The True Solution to the Booster Debate

Eric Medlin

History instructor. Writer. Rising star in the world of affordable housing.

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50 Responses

  1. Jaybird
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    says:

    Here’s something that I find vaguely troubling: Israel, one of the most vaccinated countries in the world, is now calling for fourth doses.

    Like, they’ve had one round of boosters and, looky there, it’s September and we’re calling for a fourth.

    Without getting into issues like the WHO suggesting that these doses would do more good as the first dose in a third world country than as a fourth dose in a first world country, I find myself wondering if there will be need for a fifth dose.

    And if so, good Lord *WHY*?

    Does Israel have as bad an obesity problem as the US?Report

    • Michael Cain in reply to Jaybird
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      says:

      Reported today, the 17% of Israel’s population that is unvaccinated accounts for 85% of patients requiring heart/lung support, 65% of all serious cases, and 50% of deaths. The severe cases graph makes it obvious that those numbers are getting more lopsided over time — the big problem is getting people vaccinated.Report

      • Dark Matter in reply to Michael Cain
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        says:

        60% of deaths (actually 63%).

        One would expect it will match up pretty well with “serious cases”.Report

      • Jaybird in reply to Michael Cain
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        says:

        That’s a reason for first doses, though. Not fourth ones.Report

        • Michael Cain in reply to Jaybird
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          says:

          The point is, you’re worrying about the wrong thing. Maybe we need four doses. Maybe we need an annual booster. Maybe the second generation booster doesn’t require further boosters. We don’t know. The problem right now is the people who refuse to get even the first dose. The reason Israel’s (and Mississippi’s and Idaho’s) hospitals generally and intensive care in particular are stressed to failure is the people who refuse to get the first dose. Worry about solving that.Report

          • Jaybird in reply to Michael Cain
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            says:

            We’ve tried carrots, haven’t really tried sticks yet.

            So maybe… sticks?Report

          • Kazzy in reply to Michael Cain
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            says:

            If Israel’s hospitals are overwhelmed despite an 83% vaccination, what does that mean? Do they have less hospital capacity? Are they using different vaccines with different efficacy? Or is an almost-85% vaccine rate still not enough? That is considerably higher than ours.Report

            • Dark Matter in reply to Kazzy
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              says:

              That 85% rate is probably a statistical lie.

              We can’t vaccinate children. Ergo that’s “85% of everyone who can be vaccinated” and NOT “85% of the population”.

              And yes, it’s not high enough. We need more adults vaccinated and we need to do children.Report

              • Kazzy in reply to Dark Matter
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                says:

                That makes sense.

                I’m hopeful that parents will get the kiddos vaccinated quickly. I keep saying I’m going to stab my kids right in the eye myself the first chance I get. NOT because I’m hyper concerned about their own risk level (they DID spend 5 days with their Covid-infected mom and never got sick) but every shot gets us that much closer to moving forward.Report

          • Dark Matter in reply to Michael Cain
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            says:

            Control your own actions.

            Each dose helps a lot. However 20% of a big number can still be a big number (assuming 80% efficiency). 20% of that number can still be big, and so on.

            That original “big number” comes from an unvaccinated person sharing the disease. If I’m unfortunate then that sharing will be from someone living with me so the exposure can be a lot.

            To minimize my chances of bad things happening, I may need three or four doses. At some point another dose won’t help me. That point is CLEARLY not two doses or the medical powers that be wouldn’t be suggesting a 3rd dose for HC workers.

            Yes, in terms of fighting the overall disease it would be useful if that 3rd dose were in someone who lacks even one, but that’s where we start controlling other people’s actions or not putting America first. Everyone around me can take a vaccination if they want, for free, at any pharmacy (and various other places).Report

            • Michael Cain in reply to Dark Matter
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              says:

              That works, to a point. Now explain how me getting that third or fourth dose protects me when I get hit by a drunk driver and the nearest available ICU bed is 70 miles away because the beds I would normally use within five miles are full of unvaccinated Covid patients.

