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I think this is an example of where government transparency would greatly aid the discourse and build trust. Where is the math that suggests that pausing the J

I think this is an example of where government transparency would greatly aid the discourse and build trust. Where is the math that suggests that pausing the J&J vaccine is prudent? Inputs being risk of getting covid, risk of getting a blood clot, risk of injury/death from covid, risk of a new covid variant appearing, etc. Without that transparency we’re all just guessing.

opinicus 6y ago
An analysis of the relative risks is obviously the objectively correct answer from a rational perspective, but most people aren't making decisions based on that kind of statistical reasoning (though we'd doubtless have better outcomes if they did). There's a serious risk that problems like this can spark a backlash against all COVID vaccines if not handled conservatively--there are plenty of people just waiting to have their anti-vaccine confirmation biases triggered. How to handle these events is as much a question of social behavior and public relations as it is of science.
- convexfunction 6y ago
  One could argue (and many have, persuasively, I think) that Europe making a big show of being highly conservative about the blood clot non-issue with the AZ vaccine caused people to dramatically overestimate the risk of getting any kind of COVID vaccine. e.g., I recall an anecdote about a person in the US, who was going to get a different vaccine in any case, who decided to not get a vaccine because a family member from Europe assured them that blood clots were a serious risk that they should definitely be worried about.
- peytn 6y ago
  > there are plenty of people just waiting to have their anti-vaccine confirmation biases triggered You’re probably right, but if we keep trying to front-run people’s reactions to events over and over again, I’m not sure we’re going to get great results in the long run. I get the impression that anticipating how people will respond to news is engendering more extreme responses to future events.
ppf 6y ago
And not just for the vaccines, but the choices made in Covid policies and mandates.
convexfunction 6y ago
I'll guess that you might be aware this is the reason, but just in case, I'm pretty sure the reason is that nobody who makes these decisions is actually doing any cost-benefit analysis (aside from the costs and benefits to them personally and their organization, maybe).
Trasmatta 6y ago
Looks like it was 6 cases after about 7 million doses. Even if it were caused the vaccine, the risk there is incredibly low. Much lower than the risk of an adverse COVID case, I would think. Does pausing to investigate such an incredibly rare occurrence increase the public's trust in vaccines (because they see the government is being extra careful with safety data) or decrease it (because skeptics will use this as evidence that there are problems with the vaccines)? I feel like it's mostly the latter, but I dunno. Not to mention all the COVID cases that might have been prevented while the rollout is paused to investigate a potential side effect that's less than one in a million.
- bitcurious 6y ago
  > Looks like it was 6 cases after about 7 million doses. Even if it were caused the vaccine, the risk there is incredibly low. Much lower than the risk of an adverse COVID case, I would think. Right, but the clots happened about 2 weeks after the vaccine, so that what portion of those ~7 million were administered over two weeks ago? Clots happened to a similar demographic, so what portion of those ~7 million were to women in the right age group? What about clots that cause damage that’s not immediately obvious (and thus not spotted). I hesitate to dismiss the risk outright, but I do think that we should hold the CDC/FDA to the standard of “methodical.”
tzs 6y ago
The comment by Barleyman on the Ars Technica article on this [1] has a graphic from someplace called the Winston Centre for Risk Analysis that shows the benefits in COVID reduction vs the harms from the AZ vaccine by age group. According to that graphic, if you are in a time of medium COVID infection rates (60 per 100k per day), the risk from COVID outweighs the vaccine risks in that age group. If you in a time of low rates (20 per 100k per day) the vaccine risks outweigh the COVID risks. The vaccine risk goes down as patient age goes up, and the COVID risk goes up as age goes up. The J&J risks will probably follow a similar pattern and it also appears that the J&J clots require unusual treatment. That suggests a pause to at least figure out where the risk curves cross and to make sure that doctors and hospitals are prepared to recognize and treat the J&J clots. [1] https://arstechnica.com/science/2021/04/us-cdc-fda-call-for-pause-in-use-of-jj-vaccine-due-to-rare-blood-clots/?comments=1&post=39817123 https://arstechnica.com/science/2021/04/us-cdc-fda-call-for-...
- bitcurious 6y ago
  That’s excellent, thank you for sharing! The comment you linked to suggests that the gender disparity can be attributed to women being over-represented in getting the vaccine, but I’m not sure the logic holds. Medical professionals were mostly done being vaccinated prior to J&J being approved.

