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Comment by awb | Hacker News Reader

But you ignore the fact that you likely don’t feel the need wait for long-term studies with information, technology, other medicine, etc.

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?

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The probability of negative outcomes versus the a priori knowledge of outcomes, the context of the novel thing being introduced (direct health interventions versus convenience of cell phones is a great chasm), the similar evidence surrounding the novel thing.

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.

> 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

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.

>but your decision making process was not informed by information or probabilities in any way.

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.

> 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

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.

Mate I'm not sure how to make this any clearer to you. Literally none of the examples you gave are in any way comparable to injecting a completely novel medical intervention both in mechanism and function for which zero long term data exists. You're doing the equivalent asking me to believe there's a population of unicorns underground plotting to wipe out humanity, so we should plan to combat them by building up specific unicorn destroying weapons, with no evidence they exist in the first place. "It's safe trust me" Sorry but no.

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.

> Literally none of the examples you gave are in any way comparable to injecting a completely novel medical intervention both in mechanism and function

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.

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