11 ms·

Okay, but why demand boosters from those younger than 40?? Considering new myocarditis studies and how low the risk is for someone already vaccinated and how ne

by vizzah 5y ago

Okay, but why demand boosters from those younger than 40?? Considering new myocarditis studies and how low the risk is for someone already vaccinated and how negligible it is with Omicron (even for non-vaccinated)? This blind boosterization is only demonstrating how the governments are still shitless scared of their medical system collapses with vulnerable groups, so that they want to boost anyone in sight, just to be on a safer side.

disgruntledphd2 5y ago
Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely. Look, the risks are pretty low for younger people, but from a population level every extra bit of immunity helps to reduce the likelihood of health care system collapse (which has been the goal throughout the pandemic).
- peteradio 5y ago
  Then all you need is bullet-proof evidence that transmission is significantly impacted by the vaccines. It ain't a guessing game, do the measurement. Do it all over the world and compare and contrast.
  - ada1981 5y ago
    This seems to suggest viral loads are the same for everybody - vaxxed, unvaxxed, symptomatic or asymptotic. https://www.ucdavis.edu/health/covid-19/news/viral-loads-similar-between-vaccinated-and-unvaccinated-people https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...
    - lamontcg 5y ago
      Vaccinated individuals hit the same peak mRNA loads for the same symptom severity on average. Their time to recover is faster though, and at peak you recover less viable virus indicating they are producing more viral debris. And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination. All of those studies use PCR Ct values as proxies for viruses and compare vaccinated and unvaccinated individuals with similar symptom severity, and it turns out that correlates at peak because symptoms are on average due to antigen loading. Those studies aren't very good at showing how effective vaccination is at preventing transmission. They just show that its nonzero.
      - Jensson 5y ago
        None of those old studies apply now that omicron is around. Omicron spread all throughout the world at record breaking pace via vaccinated people, so it doesn't seem like vaccines are doing much at all to prevent spread of omicron.
        disgruntledphd2 5y ago
        You may be correct, but it's too early to tell. As I have stated elsewhere in this thread, the rate of vaccine escape has gone up by about 5x, (from 6% to 30%), but that's still much better than one would get from no vaccination.
        Jensson 5y ago
        But it spreads so fast that it doesn't seem like that matters. It spreads basically as fast as people are interacting, if it gets into the student body then everyone will be infected in a matter of days even if they are all vaccinated. I can't see how it could spread any faster than it already does through vaccinated people. A few people there being unvaccinated wont make a difference.
      - disgruntledphd2 5y ago
        > And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination. This is the big one. Conditional on symptoms the viral load may be similar betwee vax/no vax, but if the vax have much less probability of getting symptoms then all is good.
      - ada1981 5y ago
        Shouldn’t we be distinguishing between unvaxxed who had Covid, and unvaxxed who didn’t?
  - disgruntledphd2 5y ago
    I haven't read the full paper, and it's pretty small data (maybe n=120 in total) but this would seem to suggest that there's about a 40% reduction in transmission associated with vaccination: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00648-4/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... I honestly don't understand how there wouldn't be protection from the vaccine. It's not a sterilising vaccine, but it does offer protection.
    - incrudible 5y ago
      "SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15–35] for vaccinated vs 23% [15–31] for unvaccinated)." In other words, once infected, there is no reduction. How effective are these boosters against Omikron infection, weeks and months down the line?
