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[flagged] Covid-19: stigmatising the unvaccinated is not justified (thelancet.com)
106 points by DyslexicAtheist on Nov 21, 2021 | hide | past | favorite | 225 comments



Of course it isn't. In highly vaccinated countries like Ireland (89.1%) the virus is spreading and the bar for "herd immunity" has been raised to 95%.

The daily death rate is the same as last year:

https://ourworldindata.org/explorers/coronavirus-data-explor...

Gibraltar has 100% vaccination rate (for the eligible) and cases are sharply rising.

Unrelated to the issue of stigmatization, the obligatory reminder that Sweden's Covid-19 policies, while they resulted in a slightly higher cumulative death rate (1,468 per million vs 1,187 per million), are now producing excellent results, and the death rates are converging:

https://www.statista.com/statistics/1104709/coronavirus-deat...

https://ourworldindata.org/explorers/coronavirus-data-explor...


[flagged]


The downvotes are coming because you've told us that cases are skyrocketing but the deaths are the same as they were last year, when cases were not skyrocketing. This shows that the vaccine is doing its job.

  Deaths Nov 2020: 6.57   
         Nov 2021: 6.14  
  Cases  Nov 2020: 386.14 
         Nov 2021: 894.86
So over 2x the cases, and yet lower death rate. I'm not sure what Ireland is like but if it's anything like where I'm from, people are out and about more this year so more cases are expected. But a lower death rate with 2x more cases seems like an unambiguous win for the vaccine to me.

You've said cases are exploding in Gibraltar, but no one has died there since October 15 due to Covid. Since they became highly vaccinated, only 4 people have died in total in Gibraltar. Almost 100 died last winter before vaccinations were distributed. Then the vaccine became available and they all got vaccinated. Now only 4 have died despite a huge outbreak. Again, seems like a huge win for the vaccine.


The primary issue causing that we keep having to lockdown is that hospitals only have a limited number of ICU beds (not physical but trained staff to operate them). Once full, all others such as traffic accident victims can't be treated. There is no way to quickly get more certified ICU beds at least if you want them at the standards expected.

71% of people in the ICU in Zürich, Switzerland are unvaccinated [1]. This is a pandemic of the unvaccinated even if the vaccinated can spread the virus, the ICU beds are full because of the unvaccinated.

[1] https://www.zh.ch/content/dam/zhweb/bilder-dokumente/themen/...


I debunked this in a dupe thread, where someone has similar claims about Minnesota, the actual hospital occupancy rate was 10%. The total covid utilization of Zurich ICU units is 14.6%. 71% of 14.6% is 10.3%. Not great, but a far cry from alarmist statements like "traffic accident victims can't be treated", when 7.5% of Zurich ICU beds are still unused, and 20% ICU beds are free in Switzerland overall.

https://news.ycombinator.com/item?id=29290732

https://www.covid19.admin.ch/en/hosp-capacity/icu


Nothing to debunk. The 71% was clearly meant regarding cases of covid not total ICU beds. I didn't say the ICUs were already full. They are starting to fill up. We don't have a lock down at this time but if the numbers keep going up we will have no choice.

Either way it's a pandemic of the unvaccinated irregardless if the hospitals are full or not.


That’s not a great argument when we’re firing health workers left and right.

Also we had two years to expand our ICU’s. What happened?


It takes at least 2 years to train them and like you said. The job sucks, underpaid, too many hours etc. That is why the vote on the 28th for better working conditions will pass [1].

[1] https://www.srf.ch/news/abstimmungen-28-november-2021/pflege...


>Also we had two years to expand our ICU’s. What happened?

You seem to think that governments are interested in actually spending money to stop the virus. They're not or they can't.


Are all vaccinated getting tested in Züri hospitals? How many hospitalized COVID-19 cases have severe acute respiratory symptoms? Age breakdown? Health status? Population representative data? Historic data on hospital capacity?


I got the virus in late January 2020, before any lockdowns or vaccines. Haven't been ill since then. Now I'm hanging out in the periphery and listening to vaccinated people calling me a burden while the entire western world falls apart due to their genius plans. They decided I'm inconveniencing them and want to force me to get shots, but won't say it to my face, yet. I'll wait and see on these vaccines, but I'm not worried about mine or anyone else's health - mostly I'm just afraid of these people.

These are the people who ordered from Uber Eats throughout the pandemic and didn't give a shit about the poor guys and girls delivering their food at personal risk. The Zoom class thinks they know better than everyone else, and god help you if you don't fall in line.

These people throw everyone under the bus when they become inconvenienced by them. I wonder, is Snowden considered a conspiracy theorist now?

This is a political and class issue, not a health one.


Ok I hear you, but what's the alternative? I get it, you don't trust the people who are forcing you to get the shot. But how do we avoid hospitals from overflowing? I also don't trust big-brother but so far they're the only ones giving us a working solution (vaccines).


There are lots of people in this situation. In USA, to meet this administration’s standards you show proof of vaccination or weekly tests. It sounds like you’re the one who’s inconvenienced.


Rapidly shifting ethics, scientism, totalitarian discourse, and stripping people's rights - all over a background of harming people while claiming to help them - is not what I consider "inconvenience". I consider it stupid and dangerous, as does any free society.

Do you know the cost/benefit analysis results of the COVID interventions? They're not good, and they're going to get a lot worse in the coming years, not just in the west but particularly in poorer countries that have to deal with the economic fallout. They're estimating 20 million people are now starving to death because of the lockdowns (https://www.oxfam.org/en/press-releases/six-fold-increase-pe..., https://unglobalcompact.org/take-action/20th-anniversary-cam..., https://www.nytimes.com/2020/04/22/world/africa/coronavirus-..., https://www.france24.com/en/20200728-coronavirus-linked-hung..., https://www.washingtonpost.com/world/2020/09/25/pandemic-pus..., https://devpolicy.org/recipe-for-disaster-covid-19-and-world..., https://ipdefenseforum.com/2021/03/u-n-official-warns-covid-...)

As for the vaccines you think should be mandated: https://aaronsiri.substack.com/p/fda-produces-the-first-91-p... and thousands of people losing their jobs because they refuse (https://www.npr.org/2021/10/24/1047947268/covid-vaccine-work...). This is amazing progress, truly: you are helping the community.

Good fucking work, please tell us what else we should be doing - I think we might be able to save some lives by doing the opposite.


Your links talk about conflict as the source of food shortages, having health clinics close that served as nutritional outposts. More recently, studies blame high retail costs and decreased wages (i.e. inflation) because the commodity costs of staples like rice have not increased.

If, God forbid, you found yourself hospitalized for Coronavirus and were asked to give up your bed for someone else, would you?


> If, God forbid, you found yourself hospitalized for Coronavirus and were asked to give up your bed for someone else, would you?

You are arguing a hypothetical that would not happen (at least in the US). If you NEED to be hospitalized for Covid and ARE…no one is tossing you out of the bed or even asking you to give up your bed once you are there.


Nice side-step, you're right the interventions have nothing to do with it (even though all of the articles, besides the first, explicitly state that it's the core cause). Where do you think the inflation is coming from?

I wouldn't be hospitalized by COVID; I've already had it as I've already said. If I were in danger of being hospitalized from it I might just take the vaccine. As for your question, I dunno, would you?


Impressive, considering there were only 3 confirmed US cases of covid-19 in January 2020. Assuming your not in the US?


This is part of a bigger trend happening in healthcare right now.

For example, health workers are asked to replace "vulnerable population" with "oppressed population". It's also interesting to see the American Medical Association talk in a medical guide about "cultural appropriation" and

> “Discovery” of the Americas

> The land known as the Americas was not discovered; it was conquered and appropriated. This violent acquisition and genocide perpetuated by European settlers followed by centuries of illinformed and harmful federal policy

https://www.ama-assn.org/system/files/ama-aamc-equity-guide....

> The Medical Establishment Embraces Leftist Language

> New guidelines urge doctors to talk like social-justice ideologues. Whether patients understand them is beside the point.

https://www.theatlantic.com/ideas/archive/2021/11/leftist-la...


I find the argument unconvincing. The phrase in the opening sentence, "pandemic of the unvaccinated" seems apt. As a vaccinated person I don't interpret it as, "we have problems because unvaccinated people are getting vaccinated people sick". Instead, I interpret it as, "we have problems because unvaccinated people are at higher risk of illness and causing unnecessary stress on healthcare".


Comparing it to discrimination based on skin color seems extremely disingenuous.

I don't care if you get vaccinated; but I also recognize that your are making a suboptimal choice, based on available data, if you don't.


> suboptimal choice

According to you.

Lots of decisions in life involve many factors. Ever get a job offer in a new city with more pay when you love your current job? So many things to consider, so many variables, means there's no "optimal" and universal decision. Your optimal is not someone else's.

