Neutralizing antibodies against SARS-CoV-2 variants after infection, vaccination(jamanetwork.com)
jamanetwork.com
Neutralizing antibodies against SARS-CoV-2 variants after infection, vaccination
https://jamanetwork.com/journals/jama/fullarticle/2777898
269 comments
Ok, we've reverted the title now. Submitted title was "Vaccines Are Effective Against Covid Variants". Submitters: please follow the site guidelines, which ask "Please use the original title, unless it is misleading or linkbait; don't editorialize."
https://news.ycombinator.com/newsguidelines.html
https://news.ycombinator.com/newsguidelines.html
I've posted this before regarding the SA paper on AZ, worth taking a look at the below.
The probable outcome is minor to moderate symptoms that would normally be blocked by antibodies can still present (So no reduced transmission) but severe symptoms are still prevented by the vaccinated patients T-cells response.
This paper is looking at a small scale human study in SA with mostly younger participants, which does make the results difficult to apply to the wider population. They also only use a 4 week dosing schedule where the suggestion and actual rollout in the UK is following the 10-12 week schedule between first and second doses which was shown to increase efficacy from ~70 to ~80% after the second dose (UK - Kent variant)
The variant in question seems to escape the majority of Antibody detection, but T-Cells still seem to provide significant protection against severe disease and death.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1
The main published results aren't yet from human scale studies but here is one in hamsters showing a comparison in organ damage and results between unvaccinated and vaccinated with the Oxford/AZ vaccine.
The probable outcome is minor to moderate symptoms that would normally be blocked by antibodies can still present (So no reduced transmission) but severe symptoms are still prevented by the vaccinated patients T-cells response.
This paper is looking at a small scale human study in SA with mostly younger participants, which does make the results difficult to apply to the wider population. They also only use a 4 week dosing schedule where the suggestion and actual rollout in the UK is following the 10-12 week schedule between first and second doses which was shown to increase efficacy from ~70 to ~80% after the second dose (UK - Kent variant)
The variant in question seems to escape the majority of Antibody detection, but T-Cells still seem to provide significant protection against severe disease and death.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1
The main published results aren't yet from human scale studies but here is one in hamsters showing a comparison in organ damage and results between unvaccinated and vaccinated with the Oxford/AZ vaccine.
We've been vaccinating people since December. There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this?
For example, everyone being tested for covid or being admitted to the hospital for covid, should be asked if they've been vaccinated, when, and which vaccination.
70 million people in the US have received vaccinations. There ought to be plenty of data by now.
For example, everyone being tested for covid or being admitted to the hospital for covid, should be asked if they've been vaccinated, when, and which vaccination.
70 million people in the US have received vaccinations. There ought to be plenty of data by now.
We do have real world results, and they’re mostly very good. For example, analysis of the real world effectiveness of the Pfizer vaccine in Israel:
> The latest analysis from the MoH proves that two weeks after the second vaccine dose protection is even stronger – vaccine effectiveness was at least 97% in preventing symptomatic disease, severe/critical disease and death.
https://www.pfizer.com/news/press-release/press-release-deta...
The AstraZeneca vaccine looks not so good, especially against the South African variant, but the early real world results for the Pfizer and Moderna vaccines look outstanding, and the Johnson & Johnson vaccine looks solid.
> The latest analysis from the MoH proves that two weeks after the second vaccine dose protection is even stronger – vaccine effectiveness was at least 97% in preventing symptomatic disease, severe/critical disease and death.
https://www.pfizer.com/news/press-release/press-release-deta...
The AstraZeneca vaccine looks not so good, especially against the South African variant, but the early real world results for the Pfizer and Moderna vaccines look outstanding, and the Johnson & Johnson vaccine looks solid.
> The AstraZeneca vaccine looks not so good
This study, from Scotland, looks at risk of hospitalization after first dose of either Pfizer or AstraZeneca vaccine. The Pfizer and AstraZeneca vaccines look equally good. If anything, in the raw numbers AstraZeneca looks a little better that Pfizer, but the difference is well inside error bars.
https://www.bmj.com/content/372/bmj.n523
> especially against the South African variant
There is this one study, a proper randomized controlled trial from South Africa with 2000 people. But it only studies the AstraZeneca vaccine. They only saw mild (15 vaccine recipients and 17 placebo recipients) or moderate (4 vaccine recipients and 6 placebo recipients) infections, so they can not say anything about severe disease, because no one got it.
And they only studied AstraZeneca. Unfortunately, this study has been giving AstraZeneca maybe an undeservedly bad reputation, as media goes around saying that AstraZeneca specifically is not effective against the B.1.351 variant, suggesting that other vaccines would be. But as far as I know, similar studies of other vaccines do not exist, so we just don't know yet if they would be, maybe, equally bad against the B.1.351 variant or not.
https://www.nejm.org/doi/10.1056/NEJMoa2102214
This study, from Scotland, looks at risk of hospitalization after first dose of either Pfizer or AstraZeneca vaccine. The Pfizer and AstraZeneca vaccines look equally good. If anything, in the raw numbers AstraZeneca looks a little better that Pfizer, but the difference is well inside error bars.
https://www.bmj.com/content/372/bmj.n523
> especially against the South African variant
There is this one study, a proper randomized controlled trial from South Africa with 2000 people. But it only studies the AstraZeneca vaccine. They only saw mild (15 vaccine recipients and 17 placebo recipients) or moderate (4 vaccine recipients and 6 placebo recipients) infections, so they can not say anything about severe disease, because no one got it.
And they only studied AstraZeneca. Unfortunately, this study has been giving AstraZeneca maybe an undeservedly bad reputation, as media goes around saying that AstraZeneca specifically is not effective against the B.1.351 variant, suggesting that other vaccines would be. But as far as I know, similar studies of other vaccines do not exist, so we just don't know yet if they would be, maybe, equally bad against the B.1.351 variant or not.
https://www.nejm.org/doi/10.1056/NEJMoa2102214
> analysis of the real world effectiveness of the Pfizer vaccine in Israel:
In Israel vaccinated population is not tested for COVID-19 unless admitted to hospital in serious condition.
In the past two month 22% of those who died because of COVID-19 have received both doses of the Pfizer vaccine.
MoH refuses to clarify further on testing policies and outcomes.
In Israel vaccinated population is not tested for COVID-19 unless admitted to hospital in serious condition.
In the past two month 22% of those who died because of COVID-19 have received both doses of the Pfizer vaccine.
MoH refuses to clarify further on testing policies and outcomes.
Note however that Israel has closed its borders tightly, so Israel can't tell us much about the vaccines' effects on variants that haven't entered that country yet.
I've only seen reporting suggesting that every variant listed as a "variant of concern" from the CDC is present in Israel. So their data should be good.
> I've only seen reporting suggesting that every variant listed as a "variant of concern" from the CDC is present in Israel.
But not present in large numbers now, so we have to wait months before we'll know if they'll be able to spread in the vaccinated population or not.
But not present in large numbers now, so we have to wait months before we'll know if they'll be able to spread in the vaccinated population or not.
Do we have any educated guesses on why we see a difference between the J&J shot and the AZ one? Is it just luck of the draw regarding different adenovirus vectors, or something deeper?
For one, AZ doesn’t use the pre-fusion stabilized spike protein in their vector, while the mRNA and J&J vaccines do.
Disclaimer no experience with vaccine development but...
Two problems with some types of engineered vaccines. The first is people can have existing immunity to some component of the vaccine. And the immune system wipes out the vaccine before it has a chance to generate strong immunity. Second people develop immunity to proteins in the vaccine that aren't present in pathogen you're trying to vaccinate against.
As an example I think one of the vaccines based on modified viruses uses a different virus in the first and second shot.
Two problems with some types of engineered vaccines. The first is people can have existing immunity to some component of the vaccine. And the immune system wipes out the vaccine before it has a chance to generate strong immunity. Second people develop immunity to proteins in the vaccine that aren't present in pathogen you're trying to vaccinate against.
As an example I think one of the vaccines based on modified viruses uses a different virus in the first and second shot.
On the latter, you mean the sputnik vaccine.
Public health England has been tracking that sort of information in their SIREN study.
https://assets.publishing.service.gov.uk/government/uploads/...
https://assets.publishing.service.gov.uk/government/uploads/...
This should be the top comment. I really wish this was addressed somewhere.
But with all the charts we see of case, hospitalization, and death counts, why isn’t someone charting data for case, hospitalization, and death counts following vaccinations?
You might see some study with possibly some data buried in it, but this should be part of the rest of the data being broadly shared so that it’s clear the effects it’s having.
But with all the charts we see of case, hospitalization, and death counts, why isn’t someone charting data for case, hospitalization, and death counts following vaccinations?
You might see some study with possibly some data buried in it, but this should be part of the rest of the data being broadly shared so that it’s clear the effects it’s having.
There are many studies on the Israeli population post-vaccination, since so many Israelis have finished the two-dose course of the Pfizer vaccine.
There are even some studies on the British variant there, since that is now responsible for >50% of infections. TL;DR: the Pfizer vaccine is extremely effective against the British variant as well.
This kind of reporting on vaccines is the kind of thing that bugged me even before Covid. It's as if the media likes to keep the 'good' facts out for controversy to continue (obviously I don't think that's what's happening, I'm just blaming incompetence).
