Fair enough, I hadn’t seen that.
My concern was simply to be clear about a comment that could be taken in a couple of different ways. I see too many threads that derail simply for want of a clarifying question. Often what is inferred is not what was meant.
I’ll leave it there.
It needs to be emphasized that Covid-19 vaccines do prevent both infection and transmission, albeit imperfectly. Any insistence that they must be 100% effective to have any value is foolish and an example of the Nirvana fallacy.
Summary version:
Without reference to any particular poster, statements referring to Covid-19 vaccines in scare quotes as “vaccines” (mRNA vaccines elicit immune responses in the same way as conventional ones), or arguments that data are being hidden or definitions of diseases/vaccines changed to suit someone’s purported agenda, are classic ploys from the antivax repertoire. Likewise, denigration of vaccines accompanied by bald statements about how someone can’t possibly be antivaccine because they allegedly had X number of vaccines themselves and/or had their children vaccinated, is common among antivaxers, sometimes accompanied by statements about how fiercely pro-vaccine they are (as in the case of RFK Jr., one of the most virulent antivaxers out there). However, if you ask these folks to point out what recommended vaccines they endorse and suggest that people get, and you’ll typically be met with dead silence or evasions.
If someone might have got Covid and ended up intubated in the ICU, but got the vaccine and due to their heightened immunity merely had moderate symptoms, lasting a few days and requiring staying at home… well, any health provider would call this effective. No intervention will completely prevent transmission, nor is this a practical goal, not least since not all will get or have access to vaccines.
No one is saying vaccines are perfect or close to perfect. No one is saying distribution was ideal. No one is saying that a given vaccine will always be effective against any mutation. None of the objections above discussed specific parts of the article. Pfizer made $50B on two medicines. They deserve a good profit on their work, but people differ on what that is too.
The purpose of my cites was obviously to show that the definition of the word “prevention” does not imply universal elimination. That is demonstrated, not undermined, by the fact that they all talk about effective prevention while noting that there is no guarantee.
So, moving on from this specific poster, the word “prevent” is not ambiguous in the way that you claim. There is no burden to enquire as to whether someone intended to say something other than the plain language of what they actually said before rebutting a false claim. Especially when the rebuttal contains substantive content and references (absent in the false claim) that make the facts of the matter clear. If someone who makes a false claim subsequently realizes that they misstated their claim, they are welcome to clarify what they really meant at any time.
It seems to me that you are bending over backwards to give antivaxxers the benefit of the doubt, and enabling them to weasel out of false claims by suggesting that the word “prevent” is ambiguous here. Because if you grant that false ambiguity, you can be damned sure that antivaxxers will be deliberately misleading people and then (when challenged) claiming that there is a possible interpretation of what they said that is technically correct.
I haven’t read the article or the original paper, so apologies if this is mentioned in either.
Vaccines also prevented more variants, any of which could have been deadlier. All of the vaccinated people clearing the virus soon after infection represent trillions (quadrillions?) of viral replications and possible mutations that never happened.
That’s too many “maybes and possiblies” to put a number of lives saved on, but I think the risk is legitimate.
There is no “moving on” from that poster seeing as the entireity of my point was to do with them potentially using “prevent” in a way that we wouldn’t.
I disagree, I think clarifying what a person actually means is an essential part of a useful discussion.
But as we can’t ask that poster and have been specifically requested to drop this, I think we should.
If someone states that the vaccines did not prevent infection or transmission, that’s simply false. The vaccines prevented millions of infections and transmissions.
Having traffic lights prevents accidents, and yet there are still accidents at intersections with lights. Shocker.
I’m all for rigorous use of language.
But when partisan thinking and A Ha Gotcha-ism causes any slight quibble around the edges to be stretched into a core fatal flaw in one’s argument, quibbling about the corner cases of common word definitions is a fool’s game. So don’t play. Fools enjoy it and you get muddied.
And even granted that protection is mostly only needed for the elderly or those who are otherwise especially vulnerable, that does not imply that vaccines should only be for the elderly and vulnerable, or only mandated for them, because vaccines don’t only protect the vaccinated. You protect the old and vulnerable by vaccinating them, and also by vaccinating those who have contact with the old and vulnerable, and also those who have contact with those people, and so on, and the list rapidly approaches vaccinating everyone in the world.
