A Fundamental Reason for Vaccine Hesitancy

You did. Yes, the vaccines don't work as well with older people, but they're quite effective, for example, in preventing the pre-vaccine outbreaks in skilled nursing facilities.

You're the one who is wrong here.

Well, good luck. My wife has been at it since 1969 when she started teaching foods and nutrition.

Unlikely. There will be a covid resolution when we have effective treatments or vaccinated folks get tired of anti-vaxxers keeping the pandemic going.

Besides, good respirators...



... are comfortable for light work and fine for shopping, even going to a movie.

What is the treatment you're touting?

 

No I’m not wrong. It was predictable the unfit would see more breakthrough infections based on previous research. Now the data is coming in on Covid and the obese and those with diabetes etc. are over represented in breakthrough infections. Here’s a bit on it if you are interested. I posted a little on how even the amount of fiber in our diet affects the efficiency of our immune responses yesterday on PF. This subject is deeper and broader than most realize.

Link
https://www.news-medical.net/news/2...-have-much-lower-risk-of-hospitalization.aspx

Furthermore, being immunocompromised is known to be a big risk factor for breakthrough infection. This demographic includes a large share of people who are cancer patients and on organ anti rejection drugs. Forty percent of cancer in the US is linked to obesity and the overweight and obese are over represented in organ failure statistics as well. So a great share of the immunocompromised are in that state because of their weight status.

So you are incorrect that age is the only variable predicting breakthrough infection risk.

As long as vaccinated individuals are able to be infected and shed virus vaccination will not make Covid go away. Treatments don’t do much to stop transmission.

Yes, we agree on using good masks if we are going to use them at all. But I doubt you want to wear one forever.

Not as much “touting” as informing people about it. I know they are too politically charged to be used in today’s environment. Monoclonal antibodies are as effective or more effective at preventing infection than our Covid vaccines.

 

There isn't much on specifics about breakthrough infections, but there is a conclusion that supports vaccines:

"Population-based hospitalization rates show that unvaccinated adults aged ≥18 years are 17 times more likely to be hospitalized compared with vaccinated adults. Rates are far higher in unvaccinated persons in all adult age groups, including during a period when the Delta variant was the predominant strain of the SARS-CoV-2 virus. Vaccines continue to play a critical role in preventing serious COVID-19 illness and remain highly effective in preventing COVID-19 hospitalizations."​

https://www.medrxiv.org/content/10.1101/2021.08.27.21262356v1

The study notes:

"Similarly, vaccine breakthrough cases were significantly more likely to be immunocompromised or were with multiple comorbidities compared to their unvaccinated counterparts. [1] Among individuals aged above 65 years, fully vaccinated patients were more likely to be immunocompromised or obese compared to unvaccinated patients. [2] Similarly, among individuals aged below 65 years, fully vaccinated patients were more likely to have neurological or gastrointestinal complications.

Although both vaccinated and unvaccinated patients showed similar susceptibility to intensive care unit (ICU) admission and mortality, fully vaccinated patients aged above 65 years were significantly more protected against these risks. A significant correlation was observed between full vaccination status and reduced risk of severe COVID-19."

[1] - If you're fully vaccinated, you're more likely to be hospitalized if you are immunocompromised or have "multiple comorbidities." Their unvaccinated counterparts could end up in ICU without being immunocompromised or having multiple comorbidities.

[2] - fully vaccinated patients were more likely to be immunocompromised or having multiple comorbidities.

"The analysis was conducted on a representative population of 4,732 hospitalized patients with confirmed COVID-19. Of them, 4,440 were unvaccinated and 292 were fully vaccinated. [3] The average duration between full vaccination and hospitalization was estimated to be 42 days. Among adults aged above 18 years, fully vaccinated individuals with breakthrough infections were significantly older than their unvaccinated counterparts and were more likely to be residents of long-term care facilities."

[3] - Only 6.2% of the hospitalized were fully-vaccinated. Of the fully-vaccinated, they were more likely to be immunocompromised or have multiple comorbidities or be obese.
​

If you're fully vaccinated, you're unlikely to end up in hospital, especially if you're under 60. If you're older and fully-vaccinated, but especially if you're immunocompromised or have multiple comorbidities, you are at greater risk than younger, healthier fully-vaccinated individuals.