- daniel-cussen 5y ago
  Maybe if the health care system had lots of staff, meaning lots of doctors, not just the trickle that comes from the tiny amount of medical schools, the system wouldn't collapse? Has America tried addressing COVID that way, increasing the number of doctors?
  - jlmorton 5y ago
    Has America considered doubling the number of doctors, nurses, hospitals, and all other medical support, building and bootstrapping many more medical schools, and graduating an enormous cadre of recruits from a seven year program, all at a cost probably over a trillion dollars a year, so that we can care for a massive influx of Covid patients in preference to advocating booster shots?
    - daniel-cussen 5y ago
      That's not the real cost. They could double the number of doctors by cutting the amount of education required by half, and get better results. And they wouldn't need to expand medical school capacity at all. The amount of education doctors get is harmful. It actually makes them worse at their job. It's effectively a form of hazing by AMA. There's a combinatorial explosion of effects and side effects in the human body. It's important to learn and memorize, and memorization is undervalued, but not to that extent. It's like memorizing optimal solutions to traveling salesman instances. Other times it's like memorizing a times table of the three-digit numbers. That is a waste of time and will make you a much worse mathematician.
      - mburee 5y ago
        That's one of the dumbest things I heard in a long time
    - horns4lyfe 5y ago
      We need to do that anyway, but then the doctors that make those decisions wouldn’t get paid nearly as much. There is absolutely an artificial scarcity of MDs in the medical field that needs to be discussed.
- incrudible 5y ago
  > Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely. Protection from Omikron quickly wanes. At what point does that "extra bit of immunity" justify heart injury? We're talking about roughly 1 in 10000 doses administered causing Myocarditis in a young male. We don't know if the risk increases after each dose, but preliminary data suggests that it may: https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
  - pfg 5y ago
    We're talking about ~1:10000 odds for one specific vaccine when vaccinating young males, which is why many countries are no longer using that vaccine for this demographic. Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19. The study also shows that there was practically no increase in risk for the third shot (though with a fairly wide CI), so it's possible the risk may just depend on whether someone is immunonaive or not.
    - deleted 5y ago
      [deleted]
    - incrudible 5y ago
      > Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19 The risk is given by the FDA as up to 1:14285 (males aged 12-17) for the second dose: https://www.fda.gov/media/154869/download https://www.fda.gov/media/154869/download However, a study from Hong Kong found an incidence of up to 1:2700 in the second dose (males aged 12-17): https://pubmed.ncbi.nlm.nih.gov/34849657/ https://pubmed.ncbi.nlm.nih.gov/34849657/ What we don't know is whether a vaccination would actually prevent Myocarditis in a breakthrough infection. These risks may well not be mutually exclusive. In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.
      - pfg 5y ago
- vizzah 5y ago
  "every extra bit of immunity helps" - Agree. But this shouldn't be mandated. Rewarded, yes. But not mandated.
- sharken 5y ago
  All the above applies for the flu as well, so why do we insist on inventing a new set of rules for Corona ? With vaccine and booster shots, both require a similar amount of hospital resources. The current way is simply not sustainable.
lamontcg 5y ago
