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Transmission of SARS-CoV-2 Delta Among Vaccinated Healthcare Workers, Vietnam

93 points by breck 5y ago

benjaminwootton 5y ago
If transmission between vaccinated people is happening relatively easy, that should totally change the narrative. - Herd immunity becomes unrealistic. - My vaccine doesn’t protect you and vice versa. Our own does however protect us very well. - Vaccine passports are essentially pointless and possibly dangerous if they give a false sense of security. Only asymptomatic, more infectious people will be allowed in. - The messaging should change towards “take a vaccine to protect yourself and not burden the health service with your own illness.” I wonder if messaging will change to reflect the new “the science” or if too much political face would be lost at this point?
- glenngillen 5y ago
  The messaging early in the pandemic seemed less about “not burden the health service with your own illness” directly, and more the indirect impact that burden created in servicing non-covid patients. I don’t think that changes much, does it? Still seems like we need to make sure people need to not be overwhelming hospitals. Either via vaccination or other means.
  - redis_mlc 5y ago
    No, "flatten the curve" was the early goal, but I don't remember any mention of that helping non-corona cases. In fact, most hospital elective surgeries were cancelled (and the nurses laid off), so I'm not sure where you got your ideas from. You might want to post a link.
- blendergeek 5y ago
  > Only asymptomatic, more infectious people will be allowed in. I don't see anything in the study that would indicate that people with the vaccine are more infectious than those without. Rather, the study says they are infectious. The variable in this study was alpha vs delta variant and the result is that while the vaccine prevented the transmission of alpha variant it does not prevent the transmission of the delta variant. This study does not address the question of whether those with the vaccine are more or less likely to spread the delta variant than those without the vaccine.
  - newbamboo 5y ago
    Well it seems like simple logic no? If the vaccine decreases symptoms but not viral load, vaccinated are more likely to transmit it. Right? Maybe I’m being dumb again. Happens. :)
    - spauka 5y ago
      The paper does not make conclusions about whether the vaccinated are more likely to be asymptomatic - but in case you are interested the results are presented in Table 1. Of The 69 cases infected, 47 developed symptoms (median 4 days post diagnosis), which is 68% of cases. Viral loads for symptomatic cases was higher (page 11). Key points: there is not enough information here to draw conclusions about the infectiousness of vaccinated vs. unvaccinated individuals, or about whether vaccinated individuals are more likely to be asymptomatic. This paper does not even try to draw such conclusions.
    - vlovich123 5y ago
      I'm not following the logic. Why would decreased symptoms mean you're more likely to spread? You're thinking that asymptomatic people are more likely to not wear masks/be in more populous places whereas symptomatic people are more likely to quarantine/wear a mask? I could see that line of reasoning, although, as a counterpoint, I understood that the main virality of COVID stems from the long lag between being infectious & symptoms. In other words, basically everyone is asymptomatic for the first 7-10 days that they're infectious anyway. If the vaccine confers a reduction in symptoms, that's still valuable. The danger of COVID is the sudden spike needed in hospital resources & deaths. Sounds like the vaccine still decreases both, even for delta. Not getting infected at all is a secondary benefit that's a nice to have & important for eradicating the virus totally. I suspect that's a pipe dream at this point & the question is how quickly we can transition it to an endemic disease like the flu.
    - SideburnsOfDoom 5y ago
      > vaccinated are more likely to transmit it. Right? The vaccinated are also less likely to have it in the first place, so no, not right. There are "similar viral loads in vaccinated and unvaccinated patients" _who have symptoms_ - that's a huge selection bias right there. You can still assume that there are very different rates at which vaccinated and unvaccinated are prone to getting infected in the first place, then developing symptoms. This conclusion is also wrong: "My vaccine doesn’t protect you and vice versa." - yet more simplistic, all or nothing, black or white thinking. Delta means that my vaccination doesn't protect you _as much as it did_ but it is incorrect to leap to "it doesn't protect you at all" It's clear that at present, vaccination alone is not the answer, but it would be very wrong to disparage vaccination, e.g. to say that "vaccination is not the answer" - vaccination is part of the answer, likely the largest part.
- refurb 5y ago
  This appears to the direction we're headed - a similar steady state as the flu (which a few people hypothesized early on in the pandemic). - Covid won't go away, we'll just keep having waves move through the population - A vaccine mostly protects the person who receives it; it likely makes them less contagious, but not enough to stop them from infecting others - The vaccines work very well in making the disease less severe; again, similar to the flu - sick enough to stay home, but rarely so severe you need to be hospitalized - Eventually you just live with it. We'll probably have new outbreaks of different variants (just like we have more severe flu seasons)
