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Antivaccine nonsense Medicine Politics

Transmission gambit: An old antivax trope is resurrected

Recently, antivaxxers were all over social media after Tucker Carlson touted a “revelation” that the phase 3 clinical trial used to support licensure of the Pfizer COVID-19 vaccine didn’t examine its ability to block transmission as meaning that its inability to block transmission had been “covered up”. It wasn’t, and antivaxxers are ignoring everything we’ve learned over the last two years to make the claim that vaccines “don’t prevent transmission”.

Earlier this month, there appeared to have been large increase in antivaccine activity on social media, in particular Twitter. I know this mainly because others whom I follow mentioned it, and a certain talking point kept bubbling up to the surface about the Pfizer clinical trial not having tested for the ability of its COVID-19 vaccine to prevent transmission of SARS-CoV-2, which was somehow some sort of horrific oversight that invalidates everything about the vaccine. The whole thing appears to have bubbled up a couple of weeks ago, when Rob Roos, a member of the European Parliament, started agitating about vaccine mandates based on this:

It didn’t take long the usual amplifiers of antivaccine misinformation in the media to run with this, including Tucker Carlson:

Antivaxxers were off to the races after this, trumpeting the “revelation” that Pfizer never tested its vaccine to determine if it prevented transmission in its phase 3 clinical trials used by the FDA to issue an emergency use authorization (EUA) for the vaccine in December 2020 and how that failure means that vaccine mandates were always illegitimate right for the beginning.

Antivaxxers and a tsunami of messaging over the last week

Before I explain why this particular line of antivax disinformation is, well, disinformation, I thought I’d include some examples of how it was being spun other than the Tweets above. I’ll start with the antivax and COVID-19 conspiracy site The Epoch Times by way of Robert F. Kennedy, Jr.:

A Pfizer executive said Monday that neither she nor other Pfizer officials knew whether its COVID-19 vaccine would stop transmission before entering the market last year. Member of the European Parliament, Rob Roos, asked during a session:
Was the Pfizer COVID vaccine tested on stopping the transmission of the virus before it entered the market? Did we know about stopping immunization before it entered the market?
Pfizer’s Janine Small, president of international developed markets, said in response:
No … You know, we had to … really move at the speed of science to know what is taking place in the market.
Roos, of the Netherlands, argued in a Twitter video Monday that following Small’s comments to him, millions of people around the world were duped by pharmaceutical companies and governments. “Millions of people worldwide felt forced to get vaccinated because of the myth that ‘you do it for others,'” Roos said. “Now, this turned out to be a cheap lie” and “should be exposed,” he added.

Meanwhile, the usual suspects were posting apocalyptic Substacks, for instance Paul Alexander (who, as an advisor to Health and Human Services assistant secretary for public affairs Michael Caputo, noted in a summer 2020 email advocating a Great Barrington Declaration-like “natural herd immunity” approach to the pandemic, “we want them infected“) wrote a post titled “Dr. Geert Vanden Bossche and Dr. Paul Elias Alexander discuss Pfizer’s failure to test COVID vaccines for transmission, the need for population chemoprophylaxis, and recommendations for the vaccinated“. (I like how Alexander uses his full name, including middle name. Who does routinely that? I usually don’t even use my middle initial!) Regular readers will remember that Geert Vanden Bossche is a veterinarian who made a name for himself fear mongering about mass vaccination during a pandemic in March 2021 because—or so he claimed—imperfect vaccines would drive the emergence of “escape mutants” that could evade prior immunity due to vaccination, ignoring observations that it is the number of people being infected, far more than vaccination, that leads to the emergence of variants that could evade prior immunity, and that these variants could evade prior immunity due to vaccines or previous infection, not just vaccines.

Unsurprisingly, Alexander went on to use that “failure” to start “just asking questions” (a.k.a. JAQing off) about the vaccine, writing “Pfizer (and Moderna) & FDA, the UNHOLIST of alliances, corrupted to the very core, did not test if the COVID gene injection stopped transmission? What else did they not test for? Dr. Koops weighs in“:

Pfizer and Moderna also: -did not test whether there were any serious drug interactions with other commonly used medicines/vaccines. -did not test whether there were genetic mutations in the host -did not test whether the “vaccine” became systemic or stayed restricted to the injection site -did not test whether “boosters” were actually beneficial (they simply stated that as the initial protocol as a two dose protocol without any data to support it) -did not test whether the “non-active” ingredients caused any problems (these were not normal excipients-some of the placebo arm data suggests that these were also causing problems) -did not test whether the “vaccine” was transmissible from the recipient -did not test as to metabolic elimination of the vaccine from the host, i.e. how long does it remain active in the host -proposed a product specification that would essentially allow for almost anything to pass -did not account (i.e. screen) for a rather pronounced natural immunity already in the population -conducted most of their studies outside of the US in countries that have been known for questionable clinical studies (Brazil in particular) -had virtually no stability data

One notes that we’ve addressed a number of these claims before; so I will not address them again, except to note a couple of common tropes. As for “natural immunity already in the population”, remember that the Pfizer vaccine was tested in the summer and fall of 2020, before a huge percentage of the population had become infected. Similarly, the mRNA-based vaccines produced by Pfizer and Moderna do not “permanently alter your DNA,” contrary to Alexander’s other claim.

Elsewhere, “health freedom groups” trumpeted “We tried to warn you“, while James Lyons-Weiler proclaimed, “Knowledge About Lack of Protection Against Transmission is Old, Not New“. Indeed it’s not, as we will show (and as even The Epoch Times article acknowledged), nor is it shocking. Lyons-Weiler tries to spin this as:

The admission by a Pfizer exec has set social media ablaze with shock. That’s what you get when you suppress inconvenient truths. Now the flawed policies must be reversed or rescinded.

That’s right! Antivaxxers are treating this “revelation” as some sort of shocking “new” news when its not, and Lyons-Weiler tries to say that the reason they’re doing this is because there was a conspiracy to cover up this “inconvenient truth”. But was there? (I think you know the answer to that.)

Before I get to that question, I’ll note that this isn’t all the antivax content, not by a long shot, seemingly coordinated to amplify the message that the approval of the Pfizer vaccine was illegitimate because it never tested for the ability of the vaccine to prevent transmission. There were, of course, many videos, because there are always antivax videos, from the usual suspects. For example, over at Rumble, Alexander interviewed Vanden Bossche about the same thing, with largely the same claims. COVID vaccine transmission. Meanwhile, John Campbell (whom we’ve met before spreading misinformation about COVID-19 and monkeypox and someone whose misinformation I should really have discussed more often) treats this “revelation” as something new that had been hidden for nearly two years, introducing his story with the exchange between Robert Roos and Janine Small, Pfizer’s president of international developed markets before describing the revelation as a “breaking international scandal”—and, near the end of his video, a “complete and utter scandal”—that Pfizer did not know whether its vaccine stopped transmission before rollout:

Around 1:27 he goes on about how:

…at the time I remember representatives of the UK government who’ve now been made into Dames and Knights and all sorts of things emphatically telling us that everything that was normally done in any clinical trial was done during these trials. They gave us their word about this, and let’s hope that this doesn’t turn out to be less than accurate.

Susan Oliver did a nice job of deconstructing Campbell’s disinformation, as usual, but I’ll discuss some of it with my spin as well, as my purpose in writing this post is not so much to point out why this whole “shocked” line of hysteria is nothing new and based on intentionally deceptive spin and outright lies, but to look at the history as well, which makes me perfectly happy to point you to sources in addition to my scintillating words to deal with this particular antivax propaganda:

Even better, Dr. Richards points out that in early 2021 Dr. Campbell was mocking the idea that the vaccine doesn’t prevent transmission.

Let’s dig in. First, I think it’s important to address a seemingly simple but poorly understood question: What is the purpose of a vaccine?

The purpose(s) of a vaccine

So what are the purposes of a vaccine, anyway? I say “purposes” because vaccines don’t have just one purpose. First and foremost, the main purpose of a vaccine is to prevent people from becoming seriously ill due to disease caused by a pathogenic microorganism such as a virus or bacterium, period. If a vaccine doesn’t do that, it’s a pretty useless vaccine, particularly in the middle of a pandemic that by late 2020 had killed over a quarter of a million people in the US alone. Ideally, the second purpose of a vaccine is to prevent infection and transmission; i.e., to prevent the pathogenic organism from getting established in a vaccinated host human in the first place and to render that person unable to spread the pathogen to others. This phenomenon is called “sterilizing immunity” and means that the immunity produced by a vaccine is so effective that the virus cannot replicate in the vaccinated individual sufficiently to gain a foothold and cause infection, much less be transmissible by that person to others.

Most vaccines that prevent severe disease also prevent transmission to at least some extent, even if far from being able to produce sterilizing immunity, and vaccines that aren’t very good at preventing infection and transmission, even if they are good at preventing severe illness, are referred to as “leaky”. I discussed this concept in a fair amount of detail when I discussed Geert Vanden Bossche’s claim that, because COVID-19 vaccines are “leaky”, they select for nasty variants in the presence of mild or asymptomatic disease in the vaccinated. I also mentioned how this particular claim is not new among antivaxxers, citing the example of long-time antivaccine activist and scientific fraudster Andrew Wakefield, who made exactly the same claim for the measles vaccine, fear mongering about a sixth “mass extinction” because of the MMR vaccine.

Ironically, I also cited an article published in Scientific American in January 2021 titled “Vaccines Need Not Completely Stop COVID Transmission to Curb the Pandemic“, when the Pfizer and Moderna COVID-19 vaccines were starting to roll out to populations other than healthcare workers and very high risk individuals, that explained that quite a few vaccines that we commonly recommend are not perfect at preventing transmission. It was an excellent article that’s worth revisiting one more time before I discuss the Pfizer clinical trial.

Here’s the key point:

Although many vaccines widely used today (against measles, for example) produce very effective sterilizing immunity, others, such as the hepatitis B vaccine, do not. With these vaccines, an individual’s immune system is trained to prevent illness, yet the pathogen can persist in that person’s body, potentially allowing them to infect others. A lack of sterilizing immunity means that the pathogen can continue to circulate in a population, where it may cause illness in unvaccinated and vulnerable people or evolve to evade our immune responses, Bowdish explains.

And another example:

The case of rotavirus—which causes severe vomiting and watery diarrhea and is especially dangerous to infants and young children—is fairly straightforward. Vaccination limits, but does not stop, the pathogen from replicating. As such, it does not protect against mild disease. By reducing an infected person’s viral load, however, it decreases transmission, providing substantial indirect protection. According to the Centers for Disease Control, four to 10 years after the 2006 introduction of a rotavirus vaccine in the U.S., the number of positive tests for the disease fell by as much as 74 to 90 percent.

Another favorite example frequently cited by antivaxxers before the pandemic is pertussis, because the vaccine doesn’t produce sterilizing immunity:

For example, vaccines against Bordetella pertussis, the primary bacterium that causes whooping cough, or pertussis, do a great job of preventing illness but do not entirely clear the pathogen. Rather, as B. pertussis replicates in the upper respiratory tract, vaccine-induced antibodies apply pressure via natural selection to weed out bacteria whose disease-causing genes are turned on. Because these same genes are responsible for the parts of the microorganisms that are targeted by antibodies, bacteria that keep them turned off evade the immune response and hang out undetected in the upper respiratory tract, Bowdish explains. This becomes a problem when someone with a naive immune system, such as an infant, contracts the pathogen. In the absence of antibodies, B. pertussis‘s disease-causing genes become activated again, causing illness. Nevertheless, the introduction of pertussis vaccines in the 1940s cut annual U.S. cases from more than 100,000 to fewer than 10,000 by 1965. In the 1980s cases began slowly climbing again as parents increasingly refused to vaccinate their children. Today there is renewed focus on reducing the chance of exposure and getting antibodies to infants by immunizing pregnant women and new mothers.

I’ve noted many times that antivaccine “thinking” about vaccines tends to be very black and white. Either the vaccine is 100% effective, or it’s useless crap; the vaccine is either 100% safe, or it’s deadly enough to cause a “vaccine holocaust“; either the vaccine prevents transmission 100% or it “doesn’t stop transmission” at all! Again, in medicine, as in life, nothing is 100% certain except that each and every one of us will one day die, and efficacy for any intervention exists on a spectrum. That’s why, in general, even a nonsterilizing vaccine can be very, very useful. Indeed, in December 2020, even a completely nonsterilizing vaccine that didn’t prevent transmission at all but was effective at preventing severe disease would have helped to prevent enormous numbers of people ending up in the ICU and/or grave.

Before any antivaxxer cries, “Straw man!” out there, I do realize that the main point of this particular conspiracy theory about Pfizer not having tested its vaccine for its ability to prevent transmission is not to claim that it doesn’t prevent severe disease (although, to be sure, antivaxxers do that a lot too) but to call into question the legitimacy of its approval by the UK and EUA in the US, in particular to claim that COVID-19 vaccine mandates were based on no data. I’ll get to that in a minute, but first let’s look at the actual Pfizer trial.

