The only way that we would not be dealing with COVID today is if it was taken seriously early on. China seriously dropped the ball. I don’t believe that the resulting quarantines and lockdowns in other nations (which were for the most part necessary to reduce death tolls pre-vaccine) could have gone any better than they did, as people simply do not care.
> Vaccine efficacy is against severe COVID illness, not against transmission
That is not and never has been - up until literally a few months ago - the definition of vaccine efficacy, nor was it the definition being used for COVID vaccines up until it turned out they can't prevent disease.
Trying to assert what vaccine efficacy is without acknowledging that this is an entirely novel use of the term is going to come across as an attempt to confuse people/make them forget that it was only recently that high efficacy was being proudly announced in terms of "preventing COVID-19".
Also bear in mind that this new definition has no real metrics or science behind it. What exactly is "severe" illness. Don't say hospitalizations because people have to choose to go to hospital and are being told that taking the vaccine means they won't have to go to hospital. That's a massive, massive confounder, and none of the public health agencies suddenly making claims about "severe" disease even recognize it exists, let alone control for it.
I remember something else. At least where I live, since the very beginning of the vaccination programme, people were advised to not wait for Pfizer and Moderna vacinnes that were in short supply, but use already widely available AstraZeneca and Johnson & Johnson vaccines because even though their efficacy against transmission was significantly lower, they still provided very good protection against severe illness; and that protection was always being explicitly stressed out as the most important.
"All of the COVID-19 vaccines approved for use in Canada are effective at preventing symptomatic SARS-CoV infection and COVID-19 related hospitalizations and death."
Because the phrase vaccine efficacy just means how good is a vaccine at something it can be defined relative to any endpoint you want. Nonetheless, both the way the term "vaccine" has been used historically and the way "vaccine efficacy" was being used as recently as this spring were in terms of, it will prevent you from getting infected and sick.
The original claim was that "vaccine efficacy is NOT against transmission" and that this is merely updated information, not an attempt to rewrite history. But it certainly looks that way to a lot of us because to truly accept that the previously distributed information was wrong would imply a major screwup and thus some sort of investigation and accountability. At minimum it means trial failure, for one thing. The pharma companies claimed the trials showed they could prevent COVID-19. They were wrong. That implies other claims made by the trials could be wrong, which implies the government should suspend the rollout until the true facts about what the vaccines actually do can be established.
Obviously no such logic is appearing anywhere in public health. Instead the message has simply shifted to be, vaccines prevent "severe illness and death" and that's why they're awesome and always were. The Pfizer trial at least, didn't actually show that however.
"A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups." https://www.nejm.org/doi/full/10.1056/nejmoa2034577
Maybe this is legalese, but I am pretty sure your average Joe online, that reads all kind of weird things on Facebook or other places, won't understand the subtleties of this language.
Here is another quote from the same paper [1]: "This report includes 2 months of follow-up after the second dose of vaccine for half the trial participants and up to 14 weeks’ maximum follow-up for a smaller subset. Therefore, both the occurrence of adverse events more than 2 to 3.5 months after the second dose and more comprehensive information on the duration of protection remain to be determined."
Person A >Transmission> Person B >Transmission> Person C
Person A >Transmission> Person B (Prevention)
So the research you are referring to is in regards to other variants of sars-cov2
"A COVID-19 Vaccine May Be Only 50% Effective. Is That Good Enough?"
https://www.npr.org/sections/health-shots/2020/09/12/9119879...
August 7, 2020:
"Fauci says COVID-19 vaccine may only be 50 percent effective"
https://nypost.com/2020/08/07/fauci-says-covid-19-vaccine-ma...
https://dictionary.cambridge.org/dictionary/english/prevent?...
If I am reading correctly (but do correct me if I am wrong because I am not 100% certain), only symptomatic cases are counted. Hence, it is quite possible for the vaccine to stop the symptoms, but not the transmission between individuals.
[1] https://www.nejm.org/doi/suppl/10.1056/NEJMoa2034577/suppl_f...