I made no such claim.

If the R<1, the number if cases will go down and that's what we want. If we keep our eye out for it and contact trace, we should be able to stay on top of it. With low rates of transmission, people will return to enjoying movies, clubs, gyms, shopping, and a lot of other activities involving being around people.

Masks would, perhaps, be used where we have outbreaks.

Nothing wrong we having and using both.

 

You claimed this when I said the obese vaccinated and other vaccinated with unhealthy lifestyle benefit less from vaccination than healthy people.

Clearly I was not confused as you claimed. The risk factors for infection in the vaccinated and unvaccinated parallel risk factors for bad outcomes. Almost nobody is aware of this so don’t feel bad. It’s my hope that this information will motivate people to live a healthier lifestyle to protect themselves from Covid as well as heart disease, cancer, diabetes, and kidney failure. I know it’s a long shot but people deserve to hear the facts whether they act on them or not. There’s no value in pretending the individual responsibility to protect themselves and others from Covid ends with vaccination.

Im a bit confused as to your reply about vaccines being effective. I agree and have never claimed otherwise. In fact I’m one of the few here who has been honest about how good they actually are. For example, has anyone else told you the Covid mRNA vaccines appear to be facilitating production of IgA antibodies directly by mucosal immune cells? This is excellent news as usually we have to move to a nasally administered vaccine to accomplish this. Mucosal IgA antibodies are about the best neutralizing cohort of antibodies we know of for respiratory diseases so these mRNA vaccines are a big deal just in this respect alone.

Yes, eventually infection rates will fall. We will accept the fact people will die from Covid every year just like influenza, bacterial pneumonia, and heart disease. I’m not sure why at this point in evolutionary time we expect viruses to stop mutating, re-assorting, and recombining just because we don’t want to die. We aren’t so special the “laws of nature” no longer apply. Eventually Covid deaths will be as uneventful to society as influenza deaths.

Masking in infection hotspots is a good logical idea. Kudos.

The problem with having both vaccines and the prophylactic use of monoclonal antibodies is that the FDA doesn’t agree with you and I that we could benefit from both. Regeneron, the maker of the antibodies that have passed phase 3 trials for prophylactic use submitted paperwork and request for an EUA months ago. Still no approval. Unfortunate in my opinion.

 

What does "benefit less" mean? How do you define "unhealthy lifestyle?" I'm well aware of the greater likelihood of an adverse outcome for vaccinated people in poor health or with a compromised immune system in comparison to other vaccinated people.

I didn't say you were confused.

What do you mean by "parallel?"

Why would I feel bad when I immediately guessed it was the case and saw it confirmed by doctors treating covid patients.

Admirable.

We don't accept measles or polio. Maybe we won't have to accept covid.

 

It means the vaccine is less likely to prevent infection. It means the obese, or diabetic, or gastrointestinal diseased, or organ failure/transplant vaccinee is more likely to have a breakthrough infection than a similar individual without those issues. It means how well the vaccine will protect you depends on how healthy of a lifestyle you live.

The most relevant part of unhealthy lifestyle in relation to Covid likelihood of infection and bad outcomes is eating too much unhealthy food and not exercising enough. Obesity and diabetes both wreak havoc on the immune system leading to increased chances of clinically diagnosed infection and hospitalization/death after infection—in both the vaccinated and unvaccinated.

Yes, most people are. What most aren’t aware of is the decreased efficacy of the vaccine in these individuals that increase the chance of a breakthrough infection regardless of outcome. Even if they don’t end up in the hospital or dead, they are infecting others and prolonging the pandemic.

You believed I was confusing risk factors for bad outcomes with likelihood of infection. If I was confusing the two, by definition I would be confused. Someone confusing things is confused—that’s how the English language works. I was not confusing risk factors for bad outcome with risk factor for infection. In most cases they are one and the same.

The conditions/factors that make a person more likely to be infected (vaccinated or unvaccinated) are the same conditions that increase the likelihood of a bad outcome after infection (vaccinated or unvaccinated).

