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Comment by Ambolia | Hacker News Reader

Seems more an acknowledgement that zero-Covid is never ever going to happen. At which point not sure if vaccinating outside of risk populations or to control hospitalizations if they are too high makes any sense.

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> not sure if vaccinating outside of risk populations or to control hospitalizations if they are too high makes any sense

Based on this logic, flu shots are useless. As is any treatment without guaranteed success, i.e. most medicine.

(Note: prioritising vaccinating when hospitals fill up is programmatically, repeatedly peaking the healthcare system. It will do to it what repeatedly flooring the gas and hard braking will to a car.)

> flu shots are useless

(I've been struggling with the following sentence for several minutes but here goes): flu vaccines aren't widely distributed - never mind recommended - for healthy young people.

Countries appear to prioritise flu vaccine for older and/or more vulnerable people.[0]

[0] https://www.nhs.uk/conditions/vaccinations/flu-influenza-vac...

On that page NHS seem to make a cost tradeoff for free flu vaccine since they have to pay the costs.

From the CDC

>Who should get a flu vaccine this season?

>Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. A full listing of people at Higher Risk of Developing Flu-Related Complications is available.

>Flu vaccination has important benefits. It can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations and deaths.

>Different flu vaccines are approved for use in different groups of people.

>There are flu shots approved for use in children as young as 6 months old and flu shots approved for use in adults 65 years and older.

> From the CDC > > Everyone 6 months and older should get a flu vaccine every season with rare exceptions

According to the Nuffield Trust[0], international flu vaccination coverage varies widely.

It appears from the chart the US is only reaching 65% - 70% of their over-65s with annual flu vaccine.

How much does it cost to get the annual flu vaccine in the US?

[0] https://www.nuffieldtrust.org.uk/resource/adult-flu-vaccinat...

Around here it's free and the pharmacy gives you a $5 coupon for getting it. They definitely see it as an easy way to get people through their doors.

Well, I assume it's covered by insurance but probably not actually free if you don't have insurance.

No insurance required. It's a loss leader to get people into the store.

> How much does it cost to get the annual flu vaccine in the US?

As with all things in the US healthcare system, nobody knows how much anything costs.

That said, annual flu vaccine is included under mandatory no direct user cost vaccinations in insurance plans covered by the Affordable Care Act (although your insurer can pick and choose what locations they'll cover).

> As with all things in the US healthcare system, nobody knows how much anything costs

Once things are opaque one has to start wondering about motivations, financial incentives and <groan> the underlying politics.

Getting the vaccine into another wealthy & healthy child "for free" vs getting the vaccine into one poor & elderly adult ("but who will pay?") would appear to have very different outcomes, at least based on what we thought we knew about seasonal flu. The wealthy & healthy child might end up being off school for half a day less (maybe). It's almost certainly a bigger deal for the poor & elderly adult.

Perhaps it's just a lot easier to convince the healthy & wealthy family to take their kids to the pharmacy and have the insurer (cough) foot the bill?

Side note: the EU doesn't seem to be that keen on vaccinating healthy youngsters against seasonal flu[0]

"The immunity that is elicited by influenza vaccines is not as long lived as the immunity following natural influenza infection. This is especially so for individuals in the so-called risk groups, hence people have to be vaccinated annually [..]

The main strategy of immunisation programmes in Europe is to directly or indirectly protect the more vulnerable individuals"

[0] https://www.ecdc.europa.eu/en/seasonal-influenza/prevention-...

They are easy o get, readily available and reasonably well distributed (nowhere near Covid-numbers so). I only took them when I was working at a retirement home years ago, more for the residents then for myself. I was, as not being in constant contact with residents, not required to take the shot (if memory serves well, nit that it would have made a difference anyway), care personal and those being in regular contact with residents were obliged so. One of the reasons I don't get the discussion about obligatory Covid shots for health care professionals...

I don't see how that follows from his statement. Maybe something more like "based on this logic, flu shots should be targetted at high risk populations or to control hospitalizations". Doesn't France already do something like that with the flu vaccine?

Given the risk variability with coronavirus, I'm not sure that it would make sense to approach it the same way, but targeting highest risk populations still seems very different from "prioritising vaccinating when hospitals fill up".

> Based on this logic, flu shots are useless

If you believe the reports stating that the flu has basically been eliminated since the start of Covid-19, it seems the shots are indeed pretty useless! All it took was some half-assed masking and social distancing measures, that half the country swears the other half isn't doing. Who knew?

If zero-covid doesn't work (it won't IMHO), necessary immunisation levels can be reached either by

a) have enough people vaccinated

or b) have enough people infected

Not sure why people come to the conclussion option b) would be a good idea...

If zero-covid doesn't work, then necessary immunization levels can't be reached. It's endemic. Everyone will get it at one point or another.

It's now just a risk management question for individuals

That's like saying back in the 70s and 80s that we cannot eliminate deaths and injuries from car accidents so it's useless to have seatbelt and air bag campaigns and laws.

>outside of risk populations

Depends on how you define risk, 59 children have died just in Texas from Covid so far. Risk goes up with age.

Every single additional vaccination helps the situation.

> 59 children have died just in Texas from Covid so far

Obviously you realize this is a controversial, at best, assertion.

What's your reasoning for why John's Hopkins wasn't able to find a single pediatric death _from_ COVID-19?

Because the study you reference only looked at data from early-ish in the pandemic, doesn't cover delta-variant or anything else that happened in the past year? (It's also not that difficult to find claims from John Hopkins that deaths in children have happened, so you obviously realize that the "wasn't able to find a single pediatric death" is a controversial, at best, assertion?)

Is there evidence of a massive uptick in pediatric deaths? So much so that we'd believe that, even as transmission patterns increasingly resemble endemic equilibrium, the results of this report (which, to my knowledge, is still, sadly, the only one of its kind) are completely reversed?

I think it's fair to say that the authors don't think so.

More like saying we should only wear seatbelts when we are in the fucking cars!

Interestingly, seat belts and air bags are still controversial among some (few?) folks.

That would only be an analogy if car accidents mutated to overcome seatbelts. Also car accidents can kill everybody, Covid not so much if you are young, have healthy lungs and are not overweight.

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