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I'm trying to understand why this isn't ridiculous, and I'm not sure what that reason could be. The disease left to its own accord has the potential to kill mi

I'm trying to understand why this isn't ridiculous, and I'm not sure what that reason could be. The disease left to its own accord has the potential to kill millions (someone please correct me on this). Why would we pause a vaccine because 6 people in 7 million got blood clots? Why would we do that and risk fueling anti-vaccine viewpoints? I'm baffled, but perhaps I'm a fool.

jsight 6y ago
Yes, but the risk is death and there are alternatives that do not appear to have this risk. Why not pause until it is more well understood? In the US, the other vaccines are starting to become really readily available.
- lisper 6y ago
  Because the rate of vaccination is still supply-limited at the moment. If everyone who would have received the J&J vaccine could get a safer alternative in the same time frame this might make sense. But they can't, so it doesn't. Do the math. It is all but certain that more people will die as a result of this pause than without it, even if you assume a worst-case clotting risk scenario under the current data.
  - jsight 6y ago
    I only know my corner of the globe well. In this area, vaccine appointments are pretty easy to get and everyone 16+ is eligible. It certainly looks like any delay caused by this would be minimal. Maybe other parts of the country are different.
    - lisper 6y ago
      What part of the country are you in? And what counts as "pretty easy to get"? In California, the most populous state, people under 50 are not generally even eligible to try to get an appointment for another two days. I don't know how it is in other states, but I don't think this is unusual. That the vaccination rate is supply-limited is manifest in the fact that less than a third of the U.S. population has been vaccinated at all. Yes, there are places where there are vaccine surpluses, but this is not because the supply isn't the limiting factor. It's because in some rural areas there are large numbers of vaccine denialists who are choosing to forego the vaccine altogether. That leaves some localized surpluses. But overall supply is still the limiting factor, and it will continue to be until everyone who wants a vaccine can get one without having to wait.
      - jsight 6y ago
        South Carolina -- availability varies, but most parts of the state have at least some appointments and they seem to be becoming more readily available. > there are large numbers of vaccine denialists who are choosing to forego the vaccine altogether. That leaves some localized surpluses. The people that do not want the vaccine are a part of why. There are different reasons for this, with some just wanting others to get a chance first. But noone is going to force people to take it. Its also really unfair to characterize this as "rural areas" with "large numbers of vaccine denialists". We have urban areas with vaccines available and rural areas with full appointment books.
        lisper 6y ago
        > We have urban areas with vaccines available Really? Where?
        jsight 6y ago
        https://vaccinefinder.org/ https://vaccinefinder.org/ - This site is halfway decent. Be careful to click through to the actual pharmacies, though. It is often out of date with actual availability being lower than indicated. Our state has also been running mobile events that have generally not been fully booked. I'm in no hurry personally, but I'm not seeing where it would be difficult to get for me.
        lisper 6y ago
        > It is often out of date with actual availability being lower than indicated My experience with VF was the exact opposite: it was showing lots of availability where in fact there was none. But the burden of proof is still on you: what urban areas in the U.S. has good vaccine availability? By which I mean: anyone who wants one can get one same-or-next day.
        jsight 6y ago
        > My experience with VF was the exact opposite: it was showing lots of availability where in fact there was none. That's exactly what I said, actually. Though it wasn't none, just low. Be sure to check back after a day or so. Availability swings pretty quickly.
- randomfool 6y ago
  All of these vaccines are approved under emergency authorization- the long-term effects are still unknown. At this same rate (6 in 6 million+), there could easily be unnoticed issues lurking in the alternatives as well. What we do know is that the alternative to not being vaccinated is much worse.
  - jsight 6y ago
    That's possible, but this isn't "unnoticed" and the others have far longer track records in the US at this point.
newacct583 6y ago
It's bad policy. But it's important to get the analysis right: the choice here isn't between a very safe vaccine and an unvaccinated world population facing a pandemic to completion (which matches "the potential to kill millions"). It's between "continued rapid vaccination with all three approved US vaccines" and "somewhat delayed vaccination with one of the three approved US vaccines". That's not remotely a million-person delta, though the number is surely much higher than the 1/1M case rate on these blood clots. Honestly the worst effect isn't with the vaccinations per se, it's the potential that this may delay vaccine acceptance rates among people sitting on the edge, due simply to fear.
ed_balls 6y ago
I suppose they don't know what is the cause and what's gonna happen in the future(6 now, 10 000 in a few years). The communication that public gets is outrageously bad.
