Sure, let's critically evaluate the guidance put forward by our public health institutions, but quoting a statement from Norway's equivalent institution without the backing evidence doesn't make the US "wrong". If the evidence available on the efficacy of vaccines for kids is so ridiculously wide that it goes from -99% to +370% risk of infection, then surely Norway is _also_ drastically overstating its case when it says (about kids) "previous infection offers as good of protection as the vaccine against reinfection" esp since it _also_ seems like the protective effect of prior infection is both uncertain and changing.
How about flatly declaring that guidance was "wrong" about school closures because minority and poor kids did markedly worse at math? Obviously these decisions are complex trade-offs, and one can't conclude that the choice was "wrong" simply by pointing out one of the costs.
How about quoting a CDC scientist, who cannot possibly have strong evidence when making the prediction "CDC guidance worsened racial equity for generations to come. It failed this generation of children." Generations to come? Show us the data that lets this scientist predict the far future with such confidence.
I get that it's deeply unnerving when these institutions make sweeping recommendations based on less firm data than we would normally demand. But not recommending anything, or not taking decisive action because of the limited data would _also_ have been irresponsible. When schools first closed, we didn't know a lot of things, but it would have been pretty reckless if agencies said "well this is putting a lot of people in the hospital and spreading fast, but we don't have the data to give definitive guidance yet, so you're on your own. Depending on the range of things your communities choose, maybe in a few months we'll have the evidence to say something."
It's complicated.
- did you make a reasonable decision with the information available at the time, but later evidence showed that another decision would likely have had better outcomes?
- did you make a poor decision which missed or disregarded information available when you made the choice?
- did you make a choice which was appropriate for your declared aims at the time, but now priorities have changed?
These decisions _are_ complex. That doesn't mean we can't find fault and demand improvement. But I think it's not constructive to merely highlight the negative outcomes; we have to find better processes which would make smarter choices next time.
I think they had good intentions behind them and may have been necessary from certain points of view, but there are questions about their legality and continue to be challenged and some overturned.
Pandemics are hard. If the CDC doesn't present a unified public voice, then a large chunk of the population will latch on to the people they agree with, and no policy would be effective. So I can understand how it came to this.
Ultimately we need someone we can trust running that org (I'm not taking a position here). And not everyone is going to trust them and they will be blamed for any mistakes. Sometimes there isn't time to do the science, so it ends up being an educated guess at maximizing reward vs risk. It's not a position I would want to hold.
The protective effect of prior infection is not uncertain, nor is it changing. There have been dozens of papers now, all saying the same thing: natural infection is at least as protective (if not more so) than even 3 doses of the current vaccines. If you are hearing otherwise, you are being misinformed. Full stop.
Here's the latest paper in a long line of consistent evidence, last week in the NEJM:
https://www.nejm.org/doi/full/10.1056/NEJMoa2203965
> No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection.
Norway is saying what it is, because we know that most people -- vaccinated or previously infected -- will eventually get re-infected. But even if you are re-infected, you will be well-protected against severe illness.
All policies have good intentions. Whether it's that nobody is the villain in their own story or that the worst tyrannies are those done for the sake of their victims, having good intentions really doesn't count for much.
What I don’t understand is how vaccination and boosting using an mRNA vaccine that contains only spike protein from the original SARS2, and which is almost completely evaded by the BA.4 and BA.5 variants, can confer protection against severe illnesses caused by those variants.
What is the biochemical process that provides that protection?
EDIT: Is this protection just a happy mantra, or is it actually that there is no protection against the new variants, but the intensity of the disease from them is far less than from the original variant (and our treatment is getting better)?
It makes a kind of intuitive sense: if you make your own body produce some key portion of the virus, maybe your immune system gets tricked into thinking it's not such a big issue?
This claim is directly contradicted in the paper you linked:
> The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1% (95% confidence interval [CI], 39.5 to 51.9).
...
> The effectiveness of three doses of BNT162b2 and no previous infection was 52.2% (95% CI, 48.1 to 55.9).
Not necessarily. You can have the data and you can have bad data. You can selectively ignore the good data to come to a drastically different decision and conclusion. Motivated thinking political or otherwise can bias the data that you select.
They are still pushing for vaccine mandates for children that will not change anything materially.
