It is likely that there will be over a dozen vaccines of some kind popping up in labs around the world in the next two to three years. If we assume this, would governments make vaccination mandatory if enough quantities were produced that rationing to high-risk individuals were no longer needed?

This brings the question, if vaccination became mandatory but sectors of the population (anti-vaccine) refused to get it, what should happen to those people?

Derico wrote:

It is likely that there will be over a dozen vaccines of some kind popping up in labs around the world in the next two to three years. If we assume this, would governments make vaccination mandatory if enough quantities were produced that rationing to high-risk individuals were no longer needed?

only if it persists in the wild and is significantly more dangerous then the flu

This brings the question, if vaccination became mandatory but sectors of the population (anti-vaccine) refused to get it, what should happen to those people?

The usual. here that means up to five years in prison if the government really wants to push it, the law is there.
But it is more the other way round. Kids going to school or Kindergarden have to have measles vaccination, if you don´t vaccinate your kid it just doesn´t go there. But by law you are required to send your kids to school, so fines and up to 6 Month in prison again, again, again... until your kid is vaccinated.

best regards
Thomas

If fragile people can be vaccinated then it doesn't matter, let natural selection take the antivaxxers. Children aren't affected so these idiots can't do much harm.

tommy1808 wrote:

Derico wrote:

It is likely that there will be over a dozen vaccines of some kind popping up in labs around the world in the next two to three years. If we assume this, would governments make vaccination mandatory if enough quantities were produced that rationing to high-risk individuals were no longer needed?

only if it persists in the wild and is significantly more dangerous then the flu

Even then, in two to three years time, it will likely have mutated into something different for which vaccines being developed today will be somewhat ineffective.

tommy1808 wrote:

only if it persists in the wild and is significantly more dangerous then the flu

Agreed. COVID-19 is a bit new, and frankly, we really don't know how virulent it is. Much like SARS, ZIKA, AVIAN, etc., etc. it may blow over.

Then again, it may persist, and mutate, much like influenza.

Derico wrote:

This brings the question, if vaccination became mandatory but sectors of the population (anti-vaccine) refused to get it, what should happen to those people?

Not quite as draconian as Tommy, but if the vaccine were to be made mandatory, the same restriction that are currently in place should be used, denial of school admission, being the primary driver. But, the question really is what to do with adults. I'm against imprisonment, or even fines for refusing to be vaccinated. But, we all use or will use some social services, so maybe make there use conditional on vaccination? But, then do we have to have some sort of national registry? Yeah, probably. We start down a slippery slope, don't we?

Really, I think we need to wait and see how ugly this thing really is.

fr8mech wrote:

Not quite as draconian as Tommy,

Oh, i would charge unvaccinated people for all costs involved if they infect anyone, and if someone dies add manslaughter to it... including charging them for the DNA test to establish

But, then do we have to have some sort of national registry? Yeah, probably. We start down a slippery slope, don't we?

Or just have a vaccination pass, no central registry needed..... that you have to show in some places....
Like it is today....

And if stuff gets really bad, you can just ask health insurances to check who they didn't pay for yet.... also no extra information and no central register needed.

Best regards
Thomas

Aesma wrote:

If fragile people can be vaccinated then it doesn't matter, let natural selection take the antivaxxers. Children aren't affected so these idiots can't do much harm.

Since you prefer natural selection, why not just let Coronavirus take the ones without wasting money on a vaccine then? It's not adversely affecting children (not that they are immune to natural selection of course).

BTW, most antivaxxers are the opposite of fragile. They likely don't take immunosuppressive antibiotics unnecessarily or at all like most Americans, don't go to the doctor much (if ever) and realize they are the ones most in control of their health.

tommy1808 wrote:

fr8mech wrote:

Not quite as draconian as Tommy,

Oh, i would charge unvaccinated people for all costs involved if they infect anyone, and if someone dies add manslaughter to it... including charging them for the DNA test

California and Washington state just decriminalized knowingly having HIV and infecting someone else and not disclosing before sex.

Just curious, what would you do if someone didn't cover their mouth when they sneezed and infected someone with Coronavirus, same thing?

afcjets wrote:

BTW, most antivaxxers are the opposite of fragile. They likely don't take immunosuppressive antibiotics unnecessarily or at all like most Americans, don't go to the doctor much (if ever) and realize they are the ones most in control of their health.

