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Is having to prove your vaccine status ok? Ethically, not epidemiologically (Read 44725 times)

AMorris

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Most reasons given relate to it only being approved for emergency use and that their chance of survival from covid is ~ 99.9% so there's no point having a vaccine at all or certainly a new one.

This opinion riles me more than anything else, I think. I accept that epidemiology is not something most people have had to put much thought into before now, but there is no way everyone who uses the "survival rate is 99.9% so there is no point" argument don't see the flaw in this. This whole year feels like one big exercise in patience.

slab_happy

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Is the uptake very poor in younger people? ...
 (not found time to get the 2nd one yet but the new rules will give me a kick up the arse).

There is your answer,  I suspect.  The main reason many people will have not been vaccinated is that they haven't overcome the tiny amount of inertia and just done it.
Apologies if you genuinely have a very time consuming job etc but it really doesn't take very long to get vaccination.  I think my second appointment took a whole 5 minutes,  check details,  shown to a table and chairs, repeat check, jab, advised to remain nearby for 15 minutes afterwards,  leave.

I have a relatively busy job, 2 kids and lots of hobbies/interests. I don't watch TV or read the news and rarely log in to social media so I generally have no idea about what's going on with covid (frankly i'm fed up with hearing about it so tend to actively avoid). I just haven't made it a priority, but I will sort it out at some point.

In case it helps, loads of places are now taking walk-ins. If you don't mind posting where you are, people could probably point you at some nearby ones, so you can drop in during a lunchbreak or whenever, knock it off.

jwi

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it would be good if the whip (that I fully support) was accompanied by a carrot.
You get a sticker.

That's more than we get in France. The whip is real though. I'm in the bouldering gym now and they are obliged to check the covid pass for everyone except the kids from today.

AMorris

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My strong suspicion is that a lot of "anti-vaxxers" would loudly protest about getting a jab and quietly get it when they realise their life will be harder and certain things impossible without it.
Doesn't that misunderstand what a lot of them believe? A lot/most/all (I don't know) are not anti-vaxx because it's not organic, they're opposed to it because they think it will kill anybody who has it within two years.

The problem is, basically anything you say will misrepresent what a lot of them believe, because there is no consistency with what they believe, because there is no solid evidence for any claim I have seen so far. I would say that even "they're opposed to it because they think it will kill anybody who has it within two years" is a misrepresentation of the majority, because there is no majority, because there is no consensus in this community. The breeding ground for these ideas are in social media comments sections, not labs.

To really think about what might be the most reasonable way forward you need to first understand what the reasons are for people not getting the vaccine, how many of them there are, and how they're distributed. We currently tolerate all sorts of objections to medical treatment because the harm to society is fairly low and dispersed, and the reasoning might be on religious grounds which we tend not to argue with. Maybe the numbers of people in the UK who are vaccine hesitant/anti-vaxx crazy are actually low enough as to not threaten society?

This is kind of what I thought the answer would be. The problem is, for the time being this necessitates most people ignoring them anyway. This is a long term data collection strategy (and a valid one), but it remains to be seen whether a long term solution will spring from this. Personally I think the current COVID anti-vax movement has little to do with what the movement was prior to the pandemic. The prior movement seemed to be very much dominated by a scepticism of western science and conventional medicine, which could be seen in their rhetoric. The current movement takes a much more anti-government stance, where a gov conspiracy tends to take centre stage and most of the focus of their rhetoric. I don't think their philosophies are, for the large part, the same. Though it stands to reason that there will be a large amount of overlap for obvious reasons that if you were anti-vax prior to the pandemic, you aren't suddenly going to accept the COVID vaccination. If the movement is retheorised like this, I don't believe it will ever actually disappear, because it is just the newest manifestation of an anti-gov philosophy.

I am pessimistic, if you can't already tell!

andy popp

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The current movement takes a much more anti-government stance, where a gov conspiracy tends to take centre stage and most of the focus of their rhetoric.

