experience to point to, that this effect doesn’t work with vaccines as much as it does with antibiotics.
It’s a long story, but part of the reason is that bacteria evolve resistance in the presence of the antibiotic, while here, the virus would need to randomly evolve it in the unvaccinated, then sustain useless adaption for a while until it gets the opportunity to infect a vaccinated person.
It’s a long story, but part of the reason is that bacteria evolve resistance in the presence of the antibiotic, while here, the virus would need to randomly evolve it in the unvaccinated, then sustain useless adaption for a while until it gets the opportunity to infect a vaccinated person.
Vaccinated people are already regularly getting infected, so it isn't quite that simple.
With Covid, many of the vaccines target a highly functional portion of the virus for the induced immunity. This means that mutations that make the vaccine induced antibodies less effective are at least somewhat likely to alter the function of the virus.
My understanding is that we aren't really able to analytically determine the possibility space.
With Covid, many of the vaccines target a highly functional portion of the virus for the induced immunity. This means that mutations that make the vaccine induced antibodies less effective are at least somewhat likely to alter the function of the virus.
My understanding is that we aren't really able to analytically determine the possibility space.
> the virus would need to randomly evolve [resistance] in the unvaccinated
That's only true if the vaccine stops almost all infections, which the COVID vaccines do not.
There's another comment in this thread from someone who's been vaccinated and sick for 9 days. That's a great environment for the virus to evolve immunity to the vaccine. And it's not an uncommon situation.
That's only true if the vaccine stops almost all infections, which the COVID vaccines do not.
There's another comment in this thread from someone who's been vaccinated and sick for 9 days. That's a great environment for the virus to evolve immunity to the vaccine. And it's not an uncommon situation.
>>That's a great environment for the virus to evolve immunity to the vaccine
Again, like the person above you said, it's not that simple. Bacteria can develop resistance to antibiotics because they can either avoid or start to digest the chemical that would normally be harmful to them. Here it's not the vaccine that's killing the virus - it's your own immune system, and every single one is different. So yeah, maybe in this person's body the immune system didn't learn to recognize the virus and kill it - it means literally nothing for how another person's immune system will behave when they encounter it.
Again, like the person above you said, it's not that simple. Bacteria can develop resistance to antibiotics because they can either avoid or start to digest the chemical that would normally be harmful to them. Here it's not the vaccine that's killing the virus - it's your own immune system, and every single one is different. So yeah, maybe in this person's body the immune system didn't learn to recognize the virus and kill it - it means literally nothing for how another person's immune system will behave when they encounter it.
> it means literally nothing for how another person's immune system will behave when they encounter it.
Vaccinations teach everyone's immune system to target the same part of the virus. Since everyone has immunity to the same spike protein, a change in that protein means something to all vaccinated people.
Vaccinations teach everyone's immune system to target the same part of the virus. Since everyone has immunity to the same spike protein, a change in that protein means something to all vaccinated people.
Yes, I have read this also.
Big pharma also has an interest in promoting booster shots. It would be a steady flow of revenue. If it causes selective pressures that create new variants, that just means a perpetual market for booster shots.
Big pharma also has an interest in promoting booster shots. It would be a steady flow of revenue. If it causes selective pressures that create new variants, that just means a perpetual market for booster shots.
>>If it causes selective pressures that create new variants
Except that it literally doesn't, there is no data to suggest that it would, and I have no idea why this particular idea is repeated so much. Like I said in the comment above, none of the vaccines that we use have ever caused super variants to emerge. Zero. We don't have a super variant of Polio, or any other diseases that people get vaccinated against.
Except that it literally doesn't, there is no data to suggest that it would, and I have no idea why this particular idea is repeated so much. Like I said in the comment above, none of the vaccines that we use have ever caused super variants to emerge. Zero. We don't have a super variant of Polio, or any other diseases that people get vaccinated against.
Polio is not a coronavirus. SARS has different mutation rate, so this needs to taken into account. Additionally cats, dogs and other animals can be infected and produce unique mutations, unlike polio.
Cross-reference it to https://www.nationalgeographic.com/science/article/leaky-vac...
I suspect we have the deadlier variants not despite, but because we are vaccinating and the vaccination is not effective in preventing spread.
I suspect we have the deadlier variants not despite, but because we are vaccinating and the vaccination is not effective in preventing spread.
Why do you think that? The Alpha and Delta variants were both first detected in late 2020 - before the vaccines were widely available.
How can i make a statement weaker and more open ended than with "i suspect"? "Could it be"? I didn't even wanted to back it up, it was more intended as an open thought, but its seems it didn't get across in the heat of the thread.