  - dehrmann 5y ago
    I'm somewhat optimistic because the vaccines are probably good enough to bring death rates to an acceptable level, we have multiple vaccines, that take different approaches, and covid has hopefully already made all the easy wins for transmission, so it won't get that much more contagious. My fear is that all these countermeasures select for something actually scary, though there's no reason to think it will get significantly more deadly.
  - grepfru_it 5y ago
    And then you have folks like Lamar Jackson who has been infected with the virus already and has a mild experience with delta just like those with the vaccine (similar to the outcome of the flu shot) Im watching intently as so far the data shows vaccine offers superb reduction in symptoms, while previous natural infection also reduces symptoms and duration (making me wonder what a vaccine passport is really accomplishing)
    - fy20 5y ago
      In my country the passport is issued to those who were previously infected (and diagnosed with an official test) as well, so it shows you are "known to have some level of immunity". I feel that's fair as it applies to both people who were infected and those who were vaccinated. Where it gets confusing though is it's also issued to people who had a recent PCR negative test (last 48 hours), so those people are "known unlikely to be infectious", but that doesn't apply to the previous groups, and the statement of the previous groups doesn't apply to this group.
- cjensen 5y ago
  Your interpretation is almost completely wrong, and is a good example of why we layfolk should leave the explaining to experts. For example, you said "my vaccine doesn't protect you and vice-versa." That is entirely unsupported by this paper which merely says "transmission between vaccinated people is possible." You have interpreted this fact well beyond any actual evidence. For example, the proposition "the vaccine makes it hard to transmit, and makes cases very mild" would be entirely consistent with this study, and is completely in opposition to your incorrect conclusion. So far, all evidence points to the vaccines working exactly as well as anticipated.
  - peytn 5y ago
    I think you’re confusing the poster’s hypothetical for an interpretation.
    - shusaku 5y ago
      How silly of him to assume the top hacker news comment was related to the specifics of the linked article and not a hypothetical
    - tsimionescu 5y ago
      What hypothetical? The comment clearly thinks that the study should be read in the light they present. They even wonder if the narrative will change based on the new science - not whetheriit would change.
  - sieabah 5y ago
    > Your interpretation is almost completely wrong, and is a good example of why we layfolk should leave the explaining to experts. "Don't think too hard, let us, the self appointed exports, do the thinking for you" I don't believe the original comment had the same direction you think it did. Your response seems to be more saving face of "how not to interpret something". Whereas the parent comment is proposing different messaging if certain things are found to be true with more studying. Appeal to authority isn't a valid argument and I'm not sure why you think it would be.
  - 5y ago
- acituan 5y ago
  > Vaccine passports are essentially pointless and possibly dangerous if they give a false sense of security. Only asymptomatic, more infectious people will be allowed in. Counterargument; mixing of vaccinated and unvaccinated populations is precisely what gives the "training" to the virus variants. Herd immunity works if the duration of the mixture of these herds is minimized. You can achieve that with distance or high and fast vaccine rollout, neither of which happened. The mistake was opening up too much, too soon, and mixing up too much. We've been focusing on protection "right now" at the expense of protection over time. I think focusing on personal protection is also a non-scaling approach; I get that it might motivate the rollout but ultimately personal immunity, unless it comes from having survived the real deal, is also a perishable state both from slow decay of vaccine immunity and constant training of variants perspective. None of these countermeasures make popular policies, so it is less about saving face and more about optimizing re-electibility.
- wesleywt 5y ago
  Many conclusions based on flimsy or next to no evidence in this comment.
- n8cpdx 5y ago
  If injury in a car accident where people are wearing seatbelts is relatively likely, that should totally change the narrative: - expecting seatbelts to prevent all traffic injuries becomes unrealistic (it never was but that doesn’t mean it’s useless - the herd immunity war was lost the moment vaccines became political, which was about 20 years ago) - My seatbelt won’t protect you from injury in the event of a crash, and vice versa (don’t confuse possibility with likelihood. Vaccines are still reducing severity and likely reducing the amount of virus that’s being shed e.g. through coughing. Seatbelts also protect other occupants from yourself becoming a projectile, but like vaccines, they don’t fully solve the problem) - seatbelt mandates to enter public roads are essentially pointless and possibly dangerous if they give a false sense of security. Only foolhardy, risk-taking seatbelt-wearing drivers will be on the road. (Passports are a tool to create a mandate in the absence of a mandate. If everyone was vaccinated delta wouldn’t have happened at all. In the absence of that, reducing the load on the hospital system is well worth the cost of the passport system) - The messaging should change to “wear a seatbelt to protect yourself and not burden the health service with your own injuries” (sure, but that’s kind of what the message already is and always has been) I wonder if the poster will understand the analogy that’s being made, or if too much face would be lost at this point?
