Pushed reply too soon. Children are at low risk, but not no risk. To the extent that kids are running around with infections, they’re transmitting virus to others and providing a reservoir for mutation. That is not productive.

Let’s get the kids vaccinated. It’s the cheapest way out of this thing.

I don’t buy the “unvaccinated as a reservoir for mutation” line of thinking. For one, there are many, many countries with a low vaccination rate and it’s going to be like that for a long time.

Also, I haven’t see data on what the R0 is from vaccinated person to vaccinated person with Delta. If it’s above 1 then all we’re doing is creating immense selective pressure for vaccine escape.

The latter seems likely to me. I don’t understand how anyone thinks the blame for mutations lies solely or even mostly with the unvaccinated. Vaccines, distributed in a pandemic, are likely to cause immense selective pressure, and that is one of the reasons that the WHO originally planned on non-vaccine herd immunity when they wrote their respiratory pandemic game-plan prior to 2020.

I’m fully vaccinated, not anti-vax, and not an expert. This is just my understanding based on what I’ve read.

Has there ever been a vaccination program that was so successful, so fast, that we reached nearly 100% vaccination in less than what, a year or so? Why wouldn't every other virus simply mutate in these "reservoirs" and make vaccines a failed idea?

Not all viruses are created equal; some are much more prone to mutation than others. And indeed, vaccines for highly mutation-prone ones do "fail" in some sense -- that's why we need flu shots every year but one or two doses of the chickenpox vaccine are preventative for a lifetime: the flu is an RNA virus and also has a mechanism for swapping genes between different strains infecting an individual organism (including animals), so it changes a lot, and vaccines only last until the in-the-wild flu changes out from under them, whereas chickenpox/varicella is a DNA virus that's much more genetically stable.

> Not all viruses are created equal

Emphasis on created

* Flu, which has a particularly high mutation rate, does exactly that: in some years the flu vaccine is only 10% effective.

* Most viruses are less infectious than covid, especially delta covid.

* The covid vaccines are novel, targeting a specific protein. Natural immunity targets more than one protein, I've heard up to 28 in case of covid. This should make vaccine escape much harder, as it is significantly more difficult to mutate around 28 proteins at the same time. By 'natural immunity' I mean immunity gained by exposure to the natural pathogen, either through live infection or an inactivated pathogen vaccine.

> To the extent that kids are running around with infections, they’re transmitting virus to others and providing a reservoir for mutation

Can make the same argument for the vaccinated people. Vaccines don’t prevent infection, they reduce symptoms. So by same logic they run around with the infection spreading it to everyone.

Vaccines don't 100% prevent infections, but there's strong evidence that they both significantly reduce the rate at which people become infected and, should they become infected, the rate at which they can retransmit the virus to others, and we have no reason to believe they wouldn't do the same in children. It's not an all-or-nothing affair.

> It’s the cheapest way out of this thing.

I think we should be wary of those "easy way outs", because nothing seems to indicate that vaccines are a panacea. They are of course the best that us adults can do right now to protect ourselves, but if restrictions get too relaxed simultaneously, then we ve just created pressure on the virus to create a variant that will escape completely. This is a marathon and we are not yet done. a combination of vaccines with distancing will be required for a long time. Humans are adaptible, the earlier we start the better.

(Also, we shouldn't argue in absolutes, it s not going to fix anything)

Some children are at greater risk from the vaccine than covid so it seems reckless to just push vaccines. You will quite possibility kill more kids by pushing the vaccine on them.

https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...

> If the R Naught is more than 1 then you don't get any benefit to vaccinating a population that isn't vulnerable.

Is that actually true, though? I'm vaccinated - am I not better off having that vaccine, being less likely to be hospitalized or die even if I get a breakthrough case?

Even if natural immunity via infection is better in every way (no idea if this is true, but suppose it is for the sake of this question), am I not better off having that occur while vaccinated and therefore less likely to die?

It seems as though natural immunity is great if it doesn't kill you. And even if the death rate is low, 1% of a large number is still a lot of dead people. We could reduce that number and just deal with the less severe breakthrough cases.

Your vaccine immunity will only last a few months. If you are in a vulnerable group, by all means vaccinate.

>Your vaccine immunity will only last a few months.

Source?

Israel mandating third shot.

> If the R Naught is more than 1 then you don't get any benefit to vaccinating a population that isn't vulnerable.

That's not how R values work at all. Firstly, an R value of 1.5 and an R value of 5 have wildly different outcomes in terms of controlling spread, and vaccines that can reduce R values can reduce spread even if the R value remains above 1. More to the point, though, "transmission is happening in vaccinated people" doesn't imply that the R value is above 1, and it doesn't look like you've provided any evidence that that's the case, nor does the fact that infections sometimes occur, in and of itself, suggest it.

