And it didn’t need to happen, and we should stop. One of the things I’ve noticed over the last eighteen months is a reluctance to claim that vaccination, while incredibly beneficial, doesn’t stop everything, since that would be interpreted as weakening the case for vaccination. If you’re on the Twitterz, you see this all the time: “[Rich famous person who is vaccinated] got COVID! I thought the vaccines worked! NEENER NEENER!” Understandably, when faced with such idiocy, people don’t want to talk about the limitations of the vaccines. But that pollyannish approach undermines the adoption of non-pharmaceutical interventions (NPIs) such as masking, improved ventilation, testing, and the social supports such as sick leave that allow people to recover safely (for themselves and others).

Just to review (and to spray some Troll-B-Gone), here are some of the benefits of vaccination:

1. Decreased probability of death if you’re infected.
2. Decreased probability of hospitalization if you’re infected.
3. Decreased likelihood of infection, even against Omicron, even after two months, when waning effectiveness against Omicron kicks in.
4. Decreased likelihood of infecting others, even in close quarters, even against Omicron.
5. Decreased likelihood of contracting long COVID if you’re infected.

These are all great things! You should get vaccinated and boosted if you’re not already!

But decreased is a vague word. None of the adverse events listed above go anywhere close to zero or ‘medically rare’ (less than one in a thousand). Leaving aside the sociopaths among us, including those at major publications, who think 100,000 dead people, disproportionately the elderly, the immunocompromised, and those with comordibities, are acceptable casualties, at a population level, vaccination by itself isn’t enough to prevent a lot of American Carnage (to use a phrase). For example, long COVID is far less likely, but it still probably affect one to three percent of vaccinated people who are infected (which, again, is significantly better than the unvaccinated). If 100 million vaccinated people get COVID, that’s a lot of disabled people, some of them possibly for life.

If people were aware of this, we might see more support for masking and the other interventions (horrible band name, by the way). These would prevent many infections, until we can hopefully (assuming the Republicans in Congress stop acting like assholes) deploy Omicron-based vaccines or intranasal vaccines. Instead, because we’re not being forthright about the strengths and the limitations of the vaccines, we’re actually harming the uptake of NPIs.