Book Review: Anti/Vax: Reframing the Vaccination Controversy (2020)
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
I don't think it is that complicated. I don't think "science" is even the answer. The answer, to me, revolves around people and their actions.
1) An open and up front admission that medical breakthroughs are not typically as definitive as we want them to be.
2) A concerted effort to recognize and validate both the pros and cons of a medical procedure. No medical procedure (even one as simple as taking an OTC painkiller or allergy medication) is risk free. No medical procedure is perfect. If something is being touted as a miracle cure/perfect solution or as demon spit designed to make it easier for the government to control us, more information is clearly needed.
3) Research figureheads and teams being willing to say "We don't know" instead of trying for platitudes and reassurances and unsupported suggestions.
4) If a recommendation is going to be made, make it just that, a recommendation. Do not try and force that recommendation on people and be willing to have that recommendation challenged.
5) Repeat, repeat, repeat. The bread and butter of the scientific method is for ideas to be challenged and verified through repeated quality experimentation and study trying to get the same results. The idea that a single study can prove a concept or process is laughable, and study/experiment authors should by up front on just about everything on their process so that their results can be tested. Be willing to take criticism and never operate under the assumption that your work is the end-all/be-all of a field.
How dangerous does "not doing the thing" need to be to the people around those making the decision before it should be forced? Obviously there is a limit -- for instance, we all agree that deciding not to change your plans to drive home when you get shit-faced is and should be illegal -- so where does that limit occur, and why there?
2) There is no "one-size-fits-all" solution to anything. Drunk driving doesn't seem like an apt comparison to the vaccination thing because while we know a whole bunch about drunk driving, there are a whole lot of questions around vaccines (and other medical procedures. Beyond that, current medical practices are constantly being challenged and improved. Trying to keep the idea broad, but also not ignore the vaccine elephant in the room), in particular the COVID ones. Some of these are questions that require more research into COVID itself. Some of the questions require more research into the delivery method. Some of them require more research into human biological functions as we understand them. Since these questions remain (and on the same vein there are questions about a vast portion of medical procedures), medical practices (even above and beyond vaccines) should remain in question and as recommendations only.
EDIT: 3) There are portions of our community that seem to think we should just take a medical professional's word without any additional consideration, in particular with vaccines, but even though I think the COVID vaccine has likely helped a large group of people I also think there is a valid argument that the messaging and integrity of those most pushing the vaccine have shown themselves to be very poor, in large part because there was no willingness to acknowledge that they don't know something or that they could possibly be wrong. For example, the vaccine, in it's early days, was touted by many people (Trump, Fauci, Biden, Pfizer and Moderna execs, Walensky, etc.) as the perfect solution. You get the vaccine, you never have to worry about COVID again. You won't get the disease, you won't transmit the disease, you are no longer a danger. But that clearly wasn't the case and we are being shown data that shows that all of these people should have known better. None of them have turned around and said they were wrong. None of them even acknowledged the possibility. That, in and of itself, hits one's integrity and reliability hard.
4) Anything that falls under the umbrella of "science" should be open to challenge and should welcome the challenge. The scientific method demands no less.
2) I wonder what evidence you think is missing from the safety and efficacy testing of COVID vaccines, which you don't think is missing from the safety and efficacy studies of abstaining from drunk driving? And what evidence would you need before you'd consider them "equally understood"?
2) There are a lot of questions still around COVID itself and how it affects the human body that we are still learning. Things like long-COVID, certain attack vectors of the spike protein COVID uses, why COVID affects people the way that it does when it comes to severity of symptoms, etc. All of these are questions that effect how a vaccine should be made. Beyond that, for the vaccine itself I tend to look at questions like was there enough initial testing given the shortened time frame of both knowing the disease and the time to develop the vaccine, questioning the methodology and how the initial trials were handled in the development phases, does the body treat these RNA fragments differently after they have broken up, is producing the spike protein (which has it's own dangers beyond COVID on the body) the best option for protecting against the disease or is there another vector that would prove to be more effective, does the body suffer from having an increased protein development response at the injection site, etc. Even now, we are discovering more effective ways to treat the disease and I would image the next 5 years or so will yield treatments that potentially reveal how the vaccine was a stop-gap measure and that there are likely better ways to treat this disease.
Well, sure. But that's what's happening here: experts in multiple fields of medicine, epidemiology, etc. formed a consensus about what will help reduce the spread of a lethal disease. It's not just a single area of expertise, or a single group of people.
> 2) There are a lot of questions still around COVID itself and how it affects the human body that we are still learning. Things like long-COVID, certain attack vectors of the spike protein COVID uses, why COVID affects people the way that it does when it comes to severity of symptoms, etc. All of these are questions that effect how a vaccine should be made.
