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I said that the immune system can cause damage. Vaccines have a very high safety standard as they are given to large numbers of healthy people, so the tolerance

I said that the immune system can cause damage. Vaccines have a very high safety standard as they are given to large numbers of healthy people, so the tolerance for serious side effects is very low. So the development there is very careful, and anything that looks too dangerous is hopefully caught in animal experiments or at worst at phase I. A well known example of how dangerous the immune system can be is the following phase I trial: https://www.nejm.org/doi/full/10.1056/nejmoa063842 https://www.nejm.org/doi/full/10.1056/nejmoa063842 That drug caused a cytokine storm in the participants in the phase I trial. Allergies are another example of how dangerous the immune system can be if it is triggered against the wrong targets.

jerf 6y ago
I have suspected for much of the last year that a lot of people are running on an unexamined "Only crazy people think vaccines cause autism -> Only crazy people think vaccines are ever dangerous in any way -> All vaccines are perfectly safe" psuedo-syllogism. This is false. Put another way, the very fact that we run such massive tests on them before deploying them is itself evidence that the wrong ones can be very dangerous. (Mostly, as I understand it, "very dangerous" to a small set of people who will have very large reactions, even if most people are fine. The ones that are very dangerous to everyone never gets past the initial phases at all, of course.) We're not doing that because vaccines are all perfectly safe under all conditions, but we just want to hold them back for a year for no reason. We're doing it because we need to be very careful with them. Though I'd also observe a non-trivial component of that danger is also because we're injecting them. Bypassing the body's co-evolved with the environment's defenses is not to be done lightly. This sort of inhaled vaccine is likely to be much less dangerous. I won't say "safe", but less dangerous; the body already has to deal with essentially arbitrary small amino acid sequences being inhaled all the time. I'd still be a bit worried about sythesizing things that we haven't co-evolved with. (If you don't know what co-evolution is, I'd suggesting taking a moment to learn about it: https://www.britannica.com/science/coevolution https://www.britannica.com/science/coevolution It's a very important part of understanding the disease landscape holistically.)
- bawolff 6y ago
  [Deleted. I didn't fully read the parents post, and responded emotionally. That was wrong of me and I apologize]
  - yters 6y ago
    I personally know very intelligent and highly educated people who went to top universities who are convinced vaccines caused mental retardation in their children. They may be wrong, but I would not call them nutjobs.
    - bawolff 6y ago
      Being smart and being crazy are not mutually exclusive
      - macintux 6y ago
        I think it’s more accurate to say that intelligence is not adequate defense against trusting the wrong sources of information, and people are extremely resistant to changing their minds once they’ve placed a stake in the ground.
        bawolff 6y ago
        I'd go with both. There are plenty of smart people who i would consider delusional. Which is separate from people stuck in their views. However, as the saying goes, science advances one funeral at a time.
    - pwython 6y ago
      > "very intelligent and highly educated people who went to top universities" Imagine trusting a "rocket scientist" to even weigh in on medical topics because they are "very intelligent" in their totally unrelated field. This is an unfortunate misconception that plagues conspiracy theory extremists who reference PhD graduates in their arguments against things like 5G brain control.... pointing to people with doctoral degrees in Music or something.
zests 6y ago
I have no doubts about the safety of vaccines in healthy people. I have some harmless curiosity about people who are not known to be healthy. How do you actually determine if someone is "too immunocompromised" for a vaccine? This must be a question with no good answer.
- majormajor 6y ago
  > I have no doubts about the safety of vaccines in healthy people. I have some harmless curiosity about people who are not known to be healthy. How do you actually determine if someone is "too immunocompromised" for a vaccine? My understanding is that being too immunocompromised for a vaccine happens in two different ways: 1) the vaccine contains live virus and so there's danger that the weak immune system couldn't fight this off 2) the vaccine isn't live, so it's not dangerous on its own, but the immune system is too weak to recognize it, so it doesn't build any immunity to the real thing. (One doctor I was talking to said the mRNA ones should be good here, because your own body produces so much of the lookalikes that even a weak immune system should notice it - and then you're much better prepared to fight the real thing off faster.) Only the first is immediately dangerous, so the standard seems to be to just stay away from those. I'm not sure if much is commonly done for the second, in terms of looking for response, but you can get tests for measles antibodies and such, so that would probably be how?
  - gus_massa 6y ago
    The MMR vaccine has live virus, and before injecting the kids the nurse make a few additional questions about the health of the children and IIRC about the people that live with the children. (Like: Does someone in the family have cancer or is immunosuppressed? I don't remember the details.) It's safe, but they must check that the nearby persons are healthy.
- matthew_stone 6y ago
  High-risk populations such as the immunocompromised are tested in a Phase 4 trial.
Symmetry 6y ago
That's true in general but I'd be very surprised if an inhaled rather than injected vaccine that didn't use any adjuvants or live virus was going to cause a serious problem.
- pazimzadeh 6y ago
  Pretty sure omitting adjuvant would probably tolerize you to the peptide, which means you'd be more susceptible to COVID.