It always only takes one number to silence the debate, and it's always missing. E.g. "new mumps epidemic, kills 200, wave of low trust against vaccines to blame". Maybe. Maybe not? You could clear this up instantly by also reporting how many of those dead were unvaccinated, and then it's crystal clear. But that kind of info is never in the story.
It always only takes one number to silence the debate, and it's always missing. E.g. "new mumps epidemic, kills 200, wave of low trust against vaccines to blame". Maybe. Maybe not? You could clear this up instantly by also reporting how many of those dead were unvaccinated, and then it's crystal clear. But that kind of info is never in the story.
There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this?
How much energy do you want to put into tracking so that you can draw better conclusions?
We have good evidence that people don't become symptomatic, because that is easy to track. But we haven't generally been constantly testing to see how many caught it and fought it off. Or how many could have spread it to unvaccinated people while they were asymptomatic. Which are both very useful for epidemiologists to know for modeling purposes.
How much energy do you want to put into tracking so that you can draw better conclusions?
We have good evidence that people don't become symptomatic, because that is easy to track. But we haven't generally been constantly testing to see how many caught it and fought it off. Or how many could have spread it to unvaccinated people while they were asymptomatic. Which are both very useful for epidemiologists to know for modeling purposes.
The data from Israel is pretty good: https://ourworldindata.org/vaccination-israel-impact
How do you collect the data? How do you validate it? How do you make sure your treated and control arm are balanced?
figaroniguzo(2)
Agree we should now have data to look at but don't? They can have their kayfabe but when it comes to me injecting stuff to believe it I have questions.
There are thousands of actually qualified professionals looking at that data, including the licensing bodies of every developed nation. The EU has recently gone back-and-forth on the AZ vaccine. which would seem to only make sense under the assumption that they are actually cognisant of possible risks and trying to avoid them (and alternative some might want to argue is their hatred of the British, but that cannot explain the ultimate resolution, since EU still very much hates at least the Johnson government)
If you trust them, get the vaccine. If you don't trust them, why would you trust any data they might release?
If you trust them, get the vaccine. If you don't trust them, why would you trust any data they might release?
For people arguing that not being part of a risk group is a reason not to protect yourself, please take a lesson from brazil. Being part of a 'high risk group' does not saves you from infecting other people who are part of such groups.
That's basically what happened in brazil: people who were not part of risk groups crowded, encouraged by the president himself[0][1][2]. The number of infected poeple soared and variants that affect younger people appeared[3][4]. The health system has now collapsed because there is not enough ICU for such a high number of ill people[5][6].
[0] https://www.em.com.br/app/noticia/politica/2021/02/26/intern...
[1] https://noticias.uol.com.br/politica/ultimas-noticias/2021/0...
[2] https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha...
[3] https://www.cartacapital.com.br/saude/segunda-onda-de-covid-...
[4] https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-...
[5] https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o...
[6] https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-col...
That's basically what happened in brazil: people who were not part of risk groups crowded, encouraged by the president himself[0][1][2]. The number of infected poeple soared and variants that affect younger people appeared[3][4]. The health system has now collapsed because there is not enough ICU for such a high number of ill people[5][6].
[0] https://www.em.com.br/app/noticia/politica/2021/02/26/intern...
[1] https://noticias.uol.com.br/politica/ultimas-noticias/2021/0...
[2] https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha...
[3] https://www.cartacapital.com.br/saude/segunda-onda-de-covid-...
[4] https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-...
[5] https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o...
[6] https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-col...
I am hearing from friends and family in Brasil that the Brasilian variant is more severe among younger victims than the original COVID version. There is an increase of deaths among twenty-year-olds as a result.
The second wave of the 1918 pandemic was also more deadly to younger people.
Various theories have been offered as to why, none of which are proven, including that it may have been observational errors or due to overcrowding conditions due to the war and viral dose.
I wonder if it isn't due to the virus coming under pressure due to a large chunk of the population becoming immune, so evolution favors higher transmissibility. And the easy knob the virus has to increase transmissibility is to increase viral load, which has the side effect of increasing virulence/lethality. That is consistent with that fairly well studied mechanism of parasites/viruses, along with being consistent with what we're observing.
At any rate considerations like that are why I'm not letting my guard down until I'm vaccinated and why it seems stupid to do so.
Various theories have been offered as to why, none of which are proven, including that it may have been observational errors or due to overcrowding conditions due to the war and viral dose.
I wonder if it isn't due to the virus coming under pressure due to a large chunk of the population becoming immune, so evolution favors higher transmissibility. And the easy knob the virus has to increase transmissibility is to increase viral load, which has the side effect of increasing virulence/lethality. That is consistent with that fairly well studied mechanism of parasites/viruses, along with being consistent with what we're observing.
At any rate considerations like that are why I'm not letting my guard down until I'm vaccinated and why it seems stupid to do so.
I dont believe virus ever increase in lethality as pressures increase, I thought the opposite happens, they naturally becomes less lethal to be able to spread more effectively.
Also when you said " stupid to do so" what are you referring to?
thx
Also when you said " stupid to do so" what are you referring to?
thx
That law doesn't exist.
Mostly all the virus cares about is increased transmission, particularly with this virus with a long presymptomatic transmission period, it can evolve to become more lethal if that increases transmission. What would not be selected for would be enhanced virulence that shortens the presymptomatic transmission period.
Short term the virus benefits by having higher viral loads and enhanced transmission and enhanced virulence, because it wants those higher viral loads in order to spread more. There's a limit because those higher viral loads are eventually what cause people to feel sick and stay home instead of attend superspreading events, so there's an optimum that its trying to find. As more and more people are immune though, there's probably selection pressure to make the most of whatever superspreading events occur at the expense of non-superspreading transmission. So more people get sick earlier and stay home, but the people who will try to push through a 101F fever the virus wants to have them infecting 100 people instead of 50.
Long term the virus is going to evolve to become less lethal though because eventually we're going to hit herd immunity at the point where it can't evolve along the same fitness function to spread epidemically. At that point it needs to make many more mutations to all its epitopes that might be recognized by antibodies and T-cell and achieve enough immune escape to raise its R0 above 1.0 again.
There's mutations which slide up and down the existing fitness curve (and some lucky mutations that might make the curve even better) but then there's mutations which are costly which are necessary due to the need for stealth and immune escape. Two different things.
Also we have the example of the 1918 pandemic where the later waves were more virulent and lethal than the first wave (but much later it evolved to become seasonal influenza). Got much worse, then got better.
Mostly all the virus cares about is increased transmission, particularly with this virus with a long presymptomatic transmission period, it can evolve to become more lethal if that increases transmission. What would not be selected for would be enhanced virulence that shortens the presymptomatic transmission period.
Short term the virus benefits by having higher viral loads and enhanced transmission and enhanced virulence, because it wants those higher viral loads in order to spread more. There's a limit because those higher viral loads are eventually what cause people to feel sick and stay home instead of attend superspreading events, so there's an optimum that its trying to find. As more and more people are immune though, there's probably selection pressure to make the most of whatever superspreading events occur at the expense of non-superspreading transmission. So more people get sick earlier and stay home, but the people who will try to push through a 101F fever the virus wants to have them infecting 100 people instead of 50.
Long term the virus is going to evolve to become less lethal though because eventually we're going to hit herd immunity at the point where it can't evolve along the same fitness function to spread epidemically. At that point it needs to make many more mutations to all its epitopes that might be recognized by antibodies and T-cell and achieve enough immune escape to raise its R0 above 1.0 again.
There's mutations which slide up and down the existing fitness curve (and some lucky mutations that might make the curve even better) but then there's mutations which are costly which are necessary due to the need for stealth and immune escape. Two different things.
Also we have the example of the 1918 pandemic where the later waves were more virulent and lethal than the first wave (but much later it evolved to become seasonal influenza). Got much worse, then got better.
Thank you for taking the time to reply. I don't believe you countered my point.
The information in your post was however super interesting and I appreciate that.
Why would a virus evolve to be more lethal - if it wanted to increase transmission?
The information in your post was however super interesting and I appreciate that.
Why would a virus evolve to be more lethal - if it wanted to increase transmission?
All the more reason to stop all strains as soon as possible. If more contagious strains can be knocked below the sustainability threshold then they'll die out too.
It is not possible to stop all strains. SARS-CoV2 has multiple zoonotic reservoirs, transmits easily, and persists in the population via asymptomatic infection.
We have eradicated one human virus in all of history, and it took a highly effective vaccine and a hundred years. The long tail is very long.
We have eradicated one human virus in all of history, and it took a highly effective vaccine and a hundred years. The long tail is very long.
It is still important to stop this particular strain and to achieve sufficient vaccination levels to achieve herd immunity.
That immunity will likely be durable for many years (based on the somewhat recent study of HCoV-229E).
That will force the virus to mutate to achieve true escape immunity (a strain, not a variant, which can reinfect everyone all over) which will likely come at a cost to fitness, since one or two mutations to spike isn't enough, and there will need to be a few tens of mutations to spike.
That virus strain will not be as transmissible or virulent as what we are dealing with now, because it has had to make those costly "decisions".
