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Comment by fsagx | Hacker News Reader

Moderna presentation on the vaccine from ReSViNET Conference (RSVVW 2023):

https://s29.q4cdn.com/435878511/files/doc_presentations/2023...

some commentary summarized from alexberenson.substack.com :

Nine people who received the shot got RSV. Fifty-five who received the placebo did. Thus the 17,500 shots prevented 46 cases of RSV.

It shows people who received the jab instead of the placebo reported an extra 10,156 side effects such as headache or fatigue. Those side effects included an extra 455 severe effects, rated as Grade 3 or worse.

Side effects are rated on a five-point scale, with Grade 5 being death and Grade 4 usually requiring immediate medical treatment and hospitalization. Grade 3 side effects are defined as “severe or medically significant.”

For example, a Grade 3 fever is usually defined as over about 102 degrees, while a Grade 4 is over 104.

In other words, a single Grade 3 side effect is likely to be considerably more severe than a case of RSV for most adults. Again, Moderna’s shot caused 10 of those side effects for every RSV infection it prevented.

https://alexberenson.substack.com/p/how-can-modernas-rsv-jab...

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(I vouched for this post because I think it's important to actually address these issue head on with facts and not just shout people down.)

Berenson's numbers based on the presentation you shared seem to check out, but the interpretation seems odd.

Just looking at how many cases were averted doesn't tell you what types of tail risks were averted. It may be a worthwhile trade off to have 10x as many "severe side effects" in exchange for having many many fewer severe, debilitating, or fatal infections.

Also, Berenson is looking at the ratio of severe side effects induced to RSV cases prevented. But the vaccine side effects only happen once, at the time of injection, while the vaccine may continue to confer long term benefits. So this ratio is highly dependent on the time period in question.

> But the vaccine side effects only happen once, at the time of injection, while the vaccine may continue to confer long term benefits. So this ratio is highly dependent on the time period in question.

One must be extremely skeptical of these kind of claims now, though, given what we just went through as a society. The side effects of the mRNA vaccines seemed to become uncapped (some people I know have now received 4 shots), and the long term benefits went to nil (if not negative), commonly thought due to mutation.

So the question is what are the odds that it really will be just "once" and what are the odds that it will really provide protection against RSV, and future mutated strands.

It seems to me the vaccine industry should be put in a severe category of "distrusted entities" until we have significant improvements in our symbolic infrastructure to the point where they could be trusted again.

Are you suggesting that the limited duration of protection and hence the need for followups (like flu shots) is.. the result of a conspiracy? Its not clear why you think they should be 'distrusted' which calls your judgement into question.

the common argument I heard from the anti-vaxxers was that the mRNA COVID vaccine was obviously bad/fake/contrived because it required a booster and "no other vaccine requires a booster!" And if you mention tetanus, hepatitis or meningococcal, or other vaccines that required a booster/multiple shots then you just get ignored. Ignorant gonna ignorant.

https://en.wikipedia.org/wiki/Straw_man

No I am saying that there was no protection and the follow ups provided none either.

Yes, with 99% odds I am saying there was a conspiracy to end the randomized placebo control group early to bury any chance that someone could ever conclusively prove these vaccines were ineffective.

The claim was they decided it was unethical to withhold a "life-saving" vaccine from control participants and that's why they ended it. I would bet with 99% odds that if there was a funded investigation with subpoena power you would find strong evidence that the primary reason that control group was ended because of extreme financial incentive to end it. If the control group were allowed to continue and it were shown that the vaccines were ineffective (which is what ended up being the case), tens of billions would have been lost. I am counting on someone being sloppy and letting the truth spill somewhere internally.

Now if you are saying that I am showing bad judgement for speaking truth to power, for caring about honesty, I could see a valid argument there. But to me truth and honesty is more important than money.

There is zero scientific evidence that this thing saved a single life. The only randomized control group experiment showed zero lives saved.

Have you not updated your priors given the difference in infection rate and severity between vaccinated and unvaccinated populations? It seems odd to be so fixated on a control study that was abandoned for ethical reasons when so much evidence amassed regardless.

> difference in infection rate and severity between vaccinated and unvaccinated populations?

I have never seen a trustworthy dataset that showed this. I was the Senior Software Engineer at Our World in Data who built the Covid Data Explorer so it was literally my job for a year to work with Covid data.

