Delaying a Covid vaccine’s second dose boosts immune response(nature.com)
nature.com
Delaying a Covid vaccine’s second dose boosts immune response
https://www.nature.com/articles/d41586-021-01299-y
226 comments
And how much antibody response is enough? Is more always better? Or is it diminishing returns?
IIRC one of the tricky things in the development of mRNA vaccines was being careful to not overstimulate the immune systems, triggering autoimmune types of reactions.
It seems plausible to me that there is a "safe" level of immune response, and either too much or too little could be less desirable (maybe for different reasons).
IIRC one of the tricky things in the development of mRNA vaccines was being careful to not overstimulate the immune systems, triggering autoimmune types of reactions.
It seems plausible to me that there is a "safe" level of immune response, and either too much or too little could be less desirable (maybe for different reasons).
This is exactly what they are finding.
https://www.medrxiv.org/content/10.1101/2021.05.03.21256520v...
The Pfizer vaccine is shown here to elicit increased cytokine immune response to many types of non-covid agitants like mold and bacteria. The danger there would be cytokine storm in the extreme or cytokine-induced inflammation in mild cases.
https://www.medrxiv.org/content/10.1101/2021.05.03.21256520v...
The Pfizer vaccine is shown here to elicit increased cytokine immune response to many types of non-covid agitants like mold and bacteria. The danger there would be cytokine storm in the extreme or cytokine-induced inflammation in mild cases.
Might be chance (it is spring) but my allergies were rocked after the shots. I wonder if revving up your immune system also revs up allergies since they're just an immune over-response?
I was hammered by allergies before I had any shots. After the second shot my allergies got a lot better. Probably totally cured my allergies. Magic.
Except it didn't because past week or so they've been back again.
Except it didn't because past week or so they've been back again.
The second Pfizer shot made my allergies better for about two days. They're back :(
Could it be because the immune system is busy with something else than fighting harmless agents ?
It’s a known strategy.
One guy infested himself with various worms to give his immune system something productive to do.
I myself didn’t really eat for a month once. That ended a multi month long flare. Idea is it kills off immune system for awhile.
One guy infested himself with various worms to give his immune system something productive to do.
I myself didn’t really eat for a month once. That ended a multi month long flare. Idea is it kills off immune system for awhile.
Your body has a lot of possible immune responses. Runny nose, inflammation, fever. My guess is that it just switches strategies to something less annoying.
It hadn't occurred to me that the two could be related, but my allergies were pretty quiet until I got the first shot, then it was like I'd just motorboated a vase full of pollen.
Again, could just be timing.
Second shot in a week, so we'll see if it happens again!
Again, could just be timing.
Second shot in a week, so we'll see if it happens again!
cmon guys it's mid may, it's peak grass pollen season (in the northern hemisphere)... that has nothing to do with vaccines. smh, anectdotal this, anectdotal that
Anecdotal, yes: I've never had allergies before (at least not ones I acknowledged) and now that I'm fully vaccinated, I've got crazy responses. Interesting nonetheless.
Which shot did you get? The different vaccines also use different adjuvants (or even none in case of BionTech), so maybe that also plays a role.
Fascinating - that was my experience as well. But I can't say whether it's just been an especially bad allergy season in general.
It is worth noting that cytokine responcse is implicated in many models of dementia, including alzheimer's. It is terrifing to imagine senarios where this leads to a billion early onset cases a few decades from now
Normal Covid infection apparently causes cytokine storms as well, so maybe there was no escaping it assuming every individual would eventually either have Covid or get the vaccine.
I hate to even say this, but maybe it's possible that excessive vaccinations increase mental diseases in the elderly?
and too few vaccinations increases fatal sickness for the elderly.
Or just a general lack of elderly
Why are you asking this? This seems fairly out of left field.
As pointed out by the preprint, the same effect is observed in serval other common vaccines (BCG, Measles, etc.)
Trial data for the mRNA vaccines has not yet indicated an elevated risk of experiencing a cytokine storm.
There’s really not much to get excited about here.
Trial data for the mRNA vaccines has not yet indicated an elevated risk of experiencing a cytokine storm.
There’s really not much to get excited about here.
If the infection model of Alzheimer's Disease is correct, then it might actually provide a protective effect.
Related to this, vaccinations are correlated with a lower risk of Alzheimer's:
https://www.alz.org/aaic/releases_2020/vaccines-dementia-ris...
Related to this, vaccinations are correlated with a lower risk of Alzheimer's:
https://www.alz.org/aaic/releases_2020/vaccines-dementia-ris...
not to worry ! Lots of cytokine inhibiting drugs on the market, like anti-tnf drugs and anti-IL biologic drugs. All for the low price of about $5-10k/month. Ask your doctor about ustekinumab/adalimumab/vedolizumab. May cause cancer, demyelination and death.
Would this manifest as increased side effects from the vaccine?
I'd also be curious to hear about an expert weigh in on "original antigenic sin" in this context. (My lay understanding: your immune system gets partially locked onto its first response to an antigen, and may fail to respond as well as it could to future variants).
If you power up the response to massive levels, does it also augment the downsides of that "original antigenic sin"?
If you power up the response to massive levels, does it also augment the downsides of that "original antigenic sin"?
Yes, this is why I’m curious whether the MRNA interacts badly with pregnancy, since pregnancy involves a poorly understood modulation of the immune system (so it doesn’t attack the fetus)
The data on pregnancy shows no impact. In fact if I remember correctly there were fewer incidents than the placebo group. So maybe it helps reduce pregnancy related issues??
For a statement written with such apparent certainty, a link to a study (or any similar substantiation) would be pretty useful
There are multiple studies:
https://www.nytimes.com/2021/05/13/health/vaccine-pregnancy....
And from Pfizer and Moderna's research: https://www.latimes.com/science/story/2021-01-27/covid-19-va...
There is now a large trial of pregnant women getting the vaccinces. So far no evidence to suggest it is problematic.
https://www.nytimes.com/2021/05/13/health/vaccine-pregnancy....
And from Pfizer and Moderna's research: https://www.latimes.com/science/story/2021-01-27/covid-19-va...
There is now a large trial of pregnant women getting the vaccinces. So far no evidence to suggest it is problematic.
Hmm, the first trial is just 103 women, the second one is 84. Wow wait, the Pfizer one was _12_ women and Moderna was 13. I'd be more convinced when a more comprehensive trial with thousands of participants is done. Still, thanks for the links!
And GI function, which affects us all, every day.
Some more info from the uni that performed the study[1]:
> In relation to the cellular (or T cell) immune response, which plays an important role in supporting and maintaining antibody production, the team found that within the three-week interval group, 60% had a confirmed cellular response at two to three weeks following the second vaccine - although this fell to only 15% eight to nine weeks later.
> The proportion of participants showing a cellular response in the 12-week-interval group was only eight per cent at five to six weeks after the first vaccine, but this rose to 31% two to three weeks after the second vaccine. Research is required to further explore these variations in responses.
You're correct that the evidence isn't dispositive yet, but it's an encouraging signal. Antibody response in the short-term is positive and in the medium-term cellular response possibly converges.
More importantly, the implications for the first doses first strategy are positive. Those who know how to reason under uncertainty saw the UK's strategy as a calculated gamble based on a model that extended the point information provided by the vaccine efficacy RCT; critics were generally incoherent but their claim was that it was likely to cause large _negative_ effects on efficacy, worth paying the cost of vaccinating far fewer people.
On top of the priors that led to the decision, we now have signal from the way the winter surge played out in the UK, and the increased antibody response alone provides further weak signal that the delay was worth it - and conversely, that the US's approach cost lives).
The evidence still isn't dispositive, but crucially, there's no such strong basis for believing the alternative either: that extending doses _reduces_ efficacy and that vaccine availability should be limited in the name of adhering rigidly to the RCT-studied timeline.
The status quo bias of medical culture killed a lot of people during this pandemic by continuing their habit of pretending that certainty exists where none does and refusing to engage in critical thinking about uncertainty. Refusing to explicitly extrapolate a model from few high-quality samples really just means "implicitly extrapolating a crappy model through bias and guesswork". This may be adaptive in the normal medical context, where the status quo is generally fine, but is an incredibly poor fit for a fast-moving pandemic that was killing thousands a day in the US alone.
[1] https://www.birmingham.ac.uk/news/latest/2021/05/covid-pfize...
> In relation to the cellular (or T cell) immune response, which plays an important role in supporting and maintaining antibody production, the team found that within the three-week interval group, 60% had a confirmed cellular response at two to three weeks following the second vaccine - although this fell to only 15% eight to nine weeks later.
> The proportion of participants showing a cellular response in the 12-week-interval group was only eight per cent at five to six weeks after the first vaccine, but this rose to 31% two to three weeks after the second vaccine. Research is required to further explore these variations in responses.
You're correct that the evidence isn't dispositive yet, but it's an encouraging signal. Antibody response in the short-term is positive and in the medium-term cellular response possibly converges.
More importantly, the implications for the first doses first strategy are positive. Those who know how to reason under uncertainty saw the UK's strategy as a calculated gamble based on a model that extended the point information provided by the vaccine efficacy RCT; critics were generally incoherent but their claim was that it was likely to cause large _negative_ effects on efficacy, worth paying the cost of vaccinating far fewer people.
On top of the priors that led to the decision, we now have signal from the way the winter surge played out in the UK, and the increased antibody response alone provides further weak signal that the delay was worth it - and conversely, that the US's approach cost lives).
The evidence still isn't dispositive, but crucially, there's no such strong basis for believing the alternative either: that extending doses _reduces_ efficacy and that vaccine availability should be limited in the name of adhering rigidly to the RCT-studied timeline.
The status quo bias of medical culture killed a lot of people during this pandemic by continuing their habit of pretending that certainty exists where none does and refusing to engage in critical thinking about uncertainty. Refusing to explicitly extrapolate a model from few high-quality samples really just means "implicitly extrapolating a crappy model through bias and guesswork". This may be adaptive in the normal medical context, where the status quo is generally fine, but is an incredibly poor fit for a fast-moving pandemic that was killing thousands a day in the US alone.
[1] https://www.birmingham.ac.uk/news/latest/2021/05/covid-pfize...
I completely agree with everything you said.
That said, the most effective defense I've seen for the seemingly incoherently cautious status quo approach is that the medical community doesn't operate on the span of one pandemic, but is rather in a perpetual struggle. So even if the short-term expected value of an excessively cautious approach is negative, resulting in more deaths and a longer pandemic, it might be outweighed by reducing the chance of damaging public faith in medicine long-term by an erroneous more aggressive move.
I still don't agree, but that very long-term view is the only defense I see for the approach given what we knew at the time.
That said, the most effective defense I've seen for the seemingly incoherently cautious status quo approach is that the medical community doesn't operate on the span of one pandemic, but is rather in a perpetual struggle. So even if the short-term expected value of an excessively cautious approach is negative, resulting in more deaths and a longer pandemic, it might be outweighed by reducing the chance of damaging public faith in medicine long-term by an erroneous more aggressive move.
I still don't agree, but that very long-term view is the only defense I see for the approach given what we knew at the time.
Thank you for bringing that up. That makes a lot of sense, and public health absolutely does need to consider mass psychology and their credibility.
The theory that they're overindexing on protecting that credibility doesn't really comport with their behavior the rest of pandemic, however. Leaving aside all of the blood on the hands of mindless bureaucracy (like effectively banning testing for Covid in the early pandemic when it was most crucial), there has been decision after decision that prioritized status quo bias and RCT-worship even when the long game suggests it would damage their credibility (the fervent anti-mask recommendations in the early pandemic is a great example, as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late).
More importantly, "public health is misleading you at the cost of your health/life because they're playing the long game" doesn't actually preserve much credibility. It certainly casts public health figures in a more positive light, but I'm not really thinking in terms of blaming individuals over institutions/cultures anyway. It doesn't really matter _why_ public health advice is wrong in obvious and significant ways. What matters is the ultimate conclusion: if you have basic scientific literacy and an IQ over 105, form your own broad understanding of the science. This isn't a call to jettison epistemic humility: you're not going to be able to understand things anywhere close to as well as an individual epidemiologist can. But the point is that listening to the science as filtered through public health advice _is even worse_, in the same way that getting nutrition advice from the USDA will.