              Distance makes a difference. It’s the principle reason that statistically, it’s more dangerous to live in rural Colorado than along the Front Range urban corridor.Report

    • Dark Matter in reply to Jaybird
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      says:

      Without getting into issues like the WHO suggesting that these doses would do more good as the first dose in a third world country than as a fourth dose in a first world country

      I don’t think we can avoid that issue since it’s likely driving some of the advice coming out of the medical advisory committees.

      good Lord *WHY*?

      We already have appropriately targeted vaccines against other viruses that require 4 jabs. This virus has been mutating. I have been vaccinated against the flu 20+ times.

      It’s reasonable to think we’ll end up with a new vaccine that targets the mutants. Absent that, it’s reasonable to think that, within the margin of error, the correct number of jabs might be 5.

      It might also be the sort of thing we do every year like the flu.

      And yes, it might be that the vaccine wears off.Report

    • Brandon Berg in reply to Jaybird
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      says:

      It says they’re trying to reserve (stockpile?) a supply in case it’s needed, and a health official is quoted as saying that he hopes that the third dose will last longer. I figure that by the time the third dose runs out of steam, even if it only takes six months, a variant-targeted vaccine will be ready.Report

  2. Kazzy
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    says:

    Doesn’t getting doses to other countries also help us here, by limiting the potential for new variants evolving elsewhere?Report

    • Dark Matter in reply to Kazzy
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      says:

      Yes and no. You get evolutionary pressure to mutate into a drug resistant variant when you have a population of vaccinated and a population of unvaccinated. So in theory we should be fully vaccinating one country at a time.Report

      • Kazzy in reply to Dark Matter
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        says:

        But if we’re allowing travel between countries, than does it really matter? Can we really think of “distinct” populations?Report

        • Dark Matter in reply to Kazzy
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          says:

          In theory it matters a lot. You squish the disease in one country, dropping it’s mutation level to zero and not putting it under evolutionary pressure to becoming drug resistant, then you move to do a different country.

          In terms of travel between countries, you vaccinate everyone who comes into a vaccinated country… or just have two week quarantines which is what some countries do now, and the amount of evolutionary pressure raised by vaccinated people being out in non-vaccinated countries would be close to zero.

          Think of it this way, at the moment (counting kids), about half the country isn’t vaccinated. You meet someone from the opposite sex pretty often, maybe hundreds of times a day if you go to walmart and maybe even thousands if you work somewhere like that.

          The number of people from France that I meet rounds to zero. Ditto the number of people who are freshly from another country.

          Our populations are pretty distinct for this sort of purpose… at least in theory. In practice we have half the country not-vaccinated so we’re back to huge evolutionary pressure again.

          Now there are strong arguments for giving vaccine to other countries, like reducing the number of dead people (ethics) and economic damage (we trade with these people) and generating good will and so on. But the “there will be fewer mutants” is not one of them.Report

          • Kazzy in reply to Dark Matter
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            says:

            Didn’t Delta start overseas? Have we been allowing international travel without restriction?

            Happy to be wrong about this.. just trying to understand.Report

            • Dark Matter in reply to Kazzy
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              says:

              Delta did start overseas, and we have NOT been following the best practices of vaccinating everyone in this country (children because it’s not approved, unvaccinated adults because they refuse.

              That doesn’t change that the biggest place for a drug resistant mutant to show up would be where the vaccinated are mixed with the unvaccinated.

              We’re not going to have a drug resistant Covid show up in a country where there are no vaccinated people. There would be no advantage to it being there. Instead we might see something that spreads more quickly than the one that currently exists, like say Delta.

              You’re not wrong about it helping us if we fight covid in other countries. However we don’t have the ability at the moment to supply other countries with all the vac they need and if we’re interested in fighting break-through cases then we need to have a 3rd booster.

