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I did not say that prior infection does not reduce severe outcome. It does but _it does not change the fact_ that the severe outcomes are much more rare among v

I did not say that prior infection does not reduce severe outcome. It does but _it does not change the fact_ that the severe outcomes are much more rare among vaccinated people. This means that there are still too few people with prior infection, for this to be an important factor in policy making. It will be once the proportion of unvaccinated people in hospitals starts to resemble the proportion in the general population.

JPKab 5y ago
The severe outcomes are even more rare amongst prior-infected, unvaccinated people. I suggest you look up seroprevalence surveys. The bulk of COVID infections (barring mandatory and regular testing being extant in a given locality) go undetected, due to the mild symptoms in the vast majority of the population. The seroprevalence surveys have shown this since May 2020.
- bonzini 5y ago
  And again I do not debate that. But they are too few to have an impact on the overall statistics of unvaccinated people. It they were not such a small minority, you would not be seeing so many more severe outcomes among the unvaccinated.
  - MatteoFrigo 5y ago
    See https://covidestim.org/us https://covidestim.org/us for an update to your "too few" statement. The number of previously infected people is at least 70% in all US states I have looked at (80% in NY and CA). While not directly comparable, an official report from the UK [1, Figure 3] estimated that effectively 100% of blood donors were either vaccinated, previously infected, or both. This was in September. Blood donors are not a representative sample of the population, but it's not hard to believe that by now effectively everybody (in the UK) has some kind of immunity. [1] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1019992/Vaccine_surveillance_report_-_week_38.pdf https://assets.publishing.service.gov.uk/government/uploads/...
    - bonzini 5y ago
      It 70-80% has been infected, then most of the vaccinated population will be vaccinated and infected, which provides still stronger protection than just infections. The end result is the same: higher proportion of severe illness among the unvaccinated, which is most easily fixed by vaccinating them.
      - pdonis 5y ago
        > higher proportion of severe illness among the unvaccinated No, among the unvaccinated and uninfected, which, as the data others have been giving shows, is nowhere near even a majority of the unvaccinated any more, let alone enough of a majority to treat it as if it represented all unvaccinated people. So your claim that the unvaccinated but infected are too few to matter and should not affect vaccine recommendations, let alone vaccine mandates, is egregiously wrong.
      - JPKab 5y ago
        Again, a category error: You are failing to differentiate between the two subgroups of unvaccinated people, the previously infected/unvaccinated, and the purely unvaccinated. Additionally, you are not doing any further subdivision on these two groups by age. The blanket "one size fits all" strategy you are advocating is assuming that all of these groups are at zero risk for adverse events from the vaccine. Young, healthy males have a statistically zero risk of severe COVID complications, and a statistically small but non-zero risk of myocarditis. The risk of myocarditis from the vaccine falls to practically zero as you progress upwards up the age distribution, which is the exact group of people who have the highest benefit from the vaccine. You are talking about a gradient which impacts both the cost and the benefit, with a diminishing cost and an increasing benefit going up in age. Not taking this into account is so illogical, that in my opinion, people who hold this view are clearly blinded by bias. If I'm going to get smeared as an "anti-vaxxer", I'm going to go ahead and use a label to describe humans who hold the rigid, data-resistant view that you possess: Immunity deniers
        MatteoFrigo 5y ago
        > Immunity deniers Let's not do this. When this mess is over we'll all want to work and break bread together again, and that's much more important than whatever any of us happened to believe or say in the fog of war.
timr 5y ago
You said: > Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction The data clearly shows that protection from natural infection is at least as substantial as from vaccination, and that ~half (if not more) of the US population has had it. This fairly obviously impacts the most effective strategy. Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior. Most countries recognize prior infection. We're in a small, small club of scientifically illiterate nations here, and it's rather embarrassing. > It will be once the proportion of unvaccinated people in hospitals starts to resemble the proportion in the general population. If the total number of hospitalizations is a manageable number, the percentage that are vaccinated is irrelevant. It's a metric of punishment, not a realistic policy goal. I have no idea what the future will bring with regard to the ratio of unvaccinated hospitalizations, but I know that hospitalizations in general will fall as the population achieves broad immunity -- and natural infection certainly counts toward that goal.
- kevhito 5y ago
  > Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior. The idea that a vaccine is a punishment is disturbing. I'm glad to have been able to get it.
  - timr 5y ago
    I said the mandate is punitive, not the vaccine. If you feel more comfortable getting an unnecessary vaccination, nobody is stopping you. Other people should not be coerced into doing the same against their will. College kids are currently being expelled for refusing boosters. Children are being refused classroom education. Prior infection is not taken into account, and risk/benefit is not a factor. There's no other way to frame this than as coercive behavior.
    - 5y ago