In this case there are plenty of factors. Personal ones like:

* Have you already had and recovered from covid giving you far superior immunity than the short-term shot-based immunity?

* Are you likely to encounter covid if you rarely encounter many other humans in a rural location? * Are you someone with high-risk of covid complication or not? That is, are you fit and healthy and young or old or fat or sickly?

* Do you encounter regularly people who are more vulnerable like grandparents or fat people?

Then less personal concerns, like how well you understand pharmaceutical dev. Three brand-spankin' new vaccine technologies with zero long-term safety data. (Sure the news says "PERFECTLY SAFE AND EFFECTIVE!" but we all know we can't know that--but we all have different perceptions of risk and risk tolerances.) Etc. Etc.

So engineer-y to just say, "Yes, I've boiled down the situation, here's the optimal solution."


> * Have you already had and recovered from covid giving you far superior immunity than the short-term shot-based immunity?

This one is fair

> * Are you likely to encounter covid if you rarely encounter many other humans in a rural location?

If you never leave your farm ... I don't care. If you tend to mingle with other people even sometimes, I'd already consider it pretty reckless.

> * Are you someone with high-risk of covid complication or not? That is, are you fit and healthy and young or old or fat or sickly?

This one tires me out a bit because it's been a pandemic for a while now, but it's not only yourself you are protecting by getting the shot.

> * Do you encounter regularly people who are more vulnerable like grandparents or fat people?

Again, even if you sometimes encounter vulnerable people, you should go ahead and get the shot. What exactly is the measurement here? "Oh, I cross paths with a maximum of five old people and eight overweight people a month. That's too little to care about."

IMO, all points following your first one are not good reasons to not get the shot.

Regarding the "less personal concerns", how many more shots does the rest need to get for people to stop screaming long-term safety data? Do you honestly believe that only a fraction of the people wanting to see the "long-term studies" have any idea how pharmaceutical developments usually function? What constitutes as long term? How many more times do we need to point out that no vaccine ever had any side-effects on a multi-year scale?

So yes, there may be a couple factors to consider, but most of what you listed shouldn't fly as an actual factor. It may be very engineer-y to say they have analyzed the situation and found the optimal solution, but I 100% understand where they are coming from.

Idk man, I'm tired.


> I don't care if you get vaccinated, but I also recognize that your are making a suboptimal choice, based on available data, if you don't.

The [dead] comments in reply to yours seem to imply that choosing to refuse a vaccine (without a sound medical reason to do so, e.g allergies) isn't a choice, which is how they — and I assume millions of others — justify the comparison to racism.

It is, of course, ludicrous on its face as traits such as race are in fact truly immutable, whereas a decision whether or not to vaccinate is certainly subject to change up until onset of illness leading to death.


Perhaps a better comparison should be discrimination on the basis of religion, then.


This is a very charitable reading of the [dead] comments. In spite of that, I think I agree with your final point:

“It is, of course, ludicrous on its face as traits such as race are in fact truly immutable, whereas a decision whether or not to vaccinate is certainly subject to change up until onset of illness leading to death.”


In fairness, I only skimmed them and didn't really give them the time of day.

You know, [dead] and all.


Vaccination-based "discrimination" is not discrimination at all.

Discrimination can only happen based on factors beyond your control. You can't control your skin color. You can't control your gender, sexual preferences, country of origin, etc. either.

Not getting the vaccine is a choice. Choices have consequences.

This logic also dictates further scenarios:

- vaccine not available to everyone? ⇒ yes, distinguishing on vaccination status would be discrimination since you may not have the choice.

- vaccine required or forbidden by law? ⇒ yes, now things get really complicated. Especially if you travel elsewhere with different rules.


> Discrimination can only happen based on factors beyond your control.

What about religious discrimination, since converting to a new religion is possible?


That's one for the philosophers that I'm not gonna touch with a 10ft pole.

[Ed.: to clarify, "sensible" arguments can be made either way, and I'm not sure it's easily decidable.]


If you get vaccinated is a choice heavily correlated to skin color, at least in my neck of the woods. Less than 40% of black men are vaccinated here, and conspiracies that covid-19 was created by Israel so that they could create the vaccine so that they could sterilize black men are aired on the radio. (There was an anti vax program and a pro vax program, but like, what could some moderate pastor say to respond to that? I don’t think that’s true?)


[flagged]


Please review the site guidelines and don't post flamebait to HN.

https://news.ycombinator.com/newsguidelines.html


[flagged]


It was obvious flamebait. You may have had a more nuanced intention in your head, but those don't communicate themselves—the burden is on the commenter to disambiguate (https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...).

The kind of thing you did post is statistically highly likely to turn into a nasty flamewar, so please don't do it again. Your reply here contains some of the same, though not quite as bad. Please edit this sort of flamebait swipe out of your HN posts in the future.


Current numbers [0] show 1 in 417 people in the U.S. have died of covid. These fatalities tend to occur to people who are older and/or have other health problems [1].

Many people intuit that this is not the end of the world. Many may not be able to argue the case well, but they believe that the fear of covid is overblown. They don't believe that lockdowns and masks will make enough difference in the end, not for the pain incurred. Some are freaked out more by the vaccine but often this is subconscious reaction to being forced through all this trouble by a bunch of people whipped up into unreasonable fear by clickbait headlines and fanned by meddling or power hungry politicians. Quibbling over details doesn't change what they believe.

I would defend their position by saying that the per capita mortality rate for covid is similar to the 1968 hong-kong flu [2], maybe less. That was not the end of the world, either. Many people who were alive in 1968 don't remember it. We live in a word of longer than ever life expectancy. We are better than ever at keeping vulnerable unhealthy people alive. What do you expect? These things have happened before, and will happen again, part of living in the real world.

These people opposed to punishing young, and non-young, people who have a 1 in 10,000+ chance or less of dying, taking away years of their schooling, social life, and careers, because a bunch of people have a skewed perspective of risk.

Whether or not you agree, this is what a lot of people think, and why.

Supporting and expanding hospital facilities and targeted protection of vulnerable people like in nursing homes would have been my biggest concern.

Some people have good reason to be afraid. Others do not. I don't blame anyone for wanting to protect themselves. We should support that, too.

EDIT: minor edits for clarity

[0] https://www.worldometers.info/coronavirus/country/us/

[1] https://www.cdc.gov/nchs/data/health_policy/covid19-comorbid...

[2] https://en.wikipedia.org/wiki/Hong_Kong_flu


Breakthrough hardly means breakthrough anymore. Perhaps it's the deluge of strains, or maybe it's just that vaccines were never very effective at preventing transmission. People keep trying to compare taking the Covid vaccine to taking the Polio vaccine but the Polio vaccine lasts nearly a lifetime and is 99.9% effective...

Recently a nursing home had 89 total infections, and 87 people were fully vaccinated. Are we still gonna call these cases breakthrough if it's nearly guaranteed that the vaccine won't stop you from getting covid? I don't dispute that it will help protect one from becoming seriously ill.

https://nypost.com/2021/11/16/covid-19-outbreak-kills-8-in-c...


Just a reminder that medical consent is your right. You have the right to say no to any medical procedure for any reason.


This is absolutely true. Rights are also responsibilities.

Inasmuch as you have a right to authorize or deny medical procedures on your own body, you are responsible for how your own body affects those around you. When you allow your body to become a vector for transmission you bear responsibility for spreading the disease.


Only way to not spread this disease is quarantine and testing. Why aren't vaccinated doing that? Why are they so evil or callous that they take risk of spreading it? Why isn't there talk that anyone who wants to protect others must regularly take the test?


What do you mean? I'm fully vaxxed, and I get tested twice a week. If I ever get a positive result, I'll quarantine.


Several universities I have colleagues at have regular testing requirements for all uni community members, on top of vaccine requirements. Maybe it could be a more widespread thing, but I think you make it seem more one sided than it is.


The cruel workaround that's playing counter to this is to diminish the person's life and freedoms until they take it out of desperation, and if they still don't give in; forsake the pretence of choice and mandate it anyway.


The unvaccinated diminish other’s lives by being a vector. Why in your opinion are they entitled to do that?


Medical consent is their right. They have the right to say no to any medical procedure for any reason. Right there in the GP funnily enough.


I was not disputing that. I was disputing that it’s a “cruel workaround” to eg require that people who work with the public get a vaccination to keep their job. Those who choose not to get to vaccinated are not entitled to force their presence on private individuals and to a certain extent the public.


I'm not explaining why segregation is cruel to you.


It’s really more of a quarantine.


I encourage everyone eligible to get vaccinated, but vaccinated people are also vectors. The vaccines don't reliably prevent infection or transmission.

https://www.businessinsider.com/delta-variant-made-herd-immu...


As far as we know now, vaccinated people who contract covid shed less virus for a shorter period of time: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-var...