> This blind boosterization is only demonstrating how the governments are still shitless scared of their medical system collapses with vulnerable groups, so that they want to boost anyone in sight, just to be on a safer side. I mean yes, that's still sort of the point. There's still probably about 10% of the population which is unvaccinated and unexposed. If they all wind up catching Omicron in the next 2-3 months (due to its ability to reinfect and ignore neutralizing antibodies to travel through the population to find those still-vulnerable hosts) then the fraction of them winding up in the hospital will be sufficient to knock over the hospital system again. We didn't have any excess capacity in our medical system when this started, and we have less now. The population's tolerance for any sort of behavioral changes is low, and the unvaccinated aren't listening to anyone, so the real only remaining lever to pull is recommending boosters to try to provide some level of protection against disease and transmission over the next couple of months in order to flatten the curve yet again. The modelling estimates that I've read though are that we're at about 90% of the population being exposed (depends somewhat widely on vaccination status and how hard the area was hit by Delta though), so we're just about done with the pandemic. Omicron should mostly finish the job that Delta started of finding all the holdouts and burning through all the dry wood in the population. In the meantime though that last 10% is enough to put the medical system under too much stress again.
- peteradio 5y ago
  When 100% of the population was dry tinder hospitals were under strain X. Now we have 1/10th that by your estimate. Why wouldn't we be under significantly less strain?
  - pfg 5y ago
    Current variants are significantly more infectious (R0 used to be around 2.5-3.0 for the ancestral strain, Delta was 5+, Omicron estimates go up to 10). Vaccine efficacy is also reduced for these variants. We've also scaled back non-pharmaceutical interventions in many places.
    - krona 5y ago
Youden 5y ago
> those younger than 40 I think your concern is based on the heightened risk of myocarditis, right? My understanding (mostly from [0], made by a UK cardiologist) is that the danger of myocarditis from the vaccine is higher than the danger of myocarditis from COVID only for males under the age of 30 who receive a Moderna shot. For every other case, the vaccine is an improvement (so males under 30 should get Pfizer/BioNTech, which is the government recommendation at the moment in my country). [0]: https://youtu.be/5iABaxRWGxk https://youtu.be/5iABaxRWGxk
- sharken 5y ago
  I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters. People should be free to choose booster shots, those who are worried can continue to get booster shots. In essence the same system we have with the flu is what we should have with Corona. And then we can focus on some of the bigger problems such as Global Warming.
  - Youden 5y ago
    > I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters. I don't see the point written anywhere so I suppose I did. In my opinion, people should get the vaccine as long as the harm of not having it is greater than the harm of having it. Adverse reactions are very uncommon and unvaccinated people are at heightened risk of hospitalisation (even under 40s) so the balance tips in favour of the vaccine. The booster seems like a good idea due to Omicron. > People should be free to choose booster shots, those who are worried can continue to get booster shots. I do agree that people should have a choice to take it or not. However just as I believe the right to free speech doesn't mean I'm obliged to listen, I believe the right to choose not to be vaccinated (or receive a booster) doesn't mean I'm obliged to be around you. That is, I think it's fine for participation to be refused to people based on their vaccination status (though I support say testing as an alternative).
    - anonair 5y ago
random314 5y ago
Myocarditis is not the same as death. Boosters are required because the efficacy of the vaccine has been observed to wane with time. Too bad the health systems couldn't come up with one tiny sugar pill that would confer 100% protection against all variants for the next 100 years. The are asking us to take 3 shots, the horror!