opinicus 6y ago

An analysis of the relative risks is obviously the objectively correct answer from a rational perspective, but most people aren't making decisions based on that kind of statistical reasoning (though we'd doubtless have better outcomes if they did). There's a serious risk that problems like this can spark a backlash against all COVID vaccines if not handled conservatively--there are plenty of people just waiting to have their anti-vaccine confirmation biases triggered. How to handle these events is as much a question of social behavior and public relations as it is of science.

convexfunction 6y ago
One could argue (and many have, persuasively, I think) that Europe making a big show of being highly conservative about the blood clot non-issue with the AZ vaccine caused people to dramatically overestimate the risk of getting any kind of COVID vaccine. e.g., I recall an anecdote about a person in the US, who was going to get a different vaccine in any case, who decided to not get a vaccine because a family member from Europe assured them that blood clots were a serious risk that they should definitely be worried about.
peytn 6y ago
> there are plenty of people just waiting to have their anti-vaccine confirmation biases triggered You’re probably right, but if we keep trying to front-run people’s reactions to events over and over again, I’m not sure we’re going to get great results in the long run. I get the impression that anticipating how people will respond to news is engendering more extreme responses to future events.

ppf 6y ago

And not just for the vaccines, but the choices made in Covid policies and mandates.

convexfunction 6y ago

I'll guess that you might be aware this is the reason, but just in case, I'm pretty sure the reason is that nobody who makes these decisions is actually doing any cost-benefit analysis (aside from the costs and benefits to them personally and their organization, maybe).

Trasmatta 6y ago

Looks like it was 6 cases after about 7 million doses. Even if it were caused the vaccine, the risk there is incredibly low. Much lower than the risk of an adverse COVID case, I would think. Does pausing to investigate such an incredibly rare occurrence increase the public's trust in vaccines (because they see the government is being extra careful with safety data) or decrease it (because skeptics will use this as evidence that there are problems with the vaccines)? I feel like it's mostly the latter, but I dunno. Not to mention all the COVID cases that might have been prevented while the rollout is paused to investigate a potential side effect that's less than one in a million.

bitcurious 6y ago
> Looks like it was 6 cases after about 7 million doses. Even if it were caused the vaccine, the risk there is incredibly low. Much lower than the risk of an adverse COVID case, I would think. Right, but the clots happened about 2 weeks after the vaccine, so that what portion of those ~7 million were administered over two weeks ago? Clots happened to a similar demographic, so what portion of those ~7 million were to women in the right age group? What about clots that cause damage that’s not immediately obvious (and thus not spotted). I hesitate to dismiss the risk outright, but I do think that we should hold the CDC/FDA to the standard of “methodical.”

tzs 6y ago

The comment by Barleyman on the Ars Technica article on this [1] has a graphic from someplace called the Winston Centre for Risk Analysis that shows the benefits in COVID reduction vs the harms from the AZ vaccine by age group. According to that graphic, if you are in a time of medium COVID infection rates (60 per 100k per day), the risk from COVID outweighs the vaccine risks in that age group. If you in a time of low rates (20 per 100k per day) the vaccine risks outweigh the COVID risks. The vaccine risk goes down as patient age goes up, and the COVID risk goes up as age goes up. The J&J risks will probably follow a similar pattern and it also appears that the J&J clots require unusual treatment. That suggests a pause to at least figure out where the risk curves cross and to make sure that doctors and hospitals are prepared to recognize and treat the J&J clots. [1] https://arstechnica.com/science/2021/04/us-cdc-fda-call-for-pause-in-use-of-jj-vaccine-due-to-rare-blood-clots/?comments=1&post=39817123 https://arstechnica.com/science/2021/04/us-cdc-fda-call-for-...

bitcurious 6y ago
That’s excellent, thank you for sharing! The comment you linked to suggests that the gender disparity can be attributed to women being over-represented in getting the vaccine, but I’m not sure the logic holds. Medical professionals were mostly done being vaccinated prior to J&J being approved.