yborg 5y ago
This was the Astra-Zeneca vaccine, similar studies will have to be done for the mRNA vaccines.
- readthenotes1 5y ago
  Similar? https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v1 https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v...
  - sterlind 5y ago
    yikes! this is the first I'm reading that Pfizer seems (statistically) significantly inferior to Moderna in efficacy against Delta. seems Moderna has 60% better protection against infection, and 2x better against hospitalization (though ICU admission and deaths are at par between them.) having gotten Pfizer, I'm getting a little nervous.
    - hnyolo081221 5y ago
      having gotten Pfizer, I'm getting a little nervous. As someone that got my 2nd Pfizer dose at the end of February (coming on 6 mo. when efficacy might? drop off some) I'm not saying that I did go get a first round Moderna shot[1], but I'm not saying I didn't either. 1. If doses in my area of the country weren't going un-used and spoiling, and I wasn't in a household with people that aren't eligible, I never would have done something I haven't said I've done.
      - keneda7 5y ago
        I don't think you trying to take extra steps to protect yourself should be be looked down on by either side here. It your choice and right to do that especially if you checked that vaccines were being wasted in your area.
    - vladvasiliu 5y ago
      I'm not sure how to read the linked abstract, maybe someone with more knowledge could chime in. The information I'm missing is what the absolute efficacy of those vaccines is against Delta. If the risk of being hospitalized while vaccinated with Moderna is "very, very low", then the risk of hospitalization while vaccinated with Pfizer, even if twice as high, would still be pretty low. I think this kind of actually useful info would be very useful in our current climate, where many people argue against vaccination. "Look, Pfizer is twice as bad as the other! Who knows what the other does? Better not get vaccinated at all!".
SV_BubbleTime 5y ago
> There was no correlation between vaccine-induced neutralizing antibody levels and viral loads or the development of symptoms. Not what you would expect is it?
- grepfru_it 5y ago
  It’s a novel virus and an even more novel vaccine. No one should have any expectations of outcome right now
  - carlmr 5y ago
    But it's not the first virus ever, nor the first Corona virus, or the first SARS virus. So there is precedent to compare against.
  - nradov 5y ago
    It's not that novel. SARS-CoV-2 is genetically quite similar to both the original SARS-CoV and HCoV-OC43.
- sterlind 5y ago
  that is surprising, I'm not sure what to make of it. maybe the "noisiness" of antibodies matters - the response they elicit in the immune system upon binding something, not simply how many of them are binding. I wish the immune system came with better documentation.
- dragonwriter 5y ago
  While I’m not an expert and I wouldn't be too surprised to find something different, I would expect exactly that but that neutralizing antibody levels would be inversely correlated with probability of getting a detectable infection at all. Once you limit the universe to detected cases, though, I don't think the absence of relationship reported here is surprising.
  - SV_BubbleTime 5y ago
    So would it in theory be surprising to find if viral loads are not lower in vaccinated people relative to unvaccinated?
titzer 5y ago
Local outbreaks here among vaccinated family members and extended family members supports the emerging data that Delta spreads easily via vaccinated folks. The CDC recommendation for indoor mask wearing is motivated by data from Israel that was derived from testing vaccinated people without symptoms. Delta is damn good at spreading, it seems. This sucks.
- tinus_hn 5y ago
  Do you think these healthcare workers forgot to wear those masks?
  - bufferout 5y ago
    Maybe it's not a binary thing?
- christkv 5y ago
  I remember reading that the ideal vaccine location for respiratory illness would be a nasal and lung aerosol so there would be a strong local immune response making it harder for any future infections to replicate effectively. Don’t know if that is still being looked at.
  - dehrmann 5y ago
    Just found this: https://www.pbs.org/newshour/health/scientists-debate-potential-benefits-of-intranasal-covid-19-vaccines https://www.pbs.org/newshour/health/scientists-debate-potent... It leads with this: > Vaccines that are injected into arm muscles aren’t likely to be able to protect our nasal passages from marauding SARS-CoV-2 viruses for very long It might be true, but I would have liked to read more. It's pretty easy to envision a case where that's not true, and the immune system doesn't really care where the vaccine was given.
- akira2501 5y ago
  > Delta is damn good at spreading, it seems. This sucks. It does not appear to be as good at killing, though. Which is hopeful.
NhanH 5y ago