The same applies to mask mandates. The only studies I have seen only show a marginal impact on preventing infections. At the same time we are told new variants (omicron) are many times more contagious that the variants the masks were not really stopping in the first place. Mask mandates have become a similar security theatre than bugging old ladies with their liquids at airport security.
The problem is that on insisting on measures that even laymen can tell are bullshit, they are undermining the credibility they will need the day there is something that needs to be done that will make a difference.
Credibility takes decades to build and minutes to lose. Look at Ukraine. No one believed the US intelligence when they claimed Putin was serious about invading, because of the bullshit they pushed 20 years earlier with Iraq.
That said there are conflicting studies: “This report details the findings of a case-control evaluation of the association between vaccination and SARS-CoV-2 reinfection in Kentucky during May–June 2021 among persons previously infected with SARS-CoV-2 in 2020. Kentucky residents who were not vaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.58–3.47).” https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...
The nuances are complicated. False positives are a real concern for people avoiding vaccination. People that survive the first infection without vaccination are a meaningfully different population than the vaccinated population. Similarly people that get vaccinated after infection have received vaccination more recently etc.
Long covid, and greater impact on certain individuals were well known by that point. Just saying "let 'er rip, go natural immunity" isn't the responsible move. Perhaps you're ok with the risks for you, but faulting a health officer for taking a different more conservative position is hardly a reasonable opinion.
At a very high level, this is the explanation: the spike protein in Omicron has many differences from the vaccine strain spike, but it's still largely the same protein. The immune system is chopping up the protein into chunks, and T- and B-Cells are specializing to recognize those chunks. This kind of immune response (the "cellular immune response") is slower to ramp up than the antibody response that many people have fixated on, but it's a much more robust defense mechanism; B- and T-Cells are very good at providing generalized antigen recognition. There have been at least 2-3 papers I'm aware of where labs have directly demonstrated that vaccinated people are producing robust immune responses to Omicron proteins.
I'd have to dig these up again, and they're not exactly comprehensible by non-specialists, but the executive summary is that we have laboratory and clinical and epidemiological data that the vaccines are still very effective against severe disease.
What the vaccines don't do anymore, is protect against infection. That was probably never a realistic goal for a respiratory virus, but it's definitely not practical with a vaccine that produces antibodies that target a very old spike protein.
"Long covid" is not defined. There is no test. There is no objective signature. Literally anyone can claim that they have it, and not be wrong. I'm not saying it doesn't exist, but I'm telling you that we have no idea how prevalent "it" is, and we don't have any idea how "it" compares to the consequences of other common respiratory illnesses. We've simply never bothered to look, and uncontrolled studies where someone enumerates a long list of things that happened after Covid, in a large group of people, are not evidence of those things being caused by Covid.
Said differently: if you have a nearly ubiquitous illness, how can you say anything about causality regarding anything that follows?
So what we have here is a pile of questionable research, a large group of people who are scared and demanding that action be taken, and politicians who are more than willing to "take action" by pushing aside, censoring, and otherwise bullying the scientists who stand in the way of their actions.
For example, let's take just this single paragraph:
> As of February, 75% of children in the U.S. already had natural immunity from prior infection. It could easily be over 90% of children today given how ubiquitous Omicron has been since then. The CDC’s own research shows that natural immunity is better than vaccinated immunity and a recent New England Journal of Medicine study from Israel has questioned the benefits of vaccinating previously infected persons. Many countries have long credited natural immunity towards vaccine mandates. But not the U.S.
First, there's this statement: "The CDC’s own research shows that natural immunity is better than vaccinated immunity." The linked study, reading through it, makes a different claim. The study showed that completion of a course of primary vaccination PLUS having had a prior Covid infection led to reduced severe outcomes more than just having had the primary course of vaccination alone. And even there, the CI (0.27 (0.09–0.84)) on the first scenario overlaps with the CI for vaccination alone.
It would be notable if this showed that prior infection alone conferred better protection than vaccination alone, which is the author's claim. This study doesn't show that. It shows infection plus vaccination confers better immunity than vaccination alone. And, well, that's what basically any expert would have predicted as the most likely result.
