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I was recently speaking with a medical friend of mine who spends a lot of her time reviewing clinical trials. She had an interesting perspective that made me re

by enjeyw 6y ago

I was recently speaking with a medical friend of mine who spends a lot of her time reviewing clinical trials. She had an interesting perspective that made me rethink my attitude. She didn't go into details, but she feels that the usual safeguards have been bypassed in an unprecedented manner when approving the covid vaccine, which in any normal situation would be considered completely unethical by the medical community. She noted that this is an extraordinary situation and rushed approval was almost certainly the right move, but cautioned against judging anyone who refuses to get the vaccine and simply dismissing them as antivaxers. They have reason to be uncertain.

Exmoor 6y ago
I think there's a great deal of misunderstanding about what the processes that go into vaccine trials are. I've seen people talk about all this long-term post-trial monitoring that is getting skipped and then have people who've actually run studies comment and say that's not something they've ever done. Honestly, people skipping the vaccine don't really "matter" in the near term. We have more than enough people willing to get the vaccine for many, many months, so if people want to risk reaching immunity the hard way that's their choice.
- petertodd 6y ago
  > actually run studies comment and say that's not something they've ever done. I mean, if that's true, that's really disappointing. Though I find it hard to believe, as I've seen examples of medical papers written from long-term post-vax surveillance. For instance this one from the WHO, finding that they could prevent the deaths of about 500,000 more young girls per year in Africa alone by using a different, more effective, measles vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052142/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052142/ I particularly like that example as it shows what's at stake: literally millions of lives are saved by vaccinations. Screwing up that with hasty approvals, and misleading the public about how much safety data we have, could lead to literally millions of additional deaths in the future if vaccination rates go down. Health authorities should be thinking about the long term, not just getting through the covid crisis.
petertodd 6y ago
Re: nurses specifically, the trials simply didn't enroll people who had already had COVID-19, so they just don't have data on how safe that is. It probably is. But we just don't know yet. There's also little reason to get the vaccine in that case as we're now very confident that immunity after infection is effective and long lasting. Obviously, being exposed to it, many nurses would have been infected already and recovered; if I knew I had been infected already, I would not get vaccinated.
- geoduck14 6y ago
  By the way, even if you had been infected, you still benefit from the vaccine. You should still get the vaccine.
  - petertodd 6y ago
    Do you have a citation for that?
olliej 6y ago
They performed massive trials, what a lot of people are doing is conflating time to develop a vaccine with time to do trials. The trials were not abbreviated, they weren't below usual sample sizes. The only difference is the development time for the vaccine, which is only abbreviated due to the massive advance in development time that new mRNA techniques give us.
- petertodd 6y ago
  The Pfizer trial had about 20,000 people in each arm. That's just not enough data to detect rare side effects at a rate anywhere near high enough to know that the vaccine is safer than covid itself for younger/healthier populations who aren't at risk. For the young, healthy, 0 to 19 age range the infection fatality rate of COVID-19 is around 1 in 2.5 million: https://gh.bmj.com/content/5/9/e003094 https://gh.bmj.com/content/5/9/e003094 Normally that wouldn't be a big problem, as vaccines are usually rolled out relatively slowly, so population wide monitoring should pick up on any issues. But countries are aiming to vaccinate as close to 100% as they can get within a matter of months.

by enjeyw 6y ago

Exmoor 6y ago

I think there's a great deal of misunderstanding about what the processes that go into vaccine trials are. I've seen people talk about all this long-term post-trial monitoring that is getting skipped and then have people who've actually run studies comment and say that's not something they've ever done. Honestly, people skipping the vaccine don't really "matter" in the near term. We have more than enough people willing to get the vaccine for many, many months, so if people want to risk reaching immunity the hard way that's their choice.

petertodd 6y ago
> actually run studies comment and say that's not something they've ever done. I mean, if that's true, that's really disappointing. Though I find it hard to believe, as I've seen examples of medical papers written from long-term post-vax surveillance. For instance this one from the WHO, finding that they could prevent the deaths of about 500,000 more young girls per year in Africa alone by using a different, more effective, measles vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052142/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052142/ I particularly like that example as it shows what's at stake: literally millions of lives are saved by vaccinations. Screwing up that with hasty approvals, and misleading the public about how much safety data we have, could lead to literally millions of additional deaths in the future if vaccination rates go down. Health authorities should be thinking about the long term, not just getting through the covid crisis.

petertodd 6y ago

Re: nurses specifically, the trials simply didn't enroll people who had already had COVID-19, so they just don't have data on how safe that is. It probably is. But we just don't know yet. There's also little reason to get the vaccine in that case as we're now very confident that immunity after infection is effective and long lasting. Obviously, being exposed to it, many nurses would have been infected already and recovered; if I knew I had been infected already, I would not get vaccinated.

geoduck14 6y ago
By the way, even if you had been infected, you still benefit from the vaccine. You should still get the vaccine.
- petertodd 6y ago
  Do you have a citation for that?

olliej 6y ago

They performed massive trials, what a lot of people are doing is conflating time to develop a vaccine with time to do trials. The trials were not abbreviated, they weren't below usual sample sizes. The only difference is the development time for the vaccine, which is only abbreviated due to the massive advance in development time that new mRNA techniques give us.

petertodd 6y ago
The Pfizer trial had about 20,000 people in each arm. That's just not enough data to detect rare side effects at a rate anywhere near high enough to know that the vaccine is safer than covid itself for younger/healthier populations who aren't at risk. For the young, healthy, 0 to 19 age range the infection fatality rate of COVID-19 is around 1 in 2.5 million: https://gh.bmj.com/content/5/9/e003094 https://gh.bmj.com/content/5/9/e003094 Normally that wouldn't be a big problem, as vaccines are usually rolled out relatively slowly, so population wide monitoring should pick up on any issues. But countries are aiming to vaccinate as close to 100% as they can get within a matter of months.