Here in the Netherlands, as elsewhere, hospitals are again seeing a huge surge in admissions of COVID-19 patients. But this time, as in many other countries, the overwhelming majority of these patients are unvaccinated. The disproportional burden on ICU capacity caused by these unvaccinated COVID-19 patients means that non-urgent care is now postponed in most hospitals.
Those opposing the COVID-19 vaccines (also known as ‘anti-vaxxers’) are rightly blamed for this situation. But the anti-vaxxers themselves disagree with that point of view. One of the more popular responses from anti-vaxxers is the argument that the choice not to get vaccinated is no different than any other life-style choice, like smoking, not exercising enough, eating too much, engaging in sports with high risk of injury, or drinking alcohol. The ardent anti-vaxxer will often claim that these risky behaviours are on equal foot with refusing the vaccine, and go on to remind us that smokers also take up ICU beds. Here I will illustrate why that argument is completely fallacious.
Let’s start with smoking. Smoking tobacco is an immensely complex addiction problem, involving strong physical and psychological dependence. And smoking related illnesses do not manifest immediately. It typically takes many decades before smoking cigarettes leads to disease. We should therefore remember that people who may occupy an ICU bed today because of smoking tobacco, often started this extremely addictive habit at a time when smoking was still allowed in public places and was widely considered socially acceptable behaviour. Furthermore, while a long-term smoker who quits today will certainly experience an enormous health-benefit by doing so, there will nonetheless always remain some permanent damage from the many years of smoking. Medical conditions from past smoking may thus still arise years later, requiring some degree of ICU level care. But this is in no way comparable to ending up in the ICU during a pandemic, when everyone floods the ICUs at more or less the same time by refusing a proven safe and highly effective vaccine. This just doesn’t happen with smoking: they don’t all just get lung cancer in the same year. And when (ex-)smokers do end up in an ICU, they don’t stay there for two to three weeks or longer. Refusing a safe medicine is not the same—at all— as a huge societal problem as tobacco abuse, or any other drug problem for that matter. In many cases, substance abuse is related to genetic factors, socioeconomic factors, and in some cases is considered by specialists to be a form of self-medication for certain mental illnesses. Oftentimes there is not so much ‘choice’ at all regarding this lifestyle. And refusing a vaccine, usually based on misinformation and by simply ignoring common sense, is nothing like that.
Other comparisons anti-vaxxers frequently make involves obesity and alcohol abuse. But just like smoking, these are intractably complex issues that cannot be readily solved in the short term. Extreme cases of morbid obesity are even treated with surgery, for Christ’s sake! How is that in any way comparable to refusing a vaccine? It’s insane! There are nations who have declared obesity a pandemic, and have literally imposed special taxes on certain foods (e.g. sugar-tax in the UK) in an attempt to stem the tide. Again, this has nothing to do with refusing a safe vaccine; an addiction or genetic predisposition to not getting vaccinated is unknown to science. A genetic component to the pigheaded stupidity of the anti-vaxxer also remains to be elucidated.
The final comparison I have seen is that in which the choice not to get vaccinated is likened to the choice to engage in high-risk sports. And for some reason I often hear skiing used as an example. Well, alright, let’s do the math. First we’ll look at COVID-19. In the case of unvaccinated people, let’s say the average risk of ending up in the ICU because of COVID-19 is about 5% and the chance of dying is about 1•6%. Could be more and could be less, depending on the country you look at. That’s 50,000 ICU patients and 16,000 deaths for every one million people. So how does skiing compare? Well, in the US the chance of dying from a skiing accident is just shy of one-in-a-million; for every million people visiting a ski-resort, statistically speaking one of them will die during their visit. ONE IN A MILLION! Skiing is over three orders of magnitude safer than getting COVID-19! An NSAA report from 2011 tells me less than 50 skiing related deaths were reported over a period of ten years in the US (at least from in the >90% of US ski-resorts represented by the NSAA). While every death is one too many, 50 deaths in 10 years is about 0.007% of the US COCID-19 deaths in a little over a year. Thus, comparing skiing to COVID-19 is statistically—in terms of fatality risk— just about the same as comparing a trip to the beach in a Volvo to a goddamn NASA rocket mission to outer space! That is literally how ridiculous the comparison is. So let me learn you something that is generally true: ANY sport or activity that is as dangerous as getting COVID-19 would be declared ILLEGAL immediately, without question. Normal people wouldn’t even be able to get insured for such an incredibly dangerous activity, unless you paid an ASTRONOMICALLY high insurance fee.