That assumption is based on the belief that an infection prevents reinfection, i.e. an infection is just as good at protecting a (recovered) patient as a vaccine is at protecting an uninfected person.
But we have seen that Delta reinfects previously infected patients, ergo, an infection is at a best a leaky vaccine (ie as good as current vaccines, though there are indications that it is not [1]), and at worse, a catalyst to worse outcomes considering the danger done during previous infection, b) a vaccine is not offered to the previously infected, c) the effects of long term covid.
[1] https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
But we have seen that Delta reinfects previously infected patients, ergo, an infection is at a best a leaky vaccine (ie as good as current vaccines, though there are indications that it is not [1]), and at worse, a catalyst to worse outcomes considering the danger done during previous infection, b) a vaccine is not offered to the previously infected, c) the effects of long term covid.
[1] https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
But people that have been vaccinated have also been infected. Why would you call it a leaky vaccine when the vaccine leaks too? Or am I mistaken here?
I didn't mean to imply that the vaccines we use aren't leaky, they are. Even so, there are indications that getting the vaccine provides more effective defense than getting infected [1].
[1] https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
[1] https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
For some reason, I misread that to be "https://dictatorsblog.nih.gov/2021/06/22/how-immunity-genera...".. and then I realized that I was right after all.
"three-fourths of the nearly 470 cases were in vaccinated people"
https://www.medpagetoday.com/infectiousdisease/covid19vaccin...
(from a leaked CDC memo; it seems like figuring out whether the CDC data should have been kept secret at all is left as an exercise for the reader.)
(edit: better source)
https://www.medpagetoday.com/infectiousdisease/covid19vaccin...
(from a leaked CDC memo; it seems like figuring out whether the CDC data should have been kept secret at all is left as an exercise for the reader.)
(edit: better source)
If you have an outbreak in a highly vaccinated population, guess what is true of the people that get sick?
Consider the limit case, a 100% vaccinated population. If you have an outbreak, everyone that gets sick will have been vaccinated.
Consider the limit case, a 100% vaccinated population. If you have an outbreak, everyone that gets sick will have been vaccinated.
This is using a clever (and true) thought experiment to warp actual reality. We are nowhere close to being 100% vaccinated, and so 3/4 is a horrible ratio for the vaccine.
Put another way, if 3/4 of the population was vaccinated, vaccinated people representing 3/4 of the cases would mean that the vaccine has no impact on the cases.
Put another way, if 3/4 of the population was vaccinated, vaccinated people representing 3/4 of the cases would mean that the vaccine has no impact on the cases.
The link in GP refers to an outbreak (Provincetown, MA. in July) that is not representative of pretty much any situation but itself. It is not by any means evidence for vaccine ineffectiveness. For context:
https://twitter.com/ashishkjha/status/1421313594063458304
https://twitter.com/peterstaley/status/1421215604481142785
https://twitter.com/ashishkjha/status/1421313594063458304
https://twitter.com/peterstaley/status/1421215604481142785
Tangentially related but I’m on day 9 of COVID infection which is easily the longest I’ve been sick in years. I got two shots of Pfizer last one on the 13th of July. If the vaccine has kept this relatively mild then I’m very glad. It sucks. My main symptoms are a stuffed up face, cough, sore throat, aching body and an extremely fuzzy head that seems to come and go. I had a slightly raised temp at the start but otherwise it’s been normal and no problems breathing.
Annoyingly my first test was negative even though I was symptomatic so I was wandering around being infectious for seven days. I’m now in isolation and my wife and kids are quarantined. Thankfully my wife tested negative yesterday, she was a couple of weeks ahead of me in terms of getting vaccinated so hopefully a combo of that and me having a relatively mild case means she stays healthy. I’ve got at least another 13 days of being stuck by myself in an apartment to go before I can rejoin the world.
TLDR; please get vaccinated, this sucks.
Annoyingly my first test was negative even though I was symptomatic so I was wandering around being infectious for seven days. I’m now in isolation and my wife and kids are quarantined. Thankfully my wife tested negative yesterday, she was a couple of weeks ahead of me in terms of getting vaccinated so hopefully a combo of that and me having a relatively mild case means she stays healthy. I’ve got at least another 13 days of being stuck by myself in an apartment to go before I can rejoin the world.
TLDR; please get vaccinated, this sucks.
Uh, you did get vaccinated and still have these symptoms. You could also fairly end your TLDR with 'did get vaccinated, this sucks'. It seems we are still learning about the efficacy of the vaccines, and the nature of the virus. From this pov I understand why some are hesitant to be vaccinated in this phase of the pandemic
We have mountains of data about the current vaccine. This amount of disease-tracking is unheard of. Almost any institution in the world has regular discussions about this singular disease. Governments spend huge resources to pinpoint the exact minimum measures that can control the spread enough.