by vizzah 5y ago

disgruntledphd2 5y ago

Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely. Look, the risks are pretty low for younger people, but from a population level every extra bit of immunity helps to reduce the likelihood of health care system collapse (which has been the goal throughout the pandemic).

peteradio 5y ago
Then all you need is bullet-proof evidence that transmission is significantly impacted by the vaccines. It ain't a guessing game, do the measurement. Do it all over the world and compare and contrast.
- ada1981 5y ago
  This seems to suggest viral loads are the same for everybody - vaxxed, unvaxxed, symptomatic or asymptotic. https://www.ucdavis.edu/health/covid-19/news/viral-loads-similar-between-vaccinated-and-unvaccinated-people https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...
  - lamontcg 5y ago
    Vaccinated individuals hit the same peak mRNA loads for the same symptom severity on average. Their time to recover is faster though, and at peak you recover less viable virus indicating they are producing more viral debris. And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination. All of those studies use PCR Ct values as proxies for viruses and compare vaccinated and unvaccinated individuals with similar symptom severity, and it turns out that correlates at peak because symptoms are on average due to antigen loading. Those studies aren't very good at showing how effective vaccination is at preventing transmission. They just show that its nonzero.
    - Jensson 5y ago
      None of those old studies apply now that omicron is around. Omicron spread all throughout the world at record breaking pace via vaccinated people, so it doesn't seem like vaccines are doing much at all to prevent spread of omicron.
      - disgruntledphd2 5y ago
        You may be correct, but it's too early to tell. As I have stated elsewhere in this thread, the rate of vaccine escape has gone up by about 5x, (from 6% to 30%), but that's still much better than one would get from no vaccination.
        Jensson 5y ago
        But it spreads so fast that it doesn't seem like that matters. It spreads basically as fast as people are interacting, if it gets into the student body then everyone will be infected in a matter of days even if they are all vaccinated. I can't see how it could spread any faster than it already does through vaccinated people. A few people there being unvaccinated wont make a difference.
    - disgruntledphd2 5y ago
      > And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination. This is the big one. Conditional on symptoms the viral load may be similar betwee vax/no vax, but if the vax have much less probability of getting symptoms then all is good.
    - ada1981 5y ago
      Shouldn’t we be distinguishing between unvaxxed who had Covid, and unvaxxed who didn’t?
- disgruntledphd2 5y ago
  I haven't read the full paper, and it's pretty small data (maybe n=120 in total) but this would seem to suggest that there's about a 40% reduction in transmission associated with vaccination: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00648-4/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... I honestly don't understand how there wouldn't be protection from the vaccine. It's not a sterilising vaccine, but it does offer protection.
  - incrudible 5y ago
    "SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15–35] for vaccinated vs 23% [15–31] for unvaccinated)." In other words, once infected, there is no reduction. How effective are these boosters against Omikron infection, weeks and months down the line?
daniel-cussen 5y ago
Maybe if the health care system had lots of staff, meaning lots of doctors, not just the trickle that comes from the tiny amount of medical schools, the system wouldn't collapse? Has America tried addressing COVID that way, increasing the number of doctors?
- jlmorton 5y ago
  Has America considered doubling the number of doctors, nurses, hospitals, and all other medical support, building and bootstrapping many more medical schools, and graduating an enormous cadre of recruits from a seven year program, all at a cost probably over a trillion dollars a year, so that we can care for a massive influx of Covid patients in preference to advocating booster shots?
  - daniel-cussen 5y ago
    That's not the real cost. They could double the number of doctors by cutting the amount of education required by half, and get better results. And they wouldn't need to expand medical school capacity at all. The amount of education doctors get is harmful. It actually makes them worse at their job. It's effectively a form of hazing by AMA. There's a combinatorial explosion of effects and side effects in the human body. It's important to learn and memorize, and memorization is undervalued, but not to that extent. It's like memorizing optimal solutions to traveling salesman instances. Other times it's like memorizing a times table of the three-digit numbers. That is a waste of time and will make you a much worse mathematician.
    - mburee 5y ago
      That's one of the dumbest things I heard in a long time
  - horns4lyfe 5y ago
    We need to do that anyway, but then the doctors that make those decisions wouldn’t get paid nearly as much. There is absolutely an artificial scarcity of MDs in the medical field that needs to be discussed.
incrudible 5y ago
> Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely. Protection from Omikron quickly wanes. At what point does that "extra bit of immunity" justify heart injury? We're talking about roughly 1 in 10000 doses administered causing Myocarditis in a young male. We don't know if the risk increases after each dose, but preliminary data suggests that it may: https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...
- pfg 5y ago
  We're talking about ~1:10000 odds for one specific vaccine when vaccinating young males, which is why many countries are no longer using that vaccine for this demographic. Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19. The study also shows that there was practically no increase in risk for the third shot (though with a fairly wide CI), so it's possible the risk may just depend on whether someone is immunonaive or not.
  - deleted 5y ago
    [deleted]
  - incrudible 5y ago
    > Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19 The risk is given by the FDA as up to 1:14285 (males aged 12-17) for the second dose: https://www.fda.gov/media/154869/download https://www.fda.gov/media/154869/download However, a study from Hong Kong found an incidence of up to 1:2700 in the second dose (males aged 12-17): https://pubmed.ncbi.nlm.nih.gov/34849657/ https://pubmed.ncbi.nlm.nih.gov/34849657/ What we don't know is whether a vaccination would actually prevent Myocarditis in a breakthrough infection. These risks may well not be mutually exclusive. In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.
    - pfg 5y ago
vizzah 5y ago
"every extra bit of immunity helps" - Agree. But this shouldn't be mandated. Rewarded, yes. But not mandated.
sharken 5y ago
All the above applies for the flu as well, so why do we insist on inventing a new set of rules for Corona ? With vaccine and booster shots, both require a similar amount of hospital resources. The current way is simply not sustainable.