Yes but so what? Since the virus is now endemic and can't be eradicated, all of us will be exposed multiple times throughout our lives no matter what we do or how many people are vaccinated. Vaccination provides good protection against severe symptoms, but over the long run it won't prevent others from being exposed.


I imagine you know this, but maybe there’s some reason you think it doesn’t matter: It will lower the rate of exposure.


Windows 10 all over again?


And the rest of society has the right to exclude you if your carrying a deadly virus.


So why don't we mandate testing from the vaccinated? Isn't that only way to guarantee that they don't spread this disease?


Perhaps tangential but you actually do not have the right to refuse quarantine.


Some countries have mandatory measles vaccination.

Also (to contradict your statement) if police believes your are DUI they can force to take your blood, is this different in the US?


We're in the middle of a global pandemic and we can't all agree that vaccination is the best strategy and that unvaccinated people are placing themselves, and by the strain they put on the healthcare system, the rest of the population at risk.

This is very deeply into idiocracy territory.


I'll venture a guess that a worse mortality rate would've changed the balance on this.


People making a risk assessment would assess differently if the risk was different? You don't say...


> People making a risk assessment would assess differently if the risk was different? You don't say...

People unqualified to make a risk assessment would assess differently if the perception of risk was different.

If it was as cut and dry as "1 out of every 10 would die" yeah, tons would sign up. But people can't reasonably value risk when the numbers can be framed differently, e.g "98% of people survive" (but with what issues?)


Snowden Warns Governments Are Using Coronavirus to Build ‘the Architecture of Oppression’.


I've found it interesting to note how folks who are pro-choice/pro-life on the issue of abortion often have a morally contradictory stance in supporting mandatory vaccination. So if you are pro-choice, you believe women have the right to decide what happens to their bodies, even if it involves ending a potential life (a fetus), while people do not have the right to decide what happens to their body with respect to vaccination, even if it involves transmitting a potentially deadly virus. And vice-versa for pro-life.


In my mind, the key differentiator there is whether ending a life is the goal of the choice or an unintended consequence of it.


To the author, here's a proposal:

I'll stop stigmatizing unvaccinated by choice people going around endangering others when you stop stigmatizing drunk by choice drivers going around endangering others.


The comparison to drunk driving is apt. If you have to go to hospital with active covid you endanger the personnel and you take up a bed that someone else could use. Not too long ago there was a man in Alabama who couldn't get an intensive care bed because they were all taken up by Covid patients. (Let's face it, we know how that goes - if you end up in intensive care because of Covid there's a 50 % chance that you die, but only after a month, and a 50 % chance that you make it out of there with multiple disabilities.)


Imagine a police officer stopping you at the side of the road. "When was the last time you drank alcohol?" "A couple of months ago at my brother's birthday party, I had a can of beer." "Step out of the car, you are under arrest for drunk driving."

This manichean logic worked wonders last time it was tried.


The funny thing about the unvaccinated, when they get sick with COVID, 100% of them will immediately start trusting doctors again and run to the nearest hospital. If you're supposedly making a choice about your own body, then stick with that choice, right to the very end.


There’s increasing evidence that the mrna immunity wanes after about 6 months. That’s an argument for booster shots, not a valid justification to stay unvaccinated.


That is one "failing" but not the most important one. No intramuscular shot seems to provide protection against infection of upper respiratory aerosol spread viruses. They provide IgG antibodies in the body serum, and that seeps into the lower lungs to provide protection from serious disease. But intramuscular vaccination does not provide even medium term protection against infection of the upper respiratory mucosal tissues. And that's really unfortunate but not unexpected if you knew anything about how influenza vaccination works. Those muscosal surface tissues require local IgA antibodies and resident B and T cells to prevent infections. Intramuscular vaccination does not cause this (though it does train the T cells that will go there when you do get infected).

So, intramuscular vaccination is not preventing sars-cov-2 infection of the upper respiratory and spread of the virus to others. This does not mean intramuscular vaccination is not needed. It is the vital first step. The next step is an intranasal vaccination booster to provide resident T cells to the upper respiratory (as well as a brief period of IgA antibodies and B cell residence).

If we're gonna get through this both "sides" have to acknowledge their failings. Intramuscular vaccination is both not enough and a required first step. Intranasal is next. Then we can finally start ending this pandemic.


Note: this is just a letter (someone’s opinion, not peer-reviewed.)


justification aside, stigmatizing the unvaxxed seems to be completely ineffective


If you're not vaccinated by now, you're pretty much immune to 'stigma', I should think. Time to get over it folks; the unvaccinated are among us and they will be for the rest of time. Continuing with this stigmatization will upset yourselves far more than will upset them. In my country at least, it's obvious there will be no law requiring injection, so continued complaints are really just yelling into the wind (unlike something like drunk driving for example).


At some point of the pandemic, we will discover we should have put more effort in the psychology effects of the words.

Make people panicking is probably not a very good thing to do if we want to expect them to take the best decisions.

Special mention to French president that described March 2020 situation as « This is a war ».


He actually called, and held regular "defense councils" (with generals, etc.) to deal with the Covid situation.

Was it because they are less compromised by industry than public health officials? Or just because it's popular with voters? Your guess is as good as mine.


war on freedom.


Here is a proposal: divide ICU beds in hospitals proportionally between vaxed and unvaxed population. If all unvaxed beds are taken you don't get one.

As all libertarians know there can't be freedom of choices without responsibility or responsibility without freedom.


This is a reasonable proposition in principle. But there are other admission criteria. For example, you might end up passing over a 30yo mother of two for a 85yo nursing home resident, just because all nursing home residents get vaccinated, while still having relatively large numbers of hospitalizations. From the UK covid reports (Table 4), notice how hospitalization raw numbers are majority vaccinated >50yo, with 5389 out of 9831 (55%) cases.

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


Well, I believe you shouldn't discriminate on age in those situations. After all older people were paying to the system for their whole life and still pay (well, depends on the country). If 30yo mother refused the vaccination I believe it's reasonable to refuse the care. I think it's unjust to save someone irresponsible instead of someone responsible just because of age.


It is a tough call. My hope is that in spite of failing to expand surge hospital capacity, the winter delta covid waves will recede before reaching spillover point.


> I call on high-level officials and scientists to stop the inappropriate stigmatisation of unvaccinated people, who include our patients, colleagues, and other fellow citizens, and to put extra effort into bringing society together.

Or on the flip side, we can keep describing it as what it is, i.e an illness which largely inconveniences the vaccinated and jeopardizes the lives of those who are not.

This really seems like it's just an opinion piece. The vaccine cuts the window of contagion, spares capacity in hospitals for the immunocompromised as well as for people suffering other ailments beyond covid, and enables a resumption of normality necessary for mental health.

People who choose not to vaccinate for reasons other than contraindications or other medical exclusions such as allergies to vaccine components are really just choosing to play Russian roulette with a 50 chamber revolver — and risking the lives of those who can't vaccinate by projecting the virus for longer durations of time and occupying ventilators, ECMOs, hospital beds, and pricey monoclonal antibodies.


> Or on the flip side, we can keep describing it as what it is, i.e an illness which largely inconveniences the vaccinated and jeopardizes the lives of those who are not.

This description suggests that vaccination status is the most significant risk factor for dying of covid. That is factually wrong. Moreover, it's politics, it's an attempt to convince people to get vaccinated.

Age and health are more significant factors than vaccination status. Therefore it would be more accurate to describe covid as "an illness which largely inconveniences the young and healthy and jeopardizes the lives of those who are not".

Source: https://nymag.com/intelligencer/2021/09/covid-19-vaccine-sta...


"Fully 25 percent of deaths were among vaccinated people, the county reported. How can this be? If the vaccines are so effective that they reduce mortality 42 times over, how could the vaccinated account for such a large proportion of the deaths?"

Someone needs to learn statistics there. The 25% number is useless without knowing what rate of the general population is vaccinated. If 100% are vaccinated, all deaths would be vaccinated too. If, say, 50% of the population are vaccinated, but only 25% of covid deaths are vaccinated people, the vaccine is in fact quite effective in reducing death in hospitalized covid cases[¹] — by a factor of 3.

[¹] assuming they would mirror the vaccination rate, which they don't.


> the vaccine is in fact quite effective in reducing death in hospitalized covid cases

No one in this thread, including me and the article I linked, is arguing otherwise.


You would have to have around 94% vaccinated to have 25% of deaths be vaccinated at 42x protection. No country has that.


In the USA, something like 85% of people older than 65 are "fully vaccinated", and a almost all of the rest have had one dose.

These still make up a substantial proportion of hospitalizations, because Covid is 2–3 orders of magnitude more likely to lead to serious symptoms for this age category, so that vaccinated elderly people have comparable risk to unvaccinated people 30–40 years younger.


