5 ms·

RFK Jr. to require placebo-controlled studies for new vaccines

38 points by srameshc 1y ago

Spivak 1y ago
God the US is so far on the Authoritarian side of the graph that even our "burn down the government deregulate everything" party can't help themselves. Any voter romanticism about having the government have less control over your life surely has to be dispelled by this point. This was the GOPs moment to actually deregulate things in a manner that's good for people and they just said, "we're keeping everything the same, just with conspiracy theories added." I mean it's probably for the best that they're squandering their shot on stupid shit like this but I still wonder if they will ever wake up and realize their position as not the opposition party anymore and that they have to / get to lead — tackle the bigger issues and shape the direction of the country going forward. They won, they owned the libs mission accomplished whatever and now it's their moment to govern and they're still acting like pissed off back seat drivers. In tech terms they're the principal architects now and they're using that power to get their preferences on minor PR reviews merged.
- giraffe_lady 1y ago
  They're doing exactly what they wanted to do and planned to do. To a significant extent these were the goals of the american conservative movement going back decades. This is what leadership means to the right and what it always has. Death and destruction.
  - techpineapple 1y ago
    I feel like it’s a very strange person that is comforted by all of this. I am super susceptible to nostalgia, but in a nerdy VHS and Afghan blanket kind of way, nothing about any of what Trump is doing makes me think of the good old days. And I long for the good old days!
    - andrekandre 1y ago
      > the good old days. probably we are not old enough to remember them (with the arguably rose-tinted glasses) as some others...
- watwut 1y ago
  I really do not understand why you think "this was the GOPs moment to actually deregulate things in a manner that's good for people". Nothing about this moment created conditions for such a thing. There was no support for such a thing and no real promiss to do such a thing. No track record fod GOP proposing good regulation. Project 2025 was known and not about helping people. The anto vaccine regulations are already a thing in red states.
jljljl 1y ago
What would be the benefit of a placebo study vs studying the differences between vaccinated and unvaccinated populations? Is the hypothesis that there is some kind of psychosomatic/placebo effect to vaccines, where just the process of getting injected changes outcomes? I find that hard to believe.
- techpineapple 1y ago
  Maybe they should be double blind. Maybe whether or not your doctor thinks you got the vaccine impacts your later susceptibility.
  - jljljl 1y ago
    I guess the danger here is that for vaccines that we already know reduce the risk of deadly diseases, you’d either: Randomly expose patients to the risk of contracting a known debilitating/deadly disease Or No one who comes in for the vaccine will consent the trial
- giraffe_lady 1y ago
  Vaccines are already double blind tested with a placebo, but the yearly updates for seasonal vaccines based on a previously tested mechanism are not. The goal of this new requirement is to create delays making it effectively impossible to create annual flu & covid vaccines within these constraints. The reason the updates aren't currently tested this way is because medical research ethics perspectives on the balance of risk of novel unknown effects vs known risk of withholding effective treatment from the placebo group. https://en.wikipedia.org/wiki/Clinical_equipoise https://en.wikipedia.org/wiki/Clinical_equipoise
  - jljljl 1y ago
    Yeah that makes sense. If there was an update of MMR, and there was a 50/50 chance that your child does not actually get vaccinated against MMR, you’d refuse to participate in the trial.
- nradov 1y ago
giraffe_lady 1y ago
[flagged]
nailer 1y ago
Regardless of what you think of RFK, there's no good reason to think more testing of medicine is a bad thing.
- giraffe_lady 1y ago
  Medical research ethical standards disagree: > An ethical dilemma arises in a clinical trial when the investigator(s) begin to believe that the treatment or intervention administered in one arm of the trial is significantly outperforming the other arms. A trial should begin with a null hypothesis, and there should exist no decisive evidence that the intervention or drug being tested will be superior to existing treatments, or that it will be completely ineffective. As the trial progresses, the findings may provide sufficient evidence to convince the investigator of the intervention or drug's efficacy. Once a certain threshold of evidence is passed, there is no longer genuine uncertainty about the most beneficial treatment, so there is an ethical imperative for the investigator to provide the superior intervention to all participants. > https://en.wikipedia.org/wiki/Clinical_equipoise https://en.wikipedia.org/wiki/Clinical_equipoise
- cosmicgadget 1y ago
  Here's the 2021 flu vaccine, that'll be $500. Good news, we verified it won't turn you into a unicorn.
  - nailer 1y ago
    But people have been injured by vaccines. Testing seems reasonable.
    - cosmicgadget 1y ago
      [flagged]
      - nailer 1y ago
        > no one suggested a reduction in testing If you somehow haven't read either the article or any of the comments in this HN thread, many readers would prefer less testing than what was announced: "none of the vaccines on the CDC's childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products" I don't need to convince you or anyone else, my own hands, arms and legs were covered in bloody blisters a few hours after the J & J booster. Anecdotes aren’t data but the way I suggest we collect data is by: testing medicines.
pdjoyce 1y ago
Here is a fun example of a randomized controlled trial from the British Medical Journal: Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094
- nailer 1y ago
  That’s a solid point, I’m going to invest in some snake oil now.
jmye 1y ago
[flagged]
- perilunar 1y ago
  Don't know about the flu, but there has been discussion about the ethics of vaccinating old people against pneumonia. Sir William Osler famously called pneumonia the “old man's friend”, because it kills the elderly without too much suffering. e.g.: https://www.sciencedirect.com/science/article/abs/pii/S0264410X05003270 https://www.sciencedirect.com/science/article/abs/pii/S02644...
- stefantalpalaru 1y ago
  [dead]
- nailer 1y ago
  Somebody responded to you with medical research and Hacker News readers flagged it. https://news.ycombinator.com/item?id=43866237 https://news.ycombinator.com/item?id=43866237 There might be many reasons to disagree with the research - it’s not peer reviewed for one - but flagging seems to be somewhat antiscience, which is a shame for a forum about software engineering and innovation.

