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Comment by vanderZwan | Hacker News Reader

Something I've noticed: when people in my surroundings bring up worries of long-term effects of the fast-tracked vaccines, they somehow tend to not consider the unknown long-term effects of covid. Even though the argument that we cannot know the long term effects yet should apply equally.

When I bring this up they do seem receptive to this argument though, provided I'm not dismissive of their own skepticism. I'm not trying to convince them to get vaccinated, but I do wish that my friends stay safe until the pandemic is over at least, so I ask them to please be consistent and be worried about the unknown long-term effects of getting covid. Especially given that for the latter we do know that it's an actual disease that has already taken lots of lives and given lots of people long-term symptoms.

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You can't neglect the prior. In most European countries, somewhere around 5% of the population might have been infected with covid. Up to around 10% in the US. Therefore, to have comparable posterior probabilities for long-term side effects, you would need the side effects argument not to merely "apply equally", but to favour the vaccine over the disease by a factor of about 10.

You're not wrong, but my priority is to ensure that my friends who rely on emotion-based arguments (fear of the unknown regarding the vaccines, dismissing the risks of covid and taking too few precautions as a result) to be safe and to not contribute to keeping the pandemic going. Going this deep into statistics would just lose them, because I'd come across as trying to intimidate them into taking my viewpoint on how to reason about these things.

edit: apparently none of you have ever been accused of being an ivory tower jerk in their lives, explicitly or implicitly, ever? We're not talking about a discussion between people trying to weigh uncertainties based on what they do and do not know and working it out on a paper napkin. We're talking about people being overwhelmed by the complexity of it all and as a result starting from what they're most scared of and reasoning backwards from there. Which is how most people out there function, like it or not.

>my friends who rely on emotion-based arguments

Isn’t every argument based in emotion? Do unpalatable facts have a strong track record of success in arguments?

No. A lot of modern physics for example still seems objectively wrong when hearing about it as a student. Physical experiments and math has converted a lot of skeptics into believing some very “strange” things about how our universe works.

Are you saying that over a time period longer than a conversation or argument people who committed to learning a topic in depth were able to alter prior beliefs that were based in their lived experiences?

An argument isn’t some specific length of time. A 20 year bet on some outcome is a single argument that takes decades.

>Going this deep into statistics would just lose them

The comment’s text quoted above leads me to believe “argument” in this context refers to a shorter length of time rather than a longer one spent in deliberate study of the argument’s topic. Do you have a different interpretation of the comment to which this particular thread is devoted?

Acceptance of some of those strange observations relied on the older generation - with strong emotional attachment to the old way of looking at things - dying off.

That’s extremely overstated.

Einstein for example complained about spooky action at a distance, but didn’t disagree with the results. “Quantum mechanics is very worthy of respect. But an inner voice tells me this is not the genuine article after all. The theory delivers much but it hardly brings us closer to the Old One's secret. In any event, I am convinced that He is not playing dice.”

So, he was completely on board with the results of the single photon double slit experiment and other observable results which are very odd. But, he may have favored non local hidden variable theories which are indispensable from QM and all it’s observable oddities.

It's a dynamic not entirely confined to quantum physics in the 1930s, and there's a range of graciousness involved. It's a side effect of the paradigm shifts described by Kuhn: What happens to the old guard? Some will adapt to the new paradigm, some will enjoy tenure and let their students carry the new torch, and some will join the church in denouncing these heretics who deny the primacy of the earth. (And will happily say as much in their grant reviews!)

Also keep in mind that the stakes are higher when it's the academic's core area of contribution which is under attack. Einstein's contributions to large scale physics were secure. If instead good we're playing dice at the scale of solar systems, threatening to obviate his primary contributions and consign his name to the dustbin of history, the reaction may have been a bit different.

Not to completely disagree, but Einstein won the 1921 Nobel prize for photoelectric effect which demonstrates the quantum nature of light. I was using him as one of those pioneers which where faced with the universe acting strangely rather than anything to do with relativity.

So, yes some people will object long term, but it’s important to keep their objections in context. Plate tectonics is a slightly more recent revolutionary idea that actually converted most skeptics, but the early objections where reasonable and the actual conversion was quick once the idea approached it’s modern form.

"I was using him as one of those pioneers which where faced with the universe acting strangely rather than anything to do with relativity."