A few things that the paper did not mention explicitly, but I think was worth mentioning: - It was AstraZeneca vaccine for both dose. With 4-5 weeks between doses (as opposed to the recommended 8-12 weeks). We have known now that too early 2nd doses will not be as effective. - Healthcare workers includes non direct healthcare staffs of the hospital. The majority of the 69 cases was the IT department of the hospital, iirc. Someone was wondering if the healthcares workers might forgot to wear masks or not. Seeing that they are office workers instead of nurses and doctors, it's possible that they didn't. I don't know if they did or not.
tzs 5y ago
> We studied breakthrough infections among healthcare workers of a major infectious diseases hospital in Vietnam Vaccines greatly reduce your chances of getting infected from a given exposure, but they don't reduce your chances to 0. The more times you are exposed, the more likely you are to eventually get infected. I assume that workers at a major infectious diseases hospital during an infectious disease pandemic get exposed many more times than a typical member of the general population. (Worse...they are exposed to people who are sick enough to need hospitalization, which probably means that they are dealing with people with higher viral loads than the infected people the general population usually encounters). This is not COVID specific. There are breakthrough infections for measles and polio, for instance. They are extremely rare in large part because most people are not repeatedly exposed to measles or polio. Measles is ridiculously contagious (9 out of 10 unvaccinated people will get it after just a short exposure to an infected person--R0 for measles is around 12-18), but two doses of measles vaccine are 97% effective so even with it being highly contagious the spread is slow enough in highly vaccinated populations to keep outbreaks small. Polio's R0 is around 5-7. The first widespread vaccines for polio (the Salk vaccine and then a little later the Sabin vaccine) were around 90% effective. They reduced the number of cases per year in the US by 2 to 3 orders of magnitude within a few years of their introduction. For comparison the delta variant of COVID has an R0 about the same as that of polio and the mRNA COVID vaccines are at least as effective as the Salk and Sabin polio vaccines were.
- trhway 5y ago
  >the mRNA COVID vaccines are at least as effective as the Salk and Sabin polio vaccines were. that is simply not true. The scientific data has been widely available for several weeks at least, yet ultra-zealot covid vaccine pushers are just ignoring it and continue pushing Moderna/etc. stock up together with political establishment. https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-may-be-superior-pfizer-against-delta-breakthrough-odds-rise-with-time-2021-08-09/ https://www.reuters.com/business/healthcare-pharmaceuticals/... "the effectiveness of Moderna's vaccine against infection had dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said. " In general your post does the same propaganda trick that many similar posters here and elsewhere do - tightly associate covid vaccines which are failing for delta (nothing exceptional in such situation, happens all the time with flu vaccines) with success of proven vaccines. What is your point? To undermine the people trust in the proven vaccines like measles and polio and even in the general vaccination principle by forcefully pushing failing covid vaccines upon them?
splittingTimes 5y ago
Germany is following suite with other European countries and stops free testing in October. Why? Free testing on a massive scale and using masks felt like the fastest road to normality. 1. Protect children Even though I am vaccinated i can still catch and transmit the Rona. That chance is even higher as i am potentially asymptomatic. Living together and having often contact with children who cannot be vaccinated makes that a huge problem. I do not want to expose the little ones to serious long term health issues. 2. Go to events / economy In that regard, i felt safe to go to events or indoor activities where I knew everybody was tested negative. Now we can have super spreader events again. So I will avoid indoors. 3. Stop mutations Until we have an anti viral that is effective once you are sick, the overarching goal should still be to have as few infected as possible. The more people have it, the higher the chance of further mutations. The kicker is that now when a mutation occurs in a vaccinated person it will favor a variation that properly has immune escape rendering the vaccine efforts useless. If the government thinks it is an effective instrument to convince anti vaxxers to get a shot (which I doubt) make only them pay for tests. If the arguments would have been that the tests themselves have become less effective to detect the Delta strain or that too many test centers are scammers, i could totally get behind a discussion. But then the solutions would be much different and not "stop free testing". Our short sighted government has bet everything on the vaccines to be the ultimate answer to the pandemic. Watch them scramble in 7 month when a omega variant occurs that hits like a hammer and circumvents the immune response of the vaccinated. Then we will again hear the all to familiar phrases of "who could have seen that? No one predicted that!" We get full lockdowns as there have been no further improvements in the public health departments, IT infrastructure or new concepts to make class rooms safe. In the end our children, teens and 20 somethings will suffer under the measures the most by robbing them of another year of what should have been carefree joyful youth.
- dehrmann 5y ago
  What you'd really want is daily at-home tests, even if they're not that accurate.