              So basically Biden is correct in that we need to be doing all of these things, i.e. supplying the rest of the world, fighting break through cases, and expanding our ability to manufacturer vac.Report

              • Kazzy in reply to Dark Matter
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                says:

                “ That doesn’t change that the biggest place for a drug resistant mutant to show up would be where the vaccinated are mixed with the unvaccinated.”

                This is what I was failing to understand. Thanks for patiently explaining to my dense self.

                Did Delta just kinda get lucky? Or did it emerge in such a country?Report

              • Dark Matter in reply to Kazzy
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                says:

                This isn’t my field. However my impression is Delta isn’t vaccine resistant, it’s just the vaccine was targeted against the original virus to a level that gave us crazy good results.

                The virus changed, not to be resistant against vaccination but to increase transmitting spread, however it was different enough that we’re at “average vaccination” levels of protection.

                This is still pretty huge and a world away from “no vaccination at all”. (So take the vaccine if you haven’t). If we could get everyone to take the vac that would crush the pandemic.

                However yes, it’s also not the “close to immunity” we had against the original strain.Report

              • Jaybird in reply to Dark Matter
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                says:

                The arguments in favor of the mRNA shots that I had seen to this point were something like “this is a *HUGE* leap. This is the equivalent of antibiotics. Only, this time, we fight viruses with it!”

                I worry that Delta is the equivalent of what antibiotic resistance would look like.

                Viruses seem to be a bit more robust than biotics.Report

              • Dark Matter in reply to Jaybird
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                says:

                Delta came out in India in 2020. Given the total lack of vaccine then it’s highly unlikely it’s actually vaccine resistant, as opposed to just different.

                Having said that, I wouldn’t be surprised if we get a vaccine resistant strain before this is over. I think I remember the CEO of Pfizer saying as much.

                So… given that Delta is the most “popular” guy around right now, and how he’s doing his thing in countries that have the vaccine, odds are he’ll be the base.

                This suggests we need to “stick” the unvaccinated until they do the sane thing. This also suggests we need to finally approve children.Report

              • Kazzy in reply to Dark Matter
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                says:

                Have we considered… not telling the virus about the vaccine? Maybe that’ll make it less likely to mutate in response.

                I’m joking of course. Mostly. I’m also dumb. More than mostly.

                It does seem like kids (at least 5 and up) will be approved within a month. And while I’m no expert, I believe that the major hold up was determining the correct dosage. Whereas the 12-16 or 12-18 set received the same dosage and testing was required to make sure it worked the same, younger kids needed to have the dosage level played with. Hopefully they can build off all that and quickly figure out the right dosage for 0-5 (or 2-5 and then 0-2, whatever).

                I do know other countries have begun administering to kids under 12, but I’m not sure if those are the same vaccines or not. I read Cuba started a week or so ago.Report

              • JS in reply to Jaybird
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                says:

                No, vaccines don’t work like antibiotics. Viruses don’t mutate in the same way as antibiotics.

                Antibiotics work like poisons — anything that survives the poison is resistant to the poison.

                Vaccines work by priming your immune system to produce antibodies, which are akin to taking a blowtorch to weeds.

                No weed will become fireproof. What will happen is all the weeds that pop up will be burned.

                Or, I suppose, the way that bacteria haven’t really become immune to bleach despite generations of cleaning with it. it’s because those that survive are simply those that didn’t get exposed, as every one that did got exploded.

                The survivors of Pompeii weren’t immune to lava, they were just lucky.

                None of the current COVID variants evade the vaccine provoked immune response. It looks like Delta requires a higher antibody load to no-sell, due to some variation, and got really popular right as antibody production in a lot of the vaccinated folks was dwindling. (Antibodies don’t stick around forever. A different part of the immune system handles ‘remembering’ immune responses and churning out new antibodies are required)

                That’s why breakthrough infections are what, 10 or 12 times less likely to lead to hospitalization or death? It’s because your body has a perfectly valid immune response. Just a limited initial quantity of foot soldiers to go stabbing.

