Tuesday, September 21, 2021

Boosters

I was going to write about the FDA's idiotic booster recommendations, and then I found the perfect answer on Marginal Revolution, which I will quote in its entirety for the few readers who don't read MR every day

My first reaction upon hearing that boosters were rejected was to ask the same thing: would these same “experts” say that, because the vaccines are still effective without boosters, vaccinated persons don’t need to wear masks and can resume normal life? Of course not. They use the criterion “prevents hospitalization” for evaluating boosters (2a) but switch back to “prevents infection” when the question is masks and other restrictions. What about those that are willing to accept the tiny risk of side effects to prevent infection so that they can get back to fully normal life? The Science (TM) tells us that one can’t transmit the virus if one is never infected to begin with.

Also, one of the No votes on boosters said that he feared approval would effectively turn boosters into a mandate and change the definition of fully vaccinated. So, it appears that the overzealousness to demand vaccine mandates has actually contributed to fewer people getting access to (booster) vaccines, thus paradoxically contributing to spread. A vivid illustration of the problem with, “That which is not mandatory should be prohibited.”

The biggest problem with public health professionals continues to be (1) elevation of their own normative value judgements — namely that NPIs are no big deal no matter how long they last — which have nothing to do with scientific expertise, (2) leading them to “shade” their interpretation of data to promote their preferred behavioral outcome rather than answering positive (non-normative) questions with positive scientific statements, (3) thus undermining the credibility of public health institutions (FDA, CDC) and leading to things like vaccine hesitancy.

What happened to the idea that the FDA's job is to proclaim only whether a vaccine is safe and effective? Then if you want to take it, that's up to you? (And we could argue about even that, i.e. whether "safe" is enough, whether FDA should have authority to make something unproven illegal, etc.) 

I want a booster. Pfizer wants to sell me a booster. The data say it's safe and effective. Way more effective than masks. Period. 

They hypocrisy on masks vs. boosters is amazing.  

12 comments:

  1. Amazing doesn't fully describe the hypocrisy. Disgusting does.

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  2. > positive (non-normative) questions with positive scientific statements

    Positive scientific statements must be evaluated for man's life. Life is valuing. Those are positive, scientific, non-normative statements. Of course, one can reject life and the values needed for it. One can choose altruist sacrifice, common good mysticism and equity nihilism. And mindless tribalism. America's response to Covid is a virtually universal failure of Reps, Dems, Congress, the Presidents, the Feds, states and cities. What we have here is statist Pragmatism, a headless chicken with a club, swinging wildly, doing nothing and then panicing.

    Looking Back on the Pandemic: What Went Wrong, What Went Right, and Why? by Dr. Amesh Adalja ,epidemiologist ,Sep 10, 2021, Ayn Rand Institute, YouTube

    A Pro-Freedom Approach To Infectious Disease-Onkar Ghate, philosopher, Ayn Rand Institute, pdf.

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  3. The epidemic models that we were using last year in order to understand the dynamics of Covid-19, do not apply to the SARS-CoV-2 virus. We don't achieve "herd immunity" with the vaccines because the vaccines, as those are currently designed, do not prevent infection. Fully vaccinated people can and likely do become infected but the infection does not result in Covid-19 (the disease) in the majority of cases of vaccinated people. The proportion of patients hospitalized for Covid-19 who are vaccinated is approximately 1-in-8, the other 7-in-8 hospitalized are unvaccinated. If 45 percent of the adult population of the U.S. is unvaccinated, and it appears that efforts to vaccinate that cohort is running up against logistical constraints, it makes little sense to dispense with NPI at a time when hospitals are cancelling surgical procedures for want of beds and staff.

    The S.I.R. and S.E.I.R. compartmental models were developed for epidemics that left the recovered with immunity against the disease vector. The proportion of susceptibles in the population declined as the proportion of infectives and recovereds increased up to the point where the basic reproduction number fell below unity. In the case of SARS-CoV-2, recovereds ("R", in S.I.R. and S.I.E.R) remain susceptible ("S") and may subsequently become infective ("I") after further exposure ("E"). This is one reason why polymerase chain reaction tests ("PCR") are required of travellers entering the U.S., along with evidence attesting to full-course vaccination. The PCR test reduces the likelihood of passing infectives into the U.S., and the full-course vaccination reduces the probability that the visitor will become a burden on the domestic healthcare system (i.e., require hospitalization).