93 points by breck 5y ago

If transmission between vaccinated people is happening relatively easy, that should totally change the narrative. - Herd immunity becomes unrealistic. - My vaccine doesn’t protect you and vice versa. Our own does however protect us very well. - Vaccine passports are essentially pointless and possibly dangerous if they give a false sense of security. Only asymptomatic, more infectious people will be allowed in. - The messaging should change towards “take a vaccine to protect yourself and not burden the health service with your own illness.” I wonder if messaging will change to reflect the new “the science” or if too much political face would be lost at this point?

glenngillen 5y ago
The messaging early in the pandemic seemed less about “not burden the health service with your own illness” directly, and more the indirect impact that burden created in servicing non-covid patients. I don’t think that changes much, does it? Still seems like we need to make sure people need to not be overwhelming hospitals. Either via vaccination or other means.
- redis_mlc 5y ago
  No, "flatten the curve" was the early goal, but I don't remember any mention of that helping non-corona cases. In fact, most hospital elective surgeries were cancelled (and the nurses laid off), so I'm not sure where you got your ideas from. You might want to post a link.
blendergeek 5y ago
> Only asymptomatic, more infectious people will be allowed in. I don't see anything in the study that would indicate that people with the vaccine are more infectious than those without. Rather, the study says they are infectious. The variable in this study was alpha vs delta variant and the result is that while the vaccine prevented the transmission of alpha variant it does not prevent the transmission of the delta variant. This study does not address the question of whether those with the vaccine are more or less likely to spread the delta variant than those without the vaccine.
- newbamboo 5y ago
  Well it seems like simple logic no? If the vaccine decreases symptoms but not viral load, vaccinated are more likely to transmit it. Right? Maybe I’m being dumb again. Happens. :)
  - spauka 5y ago
    The paper does not make conclusions about whether the vaccinated are more likely to be asymptomatic - but in case you are interested the results are presented in Table 1. Of The 69 cases infected, 47 developed symptoms (median 4 days post diagnosis), which is 68% of cases. Viral loads for symptomatic cases was higher (page 11). Key points: there is not enough information here to draw conclusions about the infectiousness of vaccinated vs. unvaccinated individuals, or about whether vaccinated individuals are more likely to be asymptomatic. This paper does not even try to draw such conclusions.
  - vlovich123 5y ago
    I'm not following the logic. Why would decreased symptoms mean you're more likely to spread? You're thinking that asymptomatic people are more likely to not wear masks/be in more populous places whereas symptomatic people are more likely to quarantine/wear a mask? I could see that line of reasoning, although, as a counterpoint, I understood that the main virality of COVID stems from the long lag between being infectious & symptoms. In other words, basically everyone is asymptomatic for the first 7-10 days that they're infectious anyway. If the vaccine confers a reduction in symptoms, that's still valuable. The danger of COVID is the sudden spike needed in hospital resources & deaths. Sounds like the vaccine still decreases both, even for delta. Not getting infected at all is a secondary benefit that's a nice to have & important for eradicating the virus totally. I suspect that's a pipe dream at this point & the question is how quickly we can transition it to an endemic disease like the flu.
  - SideburnsOfDoom 5y ago
    > vaccinated are more likely to transmit it. Right? The vaccinated are also less likely to have it in the first place, so no, not right. There are "similar viral loads in vaccinated and unvaccinated patients" _who have symptoms_ - that's a huge selection bias right there. You can still assume that there are very different rates at which vaccinated and unvaccinated are prone to getting infected in the first place, then developing symptoms. This conclusion is also wrong: "My vaccine doesn’t protect you and vice versa." - yet more simplistic, all or nothing, black or white thinking. Delta means that my vaccination doesn't protect you _as much as it did_ but it is incorrect to leap to "it doesn't protect you at all" It's clear that at present, vaccination alone is not the answer, but it would be very wrong to disparage vaccination, e.g. to say that "vaccination is not the answer" - vaccination is part of the answer, likely the largest part.
refurb 5y ago
This appears to the direction we're headed - a similar steady state as the flu (which a few people hypothesized early on in the pandemic). - Covid won't go away, we'll just keep having waves move through the population - A vaccine mostly protects the person who receives it; it likely makes them less contagious, but not enough to stop them from infecting others - The vaccines work very well in making the disease less severe; again, similar to the flu - sick enough to stay home, but rarely so severe you need to be hospitalized - Eventually you just live with it. We'll probably have new outbreaks of different variants (just like we have more severe flu seasons)
- dehrmann 5y ago
