polio vaccination is often performed sequentially, first with a very safe inactivated virus vaccine, then with a riskier attenuated live virus. the first vaccination renders the second one much less dangerous. cochrane.org/CD011260/BEHAV… 1/
given the extraordinary transmissibility of delta and frequent reports of usually mild “breakthrough infections”, i wonder if the end game here is that we’ll be dragged involuntarily through an analogous protocol. 2/
the role of vaccination becomes not to prevent infection, but to ensure the infection that eventually (hopefully) deepens and completes our immunity is very mild. 3/
this is not a great outcome. 4/
obviously it leaves the immunocompromised at great risk as well as the vaccine hesitant, and postvaccination delta infection is not a carefully tested live virus vaccine but a wild virus whose risks beyond acute mortality, even for the vaccinated, remain mysterious. 5/
i don’t think this is the outcome public health policy should strive for. if we can resist it in favor of suppressing delta until we have vaccine boosters, we should. 6/
but if delta is as transmissible as some of the (hopefully exaggerated!) claims i’m reading, one of the mist contagious airborne respiratory viruses known, this seems the likely endgame. 7/
so get vaccinated! in this scenario, exposure and infection are extraordinarily likely, all you can control is the risk the infection will be severe. vaccination is how you can close-to ensure that it won’t be. /fin
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