At 85% vax rate with 42x protection you would still expect almost 90% of deaths to be in the unvaccinated.


Looking at the source, this was about King County, Washington, where more people over age 65 have completed the full vaccination series than there are census-estimated residents of that age. Effectively everyone over 65 has been fully vaccinated there. https://kingcounty.gov/depts/health/covid-19/data/vaccinatio...

If you tally up more age categories, about 92% of people over the age of 35 have been fully vaccinated.

Or flipped around, 80% of unvaccinated people in that county are under the age of 35, 15% are age 35–50, 5% are age 50–65, and essentially none are older than that.

It is amazing that even so, 83% of hospitalizations and 75% of deaths were among the unvaccinated. These vaccines are astonishingly effective!


In King County, for age group >65yo, vaccination rate is >95%, and the percent of vaccinated hospitalizations for this age group is 3%.

In UK, for age group >60yo, with similarly high vaccination rates, the percent of vaccinated hospitalizations for this age group is 82.5%.

These numbers inhabit different realities. I cannot think of any reasonable explanation. Some attempts:

* King County is failing to vaccinate the highest risk subpopulation within this age group.

* King County is hospitalizing comparatively vast numbers of unvaccinated elder covid patients.

* King County, UK, or both, is having serious data collection and/or reporting problems.

* UK is using a different vaccine

https://public.tableau.com/app/profile/public.health.seattle...

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

Edit. Peeking at the Singapore dashboards, they are much closer to the King County picture than the UK picture.

https://www.moh.gov.sg/covid-19/statistics


Yeah, I am not trying to say the vaccines are not extremely effective.


That is incorrect because it fails to take into account that the elderly are much more likely to be vaccinated, and also much more likely to die from COVID.


… that's where the [¹] comes in. None of these statistics can really be done with naïve back-of-the-envelope calculations. How many people get hospitalized with covid to begin with? How many people require intensive care? How many just die outside a hospital because no ICU beds are available?


> This description suggests that vaccination status is the most significant risk factor for dying of covid

...

> Age and health are more significant factors than vaccination status.

You can't easily change your age or health to reduce your risk. You can change your vaccination status. Thus for any given individual vaccination is the most significant action that can be easily taken to significantly reduce their chance of dying of COVID.


> You can't easily change your age or health to reduce your risk

It's still useful information. An elderly person, informed of his elevated risk, may make different choices than if he thought "well I'm vaccinated so I'm safe".

Anyway, your post is proving my point. The goal in describing covid as "dangerous to the lives of unvaccinated; inconvenient for the vaccinated" is to convince people to get vaccinated, not to describe reality.

There's a factual case for vaccination, and many have made it. But others are being dishonest and manipulative. There's a price to be paid for that and it may end up being more expensive than the benefits accrued.


That doesn't change the fact that shaming and bullying younger people into getting vaccinated cannot possibly stop hospitals getting overwhelmed with Covid patients, and that in countries with reasonably high vaccine uptake amongst the elderly (which is fairly common - they've been much more willing to get vaccinated in most places because they're at higher risk) blaming the unvaccinated for hospitals being full has more to do with politics than actual on-the-ground reality. Sure, on an individual level getting vaccinated reduces your personal risk, but in terms of society-wide risks many places have reached a point of substantial diminishing returns precisely because age and health are the most significant factors.


> You can't easily change your age

Strictly speaking, my age changes constantly without me even thinking about it :P


Your Russia roulette comparison is pretty disingenuous.

Here are the latest survival rates by age:

0-19: 99.9973%

20-29: 99.986%

30-39: 99.969%

40-49: 99.918%

50-59: 99.73%

60-69: 99.41%

70+: 97.6% (non institutionalized, not in a care home)

70+: 94.5% (all)

Source: https://www.medrxiv.org/content/10.1101/2021.07.08.21260210v...


And what are the hospitalization rates? Occupying beds and Heath care providers that could be treating conditions that are not preventable? What about long covid rates? It isn’t death or you’re fine.


Since it appears you are advocating for policy based on those numbers, why don't you provide them?


You can find hospitalization rates by age group here.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...


By that metric we shouldn't worry about measles, either. Survival rate is 99.9 %, the change of getting encephalitis is only 1 in 10000. But somehow we do.

And why is everyone over 50 running out to get the shingles vaccine? It's not like shingles kill you.


The difference between COVID and measles is that the measles vaccine is actually effective (i.e., people vaccinated against measles never need to worry about it or take precautions against it in everyday life again), and it's also been around long enough to be confident there's no long-term side effects.


The measles vaccine is not perfect either. The only reason we don't have to worry abour measles is because enough people have been vaccinated to achieve herd immunity and bring down the transmission to zero. However, if vaccination rates drop even a little bit then outbreaks can pop up again because measles is extremely contagious.


Like last years flu vaccines, the current covid vaccines are targeting last years version of the virus, since then the virus has evolved to escape the vaccine[0]. 100% uptake of the current vaccine won't eliminate the virus.

[0]https://pubmed.ncbi.nlm.nih.gov/34593004/


I encourage everyone eligible to get vaccinated, but since the vaccines don't reliably prevent transmission there will be no significant herd immunity effect.

https://www.businessinsider.com/delta-variant-made-herd-immu...


> However, if vaccination rates drop even a little bit then outbreaks can pop up again because measles is extremely transmissable.

But in cases when that's happened, how many people caught "breakthrough" measles, as opposed to unvaccinated people catching measles?


Not exactly what you are asking, but close enough: From https://en.wikipedia.org/wiki/Measles_vaccine

> This is often done at age 15 to 18 months. After one dose at the age of nine months 85% are immune, while a dose at twelve months results in 95% immunity.

This graphic is interesting https://en.wikipedia.org/wiki/Measles_vaccine#/media/File:Me... With one dose the case number is reduced a lot, but there are still some smaller peaks aver few years. After the second dose was made mandatory, the number of cases goes to almost zero.

I'm not sure about Canada, but here in Argentina kids get two doses, and every 5-10 years there is a effort to give an additional dose to some groups with more risk (like small children).


If you have a vaccine that protects against something that is 0.1% deadly you should take it. But when measles was out in the wild killing people we didn't wear masks and have lockdowns to stop it either.


There is no time in US history when measles killed anywhere near 100k+ people per year. The numbers I am seeing are in the thousands.

https://i1.wp.com/vaxopedia.org/wp-content/uploads/2016/10/a...

Covid has killed upwards of 770k people in the US.


Comparing death rates in the population is a misleading comparison. In a world of endemic measles most people get measles at some point; new outbreaks tend to hit mostly children, because they weren't born yet during the previous outbreak. To compare disease lethality we have to look at the number of infected patients, not the total population.

If measles were a brand-new disease introduced today, it would also be a bloodbath.


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I'm saying that if measles were a brand new disease, it's possible that it would cause a pandemic that's even worse than covid-19 was. Measles is nasty.


This entire line of reasoning makes no sense at all. Any new disease could cause a massive death toll if we had no resistance to it at all.

Our public health systems responds to reality, not theoretical casualties in populations that do not exist.

If measles was killing 1 million people per year we would've absolutely locked down much harder to stop the spread. That is just common sense.

It never was doing that. It was killing like 10k people or less per year. So any kind of comparison of our response to covid is ridiculous, except in acknowledging that even though measles was far less dangerous to our population, we still have mandated vaccination against it.


What percentage of survivors get Long Covid symptoms? Is that information available broken down by age, like the IFR you're quoting?


I’ve never been able to find similar numbers. Let me know if you can. but I’d be curious to get your take on this French study.

https://jamanetwork.com/journals/jamainternalmedicine/fullar...

It seems like good news for people worried about long Covid.


Couldn't find it at a glance, does the data included vaccinated people? If so it's not surprising mortality is lower than previously reported (because there are more vaccinated people than in the past).


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The overall infection fatality rate is 0.6%, not 2%.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...


> I’ve read, people dying of COVID seem to spend a lot of their last days and hours of consciousness wishing they could go with the revolver instead.

Do you have a good source from that? Preferably an article in a serious newspaper that verified the sources. I really expect people to be asking for a painkiller and a miracle cure.


The WHO agrees with the author:

  Does it prevent infection and transmission?
 
  There is currently no substantive data available related to impact of Pfizer BioNTech vaccine on transmission or viral shedding.
https://www.who.int/news-room/feature-stories/detail/who-can...


Actually, there is. The new-daily-cases-per-capita rate for unvaccinated people is at least 6x the rate of vaccinated people, per the most recent data in this NYT analysis [0]. And the reduction was observed for Pfizer, Moderna, and J&J vaccines.

[0] Who Had Covid-19 Vaccine Breakthrough Cases? https://nyti.ms/3nFvITV


That's the US data which is hopelessly corrupted by politics; the CDC simply hasn't been reporting honest statistics about vaccines from the start.