On the contrary, they are obviously fragile-minded if they cannot grasp basic science or statistics.

For a Human I include our science and technology in natural selection of course, don't use it (or abuse it) and suffer the consequences.

Aaron747 wrote:

afcjets wrote:

BTW, most antivaxxers are the opposite of fragile. They likely don't take immunosuppressive antibiotics unnecessarily or at all like most Americans, don't go to the doctor much (if ever) and realize they are the ones most in control of their health.

On the contrary, they are obviously fragile-minded if they cannot grasp basic science or statistics.

It was clear from the context he was referring to physically not mentally.

Depends. If it mutates to a deadlier form where a vaccine is the only way to prevent it, then in the interest of eradication, yes, I'd make it mandatory.

But just likes SARS, MERS, and H1N1, it may be a temporary thing before it settles down.

I didn't take the H1N1 vaccine when it was out there because I knew I wasn't at risk. The same thing is happening with Covid-19 (and it's encouraging to know that most cases are mild, though for all I know, I may win the lottery and be among those rare, extreme cases).

I think vaccines for high fatality rate viruses should be highly recommended, at the same time I think CDC should recommend skipping flu vaccine when it is mild. Let the immunity improve a little without medical assistance.

Now we have a section of the population who cannot survive without a vaccine. It becomes an issue when there is no vaccine.

dtw2hyd wrote:

I think vaccines for high fatality rate viruses should be highly recommended, at the same time I think CDC should recommend skipping flu vaccine when it is mild. Let the immunity improve a little without medical assistance.

Now we have a section of the population who cannot survive without a vaccine. It becomes an issue when there is no vaccine.

Vaccines do not work how you think they do.

https://www.cdc.gov/vaccines/hcp/conver ... office.pdf

Some people believe that naturally acquired immunity—immunity
from having the disease itself—is better than the immunity
provided by vaccines. However, natural infections can cause severe
complications and be deadly. This is true even for diseases that many
people consider mild, like chickenpox. It is impossible to predict
who will get serious infections that may lead to hospitalization.
Vaccines, like any medication, can cause side effects. The most
common side effects are mild. However, many vaccine-preventable
disease symptoms can be serious, or even deadly. Although many
of these diseases are rare in this country, they do circulate around
the world and can be brought into the U.S., putting unvaccinated
children at risk. Even with advances in health care, the diseases that
vaccines prevent can still be very serious – and vaccination is the best
way to prevent them

afcjets wrote:

Just curious, what would you do if someone didn't cover their mouth when they sneezed and infected someone with Coronavirus, same thing?

You can forget to cover your mouth, not being vaccinated is a decision.

Best regards
Thomas

tommy1808 wrote:

afcjets wrote:

Just curious, what would you do if someone didn't cover their mouth when they sneezed and infected someone with Coronavirus, same thing?

You can forget to cover your mouth, not being vaccinated is a decision.

Best regards
Thomas

So just charge them with involuntary manslaughter vs. manslaughter then?

casinterest wrote:

dtw2hyd wrote:

I think vaccines for high fatality rate viruses should be highly recommended, at the same time I think CDC should recommend skipping flu vaccine when it is mild. Let the immunity improve a little without medical assistance.

Now we have a section of the population who cannot survive without a vaccine. It becomes an issue when there is no vaccine.

Vaccines do not work how you think they do.

https://www.cdc.gov/vaccines/hcp/conver ... office.pdf

Some people believe that naturally acquired immunity—immunity
from having the disease itself—is better than the immunity
provided by vaccines. However, natural infections can cause severe
complications and be deadly. This is true even for diseases that many
people consider mild, like chickenpox. It is impossible to predict
who will get serious infections that may lead to hospitalization.
Vaccines, like any medication, can cause side effects. The most
common side effects are mild. However, many vaccine-preventable
disease symptoms can be serious, or even deadly. Although many
of these diseases are rare in this country, they do circulate around
the world and can be brought into the U.S., putting unvaccinated
children at risk. Even with advances in health care, the diseases that
vaccines prevent can still be very serious – and vaccination is the best
way to prevent them

I think you misread my post, I am not against vaccines, just don't medically manage human bodies.

Humans survived before vaccines were developed and the annual flu shot doesn't cover all viruses in circulation.

