Thoughts on vaccine passports

[MediMike]

7 minutes ago, CJAadmission said:

No, not at all. But I'm also not opposed to a business saying they don't want to bake a cake for a gay wedding, so you'd find my overall views odious. 

I mean, you're not wrong. You're equating placing folks at risk of a disease in a pandemic with being gay but whatever.

If you're ok with that then I really don't see what your argument is here? The current administration has come out and said they are not encouraging or supporting any type of required vaccine credentialing/database/requirements? Are you arguing against state government? Hopefully you're just as upset with DeSantis not allowing businesses to require proof of vaccination.

[TheFatMan]

19 minutes ago, CJAadmission said:

No, not at all. But I'm also not opposed to a business saying they don't want to bake a cake for a gay wedding, so you'd find my overall views odious. 

What are your thoughts, then, on governors not allowing business to require this (Texas and Florida for example)?

[briansk]

4 minutes ago, TheFatMan said:

What are your thoughts, then, on governors not allowing business to require this (Texas and Florida for example)?

Texas has banned state agencies and entities that utilize public money from requiring, not private entities (per CBS news report)

[TheFatMan]

Just now, briansk said:

Texas has banned state agencies and entities that utilize public money from requiring, not private entities (per CBS news report)

Thank you for the correction. Hypothetically then.

[MediMike]

12 minutes ago, briansk said:

Not necessarily, their business, their choice. I would say that is potentially a form of discrimination based on health status. Let me ask a hypothetical. Would you be opposed to businesses requiring a flu vaccine prior to entering? How about meningitis vaccine? What about requiring face shields and gloves? And then where does it stop? Would it then be acceptable to deny access because of disability, BMI, (I get that is not exactly the same, but that is the type of slippery slope I fear).

I think that if businesses start creating barriers for customers, their business will likely suffer and may not survive. That would be their choice. What I have a problem with is the GOVERNMENT making those decisions for those companies as the shutdowns did over the past year in states such as Pennsylvania where I live. Many of those small companies deemed non-essential will never return.  

First, let me point out the the slippery slope argument is literally a logical fallacy.

How is it discrimination? If you are unable to obtain a vaccination due to an underlying condition there would likely be workarounds. (I say likely as this is all theoretical). The government says I can't walk around with my genitals hanging out and that's a lot lower risk to most people than COVID, I'm assuming you have no issue with my junk being forced to be tucked in my pants? Or are you more of the true anarchist type? Where do you draw the line for government overreach? 

The shuttering of essential vs nonessential businesses should be held for a separate thread. I believe you were the individual downplaying the mortality of this disease as "only 1.8%" in an earlier post, as such I doubt we'll have much of a civil conversation. (If that was not you then I apologise)

[CAAdmission]

1 minute ago, TheFatMan said:

What are your thoughts, then, on governors not allowing business to require this (Texas and Florida for example)?

I think it's government doing what they enjoy most: intruding into affairs that they have no business getting involved with. 

I remember decades ago congress got involved in holding hearings related to steroid use in baseball. I'm too lazy to look up the details, but in the approximate timeframe the Cold War was still on, AIDS was fairly new and crack was getting popular. And our chief legislative body subpoenaed people to testify about... baseball.

We send several hundred narcissistic morons to Washington every few years and they create hundreds (thousands?) of new laws and regulations annually. We are going to do this in perpetuity? There will never come a time when we have enough laws? 

 

[ANESMCR]

4 hours ago, MediMike said:

I believe you were the individual downplaying the mortality of this disease as "only 1.8%" in an earlier post, as such I doubt we'll have much of a civil conversation. (If that was not you then I apologise)

I believe that was the other one. But to my point, this thread has merely exposed people making scientific and medical decisions based on bar talk banter and political affiliation. There’s no other explanation when minimizing the severity optics and latching to alternative facts for the virus.

[CAAdmission]

4 hours ago, ANESMCR said:

I believe that was the other one. But to my point, this thread has merely exposed people making scientific and medical decisions based on bar talk banter and political affiliation. 