The second linked study (the NEJM one) gets closer, but largely only looks at infection rates (it does have some commentary on severe covid-19 rates, but this isn't adjusted for any confounders). It's most useful as a study on how immunity against infection wanes since the last immunity-conferring event, although it allows for some cross comparisons, such as comparing infection rates for natural immunity alone vs 2 doses alone vs 3 doses alone vs hybrid immunity. Possibly the biggest caveat is that the rate of testing for the different cohorts wasn't adjusted for:
> Although differences in testing rates among cohorts and among subcohorts within specified cohorts were observed, their overall magnitude was relatively small. The rate of PCR testing was typically lower in the recovered, unvaccinated cohort than in the other cohorts, so the level of protection in this cohort as compared with that in the two-dose cohort may have been overestimated.
So, it makes it harder to directly compare across cohorts. But, even assuming the cross comparison does hold up if you did correct for testing rates, there are a couple of things to call out in this study. First, three doses had significantly better numbers than two doses. However, the three-dose cohort was new at the time of this study, so this cohort only has results for the very first time slice, and that time slice doesn't exist for the natural immunity scenario, so we can't directly compare them. Second, this study also seems to show, with respect to immunity, that infection followed by vaccination is better than infection alone.
Third, and most notably given this piece's commentary, is vaccination after natural immunity has waned. The study linked explicitly ends with this sentence in its discussion section:
> We found that protection against the delta variant waned over time in both vaccinated and previously infected persons and that an additional vaccine dose restored protection.
Let's look back at the wording in the original piece:
> a recent New England Journal of Medicine study from Israel has questioned the benefits of vaccinating previously infected persons
It is telling that a study that ends by recommending a dose of vaccine to restore waning natural immunity is used to "question the benefits of vaccinating previously infected persons" in this piece.
Now, there's a reasonable debate around how previous infection should be counted w.r.t. to immune status. E.g. one can make a reasonable case that documented prior infection plus a single dose should count as "fully vaccinated." Or, that hitting a minimum threshold on an antibody test should count as documentation of immunity. Etc. But, that's not what the piece is arguing - it misrepresents both of the studies linked in this one paragraph, and then puts forward a conclusion that is unsupported by either study. If anything, both studies provide evidence that is quite supportive of getting vaccinated at some point after infection, yet you'd never know that if you just read the paragraph from this piece.
Pieces like this one are frustrating because they have the veneer of legitimacy - written by someone in the field, linking studies, etc. It takes a lot of time to really dive in to understand whether or not the claims being made are supported. And even then, it often takes broader knowledge of the state of research in the field. It's easy to cherry pick research that supports a bias while simply leaving out competing research.
Ultimately, this piece does not come off as a good faith review of the scientific evidence.
"Response" is many different things. The vaccine boosts response b/c you have antibodies, so it's much less likely that your body has to do a hail mary las ditch (cytok storm).
> why so many governments have stopped publishing the case rate breakdowns by vax status.
But there's enough data out there to have a clear picture: vaccines or previous infections won't protect you from being infected by the recent strains (BA.2.75, BA.5, etc) but will protect you from severe disease or dying. Maybe it can be improved by nasal vaccines (what happened to those?) but who knows...
> It makes a kind of intuitive sense: if you make your own body produce some key portion of the virus, maybe your immune system gets tricked into thinking it's not such a big issue?
This one is completely off the mark. For starters, not all vaccines have your "body produce part of the virus", yet all help to prevent severe cases and death.
But also, it was just methodologically flawed -- they didn't bother to correct for the bias that people who were vaccinated after infection in early 2021 were probably behaving differently than those who had not been vaccinated at that time.
If you're going to cite an old MMWR article as "evidence" against the now overwhelming pile of papers demonstrating that the immune system works pretty much as we expect from immmunology 101, don't forget that in early 2022 they released this much better, much larger (N=1.1M people) cohort study, which dramatically showed the opposite of what you're claiming. Prior infection obviously provided robust protection against Delta, on par with the vaccines:
okay, well, others with relevant qualifications are saying it DOES exist, so since nobody seems to be saying it doesn't, I guess we can go with their expert conclusions.
where did you read this?
GP is citing a part of the paper where they show...that natural infection is statistically indistinguishable from 3 doses. QED.
Thats a bit outdated information. Yes, some cloth mask doesnt protect you. A correctly worn N95 however does offer a ~99%+ protection against contracting COVID. Once they are available in enough numbers to go to non medicinal personal as well, which they have been for years at this point, personal protection does absolutely work.
