Taking into account booster recommendations would be the best kind of correct, but is going to further increase the complexity and dilemmas associated with nonmedical personnel being asked to screen individuals' vaccination status.
I wonder if we'll see a kind of 'vaccine as a service' economy, in which our immune systems require regular maintenance to active threats (more so than flu shots.)
Accenture and IBM and all the other bottom tier software configuration consultancies must be foaming at the mouth at all the opportunities to implement tracking of increasingly confusing sets of rules for who is allowed to go into the office. The main thing (other than violate peoples rights) that these things accomplish is create work for legacy enterprise software companies.
Its obviously of a different magnitude, but it's interesting (scary) to see the parallel that once a state wants to do something, regardless of the morality, companies line up with proposals on how to do it, without any thought for if they should be helping repress people or violate their rights. I hope when we wake up from our collective delusion the companies that are enabling this will be held accountable, I also know there is no chance of that
There's nothing to wonder. It's in the "health pass" specs from WHO, which I reviewed. It leaves space for future treatments. If you see what's going on in parts of Europe and Australia, it's pretty obvious what the intentions are.
You, my friend, sound like a pro nazi, conspiracy theorist, trump supporter, anti vAx, murderer.
Don’t ever doubt my beloved authority figures again: they are the only ones who can find me the answer to return to Normal. What do you think, that you’re some kind of critical thinker or something? I think we should leave that to the ones who are qualified to do so.
The CDC once again continues to bungle its messaging, which is only going to fuel vaccination controversy and anti-vaxxer talking points.
According to the CDC, "The COVID-19 vaccines approved and authorized in the United States continue to be effective at reducing risk of severe disease, hospitalization, and death."[1]
Walensky has repeated this[2]:
> “The evidence shows that all three COVID-19 vaccines authorized in the United States are safe — as demonstrated by the over 400 million vaccine doses already given," Walensky said.
> "They are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating Delta variant," she added.
If you have vaccines for which the initial series is "highly effective" at reducing the risk of severe disease, hospitalization and death, why would you tell people that you're considering changing the definition of "fully vaccinated" to exclude individuals who have received the initial series?
Well none of the push for mandates or vaccine passports or other such nonsense makes much sense if the vaccines don't prevent spread and only provide an individual benefit of reduced risk. I mean, although many people are able to hold a blatant contradiction like this in their heads without experiencing cognitive dissonance, you can't really sell "we need to protect the vaccinated from the unvaccinated" without inherently casting doubt on the vaccines' efficacy against severe disease.
While I personally have reservations about mandates/passports for being able to travel domestically, eat at restaurants, etc., in terms of things like international travel, which is a privilege, there is a valid argument for treating people with no immunity differently as they are at a higher risk of severe illness, hospitalization and death. Those can cause high costs that are borne by others.
But yes, statements like the one about protecting the vaccinated from the unvaccinated have been head-scratching, which goes back to my point about how the CDC and other authority figures continue to bungle the messaging and shoot themselves in the foot.
I'm fully vaccinated but am not sold on getting a booster because I'm not in a high-risk group and understand the current science to indicate that the initial series I received continues to significantly reduce my risk of illness, hospitalization and death. Of the friends and family I've discussed boosters with, most say they have similar thinking. I find it hard to believe that somebody who has not yet been vaccinated will see Walensky's comment about the "fully vaccinated" definition possibly changing and suddenly feel eager to get the initial series.
Just as another data point, I probably will get a booster shot if they're available for my demographic (and it's just the same Pfizer shot I've already had two of).
But it would only be under real duress that I'd prove to someone other than my doctor that I'd had it. The point to me is individual choice, and limits on what kind of information the state can compel from you. Generally I think the vaccines (even if they don't work to well) are not a big deal.
For international travel I would accept mandatory testing and quarantine. It is entirely sensible solution to problem, also I don't think vaccination status should make difference until we have sterilizing vaccine.
People with natural immunity should be considered to have immunity. The science clearly shows that their immunity is not inferior and is perhaps superior to those with vaccine-based immunity. It's crazy to me that we're even having a debate about whether natural immunity should count as immunity.
