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To play devil's advocate, the retort to this is that if you don't get the vaccine you're some <100 percentage more likely to get the virus, but if you do get th

by rory 5y ago

To play devil's advocate, the retort to this is that if you don't get the vaccine you're some <100 percentage more likely to get the virus, but if you do get the vaccine you're 100% likely to get the vaccine. I think the related mistake some vaccine-hesitant people make is that they greatly underestimate their likelihood to get the virus in the future. This is reinforced by some pro-vaccine people (incorrectly) claiming we can eradicate the virus through high vaccination rate.

whatshisface 5y ago
That's not a retort, that's a question. "Do the odds of getting the virus attenuate its expectation value enough to make it equal to the expectation value of the vaccine?" The answer to the question is related to the question of how many people are going to get this thing before it stops spreading. From what I've heard we're looking at 70-80% based on herd immunity estimations, which is not a lot of risk attenuation on the virus side. If someone wants to chime in with a better-justified estimate, I'd appreciate that.
- nradov 5y ago
  Those herd immunity level estimates were based on R0 estimates for earlier variants. The Delta variant is so contagious that there will be no significant herd immunity effect to protect unvaccinated people. Almost all of us will eventually be exposed no matter what we do, but fortunately the vaccines are very effective at preventing deaths. https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu...
- SkyMarshal 5y ago
  True, and also keep in mind that expectation value incorporates not just relative odds of occurrence, but relative harm as well. The immediate harm of getting the vaccine is much lower than the immediate harm of contracting the virus, and furthermore the vaccine reduces both the odds and harm of the virus. All that is factored into the comparative E(V) too.
- rory 5y ago
  No, it's not a question, because vaccine-hesitant people generally aren't doing the math like you are. They're just saying "<100 is better than 100, so I'll go with the option that might be fine."
giantrobot 5y ago
> This is reinforced by some pro-vaccine people (incorrectly) claiming we can eradicate the virus through high vaccination rate A high vaccination rate of high efficacy vaccine(s) can most certainly eradicate a disease. A virus can't do a whole lot without a host to incubate and spread it. If potential hosts can't meaningfully incubate or spread the virus, it stops spreading. Once the good vaccines (80+% efficacy) became available, if they could have magically been distributed to everyone, COVID would be entirely contained by now and on the way to being eradicated in the population at large. Only the most remote reservoirs would contain the virus at transmissible levels. That is not saying some 70% vaccination rate will eradicate the virus. It will bring the infection rates down to below pandemic and epidemic levels. If someone is unvaccinated for medical reasons but everyone around them is vaccinated the virus has a pretty huge moat to cross to infect them. Even when the vaccinated get a breakthrough infection the odds of it being serious are very low as is its transmissibility.
- codycraven 5y ago
  I don't know the stats behind it, but I've heard from news that those with the vaccine do still host the virus when exposed and even continue to pass it along (although they experience lesser/no symptoms). If vaccinated people do become infected at the same or similar rate to unvaccinated (and a whole lot of other assumptions), it almost seems like there is a scenario where the vaccine could be worse than the virus because we're essentially creating many Typhoid Marys that continue to host and spread the virus unaware that they're contagious, giving the virus a massive pool to mutate within.
  - giantrobot 5y ago
    > If vaccinated people do become infected at the same or similar rate to unvaccinated (and a whole lot of other assumptions) They do not though. You getting sick from any virus is a function of your particular immune system, the viral load you're exposed to, the virus' infection mechanisms, and your manner of exposure. Vaccines affect the first two points. They train your immune system to recognize the virus as something its seen before and it has ready antibodies to fight. Your immune system responds more efficiently to the virus and neutralizes it faster meaning that any point during your "infection" you've just got fewer virus particles to shed and spread to others. If you're exposed to a high viral load you might become symptomatic, your white blood cells can only work so fast, with a breakthrough infection but since your immune system is pre-trained for the virus it'll be a shorter and likely a less severe infection than if you were unvaccinated. The Typhoid Marys you're describing are the massive pools of completely unvaccinated people getting sick. The unvaccinated remain infected longer and end up producing more copies of the virus from their infected cells. If the virus generates a beneficial mutation (named variant) after a trillion replications and each unvaccinated person produces a billion replications (made up round numbers) then we'd expect a variant every thousand people infected. If a vaccinated person only produces a million replications then it'll take far longer for a vaccinated population to generate a variant. You may never even see a variant emerge if the infection rate drops below pandemic and epidemic levels.
SkyMarshal 5y ago
> This is reinforced by some pro-vaccine people (incorrectly) claiming we can eradicate the virus through high vaccination rate. Considering we’ve eradicated other diseases with vaccinations, this is not an inherently incorrect assessment.
- nradov 5y ago
  We eradicated smallpox and (almost) polio because there were no animal reservoirs and the vaccines were highly sterilizing. Those criteria do not obtain with SARS-CoV-2. Many other mammal species can catch and spread the virus. The original bats which presumably transmitted it to humans are still out there. And vaccinated people can also still catch and spread the virus; there is probably some reduction in contagiousness but the magnitude is unclear.
- rory 5y ago
  Inherently, no. Currently, yes.