In the UK where the health authorities break down by age and vaxx status with what seems to be reasonably accurate reporting, the vaccinated per capita rate is ~2x the unvaccinated rate and nobody knows why.


This is incorrect: we don't know the rates, because we don't know the denominators. Published figures use estimated denominators: "because the proportion of unvaccinated people is small and the NIMS population estimates are high, it makes the unvaccinated population appear significantly larger than it is. As a consequence, the Covid case rate per 100,000 unvaccinated people, when calculated using this figure, is suppressed. Just being out by 1 or 2 per cent could change the apparent population of unvaccinated people by 30 per cent." (from https://www.thetimes.co.uk/article/cfaadc98-35ab-11ec-8ef4-8... )


The quote from parent was about transmission.


As every new case is a result of transmission, a difference in the per-capita rate of new cases between vaccinated and unvaccinated people shows an identical difference in the rate of transmission.


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Personal attacks are not allowed here, regardless of how wrong someone else is or you feel they are. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.


>Immediately before that: The Pfizer BioNTech vaccine against COVID-19 has an efficacy of 95% against symptomatic SARS-CoV-2 infection.

I'm not sure how that contradicts the parent post? You could be protected from hospitalization/symptoms, but still be transmitting it.


Argumentum ad hominem usually implies an irrational opinion or manipulative rhetoric.


Covid broke our institutional reality. There's clearly something about the events of the last two years that's caused a large segment of the population to instinctively reject what we're being told by authorities of all stripes. The whole issue has been so hopelessly obfuscated by political, economic and media interests that numbers simply don't matter. They've lost our confidence. Competent leaders would realize that you aren't going to change XX% of the population's minds by coercion, "nudging," or pathologizing. Resources would have been better spent on building more health care facilities, training more medical staff, and better/cheaper rapid testing.

Two years of lockdowns, reckless spending, mandatory vaccinations, extreme media gaslighting. Soon there will be real consequences to these simplistic and heavy-handed authoritarian measures, and they're going to be of much greater significance than covid itself. And when they do come to pass the midwits will cry, "We couldn't have known!"


>Two years of lockdowns, reckless spending, mandatory vaccinations, extreme media gaslighting. Soon there will be real consequences to these simplistic and heavy-handed authoritarian measures, and they're going to be of much greater significance than covid itself.

I think many people don't realize the levels of resentment growing in the other half of the country. The Marine Corps is about to boot ~10,000 active service members for not getting the shot. [1] The other branches have only slightly better numbers, with the Guard and Reserves far worse. The Oklahoma National Guard has refused to enforce the mandate and is currently in a stand-off with the DoD. [2] This is not a recipe for long term stability.

[1]. https://www.marinecorpstimes.com/news/your-marine-corps/2021...

[2]. https://www.armytimes.com/news/your-army/2021/11/12/oklahoma...


> There's clearly something about the events of the last two years that's caused a large segment of the population to instinctively reject what we're being told by authorities of all stripes.

Indeed. The "something" is said authorities having repeatedly been caught lying.


If you follow this reasoning, then you must also beleive that we should stigmatise people with other life choices that fill hospitals? Stigmatising obese people, people who drink alcohol, people who do extreme sports, people who have children late in life. Where does it end?

I agree we should be realistic and truthful about consequences for our decisions, but I do not think stigma will help improve the situation. It is more likely to lead to resentment, and polarisation.


> Stigmatising obese people, people who drink alcohol, people who do extreme sports, people who have children late in life. Where does it end?

You sound as if you live in a weird parallel universe where we don't stigmatise those people.

It's not difficult to find people who think along all or some of these lines: Obese people are ugly gluttons, drinkers are a danger to others and themselves and have no self control, extreme sports athletes are crazy, people who have children in their forties are inconsiderate and will get retard babies.

The reason we don't get worked up about those as much as about covidiots, is that the groups you mention don't endanger anyone else. The one exception is extreme sports (think drag racing, not wingsuit flying), and that's why we require those athletes to buy insurance.


The fallacy here is the use of the word "we". The people trying their hardest to stigmatize anyone who doesn't like the COVID vaccine are the same ones saying that being obese isn't your fault and isn't unhealthy.


Nope, because according to me, if you're fat, it's because because you like sugar more than being slim, and if you're not vaccinated, it's because you can't do simple math.

Looking forward to statistics supporting your assertion.


I don't mean literally everyone. I just meant that I've noticed quite a correlation in one direction, but you used the word "we" in a way that only makes sense if there's a correlation in the other direction.


> If you follow this reasoning, then you must also beleive that we should stigmatise people with other life choices that fill hospitals? Stigmatising obese people, people who drink alcohol, people who do extreme sports, people who have children late in life. Where does it end?

It's pretty simple: we stigmatize people whose choices place undue burden on others' ability to live safely.

Driving drunk?

Driving 90/55 on a crowded road?

Indiscriminately discharging a firearm into the air?

Exposing people to typhi salmonella after being established as a carrier?

Exposing people to HIV (and other STDs) knowingly?

Choosing to be unvaccinated against covid?

We seem to have a pretty consistent pattern here, and considering that remaining unvaccinated increases spread and increases everyone's risk of death (especially those who can't receive the vaccine), stigmatization of those who choose not to vaccinate without sound medical grounds fits this easy binary filter.


Difficult to categorize as such, because the vaccinated still spread the virus. And as long as R_t>1 pretty much everyone will get it.

So unvaccinated cause harm to others indirectly by burding the healthcare system. And one also does that by socially acceptable stuff like motorcycling (or maybe that's a plus if one is organ donor?).


https://www.pharmacytimes.com/view/vaccinated-individuals-ca...

> The viral load declined more rapidly for those who were fully vaccinated than those who were unvaccinated. However, investigators noted that vaccinated individuals did not have a lower peak viral load than those who were vaccinated.

Tldr: there's probably a window where vaccinated people can transmit the virus as effectively as unvaccinated people, but that window is almost certainly shorter.

While that's probably not helpful in household settings, it's still plenty useful in cutting disease spread during short terms in confined spaces.


Indeed. That's why helmets are mandatory for motorcyclists. Helmets are to motorcycles as vaccines are to COVID. Neither guarantees that you don't die or need intensive care, but both reduce the likelihood.


I really like this comparison but it misses the main reason that this is such a huge issue: there are basically no downsides to wearing a helmet, but for some people vaccinations will cause health problems. I know that P(issues from Covid) > P(issues from Covid Vaccines) for almost all cases, but the downside is hard for people to ignore.


> Exposing people to HIV (and other STDs) knowingly?

But doesn't California's SB 239 mean that a lot of people don't believe this anymore? And don't most people who think SB 239 was a good thing also hate people who don't want the vaccine?


> But didn't California just move in the exact opposite direction on this particular point?

From my reading, Cali HSC 120290 criminalizes knowingly transmitting any STD, which fits the bill for stigmatization. I'm guessing your point is it seems like transmitting any STD is a misdemeanor now, whereas in the past, only HIV would be tagged — with a felony, specifically. Right?

I'd venture that it's an adjustment with the times, specifically that HIV is no longer a death sentence especially as drugs for HIV come upon patent expiration in ~6 years time.

Still a stigma, and it still impairs a person's ability to have a normal romantic life, but it's no longer murder-adjacent.


But shouldn't the punishment for knowingly transmitting a permanent STD be worse than for transmitting ones that can be completely cured with some antibiotics?


I haven't heard something as offensive to my sense of justice as downgrading giving STDs to others from felony to misdemeanor for a very long time.

I mean seriously, is there anyone out there who prefers getting an STD (let alone a very serious one) then getting punched in the face for example or getting your home broken into?


I'm not defending it; just giving context around how it may have come to pass.


Why did you ignore all the counter-examples I gave? Are you saying you stigmatise obese people, and people who drink?


> Why did you ignore all the counter-examples I gave? Are you saying you stigmatise obese people, and people who drink?

Your points were addressed implicitly, but I can do so explicitly at your behest:

Obesity and alcoholism aren't preventing people with other conditions from seeking medical care because the current medical system (at least in western nations) can account for and manage these conditions successfully, unlike COVID which has consistently resulted in resource, capacity, and utility shortages throughout the pandemic thereby posing an undue risk to general welfare and the lives of others.

I also say this as someone who's been both obese and not obese: unlike a decision to refuse a life-saving vaccine, refusing to eat is far, far harder. And as someone who refuses to drink specifically because I know my own tendencies towards addiction, I empathize with those who started drinking socially and suddenly found themselves trapped by the vice grip of an alcohol abuse disorder.

None of these compare to to choosing to refuse a vaccine without sound medical grounds.

There's nothing much to debate here; the topics you flagged are pretty personal topics for me, so I'll gladly and passionately defend against their misuse in debate.


Thankyou for your explanation, I genuinely didn't understand the implicit response.

