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Comment by robbiep | Hacker News Reader

Because a prophylactic means taking it regularly in order to avoid catching it, with the implication of the poster’s statement being that ivermectin, which carries significant risks when taken by a human at various doses, was the cause of the person going to ICU

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Exactly. Just because someone doesn't dose something correctly, doesn't mean there is necessarily anything wrong with it.

Shall we ban water? Sometimes people don't dose that correctly either, and drown.

What a dangerous substance!

The valuable part of your comment would have been more impactful if it weren't for the following 2 paragraphs about water.

Maybe, it depends on your opinion of the established safety profile of Ivermectin prior to its attempted maligning. It's a fair comparison to this commenter.

Your absurdist attempts aside, the important thing to consider with a prophylactic medication is the therapeutic index.

Let’s take vaccines. Covid itself has a risk of harm of around 1:100 for older age groups of requiring hospitalisation. Risk of harm for vaccines is established at around 1:200,000.

Ivermectin? There is no good data on the therapeutic index however it is a toxic substance with a low therapeutic index and a narrow therapeutic window.

The sensible thing given the available data is to encourage vaccination. Barring that, masks and social distancing. And of course there are places where both there is no vaccine supply, and social distancing is economically in feasible. Is this a use case for ivermectin? Most data says no because establishing TI and TW and ensuring adequate safety of dosing is logistically about as difficult as maintaining social distancing.

Good chat

Risk of serious harm from vaccines from a country where I trust the people a lot more than Americans is 1:3571 (based on 446,380 doses). Where are you getting the 1:200,000 from?

https://www.medsafe.govt.nz/COVID-19/vaccine-report-overview...

125 serious AEFI in 446,380 doses. 1:3571 indeed.

But here too the reporting is open to anyone, and is voluntary. So chances of large under reporting is present here as well. Which is a bit scary..

Let me add that these reports don't show cause, just correlation. Attempting to determine cause is very speculative and tenuous, and so all adverse events should be reported. So long as everyone understands the vaccines don't actually cause this many adverse events. To be fair, the same goes for COVID-19: deaths associated with COVID-19 are not necessarily caused by COVID-19.

That point being addressed, I would expect the elderly to have a lot more background adverse events, such as death. If we live 28835 days on average, 15 people in this vaccinated group are expected to die every day from non-vaccine causes, and heavily weighted towards the elderly. But I'm not even seeing death as a side-effect, and the number of adverse events among the elderly (who got the vaccine first and have had the lions share of vaccine administration) is actually less than among younger groups. This perplexes me and if anyone thinks they know the answer to this riddle, please share.

[Oh wait... there aren't as many elderly people. hits head]

Huh? Ivermectin has been in use for decades and administered in the billions of doses and had only a handful of associated deaths in that time. How to safely dose it is extremely well-known and established.

If you look at any vaccine adverse events reporting system, you do indeed find the 1:200,000 number - as that's indeed where it came from - for all ~70 previous vaccines on the schedule (and adjusted for under-reporting - the raw numbers in the systems are in the 1 in millions in most cases).

The COVID-19 vaccines however, unadjusted, are in the low 1 in 10,000's.

Check any reporting system independent of country/region, you'll find the same massive safety disparity between COVID-19 vaccines and all other vaccines being tracked.

So, basically everything you've said is wrong.

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