[alecst]

Great reply, thank you. I don't want to get into a long argument, but a lot of what you say hinges on that 40% number. I'd like to know what that refers to. My reply to that 40% number:

I thought that vaccines made you something like 20x less likely to end up in the hospital from coronavirus (widely cited as 95% protective.) And that unvaccinated people spread at 5x the rate of the vaccinated ones. https://www.nature.com/articles/d41586-021-02054-z

Despite having done some research in virology for my MSc I definitely don't claim to be an expert. The field is really complex, and I'm always open to learning. So feel free to reply and educate me as long as we can keep it cordial.

To answer your last question (presumably non-rhetorical) I worry about unvaccinated people allowing for mutations via community spread, as well as getting sick when they didn't have to, hurting themselves while taking up healthcare resources in the process. Is that unreasonable?

[tzs]

There was some CDC data published recently on breakthrough infections in the US (I don't have a better site--saw it somewhere on Apple New+). It worked out to 4 COVID hospitalizations or deaths per 100k.

For comparison, that's about twice the US death rate due to flu in 2019, and about 1/40th the US death rate due to COVID before vaccinations were available (and before the delta variant was in the US). That's about 10x better than death rate pre-vaccination in the state that had the lowest death rate (Hawaii).

[kadoban]

Aren't you comparing Delta numbers for vaccine and pre-Delta numbers for no-vaccine then? So really you'd expect the difference to be even greater than that.

[keneda7]

Not the original poster but

The article you link says the delta is unknown. Delta is rapidly becoming the most common variant in the US. (https://www.webmd.com/lung/news/20210720/delta-variant-now-a...)

I believe the 40% is coming from the data out of Israel. (https://www.cnbc.com/2021/07/23/delta-variant-pfizer-covid-v...)

Also data from the CDC on the latest outbreak they studies shows that 74% of the positives were vaccinated. At the time the vaccination rate was about 69% for the state. I can't find anything on the actual town. (https://arstechnica.com/science/2021/07/this-900-person-delt...)

The CDC also has said vaccinated do in fact have high viral loads of the virus and can spread it (https://www.npr.org/sections/coronavirus-live-updates/2021/0...)

Do you happen to have any actual studies showing unvaccinated people are causing mutations? I have seen it repeated but never seen the study behind it. I do know leaky vaccines cause outbreaks to spread faster. This can be seen in the past. (https://www.pbs.org/newshour/science/tthis-chicken-vaccine-m...)

As for your last part. Lets look at it another way. Heart disease is the leading killer in the US. One of the best way to prevent heart disease is being physically fit and active. By your logic we should be mandating exercise for everyone to prevent it right? Shouldn't we also be forcing people to quite drinking and smoking as well?

Overall its just a slippery slop when you give the government this right. What happens if conservatives get in power and decided abortion should be banned outright as they consider a fetus a person? By the same logic you are using, they would be perfectly reasonable to do that.

[thinkharderdev]

Whether it is proper for the government to mandate vaccines in certain situation is a complicated question but I think some of your priors are incorrect.

1. The data out of Israel on vaccine efficacy with Delta is out of line with other studies on the matter and is generally considered to suffer from some methodological flaws. See https://www.nejm.org/doi/full/10.1056/NEJMoa2108891 for a study out of Britain showing an efficacy of 88% against symptomatic infection. There is much more data that corroborates only slightly reduced efficacy and the Israel study is the outlier so anchoring to that number is probably a mistake.

2. The Pronvicetown study (where 74% of infected were vaccinated) doesn't tell you anything about vaccine efficacy. The vaccine rate for the town or state are irrelevant since the event in question included a large number of tourists. The town itself only has ~3000 people but there were 60k people there from all over the country at the week-long event.

3. Here is a study showing higher mutational variance in unvaccinated patients: https://www.medrxiv.org/content/10.1101/2021.07.01.21259833v.... This is exactly what we should expect. Vaccines drastically reduce the rate of transmission so we should have a strong prior that they would also reduce the rate of mutation.