The Pfizer trial

As Susan Oliver (and many others) noted, the results of the phase 3 clinical trial of the Pfizer BNT162b2 mRNA-based vaccine were published in The New England Journal of Medicine on December 31, 2020. It’s right there in the paper’s methods section:

The first primary end point was the efficacy of BNT162b2 against confirmed Covid-19 with onset at least 7 days after the second dose in participants who had been without serologic or virologic evidence of SARS-CoV-2 infection up to 7 days after the second dose; the second primary end point was efficacy in participants with and participants without evidence of prior infection. Confirmed Covid-19 was defined according to the Food and Drug Administration (FDA) criteria as the presence of at least one of the following symptoms: fever, new or increased cough, new or increased shortness of breath, chills, new or increased muscle pain, new loss of taste or smell, sore throat, diarrhea, or vomiting, combined with a respiratory specimen obtained during the symptomatic period or within 4 days before or after it that was positive for SARS-CoV-2 by nucleic acid amplification–based testing, either at the central laboratory or at a local testing facility (using a protocol-defined acceptable test). Major secondary end points included the efficacy of BNT162b2 against severe Covid-19. Severe Covid-19 is defined by the FDA as confirmed Covid-19 with one of the following additional features: clinical signs at rest that are indicative of severe systemic illness; respiratory failure; evidence of shock; significant acute renal, hepatic, or neurologic dysfunction; admission to an intensive care unit; or death. Details are provided in the protocol.

In other words, the primary endpoint for efficacy was clinical, symptomatic disease confirmed by laboratory testing, and the secondary endpoints were efficacy against severe disease, not transmission or asymptomatic infection. Again, it’s all right there in the methods.

It was also in the FDA press release dated December 11, 2020:

At this time, data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of SARS-CoV-2 from person to person.

Interestingly, the Epoch Times article cited by RFK Jr. specifically quotes the above statement:

The U.S. Food and Drug Administration wrote in late 2020 that there was no data available to determine whether the vaccine would prevent transmission and for how long it would protect against transmission of the SARS-CoV-2 virus that causes COVID-19. “At this time, data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of SARS-CoV-2 from person to person,” the agency specifically noted. Meanwhile, Pfizer CEO Albert Bourla, around the same time, said his firm was “not certain” if those who receive its mRNA vaccine will be able to transmit COVID-19 to other people. “I think this is something that needs to be examined. We are not certain about that right now,” Bourla told NBC News in December 2020 in response to a question about transmissibility.

And in a UK guidance document dated June 8, 2021 (thanks to Dr. Oliver without whom I probably wouldn’t have found this one):

Clinical trial evidence demonstrates that the vaccine reduces clinically severe infection and severe disease. The impact of the vaccine on preventing transmission remains unknown and individuals who have been vaccinated may still carry and be able to transmit the virus. We advise anyone who has been vaccinated to continue to observe national lockdown restrictions and engage with asymptomatic LFD and PCR testing if appropriate

Meanwhile, in January 2021, scientists were noting:

Current estimates of the level of effective population immunity for interruption of transmission is ~60–70%, but vaccination coverage required by a partially effective vaccine to interrupt transmission might be higher. With 8 billion people to vaccinate with a two-dose regimen, we might need 10–11 billion doses to interrupt transmission.

In other words, the vaccines were not being sold as a panacea, at least not by the scientific community.

But wait! Antivaxxers will say that this was all buried in clinical trial methods, FDA press releases, and government guidance documents that no one reads! That’s how “they” covered it up! Unfortunately, it’s not hard to find contemporaneous examples of press reporting that did no such thing. For instance, this Washington Post article explained that the trial didn’t look at the ability of the vaccine to prevent transmission:

Major questions that remain unanswered about the vaccine include how long the protection will last and whether the vaccines prevent people who are infected despite vaccination from spreading the disease. The trial showed no evidence that immunity subsided during the two months after the second dose, but more data will need to be gathered to assess whether protection tapers off. The reviewers called for further study of whether people, particularly those with asymptomatic infections, spread the disease. Epidemiologists have worried about a worst-case scenario in which people who are vaccinated stop wearing masks but may become asymptomatically infected and spread the disease. “It is possible that if efficacy against asymptomatic infection were lower than efficacy against symptomatic infection, asymptomatic cases in combination with reduced mask-wearing and social distancing could result in significant continued transmission,” the review states.

In other words, it was not kept a secret that, in December 2020 at least, we did not yet know how well (or even if) the Pfizer vaccine could prevent transmission of SARS-CoV-2 because that’s not what the clinical trial was designed to do. Nor, contrary to claims from antivaxxers like Campbell, do most phase 3 trials for vaccines examine transmission as an endpoint to be used for licensure, as Susan Oliver explains in her video, citing trials of various measles and HPV vaccines. To that I’ll add some other vaccine trials, including this one of a rotavirus vaccine in which prevention of transmission was not an endpoint or clinical trials of Rotateq, for which—again!—prevention of transmission was not an endpoint.

Dr. Oliver also very nicely hoisted Campbell on his own petard, including a video from May 2021 (which was before he’d become an antivaxxer), in which he demonstrated that not only did he know why the complaint that the Pfizer trial didn’t assess the ability of its vaccine to block transmission but cited a result from the paper suggesting that the vaccine likely was very effective in actually—you guessed it—blocking transmission:

Again, the purpose of clinical trials of vaccines is to determine if the vaccine is safe and effective at protecting the recipient against the disease targeted. You might reasonably ask why vaccines are usually not tested for their ability to prevent transmission in phase 3 trials. The answer is fairly simple and two-fold. First, again, the primary purpose of a vaccine is to prevent disease and death from infectious microorganisms. Everything else, including prevention of transmission, is gravy. Second, study designs to identify interruption of pathogen transmission are different than for determining efficacy and safety, which is why they are best carried out during post-licensing surveillance, not during the randomized controlled phase 3 trial for licensure:

Conversely, RCTs might underestimate the protective effect of vaccines at the population level. This would occur if the COVID-19 vaccine, in addition to conferring direct protection to individuals, reduces transmission of COVID-19 between individuals, providing protection to unvaccinated individuals and enhanced protection of vaccinated individuals in contact with vaccinated individuals. Vaccine-induced herd protection, which might be crucial to the public health value of a vaccine, will be missed when trials are individually randomized and analyses fail to take account of the geographical distribution of individuals in the population. Table 1 provides a summary of estimates of the basic reproduction number, herd immunity, efficacy and effectiveness for several vaccine-preventable diseases. The definition of effectiveness might vary by study.

In general, “effectiveness” includes the ability of the vaccine to prevent infection and transmission:

Collection of effectiveness data and understanding indirect protective effects of vaccination will allow countries to make rational plans for maintaining herd protection

Remember, all of this was published around the time the vaccines were introduced and shortly after.

Another bit of antivaccine messaging around the Pfizer trials seeks to impute nefarious intent as Pfizer went from earlier stage clinical trials to its phase 3 trial. Sadly, some of this misinformation showed up in the comments here:

Pfizer’s phase-1/2 trial did indeed study antibodies which is the best gauge for assessing transmission. Binding antibodies was reported for the 45 subjects but crucial neutralizing antibodies was only assesed [sic] for only seven subjects with Pfizer promising that data was forthcoming. I don’t believe it ever got reported before they eventually switched to assessing whether the vaccine prevented symptoms for the phase-3 trial. https://pubmed.ncbi.nlm.nih.gov/32785213/

And then, in another comment:

Further to my comment above and speaking of shifting goalposts, the mother of all goalposts shifts occurred when Pfizer moved from studying efficacy of its vaccine by its immunogenicity profile in phase-1/2 to assessing symptoms in phase-3. This goalposts shift went largely unnoticed; drowned out by the thunderous fanfare and jubilation that proceeded the phase-3 trial news that the vaccine was 95% effective at preventing symptoms. And, perhaps the shift would’ve remained inconsequential if the vaccine hadn’t now proven to be ineffective at stopping shit. Let it be known that it’s not just a case of Pfizer not assessing whether its vaccine is effective at stopping transmission, but them deliberately choosing this.

First, this commenter didn’t bother to scroll down and see under “Similar articles” this follow-up article in which antibody levels and T-cell responses were reported. Second, only someone who has no clue how clinical trials proceed from preliminary to phase 3 could write something this ignorant. The purpose of phase 1 trials of vaccines is to assess gross safety; i.e., that the vaccine doesn’t cause any obvious toxicity detectable in a relatively small number of patients. In other words, it’s looking for obvious and serious safety signals before larger trials are done, usually also with correlative studies of the vaccine’s ability to provoke an antibody response to the antigen. Phase 2 trials look at a larger number of patients and are focused on looking for signals of efficacy (in the case of vaccines, immunogenicity) and more safety data. However, by the time you get to the phase 3 trial, what a regulator really wants to know before approving a vaccine is whether the immunogenicity detected in earlier phase trials actually translates into prevention of disease. That’s where the rubber hits the road. If the immune response and antibodies detected in phase 1 and 2 trials don’t translate into a significant prevention of disease, then the vaccine is indeed useless. So, yes, Pfizer did deliberately choose not to assess interruption of viral transmission and likely did so in consultation with the FDA, which frequently advises companies on what it needs to see in the clinical trials carried out to support the approval of an investigational drug or vaccine.

Do COVID-19 vaccines prevent transmission?

The antivax propaganda message of ‘the clinical trials used as the basis for an EUA of the Pfizer vaccine never examined whether the vaccine can prevent transmission’ reminds me of Peter Doshi’s obsession—shared by many antivaxxers—with the original clinical trials used to license the Pfizer and Moderna vaccines. How? This line of disinformation intentionally completely ignores what we have learned during the nearly two years since the publication of the results of those phase 3 clinical trials in favor of falsely portraying the phase 3 trials as the be-all and end-all of what we know about the efficacy of the vaccines in preventing transmission, rather than as a starting point sufficiently robust to issue an EUA for the vaccines. It is true that we knew little or nothing then about how effective the Pfizer vaccine was in preventing onward transmission of the coronavirus, but It’s not as though we haven’t learned anything since then regarding whether the Pfizer and Moderna vaccines (as well as the other existing COVID-19 vaccines) are able to prevent transmission. Quite the contrary. There are literally dozens of studies of just the Pfizer vaccine (originally named BNT162b2) alone for the primary course and for boosters for the original strain of SARS-CoV-2 as well as the Delta—and now Omicron—strains. These are all ignored by antivaxxers promoting this narrative.

Susan Oliver cited two of these studies, including an early one that I used to cite last year from April 2021 that showed that, among healthcare workers in England, the vaccine was very effective in preventing both symptomatic and asymptomatic infection and a more recent one from Denmark that demonstrates that vaccination does reduce transmission, even with the more recent immune-evading variants Omicron BA.1 and BA.2.

It is, unfortunately, quite true that vaccines are less effective at preventing transmission of the Delta and Omicron variants, which is not unexpected given that these strains have evolved changes in the protein sequence of their spike proteins that make antibodies produced by the vaccine less effective in neutralizing the virus. For instance, this study from Belgian used contact tracing to estimate vaccine effectiveness against transmission (VET) for the original SARS-CoV-2 strains and Delta variants:

VET-estimates were higher for mRNA-vaccines, over 90%, compared to viral vector vaccines: 66% and 80% for Ad26COV2.S and ChAdOx1 respectively (Alpha, 0-50 days after vaccination). Delta was associated with a 40% increase in odds of transmission and a decrease of VEs (72-64%) and especially of VEi (71-46% for BNT162b2). Infection-acquired and hybrid immunity were less affected by Delta. Waning further reduced VET-estimates: from 81% to 63% for BNT162b2 (Delta, 150-200 days after vaccination). We observed lower initial VEi in the age group 65-84 years (32% vs 46% in the age group 45-64 years for BNT162b2) and faster waning. Hybrid immunity waned slower than vaccine-induced immunity.

There is also good evidence that mRNA-based vaccines against COVID-19 can prevent transmission among children and even in high-risk situations, such as among the residents of nursing homes and long-term care facilities. Additional evidence suggests that the VET fell for the Delta variants. For Omicron variants, particularly the BA.4 and BA.5 variants, there is less evidence published given that the variant took off a year ago and it takes many months to do these kind of epidemiological studies, but there is still a growing body of evidence (for example, this) that Omicron variants can evade prior immune responses from vaccines and from infection with previous SARS-CoV-2 variants, but that does not mean that the vaccines “don’t prevent transmission,” but rather that they still do prevent transmission, just not nearly as effectively as they did for the original strain against which they were designed to protect. (There’s that black-and-white thinking again characterizing a vaccine that is only partially effective against preventing transmission as “not preventing transmission” at all.) That is not surprising and is why updated vaccines will be important in the future, particularly given that Omicron has demonstrated itself to be able to evade “natural immunity” due to prior infection with a previous strain of SARS-CoV-2, such as Delta or the original strain that emerged from Wuhan.

Why is this message about transmission being resurrected now?

Again, there is nothing new here. Indeed, Dr. Allison Neitzel of the Counter Disinformation Project led me in a weekend roundup to a whole Tweet thread documenting how long antivaxxers have been hitting this particular fake criticism noting what a short memory antivaxxers have:

I could go on, but you can follow the whole thread for more. Some of the Tweets date back to December 2020, making this one of the oldest COVID-19 antivax talking points there is.