And this is important for people who for medical reasons cannot be vaccinate or who are at high risk even if they are vaccinated. They're much better off being infected by subsequent strains down the road than being infected with version 1.x of this virus.
This is also what has been observed in the past with 1918 H1N1 which later evolved into seasonal influenza.
That immunity will likely be durable for many years (based on the somewhat recent study of HCoV-229E).
That will force the virus to mutate to achieve true escape immunity (a strain, not a variant, which can reinfect everyone all over) which will likely come at a cost to fitness, since one or two mutations to spike isn't enough, and there will need to be a few tens of mutations to spike.
That virus strain will not be as transmissible or virulent as what we are dealing with now, because it has had to make those costly "decisions".
And this is important for people who for medical reasons cannot be vaccinate or who are at high risk even if they are vaccinated. They're much better off being infected by subsequent strains down the road than being infected with version 1.x of this virus.
This is also what has been observed in the past with 1918 H1N1 which later evolved into seasonal influenza.
For all the reasons I cited above, we are not going to “stop this strain”.
Covid is endemic. It is not going away. It doesn’t meet any of the standards set up by the WHO for eradication, and even if it did, it would take decades of intensive work, on par with what we’ve been doing for polio.
Covid is endemic. It is not going away. It doesn’t meet any of the standards set up by the WHO for eradication, and even if it did, it would take decades of intensive work, on par with what we’ve been doing for polio.
“That virus strain will not be as transmissible or virulent as what we are dealing with now, because it has had to make those costly "decisions".”
I’m not convinced you can absolutely guarantee these changes will make the virus less dangerous, we could be unlucky and it could become worse.
I’m not convinced you can absolutely guarantee these changes will make the virus less dangerous, we could be unlucky and it could become worse.
Right now that is what is happening, but as the title shows those variants don't achieve immune escape.
The sum total of mutations necessary to achieve immune escape and overcome herd immunity is a lot more likely to come at a cost to overall fitness.
Also I can't guarantee that West Ham United won't win the Premier League, but the safe money is all on Man City.
Paper on the possibility of mild disease endemicity:
https://science.sciencemag.org/content/371/6530/741
AP coverage of that paper:
https://apnews.com/article/common-cold-india-coronavirus-pan...
The sum total of mutations necessary to achieve immune escape and overcome herd immunity is a lot more likely to come at a cost to overall fitness.
Also I can't guarantee that West Ham United won't win the Premier League, but the safe money is all on Man City.
Paper on the possibility of mild disease endemicity:
https://science.sciencemag.org/content/371/6530/741
AP coverage of that paper:
https://apnews.com/article/common-cold-india-coronavirus-pan...
I'm not convinced we can get an effective global, rolling vaccination program in place to set up effective population immunity.
From what I can tell, almost all public discussion of the future of Covid is similar to a "happy path."
From what I can tell, almost all public discussion of the future of Covid is similar to a "happy path."
Curious, what virus we eradicated?
Smallpox. I think we're close on polio?
We're getting there but it's super hard to do it in remote areas and conflict regions.
https://www.gatesnotes.com/health/in-pakistan-victory-agains...
https://www.gatesnotes.com/health/in-pakistan-victory-agains...
Smallpox. Except for some samples in secure laboratories.
Smallpox and Rinderpest.
Polio and Measles are doable, and at this point more logistical and political problems than biological ones.
Polio and Measles are doable, and at this point more logistical and political problems than biological ones.
The “logistical” and “political” problems being that they’re endemic in countries with major political and economic instability, where the locals have a bad tendency to kill the people doing the vaccinations.
It isn’t a trivial problem. And oh yeah: Covid is in those countries now, too.
It isn’t a trivial problem. And oh yeah: Covid is in those countries now, too.
I never said they were trivial, and have argued exactly the opposite elsewhere. But it remains that they are logistical and political challenges, not biological ones.
Smallpox.
Sure, the president is responsible for that too https://www.youtube.com/watch?v=N3osqOIT7SQ ? One thing is poor people arguing to have to work. Other thing is this "funk train".. The video is from yesterday. You can count, like 2 or 3 masks on the train.
Also for selfish reasons. I know a 24 year old ballerina (so a professional athlete) who had it two months ago and is now at 80% lung capacity.
And the even more selfish evolutionary reason: viruses mutate. If we spread it a ton while it's still "safe" for someone young, we're risking major mutations. It's like playing Russian roulette with 8+ billion bullets x probably millions/billions of viruses per person.
We just need one strain to go to something like 5% mortality + mortality across all age groups for this pandemic to become a civilization ending event. Maybe not ending, but "setting back by 20-40-60 years" event.
We just need one strain to go to something like 5% mortality + mortality across all age groups for this pandemic to become a civilization ending event. Maybe not ending, but "setting back by 20-40-60 years" event.
This kind of thing isn't rare
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
And to pile on this, I know a triathelete in my group, 24 years old, who had it in April of LAST YEAR and is still not at 100% (can't do any hard aerobics without getting wildly out of breath).
We are still in a pandemic. Stay distant.
We are still in a pandemic. Stay distant.
I have a coworker that never went to the ICU but can no longer taste or smell. Their family was never at a high risk and only felt normally sick. None the less the damage is done. No one wants to be maimed by this. Claiming “I’m not high risk (of death)” does not mean there is no risk of damage.
We all need to do our part to stop the spread of the virus.
We all need to do our part to stop the spread of the virus.
We have a friend in their late 30s who also never went to the hospital but got sick with covid five months ago. They have yet to regain their sense of taste or smell.
[deleted]
anedcata(6)
[deleted]
A January 2021 study in the annals of internal medicine estimating the death rates of non institutionalized patients of
.26 percent with age breakdowns .
https://www.acpjournals.org/doi/10.7326/M20-5352?utm_source=...
That seems pretty low compared to what is happening here in Belgium.
We are at 22k deaths with +/- 25% of a 11M of the population having been infected (based on serology and statistical estimates).
We are at 22k deaths with +/- 25% of a 11M of the population having been infected (based on serology and statistical estimates).
If I'm not mistaken, the rate in the paper is bigger, 0.25% against 22k/11M = 0.20% in Belgium.
But if the newspaper I read are right, there is a catch: when tests were not available, Belgium counted as a covid death every case where it could be suspected. Even nowadays, in case of comorbidity, covid is always written down as the cause of death. So 22k is probably a maximum, and, taking into accound the 25% uncertainty on the denominator, the real rate could very different.
But if the newspaper I read are right, there is a catch: when tests were not available, Belgium counted as a covid death every case where it could be suspected. Even nowadays, in case of comorbidity, covid is always written down as the cause of death. So 22k is probably a maximum, and, taking into accound the 25% uncertainty on the denominator, the real rate could very different.
I think you're misreading the comment you replied to. "+/- 25% of a 11M of the population having been infected" means about 25% of 11M, or 2.75M, officially infected. 22k/2.75M would imply a 0.8% fatality rate.
Exactly.
And with respect to the counting, it seems like the Belgian numbers more of less match the reported excess deaths in 2020 within 10% [1].
[1] https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v...
And with respect to the counting, it seems like the Belgian numbers more of less match the reported excess deaths in 2020 within 10% [1].
[1] https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v...
Seems low compared to New York City as well. NYC has already had 30,564 deaths. Even if the whole population had already been infected, that would put the death rate at around 0.36%
Antibody surveys suggest around 40% have been infected which puts the death rate around 0.91%
Antibody surveys suggest around 40% have been infected which puts the death rate around 0.91%
Keep in mind that the GP's link shows a ratio of more than 1% for people older than 60 years. The 0.26% average is certainly not the same everywhere.
Some more:
> Indiana's IFR for noninstitutionalized persons older than 60 years is just below 2% (1 in 50). In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza, 0.8% (1 in 125), among those aged 65 years and older (5).
> Indiana's IFR for noninstitutionalized persons older than 60 years is just below 2% (1 in 50). In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza, 0.8% (1 in 125), among those aged 65 years and older (5).
That is just one factor though in which COVID-19 is worse than the seasonal influenza though.
COVID-19 has a basic reproduction number of 3.3 – 5.7, while the seasonal influenza has one of 0.9 – 2.1 [1], which means that it spreads far more easily. You cannot just wait until summer for influenza season to be over.
With influenza you have a higher rate of existing immunity in the population. With COVID-19 it is basically non-existent, except maybe for a few single people that had SARS or MERS before.
Younger people are also more affected [2]
You are longer sick from COVID-19 and if you have to stay in the hospital you will stay there longer and are more likely to end up on the intensive care unit [2]
In the end you cannot compare a pandemic situation to influenza season.
[1]: https://en.wikipedia.org/wiki/Basic_reproduction_number [2]: https://www.nature.com/articles/s41598-021-85081-0
COVID-19 has a basic reproduction number of 3.3 – 5.7, while the seasonal influenza has one of 0.9 – 2.1 [1], which means that it spreads far more easily. You cannot just wait until summer for influenza season to be over.
With influenza you have a higher rate of existing immunity in the population. With COVID-19 it is basically non-existent, except maybe for a few single people that had SARS or MERS before.
Younger people are also more affected [2]
You are longer sick from COVID-19 and if you have to stay in the hospital you will stay there longer and are more likely to end up on the intensive care unit [2]
In the end you cannot compare a pandemic situation to influenza season.