So to summarise: COVID-19 is not to be compared to health risks associated with ANY life-style. That has to stop right now. Not getting vaccinated is quite simply both insensible and irresponsible, and unnecessarily burdens public healthcare. Yes, in Western countries we have a lot of freedom. However, while you may very well exercise your freedom to refuse the vaccine, that choice does not liberate you from responsibility and consequence. And believe you me that choices always have consequences. In the absolute worst case scenario, if ICUs get completely overrun, you could very well find yourself being triaged right out of the ICU to receive just standard hospital care, with perhaps in the end some palliative sedation to ease your passing while your wailing loved ones can’t even give you a last kiss. This is a nightmare scenario no doctor ever wants to see, but the unvaccinated seem to be doing everything in their power to make it happen. If you are one of them, then please reconsider. Get the vaccine. It’s safe, it’s extremely well tested, and it really works. It’s never too late to change your mind.
I know this post will not convince all sceptics. That is because in order to convince someone with scientific evidence and logic, that someone must first of all appreciate the value of scientific research and have a basic capacity for logical reasoning. Some people fail to meet one or both of these conditions, and consequently prove impervious to any attempt to change their minds. Tragically, unvaccinated sceptics have already ended up in hospital with COVID-19. Even as they are put on a mechanical ventilator, some literally continue to deny the pandemic or defend their decision not to get vaccinated. So this writing is not for them, for they are already lost. Instead, I write this for the otherwise reasonable people who have simply been misinformed by friends, relatives, conspiracy theorists, and quacks. This blogpost isn’t final, it will be updated if needed when I encounter more silliness on social media.
No, that is incorrect. COVID-19 is caused by (variants) of SARS-CoV-2, which is a new pathogen. The flu is caused by different viruses. While some symptoms are similar, some of the symptoms of COVID-19 are really quite different from the seasonal flu (see this page on the CDC website). And COVID-19 has greater mortality rate (see for example this French study recently published in The Lancet). There’s a good reason that “SARS” in SARS-CoV-2 stands for “Severe Acute Respiratory Syndrome”, and that reason is that it ain’t the flu.
That is an over-simplication, and therefore incorrect. Epidemiologists don’t look at one number. There are several factors that inform healthcare professionals about how the pandemic is developing. They look at absolute number of positive tests, the relative percentage of positive tests out of all tests, the change in number of hospitalized COVID-19 patients, the number of deaths, and they use contact-tracing. All that kind of information combined, gives a reasonable indication of how the pandemic is developing. See also this page on the CDC website.
First of all, it’s true that vaccinated people can still get COVID-19. None of the COVID-19 vaccines were ever claimed to be 100% effective at preventing infections. A relatively small number of vaccinated people may still get sick, and this is called a ‘break-through’ infection. But that doesn’t mean the vaccines don’t work. The risk of a COVID-19 infection is a lot lower when you’re vaccinated, and even if you do get infected the symptoms are less severe. That’s allready a huge benefit. Seatbelts aren’t 100% effective either, and people can also die from wearing a seatbelt, for example when a car becomes submersed in water. But that is an exceedingly rare event and seatbelts are statistically speaking far more likely to prevent death or serious injury than cause it. A similar kind of trade-off is made when judging the benefits of vaccination. An averse reaction from a vaccine that results in death is an exceedingly rare occurrence. Since vaccines are incredibly safe and are highly effective at preventing severe COVID-19, getting vaccinated is simply the smart thing to do.
This claim contains an obvious contradiction. Either deaths are underreported in both cases, or both are exagerated. Pick a lane. But what do the actual facts tell us? They tell us that the number of COVID-19 deaths are very likely underreported. In India alone, there are probably at least 3 million more COVID-19 deaths than reported. And all vaccine related deaths that have been investigated so far, show that it is exceedingly rare to die from a vaccination. Thus, the benefits of vaccination vastly outweigh the risks. Further reading HERE, HERE, and HERE. Vaccines are safe and effective. Get the jab.