> I'm fully vaccinated but am not sold on getting a booster because I'm not in a high-risk group and understand the current science to indicate that the initial series I received continues to significantly reduce my risk of illness, hospitalization and death.
One thing that I think is getting lost in all of these discussions is that it's okay for there to be a range of comfort levels. But a range implies there are boundaries, somewhere.
I got a booster shot of Moderna a little over a month ago, by lying to the clinic and telling them it was actually my first dose. (This is why I'm on a throwaway account, btw.) I'm aware this was kind of risky, because third doses haven't been well studied in my age cohort. And I also got really ill for a day!
I wouldn't recommend that anyone else jump ahead of the FDA guidelines like this—but it was something I wanted to do. I'm being very bad about masking and social distancing right now, and I'm in close contact with a lot of children, so I really wanted to do something extra to protect them.
At the other end of the spectrum, I think it's totally okay for anyone who is vaccine-skeptical, for whatever reason, to take a wait and see approach. But there eventually comes a point when a majority of the public has actually gone ahead and been guinea pigs for you, and you're just needlessly endangering people.
> One thing that I think is getting lost in all of these discussions
What's really being lost in all of these discussions is science. Looking at your case:
1. You decided to lie to get a booster even though it has apparently not been approved for your use.
2. The vaccines do not provide sterilizing immunity and it is possible to become infected even when vaccinated. While the data does suggest that vaccination reduces transmission, it also indicates that infected vaccinated individuals are still capable of spreading the virus.
3. Despite the fact that you have no idea how much additional protection your booster will give you, and for how long, or if and how much it might reduce your ability to transmit the virus to others, you're choosing to be "very bad about masking and social distancing right now" which will increase your potential exposure, especially if you live in an area with a higher positivity rate. More exposure, even while vaccinated, increases your risk of infection.
4. You say you're doing this to protect the children you are in close contact with, but according to the CDC, only 542 children under the age of 18 have died in the US during the entire pandemic.
> At the other end of the spectrum, I think it's totally okay for anyone who is vaccine-skeptical, for whatever reason, to take a wait and see approach. But there eventually comes a point when a majority of the public has actually gone ahead and been guinea pigs for you, and you're just needlessly endangering people.
How long before the definition of "vaccine skeptical" changes? Will someone eventually be labeled "vaccine skeptical" because they refuse to get their 10th booster?
> I'm fully vaccinated but am not sold on getting a booster because I'm not in a high-risk group and understand the current science to indicate that the initial series I received continues to significantly reduce my risk of illness, hospitalization and death.
Well the problem is that this ship already sailed. You can be “not sold” on getting a booster all you want, but give it a few months and for employment/entertainment/etc venues you will be considered unvaccinated, period. This is what most “got vaccinated but not sure about passports” crowd don’t seem to understand, there is not gonna be a middle ground, you either have your nth (and go figure the value of n if they want to establish 1 or 2 a year…) booster or you might as well be Andrew Wakefield.
> You can be “not sold” on getting a booster all you want, but give it a few months and for employment/entertainment/etc venues you will be considered unvaccinated, period.
For what it's worth, in NYC right now indoor dining, gyms, government jobs, etc don't even require two vaccine doses, only one.
At my Bay Area employer you definitely need to be 14 days past your second shot (in the case of a 2 dose vaccine) to be considered. Wording on the internal emails about the topic makes it pretty clear that this status is subject to the changes by health authorities. So in this particular case I can assure you that the door for infinite boosters is not only open, but it has been clearly spell out that it will be used.
Data has shown that the HEPA filters in planes are working very well to prevent transmission between passengers already. If anything you are much less at risk in a plane than anywhere else. These restrictions make as much sense as throwing water bottles before taking a flight.
I wasn't referring to transmission on the plane. I was referring to the fact that international travel for purposes of tourism, etc. is a privilege, not a right. No country is obligated to allow in foreign nationals who are at a higher risk of serious illness if they get infected. This especially makes sense for poorer countries that are already under pandemic strain.
Furthermore, border controls can be effective at limiting the introduction of variants.
