And now we've given up

I would definitely disagree with that; too many animal reservoirs for it to breed and mutate in to ever be completely eliminated.

When the media (and frankly a lot of public health authorities) refer to breakthrough infections they actually mean symptomatic presentations. However, despite the amazing effectiveness of the first generation SARS-CoV-2 vaccines in reducing severe morbidity to a fraction of a percent and mortality to almost none, the effectiveness during trials where participants were periodically monitored for asymptomatic infections via rtPCR testing were generally in the area of 80% (and these were all nominally healthy individuals between 18 and 60 years of age), indicating that the disease can still take hold enough in some vaccinated people to replicate and potentially transmitted to others even in a completely vaccinated population. This is actually more reason to push for high vaccination rates because essentially the only way to reduce contagion to endemic levels and maintain it there is for a very high rate of sustained inoculation in the population (possibly >90%), and of course because the protective benefits of the vaccine if one is infected, particularly against COVID-19 post-acute sequelae (‘long hauler’) syndromes.

Poliomyelitis could potentially be eradicated by global vaccination and sanitation because while highly infectious it transfers via fecal-oral route; thus, hand washing, water treatment, not sharing bathwater, et cetera is enough to reduce contagion to endemic levels, and there are no reservoirs for the virus among domestic animals, so a nearly comprehensive vaccination could reduce incidence to the point that residual infections could be traced and isolated.

Measles, on the other hand, is highly transmissible with an R0 of 12–18 and can potentially host and spillback from numerous domestic animal reservoirs. (Although no specific domestic animal reservoirs are known to exist, morbilliviruses are common in domesticated mammal species and the ancestor of Measles morbillivirus likely came from cattle and spread in the post-Bronze age migrations.) Eradication of measles would require successive generations of vaccination campaigns and a vaccine with sterilizing immunity because even just a few percent of the population remaining vulnerable through non-vaccination and breakthrough infections would be enough to sustain the pathogen as endemic in the population the same way that chickenpox (Varicella zoster) is, and we would almost certainly still have to surveil for spillover infections; in essence what was done to eliminate rinderpest in cattle.

Stranger

I understand that this is a very difficult thing to pin down, but are you aware of a confirmed case of a vaccinated person transmitting the disease to someone else?

I would like to read more about this, so I will seek out some concrete sources.

No, I don’t have a specific instance to cite, and because the majority of infections of vaccinated people are at most mildly symptomatic or asymptomatic, identifying and tracing potential contagion is very difficult, especially since little focus is being given to tracing efforts. Based on relatively low cycle threshold values of rtPCR, it would appear that some breakthrough infections are still potentially contagious although CT values can be misleading as they can magnify RNA fragments that are not active virus. In any case, there are plenty of unvaccinated (whether through unavailability or unwillingness to receive the vaccine) around the world to ensure that the vaccine will have human harbors as well as potential animal ones, hence the need to maximize vaccination and maintain surveillance for the foreseeable future.

This brief from the CDC Morbidity and Mortality Weekly Report indicates an effectiveness of partial vaccination (one shot) of 80% and full vaccination (two shots) as 90% for the Moderna and Pfizer-BioNTech mRNA vaccines (which are the most effective vaccines in trials) against detectable infection regardless of symptoms (as determined by rtPCR testing). The adenovirus-vectored vaccines (Janssen/Johnson & Johnson, Oxford/AstraZeneca, and ) have shown somewhat lower effectiveness against protections against infection, though again they seem to be highly effective in preventing severe disease and death in all recipients except for those who are severely immunocompromised or have underlying conditions that already contribute to poor outcome. How much immunogenicity those vaccines will have with booster doses or a mix of different vaccines is under study, but it is clear that the vaccines while highly effective do not provide so-called sterilizing immunity.

Stranger

I never thought that COVID would be wiped out to the extent that smallpox was. Nor did anyone try to make me think that. Whenever anyone spoke about “herd immunity”, it was always compared to flu, measles, etc, which do exist, and are infectious, but not running rampant.

I suppose herd immunity might be compared to a wildfire which is “under control”. It’s still burning, and still destroying, but we have a handle on it to some extent.

Yeah, I think we all need to understand that herd immunity ≠ eradicated.

In question by whom, and according to who? Every knowledgeable source I’ve seen indicates that in America, at least, there are zero legal issues, at least significant ones, with making vaccination a job requirement. The only thing that MIGHT be an issue is the small number of people who refuse vaccines for genuine religious beliefs.

We will see what happens when the actual lawsuits reach actual courts. Part of the problem is that you already have Republican governors who are overreaching to try to mandate anti-vax behaviors by businesses, e.g. Texas passing a law banning any business from inquiring about vaccination status.

Current interpretation of “reasonable accommodation” tends to mean that you do not have to create an entirely separate job for a religious belief. If the only shift you need help with does essential work on Saturday then you do not have to hire someone for an unneeded Thursday shift just to accommodate an observant Jewish applicant. If your paper mill is inherently a job where people work closely in a physical place then you do not have to create a fake “work from home” position to accommodate someone who won’t get vaccinated. Etc.