- ravenstine 6y ago
  Isn't that as true, if not greater, for the mRNA based vaccines, despite them not having that observed side effect? For all we know, everyone's butts might fall off because of them in the future. (yes, I'm being somewhat facetious)
  - ed_balls 6y ago
    My understanding is the that AstraZeneca and J&J are also new tech. Vector-based and mRNA are different than attenuated (weakened) form of the virus which is used in most vaccines. (I'd be good if someone with more knowledge could comment)
    - ravenstine 6y ago
      Yes, you are right. Both are experimental / new tech.
deleted 6y ago
[deleted]
krastanov 6y ago
For many people the risk of serious complications from COVID is similar. I am a young, healthy introvert working from home and enjoying the social isolation in a location that does not have explosive spread right now. The product of "probability of getting COVID" * "having serious long term effects or death" is in the same ballpark for me. I would still get this vaccine (or the AZ one) if offered because I consider it my duty to be part of the herd immunity. But not everyone will do that, and the moment you have people in privileged position refusing one of the vaccines, you start (1) exacerbating inequalities (2) fueling conspiracy theories, mistrust, and vaccine hesitancy. If you assume that the world is perfectly rational, then you are right, but it is a running joke on HN to point out how economists used to make that same mistake and derive silly conclusions.
- CannisterFlux 6y ago
  The risk of a vaccine is very low. But emotionally it is hard to accept. It is my actual choice to have the vaccine and go from 0 chance of vaccine-related blood clots to some non-zero value. Whereas catching covid feels more like I'm in control of not catching it by not leaving the flat, and even if I did catch it, chances are it'd not affect me that much. I know this is not totally logical, but it is difficult to get past emotionally. Imagine if I did get blood clots from the vaccine - I'd go from safe in my flat and healthy, to dead, and for what? To protect me from a virus that has an even lower chance of causing long-term problems, and from which I can protect myself by being careful.
dragonwriter 6y ago
> Why would we pause a vaccine because 6 people in 7 million got blood clots? Because J&J isn’t the only vaccine in the inventory, and the others don’t have that problem (or, IIRC, the same level of other adverse reactions), and because: > Why would we do that and risk fueling anti-vaccine viewpoints? What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especially giveb that people often don’t have a choice of which vaccine they are administered.
- ravenstine 6y ago
  > What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especially giveb that people often don’t have a choice of which vaccine they are administered. Your point about other vaccines being available is totally valid and sound, but... what is our standard here, then? For absolute-zero people to die of any vaccine we produce? What if it was 1 person who got a blood clot? It probably sounds like I'm being pedantic, but I'm serious in that I want to know why people find it reasonable to pull an otherwise effective vaccine because of this. It just doesn't seem worth it to tell everyone that the vaccine is dangerous enough that it had to be pulled entirely. Ignoring adverse impacts definitely fuels anti-vaccine sentiment, but so does giving people concrete evidence that the vaccine can possibly kill people, possibly leading them to be resistant to getting any COVID vaccine at all until they're forced to get it. I mean, if I were at all skeptical of getting a COVID vaccine, and I was told the J&J vaccine was so dangerous they had to pause it, why would I get any of the more experimental vaccines knowing that they also have the potential to kill me but we don't even know yet because they're experimental? I don't think people on HN realize the full magnitude to which the public can be timid and irrational. It just doesn't seem worth it to me for us to possibly fuck up the rollout of vaccinations when we are facing a possible 4th wave of COVID and more virulent variants. Let's compare some numbers here. The number of known blood clot cases with the J&J vaccine seems to be 6 in 7 million. That's a ~0.00000085% chance of getting a blood clot caused by the vaccine, give or take a zero since I suck at math and calculators refuse to not use scientific notation. According to the CDC, around 100,000 people die of blood clots in the United States every year, and the US population is 308,401,808, meaning that Americans have a ~0.0003% chance of dying of a blood clot in their lifetime. The only concerning factor as far as I can tell is that the people who got the blood clots were women under 50. I mean, fine, if that's a risk profile we are averse to, then so be it. I don't really understand that.
tzs 6y ago
What you may be overlooking is that this is a biology problem, not a physics problem, so you cannot assume a uniform population of spherical humans with identical characteristics. :-) COVID risk goes up with age. In the other COVID vaccine with a clotting issue (the AZ vaccine) clotting risk goes down with age. If that turns out to also be the case with J&J, then for a lot of people in the US (up to 20% or so) at the current levels of COVID the vaccine has a good chance of being more of a danger to them than COVID. A short pause to determine if they should add a minimum age (possibly a variable minimum age that depends on the overall COVID rates) for J&J is prudent.