When countries do choose to let foreign nationals in, at this stage of the pandemic, it's not unreasonable for them to limit arrivals to those with immunity, whether vaccine-based or natural, or apply different requirements (such as quarantine) for people with immunity versus without.
Planes and such are secondary. Main point should be borders themselves. Make entering to quarantine sufficiently efficient process and shoot on sight anyone who tries to pass it after all their goal is massmurder by spreading covid(at least many people think so). It won't be a problem if person catches covid on plane if after landing they spend a few weeks in quarantine.
> Well none of the push for mandates or vaccine passports or other such nonsense makes much sense if the vaccines don't prevent spread and only provide an individual benefit of reduced risk.
Perhaps you'd prefer overrun ICU units so people die of treatable diseases because nobody can find a bed?
Vaccines absolutely benefit everybody even if they just reduce severity but don't contain spread (and I don't concede that point).
The "overrun ICUs" thing is a canard, and to the extent it's true is mostly the fault of our having slashed the number of hospital beds over the past decades under the imperatives of for-profit healthcare. Prior to 2020 you can find all kinds of examples of hospitals being overwhelmed by bad flu outbreaks. It's been 20 months and hundreds of billions spent on pandemic response -- where is the added hospital capacity?
Not sure if this applies to you, but I also just can't take seriously anyone who professes great concern about ICU capacity while also supporting the mass termination of any nurses who won't take the vaccine.
> and to the extent it's true is mostly the fault of our having slashed the number of hospital beds over the past decades under the imperatives of for-profit healthcare.
I don't disagree with this.
Unfortunately, the anti-vax people are almost a 1:1 Venn diagram with the people who are all-in on for-profit healthcare.
So, you can complain about this, but you can't use it as justification for anti-vax accommodation since it is caused by the same group of people.
> but I also just can't take seriously anyone who professes great concern about ICU capacity while also supporting the mass termination of any nurses who won't take the vaccine.
Prophylaxis is an expected minimum thing for the sake of patients. Any nurse who will not wash her hands between operations should be fired even if there is a nursing shortage. If someone is not willing to follow medical prophylaxis, they shouldn't be in medicine.
> How about 5yrs from now, will the 17th booster shot still be as affective?
...yes? Why wouldn't it be?
(Although I truly can't imagine any scenario where you end up with so many booster shots, only the flu is like that and it's a different shot every year, because the flu is a very unusual virus.)
The flu is a completely different virus. In fact, what we call "the flu" is actually several different influenza viruses, so your flu shot isn't targeting just one virus, it's targeting multiple influenza viruses. The rate of mutation of these viruses is very different than that of SARS-CoV-2.
The reason there's a different flu shot every year is that the efficacy of last year's vaccine against the current influenza viruses will likely be too low to provide adequate protection, not just against infection but against serious illness. This again is because of how much the influenza viruses mutate in a short period of time.
Currently, the data indicates that the SARS-CoV-2 vaccines are holding up very well in preventing severe illness, hospitalization and death for all SARS-CoV-2 variants. This is the reason why the boosters that were approved are the same vaccine, not a new variant-specific one.
SARS-CoV-2 vaccines do not provide sterilizing immunity, and it is clear that the neutralizing antibodies produced immediately after vaccination wane quickly, which allows vaccinated individuals to still become infected.
Unless and until you see a drop in the efficacy against severe illness, hospitalization and death, this idea that we will or should be taking COVID vaccines indefinitely every year is hard to justify with science.
I understand the differences betwen flu and Covid. My analogy was limited to the (widely accepted) routine of vaccination.
We don't yet know whether protection from hospitalization will wane, but waning protection from infection[1] is still a problem.
An infection can take time away from work or family, spread to others, and have long-term effects that we can't yet understand. Again, not unlike flu: we try to prevent infections with vaccines, not just hospitalizations.
Public health orgs have to weigh the benefit of boosters over the risk of lower supply where it's needed, but given unlimited vaccine supply, I would be surprised if we don't get a new Covid vaccine every year.
Vaccinating large numbers of people every 6-12 months with a non-sterilizing vaccine when the initial vaccination series is said to remain highly effective at preventing serious illness against all major variants that are currently in wide circulation is not at all routine or "widely accepted".
