4 ms·

To a point that's understandable, based just on trials it's reasonable to be skeptical of the results. However once the vaccines have been in mass distribution

by simonh 5y ago

To a point that's understandable, based just on trials it's reasonable to be skeptical of the results. However once the vaccines have been in mass distribution and there is copious evidence of their efficacy and the extreme rarity of adverse affects, I don't think it's reasonable anymore. The mandates only came in once enough of the population had been inoculated to make a requirement possible. At that point the initial trials are a footnote compared to the results from mass vaccinations. IMHO it's just not reasonable for that objection to carry any weight. There may be other reasons, of course.

twofornone 5y ago
>and the extreme rarity of adverse affects, I don't think it's reasonable anymore There's a major caveat here, sudden and obvious adverse effects are rare. The subtle and possibly long term ones are still unknown. It took some 5-10 years before Thalidomide was found to cause severe birth defects, for example.
- _jal 5y ago
  > The subtle and possibly long term ones are still unknown So just say you won't take it and be done, because there is no mechanism that can satisfy you.
- simonh 5y ago
  Thalidomide isn’t a vaccine so that hardly seems relevant. We have extensive experience with many vaccines across huge populations and no reason to expect these ones to be any more dangerous than the others. Also it seems somewhat unlikely that any possible side effects, if they were to manifest, could possibly be as bad as millions of deaths and tens of millions with long term complications . The vast majority of people objecting to covid vaccines have no history of vaccine denial, and no good reason to suspect the covid vaccines are particularly dangerous compared to the many vaccines they have accepted previously without a thought or any interest in their history, testing or method of action. It’s politically motivated from start to finish and has nothing to do with the medical facts.
- fabian2k 5y ago
  It took 4 years for thalidomide until it was removed from the market. And this is the text book case that triggered more stringent regulation for drugs.
tricky777 5y ago
Even if this particular vaccine was ok (and I still feel fine after the booster), the process seems shady if results are kept secret (having good processes is very important. remember "checks and balances")
- simonh 5y ago
  Trial data is kept confidential due to the risk that access to the data or information about it by research teams could influence or bias the design or conduct of further trials. This is routine in medical trials based on hard won lessons from previous problems due to biased trials and conflicts of interest. It might seem shady if you don’t know the reasons for it (what are they hiding?). I understand that, but the fact is this is standard practice and releasing the raw data would be reckless and irresponsible.
cuspy 5y ago
The problem with this line of reasoning is that there is a huge difference between controlled trials (which are obviously imperfect themselves) and post-hoc analyses of uncontrolled real-world outcomes. There's a big leap of faith in trusting our public health authorities' ability to accurately measure and faithfully represent the real situation. Just to name one small issue, our only measurements of vaccine efficacy are case counts, covid hospitalizations and covid deaths. Each one of these measurements is confounded by population-level differences in testing rate, testing polices (ie routine testing on entrance to hospital), PCR cycle count, and many other factors. There is no longer a monitored control group, so we can't ever account for any group-level differences or confounds. I've seen no attempt to address these issues. We also have no access to reliable data about confirmed adverse effects. A year later, it is still very hard for a person to quantitatively assess his/her own age-stratified risk/benefit tradeoff, even with the confounded efficacy measures. So, given all that, why isn't skepticism reasonable anymore?
- fabian2k 5y ago
  The effect of vaccinations is huge here, especially if we focus on deaths and hospitalisations in elderly people. There are of course issues with using data that only observed and not part of a strict randomized and blinded trial. But the difference observed in many different studies between unvaccinated and fully vaccinated is simply so enormous that it doesn't really leave any room for doubt. The effect of the vaccines is so huge that you only have to look at a Kaplan-Meier plot and will immediately see the huge difference. And we don't have a single study here, we have a lot of different ones that all indicate that the vaccines are very effective and safe.
  - cuspy 5y ago
    I would trust sound data and transparent analyses showing age-stratified risk analyses if they existed. With all respect, what you just wrote is essentially hand-waving and talking past what I wrote. High effectiveness for elderly people (which I find plausible but also still deeply confounded by testing rate differences) in no way justifies mandates for people in their early 20s. In some proportion of hospitals, when someone who is not vaccinated goes to hospital for any reason, they are tested for COVID-19. If found positive this is counted as a COVID-19 hospitalization. We have no access to the precise rate of these incidental hospitalizations. In some of these hospitals, it is the policy that vaccinated people who go to the hospital are NOT routinely tested unless they have symptoms. If this is the policy at a substantial number of hospitals, it could dramatically change the "effect size" of the measurements that we are talking about. The same issues essentially applies to COVID-19 deaths and cases. Large effect size alone generally isn't convincing when you're using such fundamentally confounded sampling procedures, merged age-groups with wildly different risk profiles, and data aggregated across long time-windows with different population sizes.

by simonh 5y ago

twofornone 5y ago

>and the extreme rarity of adverse affects, I don't think it's reasonable anymore There's a major caveat here, sudden and obvious adverse effects are rare. The subtle and possibly long term ones are still unknown. It took some 5-10 years before Thalidomide was found to cause severe birth defects, for example.

