OT: Coronavirus 4 - or is that thread 2.75?

[Anton Dubinchuk]

Grocery Store Guy stated a true fact about what words like "immunity" and "effectiveness" mean in a vaccine context.

It's fair to be annoyed at people building up unrealistic expectations of actual total immunity, either through ignorance or carelessness, and causing people to feel let down. I don't understand getting mad at Grocery Store Guy for pointing out what we should all have known from either Biology 101 or past personal experience with flu shots.

Well then maybe I'm just ignorant, not the first time that's happened - please explain what this is supposed to mean. NJ study: Vaccines more than 99% effective against COVID-19

Everything in here says that studies from places like Yale said that the vaccine prevented infections. It uses breakthrough cases of testing positive for Covid after being vaccinated as a measure. It talks about reducing infections and finding significantly fewer infections amongst vaccinated than non-vaccinated.

From the CDC's page on the flu shot: Key Facts About Seasonal Flu Vaccine

"Can I get seasonal flu even though I got a flu vaccine this year?
Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

• You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
• You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
• Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

"

The point being - infection is the exception, not the rule. Also from the same page:

"Some people who get vaccinated may still get sick with flu. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. "

All of this to say: it provides some protection against infection, and then even if you do get infected it won't be as bad. This has been the narrative on all of this since this started, at least from what I've read, heard, discussed, etc. I'm willing to just say I'm an idiot, but I don't see how a normal person reads this stuff any differently.

Another one here, on the flu shot from the CDC: Vaccine Effectiveness: How Well Do Flu Vaccines Work? | CDC

• Flu vaccination can keep you from getting sick with flu.
  • Flu vaccination prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020 flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
  • During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.

 

[tarheelhockey]

Well, that's with the initial pass. Your post was in response to the $5k thing, no? That's behavior given an input, change the input and behavior can change.

Oh yeah, I think I gave a wrong impression above -- I meant the number of people willing to be swayed by public debate is quickly reaching zero. At this point it's been over a year, people have made their decisions and there are very few actual "independent voters" left out there.

Providing incentives is a different story. Lots of folks put their principles aside when offered a monetary incentive (or on the other side of the coin, some sort of penalty). So that would potentially move the needle a bit. I suspect it would still leave us somewhere like 10%-15% short, but that's just a gut feeling on my part.

 

[Svechhammer]

Oh yeah, I think I gave a wrong impression above -- I meant the number of people willing to be swayed by public debate is quickly reaching zero. At this point it's been over a year, people have made their decisions and there are very few actual "independent voters" left out there.

Providing incentives is a different story. Lots of folks put their principles aside when offered a monetary incentive (or on the other side of the coin, some sort of penalty). So that would potentially move the needle a bit. I suspect it would still leave us somewhere like 10%-15% short, but that's just a gut feeling on my part.

If it bumps the total vaccinated rate to 80-85%, that might be all we need for this to eventually get behind us from what I remember reading last year.

 

[Lempo]

Someone said "what these idiots don't realize is that the vaccine was never about preventing the disease, it's all about reducing symptoms." I came embarrassingly close to stopping and injecting myself into the conversation. I'm sorry, what? The vaccine was never about preventing the disease? Look up any talking point from the last 6 months. Seriously. Is your memory that bad? Are you simply not paying attention to anything that's been told to you? The vaccine was all about actual effectiveness, and it was effective for awhile, and then... not so much.

I could be that guy. I'm pretty sure as the first bigger studies came out it was clearly reported that the vaccination didn't so much prevent you from getting the infection, but it did make the COVID-19 less severe.

What the initial intentions of the vaccine manufacturers was, I don't know, but very early on it was reported that this is what the vaccine actually is good for.

I obviously don't know how many people, politicians and whatnot have been selling the vaccination as an infection preventer, but I'd be hard nodding with the grocery store folks and we'd be looking at you along our noses.

 

[the halleJOKEL]

Well then maybe I'm just ignorant, not the first time that's happened - please explain what this is supposed to mean. NJ study: Vaccines more than 99% effective against COVID-19

Everything in here says that studies from places like Yale said that the vaccine prevented infections. It uses breakthrough cases of testing positive for Covid after being vaccinated as a measure. It talks about reducing infections and finding significantly fewer infections amongst vaccinated than non-vaccinated.

From the CDC's page on the flu shot: Key Facts About Seasonal Flu Vaccine

"Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection."