I know an anti-vaxxer who is very, very, very far right (I'm being very polite is describing them this way) and their "thinking" is pandemic = plandemic = great replacement/NWO/Jewish cabals etc. But this is obviously an extreme position, even if a wider pool of people share aspects of this essentially paranoid perspective, sometimes unknowingly - I've definitely seen people who don't realise they are sharing anti-semitic tropes. Plenty of this stuff on display at anti-lockdown events. Then there are the "Big Pharma" tribe.

But I suspect that the majority who have so far declined vaccination are simply unsure and perhaps afraid. They don't feel well-informed, poor at evaluating scientific information and weighing differing risks, and easily swayed by immediate peer groups. They are genuinely unsure getting vaccinated is the right or necessary choice for them ... and hesitate.

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AMorris

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The current movement takes a much more anti-government stance, where a gov conspiracy tends to take centre stage and most of the focus of their rhetoric.
I know an anti-vaxxer who is very, very, very far right (I'm being very polite is describing them this way) and their "thinking" is pandemic = plandemic = great replacement/NWO/Jewish cabals etc.

Well of course we can all think of exceptions, which is why I began my post with a throat clearing, saying "basically anything you say will misrepresent what a lot of them believe". My claim here is not that this is the philosophy which drives all anti-vaxxers. It was more that this seems to be the general trend of thought in the new movement. But by any rate, using your friend (might be the wrong word, thinking about it!) as an example kind of demonstrates my point. From what you have said, their opposition is not born from the same place as much of the opposition to vaccination prior to the pandemic. It appears that your friend has used their anti-zionist conspiracy theorism to determine their position on the COVID vaccine, rather than an opposition to the science. If they believe in NWO/Jewish cabals, then they are driven by the same anti-authoritarian philosophy that I was describing, just on a global rather than national scale.

But I suspect that the majority who have so far declined vaccination are simply unsure and perhaps afraid. They don't feel well-informed, poor at evaluating scientific information and weighing differing risks, and easily swayed by immediate peer groups. They are genuinely unsure getting vaccinated is the right or necessary choice for them ... and hesitate.

These are the kinds of people I would absolutely love to reach out to, but have never found or heard anything from. If they are the majority, then they are the silent majority. The unvaccinated-by-choice who I have seen have not hesitated to spray their opinions everywhere they go. This pandemic and the vaccine has been accompanied by just about the largest amount of "layman digestible" information I have ever seen of anything remotely sciency. There has been enormous effort made by a huge number of people to relay all this technical information in an understandable way, so that people can make something closer to an informed decision. If the "silent-uncertain" make up the majority of people who have chosen not to become vaccinated, then all this information must have absolutely failed to either reach them, or persuade them. This is a massive problem.

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The current movement takes a much more anti-government stance, where a gov conspiracy tends to take centre stage and most of the focus of their rhetoric.

I know an anti-vaxxer who is very, very, very far right (I'm being very polite is describing them this way) and their "thinking" is pandemic = plandemic = great replacement/NWO/Jewish cabals etc. But this is obviously an extreme position, even if a wider pool of people share aspects of this essentially paranoid perspective, sometimes unknowingly - I've definitely seen people who don't realise they are sharing anti-semitic tropes. Plenty of this stuff on display at anti-lockdown events. Then there are the "Big Pharma" tribe.

But I suspect that the majority who have so far declined vaccination are simply unsure and perhaps afraid. They don't feel well-informed, poor at evaluating scientific information and weighing differing risks, and easily swayed by immediate peer groups. They are genuinely unsure getting vaccinated is the right or necessary choice for them ... and hesitate.

As an aside…

This Jewish cabal/NWO/Great replacement organisation, must be the most ineffective, inefficient, lazy, incompetent conspiracy in human history. They’ve been on the cusp of taking over since, what, the 13th century?
These guys are even less effective than UKIP.

Will Hunt

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One friend had the 1st dose and had such a ghastly reaction that they won't be going for the 2nd. I believe they have a family history of this sort of reaction to vaccinations. If I remember correctly there are multiple medics in the family (late father was a consultant) who they have discussed this with, so hardly ignorant.