Unfortunately it's a major source of public distrust in science since when someone changes their mind it's perceived as weakness or deception. A dogmatic idiot who never learns anything looks like a stronger person of greater integrity.
The fact that we got any form of vaccine at all in one year is absolutely incredible. That it doesn't work quite as well as we originally thought isn't surprising given that it wasn't out long enough to observe long term efficacy in the wild. Original numbers were based on limited clinical tests and models.
When you have people screaming at the top of their lungs: The Science is Settled!!111 They are Science Deniers!!! Science does not care about your opinion!!! Etc.
And then scientific learning happens, all those people who were screaming look like dogmatic idiots to those who they were screaming at. It doesn't matter they the ones screaming adopted the new position. I will pull out the old and tired mask issue; when this first started, the people on the "side of science" were screaming that the masks did not help and they trotted out all sorts of scientific studies to back this up, from virus size vs mask to saying ti would be harmful due to keeping more virus at your face. Those who thought masks were important all looked around and said "If masks are such a bad idea, then why are the doctors all wearing them". Now we know it was a stupid and harmful lie.
It is incredible what we accomplished in a year but it is also very frustrating to see how stupidly political and how unnecessarily opaque everyone is being. From the mask lie to the vaccination tempo(we pushed for a shorter amount of time between both shots because we were worried about followup, now we need a third shot?). No-one is willing to sit down and frankly state what we know and what we doesn't know. Our media isn't willing to accept it either. Trust is a two way street but We are all so afraid that uncertainty will breed fear that we take strong positions and end up killing trust.
I think calling people "dogmatic idiots" is exactly what actually drives people away from these discussions.
> It was never designed to stop transmission.
I can't find any source confirming or denying that claim, but I can say it's absolutely not the impression I got from governments and the media. Does anyone have a source saying these vaccines were designed as non-sterilizing?
science and history are two distinct things
it's ok to rewrite science
it's not ok to rewrite history
Exactly! Those initial numbers were based on limited clinical trials because time was not on our side. We needed to get something out fast, so we didn't go through all trial options.
With which variant alpha or delta? and how much time after the vaccination?
it's ok to rewrite science
it's not ok to rewrite history
Since children have very little chance of a severe COVID infection, why the push to vaccinate them then?
Nuance: Not mentioning that their own full application estimates saving one in a million children, under the best circumstances. See Table 14 on page 34.
The difficult ethical question: on one hand there is 1 child you may save given the information available today. On the other hand you don't know which one ahead of time, you need to inoculate 1 million children with a vaccine for which you don't have any longterm data on.
BioNTech/Pfizer [1]: "This report includes 2 months of follow-up after the second dose of vaccine for half the trial participants and up to 14 weeks’ maximum follow-up for a smaller subset. Therefore, both the occurrence of adverse events more than 2 to 3.5 months after the second dose and more comprehensive information on the duration of protection remain to be determined."
Moderna [2]: "Another limitation is the lack of an identified correlate of protection, a critical tool for future bridging studies. As of the data cutoff, 11 cases of Covid-19 had occurred in the mRNA-1273 group, a finding that limits our ability to detect a correlate of protection. As cases accrue and immunity wanes, it may become possible to determine such a correlate."
AstraZeneca [3]: "In this interim analysis, we have not been able to assess duration of protection, since the first trials were initiated in April, 2020, such that all disease episodes have accrued within 6 months of the first dose being administered. Further evidence will be required to determine duration of protection and the need for additional booster doses of vaccine."
Johnson & Johnson [4]: "A limitation of the trial is the relatively short follow-up, which was necessitated, as in other Covid-19 vaccine trials, by the urgent need for vaccine. The data do not suggest a waning of protection."
[1] https://www.nejm.org/doi/full/10.1056/nejmoa2034577 [2] https://www.nejm.org/doi/full/10.1056/nejmoa2035389 [3] https://www.thelancet.com/journals/lancet/article/PIIS0140-6... [4] https://www.nejm.org/doi/full/10.1056/NEJMoa2101544
There is also the official reaction. Aug 18, 2021: "CDC Director Says Coronavirus Vaccines Less Effective For Delta But Still Prevent Severe Infection".