And I think I agree with you, that the essential difference is how easy it is to get vaccinated.

I probably come to different conclusions because I know people for whom it's not "easy". This is because they are fearful of vaccines, mistrust authority, are uneducated or are paranoid. I think there is a parallel between an alcoholic slowly ruining their life through denial of the effects of drinking, and someone refusing a useful vaccine due to fear. In both cases, stigma may help them change course, but in my experience is is more likely to entrench the behaviour. Thus I don't think it should be used.


The reason hospitals still "can't cope" (this is frequently a relentless exaggeration but let's roll with it) is because the healthcare system has persistently refused to train new people or lift a finger to increase capacity in any way, and in fact, is now firing healthcare workers en-masse for not taking it, even though many don't need to and it doesn't eliminate transmission anyway.

At some point people need to stop being so lenient on health suppliers. They are implicitly demanding society trashes itself to avoid them having to hire and train. It's endemic now, there is no cure, the treatment is mostly still oxygen+drugs. There's no excuse.


I find this sort of lack of future planning occurs in many industries. Where I live there is a high demand for engineers, but few companies are willing to train graduates, they prefer to import workers since without loyalty, training is simply a cost-centre. If the problem gets bad enough, governments respond with University funding, which takes at least 4 years before this flows on to industry.


I encourage everyone eligible to get vaccinated, but obese patients are the majority of the COVID-19 hospital load. In other words, if we had zero obesity rate there would be no concern about overwhelming the hospitals.

https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...


Pretty much all experts now admit the virus will be endemic (even if everyone were vaccinated), so you will encounter it eventually. This means that refusing the vaccine is really just hurting yourself.


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The Alabama department of Public Health puts posters up asking you to walk more, eat healthy, all that stuff. So, yes, obesity is a public health problem, and it's being addressed. What are you trying to say with that comment?


But we're doing way, way more than putting up posters saying to get vaccinated. For example, imagine how you'd react if Alabama mandated that every worker with a BMI above 30 had to be fired.


How does a BMI of over 30 put other workers at risk? These situations are not analogous. And unless Alabama has a far more strict proposal than the proposed federal mandate, no one is requiring unvaccinated workers be fired, only they be tested weekly, so the analogy breaks down on that front as well.


> How does a BMI of over 30 put other workers at risk?

How do unvaccinated people who work from home put other workers at risk?


I didn't say that they did? You've ignored the entire content of my comment to engage with an argument I didn't make.


You said the situations weren't analogous. I'm saying they are, because firing an unvaccinated remote worker doesn't make anyone else any safer than firing an obese remote worker does.


Except most workers aren't remote workers, and as stated in my original comment that you chose to ignore, there is no mandate that anyone be fired for being unvaccinated.

So being unvaccinated is risky to others around you while having a high BMI is not, and you suggested firing employees with a high BMI, while the mandate only calls for testing unvaccinated employees.

So again, the analogy falls apart two different ways.


Maybe it would be a better comparison if they called obese people "fat and crazy persons that endanger society by using up capacity in the healthcare system" or similar. Because this kind of speech is used by officials to describe people that don't want the vaccination.


How does obesity place undue burden on others' ability to live safely?


Because obesity makes it more likely you'll end up taking up a hospital bed that someone else might need.


Obesity isn't contagious, so it doesn't really tax healthcare systems like a virus that produces exponentially increasing demands on local healthcare systems.

It's kind of like trying to compare O(n) to O(2^n) without admitting that [the system was operating fine in the O(n) regime and is falling apart in the O(2^n) regime]. My sister-in-law is a nurse practitioner and she has been reposting job listings for RNs and NPs over the past year or so offering $6k+ per week (!!!) for RNs and NPs to do stints in hospital systems under extreme load around the country.


The healthcare system manages this inconsequentially because relative to refusing a vaccine, the increased likelihood of this happening with obesity is marginal.

Prior to the pandemic (and also today during the pandemic), there wasn't a concern about people dying from treatable medical conditions because healthcare capacity was taken up by those suffering from obesity.


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I understand what the _point_ is, I'm just not convinced that the upsides are worth the downsides.

I didn't try and avoid anything, I actually don't know how racism or anti-semitism has anything to do with this?

I agree on your point that there is some stigma for most damaging behaviours but the Covid vax stigma is much more severe where I live. People who make the "wrong" choice are being treated as second-class citizens, with rights being removed as a punishment for their sins. This is not a healthy way to gain compliance.


The whole point of stigmatization is that it makes people feel better about themselves and inserts them into a camp of other people who also stigmatize a certain group, giving them a sort of inclusivity. All else is rationalizations for the actions of the emotions.


Hyperbole much?

Sorry dude the emperor is naked, and no one is buying this line anymore.

Worried about unvaccinated people filling up hospitals? Why then are we firing health care workers who have had covid and recovered but aren’t vaccinated?

No, this is about control, the tactics are far more defensible and less heinous then we’ve seen with other nation states in the past, but that is because it is all that is needed to convince people like you that it is good to stigmatize people who following their own conscious or medical reasons don’t get vaccinated.


> Or on the flip side, we can keep describing it as what it is, i.e an illness which largely inconveniences the vaccinated and jeopardizes the lives of those who are not.

Well actually, it largely inconveniences the unvaccinated /and/ the vaccinated. The difference in severity comes with age. Older people and babies are far more susceptible to the virus than are children and adults.

The amount of people who truly can't vaccinate is probably small enough that someone who is exercising their right to choose is probably not going to take beds from those who could not get the vaccine.


Except people might need hospital beds, urgently, for things other than COVID?


The hospitalization rate among the vaccinated is much lower.


It says “Correspondence” at the top of the page. That suggests to me that it’s the equivalent of a “Letter to the Editor.”


A poor argument. I'm unvaccinated because I am unconvinced that it is in my or society's beat intereat for me to do so. The avoidance of shaming those who are not vaccinated should be:

1) Because telling someone they're stupid almost never works when they have a community of people who agree with them.

2) Because it activates moral faculties that keep the shamers from contemplating if they might be mistaken.

3) Because bodily autonomy is an important enough issue for a principled stance to be taken against even effective and safe treatments.

I think shaming the unvaccinated is foolish, but playing to people's empathy to prevent it? That's the thing about "othering" a group: empathy no longer exists there. A poorly constructed emotional argument, but perhaps the only kind allowed here, as evidence based discussion of why one might not want to get the shot is an instant ban hammer.


This is a very low quality article and the arguments seem to be very poor and don't really align with the data.

Maybe I'm just old enough to remember there was a period of time when people actually thought stigmatizing unintelligence was the only way to have a healthy society and a second and third industrial revolution happened; this paper seems ridiculous.

It's worth noting, also, that The Lancet contributed much to global vaccine hesitancy with its historical lack of quality control. We might not be in the present situation if not for this:

https://en.wikipedia.org/wiki/The_Lancet#Andrew_Wakefield_an...


It screams cherry-picked data. Look at how oddly specific each citation is:

> In Massachusetts, USA, a total of 469 new COVID-19 cases were detected during various events in July, 2021

> In the USA, a total of 10 262 COVID-19 cases were reported in vaccinated people by April 30, 2021

> In Germany, 55·4% of symptomatic COVID-19 cases in patients aged 60 years or older were in fully vaccinated individuals

> In Münster, Germany, new cases of COVID-19 occurred in at least 85 (22%) of 380 people who were fully vaccinated or who had recovered from COVID-19 and who attended a nightclub

If the author has a strong argument, why not present more than disjointed months of data in specific cities, states and populations?


Because he would have to revert his whole point. 10262 cases among vaccinated people is actually lower than any 7-day moving average and he points out on a data (check the source ref) from 1 Jan 2021 - a day with over 100k cases per day.

Full story laughs at its author.


While vaccine hesistancy is at crazy levels, the so called scientists that get invited to news are regularly underreporting the seriousness of possible side effects of COVID vaccines, which can add to the hesistancy. Of course it's still much better than getting the virus itself, but it's usually not explained honestly in the media.


Every single person I know has gotten the vaccine at least twice, some three times, and not a single person has had any persistent side effects.

I think the problem with saying the vaccine has all these side effects is that in placebo controlled trials a lot of people also get “side effects” from the placebo, either by random chance or they make it up. There really isn’t any evidence these vaccines (mRNA at least) have any serious level of side effects above background noise.


They might just not be telling you about it.

Of the people I know who have taken the vaccine, a lot have had persistent side effects. But I didn't start hearing about this for a couple of months, and even then, well, it's personal medical situations and scary ones at that. I think a lot of people are being told by doctors to just ignore it and hope it'll get better. As the months go by and things don't improve, people become more willing to speak up to friends. Of course, it's also possible me and my gf hear these stories because these people know we haven't taken it yet. If we were rah-rah pro vaccine I bet nobody would mention it because they wouldn't want to be criticized or start an argument.

