...vaccines happen to be safe and effective, but it’s not clear that we wouldn’t be in a similar position in the future where the thing in question wasn’t safe and/or wasn’t effective
I think both that the vaccines are safe and effective based on the evidence, and also that if the evidence did not strongly say they were safe and effective, we wouldn’t be contemplating such policies
Could you explain how you arrived at the safety conclusion? Wait, let me explain why I myself am getting overwhelmed (maybe I start from the wrong viewpoint).
There is an unprecedented need for a vaccine, and a few companies / people have got an opportunity to get extremely rich fast (and so they have). I cannot seem to get it out of my head how media and papers are all unanimous in supporting the vaccine. How do we discern honest from swayed / funded unjustly?
Last February, you could still find articles / papers like this:
...to prevent Covid-19 transmission, another type of antibodies could be the more important player. The immune system that patrols your outward-facing mucosal surfaces—spaces like the nose, the throat, the lungs, and digestive tract—relies on immunoglobulin A, or IgA antibodies. And we don’t yet know how well existing vaccines incite IgA antibodies.
People who get sick and recover from Covid-19 produce a ton of these more-specialized IgA antibodies. Because IgA antibodies occupy the same respiratory tract surfaces involved in transmitting SARS-CoV-2, we could reasonably expect that people who recover from Covid-19 aren’t spreading the virus any more. (Granted, this may also depend on how much of the virus that person was exposed to.)
Now it’s all just “safe and effective”.
One more red sign in my head: there’s a vaccine for a previously unknown virus made with completely new technology (granted, mRNA wasn’t discovered yesterday, but it’s never been used like this before), in an astonishingly short time, which is also safe and effective. How probable would this sound to someone completely ignorant of all the media and the whole Covid-19 thing?
Please note, I am not an angry antivax. I am confused and seeking answers.
The only thing that people can be really sure of, for all patients, and all disease conditions, in general, is that some things are NOT safe (like: literal poison or just peanuts for someone allergic to peanuts) and something are NOT effective (like: homeopathy or chemotherapy for something other than the relevant kind of cancer).
The entire concept of a legal declaration that a drug is totally Safe(tm) and totally Effective(tm) is basically just marketing.
The thing that actually makes things safe and effective is that the doctor diagnoses you correctly and prescribes the right thing at the right dose without causing complications FOR YOU. Sometimes some problems happen despite the best guesses and efforts (because every human is a snowflake), and this is just how biology is: extremely complicated in general.
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Something to note is that antibiotics and vaccines are insanely more important than heart valve replacements and boob jobs, in terms of making life for humans possible under modern conditions. For basically all of human history cities were net death traps, full of disease, where the excess people born in the country went to have sub-replacement numbers of kids and then die of smallpox or whatever. If we can’t make new communicable disease treatments fast enough… this is what cities will go back to.
However the REST of medicine is often nigh unto homeopathy itself?
Perinatal care, and gunshot trauma treatment, and setting bones, and insulin for type I diabetics work, but these are unusual.
A lot of stuff “treats” the thing you went in for… while causing a new problem. Making all cause mortality go down is HARD. This paper argues that ignoring all cause mortality is fine. I think it is fine if the goal is to give people quite a bit of make-believe-medicine that causes them to feel cared for and helps doctors pay off their med school debts.
The real experiments are the early patients. If the patients are smart and have a good doctor and the cost-benefit-analysis for THAT patient in THAT situation pencils out… then the risks are worth the benefits and you take the bet and get your outcome. Then the doctor learns something.
That’s how medicine gets better in real life. The more clinical experience that builds up, the better a judicious clinician can make this determination. To pretend otherwise is crazy.
There have been a LOT of people taking the vaccine. Empirically, it seems to help more than it hurts. For a very large “clinical N”.
there’s a vaccine for a previously unknown virus made with completely new technology (granted, mRNA wasn’t discovered yesterday, but it’s never been used like this before), in an astonishingly short time, which is also safe and effective. How probable would this sound to someone completely ignorant of all the media and the whole Covid-19 thing?
Personally, I think that the thing that happened was: Moncef Slaoui (and Kushner?) did an end run around The Evil Ones?
Clinical practice reveals, over and over and over, that things approved by the FDA as “safe” actually weren’t “safe” and should maybe be recalled (or maybe they were safe if used properly and doctors weren’t using them properly, and so someone decided that rather than let people get hurt, and rather than purge the doctors of incompetence, they should purge the legal drugs of things that were being mis-used a lot)?
This is the fundamental lie of the FDA: they REALLY can’t do, during clinical trials, what they claim to do, and they get in the way of the people who MIGHT be able to do it for real eventually by just trying shit and repeating what works.