All of this leads me to wonder: Why are antivaxxers resurrecting this particular message now? The best reason I can come up with is that it’s opportunistic. Rob Roos thought he got a “gotcha moment” from a Pfizer executive, which caught the attention of Tucker Carlson’s producers, which led to him appearing on Tucker Carlson’s Fox News show last week, which amplified the message by providing convenient suspicious-looking (and misleading) clips that antivaxxers could share on social media and that antivax influencers like Paul Alexander could share on their Substacks, RFK Jr. could amplify on his website, and vloggers like John Campbell could make viral videos about. Add to that the human tendency towards black-and-white, either-or thinking in which, instead of existing on a continuum, people tend to conclude that a vaccine is either effective or not, safe or not, and you have a perfect storm of antivax propaganda, particularly when a conspiracy theory is suggested in which Pfizer and the government “covered up” the lack of data on forward transmission in the phase 3 clinical trial, all in order to enforce vaccine mandates as protecting others. The interesting thing is that the Moderna phase 3 trial for its vaccine (mRNA-1273) used a very similar design to Pfizer’s phase 3 trial and also did not examine virus transmission as an endpoint, but I’m not seeing this claim applied to that vaccine. This further suggests the opportunistic nature of this particular outbreak of viral disinformation.

Dr. Neitzel suggests politics as the reason, and she could have a point:

That all the usual characters have jumped on this at the same time feels like an effort to build on the escalation in previous weeks. In the US this appears to be an effort to mobilise the anti-vax base in preparation for the mid-term elections next month when many disinformation doctors are standing for office. We see far-right groups in Canada and Europe seeking to capitalise on this while in the UK Richard Tice’s Brexit Party has transformed into the sceptic Reform Party which is seeking to benefit from the chaos within the Conservative Party. Several other parties like the far-right English Democrats and Heritage Party which are working with disinformation groups are trying to do the same.

Whether she’s correct or not, I note that none of this is new. Those of us who’ve followed antivaccine messaging for a long time have seen it all before, be it with the pertussis vaccine or even with the measles vaccine, for the latter of which apparently 95% efficacy at preventing infection is not good enough for antivaxxers to accept that it works. The pandemic has vastly amplified the voice and reach of antivaxxers promoting such conspiracy theories. Each antivax narrative like this one in which Pfizer and the FDA supposedly “hid” the fact that the phase 3 clinical trials for the Pfizer vaccine didn’t test for its ability to prevent transmission pops up, disappears, and then pops up again elsewhere, resulting in an endless and frustrating game of Whac-A-Mole for those dealing with disinformation. That’s the idea. There is no doubt that this kerfuffle will fade, only to be resurrected again when a piece of news makes it convenient for antivax disinformation peddlers like Roos to resurrect it. That’s why, increasingly, I am coming to think that prebunking the form of antivax disinformation will be more important going forward than just trying to whack each mole as it pops up.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

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DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

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180 replies on “Transmission gambit: An old antivax trope is resurrected”

The justification for mandates is prevention of transmission. Conceding that we knew that we didn’t know about that from the get go, makes the mandates look at least as bad as if it were covered up by Pfizer.

Except that we did know soon. I cited some of the evidence that the vaccines prevented transmission. That evidence just wasn’t the original Pfizer clinical trial. Moreover, even from the Pfizer clinical trial you could infer (albeit not rigorously prove) that the vaccines were pretty effective at blocking transmission. Even more, as someone pointed out, transmission is exponential; so even a 25-50% decrease in transmission is huge in slowing down the spread of the virus. Add that to the finding that the virus did then (and still does now) very effectively keep people out of the hospital and from dying, and the vaccine is a very useful tool to combat the pandemic.

I’m not one to police typos. I know what he meant. I don’t agree with it as I think the numbers have been manipulated (and the seasonality of the trials matter as well). Regardless the case for the mandate with a less than majority reduction in transmission seems extremely weak when balanced against human freedom.

I knew what he meant too, but there’s no certainty others like you would — or that they would honesty report what he meant but instead take a typo and dishonestly use it.

I don’t agree with it as I think the numbers have been manipulated

If you mean analyzed, yes. But that isn’t what you mean, you mean artificially altered to fit “big pharma’s” narrative. That’s crap, of course, since it would require a conspiracy of unbelievable size and expense to pull off.

Your problem is simple: you don’t understand the results, don’t like what they say, and so you conclude they have to be false. The problem with spreading that narrative is that you need to toss out so many wrong things, that have no support from data or research, that you become “just another loon”. Which is fine, because that’s what you are — but just remember, you don’t get to get butt hurt for having that pointed out. (Don’t feel bad: the same thing applies to greg, ginny, ir, mjd, and the other cranks that push garbage.)

I don’t trust the numbers because everyone representing them has an extreme conflict if interest.

I don’t trust the numbers because everyone representing them has an extreme conflict if [sic] interest.

So everyone? Every doctor, researcher, lab tech, statistician, science reporter, everyone has a conflict?

In another thread when you were called out for stating everyone was involved you tried to claim you hadn’t said it: now you are again.

You bullshit so much you can’t even keep your bullshit straight.

A justification of mandates is reduction of transmission. Complete prevention is not required.

As you point out, we had these debates in relation to mandates for vaccines for pertussis, influenza, and I can add polio, all of which reduce transmission but do not completely prevent it.

As you point out, we do and did have evidence that the vaccines reduce transmission.

Clinical trials showed that vaccines prevented most (95 %) clinical.PCR confirmed infections. This is a good reason for mandaes.

But we soon knew that this was inaccurate. There could be lots of confounders that gave rise to that number.

Actually follow up studies confirmed the results:
Saciuk Y, Kertes J, Mandel M, Hemo B, Shamir Stein N, Ekka Zohar A. Pfizer-BioNTech vaccine effectiveness against Sars-Cov-2 infection: Findings from a large observational study in Israel. Prev Med. 2022 Feb;155:106947. doi: 10.1016/j.ypmed.2021.106947. Epub 2021 Dec 30. PMID: 34974072; PMCID: PMC8717697.
BNT162b2 was found effective for the total population group for infection, hospitalization and mortality, with adjusted VE of 93·0% (CI:92·6–93·4%), 93·4% (CI:91·9–94·7%) and 91·1% (CI:86·5–94·1%) respectively. VE for infection was lower for participants aged 75 and over, and for those with hypertension, diabetes and obesity.

Your ignorant beliefs don’t make something true, Jonnie. You cannot bring evidence for your claims, so stop making them. It just continues to show you can’t accept scientific evidence.

Pfizer also didn’t test their vaccine as a floor wax or as a dessert topping, which really makes you wonder what they’re hiding!

Why are antivaxxers resurrecting this particular message now? The best reason I can come up with is that it’s opportunistic.

A complete mystery.

I’ll approach this as a layman, no clinical credentials whatsoever, just like the audience this trope is aimed at. It’s been two years since vaccine rollout and we (all us laymen) have made up our minds where we stand, so to me (pro vaxxer) it’s too late to persuade me, and so to anti vaxxer it’s proof of their point. No one is being persuaded one way or the other. However, as a layman I bothered to actually try and understand the enormity of the problem, understand what a vaccines purpose is actually. So, as I have pointed out in other comments, this isn’t new news, this isn’t new damning evidence. But having followed events, it became plain to me that it does, indeed, prevent transmission. Ok, not 100%, but I have always known no medical intervention is 100%, but it’s better than nothing. Another however is, those in an influential position (as identified throughout the article) ALSO knew this, which is despicable.

My argument is ‘don’t let people die when something could be done’ and I don’t care about your ‘freedumbs’

Except for those whose die from the vaccine or inspire of it.</blockquote

Your imaginary death numbers are, of course, imaginary, as are all of the "risk" and "manipulated" numbers you continue to bullshit about. Whatever you might mean by

inspire of it is unclear to me.

Argument here is that fraudulent clinical trials resulted mandates. But follow up studies confirmed 95% efficacy,
Speaking about omicron, give us your own efficacy numbers, and we can begin to talk.

Those studies confirmed nothing of the sort because it didn’t happen that way in the real world.

Fraud versus perfect is a spectrum. What about they were overly optimistic because the people running them like getting paid and know who signs the checks?

Follow up studies confirmed results of the trials. Conspiracy deepens, or idoesnot.

This post is all about whether the covid vaccines prevent transmission. You would think there would be at least a short summary in the post about how much the vaccines are thought to prevent transmission, and why that is thought. No, I did not see anything like that in the post. He says they don’t work 100% to prevent transmission, no vaccine is perfect. Ok, well there are many possibilities between 100% and not at all. We would like to know. He gives us links, so we can spend hours reading through all the research. No summary.

There are MDs and medical researchers who say the covid vaccines do NOT prevent infection or transmission AT ALL. I don’t know where they got that idea. They have not been very helpful either, as far as providing a summary. How does anyone know? There have been no RCT’s since the early drug company research. No control groups, just epidemiological studies and computer models. Forget computer models, they are too easy to bias.

How do you know, Orac, that the covid vaccines are effective at preventing transmission? You make that statement and don’t bother to tell us how you know. Maybe that’s just what you want to believe?

When the vaccines came out, we were told if we did not get vaccinated we were endangering the vulnerable and prolonging the pandemic. But if they actually do not prevent infection or transmission, then that was not true. Then the only reason to get the vaccines would be to protect oneself, if you happened to feel vulnerable.

A vaccine that is injected is not likely to prevent transmission of a respiratory virus, because of the way these viruses are transmitted. So please tell us how you know they prevent transmission anyway. And how much do they prevent it? Don’t just say “less than 100%,” that is not helpful.

Speaking of black or white thinking, Orac ALWAYS defends the covid vaccines, and NEVER expresses the slightest bit of skepticism regarding anything the vaccine makers say. That kind of “thinking” is easy. Do you want to be a propagandist or a scientist?

He says they don’t work 100% to prevent transmission, no vaccine is perfect. Ok, well there are many possibilities between 100% and not at all. We would like to know. He gives us links, so we can spend hours reading through all the research. No summary.

Did you actually bother to read the post? I cited studies with estimates of VET, and I even quoted a whole paragraph from one summarizing the findings. For instance the Belgian study estimated a 90% effectiveness in decreasing transmission of the original Wuhan strain and 64-72% for Delta. You can click on some of the studies, but you won’t. If it’s not spoon fed, you’re not interested because it might challenge your antivax views.

There have been no RCT’s since the early drug company research. No control groups, just epidemiological studies and computer models.

You do realize, don’t you, that it would be highly unethical to do RCTs now, for the same reason that antivax calls for RCTs of the childhood vaccination schedule to determine whether vaccines cause autism would have been very unethical. In the case of COVID-19 vaccines for the purposes that you want, the reason is that, after the original trials showed strong efficacy against severe disease, there would be no clinical equipoise. Google the term if you don’t know what it is. That leaves epidemiology, which is actually very good at estimating the ability of a vaccine to decrease transmission, contrary to your claims.

You do realize, don’t you, that it would be highly unethical to do RCTs now

Doesn’t know. Doesn’t care. Is solely concerned with catching y’all in some comically contrived fake Catch-22 to prove her toddler-level intellect is way smarter than you. Bitch expects you to stick your neck willingly in the Nuremberg noose and when you rightly refuse to do so throws an emotional strop that you won’t bend to her will. Same with the rest of these poisonous intellectual chubs (i.e. thick & stunted). That’s on them.

Sadly, you can keep on dilligently disproving their shit pretend-science all day every day and they will never, ever, ever stop. They feed on your attention. All that will happen is you wear yourself down, while even allies grow tired of hearing the same thing said over and over yet seeing zero improvement. That’s on you.

Ayiyi, smart people. Y’all over-think things way too hard. This is not about Science. It never was. It’s about People and Power. That’s all.

Do you think that by fighting the good and noble fight on your solid scientific territory, where you already know you are correct (within proper confidence intervals), you can righteously triumph? You only mount a Maginot defence! If your dumber opponents wish to throw themselves directly at your guns, it is only for their own amusement as your shells bounce off their endless stupid. Meantime, the smart ones route right around and past you in order to murder epistemology itself, and so seize power to remake reality itself in their own image.

For every Fauci there’s a Ladopo, for every Gorski a Raoult; a greedy narcissistic Lysenkoist peddler hyperfocused on his own end goal for every modest well-intentioned scientific truth teller. Just ask Hypatia, Bruno, Lavoisier; Putin, Xi, Modi, your GOP; Krystallnacht, the Cultural Revolution, the killing fields of Cambodia, Rwanda, Yugoslavia, and so on. Your knowledge, your science, your honestly, your integrity; none of it amounts to squat.

These liars can finish you and never even notice your opposition, because you still naively believe you are fighting for Science whereas they fully understand—and have from the start—that they are not. They are fighting for Control—absolute and eternal—and there is nothing and no-one they will not sacrifice to achieve it. Least of all now when they are so close.

You have already proven beyond all reasonable doubt that these people are liars. It is well past time you show the whole world why.

These people are abusers, plain and simple.

The one science you need now is of psychopathologists, to teach everybody how abusers and their abuses work. And quickly too…chop-chop!