>No one believed the US intelligence when they claimed Putin was serious about invading
I don't know from where you draw this conclusion, considering his track record of doing it previously in Ukraine in 2014, and Georgia before that, and given his moving of an entire army to the border, and subsequently issuing threatening ultimatums to the world they knew the world would never subjugate themselves to
If you made a trade-off that folks of a certain political persuasion believe was the wrong trade-off, but most people and most qualified experts believe was a reasonable trade-off? That's the job.
I don't really understand this thinking. Yes, covid deaths in the under 18 group are a drop in the bucket compared to covid deaths in other age groups. But that's only because covid had such a massive toll in other age groups. We're still talking over a thousand deaths in the under 18 group, tens of thousands of hospitalizations, and many many more who had symptoms that persisted beyond a month. Even knocking those numbers down by half would be significant.
And, re masks, the general scientific consensus at this point is that yes, masks do have an effect on transmission rates, and the quality of the mask matters in how much of an impact is seen. Mandates also have an impact, although it depends on how much the mandate actually impacts behavior. It's not security theater, but some mandates will be much more effective than others.
And I'll note - US public health authorities did, in my view, lose some credibility on masks. But for different reasons than you mention. Statements early on saying masks weren't necessary for general use I think did a lot of harm. Personally, I can understand - evidence was weaker for general population usage at the time, and there was a dire shortage of even surgical masks for healthcare workers. So, I get that they wanted to avoid even more shortages for healthcare workers, but this original messaging really hurt later on when masks were being recommended. My second complaint is that, once the supply was there for surgical masks (and then for N95 and equivalents), public health authorities were really slow to push better masks, and only meekly did so.
> Credibility takes decades to build and minutes to lose. Look at Ukraine. No one believed the US intelligence when they claimed Putin was serious about invading, because of the bullshit they pushed 20 years earlier with Iraq.
Lots of us who were entirely skeptical of US intelligence re Iraq found US intelligence re Putin's intent to invade entirely believable and plausible.
Shocker. Why did we have to learn this again? How were the policies that diverged from the immunology 101-based position justified? This should be our starting point and we should not base policies on the opposite conclusion without good evidence to the contrary.
Pretty much anything public health people say on the topic of COVID turns out to be wrong on close inspection. It's really astounding. Even very basic things like getting an actual clinical definition of COVID itself (let alone long COVID) turns out to be impossible, which is why the official definition governments use is "got a positive on a COVID test". That's not actually a disease symptom but COVID isn't defined by symptoms any more than long COVID is.
The reason this happens is that public health is an authoritarian collectivist concept - the government will make decisions for the collective good even if individuals must suffer as a consequence. The entire culture of that space is dominated by a mindset that says, "we will obtain compliance by making scientific sounding claims, because people respect science and will follow it". That's why COVID research is so full of conflicting and nonsensical claims.
"Ultimately we need someone we can trust running that org (I'm not taking a position here)"
Or, those organizations should just be scrapped. There's no fundamental reason a CDC must exist. Sweden's CDC boiled down to one man, and his entire policy response was to tell people to chill out. The country was rewarded with better outcomes than most other places - lower COVID mortality than the European average, less economic damage, way less damage to the fabric of society and so on.
Given the CDC's performance it's pretty clear it has no idea how to control diseases and isn't even institutionally capable of maintaining a very basic, grandmother level understanding of respiratory diseases (natural immunity exists, seasonality is important, not actually everyone will get ill simultaneously, etc).
Go read the Wikipedia page for Dr. Makary; he's a well published and awarded researcher, not a partisan hack like your comment makes him out to be. It's distressing to me that in America "he/she supports a different party than I do" is enough reason to cast doubt on an entire career of great work.
Do you think we all have the memory of goldfish? In the height of the pandemic people were saying natural immunity was insufficient to prevent further infection to the degree that would matter the few who were talking about the "cost of natural immunity" (or any other sort of level headed adult discussion about tradeoffs) were ridiculed as enabling the anti-vaxers.
>Perhaps you're ok with the risks for you, but faulting a health officer for taking a different more conservative position is hardly a reasonable opinion.
This is a two way street. If you get to be conservative about natural immunity the other guys get to be conservative about the vax.
