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>certain populations are refusing vaccination for mostly irrational reasons. It's not irrational for people to be cautious about a new treatment for which ther

• fabian2k 5y ago
  The vaccines have regular approval in the EU by the EMA, the US approval is the odd case here. And there is no reason to expect a significant risk for side effects that only appear after several years, for vaccines they generally appear reasonably close to the date of the vaccination. And you're seriously downplaying the risks of COVID-19 here, of course it is relatively harmless for very young people. But it is seriously dangerous for a large part of the population that is older.
  • logicchains 5y ago
    >And you're seriously downplaying the risks of COVID-19 here, of course it is relatively harmless for very young people. But it is seriously dangerous for a large part of the population that is older. It's not only "very young" people. Did you look at the link I provided? For people 20-30, it's around one in a hundred thousand. For people 30-50, it's around one in ten thousand (similar to giving birth). When someone's making a rational decision, it's with regard to their individual risk; the risk of covid to an eighty-year-old is irrelevant to a twenty-year-old deciding whether to take the vaccine, especially given the vaccine doesn't prevent them infecting others if they get it (see this data from the Singapore government: https://covid.viz.sg/ https://covid.viz.sg/ ). >for vaccines they generally appear reasonably close to the date of the vaccination. The MRNA vaccines are quite different from normal dead/live virus vaccines and have never been used at scale.
    • johncolanduoni 5y ago
      > The MRNA vaccines are quite different from normal dead/live virus vaccines and have never been used at scale. Their closer relative, the viral vector vaccines (like J&J’s), have been. You’re right about calculating risk, but when’s the last time a vaccine in normal, longer term stage three trials resulted in a higher fatality rate than COVID (for any age group)? The link for the SARS vaccine candidate was a failure that was caught in a mouse model, which unsurprisingly they also did with the new vaccines before the human trials started. To echo the parent comment, these were immediate side effects on challenge (which would likely been caught in stage 2 trials even if they only happened in humans and not in animal models). If we want to go with unusual reactions that only show up over time, what about the chance that whatever long term side effect you’re imagining from the vaccines instead happens for people who have been infected with COVID 5 years from now? Once you decide to make decisions based on rare and novel events with unquantifiable risks, you’ll find they show up absolutely everywhere if you’re being intellectually honest. > given the vaccine doesn't prevent them infecting others if they get it (see this data from the Singapore government That data’s N is a little low, but let’s take it seriously for a moment. The vast majority of vaccinated people in that dataset did not go on to infect others, and none of them were epicenters for super-spreader events. Eyeballing it, it’s consistent with a sterilizing immunity in excess of 80%. If the vaccines turn out to be that effective at preventing transmission, that’s an excellent outcome (it is higher than most vaccines).
      • logicchains 5y ago
        >You’re right about calculating risk, but when’s the last time a vaccine in normal, longer term stage three trials resulted in a higher fatality rate than COVID (for any age group)? The link for the SARS vaccine candidate was a failure that was caught in a mouse model, which unsurprisingly they also did with the new vaccines before the human trials started. To echo the parent comment, these were immediate side effects on challenge (which would likely been caught in stage 2 trials even if they only happened in humans and not in animal models). It's basically like saying: "the unit tests have all passed now, the regression tests all pass, so let's roll out the fix straight to prod, because it's urgent and we don't have enough time to do the normal amount of staging environment testing". Sure, probably it's fine. But mistakes happen. In any other context, a 1/100,000 chance of error would be considered incredibly low, a great achievement. But in this case, a 1/100,000 chance of seeing after 2-3 years a failure like happened early on in those previous trials would be an incredible tragedy, if the vaccine was taken by people with less than 1/100,000 chance of being killed by covid. https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13795 https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13795 makes a better case than I can that "a finite, non-theoretical risk is evident in the medical literature that vaccine candidates composed of the