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> is so fatally flawed. The reason that previously infected people have lower hospitalization rates is that some percentage of people who were previously infected and at risk of hospitalization _died_.

The deaths are obviously a tragedy, but given that they've already happened, what is their relevance here? Having survived a past infection predicts better outcomes. If that's because all of those that would have succumbed already did, it doesn't change that the surviving convalescent crowd is not high risk.

I am from EU where previous infection is somewhat recognized. If the discussion is about why convalescents are not equally recognized, I am for it.

If the discussion is about not vaccinating and promoting natural immunity as the solution to end the pandemic then I must note that this has been tried and it failed.

We got delta, gamma and lambda from it and now omicron. Natural immunity did not end pandemic, it has prolonged it greatly.

The article claimed that mandating vaccines for convalescents doesn't make sense since it's been shown that they don't benefit.

Parent said that this argument is so fatally flawed... because people died? I couldn't quite follow.

The article is "why I'm for vaccines but against vaccine mandates", so that's what the discussion is about.

We've done something like 10B doses worldwide. A massive proportion of the population has had exposure via vaccine and/or infection. Mandates are an odious, blunt instrument, especially when there are so few remaining naive hosts.

I wrote about this opinion piece in more detail here https://news.ycombinator.com/item?id=30172569

I think its arguments are really flawed and not grounded in reality but like I said, I do not think that convalescents should vaccinate but I think they should be highly encouraged to have a booster shot because it about halves the change to become reinfected.

I think that this discussion if previously infected should or should not be vaccinated has generated just too much distraction.

Even in EU, where one, who had PCR test confirmed infection, can get COVID-19 certificate for 6 months (compared to 12 months for double vaccinated, now 9 months), it has given the anti-vaxxers too large platform.

They would not have gained it without this mistake in politics.

I'm interested in your thoughts about the quality of the authors argument. What I'm decidedly not interested in is this stuff about "the antivaxxers" (whoever that may be to you), and them winning or losing.

At some point, people started losing the plot. The win condition here is not "every single human vaccinated with the current batch of vaccines, and anyone in the way labeled and punished".

That was a potential strategy for achieving the actual win condition of keeping society running. For a variety of reasons, we seem to have wrung the majority of the benefit we can out of that strategy. Now we have to go to the next phase, and it'd be nice to start undoing this bullshit division that's been created among us.

Anti-vaxxers are people who find for some reason that vaccines are bad or somewhat bad and should be avoided and then desperately constructs articles like this to mislead other people and convince them to accept their beliefs.

I touched this topic only because the author tries to convince us that he is not one.

Why is it important? Because their beliefs distract them to view this issue objectively.

For example if two doses of vaccine do not work against new variant, they conclude that vaccines are bad and should be abandoned instead of asking and testing if three doses might work.

I am seeing the same again with omicron. Vaccines do not work, should be abandoned. I am seeing that they still work fairly well, at least against serious illness that requires hospitalization and actually after boosting also against infection but just the virus is everywhere and changes to get it are enormous and this makes it hard to avoid even when vaccinated by three doses (efficacy is around 60% with 3 doses that is about the same as was 2 doses with delta but delta was just much much slower virus (even though I thought that it was fast back then)).

Maybe this doctor really is not one but people who are, are going to use this opinion piece to confuse other people and gain support against vaccination even when it really is the best option that they got at the moment.

This is why I find this aspect also important.

I think that his argument is totally misplaced.

He tries to argue that vaccine mandates are bad because natural immunity after infection is superior.

Honestly, this is ridiculous conclusion. If natural immunity gives about the same or better or not too much worse outcome than vaccines, we should treat it equally. Period.

If somebody gets unlucky and gets infected. Let it be. If they want to have one additional shot, encourage them. If they are afraid to get one, calm them with correct information. But let them decide.

Of course then somebody would claim that we would encourage then people to get infected.

Yes, there would be some people who are stupid enough to try to get intentionally infected. I know that they exists through media and my personal contacts. But this very limited number of bad actors should not affect well behaving majority.

If we made convalescence passports equal to vaccine passports, we could have avoided a lot of unnecessary discussion and divide.

The argument that is being made by the article is "natural immunity is better than vaccine acquired immunity because unvaccinated and previously infected people get hospitalized when they are reinfected less often, so vaccine mandates are bad" - and my point is - that's an absurd comparison, because you're not comparing apples to apples. The people who are the most likely to end up in the hospital in both populations (65+, multiple comorbidities), are also the most likely to die when they are unvaccinated _the first time_.

A more accurate way to frame that would be, "If you don't die from covid because you are unvaccinated, you are less likely to end up in the hospital the second time you have it, compared to people who never had it and didn't die but did get a shot" - and we would then compare the absolute mortality rate for unvaccinated individuals and vaccinated and see the obvious numbers that vaccinated people are less likely to die. It invalidates the argument in the article.

Thanks for clarifying.

