<html><head></head><body><div class="ydpd06b8889yahoo-style-wrap" style="font-family:Helvetica Neue, Helvetica, Arial, sans-serif;font-size:13px;"><div></div>
<div dir="ltr" data-setdir="false">San Mateo Public Health refers to CDC for vaccination information.</div><div dir="ltr" data-setdir="false"><a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html" rel="nofollow" target="_blank">https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html</a><br></div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">For 18 and older, CDC:</div><div dir="ltr" data-setdir="false"> 2 doses of Pfizer-BioNTech 3 to 8 weeks apart</div><div dir="ltr" data-setdir="false"> or</div><div dir="ltr" data-setdir="false"> 2 doses of Moderna 4 to 8 weeks apart</div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">The 2 shots followed 2 months later by a bivalent booster of either Pfizer or Moderna. It's OK to have the other brand of booster.</div><div dir="ltr" data-setdir="false"><br></div><div><br></div>
</div><div id="ydp5b194ef0yahoo_quoted_9362879167" class="ydp5b194ef0yahoo_quoted">
<div style="font-family:'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;color:#26282a;">
<div>
On Thursday, November 17, 2022 at 04:49:01 PM PST, Rick Moen <rick@linuxmafia.com> wrote:
</div>
<div><br></div>
<div><br></div>
<div>Quoting Les Faby (<a shape="rect" href="mailto:lfaby2018@gmail.com" rel="nofollow" target="_blank">lfaby2018@gmail.com</a>):<br clear="none"><br clear="none">> Thanks for responding. The only thing important in requiring a vaccine is<br clear="none">> ***transmission***<br clear="none"><br clear="none">See, this stuff is tricky, Les.<br clear="none"><br clear="none">I try to write my mailing list postings quite carefully, even when<br clear="none">rushed, so as to be comprehensive and fair, and also trying to be<br clear="none">thoughtful -- which is difficult indeed when writing extemporaneously,<br clear="none">so one tends to get all the spontaneity of oral speech with all the<br clear="none">you-said-it-on-the-record problems of written speech. Anyhow, I'm<br clear="none">rushed again at the moment, so apologies in advance for not being able<br clear="none">to take a _slow, careful_ time on this one.<br clear="none"><br clear="none">Remember I said there were a number of questions a person worried about<br clear="none">an infectious disease could worry about, and that it's crucial in<br clear="none">science to pick the correct question to investigate? Here were the <br clear="none">person-worried-about-infection-disease questions I listed:<br clear="none"><br clear="none">"Will X make it less likely to become infected if exposed?" <br clear="none">"Will X affect my likelihood of symptomatic disease?"<br clear="none">"Will X affect my period of infectiousness to others?" <br clear="none">"Will X affect my probable time to recovery?"<br clear="none"><br clear="none">(I should have added "Will X affect my likelihood of severe disease?", <br clear="none">but the above was the list.)<br clear="none"><br clear="none">Ask yourself what we mean when we speak of risk of "transmission".<br clear="none"><br clear="none">We mean the risk of a hypothetical person who is _infected_ being the<br clear="none">vector for transmission to another person. So, we're talking about two<br clear="none">things in sequence: 1. Person A contracts the pathogen, which has<br clear="none">likelihood P1. 2. Person A then infects person B, which has likelihood<br clear="none">P2. The composite likelihood, from the viewpoint of justifiably peeved<br clear="none">person B, is P1 * P2.<br clear="none"><br clear="none">But here's the thing, Les: You seem to be asserting a view about<br clear="none">probability P2. (Remember, because of the high, high incidence of<br clear="none">asymptomatic infections, one must consider anyone a potential vector.)<br clear="none"><br clear="none">And, actually, it's somewhat more complicated. Again, a framing<br clear="none">question: What is _my_ objective? My objective, as part of<br clear="none">Scandinavian standards of hospitality, is to assure Guest B that I've<br clear="none">done what I can to reasonably eliminate risks from the statistical<br clear="none">average Guest A. But is that the multiplicative product of P1 and P2?<br clear="none">No. The actual composite risk to Guest B starts with that<br clear="none">multiplication, but then logically it also matters whether factor X<br clear="none">(where X is, say, some particular booster) makes the average period of<br clear="none">viral shedding longer, and/or the average viral titer of someone<br clear="none">shedding.<br clear="none"><br clear="none">Now, as my 1980s boss David Carroll used to say when we started to<br clear="none">diagnose a technical problem, "What do we know?" As Dr. Offit was<br clear="none">quick to point out, we didn't have, at the time of adopting the <br clear="none">bivalent booster, clinical data proving that it was better than the <br clear="none">earlier booster against current strains -- but that doesn't mean we knew<br clear="none">nothing about that. There are sound scientific reasons to think that<br clear="none">the second portion, which IIRC is mRNA coding for the Omicron BA.2<br clear="none">"spike" protein, does successfully train B memory cells in the patient's<br clear="none">adaptive immune system in a way that _does_ create better-targeted<br clear="none">neutralising antibodies, both during the 3 month immediate horizon and, <br clear="none">if needed to be re-generated after the infamous antibody fade, will <br clear="none">be ramped up.<br clear="none"><br clear="none">Dr. Offit is correct that we also need clinical confirmation that this<br clear="none">actually happens as expected. A couple of weeks ago, I had in hand<br clear="none">preprints that appeared to show that. I don't have them now.