Now, early on when vaccines were still in short supply, yes, it absolutely made sense to make decisions about whom to vaccinate first, because vaccinating some people will have more effect than others. Even there, I think it might have been more effective to, say, vaccinate nursing-home workers before nursing-home patients (I say “might”; I’m not sure about that). But in the long term, once you’re capable of vaccinating everyone, of course that should be your goal.
And the fact that vaccines protect those other than the vaccinated themselves is why it is perfectly reasonable and proper to mandate the vaccine: It’s one thing for people to make choices that endanger themselves, but people should not be permitted to choose to endanger others, without strong counterarguments (that were lacking in the case of vaccines).
People in this thread note, several times, that a vaccine teaches your immune system what the virus looks like. But they also then seem to immediately leap away from considering the practical ramifications of that, expecting the vaccine to act like a magical forcefield that stops the virus from ever entering your body, rather than expecting it to simply allow your body to catch and fight the virus earlier, because it knows what to look for.
But, likewise, when it works by teaching your immune system, there’s the ramification that it won’t do anything if you don’t have an immune system. Spray as much vaccine into an immunocompromised person as you want and nothing is going to change for them. There’s no one home, to teach.
The people who are the most likely to die from Covid aren’t people who are unvaccinated, it’s people who have a weak or absent immune system. That tends to correlate with old age but it’s not the lifestyle of bingo and watching old cowboy movies that let’s Covid get you, it’s that - as an older person - you’re more likely to suffer from something that has devastated your immune system, is already maxing it out, etc. And thus, you’re more likely to be a person who won’t be able to fight off the disease - vaccinated or not.
Vaccination of the elderly doesn’t necessarily protect the elderly who are at risk, because the ones at risk are much more likely to be “immune” to the vaccine for much the same reason that they are the ones who are the most at risk of dying of Covid.
If those particular elderly almost purely interact with other elderly folk then high vaccination rates along their associates will help to protect them. Not all elderly have poor immune systems, and those ones are more likely to suppress the disease quickly, without spreading, for having been vaccinated and thus the disease is less likely to get to the immunocompromised. But, on average, it’s still very likely that the elderly will interact with young folk and those younguns are still a risk.
The only protection for the immunocompromised is the vaccination of other people. There’s no amount and no quality of vaccine that will protect them, directly, any more than some magic steroid will help a man with no legs to run faster. No legs, no runny. Steroids can’t fix that.
Vaccines aren’t magic. They have a specific and limited mechanism of operation and that mechanism is mostly the healthy functioning of your body. If you’re not in a healthy body, well… You better hope that the general public is vaccinating.
Covid-19 vaccination is recommended for people with moderate to severe immunosuppression. It may not work as well as in people with intact immune systems, but supplies a degree of protection.
Many vaccines are recommended for the immunocompromised, as the results of infection can be very serious. Live vaccines are generally contraindicated in this population, but there are exceptions.
My now deceased first wife got her COVID vaxxes right away. Despite being loaded to the gills w immunosuppressive chemotherapy drugs at the time and for most of her remaining life. Oncologist’s comment was “Can’t hurt, might / probably will help some. And in your condition you REALLY don’t want COVID.”
In the end she never got COVID before her cancer finished her. Despite 2 full years of pandemic raging around us.
Bottom line for this layman: Immunocompromised means just that: “compromised” as in “somewhat less than normal.” Not as in “substantially absent.” There are people in the latter state. But IMO their life expectancy is just days or weeks outside of a sterile air tent in a hospital. BTDT w wife too.
Yeah, my mom was vaccinated and boosted when she died of covid. Her caretaker, who probably gave it to her, had a cold.
Naw, there are lots of other things. If her caretaker had admitted she had a cold and called in sick, my mom might not have caught it. (I know she had a cold because her friend told me that. She denied it even when staring at her positive covid test.) If they’d been willing to wear masks (admittedly a big ask to wear a mask all the time) my mom might not have caught it.
But both being careful about what you do when you have a “minor bug” and mask wearing help the immunocompromised. And since masks work better for source control than to protect the wearer, a social norm of wearing masks whenever you feel under the weather but need to go out in public would make a big difference.
Vaccines are important, too, of course. And some of them do work pretty much completely. It’s too bad the covid vaccine works like flu and whooping cough vaccines, and not like measles and smallpox vaccines.