SARS-CoV-2 viral spike and eliciting anti-SARS-CoV-2 antibodies, be they neutralising or not, place vaccinees at higher risk for more severe COVID-19 disease when they encounter circulating viruses" >If we want to go with unusual reactions that only show up over time, what about the chance that whatever long term side effect you’re imagining from the vaccines instead happens for people who have been infected with COVID 5 years from now? Once you decide to make decisions based on rare and novel events with unquantifiable risks, you’ll find they show up absolutely everywhere if you’re being intellectually honest. The difference is that covid does not have a big qualitative difference from other respiratory viruses, and no circulating respiratory viruses are known to cause serious long-term symptoms in people who were short-term asymptomatic. Whereas the MRNA treatment is quite a different mechanism from previous vaccines. Separately, ethically it's generally considered worse if a death results from deliberate human action than from an "act of nature". E.g. nowhere is it morally acceptable to murder somebody just because their organs could be used to save ten people. In this case that means it would be considered morally worse if people were coerced into taking a vaccine that ended up killing them than if, absent the vaccine, they died from natural causes of equivalent risk. >That data’s N is a little low, but let’s take it seriously for a moment. The vast majority of vaccinated people in that dataset did not go on to infect others, and none of them were epicenters for super-spreader events. Eyeballing it, it’s consistent with a sterilizing immunity in excess of 80%. If the vaccines turn out to be that effective at preventing transmission, that’s an excellent outcome (it is higher than most vaccines). There's one super-spreader there, a prison cook. I pulled the data from the backing rest API (if you want I could upload the notebook and show you): pd.Series(vax_links).describe() count 17.000000 mean 2.705882 std 3.670230 min 1.000000 25% 1.000000 50% 1.000000 75% 2.000000 max 14.000000 dtype: float64 pd.Series(unvax_links).describe() count 127.000000 mean 2.181102 std 1.965647 min 1.000000 25% 1.000000 50% 2.000000 75% 2.000000 max 15.000000 dtype: float64 While there are way fewer vax cases than unvax cases, looking at the average number of infectees it doesn't appear that vaccinated people infect fewer on average than the unvaccinated do, at least given the limited data.
• logicchains 5y ago
  If anything, it's irrational that people who would normally refuse to take a novel treatment that has not passed standard FDA approval procedures would suddenly decide to take it just to minimise a one-in-a-hundred-thousand risk, a risk lower than many other risks people usually take like giving birth and driving.
• psychometry 5y ago
  Know what else we don't know the 2-3 year effects of? Fucking Covid-19. Unlike the vaccine, that one actually has a decent chance of killing you.
  • anshorei 5y ago
    Yes, and I'll take any reasonable precaution I can to avoid getting COVID: social distancing, wearing a mask, regularly using disinfectant, working from home, etc. The choice isn't between the vaccine or COVID.
• mbesto 5y ago
  > which has bypassed normal treatment approval processes (the covid vaccines only have FDA emergency use authorisation, and have not yet passed the requirements for full FDA approval, requirements which are strict for a reason), FDA approvals are largely based on the ability to provide reliable test cases. You literally have the largest test case known to human history. No amount additional FDA testing is going to make that change. > to prevent a disease that for many people has less than a 1/100,000 to 1/1,000,000 fatality rate This figure is meaningless. We have a steady history of "excess deaths" and can predict what annual death rates are on average on a yearly basis. This number jumped significantly even with mask mandates, lockdowns, etc over the last 18 months: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
  • logicchains 5y ago
    >FDA approvals are largely based on the ability to provide reliable test cases. You literally have the largest test case known to human history. Nine women can't have a baby in one month. A billion test cases for short-term side effects still aren't test cases for long-term side effects. >This figure is meaningless. We have a steady history of "excess deaths" and can predict what annual death rates are on average on a yearly basis. This number jumped significantly even with mask mandates, lockdowns, etc over the last 18 months: For making a rational decision, the figure to use is the personal risk to the individual. Using excess deaths is meaningless, because if the vast majority of those deaths were in old and overweight individuals and you're neither, then those numbers are irrelevant to quantifying the risk you face.