jsight 6y ago

Yes, but the risk is death and there are alternatives that do not appear to have this risk. Why not pause until it is more well understood? In the US, the other vaccines are starting to become really readily available.

lisper 6y ago
Because the rate of vaccination is still supply-limited at the moment. If everyone who would have received the J&J vaccine could get a safer alternative in the same time frame this might make sense. But they can't, so it doesn't. Do the math. It is all but certain that more people will die as a result of this pause than without it, even if you assume a worst-case clotting risk scenario under the current data.
- jsight 6y ago
  I only know my corner of the globe well. In this area, vaccine appointments are pretty easy to get and everyone 16+ is eligible. It certainly looks like any delay caused by this would be minimal. Maybe other parts of the country are different.
  - lisper 6y ago
    What part of the country are you in? And what counts as "pretty easy to get"? In California, the most populous state, people under 50 are not generally even eligible to try to get an appointment for another two days. I don't know how it is in other states, but I don't think this is unusual. That the vaccination rate is supply-limited is manifest in the fact that less than a third of the U.S. population has been vaccinated at all. Yes, there are places where there are vaccine surpluses, but this is not because the supply isn't the limiting factor. It's because in some rural areas there are large numbers of vaccine denialists who are choosing to forego the vaccine altogether. That leaves some localized surpluses. But overall supply is still the limiting factor, and it will continue to be until everyone who wants a vaccine can get one without having to wait.
    - jsight 6y ago
      South Carolina -- availability varies, but most parts of the state have at least some appointments and they seem to be becoming more readily available. > there are large numbers of vaccine denialists who are choosing to forego the vaccine altogether. That leaves some localized surpluses. The people that do not want the vaccine are a part of why. There are different reasons for this, with some just wanting others to get a chance first. But noone is going to force people to take it. Its also really unfair to characterize this as "rural areas" with "large numbers of vaccine denialists". We have urban areas with vaccines available and rural areas with full appointment books.
      - lisper 6y ago
        > We have urban areas with vaccines available Really? Where?
        jsight 6y ago
        https://vaccinefinder.org/ https://vaccinefinder.org/ - This site is halfway decent. Be careful to click through to the actual pharmacies, though. It is often out of date with actual availability being lower than indicated. Our state has also been running mobile events that have generally not been fully booked. I'm in no hurry personally, but I'm not seeing where it would be difficult to get for me.
        lisper 6y ago
        > It is often out of date with actual availability being lower than indicated My experience with VF was the exact opposite: it was showing lots of availability where in fact there was none. But the burden of proof is still on you: what urban areas in the U.S. has good vaccine availability? By which I mean: anyone who wants one can get one same-or-next day.
        jsight 6y ago
        > My experience with VF was the exact opposite: it was showing lots of availability where in fact there was none. That's exactly what I said, actually. Though it wasn't none, just low. Be sure to check back after a day or so. Availability swings pretty quickly.
randomfool 6y ago
All of these vaccines are approved under emergency authorization- the long-term effects are still unknown. At this same rate (6 in 6 million+), there could easily be unnoticed issues lurking in the alternatives as well. What we do know is that the alternative to not being vaccinated is much worse.
- jsight 6y ago
  That's possible, but this isn't "unnoticed" and the others have far longer track records in the US at this point.

newacct583 6y ago

It's bad policy. But it's important to get the analysis right: the choice here isn't between a very safe vaccine and an unvaccinated world population facing a pandemic to completion (which matches "the potential to kill millions"). It's between "continued rapid vaccination with all three approved US vaccines" and "somewhat delayed vaccination with one of the three approved US vaccines". That's not remotely a million-person delta, though the number is surely much higher than the 1/1M case rate on these blood clots. Honestly the worst effect isn't with the vaccinations per se, it's the potential that this may delay vaccine acceptance rates among people sitting on the edge, due simply to fear.

ed_balls 6y ago

I suppose they don't know what is the cause and what's gonna happen in the future(6 now, 10 000 in a few years). The communication that public gets is outrageously bad.