                Even vaccine evasion (changing the viral coat sufficient to fool the human immune system’s previous antibodies) isn’t that common. Influenza has a rather nifty trick it uses to do that, but it’s pretty unique. COVID’s got plenty of variants, but vaccines deliberately target the spike protein because it’s integral to infection AND has a cap on how much it can be changed and still infect human cells.

                What Delta is good at is pumping out high viral loads and spreading a lot faster and harder, meaning that those with waning antibody levels (say, those who haven’t had their vaccinated immune systems challenged by COVID exposure in months or perhaps not since vaccination) are more likely to see breakthrough cases. Their initial viral load at infection, coupled with it’s fast reproduction, can overwhelm their limited antibodies.

                But the breakthrough cases are an order of magnitude less likely to result in serious illness or death because the antibody pattern the body HAS is sufficient to deal with it, it’s just a matter of pumping them out.

                And it’s why antibody therapy works fine for any variant — they’re dumping the same antibodies in that your body would produce. They’re just ramping you up to maximum instantly, rather than wait a few days as your body works to churn them out to get to a high enough level to make sure they no longer reproduce.Report

              • Jaybird in reply to JS
                Ignored
                says:

                I didn’t say that vaccines worked like antibiotics, I said that mRNA vaccines were as much a breakthrough as antibiotics were.

                I am not a medical professional but, from what I understand, an mRNA vaccine doesn’t work the same way that a traditional vaccine does.

                Now I do know that antibiotics have some nasty emergent effects such as: antibiotic resistant biotics.

                And I find myself wondering if mRNA vaccines will have any emergent effects.

                You know, like we used to wonder when they were Trump vaccines.Report

              • Kazzy in reply to Jaybird
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                says:

                “ You know, like we used to wonder when they were Trump vaccines.”

                Who wondered this?Report

              • Chip Daniels in reply to Jaybird
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                says:

                It’s like a dril tweet come to life.Report

              • Jaybird in reply to Chip Daniels
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                says:

                Or a CNN tweet come to life!

                Report

              • Chip Daniels in reply to Jaybird
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                says:

                I’m not seeing a connection here. Elaborate?Report

              • Jaybird in reply to Chip Daniels
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                says:

                “Why do you think we were ever at war with Oceana? They are our ally!”Report

              • Chip Daniels in reply to Jaybird
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                says:

                Like I said, a dril tweet.Report

              • Kazzy in reply to Jaybird
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                says:

                That doesn’t say what you said it says.

                But what else is new?Report

              • Jaybird in reply to Kazzy
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                says:

                Kazzy, there were a *TON* of people skeptical of the vaccine back before the election. Do you not remember that?

                Hell, even more recently, there were discussions about FDA approval and whether it was bad form on the FDA’s part to wait as long as it did to approve a shot that everybody knew they were going to approve anyway.

                That’s the soft version. The harder version is prominent democrats mocking the idea of a vaccine in such a short time period *BEFORE* the election.

                And the fact that you don’t remember this is weird.

                Seriously.Report

              • Jaybird in reply to Jaybird
                Ignored
                says:

                But if you want some more examples from before the election of prominent influencers:

                Do you need more? Or are we well into “well, there’s no reason that people who aren’t too online would have seen any of that skepticism.”Report

              • Kazzy in reply to Jaybird
                Ignored
                says:

                There is a difference between “People politicized their take on the Covid vaccine and therefore were leery of a vaccine developed under Trump but not one developed under Biden” and “And I find myself wondering if mRNA vaccines will have any emergent effects.”

                Were any of these folks questioning the mRNA vaccine technology in general?

                Again, here is what is happening:
                “Remember when A happened?”
                “Did A happen?”
                “Here is evidence of C happening, which is sort of like A but not really.”
                “So A didn’t happen?”
                “You’re weird for not remembering all the examples I just offered of C happening.”