The theory that they're overindexing on protecting that credibility doesn't really comport with their behavior the rest of pandemic, however. Leaving aside all of the blood on the hands of mindless bureaucracy (like effectively banning testing for Covid in the early pandemic when it was most crucial), there has been decision after decision that prioritized status quo bias and RCT-worship even when the long game suggests it would damage their credibility (the fervent anti-mask recommendations in the early pandemic is a great example, as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late).
More importantly, "public health is misleading you at the cost of your health/life because they're playing the long game" doesn't actually preserve much credibility. It certainly casts public health figures in a more positive light, but I'm not really thinking in terms of blaming individuals over institutions/cultures anyway. It doesn't really matter _why_ public health advice is wrong in obvious and significant ways. What matters is the ultimate conclusion: if you have basic scientific literacy and an IQ over 105, form your own broad understanding of the science. This isn't a call to jettison epistemic humility: you're not going to be able to understand things anywhere close to as well as an individual epidemiologist can. But the point is that listening to the science as filtered through public health advice _is even worse_, in the same way that getting nutrition advice from the USDA will.
> as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late
I watched Contagion for the first time last week, and they had the same attitude toward fomites, where it was spread through knobs and cash registers.
I’m convinced that the movie was interpreted as a documentary on what to do rather than science.
Now I question how much hand-washing helps prevent the spread of other respiratory viruses.
Looks like, for flu, in this study, fomites were responsible for 4% of cases:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/
… and
> Mask wearing is much more useful than hand washing for control of influenza A in the tested office setting. Regular cleaning of high-touch surfaces, which can reduce the infection risk by 2.14%, is recommended and is much more efficient than hand-washing.
But I’m just a guy that spent 2 minutes searching studies on Google of respiratory viruses, why make decisions so easily based on that when you can base decisions on a movie on Netflix.
I watched Contagion for the first time last week, and they had the same attitude toward fomites, where it was spread through knobs and cash registers.
I’m convinced that the movie was interpreted as a documentary on what to do rather than science.
Now I question how much hand-washing helps prevent the spread of other respiratory viruses.
Looks like, for flu, in this study, fomites were responsible for 4% of cases:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/
… and
> Mask wearing is much more useful than hand washing for control of influenza A in the tested office setting. Regular cleaning of high-touch surfaces, which can reduce the infection risk by 2.14%, is recommended and is much more efficient than hand-washing.
But I’m just a guy that spent 2 minutes searching studies on Google of respiratory viruses, why make decisions so easily based on that when you can base decisions on a movie on Netflix.
Very interesting, thank you. Call it Gell-Mann Amnesia, but I had not thought to extend my skepticism of the basic competence of public health authorities to flu recommendations. I suppose my model is that they were bad in the fast-moving epistemic environment of the pandemic, and that this wouldn't extend to relatively stable and well-understood cases like influenza.
Isn't there a potential downside to the UK approach in an environment where variants are increasing? I've seen some data suggesting that with only one jab the mRNA vaccines are only about 20% effective against the UK, SA and Brazilian variants (no data yet on the India variant), but that number jumps in to the 70% range with the 2nd dose. A delay of 12 weeks leaves a lot of people in that 20% efficacy range for those variants. Now some parts of the UK are starting to see increasing cases of the Indian variant.
Do you have a source for this number? All of the evidence I've seen shows the mRNA vaccines are in the 80% effectiveness range after a single dose, but that data was not specific to any variants.
One study from Qatar: https://www.nejm.org/doi/full/10.1056/NEJMc2104974
For preventing infection:
B.1.1.7: 29.5% effective after one dose (Pfizer)
B.1.351: 16.9%
Would have been really nice if they had separated the effectiveness data by days after first dose, we know the curve is substantial for the first few weeks so it would not be surprising for people to still catch it in week one, I would be surprised by data showing <50% effectiveness in week three and four.
Canada has some opposing data: https://www.cdc.gov/mmwr/volumes/70/wr/mm7020e2.htm
I believe the author said people were misinterpreting the study. It included people who caught it before the protection of the first dose kicked in.
> with only one jab the mRNA vaccines are only about 20% effective against the UK, SA and Brazilian variants
Do you have a source for this I could see? I did some light Googling and couldn't find anything that said as much; it also runs contrary to the impact of Britain's choice of widespread vaccination over incremental effectiveness gains (though this is of course just a correlation). A study I did find[1] looking at effectiveness in the UK has first-dose effectiveness at 70%, roughly as expected (I'm using the UK here as a noisy proxy for the UK variant, but I think that's reasonable).
Leaving aside the veracity of this concern, the counterfactual was facing the massive winter surge many countries saw while intentionally choosing to vaccinate half as many people. It's not clear at all that it would be good policy, especially given the ability to change policy[2] as the reality on the ground changes. Seeing how public health has conducted themselves throughout pandemic, I simply don't have the blind faith that they handled this cost-benefit analysis competently.
To pick just one example I came across[3]: as much as I respect Bob Wachter, the Chair of Medicine at UCSF, he was exemplary of this flaw in critical thinking ability that medical culture indoctrinates into HCWs. He came around to FDF on New Year's, after a month of arguing against it. It's amazing to see him discover the concept of quantitative rigor in the face of uncertainty when speed is crucial. This is especially striking when contrasted against his prior argument in the opposite direction, which consists of handwavy platitudes around "unnecessary curveballs".
My sister and her husband are both (Ivy League-educated, very successful) physicians, one a clinician and one a clinician scientist. We've had a decade-long conversation about this tendency, the degree to which it exists, the degree to which it's salutary, how it should affect patient/informed-citizen behavior, etc. Part of my relative confidence in my model of this epistemic culture is that these pitfalls were entirely predictable, and indeed, I pre-registered concerns[4] about the pandemic's characteristics and how modern medical culture was likely to interact with it.
This isn't as damning an indictment of medicine as it may sound (the FDA's Vogonic bureaucracy fetish has way more blood on its hands than any of the flaws in medical culture). And one thing I've picked up from all my conversations with my brother-in-law is that the average consumer of medical information is almost unbelievably stupid (not how he would phrase it) and is far better off following public health (and nutrition) advice as dogma than trying to understand and pick it apart. But if you are basically scientifically-literate, say to the point that you can read and mostly understand the paper I shared in [1], you're likely far worse off uncritically accepting their epistemic flaws than using them as a baseline and doing your own research (and as always, retain a heaping dose of epistemic humility around your error bars and counterfactuals)
[1] https://www.bmj.com/content/373/bmj.n1088
[2] https://www.nytimes.com/2021/05/14/world/india-covid-second-...
[3] https://twitter.com/Bob_Wachter/status/1344667655324585986
[4] This was in conversation with them. Sadly, I have no online proof I can share without self-doxxing
Do you have a source for this I could see? I did some light Googling and couldn't find anything that said as much; it also runs contrary to the impact of Britain's choice of widespread vaccination over incremental effectiveness gains (though this is of course just a correlation). A study I did find[1] looking at effectiveness in the UK has first-dose effectiveness at 70%, roughly as expected (I'm using the UK here as a noisy proxy for the UK variant, but I think that's reasonable).
Leaving aside the veracity of this concern, the counterfactual was facing the massive winter surge many countries saw while intentionally choosing to vaccinate half as many people. It's not clear at all that it would be good policy, especially given the ability to change policy[2] as the reality on the ground changes. Seeing how public health has conducted themselves throughout pandemic, I simply don't have the blind faith that they handled this cost-benefit analysis competently.
To pick just one example I came across[3]: as much as I respect Bob Wachter, the Chair of Medicine at UCSF, he was exemplary of this flaw in critical thinking ability that medical culture indoctrinates into HCWs. He came around to FDF on New Year's, after a month of arguing against it. It's amazing to see him discover the concept of quantitative rigor in the face of uncertainty when speed is crucial. This is especially striking when contrasted against his prior argument in the opposite direction, which consists of handwavy platitudes around "unnecessary curveballs".
My sister and her husband are both (Ivy League-educated, very successful) physicians, one a clinician and one a clinician scientist. We've had a decade-long conversation about this tendency, the degree to which it exists, the degree to which it's salutary, how it should affect patient/informed-citizen behavior, etc. Part of my relative confidence in my model of this epistemic culture is that these pitfalls were entirely predictable, and indeed, I pre-registered concerns[4] about the pandemic's characteristics and how modern medical culture was likely to interact with it.
This isn't as damning an indictment of medicine as it may sound (the FDA's Vogonic bureaucracy fetish has way more blood on its hands than any of the flaws in medical culture). And one thing I've picked up from all my conversations with my brother-in-law is that the average consumer of medical information is almost unbelievably stupid (not how he would phrase it) and is far better off following public health (and nutrition) advice as dogma than trying to understand and pick it apart. But if you are basically scientifically-literate, say to the point that you can read and mostly understand the paper I shared in [1], you're likely far worse off uncritically accepting their epistemic flaws than using them as a baseline and doing your own research (and as always, retain a heaping dose of epistemic humility around your error bars and counterfactuals)
[1] https://www.bmj.com/content/373/bmj.n1088
[2] https://www.nytimes.com/2021/05/14/world/india-covid-second-...
[3] https://twitter.com/Bob_Wachter/status/1344667655324585986
[4] This was in conversation with them. Sadly, I have no online proof I can share without self-doxxing
One study from Qatar: https://www.nejm.org/doi/full/10.1056/NEJMc2104974
Is having a lower peak cellular response meaningful in the long run, or not so much?
Great question, that I don't know the answer to. The answer to that question is part of the uncertainty that attenuates the signal I described as "weak". I think the reason I like the approach I'm describing is that you can model uncertainty at every level of knowledge: you don't need to become an epidemiologist to reason about the facts (with correspondingly higher error bars than a domain expert would have), _and_ you don't need to blindly trust that experts in every domain are somehow magically optimal when it comes to reasoning under uncertainty.
To put it another way, that's the kind of information I would spend the time digging into once knowing the answer would push my model across a decision threshold. I look forward to seeing the follow-up research, which is usually the quickest way to fill in gaps in the "primitives".
To put it another way, that's the kind of information I would spend the time digging into once knowing the answer would push my model across a decision threshold. I look forward to seeing the follow-up research, which is usually the quickest way to fill in gaps in the "primitives".
Lots of people in the medical/scientific community expected this result. The best explanation I have heard is that the vaccine companies planned these sub-optimal trials with 2-3 weeks between shots, because it meant getting the vaccines to market much more quickly. Instead of having vaccines available in December, they might not have been available until February.
So far, the evidence is pretty compelling that the vaccines have continued efficacy 6-7 months post-administration. It's obviously impossible to know much beyond a couple months however.
So far, the evidence is pretty compelling that the vaccines have continued efficacy 6-7 months post-administration. It's obviously impossible to know much beyond a couple months however.
Mind you, there's a delicate balancing game here though. Slower vaccines, even if more optimal, come with their own costs.
> This info doesn't seem sufficient to draw meaningful conclusions about longer term protection.
Is it because the study period is just that i.e. 12 weeks? Even the studies on natural immunity from COVID suggests at least 6 - 8 months antibody persistence because the study period were just that[1][2]. Note that policies are being made now to defer the jab for those who got infected by COVID, based on these studies.
We'll likely see studies confirming long term protection from vaccines & natural immunity after disease in coming months. Btw, How much is long term?
[1]https://www.nih.gov/news-events/nih-research-matters/lasting...
[2]https://www.nejm.org/doi/full/10.1056/NEJMoa2034545?s=09
[3]https://twitter.com/PTI_News/status/1392715110821494789
Is it because the study period is just that i.e. 12 weeks? Even the studies on natural immunity from COVID suggests at least 6 - 8 months antibody persistence because the study period were just that[1][2]. Note that policies are being made now to defer the jab for those who got infected by COVID, based on these studies.
