Are the vaccines doomed, or are we?

In the period from 6 December to 2 January (Table 5 on p. 25), double (but not triple) vaccinated teenagers and adults were substantially over-represented in Omicron infections across Germany.

About 45% of teenagers aged 12–17 are vaccinated but unboosted, but they accounted for almost 55% of symptomatic Omicron cases. Only 37% of adults aged 18–59 are vaccinated but unboosted, but they accounted for 66% of symptomatic Omicron cases. Finally, a mere 21.8% of adults aged 60 or over are vaccinated but unboosted, but they accounted for 46% of Omicron cases.

Yes, these data might be called “unadjusted.” You might hope that population density, or differences in treatment-seeking behaviour, or relative risk perception – anything but properties inherent to the vaccines – can explain them away. But Germany is not alone in these numbers; preliminary evidence for negative vaccine efficacy against Omicron every day grows more abundant. There was also evidence of negative efficacy against Delta; the effect was merely less pronounced and took longer to emerge. Omicron, which has immune escape properties, simply gets further into negative efficacy, faster.

It seems clear the problem is related to vaccine fade. The older double-vaccinated, whose vaccinations happened earliest of all, are experiencing worse negative efficacy than the younger double-vaccinated, whose vaccinations are much more recent. Of 797 Omicron cases in children aged 5 to 11, only two are in the (disgracefully) double vaccinated. These are very recent vaccinations indeed. For the moment, the boosted are doing very well against Omicron, but I doubt anybody believes that will last. In all likelihood, the third dose will fade just like the first two, and then negative efficacy will come back.

On balance, this strikes me as a bad thing, and urgently requiring investigation. It throws the entire doctrine of maximum vaccination into confusion. Against the advantage of substantial protection against severe outcome, must be weighed the substantial disadvantage of indefinitely heightened transmission, which can only be mitigated temporarily by vaccinating the whole population all over again. In a rational world, this phenomenon would be met (at the very least) with a halt in most or all vaccinations, but that is very far from the world we inhabit.

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Omicron is a much milder variant, it is true. Official sources now widely acknowledge this property, although it is not terrifying, and so not discussed as eagerly as the alleged greater virulence of Alpha or Beta or Delta. Nevertheless, even mild viruses can cause serious disruptions if everyone gets them at once, and the possibility that we may have condemned large segments of our population to suffer repeated reinfection or accept quarterly vaccination is disturbing.

For this and other reasons, I think the vaccines are doomed and will probably be discredited even in the medium term. My learned friend @Astuages, however, disagrees, and it’s worth considering his perspective (here reformatted and lightly edited):

… I am not, by nature, an optimist about the right side being rewarded in the end. … To begin with, the media discussion landscape for vaccination was already poisoned by the autism debate, and the vast majority of people are simply never going to grasp the idea that there is any difference between an mRNA SARS-CoV-2 vaccine and the smallpox vaccine.

There are (at least) two counterfactual assumptions that justify vaccine approval for low-risk groups, and even mandates. They are important counterfactuals because the FDA/CDC has used them to justify their decisions to date:

1) The vaccine is sterilizing.

2) The vaccine provides long-term protection from disease (either total protection from infection or amelioration of symptoms).

If either of these are true, then the vaccine can be justified on either public health grounds (get rid of the virus) or personal risk grounds.

Counterfactual 1, sterilization: Of course the vaccine is non-sterilizing. In fact, the negative efficacy for omicron should be causing people to freak out. Vaccine amplified infection is pandemic scifi level bad. Vax negative efficacy for omicron means that over the next few years there is the very high probability of even more vaccine-amplified variants. There is the possibility (how high I can’t guess) that some of these will be severe instead of mild. Maybe they’ll kill the vaccinated and be a win for anti-vax. But maybe they’ll kill the unvaccinated and be a win for pro-vax, even though it’s actually the fault of the pro-vax side. It’s even possible that omicron itself could be like this. Very early days.

Counterfactual 2: Long-term protection: If the vaccine really protected you forever from covid, it makes a lot of sense for many groups, even lowish risk groups. It still wouldn’t make sense for healthy kids, but it might be the sort of thing that your doctor recommends when you turn 30. But in the real world scenario where the vaccine does not protect you for very long, it begins to make negative sense from a personal risk standpoint. That is, should someone who is 45 and obese—at small, but non-trivial risk of death from covid—get vaccinated now for x number of years of protection? Maybe infinite boosters work out over the next decade and he’s okay. Maybe there are no more vaccine-amplified variants.

More likely, things aren’t quite that perfect, and he gets covid when he’s 55 and dies because he didn’t get the wild-type infection that would have granted him more protection when he was younger and safer from it. Basically, even apart from side effects, these vaccines, under what we now know to be true, only make sense for a much smaller, higher-risk, group of people than initially thought. Unfortunately, there is no process for the FDA/CDC—or the media—to revisit those basic counterfactuals. They can stay wrong forever, and Pfizer will be happy to rake in the cash.