  I'm somewhat optimistic because the vaccines are probably good enough to bring death rates to an acceptable level, we have multiple vaccines, that take different approaches, and covid has hopefully already made all the easy wins for transmission, so it won't get that much more contagious. My fear is that all these countermeasures select for something actually scary, though there's no reason to think it will get significantly more deadly.
- grepfru_it 5y ago
  And then you have folks like Lamar Jackson who has been infected with the virus already and has a mild experience with delta just like those with the vaccine (similar to the outcome of the flu shot) Im watching intently as so far the data shows vaccine offers superb reduction in symptoms, while previous natural infection also reduces symptoms and duration (making me wonder what a vaccine passport is really accomplishing)
  - fy20 5y ago
    In my country the passport is issued to those who were previously infected (and diagnosed with an official test) as well, so it shows you are "known to have some level of immunity". I feel that's fair as it applies to both people who were infected and those who were vaccinated. Where it gets confusing though is it's also issued to people who had a recent PCR negative test (last 48 hours), so those people are "known unlikely to be infectious", but that doesn't apply to the previous groups, and the statement of the previous groups doesn't apply to this group.
cjensen 5y ago
Your interpretation is almost completely wrong, and is a good example of why we layfolk should leave the explaining to experts. For example, you said "my vaccine doesn't protect you and vice-versa." That is entirely unsupported by this paper which merely says "transmission between vaccinated people is possible." You have interpreted this fact well beyond any actual evidence. For example, the proposition "the vaccine makes it hard to transmit, and makes cases very mild" would be entirely consistent with this study, and is completely in opposition to your incorrect conclusion. So far, all evidence points to the vaccines working exactly as well as anticipated.
- peytn 5y ago
  I think you’re confusing the poster’s hypothetical for an interpretation.
  - shusaku 5y ago
    How silly of him to assume the top hacker news comment was related to the specifics of the linked article and not a hypothetical
  - tsimionescu 5y ago
    What hypothetical? The comment clearly thinks that the study should be read in the light they present. They even wonder if the narrative will change based on the new science - not whetheriit would change.
- sieabah 5y ago
  > Your interpretation is almost completely wrong, and is a good example of why we layfolk should leave the explaining to experts. "Don't think too hard, let us, the self appointed exports, do the thinking for you" I don't believe the original comment had the same direction you think it did. Your response seems to be more saving face of "how not to interpret something". Whereas the parent comment is proposing different messaging if certain things are found to be true with more studying. Appeal to authority isn't a valid argument and I'm not sure why you think it would be.
- 5y ago
acituan 5y ago
> Vaccine passports are essentially pointless and possibly dangerous if they give a false sense of security. Only asymptomatic, more infectious people will be allowed in. Counterargument; mixing of vaccinated and unvaccinated populations is precisely what gives the "training" to the virus variants. Herd immunity works if the duration of the mixture of these herds is minimized. You can achieve that with distance or high and fast vaccine rollout, neither of which happened. The mistake was opening up too much, too soon, and mixing up too much. We've been focusing on protection "right now" at the expense of protection over time. I think focusing on personal protection is also a non-scaling approach; I get that it might motivate the rollout but ultimately personal immunity, unless it comes from having survived the real deal, is also a perishable state both from slow decay of vaccine immunity and constant training of variants perspective. None of these countermeasures make popular policies, so it is less about saving face and more about optimizing re-electibility.
wesleywt 5y ago
Many conclusions based on flimsy or next to no evidence in this comment.
n8cpdx 5y ago
If injury in a car accident where people are wearing seatbelts is relatively likely, that should totally change the narrative: - expecting seatbelts to prevent all traffic injuries becomes unrealistic (it never was but that doesn’t mean it’s useless - the herd immunity war was lost the moment vaccines became political, which was about 20 years ago) - My seatbelt won’t protect you from injury in the event of a crash, and vice versa (don’t confuse possibility with likelihood. Vaccines are still reducing severity and likely reducing the amount of virus that’s being shed e.g. through coughing. Seatbelts also protect other occupants from yourself becoming a projectile, but like vaccines, they don’t fully solve the problem) - seatbelt mandates to enter public roads are essentially pointless and possibly dangerous if they give a false sense of security. Only foolhardy, risk-taking seatbelt-wearing drivers will be on the road. (Passports are a tool to create a mandate in the absence of a mandate. If everyone was vaccinated delta wouldn’t have happened at all. In the absence of that, reducing the load on the hospital system is well worth the cost of the passport system) - The messaging should change to “wear a seatbelt to protect yourself and not burden the health service with your own injuries” (sure, but that’s kind of what the message already is and always has been) I wonder if the poster will understand the analogy that’s being made, or if too much face would be lost at this point?