The point being - infection is the exception, not the rule. Also from the same page:

"Some people who get vaccinated may still get sick with flu. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. "

All of this to say: it provides some protection against infection, and then even if you do get infected it won't be as bad. This has been the narrative on all of this since this started, at least from what I've read. I'm willing to just say I'm an idiot, but I don't see how a normal person reads this stuff any differently.

these percentages are typically pulled from vaccine clinical trials. there was a lot of confusion about this when vaccine efficacy of 95% was being thrown around as if vaccines were some magical shield earlier in 2021. vaccine clinical trials are designed with two blinded groups - a placebo group and a trial group. when the total population of individuals in the trial hits a certain threshold of, in this case, covid cases, then the placebo group and trial group are unblinded. the percentage is then the number of vaccinated vs placebo individuals that had covid.

pfizer's phase 3 covid trial is a decent example of this: ~18000 vaccinated individuals & ~18000 placebo individuals, 8 vaccinated covid cases, 162 placebo covid cases

162 out of 170 covid cases observed during the trial were unvaccinated, or 95.3%

this type of statistical analysis is where a lot of the percentages you are referring to are likely originating. the vaccine does not prevent you from getting covid, but it decreases the likelihood and decreases the severity. the more people who are vaccinated, the less transmission we see. fewer severe cases means less strain on the hospitals. it also means less opportunity for viral mutation. most of our current vaccines are targeting the covid spike protein, so mutations to that part of the virus are particularly worrisome as they result in additional viral evasion of the current vaccines in use.

 

[tarheelhockey]

Well then maybe I'm just ignorant, not the first time that's happened - please explain what this is supposed to mean. NJ study: Vaccines more than 99% effective against COVID-19

Everything in here says that studies from places like Yale said that the vaccine prevented infections.

They're linking to their own articles as a source, so it's a bit tough to parse out their sources of info. My guess is that at the end of the day, "infection" is being used here in the sense of clinical infection. I'm just going to shamelessly copy Wiki for definitions on this:

Subclinical versus clinical (latent versus apparent)[edit]

Symptomatic infections are apparent and clinical, whereas an infection that is active but does not produce noticeable symptoms may be called inapparent, silent, subclinical, or occult. An infection that is inactive or dormant is called a latent infection.[33] An example of a latent bacterial infection is latent tuberculosis. Some viral infections can also be latent, examples of latent viral infections are any of those from the Herpesviridae family.[34]

The word infection can denote any presence of a particular pathogen at all (no matter how little) but also is often used in a sense implying a clinically apparent infection (in other words, a case of infectious disease). This fact occasionally creates some ambiguity or prompts some usage discussion; to get around this it is common for health professionals to speak of colonization (rather than infection) when they mean that some of the pathogens are present but that no clinically apparent infection (no disease) is present.

"Breakthrough" cases are clinically apparent infections where the virus manages to establish itself enough to be detectable, often through an immune response that we experience as a symptom (e.g. coughing, sore throat) or at least enough viral load to show up on a test (asymptomatic). For those who don't have breakthrough cases, it's because they either had a sub-clinical infection which was beaten back by the immune response, or were either never exposed at all because they've been living in a cave for the past 2 years.

Needless to say, most people don't talk about infections in these terms and the CDC doesn't make the distinction in their press releases. So we end up talking about the virus as though we can be absolutely 100% immune from it, which isn't really true.

 

[Anton Dubinchuk]

these percentages are typically pulled from vaccine clinical trials. there was a lot of confusion about this when vaccine efficacy of 95% was being thrown around as if vaccines were some magical shield earlier in 2021. vaccine clinical trials are designed with two blinded groups - a placebo group and a trial group. when the total population of individuals in the trial hits a certain threshold of, in this case, covid cases, then the placebo group and trial group are unblinded. the percentage is then the number of vaccinated vs placebo individuals that had covid.

pfizer's phase 3 covid trial is a decent example of this: ~18000 vaccinated individuals ^ ~18000 placebo individuals, 8 vaccinated covid cases, 162 placebo covid cases

162 out of 170 covid cases observed during the trial were unvaccinated, or 95.3%

this type of statistical analysis is where a lot of the percentages you are referring to are likely originating

Ok so help me out here then, if all vaccines are supposed to do is reduce symptoms but not prevent infection, how did the 18000 vaccinated individuals only have 8 Covid cases while the 18000 unvaccinated individuals had 162 Covid cases? Wouldn't that be an instance of the vaccine... preventing infection?

 

[Sens1Canes2]

“Breakthrough infections” were initially reported on, and spoken about by people like Fauci, like they were just that - breakthrough, rare, unexpected, etc.

It’s ok for the initial intentions to have been wrong - it’s not ok to out and out lie about it.

just say, yep, we thought different.

 

[Anton Dubinchuk]

They're linking to their own articles as a source, so it's a bit tough to parse out their sources of info. My guess is that at the end of the day, "infection" is being used here in the sense of clinical infection. I'm just going to shamelessly copy Wiki for definitions on this:




"Breakthrough" cases are clinically apparent infections where the virus manages to establish itself to be detectable, often through an immune response that we experience as a symptom (e.g. coughing, sore throat). For those who don't have breakthrough cases, it's because they either had a sub-clinical infection which was beaten back by the immune response, or were either never exposed at all because they've been living in a cave for the past 2 years.

