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by thinkharderdev 1784 days ago
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.

2 comments

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 It appears to be outdated and does not use the June and July stats when Delta actually took off.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?

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.

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.

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