I know it's hard to believe in this day and age, but some of us don't have a political affiliation. 

I'm still waiting to see the outcomes difference between northeastern states that went into "scientific and medical" draconian lockdowns vs southern states that took a much more targeted approach. It will take some years to fully assess (and disentangle the political spin) but I suspect it will be interesting.

[Photograph51]

18 hours ago, briansk said:

Not necessarily, their business, their choice. I would say that is potentially a form of discrimination based on health status. Let me ask a hypothetical. Would you be opposed to businesses requiring a flu vaccine prior to entering? How about meningitis vaccine? What about requiring face shields and gloves? And then where does it stop? Would it then be acceptable to deny access because of disability, BMI, (I get that is not exactly the same, but that is the type of slippery slope I fear).

BMI is not contagious.  That's the difference.

[TheFatMan]

51 minutes ago, Photograph51 said:

BMI is not contagious.  That's the difference.

Yep. Someone else's BMI never killed 500,000 people in a single year. 

Also, before I forget...someone on here said the covid's direct effect on kids was "negligible." And while infection and severe disease in children is rare, keep in mind that roughly 40,000 kids have lost a parent in the past year due to this. Not negligible. 

[briansk]

3 hours ago, Photograph51 said:

BMI is not contagious.  That's the difference.

 

2 hours ago, TheFatMan said:

Yep. Someone else's BMI never killed 500,000 people in a single year. 

Also, before I forget...someone on here said the covid's direct effect on kids was "negligible." And while infection and severe disease in children is rare, keep in mind that roughly 40,000 kids have lost a parent in the past year due to this. Not negligible. 

Point 1: Yes- I agree BMI is not contagious, therefore I stated "(I get that is not exactly the same, but that is the type of slippery slope I fear)."    When does the government decide that people with BMI over let's say 32 can't eat at McDonalds because obesity is a public health concern due to the excessive costs of co-morbid conditions associated with obesity? New York already tried this with limiting soft drink sizes, so my fear isn't that far-fetched.

Point 2: I said early in this thread that I would not be getting MY children vaccinated due to the low risk to them. My parents and in-laws are vaccinated (or in the process of finishing their course). They didn't ask, and I didn't try to persuade or dissuade them. They are adults and can make that decision for themselves. If they wanted my opinion, I would have suggested it for them based on their individual health statuses. When my kids are adults, they can make that decision for themselves. 

 

The original point of this thread was opinions on mandating vaccine passports. I remain opposed to requiring  vaccine passports for any activities in this country.

Edited April 9, 2021 by briansk

[Cideous]

Long haulers is real and kids/teens are experiencing it.  Not vaccinating your kids is your choice as a parent, but damn will you have a lot to answer for to those kids.  Our son has a friend whose parents are anti-vaxers and the kid resents the shit out of them.  He is counting the days until he is 18 and planning to start the catch up series, something he should have never had to do.  

And for whoever said they will not get their kids the Gardasil vac?  It's quite literally a anti-cancer vaccine.  What, do you think your kids are never gonna have sex?  Keep on preaching that abstinence and see how that works out when your daughter has cervical cancer at 32.  So damn stupid.  Science is real folks.

[ANESMCR]

1 hour ago, Cideous said:

And for whoever said they will not get their kids the Gardasil vac?  It's quite literally a anti-cancer vaccine.  What, do you think your kids are never gonna have sex?  Keep on preaching that abstinence and see how that works out when your daughter has cervical cancer at 32.  So damn stupid.  Science is real folks.

Lmao I just went back and read that. I originally read that he/she HAD given it to them, but sadly you are correct. 
 

Any medical provider (particularly MD, PA, NP) that even slightly implies antivax rhetoric, vaccine hesitancy, or alternative vaccine schedules should be actively ridiculed. You are the finest example of dereliction of duty. 
 

I have a higher expectation of the posters here, sorry. And this thread has exposed some true incompetence. 

