Even non sterilizing could be argued, it effects other people if you cannot find an ICU after your car accident because they are full with unvaccinated (and some vaccinated) covid patients.

The problem with this argument is that you can use it to also ban tobacco, and alcohol, and sugar, and red meat, and then you can move to things like sports, and start banning bungee jumping and rock climbing,…

There’s no obvious way to draw a line, but you definitely need one.

> There’s no obvious way to draw a line, but you definitely need one.

That's why you look at the magnitude of the effect, not just the direction of the effect. Not all slopes are slippery. Our legal system does not collapse as soon as it is tasked with determining which harm is more important to prevent.

> Our legal system does not collapse as soon as it is tasked with determining which harm is more important to prevent.

No, it just sucks at drawing lines and harms thousands if not millions of innocent bystanders.

> is that you can use it to also ban tobacco, and alcohol, and sugar, and red meat, and then you can move to things like sports

To be honest, IMHO both smoking tobacco and sports that cause a lot of concussions (eg. Rugby, American Football) are not going to last in the long term, or become marginal not mainstream activities.

This might involve legislative pressures on them, as well as a decline in social acceptance. In the case of Tobacco, we see this drop well advanced already. This is no bad thing, considering the outcomes from these activities.

If eating red meat was causing the ICUs to fill up, then I think the public health concerns should take precedence. And then we should be talking about a nationwide ban of the practice.

Likewise with smoking.

But neither of those activities has that level of impact on public health. So, the measures to be taken to curtail that kind of activity likewise should not be as strong.

But COVID is that bad. So, yes — vaccinations should be mandatory. Masking in public should be mandatory. At least, until the pandemic is over and we have sterilizing vaccines as well as medications that are proven to help cure the disease. And yes, this period could last years.

And if you don’t want to be vaccinated and you don’t want to wear a mask in public, then you don’t have to go out into public. You can stay home. And if you want to violate that rule too, then we should be able to lock you up in a COVID hotspot jail.

Smoking _does_ cause hospital wards to fill up. But it happens on average a few decades later. So, the measures taken to curtail it have also come in over decades. But in the end, they will be strong.

I'm in agreement with you on COVID and the necessary public health measures during an active pandemic.

It can, but it's a lousy argument. If my body doesn't affect your body, it should be my choice. Freedom is an American value. It's not a world value, and I wouldn't impose it on other countries, but it is an American one.

I'm 100% for vaccine mandates iff vaccines significantly reduce R0.

I'm 100% against them if they do not. Once my vaccination stops affecting the public health, it's my choice.

Banning unsafe things IS a mistake. Yes, I ought to be able to sword fight on a tightrope with sharp swords and no protection over a pit of alligators, if I decide that's what I want to do.

If that's the concern, then triage the unvaccinated COVID19 patients last. But in the long term, capacity expands to meet demand, and it's perfectly okay to change insurance premiums for anti-vaxers, smokers, or otherwise (or sword fighting over a pit of crocodiles, for that matter).

> If that's the concern, then triage the unvaccinated COVID19 patients last.

This is an ethics violation.

I don't really get your argument on risk. Non-vaccinated people with natural acquired immunity each got their special card rights by having caused a definite risk to everyone because they computed potential mutations perpetuating the pandemic and most likely perpetuated them. We have too high a population compared to 1918 to even have a that rough equivalent of what happens with a new virus in a pool of any more than 2 billion who aren't vaccinated.

All I hear when I hear anti-vax arguments is a freeloader who refers to natural things that are completely unrelated to the life science is letting them live. If you don't like artificial vaccination, you need to propose how you want to lower the population to pre-science era levels.

What if there was a medical treatment prbabisticly reduced aggression, violence, or other antisocial behavior?

Well today if you were to punch me you'd likely be on trial for assault, and if you killed me, murder. Antisocial behaviors generally aren't legally punishable until they're taken out on someone else.

In this case, if you choose not to get the vaccine and then through contact tracing or some other mechanism an outbreak is traced to you when you could have gotten a vaccine? Assault sounds correct to me and if you killed someone through inaction, then something equivalent to negligent homicide sounds correct to me. You're not necessarily malicious but I'd say fairly negligent.

Not that that's what is currently the case, but it seems fair to me and in that world, rolling the dice on criminal charges instead of just getting a vaccine that 169million people in US alone currently have taken with no issue seems like a dumb dice roll to me, but most people have steadily proven to me over the last few years that they're not great at risk calculation over and under.

I am vaccinated and pro-vaccine, but it is not “zero issues”. There are side effects with the vaccines, and some of them are significant (partial paralysis).

The numbers still work that we should get vaccinated, but it’s unclear if people who have the worst side effects from the vaccine would be the same ones who would have suffered the worst effects of COVID (death).

So I get it - if you’re young, healthy, and unlikely to die from COVID, it is a non-zero (very, very small) risk from talking the vaccine. But I still think people should get the shot.

I'm not aware of any actual data on this, but it seems to me that those who choose not to be vaccinated are probably also very unlikely to be tested on any regular basis (if at all), and also (at least in the UK, where I am) not engage in any kind of voluntary contact tracing.

There seems to me to be a gap between what people think is happening, and what is actually happening. How exactly are people who haven't tested positive for Covid (either through a negative result, or simply avoiding testing altogether) going to be identified as the source of an outbreak if they're also not engaging in contact tracing in the first place?

As it stands, it seems to me like the most likely people to be contact traced are those who are also testing regularly, and are also the most likely to be vaccinated. I would be surprised if non-vaccinated people are anything but rarely identified as the source of an outbreak, precisely because they're also much less likely to ever get tested (unless seriously ill) or engage in contact tracing.

If you look at "reducing environmental levels of the metal lead" instead of a "medical treatment" then yes it does exactly that (and other harms). This is the reason for banning of lead in Gasoline, paint, pipes etc etc.

Yes, but this gets away from the bodily autonomy topic which the thread was exploring.

People want bodily autonomy.

People want to be free of the 2nd order harms of the medical decisions others make.

> Compulsory mass vaccination does not come without significant risks to public health.

It's bold of you to keep raising this "anti-vaccination" point verbatim, after it keeps getting flagged, and the responses do not agree with you at all. What is your agenda here?

One response:

> a shameful misinformation tactic and you should stop doing it immediately

So, why did you not stop?

https://news.ycombinator.com/item?id=28251661

https://news.ycombinator.com/item?id=28252125

> It's bold of you to keep raising this "anti-vaccination" point

By reducing my statements to simply "anti-vaccination" you're missing the entire nuance of the argument.

I've cited substantial scientific literature which supports the fact that leaky vaccines combined with COMPULSORY mass vaccination can have unexpected and dangerous consequences in terms of viral evolution.

Vaccines are a powerful tool and help save lives, and we should definitely use them. But if used indiscriminately, they can backfire in complex ways. This is extremely pertinent to OP and the discussion on this thread.

It's not charitable or informed of you to reduce my comment to "anti-vaccination" rhetoric. To suggest that I have an "agenda" or that I'm spreading "misinformation" - especially without any supporting references - means your comment is purely ad hominem.

Like you, many others here immediately react negatively to comments that promote anti-vax misinformation. I understand, empathize with, and support that. But after lengthy debate, the person who made the comment you quoted eventually admitted that they over-reacted, and that my argument was more nuanced than they initially realized.

I have not stopped sharing the literature supporting these ideas because many people are completely unaware of the possibility and consequences of vaccine induced immune escape. My comments are in the spirit of fostering sincere and informed debate - nothing more, and nothing less.

Spirited and informed debate:

Virtually everything I see suggests that the effect is bimodal:

1. Everyone gets vaccinated at the same time, and the disease goes away. Not a lot of disease means not a lot of mutations.

2. No one gets vaccinated, and there is no such effect.

If immune escape is an issue, it seems like the solution would be 100% MANDATORY vaccinations, and to perform vaccinations all at once, region by region, so there are no populations which mix vaccinated and unvaccinated individuals.

I can't see how making vaccinations non-compulsory will do anything good. Where I live, 2/3 are vaccinated, and 1/3 are not. Virus is spiking, and there are a lot of opportunities for escape from the unvaccinated to the vaccinated. After a few months of similar effect, vaccine effectiveness fell from 95% to around 50%.

I think you gave a very strong argument FOR compulsory vaccination.

> Everyone gets vaccinated at the same time [...] region by region, so there are no populations which mix vaccinated and unvaccinated individuals

This is logistically impossible and completely unrealistic. If you can find any literature or any experts suggesting that this is feasible, please share.

> and the disease goes away

Even if we did manage do achieve what you suggested, the current vaccines do not guarantee sterilizing immunity. This means that even vaccinated individuals can be infected and transmit the virus, which still gives plenty of opportunity for the virus to mutate and eventually evolve to escape the immune response in the theoretical 100% vaccinated population.

> I can't see how making vaccinations non-compulsory will do anything good

There are many viral elimination strategies that complement vaccination - for example multi-drug treatment using widely available and existing medicines [1][2][3][4][5]. The key is that using a diverse set of strategies helps reduce the possibility and risk of vaccine resistance.

> I think you gave a very strong argument FOR compulsory vaccination.

I appreciate the spirited discussion but your comment does not seem particularly well informed - it completely disregards the concerns and arguments put forth by experts in the field, which I've outlined in my previous comments.

[1] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...

[2] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a...

[3] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S03069...

[4] Multidrug treatment for COVID-19 https://www.jstage.jst.go.jp/article/ddt/advpub/0/advpub_202...

[5] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/

> This is logistically impossible and completely unrealistic. If you can find any literature or any experts suggesting that this is feasible, please share.

This doesn't need to be 100%. Large swaths of the world rely on help for vaccines. Instead of distributing aid evenly by country, it could go country-by-country. "At the same time" also doesn't mean everyone gets a shot on the same day, just not spread out over years as we're doing now.

> Even if we did manage do achieve what you suggested, the current vaccines do not guarantee sterilizing immunity.

They're about 50% effective for delta 6 months after vaccination, and about 95% effective for the original at vaccination. That's a big difference. We don't need sterilizing immunity; just for R0<1. Yes, the odd person will catch COVID19 from a deer, but if 7 billion people catch it, versus 1 million, that's a 7 million times difference in number of mutations.

> The key is that using a diverse set of strategies helps reduce the possibility and risk of vaccine resistance.

I agree 100%. This is the key. What amazing to me is the effectiveness of proper PPE. I don't understand why anyone uses cloth masks anymore. Proper masks are cheap, available, and help far more than vaccines or drug regiments. My opinion is that we should have vaccines, modest social distancing, N95-equivalent masks, universal HEPA filters, move what we can outside, etc. I think if we do all the cheap things consistently, we'll eliminate the need to do big, expensive things.

> I appreciate the spirited discussion but your comment does not seem particularly well informed - it completely disregards the concerns and arguments put forth by experts in the field, which I've outlined in my previous comments.

I'm not sure what you're referring to.

As a recommendation to individuals, the suggestion to seek early treatment -- indeed, to apply certain treatments immediately to oneself -- is, I believe, sound, and I second it.

But the situation as regards public health policy and messaging is more complicated. Denial is among the most human of emotional patterns; many people do not want to face the possibility that they've contracted a dread disease, and will procrastinate seeking treatment until they are quite ill. Altering that behavior on a large scale strikes me as a very heavy lift; but that is what we would have to do to pursue a public health strategy that leans heavily on early treatment. If you think it's doable anyway, why has no other country done it?

That said, the risk of vaccine escape seems to be real. Perhaps that's why the CDC is telling us to expect boosters.

Well put, and I agree that people have a tendency to procrastinate which can be detrimental to early treatment strategies.

> why has no other country done it?

Since early in the pandemic many front-line doctors have been successfully reducing hospitalization and death through early treatment with a multi-drug approach. Those are the doctors and researchers that authored the publications I cited in my previous comment, especially [1]. Those doctors had to treat patients early in the pandemic with a very little scientific literature and clinical trials to guide them, hence the world wide collaboration in putting together reasonable guidance based on existing medicine with established efficacy and safety profiles.

They continue to use these techniques - which are being further investigated for efficacy and safety in ongoing clinical trials - but with scarce media coverage compared to the vaccines.

So in many ways countries around the world have been doing it to some degree, but it hasn't been the primary strategy, as you point out. Why hasn't it been the primary strategy? Well that's a good question and tough to answer with any certainty. To speculate, I'd say that vaccines had a tremendous amount of funding and media attention poured into them, more so than any multi-drug therapy regime.

Sure, these early treatments have happened on a small scale; I've seen some of the papers. And don't get me wrong here; clearly we have to start with informal experiments and progress to small studies, to find promising treatments, before we expand their use. But there's still a world of difference between one doctor in one hospital cherry-picking the patients who happen to come in early and treating them successfully, versus basing one's entire public health strategy on early treatments. For one thing, if you do somehow convince people to come in early, you're going to have a lot more patients to treat. Not only do you have to make sure you have enough of the drugs and other supplies, but you have to have enough trained staff to administer them.

All that said, I would actually like to see someone try it. There are plenty of countries that have little expectation of receiving much vaccine supply this year anyway; they have little to lose. But it's no slam dunk; they face a daunting public education problem first, and then if they somehow solve that puzzle, they'll have to deal with the logistical difficulties.

Against all that, I think vaccines have more than just a marketing advantage. As long as they're reasonably safe and effective, they're a much more practical solution. Of course, what counts as "reasonably safe and effective" is debatable.