My country attempted a 3rd dose, and within 2 weeks they were already reporting data on reduced risk of catching the virus in comparison to 2, 1, and 0 doses. These are studies done with sample sizes of millions of people.
My country attempted a 3rd dose, and within 2 weeks they were already reporting data on reduced risk of catching the virus in comparison to 2, 1, and 0 doses. These are studies done with sample sizes of millions of people.
Sampling 3rd dose after two weeks would be statistically insignificant and not enough time to record stats from sickness.
I dont understand, why would that be "statiatically insignificant"? for what analysis?
I replied to the last paragraph of parent poster. If you study the few people getting dose 3 two weeks after, you're not going to learn anything about effectiveness of dose 3.
If I understand what you're saying, that's not what was done, at least here in Israel.
After the 3rd vaccine, afaik, they compared the rates of hospitalizations of people do did vs. didn't yet get the 3rd vaccine, as compared to what happened the week before. They saw a drop in 3rd-vaccinated, and only in 3rd-vaccinated, implying that it did have an effect. And this wasn't a small population (I don't know exact numbers but I assume several 10s/100s of thousands).
After the 3rd vaccine, afaik, they compared the rates of hospitalizations of people do did vs. didn't yet get the 3rd vaccine, as compared to what happened the week before. They saw a drop in 3rd-vaccinated, and only in 3rd-vaccinated, implying that it did have an effect. And this wasn't a small population (I don't know exact numbers but I assume several 10s/100s of thousands).
This is the initial report that was published after two weeks: https://www.reuters.com/business/healthcare-pharmaceuticals/...
Links to studies?
Here's a study with a sample comparing 596,618 vaccinated matched with the same number of unvaccinated people by my own healthcare provider:
https://www.nejm.org/doi/full/10.1056/nejmoa2101765
This healthcare provider is able to follow up on people with detail for a really long time - they are notified of any vaccination, PCR test result, hospitalization and death within the country. They've likely made it possible to calculate the same data for the current day within a moment's notice, and use this information for quick decision-making.
I would expect other healthcare providers in other countries to have pooled this information if they are able to do so (and possibly publish it too).
https://www.nejm.org/doi/full/10.1056/nejmoa2101765
This healthcare provider is able to follow up on people with detail for a really long time - they are notified of any vaccination, PCR test result, hospitalization and death within the country. They've likely made it possible to calculate the same data for the current day within a moment's notice, and use this information for quick decision-making.
I would expect other healthcare providers in other countries to have pooled this information if they are able to do so (and possibly publish it too).
Its unfortunate that they exclude prior infection from study. Why not study them as a separate cohort? 36% of Americans have been infected. What percent of the unvaccinated public have a prior infection? It seems like a 100% prior infected control group would be appropriate. Where is that data?
From Bloomberg today, https://archive.is/fy4Wf
> In lieu of answers, what has emerged is a host of case studies providing somewhat different pictures of breakthrough infections. Variables including when the surveys were conducted, whether the delta variant was present, how much of the population was vaccinated and even what the weather was like at the time make it hard to compare results and suss out patterns. It’s difficult to know which data might ultimately carry more heft.
> For the time being, there are simply more questions than answers. Are breakthrough infections ticking up because of the delta variant, waning immunity or a return to normal life? Are vaccinated people more vulnerable to severe illness than previously thought? Just how common are breakthrough infections? It’s anyone’s guess. “It is generally the case that we have to make public health decisions based on imperfect data,” Frieden said. “But there is just a lot we don’t know.”
> In lieu of answers, what has emerged is a host of case studies providing somewhat different pictures of breakthrough infections. Variables including when the surveys were conducted, whether the delta variant was present, how much of the population was vaccinated and even what the weather was like at the time make it hard to compare results and suss out patterns. It’s difficult to know which data might ultimately carry more heft.
> For the time being, there are simply more questions than answers. Are breakthrough infections ticking up because of the delta variant, waning immunity or a return to normal life? Are vaccinated people more vulnerable to severe illness than previously thought? Just how common are breakthrough infections? It’s anyone’s guess. “It is generally the case that we have to make public health decisions based on imperfect data,” Frieden said. “But there is just a lot we don’t know.”
> “It is generally the case that we have to make public health decisions based on imperfect data,”
Why can't the public draw their own conclusions and make their own health decisions, based on (imperfect) public data? Why does the data have to be kept secret? (Perhaps the data doesn't support the "public health decisions" and dictates of the state?)
