Early, but growing evidence vaccines less effective against Delta

I guess there’s a “glass half full” effect with interpreting such information. I read that as the remaining 12% generally just have enough symptoms to be noticeable – basically, in 11%+, they’ve got noticeable “cold symptoms” caused by COVID infection. Though I can’t link to it, I suspect that severe cases (hospitalizations) arising from Delta in vaccinated persons are exceedingly rare.

As a thought experiment:

If the vaccine is preventing serious illness and death, Should we be that worried about new infections? If those people recover, they will then have a strengthened immune response.

Vaccinations may allow us to build herd immunity through infection without serious risk of death or swamping the medical system. If we let younger, healthy people do their thing, and protect those who are still at risk of serious outcomes, that might be the fastest way to kill the virus once and for all.

I worry that if we always try to lock down and isolate people so they can’t get infected, we will be locked into a cycle of vaccinations, then rises in cases as vaccines wear off, then a new cycle of lockdowns while we work up new vaccines or get everyone booster shots. Rinse and repeat.

It may be smarter to simply try to protect people from serious outcomes, then let the virus run its course and have everyone get boosts to their immune systems that way. The focus should be on keeping people from getting sick enough to tie up hospital respurces or die. If we’ve done that, what are we really afraid of?

Because if you can get everyone vaccinated, you can prevent deaths and hospitalizations almost entirely.

I’m not saying we shouldn’t vaccinate. I’m saying that as long as we are vaccinating everyone, should we really be locking down if vaccinated people are getting infected, so long as they aren’t being hospitalized or dying?

I assume getting infected would likely be more like a cold or mild flu, with the end result being an immune system that has learned to defend against the variant. That doesn’t sound like a terrible outcome to me, and might even be the fastest way to protect the population against variants before they mutate into something more deadly.

Well, in the US, NY and NJ, for example, have opened up, but waited until vaccination rates were high enough (other areas opened up sooner, of course, even though the vax rates were and are still much lower). In Canada, I think the vaccine rollout has been much, much slower – I don’t think the NY area opened up until vax rates were higher than they are in Canada.

The problem is that we aren’t vaccinating everyone. We’re vaccinating everyone who wants it, but there are still way too many who don’t.

A year and a half into this pandemic, four million excess deaths worldwide, and we’re still having to endure this “let it run wild and rush to herd immunity” bullshit?

For the record, as variants have developed they’ve become more adept at infecting and causing severe disease in younger people with no underlying conditions or co-morbidities. Even though younger people still comprise a minority of serious cases requiring hospitalization the relative rates have gone up manyfold and the B1.1.67.2 “Delta” variant appears to be highly transmissible among younger people, who even if they are not severely impacted are able to efficiently convey the disease throughout the population, including to people who have not been vaccinated or are immunocompromised. It has been well illustrated that the natural immunity from infection is not long-lasting, and while the immune response from the mRNA vaccines appears to be quite robust, mutations in the variants and particularly in the furin cleavage sequence threatens to significantly reduce the effectiveness of the current vaccines, requiring the development of modified vaccines.

We will not kill the virus once and for all; even though from the very beginning people kept promoting the idea that if we hit some herd immunity threshold (with people initially guessing it at ~30% despite the fact that the data in no way supported that estimate) that the virus would ‘disappear’, i.e. be eradicated, even though that isn’t the case for the majority of pathogens. Even if we assume that there are no animal reservoirs from which backspill could occur, the infectiousness of this pathogen and the fact that the majority of contagious carriers are asymptomatic makes it virtually impossible to eradicate this virus short of simultaneously vaccinating everyone on the planet.

Even setting aside the serious and chronic effects of what is now being called “Post-Acute Sequelae of COVID-19”, e.g. ‘Covid long-haulers’ which are affecting untold millions of people, to “let the virus run its course and have everyone get boosts to their immune systems that way,” means not only millions of more deaths but the emergence of more variants which could both evade current natural and vaccinated immune response and potentially developing into a substantially more virulent pathogen which could demonstrate much higher morbidity and mortality. The way out of this pandemic is to promote and pursue comprehensive vaccination while pursing more effective therapeutic treatments and continuing social protective measures to reduce contagion. Of course, that won’t happen because people need their luxury ocean cruises and theme park vacations, and to that end will rationalize why no protective or precautionary measures are needed.

Stranger

Possible evidence in the other direction: Vaccines extremely effective against COVID variants of concern: Canadian study - Macleans.ca

@Stranger_On_A_Train what’s your opinion on the hypothesis that the really high efficacy levels seen earlier were due to the fact that the trials were conducted in a time of mass masking and social distancing and so were the early vaccine roll outs and that the vaccinated and real world ie vaccinated but unmasked/non socially distant protections levels is significantly lower?

This is great news!

So having a vaccine which mitigates the worst outcomes doesn’t change the thinking on this at all?

It does when only 47.5% of Americans are fully vaccinated (source: Washington Post). Even if the fully-vaccinated are, themselves, much less likely to die or become seriously ill, even from the Delta variant, if they become infected, without mitigation measures, they would spread it to the unvaccinated.