Again, the flu vaccine is different each year because the influenza viruses it aims to protect against are different. You are getting a different vaccine, not a "booster".
The flu vaccine is not a sterilizing vaccine and neither are any of the COVID vaccines. It is widely accepted that the flu vaccine is usually 40-60% effective at preventing illness in years where we target the right influenza viruses, and that many vaccinated individuals will get (mostly) mild infections.
From the CDC:
> A 2021 study showed that among adults, flu vaccination was associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared to those who were unvaccinated.
> A 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
By these metrics, against the endpoints of severe outcomes, the COVID vaccines currently look much more efficacious than the flu vaccine after the initial series, even without boosting.
While "long COVID" is of concern, many of the post-infection sequelae of COVID appear similar to known post-viral sequelae. Furthermore, the initial data suggests that the initial series of vaccination reduces the risk of long COVID sequelae in breakthrough infections. To my knowledge, there is not yet any data on long COVID and boosters, so it is highly premature to hint that repeated boosters are required to maintain protection against "long COVID".
Shutting down the world indefinitely because of COVID "infections" when the vast majority of people will have mild courses of illness makes no sense. We don't do this for the flu even though in bad flu seasons, people lose work and school days and the ERs and ICUs fill up. Furthermore, as time goes on, fewer and fewer people will be SARS-CoV-2 naive. They will either have some level of protection from exposure to the initial vaccine series or prior infection. The immune system is miraculous and there is a reason it doesn't indefinitely keep high levels of neutralizing antibodies in circulation for every pathogen (or vaccine) you're exposed to.
Finally, you should consider including repeated frequent booster vaccination in your "long-term effects that we can't yet understand" thinking. While I am not suggesting that the mRNA are "unsafe" or responsible for die-offs of baby dolphins, the reality is that we have no long-term data around giving people these jabs on a regular basis. The issue with myocarditis in some populations, questions about whether the vaccines affect the menstrual cycle[1], etc. are a reminder that there is still a lot we don't know and it is contrary to the principle of "first, do no harm" to strongly recommend (or try to force) people to receive regular pre-exposure prophylaxis when there is strong evidence that they already have substantial protection against serious outcomes from an initial vaccination series.
As somebody who has spent a fair amount of time in elder care facilities around these times of the year (mandatory Civilian service in my country), boy do I have some depressive anecdotes for you.
Flu shots can be just this side of too strong for some frail and fragile elders, and cause nearly as many victims as the flu a month later, when the vaccine turn's out to be not good enough.
Question for the vaccinated: would you accept it if your government mandated annual COVID shots or they'll rescind your current freedoms (right to be employed, to use public transport, supermarkets, eat and drink venues, etc)?
I'm vaccinated and even though my country hasn't got you're-not-allowed-to-do-anything-unless-you're-vaccinated authoritarianism like Lithuania for example, I would want off this ride if things go in that direction.
Just curious: Why is this only a question for the vaccinated? Do the unvaccinated have some quality that makes their answers to this unreasonable or untrustable?
Not the gp, but I think their point is that the usual divide that's made out is vaccinated/ unvaccinated as if that decision puts you automatically in a camp. When the actual relevant distinction is authoritarian vs pro choice (or whatever you want to call it if there is a more neutral way) and the gp is pointing out that the "vaccinated" are not all in the papers please camp, they may just have decided it was right for them on the balance of evidence
Yes. You don’t have a “right” to participate in modern society if it will make others deathly ill. You have the “freedom” to go build a cabin in the woods if you’d like.
Just get the damn vaccine. I’m not suggesting you need to run out and get the first ones off the production line if you want to be more cautious, but once half the country has gotten it there’s really no logical reason to be hesitant.
I also think we’d save an awful lot of lives if the flu vaccine was mandatory at least for K-12 children, at basically no cost.
> You don’t have a “right” to participate in modern society if it will make others deathly ill.
Everyone who engages in any social contact with others could potentially transmit to them a pathogen which proves lethal. This emphatically includes those who have taken the COVID-19 vaccines.