If there's a concern that we can't effectively interpret the data, why can't we listen to whatever quack that we prefer and trust on national television that tells us that we really should not wear masks and couldn't wear them effectively, and they'd make us super sick because we'd be stupid about it and are completely untrainable (oh, and they're needed for health workers) -- no, wait, we should all wear masks, even if they're just thin pieces of cotton -- no, wait, even kids should wear at least two masks, even if they're running track and passing out.
Why can't the public draw their own conclusions and make their own health decisions, based on (imperfect) public data? Why does the data have to be kept secret? (Perhaps the data doesn't support the "public health decisions" and dictates of the state?)
If there's a concern that we can't effectively interpret the data, why can't we listen to whatever quack that we prefer and trust on national television that tells us that we really should not wear masks and couldn't wear them effectively, and they'd make us super sick because we'd be stupid about it and are completely untrainable (oh, and they're needed for health workers) -- no, wait, we should all wear masks, even if they're just thin pieces of cotton -- no, wait, even kids should wear at least two masks, even if they're running track and passing out.
What is the greater evil here? The slight odds of infection when they are likely outdoors, or that they are running track, passing out, getting dehydrated, breathing high levels of CO2, and the unknown long-term health effects of that?
It doesn't take much common sense to realize that exposure to virus is bad, masking while running is potentially much worse for everyone and not just the odd infection, and that it should be a choice if there are two evils.
It doesn't take much common sense to realize that exposure to virus is bad, masking while running is potentially much worse for everyone and not just the odd infection, and that it should be a choice if there are two evils.
> The slight odds of infection when they are likely outdoors, or that they are running track, passing out, getting dehydrated, breathing high levels of CO2, and the unknown long-term health effects of that?
Unless you are wearing something like an SCBA mask without an appropriate air supply—which is very much not the masking recommended against COVID—that’s not going to happen, even while exercising strenuously.
> It doesn't take much common sense to realize that exposure to virus is bad, masking while running is potentially much worse for everyone
You are correct, having that “realization” definitely requires very little common sense.
Unless you are wearing something like an SCBA mask without an appropriate air supply—which is very much not the masking recommended against COVID—that’s not going to happen, even while exercising strenuously.
> It doesn't take much common sense to realize that exposure to virus is bad, masking while running is potentially much worse for everyone
You are correct, having that “realization” definitely requires very little common sense.
I realize that in a few cities people are pushing for universal outdoor masking, but I don't think that measure is all that widely supported by public health officials.
Masking doesn't change your CO2 status. Or dehydrate you.
Outdoor masking, outside the context of something like a crowded concert, is probably silly. But we can be pretty confident it won't affect your respiratory health.
Outdoor masking, outside the context of something like a crowded concert, is probably silly. But we can be pretty confident it won't affect your respiratory health.
Because if you saw just how “imperfect” the data was… you’d borderline call it willful negligence and demand a recall/revolution.
The person running an excel sheet at a state public health office has never had to “clean” data to find duplicates with St and Street… heck even the IRS website needed your exact address in ST or Street form (case sensitive) to inform you of a economic relief payment.
So in a way, I’m very happy our brightest minds are working on clicking ads rather than building an oppressive regime.
The person running an excel sheet at a state public health office has never had to “clean” data to find duplicates with St and Street… heck even the IRS website needed your exact address in ST or Street form (case sensitive) to inform you of a economic relief payment.
So in a way, I’m very happy our brightest minds are working on clicking ads rather than building an oppressive regime.
"But there is just a lot we don’t know."
Well... as a citizen, I should have the right to stay back and watch what happens, and take it when I feel safe, instead of being forced to join the experiment.
Well... as a citizen, I should have the right to stay back and watch what happens, and take it when I feel safe, instead of being forced to join the experiment.
You definitely have that right, but at this point the choice isn't vaccine vs no vaccine, it is vaccine vs getting covid. It is much more contagious than it was last year.
Your logic gate is faulty; it sounds like you are concluding that you will definitely get covid if you are not vaccinated, but that still depends on a number of things; people can get deliveries and work out of their home and never get it. It is also demonstrably incorrect that the vaccine is an amulet of proof against covid.
Ditto. When lockdown cease the contagion will spread much more widely. Everyone will be exposed to some of it. What matters are fewer critical conditions and less spread from vaccinated.
Just as long as you stay away from the rest of us, I agree. In fact, I'd pitch in to a fund aimed at shipping you all to desert island together and letting you return when you decide to like the science.
I'm naturally immune asshole. Science tells me I should avoid a treatment which is more likely to cause no benefit to anyone.
Yes my point is that it’d be worse without being vaccinated and that my wife who is also vaccinated and spent seven days in close proximity with me whilst symptomatic has not been infected.
You missed the point. The virus is usually much worse without the vaccine.
Please provide data for that claim.
