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TFA is extremely light on actual details of who is and who is not taking the vaccine. Most importantly is that it’s perfectly valid for someone to be hesitant

by zaroth 6y ago

TFA is extremely light on actual details of who is and who is not taking the vaccine. Most importantly is that it’s perfectly valid for someone to be hesitant to take a newly released medical treatment. You won’t convince anyone to take the vaccine without first admitting their concerns are valid and trying to address them. I would say there are two major groups who would most reasonably decline a vaccine. First, is anyone who has already had COVID. Natural immunity is more effective than the vaccine at preventing COVID, and I don’t know of a single case of someone spreading COVID after recovering. The vaccine on the other hand is not proven to prevent spread, and is not proven to provide longer duration immunity than natural infection. The article makes no mention at all of what percentage of health care workers declined a vaccine because they are already naturally immune. Second, is anyone who is pregnant, as the vaccine is completely untested in that scenario. Curiously, TFA’s only specific example of someone who declined is someone who was pregnant. Given the efficacy of the vaccine, anyone who hasn’t already had COVID who doesn’t want to get COVID should take the vaccine. Anyone who hasn’t already had COVID who doesn’t mind taking the risk of getting COVID can pass on it. We should give doses to those who want it, as fast as possible. Doses sitting on shelves are the biggest problem, because we are overly concerned with micromanaging the queue. It’s like loading passengers on a plane. Going from front to back in strict order is the slowest possible way to do it. As I recall, a purely random ordering will load the plane at nearly the optimal rate, and if you include the time outside the plane spent on ordering, random is by far the fastest. COVID vaccination rate probably works about the same way.

n8henrie 6y ago
I'm an emergency physician on the Navajo Nation in the US. I've seen multiple people quite ill the second time they've caught COVID (based on positive PCR twice, months apart, with compatible symptoms both times, resolution of symptoms in between, and a negative test in between). All had multiple sick family members the second time, hard to say who infected who, but I have no reason to believe they were not infectious the second time. (All were young and healthy, young children and youngish adults, seems like they were generally not very ill the first time so perhaps didn't mount a very robust immune reaction?) In speaking to colleagues that are hesitant about the vaccine, the evidence that having had COVID once does not guarantee protection against a subsequent and possibly more serious infection is actually something I specifically point out. Note that I'm not arguing that we have evidence that the vaccine guarantees long-lasting immunity either. EDIT: typo
bsder 6y ago
> Natural immunity is more effective than the vaccine at preventing COVID You have no evidence of this and at least weak evidence to the contrary--both for COVID and other viral diseases. The human immune system seems to be capable of clearing COVID with with the innate, non-specific immune response--especially in younger people. This will not necessarily provoke the antibody response that gives long term immunity. A vaccine, on the other hand, is engineered to provoke a long-term response from the antibody system.
- zaroth 6y ago
  Of course we have evidence that natural immunity is more effective than the vaccine. There have been tens of millions of people infected, and it’s front page news when they find someone who has been re-infected. They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%.
  - n8henrie 6y ago
    > it’s front page news when they find someone who has been re-infected Absolutely false. As I pointed out, I've seen multiple cases myself, as have many of my colleagues. Not only are they not newsworthy, they are hardly interesting at this point.
  - bsder 6y ago
    > They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%. That's not true for any disease known to man. In addition, the reason why reinfections are so "rare" medically is that the criteria for it are so stringent. The patient has to have a positive COVID test, get over COVID, have a negative COVID test after long enough to believe that the virus cleared, catch the disease again after some time, and then get another positive test. There are very few people who will meet that criteria given the rarity of COVID tests until about October. Sadly, given the current rate of spread and the anecdotal evidence from others about reinfections, we should start getting enough people in that cohort to begin estimating the reinfection rate.
mytailorisrich 6y ago
The analogy with loading a plane is poor. A seat is a seat and the aim is only to fill them as fast as possible. On the other hand, with the covid vaccine not all injections are equal: some people have a higher risk of catching the virus, a higher risk of complications from the virus, a higher impact on society if they are off sick, a higher chance of spreading the virus, etc. The aim is thus to get the maximum effect with each injection, especially when the supply of vaccines is limited. Healthcare workers are critical and are at higher risk of catching the virus and of spreading the virus. For some of them at least vaccination should be mandatory for maximum impact and patients safety. There is also symbolism and example: if healthcare professionals are wary of getting vaccinated then it sends a very bad message to the public that they should probably be wary as well instead of encouraging uptake. In some countries, the President/PM took the jab live on TV. That's a form of leading by example and I believe healthcare workers of a responsibility to society on those issues.
mapgrep 6y ago
> Curiously, TFA’s only specific example of someone who declined is someone who was pregnant. This is false. The person you refer to, April Lu, is not the only specific example in the article, just the first. The second is Nicholas Ruiz, who I think it’s safe to say is not pregnant.

