By virtue of its distribution these vaccines have already been tested far more extensively than any other vaccine in history at the time of their release. If you don't trust this vaccine then you should never trust any future vaccine.
All your "what if"s remind me of the "what if it causes fertility issues?" that swept the internet last year despite zero valid supporting data. Well my wife and I trusted the actual data instead of internet speculation, as well as the data showing what COVID can potentially do to fetuses, and we got pregnant well after both being fully vaccinated. Thus far the baby appears healthy (genetic testing clean, strong heart beat, correct size). So it turns out the experts were right on that one, and it's more directly relevant than your Vioxx example.
At this point it's not a matter of time in many cases, because it's already been shown in the data for certain demographics that the personal risk is not worth the personal benefit.
Non eradicating vaccines during a pandemic of disease with transmissibility as high as COVID are actually a terrible idea for the same reason not finishing your antibiotics is: It applies selective pressure that promotes immune escape and treatment resistance.
>By virtue of its distribution these vaccines have already been tested far more extensively than any other vaccine in history at the time of their release. If you don't trust this vaccine then you should never trust any future vaccine.
This is a new level of newspeak. Releasing without testing is testing. Slavery is freedom. War is peace.
This is a completely normal part of the approval process, simply because (phase 3) studies with a couple thousand participants will miss very rare side effects (if they exist) because, you know, statistics.
Of course you can trust a vaccine much, much, much more if it has been administered to a couple billion people as opposed to a couple thousand people, with no serious side effects being observed (or the side effects that are observed accounted for and reacted to).
You implication that this is somehow newspeak is deeply weird and irrational.
Newspeak isn't newspeak. Got it.
Long term data doesn't exist. There's no evidence the vaccines are safe long term. They also experienced greatly accelerated trial periods with data and time that would have been woefully insufficient for any other medical intervention. The data, results, and methodology for the trials is currently embroiled in scientific and ethical controversy.
To state they are "the most well tested vaccines ever" is blatant gaslighting. Widely distributed is not tested.
This is something that I see authoritarian pro-mandate people do all the time and it genuinely confuses me. Why do you do this? Do you think that testing with a billion people for a year will give you the same data as testing a hundred million people for ten years? Or is it just a genuine mistake?
I work in medical R&D and there is a long history of drugs and products with delayed failure and unintended consequences. I think the chances are low, but anyone who claims they are zero is lying.
Chronic lead poisoning, mesothelioma (cancer usually caused by abestos), lung cancer (cigarettes), various types of cancer caused by Agent Orange, and cancers caused by DDT take years-to-decades to manifest. Asking for 20 years is completely reasonable and supported by a dozen other substances that do have long-term side effects on that timescale.
> Also their timespan is almost certainly long enough that any pandemic would be long over by the time they'd trust it, essentially precluding vaccines as tool during a pandemic if everyone were to adopt their perspective.
Almost everyone that I've heard (except for a lone hardcore anti-vaxxer) who has expressed unease at the safety of the mRNA technology in general, not the specific application of it to SARS-CoV-2 - which is understandable, as there's no long-term trial data available about it. Several said that they were waiting to take the Novavax vaccine, which uses an older technology (subunit) that has been in use for decades.
So, assuming that the majority of people uneasy about taking the vaccine adopt that stance above, then no, there's no "precluding vaccines as tool during a pandemic" because the criteria is whether a particular vaccine technology has been tested for decades or not, not the particular payload.
> By virtue of its distribution these vaccines have already been tested far more extensively than any other vaccine in history at the time of their release. If you don't trust this vaccine then you should never trust any future vaccine.
Testing a vaccine with one million people for one year does not translate into ten years of study for one hundred thousand people. You cannot predict long-term effects with short-term data, and long-term effects are what these people are worried about. Nobody except hardline anti-vaxxers (who make up a tiny tiny minority of the population that I'm not discussing here) wants every single payload+technology combination to be tested for decades before use.
> Well my wife and I trusted the actual data instead of internet speculation, as well as the data showing what COVID can potentially do to fetuses, and we got pregnant well after both being fully vaccinated.
I'm reminded of a line from a sibling comment: "you get 0 applause from me if you randomly guess a “what if” correctly" - and without actual data as to whether mRNA vaccines have any long-term side effects (which is the issue under discussion), you're just guessing.
Finally, I'll preempt one of your talking points "We don't know what the long-term side effects of covid are either, yet, so why not pick the less risky of the two?" Because that is a personal choice - so it's up to the individual, not the government to impose.
It's generally a good strategy that, given ambiguous information, you still make the best use of what you have and pick the least risky option (i.e. vaccines) - however, in the specific case of vaccines in the US, the fact that the US government has shielded vaccine manufactures from legal liability means that there's significant downside in case there are long-term side effects.