Another friend had the first dose and a day or two later her jab-arm went completely dead (and remained so for a while). Reported to the hospital where the doctors did plenty of tests but found no explanation.

These are the two that I know about. Both seem reasonable to me, though their GP (who would presumably provide the hypothetical exemption letter) might not agree.

petejh

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slab_happy

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As an aside…

This Jewish cabal/NWO/Great replacement organisation, must be the most ineffective, inefficient, lazy, incompetent conspiracy in human history. They’ve been on the cusp of taking over since, what, the 13th century?
These guys are even less effective than UKIP.

My dad occasionally complains that the International Jewish Conspiracy still hasn't sent him his membership card, so, you know, they've not even got the mailing list sorted.


slab_happy

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Also the data around vaccination preventing spread (rather than the data for prevention of serious illness) isn’t as good, afaik?

Well, we have pretty solid evidence that the vaccines substantially cut the chances of infection, with some data indicating that if you get a breakthrough infection they still reduce the chances you'll transmit.

I think the worst performer among the vaccines currently licensed here is AZ, "only" preventing infection with circa 60% efficacy (Pfizer's at around 88% with Delta, I believe, and Moderna should be the same). Which isn't spectacular, but people forget that at the start of this, the brief was that the FDA would consider approving anything that got over 50%; we've been spoiled by the crazy crazy efficacy numbers the mRNA vaccines got with original flavour Covid.

The vaccines are much better at preventing severe illness and hospitalization (up in the 90s with both AZ and mRNA) than they are at just blocking infection, but I feel people shouldn't underestimate the fact that they're still fairly decent at the latter.

Apologies if this is stuff you already know backwards, but I think it's worth emphasizing because I've seen people out there saying that the vaccines don't do anything to prevent you from getting Covid, they only stop you from getting severely ill. Which is incorrect.

slab_happy

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This pandemic and the vaccine has been accompanied by just about the largest amount of "layman digestible" information I have ever seen of anything remotely sciency. There has been enormous effort made by a huge number of people to relay all this technical information in an understandable way, so that people can make something closer to an informed decision. If the "silent-uncertain" make up the majority of people who have chosen not to become vaccinated, then all this information must have absolutely failed to either reach them, or persuade them. This is a massive problem.

Agreed, but the problem is that the accurate "layman digestible" information is being drowned in the flood of anti-vaxx garbage, a lot of which comes with all the trappings of respectability: you've got someone with "Dr" before their name (maybe it's a literature PhD but never mind) explaining confidently that the spike protein in the vaccine will cause the body to develop antibodies to a protein in the placenta and cause infertility.

For a lot of people that'll make them go -- wow, maybe they're on to something, maybe I shouldn't get the vaccine yet, here's this other thing saying Covid's no worse than flu and "only" elderly and disabled people die from it, and the vaccines can cause very severe and dangerous side-effects (like the blood-clotting thing with AstraZeneca) which the doctors and researchers didn't know about initially, so maybe it's more cautious and sensible to not get the vaccine.

All seems very reasonable! Unfortunately, also based on flat-out false information and lies.

But then someone who wants to explain why that's not actually reasonable (and present all the evidence why the spike-protein-infertility thing is utter bullshit and we can prove it) has got to fight uphill against that uncertainty and suspicion.

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Ethically, I think it's wrong to only letting people participate who are double vaccinated when spot tests are available which enable people to prove (more or less) that they are not infectious immediately prior to participating.

With people being incentivised to return a negative result, a self-administered negative test result does little to prove that someone is not infectious.

A small number of people will both perform the test correctly and report a positive test result honestly, but most won't when a negative result is a requirement for entry to something that they value.

What SDM said, plus as per the “more or less” in Colin8ll’s post, LFTs are not sufficiently sensitive to tell you you haven’t got it. I got COVID a few weeks ago and had negative LFTs 3 days in a row while waiting for my PCR test result, which came back positive. I subsequently tested positive on an LFT.