We'll likely see studies confirming long term protection from vaccines & natural immunity after disease in coming months. Btw, How much is long term?
[1]https://www.nih.gov/news-events/nih-research-matters/lasting...
[2]https://www.nejm.org/doi/full/10.1056/NEJMoa2034545?s=09
[3]https://twitter.com/PTI_News/status/1392715110821494789
Does this suggest anything about side effects? Is it likely to make them better, worse, or none at all?
I'm aware that there's not enough information to say yet, but it's something I'd like to see them look out for. The side effects are absolutely not a good enough reason to avoid getting vaccinated, both for your own sake and as a participant in herd immunity, but I've personally witnessed enough unpleasantness to know that there will be people who avoid it just to avoid the side effects.
Being able to provide good advice to help the rational but fearful may help get us over the threshold, despite the large numbers of irrationally fearful. We'll need every single one to get there.
I'm aware that there's not enough information to say yet, but it's something I'd like to see them look out for. The side effects are absolutely not a good enough reason to avoid getting vaccinated, both for your own sake and as a participant in herd immunity, but I've personally witnessed enough unpleasantness to know that there will be people who avoid it just to avoid the side effects.
Being able to provide good advice to help the rational but fearful may help get us over the threshold, despite the large numbers of irrationally fearful. We'll need every single one to get there.
Anecdotally, in my home, my wife had chills and general ickyness from about 12-36 hours post 2nd dose. Myself and my teenager had no side effects at all. Even the soreness at the injection site was less after shot #2 than it was for the first.
Don't let fear of side effects drive you away from getting the necessary booster. As of today, Fauci says I can ditch the mask. I'll still be keeping one in my pocket just in case though.
Don't let fear of side effects drive you away from getting the necessary booster. As of today, Fauci says I can ditch the mask. I'll still be keeping one in my pocket just in case though.
I really wish more were being done to openly address the more extreme cases of side effects, so we could try to find other contributing factors and perhaps mitigation strategies.
The number of poor reactions is very small, but pretending like they don’t exist or failing to address ways to overcome them only further fuels the fear in those hesitant to get vaccinated, and furthers the divisiveness in an issue we should all be working together on.
Which makes sense if you’re a politician or Dr. Fauci, but doesn’t make sense if you just care about the health and safety of everyone and want to get this damn pandemic over with already.
Forcing or shaming the hold outs to get vaccinated won’t do this, but giving honest confidence in the vaccine to people will.
The number of poor reactions is very small, but pretending like they don’t exist or failing to address ways to overcome them only further fuels the fear in those hesitant to get vaccinated, and furthers the divisiveness in an issue we should all be working together on.
Which makes sense if you’re a politician or Dr. Fauci, but doesn’t make sense if you just care about the health and safety of everyone and want to get this damn pandemic over with already.
Forcing or shaming the hold outs to get vaccinated won’t do this, but giving honest confidence in the vaccine to people will.
in particular, a linear change in antibody levels, which trigger an exponential response, doesn't really mean very much!
And 12 weeks is a long time. I honestly would rather get an immunity boost after 3 weeks than wait the 12 for a second. A lot can happen in twelve weeks.
We'll soon find out from Canada what the effects of a 4 month gap does to response for all age groups.
Similar span for those in the UK I was hearing. There strategy, from what I understand, was mainly get the 1st dose in most of the population and move onto the second dose. I believe those in high risk groups may have been prioritized, but I'm not sure. (just what I am remembering from a side conversation on a zoom call with a colleague in the UK)
In the UK here. You're pretty much right; the goal as stated was to get a first dose into all of the clinically vulnerable people (long term illness, diabetic, severely asthmatic, etc) and those over 50 before moving on to second doses. IIRC
those groups accounted for about 99% of deaths from covid.
In other words, the supply was enough to make sure that all of those people could get one dose in twelve weeks, so that's the dose interval that was set.
That goal (quickly vaccinate all of the at risk population with one dose) was pretty much achieved. I guess it remains to be seen whether it was the right goal, but early indications (deaths/day down from 1,000 to 10 or so) are positive. (Obviously correlation is not causation and so on, and there undoubtedly a ton of confounders.)
In other words, the supply was enough to make sure that all of those people could get one dose in twelve weeks, so that's the dose interval that was set.
That goal (quickly vaccinate all of the at risk population with one dose) was pretty much achieved. I guess it remains to be seen whether it was the right goal, but early indications (deaths/day down from 1,000 to 10 or so) are positive. (Obviously correlation is not causation and so on, and there undoubtedly a ton of confounders.)
And 6 weeks for a small proportion. Might also end up narrowing that 4 month gap for many and seeing how that works.
It might take a while, as immunity wanes, to see what these different intervals really mean.
It might take a while, as immunity wanes, to see what these different intervals really mean.
They say that as a standard answer. Will be much faster. First dose is gonna be done in June at the current speed.
As a Canadian (read: lab rat) I'm hoping this forced experiment I'm participating in, run by someone with no scientific background, ends well also. Thousands of lives are depending on what, at this point, amounts to a gamble on minimal evidence.
This was not a personal decision from the prime minister, this is from the National Advisory Committee on Immunization. You can disagree of course, but let's not lie and pretend that this is just Trudeau that woke up one morning and decided to do that, lots of people are behind that decision and they also had the benefit of insight looking at what the UK had been doing.
Yeah. I count 13 doctors and professors out of a team of 14 people. "someone with no scientific background" is not an accurate description of the decision-makers.
https://www.canada.ca/en/public-health/services/immunization...
https://www.canada.ca/en/public-health/services/immunization...
Not to mention that the Chief Medical Officer of British Columbia, Dr. Bonnie Henry, came to the same conclusion even before the national level bodies had decided. Dr. Henry implemented the strategy by stopping second vaccinations so more people could get first vaccinations.
In Bonnie we trust.
Let me attempt to give a defense of "first shots first" as someone who initially wrote it off as foolish, and later came round to it.
In an ideal world, you'd do a few clinical trials and figure out the optimal dose regime and timing. (I'm not really sure why they didn't run 5 parallel trials with different timings to begin with).
In the world we inhabit, alas we didn't have those studies. But that doesn't mean we have no reason to believe that the first shot is protective! You can still look at how vaccines in general work, and our basic understanding of immunology. In general, for vaccines with multiple shots, the model seems to be that the first shot gets you >50% of the protection, and the second shot mainly extends the protection over time. This might not be how the COVID vaccines work, but your priors should be fairly strong that this is what the clinical trials will ultimately show, because that's what they have shown for a bunch of different vaccines with different mechanisms.
If you're in an ideal world where inaction doesn't cost you anything, sure, do the studies.
In the world we inhabit, thousands were dying every day, and so inaction is morally horrifying. Giving a pair of doses as first shots to two >65yo results in far fewer people dead than giving that pair of doses as a full course to one 65yo. The expected value is pretty clear on this one, even though the clinical trials were not.
You should probably have started to feel tentatively confident that the first-dose-first strategy was sound circa mid-Feb, when it the UK's death rate had been falling rapidly for about two weeks: https://lh4.googleusercontent.com/GGlgMxEKIoaxyuZbuHjjEBH2er... -- while it's hard to disentangle lockdown effects, EU vs. UK was mainly a difference between "locked down with vaccines" and "locked down without vaccines", at risk of oversimplifying.
If I had to summarize in a sentence: use Bayesian reasoning rather than applying unjustifiably strict error bars on your decision process.
In an ideal world, you'd do a few clinical trials and figure out the optimal dose regime and timing. (I'm not really sure why they didn't run 5 parallel trials with different timings to begin with).
In the world we inhabit, alas we didn't have those studies. But that doesn't mean we have no reason to believe that the first shot is protective! You can still look at how vaccines in general work, and our basic understanding of immunology. In general, for vaccines with multiple shots, the model seems to be that the first shot gets you >50% of the protection, and the second shot mainly extends the protection over time. This might not be how the COVID vaccines work, but your priors should be fairly strong that this is what the clinical trials will ultimately show, because that's what they have shown for a bunch of different vaccines with different mechanisms.
If you're in an ideal world where inaction doesn't cost you anything, sure, do the studies.
In the world we inhabit, thousands were dying every day, and so inaction is morally horrifying. Giving a pair of doses as first shots to two >65yo results in far fewer people dead than giving that pair of doses as a full course to one 65yo. The expected value is pretty clear on this one, even though the clinical trials were not.
You should probably have started to feel tentatively confident that the first-dose-first strategy was sound circa mid-Feb, when it the UK's death rate had been falling rapidly for about two weeks: https://lh4.googleusercontent.com/GGlgMxEKIoaxyuZbuHjjEBH2er... -- while it's hard to disentangle lockdown effects, EU vs. UK was mainly a difference between "locked down with vaccines" and "locked down without vaccines", at risk of oversimplifying.
If I had to summarize in a sentence: use Bayesian reasoning rather than applying unjustifiably strict error bars on your decision process.
> Giving a pair of doses as first shots to two >65yo results in far fewer people dead than giving that pair of doses as a full course to one 65yo.
In the US, though, I don't think we have ever been forced between these two scenarios: we have always had enough vaccine doses for people in our high risk classes. The question thereby is more whether it is better to have all the essential workers and everyone over 65 years old along with maybe third of everyone else with a single dose or to have the first two classes of people fully dosed... and "I dunno", right? ;P
In the US, though, I don't think we have ever been forced between these two scenarios: we have always had enough vaccine doses for people in our high risk classes. The question thereby is more whether it is better to have all the essential workers and everyone over 65 years old along with maybe third of everyone else with a single dose or to have the first two classes of people fully dosed... and "I dunno", right? ;P
> I don't think we have ever been forced between these two scenarios
I'm not sure; January->April the US was constrained by vaccine supply. The initial rollout to at-risk groups was not a case of "we got a shipment of 100m doses, now we need to figure out how to use them", it was more "we're manufacturing 1-2m doses per day and trying to ramp that up". It took months to go through the gradually broadening risk tiers. (e.g. see https://investors.modernatx.com/news-releases/news-release-d..., which says "deliver 100m vaccines by end of March, 100m more by end of May").
I believe the US was keeping shots back in favor of using them later as second doses, rather than giving them immediately as first doses, though I don't have a citation for that to hand. If that's right, the US could have ~doubled its rate of vaccination, i.e. got to the April 15 "all age group open vaccination" milestone in 2 months instead of 4 months, with first doses only administered to that population. At the very least, we were giving second doses in Feb (21-28 days after first doses in Jan) that could have been given as first doses to the higher-risk groups we were still prioritizing through April.
There's a follow-up question on which I have not run the numbers -- are there any X,Y pairs for which you'd rather hold back a shot to give as a second dose later for a >X year old, instead of giving it immediately as a first dose to a <Y year old. Interesting question, I don't think that's what you were getting at though.
I'm not sure; January->April the US was constrained by vaccine supply. The initial rollout to at-risk groups was not a case of "we got a shipment of 100m doses, now we need to figure out how to use them", it was more "we're manufacturing 1-2m doses per day and trying to ramp that up". It took months to go through the gradually broadening risk tiers. (e.g. see https://investors.modernatx.com/news-releases/news-release-d..., which says "deliver 100m vaccines by end of March, 100m more by end of May").
I believe the US was keeping shots back in favor of using them later as second doses, rather than giving them immediately as first doses, though I don't have a citation for that to hand. If that's right, the US could have ~doubled its rate of vaccination, i.e. got to the April 15 "all age group open vaccination" milestone in 2 months instead of 4 months, with first doses only administered to that population. At the very least, we were giving second doses in Feb (21-28 days after first doses in Jan) that could have been given as first doses to the higher-risk groups we were still prioritizing through April.
There's a follow-up question on which I have not run the numbers -- are there any X,Y pairs for which you'd rather hold back a shot to give as a second dose later for a >X year old, instead of giving it immediately as a first dose to a <Y year old. Interesting question, I don't think that's what you were getting at though.
As a fellow Canadian I'm happy that finally we get some common sense in this pandemic. If we hadn't taken this approach we'd still be heading up on case counts instead of heading down, increasing the vaccinated base is what has turned the tide on the third wave and is what's going to end the pandemic here months sooner than it would have ended otherwise.