yborg 5y ago

This was the Astra-Zeneca vaccine, similar studies will have to be done for the mRNA vaccines.

readthenotes1 5y ago
Similar? https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v1 https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v...
- sterlind 5y ago
  yikes! this is the first I'm reading that Pfizer seems (statistically) significantly inferior to Moderna in efficacy against Delta. seems Moderna has 60% better protection against infection, and 2x better against hospitalization (though ICU admission and deaths are at par between them.) having gotten Pfizer, I'm getting a little nervous.
  - hnyolo081221 5y ago
    having gotten Pfizer, I'm getting a little nervous. As someone that got my 2nd Pfizer dose at the end of February (coming on 6 mo. when efficacy might? drop off some) I'm not saying that I did go get a first round Moderna shot[1], but I'm not saying I didn't either. 1. If doses in my area of the country weren't going un-used and spoiling, and I wasn't in a household with people that aren't eligible, I never would have done something I haven't said I've done.
    - keneda7 5y ago
      I don't think you trying to take extra steps to protect yourself should be be looked down on by either side here. It your choice and right to do that especially if you checked that vaccines were being wasted in your area.
  - vladvasiliu 5y ago
    I'm not sure how to read the linked abstract, maybe someone with more knowledge could chime in. The information I'm missing is what the absolute efficacy of those vaccines is against Delta. If the risk of being hospitalized while vaccinated with Moderna is "very, very low", then the risk of hospitalization while vaccinated with Pfizer, even if twice as high, would still be pretty low. I think this kind of actually useful info would be very useful in our current climate, where many people argue against vaccination. "Look, Pfizer is twice as bad as the other! Who knows what the other does? Better not get vaccinated at all!".

SV_BubbleTime 5y ago

> There was no correlation between vaccine-induced neutralizing antibody levels and viral loads or the development of symptoms. Not what you would expect is it?

grepfru_it 5y ago
It’s a novel virus and an even more novel vaccine. No one should have any expectations of outcome right now
- carlmr 5y ago
  But it's not the first virus ever, nor the first Corona virus, or the first SARS virus. So there is precedent to compare against.
- nradov 5y ago
  It's not that novel. SARS-CoV-2 is genetically quite similar to both the original SARS-CoV and HCoV-OC43.
sterlind 5y ago
that is surprising, I'm not sure what to make of it. maybe the "noisiness" of antibodies matters - the response they elicit in the immune system upon binding something, not simply how many of them are binding. I wish the immune system came with better documentation.
dragonwriter 5y ago
While I’m not an expert and I wouldn't be too surprised to find something different, I would expect exactly that but that neutralizing antibody levels would be inversely correlated with probability of getting a detectable infection at all. Once you limit the universe to detected cases, though, I don't think the absence of relationship reported here is surprising.
- SV_BubbleTime 5y ago
  So would it in theory be surprising to find if viral loads are not lower in vaccinated people relative to unvaccinated?

titzer 5y ago

Local outbreaks here among vaccinated family members and extended family members supports the emerging data that Delta spreads easily via vaccinated folks. The CDC recommendation for indoor mask wearing is motivated by data from Israel that was derived from testing vaccinated people without symptoms. Delta is damn good at spreading, it seems. This sucks.

tinus_hn 5y ago
Do you think these healthcare workers forgot to wear those masks?
- bufferout 5y ago
  Maybe it's not a binary thing?
christkv 5y ago
I remember reading that the ideal vaccine location for respiratory illness would be a nasal and lung aerosol so there would be a strong local immune response making it harder for any future infections to replicate effectively. Don’t know if that is still being looked at.
- dehrmann 5y ago
  Just found this: https://www.pbs.org/newshour/health/scientists-debate-potential-benefits-of-intranasal-covid-19-vaccines https://www.pbs.org/newshour/health/scientists-debate-potent... It leads with this: > Vaccines that are injected into arm muscles aren’t likely to be able to protect our nasal passages from marauding SARS-CoV-2 viruses for very long It might be true, but I would have liked to read more. It's pretty easy to envision a case where that's not true, and the immune system doesn't really care where the vaccine was given.
akira2501 5y ago
> Delta is damn good at spreading, it seems. This sucks. It does not appear to be as good at killing, though. Which is hopeful.