[1]: https://en.wikipedia.org/wiki/Basic_reproduction_number [2]: https://www.nature.com/articles/s41598-021-85081-0
"Younger people are also more affected [2]"
The paper you're citing says "younger" means 59, vs 66 for influenza:
> Patients with COVID-19 were younger (median age [IQR], 59 [45–71] vs 66 [52–77]; P < 0001) and had fewer comorbidities at baseline with a lower mean overall age-adjusted Charlson Comorbidity Index (mean [SD], 3.0 [2.6] vs 4.0 [2.7]; P < 0.001) than patients with seasonal influenza.
Also, this is data from a single hospital, across two different years. The overall trends for SARS-CoV2 are not even remotely debatable: the risk of mortality rises exponentially with age. It's one of the most striking features of the virus. To claim, based on this one paper, that "younger people are more affected" is to miss the forest for the trees.
"In the end you cannot compare a pandemic situation to influenza season."
You absolutely can, and in fact, you're doing it. What you're trying to say is that Covid is somehow unilaterally much worse than influenza, but that isn't true. It's much worse for the elderly (>65), but for most other age groups, it's about the same, if not a little bit better. You have to squint and split hairs and pick sources selectively to start making strong claims of increased severity in age groups under ~50, and it's simply not a believable claim for people under the age of ~30.
The disease can be bad without exaggerating its threat.
The paper you're citing says "younger" means 59, vs 66 for influenza:
> Patients with COVID-19 were younger (median age [IQR], 59 [45–71] vs 66 [52–77]; P < 0001) and had fewer comorbidities at baseline with a lower mean overall age-adjusted Charlson Comorbidity Index (mean [SD], 3.0 [2.6] vs 4.0 [2.7]; P < 0.001) than patients with seasonal influenza.
Also, this is data from a single hospital, across two different years. The overall trends for SARS-CoV2 are not even remotely debatable: the risk of mortality rises exponentially with age. It's one of the most striking features of the virus. To claim, based on this one paper, that "younger people are more affected" is to miss the forest for the trees.
"In the end you cannot compare a pandemic situation to influenza season."
You absolutely can, and in fact, you're doing it. What you're trying to say is that Covid is somehow unilaterally much worse than influenza, but that isn't true. It's much worse for the elderly (>65), but for most other age groups, it's about the same, if not a little bit better. You have to squint and split hairs and pick sources selectively to start making strong claims of increased severity in age groups under ~50, and it's simply not a believable claim for people under the age of ~30.
The disease can be bad without exaggerating its threat.
I just took the first study I could find. You seem to claim that it’s conclusions are wrong and that young people are less affected of COVID than influenza. Do you have good studies to back this up?
I am telling you that your comment is not supported by the source you cited.
You can find a wide range of publications showing the age-specific mortality profile of Covid by Googling. Here is one that is commonly cited:
https://link.springer.com/article/10.1007/s10654-020-00698-1
You can find a wide range of publications showing the age-specific mortality profile of Covid by Googling. Here is one that is commonly cited:
https://link.springer.com/article/10.1007/s10654-020-00698-1
I wasn’t comparing it to anything. I was just writing more of the studies findings.
For every person that dies (an agonizing death akin to medieval torture), a few more are in intensive care fighting for their lives. For every one of those, others end up in the hospital, spread the disease to others, suffer from “long covid”, or merely suffer greatly. Every person that gets covid adds to the likelihood the disease will become uncontrollable in the long term and endemic.
Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
I don’t see any reason new variants would ever stop coming. What are you proposing is the end point of all of this?
Think about what leads to new variants: every time someone is infected, the virus replicates and has 10e9 chances to come up with something which is advantageous for it. If, like the U.K variant, it lucks into someone with a compromised immune system it might get even more chances to evolve an effective combination.
The way we get it to stop winning is to stop buying it lottery tickets. Masks, vaccines, and other measures like paid sick leave cut into that number enormously.
The way we get it to stop winning is to stop buying it lottery tickets. Masks, vaccines, and other measures like paid sick leave cut into that number enormously.
New variants are going to come, but vaccinated people may have some protection against them, or they may recieve a booster tailored to new variants, if they are extra vulnerable.
Also, treatments are being developed. If we can turn future variants of Covid into something like a common cold, we are going to be fine living with it. We just need to prevent bilateral pneumonia with a cytokine storm that threatens to kill the patient.
Also, treatments are being developed. If we can turn future variants of Covid into something like a common cold, we are going to be fine living with it. We just need to prevent bilateral pneumonia with a cytokine storm that threatens to kill the patient.
The reason COVID=19 hit the way it did was because it was novel; there were not similar diseases from an immunological standpoint being spread widely. Right now, exposure to one COVID strain (or a vaccination against a COVID strain) seems to confer some benefits against infection and/or serious disease from another COVID strain. In other words, as COVID becomes less novel, we become more prepared for new variants. We may end up having to have annual COVID vaccines the way we do flu vaccines, but even people who are unvaccinated against a particular flu strain have antibodies from previous flu strains that offer some measure of protection. That's going to drive down the reproduction rate and the lethality of future COVID strains.
That said, there may not be a clear "end point" in the sense of we go back to how things were before. We may simply be heading towards a new steady state with periodic vaccination efforts and some risk of COVID variants all the time.
That said, there may not be a clear "end point" in the sense of we go back to how things were before. We may simply be heading towards a new steady state with periodic vaccination efforts and some risk of COVID variants all the time.
Regular vaccinations, just like the flu
Plus widely available monoclonal antibodies to be administered as soon as a positive test.
Plus the development of other antivirals.
Plus the development of other antivirals.
Here is something for you to consider: this is the new 'normal'.
That world you lived in 18 months ago? Gone. Not coming back. There is no 'end point', it just goes on and we learn to adapt. Eventually we get better at it, learn more about what is and is not a risk, and a few things start to look like the 2019, but most things don't go back.
This is the reality you need to adjust to.
That world you lived in 18 months ago? Gone. Not coming back. There is no 'end point', it just goes on and we learn to adapt. Eventually we get better at it, learn more about what is and is not a risk, and a few things start to look like the 2019, but most things don't go back.
This is the reality you need to adjust to.
Why are you saying this with such an absolute certainty without providing a convincing argument?
I am not saying it is certain, but there is a distinct class of people who expect everything to go back to the way it was and to do so immediately. They need to consider the possibility that things might _never_ return to the way they were. It is possible that all of the vaccines will work better than we expect and covid-19 will become a mostly-controlled intermittent disease that eventually becomes background noise like influenza (still a killer, but almost a part of the landscape), but it is equally possible that it takes more work for a longer period to get it under control.
The person I was responding to was demanding an 'end point to all of this' and I was suggesting that maybe there isn't one. I don't need to provide proof, only to show that it is possible and the request for some sort of definitive planned end to all of the containment and mitigation work is an unreasonable and childish demand.
The person I was responding to was demanding an 'end point to all of this' and I was suggesting that maybe there isn't one. I don't need to provide proof, only to show that it is possible and the request for some sort of definitive planned end to all of the containment and mitigation work is an unreasonable and childish demand.
I think you're misunderstanding the question.
Many of the components of "back to normal" are about voluntary compliance with disease control measures. For example, I currently hang out with friends only outdoors or in very small groups - not because I couldn't do more, or because I'm afraid to, but because I'm hoping to prosocially blunt the spread of disease. Right now, I've already started going to restaurants (although I was never a big restaurant guy to begin with); I plan to start hosting and attending parties a few weeks after I've been vaccinated, and I plan to stop wearing a mask in public once Covid vaccines become as available as flu vaccines in my local area.
I'm very open to suggestions that it might make sense to wait a little longer before partying or taking off my mask. I'm sure other people are too. But the burden of proof is on you (or others who think the same way) to explain why this is important and what the timeline is. If your position is just a lecture about what we "need" to adjust to, or an assertion that life might never be normal again, that's not really going to get anyone to comply.
Many of the components of "back to normal" are about voluntary compliance with disease control measures. For example, I currently hang out with friends only outdoors or in very small groups - not because I couldn't do more, or because I'm afraid to, but because I'm hoping to prosocially blunt the spread of disease. Right now, I've already started going to restaurants (although I was never a big restaurant guy to begin with); I plan to start hosting and attending parties a few weeks after I've been vaccinated, and I plan to stop wearing a mask in public once Covid vaccines become as available as flu vaccines in my local area.
I'm very open to suggestions that it might make sense to wait a little longer before partying or taking off my mask. I'm sure other people are too. But the burden of proof is on you (or others who think the same way) to explain why this is important and what the timeline is. If your position is just a lecture about what we "need" to adjust to, or an assertion that life might never be normal again, that's not really going to get anyone to comply.
If you told people in March, 2020, that this would still be going on over a year from now, and likely 18+ months from now, what do you think the reaction would be? "You're crazy"???
Trump was talking about "reopening" things for Easter last year. He should've said Easter, 2022.
I was looking back at some old texts from a friend, last year around this time... "I hope this isn't going on 6 months from now."
People want to be optimistic. We need to prepare people for reality.
Trump was talking about "reopening" things for Easter last year. He should've said Easter, 2022.
I was looking back at some old texts from a friend, last year around this time... "I hope this isn't going on 6 months from now."