Funny how you keep ranting about what I’m doing as a useless waste of time but never seem to have concrete, useful, or practical suggestions about what to do differently. You just seem to like bashing allies, who are getting as tired of your comments as you portray them of the supposedly repetitive debunkings other than calling in psychopathologists and ranting about how our all about power. How about a concrete example of a strategy that worked instead, preferably more than one—case studies, if you will. Without including concrete, achievable strategies, your rants strike me as being just as useless as you characterize this blog and the efforts of skeptics. Even sadmar provides more constructive and useful criticism than you do. Just sayin’.

For me, it’s most important to reveal how alt med/ anti-vax is pri-marily abusiness
— it earns BIG money and stokes egos of its purveyors
— it allows followers to feel superior to the ‘common herd’
HOWEVER
— it is difficult to explain how wrong it is because its audience often are not well versed in the necessary background material ( vaccine science and immunology are not something one can learn in a few paragraphs- which makes it easy for alties to fool followers by inventing stuff, omitting important details etc)
— certain personalities gravitate to these “professions” and also follow their lead more
— some people just cannot or will not learn

Thus, showing readers how the scams work and how their perpetrators benefit is a start for me.

There’s another ‘has’-been at RI…Idw56old. In this post, here are some choice words written by Idw56old: loon; cranks; garbage; bullshit; lunacy; ignorant; ass; and pathetic POS. Idw56old is simply out of control…

Funny how you keep ranting about what I’m doing as a useless waste of time but never seem to have concrete, useful, or practical suggestions about what to do differently.

I apologize: if that is your takeaway, it means my messaging is shit, worse than useless.

No great surprise to me, I am an incompetent messenger. Mea culpa. Arrogantly presumptive too: I never actually asked what your goal is, in writing RI these last 16 years!

So, rather than me bladder on further, uselessly and to everyone’s annoyance, might I try a different tack: asking two questions, so that I can educate myself.

What is your goal in writing RI? Is it simply to document the activity of AltMed scammers, and annotate their endless falsehoods for historical record? Or is your goal to effect active change: to push back on the bastards, and make them pay dearly for all their abuses?

If the answer to #1 is the latter, then question #2:

When Mehmet Oz (I refuse to say “Doctor”) announced his candidacy for the Pennsylvania Senate, did you approach Fetterman’s team to offer them your expert services? If not, why not?

If you are inclined to respond to both of the above, many thanks; and I will be equipped to answer your own request in return.

@MJD: In midst of planetary-scale fascist meltdown, I thank you, sir, for your timeless gift of laughter.

There’s another ‘has’-been at RI…Idw56old.

By the way mjd, are you sure you really want to defend people who routinely lie about the data behind vaccines, lie about deaths caused by vaccines, and more? That seems to work against your claim that you aren’t like them.

What, exactly, is there positive to say about folks like labarge, greg, ginny, ir, when the continue to make false statements about covid and vaccines (and other issues) while routinely ignoring the data that puts the lie to their comments — or simply push asinine conspiracies like I don’t trust the numbers because everyone involved is corrupted [from labarge]?

I don’t expect an honest, rational response from you, because you’ve never made one about anything. But there’s always a first time — so unleash a surprise.

Idw56old writes,

“I don’t expect an honest, rational response from you, because you’ve never made one about anything.”

MJD says,

I trust that Orac’s next three posts will be a doozy. I’m here because Orac, in my opinion, is the best science teacher on the planet. Orac reads every comment MJD presents and very rarely rejects them. Thanks, Orac (The One).

I can’t think of a more useless tactic for dealing with science deniers than to 1) label them all as power-mad fascists and murderers, while 2) sneering at one’s erstwhile allies as naive and futile.

The former copies the deniers’ tactic of demonization of opponents; the latter dismisses useful education and efforts to rally evidence-based supporters while aggravating and alienating them.

Evidently it gratifies has’s ego to behave this way, but it’s gotten to be a pain in the ass.

Knock it off, OK?

I can’t think of a more useless tactic for dealing with science deniers than to 1) label them all as power-mad fascists and murderers

Nope. You label the power-mad fascists and murderers for exactly what they are—with full receipts that prove it—and then you move right along. Don’t waste an ounce more of your life on sworn scum; they are irredeemable. And if you do the job right they won’t be your problem either.

It’s not the Abusers you have to change. It’s their Enablers.

You call out the große Lüge and the große Lügner, and that is right, a necessary part of your due dilligence. But the Big Lie is not the problem. Its existence is inevitable; it is only human nature. Its empowerment, however, is not.

The enablement and empowerment of Abuse and Abusers is a choice; a choice made by millions of ordinary unremarkable people, no different to me and you, which they have deliberately made to serve their own interests in some way or other.

The problem is these kleine Lüger, all 70 million of them, all telling themselves (and each other) the same little lie: the precious comforting little lie that says “I—We—are Good People.”

You take that little lie away from them—you deny them the opportunity, the right, to deceive themselves any longer. And force them to acknowledge themselves, for what they truly are.

Now, they can continue to embrace the pleasing Big Lie if they wish; that is their right as autonomous cognizant creatures. But with it they swallow the ugly self-loathing truth: in doing so they make of themselves Abusers too. Good Germans. The personal owners of every charnel truck that has gone before, and every one that is yet to come. Make them wear those ashes, every day, for their own peers to judge. See how well the Big Lie stands when the little lie, its entire foundation, no longer holds united and solid.

Or, they can choose the Right to Fight Back. Because there is no shame in being wrong. Everyone does it. Science, for instance, does nothing else! And look how far science has brought our entire world, just by owning, embracing, its own errors instead of denying them. Science didn’t do all that for an ivory institution—it did it for People!

People is what Science fights for. Because Science is people too, and these people are furious at what they see every day being done to fellow humans, for ego, for profit, for power.

Nor is there any shame in being fooled by an elite cadre of professional liars; none of us are immune, we are all vulnerable. All these wealthy powerful deceivers didn’t get this wealthy and powerful today without first triumphantly deceiving millions of people. The evil bastards are Good.

The only shame is in, on the scam being revealed, eagerly dropping one’s pants, grabbing ankles, and exclaiming “More Please!” But okay, to those who do choose that easy option: “Well, hey. You do you.” Waste no more of yourself on those spineless chuds either; they haven’t earned it. The ones you want are the ones who are prepared to accept that they got done; and bring them onside by selling them a new and far better and purer product than they were getting before: righteous, moral revenge. The chance to be the real heroes they dreamed of, fighting to protect themselves and others from those who would abuse us all. And you sic them on those alpha Abusers and every one of their groveling Enablers still willingly defending, supporting, and promoting that abuse; supply them the weapons they need (you hold a mighty arsenal) in forms they can use (well okay, that part needs work), and cheer them to have at.

2) sneering at one’s erstwhile allies as naive and futile

Observing that you have lost all perspective as is what is important versus what is not; that you fail to distinguish being busy (which you are) from being productive (which you’re not); that you are stuck in a comforting, lazy rut where the only thing you’re doing is making the abusive non-entities that infest RI here feel powerful and engorged, as the world goes to hell all around you as no-one is organized to stop it is not sneering. It’s doing you a solid.

I may be an asshole, incompetent, and moron; but I’m not the one here feeding my life energy to Greg. I mean, FFS: In the annals of energy vampires, you couldn’t possibly have picked a more pathetic muncher. Where is your self-respect? And further: How dare you! How dare you feed decent honest people to that scraven tit! You deserve better treatment than that. Talking about Abuse: stop abusing yourselves by offering yourselves up to Known Abusers!

Cut the little shit off. Permanent. Absolute. Zero-tolerance. Every other one of RI’s frequent fliers too: ’cos now you’re not just feeding their addiction, you’re indulging your own too. Flat ban them all if you can’t find the strength to resist their temptations. But either way, stop telling them that they can have you and use you and stop teaching them how to press all your buttons to get exactly what they want out of you: dial-a-victims. You humiliate yourselves, you set terrible role models, and no-one who’s watching sees strong focused moral fighting human beings with a clear plan of war to turn this world better; they just see more dogs rolling in poo.

You want to effect change? Real change? Stow your shit. Now. You need to make yourselves fit to lead it—because if you can’t do it with all of your advantages to build on, who will? Y’all have a lot of catching up to do before you are even fit to begin writing your narrative; while all the global-scale mutterfuckers are already up to their Act IV.

So don’t look to me for what to do: look to them. You could not find finer teachers. See all the things that they are doing well, which you are not doing yourselves, and learn yourselves how to do those things too.

Answering my two questions above will be a good next move too. Those questions were not accidental.

You want to effect change? Real change? Stow your shit. Now. You need to make yourselves fit to lead it—because if you can’t do it with all of your advantages to build on, who will? Y’all have a lot of catching up to do before you are even fit to begin writing your narrative; while all the global-scale mutterfuckers are already up to their Act IV.

One wonders why you lead us, since you seem to have all the answers? Instead, you’re naught but an anonymous commenter who castigates erstwhile allies for supposedly being clueless and ineffective while providing no concrete strategy for action, all in the comment section of a moderately popular, but nowhere near huge, science/skepticism blog, where maybe a few hundred people see your comments (given that only a small fraction of a typical blog’s readership is active in the comments).

Just sayin’. You’re not the one putting yourself on the line; certainly if you’re doing it in real life there is no indication from the comments to indicate it.

I’ve been hearing this bs in clinic. “Something…something…I’ll get the vaccine when there’s a nasal one.” It must be making the rounds in kook circles on social media.

I just read that there’s one (inhaled vaccine, but in the mouth) out in China, but it’s only being used as a booster, not the initial series.

So maybe a weird game of telephone is where this one is coming from?

“A vaccine that is injected is not likely to prevent transmission of a respiratory virus”

????

“the Belgian study estimated a 90% effectiveness in decreasing transmission of the original Wuhan strain and 64-72% for Delta. You can click on some of the studies, but you won’t. If it’s not spoon fed, you’re not interested because it might challenge your antivax views.”

I have read plenty of studies, I am not an antivaxxer, and I like to see evidence that contradicts what I had already heard. I will look at those studies, and won’t be surprised if the 90% and 64-72% effectiveness estimates are deceptive. That’s probably why you didn’t bother saying how they arrived at those estimates.

As for RCTs being unethical, that is always something the drug companies can count on. Do a weak initial RCT that shows what they want, and ever after questioning it will be unethical.

Hi my name is Polly the anti-vaxxer and when I read something with strong evidence that I don’t like I call it deceptive and continue to embrace the lies that make up my core beliefs

It’s easy to get caught up in the “white noise” associated with viral infections e.g., viral transmission. In reality, hyper immune-activation to an acute infection(s) is the greatest threat for increased morbidity and mortality. When our immune system attempts sterilizing immunity to a “new” virus, cytokine/bradykinin storms can increase suffering and death. Getting a vaccine for the “new” virus better regulates our immune response resulting in decreased pain and/or termination.

@ Orac,

It’s beneficial to be in Respectful Insolence auto-moderation in that you are a valued peer-review. Thanks!

@Michael J. Dochniak:
“In reality, hyper immune-activation to an acute infection(s) is the greatest threat for increased morbidity and mortality. When our immune system attempts sterilizing immunity to a “new” virus, cytokine/bradykinin storms can increase suffering and death. Getting a vaccine for the “new” virus better regulates our immune response resulting in decreased pain and/or termination.”

Yes, so the reality is the mRNA covid vaccines WEAKEN the immune response to the virus, rather than strengthening it. Covid mainly killed people whose immune systems over-reacted, probably because they had chronic inflammation from diabetes 2.

So these vaccines can effectively at reduce symptoms, by weakening the immune system’s response. And that is why they do not prevent infection.

@ Indie Rebel,

Vaccines based on mRNA technologies are simply an effort to support our immune system during viral transmission; said technologies are designed to provide state of the art safety and efficacy.

@ Everyone,

The Pfizer/BioNTech, Moderna and Johnson & Johnson COVID-19 vaccines include vial stoppers that are not made with natural rubber latex. People with latex allergy are not at risk for a latex allergy reaction from the vaccine.

https://allergyasthmanetwork.org/allergies/latex-allergy/latex-allergy-vaccines/

@ Orac,

Believe it or not, RI has played an important role in vaccine safety awareness.

“Yes, so the reality is the mRNA covid vaccines WEAKEN the immune response to the virus, rather than strengthening it. Covid mainly killed people whose immune systems over-reacted, probably because they had chronic inflammation from diabetes 2.

So these vaccines can effectively at reduce symptoms, by weakening the immune system’s response. And that is why they do not prevent infection.”

This is obvious. It explains why they lessen symptoms but do not prevent infection.

What part of the immune system is “weakened”? What cell type? Which pathway or cascade?

Be specific.

JustaTech asks.

“What part of the immune system is “weakened”? What cell type? Which pathway or cascade?”

MJD contribution,

A study showed that immune function among vaccinated individuals 8 months after the administration of two doses of COVID-19 vaccine was lower than that among the unvaccinated individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167431/

@ JustaTech,

JustaMJD saying…

MJD,
That’s not a study, that’s an opinion paper talking about a speculative paper published by a known anti-vaxxer. Neither talks about a specific pathway or cell type.

Of all people I would expect you to be banging on about your favorite pathway of the week rather than quoting a whole bunch of “well, maybe…”

Immune system defends us are against pathogens. Pathogens cause symptoms. If symptoms are reduced, immune system is working.
Original Pfizer I/II trial is available. It showed roust immunogenity, in fact greater than infection itself.

