4 ms·

Not disagreeing with your general message regarding individual risk assessment based on age, sex, health etc. What I will say though is that you seem to be comp

Not disagreeing with your general message regarding individual risk assessment based on age, sex, health etc. What I will say though is that you seem to be comparing to the baseline scenario "Covid stops spreading". After one year of Covid (and its mutations) that baseline simply doesn't exist (any more). Instead we are in a no-win situation: (a) We keep lockdowns/non-pharmacological measures and border closures, (b) We let Covid spread slowly, (c) We vaccinate. Each scenario has associated cost. Now back to your point: > But because everyone gets vaccinated, we require exceptional proofs of safety. Safety is neither binary (exceptional/not exceptional) nor absolute and always relative to Covid. Each and every vaccine up to now is orders of magnitude safer than Covid for the vast majority of people (YMMV!). Not an expert, but what's even more interesting is that among the already very few severe side effects, even fewer are due to the 'vaccine ingredients' (e.g. allergic reactions incl. blood clots) and many are conjectured to be due to the 'SARS-Cov-2 ingredients' (e.g. myocarditis). Heuristically speaking you can choose between Covid or a very very very mild version of Covid.

beagle3 5y ago
No, I'm not comparing to "covid stops spreading", but I'm also not assuming (as you seem to be) "everyone will eventually get it in the way whoever got it so far got it". > Each scenario has associated cost. There are other scenarios, e.g. https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment-reduces-need-hospitalisation-covid-19-patients-study https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment... shows a cheap widely available steroid inhaler has comparable efficiency to vaccines in the KPIs studied by the Pfizer trial. I'm not saying it should be used instead of a vaccine; but it's also not true that your list is close to exhaustive. We keep finding out new stuff. In the first 2-3 months, the intubation+ventilation regime was counterproductive; it took a while to realize, but now we know that. We also know (e.g. from Florida and Texas) that the NPI are much less effective than they were assumed to be. > Each and every vaccine up to now is orders of magnitude safer than Covid for the vast majority of people (YMMV!). That's ... not been shown. The Israeli study I linked to above (a report of it) says this assertion might be wrong for Pfizer for the sizable group of 16-30 ; The British think that's not true for AZ under age 30 ; many countries in the EU think that's not true for AZ under the age of 50 ; Norway thinks that's not true for frail elderly. And basically, we only have short term safety data (pfizer: less than a year for 20K people, less than 6 months for the rest), so even if it is true that "every one will eventually get it", it does NOT follow that it makes sense to vaccinate everyone right now -- if it takes 20 years until "everyone eventually gets it", and severe side effects appear 2 years later, then, no, it doesn't make sense. I linked a BMJ+Science article that showed for a similarly EUAd vaccine, "Pandemrix" in 2009 that it took over a year to figure out that it was causing narcolepsy and worse than the flu it was supposed to stop. It's not just a theoretic possibility - it happened in a very similar setting just 11 years ago, and the causes are NOT perfectly understood to the point that you can guarantee it won't happen again. > many are conjectured to be due to the 'SARS-Cov-2 ingredients' (e.g. myocarditis). Heuristically speaking you can choose between Covid or a very very very mild version of Covid. You could be right, but that's not at all clear. This paper from Nature Immunology https://www.nature.com/articles/s41590-020-00808-x.pdf https://www.nature.com/articles/s41590-020-00808-x.pdf shows that 80% of unexposed people have a T-cell response to SARS-Cov-2 - that is, they have cross-immunity. It could be that for those 80%, that response would be enough to stop the virus before it can get systemic traction, whereas the vaccine is essentially guaranteed to generate systemic effect. I asked an immunologist, who said he doesn't know the answer and does not believe anyone does without measuring.
- Pyramus 5y ago
  > There are other scenarios, e.g. https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment... shows a cheap widely available steroid inhaler [...] That is a good point, I should have defined the category more broadly as 'pharmacological interventions,' of which vaccines make up the biggest and best-studied subcategory (to date). > That's ... not been shown. The Israeli study I linked to above (a report of it) says this assertion might be wrong for Pfizer for the sizable group of 16-30 ; The British think that's not true for AZ under age 30 ; many countries in the EU think that's not true for AZ under the age of 50 ; Norway thinks that's not true for frail elderly. Yes and no. Yes, E.g. for AZ there will be a threshold (say 30) at where Covid risk equals vaccine risk. At that point, both risks are very small, to the point that it's more dangerous to drive to the appointment by car. No, when EMA says no AZ under 50 (in Germany it's 60) that's because for that age group we have other vaccines available. Still, even for a 40 year old female it is safer to get AZ than Covid. For that reason current vaccines are safer for most people but not all. Even when they are not safer than Covid, data suggests they are still very safe. > And basically, we only have short term safety data (pfizer: less than a year for 20K people, less than 6 months for the rest) [...] I believe you do know that Pfizer/Biontech, Moderna, AZ all started in 04/2020, so we have data for 12m+. As a comparison safety data for Covid is only 6m older. > I linked a BMJ+Science article that showed for a similarly EUAd vaccine, "Pandemrix" in 2009 that it took over a year to figure out that it was causing narcolepsy and worse than the flu it was supposed to stop. Yes, Pandemrix is still remembered, especially in Northern Euope, and one reason why regulators are have been super careful, to the point where it didn't make sense to halt vaccination campaigns, see e.g. AZ blood clots. In general we expect side effects of vaccines to have an onset shortly after vaccination, and that has been also true for Pandemrix. However to detect two rare events, say narcolepsy and 5x narcolepsy, you need a lot of data. In the context of H1N1 and narcolepsy, this paper is super interesting [1] https://med.stanford.edu/content/dam/sm/narcolepsy/documents/latestnews/HanAnnalsH1N1.pdf https://med.stanford.edu/content/dam/sm/narcolepsy/documents... > It could be that for those 80%, that response would be enough to stop the virus before it can get systemic traction, [...] That's not the conclusion of the paper and hopeful speculation. If you mean by 'systemic reaction' the replication of the virus in the host, it's demonstrably false. I totally get the concern about 'unknown unknowns' but looking at the safety data you are currently engaging in lifestyle choices or are taking medication that are way riskier than current Covid vaccines.