Yeah, all I'm saying is that his total collection of contributions wasn't at stake here, so it was probably a bit easier to back down.

FWIW, my 'motivating anecdote' in this discussion is an old prof describing the earlier years of algebraic topology, which he had been very active in. There were apparently a number of older topologists who were pretty resistant to algebraization of the field. Which possibly had a lot to do with Poincare's attitudes about logic and proof.

https://en.wikipedia.org/wiki/Henri_Poincar%C3%A9#Character

Depends on the setting. Among educated professionals - it's how science gets done. So even though the process is flawed, it's still more consistently fact-based than emotion-based.

But some people's arguments are based exclusively on emotion.

And they tend to be very bad at estimating risk, because they literally can't tell the difference between one specific tragedy which triggers their emotions because it's reported in great deal, and millions of tragedies which don't trigger their emotions because they're reported as dry statistics.

If we were being less polite, we'd call this a form of cognitive handicap.

https://www.eurekalert.org/pub_releases/2020-04/ttu-pra04092...

Is your claim that people whose “arguments are based exclusively on emotion” are “very bad at estimating risk?”

Do you use the term “argument” as meaning a decision making process or an advocacy method?

Is there a significant population of people who base a decision making process “exclusively” on emotion or is that a straw person? (And how do you know that?)

If there were a significant population of people whose decision making process was based on emotion, how would one falsify the premise that they are “bad at estimating risk?”

Given the causality claim that emotion based decision making poorly estimates risk due to availability cognitive bias, could the same causality claim be made that “educated professionals” are often bad at estimating wholistic risk because tunnel vision is also a product of their specialization?

Not sure why you were downvoted because what you are talking about is the reality on the ground for a lot of people. I'm dealing with this with some family members now. "I heard everyone in Europe is getting blood clots from their vaccine." is a common statement even though it's factually untrue. It's not coming from a place of logic, but emotion and has to be handled appropriately, otherwise you lose them.

If your friends accuse you of being an ivory tower jerk for adding nuance to a conversation, you should probably get better friends.

Without vaccination, the chance of eventually catching the disease is just about 100%. Yes, any single person may try and hope to be protected by herd immunity. But there are serious doubts that can be achieved given some variants' higher virulence and expected levels of eventual vaccine uptake considering justifiable reasons.

Meanwhile, long-term harms from vaccination are entirely speculative. There isn't even a real theory as to any mechanism to cause any such effects: all components of the vaccines are well-known, except the COVID-specific parts which are a strict subset of the actual virus.

"Meanwhile, long-term harms from vaccination are entirely speculative."

I don't think this is a safe thing to say about mRNA vaccines, which are brand new. IIRC one of the vaccines is essentially an old-style vaccine made for COVID, and for that one you may be able to reasonably say that, but not the new stuff that has never been mass-deployed before.

Nor does this mean they're automatically bad either. There's always a first time for something new. I'm just saying that it isn't really justified to apply decades of experience with one type of vaccine to another blindly.

The other US approved vaccine is a live viral carrier that has only been used fairly recently in experimental treatments (I think maybe an Ebola vaccine using it got approved recently?).

The CDC estimates around 25% of the US population has been infected so far.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

It'll probably settle around 33-35% since that number is just for 2020.

Roughly 37% of the US population was infected. A large fraction of Americans never took it seriously. Does that sound familiar? Oh yeah, climate change.

Well one pretty big side effect of the disease is death, which is very long term and we know the vaccines prevent way above 10x. So that should probably count for more.

> fast-tracked vaccines

It would be accurate to say that these vaccines have been developed in the optimal time, and vaccines are usually 'slow-tracked'. Nothing has been rushed here in the sense of cutting clinical corners. The development of these vaccines has gone through the same phases of testing that every other vaccine has.

Things that slow down all vaccine development: funding, finding volunteers for testing groups, committee approval for the development of vaccines, submission and resubmission of proposals to name but a few.

All of these barriers were removed by governments throwing cash at the various companies, and the companies and universities themselves removing barriers.

> Nothing has been rushed here in the sense of cutting clinical corners. The development of these vaccines has gone through the same phases of testing that every other vaccine has.

They were approved for emergency use, which means skipping tests for long-term side-effects, because those usually take around two years. Every other vaccine has been around for a while and gone through this.

Not to mention this is these are the very first mRNA vaccines deployed in this scale.