That statement is incorrect, for a number of reasons. First, you can look up what the WHO has determined about the IFR value. A recent paper suggests that depending on the region you look at, the IFR can range from 0·00% to 1·62%, with an average of about 0·23% (though it can be less than 0·20% when the best medical treatment is available). So you can’t simply pull an IFR out of your hat and apply that to every region on earth. Secondly, the IFR is calculated as the ratio between the number of deaths and the number of infections. However, the real number of deaths is unknown, and the official figures are likely to be an underestimation. Likewise, the real number of infections are also unknown, as not everyone is tested. Therefore both the numerator and enumerator are based on uncertain values. Thus, the most accurate COVID-19 IFR value is still a matter of debate among researchers, and the article that claimed the 0·15% IFR value is attracting a fair bit of criticism from other scientists. Thirdly, even if you accept the IFR of 0·15% as correct, then that means COVID-19 is still 1·5 times more deadly than the flu (IFR = 0·10%). For these reasons only an idiot would base policy regarding corona-measures on just an IFR estimate.
And now a brief word on the meaning of any value of IFR. As the name Infection Fatality Rate implies, the number of fatalities will depend on the number of infected people. Because the delta variant of SARS-CoV-2 is far more infectious than the flu, the total number of fatalities will be a lot higher even if both IFR values were the same. In other words, the basic reproduction number R0 is far greater. The net-result is a much greater death-toll, unless measures are taken to either lower the R0 (by social distancing, wearing face masks, etc), or by lowering the case fatality rate (CFR) through improved treatment options.
Here’s another example to illustrate the point. The deadly hemorrhahic fever disease Ebola has a case fatality rate (CFR) of at least 50% (which in the case of Ebola will be pretty close to IFR)—but could be about 70% or even higher according to some estimates. Nonetheless, all Ebola outbreaks combined since 1976 have claimed no more than in the order of 11,000+ lives. That is because Ebola has an exceptionally low R0: you only get infected by direct physical contact with an Ebola patient. In other words, an incredibly deadly disease like Ebola is nothing to worry about. The IFR and CFR values clearly do not tell the whole story.
However, what does tell a story is the staggering number of COVID-19 deaths. Yes, the number of Ebola deaths is great, but it’s dwarfed by the millions of worldwide COVID-19 deaths. Minimize your chances of getting infected, get vaccinated.
Recent research says otherwise. Face masks do in fact help in limiting the spread of COVID-19. There is clearly more than enough evidence now. See also the information on this page of the WHO’s website. Furthermore, a recent study shows that aerosols play a more important role in transmission than previously thought. So don’t just wear a face mask, but also practice social distancing, avoid gatherings in poorly ventilated spaces, and (most importantly) get vaccinated. But what—to me at least—stands out more in the false claim by the anti-maskers, is the word ‘sheep’. That word is used often by COVID-19 sceptics in a derogatory way, to communicate that face mask wearing people are stupid people who just blindly follow the rules without thinking. But since studies have now shown that wearing a face mask helps prevent infection, wearing a face mask clearly isn’t stupid. Additionally, some people (such as myself) began wearing face masks even before they became mandatory, and continue to wear them even though they are no longer required in many public areas. Consequently, calling people who wear face masks ‘sheep’ is now just as idiotic as calling skydivers ‘sheep’ for using parachutes. So be reasonable, wear a face mask whenever appropriate. And, again, get vaccinated.
First of all, SARS-CoV-2 is a new and rapidly mutating viral pathogen, so no one is safe. Second, COVID-19 has claimed over 600,000 deaths in the USA alone. The number of vulnerable people is clearly enormous. Obesity, one of the known risk factors for severe COVID-19, can almost be called a pandemic by itself. And diabetes, another common risk-factor, is well and truly a global pandemic. The numbers of people affected by one or more risk-factors is simply staggering. You can’t expect such a large part of the population to withdraw from public life. Third, face masks mainly work by protecting others from getting COVID-19 from you, not the other way around. Thus, the greatest effect of face mask wearing is only achieved when everyone wears them. Fourth, and finally; show some empathy, be a ‘mensch’. It only takes a bit of patience, and then this pandemic too—just as others that have plagued mankind—will pass. Every country with sufficient proportions of vaccinated people has seen a dramatic drop in hospitalizations and death. Those countries have ended lock-downs, they’ve started opening up bars and restaurants, and lifted travel restrictions. Once everyone has had a chance to be fully vaccinated, most—or maybe even all—remaining measures will cease. Until then, it’s really just such a trivial effort, and such a minor discomfort, to wear a face mask and to get vaccinated. If not for yourself, then do it for everyone else. As Spock once said: “The needs of the many outweigh the needs of the few. Or the one.” Be like Spock. Get vaccinated. It’s the logical thing to do.