Sure, totally! But taking this vaccine lowers the risk measurably. If everyone takes the vaccine, the risk is even smaller! What is the downside?
I appear to hold an unusual in-between opinion on COVID restrictions, because I'm actually against continuing mask mandates. IMO, masks have a very clear downside: in terms of psychological well-being, the ability to see faces and reading expressions is actually incredibly important! So even if there's a public health benefit to universal masking, it's not worth the trade-off except in extremely exceptional circumstances.
Is there really clear evidence of a meaningful effect of a booster at this point, for people not in specific categories?
I assumed not, or else they would be recommending it.
Personally, I got a pretty strong reaction to my second shot, and I'm not eager to experience that or worse again, nor am I sure that the severity of the reaction implies its efficacy.
> Everyone who engages in any social contact with others could potentially transmit to them a pathogen which proves lethal.
What other pathogens are similar to Covid-19 on all of the following dimensions?
- transmissibility (let's say this is equal to R number[1])
- mortality rate
- hospitalization rate
- long-term disability rate
- cost of treatment
- difficulty of preventing hospitalization
I don't know of any disease that's similar. When you take the vaccine, your risk of hospitalization and death are dramatically reduced, and you're much less likely to give it to someone else.
> This emphatically includes those who have taken the COVID-19 vaccines.
Yes, but degrees matter here. Risk is fine and a part of life. Being unvaccinated is an unnecessary risk to yourself and others.
Just playing devil's advocate. Isn't the "spirit" of the parent comment saying: because we have a free and accessible way to reduce the transmission of pathogens, excluding yourself from it for non-medical reasons should have some consequence for you?
One +1 point for scenarios like polio, where it's been virtually eliminated in the US by way of successful vaccination programs. [0] One -1 point for scenarios like influenza, which despite still causing many deaths per year, receiving a flu shot is encouraged but not required. [1]
But almost no one is "excluding themselves for non-medical reasons." They're excluding themselves because they're at very low risk from Covid, the adverse event rate for these vaccines is about 30-50 times those of the flu shot, and they have no long-term safety data.
Before the stops were pulled out for Covid, previous attempts at using these platforms foundered because waning effectiveness necessitated repeat dosing (hmmm...) and cumulative toxic effects were observed over time (hmmmmmmmm...)
> Before the stops were pulled out for Covid, previous attempts at using these platforms foundered because waning effectiveness necessitated repeat dosing (hmmm...) and cumulative toxic effects were observed over time (hmmmmmmmm...)
Everybody ignores small risks, and people are also remarkably inconsistent in what is a small risk, depending on context and cultural assumptions.
Is drinking alcohol an acceptable risk? Drinking and driving? Drinking and boating? Riding a motorcycle? Riding a bicycle? Skydiving? Riding in a small plane? Not getting a yearly flu shot? Going for a walk in the woods where Lyme disease is endemic? Drinking unpasteurized juice or milk? Eating raw eggs? Raw fish? Not wearing a seatbelt?
As far as vaccines go, I was happy to get mine when I was allowed to. I wouldn't have liked to be the first, but I wasn't permitted to, and I didn't want to look stupid by getting ill before being vaccinated, so it worked out fine.
But if it becomes a thing that everybody is encouraged to get boosters, the fact that I went right out and got the vaccine in the first place doesn't mean I'm necessarily going to automatically get another shot.
If there is another big wave, if there is another variant, if half the country has gotten a booster, maybe then. But I'm not taking people seriously who egregiously exaggerate their certainty about uncertain things.
I got vaccinated because I was comfortable with the information I had on the risks and benefits, not because I consider it unreasonable to question any recommended medical treatment.
> Everybody ignores small risks, and people are also remarkably inconsistent in what is a small risk, depending on context and cultural assumptions.
I totally agree with this, and I've made the same argument in the past as a reason to get rid of most social distancing measures (which I think we should do).
But I think of risks in terms of tradeoffs. What is the risk-benefit tradeoff of sky diving? Well, for many people, that's a life-changing experience: well worth the risk! What is the risk-benefit tradeoff of not wearing a seat-belt? You're more likely to die in a car crash, in exchange for, I don't know, not fumbling with the buckle for a half a second? This isn't hard, just put on your seat belt.