If you want more people to take the vaccine, you should be campaigning hard to get that law repealed. I don't see anyone railing against anti-vaxxers doing that, so the more likely explanation is that these people are merely using the vaccine as an attempt to increase government control.
I do stand corrected. One made it to human trials. Doesn't mitigate dozens of disastrous animal trials.
That said all vaccines have side effects for some populations. There a reason why when you get your flu shot they ask you if you've had any previous bad reactions to flu shots. That doesn't make the flu shot or any vaccine a bad bet, sometimes you bet with 99% odds and end up the 1%.
if you don't want to get vaccinated, don't. no need for poorly reasoned rationalizations
We have limited information in almost every decision we make, yet we still have to decide (inaction is itself a decision). The key is what you fill in those bits of missing information with, not the results of the decision as no one is clairvoyant.
This sounds like a gambler. “You’re putting $100 on black?” “Yeah, I could lose $100, but what if I’m right?”
For both the gambler and the anti-vaxx you get 0 applause from me if you randomly guess a “what if” correctly. You only get credit if you had a hypothesis you could intelligently explain and then tested it robustly. Kind of like the scientific process.
It’s fine to play “what if” games for fun, but not smart if you’re trying to play the odds, then you need more substance in your decision making.
Like “what if eating vegetables ends up causing heart disease?” We’ve been wrong about nutrition before so “who knows?”
Your nutrition example is a great parallel because if we would have looked at the funding and long term data regarding the food pyramid, simple carbs, etc vs fats instead of just "trusting the experts" we wouldn't have an epidemic of obese, diabetic gen x and millennials. There's tons of sound empirical evidence about the long term health benefits of vegetables. It's complete false equivalence
When I create a website, hire someone, fire someone, etc., I have no knowledge of the decision’s long term effects. My one simple act could make the world a paradise or destroy it, but I have no evidence or reason to believe in either of those scenarios so I ignore it and focus on outcomes that seem reasonable given the information I have at the moment.
It’s fine to question the long term effects of a decision, but if you’re doing so with no information or insight, you are just randomly guessing.
So better than “what if X happens?” Is “what if Y causes X to happen because of Z?” Then we have the basis of a hypothesis that we can discuss.
In the veggie example: “What if eating veggies causes heart disease because of Z?” “Z” is where the beef is :)
No you aren't. You are doing the empirically sound thing and accepting the null hypothesis, the baseline of being unvaccinated, in the absence of sufficient evidence that the long term effects of the vaccines are more beneficial than detrimental.
Do you use any technology created in the last 20 years? 20 years isn’t long enough to properly study long term effects.
Or take any medicine developed in the last 40 years?
We jump into the unknown every day. You’re free to make whatever decisions you please, but when you make the decision to maintain your current baseline and reject a new option, ideally you’re doing that out of some informed position or rational fear and not simply because that option is new.
That’s why the interesting conversation to me isn’t “I’m waiting to take the vaccine until we understand the long term effects.”, it’s “I’m waiting to take the vaccine until we understand the long term effects because _______”. That’s where the meat is because it helps convey why this decision isn’t like discussing a new topic or using a cellphone or taking Lipitor.
How about this? "I'm waiting to take the vaccine until we understand the long term effects because no data exists regarding them and it would be empirically and scientifically unsound to confirm a hypothesis (that the vaccine's long term benefits outweigh the costs) without sufficient evidence to overrule the null hypothesis and default state of being unvaccinated."
That’s my point. There’s nothing wrong with your theory on paper. But in practice I’m willing to bet those that believe it selectively apply it. And that’s where my curiosity lies. In the absence of negative evidence how do you determine when to “wait for long-term data” and when do you “just go for it”?
Like using a cellphone. I’m sure many of those that want to “wait and see” on the vaccine readily use cellphones and didn’t feel the need to “wait and see”. What’s the difference? I’m genuinely curious. Is it the expected utility?
As an example to the last point: many people did wait a long time to adopt cell phones and smart phones on the basis of worries about cancer, but there was already overwhelming evidence that non ionizing radiation doesn't cause cancer, so their concerns were misguided. Their concerns about novel devices were not applicable because the techniques and methods were not novel.
On the other end of the spectrum, X-Rays used to be a form of acne treatment, and there was no evidence on the safety of using them as such, just on the efficacy of the technique. As a result, many people ended up with all different kinds of cancer in their face, because there was no long term data on ionizing radiation's effects on DNA. The technology and the technique were completely novel and unstudied.
I never worried about getting cancer from a cell phone, because there was ample evidence proving the safety. I never would have gotten x-rays as acne treatment.
Right, but they’re taking an action in response to a specific concern: cancer. When approached in that way, it can be measured, tested, debated, etc. Even if they’re wrong, they’re putting forth a useful dialog that can be approached scientifically and then put to rest.
This is opposed to a non-specific concern: something being new.
