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Comment by CyanLite2 | Hacker News Reader

>We still don't have vaccines for retroviruses like HIV/Herpes

Good thing this isn't a retrovirus.

>But I do have concerns on trying to push out any novel vaccine in less than two years without adequate testing.

They started on this vaccine about 9 years ago, originally for the first SARS/MERS. They just gave it to 1,077 people and all 100% produced the desired effect, and the worst symptom reported was fatigue/headache that resolved on its own within 24 hours, or sooner if taken Tylenol/paracetamol. We're losing ~150,000 people worldwide EVERY MONTH to this virus, how many more months/deaths should we wait until we're sufficiently satisfied that it's safe?

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> They just gave it to 1,077 people

That's a good start. But for example, how many of them were pregnant, and at what stages? I would guess none. That would be the most famous way to get this wrong.

I hope they are thinking hard about the optimal roll-out strategy, though. It should surely be faster than in normal times. It might well be that you should run very very large not-quite-trials as the first stage of general distribution, and watch their evidence in real-time.

Right, we should just test on nobody instead.

Of course we're gonna test this on the healthiest, least-likely-to-accidentally-die humans, what's the point?

They explicitly did a pregnancy test on everyone who can be pregnant to preclude the possibility, just in case.

But then we have no idea how those vaccines will work in the real world where, when we need N% immunity achievement for herd immunity, a >N% of the population is not considered healthy (and also haven't been proven safe for). There have definitely been cases in which pregnancy is excluded from studies to prove safety with horrible consequences to pregnant people and their children.

It seems entirely logical to me to first test on healthy young people. It's a big step forward from mice! You might learn a lot.

But there are quite a few more steps from there to treating the population.

It's easy to make decision for other peoples lives without consequences for yourself.

I feel like your reply is a bit dismissive of a very real problem.

I don't understand anything about biology/vaccines or anything else relevant - but there have been several stories in history of medicine that was thought to have no side effect, that ended up being taken off the shelves because it was more dangerous than first thought.

If we're going to inject a few hundred million (if not a few billion) people with something, we need to be really really sure it won't harm then, and considering the fact that COVID has a mortality rate of 1%-ish, the vaccine has a huge burden of proof.

And more importantly to anything that I say as a non-expert - most experts on these issues seem to think you need at least ~10 months of human trials, if not more.

> I don't understand anything about biology/vaccines or anything else relevant - but there have been several stories in history of medicine that was thought to have no side effect, that ended up being taken off the shelves because it was more dangerous than first thought.

That’s the entire point of a Phase one trial. Vaccine studies may be a little different in their numbering, but the intent of a phase one trial is to figure out if the treatment is safe. The effectiveness is a separate question.

https://www.cdc.gov/vaccines/parents/infographics/journey-of...

Yes. It worked out so well the last pandemic (2009 swine flu). The vaccine had no side effects in the trials (healthy people 20-55), but caused narcolepsy for children, leaving them disabled for life. This affected over 500 children in Sweden and Finland, and an unknown number across the world.

https://en.m.wikipedia.org/wiki/Pandemrix

No one knows if this vaccine has similar side effects, what if it causes elevated risk of lung cancer?

Drugs are comparatively safer, given the time frame of the pandemic.

What about long-term side effects?

So less than 1 per 1,000 would die or suffer other damages from the vaccine. Apply this to 300M and you get 300K people.

I'd just add that nearly 20% of participants experienced a fever of over 100F after the vaccine, and about half felt feverish. Though, like you say, these numbers were reduced for participants that took Tylenol.

>>We're losing ~150,000 people worldwide EVERY MONTH to this virus, how many more months/deaths should we wait until we're sufficiently satisfied that it's safe?

Before vaccinating 7 billion people with a vaccine done in a year we should think at least twice, Darwin Award in global scale and all. Let them vaccinate 80+ year olds or people with one foot already in the grave, but be very careful before doing it in a massive scale.

I agree with your response, it's a logical concern.

However we're going to try dozens of vaccines on probably 500k-1m people in total globally before deploying them in an increasingly broad way. The next stage of the Pfizer-BioNTech trial is going to be 30,000 in July/August.

Are you aware that rushed vaccines for pandemics have caused serious side effects that were not discovered until too late? This is not a theoretical concern. A study of 1000 people for 2 months is not nearly enough to detect the kinds of issues that have occurred in the past, let alone novel issues.

We need to ensure that the vaccine is extraordinarily safe. "But it saves more people than it kills" is not an argument people accept, unfortunately. If this vaccine kills anyone, the antivax fallout could be worse in the long run than just letting the virus run its course.

Good thing there are more studies after this...

Come on now, we gotta start somewhere

> We're losing ~150,000 people worldwide EVERY MONTH to this virus,

For context: That is 0.0002% of the world's population.

0.0002% of a very large number like 7 Billion is still a large number and worth worrying about. Also the number is per month.

per capita numbers are useful context but sometimes the total number is also important context that is worth worrying about. In this case a tiny percentage of a very large number results in a large enough number to cause concern.

The absolute number of cases is large, but so is the collateral damage. Both scale with the population so the trade-off doesn't depend on any absolute numbers and citing them is simply misleading.

0.0002% per month is still just 0.0024% per year. Don't forget that more than 1% of the population die each year to begin with.

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