Like it or not, we've no choice but to live through this massive planet-wide experiment in real time.
Short term we'll see lots of bursts of news, and new exciting findings, but it's only in the long term maybe even years from now that we'll know which science is truly the "settled" science.
As a layperson I am trying to sit back and watch the experts figuring it all out, because on the surface it is frustrating how hard it is to extract truth and facts instantaneously.
To be a contrarian, wouldn't the best booster be a low dose of actual COVID-19 a few months after being vaccinated? This would give the individual natural immunity to more antigen sites than just the spike protean. Having the vaccine and COVID-19 exposure would prevent a strong case of COVID-19 and give long lasting natural immunity.
>Having the vaccine and COVID-19 exposure would prevent a strong case of COVID-19 and give long lasting natural immunity.
No one's ever going to inject a live virus into themselves. Inoculation is effective but we've moved past the need for that with modern vaccines. The current thinking is that we will end up getting a "mRNA cocktail" of different variants, and that that will provide the broad spectrum immune response you're talking about.
My understanding is that most virologists believe we will end up in an endemic situation so that is what is going to happen in the long run (the crux is how we get there).
> natural immunity to more antigen sites than just the spike protean
Current studies show that natural immunity does not seem to be superior to immunity from the mRNA vaccines (for immunologically naive persons) - so heuristically speaking it seems to be better to 'train' antibodies on one thing rather than several antigen sites at the same time (this may seem counter-intuitive at first but is in line with many other infectious diseases).
However, once you have been vaccinated (or resp. have recovered from Covid-19) exposition to the virus (or resp. to the mRNA vaccines) will have additional benefits as you suggested!
My knowledge was pre-Delta, and this study (in its current prepring form) suggests that for Delta, we have infection + mRNA vaccine > infection > mRNA vaccine.
Upon quick screening the authors do not discuss survivorship bias - which I would have expected.
Regarding what we discussed earlier the authors note:
"The advantageous protection afforded by natural immunity that this analysis demonstrates could be explained by the more extensive immune response to the SARS-CoV-2 proteins than that generated by the anti-spike protein immune activation conferred by the vaccine. However, as a correlate of protection is yet to be proven, including the role of B-Cell and T-cell immunity, this remains a hypothesis."
One thing that stands out is that the group that has been previously infected (both unvaccinated and single-jabbed post-infection) has been selected for survival already. I personally wouldn't draw the conclusion they propose from that population.
No. Risk / benefit is not favorable. There is no scenario outside of biological warfare where you would want to intentionally spread a deadly respiratory virus.
It is obvious that the antigen kinetics of ALL the vaccines require 2 shots - and they all seem to converge to ~~95% efficacy.
J&J now has the data and should relaunch as a two shot going forward.
The usual vaccines with inactivated virus have the full code(broken - but antigenic) and this full code has all the little parts that a genuine infection has - inactivated but these fragments are sensed by the immune system as foreign and hold danger = antigens are created.
The rNA vaccines are spike focussed and ignore these fragmentary 'nuts and bolts' that the virus uses to construct a reproduction capable daughter virus that emerges when the cell lyses to proliferate.
I feel these nuts and bolts are the key to the higher speed spread of the delta variant - which creates 1000 times as much virus at the infection peak = each spread droplet holds 1000 times as many virions = faster spread.
I anticipate that a full examination of the reaction kinetics will reveal that the delta virus makes and uses all these nuts and bolts in a more optimal ratio, so when the cell lyses there is less waste and more fully assembled virions.
As a mechanical analog, a car factory has an assembly line fed by subassembly lines. Let us pick, engine, transmission, gas tank, headlights, and horn. All these lines need to be tuned to make the same number of their units to make complete cars. A car can not be sold with no horn, or engine etc.
If they are not in tune, the factory will only make as many cars as the slowest(critical part) line. All these excess parts will pile up, uses steel etc, waste resources and eventually fill the factory and burst the walls = lysis.
All the functional virions will go on to infect, and all the waste parts will become scavenged by the cell for re-use.
This is a crude, but representative analogy to the beta variant - I am sure there are people analysing the reaction kinetics of virion production that lead to the observed 1000 fold increase in peak virion titer as the infection peaks and then wanes. The cell does not need to hold 1000 x virions at lysis - a faster replicative cycle to lysis and repeat will lead to the 1000 fold blood titer with only 20-25% more virions at lysis due to the shorter time to lysis = more completed cycles before the immune response suppresses the virus.