38 points by srameshc 1y ago

God the US is so far on the Authoritarian side of the graph that even our "burn down the government deregulate everything" party can't help themselves. Any voter romanticism about having the government have less control over your life surely has to be dispelled by this point. This was the GOPs moment to actually deregulate things in a manner that's good for people and they just said, "we're keeping everything the same, just with conspiracy theories added." I mean it's probably for the best that they're squandering their shot on stupid shit like this but I still wonder if they will ever wake up and realize their position as not the opposition party anymore and that they have to / get to lead — tackle the bigger issues and shape the direction of the country going forward. They won, they owned the libs mission accomplished whatever and now it's their moment to govern and they're still acting like pissed off back seat drivers. In tech terms they're the principal architects now and they're using that power to get their preferences on minor PR reviews merged.

giraffe_lady 1y ago
They're doing exactly what they wanted to do and planned to do. To a significant extent these were the goals of the american conservative movement going back decades. This is what leadership means to the right and what it always has. Death and destruction.
- techpineapple 1y ago
  I feel like it’s a very strange person that is comforted by all of this. I am super susceptible to nostalgia, but in a nerdy VHS and Afghan blanket kind of way, nothing about any of what Trump is doing makes me think of the good old days. And I long for the good old days!
  - andrekandre 1y ago
    > the good old days. probably we are not old enough to remember them (with the arguably rose-tinted glasses) as some others...
watwut 1y ago
I really do not understand why you think "this was the GOPs moment to actually deregulate things in a manner that's good for people". Nothing about this moment created conditions for such a thing. There was no support for such a thing and no real promiss to do such a thing. No track record fod GOP proposing good regulation. Project 2025 was known and not about helping people. The anto vaccine regulations are already a thing in red states.

jljljl 1y ago

What would be the benefit of a placebo study vs studying the differences between vaccinated and unvaccinated populations? Is the hypothesis that there is some kind of psychosomatic/placebo effect to vaccines, where just the process of getting injected changes outcomes? I find that hard to believe.