But what about side effects? The myocarditis side effect is enough to demonstrate that we shouldn’t be vaxxing under-40s under the realistic scenario (the one where we already know we shouldn’t be vaxxing them) but not enough under the counterfactual scenario FDA/CDC operates under.

The problem for “anti-vax” is that the rate of hospitalization and death remains minuscule. I personally think these myocarditis side effects are legitimately scary in an infinite booster scenario given how risk jumps on the 3rd shot. But that’s just not the scenario that FDA (or Pfizer, lol) is evaluating it by. They are still operating under their two counterfactuals. And they will continue to do so, and they will get plenty of media cover.

If anybody thinks the side effects are enough to cause a serious re-evaluation of vaccine policy all on their own: there is not nearly enough hospitalization and death yet. I’ve watched all-cause mortality graphs like a hawk looking for it. There are some minuscule signals. But nothing that can’t be easily ignored. For real public attention, we’ll need orders of magnitude (at least 2, but possibly 3) more vaccine injuries than we’ve currently got or likely to get. Maybe in 10 years, if there’s enough booster uptake and injuries because too much to ignore (but don’t bet against the power of wilful ignorance), we may see a serious re-evaluation of vaccine injury.

Anti-mandate political positioning sidesteps the entire medical muck, and I suspect that it is where the savvy politicians will gravitate. People may not be able to tell the difference between an mRNA SARS-CoV-2 vaccine and a smallpox vaccine, but they don’t like being mandated. They don’t like their children being mandated. And really don’t like being fired. The FDA and drug companies don’t evaluate personal freedom. But most normal people do. Personal autonomy in medical decisions is a vital freedom. Pfizer can release whatever poison they want, as long as people have the personal freedom not to take it (for themselves and their families), and as long as they have the speech freedom to criticize Pfizer about it. Take away those freedoms, and even if it’s some sort of magical healing elixir (lol, right), a lot of people get upset. Or at least I do.

These are very good reasons to doubt that vaccine side effects, whether at the individual or the population level, can bring the vaccination regime down by themselves. Establishment propaganda has successfully defended these oversold and misused products in the eyes of millions of people.

It is, however, hard for me to see how this can last. To begin with, there is the old point of mine, that propaganda is expensive. Setting up and promoting dishonest worldwide messaging campaigns costs a lot of money, energy and attention. These are resources that can’t be spent on other things. The more obvious the lies become, the more expensive it will get to maintain them. I am not sure how long our governments, our public health establishments, and our pharmaceuticals can remain committed to this project, or how long they’ll even stay interested in it. Corona is constantly threatening to become unimportant, and when that happens, who will even care about maintaining this entire rotten morass? If Pfizer’s profits are all that matter, the government can just give them money, or buy vaccine doses and fire them off into space, in case the aliens want them.

The vaccines have also benefited, over the past year, from enormous bureaucratic and public enthusiasm, not all of it seeded from on high. It feels bizarre to type this, but lockdowns enjoyed much the same dynamic at first. They very quickly burnt through most of their public support, as everyone but a few crazy people realised that house arrest wasn’t very much fun. In the northern hemisphere they are now consigned to the dustbin and studiously ignored almost everywhere. The vaccines must follow the same trajectory. For most people, who suffer only mild side effects, they cost far less than lockdowns, but there is the constant, exhausting rhetoric; the near-daily rule changes; the disquieting prospect of infinite boosters; and, in places like Germany, the constant postponement of a return to normal life, regardless of how many people are vaccinated, or boostered, or infected.

Every day that Corona does not go away in heavily vaccinated populations, is a day that the vaccines are further discredited. As the absurdities continue, the risk emerges that our mRNA vaccines will begin to pollute in the minds of many the broader notion of vaccination, and there are powerful people who don’t want that to happen – people with political power, who are not just internet crazies like me.

It is hard to predict the future, and what follows will probably turn out to be substantially wrong. Nevertheless, this is my best guess about what will come: Omicron is a bad cold, and it appears to infect the vaccinated preferentially. This will make it harder for the vaccinators to maintain their fear campaign, without which eternal boosting will prove impossible. With each further dose, enthusiasm for the entire project of mass vaccination will wane, as will tolerance for maintaining the rest of the pandemic circus. A lot of incentives will align for people in charge to wind down the containment regime over the course of the coming months. It won’t happen evenly everywhere, but by 2023, I think this will be over in most places. Some kind of green pass system will linger in the Eurozone, at least for travel; vestigial masking rules might continue in some countries for a very long time, but they will gradually be made less onerous and everyone will lose interest in enforcing them. The vaccinators will come out with updated vaccines, and these will be urged on the population, but no longer overtly mandated. Nobody will want to talk about this period of vaccination hysteria for years and years, perhaps not until I am an old man. Nobody will allow us to be right anytime soon, but everyone will know that we were.