It makes more sense when you remember the stated purpose: preventing spread. Once Omicron ratcheted the spread rate up by an order of magnitude and demonstrated enough evasion that the original vaccines couldn’t plausibly prevent enough transmission, that changed from a shared model where everyone is masked & vaccinated to stop the pandemic to a more individual risk tolerance question.
In the former case, having a firm policy to get vaccination rates over the critical threshold to halt spread has a reasonable justification: we literally can’t do that without you.
The problem is, all these mandates were instituted long after the Provincetown study, which made it clear that Delta was also exhibiting significant vaccine escape and herd immunity was impossible. Any notions of "stop the pandemic" were absurd past that point.
A lot was missing from the original trials as well. No study of impact on transmission, no routine testing to detect asymptomatic cases.
Wait, I thought these vaccines weren’t supposed to prevent spread. Instead, they were supposed to keep hospitals from filling up. After all, illness severity was the primary endpoint of the clinical trials used to support marketing approval.
Plenty of senior government officials said they would stop the spread. This seemingly despite no testing of that outcome.
Most vaccines are neutralizing meaning that it primes your immune system so well that you couldn't possibly get sick. It seems that these new vaccines, for whatever reason, doesn't elicit the same benefits that we're used to seeing from traditional vaccines.
That last part is complicated because it’s a function of not just the vaccines but also the virus: some mutate more readily than others both by how well they tolerate mutations and how rapidly they spread (more cases = more chances to get the next big mutation). Our influenza vaccines have a similar problem because that’s also a respiratory virus which mutates frequently. Something which only spread by skin contact might, for example, be an easier target simply because it has a much slower spread and thus mutation rate — nobody gets on a bus and licks all of the other passengers!
The level of effectiveness at preventing spread wasn’t known - that’s harder to measure - and since the protective effects were so strong there wasn’t an approval delay trying to get those numbers.
If memory serves, the subsequent data suggested that we could have reached herd immunity with something like 90% vaccination rates against the original strain. Delta and especially Omicron put paid to that, however, and closed any chance of most people being able to avoid infection.
It could have been measured during the trials. Give everyone regular PCR tests even if not symptomatic and measure viral load. If it's the same then it's reasonable to infer the vaccines are suppressing symptoms but you still get infected.
Researchers did eventually do that, after the vaccines had all been approved and people forced to take them. They found there's no difference in viral load between vaccinated and unvaccinated people. So reducing symptoms is now the consensus position on what they do, but that could easily have been known from the start.
That’s a solid repetition of antivax talking points but none of it is accurate. Data was being collected during the trials and in other studies but it’s harder because you also need to establish the direction of spread, which in the simple PCR model you outlined would require testing not only the person in the trial but everyone around them with timing precise enough to start establishing direction (if my wife and I both get sick and she’s in the vaccine trial, a point in time PCR showing both of us with antibodies doesn’t distinguish between the vaccine failing to prevent her from giving it to me or the reverse).
When the efficacy of the vaccines was so high for preventing serious cases, it would have been a medical ethics problem to delay getting them out to the public while trying to get better data on spread.
When that kind of data did come out later, it showed strong effects — unfortunately, as noted this was against Alpha and Delta was already chipping away at efficacy:
> Two studies1,2 from Israel, posted as preprints on 16 July, find that two doses of the vaccine made by pharmaceutical company Pfizer, based in New York City, and biotechnology company BioNTech, based in Mainz, Germany, are 81% effective at preventing SARS-CoV-2 infections. And vaccinated people who do get infected are up to 78% less likely to spread the virus to household members than are unvaccinated people. Overall, this adds up to very high protection against transmission, say researchers.
> Before the emergence of the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccination reduced transmission of SARS-CoV-2 from vaccinated persons who became infected, potentially by reducing viral loads. Although vaccination still lowers the risk of infection, similar viral loads in vaccinated and unvaccinated persons who are infected with the delta variant call into question the degree to which vaccination prevents transmission.
Not on infectiousness or spread, that's the whole point we're making here.
"When the efficacy of the vaccines was so high for preventing serious cases"
They claimed based on trial data 95% efficacy against infection, not just serious cases. That wasn't accurate.
"it would have been a medical ethics problem to delay getting them out to the public while trying to get better data on spread"
They had many months. Regardless even if this wasn't the case, it's easy: make them available and then don't impose any requirements or passporting until such data is available. They didn't do this.
You appear to classify literally any criticism of any process or happening to do with vaccines as "antivax talking points" even though they're precise and specific to this event. Do you realize that for vaccines to be safe and effective, you need a whole lot of people who are willing to be "antivax" in the regulators, pharma companies, doctors surgeries and more? The only reason anyone believes in vaccine safety at all is the assumption of lots of people who will yell stop at the slightest hint of problems. It's clear that this assumption is wrong and the people most afraid of being classed as "anti-vaxxers" are the very people meant to be watching out for safety problems.
> You appear to classify literally any criticism of any process or happening to do with vaccines as "antivax talking points" even though they're precise and specific to this event
The thing is, they’re not precise or specific. You keep repeating vague claims which are contradicted by the scientific evidence. If you’re not anti-vax you should ask whether you’re getting these points from people who are, or whether your belief about how science works is shared by actual scientists. For example, it is a complete falsehood that ‘you need a whole lot of people who are willing to be "antivax" in the regulators, pharma companies, doctors surgeries and more’ — critical review is a core part of the scientific process, nowhere more true than for new drugs and vaccines, but that’s not antivax — that’s scientists doing their jobs. The problem with antivax thinking isn’t that it’s skeptical but that it’s based on unwillingness to follow or accept the scientific process.
Actually, effectiveness against symptomatic infection was the primary endpoint of the trials. There weren't sufficient cases of severe illness in the vaccinated or placebo groups to draw any conclusions from the trials about protection from hospitalization/death.
