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This entire article assumes that the vaccine provides sterilizing immunity (where you can't spread it) rather than just disease protection (where you get and sp

This entire article assumes that the vaccine provides sterilizing immunity (where you can't spread it) rather than just disease protection (where you get and spread the virus but aren't as symptomatic). But even now no one knows if these vaccines provide sterilizing immunity, as they were only testing for disease protection in the trials. Some even theorize some vaccinated individuals might be _more_ contagious, as they are less likely to socially distance and could be more likely to be asymptomatic carriers. Indeed the article itself is evidence of this risk, as the author seems to advocate giving the vaccine to people who are willing to pay a lot so they can go party. That said, if sterilizing immunity is provided by the vaccine, then a lot of the arguments are more plausible. But I don't think it's valid to just assume that, and it's not fair to health officials who don't assume that either.

xwdv 6y ago
If everyone gets the vaccine, it doesn’t matter if it doesn’t provide sterilizing immunity.
- geofft 6y ago
  While that statement is true, it's not relevant to the author's claim - that if you have a limited dose of the vaccine, you should allocate it as quickly as possible (and the free market is a good way to do so) and to people who risk infecting other people. We don't have enough doses for everyone to get the vaccine, so whether it provides sterilizing immunity very much does matter to the question of who to allocate it to and how. (If we did have enough doses ready to go for everyone, the government solution of "have the government buy it and distribute it to everyone" and the free market solution of "everyone and their insurance is very willing to buy one dose but values a second dose at $0" would basically collapse to the same thing, and so the author's argument would be moot.)
  - mlyle 6y ago
    I think the current tradeoff is decent: 1A) healthcare workers (highest unavoidable exposure rate) & LTCF (highest mortality rate) 1B) frontline workers (high unavoidable exposure rate, and may be crucial transmission links) & the very old (high mortality rate). If the vaccine lowers transmission, we'll see a big effect from the frontline worker portion, which I suspect factored into the decision somewhat even if it is not acknowledged in the documents. 1C) This category is too big-- all essential workers and anyone with a health condition increasing risk or over age 65. This phase is actually bigger than 2. It needs to be split up some to prevent a mad rush for doses, and certainly we can benefit from further prioritization. Hopefully this is addressed, but it's tomorrow's problem. 2) The remaining group is smaller and probably the least interest in getting vaccinated, so I assume when we get to phase 2 we'll be facing different logistical concerns. The really stupid thing we're doing, IMO, is reserving 55% of doses to ensure everyone gets dose 2. It should be a much smaller reserve (~25%): it's unlikely that Pfizer's production will stall entirely and even in that worst case scenario, most people would get a second dose, AND the data looks like 1 dose is likely effective. This reserve is preventing many areas from having enough doses to enter phase 1B, and portions of phase 1B are parallel infrastructure (e.g. mass-vaccination clinics). So, allocating those additional doses could be expected to significantly increase throughput by activating other channels through which the vaccine is distributed.
- bjornsing 6y ago
  But that’s not what the OP was arguing...
graeme 6y ago
This is scientific poor communication + regulatory inhibition. No, the drug companies did not study sterilizing immunity. No, they make no claims. However, ask any expert and they would say they expect there will probably be some sterilizing immunity and reduction in spread for those who do get it. Some moderna data showed a 2/3 reduction in asymptomatic cases. It would be astonishing if vaccines cause no decrease in spread. This meme is the new “masks protect others, they don’t protect you”. They do, in fact, protect the wearer to some extent. How could they not?
- monoideism 6y ago
  > They do, in fact, protect the wearer to some extent. That may be the case with N95 masks, but there is absolutely no way that a surgical mask protects the wearer to any measurable extent. At best, it helps prevent the wearer from spewing more viral particles into the air (and even that is far from proven). I was an early advocate for masks (check my HN history) back in February, but it's bizarre how they've become a kind of magic talisman for half the population. Some of my "mask-skeptical" HN critics at that time were worried masks would make wearers overconfident, and go into high-risk situations, and they were right.
  - rightbyte 6y ago
    The only empirical study I know of is the Dannish one: https://www.acpjournals.org/doi/10.7326/M20-6817 https://www.acpjournals.org/doi/10.7326/M20-6817 I thought that the effect would be like 80-90% or something. But given what was established practice in january last year I should not be too suprised with the results ...
  - graeme 6y ago
    The CDC says masks protect the wearer. Not nearly as much as an n95 surely, but how could a mask not protect the wearer to some extent? Virus in aerosols moves on very tiny water droplets, and a porous barrier will stop more than no barrier at all. Obviously it’s way safer to simply not be in a risky situation. You’re reading stuff into my comment that I didn’t say. https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html https://www.cdc.gov/coronavirus/2019-ncov/more/masking-scien...