People want to be optimistic. We need to prepare people for reality.
There are already areas of the country where "this" isn't going on, where businesses are open at full capacity and the public is happy to patronize them. Even in the most socially distanced areas, there's lots of people going on vacations and eating in restaurants and having house parties with their friends and family. So when you talk about reopening in Easter 2022, it's hard to connect that with the state of things today, much less the likely results when vaccines finish rolling out.
We will absolutely see another surge before the vaccine roll out is completed. So tens of thousands of more people will die because states reopened too quickly.
Easter, 2022 is no more realistic than Easter, 2020. Expectations need to be set that are reasonable and err on the side of caution and pessimism.
Easter, 2022 is no more realistic than Easter, 2020. Expectations need to be set that are reasonable and err on the side of caution and pessimism.
The source of this thread was a comment attempting to set the expectation that things will never get better, and nobody will ever again live the way they did in 2019. There’s a huge chasm between that and your (reasonable) claim that some people have moved a bit too fast and there may be public health consequences.
"Never" is always an exaggeration. I took that to be hyperbole, meaning "not for a very, very long time." Maybe the western world has this fully under control in a year. What about the virus mutating everywhere else? All you need is the next patient zero to get on a plane with some highly resistant variant and this starts all over again.
[deleted]
Of course, nobody wants to believe this, but I suspect you will ultimately be proven right.
> For every person that dies (an agonizing death akin to medieval torture)
I think this is wrong, at least in rich countries, at least those that are sane enough to cure their ill citizens.
A friend of mine died of covid last year. Then a family member this year. They were both sedated, and did not suffer at all on their last days in hospitals.
I think this is wrong, at least in rich countries, at least those that are sane enough to cure their ill citizens.
A friend of mine died of covid last year. Then a family member this year. They were both sedated, and did not suffer at all on their last days in hospitals.
Sedation is death with a respiratory illness like this. How were they feeling before they were sedated? Probably like they’d been drowning for hours. For all intents and purposes, that was the end of their life as far as their experience of it.
Don’t get me wrong, it’s great that we can provide palliative comfort for those final hours/days. But it doesn’t tell the full story.
Don’t get me wrong, it’s great that we can provide palliative comfort for those final hours/days. But it doesn’t tell the full story.
Just for clarity/augmentation/pedantic detail: you might be sedated and end up an a ventilator.
But ventilators are really bad for COVID survival and really a last ditch, long-shot chance try to salvage your life. Practitioners hold off on the sedation and associated required ventilation as long as possible to try and spare your life.
But ventilators are really bad for COVID survival and really a last ditch, long-shot chance try to salvage your life. Practitioners hold off on the sedation and associated required ventilation as long as possible to try and spare your life.
> Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
This ghost is not going back into the bottle. It's way too widespread for that now. Even the WHO has determined that. Even if one country manages it, some tourist will bring it in.
The vaccines don't stop the spread enough either to kill it completely. People will still get sick and spread it, they just don't get as sick in large numbers. The simple fact that even a country that has the ability to rigidly control all outside sources like New Zealand is unable to avoid the occasional outbreak. However they do seem to reduce the risk of severe illness enough to bring it to a level comparable to other endemic diseases. PS: Don't get me wrong, I'm totally pro-vaccine and will get at as soon as I finally can.
I really hope that politics will deem the resulting levels sufficient to drop the other measures like the masks and distancing. Once the danger level is comparable to other endemic diseases I think we should.
And I really hope that SARS-CoV-2 mutates to a variant that isn't as deadly. Most diseases have, after all as evolution favours it (not as deadly means we won't fight it as hard). But I doubt we'll ever be COVID free. That point was passed once we didn't strictly quarantine China back in Feb 2020. But anyway that's water under the bridge.
This ghost is not going back into the bottle. It's way too widespread for that now. Even the WHO has determined that. Even if one country manages it, some tourist will bring it in.
The vaccines don't stop the spread enough either to kill it completely. People will still get sick and spread it, they just don't get as sick in large numbers. The simple fact that even a country that has the ability to rigidly control all outside sources like New Zealand is unable to avoid the occasional outbreak. However they do seem to reduce the risk of severe illness enough to bring it to a level comparable to other endemic diseases. PS: Don't get me wrong, I'm totally pro-vaccine and will get at as soon as I finally can.
I really hope that politics will deem the resulting levels sufficient to drop the other measures like the masks and distancing. Once the danger level is comparable to other endemic diseases I think we should.
And I really hope that SARS-CoV-2 mutates to a variant that isn't as deadly. Most diseases have, after all as evolution favours it (not as deadly means we won't fight it as hard). But I doubt we'll ever be COVID free. That point was passed once we didn't strictly quarantine China back in Feb 2020. But anyway that's water under the bridge.
The vaccines appear to be plenty effective enough to stop the spread, if enough people get them.
We don't have great information about the variants, but the big improvements in Israel and England are encouraging, even with vaccination still ongoing.
We don't have great information about the variants, but the big improvements in Israel and England are encouraging, even with vaccination still ongoing.
Not sure why the GP is being downvoted. SARS-CoV-2 will most likely become endemic.
[1] https://science.sciencemag.org/content/370/6516/527.full
[1] https://science.sciencemag.org/content/370/6516/527.full
> Should reinfection prove commonplace, and barring a highly effective vaccine delivered to most of the world's population, SARS-CoV-2 will likely become endemic.
The thing is, we don't know if reinfection will prove commonplace. We don't know how long immunity will last given a two-shot regimen—though the strong immune response that people are having on the second shot might be cause for hope. We don't know how the virus will mutate on it's point/spike, the main infection vector that the RNA vax target. We just don't know.
Research is emerging, time will tell. In the meantime, it's fear mongering.
The thing is, we don't know if reinfection will prove commonplace. We don't know how long immunity will last given a two-shot regimen—though the strong immune response that people are having on the second shot might be cause for hope. We don't know how the virus will mutate on it's point/spike, the main infection vector that the RNA vax target. We just don't know.
Research is emerging, time will tell. In the meantime, it's fear mongering.
Well I will get the vaccine as soon as I can get it (which is not very soon, sadly). I'm not anti-vax, but the last few weeks the news has been all about "Don't be surprised if people still get COVID after being vaccinated". Like here: https://news.ycombinator.com/item?id=26522853
With that in mind I don't think eradication will be achievable. It only takes one person with a resistant mutation. I think we can hope to bring it under control. But not eradicate it.
With that in mind I don't think eradication will be achievable. It only takes one person with a resistant mutation. I think we can hope to bring it under control. But not eradicate it.
What does 'control' mean? In humans, if a small number of people are sick and you know who they are, you can eradicate the infection with isolation (it would only take a couple months).
That it infects various animals may make that unworkable, and the difficulty in vaccinating a large percentage of people globally is another problem.
But the effectiveness of the vaccines against the current variants does not appear to be a problem, high levels of vaccination will slow the spread of the virus dramatically in those populations, to the point where it barely exists (compare to polio, which is still endemic in some places around the world).
That it infects various animals may make that unworkable, and the difficulty in vaccinating a large percentage of people globally is another problem.
But the effectiveness of the vaccines against the current variants does not appear to be a problem, high levels of vaccination will slow the spread of the virus dramatically in those populations, to the point where it barely exists (compare to polio, which is still endemic in some places around the world).
As far as zoonosis (animal-transmitted human diseases) go...
Rabies infects a lot of animals, but many places of the world are now effectively rabies-free thanks to smart inoculation of foxes etc. with baits.
We had last proven rabies case in the wild in 2002. (The Czech Republic, a landlocked continental country, not an isolated island.)
You can still fall to rabies contracted from bats if extremely unlucky, but compared to countries like India where the disease still runs rampant, rabies is a solved problem in most of Europe.
Maybe there will be a similar way to inoculate the wild mustelids against Covid one day. To be honest, human antivaxxers strike me as a bigger problem than random mink. I don't meet many mink on a regular day, but people with their masks halfway down are all too common.
Rabies infects a lot of animals, but many places of the world are now effectively rabies-free thanks to smart inoculation of foxes etc. with baits.
We had last proven rabies case in the wild in 2002. (The Czech Republic, a landlocked continental country, not an isolated island.)
You can still fall to rabies contracted from bats if extremely unlucky, but compared to countries like India where the disease still runs rampant, rabies is a solved problem in most of Europe.
Maybe there will be a similar way to inoculate the wild mustelids against Covid one day. To be honest, human antivaxxers strike me as a bigger problem than random mink. I don't meet many mink on a regular day, but people with their masks halfway down are all too common.
Yeah, I would describe myself as optimistic that we can achieve a good outcome and concerned that we'll collectively make choices that delay it.
Convincing other people to stay optimistic can be part of improving the choices we make.
Convincing other people to stay optimistic can be part of improving the choices we make.
Sounds a lot like the flu.
I don't think I've ever seen an HN thread with so many anecdotes, assumptions and off-the-cuff theories and so little data or useful links.
Somewhat ironic that this is also an an anecdote
The title of this article, which performs an in vitro test, is "Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination". The editorialization in the current Hacker News headline ("Vaccines Are Effective Against Covid Variants") is not warranted.
