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Note that placebos aren't just limited to areas like pain and depression, but were also used in clincal trials that involved infectious disease treatments, incl

Note that placebos aren't just limited to areas like pain and depression, but were also used in clincal trials that involved infectious disease treatments, including antibiotics and vaccines. In these cases, the issue is not the effect of the mind/brain/nervous system so much as the body's immune and biochemical processing systems (liver/kidneys). Thus, in some kinds of infectious disease, the body is entirely capable of clearing the infection on its own in most cases as long as the subject isn't suffering some kind of immunodeficiency (e.g. all the strange diseases that HIV patients succumbed to before antiviral therapy was introduced). Studies like this led to the movement to reduce antibiotic treatment for minor infections that are very unlikely to lead to issues like sepsis etc, given the deleterious side effects on the human microbiome and so on. A placebo study might also reveal significant problems with toxicity, such as liver-kidney damage to the subject caused by a problem with the antibiotic under study. Likewise with vaccines, careful study with placebos could demonstrate that the vaccine under study didn't prevent transmissibility of the infectious virus any better than the placebo did. Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? As far as depression/mental health studies, placebos are often readily detectable by the patient, which is a big problem in today's research into the 5-HT2a receptor drug research (eg psilocybin, LSD, DMT, mescaline). They've tried to get around this by giving subjects drugs like methyphenidate and methamphetamine as the 'placebo' (because the subject clearly can tell when they've been given a powerful psychoactive substance), but this is not a usual placebo, it's an alternative treatment.

analog31 2y ago
A difficulty with the COVID vaccine is that it received emergency approval, which I think is great. But it means traditional clinical study now has to be conducted in an environment where the population, the behavioral environment (isolation, masks, etc) -- and possibly the virus itself -- are drastically changed by widespread use of the vaccine.
notahacker 2y ago
> Likewise with vaccines, careful study with placebos could demonstrate that the vaccine under study didn't prevent transmissibility of the infectious virus any better than the placebo did. Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? The obvious answer is because vaccines are not designed to prevent viruses from ever becoming transmissible through the air according to some impossible standard devised by vaccine sceptics, they were designed to ensure that the body on average killed the virus off more quickly with less strain to their health[1]. So they tested the thing the vaccines were intended to do (against placebo), and not the thing they were not intended to do. [1]a corollary of this is that people who are infected with viruses for shorter periods are less likely to transmit it, which is in fact what happened....
- photochemsyn 2y ago
  Well, what you want to see reported in a clinical vaccine trial is the breakthrough percentage, that is, the percentage of vaccinated subjects who then became infected. In the case of the smallpox vaccine, this percentage was extremely low, which is why 'vaccination ring' strategies in India were effective in wiping out the disease, so that it now only exists in a few freezers globally (though the genetic sequence is widely available and thus it could be synthesized from scratch using modern molecular biology techniques). Since this wasn't reported to the public, but many official government sources claimed it was a sterilizing vaccine (0% breakthrough), this resulted in great public distrust of the health authorities. It's a lesson for the future: be honest with people.
  - notahacker 2y ago
    None of this is true though is it? The purpose of a vaccine is to induce the immune system to produce antibodies which typically act after infection, this is what is normally published in clinical trials, the vaccines were efficacious in doing this and efficacious against symptomatic COVID, the data was published as were numerous early studies which accurately observed that breakthrough effects were very low, and government officials accurately advised the public that it would significantly increase survival rates and reduce transmission rates. Then it did, despite the best efforts of people who had been sowing public distrust in the health system since long before there was a vaccine, so the last refuge of those particular scoundrels was to insist that the long series of lies they'd told about COVID were actually an honest desire to inform the public that the vaccine wasn't a sterilising one, as if that was a remotely good reason to advise people not to take it.
ameister14 2y ago
>Likewise with vaccines, careful study with placebos could demonstrate that the vaccine under study didn't prevent transmissibility of the infectious virus any better than the placebo did. Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? I think this is from a misunderstanding of what transmissibility people were talking about. People getting the vaccine did not transmit the disease to others simply by virtue of being vaccinated. What that means is, you can get the shot and not worry that, by getting the shot, you are going to transmit the disease to others. What that does not mean is that, once vaccinated, you cannot ever transmit the disease to others. If you get sick, the vaccine will likely make you get over it faster and have it less impactful, reducing transmission as an added bonus of those two things happening (you're coughing less so less is put in the air, you are sick for less time so the period you will be heavily contagious for and also symptomatic is shorter) but it will not entirely prevent transmission.
Izkata 2y ago
> Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? It was seen, then ignored by the media so the average person didn't realize what was going on. Remember that 95% effective? It wasn't 100% because vaccinated people not only got infected, they actually got sick (they were only testing once symptoms showed, not everyone in the study). The study it came from also only lasted 3 months, if it had gone on the planned 6 months it would have almost certainly gone much lower. I think they did end up having a follow-up at the 6-month mark (don't remember the results), but they got the EUA on the 3-month results.