lamontcg 5y ago

> This blind boosterization is only demonstrating how the governments are still shitless scared of their medical system collapses with vulnerable groups, so that they want to boost anyone in sight, just to be on a safer side. I mean yes, that's still sort of the point. There's still probably about 10% of the population which is unvaccinated and unexposed. If they all wind up catching Omicron in the next 2-3 months (due to its ability to reinfect and ignore neutralizing antibodies to travel through the population to find those still-vulnerable hosts) then the fraction of them winding up in the hospital will be sufficient to knock over the hospital system again. We didn't have any excess capacity in our medical system when this started, and we have less now. The population's tolerance for any sort of behavioral changes is low, and the unvaccinated aren't listening to anyone, so the real only remaining lever to pull is recommending boosters to try to provide some level of protection against disease and transmission over the next couple of months in order to flatten the curve yet again. The modelling estimates that I've read though are that we're at about 90% of the population being exposed (depends somewhat widely on vaccination status and how hard the area was hit by Delta though), so we're just about done with the pandemic. Omicron should mostly finish the job that Delta started of finding all the holdouts and burning through all the dry wood in the population. In the meantime though that last 10% is enough to put the medical system under too much stress again.

peteradio 5y ago
When 100% of the population was dry tinder hospitals were under strain X. Now we have 1/10th that by your estimate. Why wouldn't we be under significantly less strain?
- pfg 5y ago
  Current variants are significantly more infectious (R0 used to be around 2.5-3.0 for the ancestral strain, Delta was 5+, Omicron estimates go up to 10). Vaccine efficacy is also reduced for these variants. We've also scaled back non-pharmaceutical interventions in many places.
  - krona 5y ago

Youden 5y ago

> those younger than 40 I think your concern is based on the heightened risk of myocarditis, right? My understanding (mostly from [0], made by a UK cardiologist) is that the danger of myocarditis from the vaccine is higher than the danger of myocarditis from COVID only for males under the age of 30 who receive a Moderna shot. For every other case, the vaccine is an improvement (so males under 30 should get Pfizer/BioNTech, which is the government recommendation at the moment in my country). [0]: https://youtu.be/5iABaxRWGxk https://youtu.be/5iABaxRWGxk

sharken 5y ago
I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters. People should be free to choose booster shots, those who are worried can continue to get booster shots. In essence the same system we have with the flu is what we should have with Corona. And then we can focus on some of the bigger problems such as Global Warming.
- Youden 5y ago
  > I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters. I don't see the point written anywhere so I suppose I did. In my opinion, people should get the vaccine as long as the harm of not having it is greater than the harm of having it. Adverse reactions are very uncommon and unvaccinated people are at heightened risk of hospitalisation (even under 40s) so the balance tips in favour of the vaccine. The booster seems like a good idea due to Omicron. > People should be free to choose booster shots, those who are worried can continue to get booster shots. I do agree that people should have a choice to take it or not. However just as I believe the right to free speech doesn't mean I'm obliged to listen, I believe the right to choose not to be vaccinated (or receive a booster) doesn't mean I'm obliged to be around you. That is, I think it's fine for participation to be refused to people based on their vaccination status (though I support say testing as an alternative).
  - anonair 5y ago

random314 5y ago

Myocarditis is not the same as death. Boosters are required because the efficacy of the vaccine has been observed to wane with time. Too bad the health systems couldn't come up with one tiny sugar pill that would confer 100% protection against all variants for the next 100 years. The are asking us to take 3 shots, the horror!