If I can pass on what I’ve learned in the past 12 months as a newly minted virus enthusiast whose peak education in the area was human physiology 101:
“In vitro” means testing outside of the human body. Just because a result is confirmed in vitro does not mean it will be replicated when tested “in vivo” (in the actual human).
“In vitro” means testing outside of the human body. Just because a result is confirmed in vitro does not mean it will be replicated when tested “in vivo” (in the actual human).
In vitro literally means “In glass” (like in a test tube). In vivo means “in life” (like IRL)
Strictly speaking, in vivo means "in a living [organism]"; "in life" would be in vita (not a term used for a kind of test).
https://en.wiktionary.org/wiki/vivus#Latin
https://en.wiktionary.org/wiki/vita#Latin
https://en.wiktionary.org/wiki/vivus#Latin
https://en.wiktionary.org/wiki/vita#Latin
In other words it’s a little early to start the victory chants.
Unfortunately this will get used to justify reckless behavior.
Unfortunately this will get used to justify reckless behavior.
Thanks for sharing this. I actually see very little reporting on how this virus spreads among the vaccinated population. I would love to see new case numbers broken down by vaccinated and not-vaccinated people from countries like UK, US and Israel. So far I’m unable to find such data on the internet.
This post seems like it might be the closest to what you are looking for: https://www.reddit.com/r/COVID19/comments/loljxz/effectivene...
Breakthrough infections have been identified.
https://www.webmd.com/vaccines/covid-19-vaccine/news/2021030...
https://www.webmd.com/vaccines/covid-19-vaccine/news/2021030...
This is not well aligned with other research[1] showing the Pfizer and Moderna vaccines perform little better against the B1351 (South Africa) variant than they do against plain old SARS and distantly related bat COVIDs. They're also only semi-effective against the Brazilian P1 variant.
Right now, all of the vaccines are reasonably effective against the variants commonly circulating in the US (including B117), which is what the JAMA article tested. But I worry for how well they'll perform in a few months when the other variants get a foothold.
[1]: https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf
Right now, all of the vaccines are reasonably effective against the variants commonly circulating in the US (including B117), which is what the JAMA article tested. But I worry for how well they'll perform in a few months when the other variants get a foothold.
[1]: https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf
The article is talking about "escape neutralization".
Neutralizing antibodies are not the only mechanism of the immune system, and the article even discusses another such mechanism: T cell immunity.
T cell immunity appears robust for all variants from the data I've seen.
Neutralizing antibodies are not the only mechanism of the immune system, and the article even discusses another such mechanism: T cell immunity.
T cell immunity appears robust for all variants from the data I've seen.
As far as I can tell, both the JAMA study linked in this post and the study I linked are describing antibody responses. I was trying to make an apples-to-apples comparison by sharing a similar study with contradictory results on a broader swath of virus variants.
It seems that the AstraZeneca vaccine is not effective against the South African variant [0].
[0]: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=I...
[0]: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=I...
That's wrt mild to moderate cases. It might still be effective against severe cases.
nevertheless, you have to actually support that hypothesis with research. Just the fact that it's ineffective against mild to moderate doesn't mean it will be effective against more severe cases. it might also be ineffective against severe cases, making it just entirely ineffective against those strains.
a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
> a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
This isn't something he has made up on the spot. It's been repeated countless times in the British media and presumably has some scientific basis. Either that or the whole field is keeping quiet on the basis that the UK has a large supply of the AZ vaccine and it's better to stop deaths from the current dominant strain than to wait for a better vaccine. Since the second option requires the cooperation of vast number of people I tend to believe the former.
This isn't something he has made up on the spot. It's been repeated countless times in the British media and presumably has some scientific basis. Either that or the whole field is keeping quiet on the basis that the UK has a large supply of the AZ vaccine and it's better to stop deaths from the current dominant strain than to wait for a better vaccine. Since the second option requires the cooperation of vast number of people I tend to believe the former.
It is being worked on, animal studies only so far with human studies to come as SA rolls out their 100k doses of AZ I am sure.
Animal model study - Syrian hamsters https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
Animal model study - Syrian hamsters https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
They didn’t design the study to look for severe cases in South Africa and this variant isn’t widespread in other countries where the vaccine is in use, so it will be hard to get evidence on effectiveness against severe disease anytime soon.
good point, it might raise our IQ as well!
I am very clueless on the vaccine topic (not a denier of covid or anti vaxxer).
All I know is from listening to some interviews with a scientist in the field.
But i still do not know what is the definition of "effective vaccine". What does it do? If you have covid and take the vaccine, will the covid go away? Are you still contagious after having the vaccine or can you still get the covid but without the bad effects? What kind of immunity is given by the vaccine and how long does it last?
All I remember is that scientist said that herd immunity will likely never happen, or not in a long time(years, according to him).
There are too little comprehensive sources on the matter and too much superficial noise.
Thanks for any input.
But i still do not know what is the definition of "effective vaccine". What does it do? If you have covid and take the vaccine, will the covid go away? Are you still contagious after having the vaccine or can you still get the covid but without the bad effects? What kind of immunity is given by the vaccine and how long does it last?
All I remember is that scientist said that herd immunity will likely never happen, or not in a long time(years, according to him).
There are too little comprehensive sources on the matter and too much superficial noise.
Thanks for any input.
For complete herd immunity we'd need something like 100% that about 80% percent take, which is hard. So, our current goal is to get rid of the bad effects of Covid by limiting spread and limiting severe symptoms.
> But i still do not know what is the definition of "effective vaccine".
I'm not aware of a rigorous definition, but effective vaccine is something that helps us significantly to accomplish the goal. All the vaccines provide very good (90%+) protection from severe symptoms and it seems to be good even with the current variants. The protection is not as good against any kind of infection, but it is still very significant (like at least 66% even with some variants).
> If you have covid and take the vaccine, will the covid go away?
No, you have to take the vaccine before Covid. Usually it takes some time before the vaccine is efficient. Like you have to patch your server before it becomes part of a botnet.
> Are you still contagious after having the vaccine
You may be, but with significantly lower probability.
> can you still get the covid but without the bad effects?
This seems likely outcome of being vaccinated - your body will somehow already know what to do and will with the virus faster.
> What kind of immunity is given by the vaccine and how long does it last?
We'll see how long it lasts. It does not seem to be diminishing, so it should be at least a year or so. From the experience from other vaccines, it will probably last longer, but there is the risk of new strains that evade it.
> But i still do not know what is the definition of "effective vaccine".
I'm not aware of a rigorous definition, but effective vaccine is something that helps us significantly to accomplish the goal. All the vaccines provide very good (90%+) protection from severe symptoms and it seems to be good even with the current variants. The protection is not as good against any kind of infection, but it is still very significant (like at least 66% even with some variants).
> If you have covid and take the vaccine, will the covid go away?
No, you have to take the vaccine before Covid. Usually it takes some time before the vaccine is efficient. Like you have to patch your server before it becomes part of a botnet.
> Are you still contagious after having the vaccine
You may be, but with significantly lower probability.
> can you still get the covid but without the bad effects?
This seems likely outcome of being vaccinated - your body will somehow already know what to do and will with the virus faster.
> What kind of immunity is given by the vaccine and how long does it last?
We'll see how long it lasts. It does not seem to be diminishing, so it should be at least a year or so. From the experience from other vaccines, it will probably last longer, but there is the risk of new strains that evade it.
The rigorous definition, for efficacy in any particular outcome, is one minus the effect estimate from an RCT, usually a relative risk or hazard ratio, depending on how they approached it statistically.
Well, based on my understanding, we don't know for sure.
What we do know, is that they give you a much higher chance of avoiding serious symptoms, including that most serious of symptoms, death. You won't be "virus-proof" completely, but someone vaccinated fully (so 2 doses for vaccines which require it), after a certain immunization period, which varies between 2-4 weeks after being fully vaccinated, will be super resilient to being in contact with Covid patients. Don't go get coughed on by 10 Covid patients, though.
Regarding contagion, apparently after vaccination, you can still get Covid with most vaccines, you just become "asymptomatic", i.e. it doesn't really affect you. However it seems that you're also much less contagious, which is still great, since it reduces the infection rate, it becomes much harder to spread it.
If you get Covid while immunity from vaccination hasn't kicked in fully... you can still be screwed. People have died 1 week after being vaccinated. So you probably want to stay put for a while until your immunity ramps up.
Regarding immunity, as I was saying, it's primarily lack of serious symptoms. I think they also make it harder for you to catch it, but I don't think we have super solid proof of this yet.
And for immunity, it's hard to say. We're basically just counting up days from initial vaccinations to see how long it lasts. For the other vaccines we know the time intervals because... time has passed. So far, for the current vaccines it seems that immunity is at least 6+ months. From what I've read we should be reasonably optimistic that we'll be immune for 1+ years. I don't think anyone expects lifetime immunity, yet.
TL;DR: Get vaccinated, it will keep you much safer, it will probably also help others around you, by making you spread it less if you do get it. You'll still get Covid but it will be much less of a deal. Side effects are temporary and not massive in the vast majority of cases.
What we do know, is that they give you a much higher chance of avoiding serious symptoms, including that most serious of symptoms, death. You won't be "virus-proof" completely, but someone vaccinated fully (so 2 doses for vaccines which require it), after a certain immunization period, which varies between 2-4 weeks after being fully vaccinated, will be super resilient to being in contact with Covid patients. Don't go get coughed on by 10 Covid patients, though.