Needless to say, most people don't talk about infections in these terms and the CDC doesn't make the distinction in their press releases. So we end up talking about the virus as though we can be absolutely 100% immune from it, which isn't really true.

Makes sense, but in that case I'm mad at grocery store guy again. He was not talking about clinical vs. subclinical detection. The point he was making was that we should never have expected the vaccine to meaningfully stop us from getting Covid, it was always what the vaccine is doing today, which is just making symptoms not as bad. I'm not giving him points for being "technically correct" because he wasn't trying to be "technically correct", he was talking about infections the way we all talk about infections 99% of the time when we're not trying to be clinical or pedantic. The articles I've posted are decidedly against that narrative.

 

[the halleJOKEL]

Ok so help me out here then, if all vaccines are supposed to do is reduce symptoms but not prevent infection, how did the 18000 vaccinated individuals only have 8 Covid cases while the 18000 unvaccinated individuals had 162 Covid cases? Wouldn't that be an instance of the vaccine... preventing infection?

your body fighting off the infection before it results in any clinical symptoms would be the best case example of symptom reduction. more than 8 of those 18000 vaccinated likely were exposed to covid (same goes for the unvaccinated arm of the trial), but their body was able to deal with it without presenting any symptoms.

 

[tarheelhockey]

Makes sense, but in that case I'm mad at grocery store guy again. He was not talking about clinical vs. subclinical detection. The point he was making was that we should never have expected the vaccine to meaningfully stop us from getting Covid, it was always what the vaccine is doing today, which is just making symptoms not as bad. I'm not giving him points for being "technically correct" because he wasn't trying to be "technically correct", he was talking about infections the way we all talk about infections 99% of the time when we're not trying to be clinical or pedantic. The articles I've posted are decidedly against that narrative.

In that case, there's really only one solution. It involves you, Grocery Store Guy, and a Bojangles.

 

[Anton Dubinchuk]

your body fighting off the infection before it results in any clinical symptoms would be the best case example of symptom reduction. more than 8 of those 18000 vaccinated likely were exposed to covid (same goes for the unvaccinated arm of the trial), but their body was able to deal with it without presenting any symptoms.

Ok, yeah, I know how vaccines work then, we're all talking about the same thing. I can be mad at grocery store guy.

 

[the halleJOKEL]

a safe rule of thumb is that it is always correct to be angry at grocery store guy

grocery stores are the absolute worst

 

[Anton Dubinchuk]

In that case, there's really only one solution. It involves you, Grocery Store Guy, and a Bojangles.

He is already dead.

But anyway, my initial point stands then. We've gone from "this is a pandemic of the unvaccinated" to "it's always just been a halfway decent reduction of symptoms that keeps you out of the hospital, why would you ever think it's going to prevent breakout cases?" This is just not true, and that's ok that it's not true, Omicron is different than Delta which is different than the initial strains, and the vaccine isn't going to help as much as it did in August. And that's ok, just say that. Don't rewrite history to say the vaccine was never about preventing cases. The studies of "95% effectiveness" explicitly were about preventing cases, the receipts are there. You lose more trust when you try to rewrite the initial intent than when you just try to adjust expectations accordingly (at least with me).

 

[Anton Dubinchuk]

I could be that guy. I'm pretty sure as the first bigger studies came out it was clearly reported that the vaccination didn't so much prevent you from getting the infection, but it did make the COVID-19 less severe.

What the initial intentions of the vaccine manufacturers was, I don't know, but very early on it was reported that this is what the vaccine actually is good for.

I obviously don't know how many people, politicians and whatnot have been selling the vaccination as an infection preventer, but I'd be hard nodding with the grocery store folks and we'd be looking at you along our noses.

Given the last 10 posts or so I think we need to find a Bojangles and hash this out.

 

[tarheelhockey]

He is already dead.

But anyway, my initial point stands then. We've gone from "this is a pandemic of the unvaccinated" to "it's always just been a halfway decent reduction of symptoms that keeps you out of the hospital, why would you ever think it's going to prevent breakout cases?" This is just not true, and that's ok that it's not true, Omicron is different than Delta which is different than the initial strains, and the vaccine isn't going to help as much as it did in August. And that's ok, just say that. Don't rewrite history to say the vaccine was never about preventing cases. The studies of "95% effectiveness" explicitly were about preventing cases, the receipts are there. You lose more trust when you try to rewrite the initial intent than when you just try to adjust expectations accordingly (at least with me).