[ANESMCR]

17 hours ago, CJAadmission said:

I know it's hard to believe in this day and age, but some of us don't have a political affiliation. 

I'm still waiting to see the outcomes difference between northeastern states that went into "scientific and medical" draconian lockdowns vs southern states that took a much more targeted approach. It will take some years to fully assess (and disentangle the political spin) but I suspect it will be interesting.

Yeah, I’ve never been able to quite figure you out. But pretty obvious which way you lean. I think it will be way more complicated than that considering population, infrastructure, and demographics. 

[rev ronin]

6 hours ago, Cideous said:

And for whoever said they will not get their kids the Gardasil vac?  It's quite literally a anti-cancer vaccine.  What, do you think your kids are never gonna have sex?  Keep on preaching that abstinence and see how that works out when your daughter has cervical cancer at 32.  So damn stupid.  Science is real folks.

This sounds like a familiar argument... almost as if I wrote a JAAPA article about it or something.

[rev ronin]

12 hours ago, mcclane said:

You would benefit from reading studies describing the beliefs held by those with vaccine hesitancy and the relative success seen with various strategies to combat it. NEJM is a good source.

I'm aware of the research.  I'm still not seeing how any of it contradicts my assertion that people refusing ALL Covid-19 vaccines for adults are either misinformed or psychopaths.  That is, if anyone is sufficiently well-informed and conscientious, they will get a vaccine for any adult, including themselves, when available.  I suppose you could call this a "no true Scotsman" argument, but that's kinda the point.

[ohiovolffemtp]

The underlying question that needs to be answered is how to balance the costs of societal restrictions to slow COVID-19 or any other disease vs the costs of greater spread of that disease.  Right now, those arguments are happening in the press, social media, politics, and arguments between people.  Most of the sides base their arguments on their personal opinions and personal experiences, not data.  The data that is available is incomplete.

I'd like to see a several step process: First, get better data through retrospective analysis of:

• What is the actual effectiveness of each measure that has been taken:
  • masking
  • massive cleaning
  • shutdowns/lock downs, whether of entire geographic areas or particular industries
  • capacity limitations 
  • virtual learning
  • etc.
• What is the cost - economic and personal, e.g. psychological of each measure
• For each, what level of confidence do we have in the measures of the above

Then: a political debate, probably in the state legislatures and Congress about what measures to choose, who makes those decisions (executive vs legislative branch), how long declarations can last, etc.

Bluntly, we do need to place a value on individual lives, because these choices are about how much we're going to spend to protect them.  It does need to be a political process, because the data will be informative but not decisive.

For example, the CDC has now said that all of the cleaning wasn't as important as masking.

[UGoLong]

Sure; in x years, more will be known, but unfortunately, we live today with whatever imperfect knowledge there may be. (But we are fortunate to be living with today's technology and not yesterday's.)

I'm old enough to remember the "little yellow book" of vaccinations that you needed to move between countries. If someone feels that they don't want the vaccination, that is their right. On the other hand, I think that others also have a right to associate (on cruises, in large crowds, etc) on private property (or in jurisdictions whose laws permit it) only with people who have had the vaccination.

Heard a good discussion on the radio about it. Want to go to a golf club with a $10,000 membership fee? No money: no entrance. Want to go to a restaurant that only takes reservations? No reservation: no admission. Want to go into a fancy restaurant in flip-flops? No shoes: no service. So yes, you have a right not to get a shot. But you don't have a right to go into private spaces without one if that is what the business wants the rules to be (as long as it does not discriminate on the basis of personal attributes protected by law.)

So, yes, I see nothing wrong with vaccine passports for now. 

[CornellSPA]

Another advantage of vaccine passports....we might be able to track COVID variants/resistant forms in those of us who are vaccinated....easier tracking! 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516275/pdf/pbio.1002198.pdf

Imperfect Vaccination Can Enhance the Transmission of Highly Virulent Pathogens

Andrew F. Read, 

 

Abstract

Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek's disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.