Regarding contagion, apparently after vaccination, you can still get Covid with most vaccines, you just become "asymptomatic", i.e. it doesn't really affect you. However it seems that you're also much less contagious, which is still great, since it reduces the infection rate, it becomes much harder to spread it.
If you get Covid while immunity from vaccination hasn't kicked in fully... you can still be screwed. People have died 1 week after being vaccinated. So you probably want to stay put for a while until your immunity ramps up.
Regarding immunity, as I was saying, it's primarily lack of serious symptoms. I think they also make it harder for you to catch it, but I don't think we have super solid proof of this yet.
And for immunity, it's hard to say. We're basically just counting up days from initial vaccinations to see how long it lasts. For the other vaccines we know the time intervals because... time has passed. So far, for the current vaccines it seems that immunity is at least 6+ months. From what I've read we should be reasonably optimistic that we'll be immune for 1+ years. I don't think anyone expects lifetime immunity, yet.
TL;DR: Get vaccinated, it will keep you much safer, it will probably also help others around you, by making you spread it less if you do get it. You'll still get Covid but it will be much less of a deal. Side effects are temporary and not massive in the vast majority of cases.
I'll take a swing at this, being an infectious disease epidemiologist.
When people talk about the "effectiveness of the vaccine", what's actually happening is that they're talking about a smear of different things, which is why you're (justifiably) confused.
There's a few different aspects to think about:
1) When people say things like "The Moderna vaccine is 95% effective", the statistic they're citing is that in a clinical trial, the participants in the treatment arm of the trial had 5% of the outcomes the study was tracking as compared to the treatment arm. In the case of the early vaccine trials, this is stuff like...well...death or severe disease requiring ICU treatment.
It importantly does not mean you have a 5% chance if you get COVID. You have 5% of whatever the chance of someone who didn't have the vaccine has.
There's a reason that endpoint was chosen. A few actually. First, it's the most important one from a public health standpoint, in terms of immediately addressing the pandemic. It's also straightforward and unambiguous to study, which paves the way for faster licensing and thus getting it into the arms of the public. Studying things like if a vaccine is enough to induce herd immunity is much harder as a statistical problem.
Note that I haven't said anything about stopping the epidemic here. That's because this endpoint doesn't measure that. It's possible, for example, that the vaccine can protect you by reducing the severity of an infection, but that that would just push it to an asymptomatic infection that can be passed to others. That's why there's still public health messaging about wearing a mask even if you're vaccinated, etc.
2) There are follow up studies, which are still being done (and for which we are starting to get results) about whether or not the vaccine also reduces whether or not you can give the virus to others. This is what most people think of when we think about vaccines.
3) We don't know how long it will last, but it's likely fairly long lasting, and this is something that we can (and are) monitoring to make sure people don't need booster shots, etc.
4) Herd immunity depends on point #2 working well, and being at a fairly high level. One thing to keep in mind that I say a lot is that "herd immunity" is about a specific place at a specific point in time. It's possible for example that a city or town can have high enough vaccine levels to have achieved herd immunity, but the country (or the globe...) not being vaccinated enough for SARS-CoV-2 to have "gone away".
Public health thinks about this using a couple terms:
Control - "We've got a handle on this, but we've still got it" Elimination - "This is gone in our area, but could come back" Eradication - "This is gone forever"
TB is an example of a disease the U.S. has under Control. This is what we're aiming for with COVID-19 right now. Measles, Mumps and Rubella are, in most of the U.S., considered Eliminated. Smallpox is Eradicated.
When people talk about the "effectiveness of the vaccine", what's actually happening is that they're talking about a smear of different things, which is why you're (justifiably) confused.
There's a few different aspects to think about:
1) When people say things like "The Moderna vaccine is 95% effective", the statistic they're citing is that in a clinical trial, the participants in the treatment arm of the trial had 5% of the outcomes the study was tracking as compared to the treatment arm. In the case of the early vaccine trials, this is stuff like...well...death or severe disease requiring ICU treatment.
It importantly does not mean you have a 5% chance if you get COVID. You have 5% of whatever the chance of someone who didn't have the vaccine has.
There's a reason that endpoint was chosen. A few actually. First, it's the most important one from a public health standpoint, in terms of immediately addressing the pandemic. It's also straightforward and unambiguous to study, which paves the way for faster licensing and thus getting it into the arms of the public. Studying things like if a vaccine is enough to induce herd immunity is much harder as a statistical problem.
Note that I haven't said anything about stopping the epidemic here. That's because this endpoint doesn't measure that. It's possible, for example, that the vaccine can protect you by reducing the severity of an infection, but that that would just push it to an asymptomatic infection that can be passed to others. That's why there's still public health messaging about wearing a mask even if you're vaccinated, etc.
2) There are follow up studies, which are still being done (and for which we are starting to get results) about whether or not the vaccine also reduces whether or not you can give the virus to others. This is what most people think of when we think about vaccines.
3) We don't know how long it will last, but it's likely fairly long lasting, and this is something that we can (and are) monitoring to make sure people don't need booster shots, etc.
4) Herd immunity depends on point #2 working well, and being at a fairly high level. One thing to keep in mind that I say a lot is that "herd immunity" is about a specific place at a specific point in time. It's possible for example that a city or town can have high enough vaccine levels to have achieved herd immunity, but the country (or the globe...) not being vaccinated enough for SARS-CoV-2 to have "gone away".
Public health thinks about this using a couple terms:
Control - "We've got a handle on this, but we've still got it" Elimination - "This is gone in our area, but could come back" Eradication - "This is gone forever"
TB is an example of a disease the U.S. has under Control. This is what we're aiming for with COVID-19 right now. Measles, Mumps and Rubella are, in most of the U.S., considered Eliminated. Smallpox is Eradicated.
Thank you for your clear comment. I hope your tenure review has a positive outcome.
Thank you and all others who chimed in for this most valuable insight and contribution.
Vaccines are ways to mimic infection (hopefully) without the side effects of real infection, like getting sick.
The immune system is complex and layered. The body's primary response to an infection is to make the body inhospitable. We know this as a fever. Some infections, like the common cold, are defeated here.
There are more tools available for more resilient infections, one being antibody production. Antibodies are proteins that bind to pathogens, to act as a marker. Once marked, other mechanisms (white blood cells) can clean up.
It takes time for the immune system to design an antibody that can identify the pathogen. The produced antibodies generally hang around for a few months, or longer. This is driven by chemical factors. Fortunately, Memory T-Cells will last a lot longer, and these contain the information needed to identify the pathogen and produce new antibodies. If the same pathogen appears again, antibodies can be produced quickly.
An antigen is anything that triggers an immune response. This includes pollen, if you have hay fever. In the context of COVID, the antigens are usually spike proteins, which stick out from the surface of the virus.
It's also worth noting that this process isn't perfect. Exposure does not mean immunity. Immunity is not binary, either. T-Cells may prevent symptoms entirely, or their may be a lag.
So, now I think I can answer your questions.
The vaccine provides the antigens using a form of COVID that won't, or shouldn't, cause infection. This will still cause an immune response, which may be strong enough to cause side effects. The body will see the antigens and generate antibodies. The antigen/antibody combination is stored in memory T-cells. This process takes several weeks, and is strengthened by a second exposure.
If you already have COVID, unfortunately the vaccine won't help. Vaccines are primarily preventative. There are a few diseases with post-exposure vaccination (anthrax), but there are usually many contingencies involved. If you have had COVID, you should still get the vaccine, because you are not guaranteed immunity.
You may still be contagious or symptomatic after having the vaccine, but this should (at least) be reduced. There is still a lag between becoming infected and immune response, even if you have immunity. This will be much shorter in the immune group, however.
It's hard to say how long immunity will last for. On an individual level, you can find pessimistic cases indicating very short immunity. Remember everyone's response is unique, and unlikely cases are usually most reported. The wildcard is a mutated virus evading immunity. To eliminate COVID would be to vaccinate the world, which is highly unlikely given substantial portions of the world haven't yet admitted they have it.
The immune system is complex and layered. The body's primary response to an infection is to make the body inhospitable. We know this as a fever. Some infections, like the common cold, are defeated here.
There are more tools available for more resilient infections, one being antibody production. Antibodies are proteins that bind to pathogens, to act as a marker. Once marked, other mechanisms (white blood cells) can clean up.
It takes time for the immune system to design an antibody that can identify the pathogen. The produced antibodies generally hang around for a few months, or longer. This is driven by chemical factors. Fortunately, Memory T-Cells will last a lot longer, and these contain the information needed to identify the pathogen and produce new antibodies. If the same pathogen appears again, antibodies can be produced quickly.
An antigen is anything that triggers an immune response. This includes pollen, if you have hay fever. In the context of COVID, the antigens are usually spike proteins, which stick out from the surface of the virus.
It's also worth noting that this process isn't perfect. Exposure does not mean immunity. Immunity is not binary, either. T-Cells may prevent symptoms entirely, or their may be a lag.
So, now I think I can answer your questions.