That’s fair, and I do think it’s fair to say the vaccine was oversold as a magic bullet. Partially out of ignorance/oversimplification, and partially because there’s no room for nuance after politics enter the conversation. We should have been talking about what to realistically expect, but instead the dialogue was pushed into absurd extremes.

Realistically, the priorities for measuring success of the vaccine are:

1) Preventing death - the vaccine is extremely good at this.

2) Preventing hospitalization, life altering illnesses - the vaccine is extremely good at this.

<gap>

3) Preventing infections that feel like the flu - the vaccine is good at this, though less than the claims being made at one point

4) Preventing infections that feel like a cold or less - the vaccine is much less effective at this than we had hoped.

5) Preventing sub-clinical levels of infection - the only way to achieve this is to completely eradicate the virus, which may not be medically possible, and is definitely not possible with low vaccination rates.

In the scheme of things, it’s disappointing in terms of the day-to-day annoyance of getting sick, so I get why people would feel let down. Big picture, it’s doing the job and the issue is we can’t really solve #3-#5 under the current dynamics.

 

[Anton Dubinchuk]

That’s fair, and I do think it’s fair to say the vaccine was oversold as a magic bullet. Partially out of ignorance/oversimplification, and partially because there’s no room for nuance after politics enter the conversation. We should have been talking about what to realistically expect, but instead the dialogue was pushed into absurd extremes.

Realistically, the priorities for measuring success of the vaccine are:

1) Preventing death - the vaccine is extremely good at this.

2) Preventing hospitalization, life altering illnesses - the vaccine is extremely good at this.

<gap>

3) Preventing infections that feel like the flu - the vaccine is good at this, though less than the claims being made at one point

4) Preventing infections that feel like a cold or less - the vaccine is much less effective at this than we had hoped.

5) Preventing sub-clinical levels of infection - the only way to achieve this is to completely eradicate the virus, which may not be medically possible, and is definitely not possible with low vaccination rates.

In the scheme of things, it’s disappointing in terms of the day-to-day annoyance of getting sick, so I get why people would feel let down. Big picture, it’s doing the job and the issue is we can’t really solve #3-#5 under the current dynamics.

I don’t necessarily think it was oversold though, in that for a time these were the actual results; the effect “in the wild” matched the studies fairly well, at least reportedly. But then the strain changes. And maybe the period of effectiveness of the vaccine wasn’t as long as we thought, so people need boosters, and etc. And then people are told it was never supposed to be about the previous level of effectiveness, and people get mad at being told that, because it’s not really true. Etc.

If they think there’s even a chance of this becoming a seasonal shot like the flu, the earlier the seeds are sown for that expectation, the better. The less people feel that the goalposts will have moved regarding what “fully vaccinated” means and things like that, the better.

 

[tarheelhockey]

I don’t necessarily think it was oversold though, in that for a time these were the actual results; the effect “in the wild” matched the studies fairly well, at least reportedly. But then the strain changes. And maybe the period of effectiveness of the vaccine wasn’t as long as we thought, so people need boosters, and etc. And then people are told it was never supposed to be about the previous level of effectiveness, and people get mad at being told that, because it’s not really true. Etc.

If they think there’s even a chance of this becoming a seasonal shot like the flu, the earlier the seeds are sown for that expectation, the better. The less people feel that the goalposts will have moved regarding what “fully vaccinated” means and things like that, the better.

I would agree, but then… politics. People who have been pushing a narrative about this being some sort of tyrannical NWO takeover will have a field day, and we’ll go through a whole new round of people wanting to punch their in-laws over Thanksgiving dinner.

 

[Lempo]

Given the last 10 posts or so I think we need to find a Bojangles and hash this out.

Dear diary,

Today was the day when I became a second for the grocery store guy.

 

[Anton Dubinchuk]

I would agree, but then… politics. People who have been pushing a narrative about this being some sort of tyrannical NWO takeover will have a field day, and we’ll go through a whole new round of people wanting to punch their in-laws over Thanksgiving dinner.

Yeah, that's the thing. The thing that's my instinct to do with, say, a group of people at work that report to me, or communication within my own family, is very different than public policy instinct. This is the point of the discussion where I just focus on subsidiarity and my own areas of influence, and thank God I'm not in a position of responsibility for widespread public perception.

 

[Lempo]

@SniperHF you're eyeing to shut this shit down, aren't you?

 

[SniperHF]

@SniperHF you're eyeing to shut this shit down, aren't you?

Nah. Usually when we shut them(them being vid threads) down on team boards it's over repeat incidents not random stuff here and there.

 

[SniperHF]

It is over 1k tho if anyone wants to make a new one.

 

[Anton Dubinchuk]

Good cuz this has been fun.

 

[Lempo]

Nah. Usually when we shut them(them being vid threads) down on team boards it's over repeat incidents not random stuff here and there.

I was referring to the 1000+.