Saying a study is garbage when you disagree with the results is not how evidence based medicine works. Unless there was actual fraud or gross incompetence, every study should provide something of value.
Hypothetically, if vaccination provides enhanced short term protection for people after catching COVID which also provides short term protection then recommending waiting X months after getting COVID to get vaccinated is one option. Alternatively, if post COVID vaccination did absolutely nothing then you could recommend skipping it, ignoring false positives.
a minority of laymen who started with a conclusion and have yet to make a convincing case for it to either the experts OR the majority of americans, can't be the ones to decide, for the same reason we can't have them decide if a shooting is justified.
not sure why people qualified to do so, like public health experts and the politicians briefed by them who the people elected, can't be, though.
> I don't really understand this thinking. Yes, covid deaths in the under 18 group are a drop in the bucket compared to covid deaths in other age groups. But that's only because covid had such a massive toll in other age groups. We're still talking over a thousand deaths in the under 18 group, tens of thousands of hospitalizations, and many many more who had symptoms that persisted beyond a month. Even knocking those numbers down by half would be significant.
You are ignoring the comorbidities aspect GP was talking about.
> It's not security theater
Cloth masks are security theater. Nobody’s disputing properly worn N95s. GP is talking about what has been pushed for two years and the credibility that has been destroyed. They’re not talking about recent shifts.
the opposite of an expert is a layman. Neither a majority of experts, nor a majority of laymen, have, after analyzing the issue as you have, come to the same conclusion you have, that the trade off decisions showed bad judgement
> It doesn't really matter if the experts were "acting on the best available evidence"
is this just you stating your opinion, or do you have a compelling argument to convince a majority of americans that they should also believe this?
Where do I argue that? It's going to be years until we understand if the effects were net positive or negative. The positive effects are much more immediate, we have a generation of kids that how to grow up now to see how their development was impacted for example.
> is this just you stating your opinion, or do you have a compelling argument to convince a majority of americans that they should also believe this?
This is how leadership has worked for four thousand years. You can find elements of what I am saying in the Code of Hammurabi, The Art of War, as well as the Magna Carta. If a general orders his men to run into a minefield, even if he doesn't know that it is one, even if he uses the best available evidence, he is responsible for their deaths because he gave the order. That's the reason we play hail to the chief when the president walks into a room, that's why he gets to eat fancy dinners and hobnob with celebrities, that is the reward for the great risk you take for being responsible. Leaders eat first because they take responsibility, to have leaders who only take authority is unworkable, it is tyranny manifest.
> If he was affiliated with a Democratic governor, somehow I don't think it would be brought up with the same implication.
It would be, but from the other side (e.g. Dr Fauci anyone?)
The paper you linked shows effectiveness of previous infection alone at 46%, 3 vaccine doses at 52% (and slightly above the upper end of the confidence interval for infection only), and previous infection and 3 doses at 77%. When I looked for earlier studies, the first one that popped up was this one from Sept 2021, which finds that previous infection gives a 90% reduced risk re-infection.
This seems to be consistent with what has been reported more popularly; in 2020-2021 it seemed that the immune benefit from a previous infection could last several months, and that this informed the timing on when boosters were recommended. Whereas now it seems it's significantly easier to be re-infected with an omicron variant relatively soon after a previous infection.
The finding of 90% in late 2021 vs <50% now does sound like the protective effect of prior infection _is_ changing.
when you argued with this:
> If you made a trade-off that folks of a certain political persuasion believe was the wrong trade-off, but most people and most qualified experts believe was a reasonable trade-off? That's the job.
If you believe that it's not for a majority of experts to decide, or for a majority of laymen to decide, or for a majority of americans to decide, then who do you think should make the decision?
>It's going to be years until we understand if the effects were net positive or negative.
sure, and as soon as a majority of experts, maybe even of Americans, believe that the trade-off showed poor judgment, then we can talk about it as if it did
>This is how leadership has worked for four thousand years.
this is not how people believe leadership works in the US at least, where people (not you personally, clearly) judge based on the circumstances present at the time of the action being judged, not at the time of judgement
most people understand that the CDC is a normal org like any other, or indeed, like any normal person, which tries its best to do what it can with what it has, and aren't expected to be able to predict the future
did you forget something here?
> If you believe that it's not for a majority of experts are not to decide, and a majority of laymen are not to decide, and a majority of Americans are not to decide, then who do you think should make the decision?