Possible all of these studies are flawed. And perhaps I'm accidentally misquoting Rachel Walensky. Given that the original trials were closed by vaccinating the control arm of the studies, not even sure where to look for credible longterm tracking of VE against infection data.
On the other hand, possibly the manufacturer original studies were flawed. Or the virus evolved, Delta, duh. These conversations are difficult to carry partly because we are supposed to take the original studies, created with (acceptable) conflict of interest as gold standard, and summarily dismiss any independent verification thereof.
https://www.medrxiv.org/content/10.1101/2021.10.13.21264966v...
https://www.nejm.org/doi/full/10.1056/NEJMoa2114114
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410
https://www.forbes.com/sites/andrewsolender/2021/08/18/cdc-d...
UK, VE vs delta over 90 days
days VEaPCRI VEaSI
after
2nd
dose
14 85% 93%
30 83% 92%
60 80% 86%
90 75% 78%
The trend makes me fairly intrigued to see the follow up at 180, 270 etc. days after 2nd dose.Now the picture seems to be that vaccine effectiveness does indeed drop over time, but protection against severe disease remains pretty strong, with the possible exception of old people who tend to have a weak immune response. Most governments have reacted by recommending third shots to this group in order to further improve the protection.
I really can't see any controversy here. This is precisely the procedure one expects when a new vaccine is introduced.
It is also worth pointing out, that even without boosters the vaccines vastly outperform any medication tested against COVID so far. And they do that much cheaper and with lower side effects.
Myocarditis is very serious. Any child with it will need cardiology visits for most of their life.
[1] https://www.newscientist.com/article/mg25133462-800-myocardi...
And how stupid is it that these articles talk about studies but still don't actually link to them?
Well, the middle-man doesn't want you going to the source. What's his job gonna be if you do?
But we've already established that the vaccine doesn't prevent transmission. It may slightly attenuate transmission, but nowhere near enough to stop the spread. Given these facts, the vaccine is mainly so the vulnerable populations can protect themselves, but most children aren't among those populations (obviously immunocompromised children are).
It wasn't my point, but others in this thread have also noted with sources that the level of impact on that younger population (and even small children), including long covid, also appears to be generally underestimated by the general population.
Children exposed to COVID develop strong immunity even if they have no symptoms [1], so the vaccine likely wouldn't convey any more protection than they've already developed.
[1] https://pediatrics.duke.edu/news/children-mild-or-asymptomat...
>Given similarities in the response to natural infection in children and adults, it is likely that vaccination against SARS-CoV-2 will also elicit a similar degree of protection across the full spectrum of age, as has recently been reported for the Pfizer-BioNTech vaccine in children 12–15 years of age (42). Though we cannot directly compare our results to the neutralizing antibody titers reported in vaccine trial studies, both the vaccine trial data and our results suggest that younger age may be associated with greater neutralizing antibody responses.
I'm not a doctor, but doesn't this actually suggest that the younger the age we can administer COVID-19 vaccines, the stronger the antibody response is likely to be?
We'll only figure out the truth long after it matters, so the question being debated is the risk of complications from the vaccine compared to the risk of complications from COVID. Given younger populations have very, very low risk from COVID, this is a subtle and complicated question to answer.
Shouldn't we apply the precautionary principle to that question then ? From my primitive understanding of medical ethics there is duty of care versus do no harm.
As such, considering the slim percentages at play, there is IMHO no duty to administer preventive treatments children which are not infected, while harm may be caused.
"San Francisco says children 5 to 11 will have to comply with proof-of-vaccination mandate"
https://www.sfgate.com/bay-area-politics/article/San-Francis...
If the virus alters the spike protein (eg, the A.30 variant which is pretty much immune to the vaccine), all those other antibodies against the unchanged parts are likely still effective at slowing the virus while new antibodies are developed.
https://www.contagionlive.com/view/delta-variant-icauses-unp...
