We have benefited enormously from the vast economies of scale in the vaccine industry. Because childhood vaccines were mandated, the companies that made them could be confident that they’d be able to sell large numbers. That made it worth both doing the research and investing in capacity.

Even flu vaccines have benefited, because government agencies got a bunch of scientists to come together and produce their best guess as to what strains to vaccinate against each year, so that there only had to be one vaccine that everyone got, and mandating that insurance companies had to pay for it.

But with the current administration in the U.S. suggesting that vaccines are generally bad, I fear we’re going to see less of that: fewer mandates are going to mean fewer vaccines being administered. Obviously that’s going to mean more sick people, which is really bad. But almost as bad, it’s going to reduce the economies of scale, meaning that the per-shot cost of vaccines are likely to rise significantly.

This all got me to thinking, what would a post-mandated-vaccines world look like?

Well, only smart people would buy vaccines, and only rich people would be able to afford them.

How many people are both smart and rich? And how rich would you have to be? Depending on how much prices went up, maybe only the top 50% would be able to afford them, maybe the top 10%, maybe the top 1%.

One small upside might be that boutique vaccine shops could find it worthwhile to make better vaccines—modestly better effectiveness, modestly reduced side-effects—because there’d be vaccine competition.

Really, though, there was always a strong push for that stuff for mandated vaccines, because if you’re going to give out 300 million doses, even a tiny improvement is going to really matter.

Still, I read a year or so ago about a version of the Covid-19 vaccine that produced much longer-lasting immunity being discontinued because they couldn’t sell enough of it, because it wasn’t mandated. That’s the sort of thing that might get better in a post-mandate world.

Won’t be a net win for society. Probably not even a net win for the 1% who can afford whatever bespoke vaccines they want, because it costs billions to research and test a vaccine, and even the 1% can’t afford that, unless they all get together and fund joint projects.

A selfie showing the bandage on my arm where I just got my Covid shot

These thoughts brought to you by me getting my Covid shot now rather than waiting until just a few weeks before I go visit my 92-year-old mother—because who knows if it’ll be available then?

Just before my summer trip to Amherst, I got a Covid booster—even though the new Covid shot was just about to come out—because I wanted to minimize the chance of catching Covid on a plane or at an airport, and bringing it to my mom or brother.

Since then, I’ve been waiting for four months to pass, so I could get the new shot, now that it’s available. (It turns out that now you only have to wait two months, but nobody told me that.) Anyway, the four months are up, so I got my Covid booster and a flu shot this morning.

Me with two band aids on my left arm, where I got a Covid shot and a flu shot
Flu shot and Covid shot

My left arm is now moderately sore. In fact, it roughly matches my right arm, which has been sore for months now. (I think originally dog-walking injuries to my right elbow and right shoulder, exacerbated by sword fighting, and exercise. I’ve recently started walking the dog left-handed, cut my sword fighting practice to just once a week, and cut the weight way down on my kettlebell clean&press. Oh, and I have a modest bruise on the right bicep where yesterday I took thrust that just missed the protective plate on my fencing jacket. The jacket is also padded though, and the thrust wasn’t that hard, and the sword was nicely flexible to make it safe for sparring between friends.)

“Mounjaro and the weight loss drug Zepbound slashed by 94 percent the risk that overweight or obese adults with pre-diabetes would develop diabetes… a lot of those same people could have had a great outcome with lifestyle intervention”

Source: NYT

Great outcomes from lifestyle interventions are why almost nobody in the US has diabetes.

I’m only surprised this doesn’t happen way more often. Surely a lot of people go into health research precisely to try to cure illnesses they have. If they come up with something very promising, why not try it on themselves?

A scientist who successfully treated her own breast cancer by injecting the tumour with lab-grown viruses has sparked discussion about the ethics of self-experimentation.

Source: Nature

In histories of the period before modern medicine, people were often “sickly” in some fashion or another.

That’s been much less true the past hundred years or so. With a few exceptions (terrible accidents, horrific war injuries), if whatever you had didn’t kill you, you probably got entirely better.

Since I first heard of Long Covid, I’ve been expecting a return to the historical norm.

Looks like I was right:

A total of 17.6% of American adults have ever experienced long Covid symptoms, the survey found.

Source: The Guardian

Back at the end of September I came down with West Nile Fever, which made me pretty sick for a long time. The only time in my life before I was that sick for that long was when I had Mononucleosis when I was a freshman in college. That time I was sick for most of the term, and it took several weeks of the Christmas vacation to fully recover.

With West Nile it took about three weeks to recover from the acute phase of the illness. That is, I had a fever constantly for three weeks. Then it took another three weeks to get my energy levels back. For that period I could walk the dog, fix breakfast, and then do one thing, after which I needed to go back to bed and take a nap.

Temperature data from my Oura ring: I first showed a fever on September 25th. My temperature spiked up to a high of 5.3℉ above baseline on October 6th, and didn’t really settle back in to normal until November 6th.

As of a couple of days ago, I think I’m back to full health. I’ve been doing workouts—not as frequently as I’d like, but often enough that I’ve been able to start pushing the weights up again, although not up to what I doing before I was sick. I’ve been for a couple of runs, both of which were harder and slower than I’d like, but were okay—I didn’t feel like I was sick, just like I hadn’t been running enough the past few weeks.

On Sunday I got a Covid booster, so I felt slightly less energetic Monday, but that has already passed.

After too many weeks, I finally feel back to normal!

About three weeks ago I developed a fever and moderate flu-like symptoms. It felt like a virus, so I mostly just treated it liked one—sleeping extra, drinking extra fluids—and waited to get better.

It was kind of frustrating, because it just went on and on. For a brief period there in the middle of week two, it got a bit more exciting: I starting having trouble finding words. (I sounded exactly like my dad when his dementia made it impossible for him to say stuff. Pretty scary.) At about the same time I started suffering from double vision.

At the prompting of my mom and brother, I went to the emergency room for the word difficulty. They did a whole workup for a possible stroke: CT scan, chest x-ray, and and MRI.

I was not having a stroke.

Once I was released from the emergency room I made a follow-up with my regular doctor, who was kind of groping for possibilities, and put in an order for a few tests. The blood was draw on Monday, and today I got the results: positive for West Nile virus.

The related illness, West Nile Fever, does sound exactly like what I had. (That’s actually kind of a scary link. I’m pretty sure I’m not going to have any of the longer-term consequences. I was just sick for three weeks.)

Anyway, I think I’m on the mend. I’m resuming normal activity as each thing seems okay. It’s taking a while feel up to swordfighting, but I think I can finally do everything else on my usual list.

You don’t have to know much about me to know that the latest video from The Bioneer on training for longevity is like catnip for me:

You will not be surprised to learn that the advice comes down to move more, move more diversely, and learn a lot. (Of course, adding diverse complex movements is learning.) But there is also specific useful advice re: power, bone density, tendon strength, etc.