[aristophenes]

Without time for a study, wouldn’t it make sense to assume the most common thing, that a natural infection provides more immunity than the vaccine? Taking the line of reasoning where we assume the worst case scenario until proven otherwise, would it be reasonable to assume long term medical issues from the vaccinations?

[loonster]

Continuing with your thoughts, is it reasonable to assume that the selective pressure the vaccinated are placing on COVID variants are a good thing?

I have no clue. I hope it works out well.

[wizzwizz4]

> Without time for a study, wouldn’t it make sense to assume the most common thing, that a natural infection provides more immunity than the vaccine?

No, actually; the actual infection sometimes misfires, leaving dud spike proteins outside the cells. If the immune system finds those first, it'll attack the dud spike proteins instead of the still-functional spike proteins, attacking all the viruses that failed to get into the cells instead of all the viruses that might succeed. The mRNA vaccine doesn't produce real, active viruses, so it doesn't have this problem.

> Taking the line of reasoning where we assume the worst case scenario until proven otherwise, would it be reasonable to assume long term medical issues from the vaccinations?

Assuming the worst-case scenario until proven otherwise doesn't work like that. You have to look at the entire range of uncertainty, and choose the worst-case scenario for each question.

Example: you want to know, worst-case, how many people will die from car crashes on a road in a year, so you assume that the cars involved in collisions are travelling at the fastest recorded speeds on that road (or in the 90th percentile of speeds on similar roads, or something). But if you want to know, worst-case, how long it'll take to travel the road, you should assume there'll be loads of traffic jams, or the road will be closed.

So here's a worst-case scenario if people don't get vaccinated, bounded by my amateur knowledge of epidemiology: there's a large enough infected population passing the disease around for a really deadly, fast-spreading variant to emerge, and its antigens are different enough from normal that everyone currently vaccinated is susceptible, hundreds of millions of people die, and COVID becomes a seasonal (but much more deadly) illness, killing hundreds of millions again every few years until it reaches an equilibrium of sorts. (A real epidemiologist would know more, which would probably lead to a less apocalyptic worst-case scenario prediction – but it might lead to an even worse one.)

Here's a worst-case scenario if people do get vaccinated: everyone is vaccinated, COVID-19 starts going away, then a month later, it turns out that the vaccines – and real COVID-19 infections (there's no mechanism in the vaccines that isn't also in SARS-CoV-2, excluding the needle / delivery mechanism) cause some complicated, heretofore-unknown-to-science time-delay mechanism that causes a severe allergy or autoimmune condition. Thousands die before we identify the problem, and tens of thousands die before our politicians get their acts together and authorise the mass distribution of anti-allergy / immunosuppressant medication (which we already have manufacturing plants and distribution networks for). We live with the aftermath, but getting infected would've been just as bad.

This second scenario is a lot less realistic than the global apocalypse one, because I had to pull side effects out of my ass. If the vaccines caused chronic fatigue syndrome, which is the only COVID-19-induced disorder caused by a mechanism that the vaccines could share (because we don't know what causes it), it would've started happening already. But it hasn't. Assuming some arbitrary thing we have a fair bit of evidence against is not how you do worst-case scenarios, and it certainly shouldn't be how you do actual planning.

[aristophenes]

I don't understand your first point, what does that have to do with the immune system getting geared up for an infection months or years later?

The second point, your worst case scenario doesn't even address the worst concerns of people who don't want to take the vaccine. They don't trust that spike proteins are the only things in the vaccine. The worst case scenario is not that the vaccine acts like the virus but that it acts different than the virus. And then you get conspiracy stuff like new world order types deliberately introducing things to the vaccine that will make it harder to have kids or stuff. And unfortunately our trusted organizations telling white lies to the public to elicit the behavior they want hasn't helped this trust issue.

But this is all moot for two reasons. First, because someone actually did a study and found that the immune response from infection was ~10 times stronger than from the vaccines[0]. Second, because we've already selected for a virus that is highly contagious and can infect vaccinated people, and will thus continue to be selected to specifically infect vaccinated people since most potential hosts are vaccinated at this point.

In summary, we might have to all be infected, nearly all at once, for this to be over, or just get lucky and the dominant strains will be attenuated to the point where they aren't a major problem.

[0] https://www.biorxiv.org/content/10.1101/2021.07.29.454333v1

[wizzwizz4]

> The worst case scenario is not that the vaccine acts like the virus but that it acts different than the virus.

Worst-case scenarios should be constrained by your knowledge. I know what's in the Pfizer vaccine, so my worst-case scenarios have to be constrained by that. But sure:

“Worst-case”, somebody's poisoning the vaccines. This leads to severe side-effects from some batches, which the statisticians take entire weeks to notice because they're all asleep on the job. Vaccine roll-out stops pretty-much everywhere, but nobody's able to trace down the saboteur. A dozen new, highly-transmissible and virulent variants emerge, with different antigens to each other and to the vaccines, so vaccinating the populace becomes intractable.

