[s1artibartfast]

On the medical side, the legitimate arguments I see is:

1) Concern over long term effects which we have no data on (legitimate but low probability in my estimation)

2) Natural immunity is slightly less effective than the vaccine against alpha variants, but still very robust. These people should therefore be exempt from the vaccine.

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On the policy side, the legitimate arguments/discussions I see are:

3) We should strive for a society where consent is obtained by changing minds, not force, even if this is extremely difficult.

4) Slippery slope concern- There is no hard limit or consensus on when public health outweighs bodily autonomy and other considerations.

5) Who owns the responsibility to ensure personal safety. (should the obligation fall on people who don't want to catch covid to avoid public spaces and take defensive action, or fall on people who could be spreaders in the public spaces)

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If it helps to have a productive discussion, I declare my tribe as vaccinated and encouraging others to get the vaccine.

[nemothekid]

1) Is the only fair argument in which vaccine pushers would have egg on their faces. You need to balance this argument against (1) the predicted lives saved by the vaccine and (2) the documented long term effects of the vaccine. This argument cannot be considered in the vacuum. Let's say X number of people die due to long term effects of the vaccine. We know historically this number is low, but we cannot be certain. However we do know the cost of inaction last year cost nearly 500,000 excess deaths. Should we allow another 500,000 to die in order to do further testing of an otherwise safe vaccine? How many people, in your opinion, should suffer today until there is enough testing for you?

2) This is a public policy problem. Let's say you allow this; then everyone, in lieu of getting an actual vaccine will just claim they had COVID already.

3) No one is getting forced to take the vaccine. Vaccine mandates just mean you can be prevented from entering certain federal buildings until you are vaccinated. This is not a new power - children have been mandated to get vaccines to enter public schooling. If you don't want to get a vaccine, then society has kindly asked you to not step on a plane.

4.) This is only a slippery slope to people born after the time where vaccines have pretty much eradicated most contagious diseases. Previous vaccine mandates for polio and chickpox did not lead the USG into forcibly inoculating children with super soldier serum. It's a slippery slope to you because you weren't around that last time this power was enforced.

5.) Following this logic - should the government be banned for giving you a ticket for not wearing a seatbelt? Should the government allow the sale of cars without airbags? After all if I drive safe why should I pay extra for seatbelts and airbags? The short answer is - we do these things because, you living in a society, can cause negative externalities. If you drive a car without seatbelts and airbags you cause not only danger to your passengers, but also to the emergency services system that has to pry you from your car. You are only "free" from your responsibility as long as you pledge to not visit a hospital and operate on yourself. Otherwise it's simply unfair that someone who could have gotten vaccinated should occupy an ICU bed from someone who cancer. The second you are in the ICU, your "responsible" decision now must fall on nurses, doctors and other patients.

Again, I want to stress, I do not think these are very strong or well-researched arguments against the vaccines at all. I hope I have answered your arguments non-combatively, but I want to point out I do not think these are strong or even well intentioned arguments now that we are more than a year into this pandemic. Only one of your arguments had to do with actual safety and public policy, and the rest I believe came down to your personal opinion of how things should be done. I'm sure you are a smart individual, and again I don't mean this in combative manner but I'm going to trust the people who have been studying this for years. Going back to my original comment, most arguments against the vaccine are "gut-feel" at best and not backed by any actual data.

[s1artibartfast]

1) I fully agree that there is a tradeoff between predicted deaths and risk from vaccine. I am fine with any number of people dying because they self selected to not take the vaccine, be it 500k or 5 million. I respect their right to choose even if I don't agree with it. The debate thickens when you talk about future deaths of people who selected to get a vaccine, but died from breakthrough cases. Vaccination breakthrough cases are very rare at <0.1% of total cases[1], and vaccination still confers significant benefit against severe cases or death. For sake of argument, I would accept an annual deaths of 50K (similar to the flu) among the vaccinated before further government action is considered. I think this range is achievable given we had 500k deaths before the vaccine was widely available. We now have 160 million Americans self selected to vaccinate and this number is still climbing, The CDC also estimates that 100+ million Ammericans have already been infected.