If they weaken the immune respionse to SARS CoV 2, why they produce strong immune response to it ? (As measured by antibodies)

Is it too much to ask for you to not comment as both “Polly” and (the hilarious) “Indie Rebel,” Ms. Chase?

So, what are the purposes of a vaccine, anyway? I say “purposes” because vaccines don’t have just one purpose. First and foremost, the main purpose of a vaccine is to prevent people from becoming seriously ill due to disease caused by a pathogenic microorganism such as a virus or bacterium, period. If a vaccine doesn’t do that, it’s a pretty useless vaccine, particularly in the middle of a pandemic that by late 2020 had killed over a quarter of a million people in the US alone. Ideally, the second purpose of a vaccine is to prevent infection and transmission; i.e., to prevent the pathogenic organism from getting established in a vaccinated host human in the first place and to render that person unable to spread the pathogen to others. This phenomenon is called “sterilizing immunity” and means that the immunity produced by a vaccine is so effective that the virus cannot replicate in the vaccinated individual sufficiently to gain a foothold and cause infection, much less be transmissible by that person to others

So, I’ll ask again for the third time and hopefully someone here will answer. How can it be said that measuring for efficacy by how the vaccine stops sickness was the intent from the start when the Phase 1/2 trial examined efficacy by immunogenicity, testing for antibodies? Again, it is after they failed to report neutralizing antibodies for the 45 subjects (reporting only 7 subjects’ results) in the Phase 1/2 trial that they switched to measuring for sickness in Phase 3. Does this fact not torpedo everything that is being spin here and elsewhere?

https://pubmed.ncbi.nlm.nih.gov/32785213/

You really are very silly. How do you think a preexisting immune response prevents illness the body encounters a previously encountered pathogen against which an immune response had been raised? Hint: It involves, among other things, neutralizing antibodies.

Yes, Orac, and the point is testing for immunogenicity, antibodies, addresses transmission. This is what was done in the Phase 1/2. It was replaced by testing for symptoms in Phase 3. Why?!

What — Pfizer will argue that they switched because measuring for sickness is more important?! Then why did they not do that from the start. Heck — in addition to reporting the outcome for sickness in Phase 3, why not also respect the prior Phase 1/2 and also report on immunogenicity?! Is it asking too much to expect researchers to respect their methodology?

I guess you mean this:
Mulligan MJ, Lyke KE, Kitchin N, Absalon J, Gurtman A, Lockhart S, Neuzil K, Raabe V, Bailey R, Swanson KA, Li P, Koury K, Kalina W, Cooper D, Fontes-Garfias C, Shi PY, Türeci Ö, Tompkins KR, Walsh EE, Frenck R, Falsey AR, Dormitzer PR, Gruber WC, Şahin U, Jansen KU. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature. 2020 Oct;586(7830):589-593. doi: 10.1038/s41586-020-2639-4. Epub 2020 Aug 12. Erratum in: Nature. 2021 Feb;590(7844):E26. PMID: 32785213.
Go to chapter Immunogenity. You are flatly lying.

Phase I/II do not test transmission. They do not have anywhere near enough people to do that. They test antibodies because they do not have enough numbers to test for symptoms – in a few tens subjects, there’s a decent chance nobody would get COVID-19. The purpose of Phase I, the FDA explains, is initial safety and dosage. Not effectiveness. https://www.fda.gov/patients/drug-development-process/step-3-clinical-research

They use antibodies as a proxy to see if the vaccine does anything – and that’s not enough, which is why larger trials are needed for effectiveness as well as safety. Because antibodies do not always correlated one to one to protection.

So no. Phase I/II did not test transmission, and nor did phase III, because it’s not very feasible in a clinical trial.

As Orac pointed out, however, we have other data on transmission, and quite a bit of it.

They use antibodies as a proxy to see if the vaccine does anything – and that’s not enough, which is why larger trials are needed for effectiveness as well as safety.

Dorit, don’t be so deliberately obtuse. Yes, testing for the presence of antibodies does not guarantee protection or lack of transmission, but it is predictive of these. Other tests confirming the presence or lack of pathogens are what confirm protection or lack of transmission. Taken together, these tests are what I am referring to as immunogenicity measures for determining vaccines efficacy.

And, as I also explained to Orac, these measures were utilized for every other vaccine trials to access transmission and even if some of those trials also measured for symptoms. Of course, the salient point is none of those trials ignored transmission by solely focusing on symptoms.

Phase I/II do not test transmission. They do not have anywhere near enough people to do that.

It’s not just a question of numbers, it’s SCREAMINGLY UNETHICAL. Tuskegee bad? No, worse!

This is what antivaxxers do: Demand you tell them why you’re not sticking your neck in the obvious Nuremberg noose and then, either way, exclaiming “Ha, we got you!”

Treat them as you would the dirty raincoat flasher who’s trying to rub his naked hairy balls up your leg. Because that is exactly what they are doing.

These people are abusers: wide-open, shameless, guilty. So as a lawyer yourself you should know: hammer time.

So, what are the purposes of a vaccine, anyway? I say “purposes” because vaccines don’t have just one purpose. First and foremost, the main purpose of a vaccine is to prevent people from becoming seriously ill due to disease caused by a pathogenic microorganism such as a virus or bacterium, period. If a vaccine doesn’t do that, it’s a pretty useless vaccine, particularly in the middle of a pandemic that by late 2020 had killed over a quarter of a million people in the US alone. Ideally, the second purpose of a vaccine is to prevent infection and transmission; i.e., to prevent the pathogenic organism from getting established in a vaccinated host human in the first place and to render that person unable to spread the pathogen to others. This phenomenon is called “sterilizing immunity” and means that the immunity produced by a vaccine is so effective that the virus cannot replicate in the vaccinated individual sufficiently to gain a foothold and cause infection, much less be transmissible by that person to others

This is such a steaming pile that’s being peddle by Orac and co that I am just amazed that it’s not being called out by others including ‘antivaxxers’. Yes, it can be argued that the prime intent of vaccines is to prevent serious illness, but how often in the history of vaccine trials was that used as a gauge for determining efficacy? I think it’s fair to say almost never, if ever.

Immunogenicity, measuring antibodies, was always the standard gauge. The mRNA trials were a radical departure from that, and no doubt it influenced the CDC’s decision to change their definition of a vaccine to suggest prevention of symptoms is what counts.

Pre-covid, immunogenicity was gold for determining efficacy, and 10 out 10 scientists would agree that without sterilizing immunity that would lead to garbage protection and garbage protection would lead to increased risks of serious illness. It’s Orac and co that are now trying to turn things on its head by insinuating we can have quality protection without sterilizing immunity. No doubt, this is being challenged by the Covid reality of never ending reinfections and mRNA vaccines that can’t stop shit.

Um, no. 10 out of 10 scientists did not “agree” or say anything of the sort about COVID-19 vaccines without sterilizing immunity. Indeed, let’s look at an article published in Scientific American in January 2021, just as the vaccines were starting to roll out in earnest:

https://www.scientificamerican.com/article/vaccines-need-not-completely-stop-covid-transmission-to-curb-the-pandemic1/

Right when the vaccines were coming out, scientists who actually knew what they were talking about with respect to vaccines, infectious disease, and epidemiology were stating that a vaccine doesn’t have to produce sterilizing immunity to have a major effect slowing the spread of a disease. They cited examples, too, pointing out that prevention of transmission by vaccines is not a black/white/yes/no question, but rather exists on a spectrum. You’re citing straw man arguments.

Right when the vaccines were coming out, scientists who actually knew what they were talking about with respect to vaccines, infectious disease, and epidemiology were stating that a vaccine doesn’t have to produce sterilizing immunity to have a major effect slowing the spread of a disease.

That’s not pre-covid, Orac! That was during covid when the scientists started getting a whiff that the new experimental vaccines may not generate the quality antibodies required to prevent infection; of course they started singing a different tune!

Before then, every other vaccines were tested for its immunogenicity and sterilizing potential. Again, I kindly ask anyone here to give an example of other vaccines that were tested for their ability to prevent symptoms while their immunogenicity profile was completely ignored.

It’s not a buffet, Orac, where you get to choose ‘stop transmission’, ‘stop symptoms’, and so on. Without the ability to stop transmission by generating quality antibodies you pretty much have nothing.

Nonsense. All of the non-COVID vaccines mentioned in that article are fairly old vaccines. Your revisionist history is obviously revisionist, and you have no idea what you are talking about.

Nonsense. All of the non-COVID vaccines mentioned in that article are fairly old vaccines. Your revisionist history is obviously revisionist, and you have no idea what you are talking about.

Orac, I suppose we can settle this stand-off by you satisfying this request

Again, I kindly ask anyone here to give an example of other vaccines that were tested for their ability to prevent symptoms while their immunogenicity profile was completely ignored.

I guess you mean this:
Mulligan MJ, Lyke KE, Kitchin N, Absalon J, Gurtman A, Lockhart S, Neuzil K, Raabe V, Bailey R, Swanson KA, Li P, Koury K, Kalina W, Cooper D, Fontes-Garfias C, Shi PY, Türeci Ö, Tompkins KR, Walsh EE, Frenck R, Falsey AR, Dormitzer PR, Gruber WC, Şahin U, Jansen KU. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature. 2020 Oct;586(7830):589-593. doi: 10.1038/s41586-020-2639-4. Epub 2020 Aug 12. Erratum in: Nature. 2021 Feb;590(7844):E26. PMID: 32785213.
Go to chapter Immunogenity. You are flatly lying. Immunogenity as tested and was strong, actually stronger an after an infection.

No, I am not going to stop until Orac cries uncle, and I want to hear it loud and clear…

The funny thing is over the years there have been bad mismatches between the Influenza vaccine and the circulating strain. So much so that we have the experts groaning about how the vaccine still protect against serious illness.

Yet, groan as they do, not a single influenza trial from the past tested solely for whether the vaccine can stop symptoms and completely ignored whether it offered laboratory confirmed protection. Again, Covid mRNA vaccines were the freaking first in this regard! Who here is still not reflecting hard on that?!

EFFECTIVENESS — Influenza vaccination reduces the incidence of laboratory-confirmed influenza and can reduce the risk of serious complications and death associated with influenza illness in children and adults.4-7 The effectiveness of the seasonal influenza vaccine in preventing influenza illness depends on several factors, including the match between the vaccine and circulating strains and the immunologic response of the recipient. Vaccine effectiveness is greatest when the match is close, but even when it is suboptimal, vaccination can still substantially reduce the risk of influenza-related hospitalization and death.8,9

https://secure.medicalletter.org/TML-article-1634a

No, I am not going to stop until Orac cries uncle, and I want to hear it loud and clear…

I do not care, although if you start irritating my regulars whose opinion I do care about, I will put a stop to it.

@Greg You have not told us how a vaccie can prevent infections if it is not imunogenic

@ldw56old:

“How would someone come up with that bit of lunacy? Is it widely held?”

Yes it is widely held “lunacy” that respiratory viruses are transmitted via the respiratory system. There are vaccines that can be inhaled.

It may come as a deep shock to you but there are injected vaccines capable of preventing transmission of respiratory pathogens. In addition to Covid-19 vaccines, there are vaccines against influenza, pneumonia, Hib disease, pertussis, measles, mumps, rubella etc.

You could look this up for yourself, but would probably dismiss what you read as “deceptive”.

Yes it is widely held “lunacy” that respiratory viruses are transmitted via the respiratory system.

I daresay even someone as dim as you knew what I was referencing. Your attempt at sarcasm doesn’t make your little comment valid.

“There are vaccines that can be inhaled.”

True, however how widespread are they actually used? Similar to inhaleable Insulin, this seems a theoretically neat idea which is viable in the real world (by no means a given) but hasn’t yet developed much traction in application.

Uh, what about the measles? That’s respiratory and the injected vaccine is very effective.

What about smallpox? That was at least partly respiratory, and again, the skin-applied vaccine was very effective.

On the 24th October, UK parliament debated a petition calling for an immediate enquiry into the safety of covid vaccines.

The petition had over 107,000 signatures, I read through the transcript and made mental notes of pertinent points. Firstly the signatures were from all over the globe, not just the UK. The claims were that there was a very large increase in cardiac events after vaccination. The end result was that there was no need for an enquiry because the safety was backed up by 2 years of data, plus a full enquiry over the UK response to the pandemic is set to start.

However, a small number of MPs seemed to be in support of an enquiry and some notable scientists were quoted, firstly a cardiologist by the name of Aseem Malhotra (where have I heard that name before), then the Paul Erlich institute in Germany apparently conducted a recent study and found 1 in 20 vaccinations amongst ‘young men’ resulted in myocarditis and suchlike, I couldn’t find it.

Also, a ‘new documentary’ was recommended as essential viewing, called ‘safe and effective, a second opinion’ by Oracle films. It’s on YouTube, rumble etc. I didn’t watch it but wanted to know more about Oracle films. Set up in 2020 as an ‘independent film maker’. I found the website, but other than the documentary not much else ther. But under ‘archives’ there were about 5 interviews . They were with anti vaxx heavyweights including, Dr Tess Lawrie (roll eyes), Dr Kevin Corbett (roll eyes), none other than Robert F Kennedy jr (gasp, roll eyes) and finally Matt LeTissier (rofl)

Who the f is Matt LeTissier I hear you say, if you are not a 30+ Brit, you’ll have no idea. He is an ex English premier league footballer, played for Southampton and (a few times) England. He is now a football pundit. He is notorious over his tweets…QAnon, new world order, anti vax, covid denier, climate change denier, Ukraine war denier, you name it denier. Recently he has been mocked over a claim he made during a live football match. A goal was scored, the opposing side cried ‘handball’ the referee consulted the VAR ( video assistant referee) and agreed handball, LeTissier claimed ‘video can be manipulated, so I don’t trust decisions made on VAR’….what a Wally.

@Mr Vic Thornley:

“My argument is ‘don’t let people die when something could be done’ and I don’t care about your ‘freedumbs’”

Many people died as a result of the lockdowns, many lives were seriously damaged, and many businesses were destroyed. How many lives should be ended or destroyed to save one? No simple answers.

Also if you use ‘freedumbs’ – you think freedom is dumb. You are a fascist, authoritarian.

No labarge, “freedumbs” doesn’t indicate at all that someone things freedom is stupid. That’s your ignorant take.

It indicates that the things people like you propose as justifications when you ignore, deny, and lie about science in order to promote your positions are stupid.

A better term for the rationales you, greg, ginny, ir, etc., make would be
fuckingstupidthingsIbelievemakememoreimportantthananyoneelse
but that’s a pain to type.

“Also if you use ‘freedumbs’ – you think freedom is dumb. You are a fascist, authoritarian.”

What? Unlike the American gun loving, religious far right? The ones already forcing their religious viewpoints on others? Even easier to do this with guns and minimal government eh? You’d almost think that the libertarian dream of minimal government was a deliberate stepping stone on the path to religious dictatorship and political cleansing.

Strange take as there are more pro choice pro gay libertarians than the other way around.

Doubtful, and not even close to addressing the issues named in numberwang’s post.

I don’t think you know what libertarian means.

Self centered. No need to take responsibility for their own actions. View children as property rather than people. Believe people are poor because they deserve to be. Claim to be self made when they relied on social structures put in place by previous generations to make it to this point — and they want to eliminate them so that “others” won’t have the same opportunity. Enjoy the things society provides while saying they have no responsibility to support society. Incapable (or simply don’t care to) think hard about complicated issues since “they know” the easy answers.

All the things you demonstrate john. You make it very clear what libertarian means — and there is nothing decent about it.

Wrong. Why don’t you just say ‘bad’ and save the words. You really don’t know shit.

Why don’t you just say ‘bad’ and save the words.

Good idea. Libertarians are not good people — following a “philosophy that is essentially the mindset of a spoiled 4-year-old kid: “This is mine and I should have what yout have” is not a good thing.

As you repeatedly demonstrate john.

@ldw56old: It may help if you state the technical, theoretical definition of Libertarianism first, being an ethos which contains both strengths and weaknesses which are valuable to understand when constructing one’s own vision of a better world for all.

You can then go to town on “Libertarianism” as it is actually applied out here in the real world, where it is far more commonly egotistical virtue-signalling cosplay performed by those who proudly declare themselves the best Libertarians as they multiply all of its defects and none of its good.

FWIW, here’s my crack…

Libertarianism and Communism are both idealized systems of [self-]governance that inevitably fail and degenerate into tyranny for simple reason that they refuse to consider that people are not idealized systems, and thus fail to include the checks and balances to ensure that the most ruthless mercenary extremists and opportunists cannot exploit and subvert the entire system, quickly turning it into one that purely serves themselves.

Representative democracy and regulated capitalism may suck, but at least they contain flex to absorb and respond to these ugly unescapable real-world insults. Libertarianism and Communism are rigid all-or-nothing systems: they must either work 100% perfectly or else they cann’t work at all.

So when these fine theoretical systems inevitably fail under the mild stress of applied practical reality, their loudest, most voracious advocates (being equally inflexible and absolute themselves) immediately blame everything and everyone else for their beloved system’s failure. Because if the rest of us would just do it exactly the way that they said, everything would be Wonderful and Perfect just as they said!

Sounds a familiar tale? It should!

But if you think you will teach them to see and acknowledge the tyranny inherent in their own world objective, forget it. If they were capable of seeing and caring†, they would’ve long since have unhappily progressed to discarding their beloved ivory tower fantasy for something far more scrappy and imperfect but also proven and durable, and made their own peace with our messy and complicated uncooperative world.

They’ve made their Choice, so respect them for that, and that only, and move yourself swiftly along.

Because moving on (or getting over yourself) is a thing which you can do naturally but they can’t do at all, and therein is your advantage with which to outmaneuver them when they subsequently, inevitably double-down on their Rigid Toxic Stupid.

Wanna bet Libertarians and Communists also score high on Cluster B spectra?

So I’ve repeatedly said my starting place is libertarian. That’s probably true of most Americans. Nothing is without exception and some libertarian theory even attempts to account for wrinkles like pollution through taxation. The central theme in libertarianism is the anti-force principal. Meaning government force on individuals who aren’t infringing on other individuals is unjustifiable. As a starting premise you can see how a libertarian could be at least ambivalent about a vaccine product, but opposed to mandates as an insult to individual liberty. Worse yet, lying first and later fudging the data to try to turn it into a communalist measure is evidence that the established power behind it is untrustworthy. Indeed the cozy relation between the regulators and regulated is further evidence of such. But we would stop short of disallowing it’s manufacture or judging other more trusting folks for their choice to get vaccinated. Another problem though is the hospital bills from the reactions; without the cronyism those bills would fairly fall directly on the manufacturers. Indeed this lack of accountability due to cronyism makes us more skeptical. This would be deemed reasonable with virtually any other product but we are urged to cast reason aside for vaccines. Indeed there are several places where the pro-vax mandate crowd seeks to have the population abandon reason: accountability, natural immunity, transmission, protection against current variants, orders of magnitude more reactions, vaccinating children, likelihood of death or hospitalization across age groups and so on. To me this makes the pro-vax position look more like a religion than anything else. But I believe in freedom of religion; I just don’t want to live in any theocracy, even a civilian one.

@john labarge Did you notice what you said. Government should not infringe, expect when somebody infringes other peoples right. This is of course basis of all gevernmen actions. Better definiion would be that government should never infringe.

More than 6.5 million people have died from COVID-19. That number would have been much higher without lockdowns.

The number who died as a result of lockdowns cannot even be seen as excess deaths, that is how few there are.

There is absolutely no doubt that allowing COVID-19 to run rampant would have much more serious impacts on businesses than lockdowns. Businesses would have been unable to operate due to lack of staff and the costs of doing business would have gone through the roof.

Ah, yes. A “study” (a white paper, really) by economists, not scientists and epidemiologists, much less public health or infectious disease scientists and epidemiologists, that was roundly demolished by actual public health and infectious disease scientists and epidemiologists when it was published without peer review by a legitimate biomedical science journal.

That “study” was also panned by a number of economists as well (see for example Peter R. Hansen on Twitter https://twitter.com/ProfPHansen/status/1489698642143240195
). The short version is that the authors of the white paper gave the results from one paper in a poorly ranked (and possibly predatory) journal nearly all the weight in their meta-analysis (91.8%). And the results themselves were modified by the authors of the white paper via linear extrapolation to have a different interpretation than what appeared in the original source (the original study concluded that severe restrictions reduced deaths).

How could you not know that covid was serious mainly in people over age 75? Most of the working population was not affected.

The fact that COVID was most serious in those over 75 does not mean it wasn’t serious in those UNDER 75. A lot of the dead and permanently disabled were of working age. A fair number of the dead and disabled were under 18.
This is just the old antivaxx claim that if a disease kills or disables someone, they must have had underlying health problems. It’s an attempt to downplay the harms of the disease.

How could you not know that covid was serious mainly in people over age 75? Most of the working population was not affected.

Real life is not rule by the “exclusive or” you ignorant ass.

At the risk of double posting due to Orac’s automod persecution, I’ll try again. I like this wording better, anyway.

Orac writes….

So, what are the purposes of a vaccine, anyway? I say “purposes” because vaccines don’t have just one purpose. First and foremost, the main purpose of a vaccine is to prevent people from becoming seriously ill due to disease caused by a pathogenic microorganism such as a virus or bacterium, period. If a vaccine doesn’t do that, it’s a pretty useless vaccine, particularly in the middle of a pandemic that by late 2020 had killed over a quarter of a million people in the US alone. Ideally, the second purpose of a vaccine is to prevent infection and transmission; i.e., to prevent the pathogenic organism from getting established in a vaccinated host human in the first place and to render that person unable to spread the pathogen to others. This phenomenon is called “sterilizing immunity” and means that the immunity produced by a vaccine is so effective that the virus cannot replicate in the vaccinated individual sufficiently to gain a foothold and cause infection, much less be transmissible by that person to others

This is such a steaming pile from Orac and co that I am just amazed it isn’t being called out by others and including ‘antivaxxers’.

The foremost goal for vaccines had always been their ability to stop transmission by generating sterilizing immunity. Sterilizing immunity was sought after because it was seen as the best means for protecting people — and including from serious illness! It did so by stopping infections and outbreaks in their tracks. Notice the contrast with the current crop of mRNA vaccines that can’t prevent or stop shit and which leaves people at permanent risks of reinfections that may eventually lead to serious outcomes.

The testing for the current mRNA vaccines broke the mold with it being the first time in history vaccines were tested for their ability to prevent symptoms while immunogenicity was completely overlooked (and, again, at least in the Pfizer’s phase 3 trial). This was a huge shame, and no wonder the CDC felt compelled to change its definition of a vaccine in this regard.

And, central to the crap that Orac and co is now spinning is the insinuation that vaccines can deliver good protection without generating sterilizing immunity. Again, the performance of our current crop of mRNA vaccines begs to differ.

Since you posted basically the same thing twice, I’ll post my reply again.

Nope. Nopity-nope. Just plain no. Let’s look at an article published in Scientific American in January 2021, just as the vaccines were starting to roll out in earnest:

https://www.scientificamerican.com/article/vaccines-need-not-completely-stop-covid-transmission-to-curb-the-pandemic1/

Right when the vaccines were coming out, scientists who actually knew what they were talking about with respect to vaccines, infectious disease, and epidemiology were stating that a vaccine doesn’t have to produce sterilizing immunity to have a major effect slowing the spread of a disease. They cited examples, too, pointing out that prevention of transmission by vaccines is not a black/white/yes/no question, but rather exists on a spectrum. You’re citing straw man arguments.

Orac, is so frustrating to deal with that sometimes I think of just packing up and leaving this blog for good. Anyway, let me spell out the nature of our disagreement about the purpose of vaccines and the research goals for them as they pertain to vaccines efficacy so readers can make their most informed decision about who is right.

Orac begins by declaring prevention of serious illness as the foremost goals for vaccines and everything else such as generating sterilizing immunity and preventing transmission is secondary. From there, Orac is arguing that if a vaccine is shown to protect against serious illness then that vaccine should be regarded as a succes and despite all other shortcomings that it may suffer from such as its inability to stop transmission.

As for me, I will begin by accepting Orac’s primary premise, but I will also modify it slightly by asserting that the primary goal of vaccines is to offer the best protection against a pathogen and which includes preventing serious illness. I will then follow this up by arguing that the quality of the antibodies that a vaccine generates is the best bet for determining whether a vaccine is living up to this primary goal of providing best protection.

Looking at things from this angle, measuring for quality antibodies such as sterilizing ones is a more important gauge of a vaccine success than measuring for whether it’s protecting against serious outcomes. The logic of this is a vaccine demonstrating quality antibodies will invariably yield to best protection such as preventing serious illness and whereas simply measuring for prevention of serious illness is not in itself a guarantee that this variable is being optimized.

We can see how this arguments plays out with our experience with Covid vaccines. Yes, in the shorterm the vaccine may offer protection against serious outcomes, but that might not be the case in the longterm. The constant reinfections from such non-sterilizing vaccines threatens their longterm efficacy and where vaccinees are essentially at a permanent risk of suffering a serious outcome. Had the vaccine produce superior immunity that prevented transmission that wouldn’t have been the case.

@Greg And I post citation to the original I/II phase tudy paper again:
Mulligan MJ, Lyke KE, Kitchin N, Absalon J, Gurtman A, Lockhart S, Neuzil K, Raabe V, Bailey R, Swanson KA, Li P, Koury K, Kalina W, Cooper D, Fontes-Garfias C, Shi PY, Türeci Ö, Tompkins KR, Walsh EE, Frenck R, Falsey AR, Dormitzer PR, Gruber WC, Şahin U, Jansen KU. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature. 2020 Oct;586(7830):589-593. doi: 10.1038/s41586-020-2639-4. Epub 202 e0 Aug 12. Erratum in: Nature. 2021 Feb;590(7844):E26. PMID: 32785213.
There is robust immunigenity, actually stronger than is case of infection

There is robust immunigenity, actually stronger than is case of infection

Aarno, when were those findings for in the Phase 1? They were for 21 days after inoculation. Aarno, what were other independent studies findings about waning immunity for the vaccine?

Likely Pfizer dropped immunogenicity for its phase 3 because that passage of time would’ve showed shit protection. The vaccine would’ve likely not passed the FDA 60% efficacy threshold. The goalposts shift to symptoms was the only way of saving it.

https://www.cnn.com/2021/10/06/health/pfizer-vaccine-waning-immunity/index.html

Actually it’s not ‘likely’ but ‘definitely’. Notice the Qatar study finding that lab confirmed protection was at 20% at 6 months. The vaccinated phase 1 participants would’ve been at 10 months at the time of phase 3 testing.

@Greg As you said there were immunogenity, so Pfizer could not drop immunogenity as a target because of that. Actually immunogenity is tested first, because it does not make sense to phase III trial without immunonogenity.
FDA efficacy threshold is about preventing disease,and his is what Pfizer tested.
You have not told us how a vaccie could prevent prevent disease if is not immunogenic.
Waning immunity is another thing. Are you spinning a new yarn ?

Aarno, when I speak of Pfizer not testing for immunogenicity in Phase 3, I am speaking of them not testing for infection.

What was done in Phase 3? Subjects were vaccinated and then when they showed symptoms, they were PCR tested for Covid. That result gave the 95% efficacy rate for the vaccinated group.

This approach however is different than the traditional approach of measuring for infection, how it was done with other past trials. With that approach you would wait for a lapse of time, and you would then periodically test a sample for infection irrespective of whether they were showing symptoms. Here you are testing for prevention of disease and not symptoms because asymptomatic cases would also be captured.

How does the FDA factor into this? The FDA previously gave approval on whether a vaccine prevented infection or disease, not symptoms. So, approving Pfizer’s vaccine, the FDA broke this rule because, again, the vaccine was never shown to prevent infection or disease.

Had Pfizer tested for infection, the vaccine would have likely never been approved judging by it proving to be a non-sterilizing vaccine.

PS: Aarno, non-binding antibodies can prevent symptoms without preventing infection or disease.

Greg Non binding antibodies do not do anything, because they do not bind. Try to make sense.
Followup studies tested transmission:
https://doi.org/10.1016/j.ypmed.2021.106947
So FDA was right

Yes, Aarno, binding antibodies may mitigate symptoms but not necessarily stop infections.

And, Aarno, was that study really about infection or transmission?

Furthermore, PCR tests were performed upon request, most commonly because of accompanying symptoms. Asymptomatic members, unaware of their infection status, are less likely to have been tested and thus included in the study.

Really, Aarno?!

@Greg Neutralising antibodies were tested, too:
Sahin, U., Muik, A., Vogler, I. et al. BNT162b2 vaccine induces neutralizing antibodies and poly-specific T cells in humans. Nature 595, 572–577 (2021). https://doi.org/10.1038/s41586-021-03653-6
You should tell what study you mean. It helps commsni.

@Greg There is another study about transmission:
Braeye T, Cornelissen L, Catteau L, Haarhuis F, Proesmans K, De Ridder K, Djiena A, Mahieu R, De Leeuw F, Dreuw A, Hammami N, Quoilin S, Van Oyen H, Wyndham-Thomas C, Van Cauteren D. Vaccine effectiveness against infection and onwards transmission of COVID-19: Analysis of Belgian contact tracing data, January-June 2021. Vaccine. 2021 Sep 15;39(39):5456-5460. doi: 10.1016/j.vaccine.2021.08.060. Epub 2021 Aug 19. PMID: 34454789; PMCID: PMC8373820.
Another method, same result.

Aarno, this is what your Sahin et al study say…

We assessed S1- and RBD-binding IgG concentrations and SARS-CoV-2 neutralizing titres on day 1 (pre-dose), day 8 and day 22 (1 and 3 weeks after the priming dose, respectively), and on day 29, day 43, day 50 and day 85 (1, 3, 4 and 9 weeks after the booster dose, respectively

85 days, Aarno?! Wait! When are researchers finding Pfizer’s vaccine protection going down the craphole. Well, I believe that would be after 3 months.

@Julian Frost
“The fact that COVID was most serious in those over 75 does not mean it wasn’t serious in those UNDER 75. A lot of the dead and permanently disabled were of working age. A fair number of the dead and disabled were under 18.”

It is a FACT that MOST of the deaths and serious disease were in the very old, who were not working. You said businesses would have closed even without the lockdowns, because so many workers would have been very sick or dead. That is NOT TRUE. Maybe you heard that on propaganda drug industry owned mainstream news.

You said businesses would have closed even without the lockdowns, because so many workers would have been very sick or dead. That is NOT TRUE.

Yes it is. The fact that a majority of those killed by COVID were over 75 does not mean that nobody under 75 was affected. If we hadn’t had the lockdowns, the death toll would have been higher, both in those older than 75 and YOUNGER than 75.
I repeat what I said. You are using the old antivaxx claim that only those already vulnerable would be killed by COVID. You are wrong.

You said businesses would have closed even without the lockdowns, because so many workers would have been very sick or dead. That is NOT TRUE.

So you somehow know what would have happened?

You said businesses would have closed even without the lockdowns, because so many workers would have been very sick or dead. That is NOT TRUE.

This is nonsense on stilts.

The experiment was in fact done in Australia. Australia had lockdowns, but when they were removed, the omicron variant roared through the country. This resulted in huge number of people of working age getting sick and not being able to work. Businesses, particularly in hospitality, found they had to close, because they could not get enough people to work.

@Julian Frost
“If we hadn’t had the lockdowns, the death toll would have been higher, both in those older than 75 and YOUNGER than 75.”

So you somehow know what would have happened?

It is possible to look at what happened and extrapolate.

Prediction: lockdowns and vaccinations reduced the death toll and caused less harm than a “let ‘er rip” approach.

Data: Texas and Florida were hostile to lockdowns and to the vaccine, and had disproportionate death rates compared to the U.S. and the rest ofthe World as a whole. Countries that locked down fast and hard (like New Zealand) had lower death rates per capita.

Prediction matches data. Obviously that’s an oversimplification, but very clever people looked at the data and confirmed what I wrote above.

I’ll repeat myself:
some people can’t or won’t learn

Above, Orac, carefully disentangles the twisted ‘reasoning’ of contrarians by explaining exactly what is shown by research- he even points out where he said the same in the OP. Several other regulars do the same. Yet not one of the questioners really change their tune (although ONE might have shifted just a little bit recently).

But readers who are “on the fence” might be more amenable to change and growth. Because vaccine science and epidemiology are so fact driven and dense in material, it makes it easy for alties/ anti-vaxxers to mix up concepts, change results, substitute early studies for later more conclusive ones etc. When a contrarian firehoses vaccine “data” in a broadcast or an article, followers don’t have Orac or his acolytes around to clear up the BS.

So, what are the purposes of a vaccine, anyway? I say “purposes” because vaccines don’t have just one purpose. First and foremost, the main purpose of a vaccine is to prevent people from becoming seriously ill due to disease caused by a pathogenic microorganism such as a virus or bacterium, period. If a vaccine doesn’t do that, it’s a pretty useless vaccine, particularly in the middle of a pandemic that by late 2020 had killed over a quarter of a million people in the US alone. Ideally, the second purpose of a vaccine is to prevent infection and transmission; i.e., to prevent the pathogenic organism from getting established in a vaccinated host human in the first place and to render that person unable to spread the pathogen to others. This phenomenon is called “sterilizing immunity” and means that the immunity produced by a vaccine is so effective that the virus cannot replicate in the vaccinated individual sufficiently to gain a foothold and cause infection, much less be transmissible by that person to others

Still reflecting on this and considering the best way to communicate the problem with Orac’s reasoning.

Explaining again, I disagree that the foremost purpose of a vaccine is to prevent people from suffering serious illness. The foremost purpose of a vaccine is to prevent people from being infected with a pathogen, and not suffering serious illness is one of the logical outcomes of this.

Key to protecting people from infection is the vaccine generating sterilizing immunity. So, yes, generating sterilizing immunity as it relates to warding off infections is the most important goal for vaccines. And, as I mentioned, all vaccine trials in the past in some way measured for this and it was only our recent mRNA Covid trials that broke the mold.

Now, if a vaccine does not produce superior immunity and infection does occur, the hope is that there will be some partial protection that will guard against serious outcomes. See again how this is a secondary consideration and not the primary one of preventing the infection in the first place?

Also, Orac is correct in arguing that in the past scientists have settled for partial protection from vaccines and especially if they gaurded against serious outcomes. Yet, the key point again is those were settlements. They were never what was first sought after. Complete protection from infections were what was first sought after.

PS: I think I nailed it! Also, what is going on with, Narad? He is conspicuously absent.

Explaining again, I disagree that the foremost purpose of a vaccine is to prevent people from suffering serious illness. The foremost purpose of a vaccine is to prevent people from being infected with a pathogen, and not suffering serious illness is one of the logical outcomes of this.

You can “disagree” all you like, but that doesn’t make your opinion so, and your uninformed opinion differs from the vast majority of scientists and doctors who actually study vaccines.

You just refuse to cry uncle, don’t you, Orac?! So, I suggest that scientists have always considered the foremost purpose of vaccination is to provide immunity to an infectious pathogen; Orac, you believe that their foremost goal for vaccines was to protect people from serious illness.

Now, who will be the final arbitrator to this disagreement? I just don’t know. Wait! Maybe the CDC’s past position can serve here…

But the same CDC website defines vaccination as “the act of introducing a vaccine into the body to produce immunity to a specific disease.” And it defines “immunity” as “protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected,” CDC says.

https://cnsnews.com/article/national/susan-jones/do-covid-vaccines-produce-immunity-defined-cdc-cdc-says-were-still

In lieu of the vaccine failure in preventing infection, the CDC would go on to redefine vaccination. Now it’s about seeking protection and not immunity.

That’s how things roll with Orac and the CDC. When the results are not to your liking, change the science!

@Greg Immunity is not protection against disease ? You are immune to a disease does not mean that you do not ge the disease ? Again, you do not make sense.

@Greg Actually clinically confirmed disease is tested in RCTs. Followup studies check asymptomaic cases Vaccine effect in both cases is knon.

Quoting myself….

Also, Orac is correct in arguing that in the past scientists have settled for partial protection from vaccines and especially if they gaurded against serious outcomes. Yet, the key point again is those were settlements. They were never what was first sought after. Complete protection from infections were what was first sought after.

Scientists have settled for partial protection but is this really a good thing? At what point will scientists start rethinking their position that any vaccination or protection is a good thing, and especially in light of Bossche’s argument that vaccinating every thing that moves with a leaky vaccine is dangerous.

Related to this, is the CDC revising its definition of vaccination to account for protection and not immunity a good thing? Does this not open the door for researchers to pimp vaccines for every malady under the sun and even if the returns are dubious? Sorry -dumb question!; that door was already wide open.

Scientists have settled for partial protection but is this really a good thing?..Bossche’s argument [is] that vaccinating every thing that moves with a leaky vaccine is dangerous.

Let’s take your last point first. Bossche is talking rot. “Leaky vaccines” is a load of tripe.
On to the first part. Frequently, the first solution for a problem we come up with is less than optimal. Yet at the start it’s the only solution we have. What we usually do is use the less than optimal solution and search for a better one, replacing the less than optimal solution with the better one when we find it. This is how it works in the real world. Refusing to use the only available solution because we haven’t found the best solution yet is naive.

What we usually do is use the less than optimal solution and search for a better one, replacing the less than optimal solution with the better one when we find it

Julian, if you don’t mind me saying, the better solution was already staring you guys in the face; natural infection — at least for those under 70.

Hey, has anyone really come up with a convincing explanation of how Africa escaped Covid?!

@Greg, large numbers of people under the age of 70 have died from COVID. Less risk does not mean no risk. Your let ‘er rip strategy would have caused tens (if not hundreds) of thousands of deaths.
Africa has NOT “largely escaped COVID”.Huge numbers have died, here as on every other continent.

Quoting myself (give it up, Has! Yes, I am the centre of the universe; deal with it!)…

Hey, has anyone really come up with a convincing explanation of how Africa escaped Covid?!

To think that Africa in the past has done a reasonable job counting their famine, malaria, hiv, ebola, and monkeypox bodies; now, however, they just can’t get a read on all the hordes of their people dying from Covid. We also know for sure it’s happening given their low vaxxed rate, their people’s poor health, and the poor healthcare in those countries.

Speaking of Bossche, Weiler doesn’t agree with his doomsday prophecy of death and destruction from mRNA vaccination within three months. What’s remarkable is people are disagreeing with Bossche but without giving their own detailed account of how the pandemic will end.

So, what do you guys feel? How do you think we will escape these unending spiral of mutant strains and come out of Covid for good?

https://worldfreedomalliance.org/au/news/is-geert-right-lets-hope-not/

You really think that protection against disease is not a good thing ?This is of course the purpose of vaccines.
Vaccines work because mempry cell activation Antibodies are not only part of immuniy.

Bossche’s argument that vaccinating every thing that moves with a leaky vaccine is dangerous.