by zaroth 6y ago

n8henrie 6y ago

I'm an emergency physician on the Navajo Nation in the US. I've seen multiple people quite ill the second time they've caught COVID (based on positive PCR twice, months apart, with compatible symptoms both times, resolution of symptoms in between, and a negative test in between). All had multiple sick family members the second time, hard to say who infected who, but I have no reason to believe they were not infectious the second time. (All were young and healthy, young children and youngish adults, seems like they were generally not very ill the first time so perhaps didn't mount a very robust immune reaction?) In speaking to colleagues that are hesitant about the vaccine, the evidence that having had COVID once does not guarantee protection against a subsequent and possibly more serious infection is actually something I specifically point out. Note that I'm not arguing that we have evidence that the vaccine guarantees long-lasting immunity either. EDIT: typo

bsder 6y ago

> Natural immunity is more effective than the vaccine at preventing COVID You have no evidence of this and at least weak evidence to the contrary--both for COVID and other viral diseases. The human immune system seems to be capable of clearing COVID with with the innate, non-specific immune response--especially in younger people. This will not necessarily provoke the antibody response that gives long term immunity. A vaccine, on the other hand, is engineered to provoke a long-term response from the antibody system.

zaroth 6y ago
Of course we have evidence that natural immunity is more effective than the vaccine. There have been tens of millions of people infected, and it’s front page news when they find someone who has been re-infected. They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%.
- n8henrie 6y ago
  > it’s front page news when they find someone who has been re-infected Absolutely false. As I pointed out, I've seen multiple cases myself, as have many of my colleagues. Not only are they not newsworthy, they are hardly interesting at this point.
- bsder 6y ago
  > They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%. That's not true for any disease known to man. In addition, the reason why reinfections are so "rare" medically is that the criteria for it are so stringent. The patient has to have a positive COVID test, get over COVID, have a negative COVID test after long enough to believe that the virus cleared, catch the disease again after some time, and then get another positive test. There are very few people who will meet that criteria given the rarity of COVID tests until about October. Sadly, given the current rate of spread and the anecdotal evidence from others about reinfections, we should start getting enough people in that cohort to begin estimating the reinfection rate.

mytailorisrich 6y ago

The analogy with loading a plane is poor. A seat is a seat and the aim is only to fill them as fast as possible. On the other hand, with the covid vaccine not all injections are equal: some people have a higher risk of catching the virus, a higher risk of complications from the virus, a higher impact on society if they are off sick, a higher chance of spreading the virus, etc. The aim is thus to get the maximum effect with each injection, especially when the supply of vaccines is limited. Healthcare workers are critical and are at higher risk of catching the virus and of spreading the virus. For some of them at least vaccination should be mandatory for maximum impact and patients safety. There is also symbolism and example: if healthcare professionals are wary of getting vaccinated then it sends a very bad message to the public that they should probably be wary as well instead of encouraging uptake. In some countries, the President/PM took the jab live on TV. That's a form of leading by example and I believe healthcare workers of a responsibility to society on those issues.

mapgrep 6y ago

> Curiously, TFA’s only specific example of someone who declined is someone who was pregnant. This is false. The person you refer to, April Lu, is not the only specific example in the article, just the first. The second is Nicholas Ruiz, who I think it’s safe to say is not pregnant.