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I strongly disagree with this. I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. First, vaccines have an extremel

I strongly disagree with this. I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. First, vaccines have an extremely high success rate, 33% of vaccines make it through all trials to approval. 50% after phase 1 is complete. The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS (a bad disease). If we knew with 100% confidence that this vaccine was tied for the worst, then if you are over 65 it would be about 1,000x better for you to take this "bad vaccine" versus not. Each successive trial lost us a lot of time, and very little confidence gain. The reality is we had many groups all independently find a vaccine that worked in Q12020. It's only the government ban on their use that allowed the pandemic to proceed like it has. Right now in the US, the FDA has said it is not even planning to MEET on the Pfizer candidate's approval for 3 weeks. Just insane. Then, the CDC says it needs 24-48 hours after FDA approval to authorize it's release. Why can't the meet right now? Why can't the CDC pre approve release? Or be in the meeting and give simultaneous approval? Or be on a phone alert to give approval within 1 hour? The most likely answer is that in a nationally declared pandemic, any vaccine produced by someone who has gotten a vaccine approved in the last 10 years can sell and distribute (cash only no insurance) vaccines without approval. Require them to collect data on its usage and efficacy. Wait until normal process to require people to be vaccinated.

nabla9 6y ago
>I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. I think you should check your math. Because covid-19 infection fatality rate is "relatively low", only 10 times seasonal influenza (3X for people in their 30's 15X for people in their 70s) the limit where utility turns negative is quite low. One purpose of approval is to move responsibility from drug companies to the government. They can just pay small fee for National Vaccine Injury Compensation Program or something similar. If you allow volunteers but they have to pay the insurance from free markets, vaccines become too expensive. Drug companies are not willing to give them. Biopharma leaders unite to stand with science http://www.news.sanofi.us/2020-09-08-Biopharma-leaders-unite-to-stand-with-science http://www.news.sanofi.us/2020-09-08-Biopharma-leaders-unite... >The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS (a bad disease). During the 2009 A(H1N1) influenza pandemic Finnish health system used vaccine called Pandemrix, It was almost exactly the same as Focetria used elsewhere in the Europe but it was manufactured using slightly different method. It caused Narcolepsy for 200 kids in Finland and 100 in Sweden before withdrawn.
- mchusma 6y ago
  Thanks for responding, I am genuinely curious if my math is wrong so appreciate the discussion. First, regarding "worst case side effects", I am willing to accept your premise that elevated rates of narcolepsy was in the 2009 A(H1N1) vaccine was worse, and do some math based on that. Looking solely at deaths (let alone potential long term health risks of contracting covid). The IFR for those over 75 is about 4.6% now https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v7 https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v.... If you assume that people had a 10% chance of contracting the disease, you can say that those over 75 would have approximately a 0.46% chance of dying (4.6 in 1,000 dead) if they don't get the vaccine. If they do get a vaccine, that turns out to be as bad as Pandemrix (I believe your example of the worst case side effects), then you would expect 1 in 18400 to get narcolepsy. (source: https://en.wikipedia.org/wiki/Pandemrix https://en.wikipedia.org/wiki/Pandemrix). So if you are a regulator looking at the elderly population, and you assume this is tied for Pandemrix, then for every 18,400 people you would assume 1 case of narcolepsy if you give the vaccine, and 84.64 dead. (85x by volume). I don't know your opinion of "how much worse is death versus narcolepsy?". If you believe death is 10x worse than narcolepsy, then by severity and volume, taking a vaccine with the worst side effects ever would seem about 850x better than not taking it (in elderly populations). Earlier in the pandemic, when IFRs were over 2x as bad, this was well over 1,000x better. If you are getting different math, please let me know, because even using Pendemrix, I cannot seem to justify banning vaccines on utilitarian grounds. Now I do agree that moving responsibility from drug companies to the government is fine, but I think that can be addressed directly if that is a concern. If the argument is "without government assuming responsibility they would be too expensive", I don't think we have any proof of that, not enough for a ban.

nabla9 6y ago

>I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. I think you should check your math. Because covid-19 infection fatality rate is "relatively low", only 10 times seasonal influenza (3X for people in their 30's 15X for people in their 70s) the limit where utility turns negative is quite low. One purpose of approval is to move responsibility from drug companies to the government. They can just pay small fee for National Vaccine Injury Compensation Program or something similar. If you allow volunteers but they have to pay the insurance from free markets, vaccines become too expensive. Drug companies are not willing to give them. Biopharma leaders unite to stand with science http://www.news.sanofi.us/2020-09-08-Biopharma-leaders-unite-to-stand-with-science http://www.news.sanofi.us/2020-09-08-Biopharma-leaders-unite... >The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS (a bad disease). During the 2009 A(H1N1) influenza pandemic Finnish health system used vaccine called Pandemrix, It was almost exactly the same as Focetria used elsewhere in the Europe but it was manufactured using slightly different method. It caused Narcolepsy for 200 kids in Finland and 100 in Sweden before withdrawn.

mchusma 6y ago
Thanks for responding, I am genuinely curious if my math is wrong so appreciate the discussion. First, regarding "worst case side effects", I am willing to accept your premise that elevated rates of narcolepsy was in the 2009 A(H1N1) vaccine was worse, and do some math based on that. Looking solely at deaths (let alone potential long term health risks of contracting covid). The IFR for those over 75 is about 4.6% now https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v7 https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v.... If you assume that people had a 10% chance of contracting the disease, you can say that those over 75 would have approximately a 0.46% chance of dying (4.6 in 1,000 dead) if they don't get the vaccine. If they do get a vaccine, that turns out to be as bad as Pandemrix (I believe your example of the worst case side effects), then you would expect 1 in 18400 to get narcolepsy. (source: https://en.wikipedia.org/wiki/Pandemrix https://en.wikipedia.org/wiki/Pandemrix). So if you are a regulator looking at the elderly population, and you assume this is tied for Pandemrix, then for every 18,400 people you would assume 1 case of narcolepsy if you give the vaccine, and 84.64 dead. (85x by volume). I don't know your opinion of "how much worse is death versus narcolepsy?". If you believe death is 10x worse than narcolepsy, then by severity and volume, taking a vaccine with the worst side effects ever would seem about 850x better than not taking it (in elderly populations). Earlier in the pandemic, when IFRs were over 2x as bad, this was well over 1,000x better. If you are getting different math, please let me know, because even using Pendemrix, I cannot seem to justify banning vaccines on utilitarian grounds. Now I do agree that moving responsibility from drug companies to the government is fine, but I think that can be addressed directly if that is a concern. If the argument is "without government assuming responsibility they would be too expensive", I don't think we have any proof of that, not enough for a ban.