The various waves of coronavirus infections provoke a great deal of dispute and angst about vaccines, vaccine hesitancy, skepticism and "science." An objective review of the available evidence suggests the following:
1. Vaccines do, in fact work. The mechanism is understood, although likely not as well as vaccine advocates claim.
2. The experience with the virus is unavoidably local. Environment has much more to do with it than a simplistic notion of R values.
3. From a COVID experience perspective, it is reasonable to ask if a person is better off being unvaccinated in South Dakota than vaccinated in Florida.
4. The trajectory of disease numbers in highly vaccinated United Kingdom and the rapid decrease in cases in India following a dramatic increase, suggests that vaccination is not an especially strong determinant of the course of the pandemic.
5. Vaccines probably do mitigate the severity of infection, even if they do not prevent them.
6. Assessing vaccine effectiveness by measuring antibodies seems to make sense, but is probably vitiated by invalid assumptions. The immune response likely has much more significant determinants than antibody counts.
7. The simplest explanation for the surge in cases in the United Kingdom, is that the vaccine is effective in suppressing infections but this effect wanes over time, There is likely a half-life to the vaccines effectiveness, which is measured in months.
8. Masks may affect whether a person gets infected with COVID on a particular day, but not whether a person will eventually get COVID.
9. The Russian and Chinese vaccines provide some transient protection against COVID, but probably not enough to be part of a vaccination strategy.
10. Vaccines are associated with auto-immune complications, the risk of which in particular people outweigh the benefits of vaccination. In other people the benefits of vaccination outweigh the risks.
11. The discussion of vaccine has become so politicized that the "science" has been severely compromised.
12. Some people will die of COVID complications. Some people can avoid these complications with vaccination. Nonetheless, some people who weigh the risks and benefits of vaccination and choose to not get vaccinated are making reasonable choices. For most people though, the benefits of vaccination, even if they are likely to be transient, outweigh the risk.
13. The science of virology is not nearly as advanced as its proponents claim. There is much more that we do not know, and show no interest in knowing if it compromises a political advantage, that we actually know.
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