analog31 2y ago

A difficulty with the COVID vaccine is that it received emergency approval, which I think is great. But it means traditional clinical study now has to be conducted in an environment where the population, the behavioral environment (isolation, masks, etc) -- and possibly the virus itself -- are drastically changed by widespread use of the vaccine.

notahacker 2y ago

> Likewise with vaccines, careful study with placebos could demonstrate that the vaccine under study didn't prevent transmissibility of the infectious virus any better than the placebo did. Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? The obvious answer is because vaccines are not designed to prevent viruses from ever becoming transmissible through the air according to some impossible standard devised by vaccine sceptics, they were designed to ensure that the body on average killed the virus off more quickly with less strain to their health[1]. So they tested the thing the vaccines were intended to do (against placebo), and not the thing they were not intended to do. [1]a corollary of this is that people who are infected with viruses for shorter periods are less likely to transmit it, which is in fact what happened....

photochemsyn 2y ago
Well, what you want to see reported in a clinical vaccine trial is the breakthrough percentage, that is, the percentage of vaccinated subjects who then became infected. In the case of the smallpox vaccine, this percentage was extremely low, which is why 'vaccination ring' strategies in India were effective in wiping out the disease, so that it now only exists in a few freezers globally (though the genetic sequence is widely available and thus it could be synthesized from scratch using modern molecular biology techniques). Since this wasn't reported to the public, but many official government sources claimed it was a sterilizing vaccine (0% breakthrough), this resulted in great public distrust of the health authorities. It's a lesson for the future: be honest with people.
- notahacker 2y ago
  None of this is true though is it? The purpose of a vaccine is to induce the immune system to produce antibodies which typically act after infection, this is what is normally published in clinical trials, the vaccines were efficacious in doing this and efficacious against symptomatic COVID, the data was published as were numerous early studies which accurately observed that breakthrough effects were very low, and government officials accurately advised the public that it would significantly increase survival rates and reduce transmission rates. Then it did, despite the best efforts of people who had been sowing public distrust in the health system since long before there was a vaccine, so the last refuge of those particular scoundrels was to insist that the long series of lies they'd told about COVID were actually an honest desire to inform the public that the vaccine wasn't a sterilising one, as if that was a remotely good reason to advise people not to take it.

ameister14 2y ago

>Likewise with vaccines, careful study with placebos could demonstrate that the vaccine under study didn't prevent transmissibility of the infectious virus any better than the placebo did. Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? I think this is from a misunderstanding of what transmissibility people were talking about. People getting the vaccine did not transmit the disease to others simply by virtue of being vaccinated. What that means is, you can get the shot and not worry that, by getting the shot, you are going to transmit the disease to others. What that does not mean is that, once vaccinated, you cannot ever transmit the disease to others. If you get sick, the vaccine will likely make you get over it faster and have it less impactful, reducing transmission as an added bonus of those two things happening (you're coughing less so less is put in the air, you are sick for less time so the period you will be heavily contagious for and also symptomatic is shorter) but it will not entirely prevent transmission.

Izkata 2y ago

> Notably this was a problem with all the Sars-Cov2 vaccines, none seem to have prevented transmision from an infected person to a vaccinated person. Why wasn't this seen in the clincal trials, one wonders? It was seen, then ignored by the media so the average person didn't realize what was going on. Remember that 95% effective? It wasn't 100% because vaccinated people not only got infected, they actually got sick (they were only testing once symptoms showed, not everyone in the study). The study it came from also only lasted 3 months, if it had gone on the planned 6 months it would have almost certainly gone much lower. I think they did end up having a follow-up at the 6-month mark (don't remember the results), but they got the EUA on the 3-month results.