If you recognized the risk factors for bad outcomes are the same as risk factors for infection why do you keep asking what “parallel” means or what does “benefit less from vaccination” means? Do you think everyone unvaccinated is at the same risk for infection? Do you think everyone vaccinated is at the same risk of infection?

Thanks. Seems more productive than bashing other people’s political views!

Oh. I thought we had. If you hadn’t accepted measles you would be concerned about the current 200,000 annual global measles deaths, a 50% increase over the last 5 years. Or you would be concerned about the approximate 1000% increase in US cases annually over the last 20 years.

On polio we are doing better. Recently the last areas of the globe switched to vaccines intended to maintain low levels of infection and away from vaccines better suited to decreasing infection rates. When the live attenuated version starts causing more infections than community transmission of natural infections we switch to a inactivated version. Wild, huh? A vaccine causing more infections than community transmission. Thank goodness we don’t have to deal with that problem with Covid!

There’s an outside chance we could get Covid infection rates down to measles territory but I believe it’s highly unlikely. Most people have already accepted the current death rates.

 

More Covid shots are followed by more Covid infections, according to data from around the world. Your father-in-law's experience seems to follow that trend. I know the same thing happened at a company I worked for years ago. Nobody dead, but all those who took the shots are now "cases", FWIW.

 

My father in law was infected because he stopped self quarantine. His risk of infection increased because he exposed himself to the pathogen. He is also on chemotherapy so likely had little immune response to the vaccine.

 

But it's highly unlikely that he would follow the pattern of all the rest of the injected, right?

 

Are all vaccinated infected? He’s the only vaccinated infected I know and I know a lot of vaccinated folks.

 

I guess it depends on the timing and other factors.

I too know many vaccinated folks, and of course I cannot keep up with the health status of all those people, but I know that 12 out of 12 are sick at my former company, and 1 out of 1 became sick at the company I currently work for.

Such anecdotal evidence seems to concur with the data from Israel, Italy, Malaysia and others. More shots deliver more "cases".

 

In my state there are more cases because everyone is just living life like they were in 2019. People are going to concerts, the State Fair, restaurants, and wherever they feel like going. They have decided the virus is endemic and it’s time to accept it. Right or wrong that’s the decision the vast majority have made here. Of course this increases infection rates.

 

A 20-year-old in excellent health might "benefit less" than a 20-year-old with a compromised immune system for whom vaccination might be the difference between life and death even though the latter doesn't develop as robust a response to the vaccine as a healthy person.

This interpretation is by no means obvious.

Smoking cigarettes and using drugs is consistent with an "unhealthy lifestyle" but it probably wouldn't compromise the immune response to a covid vaccine.

Yet you appear to have assumed I was not. Because I questioned the idea people in poor health "benefit less" from a covid vaccination?

Having taught thousands of adults and high school students, I wouldn't make that assumption about most reasonably well educated people.

You were, but I had no way of knowing whether you were deliberately confusing the two as a way of defending yourself in debate, you were using language without precision, or you were actually confused.

Not necessarily. You might be deliberately confusing the two in their presentation even though might not actually be confused yourself. Dishonest argumentation is not uncommon on the forum. I would have no way of knowing if you were actually confused.

No, because people sometimes deliberately confuse issues.

No, they're never "the same," but they might correlate.

They may correlate, but does that mean the same thing as "parallel?"

Because they are rather imprecise terms, especially "benefits less."

Of course not. Why would you even ask these two questions when it's obvious from my earlier posts I don't?

We encourage measles vaccinations, so why would you think we've given up?

Why are you switching from "we" to "you?"

I have been "concerned" about anti-vaxxer BS for many years. It makes me barf that schools allow healthy unvaccinated students to attend school and potentially expose other students and staff.

"Most?" Hard to say. Many are pulling back spending on services that expose them to getting infected, enough that we'll almost certainly have a serious economic downturn if we pull the massive support to workers and business while the pandemic continues.