Do those questions affect how a vaccine should be made? We may not know the mechanism of action for every symptom and long-term effect of COVID, but we know enough about how it infects cells to know the spike protein is important, and therefore a strong target for a vaccine. And beyond that, we've tested these vaccines and shown they're effective. Could there be a more effective target? Sure. But the goal isn't "wait until we have found the best possible vaccine and let people continue dying en masse until then"; science is iterative. An effective vaccine is always better than none, even if we're waiting to find a better one.
> Beyond that, for the vaccine itself I tend to look at questions like was there enough initial testing given the shortened time frame of both knowing the disease and the time to develop the vaccine, questioning the methodology and how the initial trials were handled in the development phases...
Yes, there was. There was the same amount of testing as with any other vaccine. Partly because mRNA vaccines in general have been in testing for many years before COVID hit, and partly because of the pandemic itself. A large amount of time in most studies comes from seeking funding, approval, and test subjects. With the pandemic, there was no lack of test subjects, and emergency funding and approvals meant no waiting for those, either. The reason it was "so fast" is because of parallelized testing, faster-than-usual red tape, and a sudden large pool of subjects. It in no way reduced the validity of the tests.
> does the body treat these RNA fragments differently after they have broken up...
If it did, then we'd all be fucked from the start, because the constituent parts of mRNA are identical across all species, including our own mRNA. If the human body reacted negatively to metabolized mRNA, then our own DNA transcription would cause problems. But you don't even have to trust the logic of it: as I said, mRNA vaccines have been in testing and development for many years, and the testing shows they're safe.
> is producing the spike protein (which has it's own dangers beyond COVID on the body) the best option for protecting against the disease or is there another vector that would prove to be more effective...
As I mentioned above, if we wait for the "most effective" option before taking any action, millions more people die than necessary. We don't need to wait for "most effective"; we act on the current most effective options we have as long as they're shown to be safe. Which they are. Yes, there are possible negative reactions to the spike protein, but literally nothing in medicine is side-effect free. The question isn't "is it free of any possible negative reactions?", it's a risk-benefit analysis: "Multiply the dangers of the side effects by their prevalence, and then multiple the dangers of COVID by its prevalence, compare the two, and choose the better option." That's how all medical treatment -- and really, all decisions in general -- work.
> does the body suffer from having an increased protein development response at the injection site, etc.
Not sure what you mean by this. What does "increased protein development response" mean? If you're asking whether the body suffers from making extra proteins in general, then on the empirical front, as I said, safety testing hasn't shown that to be the case. And on the logical side, the amount of proteins a cell or tissue produces changes constantly based on internal and external factors, so if "more proteins here" was dangerous, it's another case of "we'd all be screwed because our bodies do this naturally all the time".
> Even now, we are discovering more effective ways to treat the disease and I would image the next 5 years or so will yield treatments that potentially reveal how the vaccine was a stop-gap measure and that there are likely better ways to treat this disease.
See above. A stop-gap measure is better than no measure at all when the alternative is an increased amount of death.
2/3) I will give you that the vaccines have undergone some testing, but do I think it is nearly enough? No. The testing period for these vaccines was far below what a standard testing period is for medical procedures humans participate in. Standard Phase 1 approval takes, on average, 10 years, and this vaccine did it in less than two. While this vaccine has appeared to be helpful, when it comes to a novel disease and drug testing, there is only so much leeway we can and should give.
4) If we were looking for immediate reactions, sure, but improper dealing with biological functions is a long-term game like cancer, not something typically observed or resolved in the short term.
5) The problem is, we didn't know that millions more were going to die without this vaccine, we made an assumption. This is a novel disease that we didn't have anything close to accurate mortality projection rates, even before the vaccine. They were all over the place and were about as accurate as the lottery numbers in a fortune cookie. Beyond that, we can't really know if this particular vaccine did actually save lives because the drop in case numbers not only corresponds with vaccine rates but also with natural infection recovery and immunity rates. And with estimates of over half the country appearing to show such a high level of immunity to the disease that they didn't even show any symptoms we really didn't know what to expect.
6) And this goes back to my original point. Maybe more people die without the vaccine, but orders of magnitude more? I find that unlikely. 600 million COVID cases in the world [0] and only 6.5 million have died in the whole world. I find it very hard to believe that waiting on a vaccine would have increased those numbers significantly.
7) The body's generative abilities only go so far. The protein development may be a minor issue, it may not. I still would like the question tested and answered.
8) Even if a stop-gap measure is better than no measure at all it should not be forced on people. Make the vaccine available? Sure. Be open and up front about the perceived strengths and flaws? Absolutely. Provide regular updates? Of course. Force people to take it (even just making it a condition of being able to work or go to school)? Absolutely not.
[0] https://www.worldometers.info/coronavirus/#countries
EDIT: I suspect neither of us will be able to convince the other of their position, but I did want to let you know that I do appreciate the civil tone that has been kept throughout the conversation.