Side effect reports heard about so far:

- Several menstrual problems, including completely stopped periods and suddenly near-daily bleeding, that lasts for (so far) months.

- Major fatigue including inability to perform sexually, again, months after the shot.

- Sickness for a day or so that's serious enough that the recipient can't work (heard this 4x now).

These are mostly "young" people (under 50). The virus is by itself not a serious illness for these people, some of them had it and it was a few days of feeling ill - nothing special and nothing they haven't experienced before. Given that being bedridden is a commonly reported side effect, and it seems to happen on each shot, and that COVID itself usually only lasts a few days for them, it only takes 3 shots before the vaccines have made them as sick as COVID itself. Which doesn't seem like a smart tradeoff. The goal is to not get sick.


Just because it's not persistent and not categorized as serious it doesn't mean that it's not unusual for young people and it's not a side effect.

As you get older you accept that sickness and pain is a sad part of life, but young people aren't used to even small amount of sickness.

Your thinking just emphasises not having empathy to people being afraid of even small amount of pain.

Also again you write mRNA and not emphatize with people who get AstraZeneca vaccine which has higher side effects. We have to acknowledge these things and be more open about having a tradeoff.


And what is the alternate reality where they don’t get the vaccine and also don’t ever get covid?

Some sickness and pain is going to happen, is a choice between minor, temporary side effects or gambling with a covid infection. The virus is not going anywhere.


There are more people vaccinated than infected generally, so what they see around them are young people in pain for maybe weeks from the vaccine, and the media not being transparent about those side effects, while the alternative media blowing up the side effects and negledging the real problems that COVID causes.


I had a side effect that lasted 5 months - persistent pain in the arm and is confirmed by doctors as caused by the vaccine.

This is much better than the ilness but is not something I would like to repeat.


I suggest you visit your doctor. It could have been Guillain Barre Syndrome a known rare, but possible, effect of COVID-19 vaccines.

https://www.shutterstock.com/search/guillain+barre+syndrome

"Although the cause is unknown, the underlying mechanism involves an autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves and damages their myelin insulation.[2] Sometimes this immune dysfunction is triggered by an infection or, less commonly, by surgery, and rarely, by vaccination."

https://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_sy...

It is currently criminally under investigated by the CDC, who just "noticed" the 258 cases in the US reported in the VARS system. You can also get it after after different types of infections including getting Covid. So not related to the vaccine.


It happened after the second dose of the vacinne (started 3 days after and it is not related to the virus). It is completely gone now so not sure what doctors will find.

I also didn't have any paralysis at any moment, just pain.


There are two possible ways to diagnose it:

1) Blood tests. Some documented variants of Guillain-Barré are associated with an antibody called GQ1b. If it would be present, "could be" a diagnosis of the Miller- Fisher variant

2) Lumbar puncture. A special needle is placed into the area around the spinal cord in the lower back, and a small amount of fluid is removed. Naturally this second option is only chosen in more persistent cases.


Honestly just more transparency regarding them would be fine. Stigma and insults aren't very convincing, especially when the target has a strong community for support. Things like the refusal to shut down travel with China and the about-face on masks early on in the pandemic eroded a lot of people's trust in government. Politicizing the issue didn't help either. I recall reading a report during the early days of the pandemic where the volunteer being interviewed said they had much better receptivity to masks in conservative populations than others. This stopped about the time masks become mandated. Many members of my home community were also early adopters of the vaccine - their support dried up immediately following the series of mandates, with some of them participating in anti-mandate protests. At this point, further stigmatization of unvaxxed will only create more of a bunker mindset. Perhaps it's best for the future of the country we just accept a 100% acceptance rate is not going to happen.


Bringing up an interesting point. Not refuting anything you said :).

Conservatives in some countries like Germany, Scotland are the ones who want everyone to get vaccinated while the [harder?] left want vaccines to be a choice, etc.

This follows along my own hard left politics. Vaccination should be a choice.

However the hypocrisy or lack of self awareness of liberals and of the right has made all of this stuff so politicized and vitriolic now.

IE I would have an easier time taking the rights anti mask anti authority stuff seriously if pushing for Govt to stop abortions and CRT learning weren’t massively popular policies. So it’s not about principles then.

For liberals, the amount of authority seeking is problematic and goes against the apparent principles of caring about the disenfranchised and bullying authority.


This is not a paper, it's a letter to the journal. Space is very limited. The salient point is that governments are using shame and stigmatization to try and encourage vaccination, when in reality the unvaccinated are apparently only putting themselves at risk. The vaccines appear to help patients cope with and ward off the serious effects of Covid-19, but not significantly prevent infection or transmission (although a caveat is that this may go against the RCT data reported by Pharma to validate the vaccines -- but I haven't seen it myself). Stigmatizing the unvaccinated and even denying them medical care in some cases does nothing to help save lives, which should be the goal. Governments should be spending more efforts on proving that the vaccines are safe and well tested and developing treatments rather than bashing people who may become victims.


This isn't even really a "paper" -- it is "correspondence" -- a letter to the editor and as such is not peer reviewed and is basically the same as a similar letter to a newspaper. People (and web sites) need to recognize that journals publish such letters as well as opinion pieces, neither of which are required to go through the same scrutiny as an actual paper.


What is the benefit accrued from stigmatizing the unvaccinated?

From where I'm sitting in Montana, with no mandates, low vaccine uptake, and nobody giving a crap about the "OMG CASES THE CASES", the firmament remains.


It is a position that goes against all available data. We should absolutely stigmatize stupidity. People making crowd-harming decisions despite available evidence should be shamed.

People stopped dying because of (their own) stupidity a long time ago. Selection can still occur if we stigmatize bad behaviors enough.

On the other hand, if we don't stigmatize it, people who are innocent of the sin of stupidity will be harmed. That said, selection would also do its good work in this case, just less effectively and with a sadder outcome for all.

The only way to have an intelligent nation that's pushing forward in terms of technological progress is to have a nation that embraces intelligence and shuns nonsensical stupidity.


You haven't considered the most important part of this: is stigma good at changing behaviours?

If you stigmatise something and shame people for it, you tend to push people underground. At that point rational discourse can't exist because there are social pressures to not reveal the unpopular opinion, and thus discussion doesn't occur.

It's foolish to think that people have stopped dying from stupidity, it happens every day in every country on earth. And it's foolish to think you can cure "the sin" of stupidity by using shame. This doesn't mean we ignore people's bad decisions, but that we must be realistic about the utility of our response.


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I'm open to evidence on the efficacy of shame, but your other comment does not provide that.


Right now in Australia, there is a huge gap between indigenous vs. non-indigenous vaccination rates.

Would your strategy be to stigmatize indigenous Australians as stupid, or to stigmatize them in other ways (which ones?) in order to convince them to get vaccinated?


Similar in the US, we have a “vaccine gap” for black and latinx caused by hesitancy/racism. They amazingly don’t trust a system the authorities have been spending a lot of effort telling them is a racist system.

But the media, despite the fact that the most hesitant groups are people of color, have painted a portrait of the vaccine hesitant as bad white people (rural, politically conservative, Christian). So shaming and ridicule have been embraced. The media and most elites, many posters here included, love to hate rural citizens, at least those who they presume to be privileged (ie white). They do not realize they are criticizing the uneducated poor, largely disadvantaged black people in urban areas.


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Dude, you're stupid to not be vaccinated if you already have recovered from covid and have superior natural immunity?

That's an extremely silly take.

It's like you think this is about compliance rather than, you know, ending the pandemic.


You've unfortunately been using HN primarily for political and ideological battle. That's not allowed here, because it's destructive of what the site is for. It's also the line at which we ban accounts (see https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme... for past explanations).

Would you please review https://news.ycombinator.com/newsguidelines.html and use HN as intended from now on? That means for intellectual curiosity.


Unironically yes. There are simple steps that can be taken to drastically reduce the amount of harm caused unto you and by you unto others and transmission through vaccinated individuals is lowered. We would have been done with this before any variants arrived if stupidity wasn't celebrated.

Since it's too late to genuinely fix now, the best thing that can happen is shaming stupidity. Applying evolutionary pressure to individuals that take bad actions is an incredibly good idea. Making the unvaccinated modern lepers is good for society as a whole.

It's not compliance, it's acting rationally. Politically, I'm not even very far from the group most adamant about not getting vaccinated (card-carrying anti-Democrat, here), yet I still acknowledge that not getting vaccinated is an incredible act of stupidity. People who celebrate stupidity instead of acting rationally in times of plague should have evolutionary pressure applied.

It's too late to turn back time and fix the pandemic by forcing them to act rationally, but by applying pressure to prevent them from having success in society, we can make them much less likely to be around the next time this happens. The society of the United States has been doing things like this since it began quite successfully, and it would be ridiculous to stop doing it now.