Experts have said coronavirus boosters will be needed down the road because the efficacy of these vaccines, including the two-dose Pfizer and Moderna shots, wanes over time.
"What they're saying: "Even if boosting were eventually shown to decrease the medium-term risk of serious disease, current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations," the scientists wrote."
In other words, it isn't even saying they aren't needed at all, but that it is better to have everyone fully vaccinated before we start on giving boosters - with the exception of some folks with compromised immune systems.
And to be fair, this is the sort of messaging that other places were handing out. It also isnt all that unusual that different parties give out different information, especially when some of those folks aren't medical professionals versed in such diseases or the intricacies of the immune system.
Your comment also makes me very happy to not be in the US right now. The government here (Norway) simply sent me an SMS when the vaccine was available, and prompted me to schedule both doses at that time. I imagine if we get to the point of booster shots, something similar will happen.
But I hope we get the world a dose or two of the vaccine first so that fewer people might die.
I'll bet vaccine boosters get the same "but they said masks didn't work"/"they said we didn't need masks" treatment. I would have hoped that we'd learned that lesson but it looks like we are doomed to repeat that all over again. I'm never of fan of lying/misleading the general public because it breads so much mistrust and allows mis/disinformation to spread so much easier later.
If it's not clear, I'm talking about how "we don't need to wear masks" != "masks don't work" as much as it was "we need all the masks for medical staff right now and there is a shortage". Similarly, the messaging should not be "we don't need boosters" because we we inevitably DO need people to take a booster it will be met with resistance due to "changing facts", instead the messaging should be "boosters help but it's better to get more people vaccinated with 1-2 shots before we focus on boosters".
I think the bigger issue is finding the places where strict mask use has reduced COVID. You seem to think there is a lesson to be learned however I'm unable to find any data that support that lesson. Yet, you assert it like it's truth, as if you know the truth and can back it up somehow, but you don't.
The person you are replying to isn't asserting that masks definitely work. He's asserting that stating "you don't need to wear masks" is not the same as saying "masks don't work".
The part you quoted agrees with OP, not you. "Even if boosting were eventually shown to decrease the medium-term risk of serious disease" means they feel that it has NOT been shown to decrease risk. You're not understanding the the meaning of "even if".
The second link doesn't say booster shots won't be needed down the road, they say they aren't needed now. Both articles are consistent with booster shots being needed down the road. The question is really about timing when the booster shots need to be given.
Places like Israel that immunised large swathes of population very early are already seeing signs of waning effectiveness and are planning to give booster shots in the near term. In the UK we're also in the same boat. Early vaccination has transformed life here, with low death rates despite high transmission. The protection the vaccine gives is providing us with massive benefits. It looks like boosters for older people going into winter make sense.
In the US that's not as clear. Vaccination has become a bitterly contested right vs left issue, in a way that it just isn't in Europe. Our Conservative government in Britain has been at the front line of pushing through a massively successful vaccination campaign, with broad cross party support for the strategy overall. There's plenty of political credit to go around. The contrast with the US couldn't be more stark.
I think the Biden booster plan looks ill advised, but at least he's not talking his voters into getting them or their loved ones killed or crippled by this thing. I'm sitting here, a fully vaccinated British conservative, watching interviews with dying patients in US hospitals saying they didn't get vaccinated because they are conservatives, wondering how things could have gone so horribly wrong.
>saying they didn't get vaccinated because they are conservatives, wondering how things could have gone so horribly wrong.
There's an entire subreddit dedicated to this and the patterns of behavior from these people become clear pretty quickly. They think prayers are more effective than vaccines.
The ones I've seen said it was because they are conservatives or republicans specifically, not because they were religious. It wouldn't surprise me if there's both though.
But yes there clearly is a religious dimension to this, which again there just isn't at all over here in Europe bar some fringe cults. But it's the political affiliation that seems to be the defining factor. I know there's been an anti-vax movement, but as far as I'm aware that wasn't a mainstream Christian position across the evangelical landscape in the US. Fringe yes, but a tiny fraction of the levels we're seeing for covid.
Based on what I've heard from interviews from doctors and nurses, these people change their tune incredibly quickly once they have been diagnosed with Covid and start suffering from some of the more severe the symptoms of the disease.