JPKab 5y ago

The severe outcomes are even more rare amongst prior-infected, unvaccinated people. I suggest you look up seroprevalence surveys. The bulk of COVID infections (barring mandatory and regular testing being extant in a given locality) go undetected, due to the mild symptoms in the vast majority of the population. The seroprevalence surveys have shown this since May 2020.

bonzini 5y ago
And again I do not debate that. But they are too few to have an impact on the overall statistics of unvaccinated people. It they were not such a small minority, you would not be seeing so many more severe outcomes among the unvaccinated.
- MatteoFrigo 5y ago
  See https://covidestim.org/us https://covidestim.org/us for an update to your "too few" statement. The number of previously infected people is at least 70% in all US states I have looked at (80% in NY and CA). While not directly comparable, an official report from the UK [1, Figure 3] estimated that effectively 100% of blood donors were either vaccinated, previously infected, or both. This was in September. Blood donors are not a representative sample of the population, but it's not hard to believe that by now effectively everybody (in the UK) has some kind of immunity. [1] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1019992/Vaccine_surveillance_report_-_week_38.pdf https://assets.publishing.service.gov.uk/government/uploads/...
  - bonzini 5y ago
    It 70-80% has been infected, then most of the vaccinated population will be vaccinated and infected, which provides still stronger protection than just infections. The end result is the same: higher proportion of severe illness among the unvaccinated, which is most easily fixed by vaccinating them.
    - pdonis 5y ago
      > higher proportion of severe illness among the unvaccinated No, among the unvaccinated and uninfected, which, as the data others have been giving shows, is nowhere near even a majority of the unvaccinated any more, let alone enough of a majority to treat it as if it represented all unvaccinated people. So your claim that the unvaccinated but infected are too few to matter and should not affect vaccine recommendations, let alone vaccine mandates, is egregiously wrong.
    - JPKab 5y ago
      Again, a category error: You are failing to differentiate between the two subgroups of unvaccinated people, the previously infected/unvaccinated, and the purely unvaccinated. Additionally, you are not doing any further subdivision on these two groups by age. The blanket "one size fits all" strategy you are advocating is assuming that all of these groups are at zero risk for adverse events from the vaccine. Young, healthy males have a statistically zero risk of severe COVID complications, and a statistically small but non-zero risk of myocarditis. The risk of myocarditis from the vaccine falls to practically zero as you progress upwards up the age distribution, which is the exact group of people who have the highest benefit from the vaccine. You are talking about a gradient which impacts both the cost and the benefit, with a diminishing cost and an increasing benefit going up in age. Not taking this into account is so illogical, that in my opinion, people who hold this view are clearly blinded by bias. If I'm going to get smeared as an "anti-vaxxer", I'm going to go ahead and use a label to describe humans who hold the rigid, data-resistant view that you possess: Immunity deniers
      - MatteoFrigo 5y ago
        > Immunity deniers Let's not do this. When this mess is over we'll all want to work and break bread together again, and that's much more important than whatever any of us happened to believe or say in the fog of war.

timr 5y ago

You said: > Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction The data clearly shows that protection from natural infection is at least as substantial as from vaccination, and that ~half (if not more) of the US population has had it. This fairly obviously impacts the most effective strategy. Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior. Most countries recognize prior infection. We're in a small, small club of scientifically illiterate nations here, and it's rather embarrassing. > It will be once the proportion of unvaccinated people in hospitals starts to resemble the proportion in the general population. If the total number of hospitalizations is a manageable number, the percentage that are vaccinated is irrelevant. It's a metric of punishment, not a realistic policy goal. I have no idea what the future will bring with regard to the ratio of unvaccinated hospitalizations, but I know that hospitalizations in general will fall as the population achieves broad immunity -- and natural infection certainly counts toward that goal.

kevhito 5y ago
> Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior. The idea that a vaccine is a punishment is disturbing. I'm glad to have been able to get it.
- timr 5y ago
  I said the mandate is punitive, not the vaccine. If you feel more comfortable getting an unnecessary vaccination, nobody is stopping you. Other people should not be coerced into doing the same against their will. College kids are currently being expelled for refusing boosters. Children are being refused classroom education. Prior infection is not taken into account, and risk/benefit is not a factor. There's no other way to frame this than as coercive behavior.
  - 5y ago