In Which I Finally Lose My Mind

There is almost no evidence that vaccinated individuals can transmit the virus to others

I always tell people on Twitter to go to my newsletter to find the sane version of me. I try to be very open about other perspectives, including those I do not share. I generally think that people are being honest and doing their very best in this still-unprecedented world. It takes a conscious effort to do this because it’s not the “default setting” for online discourse.

But today, I am actually going to insist that I’m right about something. I don’t think the people who disagree are evil or wrong or dishonest, but I think avoiding this debate in the name of caution is damaging to people’s long-term expectations as this crisis careens toward a conclusion.

My intent here is to encourage and lift the weight of exhaustion and expectations from our shoulders. It will strike some as dangerously reckless, but I don’t think it is. I think it’s a reasonable position to take given the evidence on the ground & we shouldn’t condemn or ostracize people who want to investigate these issues.

• An Intemperate Piece On Post-Vaccine Transmission

• Technically Correct But Misleading

• Looney Tunes: Odor-able Kitty

An Intemperate Piece On Post-Vaccine Transmission

As we get millions of doses into arms, people are starting to ask questions about what appropriate behavior is after they have been vaccinated. The official stance, given by public health officials and uncritically repeated in the news, has been “nothing changes, wear masks, continue social distancing”.

I’m going to be upfront about this: This messaging bothers me. It bothers me not because it is poor advice but because I feel like the rationales we are being given, especially around mask wearing, are not the actual reasons behind the recommendations.

If the rationale had been “Wear a mask because, as we vaccinate more and more people, it is better for the social order if we don’t create a visible class of citizens who get to have more freedoms because they got a vaccine” then I would have no problems whatsoever. Agree or disagree with it, at least that makes sense. But that is not the rationale being proffered.

Instead, we’re told that, even after vaccination, we can still be an ongoing danger to others.

Lest I be misunderstood, let’s get our terms crystal clear here: You’re not immediately immune to COVID the second after the vaccination plunger sends the life-saving elixir into your arm. It takes some time (about 2 weeks) for your body to generate an immune response strong enough to ward off infection. That first dose seems to be pretty effective by day 12 and the immune response is substantially bolstered after the second dose. You should internalize that process and act accordingly.

After that, carefully study this chart from the Pfizer Phase 3 vaccine trial. The blue line indicates the infection profile of the placebo group while the red line shows the infection profile of those who received the Pfizer vaccine.

What we see here is that it takes approximately two weeks for the initial immunity to kick in but, after that time, participants developed a solid disease resistant immunity up to their 21 day mark, at which point they were given a second dose that increased immunity for the duration of the study. This is the observed reality in the largest Phase 3 vaccine study in modern medicine.

So if the vaccinated person is no longer at risk of contracting COVID, why should they wear a mask? “Because,” goes the talking point, “vaccines may not prevent you from spreading the virus”. I want to yell at this talking point for a moment because it is scaring the hell out of people.

Where does this idea that a vaccinated person could still be carrying COVID come from? Whenever you dig into the details of this concept, it comes from the fact that a rigorous study of asymptomatic COVID transmission among vaccinated participants was not a part of the Phase 3 study. In other words, we cannot *prove* that COVID *doesn’t* asymptomatically tag along for the ride in a vaccinated person.

When it comes to transmitting COVID to another person, a mask is only helpful for airborne transmission. That means the virus would have to be coming from your upper respiratory tract for a mask to be effective at stopping it. But if there is enough COVID virus in your upper respiratory tract for you to be transmitting it, then there is enough COVID virus for a testing swab to detect. In essence, if you had enough virus in your exhalations to infect another person, you would be testing positive for COVID… which is exactly the observed measurement that the vaccine prevents.

“Ah,” continues the increasingly tiresome official position, "but they didn’t test all the participants every week. They only tested the ones with symptoms, so they might have missed these asymptomatic carriers.” The implication here is that there are all these asymptomatic vaccinated COVID carriers, we just didn’t test any of them.

That would be fair except… look at red line in the chart above. There were over 20,000 vaccinated participants including over 5,000 elderly (over 65 years old). This study was done on people with diabetes, liver disease, HIV, myocardial infarction, and congestive heart failure. This study included people who were getting sick and going to the hospital (often with COVID symptoms since COVID symptoms are basically any cough or cold symptom) during the study. They were getting tested for COVID and coming up negative, which means they were NOT asymptomatic carriers capable of airborne transmission.

Now look at the blue line in the chart above. COVID was running wild in the placebo group during this study. As the rain falls on the just and the unjust, so the COVID infections surrounded the vaccinated and unvaccinated. The vaccinated group was going to the same hospitals as the placebo group, breathing the same air, living in the same communities. If the vaccinated group was capable of expressing COVID virus through their upper respiratory tract even while not being sickened by it, that would have shown up as a “positive COVID” in this data set.

If the vaccinated population were capable of infecting others due to a lack of mask wearing, they would come into the hospital sickened with non-COVID diseases, be tested for COVID, and, even though they were not actually sick with COVID, they would be found positive due to the concentration of virus in their upper respiratory tract. If that was a thing that was happening, it is deeply unlikely that we’d get all the way to 95% efficacy for this vaccine.

“Ah,” interject the people who still can’t believe that an official source would deceive them this way even though official sources have deceived us in exactly this way repeatedly throughout the duration of this crisis, “but you can’t prove that.”