The vaccine provides the antigens using a form of COVID that won't, or shouldn't, cause infection. This will still cause an immune response, which may be strong enough to cause side effects. The body will see the antigens and generate antibodies. The antigen/antibody combination is stored in memory T-cells. This process takes several weeks, and is strengthened by a second exposure.
If you already have COVID, unfortunately the vaccine won't help. Vaccines are primarily preventative. There are a few diseases with post-exposure vaccination (anthrax), but there are usually many contingencies involved. If you have had COVID, you should still get the vaccine, because you are not guaranteed immunity.
You may still be contagious or symptomatic after having the vaccine, but this should (at least) be reduced. There is still a lag between becoming infected and immune response, even if you have immunity. This will be much shorter in the immune group, however.
It's hard to say how long immunity will last for. On an individual level, you can find pessimistic cases indicating very short immunity. Remember everyone's response is unique, and unlikely cases are usually most reported. The wildcard is a mutated virus evading immunity. To eliminate COVID would be to vaccinate the world, which is highly unlikely given substantial portions of the world haven't yet admitted they have it.
Assuming your chance of getting COVID is "100", two weeks after vaccination your chance of getting it will have dropped to "3" and your chance of dying from it will be "0". Changes to your ability to have a symptomless infection and transmit it to others aren't entirely clear yet, but seem to tend towards the "3" as well.
This is for the mRNA vaccines (Pfizer & Moderna). The others are potentially slightly less effective in preventing infection, but seem to be just about as good in preventing serious courses and death.
This is for the mRNA vaccines (Pfizer & Moderna). The others are potentially slightly less effective in preventing infection, but seem to be just about as good in preventing serious courses and death.
I might be missing something. Isn't the report solely about the neutralizing capabilities of the Moderna vaccine? What other vaccines were tested?
> Vaccines Are Effective Against Covid Variants
This Hacker News title is inaccurate, as the study concerns only the Moderna mRNA-1273 vaccine.
This Hacker News title is inaccurate, as the study concerns only the Moderna mRNA-1273 vaccine.
https://www.worldometers.info/coronavirus/#countries shows cases are increasing; Which means there is something wrong with the vaccines or with the distribution of vaccines;
I assume unless the spike protein mutates, these variants would still be covered under the current vaccines.
Good explanation on efficacy of vaccines.
https://www.youtube.com/watch?v=K3odScka55A
https://www.youtube.com/watch?v=K3odScka55A
This was not testing against the South African and Japan/Brazil variants that are much more likely to escape vaccination antibodies. This UK variant is mostly problematic against the unvaccinated.
In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant.
The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.
In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant.
The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.
the most bothersome variants (SA,P1 brazil) are not reported in the paper
The plural ‘variants’ in the title is a bit misleading. Only one of the four viruses they tested is one we are actually concerned about at this time. The first is the original virus, which was displaced by the second early in the pandemic and against which vaccines are already known to be effective. The third one is the UK variant, which is of interest and the fourth is an artificial virus with a single mutation of interest, which doesn’t circulate in nature. This is all good but the study doesn’t add anything that wasn’t already known. It appears that better funded groups at the NIH, UTMB, Fred Hutch and Columbia beat them to the goal and to publication in the even more prestigious publications like NEJM and Nature. In any case, reproducing important research is a laudable and underrated goal. However, I would suggest a more modest title - ‘Study adds to data for vaccines’ effectiveness against the UK variant of SARS-COV-2’.
There are other variants - Brazilian, South African, Californian, New York, etc - which need to be studied in more detail. There are already data from the aforementioned research groups for at least some of these variants that suggest that vaccines will continue to be at least partially effective.
There are other variants - Brazilian, South African, Californian, New York, etc - which need to be studied in more detail. There are already data from the aforementioned research groups for at least some of these variants that suggest that vaccines will continue to be at least partially effective.
psychlops(3)
54 patients total? That's not a sample size to draw strong conclusions on :(
Assuming normal distribution, the law of large numbers kicks in at n=30.
The actual number of examined vaccinated people('s serum) is 14. The other 20+20 are acute/recovering cases. (I was being generous with the 54.)
Also the page itself says Limitations include the small sample size under "Discussion".
Also the page itself says Limitations include the small sample size under "Discussion".
Still not getting my vaccine shots. So great they are, my government is sabotaging my safety by continueing to deny me access.
This is good news. Now maybe Fauci should rethink his idea that people need to wear their masks for another year even after getting vaccinated. One of his reasons was because of worry about the variants.
It’s bizarre to me that so many people seem to equate not having to wear a mask as the ultimate return to normal.
Mask wearing is probably the least invasive, least inconveniencing thing that we have been asked to do throughout this pandemic, yet half the population acts as if it is the equivalent to being handcuffed to a steel post in their basement.
If health officials said “after being vaccinated, do whatever you want, please just wear a mask for the next year and wash your hands while we monitor efficacy”, that would be a success story with respect to returning to normal, to me at least.
Mask wearing is probably the least invasive, least inconveniencing thing that we have been asked to do throughout this pandemic, yet half the population acts as if it is the equivalent to being handcuffed to a steel post in their basement.
If health officials said “after being vaccinated, do whatever you want, please just wear a mask for the next year and wash your hands while we monitor efficacy”, that would be a success story with respect to returning to normal, to me at least.
Some countries have mandated that masks be worn even outdoors and even when there is no one around. This has been the case in Poland and Romania for many months, for instance. The Polish health minister openly stated there is little scientific basis for this, he just thinks it is more likely that citizens will have their masks on when entering shops or meeting people if they have to wear it at all times.
Think about how much it sucks if you are a glasses wearer and your glasses are fogging up all the time (you can't even see the traffic lights when you want to safely cross the street), or how much it sucks to cycle long distances with this thing on your face.
I think a lot of Europeans would readily accept wearing a mask in shops for the next year. But yes, getting rid of this outdoor mask requirement would be a big relief and major return to normal.
Think about how much it sucks if you are a glasses wearer and your glasses are fogging up all the time (you can't even see the traffic lights when you want to safely cross the street), or how much it sucks to cycle long distances with this thing on your face.
I think a lot of Europeans would readily accept wearing a mask in shops for the next year. But yes, getting rid of this outdoor mask requirement would be a big relief and major return to normal.
In my mind, as an epidemiologist, discontinuing mask wearing should be the absolute last thing we discontinue.
Wearing masks have benefits beyond covid. Think about how many lives per year we could save from the flu let alone other airborne respiratory viruses if mask wearing was normalized.
Wearing foam rubber padding all the time has benefits, but that doesn't mean everyone should do it. There are other considerations beyond mere safety.
Or at least bike helmets all the time. Lots of people get seriously injured or killed because of falling and hitting their head.
I expect mask wearing will be more common in cultures where it was almost unheard of like western Europe and the US. But even in a country like Japan where it wasn't unusual, it certainly wasn't anything like the norm.
I expect mask wearing will be more common in cultures where it was almost unheard of like western Europe and the US. But even in a country like Japan where it wasn't unusual, it certainly wasn't anything like the norm.
Wearing a mask is a lot more convenient than foam rubber padding.
Just think of how many lives will be saved if people never leave their homes.
Amazing how insecure people get when you suggest a simple gesture that would ultimately better society. Mask wearing is normalized in the East, why not in the West? Is it because "mah freedoms?" Grow up.
Did you just reply to the wrong comment? I didn't say anything about masks.
Your comment wasn't constructive and at worst, sounded like you were making light of mask wearing by suggesting we should just never leave our houses. Of course if everyone was confined to their houses, there would be less sickness but nobody is debating that. We're debating the normalization of mask wearing.
It sounds like your concern is masks, not saving lives. Because if you care more about saving lives you will realize people only need to stay home. Fewer fatal accidents, infections, and other disturbances if people just never ventured outside their homes.
I'm not sure what kind of strange reality you're speaking from but it's not one that currently exists.
It has been both enlightening and pleasant to not have caught any symptom-causing diseases in the past 12 months. Unknown whether mask wearing played a part of course.
Agreed. I think of the 5+ times I’ve gotten sick from planes and airports and I kick myself for not having worn masks during air travel in years past.
You probably need everyone else wearing masks to have a big effect and that's not likely to be the case going forward although you can obviously take whatever precautions you like.
He's mostly just managing expectations. One problem starting to trouble public health professionals is the wish of vaccinated people to ditch masks even before enough people are vaccinated to reach herd immunity: since it is not easily visible if someone is vaccinated (and even then...) the appearance of more and more unmasked people in stores etc. could lead to a breakdown in adherence.
There will come a time, in early summer for the US, late summer for most of Europe, when it'll be safe to take of the mask. Until then, it's a minor annoyance.
There will come a time, in early summer for the US, late summer for most of Europe, when it'll be safe to take of the mask. Until then, it's a minor annoyance.
Also people lie about things such as whether they're vaccinated.
A counter point is that some vaccines seem to be ineffective agains some variants. For instance AstraZeneca against B.A.351 (South-Africa). From a preprint: "Conclusions A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate Covid-19 due to B.1.351 variant, however, VE against severe Covid-19 is undetermined." https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v...
The US CDC does state that, according to current publications, some variants present a "moderate reduction on neutralization". Their page about "Variants of Interest" and "Variants of Concern" mentions many scientific papers. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/vari...