I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
Given some states' track records on how they handled other things that attracted a lot of people, such as in-person voting, I'm not at all confident that we won't have some states that manage to turn vaccination clinics into super spreader events, which should be deeply embarrassing.
A good way to handle it is the way Kaiser handled flu vaccinations this year in western Washington. They had 10 minute windows available. You reserved online your spot in one of those windows. When you arrived a person at the door asked your name, checked you off the list, and gave you a pre-printed label with your information, and sent you in.
There were two or three people administering the vaccine, so two or three people for each 10 minute window. You went an stood in line with the others who shared your window, with the line very spread out.
When it was your turn you went in to get the vaccination, gave the person their your label, got vaccinated, and were sent out a side or back door so you would not cross paths with the people waiting or arriving.
In the 2009 H1N1 flu outbreak
https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemi...
I remember getting the vaccine and it was offered outdoors, with a line in a parking lot and a nurse having a tent or a table or something. So that was good (although we weren't wearing masks -- the level of concern and associated precautions with H1N1 felt high at the time but now seems pretty trivial compared to COVID-19).
I recently went to my doctor's office for a seasonal flu shot and the office had separated spaces in the waiting room, lots of air filters going, and all patients and workers wearing face masks. And I think they wouldn't allow more than 4 or 5 patients in the office at a time. So those same precautions would feel pretty decent to me for COVID vaccination.
Edit: I guess I'm reflexively thinking of San Francisco in imagining this -- the outdoor line-up seems perfectly fine here, but it might be pretty unpleasant in January in New York or St. Petersburg or Edmonton...
I don't know how many hundred dollars it cost them to buy a couple dozen devices or how much it costs to wipe each one down and put it back under the infrared/anti-cootie lamp each use. But there are orders going out the window about every 2 minutes and no customers within 50 feet of each other.
Honestly, I'd prefer to be texted - no need to pass around a hot potato.
to this point you (everybody, really) should have a burner phone number
We ended up just going to Target, which was much more risky, but actually something we could accomplish.
He points out that the standard being adopted by these studies for the point efficacy is 14 days after the second dose. That's honestly not too bad. It's no magic bullet, but it's survivable.
This was redundant. Anti-vaccination “belief“ is a serious, mental, issue.
Against HN rules, but it’s time to stop being so easy on people who try to distort science and reality and call them for what it is. You cannot have a eye to eye conversation with anti-vacciners, flat-earthers, climate-change deniers, election-fraud believers and Trump supporters.
The more leeway we give the more they try to win public opinion and damage our world.
Beliefs? Science, and scientific evidence became “beliefs”
That’s the problem right here.
But we DO have to convince people, we have to convince people by showing them how it works, and letting them decide that that makes sense, you can't just mandate belief as a science authoritarian.
And science is still performed by humans, and we're fallible, and our incentives aren't always good, and every time there's a public failure of the process, and every time a scientist goes on record to shill for a company's chosen viewpoint, it dings the general public's faith in science and scientific experts in general.
From where I'm sitting, perceived authoritarian tendencies on the democratic side is a large part of what really motivates Trump voters. That's certainly a lot of the narrative, if you ever visit that side of the media landscape.
1. Don’t even entertain their distorted reality
2. Put a stop on the spread of misinformation
Stopping your anti-vaccine post from going viral on social media is in no way any different than a scientific magazine refusing to publish the same.
> put a stop on spread of misinformation
That’s what censorship is. A small group of people will decide what is considered misinformation and will censor everything that goes against that
This is not censorship. Censorship is stopping you from expressing your thoughts. Not publishing your thoughts is not. You can say whatever you want but no newspaper is in any obligation to publish it.
Similar with social media, you can write whatever you want on your personal "page", but they are under no obligation to make sure it reaches other people's feed.
Nice euphemism for censorship.
Social media is common people writing and reading. And they choose which people to follow etc.
"stopping a post to go viral" means in this context activily manipulating and interfering what information does and does not reach other people.
That is something very different than a newspaper refusing to publish a certain article.
If you’ll permit a scientifically inaccurate analogy here: sunlight is the best disinfectant.
I believe the government should not have a say in whether or not all information circulates, but ordinary people who build information sharing systems (and I don't just mean electronic ones) have an opportunity to figure this out. Should they not?