In your linked article it explicitly states that the booster shots aren't "needed" because they would do more good as initial doses in unvaccinated people, not that it also wouldn't help already vaccinated people.
(Commenting because this mirrors a complaint I frequently see among "covid sceptics" which frustrates me greatly)
Expecting simple and final answers to questions depending on a myriad of factors (some unknown or even unknowable!) is stupid.
In my opinion, it betrays a complete misunderstanding of how <science> works, and what it can do; the fact that scientific consensus CHANGES with new data is central and necessary.
And it's also completely meaningless to complain about "disagreement between experts" unless you are willing to precisely lay out and compare all those base assumptions that were made to interpret and answer your question (something "sceptics" rarely bother with).
Sorry for the rant if I misinterpreted your position.
> Expecting simple and final answers to questions depending on a myriad of factors (some unknown or even unknowable!) is stupid.
I don't think "covid sceptics" are the only ones guilty of this. Far from it in fact.
Vocal believers in "covid orthodoxy" (can't think of a better descriptor right now) seem much worse at acting as if simple and final answers exist for everything.
Annoyingly necessary disclaimer: I am not a "covid sceptic" by any stretch, I am fully vaccinated and believe that many precautions are warranted. But I am sick of being told what to do based on uncertain emerging science.
Case in point: vaccine passports seem to be an example where the policy was concocted based on assumptions about the science which turned out to be untrue (the assumption being that vaccinated people wouldn't carry or transmit Covid.) I believe that most governments are only keeping them in place in order to inconvenience people into getting vaccinated. This is exactly the sort of thing that fosters more scepticism, even if a lot of it is misguided.
I would guess that is because all the nuance gets stripped.
There are multiple reasons for experts to be against boosters. A few that come to mind:
- Requiring boosters to maintain "fully vaccinated" status undermines public trust in the vaccine's efficacy. This depresses willingness to get it in the first place, and utterly destroys the confidence of those that already "did their part".
- While the long term prevention of COVID contraction and spread seems to be beyond these vaccines, they do significantly reduce the severity of a COVID infection. I would guess that a large portion of the scientific community has accepted that this may be the best that can be done. Getting COVID and having the vaccine means that you likely have more durable long term protection with severely reduced risk of hospitalization.
Something to remember when it comes to public health: you, the individual are unimportant. What matters is the herd. If that means sacrificing a few to save the many, governments will do it and lie to you the whole way if that is what is required to accomplish their goal.
> - Requiring boosters to maintain "fully vaccinated" status undermines public trust in the vaccine's efficacy.
Booster shots confirm that the vaccine doesn't actually work. IMHO, vaccines for colds cannot work because "cold viruses" are fundamentally different than viral diseases like chickenpox or measles.
A very large percentage of the population thinks the public health authorities are full of it. I gently poke fun at people who half-heartedly take mask recommendations seriously [0].
> - While the long term prevention of COVID contraction and spread seems to be beyond these vaccines, they do significantly reduce the severity of a COVID infection.
I think the injections were only tested/deployed in the spring/summer, when virus 'cases' would be expected to decrease anyways. I expect the injections will be recognized as a total failure by next spring.
IMHO, the pandemic-as-vaccine-marketing-campaign was obvious from the beginning. It reminded me of the time I convinced my passenger that the moon was 'going away' [1].
> Something to remember when it comes to public health: you, the individual are unimportant. What matters is the herd. If that means sacrificing a few to save the many,
At least you're honest about this.
> governments will do it and lie to you the whole way if that is what is required to accomplish their goal.
The core lie is that SARS-CoV-2 is a super-virus that warrants extraordinary measures, when in fact the commonly-used treatment (oxygenation) for SARS-CoV-2 is what drives the deterioration [2]. Public Health should have stuck with the 2019 plan for pandemics, instead of tossing all the old recommendations.
If the Government had used the "pandemic" to address the 'obesity epidemic' it would have improved public health. But instead lockdowns worsened the obesity epidemic. Whoops.
Maybe you still think there's a ventilator shortage [3]? If so, take SCUBA diving classes. They'll teach you how to not blow up your lungs.
This is normal. Not all science is as clean and unambiguous as 1+1=2. There's often judgment and interpretation in science. And that's even before science starts getting turned into policy.
