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Comment by voisin | Hacker News Reader

Man, the messaging around the vaccines is so damn frustrating. No wonder people are skeptical. “Get whatever is available when you are eligible” —> “Oh but not J&J unless you are over a certain age” —> “Or AZ unless over a certain age” —> “Don’t mix mRNA” —> “OK Mix mRNA if available. Just get fully vaxx’ed ASAP” —> “Just kidding, wait 8 weeks”

Like come on! I follow this reasonably closely and I am ready to storm the Ivory Tower over this messaging. I cannot imagine what someone who doesn’t follow this feels.

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That's complex decision-making under conditions of uncertainty for you. The authorities themselves are partly to blame for not being totally clear that they're human and figuring this out on the fly like everyone else, but the general population is also to blame for acting like a bunch of spoiled children and feeling entitled to perfect answers and zero mistakes.

Admitting the uncertainty is my point. Instead they change the messaging week by week and act like this latest messaging is certain.

Each of those steps had more nuance being communicated than the half-sentence you summarize it with, often with intense public debate and different judgment calls from different health authorities. (AZ and if/how to use it is probably the biggest example, vaccination for children is another (at least here in DE that's a massive thing)) None of these things were "this is the absolute truth forever".

Exactly, people forget that actually, the official government message is NOT the snippet on BBC or in a newspaper, there's usually a much longer and complex explanation to be found directly on NHS website or you can ask your GP. I have this problem with my mum - she watches the news and complains that the government never explains anything properly - but I'm like, mum....you realize news stations aren't the government, right? You're just getting the abridged version and complain you don't see the full picture.

Often even just "read the newspaper article" vs just the headline or the TV news snippet.

I'm in Australia, and our pandemic's management from some of our governments is a bit like dropped spaghetti. Ie it's a big mess.

Anyway, the frustrating issue is that advice seems to be risk based mixed with environmental conditions. Which seems sensible, but I actually think it's not the correct approach.

So right now we have a bloom of Delta in Sydney, and our medical advice was previously not recommending AZ because of the chance of blood clots. However now the situation is really quickly getting out of hand and they are recommending AZ.

It strongly seems like they considered Australia being some island all on it's own some massive mitigating factor which changed the impact of the virus. And as a consequence a lot of people are without any vaccine and a lot of hesitancy about AZ. The failure here was they thought they had time to wait for pfizer.

But Delta acts like Delta and is just spreading around like wildfire. I actually believe some of the advice is suffering from normalization of deviance. Where the deviance is being able to suppress the virus with things like quarantine. As opposed to getting everyone vaccinated.

Oh btw, I'm under 40 and got AZ because I'm willing to risk it. I've never been struck by lighting and i've done way riskier things.

Let's be honest. IMO the assumption of Australia being an island was right (as evidenced by the states that made sure their states were islands most notably WA). At this stage WA is clearly the "gold standard" of COVID management, not NSW. NSW, given the numbers it was taking through its "hotels" which never should of been permanent quarantine facilities in any case was not "an island" at all. They arguably were just lucky most of this time, and through hubris of the local people there this was considered good "gold standard" management.

The low tech easy solution for a country like Australia is really better quarantine facilities (i.e. not hotels in the middle of population centers) IMO coupled with a vaccine rollout geared to workers at the quarantine facility (and potentially freight facilities). Its easier to rollout the vaccine and subsequent updates to it for future variants to a smaller number quicker. States in Australia that limited their international intake seem to be doing better than particularly Sydney who were taking the most arrivals. It really isn't an island when your taking the brunt of international arrivals. The fact that it was even working (hotels) for as long as it did shows the effectiveness of a good quarantine strategy. Low tech, simple solutions usually trump high tech solutions that require everyone to participate (problem of the commons).

The main message here is not "you have to/absolutely should wait 8 weeks". The main point is "countries that did stretch the schedule compared to what was in the initial studies probably didn't make a massive mistake by doing so" (EDIT: and of course it's a press release for a single study, not an official policy announcement)

Those are each reasonable things to say with certain conditions and caveats. I would guess the issue is with various experts and policy makers trying to simplify things "for" regular people. Different people have different priorities and different summaries.

Another issue is that some health officials won't recommend something until there has been an official study result. For example, it was very likely that mixing vaccine types would result in stronger immune responses. But almost no one was willing to recommend it until there was a study done. That's why Britain finally put together a tiny quick study just to get a result out that they could point to.

A related issue there is that the recommendations are all based on the quickest results to study. The short 3-4 week spacing was recommended only because testing longer gaps takes longer.

I don't get why you're downvoted - you are completely correct in your analysis of public perception!

The key issue underlying all of the chaos is that scientific literacy isn't taught much in schools. Too many people think that "once scientists have declared something, this may be as irrevocable as the stone platters on which Moses wrote the 10 Commandments", whereas the reality rather is that scientific knowledge is always expanding, including retractions or corrections as more data becomes available!

Another part of the problem is that politicians - not just in the US but also in the rest of the Western world - have dropped their role of taking in scientific knowledge and distilling reasonable policy out of it. And to top that, media has been massively cutting down on their "science journalism" departments that could provide context and education to public debate.

I mean, that's the nature of an emerging situation. What do you _expect_ health officials to do?

not OP but the alternative strategy is to start conservatively and then relax restrictions rather than pivoting between guidelines.

So in this case I think a more clearer solution would have been to be maximally cautious in the beginning, and then only when you're certain loosen what vaccines to apply when. The same way the British handed lockdowns. They started strict, only relaxed measures slowly, and made clear they won't reimpose stronger measures once lifted.

This is understandable to people because there is reassurance and clarity about how to proceed. Which is important because everything else destroys confidence.

But… what restrictions are you suggesting? There was one major restriction right from the start; many countries didn’t allow AZ for over 65s for a while, due to deficiencies in the first trial (and that one usually was dropped). But all other current restrictions are as a result of later discoveries.

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