It all comes down to whether or not the community in question is one in which members can readily leave without cost. I don't agree with making anti-vaxxers change their ways by government force, but I'm into being intolerant of them in other ways to the point that they'll come around and obviate any need for governmental force in the first place.
Follow-up question: how can you be sure that you, personally, are on the side of the angels? Especially if you have never been allowed to hear the opposing point of view?
Seriously, the growing support for censorship in the previously libertarianish Tech community has been the worst development of the last decade.
In hindsight, I see how citing codes of conduct implies support for censorship, when my actual intent was simply to demonstrate another example of "intolerance" having noble goals.
Well, I agree with the scientific consensus on a general base. But since science was not always right, I don't see a valid argument from there to censorship.
You want to censor ideas not covered by scientific consensus?
"and their answers should sit uncomfortably in all humans"
Because, also no. I do not feel uncomfortable. I am strongly against censorship. Open, unrestricted exchange of ideas. If the scientific way is the best (which I believe), then the crackpot approaches will fail naturally. But if you censor those other approaches, you might actually strenghten them.
Netiquette 101: Don't feed the trolls. (But here we are.)
My fear that is that not enough folks will take the vaccine. I've been hearing a lot about anti-vaxxers lately. interesting bunch.
Reason is not a universal attribute of human beings. Some of us have it. Some don't (they just simulate it more or less successfully).
Most pro-vaxxers have simply picked up the dominant opinion from the surrounding society -- not a bad heuristic in practice. Most anti-vaxxers have picked up an opinion from a persuasive single source and then read some other sources that back it up.
I admit I'm in the first category, I certainly vaccinate my own children, but I can't really claim that I've come to this decision after a thorough understanding of immunology, I have simply followed the path of least resistance.
That particular version of antivaxxism is the one I would have the most trouble refuting. It's especially troubling since if it were true then the powers that be would have every incentive to try to keep it quiet and attack anyone who suggests it.
I mean, I make the same judgement call every year for flu shots. Is it at least plausible that I would be better off overall making the same call for some other disease?
> That particular version of antivaxxism is the one I would have the most trouble refuting.
What's hard to refute? I mean, the exceptionalism argument only sticks with sociopaths who believe society exists only to serve their personal interests without having to contribute anything in return.
That's not really true though. The risks involved in getting a vaccine are much, much smaller than the risks involved in not getting the vaccine, especially with diseases like Covid.
1. I couldn't find a source for your 3-4 k number,if you can point me to it I'd be greatful. I did find a a source of 532 developing Guillan-Barré https://www.newscientist.com/article/dn18014-swine-flu-myth-...
2. That same source lays out why worrying about this risk is not rational (in this case)
3. No-one is seriously calling for forced vaccination for corona
4. (my opinion) by over-emphasizing the "personal choice" angle we are letting anti-vaxxination pseudo science and conspiracy beliefs spread without being challenged. Some things are more wrong than others and the science for the harm of vaccines has oveerwhelmingly failed to arrive. So using the term "without anti-vaccination beliefs" is fair in this case, since I will argue the only reason why you'd reject a vaccine that is recommended by a physician is an irrational belief not grounded in evidence
There will be de facto mandatory vaccination, to a degree. This is a Canadian news source but read about the companies involved with creating this program (by the way—-it’s not Ticketmaster). It is definitely coming to America and already underway.
No coronavirus vaccine, no entry? Experts say it’s possible in pandemic’s next stage
https://globalnews.ca/news/7457999/ticketmaster-covid19-vacc...
In Europe, mandatory vaccinations do exist in some countries, for both children and adults. Also, in Croatia (which is part of the European Union), if you refuse to have your child vaccinated, it is legally considered to be child abuse. In Croatia, they have school doctors that literally come to the schools with nurses that not only ensure the health of all of the kids, but also have them vaccinated there. Homeschooling is also illegal in Croatia.
That is not true:
https://nysba.org/new-york-state-bar-association-calls-upon-...
>>The New York State Bar Association (NYSBA) is recommending that the state consider mandating a COVID-19 vaccine once a scientific consensus emerges that it is safe, effective and necessary.
Define forced. I'm not in favor of pinning people down and forcibly injecting them with something, but I am all for some kind of vaccination "passport", where if you don't have proof of vaccination you stop enjoying the benefits of society. No public schools or services, right for businesses to refuse service, etc. Or at the very least, a heavy tax fine or something a long those lines.