 

I’ve already made that point. Vaccination is preferable for the immunocompromised. My point here is the person with a compromised immune system is statistically likely to have been able to benefit more from the vaccination by living a healthier lifestyle. If the 20 year old is immunocompromised because of prolonged fentanyl abuse, or they are on prescription immunosuppressant because they have Crohn's disease triggered by the most preventable risk factor for Crohn’s (smoking), the immunocompromised 20 year old is benefitting less than they could have if they had lived a healthy lifestyle. Make sense?

Hmmm. Our educational system needs help. The facts are quite clear. I shouldn’t have to point this stuff out.

I would have to see contradictory evidence to this.

https://pubmed.ncbi.nlm.nih.gov/8947928/

In case you missed it, go back and read the bit about smoking and Crohn’s disease.

You are arguing both sides of the issue. I’m not sure how to reconcile that.

Whenever I mention it on PF I get either astounded disbelief or outright rejection of the idea.

There is nothing to debate. The data I have provided shows the risk factors for infection are identical to risk factors for bad outcomes. You can deny or accept, but there is nothing to debate. You even quoted one source verifying this back to me.

If you believe I was lying it would have been more honest of you to call me out for lying than to use the term confuse. LOL. I have no agenda or reason to make a dishonest argument. I want to help people avoid infection and harm, remember? Honesty about risk factors is key to protecting oneself.

How can you be deliberately confused? You can’t. It’s an oxymoron. One could act confused, but being deliberately confused isn’t logical.

I have provided evidence the risk factors for infection are the same as risk factors for bad outcomes. You can choose to accept or deny.

Accept or deny. If you want to deny, you will have to offer more valid evidence than I have presented. I tire quickly if unsubstantiated opinion.

Pick a term you prefer. I’ll adopt it.

You seem undecided. Trying to understand your position. That helps.

We have accepted the infection and death rate. Nobody stays away from their favorite pub or vacation spot because they fear measles.

Because I’m trying to get a point across to “you”

Well, I’m sure there are a lot of people who are concerned about unhealthy vaccinated kids spreading diseases around as well. If we ok allowing unhealthy behavior in one group we need to be consistent and allow it in another.

Doesn’t appear that way here. All the posts of locals on social media are of going to the state fair or a concert or a winery or something. Probably different where you are.

 

Who would even guess otherwise?

As I said:

"A 20-year-old in excellent health might 'benefit less' than a 20-year-old with a compromised immune system for whom vaccination might be the difference between life and death even though the latter doesn't develop as robust a response to the vaccine as a healthy person."​

Nonresponsive.

So, let's see your evidence a 20-year-old light smoker, light drinker and someone who has a little legal pot is going to have a significantly different immune response.

No, the risk factors and factors affecting the likelihood of infection aren't the same.

How would I know why you confused the issues? I don't know you or anyone else would bother advancing a particular argument.

No, you were confused or perhaps advancing a specious argument for your own purposes.

So, a person with a congenital heart defect is more likely to contract covid?

Uh huh. Chew on the congenital heart defect example I gave you.

They are, however, because they're avoiding some situations where they might contract covid.

No Sale. We can end the worst of the pandemic if enough people get vaccinated.

 

I wouldn’t. That’s why I can’t figure out why you keep bringing it up when it has no relevance to the subject we are discussing.

And again you repeat something not relevant.

Your claim is up in smoke. Moving goalposts is a fallacious argument in which I have no interest. Peddle that somewhere else. When I present evidence you either present countering evidence or move along. I won’t do your research for you more than once.

I have provided evidence they are. You now either provide evidence to support your claim of I will accept you have conceded the point.

You said I may not have confused the issues. Now you say I did. LOL

Neither. I made a claim and supported it with evidence. I’m now uninterested in your unsubstantiated claim until you support it with evidence.

No. Neither are they more likely to have a bad outcome after infection.

https://www.jacc.org/doi/10.1016/j.jacc.2021.02.023

There was one early study on congenital heart defects in Europe that showed some evidence of bad outcomes. But it did not control for trisomy and other developmental disabilities that highly correlate with congenital heart defects. Incidentally, developmental disabilities predict both risk of infection and bad outcome. They are actually the #1 at risk demographic for bad outcomes and infection in most studies.