techpineapple 1y ago
Maybe they should be double blind. Maybe whether or not your doctor thinks you got the vaccine impacts your later susceptibility.
- jljljl 1y ago
  I guess the danger here is that for vaccines that we already know reduce the risk of deadly diseases, you’d either: Randomly expose patients to the risk of contracting a known debilitating/deadly disease Or No one who comes in for the vaccine will consent the trial
giraffe_lady 1y ago
Vaccines are already double blind tested with a placebo, but the yearly updates for seasonal vaccines based on a previously tested mechanism are not. The goal of this new requirement is to create delays making it effectively impossible to create annual flu & covid vaccines within these constraints. The reason the updates aren't currently tested this way is because medical research ethics perspectives on the balance of risk of novel unknown effects vs known risk of withholding effective treatment from the placebo group. https://en.wikipedia.org/wiki/Clinical_equipoise https://en.wikipedia.org/wiki/Clinical_equipoise
- jljljl 1y ago
  Yeah that makes sense. If there was an update of MMR, and there was a 50/50 chance that your child does not actually get vaccinated against MMR, you’d refuse to participate in the trial.
nradov 1y ago

giraffe_lady 1y ago

[flagged]

nailer 1y ago

Regardless of what you think of RFK, there's no good reason to think more testing of medicine is a bad thing.

giraffe_lady 1y ago
Medical research ethical standards disagree: > An ethical dilemma arises in a clinical trial when the investigator(s) begin to believe that the treatment or intervention administered in one arm of the trial is significantly outperforming the other arms. A trial should begin with a null hypothesis, and there should exist no decisive evidence that the intervention or drug being tested will be superior to existing treatments, or that it will be completely ineffective. As the trial progresses, the findings may provide sufficient evidence to convince the investigator of the intervention or drug's efficacy. Once a certain threshold of evidence is passed, there is no longer genuine uncertainty about the most beneficial treatment, so there is an ethical imperative for the investigator to provide the superior intervention to all participants. > https://en.wikipedia.org/wiki/Clinical_equipoise https://en.wikipedia.org/wiki/Clinical_equipoise
cosmicgadget 1y ago
Here's the 2021 flu vaccine, that'll be $500. Good news, we verified it won't turn you into a unicorn.
- nailer 1y ago
  But people have been injured by vaccines. Testing seems reasonable.
  - cosmicgadget 1y ago
    [flagged]
    - nailer 1y ago
      > no one suggested a reduction in testing If you somehow haven't read either the article or any of the comments in this HN thread, many readers would prefer less testing than what was announced: "none of the vaccines on the CDC's childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products" I don't need to convince you or anyone else, my own hands, arms and legs were covered in bloody blisters a few hours after the J & J booster. Anecdotes aren’t data but the way I suggest we collect data is by: testing medicines.

pdjoyce 1y ago

Here is a fun example of a randomized controlled trial from the British Medical Journal: Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094

nailer 1y ago
That’s a solid point, I’m going to invest in some snake oil now.

jmye 1y ago

[flagged]

perilunar 1y ago
Don't know about the flu, but there has been discussion about the ethics of vaccinating old people against pneumonia. Sir William Osler famously called pneumonia the “old man's friend”, because it kills the elderly without too much suffering. e.g.: https://www.sciencedirect.com/science/article/abs/pii/S0264410X05003270 https://www.sciencedirect.com/science/article/abs/pii/S02644...
stefantalpalaru 1y ago
[dead]
nailer 1y ago
Somebody responded to you with medical research and Hacker News readers flagged it. https://news.ycombinator.com/item?id=43866237 https://news.ycombinator.com/item?id=43866237 There might be many reasons to disagree with the research - it’s not peer reviewed for one - but flagging seems to be somewhat antiscience, which is a shame for a forum about software engineering and innovation.