If people choose to not get a vaccine, that's fine. But its time we align incentives to eliminate these externalities being born from societal free-loaders who believe in quack-science.
> We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria?
Not specifically, but DTaP vaccinates against pertussis which has seen epidemic-level outbreaks in the past decade in multiple states.
I'd expect any SARS-CoV-2 vaccinations to be targeted at adults for the foreseeable future, but who knows.
Nope, I wonder why.
You should have mentioned that the 532 cases of Guillan-Barré were found within the 48 million people receiving the swine flu vaccine.
Accordig to Wikipedia, the incidence of Guillam-Barré is about 2 per 100,000 people per year.
Statistically speaking, your example suggests that taking the swine flu vaccine is linked with a lower incidence of Guillam-Barre syndrome, nearly lowering it to about 60% of the baseline.
If we're allowed to play fast and loose with back-of-the-napkin statistics, your example contradicts your original claims, and indeed makes a strong case in favour of vaccination.
There's a lot of unsafe stuff, but this example is so absurdly generalized that it seems either malicious or just so ignorant that it's not even a worthy position to take.
https://en.m.wikipedia.org/wiki/Dengvaxia_controversy
https://ijme.in/articles/deaths-in-a-trial-of-the-hpv-vaccin...
https://www.nationthailand.com/news/30352154
Vaccine manufacturers have a poor track record of releasing dangerous barely tested vaccines onto populations, causing deaths and avoiding lawsuits.
Personally, I am skeptical about this vaccine, or any other rushed out for a disease with a 97% survival rate.
https://www.worldometers.info/coronavirus/?utm_campaign=home...
I've had lots of vaccines in my life, the thing is, all those were for diseases that had a high risk of crippling or killing me.
Why would I want a vaccine that is actually less effective than my chances of surviving?
If I get the vaccine, there's a 95% chance it'll work, if I get covid, there's a 97% chance i'll live.
All I know is, if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash.
Why would I choose to have some barely tested vaccine with not fully studied long term side effects made by companies who have extremely poor track records with medication in general?
Pfizer is bascially responsible for the oxycontin epidemic. Their reps bribe doctors into pushing their drugs.
Moderna's some secretive biotech company that just appeared out of nowhere with this whole covid thing.
What reason do I have to trust any of these companies over the 97% survival rate I can expect from getting covid?
Your choice is between 3% and 0.15% - not 95% and 97%.
I don't think this individualistic way of looking at things is sound, though. First 3% mortality sounds way high - even given health system collapse (basically turning every ventilator survivor into a dead patient).
And on the other hand, mostly the old and those with pre-conditions will die - we alltake the vaccine to protect everyone. That way we might avoid a population wide 0.5% (or thereabouts) mortality rate.
That would still 1 in 200 - most people would likely know a handful of people dying from the disease if there's no mitigation.
I would put it differently: if we become covid carriers, we become spreaders. Those 3% are, thus, applied to a large population comprised of everyone we interact ina daily basis.
Thus even if at most the likelihood that we die of covid is only 3% tops, the likelihood that at least one person that catches covid from us does is proportional to the number of people we infect.
With a 3% fatality rate, the likelihood that at least one person we infect will die can reach 80% if we spread it to over 50 people.
If we infect someone over 60, the likelihood that they will die from covid grows from that 3% to about 20%.
So unless you are infected while living in a bubble, the real risk is far higher.
In addition I dont go out as I have elderly relatives who I dont want to sicken, they dont expect it, its my choice. So blaming others for being selfish is really missing the point and is an illustration of not really understanding the current economic situation.
At that point everything else suddenly becomes critical, because there is no ICU left.
Also, at least in CA, doctors/hospitals/dentists etc are only doing what is critical right now to avoid the whole hospital going into lockdown. That has large consequences for health outcomes and for the economy of those practises.
https://ourworldindata.org/covid-health-economy, and then specificaly this scatterplot: https://ourworldindata.org/grapher/q2-gdp-growth-vs-confirme...
(unfortunately, the graph doesn't include countries like china, vietnam, and many other asian countries, because that would make the trend even clearer.)
And there's already more dead from covid-19 in the US than casualties during the Vietnam War. Granted, more elderly people than young, but it's still a bit difficult to accept that it's insignificant.
