Comment by georgewsinger | Hacker News Reader

Comment by georgewsinger | Hacker News Reader

Good for Russia: taking steps towards allowing free & consenting adults the ability to use an experimental vaccine at their own risk, should they consent to do so, and with the potential to generate massive positive externalities for the rest of the world in the process.

How cringe is it that Russia (of all places) has beat the U.S. in allowing their population the right to access new technology?

Literally hundreds of thousands of people have died during this pandemic, and our regulatory agencies have -- in the name of "protecting us" -- literally blocked off people from being able to experiment (on their own property) with ways to prevent the spread of more mass death. Unbelievable.

Not to mention the tail risk of bottlenecking a life-saving vaccine until a government agency deems it "safe", and then suddenly releasing it all at once to massive portions of the population. If instead you let early risk-takers experiment on their own watch, you get orders of magnitude more data to work with gradually as opposed to suddenly unleashing a single vaccine (deemed "safe" by the FDA) to tends of millions of people at once.

Here's how someone in the field recently explained it to me...

Let's say you have a vaccine that appears effective (great, right?) You give it to 1000 willing test subjects, and most become immune (fantastic, right?). Then, three to six months later 50 of the subjects go into terminal liver failure due to their body's immune response to the vaccine (as determined by their genetics.)

It's not just whether a vaccine 'works' for you, it's whether it's effective AND safe over the huge genetic pool that is humanity (as measured over a sufficient period of time). This kind of stuff comes up all the time with drug trials, and it's why there's a process, and things can't be rushed.

Yeah and just imagine how the anti-vax conspiracy crowd would respond in that situation. Things would get really crazy really fast. Even in a pandemic we can't rush this.

Well, in this pandemic we don't need to rush this as mortality is relatively low. If it were a variant Ebola, but with the same transmission rate as Covid19 then we'd sure was hell be rushing it.

Your reply bugs me. Not yours personally, but especially in the US this attitude seems to be a very binary thing. You either die, or most people survive it and your chances of survival seem to be good.

What this leaves out is all those nasty consequences observed, where Covid victims survive, but encounter all sorts of health issues. From kidney - to heart damage, up to funky things it may do to your brain.

This leaves out the long timers[1], who survive it, but have massive health issues for month with no end in sight.

I, for one, are really hell bent not to catch it and as a society there seems to be number of quite simple measures to avoid spread.

Unfortunately even those, like masks, in my opinion a no brainer, get politicized.

[1] https://www.theatlantic.com/health/archive/2020/06/covid-19-...

Thank you, just to expand, as I fear there's a disconnect.

"we don't need to rush this" and put out a vaccine super-quick that might itself inadvertently kill/harm a large proportion of the population.

I'm not at all diminishing the severity of Covid19 (deaths _&_ life-changing health effects, as you remind us), but thankfully it's not killing 40% (IIRC) of the infected like Ebola. Under that pressure a vaccine would probably be advisable even if it 'only' killed 20% (!) - if you could get anyone to have such a vaccine?

All vaccination programmes cause some harm, mass inoculation in a rush has the potential to cause more harm than no vaccination.

There's some very interesting work on apparent immunity to Covid19 going on (The Lancet article recently), which I'm hoping will suggest that an endemic "common cold" coronavirus has effectively inoculated people. That would seem to give an inoculation known to already be relatively safe. But it's way out of my areas of expertise.

Funny that you've shifted your argument from death rates to "long-term effects" when it no longer fits your agenda.

> Sweden is slithering into a full blown catastrophy […] the numbers are bound to explode in the next few days.

> The grim reality, however, looks very different and Sweden is on the best way to one of the greatest corona catastrophies in Europe.

Didn't happen and the curve continued to sharply decline after you made your comment. Sweden currently has one of the lowest infection rates in Europe and exactly what I said would happen is happening in other countries.

However you put it there is a limit to how long you can wait. It’s never going to be risk free.

Of course incidents where 5% of the subjects of a drug test die do not happen ‘all the time’, if they happen it’s on the news. And it’s not on the news ‘all the time’.

Balancing risks does not mean attempting to avoid all the risks.