[rev ronin]

16 hours ago, mcclane said:

So you are "familiar" with the research, but you somehow come to your own, completely inappropriate, conclusion - one which is not supported by the body of evidence. The paradoxical behavior of coming to the opposite conclusion when presented with evidence is a significant contributor to the phenomenon of vaccine hesitancy in a nutshell.

You truly don't understand what I said, do you?

The reasons for "coming to the opposite conclusion when presented with evidence" can have one of two fundamental causes:
- the person remains ill-informed.  There's nothing about the presentation of evidence that necessarily informs any person receiving it.  It may be poorly presented, contradict strongly held beliefs of whatever nature, literally a million different reasons could interfere with a patient internalizing the correct information with which they are presented.  Thus, the patient remains uninformed despite being exposed to correct, beneficial information.

- Alternatively, they could have truly understood and internalized the message and the risk/benefit ratio to themselves and others... and simply not care. That would be psychopathological, in my technically incorrect usage of an outdated term that quite adequately conveys exactly what I mean.

Thus, my assertion remains that the set of people who 1) really understand Covid-19 vaccination, 2) refuse every available Covid-19 vaccine, and 3) act conscientiously in doing so is the null set.

[CAAdmission]

If we can remove emotion from the issue for a moment - not something that is done anymore - it's relatively logical for someone to be vaccine hesitant. The potential long-term effects of this vaccination are unknown, simply because it has not been available long term. 

Since I graduated PA school, there have been a ton of medications (including some vaccines) that were once FDA approved and subsequently removed from the market due to unforeseen effects. Each day will bring more data. If someone thinks they can adequately protect themself against catching the virus using easily available precautions, that might be a prudent judgement. Only time will tell. Each person ultimately has to do their own risk stratification.

[rev ronin]

2 hours ago, mcclane said:

I see. So in this thread, you have made up your own definitions of ill-informed, un-informed, vaccine hesitancy, psychopath, and herd immunity. Clearly, you are obfuscating and backtracking into semantics at this point, so again, I refer you to the literature to acquire a basic working vocabulary on the subject. You are neither ill-informed nor a psychopath, you are simply evidence hesitant, which is hilarious, given the argument you are trying to make.

I'll take it with under advisement, with all due and proper weight. I'll also note for the record that I have authored part of that body of research.

If you would, do answer me this: On what basis did you expect a statement that used 'psychopath', a term that has fallen out of favor and common use decades ago, to be an attempt to summarize current research on hazard communication using current terminology, rather than a value statement?

The moral of the story, for those observing, is some people will aggressively misunderstand anything substantive, whether out of simple error or malicious intent; Hanlon's razor favors the former.

[CAAdmission]

Huh.

https://www.npr.org/sections/coronavirus-live-updates/2021/04/13/986709618/u-s-recommends-pausing-use-of-johnson-johnson-vaccine-over-blood-clot-concerns

[sas5814]

6 cases out of 7 million doses administered. I'd say "abundance of caution" is an understatement.

As stated I think everyone gets to stratify risks by their own personal metric. However, on matters of public policy I don't think you get to complain if you choose not to get vaccinated and then you can't travel internationally (or get on a plane at all). 

I have an old friend who is on a rant saying it will be used to "discriminate" on things like who can get in the grocery store. Nah.....

[TheFatMan]

34 minutes ago, CJAadmission said:

Huh.

https://www.npr.org/sections/coronavirus-live-updates/2021/04/13/986709618/u-s-recommends-pausing-use-of-johnson-johnson-vaccine-over-blood-clot-concerns

6 cases of CVST out of nearly 7 million doses.

CVST occurs in 5 people per million annually.

Chance of being struck by lightning 1/700,000 annually.

Chace of VTE with OCPs is 1 in 3,000.

We'll see. In some ways this is a good thing they noticed this and are doing something about it. I'm sure it won't help confidence. On the other hand, I don't know if it is ethical to withhold a life-saving vaccine over something so rare.

Edited April 13, 2021 by TheFatMan