The real utility of LFTs is to tell you if you have got it so you and any close contacts can isolate. If the contact I caught it from hadn’t been testing, we wouldn’t have known. They were testing daily and I was in contact with them the day before they got a positive LFT, so they were clearly infectious while still LFT negative. All of their known contacts subsequently got it, even though he isolated as soon as he got a positive LFT. Because he was testing, we were isolating before we came into contact with anyone, otherwise we’d have probably been spreading it while asymptomatic.






petejh

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Also the data around vaccination preventing spread (rather than the data for prevention of serious illness) isn’t as good, afaik?

Well, we have pretty solid evidence that the vaccines substantially cut the chances of infection, with some data indicating that if you get a breakthrough infection they still reduce the chances you'll transmit.

I think the worst performer among the vaccines currently licensed here is AZ, "only" preventing infection with circa 60% efficacy (Pfizer's at around 88% with Delta, I believe, and Moderna should be the same). Which isn't spectacular, but people forget that at the start of this, the brief was that the FDA would consider approving anything that got over 50%; we've been spoiled by the crazy crazy efficacy numbers the mRNA vaccines got with original flavour Covid.

The vaccines are much better at preventing severe illness and hospitalization (up in the 90s with both AZ and mRNA) than they are at just blocking infection, but I feel people shouldn't underestimate the fact that they're still fairly decent at the latter.

Apologies if this is stuff you already know backwards, but I think it's worth emphasizing because I've seen people out there saying that the vaccines don't do anything to prevent you from getting Covid, they only stop you from getting severely ill. Which is incorrect.

Yep, aware of the figures showing reduced risk of infection and reduced risk of serious illness upon infection. That wasn't what I was getting at.

My point was more to do with a lack of data to show whether or not being jabbed reduces transmission onwards, if you do manage to get infected. A comparison showing a single jab, double jab, or no jab. This data is still unclear afaik?
Of course, reduced overall # of infections as a result of a population being vaccinated = less overall transmission than in a population unvaccinated!

I raised it because I considered that someone objecting to getting jabbed may think that there's a lack of evidence to show the jab reduces their risk of passing on covid, *if* they get infected. They could say it *only* reduces (significantly) the risk of them getting infected and of getting seriously ill. And their logic, if they're young and healthy, might be why should they care if they get infected if they'll probably be fine, and it hasn't been proven that being jabbed reduces their risk of passing it on? (yes I know this is selfish.. but many people are).
« Last Edit: July 22, 2021, 11:16:09 am by petejh »

slab_happy

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My point was more to do with a lack of data to show whether or not being jabbed reduces transmission onwards, if you do manage to get infected. A comparison showing a single jab, double jab, or no jab. This data is still unclear afaik?

Right, got it. Yeah, there's some data on that, showing some pretty substantial reduction even from a single dose, but that's from when Alpha was still dominant, so I don't know how the numbers have changed given Delta's generally increased transmissibility -- dunno if we've got studies on that yet.

They could say it *only* reduces (significantly) the risk of them getting infected and of getting seriously ill. And their logic, if they're young and healthy, might be why should they care if they get infected if they'll probably be fine, and it hasn't been proven that being jabbed reduces their risk of passing it on? (yes I know this is selfish.. but many people are).

Well, even if the vaccines had zero effect on transmissibility once a breakthrough infection's occurred, they'd still reduce the risk that you pass it on by slashing the risk that you get infected in the first place. Can't pass it on if you don't get it!
« Last Edit: July 22, 2021, 11:38:20 am by slab_happy »

petejh

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Well, even if the vaccines had zero effect on transmissibility once a breakthrough infection's occurred, they'd still reduce the risk that you pass it on by slashing the risk that you get infected in the first place. Can't pass it on if you don't get it!

Yep, I agree. That line of reasoning however relies on a mindset of getting yourself vaccinated for someone else's benefit - that is, the stranger (or relative) who doesn't get infected and doesn't suffer because of it. For young healthy people that's a very different type of mindset required towards covid vaccination compared to any other vaccination we have, where the vaccine is clearly for our own benefit as well as the general population. For young healthy people I can see a sort of selfish logic for being hesitant about getting a jab, not that I agree with it.