Look at Gibraltar's daily spike well after they acheived 99% full vaccination status on June 1. https://www.worldometers.info/coronavirus/country/gibraltar/...

Only lockdowns brought it back down which creates other problems around immune health in the population. (see NZ for example, RSV is clogging up the hospitals now with young kids who had degraded their immune systems the last year or so with all the hardcore lockdowns there)

That suggests that lockdowns and vaccination together work better than vaccination alone, which is not particularly surprising. It seems, though, like you're suggesting that that means the vaccinations did nothing, which doesn't follow. It might well be that the case counts would have been twice as high if nobody had been vaccinated (or, who knows, ten times), and maybe some percentage of those additionally infected people would have died, or suffered long-term health outcomes. There's no way to know what the appropriate counterfactual is from this data alone.

Gibraltar isn't an island in the middle of the ocean. It's a tiny peninsula attached to the Spanish city of La Linea de la Concepcion. Many Gibraltarians interact with Spaniards on a daily basis. And indeed, the spike in Gibraltar cases coincides exactly with a much larger spike in cases in Spain:

https://www.worldometers.info/coronavirus/country/spain

Fair point but the fact remains that transmission is occurring between vaccinated persons. Nobody is disputing this. Israel is one of the higher vaccinated populations and they're at R1.1 as of today.

>I have listened to scared people trying to blame people that are not vaccinated for the fact that vaccines are not that effective at preventing infection and that mild breakthrough infections are common.

Completely ridiculous.

https://kingcounty.gov/depts/health/covid-19/data/vaccinatio...

They're not perfect, but arguing they're not that effective is just stupid.

A. I reject on principle the reasoning that X must undergo unnecessary medical procedure to lower hypothetical odds of Y being afflicted by some negative outcome. STOP SCAPEGOATING.

B. Consider that the 'cases ratio' is tainted because of faulty CDC guidance. If you test more aggressively conditioned on vaccination status, you are going to get biased ratios. At this point anything but sampling studies is pretty much worthless in assessing how prevalent breakthrough infections are. We've got to thank CDC for that.

> Five days earlier, I had gone to a house party in Montgomery County. There were 15 adults there, all of us fully vaccinated. The next day, our host started to feel sick. The day after that, she tested positive for COVID-19. [...] At this point, 11 of the 15 have tested positive for COVID."

If the vaccines reduce breakthrough infections at 1 : 7 rate, an outbreak incident where 11 : 15 get infected has a probability of about 1 : 1,000,000,000. Rather unlikely, perhaps something else is at play:

> The official Centers for Disease Control and Prevention guideline stated that, since I was fully vaccinated, I didn’t need to do anything different unless I started developing symptoms. I’m an epidemiologist at a major medical research university, which has a dedicated COVID exposure hotline for staff. I called it, and workers said I didn’t need to do anything.

> The CDC announced in May that it was only going to collect data on breakthrough infections that led to hospitalization or death, which are fortunately rare. But that means that outbreaks like ours will fly under the radar.

https://www.baltimoresun.com/opinion/op-ed/bs-ed-op-0804-bre...

Edit: Especially if the ratios do not match ratios calculated in other countries where delta case reduction is around 1 : 2.

https://assets.publishing.service.gov.uk/government/uploads/...

> I reject on principle the reasoning that X must undergo unnecessary medical procedure to lower hypothetical odds of Y being afflicted by some negative outcome.

It sounds like you reject the entire concept of public health. That is going to be a bit of a problem when you are engaging in a debate about public health policy.

Indeed, I do reject scapegoat-driven 'public health'.

The burden of proof is on the health authorities to quantify win/win scenarios. Not fly by the seat of their pants, sometimes based on faulty/incomplete data and guesswork. 'First, do no harm'. If you are unsure, then don't do it.

You want to make an R-based argument? What is the contribution of children in the past 4 weeks? Do you have evidence that children shed more covid compared with vaccinated adults? Do you have evidence that R is a constant, will your calculations hold 6 months from now? Are you accounting for the selection effect of leaky vaccines on virus evolutionary trajectory? What is the cumulative 20 year ADE risk?

For worst case scenario, do you have a 20 year study of leaky mRNA vaccines against infectious disease in some animal population? No, we're experimenting on humans in a world's first. There have been vaccine disasters. Fortunately not in humans. Warning: NSFL https://www.pbs.org/newshour/science/tthis-chicken-vaccine-m...

> 'First, do no harm'. If you are unsure, then don't do it.

Inaction is not an escape from responsibility or prevent consequences. Doing nothing is sometimes the worst choice.