Given the enormous amount of advertizing bought by the pharmaceutical companies, I would not think that the "news" can be considered objective.

I did not research this, but in my undirected layman reading have encountered at least the following three cases in which vaccine was more harmful than the disease:

Live polio vaccine which wasn’t properly attenuated and caused polio;

A vaccine in the us that caused Gillan-Barre syndrome way more often than disease symptoms (1960s or early 1970s, don’t remember disease name)

A vaccine given to children in Sweden that dramatically increased chances for narcolepsy.

It is important to recognize that not all vaccines ever produced are safe for everyone, and there are a few which were a total net negative for society (even though most are net positive despite some bad outcomes)

Vaccines, especially if mandatory, need to be held to an extremely higH standard of Safety. It is my impression that the COVID-19 panic is leading us to approved though net negative vaccines. We will only know much later , unfortunately.

I’m sure you agree that 3 incidents in a century hardly mean it ‘happens all the time,’ that’s just a gross exaggeration.

As I mentioned, I didn’t research this - it is things I came across accidentally in my reading. I assume these three are not the whole story.

I agree even 10 over 60 years is likely worth it to society as a whole. But ignoring this reality and saying “all vaccines are always safe and no vaccine ever caused anything bad” which many supposedly science people do is not good either.

The biggest risk to my mind here is that if something bad (long term effects) happen to people taking this vaccine it might become an argument that anti-vaccine folks will market all over the globe. We can get actual vaccination slow down.

I'm generally of that opinion, but I have read that it seems to be more complex then that.

First off, there's a trust factor. If people start to hear about all these vaccines with side effects and misbehaving, it can cause people to fear and not trust the vaccines themselves, even when some that do work and are safe come out.

Second, and this I am not sure of the validity, but I've seen claims that a bad vaccine could actually make it more difficult to later make a good vaccine. For example, it seems certain type of vaccine can only be used once, so if you've got a bad vaccine, the good vaccine wouldn't work on you anymore, etc.

Hasn’t one of the major vaccine candidates failed out of the trails already?

Perhaps you're thinking of the pause in the AstraZeneca Phase 3 trial. That's common and it has resumed. So, in that case, no.

Yes, AstraZeneca's trial was put on hold after a case of transverse myelitis. Obviously, in a large trial there's a chance the illness was unrelated to the vaccine, but this is one of those reasons why trials exist.

And now it has resumed

Eh, if this turns out to be the next Theranos, then we'll be glad that the government stopped our innocent civilians from being duped by this trickery. It's kind of a double-edged sword.

What happens if I no longer trust our government to protect me from predatory business practices? I ask that, because I no longer trust the CDC after their series of recent scandals.

Ironically, it's largely due to successful Russian efforts that I no longer know who to trust for advice on vaccines.

From what we're hearing so far [1], it seems that POTUS will promise a vaccine is on its way just before the election, but then never deliver it. What I'm worried about, though, is that a vaccine will simply show up and start being rolled out by a compromised CDC, or FEMA, or Army, or whoever the administration can force to do it.

[1] https://www.axios.com/trump-cdc-redfield-vaccine-d266121c-88...

Maybe this is the October surprise? The rushed Russian vaccine that Trump’s friendly relationship with Putin helped to secure?

I wouldn’t put it past them to try.

> I no longer trust the CDC after their series of recent scandals

Care to link? Feel I must have missed some news, as I'm not aware of any scandals around the CDC?

https://www.marketwatch.com/story/the-cdc-says-americans-don...

https://www.foxnews.com/media/surgeon-general-explains-masks...

I mean, if not making wild guesses is considered a big scandal, well so be it, but I find it quite exaggerated to call this a "scandal". There was no lie, no one was mislead, they weren't even wrong in a sense. At first there was no evidence that masks could prevent the spread, and then there was a shortage of masks for medical workers who needed them, and only later did the data show that asymptomatic and pre-symptomatic transmission was possible, so there was now evidence to advice wearing a mask, even a non-surgical one.

You could say they are to be blamed from making the default position the status quo. But the opposite is a harder default, how far do you go when nothing has been shown to be necessary or prevent anything yet? Like do you tell people to just go full on quarantine? To wash all their delivered packages and produce with soap? Like how far? And then if you tell them to do all that, and it later shows they arn't necessary and don't help prevent the spread? So in some way, the status quo does seem like a good default.