You posted a bunch of flamewar comments in this thread. That's bad. It doesn't seem you're in the habit of it (that's good), but would you please review the site guidelines and not do this again? It's not what this site is for, and it destroys what it is for, so we'd appreciate it.

https://news.ycombinator.com/newsguidelines.html


>We should absolutely stigmatize stupidity.

Would that include stigmatizing people who insist on continuing a tactic that quite observably has flipped into being counterproductive?


Do you have some evidence that shaming people changes their behavior?


Here's an obvious one:

As a society, we went from a period of it being socially acceptable to marry ridiculously young girls as an old man to the present day where it's unheard of. People will point to the law being the reason for this, but that's not actually the truth, really. The age of consent isn't really that high; in many states it's unrestricted at sixteen and much lower with loopholes. Also, in many cases, the raising of the age of consent is a historically-recent thing that followed the shaming.

We've managed to (largely) eradicate the case of "man finds a fourteen-to-sixteen year old girl and erases her future by making her responsible for children" in under a hundred years, and it came from shaming, not law.


Has the incidence of this kind of terribleness actually gotten lower, or do people just talk about how awful it is?

I hear a lot of horrible stories about sexual abuse and enslavement in the modern world, so I'm not sure this has actually changed materially. I would be glad to see evidence that it actually has changed.


> "It is a position that goes against all available data. We should absolutely stigmatize stupidity. People making crowd-harming decisions despite available evidence should be shamed."

Is then also stupidity not to force vaccinated people to be tested regularly? "all available data" shows they spread the virus, therefore also being "crowd-harming"?

"How do vaccinated people spread Delta? What the science says"

https://www.nature.com/articles/d41586-021-02187-1


No it doesn't. All available data show that those with natural immunity are immune to covid far more than those with vaccine immunity.

Why should those with natural immunity be stigmatized?

Is this about immunity and getting out of a pandemic or is it about compliance and control or about something else entirely? Should be about the first, to me, and if so, natural immunity should not be stigmatized at all.


“So who is capable of mounting this ‘superhuman’ or ‘hybrid’ immune response?

People who have had a ‘hybrid’ exposure to the virus. Specifically, they were infected with the coronavirus in 2020 and then immunized with mRNA vaccines…” *

Natural immunity is not nearly enough. Everyone should get vaccinated. Those who have had covid should get vaccinated so that they can get a chance of super-human SARS-variants protection. Those who have not caught covid so that they avoid the very high risk of long covid, and of course to reduce their risk of hospitalization by an order of magnitude.

* https://www.npr.org/sections/goatsandsoda/2021/09/07/1033677...


You may be confused. At least here in Germany, we (mostly) implement 2G: "Geimpft oder genesen." -- vaccinated or recovered. (Depending on context, "getestet", meaning tested negatively, is also fine.)

So no, "natural immunity" is not treated any differently from "artificial immunity", and it absolutely is about getting out of a pandemic without too many people dying. By the way, there is no difference. Immunity is immunity.


I completely agree with you that shame works. I think people who pretend that shame changes nothing haven't been to Asia. But the world has already shamed these people as much as any group can be shamed in current year; there's not really any higher level of shame that can be given out at this point. The ones remaining are unaffected by shame.

So I'm not saying your plan is ineffective, I'm saying your plan was already executed and finished. That's why we're at 80-something percent instead of what it would have been.


Stupidity is in the eye of the beholder.


> From where I'm sitting in Montana, with no mandates, low vaccine uptake, and nobody giving a crap about the "OMG CASES THE CASES", the firmament remains.

You should check out places like Alaska, where the hospitals are (or were a couple weeks ago, anyway) overwhelmed. Even aside from the people directly affected by COVID, it affects anyone else who may have needed to use those hospitals for things like unrelated accidents, other diseases, complications from births, etc.

"It's not a problem right here, right now, so therefore it's not a problem at all anywhere." is not exactly a great argument.


No need for him to check out Alaska. That also happened recently in his state of Montana. If he finds that not to be a cause for concern I doubt he will find Alaska's mismanagement of COVID persuasive.

(And it was mostly not elderly people filling the ICUs. The average age of COVID patients in Montana ICUs was under 50. Before delta it was 80).


Of course, states like Montana will be hit the least by infectious diseases. The reason is population density. To spread a virus, you first need to meet another person. Montana is actually larger than Germany area-wise. But has less inhabitants than the city of Cologne. Overall the population density of Germany is 80x that of Montana. Equally the disease spread is worse and as are the consequences.


I'd say the USA is very specific because of so many places having such low population density. This is probably why Europe is most impacted by covid on paper: high population density, high urbanisation percentage and high levels of testing+reporting. Maybe it's worse in some high density poor countries but from what I understand they just pretend the problem does not exist


I believe the hope is, if being unvaccinated is stigmatised, people who are on the fence will become vaccinated, then we can finally beat this pandemic, saving tens of thousands of lives.

Of course, the fact being obese is stigmatised doesn't stop loads of people being obese, I doubt stigmatisation isn't a silver bullet for health issues.


Is there any actual indications that even if everyone was vaccinated this pandemic would go away?


Please, tell me, by what strategy do you propose we use these vaccines to end the pandemic? Please consider in your response that the pfizer vaccine wanes to 20% efficacy after 5 months [1] and the others are no better. As well consider those vaccinated still catch and spread the disease.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

From where I'm sitting it seems the vaccine maximalists believe the way we end the pandemic is a global 2-3x/year dosing regiment for all the earth's citizens.


That's a real comfort to the people I know in Montana who died of the virus.


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At the same time, we vaccinate to protect us collectively, and those with legitimate reasons to abstain can be respected. We are supposed to have margins that allow for this.


And it’s protecting those same innunocompromised people that requires everyone who can take a vaccine to do so. You can’t be both pro-care for the innunocompromised and anti-vaccine for reasons other than destructive politics.


I encourage everyone eligible to get vaccinated, however in the long run that won't protect the immunocompromised. The vaccines aren't sterilizing to any significant extent and the virus is now endemic, so everyone will be exposed regardless of how many people are vaccinated. There will be no significant herd immunity effect to protect those who lack immunity.

https://www.businessinsider.com/delta-variant-made-herd-immu...


I fully agree. Vaccinated people should also participate in regular testing at their own expense to protect the others. Anything else is just putting others lives at risk. They should be absolutely ready to make that small sacrifice. If they are not willing to do they should be heavily stigmatized.


> Ironically, the type of people who are unvaccinated are disproportionately in this camp, I suspect.

What do you mean by this?


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Very Silicon Valley mindset, grouping people up and getting them to only interact with people like themselves.


? I know unvaccinated people. I imagine most people do. Doesn't change what is happening.


Yes, this paper asserts we are “talking about a pandemic of the unvaccinated” when I think we’re talking about a system burdened by the unvaccinated and a class of workers who are underappreciated by the unvaccinated.


Hospitals so flooded the nursing staff had to cut one of their scheduled TikTok group dances this week!!


The WHO agrees:

  Does it prevent infection and transmission?
 
  There is currently no substantive data are available related to impact of Pfizer BioNTech vaccine on transmission or viral shedding.
https://www.who.int/news-room/feature-stories/detail/who-can...


The WHO agrees on "transmission or viral shedding".

The WHO disagrees if anyone's tries to claim the vaccine doesn't help.

  The Pfizer BioNTech vaccine against COVID-19 has an efficacy of 95% against symptomatic SARS-CoV-2 infection.
And each and every ICU bed taken up by an unvaccinated SARS-CoV-2 case taking a severe turn is an ICU bed that, with above 95% probability (yes, naïvely), could've been available for someone else. Like a cancer or heart patient.


This doesn't mean the WHO "agrees". A poster explained this above: " That is one "failing" but not the most important one. No intramuscular shot seems to provide protection against infection of upper respiratory aerosol spread viruses. They provide IgG antibodies in the body serum, and that seeps into the lower lungs to provide protection from serious disease. But intramuscular vaccination does not provide even medium term protection against infection of the upper respiratory mucosal tissues. And that's really unfortunate but not unexpected if you knew anything about how influenza vaccination works. Those muscosal surface tissues require local IgA antibodies and resident B and T cells to prevent infections. Intramuscular vaccination does not cause this (though it does train the T cells that will go there when you do get infected).

So, intramuscular vaccination is not preventing sars-cov-2 infection of the upper respiratory and spread of the virus to others. This does not mean intramuscular vaccination is not needed. It is the vital first step. The next step is an intranasal vaccination booster to provide resident T cells to the upper respiratory (as well as a brief period of IgA antibodies and B cell residence).

If we're gonna get through this both "sides" have to acknowledge their failings. Intramuscular vaccination is both not enough and a required first step. Intranasal is next. Then we can finally start ending this pandemic.

"




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