Look at the death rates now compared to last year’s wave in countries that have a higher vaccination rate. Not saying its a miracle or perfect, but the numbers are speaking. I’m not for booster shots or being vaccinated x times, heck, I had a problem with requiring 2 shots for something that is not 95%+ effective. But after doing the maths of probability of infection, probability of sick or long term covid vs vaccination issues… I didn’t like the conclusion but I’m not in denial and trying to find information to confirm my initial bias, I took the second shot. All this said, I won’t accept anything else before a full year or higher % now.
From our chief epidemiologist over here in Iceland:
“ Þórólfur wrote in his response to RÚV yesterday that the figures change quickly and that now the non-vaccinated infection rate is twice as high rather than three-times, the hospital admission rate is five-times higher, and the rate of admission to intensive care is also five-times higher than for vaccinated people.” https://www.ruv.is/frett/2021/08/19/unvaccinated-five-times-...
“ Þórólfur wrote in his response to RÚV yesterday that the figures change quickly and that now the non-vaccinated infection rate is twice as high rather than three-times, the hospital admission rate is five-times higher, and the rate of admission to intensive care is also five-times higher than for vaccinated people.” https://www.ruv.is/frett/2021/08/19/unvaccinated-five-times-...
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> From this pov I understand why some are hesitant to be vaccinated in this phase of the pandemic
So your take away from someone complaining about the long recovery time from an accident after putting on his seatbelt and having the airbag deploy (which is annoying at the moment) is that we should remove those features because other people in other accidents without them had less severe injuries?
So your take away from someone complaining about the long recovery time from an accident after putting on his seatbelt and having the airbag deploy (which is annoying at the moment) is that we should remove those features because other people in other accidents without them had less severe injuries?
Given the timelines mentioned, vaccinated in mid July, got sick mid August, it looks like the peak effectiveness of the Pfizer vaccine after the second shot take 15-21 days to kick in. The virus can take up to 12 days before becoming sick/symptomatic. Rough math: (Aug 21) - (9 days sick) - (12 day incubation) = (~July 31 infection date). This would appear to fall in the time period of not yet being fully inoculated, if they were unlucky with the timelines.
They got unlucky, which sucks. I wish the best for the GP, but the important thing is that this anecdote doesn’t necessarily represent a breakthrough case. But even if it did, the Pfizer vaccine is 96% effective at protecting people, so 4% are still going to get sick. All of this is inline with all the data I’ve seen at least. For this particular case we don’t even need to discuss the recent data showing Pfizer (and possibly Moderna) dropping to 80ish% effectiveness after four-five months.
Literally all the data says people are safer getting vaccinated.
They got unlucky, which sucks. I wish the best for the GP, but the important thing is that this anecdote doesn’t necessarily represent a breakthrough case. But even if it did, the Pfizer vaccine is 96% effective at protecting people, so 4% are still going to get sick. All of this is inline with all the data I’ve seen at least. For this particular case we don’t even need to discuss the recent data showing Pfizer (and possibly Moderna) dropping to 80ish% effectiveness after four-five months.
Literally all the data says people are safer getting vaccinated.
What about the point of view would make since hesitant to get vaccinated?
Without the vaccine likelihood of hospitalization is even higher.
Without the vaccine likelihood of hospitalization is even higher.
Virus kicks his ass even though he's vaccinated, and you're drawing the conclusion that the vaccines can't be trusted, rather than unvaccinated exposure to the virus will be 10 times worse... You may not be good at logic.
I am so sorry for your terrible sickness!
It's probably impossible to say whether "the vaccine has kept this relatively mild", especially since you got it despite being vaccinated twice. At least earlier strains showed no or very mild symptoms in 80% of the infected, and yours doesn't sound very mild.
Maybe you'd be dead if not for the vaccine? or perhaps the vaccine allowed your body to contain it to just your nose, where it replicated like crazy until it overwhelmed your defenses. It seems like there just isn't enough data, but it seems like getting vaccinated is not a silver bullet.
It's probably impossible to say whether "the vaccine has kept this relatively mild", especially since you got it despite being vaccinated twice. At least earlier strains showed no or very mild symptoms in 80% of the infected, and yours doesn't sound very mild.
Maybe you'd be dead if not for the vaccine? or perhaps the vaccine allowed your body to contain it to just your nose, where it replicated like crazy until it overwhelmed your defenses. It seems like there just isn't enough data, but it seems like getting vaccinated is not a silver bullet.
> yours doesn't sound very mild.
Yes his symptoms sound mild.
There's a good chance that whatever you think of as severe cold/flu is all clinically mild (unless you've actually had complications and wound up in the hospital).
Actual unvaccinated severe COVID-19 is an order of magnitude worse than what you can imagine as severe.