2) I split the topics into scientific 1 & 2 vs political 3-5, and think this is more a question of science. If natural immunity is reasonably close to vaccination immunity, I think they should be treated the same (whatever that may be). This is the question that science can answer. For your implementation concern, positive covid test or antibody test would be a simple way to administer an equivalent immunity pass.

Questions 3-5 are political because they can not be answered by science or data. Science can inform the decision, but they come down to questions of values, morality, ect.

3) I agree nobody is being tied down and given a shot, and only wackos are advocating this. There is a scale for how hard society can incentivize or punish people until they get a vaccine. I personally think society has done a terrible job of informing people to change their mind, and skipped straight to the punishments, and am deeply uncomfortable with this.

4) I agree that past vaccinations were largely a success via eradication. I have not seen a success criteria stated for the covid pandemic, as eradication is unlikely. At what point will we stop ratcheting up control mechanisms? X deaths per year, sustainable hospital capacity of Y? Is any sacrifice warranted to prevent 1 death?

5) Again, this is political question, and reasonable can and do have different opinions on how much personal risk you can take on, and when the government should protect you from yourself. You brought up seatbelts, going on somewhat of a tangent, the things you described are not true negative externalities in the technical sense. They are cost society chooses to pay, and could simply choose not to. I could give a beggar $5 but that isn't an externality. If I make a rule that I will give every beggar I see $5, it still isn't an externality. If the beggar on the corner lowers my property value, that IS a negative externality because it is imposed on me and I have no control or choice. You can say that seatbelts and vaccines both reduce the cost to the social safety net. Lots of things would reduce costs, and we can choose to to pay them, or not, opposed to controlling people. I personally love seatbelts, but think that tickets for adults are unreasonable (different story for minors in their care, ect).

>I don't mean this in combative manner but I'm going to trust the people who have been studying this for years. Going back to my original comment, most arguments against the vaccine are "gut-feel" at best and not backed by any actual data.

With the exception of the first two, these arguments aren't backed by data because they aren't questions that can be answered by data. They are simply matters of opinion, and I think we would all be best served if we acknowledge this. At the end of the day, science can conclude that universal vaccination would reduce deaths, or save $X, but it cant answer question on what public policy should be. This will be different based a multitude of values in addition to deaths and money.

Opinions you disagree with (assuming they are not based on incorrect data) are not wrong, just different.

https://www.kff.org/policy-watch/covid-19-vaccine-breakthrou...

[nemothekid]

1.) The vaccines are less effective if not everyone gets vaccines, and are much less effective if the vaccine is allowed to mutate. For that reason I _don't_ respect decisions to not get vaccinated. It's _not_ a personal decision and I consider this point wrong because I fully reject this framing. By not getting vaccinated you put others at risk. If you go to the hospital for COVID you put other people fighting other diseases at risk. I might agree with you had vaccinated people had 0 risk of getting COVID (or even getting into another accident and needing an ICU bed), but that isn't the case so you cannot assume that someone rejecting vaccine has zero negative externalties.

2.) I'll have to do more research, but I can only assume that natural immunity is not reasonably close to vaccination immunity which is why it's not an appropriate replacement. I saw a Fox News segment last night that said essentially natural immunity is a perfect solution, but I don't accept things from Fox at face value.

3.) States are literally paying people money to get vaccinated - no one "skipped straight to punishments". The vaccine is completely free with very few barriers, in a country with no socialized medicine. This kind of framing feels deliberately misleading. I don't know what more you expect the state to do at this point - even Trump is telling people to get vaccinated to boo-ing crowds.

4.) The success criteria has been ICU bed capacity. That is the key criteria that seperates the regular old flu from COVID. That is why efficacy rate stress hospitalization rates, and not breakthrough rates. When you have mass ICU usage, that is when a pandemic becomes a public policy problem.

5.) I don't feel your response has addressed my point. I brought up seat belts because it's something the government does today to enforce personal responsibility. You framed forced mandates as some government overreach on personal responsibility and I'm saying that isn't the case and the government has always had that power. Secondly if you refuse to get the vaccine and end up in the hospital - why aren't you framing this decision as someone selfishly controlling doctors, nursers and other patients to deal with their selfish decision? The doctor has "no control or choice" in being forced to treat you to a respirator. When the public health officials tell you get a vaccine that's being "imposed on you and I have no control or choice", but when you catch or infect someone else with COVID, it's 100% ok in imposing your choice on nurses? I hope I've highlighted the hypocritical selfishness of your argument.