    Until such time as a vaccine is developed that will protect the sinus and nasal mucous membranes from SARS-CoV-2, the likes of the FDA Advisory Panel and the CDC&P will continue to recommend NPI measures to limit spread of the noval coronavirus to the unvaccinated cohort of the population.

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  4. Agree w almost everything in this post (not that it matters but still). But as with every good bit of analysis and commentary, I also focus on what is not being said/written, as that shapes the narrative and opinions as much as what is highlighted. If one refers to vaccine hesitancy (as in the MR post), let's either show some data to justify the assertion (sentence below), or at least mention other main factors that could be behind vaccine hesitancy. I don't think the hypocrisy noted here (I agree w the hypocrisy) or the "confusion" about boosters is a driver of vaccine hesitancy. We are talking about months of "hesitancy" by those who need to "do their research" before there was even talk about boosters. these are the same people who were complaining about masks when there were no vaccines, or seat belts infringing on their freedom back in the 1980s. I do think there are other factors behind that - won't get into that as per comments policy. And I don't think vaccine hesitant folks are perusing the FDA, CDC websites for information or data on RCTs, etc.

    "undermining the credibility of public health institutions (FDA, CDC) and leading to things like vaccine hesitancy."

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    1. I am one who is hesitant because I cannot get good information. I had COVID in Nov and finally got one vaccine in August. Do I need the second shot? Is it worth the risk? I don’t know because there is little or no evidence on whether the vaccines actually help those who have been sick and recovered.

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    2. I am one who is hesitant because I cannot get good information. I had COVID in Nov and finally got one vaccine in August. Do I need the second shot? Is it worth the risk? I don’t know because there is little or no evidence on whether the vaccines actually help those who have been sick and recovered.

      Delete
  5. The nattering has omitted the notion that we become safe, and able to return to "normal" life, when the virus becomes unable to amplify because the whole world is sufficiently immune as a result of vaccination. The base discussion about booster jabs concerns where a limited supply should be consumed.
    --E5

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  6. This recommendation is a consequence of the government policy of insisting on "free vaccines for everyone." The government won't approve the booster and allow Pfizer to sell it to those who are willing to pay because that wouldn't be "equitable" but doesn't want to approve it and provide free boosters to all comers.

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  7. Boosters are more effective than masks, but that's not saying much. To say that the data supports boosters is to beg the question; that's what the FDA is supposed to decide.

    The FDA actually *is* just proclaiming whether boosters are "safe and effective". But those two things aren't binary, so they're doing as we economists say they should: they're making a tradeoff. Boosters, like any shot, are not completely safe. Nor are they completely effective. The question is whether the small risk of a serious side effect, and the large risk of a small side effect, is worth the reduction in disease probability. The answer isn't obvious.

    I do agree that the FDA has done more harm than good over its history. We ought to change its role to be purely informational: it would give an official opinion, and then consumers, doctors, and insurance companies could decide whether to use an unapproved drug or not.

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  8. The third-person verb "prevents" is inaccurate usage in the context of vaccines administered re: Covid-19 hospitalization or transmission, and masks re: infection and or transmission.

    We have now had sufficient experience with the novel coronavirus to know that while the vaccines do reduce the numbers of exposed vaccinated persons who develop Covid-19 at a level requiring hospitalization the vaccines do not prevent hospitalization or severe Covid-19 symptoms. Masks and social-distancing do reduce to a degree the transmission of the virus between people in close proximity to one another, the reduction is not such that it prevents transmission of the virus. Infection rates and break through cases in the vaccinated population run at a rate of 12%, roughly, 1 in 8.

    Prevention is going to have wait on new anti-viral medications and vaccines.

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