Comment by coryfklein | Hacker News Reader

Comment by coryfklein | Hacker News Reader

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> What if it turns out the vaccines do have negative long term effects

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?

[1] https://en.wikipedia.org/wiki/Pascal%27s_wager

>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.

I wholly agree with you that the approach you outlined is the correct way to arrive with a map that reflects the territory!

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.)

See my comment here:

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.

The Covid vaccine is hardly a “completely novel” health intervention, but rather it rests on a huge body of knowledge of the immune system and decades of vaccine science, does it not?

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?

>The Covid vaccine is hardly a “completely novel”

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.

A few cursory searches tell me pretty quickly that mRNA vaccines have been in use and studied for decades, including for diseases such as the flu, rabies, Zika, and CMV. So it would be hard to call it "completely new". And those decades of study have not shown long term effects either.

Which specific scientific evidence would you accept to change your opinion on this matter?

They have been neither used nor studied in humans prior to COVID-19, save for once, for rabies, with 101 participants, and that study was concluded in 2018.

> 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.

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.

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