Yes. But between the immunocompromisation and the half-life of the vaccine efficacy, I would still say that this is really just a Hail Mary. When the alternative is death, it’s certainly worth the doing but it’s not what you want to rely on.
I’ll also footnote what I wrote to make it clear that there are other risks, like having lungs that are on the edge of failing, that might also make you far more likely to die from Covid. Immunocompromisation isn’t the only risk.
That being said, though, I suspect that it’s likely that if you have one of these issues - COPD, cancer, etc. - you are also a lot more likely to have a reduced or overtaxed immune system as well.
Yeah, vaccination is cheap, and might help. Of course it’s recommended for the immunocompromised. And sometimes it does help. But on average, it helps them a lot less than it helps healthier people.
It’s quite a bit less pithy to say that “the only defense is a combination of activities including, but not limited to, the vaccination of others, Hail Mary vaccination of the at-risk person himself, mask wearing by all involved, abstinence, isolation, antivirals,etc. - many of which rely on the choices and actions of others”. But I was hoping that this would be filled in, subliminally, by the minds of the readers on this forum.
Along these same lines, this article
notes that 650,000 lives would have been saved in the US if the death rate was the same as the Bay Area.
We had some of the first cases, since we are more exposed to travelers from China than most places. But they shut down early. Our vaccination rate is high, and until very recently mask wearing in grocery and department stores was close to 100%.
It remains inaccurate to suggest that vaccination against Covid-19 is almost certainly bound to fail. Consider this evidence:
“VE (vaccine efffectiveness) against COVID-19–associated hospitalization conferred by completing a 2-dose series of an mRNA COVID-19 vaccine ≥14 days before the index hospitalization date§ (i.e., being fully vaccinated) was evaluated using a test-negative design comparing 20,101 immunocompromised adults (10,564 [53%] of whom were fully vaccinated) and 69,116 immunocompetent adults (29,456 [43%] of whom were fully vaccinated). VE of 2 doses of mRNA COVID-19 vaccine against COVID-19–associated hospitalization was lower among immunocompromised patients (77%; 95% confidence interval [CI] = 74%–80%) than among immunocompetent patients (90%; 95% CI = 89%–91%). This difference persisted irrespective of mRNA vaccine product, age group, and timing of hospitalization relative to SARS-CoV-2 (the virus that causes COVID-19) B.1.617.2 (Delta) variant predominance in the state of hospitalization. VE varied across immunocompromising condition subgroups, ranging from 59% (organ or stem cell transplant recipients) to 81% (persons with a rheumatologic or inflammatory disorder). Immunocompromised persons benefit from mRNA COVID-19 vaccination but are less protected from severe COVID-19 outcomes than are immunocompetent persons, and VE varies among immunocompromised subgroups. Immunocompromised persons receiving mRNA COVID-19 vaccines should receive 3 doses and a booster, consistent with CDC recommendations (5 ), practice nonpharmaceutical interventions, and, if infected, be monitored closely and considered early for proven therapies that can prevent severe outcomes.”
To summarize, 77% effectiveness of the two-dose series in preventing hospitalization from Covid-19 in the immunosuppressed hardly qualifies as a “Hail Mary”, even if it’s less than the 90% for immunocompetent patients and some subsets of the immunocompromised don’t fare as well.
Of course (as the article points out), other precautions need to be taken for the immunosuppressed, and a third dose of vaccine was recommended in this population.
All the more impressive when you consider how the Bay Area is one of the higher density population centers in our country. Pandemics love density. It’s not like e.g. rural TX.
That is quite impressive.
That said… Given that vaccines really do have no effect beyond teaching your immune system what to target, I can’t help but feel like if a vaccine can have such a large effect in an immunocompromised person then I’m not sure that I would - personally - back the levels used in the medical community for defining the term “immunocompromised” (or, probably better yet, split it into a few different levels with different terms).
Zero immune system should - unless I’ve wildly misunderstood something - mean zero vaccine effectiveness. Anything between 0% and 100% should have a pretty linear connection and how effective you expect a vaccine to be should directly follow from that.
If they’re giving a 77% effectiveness rate for something that has an original effectiveness of around 98% then that would seem to say that the average immunocompromised person is at about 80% and something around half (or more) of everyone in the immunocompromised group is above that. That seems - to me - like it would say that immunocompromised doesn’t reasonably mean “immunocompromised” from a lay understanding of the term.