Add to this what could happen with an exponential surge, with icus being over-run - and a) you'd end up being more likely to die from other causes, like a traffic accident - and b) many of the current covid-19 survivors would end up as casualties.
Here in Czech Republic it looks like we managed to avoid running out of capacity during the ongoing second wave, but just. The measures taken included canceling any elective and non-life-threatening surgeries, drafting medical school students, many foreign doctors that came to help and moving covid patients in critical state from overloaded hospitals hospitals.
We even built two full field hospitals which we will thankfully not need as it looks like. BTW, building one of them took about a week - which you migh not have, once you hit exponential growth. Not to mention having spare medical personnel to run it.
Good luck surviving among a bunch of simians, who think they have figured it all out.
Well, the vaccine hopefully doesn't kill you if it's ineffective, so the numbers aren't exactly comparable.
The reasoning in this comment is wild. Let's take it back to the math a moment:
Let's take your 3% chance of death (actually the population survival rate is significantly higher IIRC, but OTOH there's long haul COVID to consider too). If the vaccine is 95% effective, all else being equal you have a 3% chance of death without the vaccine, and a 0.15% chance of death with the vaccine. So the question becomes: is there a greater than 2.85% chance of the vaccine killing you or doing you crippling injury? If not, you're probably better off taking the vaccine.
0-19: 99.997% 20-49: 99.98% 50-69: 99.5% 70+: 94.6%
Edit - typo.
I would also mention that there are studies in peer review on patient populations in the United States which suggest IFRs closer to CDC planning scenario 4/5 than 3—for example, this one from Connecticut[1]:
18-29 0.01 (0.01–NE)
30-44 0.11 (0.06–1.74)
45-54 0.18 (0.11–0.63)
55-64 1.30 (0.68–16.94)
≥65 16.46 (6.58–NE)
Also, you know, all IFR estimates assume that patients will actually be able to access care. Without hospitals, IFR approaches IHR, and the hospitalisation rates from the Connecticut study are grim: 0.8%, 2.68%, 3.09%, 12.43%, and 79.89%.
[0] https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
[1] https://www.medrxiv.org/content/10.1101/2020.10.30.20223461v...
Also there is no proof that getting covid grants lifetime immunity, so lets assume immunity lasts a year, every year you now have a 3% chance of dying from covid using your numbers. 3% is not that low, there is a ~3% chance of rolling double sixes with 2 dice, and that happens all the time.
That was Purdue Pharma, not Pfizer.
Having a large enough host population to sustain an outbreak means those vulnerable parties are fucked and the rest of the population even those for whom the vaccine is 90% effective are at still at some risk. Worse the selection pressure among millions of vectors to develop a strain that can infect the previously safe population is high and the possibility is real.
This is to say that the proper assessment of safety is the likely net effect on the entire population of an increasingly large portion of society not vaccinating.
Existing precedent would seem to suggest that its impossible to force you to vaccinate but possible to prevent you from participating in society if you do not. For example the state can put you in jail for not putting your kid in school but not let you do so unless you vaccinate your kid.
I would not be terribly surprised if people, especially vulnerable people argued that a work allowing anti vaxxers to work alongside them violated their right to a safe workplace.
Imagine one lawsuit from someones family that lost a baby or a family member resulting in an 7-8 figure settlement. There wont have to be a law. The lawsuits will be from anti vaxxers alleging that this violates their rights and will take place over the following 2 years after every major workplace in America adopts such rules giving American workers the choice between employment and remaining an antivaxxer.
That this vaccine is mRNA-based makes it likely safer than some other lightly-tested vaccines, but if you're young, healthy, and at low-risk of serious COVID infection, I'm not sure it's wise to be among the first in line for this vaccine.
I leave my house about once a week, wearing a mask, to spend 20 minutes grocery shopping. My risk of contracting, contracting and dying from, or contracting and spreading the disease is extremely low and quite possibly lower than leaving that dose for someone else who is leaving their house and being around people more than 4 hours in those 3 months. Bonus is that someone at higher risk gets "my" dose and I get 3 additional months of population-wide study of safety, side-effects, and efficacy.
Parents homeschool kids in states that force vaccinations. Parents get in trouble when they are registered to a school and the kid doesn't show up.
