4 ms·

Could you clarify which elements of the response were botched?

by rrss 7y ago

yborg 7y ago
>On December 16, a one-month suspension of the vaccination program is announced by CDC head Sencer. William Foege of the CDC estimates that the incidence of Guillain-Barré is four times higher in vaccinated people than in those not receiving the swine flu vaccine. The rushed vaccine apparently substantially increased the risk of Guillain-Barré syndrome in those receiving it. The syndrome is fatal in up to 5% of those that contract it and can cause permanent damage to the peripheral nervous system. First, do no harm.
- Retric 7y ago
  Increasing the risks of catching the disease from 2 per 100,000 to 8 per 100,000 does not sound that bad. It’s an additional 6 cases per 100,000 and ~0.3 deaths per 100,000. Clearly a significant issue, but less so if it was likely to prevent a serious illness. The real issue was the vaccine was administered for a disease that never gained a significant foothold.
  - yborg 7y ago
    I don't have any objection to developing and distributing a vaccine, but it's deployment without sufficient testing. Had the disease become widespread, as you note it would have been worth the additional risk, but in the event, it made the occurrence of any serious side effects seem more egregious. These kinds of things just feed into the anti-vaccination movement and if that overall hurts vaccination rates long term, rushing a vaccine that ends up having side effects could negatively affect public health.
    - Retric 7y ago
      I am not sure how you can catch something that’s at 6 per 100,000 without giving it to an very large group of people. There are so many unusual conditions that such problems are going to look like statistical noise until your distributing something to around a million people.
  - Johnny555 7y ago
    The vaccine was thought "likely to prevent a serious illness", but that didn't pan out. So that's why testing is important, to make sure that the cost is worth the benefit. Only about 200 cases of swine flu and one death were ultimately reported in the U.S., the CDC said. More than 500 people are thought to have developed Guillain-Barre syndrome after receiving the vaccine; 25 died https://www.latimes.com/archives/la-xpm-2009-apr-27-sci-swine-history27-story.html https://www.latimes.com/archives/la-xpm-2009-apr-27-sci-swin... So in this case, the cure was literally worse than the disease.
    - Retric 7y ago
      The cure was worse than the risk not the disease. If it had actually infected people and had 1 death per ~250 people x say 50% of the population that absolutely dwarfs 25 excess deaths. Which is my point, the problem was mass vaccination for a non issue. Saving 500,000 lives at the cost of 100 lives is a really easy tradeoff to make. Costing 25 lives to save 0 is a problem.
      - Johnny555 7y ago
        The cure was better than the risk of the disease, which was not well understood. The cure was worse than the actual disease.
        Retric 7y ago
        Given the choice between contracting the disease or taking the vaccine you would take the vaccine. But, as the spread had stopped, it was a choice between taking the vaccine or having a 0% chance of catching the disease which had already died out.
  - URSpider94 7y ago
    Maybe in a truly utilitarian, rational society, but here in the USA, we expect the risk of a vaccine to be near zero, with no adverse consequences, before we give it to everyone.
    - mattnewton 7y ago
      This isn’t as irrational as you make it sound- I think it has to do with how we assign blame for actions. Less blame is assigned for failure to prevent hurt than blame for acting in a way that hurts someone directly. This reflects both the practical difficulty in assessing what harm could have been prevented vs what harm was direct caused by an action, and reflects our justice system’s role as a deterrent for people harming others, and less as a tool to compel helpful behavior. From another practical concern, we need to preserve the public perception that vaccines are low risk to them, not just that they are lower risk to society than the hypothetical alternative, before healthy people will get vaccinated.
      - URSpider94 7y ago
        I meant rationality in the economic sense, where we would purely look at the cost-benefit of the decision, and where everyone else would look at it the same way. In that case, even a slight net savings in lives would be OK, even if that meant that administering the vaccine would cause some deaths. I'm not saying that is how we SHOULD act. I'm definitely not saying that's how we DO act. Clearly, taking into account all of the factors that you mention, we have a very high standard for action, and that's a rational choice given the realities. It's still not a rational choice from the economics perspective, which strictly looks at cost/benefit.