A big reason I was so upset that they killed the control group was because this was finally going to be the trustworthy dataset where we could see the true danger of Covid, which was grossly exaggerated (10x or more), by government and the media. I was really focused on that study, and it was showing very little mortality from Covid. And then they killed the control group. Looking back it was a smoking gun that this was a "Scamdemic". Sure, a bad virus, and 2x-4x worse than the typical flu. But not even close to the Doomsday scenario it was made out to be. The real pandemic was fear.

> for ethical reasons

I 100% dispute this. I do not see how you can make the case that it is ethical to abandon the scientific process and risk the health and safety of hundreds of millions, and destroy any slam dunk evidence that could put blame on the vaccine makers. It was extremely unethical to cancel that control group. They said they did it to "save lives", and yet, at the time they did it, all the data showed zero lives saved from the vaccine. "It hasn't saved any lives yet, but trust us it will, we have a hunch". That is not scientific. That is not ethical.

You do know billions of doses of COVID vaccines were delivered and the side effects were overwhelmingly insignificant, right? Skepticism is good, but in the face of data we should be willing to pivot. The COVID vaccines are probably the single most studied and tested vaccine - heck, medical product - of all time.

It's like the aspartame or MSG of the medical world. No matter how much data you provide people will never get over the idea that it must somehow be dangerous.

I should have used a more precise term than "uncapped". The comment I was responding to used the term "once". I was saying that in most recent vaccine history, the term "twice" was used, then "three times", then "four times", then "up to date". Uncapped was a gross exaggeration. I should instead said that there "once" could not be taken seriously and the range should be "1 to a handful of times", which is a significant factor increase of at least 2x.

But anyway, in my dataset of about 1,000 acquaintances, the only one under 50 hospitalized related to Covid was a friend who was a 38 year mother of 2, in top shape, who had a heart attack within a month after her second dose, and to this day is still recovering. I do not think these vaccines are that dangerous—I would say they probably cause as much harm as one night of heavy binge drinking—but I saw zero evidence of any benefit, and yes I saw one very bad case of severe life threatening side effect.

> But anyway, in my dataset of about 1,000 acquaintances, the only one under 50 hospitalized related to Covid was a friend who was a 38 year mother of 2, in top shape, who had a heart attack within a month after her second dose, and to this day is still recovering.

There's a reason we don't use anecdotes as a substitute for medical research. Not least because they're subject to the post hoc fallacy. Just because one event follows another doesn't mean there's a causal relationship.

There's every chance that mother of 2 was going to have a heart attack anyways. It happens. The fact they had a vaccine first likely isn't relevant, clinically speaking. If you give a few billion people vaccines, you will find literally every effect that follows. Car crashes. Broken arms. Death by mauling. Syphilis. Turbo-cancer of the elbow.

In that age group, a boundary group, your risk of having a heart attack are somewhere between 17 and 97 per 100,000. [1] The risk of a heart issue from the vaccine is about two orders of magnitude lower than that.

> I do not think these vaccines are that dangerous—I would say they probably cause as much harm as one night of heavy binge drinking— ...

You have no basis to arrive at that conclusion.

> ... but I saw zero evidence of any benefit ...

It's in the data.

> ... and yes I saw one very bad case of severe life threatening side effect.

You saw one anecdotal report of a bad thing that happened to someone after they took a COVID vaccine, without any evidence they were connected. I'm sure more than once someone took a tylenol and got hit by a bus. That doesn't mean taking tylenol causes getting hit by a bus.

> The proportions of participants who reported at least 1 serious adverse event were 0.6% in the vaccine group and 0.5% in the placebo group. [2]

[1] https://pubmed.ncbi.nlm.nih.gov/32111640/

[2] https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer...

> If you give a few billion people vaccines, you will find literally every effect that follows. Car crashes. Broken arms. Death by mauling. Syphilis. Turbo-cancer of the elbow.

Yeah. Lightning-induced arrhythmia was (amusingly) a registered side effect (Serious Adverse Event) of Moderna's covid vaccine. https://metro.co.uk/2020/12/18/covid-vaccine-volunteer-struc...

You could say the same thing about infections

You're going to have to explain because I can't see how you could.