You got that one right, Greg. It is a seriously dumb question. It is dumb, because mutations are entirely a numbers game. The more virus particles floating around the more variants there will be. So not vaccinating, simply increases the chances that variants will appear. Vaccinating everyone, will dramatically reduce the number of virus particles in circulation (even if the vaccine does not stop transmission) and hence the chance that variants will appear.

The worst possible strategy is the GBD strategy where you let the virus run rampant among those at low risk of an adverse outcome, while vaccinating those at high risk. This strategy means there will be lots of variants and lots of chance that those variants will interact with a person who has been vaccinated.

To reduce the risk of the virus evading the vaccines, you need to vaccinate more people, not fewer.

But readers who are “on the fence” might be more amenable to change and growth.

How often do you find people who are truly “on the fence”? In the limited, non random sample of people in our neighborhood, families, my colleagues at school and my students, there is a hard split between the people who aren’t consumed by conspiracy, and those who are just as strongly invested in the false narratives [like those presented by the deniers here].

West MI is a fairly conservative region, especially in the Grand Rapids area where I teach, slightly less so in Portage where I live, so I’m not surprised by the strong anti-science bent of large groups of people. Disappointed, but not surprised.

Again, keeping a virus in check with quality antibodies that curb its transmission has to be our primary goal for a vaccine and not hoping that the vaccine prevents serious illness. Without curbing transmission, an outbreak can persist and things may evolve to where preventing serious illness becomes increasingly difficulty. Here is the latest big evolution challenging mRNA vaccinations’ ability to fight Covid and prevent serious illness.

https://www.cnn.com/2022/10/26/health/updated-boosters-omicron-imprint/index.html

Funny how your opinion of people’s scientific reliability depends upon whether you agree with what they are saying, rather than their knowledge and expertise.

You might note that this article also tramples on the anti-vax tenet that the government agencies and expert consultants are all uncritical drones in the pay of big pharma.

This sort of research is exactly what scientists are doing, all over the world, trying to save lives whilst you sit back on your throne of smugness and insult them.

Sitting on my throne of smugness, Numb? I think you are misunderstanding me.

I operate on the principle of if scientists and researchers are spewing total crap that is not backed up by evidence then I am not obligated to respect them more than I should respect the most ignorant person on the planet spewing similar crap. Actually, Numb, I will respect the ignorant person more thinking he just doesn’t know any better and whereas the scientists and researchers should know better but they’re just being mendacious. Numb, I sincerely believe that Orac is spewing total crap arguing that where vaccines are concerned scientists have always valued protection over immunity.

Also Numb, what do you make of imprinting impeding mRNA vaccination? Do you know that jt was over a year ago in response to one of your comments that I stumbled on this concept and predicted it would pose a problem to mRNA vaccination?

Gregsays:
October 14, 2021 at 9:39 pm
Secondly, catching Covid while vaccinated means a much lower chance of serious adverse events or death. So being vaccinated and then catching Covid is less dangerous than catching Covid and then getting vaccinated.

Related to this argument, something got me thinking. I am hoping the immunology experts around here such as Aarno, Athaic, Foolish Physicist, Squirrel or Joel will chime in. Speaking of Joel, he has been conspicuously missing; what’s up with that?

So, mRNA vaccines produce spike specific antibodies. The vaccinated person then encounters Covid, and adaptive immunity then tells innate immunity to stand down and then battles the infection with those spike specific antibodies.

What’s wrong that? The natural infection here after vaccination will still not result in the person acquiring the full breadth of antibodies that will produce superior immunity for warding off future infections. In a nutshell, I am considering covid after vaccination will result in inferior immunity than the immunity gain from fighting covid without vaccination. The mRNA vaccines in this way will irrevocably screw things up, and preventing the person to ever benefit from natural infection.

Any takers here that would like to chime in on this point?

https://www.respectfulinsolence.com/2021/10/11/on-natural-immunity-to-covid-19-and-every-other-vaccine-preventable-disease/#comments

Of course, this is NOT how the immune system works. Not at all. But nice overly-simplistic theory there, Jabroni.

“what do you make of imprinting impeding mRNA vaccination? Do you know that jt was over a year ago in response to one of your comments that I stumbled on this concept and predicted it would pose a problem to mRNA vaccination”

I think that real scientists have been looking into it for longer than you even knew it existed. You predicted nothing. You just found something that might impede vaccine effectiveness with different strains and hitched your wagon to it in hope.

https://www.imperial.ac.uk/news/232396/immune-imprinting-causes-varied-patterns-protection/

Your latest hobby horse about definitions and aims of vaccination is meaningless trolling.

I think that real scientists have been looking into it for longer than you even knew it existed. You predicted nothing.

K, I’ll never understand why you guys insist on doing things the hard way. Looks like I’ll have to get someone else to cry uncle. Loud and clear!

NumberWangsays:
October 17, 2021 at 4:06 am
While I wouldn’t like to comment on Greg’s new pet theory from a immunological perspective. I would like to point out that, if his theory was correct, it would already have been noticed.

Gregs theory says that vaccine generated immunity will prevent any possible future natural immunity from developing. So, presumably, variants like delta which the vaccines have a harder time with, will be impossible for vaccinated people to generate antibodies to. So? Greg, can you find any studies to show that this is happening? Any evidence that vaccinated people get reinfected with delta on a regular basis with no change in the severity of the disease

Isn’t the pandemic enough evidence of that, Numb, but with Delta getting replaced with Omicron and Omicron now being replaced by its siblings?! Yes, I’ll hand it to you that disease severity is lessening, but you know what’s causing that, Numb? Imprecise memory Wuhan antibodies flooding the system. They might mitigate the infection but they sure as hell are not preventing it.

Are you still pouting, Numb?! Please advise then of the rationale of even pursuing bivalent vaccines with so many people already infected.

Did you learn any real science from it? If so then it’s a good thing.

Mitigating severity and death still seems like it’s still a good idea to me and the opinion that further vaccination is pointless is a rather different debate to your original view point that vaccination is pointless.

Delta spreads more easily than alpha, and ommicron more easily than delta. This is why they hae replaced each other

Indeed. And because transmission through a population can, under ideal conditions (for the virus), be exponentional, it doesn’t take a huge difference in transmissibility for the newer, more transmissible strain to replace the previous strain as the dominant one.

@Greg New variants escape natural immunity. too,, sadly. So number of already infected is not as important as usually.

Immune memory protects against second infection by same pathogen, not antibodies.This applies natural immunity,too.

@Dangerous Bacon

“Evidently it gratifies has’s ego to behave this way, but it’s gotten to be a pain in the ass.”

Has is a disgusting and scary egomaniac. He is like a real life horror movie. Never saw anything like it, and I have been on many forums full of angry crazy people. Has gets the prize for angry crazy, should be in a mental hospital.

@ldw56old

“Libertarians are not good people — following a “philosophy that is essentially the mindset of a spoiled 4-year-old kid: “This is mine and I should have what yout have” is not a good thing.”

You don’t understand what is meant by the word. Libertarianism is essentially a reaction against collectivism, and libertarianism is a matter of degree. Like anything, it is bad when taken to extreme. Communism/collectivism certainly is also bad when taken to extreme.

A moderate libertarian might think that a central government tends to grow in power, and eventually starts becoming unresponsive to the needs of citizens. The goal might be to keep governing powers as decentralized as possible. Your county government is probably more approachable than your state government, which is more approachable than the federal government.

One could say that libertarianism is a bottom-up approach, whereas collectivism is top-down. Which is better? Well we need both, but we might not agree on how much of each.

Progressives are, generally, collectivists. They believe it is possible to elect a central government that can be trusted, however long it stays in power. Progressives have a kind of faith in human nature and human intelligence that was NOT held by the founders of the US. They believed that power always tends towards tyranny, and designed this country to prevent that.

Anyone who is scornful and dismissive of all degrees of libertarianism does not understand human nature and the danger of concentrated power.

There lots of people between libertarism and actual collectivism.A dog whistle phrase is another thing.

“Anyone who is scornful and dismissive of all degrees of libertarianism does not understand human nature”

Ha ha ha ha ha ha ha. Human nature is exactly why libertarianism is a pipe dream. Or does anyone think that big business will behave any more ethically with less regulation?

I don’t buy your lies about libertarians any more than your lies about vaccines. You (and labarge) are simply ignoring what we see in today’s libertarians. I will agree that libertarianism is “bottom up” — it’s just that the bottom feeders who choose it never leave the bottom.

“Libertarians are not good people — following a “philosophy that is essentially the mindset of a spoiled 4-year-old kid: “This is mine and I should have what you have”

The unofficial motto of today’s libertarians: “I don’t wanna and you can’t make me”.

Another bit of antivaccine messaging around the Pfizer trials seeks to impute nefarious intent as Pfizer went from earlier stage clinical trials to its phase 3 trial. Sadly, some of this misinformation showed up in the comments here:

Pfizer’s phase-1/2 trial did indeed study antibodies which is the best gauge for assessing transmission. Binding antibodies was reported for the 45 subjects but crucial neutralizing antibodies was only assesed [sic] for only seven subjects with Pfizer promising that data was forthcoming. I don’t believe it ever got reported before they eventually switched to assessing whether the vaccine prevented symptoms for the phase-3 trial. https://pubmed.ncbi.nlm.nih.gov/32785213/

And then, in another comment:

Further to my comment above and speaking of shifting goalposts, the mother of all goalposts shifts occurred when Pfizer moved from studying efficacy of its vaccine by its immunogenicity profile in phase-1/2 to assessing symptoms in phase-3. This goalposts shift went largely unnoticed; drowned out by the thunderous fanfare and jubilation that proceeded the phase-3 trial news that the vaccine was 95% effective at preventing symptoms. And, perhaps the shift would’ve remained inconsequential if the vaccine hadn’t now proven to be ineffective at stopping shit. Let it be known that it’s not just a case of Pfizer not assessing whether its vaccine is effective at stopping transmission, but them deliberately choosing this

Wow! Just wow! Those comments were mine!. I am actually staring in Orac’s blogs. No wonder Has is going ballistic about all the attention Orac is giving me. Has, see what I mean now about being too damn powerful and irresistible?!

PS: Can’t believe I missed the passage. I am considering starting to read the blogs and not just skimming over the them. Surely I can put up with Orac’s boring, predictable blatherings.

Nor, contrary to claims from antivaxxers like Campbell, do most phase 3 trials for vaccines examine transmission as an endpoint to be used for licensure, as Susan Oliver explains in her video, citing trials of various measles and HPV vaccines. To that I’ll add some other vaccine trials, including this one of a rotavirus vaccine in which prevention of transmission was not an endpoint or clinical trials of Rotateq, for which—again!—prevention of transmission was not an endpoint.

I looked over some of those studies, and it’s still unclear of whether they solely used prevention of symptoms as an endpoint, or whether any of those vaccines were licensed based only on that measure. Again, in the history of vaccine research, has any vaccine been licensed based solely on its ability to prevent symptoms?!

Again, in the history of vaccine research, has any vaccine been licensed based solely on its ability to prevent symptoms?!

Your ignorance knows no bottom, Greg. Both diphtheria and tetanus vaccines only prevent symptoms.

Both diphtheria and tetanus vaccines only prevent symptoms.

Chris, searched and couldn’t find anything of the sort. Citation please?

So much for your much vaunted research skills.

Let me help you.

“Immunisation protects against tetanus toxin. Tetanus-containing vaccines prevent disease by making antibodies that bind to the toxin, rather than the bacteria.” From here.

“The diphtheria vaccine contains a weakened form of the bacterial toxin, called a toxoid. It works by prompting the body to produce an ‘antitoxin’ – a specific antibody that neutralises diphtheria toxin.” From here.

You scratched the barrel bottom real hard for that, Chris, but I want to thank you; it’s really the case that no other vaccine just prevent symptoms!

With diphtheria and tetanus we are essentially dealing with toxin or toxoid sub-infections. Notice also how vaccine generated antibodies are still targeting them to achieve immunity: notice also how successful neutralization of such sub-infections will prevent diphtheria and tetanus symptoms.

That last point is important. If it was truly like Covid vaccination, tetanus and diphtheria vaccines would just stop those symptoms without stopping the sub-infections.

Again, thanks Chris. You have confirmed that Covid, mRNA vaccination is truly special, and not in a good way.

Gosh you are ignorant Greg, but I should have expected that.

The massive hole in your goalpost moving is that toxins have no ability to infect (whatever a sub-infection is). These toxins are produced by the bacteria that infect.

[…] Worse, antivax disinformation has infested conventional media and become public policy in some states, such as Florida, where Gov. Ron DeSantis appointed a COVID-19 conspiracy theorist, crank, and antivaxxer named Dr. Joseph Ladapo to be Surgeon General and thus in charge of the state’s entire public health apparatus. Unsurprisingly, he promptly started using his office to discourage vaccinating children against COVID-19, even faking science to do it. Given the antivax propaganda apparatus that has developed over the last few years, it can be harder to distinguish “on the ground” real antivax true believers from those who have become vaccine hesitant due to the relentless drumbeat of disinformation coming from AstroTurf groups, conservative news outlets, and even government officials like Dr. Ladapo. Indeed, antivax disinformation appears on an almost nightly basis on the most watched cable news station, Fox News, with pundits like Tucker Carlson regularly regurgitating antivax talking points to audiences of millions. […]

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