Just because a pharmacy produced a vaccine with a short shelf life, it should not be marketed as mandatory.

dtw2hyd wrote:

casinterest wrote:

dtw2hyd wrote:

I think vaccines for high fatality rate viruses should be highly recommended, at the same time I think CDC should recommend skipping flu vaccine when it is mild. Let the immunity improve a little without medical assistance.

Now we have a section of the population who cannot survive without a vaccine. It becomes an issue when there is no vaccine.

Vaccines do not work how you think they do.

https://www.cdc.gov/vaccines/hcp/conver ... office.pdf

Some people believe that naturally acquired immunity—immunity
from having the disease itself—is better than the immunity
provided by vaccines. However, natural infections can cause severe
complications and be deadly. This is true even for diseases that many
people consider mild, like chickenpox. It is impossible to predict
who will get serious infections that may lead to hospitalization.
Vaccines, like any medication, can cause side effects. The most
common side effects are mild. However, many vaccine-preventable
disease symptoms can be serious, or even deadly. Although many
of these diseases are rare in this country, they do circulate around
the world and can be brought into the U.S., putting unvaccinated
children at risk. Even with advances in health care, the diseases that
vaccines prevent can still be very serious – and vaccination is the best
way to prevent them

I think you misread my post, I am not against vaccines, just don't medically manage human bodies.

Humans survived before vaccines were developed and the annual flu shot doesn't cover all viruses in circulation.

Just because a pharmacy produced a vaccine with a short shelf life, it should not be marketed as mandatory.

The idea behind the shots is to limit the body's susceptibility and help keep everyone's health care costs down. Those folks that wind up hosptialized raise everyone's costs when it could have been prevented.

There is a reason why kids get the vaccines. It helps save lives.

Sure mandatory is a bit extreme, but it would be nice if people saw it as important enough to do.

afcjets wrote:

tommy1808 wrote:

afcjets wrote:

Just curious, what would you do if someone didn't cover their mouth when they sneezed and infected someone with Coronavirus, same thing?

You can forget to cover your mouth, not being vaccinated is a decision.

Best regards
Thomas

So just charge them with involuntary manslaughter vs. manslaughter then?

Involuntary manslaughter still requires you to do something on purpose, which applies to neither sneezing nor caughing. Gross negligence perhaps if someone is constantly not covering their mouth, but that might be the absolute limit.

And involuntary manslaughter is also manslaughter... I didn't say they should be charged with voluntary manslaughter....

Best regards
Thomas

dtw2hyd wrote:

Humans survived before vaccines were developed

Yeah.. with a life expectancy of some 35 years.

Best regards
Thomas

dtw2hyd wrote:

Humans survived before vaccines were developed

Have you got any clue how many people died at young age, or suffered terrible deceases, that these days a simple inoculation would remedy or avoid altogether?

petertenthije wrote:

dtw2hyd wrote:

Humans survived before vaccines were developed

Have you got any clue how many people died at young age, or suffered terrible deceases, that these days a simple inoculation would remedy or avoid altogether?

And what are they going to do until the COVID-19 vaccine is released? We are technically in the medical medieval period with the current pandemic, correct, other than running hot water, soap, plumbing, bleach, and sanitizers. You have to take a balanced approach. My kids have every shot required, flu shot every year. Some years I skip the flu shot.

You cannot make something mandatory which cannot even be produced.

petertenthije wrote:

dtw2hyd wrote:

Humans survived before vaccines were developed

Have you got any clue how many people died at young age, or suffered terrible deceases, that these days a simple inoculation would remedy or avoid altogether?

That or defeat the body’s ability to fight off disease in general. If you can fix something like Polio, great. But something that is constantly mutating is another matter. How much is too much to a point where the body doesn’t know how to fight anything off.

DL717 wrote:

How much is too much to a point where the body doesn’t know how to fight anything off.

That just doesn´t happen with vaccines, they use the immune system to create immunity, that is why you can´t get vaccinated if your immune system is weakend. So, that point is *never*.

dtw2hyd wrote:

petertenthije wrote:

dtw2hyd wrote:

Humans survived before vaccines were developed

Have you got any clue how many people died at young age, or suffered terrible deceases, that these days a simple inoculation would remedy or avoid altogether?