Virus is weak and has super low mortality rate (esp. if you take care of yourself and are not old or fat). Vaccine is new and w/o years of data behind it. I pick no vaccine.

Well you pick wrong. But that's fine I guess, at this point it's personal responsibility and if you want to make a stupid decision, go with god.

The virus has a fairly low mortality rate for healthy people, most people aren't healthy.

The fact the vaccine is new is irrelevant because generally speaking you can substitute time with quantity. Most effects are normally distributed in time, and so if you have enough doses given, you can replace the fact it hasn't been around too long with a high number of administrations when making a safety assessment. And it's been given literally billions of times. We've seen the full gamut of consequences.

But anyways, 'long-term side effects' don't refer to latent effects. It's not things that magically appear 10 years later. They're effects that last a long time but usually onset almost immediately. There's no reason to think that 5 years of data is better than 3 years of data when administered billions of times.

And frankly if you think 3 years and billions of data points are insufficient nothing's going to change your mind. So you may as well stop pretending it's a data issue.

As I said, irrationality is your prerogative. But you are wrong.

Yeah I'm speaking for myself, and I'm very healthy and fit. If I were not, I'd probably be on other prescription drugs, so what's one more thing? I don't think I've taken an OTC or prescription drug in 10-15 years. My medicine cabinet is empty. I've smoked some weed though. Agreed on the personal responsibility piece.

The long-term side effects piece is still undecided and that's undebatable, simply because not enough time has gone by. Maybe I'll be open to changing my mind in 5-10 years. Even then, I'd win, no?

> The long-term side effects piece is still undecided and that's undebatable, simply because not enough time has gone by. Maybe I'll be open to changing my mind in 5-10 years. Even then, I'd win, no?

Like I said long-term side effects doesn't mean latent effects. It doesn't mean things that show up years after administration. It means things that happen right after administration but last a long time. If getting the COVID vaccine caused your arm to fall off 30 seconds after administration, that's a long-term side-effect because last I checked arms don't re-grow.

Yes, we do know what the long-term side effects are. You've confused 'long-term' and 'latent'.

Yes, it's decided. No, it's not debatable.

> ... simply because not enough time has gone by.

Again that (a) doesn't matter and (b) unless you're a vaccineologist then your opinion about whether sufficient time has passed is totally meaningless.

Ok, so latent side effects are long term side effects that have no immediately observable impact. As in, we aren't aware of them until later. You're arguing over semantics, but latent effects absolutely do matter as well. And are just as important to consider in the risk profile. If I eat mad cow prions, I might not have any immediate issues, but those prions are folding around in my head. Is that a latent or a long term side effect? The only difference is whether it's observed or not. So does it matter? It's still an issue. With the mRNA vaccines, one of the only side effects that's acknowledged now in public is the cardiovascular damage they can cause. You can damage your cardiovascular system and not notice it for a long time. Likewise, the iGG4 antibody triggering for the spike proteins, this actually has an immediate side effect that can be mistaken as a beneficial side effect, less symptoms! But, now your infections are treated like common allergens by your immune system and a "mild" case of COVID causes you to die suddenly. Latent, long term... what's the difference?

> unless you're a vaccineologist then your opinion about whether sufficient time has passed is totally meaningle Also, outright dismissal of an argument based on appeal to authority is not productive.

> Latent, long term... what's the difference?

Most people conflate latent with long-term. They believe when researchers are looking for 'long-term' effects they're looking for things that magically show up somewhere down the line, and therefore 'we haven't waited long enough!!' and 'there's not enough data!!' - but that's not what they're doing, although they're open to being surprised.

We've studied mRNA for like 50 years now, we understand how it works enough to know that what you're suggesting just isn't a real outcome.

You are right it doesn't matter per se because outcomes are normally distributed in severity and time and if you give enough people the vaccine you can substitute that for waiting. And by vaccinating 70% of the world, we can be utterly, completely, 100% sure it's safe.

It's safe, end of story.

> Also, outright dismissal of an argument based on appeal to authority is not productive.

To invoke appeal to authority there would have to be an attempt to invalidate evidence on the basis that someone is or isn't an expert. The parent didn't provide any evidence whatsoever. If they had either evidence or experience in the area I'd take their claim more seriously (but still inconclusively). However at this point it's just some random person on the internet saying "we need more time!" without explaining why or why I should believe them in absence of data.

Sorry bud, it's MSG all over again. But like I said it's a personal responsibility thing now and if you want to be wrong you're free to do so.

> outcomes are normally distributed in severity and time and if you give enough people the vaccine you can substitute that for waiting

What an utterly fortunate universal truth of vaccines!

It's kind of true when you're looking for the long tail in anything.

The reality is most drugs and vaccines that you get are tested on a few hundred or a few thousand people over a long period of time. But mostly because it's very difficult to measure the efficacy of something with statistical significance if the prevalence rate is low.

So you can either give a bunch of people Ebola to check if the Ebola vaccine works, or you can wait a long time. Ethics boards frown on the former.

However with COVID like 1% of the population had it when we were ready to test vaccines so showing efficacy was very quick and very easy.

But aren't we talking about latent issues? It sounds like you are saying most drugs de-facto check this because the trials must go for so long. But that's the point isn't it? Because short term efficacy was proven so quickly the de-facto check on latent issues never occurred.

Let me ask you this.

What reason do you or anyone else on earth have to think there would be a mechanism that yields latent issues? We have studied mRNA for about 50 years now. And the adenoviral vector vaccines are a completely different mechanism studied for about 50 years too.

What exactly bad thing do you think would miraculously appear 3 years later showing zero signs, symptoms or evidence in 6 billion people? And why would that be different after 5, 10 or even 15 years? There's no law that says Tylenol doesn't cause your arm to fall off 110 years later either, but that's not the standard of proof. Nothing in life has zero risk.

That aside I think if your n is large enough, I think even issues that are ordinarily latent would be at least detectable. Certainly 3 years later. The normal development cycle is as short as 5 years, 2 of which are in regulatory approval.

At some point we have to be guided by our past experience. You can't ever prove a negative, but you don't have to prove a negative to move forward.

I'm not really worried about mRNA per-se I'm worried about an unvetted delivery mechanism. Did you know its rare but accepted that some dogs get injection site tumors and we don't really know why? That would surely be a latent effect in dogs, why do we think it could never happen in humans who live much longer?

> I'm not really worried about mRNA per-se I'm worried about an unvetted delivery mechanism.

mRNA and the adenoviral vector vaccine delivery mechanisms have been studied for 50+ years and are vetted.

> Did you know its rare but accepted that some dogs get injection site tumors and we don't really know why?

Did you know dogs aren't humans, and there's no evidence of this kind of thing in humans at all?

btw it's also extremely extremely rare in dogs, to the extent it's hard to find any kind of data on it. It wasn't thought to occur except in cats until the 70s, so I've written up the rest of this generously assuming cats.

Most study headlines you read are fun achievements that only work on the animals under study and they don't have the same effects in humans. You can significantly increase the life of worms by not feeding them, but humans not so much. Weird huh.

Again this brings us back to our 'substitution of T with N' conversation. It's always a normal distribution. While these VAS tumors develop a few years in, in some cases they develop within a few months. So if you give 6 billion people vaccines over 3 years, you would have definitely seen this kind of latent thing by now, even if its peak effect is a few years later.

> That would surely be a latent effect in dogs, why do we think it could never happen in humans who live much longer?

That's not a thing. Again you're asking to prove a negative, which is not how we do anything because it's impossible. The burden of proof is on you to explain why you think it could happen, not on me to prove why it couldn't.

Prove to me that eating a tomato won't cause turbo-cancer of the elbow. You can't.

I love the way this progressed from, latent disease doesn't happen to prove to me tomatoes don't cause turbo-cancer. There's so much text there that its really nice and smooth.

It really doesn't. I keep illustrating the premise that you can replace time with sample count to make a best-effort, reasonable estimate of the long-tail risk of normally distributed outcomes. The ones to which you are alluding. Ideally, in a way you appreciate - or at the least understand.

I'm also saying that beyond that reasonable estimate based on the 300+ years of vaccine development behind us (and 50+ years of development of mRNA and viral vector vaccines) you are asking scientists to prove a negative which nobody can do.

That's not the standard we hold literally anything else to, nor should we.

I'm sorry for the snark and I do really appreciate the back and forth. I guess what I don't grasp is how we are confident that these are all normally distributed. We don't really know what these distributions look like until we resolve them in the real world. For things that could irreversibly fuck up a population it would seem to me you'd want to take that process tediously slow. I guess what you are saying is "YES goddamnit we are already doin it!" But still we are testing the whole package live without much of a holdback. The whole process felt imprudent for the likes of Covid.

A 0.5-1% mortality rate for a virus that everyone gets is not "super low."

That's alarmingly high for such an infectious virus. It's why CoVID-19 caused such a spike in mortality around the world over the last three years, and why life expectancy in the US declined by two years.

Yeah for the super old - https://www.statista.com/statistics/1191568/reported-deaths-...

0.5-1% is the average over the population of a country like the US. The mortality rate is far higher for the "super old," and lower for the "super young."

People under 50 has a MUCH lower mortality

It changes gradually with age, and depends on a lot of other factors as well.

Given how infectious SARS-CoV-2 is, it is a very deadly virus. It's nearly a worst case for public health. It's not Ebola, but almost no one gets Ebola. It's far deadlier than other viruses that people get seasonally.

Not sure about where you live but in Australia the median age of covid deaths is 86 which is 8 years older than life expectancy here. For someone my age (43) the probability of death is less than 1 in 100,000

In Australia, because of the zero-CoVID policy, most people were vaccinated before getting CoVID.

In the US, the median age of people who died of CoVID is around 75 years. The average person who died lost about 10 years of life.

CoVID is a significant contribution to mortality for most age groups. 10% of all deaths among 40-something-year-olds are due to CoVID. There are around 40k confirmed CoVID deaths in this age group alone.

The stats are here: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Se...

And the vaccine killed zero people?

Many orders of magnitude fewer than the virus. The mRNA vaccines have proven to be very safe. Serious side effects are extremely rare, and not for lack of looking.

> Virus is weak and has super low mortality rate

It only killed millions of people...

I know people that died from the covid vaccine including a 17 year old healthy kid of a friend. A girl that had zero risk of dying from covid.

Why is your annecdote not present in VAERS?

Also

the cumulative COVID-19 mortality rate in the 15-24 year age group was 0.03%

The mortality rate of covid for your undocumented friend is higher than the target group mortality of RSV.

It is not. Those 0.03% was not healthy individuals and covid was probably not main cause of detah. In case of medical intervention like vaccination, it is different story.

I also know dead persons after covid vaccination, serious injuries also in family. How many healthly people dead from covid do you know?

No, those are deaths where a doctor has decided it was the cause, regardless of nonwitnessing internet commenters belief about their standards of judgement.

There were 3 deaths on my block, including a renowned weight lifter who was a daily staple at the gym.

Did you know them personaly? Did you know their medical records?

Even if I chose to accept your unfounded, not-reported-in-VAERS position as fact, it doesn't change anything. Anecdotes aren't substitutes for medical research. The data is clear that the risk of vaccination is extremely small, and that there are aggregate benefits to vaccination that exceed the risks.

Deaths and harm occur in some limited cases in vaccination. They occur in some limited cases without. That's why we have data.

One person being harmed cannot stop a program that reduces harm in aggregate.

I guarantee you the riskiest thing that child did on a regular basis was get into a car. There's a 1% lifetime risk of death in a car accident in America.

> One person being harmed cannot stop a program that reduces harm in aggregate.

I guess this is the trolley problem in action but do we actually think all humans are the same? Would you divert the trolley from 2 90 year olds to 1 16 year old?

This is exactly what we did during Covid. We saved 86 year olds by sacrificing young people.

> there are aggregate benefits to vaccination that exceed the risks.

Among children? Name data and studies that supporting your claim, please.

Did you read those studies about negative side effects? https://news.ycombinator.com/item?id=35094410 Those are not anecdotes.

> There's a 1% lifetime risk of death in a car accident in America.

Should we ban cars because of this data?

Were they vaccinated? How old were they? Which variant, the deadlier original one or the much less deadly Omicron?

I’m not in America. It is listed in our govt system.

The cumulative COVID-19 mortality rate in the 15-24 year age group in Australia is 0% if you exclude people with serious comorbidities.

> It seems to me the vaccine industry should be put in a severe category of "distrusted entities"

It [feels] to me the vaccine industry should be ...

FTFY

I hate being controlled by 'the man' just as much as anybody, but I think you have to ask yourself why you are so fixated on this issue?