[keneda7]

1. The Israel study was the only one I have seen so far. Thank you for linking to the other one. It seem these two studies pretty much contradict each other. Do you happen to have links or can point me in the direction of the other data you referenced? Edit: I did some more research on the UK study. It appears to be outdated and does not use the June and July stats when Delta actually took off. If you use the last two (18 and 19) UK governments technically briefings (https://www.gov.uk/government/publications/investigation-of-...) you can calculate the efficiency rating. From my understanding you do this by calculating the infection rates in the vaccinated and unvaccinated, then divide the infection rate in the vaccinated vs the infection rate by the unvaccinated. You then subtract this answer from 1 to get the efficiency. It varies with the age groups but for 50+ I got an effectiveness of about 17%. I could wrong in how I am going about this though. Please let me know if I am

2. I have to disagree here. The CDC report is dealing with Massachusetts residents infected (https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm?s_cid=mm...). It did not include out of state infections. So I would say comparing the state vaccination rate to how many vaccinated state residents got covid is a valid comparison. In fact from what I have seen this study is being used to justify the CDC recommending masks for all again.

3. Thank you very much for this link. I keep seeing a study referenced but was not able to find it. However it has not been peer reviewed yet so we don't really know if its accurate. Any chance you have a study pre-COVID that show this?

[maxk42]

Your excellent reply makes an outstanding argument for not legislating vaccination: The science is far from settled.

Until we have answers that are absolutely certain and the long-term risks are known, we are merely experimenting on the whole of the populace, which could lead to disastrous long-term outcomes.

Policy should be based on facts, not guesses.

[thinkharderdev]

As I said, actually legislating vaccination is a complicated question and it depends on the details of the legislation in question on whether I would personally support it.

However, I think your other points are incorrect. Policy making is always about making decisions under uncertainty so we have to make the best decisions we can given the data we have. And the data we have I believe is overwhelmingly clear that any risks associated with vaccination are dramatically smaller than the risks of COVID itself. To date I am unaware of any substantiated risks of vaccination which aren't also risks of COVID infection and where the risk is much higher from infection than from vaccination. It can be tricky at times because mass vaccination will generally affect more people than infection so you have to weigh the relative risks appropriately. However, in the current case where we have a highly infectious respiratory virus we seem destined to end up with an endemic disease which only happens when ~100% of the population has already been either vaccinated or infected. So to first approximation your only two choices are to get the vaccine or (eventually) get infected with COVID. Given that and the very clear data we have now about the relatively insignificant risks of the vaccine relative to infection, getting vaccinated should be the obvious best option. After all, getting infected with a novel virus that is (now) easily preventable is ALSO experimenting with your health.

[rcpt]

Funny that this is almost word-for-word what climate denialists say.

[whateveracct]

> Overall its just a slippery slop when you give the government this right. What happens if conservatives get in power and decided abortion should be banned outright as they consider a fetus a person? By the same logic you are using, they would be perfectly reasonable to do that.

This is a ridiculous argument and I'd say mostly FUD. Abortion is pretty well litigated. Conservatives have been in power in state and national govts for years and they've barely managed to get anywhere close to this.

[hellisothers]

While it’s possible to be infected and vaccinated the possibility is lower right, even “only” 40% is a huge number! If only vaccinated people are in a space it dramatically decreases the likelihood I’ll become infected by more than 40% because every one of those people is also personally 40% less likely to be infected, so this is compounding. Please correct me if I’m wrong on that assessment.

As to the hear disease comment those comparisons are disingenuous because you can choose to exercise or not and your choice doesn’t impact others. My 7yo son cannot be vaccinated, he has no choose but to rely on others doing their part

[keneda7]

I am not sure about the compounding 40%. I don't know enough about infectious disease transfer. The previous poster had asked about the 40% so I was giving him the source. Personally I agree with you 40% is still better than 0%.

As far as heart disease, in my opinion it does drastically impact other people. Heart disease patients take up hospital beds, they take up medical supplies, they take up doctors time. The CDC says ~1 in 4 deaths is due to heart disease. (https://www.cdc.gov/heartdisease/facts.htm) It is a massive drain on our medical system (perhaps the greatest).

[YooLi]

"To answer your last question (presumably non-rhetorical) I worry about unvaccinated people allowing for mutations via community spread..."

Then you also should worry about Antibody-Dependent Enhancement (ADE).

"...as well as getting sick when they didn't have to, hurting themselves while taking up healthcare resources in the process."

Like obese people?