Yes his symptoms sound mild.
There's a good chance that whatever you think of as severe cold/flu is all clinically mild (unless you've actually had complications and wound up in the hospital).
Actual unvaccinated severe COVID-19 is an order of magnitude worse than what you can imagine as severe.
> Actual unvaccinated severe COVID-19 is an order of magnitude worse than what you can imagine as severe.
“Order of magnitude worse” of disease severity isn’t defined super clearly, but if I heard that description compared to the worst cold/flu I’ve had that didn’t hospitalize me, my feeling would be that the result would be fatal.
“Order of magnitude worse” of disease severity isn’t defined super clearly, but if I heard that description compared to the worst cold/flu I’ve had that didn’t hospitalize me, my feeling would be that the result would be fatal.
Very important point. Struggling to take painful breath for days on end is the gist of "severe covid". I'd rather break my arms than experience severe covid.
Well we can’t test the null hypothesis for me specifically but the data here in Iceland shows that the illness for the population at large is much less likely amongst the vaccinated and much less severe. So it’s not impossible to say at all.
And yes my symptoms are mild and suck a lot. The average length of illness in mild cases is 14 days. COVID is worse than most people (including me before getting it) think.
And yes my symptoms are mild and suck a lot. The average length of illness in mild cases is 14 days. COVID is worse than most people (including me before getting it) think.
"mild" in terms of delta covid mMans you don't need to go to the hospital. Mild covid still can be pretty terrible, but it at least isn't life-threatening!
He didn't get vaccinated twice. He received the Pfizer vaccine. This vaccine, like Moderna, requires 2 doses spaced out in time.
> Annoyingly my first test was negative even though I was symptomatic so I was wandering around being infectious for seven days.
This is my hypothesis for why we are seeing such spread after a mass vaccine event. The moral hazard of a vaccine and negative test are more dangerous than Covid itself. 7 days of additional spread are exponentially more detrimental to the goal of stopping spread… which stops hospitalizations, which stops deaths and long covids.
Even if the “break throughs” are 1% of cases, if those 1% are 700% more transmissed through false hubris… it’s just like the early days of Covid.
This is my hypothesis for why we are seeing such spread after a mass vaccine event. The moral hazard of a vaccine and negative test are more dangerous than Covid itself. 7 days of additional spread are exponentially more detrimental to the goal of stopping spread… which stops hospitalizations, which stops deaths and long covids.
Even if the “break throughs” are 1% of cases, if those 1% are 700% more transmissed through false hubris… it’s just like the early days of Covid.
I don’t know the reason the false negative nor how the rate differs between vaccinated and non-vaccinated nor do I know of any studies looking into it so this seems like a worry you’re concocting out of thin air. Particularly as we know the delta variant is more infectious so is a much more likely reason for any increased spread.
While I agree it’s an intuitive based hypothesis — a close cousin to concocting out of thin air - I don’t think it’s improper to attempt to find the proper weight to assign to additional days in public for its effect on a variants transmission vs it’s inherent mutations. Does that make sense?
I had a similar experience, with 10-12 days of mild symptoms (up to 40°C fever), but the general feeling of tiredness and the infamous "brain fog" stayed for 3-4 weeks (it's not completely gone yet).
Definitely one of the worst sickness I've had, but both me and especially my parents (60+) had no respiratory problems and didn't need urgent treatment.
I was waiting for my second dose when I got it and my parents were vaccinated, but still I don't get how we can count on treating it as a flu and just get the virus, considering the lack of knowledge on long-term effects.
Definitely one of the worst sickness I've had, but both me and especially my parents (60+) had no respiratory problems and didn't need urgent treatment.
I was waiting for my second dose when I got it and my parents were vaccinated, but still I don't get how we can count on treating it as a flu and just get the virus, considering the lack of knowledge on long-term effects.
Two of my relatives in their 80's just got it without any vaccine and similarly had a nasty flu; they took ivermectin and didn't need any urgent treatment, although O2 levels did drop into the low 90's at times. About five days after diagnosis (and well after the worst days), they received monoclonals. They're still weak but recovering. I know another person (young, in 20's) who had similar symptoms -- brutal flu, similarly believed that ivermectin "saved" him. Of course, it's unknown (but https://www.wsj.com/articles/fda-ivermectin-covid-19-coronav... )
Most cases seem to be relatively mild. There are always the ones that aren't, though, but it does seem like (in the absence of real, double-blind, public data) the vaccine doesn't have too much of an impact on delta in terms of the harshness of the sickness in breakthrough cases, but it might reduce the overall incidence and prevent the vaccinated from getting sick at all. However, the data always seems very weak, and always lags behind.