by rory 5y ago

whatshisface 5y ago

That's not a retort, that's a question. "Do the odds of getting the virus attenuate its expectation value enough to make it equal to the expectation value of the vaccine?" The answer to the question is related to the question of how many people are going to get this thing before it stops spreading. From what I've heard we're looking at 70-80% based on herd immunity estimations, which is not a lot of risk attenuation on the virus side. If someone wants to chime in with a better-justified estimate, I'd appreciate that.

nradov 5y ago
Those herd immunity level estimates were based on R0 estimates for earlier variants. The Delta variant is so contagious that there will be no significant herd immunity effect to protect unvaccinated people. Almost all of us will eventually be exposed no matter what we do, but fortunately the vaccines are very effective at preventing deaths. https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu...
SkyMarshal 5y ago
True, and also keep in mind that expectation value incorporates not just relative odds of occurrence, but relative harm as well. The immediate harm of getting the vaccine is much lower than the immediate harm of contracting the virus, and furthermore the vaccine reduces both the odds and harm of the virus. All that is factored into the comparative E(V) too.
rory 5y ago
No, it's not a question, because vaccine-hesitant people generally aren't doing the math like you are. They're just saying "<100 is better than 100, so I'll go with the option that might be fine."

giantrobot 5y ago

> This is reinforced by some pro-vaccine people (incorrectly) claiming we can eradicate the virus through high vaccination rate A high vaccination rate of high efficacy vaccine(s) can most certainly eradicate a disease. A virus can't do a whole lot without a host to incubate and spread it. If potential hosts can't meaningfully incubate or spread the virus, it stops spreading. Once the good vaccines (80+% efficacy) became available, if they could have magically been distributed to everyone, COVID would be entirely contained by now and on the way to being eradicated in the population at large. Only the most remote reservoirs would contain the virus at transmissible levels. That is not saying some 70% vaccination rate will eradicate the virus. It will bring the infection rates down to below pandemic and epidemic levels. If someone is unvaccinated for medical reasons but everyone around them is vaccinated the virus has a pretty huge moat to cross to infect them. Even when the vaccinated get a breakthrough infection the odds of it being serious are very low as is its transmissibility.

codycraven 5y ago
I don't know the stats behind it, but I've heard from news that those with the vaccine do still host the virus when exposed and even continue to pass it along (although they experience lesser/no symptoms). If vaccinated people do become infected at the same or similar rate to unvaccinated (and a whole lot of other assumptions), it almost seems like there is a scenario where the vaccine could be worse than the virus because we're essentially creating many Typhoid Marys that continue to host and spread the virus unaware that they're contagious, giving the virus a massive pool to mutate within.
- giantrobot 5y ago
  > If vaccinated people do become infected at the same or similar rate to unvaccinated (and a whole lot of other assumptions) They do not though. You getting sick from any virus is a function of your particular immune system, the viral load you're exposed to, the virus' infection mechanisms, and your manner of exposure. Vaccines affect the first two points. They train your immune system to recognize the virus as something its seen before and it has ready antibodies to fight. Your immune system responds more efficiently to the virus and neutralizes it faster meaning that any point during your "infection" you've just got fewer virus particles to shed and spread to others. If you're exposed to a high viral load you might become symptomatic, your white blood cells can only work so fast, with a breakthrough infection but since your immune system is pre-trained for the virus it'll be a shorter and likely a less severe infection than if you were unvaccinated. The Typhoid Marys you're describing are the massive pools of completely unvaccinated people getting sick. The unvaccinated remain infected longer and end up producing more copies of the virus from their infected cells. If the virus generates a beneficial mutation (named variant) after a trillion replications and each unvaccinated person produces a billion replications (made up round numbers) then we'd expect a variant every thousand people infected. If a vaccinated person only produces a million replications then it'll take far longer for a vaccinated population to generate a variant. You may never even see a variant emerge if the infection rate drops below pandemic and epidemic levels.

SkyMarshal 5y ago

> This is reinforced by some pro-vaccine people (incorrectly) claiming we can eradicate the virus through high vaccination rate. Considering we’ve eradicated other diseases with vaccinations, this is not an inherently incorrect assessment.

nradov 5y ago
We eradicated smallpox and (almost) polio because there were no animal reservoirs and the vaccines were highly sterilizing. Those criteria do not obtain with SARS-CoV-2. Many other mammal species can catch and spread the virus. The original bats which presumably transmitted it to humans are still out there. And vaccinated people can also still catch and spread the virus; there is probably some reduction in contagiousness but the magnitude is unclear.
rory 5y ago
Inherently, no. Currently, yes.