[pfg]

Reduction of infection/transmission is only one endpoint to consider. We also need to consider the overall effect on the quality of healthcare we can expect to receive in a situation where low vaccination rates causes hospitals to be overrun. This is where the line between personal health decisions on whether to get vaccinated or not and what is fair to society as a whole gets blurry.

People tend to argue "but what about $arbitrary_unhealthy_habit, we don't regulate that!" when someone mentions this, but $arbitrary_unhealthy_habit has been accounted for in terms of resources required to treat people (assuming a working healthcare system), whereas a once-in-a-century-level pandemic hasn't, so it's not a valid comparison.

[__blockcipher__]

That's a fine argument, but I've never seen a proper quantitative assessement of the risk of hospital over-run with respect to vaccination rates (or in general, frankly). The vast majority of COVID infections are mild or completely asymptomatic, so something like 90% of the hospitalization burden is being caused by 10% of infections. Mandating that some random 20-something year old get vaccinated does not move the needle (no pun intended) whatsoever.

The at-risk populations can be vaccinated. Let's get them (voluntarily) vaccinated and be done with it. Enough of these mandates which serve more to enrich giant pharmaceutical companies than they do to improve public health.

BTW, while mortality isn't the only outcome of concern, I'd be remiss if I didn't mention that Pfizer's 6 month RCT - the highest quality data we have of this kind, period - showed no improvement in all-cause mortality in the 20,000+ people they vaccinated compared to the control: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v...

> During the blinded, controlled period, 15 BNT162b2 and 14 placebo recipients died; during the open-label period, 3 BNT162b2 and 2 original placebo recipients who received BNT162b2 after unblinding died. None of these deaths were considered related to BNT162b2 by investigators.

So the highest quality evidence indicates that vaccinating a similar population will make no difference in net deaths. (One possible counterargument would be to argue that transmission was unusually low during the study period, but AFAICT that's simply not the case)

--

Back to your comment:

> People tend to argue "but what about $arbitrary_unhealthy_habit, we don't regulate that!" when someone mentions this, but $arbitrary_unhealthy_habit has been accounted for in terms of resources required to treat people (assuming a working healthcare system), whereas a once-in-a-century-level pandemic hasn't, so it's not a valid comparison.

I won't make that argument, but I did want to mention that - while unrelated to mandates per se - we basically scaled down our healthcare capacity across 2020, at least in the US, due to all the furloughs and the like from the missed medical appointments, as well as (in many places) suspension of "elective" surgeries. And more relevant to the vaccines, a small but real number of healthcare workers have been or are in the process of being fired for non-compliance with the mandate, regardless of their prior infection history etc

[rini17]

Parent was not so much asking about mortality as about health care management. Do you imply all the data that shows unvaccinated are much more likely to require hospitalization, is flawed or fake?

[__blockcipher__]

A lot of it is statistical fuckery. The set of people hospitalized who are unvaccinated is not the same as the set of unvaccinated people who end up getting hospitalized.

But some of it is certainly true. Vaccination makes a very significant difference in hospitalization among the very at-risk subset of the population. But in the healthier demographics, vaccination status is irrelevant to "net hospitalization" because in those demographics COVID itself is irrelevant to hospitalization when compared to other causes of hospitalization.

Since I didn't mention it explicitly, I mentioned all-cause mortality because that's going to be very correlated to all-cause hospitalization as well (and the fact that mortality itself is something we should care about).