We don't have time to RCT test all scenarios. That's how life works. The long term immunity as a function of delta between the first and second shot has not been tested at all. J&J vaccine is one shot mostly because it can only be one shot yet it still works. There are other aspects that have not been tested in the trials. We need to make reasonable decisions under uncertainty in an ever changing landscape.
We don't have time to RCT test all scenarios. That's how life works. The long term immunity as a function of delta between the first and second shot has not been tested at all. J&J vaccine is one shot mostly because it can only be one shot yet it still works. There are other aspects that have not been tested in the trials. We need to make reasonable decisions under uncertainty in an ever changing landscape.
There is plenty of evidence that the first shot reduces the risk of the worst symptoms quite significantly.
> reduces the risk of the worst symptoms quite significantly.
Right, reduces, but the full dose is needed to render the virus mostly harmless. My partner's coworker has Covid and one does of the vaccine, they are still severely ill.
Right, reduces, but the full dose is needed to render the virus mostly harmless. My partner's coworker has Covid and one does of the vaccine, they are still severely ill.
First of all, when we read or hear about severe illnesses due to COVID in the news and articles, what they mean is hospitalization, ICU, and death. Are your coworkers in the hospital? If so, my thoughts and prayers go to them. I hope they make it.
Second of all, the choice was never between giving two doses to 16 million people (as of today) or giving one dose to 16 million people. The choice was giving two doses to 8 million people or one dose to 16 million people. The total death toll from the pandemic would be lower the sooner we get to the point of herd immunity. Giving everyone one dose gets us there sooner and ultimately saves lives.
Second of all, the choice was never between giving two doses to 16 million people (as of today) or giving one dose to 16 million people. The choice was giving two doses to 8 million people or one dose to 16 million people. The total death toll from the pandemic would be lower the sooner we get to the point of herd immunity. Giving everyone one dose gets us there sooner and ultimately saves lives.
FWIW, in the United States, it isn't clear we are ever going to herd immunity... like we are at the point where the New York Times is just reporting on the idea that we've lost that battle. So I can feel sympathy for the strategy of getting our essential workers and old people--at lease the ones willing to take a vaccine--double-doses before moving on to people who are less likely do die from the disease.
Do you happen to know roughly how long after getting vaccinated they caught covid?
It takes ~14 days after the first dose to get the ~80-90% protection (Pfizer/Moderna).
It takes ~14 days after the first dose to get the ~80-90% protection (Pfizer/Moderna).
Unfortunately, I think this is not true for the latest mutations that appeared within the last months (e.g. B.1.1.7 from the UK).
Please correct me in case you have different information
Please correct me in case you have different information
…in those over 80… the study says for those only reading the title.
Those over 80 make up half of the covid death count. I'd say that's pretty encouraging.
India seems to be a special case, as only 4.8% of the population is above 65.
https://www.sciencemag.org/news/2021/04/will-india-s-devasta...
Apart from India it seems that Japan should take notes, it's quite a surprise to me that only 1% of the population has been fully vaccinated.
No wonder they are reluctant to let spectators be present for the olympics.
https://www.sciencemag.org/news/2021/05/only-1-japan-fully-v...
https://www.sciencemag.org/news/2021/04/will-india-s-devasta...
Apart from India it seems that Japan should take notes, it's quite a surprise to me that only 1% of the population has been fully vaccinated.
No wonder they are reluctant to let spectators be present for the olympics.
https://www.sciencemag.org/news/2021/05/only-1-japan-fully-v...
Somewhere I read that Covid deaths are underreported. This is in the chaotic times understandable even if unfortunate. It's said it happened everywhere, even in the USA and in Europe, and the real rates are somewhere between 1.5 times to 10 times the reported rates.
And Japan seems to be an outlier with massively underreported deaths.
Probably because many elderly died alone at home and where interred or incinerated without further testing.
And Japan seems to be an outlier with massively underreported deaths.
Probably because many elderly died alone at home and where interred or incinerated without further testing.
The Economist estimates the current victim count at 10M±3M. This is really not helped by the disorganization in some countries and the utterly fraudulent data reported by others (Russia, Egypt...)
https://www.economist.com/briefing/2021/05/15/there-have-bee...
https://www.economist.com/briefing/2021/05/15/there-have-bee...
See excess mortality rate.
I was just watching on NHK that the N501Y mutated strain in Japan is putting healthy 30-60 year olds in hospital care 66% more often.
They are actively cancelling Olympic training events and reducing paralympic events, and only 10% of Tokyo residents surveyed said they are happy the games are going to continue as planned.
They are actively cancelling Olympic training events and reducing paralympic events, and only 10% of Tokyo residents surveyed said they are happy the games are going to continue as planned.
Yes it doesn't look good for Japan which also have one of the oldest populations in the world.
In Denmark the English B.1.1.7 variant needed about 3 weeks to become dominant, though it's a bit unclear which variant will become the dominant one in Japan.
Some additional links
https://asia.nikkei.com/Spotlight/Coronavirus/COVID-variants...
https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
And a link that gives some insight as to why Japan have vaccinated so few.
https://www.google.com/amp/s/www.washingtonpost.com/opinions...
In Denmark the English B.1.1.7 variant needed about 3 weeks to become dominant, though it's a bit unclear which variant will become the dominant one in Japan.
Some additional links
https://asia.nikkei.com/Spotlight/Coronavirus/COVID-variants...
https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
And a link that gives some insight as to why Japan have vaccinated so few.
https://www.google.com/amp/s/www.washingtonpost.com/opinions...
4.8% of India is still 65 million people.
I agree that is an important point. While that was the population that was tested, I think it is OK to infer that there would be a similar response to those under 80 as well.
We can hope and guess it will work at the same rate but because the response to covid between the youngest and the oldest have been so different we would have to assume it's probably different to some degree.
This suggests a third booster shot may be useful for some people. That will probably be tested. Good to have such an option, if needed.
Here in the UK the plan seems to be to provide a 3rd booster ina slightly tweaked form that better targets some of the new variants. I read that it could be available from as early as september.
Booster shots are already getting ordered.
https://investors.modernatx.com/news-releases/news-release-d...
https://investors.modernatx.com/news-releases/news-release-d...
It is currently not known if or when boosters may be needed.
what planet are you on? there have already been multiple studies that show the efficiacy of existing vaccines are not as effective against some of the variants. don't doubt that there will be bootsters for this
And we’ll probably have more mutants appear. We’re hitting all time records in new infections. The more infections, the more copies, the more risk of an imperfect replication (mutant) that’s worse.
I’m happy that pigs and birds don’t seem to get COVID-19 (and hoping that’s not a mutation away).
I’m happy that pigs and birds don’t seem to get COVID-19 (and hoping that’s not a mutation away).
No variant has been shown to evade the leading vaccines to the point that they are not effective, and there has is no established timetable for when immunity form vaccines fades.
and a fourth booster... and a fifth... sixth, seventh, etc.
Which is going to be the future. The CEO of Moderna was talking about it. An annual shot that includes COVID, flu, cold and other vaccines. We'll get to a point in which we will look back at having a cold like you look at a Nokia 3310 now.
Edit: podcast link for who's curious https://ark-invest.com/podcast/understanding-mrna-conversati...
Edit: podcast link for who's curious https://ark-invest.com/podcast/understanding-mrna-conversati...
I liked my Nokia 3310. I never liked the cold.
This was funny! I should have found a better comparison...
The CEO of Moderna has a rather obvious conflict of interest. If he overestimates future vaccine need, he can't be blamed for being 'cautious', but enjoys a potential stock boost anyway.
This is a beautiful idea, basically eliminating the threat and inconvenience that most viruses cause. But it's a bit early to conclude that this is certainly the future.
Covid is by far the worst and deadliest pandemic since 1914, which both justifies and facilitates very fast testing and use of new vaccines.
But we haven't had the time to look for long-term effects yet. This is not an antivaxxer stance - it's basic epistemology. mRNA vaccines allow us to trigger and target the immune system to point it in arbitrary directions to a degree we haven't before. The immune system is a sensitive thing that can cause lots of damage if it gets confused.
I'd want a lot of high-quality data on long-term effects in terms of risk of autoimmune disease, Alzheimers, ME and so on a world where we deliberately provoke strong immune responses versus things that are mostly minor inconveniences - the common cold, the flu, herpes, etc.
I certainly hope this is the future, but I won't be the first in line to test it out.
Covid is by far the worst and deadliest pandemic since 1914, which both justifies and facilitates very fast testing and use of new vaccines.
But we haven't had the time to look for long-term effects yet. This is not an antivaxxer stance - it's basic epistemology. mRNA vaccines allow us to trigger and target the immune system to point it in arbitrary directions to a degree we haven't before. The immune system is a sensitive thing that can cause lots of damage if it gets confused.
I'd want a lot of high-quality data on long-term effects in terms of risk of autoimmune disease, Alzheimers, ME and so on a world where we deliberately provoke strong immune responses versus things that are mostly minor inconveniences - the common cold, the flu, herpes, etc.
I certainly hope this is the future, but I won't be the first in line to test it out.
Just want to clarify that that is the "future", not the present. And just because cold and flu are minor inconveniences to you, doesn't mean that they aren't very dangerous for people with weak immune systems. And on top of that mRNA is very targeted, it's not something that carpet bombs your body like radiotherapy.
You mean 1918, I think?
Well I'd urge you to not be so hastily. This could very well go very badly. There are a lot of unproven, hypothetical, assumptions being made, and a lot of people are completely ignoring any counter argument. Often valid issues simply get deleted, people just don't want to hear it, they don't want to see it, and it scares me to be honest. It's also getting completely impossible to argue against the commitment bias of vaccinated people. You really don't even considered once that injecting spike protein on a regular basis might not be the best thing for you body? This is a harmful protein after all.
I don't know, maybe its all fine and good, but if you ask me, I think a lot of people are way too excited to be part of this study. Especially since the risk/reward doesn't seems to be that great in the first place.
I don't know, maybe its all fine and good, but if you ask me, I think a lot of people are way too excited to be part of this study. Especially since the risk/reward doesn't seems to be that great in the first place.
>You really don't even considered once that injecting spike protein on a regular basis might not be the best thing for you body? This is a harmful protein after all.
We're talking about small amounts here, that aren't replicating. If you have the virus coursing around you get a lot of contact with the real spike protein, which can replicate inside your body.
The body is used to fighting off a lot of viruses and bacteria at the same time. Why would this spike protein, without the attached virus, be different?
After all we can't compare the vaccine to a world without the virus, since we won't get that back. Instead we need to compare the vaccine to the world with the virus.
We're talking about small amounts here, that aren't replicating. If you have the virus coursing around you get a lot of contact with the real spike protein, which can replicate inside your body.
The body is used to fighting off a lot of viruses and bacteria at the same time. Why would this spike protein, without the attached virus, be different?
After all we can't compare the vaccine to a world without the virus, since we won't get that back. Instead we need to compare the vaccine to the world with the virus.
It's a good point. But delivery mechanism should probably be considered too. The virus has to go through the respiratory system, which is a first line of defense. Then it takes time to infect you, multiply, and get around. It also can only dock at ACE2 I think. The shot seems to be instant full body intracellular delivery.
Maybe it does not matter much, but the immune reaction can indeed be very strong. Just don't be completely naive when in comes to regular booster shots, there might be a fine line between benefits and negatives. Also other types of vaccines are on the way I heard, so we'll see, maybe that will open up alternative ways to combat the virus.
Maybe it does not matter much, but the immune reaction can indeed be very strong. Just don't be completely naive when in comes to regular booster shots, there might be a fine line between benefits and negatives. Also other types of vaccines are on the way I heard, so we'll see, maybe that will open up alternative ways to combat the virus.
How is the spike protein on its own dangerous? You think it's gonna go around and poke cells?
It is not yet known if boosters will be necessary for COVID-19, let alone annual shots. There is however evidence that natural immunity lasts longer than 1 year.
yes but natural immunity =/= vaccine immunity (and please don't say bUt vAcCinE aNTIBoDiEs aRe bEtTeR tHaN ThoSe pRodUCed bY nATuRaL aNtIbODiEs)
Okay, but you did not need a vaccine cert for having received the flu shot.
I personally do not get those seasonal flu shots, and I had no issues for years. It was entirely voluntary, and no one gave a shit if you got it or not (it was not the first question that left people when they met you either), it was up to you entirely. We treat the COVID-19 shot very differently, I mean, after all, there actually is a vaccine cert you receive, and without it, you are pretty much doomed these days (it varies between countries, but here many employers made it a prerequisite). What about those who cannot receive the vaccine for health reasons?
Many people here got the vaccine only to get the vaccine cert, because that meant that they could go back to work (as it was a prerequisite). This artificial limitation or restriction goes to extremes somewhere. Here they talk about not being able to receive basic health care without it! Can you believe that? But of course you have to continue paying for social insurance (that covers it).
---
If I may, I would like to have those down-votes explained as I did not say anything that is false, and I did not express my opinion regarding the vaccine either. What exactly could have been down-voted? I believe everything I said is true. If it is not, can you point it out, please?
I personally do not get those seasonal flu shots, and I had no issues for years. It was entirely voluntary, and no one gave a shit if you got it or not (it was not the first question that left people when they met you either), it was up to you entirely. We treat the COVID-19 shot very differently, I mean, after all, there actually is a vaccine cert you receive, and without it, you are pretty much doomed these days (it varies between countries, but here many employers made it a prerequisite). What about those who cannot receive the vaccine for health reasons?
Many people here got the vaccine only to get the vaccine cert, because that meant that they could go back to work (as it was a prerequisite). This artificial limitation or restriction goes to extremes somewhere. Here they talk about not being able to receive basic health care without it! Can you believe that? But of course you have to continue paying for social insurance (that covers it).
---
If I may, I would like to have those down-votes explained as I did not say anything that is false, and I did not express my opinion regarding the vaccine either. What exactly could have been down-voted? I believe everything I said is true. If it is not, can you point it out, please?
I believe comparing COVID to the flu is a pretty apples or oranges comparison, as is comparing vaccine benefits. COVID is much more contagious than the flu, hence why it's critical more people get vaccinated. Also, continuing to let COVID spread increases the chance of more mutation outside of the current variants that could circumvent both vaccine-induced immunity and natural immunity. Combined with the more contagious nature of the disease, this could essentially trigger a second pandemic. Vaccinating and bolstering immune response is critical to preventing such an outcome.
> What about those who cannot receive the vaccine for health reasons?
This is why herd immunity is so important. For those healthy adults that are able to get vaccinated, should get vaccinated. When herd immunity is reached, those who cannot be vaccinated for health reasons are protected by everyone else.
> What about those who cannot receive the vaccine for health reasons?
This is why herd immunity is so important. For those healthy adults that are able to get vaccinated, should get vaccinated. When herd immunity is reached, those who cannot be vaccinated for health reasons are protected by everyone else.
I am not speaking against vaccination though, nor am I comparing the two or at least that was not intended (see the following sentence in parentheses). I was talking about the vaccine cert specifically (which we have for COVID-19 only, so I could have replaced "flu shot" with anything else, really), and regarding that, what is it that is not true (as far as what I said) or worth down-voting? I do not understand. Is my comment being perceived as anti-vaxx for some reason and thus, gets down-voted?
I do not believe the vaccine cert being fair, I believe it is discriminatory. People who cannot receive the vaccine for health reasons may not have access to basic health care in my country (if they go with it), and they already cannot get a job in many places. How is this not discriminating? Heck, if people are so caring, then how come that I am being down-voted for expressing such a view, a view against discrimination? Actually, for the most part I was only talking about life around here (i.e. facts, that for some reason get down-voted, unless they read too much into my comment), and was not expressing such a view. In this comment, I specifically do. In any case, no worries, I do not expect you to actually give me a reasoning as you cannot possibly see inside their heads.
I do not believe the vaccine cert being fair, I believe it is discriminatory. People who cannot receive the vaccine for health reasons may not have access to basic health care in my country (if they go with it), and they already cannot get a job in many places. How is this not discriminating? Heck, if people are so caring, then how come that I am being down-voted for expressing such a view, a view against discrimination? Actually, for the most part I was only talking about life around here (i.e. facts, that for some reason get down-voted, unless they read too much into my comment), and was not expressing such a view. In this comment, I specifically do. In any case, no worries, I do not expect you to actually give me a reasoning as you cannot possibly see inside their heads.
The infection rates for Covid and flu are in the same ballpark so the infection rate is basically irrelevant. So Covid to flu comparison is more like apples to apples.
https://www.bmj.com/content/371/bmj.m3883/rr
Herd immunity doesn't mean zero cases. Covid-19 won't be eradicated. Believing some vaccination threshold exists that will prevent a future mutation seems foolish.
I caught the flu two years in a row, about 15 year ago. Just unlucky, I guess. Never had the flu before that. Each of those two times laid me out for two weeks straight, just completely miserable, couldn't even sleep lying down because it made me cough. After that I religiously got my flu shot every year.
There is lots of luck involved with the flu shot as well. They range from 1/3 to 2/3 effective, it depends on the year. In 2019, the vaccines were 37% effective against Influenza A and 50% against Influenza B, but the B variant was more prevalent that year so the overall effectiveness was 45%. (https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a1.htm?s_cid=mm...)
We are still trying to figure out how to make effective flu vaccines.
We are still trying to figure out how to make effective flu vaccines.
Yeah of course, my mom does the same. I stopped a few years ago and I was still alright, and I generally do not catch the common cold either, it has been years. In any case, I do not mind anyone getting the flu shot, of course.
I still have diseases, just other kinds. No vaccine or treatment for them.
I still have diseases, just other kinds. No vaccine or treatment for them.
Of course Big Pharma wants you locked-in on annual boosters. I'll take my chances with the virus with less than 1% mortality rate for people under 60.
Are we even remotely close to having a suitable vaccine for a common cold? What is the point of having a vaccine for a simple cold anyway...?
Are we even remotely close to having a suitable vaccine for a common cold? What is the point of having a vaccine for a simple cold anyway...?
I want to say something sarcastic, but I am in genuine disbelief that this could be anyone's vision for the future of humanity. What an abhorrent nightmare.
Why? I honestly don't see what you're suggesting?
We're already half-human half-chemical half-cyborgs. We drink coffee which includes caffeine, we use alcohol and THC regularly to "socialize", we take ibuprofen et al when feel pain, we eat sugar because we're fucking addicted. We use internet almost all the time except when sleeping and taking a shower. We check reddit, twitter, HN, facebook, instagram as if our lives depend on it. We're on track to build virtual reality googles that'll entertain us in an entire different simulated reality that we can only experience via our eyes. Not to mention most people look at monitors most of their lives anyway.
We regularly vaccinate against tetanus, HPV, chicken pox, flu etc. Do you not get the flu shot every year? I vaccinate my cat against rabies and distemper every year. I take antidepressants (anxiety) and antihistemics (allergy) every day, because I kinda need them to live normally. My girlfriend has to take pain medicine once a month due to her basic biology.
And the problem is we'll add COVID and cold to our annual flu shots, and that somehow makes our world any more dystopic. Makes absolutely no fucking sense. There are trillions of shit to be outraged about, this ain't one of those. Just chill.
We're already half-human half-chemical half-cyborgs. We drink coffee which includes caffeine, we use alcohol and THC regularly to "socialize", we take ibuprofen et al when feel pain, we eat sugar because we're fucking addicted. We use internet almost all the time except when sleeping and taking a shower. We check reddit, twitter, HN, facebook, instagram as if our lives depend on it. We're on track to build virtual reality googles that'll entertain us in an entire different simulated reality that we can only experience via our eyes. Not to mention most people look at monitors most of their lives anyway.
We regularly vaccinate against tetanus, HPV, chicken pox, flu etc. Do you not get the flu shot every year? I vaccinate my cat against rabies and distemper every year. I take antidepressants (anxiety) and antihistemics (allergy) every day, because I kinda need them to live normally. My girlfriend has to take pain medicine once a month due to her basic biology.
And the problem is we'll add COVID and cold to our annual flu shots, and that somehow makes our world any more dystopic. Makes absolutely no fucking sense. There are trillions of shit to be outraged about, this ain't one of those. Just chill.
Who knows what motivated the grandparent post to say that [EDIT: OK, now he explained and I definitely don’t endorse that, geez], but I can see some grounds for unease at aledalgrande's vision of a specifically annual vaccination mentioned above. The COVID epidemic has been accompanied by border closures, followed now by a slow and chaotic reopening of them as different countries recognize different vaccines and different certificates proving vaccination. A future where everyone must get an annual jab to prevent even the common cold, and then have to prove recent vaccination to cross borders, would only continue indefinitely what many people hoped was just a one-off thing in their lifetimes.
Incidentally, only half of people or less even in affluent countries get the annual flu shot. It is frequently believed to be relevant only for the elderly and at-risk demographics.
Incidentally, only half of people or less even in affluent countries get the annual flu shot. It is frequently believed to be relevant only for the elderly and at-risk demographics.
You live already in that world. I have already lost track of the number of "jabs" I've needed to travel to several countries, and this was way before COVID.
No, the vaccinations required for travel were virtually never expected to be taken on an annual basis but rather were good for years. For example, not only was the UN yellow-fever vaccination certificate good for 10 years, but recently the WHO announced that the yellow-fever vaccine now appears to confer life-long immunity, so border officials should accept the certificate regardless of the date on it.
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That's just the luck of the draw, though. Yellow Fever happens to be amenable to life-long immunity. COVID (may) not be.
Had the situation been reversed, you'd have had to get Yellow Fever vaccinations a lot more often if you were travelling into those regions, and the COVID situation would be one-and-done. It just happens that this is the way it worked out, instead. There's nothing dystopian about this.
Had the situation been reversed, you'd have had to get Yellow Fever vaccinations a lot more often if you were travelling into those regions, and the COVID situation would be one-and-done. It just happens that this is the way it worked out, instead. There's nothing dystopian about this.
You've lost track? The only 100% required vaccine for international travel I'm aware of is yellow fever, which poses an infection fatality risk hundreds or thousands of times higher than Covid.
Checked this - the yellow fever IFR only appears to be about 10× that of covid-19 overall.
The Wikipedia data for yellow fever IFR [0] claims that the data are based on "optimally treated patients". The problem in some of the countries where a vaccination certificate is mandatory to enter is that they do not have healthcare infrastructure to adequately treat patients. Somewhere in the past I have seen statistics that during some African yellow-fever outbreaks, 25–50% of those infected perished, which is why states were so insistent on this vaccination specifically.
[0] https://en.wikipedia.org/wiki/List_of_human_disease_case_fat...
[0] https://en.wikipedia.org/wiki/List_of_human_disease_case_fat...
That doesn't seem at odds with a single order-of-magnitude difference though. Covid IFR in the 0.5% range is also based on more or less optimally treated patients given a developed country's population demographics. There isn't really room for a fatality rate to be "hundreds or thousands of times higher", you run into the 100% fatal bound pretty quickly.
The Covid IFR is not in the 0.5% range, and a few exceptions notwithstanding, the fatality rate tends to be lower in developing countries than the developed world.
> Incidentally, only half of people or less even in affluent countries get the annual flu shot. It is frequently believed to be relevant only for the elderly and at-risk demographics.
You are right as far as about half getting it, at least for the United States. Quite a few people who are not elderly or at risk get it. Here are the age breakdowns.
About 60% of the people under 18 get it [1]. Under 18 is about 25% of the population.
About 34% of 18-49 year olds get it. They make up about 42% of the population.
That makes under 18s who get flu vaccine about 15% of the population, and 18-49s who get flu vaccine about 14% of the population. If only 50% of the population get the flu vaccine, that would mean that 58% of the people getting flu vaccine are under 50.
[1] https://www.thenationshealth.org/content/47/9/E45
You are right as far as about half getting it, at least for the United States. Quite a few people who are not elderly or at risk get it. Here are the age breakdowns.
About 60% of the people under 18 get it [1]. Under 18 is about 25% of the population.
About 34% of 18-49 year olds get it. They make up about 42% of the population.
That makes under 18s who get flu vaccine about 15% of the population, and 18-49s who get flu vaccine about 14% of the population. If only 50% of the population get the flu vaccine, that would mean that 58% of the people getting flu vaccine are under 50.
[1] https://www.thenationshealth.org/content/47/9/E45
It might not even be a shot. Would it still be an issue if it was a nasal spray that you can buy at your pharmacy once a year?
The issue is really availability of the vaccine at all. It would suck if a person from country A traveling in developing country B needs to get vaccinated yet again in order to move on to country C, but developing country B has a poor healthcare system that travelers would reasonably want to avoid contract with. One would then be compelled to visit a private hospital for expats at great expense, but sometimes even that option is not available.
Even if nasal sprays bought from a corner pharmacy are on the horizon, they would probably only reach developing countries years from now – and merely buying a product from a pharmacy in most countries might not get you an internationally recognized certificate of vaccination.
Even if nasal sprays bought from a corner pharmacy are on the horizon, they would probably only reach developing countries years from now – and merely buying a product from a pharmacy in most countries might not get you an internationally recognized certificate of vaccination.
The entire point of such vaccinations would be to prevent another major shutdown from a new coronavirus outbreak, and thus avoid a much larger issue when trying to cross borders. The expectation is nobody is going to care much if people get the next shot anymore than they do about the annual flu vaccine because significant herd immunity will be in play.
The only way that changes is if some new and extremely deadly variant is out there, but again past vaccinations are likely still helpful. Thus, regular vaccination deployment would be a pure win for travelers.
The only way that changes is if some new and extremely deadly variant is out there, but again past vaccinations are likely still helpful. Thus, regular vaccination deployment would be a pure win for travelers.
Availability and inequality is a fair concern, but why should we stop working on something that would improve everyone's lives? Nobody said it's going to be mandatory for travel.
> many people hoped was just a one-off thing.
This was never the case. If you didn't understand that COVID is here to stay indefinitely, like flu, after April 2020 I'm sorry but you aren't paying attention. Not to mention, if we follow perfect vaccination around the world, we can eradicate COVID like we eradicated smallpox etc, although this will be a lot harder.
So, I still don't see your point. Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.
This was never the case. If you didn't understand that COVID is here to stay indefinitely, like flu, after April 2020 I'm sorry but you aren't paying attention. Not to mention, if we follow perfect vaccination around the world, we can eradicate COVID like we eradicated smallpox etc, although this will be a lot harder.
So, I still don't see your point. Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.
As frequently reported in the last year, only a small niche of the scientific community is optimistic that COVID can be eradicated through vaccination. Smallpox had no animal reservoirs, while COVID does.
> Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.
No, it hasn’t. The only common annual vaccination is for influenza, it was introduced only in recent decades, and, as I mentioned, only half the population or less take it annually.
> Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.
No, it hasn’t. The only common annual vaccination is for influenza, it was introduced only in recent decades, and, as I mentioned, only half the population or less take it annually.
> No, it hasn’t. The only common annual vaccination is for influenza, it was introduced only in recent decades, and, as I mentioned, only half the population or less take it annually.
You only take flu annually but there are other vaccines you need to take periodically. E.g. tetanus booster every 10 years etc. For example, I'm supposed to take my last HPV vaccine this summer and this is the 3rd shot. I'm 25 and I took approx. one vaccine every year for the last few years. I'm not saying strictly one every 12 months, it's just that it doesn't make sense to be outraged about COVID vax since regular vax is already part of our lives.
You only take flu annually but there are other vaccines you need to take periodically. E.g. tetanus booster every 10 years etc. For example, I'm supposed to take my last HPV vaccine this summer and this is the 3rd shot. I'm 25 and I took approx. one vaccine every year for the last few years. I'm not saying strictly one every 12 months, it's just that it doesn't make sense to be outraged about COVID vax since regular vax is already part of our lives.
Note that aledalgrande’s original post above was speaking specifically about annual vaccination. That is is a completely different league than the common vaccines that require a booster shot every decade or so, and are much easier for people moving around internationally to plan around.
All those vaccines were also tested much more extensively and use techniques which have been widely deployed for much longer than the Covid vaccines.
This is exactly the point. We have decades of evidence for most vaccines and you only need them infrequently. That's a world away from a 6m old vaccine that hasn't been through the normal approval process.
> Yes people need to take yearly vaccines not to die of horrible diseases. That has been the case for the last few hundred years.
This isn't even remotely true. There's a set of vaccines taken in childhood, a few later. And that's it generally.
This isn't even remotely true. There's a set of vaccines taken in childhood, a few later. And that's it generally.
> We drink coffee which includes caffeine, we use alcohol and THC regularly to "socialize", we take ibuprofen et al when feel pain, we eat sugar because we're fucking addicted.
Who is we? I don't consume caffeine or THC, don't eat much sugar or drink much alcohol, and don't remember taking painkillers at all in 2020 or 2021 so far. I don't use social media like FB or IG. I don't remember getting a flu shot ever, maybe in childhood and I forgot.
Despite telling the other commenter to chill, your comment is bafflingly aggressive. It's possible to live without drugs and social media and we should encourage that, not take for granted that everyone should be forced to use drugs just to socialize or eat sugar.
Who is we? I don't consume caffeine or THC, don't eat much sugar or drink much alcohol, and don't remember taking painkillers at all in 2020 or 2021 so far. I don't use social media like FB or IG. I don't remember getting a flu shot ever, maybe in childhood and I forgot.
Despite telling the other commenter to chill, your comment is bafflingly aggressive. It's possible to live without drugs and social media and we should encourage that, not take for granted that everyone should be forced to use drugs just to socialize or eat sugar.
> Do you not get the flu shot every year?
I do not. I have never had a flu shot in my life.
I do not. I have never had a flu shot in my life.
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I... I use the internet in my shower and I sleep with podcasts. Am I a full cyborg ? :D
You do not have to be as you have described yourself. You do not have to rely on caffeine, thc, or alcohol. This is the practice of sobriety, which is followed by many. You can learn to be at peace with your own mind. You do not have to have to follow any social media. Many do not and billions could not in the past. Of what you listed, I use only HN, and that only to distract me at work. You do not have to be connected to dopamine goggles from <company>, you can be entertained by your own imagination, by the allure of the world, by the beauty of the people around you.
You do not have to feel that you cannot live without pharmaceuticals. The value of a tetanus shot is obvious, but it can be something you choose, not something which you are burdened to bear as the price of birth. Depressive disorders are wholly a disease of our malignant society. I would encourage you to examine the work of Stephen Ildari, for it has helped me greatly. I encourage you to see what happens to you and your gf when you eat plants instead of processed <product>.
You can be more than a tax cattle, or someone else's paycheck, or the reflection of the vision and will of powerful strangers. You are still very young. Take control of who and what you are.
You do not have to feel that you cannot live without pharmaceuticals. The value of a tetanus shot is obvious, but it can be something you choose, not something which you are burdened to bear as the price of birth. Depressive disorders are wholly a disease of our malignant society. I would encourage you to examine the work of Stephen Ildari, for it has helped me greatly. I encourage you to see what happens to you and your gf when you eat plants instead of processed <product>.
You can be more than a tax cattle, or someone else's paycheck, or the reflection of the vision and will of powerful strangers. You are still very young. Take control of who and what you are.
None of that is an argument against getting vaccinated against viruses that easily spread amongst the population with mild to horrific effect, mutating as it goes along.
We should be celebrating science, the discovery and advancement of vaccines, and their ability to give immunity or strong protection against diseases that have previously debilitated individuals or worse.
The fact that I have never known anyone with Polio is because of the strong global efforts to irradiate the disease from the face of the planet. Tragically the anti-science and anti-vaccine messaging has made that not possible for covid... something that's already resulted in near equal death of WWII in just over a year and will only continue.
We should be celebrating science, the discovery and advancement of vaccines, and their ability to give immunity or strong protection against diseases that have previously debilitated individuals or worse.
The fact that I have never known anyone with Polio is because of the strong global efforts to irradiate the disease from the face of the planet. Tragically the anti-science and anti-vaccine messaging has made that not possible for covid... something that's already resulted in near equal death of WWII in just over a year and will only continue.
I think that's a false dichotomy. You're saying the success of vaccine A implies success of vaccine B? That because some people wrongly argued against vaccine A, I can't argue against vaccine B (even at such an early point)?
And, by examination of evidence, everyone who has received a vaccine for covid is protected from it. Let them be free to make that choice.
"And, by examination of evidence, everyone who has received a vaccine for covid is protected from it."
Are you saying that every covid vaccine has 100 % efficacy? ("everyone", "a vaccine"). AFAIK this is not true for any extant vaccine.
Are you saying that every covid vaccine has 100 % efficacy? ("everyone", "a vaccine"). AFAIK this is not true for any extant vaccine.
That's all wonderful, but what does it have to do with taking an annual covid vaccine? Does contracting covid or the flu somehow make me more free? Based on my experience with fevers, the hallucinations can be fun, but overall I don't think it's worth it. Even salvia is better.
One specific thing I do find freeing about the vaccines is that I don't really need to worry about being asymptomatically infected and passing the disease onto others who are more vulnerable. I guess I could simply say "fuck those people", as many have done, but I guess for me, responsibility is a counterpart to freedom.
FWIW, Stephen Ilardi appears to support vaccination, so you may want to dig a little deeper into his thoughts around them.
One specific thing I do find freeing about the vaccines is that I don't really need to worry about being asymptomatically infected and passing the disease onto others who are more vulnerable. I guess I could simply say "fuck those people", as many have done, but I guess for me, responsibility is a counterpart to freedom.
FWIW, Stephen Ilardi appears to support vaccination, so you may want to dig a little deeper into his thoughts around them.
Nobody's forcing you to take the flu vaccine or any theoretical future cold vaccine.
Meanwhile those who do choose to take it will hopefully be able to live a life largely free of these annoyances and dangers.
Meanwhile those who do choose to take it will hopefully be able to live a life largely free of these annoyances and dangers.
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That would be amazing. A needle stick every year and significantly less (even mild) illnesses? Let's do it.
(I say this as someone who fortunately almost never gets sick. People who are often sick would relish this even more.)
(I say this as someone who fortunately almost never gets sick. People who are often sick would relish this even more.)
I get sick every year for some reason, often gastro, and the bi-yearly AC switch off/on giving me a long cold because I grew up in a country without AC. A year out of two I have a bad flu, a year out of 5, a bad otitis so painful I can't eat for a while...
Well the ONLY year of my life (I'm 33) I wasn't sick was 2020-2021. I think... the mask helped a lot. I feel like I understand now all these people telling me getting so sick every year wasn't normal...
Well the ONLY year of my life (I'm 33) I wasn't sick was 2020-2021. I think... the mask helped a lot. I feel like I understand now all these people telling me getting so sick every year wasn't normal...
I didn’t get a cold for just over 14 months. It was glorious. Now that I’m vaccinated I’ve been out a bit more and have been dealing with a head cold all week. If there’s a shot to stop colds, sign me up.
I don't see why eliminating disease is an abhorrent nightmare to you. Is the fact that no one gets polio anymore also an abhorrent nightmare?
Polio was never eliminated. It still persists in poor countries and among abject poverty stricken communities.
Wild poliovirus has been eradicated in all continents except Asia, and as of 2020, Afghanistan and Pakistan are the only two countries where the disease is still classified as endemic.[5][6]
https://en.wikipedia.org/wiki/Polio_eradication
Wild poliovirus has been eradicated in all continents except Asia, and as of 2020, Afghanistan and Pakistan are the only two countries where the disease is still classified as endemic.[5][6]
https://en.wikipedia.org/wiki/Polio_eradication
Eliminated and eradicated are not the same thing.
Polio certainly has been eliminated from the United States. The point is, polio is no longer a significant problem here.
Polio certainly has been eliminated from the United States. The point is, polio is no longer a significant problem here.
Sorry, maybe I should've specified _In the United States_
You've already benefited, either directly or indirectly, from the polio vaccine, the smallpox vaccine, antibiotics, etc. You might not even be alive if it weren't for those, because some of your direct ancestors would have been likely to die or be severely disabled.
So what is suddenly giving you pause here? Just the idea that these shots may be needed more regularly, rather than a few times during childhood?
Do you think we should return to a life in which we forage naked for berries in the forest?
Assuming the answer is no, where do you draw the line as to what technologies you're willing to accept, and which you aren't?
So what is suddenly giving you pause here? Just the idea that these shots may be needed more regularly, rather than a few times during childhood?
Do you think we should return to a life in which we forage naked for berries in the forest?
Assuming the answer is no, where do you draw the line as to what technologies you're willing to accept, and which you aren't?
I genuinely have no idea why that would be abhorrent, except to anti-vaxxers. Can you explain?
Pugs cannot give birth naturally. The continued existence of pugs is completely dependent on medical intervention. In other words, pugs are not real. They exist only to the degree that a painting or building exists. They require constant upkeep by an advanced society, which has never existed beyond a few thousand years at a time.
Why would anyone's vision for the future of humanity be an animal that can only exist in the context of an advanced civilization? Why would anyone's vision of humanity be an animal that is dependent for survival on <product> from <company> as though they were cattle? To reduce a human being to a dependent component of a pharmaceutical production chain is an abhorrent moral hazard.
Smallpox was made extinct, and other diseases may be made greatly reduced because they are unique to humanity. But the many coronaviruses are shared between mammals, and are an eternal component of the environment. We have a moral obligation to evolve to suit the environment. That is what it means to be a successful animal.
Why would anyone's vision for the future of humanity be an animal that can only exist in the context of an advanced civilization? Why would anyone's vision of humanity be an animal that is dependent for survival on <product> from <company> as though they were cattle? To reduce a human being to a dependent component of a pharmaceutical production chain is an abhorrent moral hazard.
Smallpox was made extinct, and other diseases may be made greatly reduced because they are unique to humanity. But the many coronaviruses are shared between mammals, and are an eternal component of the environment. We have a moral obligation to evolve to suit the environment. That is what it means to be a successful animal.
> We have a moral obligation to evolve to suit the environment
And we've done that by evolving our mental capacities and developing a wide range of tools that have enabled us to survive and prosper. We are apex predators of apex predators, to the point that we kill other predators for sport rather than food.
Stick me naked and toolless in the wilds of Siberia and I'd estimate my survival time in hours rather than days. Without our tools we're a pretty useless species that hasn't even evolved far enough to be able to walk on two legs without developing back pain, unlike penguins.
Vaccines taken once in a lifetime, or taken annually, or taken daily are just another tool. Why is this any worse than brushing your teeth, showering, taking medication or even getting dressed. If a doctor told you to take heart medication on a daily basis to stay alive, would you refuse on the grounds that it's better for humans to evolve hearts that are less prone to heart disease?
And we've done that by evolving our mental capacities and developing a wide range of tools that have enabled us to survive and prosper. We are apex predators of apex predators, to the point that we kill other predators for sport rather than food.
Stick me naked and toolless in the wilds of Siberia and I'd estimate my survival time in hours rather than days. Without our tools we're a pretty useless species that hasn't even evolved far enough to be able to walk on two legs without developing back pain, unlike penguins.
Vaccines taken once in a lifetime, or taken annually, or taken daily are just another tool. Why is this any worse than brushing your teeth, showering, taking medication or even getting dressed. If a doctor told you to take heart medication on a daily basis to stay alive, would you refuse on the grounds that it's better for humans to evolve hearts that are less prone to heart disease?
> We have a moral obligation to evolve to suit the environment. That is what it means to be a successful animal.
So tools as a whole are just... sins? How far down this line do you want us to go? No plastics? No computers? No structures? No roads? No clothes?
So tools as a whole are just... sins? How far down this line do you want us to go? No plastics? No computers? No structures? No roads? No clothes?
>Why would anyone's vision for the future of humanity be an animal that can only exist in the context of an advanced civilization?
That is a textbook description of Homo Sapiens Sapiens, IMO. We are not very impressive without an advanced civilization.
That is a textbook description of Homo Sapiens Sapiens, IMO. We are not very impressive without an advanced civilization.
Niches changing is pretty boringly normal.
Dolphins are evolutionarily unfit to occupy the niche they had back on land. The bacteria that precipitated the oxygen crisis were very successful until they weren't.
There are many reasons to care about environmental destruction, pollution, and the loss of biodiversity, but at the same time it's neither particularly rational nor natural to obsess about preserving exactly the niches which existed at a particular point in time, nor our fitness for them.
Dolphins are evolutionarily unfit to occupy the niche they had back on land. The bacteria that precipitated the oxygen crisis were very successful until they weren't.
There are many reasons to care about environmental destruction, pollution, and the loss of biodiversity, but at the same time it's neither particularly rational nor natural to obsess about preserving exactly the niches which existed at a particular point in time, nor our fitness for them.
Evolution is not a moral obligation; it's just the best nature could manage without thinking.
If civilization crumbles, then natural selection will take the reins and a lot of people will die, but that's not a goal we should aim for.
If civilization crumbles, then natural selection will take the reins and a lot of people will die, but that's not a goal we should aim for.
Natural selection is still at the reins. It operates in an environment. One that we, fortunately, can shape.
> We have a moral obligation to evolve to suit the environment. That is what it means to be a successful animal.
I'm not sure how any of this related to morality. What is your moral framework here?
However, if we accept it, the unique success of humanity clearly does not stem from blindly accepting whatever nature throws our way. Humanity's success, and defining characteristic is that we're able to bend nature to our will, and when that isn't possible, consciously bend ourselves.
The vaccines are another example, and the mRNA vaccines are incredible example of this. We engineered a way to use our own body as a factory.
Humanity's progress doesn't depend on giving up on technology, it depends on increasing our abilities with it. Evolution is too slow and too random, humanity can do better altering our own genome. If we survive, humanity will eventually be able to manipulate entire solar systems or even galaxies. Possibly the whole universe. That's our destiny, not dying of smallpox on our home planet.
I'm not sure how any of this related to morality. What is your moral framework here?
However, if we accept it, the unique success of humanity clearly does not stem from blindly accepting whatever nature throws our way. Humanity's success, and defining characteristic is that we're able to bend nature to our will, and when that isn't possible, consciously bend ourselves.
The vaccines are another example, and the mRNA vaccines are incredible example of this. We engineered a way to use our own body as a factory.
Humanity's progress doesn't depend on giving up on technology, it depends on increasing our abilities with it. Evolution is too slow and too random, humanity can do better altering our own genome. If we survive, humanity will eventually be able to manipulate entire solar systems or even galaxies. Possibly the whole universe. That's our destiny, not dying of smallpox on our home planet.
This is textbook appeal to nature.
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I'm at a loss as to why reduction of suffering and death is abhorrent to you.
It's an artificial reduction in suffering and death. It's a genetic loan that will one day be repaid, with interest.
The best way to prepare for future evolutionary challenges is to stockpile genetic diversity. More genetic diversity means both less of a chance of the entire population being vulnerable in the same way to a new threat, and better chances to reach new local maximas that are two or three hops through rough terrain in the evolutionary search space.
Continually applying harsh selection criteria just homogenizes a population to a local maxima and leaves them vulnerable to future change.
Continually applying harsh selection criteria just homogenizes a population to a local maxima and leaves them vulnerable to future change.
Ok, well if you want to do your part to contribute to the genetic excellence of the human race, don't use medicine. If you get an infection, instead of using antibiotics, just let it kill you. Don't get glasses, just let your bad vision get you killed. How far do you want to take this? I'm sure you can increase the immunities of future humans by drinking out of puddles like dogs do. It doesn't seem to make dogs sick, presumably because all the dogs in the past with weaker immune systems died, probably with a lot of suffering.
I doubt you do any of these things, because you aren't willing to accept the low chance of survival-to-adulthood that typical wild animals have. It may keep their genetics in tip top shape, but is that really what you want?
I doubt you do any of these things, because you aren't willing to accept the low chance of survival-to-adulthood that typical wild animals have. It may keep their genetics in tip top shape, but is that really what you want?
How about... wearing clothes? Cooking food?
Not really. This is a naive interpretation of Darwinism. If anything, humans have become more genetically fit by mixing various formerly isolated populations together. Which is very much a consequence of global civilization.
By far the largest problem of any genetic pool (animals, plants, whatever) is not having enough genetic diversity in it. See: Cavendish bananas, the Tasmanian devil.
By far the largest problem of any genetic pool (animals, plants, whatever) is not having enough genetic diversity in it. See: Cavendish bananas, the Tasmanian devil.
You’re aware that most people already have a bunch of vaccines, right?
with the current formulas this is true. https://www.forbes.com/sites/williamhaseltine/2021/03/25/mod...
seeing almost half the efficacy after 250 days.
seeing almost half the efficacy after 250 days.
Well, yes. What else? Getting rid of the novel coronavirus doesn't seem likely at this point. So, either we control it by vaccination or we go back to how it was before any vaccines.
Hopefully, eventually the virus evolves into a less deadly form and maybe our immune systems develop some more resistance. I don't know if the latter is actually reasonable to expect.
Hopefully, eventually the virus evolves into a less deadly form and maybe our immune systems develop some more resistance. I don't know if the latter is actually reasonable to expect.
> eventually the virus evolves into a less deadly form and maybe our immune systems develop some more resistance. I don't know if the latter is actually reasonable to expect.
The more people who die, the more likely it is we evolve protection
The more people who die, the more likely it is we evolve protection
The same can be said of driving. Should we remove airbags tomorrow?
If we do, over the next 10,000 years it will make a difference in human reaction times. Assuming of course that nothing else destroys us all first, or makes cars obsolete.
Since I don't have 10,000 years I prefer to make cars obsolete.
Since I don't have 10,000 years I prefer to make cars obsolete.
It has nothing to do with how long you personally have; this is about the species, remember? You could very well die from lack of airbags, and not because you had a slow reaction time but because your skull isn't optimized for surviving collisions. Further, there are a lot of stand-up people you currently like who would die. There are many reasons to protect the weak, even from an evolutionary standpoint.
I don't have 10,000 years, the species probably does.
Evolution doesn't care. There are also reasons to not protect the weak. Either way it changes the future of the species. On one hand we don't protect the weak, and thus the strong survive; on the other hand we protect the weak, the species doesn't get as strong, but we can encourage some other trait(s).
Note, strong species might be a stronger skull, better reactions, or something else that I can't even think of. I don't know how to force any choice.
Evolution doesn't care. There are also reasons to not protect the weak. Either way it changes the future of the species. On one hand we don't protect the weak, and thus the strong survive; on the other hand we protect the weak, the species doesn't get as strong, but we can encourage some other trait(s).
Note, strong species might be a stronger skull, better reactions, or something else that I can't even think of. I don't know how to force any choice.
The point though is that making ourselves dumber by making our skulls thicker so we can survive car crashes is a bad choice. We want to be getting smarter, not dumber, right now. Our instincts tend to align with that goal (including protecting the weak) when they are pro-social since that’s how we’ve been evolving lately.
And it misses the point: the evolutionary change that has already occured includes the ability to put in airbags and eventually self driving cars, not a change in reflexes. Though better intuition about risk might see the species live longer.
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Not sure why you are being downvoted. You are correct, and this is LITERALLY the case with existing virus boosters like Tetanus (actually the combined Tetanus / Polio / Diptheria / Pertusis). Many booster vaccines are recommended at regular intervals (some 5 years, some 10 years, some somewhere within that range). You wouldn't see people downvoting advice to get your Tetanus booster every 10 years! Yet they'll downvote such a suggestion about COVID boosters? I just don't understand. Its biology folks.