> The argument that is being made by the article is "natural immunity is better than vaccine acquired immunity because unvaccinated and previously infected people get hospitalized when they are reinfected less often, so vaccine mandates are bad"

I don't think that's the author's argument though. Their goal doesn't seem to be to pit the two types of immunity against each other and declare one a winner (just look at the title, and quotes like these: Can the case be any clearer, simultaneously, for both the efficacy of vaccines and natural immunity?)

The point is that in large part, a mandate would be imposed on people who already were infected, and these people won't benefit (much anyway), and neither will the vaccinated as a result.

If this was published early pandemic and the article was saying "no mandates, everyone should just get infected", I think your point would stand. But at this stage, there just wouldn't be that much benefit gained by forcing a largely convalescent population to get the shots, and you'd be incurring a heavy cost politically and ethically.

> is so fatally flawed. The reason that previously infected people have lower hospitalization rates is that some percentage of people who were previously infected and at risk of hospitalization _died_. You're literally clearing out the population that is most likely to skew these numbers.

But currently there are countries that mandate vaccination for people who did survive a previous infection without dying. Isn't that flawed?

The vaccination has reduces community spread but in much lower rate because of prolonged close contact. There is much lower amount of infectious virions compared to somebody without previous immunity and the period of being infectious is reduced.

Still breakthrough infections can infect somebody, especially somebody without previous immunity and nobody should rely on somebodies else immunity for their own security.

He actually gets the data wrong about fluvoxamine. It has about 30% efficacy against hospitalization (it is actually more complicated but I let it slide at the moment).

Even the CDC admits that vaccination has not reduced spread and infections. You're spreading misinformation now. Your graph includes no sources, no raw data, and is open to interpretation. For example, fully vaccinated people are much more fearful of covid and are more likely to self isolate. Fully vaccinated people are more likely to have minimal or no symptoms, so are less likely to be tested, while still being contagious.

I watched in December a community that is over 99% vaccinated have an omicron spike which led to 10% of the population test positive in a week. This started a spike which then spread to the outlying areas, and was likely only even discovered because of surveillance testing. If 10% of a fully vaccinated population could become infected within a week, then clearly the vaccines were not reducing spread or infections.

> If 10% of a fully vaccinated population could become infected within a week, then clearly the vaccines were not reducing spread or infections.

This is just a fallacy. Even measles vaccines have a breakthrough rate—cases are so low because there is not widespread community transmission.

Just because it's not reducing transmission to your taste doesn't mean it's not reducing transmission.

Does your 10% include false positive tests from people who recovered? I didn't quite realize this but PCR tests often test positive (repeated) for weeks post-infection.

Also where are you that's 99% vaccinated?

> Also where are you that's 99% vaccinated?

Someplace where children are forbidden, I guess.

It looks like, statistically, each person in Gibraltar has been vaccinated 3 times. So either they are vaxxing children (couldn't find any articles about that), or not including them because they're not eligble (which means saying "99% vaccinated is not correct unless there the population of Gibraltar is 1% or lower).

It looks like, statistically, the number of people crossing into Gibraltar at the border per day is 50% the resident population of Gibraltar.

Hahahah, I was going to say something abiout "covid vaccine tourism".

The combination of comments raises enough doubt about the claims of high vax rates not protecting people that we can simply ignore it.

Folks: please stop claiming your data proves something if the observation is better explained by biased samples. In this case, we're talking about a tiny nation that has significant through-traffic, so it's entirely inapplicable to more or less any large nation.

Directly from the CDC site (https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...)

"However, data show fully vaccinated persons are less likely than unvaccinated persons to acquire SARS-CoV-2, and infections with the Delta variant in fully vaccinated persons are associated with less severe clinical outcomes."

I interpret that as saying, indirectly, that vaccination protects against infection, but not fully, and leads to better health outcomes in case of infection. I doubt you can explain that with differing behavior ("fully vaxxed people are more likely to self isolate ... less likely to be tested, while still being contagious")

I interpret this probabilistically and from what I can see, CDC is saying their data analsysi agrees with that.

As another poster pointed out, the CDC says nothing of the kind, I believe what you are referring to is statements the CDC has made similar to my original point - that _once infected_ vaccinated people spread as easily as unvaccinated, something I am more than willing to believe.

As far as effectiveness against infection, the data is crystal clear:

https://twitter.com/EricTopol/status/1488255436671176704

There is not actually any evidence supporting your position from any of the research or even any of the major health authorities. All agree that vaccination reduces infection and hence transmission. So it's hard to argue that mandatory vaccination doesn't improve the overall trajectory of the pandemic.

Please make your substantive points without swipes. We're trying to avoid flamewar here, which this topic is particularly prone to.

(I'm talking about "You're spreading misinformation now," which is a swipe that no one here should be resorting to, regardless of how right they are or feel they are.)

https://news.ycombinator.com/newsguidelines.html