>They are simply matters of opinion, and I think we would all be best served if we acknowledge this.

Again, they are not. They are poorly researched opinions and that is why I continue to reject them. You said the state "skipped straight to punishments". That's not true. You said "there's no success criteria". That's not true, it has always been ICU capacity. These two "opinions" are demonstrably false statements that are masquerading as "harmless opinions". To me that's misinformation. Your fifth point just exposes your selfishness. I'll give you that you have your own personal freedom to be selfish, but I wouldn't be shocked if you are called an asshole for acting selfishly.

[s1artibartfast]

1) I fully acknowledged that vaccination choice can have impact on others. I stated that a 50k death toll would be acceptable. Do you have a death toll that you would accept the choice of other people to not get vaccinated?

2) I'm OK to defer this until the science is in.

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3) Vaccination rates are climbing, and we have no idea where they will end. In many demographics they are already quite high. Uptake is 91% in 65+ and 73% for 18+. Breakthrough cases are extremely low at <0.1% of cases, so 99.9% of cases are self imposed by choice of not to get vaccinated. One easy thing that states could do is wait, let the numbers continue to climb, let people change their mind as all their vaccinated neighbors walk around fine, or their unvaccinated neighbors die, or they get sick and get a decent level of personal immunity. As of today, the death rate is 0.3/100k per day. That is 359,160 deaths per year, of which 360 will be people who chose to get vaccinated but died of a breakthrough case. This is pretty close to the CDC numbers, which puts the the breakthrough deaths for the first 4 months of 2021 at 160 people, who had a mean age of 82 [1]. For context, lawn mower accidents kill >1000 people a year in the US.

4) I still don't think that an objective goal has been communicated. Less covid cases, or more ICU capacity is not an objective or achievable goal. What is the criteria for ICU beds, what is the metric, and what is it now? Is it a national average, or until every hospital in the country meets it, ect? The CDC has stopped tracking ICU capacity as of July 2021 with an average of 60% of beds full and doesn't even report the number of those which are covid related. All bed occupid with covid patients was 8-9% (including the asymptomatic admitted for other reasons), but I admit this could be higher in the ICU. If this is the primary goal for our pandemic response, we should at least track where we are relative to the goal. If there is a measurable goal you can share, I would be ecstatic, and it might change my opinion that we are in a foreverwar against covid with no success criteria (not unlike Afghanistan & the war on terror).

My guess is that we will continue aimlessly focus time and resources into it without any idea of what completion looks like until everyone is burnt out and comes to the realization that covid is endemic. We will check vaccination cards when traveling, for employment, and potentially events out of fear of triggering one of the 360 breakthrough deaths. My mental model for the war on Covid is largely based on the war on terror, and I think there are several parallels.

5) I would rather live in a world where doctors, hospitals, and insurers were free to refuse services to the unvaccinated, than one where people were both compelled to get medical treatment, and provide health services.

>[these] are poorly researched opinions and that is why I continue to reject them. You said the state "skipped straight to punishments". That's not true. You said "there's no success criteria". That's not true, it has always been ICU capacity. These two "opinions" are demonstrably false statements that are masquerading as "harmless opinions". To me that's misinformation. Your fifth point just exposes your selfishness. I'll give you that you have your own personal freedom to be selfish, but I wouldn't be shocked if you are called an asshole for acting selfishly.

"Skipped straight to punishments" was vague and exaggerated language. Replace that with implemented punishments faster than I would like. Is that sufficiently an opinion now? I stand my by statement that there is no success criteria. I never said opinions are harmless. For example, I said that it would be tolerable to have 50k vaccinated covid deaths. That is a real opinion, that if enacted, would let people die.

As mentioned before, I am fully vaccinated, and will probably get a booster when available. I just have a very high tolerance for other people being assholes or selfish. More so when we have what looks to be a very effective vaccine available for "free" and boosters on the way to provide a huge degree of protection to those who want them.

[1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm