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Comment by logicchains | Hacker News Reader

>all vaccines went through the same testing process as any other medication, they simply sped the process up by layering some of the steps - all that means is that rather than wait to see if one study passes before doing the next one (save money or whatever), they just overlapped them

This is misinformation. The normal process involves at least 4-5 years of observation to identify long-term side effects; you can't speed this up, as no matter how many people you test, it's not going to make long-term side effects manifest sooner. And while the technology has been around for 20 years, it certainly hasn't been trialed on humans until very recently, due to difficulty finding a safe delivery mechanism.

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> The normal process involves at least 4-5 years of observation to identify long-term side effects.

If you have for instance an Ebola vaccine, how can you show it works when there's only a few hundred cases a year? You can't just infect people. You have to vaccinate a bunch of test candidates and wait. Sometimes years until you can show a statistical advantage.

With COVID literally everyone had it so they could show it worked by the end of the weekend.

> ... it's not going to make long-term side effects manifest sooner.

They're looking for short-term side effects, they're testing efficacy and they're looking for 'long-term side-effects.' A long-term side-effect here doesn't mean one that's latent for years before presenting, it's one that presents quickly (days, weeks) but causes lasting harm. So yeah they're looking for them but they're not primarily vaccinating people and then following them for 4-5 years to see if something miraculously goes wrong 3 years later. That's what VAERS is for.

> And while the technology has been around for 20 years, it certainly hasn't been trialed on humans until very recently, due to difficulty finding a safe delivery mechanism.

mRNA vaccines and adenoviral vector vaccines have been in development since the 1970s. Vaccines have been around since 1721. We know what kinds of effects to expect, and they're (a) overwhelmingly short term and (b) we know of no mechanism where latent effects might randomly appear 4-5 years later since we know these platforms don't alter DNA.

We know from having extensively characterized the platform over fifty years that if nothing happens within the first few months, nothing's going to happen.

So really the parent post is right. Development went fast because we (a) leveraged a platform we'd extensively characterized and knew a ton about (b) were able to show efficacy very quickly due to prevalence of the disease within the population (c) layered a bunch of steps.

[edit] They didn't exactly YOLO this and I think that's born out by the fact we have like 5 different vaccines developed over comparable timeframes, administered billions of times all with the absolute bare minimum of adverse effects and incredible efficacy. Frankly it beggars belief that lightning struck so many times and we just got lucky a few billion times over. Maybe we were careful, and maybe the system worked.

Vaccines don’t have long term side effects. They have short term side effects.

And if they did have long term side effects, we’d observe them in the trials because they’d occur in the short term at a low probability.

Isn't the goal of a vaccine to induce a long term side effect?

I'm no doctor, but why would a long term side effect necessarily manifest itself in the short term? That seems like a non-obvious conclusion.

> Isn't the goal of a vaccine to induce a long term side effect?

No, long-term means something we can’t detect for a few years. You can detect vaccine effectiveness right away.

Especially in a pandemic when it’s easy to get challenged.

How does that square with this though?

> And if they did have long term side effects, we’d observe them in the trials because they’d occur in the short term at a low probability.

That's biology. It's not like we're dealing with robots with little timers in them here. They'd be "long term" side effects simply because they're so rare it'd take years to observe one. So, if you carefully watch a very large population, you'd find them sooner.

Taleb: https://www.youtube.com/watch?v=gAlHjWctpLw

What about something like cancer? If you get diagnosed with some form of cancer tomorrow, it's probably not because some cell first mutated yesterday, right?

That would essentially be a "robot with a little timer". And it's just the only one a layman like myself can come up with off the cuff. I have to assume there are more.

Edit: I watched the video, and this guy is presumably much smarter than I am, so I wouldn't be surprised if I'm missing something, but it doesn't seem very convincing.

He's basically just claiming what you said, that conditions that take an extended amount of time to manifest just dont exist. That in some portion of the population, those conditions will necessarily manifest quickly. The video doesnt explain why I should believe that other than saying something like "these things are possible, but very unlikely".

IDK if dude is smarter than you are, but he's a domain expert. He knows enough about the subject that it would likely take you something in the range of a decade of dedicated time, research, engagement, and experience to reach an equivalence. You're probably quite capable of this, if you decide to go down this path.

If you don't want to go down this path, though, know that it probably will just take that breadth of experience to develop the understanding and intuition necessary to be able to say and explain things on the subject with confidence.

You should believe it because you trust people like the one in the video when they tell you it's a good idea to clean your wounds to prevent infection. You vaguely understand this has something to do with germs, but you (probably) don't know all about the various actual diseases that cause open wound infections, their outcomes, their treatments, the history of research behind it, etc. It's an entire field of medicine, actually. Luckily for you, a lot of the important stuff can be condensed into a single important general-action for the populations: clean your wound with soap and water, then, cover it with a bandage.

So why do you trust domain experts when they tell you about first aid, and not what they tell you about hugely more complex subjects, such as vaccinations and drug trials?

Why the sudden skepticism now? During a pandemic, of all times? If this was a movie, the climax / resolution would be the development of a vaccine - thank god, the experts delivered us from this terror. What were you expecting instead? 10 years of lockdown while we wait for things to shake out?

NNT is certainly smart and is an expert, but what domain? Last time I checked it was mathematical risk modelling and options trading, not medical research. And the most robust modelling on a flawed premise is still flawed.

As sibling says, I vaguely know of the guy in the video as a math expert, not as some expert in a particularly relevant field of medicine.

But even so, I was expecting to watch the video and have it explain why I should believe x, and instead I found it just reiterating that I should believe x.

This is a little off topic for the thread (I was originally just responding to the claim that "Vaccines don’t have long term side effects"), but based on what you said:

Would you feel the same way about "you should clean your wounds to prevent infection" as you would with "you should inject this compound that we invented 1 (or 2 or 3) years ago?

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