_jal 5y ago
> The subtle and possibly long term ones are still unknown So just say you won't take it and be done, because there is no mechanism that can satisfy you.
simonh 5y ago
Thalidomide isn’t a vaccine so that hardly seems relevant. We have extensive experience with many vaccines across huge populations and no reason to expect these ones to be any more dangerous than the others. Also it seems somewhat unlikely that any possible side effects, if they were to manifest, could possibly be as bad as millions of deaths and tens of millions with long term complications . The vast majority of people objecting to covid vaccines have no history of vaccine denial, and no good reason to suspect the covid vaccines are particularly dangerous compared to the many vaccines they have accepted previously without a thought or any interest in their history, testing or method of action. It’s politically motivated from start to finish and has nothing to do with the medical facts.
fabian2k 5y ago
It took 4 years for thalidomide until it was removed from the market. And this is the text book case that triggered more stringent regulation for drugs.

tricky777 5y ago

Even if this particular vaccine was ok (and I still feel fine after the booster), the process seems shady if results are kept secret (having good processes is very important. remember "checks and balances")

simonh 5y ago
Trial data is kept confidential due to the risk that access to the data or information about it by research teams could influence or bias the design or conduct of further trials. This is routine in medical trials based on hard won lessons from previous problems due to biased trials and conflicts of interest. It might seem shady if you don’t know the reasons for it (what are they hiding?). I understand that, but the fact is this is standard practice and releasing the raw data would be reckless and irresponsible.

cuspy 5y ago

The problem with this line of reasoning is that there is a huge difference between controlled trials (which are obviously imperfect themselves) and post-hoc analyses of uncontrolled real-world outcomes. There's a big leap of faith in trusting our public health authorities' ability to accurately measure and faithfully represent the real situation. Just to name one small issue, our only measurements of vaccine efficacy are case counts, covid hospitalizations and covid deaths. Each one of these measurements is confounded by population-level differences in testing rate, testing polices (ie routine testing on entrance to hospital), PCR cycle count, and many other factors. There is no longer a monitored control group, so we can't ever account for any group-level differences or confounds. I've seen no attempt to address these issues. We also have no access to reliable data about confirmed adverse effects. A year later, it is still very hard for a person to quantitatively assess his/her own age-stratified risk/benefit tradeoff, even with the confounded efficacy measures. So, given all that, why isn't skepticism reasonable anymore?

fabian2k 5y ago
The effect of vaccinations is huge here, especially if we focus on deaths and hospitalisations in elderly people. There are of course issues with using data that only observed and not part of a strict randomized and blinded trial. But the difference observed in many different studies between unvaccinated and fully vaccinated is simply so enormous that it doesn't really leave any room for doubt. The effect of the vaccines is so huge that you only have to look at a Kaplan-Meier plot and will immediately see the huge difference. And we don't have a single study here, we have a lot of different ones that all indicate that the vaccines are very effective and safe.
- cuspy 5y ago
  I would trust sound data and transparent analyses showing age-stratified risk analyses if they existed. With all respect, what you just wrote is essentially hand-waving and talking past what I wrote. High effectiveness for elderly people (which I find plausible but also still deeply confounded by testing rate differences) in no way justifies mandates for people in their early 20s. In some proportion of hospitals, when someone who is not vaccinated goes to hospital for any reason, they are tested for COVID-19. If found positive this is counted as a COVID-19 hospitalization. We have no access to the precise rate of these incidental hospitalizations. In some of these hospitals, it is the policy that vaccinated people who go to the hospital are NOT routinely tested unless they have symptoms. If this is the policy at a substantial number of hospitals, it could dramatically change the "effect size" of the measurements that we are talking about. The same issues essentially applies to COVID-19 deaths and cases. Large effect size alone generally isn't convincing when you're using such fundamentally confounded sampling procedures, merged age-groups with wildly different risk profiles, and data aggregated across long time-windows with different population sizes.