If you don’t do something because of the unknown, that’s fine, but you don’t get any kudos for being right down the line if it turns out to be dangerous. You basically bet on something going wrong and sometimes you’ll be right, sometimes you won’t, but your decision making process was not informed by information or probabilities in any way. And as with many conspiracy theories you can never really be wrong, because who knows, maybe data will come out in 2 years, or 10 or 20. Something can always go wrong later if you don’t define what you’re worried about and then retroactively claim that thing that went wrong as the thing you were worried about.
That's exactly what it is and will be informed by, and that information right now is zero. There's no evidence to support the hypothesis' conclusion, therefore I reject the hypothesis at present. That's not always going to be the case.
It's in no way comparable to conspiracy theories because it's a falsifiable premise. Statistical significance can and will exist about the long term safety eventually. The question at hand is very easily quantifiable and qualifiable: are mRNA vaccines safe in the long term and relative to the risks of the afflictions they target? The current answer is: there is no evidence supporting that they are, therefore the reasonable, rational, and scientific thing to do is maintain the baseline until sufficient evidence exists.
Yeah maybe something can go wrong in 20 years in one person. That's not the argument I'm making. I'm arguing that we don't know what could go wrong or what the probability something can go wrong is in the long term because the data literally just doesn't exist you're trying to argue that we should just assume that the probability of something going wrong is already established as infinitesimally small. That's irrational and antiscientific. It's not established at all that's my entire point. The data will exist eventually, we are not stuck in this permanent state of ignorance.
Yeah, but we also don’t know the long-term risks of HDTVs, VR headsets, CBD oil or Impossible burgers. Not knowing the long-term risks of a product is exceedingly common.
> you're trying to argue that we should just assume that the probability of something going wrong is already established as infinitesimally small.
Not at all. I’m saying that you have to encounter this problem nearly every day. And that if you were consistently concerned about abstract, undefined, unknown potential risks that you had no knowledge or understanding of then you would not participate in any new medicine, technology or activities and I just don’t know of anyone that follows that philosophy consistently. So that’s why I’m not buying that 0 long-term data is the only reason or even the main reason someone wouldn’t take the vaccine.
A chocolate bar from a brand new chocolate company at the grocery store is familiar and easy to understand. No one studied the long-term effects of this substance you’re about to put into your body (because it was just released this month), but we assume that the ingredients are correct, we assume that we understand the effects the ingredients will have on us, we assume that someone inspected the facility for cleanliness and we assume that it was delivered to the store and stocked without being tampered with. The long-term data for this particular bar of chocolate for this new brand doesn’t exist, but you don’t care and don’t think twice about consuming it. So, that’s why I don’t think it’s about the data at all, I think it has more to do with our assumed individual knowledge of the product, the production process and the quality control (or when lacking that, our willingness to trust the relevant parties).
Even if you get long-term data, it’s a no-win scenario if you’re were never looking for anything specific in the first place. You had no hypothesis, no argument and designed no experiment.
Let’s say 2030 roles around and they announce: “No long-term negative effects!” Well, why would I believe that? My area of concern was infinitely broad. You can’t test to infinity, so you’ll never satisfy my doubts. There might still be negative effects coming in 10 years, or maybe you messed up in the data collection, or are just plain lying to me, how would I know? Why would I trust you? Only if I approach the problem with a specific, testable concern can I ever get reassurance that my concerns have been addressed.
It makes a lot more sense to me to say: I’m concerned about mRNA vaccines because Dr. X expressed concerns about Y. And then wait for that specific concern to be addressed.
> The data will exist eventually, we are not stuck in this permanent state of ignorance.
Only because people got the vaccine and didn’t wait for long-term data. That’s why this philosophy can never be adopted by a significant portion of the population, because it’s self-defeating. The moment you convince everyone that it’s smarter to wait for long-term data, you lose the ability to obtain that very data you want.
All your examples have comparable or well studied technologies and preexisting science behind them. None of them have zero comparable long term data. HDTVs and VR are built on well understood technology, CBD oil, Impossible Burgers, Chocolate bars are built on well understood food chemistries. None of them come even close to the risks imparted by direct health intervention that has failed animal trials repeatedly.
>You had no hypothesis, no argument and designed no experiment.
I've literally explicitly stated it several times. If you choose to ignore it, that's a personal problem.
>The moment you convince everyone that it’s smarter to wait for long-term data, you lose the ability to obtain that very data you want
lol no you don't, you just do actual science and studies/trials while not fear mongering the population into authoritarian complacency over unstudied medical interventions that have not mitigated excess deaths at all.