Emergency use authorization (EUA) is still approval. No approval is ever given to medication that hasn’t at least been tested for safety and passed clinical trials. Consequently, there are currently no trials aimed at studying the safety of the vaccines anymore. Indeed, that phase has already been concluded, as it is in fact a requirement even for EUA. See also this document from the FDA for the Pfizer/BioNTech mRNA vaccine. The only important thing that researchers are currently investigating is how long the vaccines provide protection, and perhaps to what degree the vaccines protect against new SARS-CoV-2 variants. Furthermore, the vaccines are not the only medicines with emergency approval use. Some of the drugs used to treat COVID-19 in the hostpital also have emergency use approval, here is an example for tocilizumab. Just because you are only now finding out how organizations like the FDA and EMA approve new medications, doesn’t mean you should suddenly distrust the evidence-based medicine and the safety protocols used by those organizations and healthcare professionals for many decades. Innumerable doctors and biomedical researchers around the world want nothing more than to help people like you. So let them. Get vaccinated.
It is extremely unlikely for vaccine related side-effects to appear after a long period of time. The mRNA vaccines break down quite rapidly, due to the way mRNA is treated in the cytoplasm of cells. See also this excellent explanation of how the Pfizer/BioNTech mRNA vaccine was developed, and how it works. And when you know a bit how mRNA vaccines work, you will come to understand that any side-effects from the vaccine can only appear within a relatively short period after vaccination. The reason for that is that mRNA is broken down rather fast. The only thing that remains after that is your own immune response, just as it is with any other type of vaccination. The first mRNA vaccinations where given well over a year ago, and no side-effects have been reported other than those that occur with a short period after vaccination. No vaccine has ever been known to cause side-effects that appear after a long time. There is nothing to worry about, just get vaccinated.
It’s true that the large pharmaceutical companies that produce effective and safe COVID-19 vaccines are making a lot of money. Nevertheless, all approved vaccines first passed independent testing in clinical trials, to demonstrate both efficacy and safety. The clinical trials are conducted by independent academic researchers, in many hospitals, with tens of thousands of participants. After publication in high-ranking, peer-reviewed medical journals, the evidence is presented to a drug authority, like the FDA. Then it is either approved, or not approved. And approval isn’t some technical formality, they really look at the data carefully. If something isn’t right, it won’t get approved. For example, the Sputnik V vaccine has not yet been approved by Europe’s EMA because the developers failed to submit research data.
But beyond the strict approval rules, enough evidence has come in from the field showing that the vaccines are highly effective in preventing COVID-19 related death or severe illness. Hospitals all over the world are beginning to see that most of their COVID-19 patients are either unvaccinated, or partially vaccinated. And hospitals don’t really care about “Big Pharma”. For example, one of the most prescribed medicines for patients with severe COVID-19 is dexamethasone. And dexamethasone is dirt cheap. If doctors wanted to make “Big Pharma” a lot of money, there are plenty of more expensive alternatives that they could have prescribed instead. If you don’t trust pharmaceutical companies, then at least just trust the doctors and academic researchers. They know what they’re doing, and they recommend getting vaccinated. So get vaccinated.
That is just plainly incorrect. It may be true that people over 65 and people with certain underlying conditions statistically have a greater chance of getting severe COVID-19, but that doesn’t mean young, healthy people don’t get sick as well. Many “anti-vaxxers” boast that they won’t get infected, because they live so healthily, take vitamin D3 supplements, and therefore have such a strong immune system that they are immune to COVID-19. But they are kidding themselves. That’s not how immunity works. Since SARS-CoV-2 is a new pathogen, no one on earth will have any immunity against it, except those who’ve either already gotten COVID-19 or were vaccinated. Specific acquired immunity against a novel pathogen can only be achieved after infection by that pathogen, and an even stronger immune response may be achieved by vaccination. You can look this up in any introductory academic textbook on immunology, even older books that existed long before the COVID-19 pandemic. For example, the second figure in the first chapter of Basic Immunology gives examples of several infectious diseases that have been drastically reduced, or almost eradicated, by vaccination. The best and safest way to produce the most anti-bodies against SARS-CoV-2 is by getting vaccinated, not by getting sick with COVID-19. The vaccinations also indirectly confer some protection to vulnerable people by limiting the spread of COVID-19, a phenomenon known as ‘herd-immunity’. There is only one logical course of action, and that is to get vaccinated.
That is a well known statistical fallacy. You can’t directly compare numbers of vaccinated, partially vaccinated and unvaccinated patients like that. For a proper comparison, you must look at the number of vaccinated patients with regards to the size of the vaccinated population, and then do the same for the unvaccinated. That will then give you two proportions that you can compare with each other. Allow me to illustrate that principle with an example.