To further confound the issue, mortality rates in infants is significantly larger than in older kids, for US something like 500/100k vs 20/100k, reflecting a number of infants with congenital issues. Some of those end up counted as "death with covid", even if they were not going to make it either way. It is better to search for epi data for kids excluding 0-1 age group, if at all available.
http://www.bccdc.ca/Health-Info-Site/Documents/Week_41_2021_...
Considering you can't sue the vaccine manufactures for anything and the vaccines are being mandated in various venues, they are definitely a "safe and effective" way to make lots of money...
[1] https://www.usnews.com/news/health-news/articles/2021-10-20/...
[2] https://www.managedhealthcareexecutive.com/view/the-price-ta...
Unfortunately, it was being sold to the public like it was.
>Herd immunity against COVID-19 should be achieved by protecting people through vaccination, not by exposing them to the pathogen that causes the disease. Read the Director-General’s 12 October media briefing speech for more detail.
>Vaccines train our immune systems to create proteins that fight disease, known as ‘antibodies’, just as would happen when we are exposed to a disease but – crucially – vaccines work without making us sick. Vaccinated people are protected from getting the disease in question and passing on the pathogen, breaking any chains of transmission. Visit our webpage on COVID-19 and vaccines for more detail.
>To safely achieve herd immunity against COVID-19, a substantial proportion of a population would need to be vaccinated, lowering the overall amount of virus able to spread in the whole population. One of the aims with working towards herd immunity is to keep vulnerable groups who cannot get vaccinated (e.g. due to health conditions like allergic reactions to the vaccine) safe and protected from the disease. Read our Q&A on vaccines and immunization for more information.
https://www.who.int/news-room/q-a-detail/herd-immunity-lockd...
To nit-pick, it is not the vaccine effect take 5 days to kick in but that the vaccine trained immune response takes 5 days to kick in.
I would be interested in seeing how long it takes for natural trained immune response for someone who had Covid previously.
Maybe the best strategy for herd immunity would be to get double vaccinated to prevent serious effects then contract Covid to gain superior antibody response.
From reading about Covid, I thought the virus had a couple of genes that make it more deadly, one of which tends to suppress the immune system for example. Why not create another variant that is a full virus without those genes and use that as a live vaccine? Sure it might escape, but so what it's less lethal than the one out there right? Obviously this raises a bunch of ethical issues, but they are similar to the issues around forced vaccination.
https://en.wikipedia.org/wiki/Attenuated_vaccine
My guess is that such a vaccine would take longer to develop, but I'm not sure about that.
Wiki also lists the following drawbacks:
In rare cases, particularly when there is inadequate vaccination of the population, natural mutations during viral replication, or interference by related viruses, can cause an attenuated virus to revert to its wild-type form or mutate to a new strain, potentially resulting in the new virus being infectious or pathogenic.[34][39]
Often not recommended for immunocompromised patients due to the risk of potentially severe complications.[34][40][41]
Live strains typically require advanced maintenance, such as refrigeration and fresh media, making transport to remote areas difficult and costly.[34][42]
Nobody really knew in precise terms what the vaccines were going to do because there was initially no long-term data about their efficacy or studies about transmission.
But it's simply a fact that the vaccines were sold to the public as The Way to end the pandemic and return to normalcy. Did you completely miss all of the talk about "herd immunity"? Are you not aware of all of the places, like California, that ended their mask mandates and told vaccinated individuals they could gather indoors together?
If the vaccines were never intended or thought to significantly reduce if not stop transmission, why was "herd immunity" ever in our pandemic vocabulary? Why did the mask requirements get lifted? Why were vaccinated individuals told they could basically resume normal activities in the company of other vaccinated individuals? And why are some places pushing so hard on vaccine passports?
It's okay that the vaccines haven't proven to be as effective as we had hoped in ending the pandemic. But there is a real issue with the way the vaccines were sold to the public. The messaging that was used to encourage people to get vaccinated was way ahead of what we knew in terms of the science and unfortunately, this is likely going to cause long-term issues. Specifically, I think it's going to be harder and harder to get people to take boosters. I'm predicting that each successive round of boosters will see fewer and fewer takers.