ravenstine 6y ago
Isn't that as true, if not greater, for the mRNA based vaccines, despite them not having that observed side effect? For all we know, everyone's butts might fall off because of them in the future. (yes, I'm being somewhat facetious)
- ed_balls 6y ago
  My understanding is the that AstraZeneca and J&J are also new tech. Vector-based and mRNA are different than attenuated (weakened) form of the virus which is used in most vaccines. (I'd be good if someone with more knowledge could comment)
  - ravenstine 6y ago
    Yes, you are right. Both are experimental / new tech.

deleted 6y ago

[deleted]

krastanov 6y ago

For many people the risk of serious complications from COVID is similar. I am a young, healthy introvert working from home and enjoying the social isolation in a location that does not have explosive spread right now. The product of "probability of getting COVID" * "having serious long term effects or death" is in the same ballpark for me. I would still get this vaccine (or the AZ one) if offered because I consider it my duty to be part of the herd immunity. But not everyone will do that, and the moment you have people in privileged position refusing one of the vaccines, you start (1) exacerbating inequalities (2) fueling conspiracy theories, mistrust, and vaccine hesitancy. If you assume that the world is perfectly rational, then you are right, but it is a running joke on HN to point out how economists used to make that same mistake and derive silly conclusions.

CannisterFlux 6y ago
The risk of a vaccine is very low. But emotionally it is hard to accept. It is my actual choice to have the vaccine and go from 0 chance of vaccine-related blood clots to some non-zero value. Whereas catching covid feels more like I'm in control of not catching it by not leaving the flat, and even if I did catch it, chances are it'd not affect me that much. I know this is not totally logical, but it is difficult to get past emotionally. Imagine if I did get blood clots from the vaccine - I'd go from safe in my flat and healthy, to dead, and for what? To protect me from a virus that has an even lower chance of causing long-term problems, and from which I can protect myself by being careful.

dragonwriter 6y ago

> Why would we pause a vaccine because 6 people in 7 million got blood clots? Because J&J isn’t the only vaccine in the inventory, and the others don’t have that problem (or, IIRC, the same level of other adverse reactions), and because: > Why would we do that and risk fueling anti-vaccine viewpoints? What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especially giveb that people often don’t have a choice of which vaccine they are administered.

ravenstine 6y ago
> What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especially giveb that people often don’t have a choice of which vaccine they are administered. Your point about other vaccines being available is totally valid and sound, but... what is our standard here, then? For absolute-zero people to die of any vaccine we produce? What if it was 1 person who got a blood clot? It probably sounds like I'm being pedantic, but I'm serious in that I want to know why people find it reasonable to pull an otherwise effective vaccine because of this. It just doesn't seem worth it to tell everyone that the vaccine is dangerous enough that it had to be pulled entirely. Ignoring adverse impacts definitely fuels anti-vaccine sentiment, but so does giving people concrete evidence that the vaccine can possibly kill people, possibly leading them to be resistant to getting any COVID vaccine at all until they're forced to get it. I mean, if I were at all skeptical of getting a COVID vaccine, and I was told the J&J vaccine was so dangerous they had to pause it, why would I get any of the more experimental vaccines knowing that they also have the potential to kill me but we don't even know yet because they're experimental? I don't think people on HN realize the full magnitude to which the public can be timid and irrational. It just doesn't seem worth it to me for us to possibly fuck up the rollout of vaccinations when we are facing a possible 4th wave of COVID and more virulent variants. Let's compare some numbers here. The number of known blood clot cases with the J&J vaccine seems to be 6 in 7 million. That's a ~0.00000085% chance of getting a blood clot caused by the vaccine, give or take a zero since I suck at math and calculators refuse to not use scientific notation. According to the CDC, around 100,000 people die of blood clots in the United States every year, and the US population is 308,401,808, meaning that Americans have a ~0.0003% chance of dying of a blood clot in their lifetime. The only concerning factor as far as I can tell is that the people who got the blood clots were women under 50. I mean, fine, if that's a risk profile we are averse to, then so be it. I don't really understand that.

tzs 6y ago

What you may be overlooking is that this is a biology problem, not a physics problem, so you cannot assume a uniform population of spherical humans with identical characteristics. :-) COVID risk goes up with age. In the other COVID vaccine with a clotting issue (the AZ vaccine) clotting risk goes down with age. If that turns out to also be the case with J&J, then for a lot of people in the US (up to 20% or so) at the current levels of COVID the vaccine has a good chance of being more of a danger to them than COVID. A short pause to determine if they should add a minimum age (possibly a variable minimum age that depends on the overall COVID rates) for J&J is prudent.