And what are they going to do until the COVID-19 vaccine is released? We are technically in the medical medieval period with the current pandemic, correct, other than running hot water, soap, plumbing, bleach, and sanitizers. .

we did have soap and germ theory of disease a long while longer than we have vaccines.

best regards
Thomas

Viccines is to benify the groups that cannot take the vaccines.

In order to do this the rest of the population need to have around 60 to 80% population vaccinated. If not it onöy becomes a personal protection.

Anti vaccine people are in reality sccepting that people weak from other sickness might die or pregnant women having babies with serious problems.

I definitely think it should be mandatory with extremely stiff penal sentences regardless of mortality rate IF somehow an effective vaccine came out BEFORE effective treatments and cures. I think smallpox was a case where the vaccine was far more effective than any treatment. So in such a case, I'm all for very harsh penalties on those who don't wish the vaccine.

Otherwise, more of the above-mentioned "already in the book" penalties are fine.

Derico wrote:

I definitely think it should be mandatory with extremely stiff penal sentences regardless of mortality rate IF somehow an effective vaccine came out BEFORE effective treatments and cures.

Its a Virus, there pretty much isn't a treatment for any virus infection sans HIV... where it took us some decades make something effective. Its vaccine or fight it of yourself.

Best regards
Thomas

Hello, everyone. I have become a bit educated on this topic lately. Our county was the first in the USA to see COVID-19 and the first to see community transmission. I also worked a year in a molecular virology lab and helped teach a molecular virology course in graduate, in addition to being a physician and an infectious diseases geek.

Aesma wrote:

If fragile people can be vaccinated then it doesn't matter, let natural selection take the antivaxxers. Children aren't affected so these idiots can't do much harm.

I think that this will depend on the efficacy of the vaccine. If it is very highly effective (>95%) then I think it should be recommended for all adults over 65, all healthcare workers, and anyone else who wants it. If it is only moderately effective (60-95%), then I think it should be recommended for everyone and during an outbreak, those who refuse the immunization should be forced to isolate, like was done during the measles outbreak in NYC. The role of children in community transmission of SARS-CoV-2 is still a matter of some debate. My personal opinion is that children are a minor part of community transmission. But there are some findings (high copy number, stool shedding) that suggest that children may play a more important role in community spread. I do not think we will know for some time.

scbriml wrote:

Even then, in two to three years time, it will likely have mutated into something different for which vaccines being developed today will be somewhat ineffective.

The evidence that we have right now shows a mutation rate of approximately one base per month. However, in any virus, there will be portions of genes that will be highly conserved (stable) because any mutations in those regions results in a reduction in viability, and there will be portions of genes that are highly variable. In influenza, the highly conserved portions of the relevant proteins are located on the virus particle in such a fashion as to protect them from immune surveillance, while the highly variable parts are on the surface. Also, different viruses mutate at different rates. Influenza mutates like crazy. The same measles vaccine that was introduced over a half century ago remains as effecive today as it was then.

dtw2hyd wrote:

at the same time I think CDC should recommend skipping flu vaccine when it is mild. Let the immunity improve a little without medical assistance.

That's not how vaccination works. It's far MORE important for more people to get lower efficacy vaccines like flu. A higher vaccination rate decreases the spread of disease and reduces the overall burden on the healthcare system.

dtw2hyd wrote:

Humans survived before vaccines were developed

Lol, it was common to lose multiple kids before vaccines were developed. Humanity survived, but your incredible privilege of not knowing what those diseases looked like is showing.

dtw2hyd wrote:

And what are they going to do until the COVID-19 vaccine is released?

Community isolation. Bring the number of cases down. Work on using existing medications as treatments and perhaps even prophylaxis.

DL717 wrote:

That or defeat the body’s ability to fight off disease in general. If you can fix something like Polio, great. But something that is constantly mutating is another matter. How much is too much to a point where the body doesn’t know how to fight anything off.

Vaccines utilize the exact same immune system and mechanism as natural diseases. They do not in any way weaken the immune system. The point is to train the immune system to fight off a disease as if it had already been exposed to it. And, in fact, we have seen some unintended benefits. Measles erases a large portion of the immune memory and causes an immune suppression for approximately two years after infection. This is not the case for the measles vaccine. The HiB vaccine was found to be associated with a lower risk of pediatric leukemia, an unexpected finding that again suggests that many vaccines strengthen the overall immune system's power.

tommy1808 wrote:

Its a Virus, there pretty much isn't a treatment for any virus infection sans HIV...