> But if it becomes a thing that everybody is encouraged to get boosters, the fact that I went right out and got the vaccine in the first place doesn't mean I'm necessarily going to automatically get another shot. If there is another big wave, if there is another variant, if half the country has gotten a booster, maybe then.
As someone who's in favor of vaccine mandates, I think this is totally reasonable—and I don't think it's going to be a problem for you. While I could certainly be wrong, I don't see the US changing the meaning of "fully vaccinated" until booster shots are widely available and a large majority of the public has them. Just as we didn't start to see vaccine mandates become a thing in earnest until this fall.
I tend to ask myself "will this enrich my life, or if I die doing it, would I feel really dumb?" Without regard to quantifying risks or benefits precisely.
If I was at the proverbial gates of heaven talking to St. Peter, I would want to be able to say I wasn't grossly negligent in whatever sent me there. Meaning I took, not the optimal, but the customary precautions.
I'm not sure that I truly understand the concept of comparing risks and benefits. If I do something risky, that's an abstract concept. In fact, either I die or I don't. If I don't, of course it was worth it. But how does that show the benefit was greater than the risk? Any risk that doesn't happen feels the same as any other.
I have gone skydiving, and at the time, it seemed like an experience worth having. After the second time, it didn't any more. Part of the thrill, I guess, is the proximity to death if you don't perform the right actions at the right time, and I tend to screw up under pressure.
I was conditioned early to always wear my seatbelt in a personal vehicle, but I don't think there is logic to it when I start comparing it to other risks.
As a child I didn't wear a belt on the school bus, because nobody else did (or there weren't any). I think I've ridden on city buses that didn't have any, but I also have the impression that accident rates are really low for various reasons. As a freshman in college, I rode in the bed of a pickup truck, even though I was uncomfortable doing it. I prefer to be secure, but peer pressure could override that.
When I'm on an airplane, I buckle my belt as instructed, but I think the decrease in risk is probably not logical justification, as the risk is already so low.
And I have sometimes ridden motorcycles, so if that's a reasonable thing to do, then why not go unbelted in a car, if you like? I mean, except for, say, being ticketed. Do 3-wheeled vehicles that legally count as motorcycles have belts? I think I've read about airbag devices for motorcycles, which are interesting, but I don't really think they should be mandated and universal like with cars.
I would very much like consistency and simplicity in rules in a particular area (like the pandemic), rather than continual murky arguments over what is optimal.
I think it's ok to compartmentalize and not try to reconcile with all our other activities.
Standing six feet apart and wearing masks in buildings open to the public is simple enough, but it's become complicated over time.
Where I live, most businesses seem to have their employees wearing masks, but the customers generally aren't. I too, am required to wear a mask at work. I dislike spending thought on what arbitrary thing to do in daily life.
Simple rules that lead to a harmonious daily life are better than obsessing over what is perfect or optimal. That is my belief.
And really we should ban from society any people who have STDs or other blood transmittable diseases. After all they could get a cut accidentally and spread it. Too much risk to take isn't it. Why not just lock them all up for our safety?
I think you missed the part where people dying from COVID is not random, but touches people with 3-4 comorbidities for the most part. So in effect you will run out of people dying well before you run out of unvaccinated.
COVID slows down all the time. Have you ever looked at a case graph? It comes and goes and the risk is not 0.2% per day, it's 0.2% or lower per infection which given that natural immunity works better than vaccination, basically happens and for many people (like me) appears to have actually never happened. But even if you assume a 100% chance of being eventually infected, it's not anything close to 0.2% per day.
0.2% of the population _per day_ would be something like 50% a year. That's worse than the black plague, a worse variant of Anthrax or runaway Marburg which spread even more easily...
Breaking the site guidelines like this will get you banned here, regardless of how right you are or feel you are. If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.
What is the probability that one will catch COVID at all AND if one does, what is the probability of serious illness or death FROM COVID not with COVID? Spend some time on the CDC website and quit listening to bureaucrats, politicians and the media.
reply