Say you have a population of 100 million, and 90% of the population is vaccinated. That means 90 million are vaccinated, and 10 million unvaccinated. Now let’s say that there are 10 million patients with COVID-19 in the hospitals. Of those patients, 4·3 million of them will be vaccinated and 5·7 million will be unvaccinated. But now you can already see that’s a whopping 5·7 million out of 10 million unvaccinated, compared to just 4·3 million out of 90 million vaccinated. Yikes! That means 57% of the unvaccinated population ended up in the ICU, compared to just 5·11% of the vaccinated population, a difference of more than one order of magnitude!
These numbers are of course fictitious, I chose them because they are easy to work with and to clearly make my point. Because whenever you see a percentage, you must always ask: A percentage of what? Scientists are looking at the real population data—using the correct statistics—and it is abundantly clear that the vaccines (and particularly the mRNA vaccines) work really well. Trust the numbers, get vaccinated.
No, it won’t. This has already been fact-checked. mRNA breaks down quickly. Your DNA is in the nucleus, which mRNA cannot enter. Also, the Moderna and Pfizer/BioNTech mRNA vaccines have successfully passed phase III clinical trials. One of the things the authorities specifically check for is whether a vaccine causes DNA changes that turn humans into zombie mutants, or melts them into a bubbling green puddle of genetic protoplasm. You may rest assured, the mRNA vaccines are safe.
Nope, that’s not true. The claim here is that because a virus can only multiply and spread effectively from living hosts, any successful virus will always evolve to keep their hosts alive as long as possible. In other words, viruses always evolve to become less lethal. But unfortunately, that statement is incorrect. While it is true that some viruses become less deadly over time, there are also viruses that become more deadly, or stay pretty much the same. That is because there may exist certain evolutionary constraints that limit the ways a virus can adapt. Take Ebola, for example, a highly infectious viral disease with a case fatality rate of at least 50%. Ebola spreads through direct contact with the bodily fluids of an infected person. But this leaking of bodily fluids also causes the hypovolemic shock that is the most important cause of death in Ebola patients. Thus, the infection pathway of the Ebola virus is inextricably linked with its lethality. In other words, it’s unlikely that the Ebola virus will evolve to become both less lethal and at the same time more infectious. That is the constraint of evolution in this particular virus. And the Ebola virus is just one example, see this fact-check for more information. Similar constraints may apply to SARS-CoV-2, showing that you cannot cherrypick some over-simplified evolutionary theory to predict what’s going to happen. You always need to look at the data coming in from the field, and the data about new dominant strains of SARS-CoV-2 are clearly telling us that COVID-19 is becoming more infectious, but unfortunately no less deadly. In fact, recent research (that I also referenced regarding use of face masks) suggests that viral RNA is more readily detected earlier in the COVID-19 infection. So, also when infected individuals are pre-symptomatic or asymptomatic. That means that the most important infection pathway takes place long before someone becomes hospitalized or dies from COVID-19 in isolation, which also means that mortality rate is less likely to be an important constraint in the evolution of SARS-CoV-2. Because if most people infect others before they get fully symptomatic, then the virus isn’t really going to care what happens to its host once the infected human is put in isolation upon becoming symptomatic. So it’s definitely okay to be worried, and now is the time to get vaccinated if you haven’t already.
First of all, we know from all the tests and the data from hundreds of millions of vaccinations that the vaccines are safe and that they are effective. Second, there’s not a single Nobel prize winning scientist in modern history who won the award without publishing in peer-reviewed magazines. Unsurprisingly, you will find that the Nobel laureates who are said to be critical of vaccinations have not published anything in peer-reviewed journals to support those theories.
However, there are indeed a few Nobel prize winners who became a bit nutty, later in life. This phenomenon is known as Nobel disease. One such Nobel prize laureate, Luc Montagnier, apparently moved to China, were he has “researched” non-peer-reviewed crackpot theories related to homeopathy.
And finally, there is another good reason why this argument fails. Against possibly one or two Nobel prize winners on the side of the anti-vaxxers, there are literally more than a hundred Nobel laureates who actively promote vaccinations against COVID-19. In other words, we have more Nobel prize winners on our side than the anti-vaxxers can shake a stick at. Not to mention the countless other distinguished scientists who also support the vaccinations. So, if titles and academic honors mean more to you than scientific publications, then you should still get vaccinated.