Sure, but that means the focus should be on getting everyone vaccinated.

I don’t disagree, but the vaccines have pretty much been available to anyone in the U.S. who wants one since the latter part of April. Various federal, state, and local health authorities have been advertising for months, trying to convince people that the vaccines are safe and effective, and trying to encourage the reluctant to actually get vaccinated.

At this point, there are very few Americans left who are unvaccinated, but are interested in getting the vaccine. Setting aside those who are unable to get the vaccine (due to underlying health issues), but would otherwise want to get the vaccine, the rest are either (a) worried about side effects from an “unproven” or “experimental” vaccine, (b) generally anti-vax, and/or (c) convinced that COVID is some level of hoax.

IMO, it’s very unlikely that you’ll be able to change large numbers of those people’s minds with facts or emotional appeals, and thus, the only way to get those people to take the vaccine is to force them to do so, which is, IMO, unlikely to go well.

Weren’t both the controls and the test subjects going around masked and observing the same social distancing protocols?

But the infection rates of the vaccinated were 90% LOWER than the placebo ones.

The various reports seem to differ a bit in level of scariness, but two reports indicate that the Pfizer and Moderna vaccines are less effective against the lambda variant. I keep an eye on the news, I like to have some warning.

So it seems.

It reminds of a friend’s tagline: “The most common elements in the universe are hydrogen and stupidity.”

And children. There are a lot of unvaccinated children under 12.

I guess I am unclear on what it is you are proposing because in one post you talk of “herd immunity through infection” and fearing “we will be locked into a cycle of vaccinations”, and next arguing for vaccination. The reality with this pathogen is that there is likely no real threshold of herd immunity that will “kill the virus once and for all.” This virus–and its every growing multitude of variants–will likely be with us for the foreseeable future and will require periodic vaccination. The notion that we should just boost vaccines through natural infection–which is going to occur at some level anyway–ignores the impact of post-infection chronic symptoms which are often popping up in people who did not have acute illness or were even initially asymptomatic. And this is hardly unprecedented; we face the same situation with seasonal influenza A infections, except the transmissibility of common influenza strains is about half an order of magnitude less than SARS-CoV-2.

Remaining in a state of perpetual or cyclic lockdown is obviously undesirable and ultimately unsustainable, which is why comprehensive vaccination needs to be promoted as the way that we get this pandemic under control. After that, we need good systems of infectious disease reporting and surveillance so that we can track an outbreak of a new, more infectious strain early. It is unfortunate that China did not share what information they had early and seems unwilling to cooperate with investigators now because while that may not have prevented this disease from becoming a pandemic, it would have allowed a running start to lock down travel, get testing and tracking in place, and take other measures to limit spread before it got to proportions that overwhelmed medical systems. Of course, given how badly various nations managed the outbreaks even when they had prior notice (India, Brazil, various parts of the US, and Russia specifically, although there are only a handful of nations that could be said to have actually done well.

And it should be made clear that for the millions of deaths it has caused (and millions more coming), this was a pretty mild pathogen. A virus with an infection fatality rate of, say, 5%, would have resulted in 25-30 million primary deaths and much wider social and political disruption. And many epidemiologists warn that we are overdue for that kind of a pandemic even without consideration for how much the opportunities for spillover will occur with habitat destruction and displacement of species.

I think we need to be careful about interpreting those numbers. The newsreaders repeated them verbatim endlessly as if carved in granite, when in fact those initial studies covered only healthy adults ages 18-55 or 18-65, efficacy against the original ‘wild type’ virus, and for the most part only reported out symptomatic illness without doing comprehensive rtPCR testing to assess the potential for asymptomatic infection. That real world efficacy against the wider population is less even before variants develop the ability to skirt the immune response is not surprising. Nonetheless, the development and approval of these vaccines has been nothing short of miraculous, and they are effective enough to reduce severe morbidity and mortality to a tiny fraction of that in the unvaccinated population. The effects of distancing and mask wearing are presumably factored into those numbers by dint of large sample sizes with equivalent propensity for wearing masks and distancing but that does have the potential to bias effectiveness. Regardless, we need to be realistic about how much protection these vaccines will continue to provide because they are not the bulletproof

That really worries me because from the beginning people have been dismissive about the effects on children just because they weren’t getting severe illness. I cautioned at the time about the concerns of long term effects (also seen in some strains of influenza) but the loudly voiced assertion was that this just wasn’t a real problem for all but a tiny minority of children. Now that we are seeing increases in the number of severe illnesses in kids and potential long haul effects, I hope people are taking this more seriously even though it is difficult to get children to distance or consistently wear masks. Certainly, getting a vaccine available for children under 12 should be a priority before we end up with a variant that prefers children and people with really active immune systems akin to the ‘Spanish Flu’.

Stranger

fwiw, none of my friends with school-aged children have mentioned any trouble at all getting their kids to consistently wear masks. They HAVE had trouble keeping their kids away from other kids – kids seem to be wired to be social creatures. But the children of parents who wear masks seem to accept masks just like they accept pants and shoes.