AMorris

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Agreed, but the problem is that the accurate "layman digestible" information is being drowned in the flood of anti-vaxx garbage ...

But then someone who wants to explain why that's not actually reasonable (and present all the evidence why the spike-protein-infertility thing is utter bullshit and we can prove it) has got to fight uphill against that uncertainty and suspicion.

That's the crux of the issue really. What you just described is referred to as Brandolini's law, aka the bullshit asymmetry principle, which states that the amount of energy required to refute an argument is an order of magnitude larger than that required to produce it. This leads to a massive overrepresentation of bullshit on any given topic existing in public consciousness. In a discussion with a self titled "PCR-sceptic" (which is a surreal title to me similar to how the term "electricity sceptic" would sound to an electrical engineer) who spouted all the compelling sounding but cynically misleading Mike Yeadon statistical slight of hand bollox, I pointed out that it took Yeadon 20 seconds to convince him, and it will take me a good 15 minutes of giving him a crash course in the statistics of binary classifiers and assorted terminology to refute what he read, assuming he get and accepts it the first time round. He listened, we discussed, he thanked me, and then he said the same shit the next time we talked :wall:

However, I would assert that although there are many more claims being made (which should indicate something in itself), there are not more people actually making those claims. There are more people who do not believe in this nonsense than do, the problem lies in social media and the echo chambers they produce, making it very hard for someone giving reliable information to reach the news feed of someone who has established themselves in the anti-vax corner.

I feel like the problem boils down to fundamentally what these claims imbue the wielder with, which is confidence. A little knowledge is a dangerous thing, as they say. Someone who has gone from never having given virology or genetics a thought to learning their first few terms and then diving into the world of conspiracy theorism, where everything is pre-packaged and easy to understand, is often going to feel confident enough to start evangelising about it on social media (see the Dunning–Kruger effect). They then get a lot of support and validation since, as previously stated, SM is an echo chamber, which galvanises them. It is far easier to believe what a load of quacks have written about, for example, PCR, than to actually go and learn what it is, what it stands for, how it works, and how we use it. It's this volume which often stands out to people, there may not be as many people making these bunk claims, but one person shouting in a café will disrupt everyone's conversation.

The problem is, people tend to be absolutely woefully bad at distinguishing reliable from unreliable information, and equally as poor at distinguishing a good scientist from a bad one.

Oldmanmatt

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Agreed, but the problem is that the accurate "layman digestible" information is being drowned in the flood of anti-vaxx garbage ...

But then someone who wants to explain why that's not actually reasonable (and present all the evidence why the spike-protein-infertility thing is utter bullshit and we can prove it) has got to fight uphill against that uncertainty and suspicion.

That's the crux of the issue really. What you just described is referred to as Brandolini's law, aka the bullshit asymmetry principle, which states that the amount of energy required to refute an argument is an order of magnitude larger than that required to produce it. This leads to a massive overrepresentation of bullshit on any given topic existing in public consciousness. In a discussion with a self titled "PCR-sceptic" (which is a surreal title to me similar to how the term "electricity sceptic" would sound to an electrical engineer) who spouted all the compelling sounding but cynically misleading Mike Yeadon statistical slight of hand bollox, I pointed out that it took Yeadon 20 seconds to convince him, and it will take me a good 15 minutes of giving him a crash course in the statistics of binary classifiers and assorted terminology to refute what he read, assuming he get and accepts it the first time round. He listened, we discussed, he thanked me, and then he said the same shit the next time we talked :wall:

However, I would assert that although there are many more claims being made (which should indicate something in itself), there are not more people actually making those claims. There are more people who do not believe in this nonsense than do, the problem lies in social media and the echo chambers they produce, making it very hard for someone giving reliable information to reach the news feed of someone who has established themselves in the anti-vax corner.