EDIT: definitely doesn't seem like getting vaccinated reduces the incidence, either: "three-fourths of the nearly 470 cases were in vaccinated people" from a leaked CDC memo: https://www.medpagetoday.com/infectiousdisease/covid19vaccin...
Most cases seem to be relatively mild. There are always the ones that aren't, though, but it does seem like (in the absence of real, double-blind, public data) the vaccine doesn't have too much of an impact on delta in terms of the harshness of the sickness in breakthrough cases, but it might reduce the overall incidence and prevent the vaccinated from getting sick at all. However, the data always seems very weak, and always lags behind.
EDIT: definitely doesn't seem like getting vaccinated reduces the incidence, either: "three-fourths of the nearly 470 cases were in vaccinated people" from a leaked CDC memo: https://www.medpagetoday.com/infectiousdisease/covid19vaccin...
Yeah am pretty concerned about there being long term effects. Two of our friends got it really early on and both still have lingering symptoms.
What about a third dose of a different vaccine? all the available ones targets the same and only protein?
We're already doing this with recent booster shots. So i think it's perfectly reasonable to also giga-vax.
>So i think it's perfectly reasonable to also giga-vax.
As always, 4chan has already done the work. (<https://i.redd.it/08qwj2r4kyw61.jpg>)
As always, 4chan has already done the work. (<https://i.redd.it/08qwj2r4kyw61.jpg>)
There's another answer here though which is to skip getting naturally infected with the worst variant of this strain of SARS-CoV-2 and instead catching whatever is going around the world in a year or two after it has been forced to make costly mutations to achieve immune escape.
SARS-CoV-2 will very likely become endemic and everyone in the world will eventually get naturally exposed to it, but delta is probably the optimally worst and most virulent form of the virus to get naturally exposed to.
And yeah kids should get vaccinated, the vaccines are safer than the virus for everyone, that shouldn't even be a question.
SARS-CoV-2 will very likely become endemic and everyone in the world will eventually get naturally exposed to it, but delta is probably the optimally worst and most virulent form of the virus to get naturally exposed to.
And yeah kids should get vaccinated, the vaccines are safer than the virus for everyone, that shouldn't even be a question.
> SARS-CoV-2 will very likely become endemic and everyone in the world will eventually get naturally exposed to it, but delta is probably the optimally worst and most virulent form of the virus to get naturally exposed to.
Is it? I thought early signs were that Lambda is worse.
Is it? I thought early signs were that Lambda is worse.
Lambda is still a VOI not a VOC even after months of monitoring. There might still be other variants after delta but at some point it cannot become infinitely transmissible and virulent. It also won't be able to become more transmissible and virulent while also achieving complete immune escape (complete escape likely isn't even possible from T-cells). Similar to the 1918 pandemic the worst case virus is likely to be at the tail end of the first round of the pandemic, the endemic virus will be less virulent.
If the question is whether vaccine should go to someone who hasn’t been vaccinated or used as a booster for someone who has, it seems clear that it should go to the unvaccinated person unless the booster candidate is very high risk. But we don’t have a shortage of vaccines in the developed world, only a shortage of smart people willing to take them.
Bottom line, a booster shot reduces the chance of a variant emerging. You don’t want immunity to parts of the virus that aren’t the spike protein; that’s a waste of resources. The spike is what’s needed to reproduce.
Bottom line, a booster shot reduces the chance of a variant emerging. You don’t want immunity to parts of the virus that aren’t the spike protein; that’s a waste of resources. The spike is what’s needed to reproduce.
There is a gross amount of commenting as fact without accompanying data in the comments on this one.
Yeah, that's often what a discussion is.
It always was. Johns Hopkins did a study, and catching covid was 6x better protection than any of the vaccines. Furthermore, your body learns how to protect itself differently from catching it.
Unfortunately if you google search, it's buried about 20 pages down. There's no profit in that.
Unfortunately if you google search, it's buried about 20 pages down. There's no profit in that.
Covid affects your intellect, vaccine doesn't. Simple choice.
What an utterly redundant point.
If you catch and do not die from the virus then yay for you I suppose, but you'll still spread it around while you have it, you still might die from the virus, and there is literally no downside to having a better immune response when you inevitably do catch COVID-19 as we're all going to eventually.
Like everything else, the goal of every single public health measure at the moment is to avoid having a huge portion of the population all need hospital services at the same time though.
This article is asking a stupid question, and the answer is predictably stupid.
EDIT: Pile on anti-vaxxer downvotes, the speed with which you're dumping these in makes it apparent you're not reading the article.
If you catch and do not die from the virus then yay for you I suppose, but you'll still spread it around while you have it, you still might die from the virus, and there is literally no downside to having a better immune response when you inevitably do catch COVID-19 as we're all going to eventually.