jerf 6y ago

I have suspected for much of the last year that a lot of people are running on an unexamined "Only crazy people think vaccines cause autism -> Only crazy people think vaccines are ever dangerous in any way -> All vaccines are perfectly safe" psuedo-syllogism. This is false. Put another way, the very fact that we run such massive tests on them before deploying them is itself evidence that the wrong ones can be very dangerous. (Mostly, as I understand it, "very dangerous" to a small set of people who will have very large reactions, even if most people are fine. The ones that are very dangerous to everyone never gets past the initial phases at all, of course.) We're not doing that because vaccines are all perfectly safe under all conditions, but we just want to hold them back for a year for no reason. We're doing it because we need to be very careful with them. Though I'd also observe a non-trivial component of that danger is also because we're injecting them. Bypassing the body's co-evolved with the environment's defenses is not to be done lightly. This sort of inhaled vaccine is likely to be much less dangerous. I won't say "safe", but less dangerous; the body already has to deal with essentially arbitrary small amino acid sequences being inhaled all the time. I'd still be a bit worried about sythesizing things that we haven't co-evolved with. (If you don't know what co-evolution is, I'd suggesting taking a moment to learn about it: https://www.britannica.com/science/coevolution https://www.britannica.com/science/coevolution It's a very important part of understanding the disease landscape holistically.)

bawolff 6y ago
[Deleted. I didn't fully read the parents post, and responded emotionally. That was wrong of me and I apologize]
- yters 6y ago
  I personally know very intelligent and highly educated people who went to top universities who are convinced vaccines caused mental retardation in their children. They may be wrong, but I would not call them nutjobs.
  - bawolff 6y ago
    Being smart and being crazy are not mutually exclusive
    - macintux 6y ago
      I think it’s more accurate to say that intelligence is not adequate defense against trusting the wrong sources of information, and people are extremely resistant to changing their minds once they’ve placed a stake in the ground.
      - bawolff 6y ago
        I'd go with both. There are plenty of smart people who i would consider delusional. Which is separate from people stuck in their views. However, as the saying goes, science advances one funeral at a time.
  - pwython 6y ago
    > "very intelligent and highly educated people who went to top universities" Imagine trusting a "rocket scientist" to even weigh in on medical topics because they are "very intelligent" in their totally unrelated field. This is an unfortunate misconception that plagues conspiracy theory extremists who reference PhD graduates in their arguments against things like 5G brain control.... pointing to people with doctoral degrees in Music or something.

zests 6y ago

I have no doubts about the safety of vaccines in healthy people. I have some harmless curiosity about people who are not known to be healthy. How do you actually determine if someone is "too immunocompromised" for a vaccine? This must be a question with no good answer.

majormajor 6y ago
> I have no doubts about the safety of vaccines in healthy people. I have some harmless curiosity about people who are not known to be healthy. How do you actually determine if someone is "too immunocompromised" for a vaccine? My understanding is that being too immunocompromised for a vaccine happens in two different ways: 1) the vaccine contains live virus and so there's danger that the weak immune system couldn't fight this off 2) the vaccine isn't live, so it's not dangerous on its own, but the immune system is too weak to recognize it, so it doesn't build any immunity to the real thing. (One doctor I was talking to said the mRNA ones should be good here, because your own body produces so much of the lookalikes that even a weak immune system should notice it - and then you're much better prepared to fight the real thing off faster.) Only the first is immediately dangerous, so the standard seems to be to just stay away from those. I'm not sure if much is commonly done for the second, in terms of looking for response, but you can get tests for measles antibodies and such, so that would probably be how?
- gus_massa 6y ago
  The MMR vaccine has live virus, and before injecting the kids the nurse make a few additional questions about the health of the children and IIRC about the people that live with the children. (Like: Does someone in the family have cancer or is immunosuppressed? I don't remember the details.) It's safe, but they must check that the nearby persons are healthy.
matthew_stone 6y ago
High-risk populations such as the immunocompromised are tested in a Phase 4 trial.

Symmetry 6y ago

That's true in general but I'd be very surprised if an inhaled rather than injected vaccine that didn't use any adjuvants or live virus was going to cause a serious problem.

pazimzadeh 6y ago
Pretty sure omitting adjuvant would probably tolerize you to the peptide, which means you'd be more susceptible to COVID.