I feel like the problem boils down to fundamentally what these claims imbue the wielder with, which is confidence. A little knowledge is a dangerous thing, as they say. Someone who has gone from never having given virology or genetics a thought to learning their first few terms and then diving into the world of conspiracy theorism, where everything is pre-packaged and easy to understand, is often going to feel confident enough to start evangelising about it on social media (see the Dunning–Kruger effect). They then get a lot of support and validation since, as previously stated, SM is an echo chamber, which galvanises them. It is far easier to believe what a load of quacks have written about, for example, PCR, than to actually go and learn what it is, what it stands for, how it works, and how we use it. It's this volume which often stands out to people, there may not be as many people making these bunk claims, but one person shouting in a café will disrupt everyone's conversation.

The problem is, people tend to be absolutely woefully bad at distinguishing reliable from unreliable information, and equally as poor at distinguishing a good scientist from a bad one.
If I anonymised this statement , would you object to it being posted on wider social media?

AMorris

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If I anonymised this statement , would you object to it being posted on wider social media?

Feel free to do with it as you wish!

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Right, got it. Yeah, there's some data on that, showing some pretty substantial reduction even from a single dose, but that's from when Alpha was still dominant, so I don't know how the numbers have changed given Delta's generally increased transmissibility -- dunno if we've got studies on that yet.

.... even if the vaccines had zero effect on transmissibility once a breakthrough infection's occurred, they'd still reduce the risk that you pass it on by slashing the risk that you get infected in the first place. Can't pass it on if you don't get it!

 I think it highly unlikely the vaccine will have a noticably smaller effect in preventing transmission with delta  than the evidence we have seen on hospitalisation etc. I'm more worried about people thinking they are immune if double jabbed, or if they had covid (Manaus had overwhelming levels of deaths from those who survived being infected the first time).  A lot of the current spread must be from people with antibodies from vaccine or infection (at the current very high level the ONS quote) or we would have already passed the peak.

On the subject of the peak the nightclub move seems blatant to me as a political jabbing incentive as we will almost certainly be on the post peak down-curve by then. People who really want to party will have just been doing so in their homes etc, and will continue. My preference would have been not to open clubs and apologise and provide some extension to financial assistance.

Also on the subject of peaks my pals who have a serious bout of long covid would just love to be able to move about for more than 5 minutes without beng completely exhausted....the idea of sex must be very much light at the end of the tunnel category at present. Given the weird range of organ damage associated with covid, fertility is very likely way more affected by catching it than from any vaccine risk.

Finally although I recognise we need to look carefully at ethics, it seems to me most people blathering on about covid restrictions affecting their human rights should not be pandered to. It would be nice if everyone paid a little more attention to very real freedoms lost or at risk under this government in wider democratic terms. Plus the checks and balances in our democracy failed to prevent our PM making decisions that led to tens of thousands of uneccesary deaths in September and December 2019 ...and way more economic damage than was neccesary if he had acted faster and had shorter lockdowns. Plus the level of illegal behaviour and blatant lies to Parliament with no obvious consequences. Our democracy is wobbling a bit (and ethics become meaningless without democracy)

I'm on the stricter side of the middle ground  on restrictions.....lockdowns were vital to prevent hospital overload but not everything was as clear. As an example very relevant to climbers, all the outdoor restrictions were scientific factors relating to behaviour. There was never any significant risk outdoors when social distancing. Outdoor surface risks were much lower than suspected intially, and we knew that from summer 2019. I think being too strict on outdoor rules from that time was a real problem and led to unnecessary mental health damage. I look forward to seeing the ethics explained behind outdoor restrictions.
« Last Edit: July 22, 2021, 02:33:18 pm by Offwidth »

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The remaining vaccine hesitant people should probably read this sort of thing https://www.theguardian.com/us-news/2021/jul/22/us-coronavirus-covid-unvaccinated-hospital-rates-vaccines?CMP=Share_AndroidApp_Other

Sounds pretty grim.

I read her FB post, after a US friend shared it, but I wasn’t sure if the implication that lots of “young” people are dying, was accurate. Anybody seen an age break down of recent deaths? I would have thought a surge in young deaths would have been headline news.

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It isn't really, is why. Not statistically. Realistically in this country we are going to get over 90% of adults vaccinated and then probably work on the last ten percent by relentlessly bollocking them about it, but deaths are almost all older people still (and they're still really low compared to cases).

 

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