In 1985, when I first learned about viruses in elementary school that was quite true. And now it is very untrue. We have antivirals to treat HIV, Herpes Simplex Virus and Varicella-Zoster Virus, influenza (we have several now), and we can outright cure hepatitis C.

For COVID-19, we are finding excellent results with the use of an experimental antiviral called remdesivir and a patient in our hospital improved very quickly after she was started on it. KALETRA (lopinavir/ritonavir), a combination of HIV protease inhibitors, is also being used as a treatment and is shortening the duration of illness. And good old choloroquine/hydroxycholoroquine, originally antimalarials, seem to be very effective.

Yet this disease is complex. For those who become very ill, the disease itself is not a direct result of the virus, but rather a massive and misdirected immune response that does nothing to fight the virus, but causes horrible tissue damage and severe alterations in other systems (blood pressure, glucose control). We are only beginning to understand the risk factors that predispose some people to this outcome, so for patients who have become very ill, antiviral treatment must be initiated early or it appears to not help.

DocLightning wrote:

Yet this disease is complex. For those who become very ill, the disease itself is not a direct result of the virus, but rather a massive and misdirected immune response that does nothing to fight the virus, but causes horrible tissue damage and severe alterations in other systems (blood pressure, glucose control). We are only beginning to understand the risk factors that predispose some people to this outcome, so for patients who have become very ill, antiviral treatment must be initiated early or it appears to not help.

Thanks for a great post, Doc!

What are those risk factors?

Also if you don't mind, what is your opinion on everything that is going on? Overreaction or necessary steps? Is the virus as dangerous as the media makes it seem?

DocLightning wrote:

tommy1808 wrote:

Its a Virus, there pretty much isn't a treatment for any virus infection sans HIV...

In 1985, when I first learned about viruses in elementary school that was quite true. And now it is very untrue. We have antivirals to treat HIV, Herpes Simplex Virus and Varicella-Zoster Virus, influenza (we have several now), and we can outright cure hepatitis C.

For COVID-19, we are finding excellent results with the use of an experimental antiviral called remdesivir and a patient in our hospital improved very quickly after she was started on it. KALETRA (lopinavir/ritonavir), a combination of HIV protease inhibitors, is also being used as a treatment and is shortening the duration of illness. And good old choloroquine/hydroxycholoroquine, originally antimalarials, seem to be very effective.

I was still under the assumption for all else we are still stuck at merely inhibiting some to give the immune system a somewhat better shot at dealing with the virus.For Hep-C is was still thinking Interferon is our best shot. Guess i am a couple of years behind now....

Thanks for the update.

best regards
Thomas

DocLightning wrote:

dtw2hyd wrote:

And what are they going to do until the COVID-19 vaccine is released?

Community isolation. Bring the number of cases down. Work on using existing medications as treatments and perhaps even prophylaxis.

Isn't it a bit late for community isolation? When there was ample opportunity to take small steps, like screening at airports or temporarily canceling a few routes, trade and commerce took priority.

Welcoming everyone without screening, no testing and praying that self-quarantine would work were the only measures.

Is insurance going to cover the treatments you are suggesting or some desk jockey is going to reject the claim stating it is "experimental"?

dtw2hyd wrote:

DocLightning wrote:

dtw2hyd wrote:

And what are they going to do until the COVID-19 vaccine is released?

Community isolation. Bring the number of cases down. Work on using existing medications as treatments and perhaps even prophylaxis.

Isn't it a bit late for community isolation? When there was ample opportunity to take small steps, like screening at airports or temporarily canceling a few routes, trade and commerce took priority.

Welcoming everyone without screening, no testing and praying that self-quarantine would work were the only measures.

With a 2 week incubation time checking temperatures at points of entry is not as useful as you seem to think it is.

Community isolation always works to slow down the spread.

Best regards
Thomas

B747forever wrote:

What are those risk factors?

Old age.

High blood pressure (unclear if treatment reduces risk, unclear if certain medicines may reduce risk more than others or INCREASE risk more than others)

Diabetes, especially Type 2.

Cancer, but perhaps not all kinds of immunosuppression.

Lung diseases OTHER than COPD and asthma.

Obesity

Another Bill Gates-funded vaccine. Nothing to worry about.