But this is very much my point: we were sold a benefit-risk ratio that assumed the vaccines effectively curb transmission.
Moreover, now that Delta is a thing, aren't the ethical issues nonetheless present.
> A recent study found that vaccinated people infected with the delta variant are 63 per cent less likely to infect people who are unvaccinated. [1]
> This is only slightly lower than with the alpha variant, says Brechje de Gier at the National Institute for Public Health and the Environment in the Netherlands, who led the study. Her team had previously found that vaccinated people infected with alpha were 73 per cent less likely to infect unvaccinated people. [2]
> What is important to realise, de Gier says, is that the full effect of vaccines on reducing transmission is even higher than 63 per cent, because most vaccinated people don’t become infected in the first place.
[0] https://www.newscientist.com/article/2294250-how-much-less-l...
[1] https://www.medrxiv.org/content/10.1101/2021.10.14.21264959v...
[2] https://www.newscientist.com/definition/uk-covid-19-variant-...
"Here we regain our freedom"
"There will not be a 4th wave"
That's what we were sold. Anyone who questioned it was called an antivax conspiracy theorist.
And the worst part is, the namecallers still think they're on the right/smart side even after miles of backpedaling.
It's like saying that flossing and tooth brushing were a lie because you had cavities after only doing either half of the month.
In late August it was announced that 80% of the Singapore population was now vaccinated against COVID-19.[1] However, in September and October there has been a dramatic surge in cases and deaths in that country.[2]
[1] https://www.reuters.com/world/asia-pacific/singapore-fully-v...
[2] https://www.worldometers.info/coronavirus/country/singapore/
https://ourworldindata.org/explorers/coronavirus-data-explor...
https://ourworldindata.org/explorers/coronavirus-data-explor...
I get it, if beds are in use by severely ill Covid patients that means less beds for others... then let the bed owners decide how they wish to allocate bed usage, just like some doctors are refusing to see non vaccinated patients.
> politicians from one side of the aisle sticking their fingers in their ears, closing their eyes, and shouting "Nah nah nah I can't hear you!"
Politicians on the other side of the aisle are attempting to ban any COVID prevention measures at all. I agree that vaccine mandates aren't the only tool available to us, but it's hard to argue with the mandates when there are people fighting against mandatory testing, mask wearing, and social distancing.
This is the cult of safetyism. A total inability to process risk/reward and tradeoffs, and eschewing basic logic for "protection" whether real or imagined no matter the cost. All I sincerely ask to people such as yourself is, "What is your long-term plan? Is this forever for you?" Usually, I watch as their brains simply break down on the side of the highway. They have no answer because their logic is so bad they get stuck in an eddy with no way to get out. Welcome to the Church of COVID.
And no, conservatives aren't banning prevention measures. Everyone alive is free to get vaccinated (and wear a mask) as most have even in places like Florida. They're banning punitive rules, and whether it's Florida or Texas or all of Scandinavia, they've demonstrated that there are no worse outcomes from simply allowing people to make their own health choices without figuratively putting a gun to their heads (mandates) or making them do anything they don't want to (masks). Meanwhile, half the world upon seeing this: "Nah nah nah I can't hear you!"
Really?
https://abc7chicago.com/chicago-police-fop-john-catanzara-ma...
But then again, that's always been what I thought the policies should be since there was never any strong claims to vaccines preventing transmission.
I don't think you're in a position to lecture people about inability to process basic facts if your partisan screed depends on ignoring this to insist that "they don't reduce spread" is an established fact about vaccines. How is one supposed to debate with someone who insists the sun rises in the west, indeed?
This is a non-sterilizing vaccine. It was never designed to stop transmission. It did surprisingly block transmission pretty well before the Delta variant. The theory presented here is that the vaccine effect takes time and kicks in on around day 5. With Delta the virus has already become highly transmissive by then. Pre-delta that probably was not the case.