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Comment by bsaul | Hacker News Reader

i'm surprised absolutely noone here talks about the fact that we have absolutely no idea what the long term consequences of this new tech are.

We've all seen people advocating new wonderful technological solutions that fail because of unknown unknowns, in every field. That's just the rules of the R&D game.

In that case we're seriously thinking about injecting a new kind of drug to the whole world population based on a couple of short term trials, for a desease that is only lethal for far less than 1 percent of the population ( and in general, only the most fragile 1 percent).

I'm just like everyone and i find this new arn cell transcription machinery hacking absolutely insanely great. And i also think it looks safe from what the expert are explaining.

But is it safe enough to have it taken by everyone in the world ??

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The case fatality rate is around 1.8% in the USA [1]. Current population is 330 million. So if the entire population becomes infected that’s 5.9 million dead.

The case fatality rate would likely increase as we overwhelm healthcare resources, so it could be even worse.

1% may sound trivial but it becomes meaningful at the scale of a population. The benefits of the vaccine far outweigh the risks.

I was injected yesterday along with my fellow emergency department and ICU staff. People seemed giddy with hope and relieved to become protected. If you see enough people die of covid then the risk of the vaccine seems trivial.

[1] https://coronavirus.jhu.edu/data/mortality

Thank you for being willing to take the still-nonzero risk of a lightly tested vaccine.

I am fortunate enough to be a remote employee with little need (or desire) to interact in ways that I could spread or receive Covid-19, so I personally will wait a while for more data on safety and efficacy.

> The case fatality rate is around 1.8% in the USA [1]. Current population is 330 million. So if the entire population becomes infected that’s 5.9 million dead.

It won't get anywhere near that, as it doesn't take into account asymptomatic (I've seen estimates in some areas as high as 20:1, which would put the number dead at ~300k) and due to herd immunity not everyone is going to get infected anyway.

That 1% have the ability to devastate the healthcare infrastructure.

ICU beds are dollar for dollar the most expensive resource in healthcare today.

Not to mention the rarity of qualified healthcare workers who are trained in working in the ICUs and the risk of losing them for 2+ weeks if they get infected.

> That 1% have the ability to devastate the healthcare infrastructure.

Additionally, other people will die at a higher percentage from other-than-covid reasons because covid patients are taking up all the resources, which can no longer be used to treat other patients.

Okay, we've researched mRNA medicine since the 90s. But have similar medicines been given to a million people? Have those been tracked for three decades? We're talking about scaling that up by a factor at 10-100+, and giving it to millions of healthy people with many decades of life ahead. What if some serious adverse reaction happens ten years later, to 0.1% of the 20-year olds who take it today? Worth it?

The efficacy of the new mRNA vaccines is fantastic. It's a no-brainer to give them to people with a high likelihood of having a serious covid case.

Maybe it's justified to also give it to everyone else, to mitigate the economic effects of the epidemic. But asking this question is qualitatively different than what you hear from people who are normally skeptical towards vaccines. This is a completely new type of prophylactic, there is potential of an unknown unknown.

I'm typing this contrarian comment mostly to document that I've thought about it, in case, heaven forbid, we make a horrible discovery about it in 2025.

Honestly - aren't there researchers working in the field thinking similar thoughts? Is it such a taboo interjection that they don't dare speak it out loud out of fear of being compared to antivaxxers? I don't believe that it's an excessively cautious concern.

I'm somewhat offended that this post has downvotes. It's not like this is some anti-vax bullshit.

If we never questioned ourselves we'd still be using bloodletting as medical treatment.

It won't be taken by everyone in the world. There are countless vaccines being developed. The two mRNA based ones were the quickest to fulfil the criteria of their phase three trials. The AstraZeneca/Oxford vaccine and Sputnik V are based on more conventional methods (adenovirus vector) for example.

Also: the implication of your statement about the "most fragile 1 percent" is that their lives are worth less than others. I cannot begin to describe the disgust I am feeling towards such an inhumane attitude.

"inhumane attitude" could also be a good qualifier for using the population as lab rats.

it's called a tradeof , and public policies is doing it all the time, including accepting people dying for the greater good of others. Otherwise we would have banned cars a long time ago.

So vaccine looks more dangerous to you than COVID, despite numbers showing that's not the case? 20 in 1000 dying from COVID-19 is somehow acceptable, but two in hundreds of thousands getting some allergic reaction is not? How does one even justify that logic?

The problem is covid is short-term and part of a family of well-known and well-studied virus. Some vaccine can have very long-term consequences.

There is simply no way to correctly assess the risk, unless you think that ARN therapy is a known technique. Which it clearly isn't.

No one is forcing you to take the vaccine. What’s wrong with you?

Wait until countries decide to close their borders to people that haven't been vaccinated.

Most countries in asia already ask for a negative PCR test for tourists, and some (like malaysia) have been in lockdown for almost the whole year despite having had less than a thousand casualties in total.

I wouldn't be surprised if madness reaches another level very soon.

Ok, what the mechanism for the long term consequences would be? mRNA itself is gone in days. All what's left is antibodies and some immune memory which should be the same as if you had real COVID. Is that more dangerous than catching covid which may affect your body in many more ways than vaccine which makes your cells to produce a particular protein?

I do not know what the long term effects of the glass of water I just drunk will be.

This is not necessarily specific to the mRNA vaccines, but one potential consequence of population-wide deployment of a 90% effective vaccine might be to create selective pressure for a more virulent strain of Covid without actually eliminating it.

By that logic, we'd be ravaged by polio, the plague, tetanus, super-smart bears, and evil spirits.

We should also stop all research.

(I was going to also sarcastically suggest disbanding the military. But that actually happens to sort-of work along the lines you have in mind, because we can disarm tit-for-tat along with everyone else. So what we really need is for COVID to evolve faster, until it is capable of negotiating a truce and make strategic decisions)

The polio vaccine, as administered, is over 99% effective, which is an order of magnitude difference.

If what I wrote is correct I don't see how it lends itself to "stop all research" as opposed to "wait until we have a more effective vaccine." I'm not even saying it's a greater than 50% probability, but it is a risk.

I wonder what field you’re working on, but it seems that you’ve never experienced the difference between theory and practice.

Who knows? There is so much that we don't understand. And so much of what we claim to understand, we do not understand completely.

The thing about "unknown unknowns" is that they are unknown. It's like asking "what could possibly be outside the edge of the map, surely it's more of the same".

This isn't a matter of water flowing downhill through a pipe or a piston moving through a cylinder. Although we have a good understanding of the process, we don't have decades of extensive engineering experience to give us empiric reassurance that there are no gotchas. We didn't put a billion people into airplanes nine months after the first commercial airliner was developed.

Sure, hopefully our current understanding is good enough and there are no long-term side effects. But it's naïve to assume a likelihood of 100%.

Although the elderly and sick have a high likelihood of a serious covid case, young and healthy people are exceedingly likely to have a mild disease. These probabilities are what you have to judge the confidence of long-term vaccine safety against.

>is it safe enough to have it taken by everyone in the world ??

Alternative: if we don't know it's safe, better have everyone take it, or at least as many as possible. That way there's no reliable control group to compare outcomes, and no one can blame the vaccine, and it's easier to blame other external factors or say we don't know.

This is (systemically) the general approach taken with many environmental toxins. It's only when unfortunate, acute "cancer clusters" etc appear that some really nasty chemicals which are prevalent everywhere - like PFAS, etc - come to attention.

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