xwdv 6y ago

If everyone gets the vaccine, it doesn’t matter if it doesn’t provide sterilizing immunity.

geofft 6y ago
While that statement is true, it's not relevant to the author's claim - that if you have a limited dose of the vaccine, you should allocate it as quickly as possible (and the free market is a good way to do so) and to people who risk infecting other people. We don't have enough doses for everyone to get the vaccine, so whether it provides sterilizing immunity very much does matter to the question of who to allocate it to and how. (If we did have enough doses ready to go for everyone, the government solution of "have the government buy it and distribute it to everyone" and the free market solution of "everyone and their insurance is very willing to buy one dose but values a second dose at $0" would basically collapse to the same thing, and so the author's argument would be moot.)
- mlyle 6y ago
  I think the current tradeoff is decent: 1A) healthcare workers (highest unavoidable exposure rate) & LTCF (highest mortality rate) 1B) frontline workers (high unavoidable exposure rate, and may be crucial transmission links) & the very old (high mortality rate). If the vaccine lowers transmission, we'll see a big effect from the frontline worker portion, which I suspect factored into the decision somewhat even if it is not acknowledged in the documents. 1C) This category is too big-- all essential workers and anyone with a health condition increasing risk or over age 65. This phase is actually bigger than 2. It needs to be split up some to prevent a mad rush for doses, and certainly we can benefit from further prioritization. Hopefully this is addressed, but it's tomorrow's problem. 2) The remaining group is smaller and probably the least interest in getting vaccinated, so I assume when we get to phase 2 we'll be facing different logistical concerns. The really stupid thing we're doing, IMO, is reserving 55% of doses to ensure everyone gets dose 2. It should be a much smaller reserve (~25%): it's unlikely that Pfizer's production will stall entirely and even in that worst case scenario, most people would get a second dose, AND the data looks like 1 dose is likely effective. This reserve is preventing many areas from having enough doses to enter phase 1B, and portions of phase 1B are parallel infrastructure (e.g. mass-vaccination clinics). So, allocating those additional doses could be expected to significantly increase throughput by activating other channels through which the vaccine is distributed.
bjornsing 6y ago
But that’s not what the OP was arguing...

graeme 6y ago

This is scientific poor communication + regulatory inhibition. No, the drug companies did not study sterilizing immunity. No, they make no claims. However, ask any expert and they would say they expect there will probably be some sterilizing immunity and reduction in spread for those who do get it. Some moderna data showed a 2/3 reduction in asymptomatic cases. It would be astonishing if vaccines cause no decrease in spread. This meme is the new “masks protect others, they don’t protect you”. They do, in fact, protect the wearer to some extent. How could they not?

monoideism 6y ago
> They do, in fact, protect the wearer to some extent. That may be the case with N95 masks, but there is absolutely no way that a surgical mask protects the wearer to any measurable extent. At best, it helps prevent the wearer from spewing more viral particles into the air (and even that is far from proven). I was an early advocate for masks (check my HN history) back in February, but it's bizarre how they've become a kind of magic talisman for half the population. Some of my "mask-skeptical" HN critics at that time were worried masks would make wearers overconfident, and go into high-risk situations, and they were right.
- rightbyte 6y ago
  The only empirical study I know of is the Dannish one: https://www.acpjournals.org/doi/10.7326/M20-6817 https://www.acpjournals.org/doi/10.7326/M20-6817 I thought that the effect would be like 80-90% or something. But given what was established practice in january last year I should not be too suprised with the results ...
- graeme 6y ago
  The CDC says masks protect the wearer. Not nearly as much as an n95 surely, but how could a mask not protect the wearer to some extent? Virus in aerosols moves on very tiny water droplets, and a porous barrier will stop more than no barrier at all. Obviously it’s way safer to simply not be in a risky situation. You’re reading stuff into my comment that I didn’t say. https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html https://www.cdc.gov/coronavirus/2019-ncov/more/masking-scien...