Basically, the CDC just said: Go on with your daily life, don't panic, don't buy all medical equipment that the medical professionals need, and as the data arrives and shows evidence of what measures actually help to prevent the spread we will update our guidelines.

Posting stuff that was not approved by CDC scientists, as coming from the CDC is a pretty massive scandal however you want to slice it.

Sure, most of it comes down to the administration putting unqualified people with poor financial incentives in positions of high power.

There was this particularly transparent example by the Director of the CDC a couple of years ago, about buying tobacco stocks when put in charge of programs for reducing tobacco usage: https://www.politico.com/story/2018/01/30/cdc-director-tobac...

Also this story about how FDA appeared to bend to political pressure to greenlight an experimental treatment due to political pressure, bypassing the normal guidelines for demonstrating efficacy: https://www.nbcnews.com/health/health-news/why-did-fda-autho...

There's also been a general failure to respond appropriately to the pandemic. We're so many months in and PPE is still an issue: https://www.msn.com/en-us/news/world/8-months-into-pandemic-...

And that's not even counting what the White House is doing, which is not good. Especially with the recently leaked audio tapes from Woodward from the same time POTUS was publicly downplaying it: https://youtu.be/-cfd_pJVYiM?t=179

Plus the hydroxychloroquine thing...

There's a lot of buzz lately about how the administration is trying to influence the CDC, but most of it is journalism/politics blue twitter insider type chatter:

* https://www.motherjones.com/kevin-drum/2020/09/politico-trum...

* https://www.msn.com/en-us/health/medical/trump-e2-80-99s-att...

* https://www.motherjones.com/kevin-drum/2020/09/politico-trum...

* https://www.msn.com/en-us/news/politics/trump-appointees-sou...

But there is a lot of it, and that's pretty unusual for an organization like the CDC. Maybe it's all disinformation, but keep in mind it's the President's job to appoint the Director of the CDC: https://www.motherjones.com/politics/2020/03/trumps-cdc-dire...

I'm not saying every smear against the man is true. But after the last director had to resign over the tobacco thing, and the current director is now clearly affiliated with the President, so I'm skeptical if he has the public interest at heart.

I've never had less faith in American institutions, and I think it's for good reason. There's a lot of corruption at the top, and it's clearly infiltrating the institutions.

If they say a vaccine is safe to get, I don't think I can trust it. I'm going to need to dive deeper into opinions of professionals when it becomes available before I get it.

Hum, okay I see what you mean. I think maybe it's premiditated to conclude that it's untrusworthy yet, but I wouldn't blame anyone from being a bit skeptical and double checking with say the Canadian and European health institutions to see if the advice is similar, and if not that might need to trigger some investigation into why they'd differ so much? And I don't know, throw in China and South Korea and Russia in there as well, in theory, all country should advise pretty similar things, medical science is mostly universal so any major discrepancy would be disconcerting a bit I admit.

That said, I also don't want to fall into some fallacy of nirvana, I don't believe any governement ever existed in a perfect state with zero bias and total absence of corruption, sometime all we have is good enough to go by.

And I also wouldn't want to fall in the fallacy of inflation of conflict, where because there are scientific disagreement in the medical community, especially given a very new very unknown problem such as Covid, that no conclusion can be reached or that the legitimacy of that field of knowledge is questionable.

I agree with you entirely, and I think that will be my plan. It could be a problem though if US society is back to "normal" with a "vaccine" that ends up rushed through some how, and I'm one of a few crazy holdouts that don't trust it.

Would any of our Russian comrades reading along care to weigh in on how they're feeling about getting the vaccine on release day?

eugene3306 summarized it best: https://news.ycombinator.com/item?id=24512974. As someone fairly familiar with Gamaleya I agree completely, they are known to be responsible for some "bullshit-micyn" drugs as we call it here, so I'd hesitate to be an early adopter for their vaccine. (also you'd get funny looks if you called someone comrade in Russia, just saying)

Thalidomide or maybe the Cutter Labs Polio vaccine might be a better comparison than Theranos.

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