We’re going to be honest about long-term risks, and possibilities, we can’t just hand waive this away.

It’ll be fine. But pretending that long term risk isn’t there because we don’t want it to be isn’t very sciencey.

It’s wrong to equate these to previous vaccines in multiple ways.

In the past "long term" side effects meant within weeks after the fact. This includes things like autoimmune disease. However, the statistical signal may only appear years later. The mRNA vaccines also don't "infect" the whole body, but only the injection site, and they are metabolized quickly. There really is no reason to assume any late effects say 5 years later.

If they were frequent late side effects, we would totally know by now.

By the way, they are a brilliantly less complex system, much easier to reason about, than traditional vaccines.

> because those usually take around two years

As I said in my parent comment, COVID vaccines appear 'fast tracked' because all the bureaucracy was removed to expedite them.

Every phase of clinical trials have been followed otherwise the MHRA (and the EMA) would not have approved them.

https://www.nhs.uk/conditions/clinical-trials/

All vaccines have been through phases 1-3.

> skipping tests for long-term side-effect

That would be the standard phase 4 being "The safety, side effects and effectiveness of the medicine continue to be studied while it's being used in practice." "Only carried out on medicines that have passed all the previous stages and have been given marketing licences – a licence means the medicine is available on prescription."

Phase 3 under normal circumstances from that link:

> Trials often last a year or more and involve several thousand patients.

Also this seems to be a US/UK difference, as over here phase 3 includes long-term safety before it's approved for use, with emergency use authorization to skip that being the exception: https://coronavirus.jhu.edu/vaccines/timeline

> Trials often last a year or more and involve several thousand patients.

Agreed. Though not all last a year, and the COVID trials had large numbers of volunteers.

I defer to someone that works in the industry to say whether vaccine trials last longer than regular medicine (e.g. Parkinsons or Alzheimers drugs).

But I suspect that vaccines need less time for trials because vaccines are made using standardised processes that are tweaked to produce the expected responses, vs. novel drugs that have never been synthesized before.

This one [0] in the UK famously went wrong: "The German company that developed the drug hoped it would revolutionise treatment of leukaemia and rheumatoid arthritis.

But within minutes of having the drug administered, all of the test subjects began feeling unwell."

0. https://www.bbc.co.uk/news/magazine-35766627#:~:text=When%20....

Normally you won't have an incidence rate this high, therefore you need to run the trails for longer to get enough people in the control group sick. Massive amounts of volunteers and a high prevalence made sound statistics possible in a relatively short amount of time.

"Long term" side effects mean weeks or few month later, not years as many people assume. In the past things like rare autoimmune disease associated with vaccination appeared within weeks after the dose, but it may take years to pick up the statistical signal, which may explain this belief. There is literally no reason to assume the mRNA vaccines will cause side effects 5 years later or something.

That the vaccine is better than the disease seems a ridiculously low bar to me. I'd be much more reassured if they listed the side effects with their likelihoods (1 in ??) subdivided this with age groups if appropriate, I've seen this in NHS prescriptions in the past and its always been very reassuring.

Every medication publishes this information and must include it in every box shipped. It has been available since approval if you Google “vaccine name” + prescribing information.

The fact that I have yet to see it discussed in 1000s of news articles shows how ineffective news is as an information source.

The known effects of LC are horrendous: permanent damage to the brain, heart, lung, kidneys, liver, and pancreas.

> The known effects of LC are horrendous: permanent damage to the brain, heart, lung, kidneys, liver, and pancreas.

None of these are "known effects". If you count "things that have happened to someone after contracting SARS-CoV2" as "long covid", then an entire universe of medical maladies is included in the set that may or may not be causally related.

There are specific examples of patients with severe cases of SARS-CoV2 infection who have had damage to particular organs. However, it is misleading to draw a connection from these to the broader phenomenon of "long covid", which is neither well-characterized, nor necessarily related to these acute situations.

The ambiguity in terminology here is being used to loop in everything from minor headaches to lung damage due to mechanical ventilation.

Look at the cadaver studies.

Cadavers from Covid 19 have (by definition) not had very much time to recover from long covid.

Strawman. That's not the point. The point is the permanent damage SARS-CoV-2 has on numerous organ systems. People also survive COVID-19 illness and die from other things.

If you pick a pile of dead bodies and look for things that killed them, you will find things.

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