Actually this _really_ pisses me off that you were downvoted. Everyone is treating this vaccine plan (and I mean speaking from the US point of view vaccine plan) like it is the end of the pandemic permanantly. I can assure everybody that it is NOT. Indeed, there has been talk of these universal flu & cold vaccines for decades, but they have yet to be produced - just look how long the COVID vaccines took to be released worldwide when the first one was produced in January of 2020 (not a typo). Meanwhile, multiple countries in Africa, as well as all of India are still being ravaged by this virus - where is thier vaccine help? There is such a western centric twist on HackerNews that it really makes me question just how intelligent our "best programmers in the world" really are. From my initial view point, it seems everyone here understands the entire situtation no better than any other anectdotal theory from the average lurker on 4chan or reddit.
Actually this _really_ pisses me off that you were downvoted. Everyone is treating this vaccine plan (and I mean speaking from the US point of view vaccine plan) like it is the end of the pandemic permanantly. I can assure everybody that it is NOT. Indeed, there has been talk of these universal flu & cold vaccines for decades, but they have yet to be produced - just look how long the COVID vaccines took to be released worldwide when the first one was produced in January of 2020 (not a typo). Meanwhile, multiple countries in Africa, as well as all of India are still being ravaged by this virus - where is thier vaccine help? There is such a western centric twist on HackerNews that it really makes me question just how intelligent our "best programmers in the world" really are. From my initial view point, it seems everyone here understands the entire situtation no better than any other anectdotal theory from the average lurker on 4chan or reddit.
There is a problem with programmers thinking/acting/talking like they know quite a lot more than they do. Any thread on HN not about programming is sure to be full of confident ignorance (and honestly the programming threads too).
People don’t have very broad knowledge or education, a few do, but it can be hard to pick out.
People don’t have very broad knowledge or education, a few do, but it can be hard to pick out.
>It's biology folks?
Read up about philosophy of science. Science has to be subjected to scrutiny and stand the test of time before we can be confident. Covid jab needs more time.
Yes. Like yearly vaccination campaigns.
Like the flu. Or even Tetanus requires boosters. I don't know why that makes it a dealbreaker.
Can't help but feel the UK had incredible luck on their side here. Being in the UK I'm thankful it played out well...but wow...talk about a roll of the dice.
(As best as I know there was little scientific evidence available when they decided to delay)
(As best as I know there was little scientific evidence available when they decided to delay)
> Can't help but feel the UK had incredible luck on their side here.
Some people might call it incredible luck, while others might say that it was a good decision made by world leading vaccine experts informed directly by the scientists who created the vaccine.
In fact, the BMJ said at the start of January:
> The trials of the Oxford-AstraZeneca vaccine did include different spacing between doses, finding that a longer gap (two to three months) led to a greater immune response, but the overall participant numbers were small. In the UK study 59% (1407 of 2377) of the participants who had two standard doses received the second dose between nine and 12 weeks after the first. In the Brazil study only 18.6% (384 of 2063) received a second dose between nine and 12 weeks after the first.3 The combined trial results, published in the Lancet,4 found that vaccine efficacy 14 days after a second dose was higher in the group that had more than six weeks between the two doses (65.4%) than in the group that had less than six weeks between doses (53.4%).
So there was knowledge/thoughts when the decision was made that an extended gap could change efficacy.
Besides, let’s give the UK’s biomedical community more credit than assuming it was a fluke anyway!
Some people might call it incredible luck, while others might say that it was a good decision made by world leading vaccine experts informed directly by the scientists who created the vaccine.
In fact, the BMJ said at the start of January:
> The trials of the Oxford-AstraZeneca vaccine did include different spacing between doses, finding that a longer gap (two to three months) led to a greater immune response, but the overall participant numbers were small. In the UK study 59% (1407 of 2377) of the participants who had two standard doses received the second dose between nine and 12 weeks after the first. In the Brazil study only 18.6% (384 of 2063) received a second dose between nine and 12 weeks after the first.3 The combined trial results, published in the Lancet,4 found that vaccine efficacy 14 days after a second dose was higher in the group that had more than six weeks between the two doses (65.4%) than in the group that had less than six weeks between doses (53.4%).
So there was knowledge/thoughts when the decision was made that an extended gap could change efficacy.
Besides, let’s give the UK’s biomedical community more credit than assuming it was a fluke anyway!
Depends what you mean by "little". At the start of the year, if not the end of 2020, there were studies showing the prevailing effectiveness with delays on the second shot so it was pretty clear where the trend was.
And then, merely hours ago, they decided because of the Indian variant they'd instead change the recommendation from 12 weeks to 8. So, at least in my opinion, it's a bit of a random walk down statistics street.
And then, merely hours ago, they decided because of the Indian variant they'd instead change the recommendation from 12 weeks to 8. So, at least in my opinion, it's a bit of a random walk down statistics street.
I know our govt can be swines but we still have a pretty amazing scientific / medical community here.
Not much positive to say about the handling of covid but when it comes to vaccine plans they've really done brilliantly.
Probably because it's scientists, doctors and the NHS that have handled it and not the government.
Not much positive to say about the handling of covid but when it comes to vaccine plans they've really done brilliantly.
Probably because it's scientists, doctors and the NHS that have handled it and not the government.
You’re correct, no evidence at the time JCVI (joint committee for vaccination and immunisation) made the call. However the decision was made on best interests [1] from a public health perspective. Delaying to 12 weeks allowed absolute numbers of people to be immunised once and build up some immunity versus absolute numbers of people vaccinated twice and having higher number of vulnerable populations without any immunity. Of course, this wasn’t taking into the people who had had COVID-19 and had a level of immunity to the virus from exposure.
[1] https://www.gov.uk/government/news/statement-from-the-uk-chi...
[1] https://www.gov.uk/government/news/statement-from-the-uk-chi...
> You’re correct, no evidence at the time JCVI (joint committee for vaccination and immunisation) made the call.
This isn't true, the JCVI did have evidence. In fact their statement showing reasons behind the call said:
"There is evidence that a longer interval between the first and second doses promotes a stronger immune response with the AstraZeneca vaccine."
https://www.gov.uk/government/publications/prioritising-the-...
(Statement first released on 31st of December 2021, only available via google archive https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c...)
This isn't true, the JCVI did have evidence. In fact their statement showing reasons behind the call said:
"There is evidence that a longer interval between the first and second doses promotes a stronger immune response with the AstraZeneca vaccine."
https://www.gov.uk/government/publications/prioritising-the-...
(Statement first released on 31st of December 2021, only available via google archive https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c...)
Delaying the 2nd dose to 12 weeks was always most likely going to elicit a better response, this is customary for vaccines. It would have been much more supposing scientifically if this much shorter timeline did better. The UK's approach was never much of a gamble.
I think luck is the true national skill of the UK. We are a nation of gamblers and risk-takers, and often that tends to lead us down paths that make no or little sense, but _sometimes_ we get really, really lucky.
This story back in February reported 'Single Pfizer shot 90 percent effective after 21 days' and that 'vaccine effectiveness was still pretty much zero until about 14 days after people were vaccinated. But then after day 14 immunity rose gradually day by day to about 90 percent at day 21....' [https://medicalxpress.com/news/2021-02-pfizer-shot-percent-e...]
This looks to fit in with that trend ... after 14 days, slowly growing immunity.
This looks to fit in with that trend ... after 14 days, slowly growing immunity.
I just had a conversation with a doctor. She mentioned her clinical team thinks that if you had COVID recently you should wait 3 to 4 months before getting vaccinated. The reason being because your immune system is messed up. Any doctors or immunologists here that can comment on this advice ?
Great. My local health clinic auto-booked my next appointment (despite telling me I had to do it) just inside 3 weeks from my first shot. I think they're a little worried about people coming back for their second shot.
I'm curious about non-mRNA vaccines like CoronaVac on Brazil where second dose shots are being delayed due to supply problems.
Does this mean that a one-shot vaccine like Johnson & Johnson's is inherently less effective?
J&j could have been formulated as 2-dose, but they didn't test it that way, because the type of vaccine it is is well tested already to have reasonable effectiveness with a single dose.
No rna jab had never passed phase iii before, so they hedged their bets and tested a 1/2 + 1 formula, knowing that it had higher likelihood to succeed testing.
No rna jab had never passed phase iii before, so they hedged their bets and tested a 1/2 + 1 formula, knowing that it had higher likelihood to succeed testing.
Is there any evidence one shot of J&J protects better than one shot of Moderna/Biontech, or is the main difference that the companies chose different strategies for their studies/marketing? (Moderna/Biontech hoping to achieve better results and 2x the doses sold, J&J hoping to be done with the studies 3-4 weeks earlier and having a marketing advantage because it only requires one shot)
I suspect that it is. There may be some reason it is good enough with a single shot, but the others aren't, but still... I didn't want J&J, not because I think it is a worse vaccine, but because it is currently only a single shot.
I think it only protects about 60-70%
Wow Canada finally got something right by being a laggard
> For the United Kingdom, extending the interval between doses was clearly the right choice, but the country’s lockdown deserves part of the credit for that success
This is important for anyone who thinks it might be a good idea to wait. You have to carefully weigh the risk of being vulnerable in the meantime.
This is important for anyone who thinks it might be a good idea to wait. You have to carefully weigh the risk of being vulnerable in the meantime.
The vaccines are still quite effective after the first dose, and, I'm saying this without being a researcher in this area, should be enough to flatten the curve.
"The Moderna vaccine has been shown to have an efficacy of approximately 92 per cent in protecting against COVID-19, starting 14 days after the first dose." - https://www.who.int/news-room/feature-stories/detail/the-mod...
"The Moderna vaccine has been shown to have an efficacy of approximately 92 per cent in protecting against COVID-19, starting 14 days after the first dose." - https://www.who.int/news-room/feature-stories/detail/the-mod...
Wow that's impressive, I thought it was ~50% after the first dose. I guess it's like ML, to get the last percentage points you need exponential effort?
You might be thinking of this paper about very extensive data from Israel: https://www.nejm.org/doi/full/10.1056/NEJMoa2101765
One conclusion a friend of mine wrote about this is "One other surprising thing which is not obvious, but is made very clear from the results, is that it really takes real time for this vaccine to get effective. It only starts becoming truly useful after 2 weeks, but even then keeps getting better with time. This effect is one reason why there was a very real lag between when Israel got vaccinated at a very high percentage of population and when the cases started freefalling (2-3 weeks+). "
One conclusion a friend of mine wrote about this is "One other surprising thing which is not obvious, but is made very clear from the results, is that it really takes real time for this vaccine to get effective. It only starts becoming truly useful after 2 weeks, but even then keeps getting better with time. This effect is one reason why there was a very real lag between when Israel got vaccinated at a very high percentage of population and when the cases started freefalling (2-3 weeks+). "
It's 50% if you start counting immediately, before the first dose has had time to work.
> I guess it's like ML
It's very like simulated annealing.
It's very like simulated annealing.
It isn't that simple though. The first dose still provides some protection. The choice is usually between a lot of people having some protection, vs a smaller amount of people having full protection.
(and some protection can be in the 70% range [1])
[1]: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
(and some protection can be in the 70% range [1])
[1]: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Yes, rather than "some", I would say that the first dose provides the majority of protection, and the second is a booster, upping the effectiveness from the 70s to the 90s. If you are short vaccine, it makes a lot of sense to give out only a single dose to more people than both doses to a smaller group of people and then circle back when more is produced. The only question is whether it makes sense to circle back if the time elapsed is long, and this study is evidence that it does.
Good reason to delay one's second shot, I already pushed back by a week thinking of delaying even more.
"Peak antibody levels were 3.5 times higher in those who waited 12 weeks for their booster shot than were those in people who waited only 3 weeks. Peak T-cell response was lower in those with the extended interval. But this did not cause antibody levels to decline more quickly over the nine weeks after the booster shot."
I care less about short-term peak antibody response than longer-term T-cell response or longest-term immunizing antibody response. On the latter two points, this study was not encouraging or outright silent. Nor was there any indication of how well these folks fared after they returned to the wild.
This info doesn't seem sufficient to draw meaningful conclusions about longer term protection.