Like everything else, the goal of every single public health measure at the moment is to avoid having a huge portion of the population all need hospital services at the same time though.
This article is asking a stupid question, and the answer is predictably stupid.
EDIT: Pile on anti-vaxxer downvotes, the speed with which you're dumping these in makes it apparent you're not reading the article.
The question asked by the article is sensible. The uncertainty explored is whether, having had an initial vaccination, future natural infection would produce a better defence against variants than booster shots that target the spike protein alone.
Which is irrelevant: the booster vaccines are to provide sustained protection against the variants we have now and reduce the risk of serious complications.
There is no situation in which it is a good idea to be infected with a virus rather then vaccinated against it, and comments on provided immunity from infection are irrelevant: you either become immune to what infected you or it kills you.
There is no situation in which it is a good idea to be infected with a virus rather then vaccinated against it, and comments on provided immunity from infection are irrelevant: you either become immune to what infected you or it kills you.
Current Covid vaccines are non-sterilizing. They reduce symptoms, but cannot guarantee that you will not be infected. This is covered in the article in the discussion of antibodies in the upper respiratory system (obtained from natural infection) vs antibodies in the blood (obtained from vaccination or natural infection). Future nasal vaccines, delivered by inhaler, could potentially provide sterilizing immunity, preventing infection: https://news.ycombinator.com/edit?id=28256342
The vaccines reduce infection chances greatly, and even if you get it they reduce the time you have it and thus how much time you can spread.
Non sterilizating is technically true, but misleading. We are still better off with vaccines and can probable eliminate covid with high enough vaccine rates.
Non sterilizating is technically true, but misleading. We are still better off with vaccines and can probable eliminate covid with high enough vaccine rates.
Hopefully upcoming nasal vaccines will be even better, as noted by the UK's SAGE, https://www.gov.uk/government/publications/long-term-evoluti...
> Whilst we feel that current vaccines are excellent for reducing the risk of hospital admission and disease, we propose that research be focused on vaccines that also induce high and durable levels of mucosal immunity in order to reduce infection of and transmission from vaccinated individuals. This could also reduce the possibility of variant selection in vaccinated individuals.
> Whilst we feel that current vaccines are excellent for reducing the risk of hospital admission and disease, we propose that research be focused on vaccines that also induce high and durable levels of mucosal immunity in order to reduce infection of and transmission from vaccinated individuals. This could also reduce the possibility of variant selection in vaccinated individuals.
Funny how those anti-vaxers in hospitals don’t advocate that it was all worth it for their immunity they just built.
You either get the immunity through a shot or through an infection. One has very much worse chances of bringing you to the hospital.
You either get the immunity through a shot or through an infection. One has very much worse chances of bringing you to the hospital.
Why? Natural boosting is totally legitimate, look at the rotavirus strategy in the US for example. You get the vaccine three times soon after you are born, and then never again after that, because your immune system matures and you get infected (without severe symptoms) many times.
For sake of discussion assume all infections are accidental, and everyone follows anti-infection protocols to the letter.
Here are a few (but not all) states someone can be in.
But even if boosters are a good idea in all cases, it is worth studying whether people in state B or C have better efficiency against covid variants. Gaining knowledge is good. It may (or may not) be a fact that state B has superior efficiency to state C.
Here are a few (but not all) states someone can be in.
A. vaccinated
B. vaccinated -> natural infection -> recovered
C. vaccinated -> booster
D. vaccinated -> booster -> natural infection -> recovered
But even if boosters are a good idea in all cases, it is worth studying whether people in state B or C have better efficiency against covid variants. Gaining knowledge is good. It may (or may not) be a fact that state B has superior efficiency to state C.
I'm not an anti-vaxxer, I got vaccinated. I don't think the article is stupid. Even if you disagree with the idea (and I don't, necessarily), it's a valid question to raise, and the discussion is a productive one to have.
> EDIT: Pile on anti-vaxxer downvotes,
You don't need to be an anti-vaxxer to disagree with what you wrote.
You don't need to be an anti-vaxxer to disagree with what you wrote.
Sure. But. There is more to life then just maximizing safety in perpetuity. We must live and move on with the business of life.
> no downside to having a better immune response
Side effects increase when we vaccinate younger population - that includes long term ones - Whereas younger population are very unlikely to have serious symptoms from the virus.
Side effects increase when we vaccinate younger population - that includes long term ones - Whereas younger population are very unlikely to have serious symptoms from the virus.
Thread on intramuscular (arm injection) vs intranasal (inhaled) vaccines: https://news.ycombinator.com/item?id=28165287