You see that this scenario is incompatible with “everyone gets vaccinated”. The bad stuff largely comes from “people don't get vaccinated”; the only way everyone*'s going to get vaccinated is if the vaccines don't suddenly get poisoned or otherwise become dangerous.

* except the immunocompromised, and others who don't get vaccines for health reasons.

I can't do a “worst-case scenario” where the vaccines are already poisoned, because they're not. It'd be bloody obvious if they were, given how big a sample size the statisticians have to work with. That would be even more blatantly fictional than my “tens of millions die every year” scenario.

[aristophenes]

I got the vaccine, and recommend others to do so. The reason I have this debate is because the people who are so offended by anti-vaxxers constantly straw-man them instead of being sympathetic and trying to understand them. Like you are straw-manning me, implying that some obvious poison that immediately makes people sick is what I am talking about. Telling people they are stupid is not going to win them over, and forcing them to vaccinate will entrench their opinions and convert more to their point of view.

Try to understand, they don't trust the government, they don't trust the CDC, they don't trust Pfizer and they don't trust you. Yes you have an official list of ingredients that someone with an appropriate degree can understand. But what's the stuff in the actual needle that you are so intent on making sure gets injected into them? Seems perfectly reasonable to them that some PhDs in some pharma companies are really worried about global warming and a coming Idiocracy. Why not put something in the vaccine that reduces fertility for the unwashed masses?

Maybe it sounds crazy to you and me, but a lot of people hear experts saying seemingly ridiculous things (like needing a vaccine for a disease you already got and recovered from), see how everyone falls in line with the narratives as they come and go, watch mainstream news and social media restrict all alternative points of view. And they don't trust the system. And its clear to them that this system they don't trust, also doesn't like them. From that perspective, of course they don't want the people who lie to them and hate them to have the authority to stick some chemicals and DNA (I know, mRNA) in their arm.

[wizzwizz4]

The only thing that'll convince those people is for authority figures to become trustworthy.¹ I don't see that happening any time soon.

So who're left? The people who are concerned about vaccines because other people are, rather than because of (misplaced in this instance, but not in general) scepticism of the claims of untrustworthy, powerful people. Those people can be reassured by thought experiments, because they're assuming dangers due to incompetence moreso than malice.

¹: I suppose an argument from game theory might, but only if they think the vaccine-poisoning enemy is in it for the long run, so the threat of the truth coming out in (e.g.) 20 years would be enough to dissuade them from something like that. If they think the enemy's plans are shorter-term, or they can afford the loss of face, I don't think there's any way to convince them short of convincing them that the industry behind “non-addictive” heroin, thalidomide (developed by a Nazi war criminal!!) and the contaminated blood scandal is totally cool and in no way out to get you.

[mrhands69]

> Assuming the worst-case scenario until proven otherwise doesn't work like that. You have to look at the entire range of uncertainty, and choose the worst-case scenario for each question.

It seems to me the worst case scenario is always applied when looking at things like natural immunity from prior infection, long covid, etc

If you model Sars-Cov-2 after Sars-Cov-1 or MERS then you would be lead to believe natural immunity lasts around 5+ years.

Where is worst case scenario not applied? Anything to do with vaccines. We're not even allowed to question it.

We are extremely conservative on one side of the coin, but not the other. Why?

[outworlder]

We have to err on the side of saving lives, not speculation. Over 2 billion humans have been vaccinated so far, and rising.

What's the worst case scenario here?

[aristophenes]

That by not focusing on vaccinating only the most vulnerable, we are just selecting for strains that the vaccines are not effective against.

[wizzwizz4]

And selection is useless if the “gene pool” is small enough that the selection pressure just eradicates the disease entirely. If we get the R number to something like ⅒ and hold it there for a few months? Disease eradicated, job done, everybody goes home.

[mrhands69]

Because lockdowns are detrimental to society (mental health, division, etc). Why can't we take a level headed approach. It seems like our approaches don't take into any consideration past experiences with similar viruses, or leverage data. We have a lot more data this time around.

[AndrewBissell]

> Here's a worst-case scenario if people do get vaccinated: everyone is vaccinated, COVID-19 starts going away

How do you figure that last part?

If we're talking worst-case scenarios from mass vaccination I would think you would need to put Marek's or ADE type outcomes on the table.

[manwe150]

Those are already the complications associated with not vaccinating, so putting them on the table again would double-count them.

Not sure I agree with their ‘hundreds of millions (per year)’ figure. That seems like unnecessary fear-mongering. But maybe ‘hundreds of thousands’ or ‘millions’, which is still not great.

[wizzwizz4]

I'm not fear-mongering; I'm just a pessimist. My scenarios are “unbelievably unrealistic” and “apocalyptic sci-fi”, respectively, but I wanted to make sure I got an upper bound on the worst-case. I don't know much about the topic, so I had to go into “I know this is unrealistic” territory for that.

See also: https://xkcd.com/2261/ and https://xkcd.com/883/.