Democracy. In our system of government we elect leaders, those leaders are responsible to the people who have elected them. This has been sidestepped in recent decades by appointing experts who have the ability to use the force of law without explicit congressional approval. This is unconstitutional and the supreme court in the past year has twice affirmed this view[0][1]. We can't allow our leaders to hide behind people that they themselves have appointed when those appointees make choices that may have disastrous consequences.
> most people understand that the CDC is a normal org like any other, or indeed, like any normal person, which tries its best to do what it can with what it has, and aren't expected to be able to predict the future
Funny they didn't mention that while making proclamations from on high. "I did my best" is of little comfort to someone harmed by their choices.
[0]https://www.supremecourt.gov/opinions/20pdf/21a23_ap6c.pdf
[1]https://www.supremecourt.gov/opinions/21pdf/20-1530_n758.pdf
>It would be, but from the other side (e.g. Dr Fauci anyone?)
You've actually illustrated my point very well here. What I'm saying is that it's great that places like HN are largely able to discuss public health at face value, rather than through the Red v. Blue lens that most Americans insist on reducing things to. Unfortunately, as soon as you accuse "the other side" of doing just about anything, your intentions are revealed, the water is muddied, and the discussion becomes useless.
I feel like everywhere I look in the anti-COVID-vax community, no one reckons with the fact that their position gets others sick, and those people might die. Even this article focuses strongly on children not needing masks or vaccines, mentioning not at all kids getting others sick.
Some cites:
https://pubmed.ncbi.nlm.nih.gov/33721405/
https://hms.harvard.edu/news/children-spread-covid-19
https://ufhealth.org/news/2021/uf-study-sheds-light-roles-ch...
> What I'm saying is that it's great that places like HN are largely able to discuss public health at face value, rather than through the Red v. Blue lens that most Americans insist on reducing things to.
Not really true anymore, sadly.
that is precisely what happened, and what has been happening, and the result is still that neither most voters nor most voters' elected representatives believe that the trade-offs made constituted poor judgement
> This has been sidestepped in recent decades by appointing experts who have the ability to use the force of law without explicit congressional approval.
most americans would not agree with this framing or sentiment, as we are fine with our elected representatives delegating some of their power, given how slowly and infrequently congress can act
> This is unconstitutional and the supreme court in the past year has twice affirmed this view
to some degree, recently, yes, but not all delegated authority is unconstitutional
> We can't allow our leaders to hide behind people that they themselves have appointed when those appointees make choices that may have disastrous consequences.
We don't believe that is happening at all, neither the hiding, nor the disastrous consequences
> "I did my best" is of little comfort to someone harmed by their choices
pithy witticisms are of little use in convincing the country that people or organizations should be judged for not acting based on knowledge they didn't have at the time of the action being judged
Most blatant examples:
- Masks are not protective
- The vaccine prevents infection (entire basis for mandates)
- There is no evidence for lab leak
- Natural immunity is not as effective as vaccine immunity
- the virus is not spread via aerosols
1) in retrospect it was obviously incorrect, and
2) even at the time, a reasonable scientist could have concluded that it was flawed
I don't generally call papers "flaming garbage", but some are so egregiously, transparently awful -- at the time of publication -- that saying otherwise is dishonest. That MMWR study was one.
https://www.sciencedirect.com/science/article/pii/S009286742...
Here's another:
https://www.nature.com/articles/s41586-022-04460-3
> Between 70% and 80% of the CD4+ and CD8+ T cell response to spike was maintained across study groups. Moreover, the magnitude of Omicron cross-reactive T cells was similar for Beta (B.1.351) and Delta (B.1.617.2) variants, despite Omicron harbouring considerably more mutations. In patients who were hospitalized with Omicron infections (n = 19), there were comparable T cell responses to ancestral spike, nucleocapsid and membrane proteins to those in patients hospitalized in previous waves dominated by the ancestral, Beta or Delta variants (n = 49). Thus, despite extensive mutations and reduced susceptibility to neutralizing antibodies of Omicron, the majority of T cell responses induced by vaccination or infection cross-recognize the variant.
I may have read a third, but I can't find it easily, and these two should be more than enough to back up what I wrote / get you started.
