Vaccinated Socializing

A good starting point is the measured efficacy of the vaccine, which for the Pfizer and Moderna vaccines, the only ones I'll be talking about in this post, is ~95% (1/20th) two weeks after the second shot. This predicts that an interaction between two vaccinated people is ~0.25% (~1/400th) as likely to transmit covid as if they were both unvaccinated. 

Efficacy at presenting symptoms is not the same thing as efficacy at preventing infection.

The FDA decided to allow vaccines to get approved without measuring infectiousness. That was a good decision because it allowed approving them faster (and not taking up important PCR capacity) but it comes at the cost of not knowing how protective it is against spreading the virus.

Given that nonsymptomatic spread is a thing and the way the underlying biology works it makes sense to expect less then 95% protection but significantly more then 0% protection for spreading the virus.

In recent news, the Oxford vaccine seems to have a 67% effect on transmission. Even if you expect the Biontech/Moderna vaccines to be better, eye-balling them for 75-80% would make more sense then 95%.

| This does not make sense.

The advice makes sense from a medicalized "do no harm" perspective. Given the baseline behavior of extreme behavior modifications to prevent infection, relaxing those constraints poses a risk. Therefore the only acceptable advice to give is "continue behaving just as cautiously even after getting the vaccine."

This is clearly stupid, but medical institutions are not required to not be stupid; they are required to obey their hippocratic oath.

I think this might be missing a dimension of fairness considerations:

1. People who were least at risk (broadly: the young) from COVID-19 were asked to give up socializing & income during the lockdowns for the people who are most at risk.
2. People who are most at risk (broadly: the old) from COVID-19 get vaccinated first.
3. Giving people who get vaccinated early an advantage would signal people who were least at risk that they incurred two costs (lockdown & late vaccination) and received no tangible benefits, which might damage future willingness to cooperate.

I think ojno has a point. Furthermore, to the best of my knowledge the protection from the vaccines takes a bit of time (10 days? 14 days?) to kick in after the vaccination. Arguably "proceed with the same caution as before" is a better message than "go nuts, dance and hug and visit all your friends" in this period, and for simplicity's sake this has become the default message.

Who am I kidding, this is of course because we don't want vaccination to be unfair. If you get social benefits from being vaccinated (by not having to abide by some of the restrictions) then the prioritisation discussion would be even fiercer than it is now. Plus, the more Sacrifices to the Gods you publicly support (h/t Svi) the more of a Serious Person you are, which the CDC tries very hard to be.

I have yet to see anything convincing me that a vaccinated person is unlikely to give me COVID, even 2 weeks after dose 2. Especially because right now, the vaccinated people are the ones most likely to be exposed to COVID (e.g. nurses, grandparents living in group facilities). I would not be comfortable being unvaccinated and unmasked around a vaccinated unmasked person for this reason. I am eagerly awaiting information to change my mind on this, but I have not seen it yet.

If I were also vaccinated, I would feel reasonably good that even if I got COVID, I would make it through OK. There's still some uncertainty about long term effects from mild cases that worry me, but I haven't seen anything on long term effects from asymptomatic cases. So, at that point I would probably be OK being unmasked around other vaccinated people who were unmasked, and possibly around unvaccinated lower-risk people who were unmasked. 

I find it to make sense, at least for public places like, say, shops, for a very simple reason: how do you tell if a random person has been vaccinated and is not merely lying to you that they have been vaccinated, as they have an incentive to do if they don't like wearing masks or whatever?