For jobs that can “reasonably accommodate” by keeping the unvaxxed employee separate from the office, then there may be more issues with mandating vaccines. This also runs into some of the unintended consequences of laws passed 10-15 years ago about “conscience exceptions” designed to let pharmacists decline to dispense birth control. These laws were written over-broadly in a haste to get them passed and they broke new ground by essentially letting someone object to the fundamental nature of the job. It’s one thing to say that, if Kroger has 25 employees in the building at any time and 5% of their transactions involve alcohol, it’s not an unreasonable burden to allow someone who objects to selling alcohol to request that another employee handle those transactions (I think that in some states, underage employees have to do it that way, in fact). It’s another to say that a pharmacist, whose job consists entirely of dispensing medication and more often than not is the only person on duty allowed to do that job, can earnestly claim a religious objection to dispensing medication. It’s of a kind with a Muslim getting a job at a pork processing plant and then claiming exemption from 100% of work because they won’t touch pork - the only reason the law hasn’t been interpreted to allow for that when, by the letter, it should is because everyone knows these bills were only designed to protect Christians and pharmacists.

Eventually this will become a national-level issue to be resolved by Congressional statute or Supreme court decision.

Several major US companies have announced they are now demanding COVID vaccination as a condition of hiring. They seem to be on very clear legal ground there. In the USA it’s well-settled law that employers can refuse to hire somebody for any reason whatsoever, except the very short list of protected class reasons (race, sex, etc.) Vaccination status, or ridiculous attitudes to science or politics are not protected classes.

Which is very different from demanding vaccination of existing employees. Though I certainly hope that being able to require vaccination of existing employees becomes settled law soon.


Here’s a recent vid and transcript by a well-credentialled medical ethicist on the topic of religious exemptions:

If this is paywalled, you can sign up for free. Their COVID coverage is first rate.

Maybe I’m wrong, but it seems to me that some of you are responding to the word “eradication” and not to what the OP quoted. I didn’t necessarily expect actual eradication, but the quote seems to indicate that we’re giving up on herd immunity, too. We’ll just accept a certain level of death, and nothing else can be done.

I knew eradication wasn’t necessarily possible. But the goal as I understood it was to get as close as we could. That quote seems to indicate that we’re done trying.

@Qadgop_the_Mercotan Can you link anything on people reacquiring the disease from an animal infected by a human? Last I was looking into this, the animals who were infected from humans were rare, and none had been known to spread the virus back to humans. With contact tracing the way it is now in some places, we should have data on that, I would think. With examples, then we could make models, and thus see how big the reservoir problem would likely be.

@Deeg I can’t see how combining the C19 shot with the flu shot is the “best we can do.” The flu shot is a shot that the majority of people don’t take, as most people don’t consider the risk to be high enough. And we definitely don’t want to help out those who think that COVID-19 is no worse than the flu. It would seem very counterproductive to link the two. Sure, flu vaccines might go up, but I’d expect COVID-19 vaccines to go down, and that’s the last thing we need.

The best we can do is treat the vaccine more like the mandatory vaccines. We already have employers saying it will be required to work for them. We need to get that to spread. Make it required in schools, too. Get it approved for even younger kids, so it can be treated like other vaccines.

Now, will we do that? I’m worried we won’t. But I cannot at all see how combining it with the flu vaccine would be better than where we are now.

I’d like to see some business try my proposed workaround (“We’re not requiring proof of vaccination; we’re just offering you the option to present it and bypass the temperature check. You’d rather do the temperature check? OK, drop your drawers and bend over*…”), if only to watch the resulting fireworks.

*Possibly followed by “You don’t want to do that either? Meh, I guess the thermometer will work OK if you put it in your mouth instead…”

If you’ve got a better idea I’m listening. States are resorting to lotteries and free beer give-aways and we still aren’t close to 70%. At some point we’ll just be trying to manage it for the most vulnerable, who are also (generally) the ones who get the flu shot.

I don’t see it politicaly feasible to mandate the vaccine; maybe the private sector can get us over the finish line.

Again, flu vaccine rates are at best ~30%, and the same people who are refusing the SARS-CoV-2 vaccine are likely the same who do not get a seasonal influenza shot. Other than the theoretical advantage of getting both vaccines in a single jab rather than two individual shots (with the attendant logistical issues and regulatory hurdles of combining the mRNA vaccines with the range of influenza vaccines) this wouldn’t solve any problem whatsoever, and introduces a whole new set of problems into both vaccination campaigns.

Stranger

The federal government would be on shaky ground, legally speaking, to try to mandate the vaccine for everyone. States could do it legally. Whether it’s politically feasible for states doubtless varies from state to state.

And maybe bundling it with the flu vaccine would help (or maybe not). But it’s certainly not the only thing that can be done. Many institutions have already said that they’re going to mandate the vaccine, once it reaches full approval. That’s another thing that can be done.

Yes, herd immunity involves a certain level of death. Nearly everything in life involves a certain level of death. The questions, as always, are what that level of death is, what we can do about it, and what the tradeoffs are.

State laws can be more expansive than federal law. In California, the 1959 Unruh Civil Rights Act is nearly identical to the corresponding Federal law (but has been amended several times to enumerate additional protected classes, e.g., sexual orientation). BUT . . .

The Federal law has been tested in Federal courts, while the State law has been tested in State courts, and they have come up with different interpretations: The Federal courts have held that the Federal law protects exactly those classes that are listed. The CA Supreme Court has held that the State law simply lists examples of protected classes, and that in fact the law protects a wider range of classes than those explicitly listed. Thus, for example, sexual orientation became a protected class even before it was explicitly added to the law.

Would that the whole country lived under California law.

As a CA native I’d like to export our law to the rest of the country as well as export about half the current CA residents. With extreme prejudice for those from the northeast. Then the place would be populated with about the right number of the right attitudes for me to exercise my right of return. :wink:

Again, I’m waiting to hear better ideas. There are all sorts of problems with what I’ve proposed but as Winston might say it’s better than the others.

I wish they all could have California Laws - the Bench Boys.