Vaccine reversals

My opinion of the COVID-19 vaccines has changed slightly. Originally we thought the vaccine would come and end the pandemic, specifically by stopping the spread of the disease. In other words we thought one’s strategy would be like this:

Avoid catching COVID ➔ Everyone get vaccinated ➔ Epidemic ends

Based on that understanding, we urged everyone to get the vaccine for the common good. I personally thought my risk was much lower than the general population, low enough that if no medical progress happened I’d be fine to live my life as normal, but I really didn’t want to give COVID to anyone else. As such I welcomed the vaccine when it arrived.

I also questioned, if the priority is to stop the spread, why did we open schools and why did we start by vaccinating old people? Surely the highest benefit would be to vaccinate young and working age people first since they’re the ones who do the spreading.

That was a reasonable thing to assume based on how other vaccines work. In this case though it seems to be a little different. The various COVID vaccines do not stop infections completely but make them mild. As far as I can tell it’s completely clear that the vaccine makes the disease mild, but unclear if it’s even helpful to stop spreading. You would think probably a better immune response makes people less infectious but it’s not obvious. For example what if it makes more people asymptomatic vectors.

That means the recommendation is still to get everyone vaccinated, but the reason and the arguments you can use to support it are different.

Instead of urging people to get vaccinated for the common good, and claiming you have the right to demand such a thing because the unvaxxed are a danger to you, we now have to suggest that everyone vaccinate to protect themselves. Given the majority of unvaxxed are right wing selfish people suspicious of “the common good”, that argument may carry better.

In the west we’re slowly coming to terms with the idea that the virus won’t be eradicated but it’s going to be endemic. You’re going to encounter it in the wild sooner or later. In China, NZ, etc. they went with a strategy of “keep it out” and I think that’s fragile. They have the problem ahead of them. But in the west it’s behind us. Right now my personal strategy is as follows:

Get vaccinated ➔ Catch a mild COVID ➔ Recover with robust immunity

I’m not going to recommend this for anyone else because I’m not an epidemiologist, and I’m not going out deliberately to seek infection. Also it conflicts with not spreading it. But pragmatically I think the safe thing to do is get exposed to COVID sooner rather than later. I worry that if I get regular boosters and eventually catch a resistant variant when I’m 70 it’ll be a lot worse.

That means our governments have to own up that we’re no longer aiming for eradication but for endemic disease. Everyone should be urged to get vaccinated because after some deadline we’ll drop the masks and all other anti-contagion measures and the virus will circulate freely. The message to the vaccine hesitant should be: We’re not going to force you, but for crying out loud please do it because we’re going to go back to living our lives and we want you to be safe too.

Crucially, the current narrative that the unvaxxed are anti-social idiots putting everyone at risk is wrong. Some of them are idiots, most of them are trying to make rational decisions with bad data and in a system that’s been profoundly untrustworthy. Taking the US as the worst case:

• Initial advice from the government was authoritative but incoherent and often wrong: Wash hands, don’t get masks.
• A healthcare system and pharma that is out to get you, make you dependent and screw you over financially.
• COVID boosters increasingly looking like flu shots, which are a useless if not harmful money spinner.
• Decades of a political system that demonizes “the common good”. If the vaccine is for the common good it must be bad for me, right?
• Good and bad people mentality where we (Tech, Democrats etc.) are the good people and all of you over there are deplorables.

It is no wonder that people rebel under these conditions, and calling them idiots or a public menace does not help. In fact, we have to change the narrative to: We, the vaccinated, wish to go back to normal and we’ll pose a greater risk to you. We’d like you to be safe but also live our lives so will you get vaccinated please?

I also take issue with restaurants, theatres, concert halls, and random well-wishers demanding vaccine passes as a condition of entry to their services. I think that’s based on the out of date idea that vaccination is the route to eradication, as well as no small part of moralizing nudge. In Europe you have to have proof of vaccination to sit anywhere inside and here some big venues are doing it. That’s wrong. If a venue required that you take contraceptives as a condition of entry would you accept it?

The rational compromise here is it’s OK to demand vaccination where you have a duty of care to the person becoming ill under your watch. For example it makes sense to demand vaccination for entry to a country, health system, insurer, island or other remote region, cruise ship where you’ll spend several days, etc. It makes no sense for a restaurant or a theatre unless you base it on the idea that unvaxxed = spreaders or you’re nudging.

Unfortunately I think our governments are stuck in the narrative where vaccination was the path to eradication and that’s no longer accurate. We’re going to end up in vaccination limbo as well as endless performative distancing and mask-wearing unless we move on. We have to switch to a narrative that the virus will be endemic but mild and, awkwardly, the vaccinated will go on to live their lives and put the unvaxxed at risk. Thus we should be kind to people and urge them all to get vaccinated, but use almost the opposite words to what we’re using now.