beagle3 5y ago

No, I'm not comparing to "covid stops spreading", but I'm also not assuming (as you seem to be) "everyone will eventually get it in the way whoever got it so far got it". > Each scenario has associated cost. There are other scenarios, e.g. https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment-reduces-need-hospitalisation-covid-19-patients-study https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment... shows a cheap widely available steroid inhaler has comparable efficiency to vaccines in the KPIs studied by the Pfizer trial. I'm not saying it should be used instead of a vaccine; but it's also not true that your list is close to exhaustive. We keep finding out new stuff. In the first 2-3 months, the intubation+ventilation regime was counterproductive; it took a while to realize, but now we know that. We also know (e.g. from Florida and Texas) that the NPI are much less effective than they were assumed to be. > Each and every vaccine up to now is orders of magnitude safer than Covid for the vast majority of people (YMMV!). That's ... not been shown. The Israeli study I linked to above (a report of it) says this assertion might be wrong for Pfizer for the sizable group of 16-30 ; The British think that's not true for AZ under age 30 ; many countries in the EU think that's not true for AZ under the age of 50 ; Norway thinks that's not true for frail elderly. And basically, we only have short term safety data (pfizer: less than a year for 20K people, less than 6 months for the rest), so even if it is true that "every one will eventually get it", it does NOT follow that it makes sense to vaccinate everyone right now -- if it takes 20 years until "everyone eventually gets it", and severe side effects appear 2 years later, then, no, it doesn't make sense. I linked a BMJ+Science article that showed for a similarly EUAd vaccine, "Pandemrix" in 2009 that it took over a year to figure out that it was causing narcolepsy and worse than the flu it was supposed to stop. It's not just a theoretic possibility - it happened in a very similar setting just 11 years ago, and the causes are NOT perfectly understood to the point that you can guarantee it won't happen again. > many are conjectured to be due to the 'SARS-Cov-2 ingredients' (e.g. myocarditis). Heuristically speaking you can choose between Covid or a very very very mild version of Covid. You could be right, but that's not at all clear. This paper from Nature Immunology https://www.nature.com/articles/s41590-020-00808-x.pdf https://www.nature.com/articles/s41590-020-00808-x.pdf shows that 80% of unexposed people have a T-cell response to SARS-Cov-2 - that is, they have cross-immunity. It could be that for those 80%, that response would be enough to stop the virus before it can get systemic traction, whereas the vaccine is essentially guaranteed to generate systemic effect. I asked an immunologist, who said he doesn't know the answer and does not believe anyone does without measuring.

Pyramus 5y ago
> There are other scenarios, e.g. https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment https://www.ox.ac.uk/news/2021-02-09-common-asthma-treatment... shows a cheap widely available steroid inhaler [...] That is a good point, I should have defined the category more broadly as 'pharmacological interventions,' of which vaccines make up the biggest and best-studied subcategory (to date). > That's ... not been shown. The Israeli study I linked to above (a report of it) says this assertion might be wrong for Pfizer for the sizable group of 16-30 ; The British think that's not true for AZ under age 30 ; many countries in the EU think that's not true for AZ under the age of 50 ; Norway thinks that's not true for frail elderly. Yes and no. Yes, E.g. for AZ there will be a threshold (say 30) at where Covid risk equals vaccine risk. At that point, both risks are very small, to the point that it's more dangerous to drive to the appointment by car. No, when EMA says no AZ under 50 (in Germany it's 60) that's because for that age group we have other vaccines available. Still, even for a 40 year old female it is safer to get AZ than Covid. For that reason current vaccines are safer for most people but not all. Even when they are not safer than Covid, data suggests they are still very safe. > And basically, we only have short term safety data (pfizer: less than a year for 20K people, less than 6 months for the rest) [...] I believe you do know that Pfizer/Biontech, Moderna, AZ all started in 04/2020, so we have data for 12m+. As a comparison safety data for Covid is only 6m older. > I linked a BMJ+Science article that showed for a similarly EUAd vaccine, "Pandemrix" in 2009 that it took over a year to figure out that it was causing narcolepsy and worse than the flu it was supposed to stop. Yes, Pandemrix is still remembered, especially in Northern Euope, and one reason why regulators are have been super careful, to the point where it didn't make sense to halt vaccination campaigns, see e.g. AZ blood clots. In general we expect side effects of vaccines to have an onset shortly after vaccination, and that has been also true for Pandemrix. However to detect two rare events, say narcolepsy and 5x narcolepsy, you need a lot of data. In the context of H1N1 and narcolepsy, this paper is super interesting [1] https://med.stanford.edu/content/dam/sm/narcolepsy/documents/latestnews/HanAnnalsH1N1.pdf https://med.stanford.edu/content/dam/sm/narcolepsy/documents... > It could be that for those 80%, that response would be enough to stop the virus before it can get systemic traction, [...] That's not the conclusion of the paper and hopeful speculation. If you mean by 'systemic reaction' the replication of the virus in the host, it's demonstrably false. I totally get the concern about 'unknown unknowns' but looking at the safety data you are currently engaging in lifestyle choices or are taking medication that are way riskier than current Covid vaccines.