> No, really, asking for a booster every six months that knocks a lot of people on their ass for a day or two? Yeah, that’s kind of a huge ask. The short term side effects are sufficiently costly that most people will correctly decide that it’s not worth it even if there’s lots of Covid out there.
I am not convinced that this assessment is necessarily correct. It seems to be ignoring the possibility of being ‘knocked on your ass’ for maybe several days with COVID.
If the issue is that immunity is waning, then you might effectively be left with a choice of a certain exposure to vaccine with a possible (or even probable, depending on prevalence) exposure to the virus. Hand-waving away the risks of any more serious outcomes from infection, a calculation of the trade-off would want to include the probability of side effects of each (vaccine vs. virus) and duration of each.
My prior is that if you let your immunity wane for, say, 12 months, and then catch COVID, but are otherwise relatively young and healthy, there’s a pretty high chance that you’d have symptoms in the region of ‘knocked on your ass for several days’.
It would also be good to think about what changes we expect to see over time. Immunity might fade more slowly (or fade to a higher remaining level) as your total number of doses (or virus exposures) increases, which might mean that boosters could be every 12 months rather than every 5-6 months. (The seasonality stuff that ACX has touched upon has left me feeling that annual seems more like a longer-run default than 6-monthly.) I guess there might also be a change in likelihood and duration of vaccine side effects with increasing numbers of boosters, though I don’t have much of an intuition of what that might look like.
The Covid you get will be a reinfection (or at least, every time after the first will be), plus you’ll have been vaccinated. So mostly it will be asymptomatic. And over the long run, how many infections would you be preventing per booster? I have a hard time thinking it’s more than one every three or four boosters.
Every 12 months, if you can update to ‘this year’s’ like the flu and get it in time, might plausibly prevent e.g. 0.5 Covid infections in expectation at equilibrium and be worth it, but every 5-6 months is NGMI.
I had to look up “NGMI”. Full disclosure, I snuck in a 4th Pfizer in mid-November in order not to punch a vaccine hesitant co-worker. My antibodies are still over 2500u/mL, and she’s since gotten infected and recovered (and she infected zero people). Now that I’m convinced that I have fairly durable antibodies, most of my future boosts will come from frequent exposure.
Probably will depend on how many tricks Covid has up its sleeve (it’s far from infinite—convergent evolution is real) and how much affinity maturation we get from the first few boosts. My guess is we’re all going to require a fair number of immunizing events at first, but it will settle down.
> No, really, asking for a booster every six months that knocks a lot of people on their ass for a day or two? Yeah, that’s kind of a huge ask. The short term side effects are sufficiently costly that most people will correctly decide that it’s not worth it even if there’s lots of Covid out there.
I am not convinced that this assessment is necessarily correct. It seems to be ignoring the possibility of being ‘knocked on your ass’ for maybe several days with COVID.
If the issue is that immunity is waning, then you might effectively be left with a choice of a certain exposure to vaccine with a possible (or even probable, depending on prevalence) exposure to the virus. Hand-waving away the risks of any more serious outcomes from infection, a calculation of the trade-off would want to include the probability of side effects of each (vaccine vs. virus) and duration of each.
My prior is that if you let your immunity wane for, say, 12 months, and then catch COVID, but are otherwise relatively young and healthy, there’s a pretty high chance that you’d have symptoms in the region of ‘knocked on your ass for several days’.
It would also be good to think about what changes we expect to see over time. Immunity might fade more slowly (or fade to a higher remaining level) as your total number of doses (or virus exposures) increases, which might mean that boosters could be every 12 months rather than every 5-6 months. (The seasonality stuff that ACX has touched upon has left me feeling that annual seems more like a longer-run default than 6-monthly.) I guess there might also be a change in likelihood and duration of vaccine side effects with increasing numbers of boosters, though I don’t have much of an intuition of what that might look like.
The Covid you get will be a reinfection (or at least, every time after the first will be), plus you’ll have been vaccinated. So mostly it will be asymptomatic. And over the long run, how many infections would you be preventing per booster? I have a hard time thinking it’s more than one every three or four boosters.
Every 12 months, if you can update to ‘this year’s’ like the flu and get it in time, might plausibly prevent e.g. 0.5 Covid infections in expectation at equilibrium and be worth it, but every 5-6 months is NGMI.
I had to look up “NGMI”. Full disclosure, I snuck in a 4th Pfizer in mid-November in order not to punch a vaccine hesitant co-worker. My antibodies are still over 2500u/mL, and she’s since gotten infected and recovered (and she infected zero people). Now that I’m convinced that I have fairly durable antibodies, most of my future boosts will come from frequent exposure.
Probably will depend on how many tricks Covid has up its sleeve (it’s far from infinite—convergent evolution is real) and how much affinity maturation we get from the first few boosts. My guess is we’re all going to require a fair number of immunizing events at first, but it will settle down.