                I’ll fully concede that lots of people wrongly based their trust in the vaccine on who was in office. Those people were wrong and dumb and should be mocked and worse because they actively did/are contributing to the ongoing challenges of getting folks vaccinated. Fully conceded. 100%.

                But I have no recollection — and you’ve provided no examples of — folks who doubted the mRNA vaccine technology simply because of the work done while Trump was in office.Report

              • Kazzy in reply to Kazzy
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                says:

                To add…

                You yourself seem somewhat skeptical of the mRNA vaccine technology. And you seem to be proactively defending this position by saying, “No one thought it was foolish when all the liberals had that take when Trump was in office.”

                But, again, you haven’t shown any folks doing that. And it wouldn’t matter anyway. Either you’re right about the tech or you’re not. Time will tell.Report

              • Jaybird in reply to Kazzy
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                says:

                You yourself seem somewhat skeptical of the mRNA vaccine technology.

                I got the Moderna, for the record. That’s the mRNA shot.

                So see my worry not as “skepticism” but an after-the-fact “uh-oh”.

                For the record, I’m mostly confident that the vaccine will protect me (the only doubt comes from the coverage of so-called “breakthrough” infections).

                My worry is the whole “can I carry particularly bad variants that won’t affect me but might affect others?”

                And if you want to argue that that is silly, well… Do you think that vaccinated people masking is silly?

                Do you think mask mandates for vaccinated people are silly?Report

              • Jaybird in reply to Kazzy
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                says:

                But I have no recollection — and you’ve provided no examples of — folks who doubted the mRNA vaccine technology simply because of the work done while Trump was in office.

                I suppose it’s true that I’m only finding examples of people making statements about the Trump Vaccine rather than making statements, specifically, about the mRNA technology.

                Which, might I add, was not approved by the FDA until August 23rd of this year.

                One month ago.

                I only have examples of people expressing deep skepticism of the vaccine.Report

              • Jaybird in reply to Jaybird
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                says:

                Fun ones:

                There are a handful more good ones I saw evidence of but they got deleted by their authors.Report

              • Kazzy in reply to Jaybird
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                says:

                Again, doesn’t support the initial claim.

                All you’re doing is defending a claim no one is disputing.Report

              • Kazzy in reply to Kazzy
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                says:

                “You know, like we used to wonder [if mRNA vaccines will have any emergent effects] when they were Trump vaccines.”Report

              • Jaybird in reply to Kazzy
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                says:

                Kazzy, you are absolutely right.

                I have no examples of people expressing skepticism of mRNA technology back in 2020.

                I only have them doubting the vaccine.Report

              • Kazzy in reply to Jaybird
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                says:

                Only took… how long?Report

              • Kazzy in reply to Kazzy
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                says:

                Oh… and because you seem to think people’s trust or doubt in the vaccine is something worth discussing… what is your level of trust or doubt in the available vaccines?Report

              • Jaybird in reply to Kazzy
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                says:

                Great enough to take it, but not absolute to the point where I refuse to wear a mask.

                I worry that I could be a carrier for particularly bad variants of the ‘vid that wouldn’t affect me anywhere near as bad as unvaccinated people.Report

              • Dark Matter in reply to Kazzy
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                says:

                what is your level of trust or doubt in the available vaccines?

                I am deeply skeptical of Russia’s. I’m fine with all three of the US vaccines but I think boosters would be more useful than is being admitted.Report

              • Jaybird in reply to Kazzy
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                says:

                Apparently until the second the election was certified.Report

  3. Mike Schilling
    Ignored
    says:

    There is now a Florida state senator who wants to “review” the vaccine policies for childhood diseases like measles, Guess what party he belongs to?

    https://floridapolitics.com/archives/458805-diaz-review-vaccine-mandates/Report

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