It's not our job to be virologists, it's not our job even to be scientists. It is our job to conceptually understand science well enough to know that disagreement between scientists does not imply that one of them is wrong, or that their "expertise" is suspect, or that they're motivated by culture wars.
Isn't that sort of what science is though? This is just probably the most public exposure of the scientific method that I'm aware of. Experts sometimes disagree, then we test the heck out of something, then we hit a consensus. This stuff is usually wayyyyyy slower than this, it's a miracle we hit consensus as fast as we are on anything related to Covid.
Natural antibodies seem to last longer, based on the current research. My simple algorithm is:
P(long-term damage | short observation window) = non negligible
P(death | previous infection, age (30), healthy, etc.) = incredibly low
“If you have had COVID-19 before, please still get vaccinated,” said CDC Director Dr. Rochelle Walensky. “This study shows you are twice as likely to get infected again if you are unvaccinated. Getting the vaccine is the best way to protect yourself and others around you, especially as the more contagious Delta variant spreads around the country.”
Is it? You seem to be conveniently choosing your data providers. The study out of Israel showed prior infection provides 13X increase in protection over vaccination. Unfortunately, the data aren't clear.
What is clear, however, is young people with antibodies (either through vaccination or prior infection) don't need to live in fear.
"SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well."
I'm not sure why I'm being downvoted for posting the truth, but your article does not refute anything I stated or what the article I posted states. They could both be true. It's better to be vaccinated and have natural immunity than one or the other.
I wouldn't put the scare quotes around experts but around "talk". What is getting reported is often not quite nuanced enough. I would suggest to cut down on news if the reporting makes you feel bad.
Many people will think it must be like masks: once the "experts" get their boosters, then they'll tell everyone else it's a good idea to get it. They just want to be sure there's enough for them, first.
I have some travel coming up in October. I plan to get the Moderna booster even though I'm not in an eligible group.
Even if it turns out that the data is clear in the long run: I had my third Pfizer today (along with influenza minutes later) and if this is the vaccine hangover I'm going to get twice a year, that's pretty exhausting too.
Still waaay better than covid or the flu, but damn. The world is never going to be the same.
I’ve got to think they’ll develop a 2nd generation vaccine with fewer side effects especially if a new one is actually needed yearly (still not convinced we don’t just need the vaccine re-tuned for Delta rather than blindly shoving booster after booster of the original strain).
I get the flu shot every year and have zero side effects, it’s a different type of vaccine but I believe the Chinese have developed an inactivated virus vaccine for covid.
Part of it is just dose. Moderna had different Phase 3 trials than Pfizer and didnt hone in on dose as much, so its shot was probably overkill. But seeing how it now seems to have more longevity, maybe that overkill comes with a bonus staying power.
Im not sure it quite works that way but maybe it really is as simple as "less more often" = fewer side effects, "more less often" = more side effect, less often"
I tried to get a 3rd Pfizer shot yesterday, but neither CVS or my doctor would give it to me because I am not 65 or immunocompromised. I have some work travel coming up, and I thought that would be enough reason.
I could have easily lied and said that I am immunocompromised, but that is not my style. Maybe I need to keep looking to find someone who will give it to me.
The world will go back to normal when we accept that everyone will get Covid and there's no need to hide from it. People have some kind of mild mental illness from Covid and they haven't even gotten it.
I mean we went back to normal after Spanish Flu and Hong Kong flu didn't we? Spanish flu killed 50 million (edit). Hong Kong killed 1 - 4 million.
People will forget, it's in our nature to push on and survive.
> Technology advances, fortunately.
If you have the current technology you will get Covid. It's not if, it's when. Eventually we will have good vaccines (in a decade or two?) and maybe people won't get it. By that point it will have mutated into being a cold for most people.
> This sort of fatalism is not a really useful approach for reasoning about the risk, in my view.
Covid is a serious thing and I'm sad for the people that died from it, before vaccines and the unvaccinated. If someone is carrying even a little extra weight I would plead with them to get the vaccine. Let's just be honest though, the risk is just really really low for anyone in decent health. With the vaccine it's 0.
> By that point it will have mutated into being a cold for most people.
Just to clarify that it's not the virus that will become more benign in an endemic situation - it's the hosts that will adapt to it, similar to how baby's/children's immune systems develop. At birth they are immunologically naive but then their immune systems are being primed by exposure to common pathogens like coronaviruses, influenza etc (which is why young children are ill all the time).