And you’ve got me there. This is why the headlines say “Vaccines *may* not stop the virus” instead of “Vaccines do not stop the virus”. They couch this in a language of uncertainty because “proof” has a very specific definition.

No, there is not “proof” that the COVID vaccine prohibits transmission of the virus. We have not run a double-blind study carefully monitoring the vaccinated group against the placebo group, testing them weekly to ensure we catch all asymptomatic carriers. We have not traced all of their contacts to see if COVID transmission came from a vaccinated asymptomatic carrier instead of an unvaccinated community transmission. We have not “proven” anything.

You know what else we don’t have “proof” for?

That’s a provocative statement and it seems to go against everything I’ve recommended for the last 10 months. I believe that high-filtration masks do help reduce the amount of COVID particles we exhale and inhale and I was making that case when the CDC still told us that masks were bad.

But I cannot prove it.

If what we’re looking for is the kind of “proof” people are demanding in order to let people go unmasked, then let’s apply it evenly. We have no “proof” that masks work to reduce COVID transmissibility. We have no double-blind study with masked and unmasked participants measuring them in identical situations using placebo masks for 30 percent of the participants to see how COVID transmission works in masked, placebo masked, and unmasked environments.

The lack of proof has has not stopped states and municipalities from mandating masks for everyone and declaring all mask-skeptics are anti-science. We make decisions in the absence of proof all the time. We tell people to put on masks entirely without proof and then tell them they can’t take the masks off until we get positive proof that they aren’t needed.

We actually are not capable of running a study to obtain “proof” that vaccinated but unmasked citizens aren’t a risk of spread when compared to vaccinated but masked citizens because you would have to demand that your placebo group go around unmasked. You would have to give the unmasked participants some special permission to enter restaurants and grocery stores without a mask so you could study the effects. If everyone in your study wears a mask all the time, all you’re proving is that vaccinated people with masks on aren’t a risk but it still could be that vaccinated people without masks are a risk.

We literally cannot study this thing because it would be considered unethical to demand that a control group walk around unmasked. It’s a Catch-22 in which you can’t prove that unmasked activity is safe but you also can’t study unmasked activity because you don’t know if it is safe.

So… no, we have no proof that the vaccine cuts off all possibility of asymptomatic transmission. But the reverse is true as well. We also have no proof that the vaccine allows asymptomatic transmission. And, unlike the first statement, we have plenty of evidence to believe that it does not.

Technically Correct But Misleading

I am all in favor of technically correct information but I despise rhetoric that is technically correct while giving an incorrect impression. People remember things through impression, not technical rhetorical accuracy. If you run a news story that says “You still need to wear a mask because transmission while vaccinated may be possible”, what people read out of that is “the vaccine doesn’t actually stop this thing from transmitting”. They will take that information and use it as a rung in a logic ladder to come to some very dangerous conclusions. I am exhausted with people who come back to the story 3 months later and claim “oh, I never actually *said* the vaccine doesn’t protect you, I just implied it heavily without offering any glimpse of hope.”

Please stop doing this! I recently had an extremely intelligent friend ask me if the vaccine actually stopped the virus from infecting people or if the virus still infects people at the same level but stops them from getting as sick. (The answer is yes, the vaccine does stop the virus from taking over your cells and using them to generate more virus. If it didn’t do this, the study participants would test positive for COVID, which they didn’t.)

This is a devastating indictment of our disastrous media culture and a deep failure in the field of public health policy, which has now developed a fairly reliable reputation of lying to people “for their own good” instead of trusting people with complex information.

If we had taken 10 years to study this vaccine instead of 9 months, we would have more information about the details of this vaccine and its effects on transmissibility and viral load and a hundred other questions. That’s what normally happens with vaccine trials and studies; that is why they take so long. But we decided to get it out as fast as possible and that means incomplete information.

However, every inch of evidence we have points toward the vaccine reducing transmissibility, reducing viral load, decreasing the chance of both asymptomatic infection and symptomatic infection, and reducing the severity of the disease when a vaccinated individual does end up contracting it. We can “prove” very little of this in the sense that we are used to demanding medical proof. But, again, we also can’t “prove” that masks are effective and we’ve still allowed states and private companies to make massive population-wide rules about something for which we have plenty of evidence for but no formal proof.

So what should you do?

This is what I’m planning for myself and within my family, which includes a number of high-risk individuals.

After a reasonable amount of time for the vaccination to produce an immune response (aim for 2 weeks), you are not in danger and you are not a danger to others. Yes, wear a mask for social cohesion or to follow the rules or just generally to be polite. Wash your hands, use your common sense, and ignore the news written by people who seem to want this crisis to last forever. Make it a priority to get your second dose on schedule. Once you are vaccinated with the second dose, this crisis is over for you.

Looney Tunes: Odor-able Kitty

This is the very first Pepe Le Pew short. While most of the LePew shorts involve an unsuspecting female cat accidentally finding herself painted to look like a skunk, this short starts with a persecuted feline purposely putting on the airs of a skunk in order to exact revenge on a society that has rejected him.

Only after his successful deception is the poor cat accosted by Pepe with his amorous intent. The resulting cat-and-mouse game is hilarious and adorable. The jokes are thick on the ground and the addition of Le Pew’s wife at the end (the only time she appears) is so good that I wish they had made it a running gag in the Le Pew shorts.

Even so, it’s delightful to witness the birth of such an iconic character.