What's your position on gun ownership? If you really want to keep mothers of two, or their children for that matter, from dying; then maybe focusing your outrage there would save more lives.

... it's numbers about a different vaccine, how are they relevant here?

> while the vaccine may continue to confer long term benefits

It had better! Otherwise (in my opinion) it has little claim to the label “vaccine”.

The approved vaccine (Arexvy) is a GSK vaccine. It's also not an mRNA vaccine - it's recombinant subunit vaccine (ie, you tinker with microbes to spew out relevant pieces of the virus which you harvest and purify).

Edit: Also your linked commentary basically completely hinges on what we believe the risk of RSV to actually be (fair). The lower bound estimate provided by tallying up actual death certificates is just that - a lower bound. The linked study for that number dedicates a huge pile of its discussion section to the very weakness of just using death certificates. I'm not saying that the 14k number must be true, but it's also quite unlikely that the 35 per year number is the right order of magnitude as well.

If you look at the actual data ( https://s29.q4cdn.com/435878511/files/doc_presentations/2023... ), 0.6% with the vaccine had a grade 3 fever, compared to 0.4% of placebo.

The population in question is 60+ or 70+. RSV can be very significant in that population, even in young kids, it is a virus that shuts down schools. The author is a well known anti-vax guy, so I’d assume he’s presenting the most negative scenario possible.

No skin in the game, but a cursory look at this article indicates it is bogus. Citing supposed death certifications is a really disingenuous tactic IMO:

>A review of death certificates found that RSV kills about 35 American adults a year

National Foundation for Infectious Diseases claims it kills 14,000[0]:

> RSV is second only to influenza as a cause of medically significant respiratory tract illnesses in adults7,8 and is estimated to cause 177,000 hospitalizations and 14,000 annual deaths in US adults age 65 years and older

[0]https://www.nfid.org/wp-content/uploads/2019/08/rsv-report.p...

Note: OP posted about the GSK vaccine, not the Moderna one.

Like it or not, these sort of not-very-effective-vaccines-for-mostly-mild-diseases are going to be a very tough sell for a lot of people post-covid. I assume there will be ongoing attempts to ride of covid's coattails to get them pushed or mandated wherever possible.

The real concern is that if we ever get new effective vaccines for bad diseases, there are going to be lots of people not taking them after all the abuse of trust that's happened. At this point, how do you even know who to belive?

Honestly, who cares.

If you think reducing likelihood of getting really sick by 80%, especially if you’re vulnerable is no big deal, and you want to suffer or spend your life savings on unnecessary medical care because some YouTuber told you so, that’s your problem.

If you want to base your medical decisions on wildly average data that's your problem.

I don't think I would agree broadly with the person you are responding to (riding the coattails of covid is a phrase that paints a picture), but this narrow point has merit due to the way herd immunity works. It is genuinely a matter of community health.

No idea what to do about it given all the absolutely unhinged perspectives on the topic, but still, I care.

Then one time, I believe it was July ... no August, there's a knock on the door. Open the door and there's this cute little girl scout. Ah she was so adorable with her little pigtails and all. And she says to me "how would you like to buy some cookies?" I said "well what kind do you have?" She had thin mints, graham crunchy thins, oatmeal raisin... I said "we'll take a graham crunchy. How much will that be?" She looks at me says "I'll need about three fitty." WELL! IT WAS ABOUT THAT TIME I NOTICED THIS LITTLE GIRL SCOUT WAS ABOUT 8 STORIES TALL CRUSTACEAN FROM THE PALEDOZOLIC ERA! THE LOCHNESS MONSTER!

Is this a reference to something?

Yes it's south park probably very random.

The last panel of: https://www.qwantz.com/index.php?comic=14

100%. I am in my late 30s and have not received a vaccine since I was in middle school ... literally never sick, never got covid. There'd have to be zombies or bubonic plague to convince me, and even then, there'd be bigger fish to fry.

Does someone have the same stats re side effects for the approved vaccine?

This feels like something that will be of benefit to the immunocompromised, or with conditions such as Asthma (RSV can be super non fun with Asthma)

I wish there was a way to determine more stratified outcomes according to potential correlates... without having to perform high statistics human trials. I imagine that kind of detail is released after some time, I wonder how long that usually is.

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