Could you clarify which elements of the response were botched?

by rrss 7y ago

Could you clarify which elements of the response were botched?

>On December 16, a one-month suspension of the vaccination program is announced by CDC head Sencer. William Foege of the CDC estimates that the incidence of Guillain-Barré is four times higher in vaccinated people than in those not receiving the swine flu vaccine. The rushed vaccine apparently substantially increased the risk of Guillain-Barré syndrome in those receiving it. The syndrome is fatal in up to 5% of those that contract it and can cause permanent damage to the peripheral nervous system. First, do no harm.

Retric 7y ago
Increasing the risks of catching the disease from 2 per 100,000 to 8 per 100,000 does not sound that bad. It’s an additional 6 cases per 100,000 and ~0.3 deaths per 100,000. Clearly a significant issue, but less so if it was likely to prevent a serious illness. The real issue was the vaccine was administered for a disease that never gained a significant foothold.
- yborg 7y ago
  I don't have any objection to developing and distributing a vaccine, but it's deployment without sufficient testing. Had the disease become widespread, as you note it would have been worth the additional risk, but in the event, it made the occurrence of any serious side effects seem more egregious. These kinds of things just feed into the anti-vaccination movement and if that overall hurts vaccination rates long term, rushing a vaccine that ends up having side effects could negatively affect public health.
  - Retric 7y ago
    I am not sure how you can catch something that’s at 6 per 100,000 without giving it to an very large group of people. There are so many unusual conditions that such problems are going to look like statistical noise until your distributing something to around a million people.
- Johnny555 7y ago
  The vaccine was thought "likely to prevent a serious illness", but that didn't pan out. So that's why testing is important, to make sure that the cost is worth the benefit. Only about 200 cases of swine flu and one death were ultimately reported in the U.S., the CDC said. More than 500 people are thought to have developed Guillain-Barre syndrome after receiving the vaccine; 25 died https://www.latimes.com/archives/la-xpm-2009-apr-27-sci-swine-history27-story.html https://www.latimes.com/archives/la-xpm-2009-apr-27-sci-swin... So in this case, the cure was literally worse than the disease.
  - Retric 7y ago
    The cure was worse than the risk not the disease. If it had actually infected people and had 1 death per ~250 people x say 50% of the population that absolutely dwarfs 25 excess deaths. Which is my point, the problem was mass vaccination for a non issue. Saving 500,000 lives at the cost of 100 lives is a really easy tradeoff to make. Costing 25 lives to save 0 is a problem.
    - Johnny555 7y ago
      The cure was better than the risk of the disease, which was not well understood. The cure was worse than the actual disease.
      - Retric 7y ago
        Given the choice between contracting the disease or taking the vaccine you would take the vaccine. But, as the spread had stopped, it was a choice between taking the vaccine or having a 0% chance of catching the disease which had already died out.
- URSpider94 7y ago
  Maybe in a truly utilitarian, rational society, but here in the USA, we expect the risk of a vaccine to be near zero, with no adverse consequences, before we give it to everyone.
  - mattnewton 7y ago
    This isn’t as irrational as you make it sound- I think it has to do with how we assign blame for actions. Less blame is assigned for failure to prevent hurt than blame for acting in a way that hurts someone directly. This reflects both the practical difficulty in assessing what harm could have been prevented vs what harm was direct caused by an action, and reflects our justice system’s role as a deterrent for people harming others, and less as a tool to compel helpful behavior. From another practical concern, we need to preserve the public perception that vaccines are low risk to them, not just that they are lower risk to society than the hypothetical alternative, before healthy people will get vaccinated.
    - URSpider94 7y ago
      I meant rationality in the economic sense, where we would purely look at the cost-benefit of the decision, and where everyone else would look at it the same way. In that case, even a slight net savings in lives would be OK, even if that meant that administering the vaccine would cause some deaths. I'm not saying that is how we SHOULD act. I'm definitely not saying that's how we DO act. Clearly, taking into account all of the factors that you mention, we have a very high standard for action, and that's a rational choice given the realities. It's still not a rational choice from the economics perspective, which strictly looks at cost/benefit.