Your only complaint relevant at the time of publication was people that where vaccinated acted differently, that’s also true of the study you linked. It wasn’t double blinded making it “hot garbage” by your logic. Presumably the only reason you linked it was it didn’t contradict your assumptions, even though it failed to address the actual question of how useful post COVID vaccination is.
Except we care about real world outcomes so a double blind study would be less relevant making your original complaint pointless.
Look a Figures 1, 2 and 4, and you'll see clearly that protection against severe disease remains quite robust. Protection against severe, critical or fatal Covid-19 due to any Omicron infection is shown at 91% (95% CI 60-100) after prior infection (Figure 2D).
Even if we split this into two groups - those under 18 with comorbidities, and those without, there's still good evidence for both groups to get vaccinated. I don't know if there is a good breakdown nationally, but even just looking at NYC, the evidence becomes compelling. NYC has a dataset that breaks down deaths by age group and by comorbidity status:
https://github.com/nychealth/coronavirus-data/blob/master/to...
For under 18, as of 9/11/21 (yes, I wish they'd push a more recent update), 29 total deaths, 19 with an underlying condition, 5 without, and 5 pending/unknown. Underlying conditions by NYC's metric is pretty broad:
> Underlying conditions currently include diabetes, lung disease, cancer, immunodeficiency, heart disease, hypertension, asthma, kidney disease, gastrointestinal/liver disease, and obesity.
So, in New York City alone, and as of nearly a year ago, you had 5 kids under the age of 18 with no known underlying conditions who died of Covid. Just an educated guess, but it's quite plausible we've had 100+ deaths nationally in the under 18 with no underlying conditions group. That alone is pretty strong evidence in favor of vaccinating everyone in the under 18 group, and not just those with underlying conditions.
All that said, the primary reason for vaccine mandates for schools is related to transmission. And here too, there is good efficacy.
Ultimately, the harm/benefit calculation is quite clear in favor of vaccinations for kids, outside of rare scenarios. The main debate is whether the risk of backlash from schools mandating vaccination is worth the clear benefits of increasing vaccine uptake in these age groups.
> Cloth masks are security theater. Nobody’s disputing properly worn N95s. GP is talking about what has been pushed for two years and the credibility that has been destroyed. They’re not talking about recent shifts.
Cloth masks reduce transmission. They're not great at doing so, but they do still have an effect. Surgical masks are better. KN94/N95/etc are much better. Yes, we should have long ago moved to surgical as the minimum viable mask in mask mandate scenarios. It's unfortunate that we didn't. But even still, cloth masks do still help a small amount.
> You are going to get Covid multiple times in your life, regardless of your vaccination or infection status.
Yeah but whether you expect to get it once every couple years or multiple times a year is meaningful to what living in a post-covid world looks like.
Earlier your very firm statement did not qualify the unchanged protective effect as being limited to severe, critical or fatal disease, and I think you're moving goalposts.
> The protective effect of prior infection is not uncertain, nor is it changing.
That is perhaps beyond the measure of the study to even conclude that those are properly labelled data points. It is such a small number it would make sense to publish a report detailing exactly how each death played out, when they likely were exposed, by whom, and as best as possible what they were doing each hour of the days leading to death. They may have had no known underlying condition but what was unique about their situation that it led to death? Can this really happen to anyone as you seem to be suggesting? Surely it would be prudent to be sure? Advocating for mandated vaccines based on that slim evidence is not an exercise in harm reduction, its reckless.
> The protective effect of prior infection is not uncertain, nor is it changing. There have been dozens of papers now, all saying the same thing: natural infection is at least as protective (if not more so) than even 3 doses of the current vaccines.
I was saying that natural infection is equivalent to vaccination -- if not better. Then, in the same comment, I explicitly said that none of this will prevent re-infection:
> Norway is saying what it is, because we know that most people -- vaccinated or previously infected -- will eventually get re-infected. But even if you are re-infected, you will be well-protected against severe illness.
Did people originally overstate the claim that vaccination would prevent infection? Absolutely. Do we now know this to be untrue? Again, absolutely. You're going to be re-infected multiple times in your life. Cannot be helped.
But it's still true that infection and vaccination offer at least equivalent levels of protection. So if you're concerned about the protection of "natural immunity" -- by whatever standard -- then I have bad news for you: the vaccines are no better.