4 ms·

> We do have multiple studies about how immunity wanes over time from vaccination. Those provide better ground-truth data than theoretical arguments. I believe

> We do have multiple studies about how immunity wanes over time from vaccination. Those provide better ground-truth data than theoretical arguments. I believe the studies you're referring to are those that address efficacy against symptomatic infection, not severe illness. Unless you're in a high-risk group because of age or comorbidities, with two doses of an mRNA vaccine within the past 8 months, to my knowledge all studies to date indicate that the average person's protection against severe illness and hospitalization is exceedingly high. This is probably related to the T and B cell immunity created by your body's response to the vaccines, which are more difficult to measure than antibody titers. I traveled to/from a hotzone in Asia at the beginning of the pandemic and from Asia to the US and back to get vaccinated. My opinion as an expat and avid traveler is that if you have any concerns about your ability to receive adequate care in the case that you get sick, you should reconsider travel at this time. Since the vaccines clearly do not provide sterilizing immunity and everyone's immune response is different, there really are no guarantees, especially if you're going to be in environments where your exposure is high (both in terms of number of contacts and contacts that could lead to exposure of high viral loads).

paulmd 5y ago
This is my clear (amateur) conclusion as well. The exposure amount and dose varies, exposure in high-density hot zones is high risk and the cumulative dose does seem to pose some additional risk, as does the risk that you may not be able to receive a high level of clinical care in various areas. I'm not necessarily talking about adventures in southeast asia there either.
blagie 5y ago
Now we're getting into value systems. - How much do you value your life? - How much do you value the trip? - How much do you worry about spending two weeks in a hospital? - How much do you mind memory lapses and brain fog from long COVID? From what you wrote, it's clear we have at least somewhat different value systems. Since you're an avid traveler, you should realize that's good, common, and healthy.
- LurkingPenguin 5y ago
  The subtle implication of your comment seems to be that I value my life and health less than you do? If so, I think that's unfair. But I'm happy to roll with it. If, in the face of substantial evidence that two doses of one of the mRNA vaccines remain highly effective at preventing hospitalization and death 8 months on, you still cannot tolerate the potential that you could end up in a hospital in a developing country, suffer from long COVID following infection and/or die, logic dictates that you should reconsider travel. You might strongly believe or suspect that a booster will provide meaningful additional protection to you, but the ongoing booster debate reflects the fact that at the current time, there is no conclusive proof that a booster will definitely reduce risk in healthy already vaccinated individuals, nor has any potential risk reduction that booster proponents believe exists been conclusively quantified. Put simply, just because one believes that they have meaningfully increased protection from a booster does not necessarily mean that they actually do. Science will eventually tell us but the data isn't in yet.
  - blagie 5y ago
    I don't think you've traveled so much if you think that's the implication, or at least not for long enough to soak in how values differ between cultures. No. That's not the implication. I don't know you well enough to tell you what the differences in our value systems are. Since you do ask, if I were to speculate, I would guess you value your life and comfort more than I value mine. I was never fearful of dying of COVID, or of hospitalization, even pre-vax. Americans place an exceptionally high value on their own life and comfort relative to most cultures. I've also been in several hospitals in developing countries, and that's also not something which has really concerned me. On the other hand, I suspect I am much more concerned about long COVID than you are. And no, we don't know much for sure about COVID, but we have to work from best available evidence. If there's e.g. a 50% chance that a booster shot increases protection from 30% breakthroughs to 15%, and a 50% chance it does nothing, that means I've reduced my odds of breakthrough by (30-15)*50% = 7.5%.
    - LurkingPenguin 5y ago

paulmd 5y ago

This is my clear (amateur) conclusion as well. The exposure amount and dose varies, exposure in high-density hot zones is high risk and the cumulative dose does seem to pose some additional risk, as does the risk that you may not be able to receive a high level of clinical care in various areas. I'm not necessarily talking about adventures in southeast asia there either.

blagie 5y ago

Now we're getting into value systems. - How much do you value your life? - How much do you value the trip? - How much do you worry about spending two weeks in a hospital? - How much do you mind memory lapses and brain fog from long COVID? From what you wrote, it's clear we have at least somewhat different value systems. Since you're an avid traveler, you should realize that's good, common, and healthy.

LurkingPenguin 5y ago
The subtle implication of your comment seems to be that I value my life and health less than you do? If so, I think that's unfair. But I'm happy to roll with it. If, in the face of substantial evidence that two doses of one of the mRNA vaccines remain highly effective at preventing hospitalization and death 8 months on, you still cannot tolerate the potential that you could end up in a hospital in a developing country, suffer from long COVID following infection and/or die, logic dictates that you should reconsider travel. You might strongly believe or suspect that a booster will provide meaningful additional protection to you, but the ongoing booster debate reflects the fact that at the current time, there is no conclusive proof that a booster will definitely reduce risk in healthy already vaccinated individuals, nor has any potential risk reduction that booster proponents believe exists been conclusively quantified. Put simply, just because one believes that they have meaningfully increased protection from a booster does not necessarily mean that they actually do. Science will eventually tell us but the data isn't in yet.
- blagie 5y ago
  I don't think you've traveled so much if you think that's the implication, or at least not for long enough to soak in how values differ between cultures. No. That's not the implication. I don't know you well enough to tell you what the differences in our value systems are. Since you do ask, if I were to speculate, I would guess you value your life and comfort more than I value mine. I was never fearful of dying of COVID, or of hospitalization, even pre-vax. Americans place an exceptionally high value on their own life and comfort relative to most cultures. I've also been in several hospitals in developing countries, and that's also not something which has really concerned me. On the other hand, I suspect I am much more concerned about long COVID than you are. And no, we don't know much for sure about COVID, but we have to work from best available evidence. If there's e.g. a 50% chance that a booster shot increases protection from 30% breakthroughs to 15%, and a 50% chance it does nothing, that means I've reduced my odds of breakthrough by (30-15)*50% = 7.5%.
  - LurkingPenguin 5y ago