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Comment by waterheater | Hacker News Reader

Two relevant perspectives to share:

"It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine." -Marcia Angell

"If the image of medicine I have conveyed is one wherein medicine lurches along, riven by internal professional power struggles, impelled this way and that by arbitrary economic and sociopolitical forces, and sustained by bodies of myth and rhetoric that are elaborated in response to major threats to its survival, then that is the image supported by this study." -Evelleen Richards, "Vitamin C and Cancer: Medicine or Politics?"

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Serving as editor of a major journal in any discipline can make one cynical. I read many years ago a quote from a mathematics editor that a large fraction of published proofs were faulty, and from a computer science editor that a large fraction of published theorems were false. (My foggy memory gives 1/2 and 1/3 for the fractions, but I don't remember which was which.)

Almost nobody has the throughput to check equations at all

You mean the 10 pages of the proofs located in the Appendix aren't read? I hate CS academia...

Ah, but don’t worry folks, those vaccines which generated $40B in profits for Pfizer and Moderna, those are just A-ok. Trust the science, which in this case is perfect, unassailable and uncorruptible (unlike everything else the pharma industry does). Don’t question the faith.

And those weren't simple studies they were self-policed and self-reported trials. Trials that determined FDA green lighting. How can the FDA operate like that when the incentives to profit are 40B x more than being honest.

File under: Follow the money

"Trust the science" is dumb, but "trust that the single-most reviewed medical studies of the past decade with 30k+ participants aren't outright bullshit" is enough for me. The risk for those studies is probably closer to what happened with Astrazeneca, where a very rare side effect got missed because 30k people weren't enough to detect it.

I think skepticism is healthy to a degree, but ironically, the more adversarial the general public is to an area of study the more rigorous it usually is.

I mean I’m as vaccinated as anyone, but the originally reported 95% effectiveness against symptomatic COVID-19 with the monovalent vaccine just doesn’t seem realistic in hindsight. Who knows what complex set of incentives was at play. If you’re running a trial site and your business relies on continued contracts from Pfizer, are you reporting every cough, fever, or headache?

I wonder if the 95% effectiveness was actually true: against the strains prevalent at the time they ran the trial. But effectiveness against later strains was diminished.

I don't think the claim was 95% against symptomatic covid, it was against hospitalization or death.

The vaccine was tested against the original virus but Omicron was almost a different disease with much more immune escape. We're lucky the vaccine held up as well as it did. This is also why the alternative doctors that wanted everyone to catch covid to build up herd immunity were wrong, but nobody seems to bring them up. These discussions just devolve into the usual polarized political talking points.

Whether the original study said so or not, that is absolutely how it was universally sold to the public. This [1] is a collection of various high profile individuals talking about the efficacy of the vaccines, why that means you won't carry the virus, you won't get sick, and and how that will completely stop the spread of COVID.

It's only as this very obviously failed to be the case that the metric was completely shifted to hospitalization/death. I'd also add this is about the time that the 'public messaging' swapped from talking about efficacy and other topics to outright vitriol and attacks on unvaccinated individuals, which is probably where the politicization of the topic began.

[1] - https://twitter.com/i/status/1472327161352798212

> Whether the original study said so or not, that is absolutely how it was universally sold to the public.

Trust the politics, blame the science?

By "the politics" you're including individuals like Fauci, the head of the CDC, and so on. These are individuals that were perceived as "the science." Beyond this, a peer comment motivated me to look up the original trial results and reporting. And yeah, it was entirely about cases. Here [1] are the data from Moderna. Oddly enough, it seems to have been moved, if not removed, from their website, but fortunately nothing ever dies on the internet.

"There were 11 COVID‑19 cases in the Moderna COVID‑19 Vaccine group and 185 cases in the placebo group, with a vaccine efficacy of 94.1% (95% confidence interval of 89.3% to 96.8%)."

They were claiming it outright prevented COVID, as vaccines generally do. So "the politics" and "the science" were in lockstep on this one. As were they when they seamlessly dropped this narrative and swapped over to hospitalization/death.

[1] - https://web.archive.org/web/20210202223626/https://www.moder...

There is no need to think, you can go read it. There was no indication that it was any help against severe disease, hospitalization, or death. The touted 95% was indeed against some definition of “symptomatic Covid” (a subjective one). In the all cause mortality section, there were more deaths in the vaccine arm than in the placebo arm. (But that was not statistically significant). At any time before 2020, the study would have been laughed at. But scientific standards were thrown out the door in 2020, and have not yet returned. (And … as it turns out from this and similar studies e.g. Ioannidis’ seminal paper showing most research is wrong from 2005 - it wasn’t as good as most people thought in 2020 already)

I think this was the original paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745181/

Sample size was 43k people split in treatment and control group. Adding it here for context.

Peer review is not a magic spell that reveals the truth. “Most-reviewed” is meaningless here if the underlying data was not collected or reported properly.

Peer review, no. Review by a substantial percentage of world-wide immunologists along with everyone who's even remotely interested and a bunch of people who believe your work is killing people, still not a magic spell, but it's a hell of a lot better.

Did they review the raw data or did they just read the paper? AFAIK, Pfizer did not release the "summaries" of the data until March 2022 (forced by the FDA if i recall), long after these debates reached critical mass. I don't believe they released the data itself still. Google makes this hard to search for because it's still censoring...

Yeah, because hundreds of health authorities simultaneously collecting their own data (often with larger groups of each cohort) wouldn't be able to replicate or disprove the outcome of the original research.

You trust health authorities? Come on.

You on the other hand believe that, somehow, absolutely independent (and often confronted) authorities, both governmental and private, would magically agree on something false instead of calling each other out.

That's the-moon-landing-was-fake tier denial-ism.

If the political pressure is big enough, yes.

You cannot compare the moon landing to the COVID circus.

> "Trust the science" is dumb, but "trust that the single-most reviewed medical studies of the past decade with 30k+ participants aren't outright bullshit" is enough for me.

What does "aren't outright bullshit" translate into in quantitative (%) terms?

I'd say bullshit means data that's worthless, because it's fabricated, collected by P-hacking, or otherwise means nothing. There's no useful quantitative measurement that tells you more than "Professor Bullshit just filled out random junk in Excel."

Severe side effects or death cases were excluded from the Pfizer phase 3 study by conveniently shifting blame on patients, inventing diagnoses or claiming they had a Covid infection.

Even if all that were not intentional, it would certainly raise the question why this should be the only case of fabricating data for studies. Since the RNA-vaccines are obviously not as positively effective as claimed, what else is there that might be not talked about? And lastly why is the topic still that controversial when the safety and effectivity claims have not stood up to the real world test?

Early into the pandemic, the original COVID strains had like 40% rate of permanent aftereffects, and the hospitalisation and death rates were insane. At the time, the vaccines have definitely saved lives, and the "covered up severe side effects or death" you talk about never came up in the real world, so...

No.

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