Oh, the example that doesn’t have a higher risk of bad outcomes? That one. LOL. You should probably not just throw stuff at the wall hoping it will stick. I know too much about this subject to fall for that. Nice try though.

I’m not aware of anyone modifying their consumption of goods or services based on measles risk. I see very few even modifying for Covid risk.

Sure. Just like Israel. Oh, wait…

 

Rebleating talking points is no substitute for facts. You forgot to add killing grandma!

 

Already proven false.

 

Just addressing what you wrote.

More of your BS.

Even more of your BS.

So, does this mean you claim that someone with congenital heart problems is more likely to catch covid?

So, will you concede that some people have conditions that may lead to bad outcomes with a covid infection that don't make them more susceptible to catching covid?

That was your straw man, not my claim.

Reality and what you "see" may not be the same.

Oh, no--not another straw man...

 

Depends upon what means by beating it. I figure we've beaten polio although there is still some of it around.

 

No evidence from you. I accept your concession.

I’ve seen no evidence to support such a claim. All the evidence is to the contrary. I know your next goalpost move so don’t intentionally make the mistake the European researchers made by no fault of their own. You want independent variables (as do I). You chose congenital heart defects all by yourself. I don’t want to hear about something else now.

If you provide evidence I’m very happy to consider it. It’s possible there are. But the ones I listed and you accused me of lying or being confused about are not examples as I’ve shown. You are welcome to try again. I’ve learned things from you before there’s a chance I could here as well. But I’m after evidence not opinion.

No sir. You introduced polio and measles to the conversation. If measles is a strawman it’s wearing your trousers and hat.

That’s why I said things are likely different where you live. You are seeing different behaviors than are exhibited here. Both are reality.

LOL. Israel is a huge natural study and is solid evidence we aren’t going to vaccinate our way to low Covid infection rates. If you still think it’s a strawman look at infection rates in the US. They are climbing even in places where vaccination rates are high and climbing. Good evidence is easily collaborated. Israel is just a little ahead of us time wise.

 

Why would you need to push a vaccine? If it's against a virus that causes mostly discomfort it should sell itself. It should be a vaccine everybody wants.

The fact that they have to push a vaccine to the point of possibly bribing people to get it out extorting people to get it should be something to look into. But this is just hand waved away as though anybody with any objection is nuts.

If you are really interested in getting people vaccinated you shouldn't be insulting them for being tentative.

 

Well, then, so much for your claim medical conditions that make you at increased risk of bad outcome if you contract covid parallel an increased risk of getting covid.

We can vaccinate our way to a lower infection rates than there would be otherwise.

Making up positions for me again?

It appears Israel may have opened up before its vaccination rate was high enough.

 

Congenital heart defects are not a risk factor for infection nor are they a risk factor for bad outcomes. So yes, my point that risk factors for infection parallel risk factors for bad outcomes stands. I’ve shown you the evidence. You really are confused.

I think what people don’t realize is vaccination is not preventing infections as well as masking, social distancing, and partial lockdowns. I know six people who have Covid or are recently recovering. One was hospitalized and now out, one is in ICU, one is symptomatic isolating at home, and three were mildly symptomatic but now recovered. All six are fully vaccinated. I do not know anyone who is unvaccinated and infected or recently recovered from Covid. Now don’t get all squirrelly on me and accuse me of being anti vax or of bashing vaccines. Not at all. But the vaccinated have given up other mitigations and are being infected. Of course vaccinations are keeping most from bad outcomes, but because the vaccinated altered their behavior to increase their risk of infection the societal infection rates are still high. Yes it looks like if everyone gets a shot every few months we might decrease rates. But we are now at the point or close to it where natural infection immunity will likely have more to do with decreasing infection rates than new vaccinations.

WUT? You said Israel was a strawman. You change your mind?

Before delta a decent level of herd immunity was a worthy goal. Delta blew that up. Everyone will have to open up before the vaccination rate is “high enough”. If we have to vaccinate everyone 3 times a year, herd immunity is “unicorns farting rainbows” fantasy.

 

Yes, increased infection rates and increased herd immunity.