<br clear="none"><br clear="none">> Why I asked about transmission 2 months after vaccination:<br clear="none">> There are 12 months in a year and if it is only even somewhat effective<br clear="none">> less than 17% of the time then an annual booster is close to useless.<br clear="none"><br clear="none">Non sequitur. This assumes, for starters, that the only point of a<br clear="none">booster is to supercharge over a 3 month (not 2, IIRC) period a set of<br clear="none">neutralising antibodies, which is _not_ true. If, as expected, a useful<br clear="none">revised recipe for memory B cells gets encoded into the adaptive immune<br clear="none">system, then that is a significant advantage.<br clear="none"><br clear="none">Some people say "But that's useless because without a full stock of<br clear="none">neutralising antibodies, you will get ill while your memory B cells<br clear="none">start cranking out a fresh set of neutralising antibodies." Again,<br clear="none">this is non-sequitur argumentation. The advantage of having the <br clear="none">_recipe_ for making appropriate neutralising antibodies has value<br clear="none">_particularly_ to the Guest A, but there are very probably also <br clear="none">benefits to Guest B. Why? There is, to the best of my understanding,<br clear="none">based on general principles and past, similar matters, reasonable<br clear="none">expectation that Guest A will tend to have a shorter period of viral<br clear="none">shedding than without variable X (in this case, the bivalent vaccine).<br clear="none">Again, no, last I heard, we don't have solid clinical data on this, <br clear="none">because (as usual) not enough time has passed. As usual, intelligent<br clear="none">people are obliged to do rational planning as best they can using what<br clear="none">data _are_ available.<br clear="none"><br clear="none">> Also, I read Katherine Wu's paper. Good choice of authors, BTW. She is<br clear="none">> recommending the vaccine because it keeps you from getting seriously<br clear="none">> ill. She does NOT say it will keep you from transmitting the disease<br clear="none">> or you should take it for that purpose.<br clear="none"><br clear="none">That question is, as I'm sure you saw, simply not the focus of the<br clear="none">referenced article at all -- for starters. Ms. Wu has written a lot, a<br clear="none">lot, a lot, on the subject, more than I have any intention of delving<br clear="none">through at this moment. As I said, I'm rushed, for which, I'm sorry, <br clear="none">but that's life.<br clear="none"><br clear="none">The referenced article's gravamen was simply that our language should<br clear="none">now change from "has had N doses" to "is up to date for the season" --<br clear="none">and why.<br clear="none"><br clear="none">In the current piece, Wu doesn't flog the previously done-to-death <br clear="none">rational for exactly what benefits one gets from having booster N --<br clear="none">which makes me disappointed in seeing you say "Wu doesn't say in that<br clear="none">article that you should get a certain booster for XYZ reason". No, <br clear="none">she doesn't -- in that it's not an article trotting out reasons.<br clear="none"><br clear="none">Nor is Ms. Wu's article's focus on "Are you a danger to others if you<br clear="none">haven't done XYZ?" Instead, it contains layman-accessible advice<br clear="none">about how to judge, going forward, "how long it’s been since your last<br clear="none">immunity-conferring event" (to quote the article) and when it might be<br clear="none">prudent to schedule the currently appropriate booster-du-jour.<br clear="none"><br clear="none">Wu quotes several credible parties (fortunately _not_ just Unc'a Joe<br clear="none">Biden, who is not known for his epidemiological genius) as saying that<br clear="none">we're probably headed towards an annual booster every fall for the<br clear="none">foreseeable future. Because, as you say in your helpful and kindly<br clear="none">effort to teach grandma to suck eggs ;-> , SARS-CoV-2 has evolved --<br clear="none">and, I will add as long as we're piling on tedious platitudes, is<br clear="none">continuing to do so.<br clear="none"><br clear="none">> Which of your papers, if any, say it has a big effect on you<br clear="none">> transmitting the virus? <br clear="none"><br clear="none">Talk to me after you have read the above about the problems with your<br clear="none">overly reductionist probabilistic concept of "transmitting" in the<br clear="none">context of my hospitality. Because otherwise we are not communicating,<br clear="none">and you are just talking at me.<br clear="none"><br clear="none">Also, I currently have no time to go re-find science papers for you.<br clear="none">Maybe after work, Deirdre will be interested in that.<br clear="none"><br clear="none"><br clear="none">> The Other people on the committee disagreeing with Dr. Offit are NOT saying<br clear="none">> it will keep you from infection because they know that is an impossible<br clear="none">> standard.<br clear="none"><br clear="none">Wrong question.<br clear="none"><br clear="none">As I said, in science, one must to be very careful that you are<br clear="none">investigating the correct question.<br clear="none"><br clear="none">Which is also true in computer hardware and software debugging.<br clear="none"><br clear="none">At this point, I'm sorry, but I'm not just out of time on this, but have<br clear="none">just gobbled up the second overtime.<div class="ydp5b194ef0yqt9641065796" id="ydp5b194ef0yqtfd15108"><br clear="none"><br clear="none"><br clear="none">_______________________________________________<br clear="none">conspire mailing list<br clear="none"><a shape="rect" href="mailto:conspire@linuxmafia.com" rel="nofollow" target="_blank">conspire@linuxmafia.com</a><br clear="none"><a shape="rect" href="http://linuxmafia.com/mailman/listinfo/conspire" rel="nofollow" target="_blank">http://linuxmafia.com/mailman/listinfo/conspire</a><br clear="none"></div></div>
</div>
</div></body></html>