Exactly, and that's why I listed them. The 0 long-term data part and interaction with novel technology is so commonplace in everyday life, it isn't the core issue and IMO, it's a byproduct of some other concern. The core issue for many people is 0 long-term data + [something]. The [something] is interesting. Here you identify "novel medical intervention both in mechanism and function" as the [something]. That [something] can be researched online, debated, etc. My guess is that if you had 0 concern over how mRNA vaccines work (like you had 0 concern over cellphone radiation), you wouldn't still be waiting on long-term data. Using your earlier example, it's like saying "I have 0 concern that cellphones produce harmful radiation, but I still want to wait for long-term data before using this new technology because long-term data is the most important thing in my decision making process." No one does that. They focus on the radiation, because that's what matters, and once they're comfortable with that concrete, specific concern they make an informed decision.
The 0 long-term data is a concern we overcome everyday without much hesitation. The fact that CBD oils have well understood food chemistries ignores the fact that their largely unregulated production process, quantity of application and internal/external application processes in combination with an infinite number of genetic or medical pre-conditions or other substances like over-the-counter drugs, alcohol, etc. could have an unstudied long-term effect. We have 0 long-term data on this and no one cares, because in the "0 long-term data + [something]" equation, if there's no [something], no one cares about the 0 long-term data part of the equation.
> the risks imparted by direct health intervention that has failed animal trials repeatedly
OK, now we're getting more detail. Now you can research and debate this more specific concern.
> you just do actual science and studies/trials
You could simulate it in the lab or animals all you want, but you need to study a large sample size of people over long periods of time to see any long-term effects in humans. That means in order for this "wait and see" philosophy to work for you, you need a large number of people to disagree with it.
> not fear mongering the population into authoritarian complacency over unstudied medical interventions that have not mitigated excess deaths at all
And more specific concerns. This is the heart of it IMO. Now you can have a conversation.
When you refuse to have a conversation or make a decision until you have robust long-term data, you're creating an impossible hurdle that you yourself can't possibly adhere to consistently with every new technology, medicine or medical procedure.
This is like the inverse of Pascal's Wager [1]!
"What if taking some action results in negative long term effects that we don't yet know about? Better not do anything new just to be safe."
That reasoning could be applied to anything novel, and yet folks seem most ready to apply it to COVID-19 vaccination. The flu vaccine changes every year, but I've never heard folks expressing concern of the long-term effects of this year's new formulation. Let me rattle off a few more off the top of my head:
* Was there a large cohort of the population that refused microwave ovens in the 1970's?
* What if a doctor prescribes you a new medication that was developed in the last 5-10 years?
* VR headsets?
* Social media!
* Sitting at a desk in front of a computer working 8 hours a day
* Getting a smartphone
Is there some reason why we would expect a priori for the COVID-19 vaccine to have a particularly high risk of adverse affects that only show up long-term?
The correct question is, is there sufficient evidence that we shouldn't? You don't ever assume the confirmation of a hypothesis (in this case long term safety) when introducing something novel. That's the exact opposite of science.
My answer is: I believe in science, empirical evidence, and hypothesis testing. I'm not going to assume the hypothesis that they're safe long term is correct without empirical evidence. You don't disrupt baseline systems with something novel on the basis of faith when no empirical evidence exists. That's completely antithetical to science.
It's funny because most of your examples are great illustrations that assuming novel things are safe has disastrous consequences.
But what I’m pointing out above is the contradiction of how most of the folks worried about long term effects (and I have no idea whether this includes you specifically) seem to selectively apply this behavior strategy to only the COVID vaccine! And I personally think that one would miss out on a lot that is good and enjoyable in life by applying that strategy consistently across all decisions, but to each his own.
But for average folks that apply this caution to the Covid vaccine, I am highly skeptical that they are also applying it to all many other things in their life that could have equally high or even greater risk. (Which is why I intentionally included examples of behaviors that we know to have long term negative consequences.)
https://news.ycombinator.com/item?id=29885809
Completely novel direct health interventions are in no way comparable to technological advances built on well understood foundations and methodologies for which a wealth of data exists.
Sure the process used for this particular vaccine was novel, but do you think it’s mechanism of action is so fundamentally different from other vaccines such that it is likely to have fundamentally different long-term outcomes?
It really is. Its mechanism of action is completely new and involves cell alterations and inducing protein synthesis that has never been done before and for which no long term data exists.
>Sure the process used for this particular vaccine was novel, but do you think it’s mechanism of action is so fundamentally different from other vaccines such that it is likely to have fundamentally different long-term outcomes?
I don't know, maybe it could, maybe it couldn't. The data proving otherwise doesn't exist. That's why I'm going to wait for the actual science to be done.
Which specific scientific evidence would you accept to change your opinion on this matter?
It's not a new formulation every year. They pick a few from a preexisting set of vaccines to try and get a best match to the strains they expect to be most prevalent in the coming flu season.
For the second part, being generous, you could say that the point of a vaccine is to modify your immune cells but it's more likely it was unfounded paranoia.