Also, there are some interesting treatments targeting the ACE2 receptors that SARS-CoV-2 binds to which looks like they are reducing mortality rates, and perhaps long-term scarring in the lungs. Among these are Vitamin-D (which people are probably nutritionally-deficient anyways), and human recombinant soluable ACE2 (basically, injecting a form of ACE2 into the body so that the virus binds to that, instead of to cells with a lot of ACE2 receptors, thus short-circuiting the replication pathway). I would be interested to see if nutritionally-sufficient vitamin-d is better at preventing severe cases of covid-19 than masking or social distancing.
My own opinion is that it is foolish to pin all the hopes on a single strategy (prevention, via vaccination), which is not guaranteed to work or guaranteed to be safe. To add forced vaccination is folly. I think it is better to see a depth of prevention and treatment options (including vaccination).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335060/
The study described findings of antibody-dependent enhancement with the original SARS. I am no expert, but my understanding is that when test subjects were given the vaccine, and then later 'challenged' by the SARS virus, they developed a pathological response. In other words, taking the vaccine had a potential to make their response to SARS and potentially other coronaviruses worse.
The study I linked therefore recommended caution in giving the vaccine to humans.
Obviously this is something that vaccine researchers are aware of (see https://www.nature.com/articles/s41564-020-00789-5), but I think it's something that is perfectly rational to be concerned about given the time and money pressures available with SARS-CoV-2 vaccination.
There won’t be enough vaccines to go around, so no one will be forced to take anything for at least a year. By then we might be at 60-70% of the population vaccinated, at which point the R0 of the virus would be much lower.
Don’t worry about it for now, the rest of us will take the risk so you don’t have to.
I feel like we are about to enter the variation on the prisoner's dilemma where we all get a massive benefit if at least 70% of us get the vaccine, but getting the vaccine has a cost (please roll a D20 to select your random side effect) so everyone has an incentive to be one of the shirkers.
I foresee things getting ugly as we collectively all get together to shame, bully and trick the shirkers into compliance.
I’ll allow that there is seemingly a significant portion of the population who believes they don’t personally benefit from a vaccine, but your comment said -everyone- is incentivized to shirk: that’s just not true.
Of course this depends on the unknown factor of how bad the side effects are, if they are nonexistent then it's a different story, but if they are on average as bad as a flu shot then it becomes tricky.
I suppose I'm really thinking in the context of countries like Australia which have essentially eradicated the virus. My risk of getting the virus right now is practically zero, so my only incentive to get vaccinated is that we can eventually reopen our borders once enough people are vaccinated. And personally I'm in no hurry to get flooded by foreign tourists anyway.
Unless of course your alternative plan is full isolation for years, in which case not taking the vaccine is the correct choice, but such isolation is only reasonable if you don't care about going outside anyway at all.
It isn't so binary or black and white -- vaccinate or risk dying. We're starting to get other options.
I do see a lot of people fixating on vaccines as if it will make everything better. Vaccines will help, but better if there are other treatments as well. I think that if mortality rates and long-term scarring decreases, then people won’t feel like their survival depends upon other people’s cooperation.
It really is vaccinate or risk dying. The other options are too expensive, too timing-dependent or too ineffective.
https://www.sciencedirect.com/science/article/pii/S096007602...
According to this study, vitamin-d gives better outcome than the other treatments, including hospitalization:
"Regarding care dedicated to COVID-19, only the proportion of patients who received a bolus of vitamin D3 during or just before COVID-19 differed between deceased participants and survivors, with a higher prevalence in survivors (respectively 92.2 % versus 66.7 %, P = 0.023). In contrast, there was no between-group difference in the proportion of patients treated with corticosteroids, hydroxychloroquine or dedicated antibiotics, or hospitalized for COVID-19."
And this has to do with Vitamin-D's role with the ACE2 receptor. SARS-CoV-2 has a binding affinity to ACE2, aggressively invading cells with proportionally higher ACE2 receptors (including the lungs).
In fact, someone had tried injecting hrsACE2 into someone as a treatment -- that is, letting the virus bind to hrsACE2 instead of the ACE2 receptors in the cells.
https://www.nature.com/articles/s41392-020-00374-6
A treatment with hrsACE2 isn't generally-available, and needs a lot more study. The logsitics in producing them at scale would need to be solved, if this is a viable treatment. But this looks promising to me.
https://www.healthline.com/nutrition/vitamin-d-side-effects#...