> Let's just be honest though, the risk is just really really low for anyone in decent health. With the vaccine it's 0.
I agree with your assessment but let's not forget that the IFR of Covid-19 scales exponentially with age. Which is another reason to get the vaccine.
Yes; we now have a gigantic effort every single year to get out in front of the annual flu, identify the dominant strain via global viral surveillance, and produce and distribute and administer billions of vaccine doses in a few short months, each and every year.
It's a huge system that involves thousands of people.
Yea you have a point in our futile efforts to develop flu vaccines. If we ever have something that's actually deadly infect the world we're probably just screwed. The governments have used all the clout on Covid. Best just to get the vaccine and move on with life. Let's just be honest, we will probably die of Cancer or Heart Disease.
I'm convinced if Covid hit in the 50's we wouldn't have near the deaths. We're such a unhealthy society now. Best just to focus on health going forward.
If you’re suggesting everyone should get Covid without being vaccinated, then that’s a really great way to cause millions of unneeded deaths. Just because you’re ok with that outcome don’t expect everyone else to be.
edit: that's not what they were suggesting. I misunderstood!
He is repeating what experts have said, which is basically, because Covid is dormant in animals and domestic pets, and because you can spread it while vaccinated, essentially everyone will eventually get Covid. If you are vaccinated, your symptoms will be, on average, less severe.
It's probably more than everybody will get it, more like everybody will get it every couple years. Expect it to displace one of the colds, and become a common cold.
Will babies be exposed to it enough, to eventually make vaccination a thing of the past? Do we vaccinate for other common colds right now (OC43)? Or maybe the opposite conclusion, that as you age you should be vaccinated against the common colds.
I think if the pandemic has taught us anything it's that we need to be flexible in our opinions and approach as new information comes to light. Anyone who hasn't had to change their opinion on a whole bunch of issues to do with the virus over the last year and a half is either an unfeasibly lucky guesser or is doing something wrong.
Also, we've got to stop assuming a conspiracy and bad intent all the time. Whenever underlying information changes, and the experts must therefore change their guidance, people come out of the woodwork to declare "See! Mr. Expert changed his mind! He was obviously lying before. Is he lying now? What can we believe with all these liars lying?"
more like journalists are good at writing misleading headlines from studies, and chasing random quote bites to print out of context.
if your decision making is fueled primarily by click bait bylines, youre going to have a bad time. if you read through to the nuance of each story, the narrative doesnt flip flop quite as much as it first appears.
quite honestly, the details havent changed that much since the beginning. primarily effects the elderly, travels by spit through the air but not as airborn as measles, on a spectrum more load is worse, if infected seek monoclonal antibodies and quarantine yourself, vaccines prevent hospitalization, occasional boosters will be likely until entire population develops built in immunity. delta has brought the age bracket down (or is that because the first round of most likely to be infected are already gone) a bit and increased the transmission rate.
It's just like nutritional science. Only the time scale between the changes in recommendations is now weeks instead of years, and instead of recommendations it's laws.
When will they finally release a vaccine targeting surface proteins instead of the mutating spike protein? All we got are ancient spike protein-based vaccines that need to be renewed, while it's been sufficient time to develop a proper vaccine targeting all variants, or at least adjust spike fragments to new variants. Is this really just business-driven decision now? Is a vaccine subscription coming next?
I find the "one and done" way in which the J&J shot was marketed and approved was really disingenuous. It seems more like J&J knew they had a slightly riskier vaccine and wanted to cover themselves from the additional liability of a second shot, while also speeding up the approval process.
Well, vaccines based on a single aspect - the spike are weaker than a natural infection immune response, but of course the patient suffers the disease which stimulates the immune system with all the carried detritus of an infection = a more comprehensive immunity.
I suspect later rNA based Covid vaccines will add some of this detritus code to broaden the response? This will complicate testing, but will improve the vaccines.
Short term we'll see lots of bursts of news, and new exciting findings, but it's only in the long term maybe even years from now that we'll know which science is truly the "settled" science.
As a layperson I am trying to sit back and watch the experts figuring it all out, because on the surface it is frustrating how hard it is to extract truth and facts instantaneously.
But, it is what it is...