NhanH 5y ago

A few things that the paper did not mention explicitly, but I think was worth mentioning: - It was AstraZeneca vaccine for both dose. With 4-5 weeks between doses (as opposed to the recommended 8-12 weeks). We have known now that too early 2nd doses will not be as effective. - Healthcare workers includes non direct healthcare staffs of the hospital. The majority of the 69 cases was the IT department of the hospital, iirc. Someone was wondering if the healthcares workers might forgot to wear masks or not. Seeing that they are office workers instead of nurses and doctors, it's possible that they didn't. I don't know if they did or not.

tzs 5y ago

> We studied breakthrough infections among healthcare workers of a major infectious diseases hospital in Vietnam Vaccines greatly reduce your chances of getting infected from a given exposure, but they don't reduce your chances to 0. The more times you are exposed, the more likely you are to eventually get infected. I assume that workers at a major infectious diseases hospital during an infectious disease pandemic get exposed many more times than a typical member of the general population. (Worse...they are exposed to people who are sick enough to need hospitalization, which probably means that they are dealing with people with higher viral loads than the infected people the general population usually encounters). This is not COVID specific. There are breakthrough infections for measles and polio, for instance. They are extremely rare in large part because most people are not repeatedly exposed to measles or polio. Measles is ridiculously contagious (9 out of 10 unvaccinated people will get it after just a short exposure to an infected person--R0 for measles is around 12-18), but two doses of measles vaccine are 97% effective so even with it being highly contagious the spread is slow enough in highly vaccinated populations to keep outbreaks small. Polio's R0 is around 5-7. The first widespread vaccines for polio (the Salk vaccine and then a little later the Sabin vaccine) were around 90% effective. They reduced the number of cases per year in the US by 2 to 3 orders of magnitude within a few years of their introduction. For comparison the delta variant of COVID has an R0 about the same as that of polio and the mRNA COVID vaccines are at least as effective as the Salk and Sabin polio vaccines were.

trhway 5y ago
>the mRNA COVID vaccines are at least as effective as the Salk and Sabin polio vaccines were. that is simply not true. The scientific data has been widely available for several weeks at least, yet ultra-zealot covid vaccine pushers are just ignoring it and continue pushing Moderna/etc. stock up together with political establishment. https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-may-be-superior-pfizer-against-delta-breakthrough-odds-rise-with-time-2021-08-09/ https://www.reuters.com/business/healthcare-pharmaceuticals/... "the effectiveness of Moderna's vaccine against infection had dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said. " In general your post does the same propaganda trick that many similar posters here and elsewhere do - tightly associate covid vaccines which are failing for delta (nothing exceptional in such situation, happens all the time with flu vaccines) with success of proven vaccines. What is your point? To undermine the people trust in the proven vaccines like measles and polio and even in the general vaccination principle by forcefully pushing failing covid vaccines upon them?

splittingTimes 5y ago

Germany is following suite with other European countries and stops free testing in October. Why? Free testing on a massive scale and using masks felt like the fastest road to normality. 1. Protect children Even though I am vaccinated i can still catch and transmit the Rona. That chance is even higher as i am potentially asymptomatic. Living together and having often contact with children who cannot be vaccinated makes that a huge problem. I do not want to expose the little ones to serious long term health issues. 2. Go to events / economy In that regard, i felt safe to go to events or indoor activities where I knew everybody was tested negative. Now we can have super spreader events again. So I will avoid indoors. 3. Stop mutations Until we have an anti viral that is effective once you are sick, the overarching goal should still be to have as few infected as possible. The more people have it, the higher the chance of further mutations. The kicker is that now when a mutation occurs in a vaccinated person it will favor a variation that properly has immune escape rendering the vaccine efforts useless. If the government thinks it is an effective instrument to convince anti vaxxers to get a shot (which I doubt) make only them pay for tests. If the arguments would have been that the tests themselves have become less effective to detect the Delta strain or that too many test centers are scammers, i could totally get behind a discussion. But then the solutions would be much different and not "stop free testing". Our short sighted government has bet everything on the vaccines to be the ultimate answer to the pandemic. Watch them scramble in 7 month when a omega variant occurs that hits like a hammer and circumvents the immune response of the vaccinated. Then we will again hear the all to familiar phrases of "who could have seen that? No one predicted that!" We get full lockdowns as there have been no further improvements in the public health departments, IT infrastructure or new concepts to make class rooms safe. In the end our children, teens and 20 somethings will suffer under the measures the most by robbing them of another year of what should have been carefree joyful youth.

dehrmann 5y ago
What you'd really want is daily at-home tests, even if they're not that accurate.