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The science communication on vaccines was really bad. Expecting long-term protection from anything other than severe disease was unscientific wishful thinking that a lot of people who should have known better repeated. TWiV ("This Week in Virology" podcast which tries hard to limit their claims to ones backed by published scientific papers) talks about this a lot, especially in their recent episodes with Andy Slavitt and Paul Offit (another with Offit a few weeks earlier) (Paul Offit is a vaccine scientist who was one of two "no" votes on the FDA panel deciding whether to recommend the new bivalent boosters). (BTW, those links are all to podcasts; for transcripts, they recommend you view them on YouTube and use YouTube's auto-transcription feature.)
It's unclear where the science breakdown happened, but in general vaccines do not prevent infection, only serious disease; the question is whether the vaccine's effect on the disease progression is sufficient to prevent/reduce transmission and without modern tools like PCR tests it's really hard to tell the difference. COVID-19 is not the only disease we know this is true for. IPV (Inactivated Polio Vaccine), the injected Polio vaccine used in most developed countries) does not prevent transmission of Polio, it only protects from severe disease (mild Polio looks like any other cold and no one tests people with minor colds for Polio infection). That Wikipedia link strongly implies that the vaccine does a lot more than that, and the common belief that IPV confers immunity to Polio is probably an indirect cause of the recent case of severe Polio in New York. Polio is apparently a specialty of the host of TWiV so he talks about it a lot and in detail. Our entire Polio eradication effort is based partially on this misunderstanding and they talk on TWiV about how the entire approach may be misguided; that is, that the end-game looks like everyone gets IPV forever, not that we can eventually feel safe not bothering like with Smallpox (although, uh, see Monkeypox).
Note this appears to be mostly a property of the infectious agent (and its interactions with the human immune system), not the vaccine. For whatever reason, the human immune system doesn't maintain long-term a strong enough defense against coronaviruses to be able to fight them off fast enough to stop the infection before transmission; it's not clear to me this has anything to do with the virus mutating. Other viruses take long enough from infection to transmission that a second exposure usually does not result in the individual becoming contagious.
TWiV repeatedly harps on this, that "vaccine efficacy" without specifying efficacy against what is poor communication. Efficacy against death is relatively straightforward to define. Efficacy against severe disease... actually already gets tricky because this usually is measured through counting hospitalizations with certain codes and different countries and different times through the pandemic have had very different standards for who to hospitalize (and how good they are at coding them properly). Efficacy against infection requires defining what counts as an "infection": a rapid test? a PCR test? if so, at what cycle count threshold? or infectious viral load? once again at what threshold? (and in whose BSL-3?)
Here you’re using the scientific definitions of “infection” and “serious disease” which most people don’t know. In culture they use the colloquial definitions.
If you’re around someone with chicken pox and you don’t get big itchy spots, colloquially you didn’t catch it or “get infected”, no matter how big a viral load can be found in their systems. This could be due to vaccination or immunity due to a previous case.
Thus, what most people expected from a COVID-19 vaccine was that they wouldn’t “catch it” afterward. A sense of betrayal is, therefore, reasonable given the political medical messaging.
Yes, I was trying to get at the disconnect between what the science says and what the media/public believe the science says. That oversimplification of how vaccines work has resulted in a lot of bad policy and people feeling lied to and writing things like (quoting the original post in this thread):
which is based on a misunderstanding of what vaccines do, albeit one that was justifiably common before we had an easy way to check for infection separate from disease.
I'm really unclear from listening to TWiV how long scientists have known this / how wide-spread the knowledge was. The scientists on TWiV maintain they have been saying that all along (and, obviously, their episode history is public so they've pointed to instances of them saying it in 2020).
The following are all different possibilities:
The politicians/media lied to us, knowing vaccines wouldn't stop transmission,
Their science advisors told them vaccines would stop transmission because that was the scientific consensus,
[...] but their science advisors should have known better,
[...] there's no reasonable way their science advisors could have been expected to know better but actually new science later showed that was wrong.
I think we're unlikely to have a productive conversation if we can't agree on which of those (or possibly some other option I haven't listed; that certainly isn't an exhaustive list) worlds we live in. TWiV seems to be saying that (3) is accurate. (And TWiV appears to be a group of appropriately qualified experts to be making such claims.) (EDIT: Or to be less consensus building-y, at least be having a discussion about which world we live in.)
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