I’m not entirely against trying random shit on consenting old people who are going to die anyway.
SUPPOSE that things are hopeless… then why NOT try something that is likely to fail? It MIGHT work?
The right argument against such experimentation is more complicated and more about economics than medicine: how many bits of information about what parameters of various biological systems are you really buying when you try something new in medicine and is that worth it to whoever is footing the bill compared to their alternative uses for the same money.
However, the FDA also forbids this in general. Experiments should be as cheap as possible to get as many of them as possible. And it is NEVER cheap right now!
In order to try such an experiment you’d first file a New Drug Application (NDA) which is like $1M a pop.
So you can’t just notice that you have a weird disease, and are basically gonna die no matter in the near future for a predictable cause… and then “just try something that your doctor thinks MIGHT work based on first principles medical reasoning and wikipedia”. You you have to get permission from people in DC first.
Sometimes I wonder if they are INTENTIONALLY holding off medical innovation in general because like… abortion and transsexuality and cures for venereal diseases are already out of pandora’s box… what else is in there? Maybe immortality? Maybe EXPENSIVE immortality? So maybe they are outlawing “medical innovation in general” to the best of their ability? And they pretend that their destruction of medical innovation is actually in support of “safe and effective and scientific” medical innovation because… they think we’re dumb enough to believe their lies? (And maybe they are right?)
So, turning off some of the dumber laws momentarily enabled us to invent a new and effective vaccine.
And this isn’t surprising to me because science works. The thing in the US that’s broken is our political economy, not our actual physical sciences (yet).
In terms of safety, the argument for LONG TERM safety of this vaccine technology is not, and never could be, empirical. To verify the safety empirically you’d… have to wait a long time for results.
Instead the thing you do is… guess. Just like with masks. Based on reasoning about reality?
So far as I’m aware the key idea here is Kariko’s work with things like pseudouridine. That’s what made this new kind of mRNA vaccine work where the old mRNA vaccines had unacceptable side effects.
Honestly, it doesn’t seem totally impossible to me that having a lot of this in your body might do… something? (Keep in mind though: water is poison at the right dose.)
But it empirically hasn’t done much yet now that it has been rolled out to millions. Like with masks… you reason about reality directly to the best of your ability, and ask for peers to check your thinking?
One central comforting thing for me (if you click through to Kariko) is that the clever chemistry ALREADY EXISTS in our bodies. Human biology makes chemical adjustment to the backbone and microstructure of mRNA, then looks for these adjustments actively. Then viruses either have to also attempt this (which is very hard for many of them) or else the lack of these adjustments in certain cellular compartments can work as a trigger of certain kinds of “kill it all with fire” immune reactions.
So the current clever mRNA vaccines are giving “viral code” with “human-like chemical signatures” to dodge this reaction, and thereby sneak viral protein manufacturing instructions “deeper into our cell’s machinery with less trauma” for at round of protein manufacturing, in a way that gives us “pieces of virus” (for our immune system to learn to recognize), but no second generation of virus (to be an actual infection), while avoiding some innate immune side effects.
I personally think it would be foolish to say that it can’t possibly hurt in any way ever at all. The best medicine is the ancient stuff like aspirin (ie the active ingredient in willow bark tea which is 4000 year old medical tech with mentions in Sumerian and Egyptian texts). Time allows information to accumulate <3
I just think that the bet seemed to be worth it. I have two doses of Pfizer. I got them as fast as I legally could because the testing on the old people seemed like “enough” basically? Also both parents got the vaccine, and presumably they have the same genes as me more or less, so if they didn’t specifically have a reaction then I wouldn’t either most likely?
Empirically: pretty safe and decently effective (for N>millions) over months against the strains that are out there right now.
Theoretically: clever and probably pretty similar to what human bodies already have in them.
Surprisingly: generated “unusually fast” because heroes started ignoring a bunch of catastrophically stupid laws.
Now I realize there’s another: the mRNA vaccines are not that new, they simply never made it public before. Just something that dawned on me.
Early papers on mRNA therapeutics date back to the late 1980s/early 1990s, with a number of small scale tests and trials starting by the late 1990s. Making custom arbitrary mRNA has been affordable/feasible since at least the mid-2000s. BioNTech was founded in 2008, and Moderna was founded in 2011, which means the relevant tech at that point was already far enough along to warrant founding companies that were going to need a lot of funding to bring anything to market. But instead of making vaccines targeting infectious diseases, they both mostly targeted cancer immunotherapy. I assume that’s because those are the treatments they were able to get funding for, even though it’s a much harder problem technically.
I don’t know when the first year was they they could have designed a successful vaccine against a novel virus in a day and a half, but the odds of that happening just before covid hit are obviously very low, especially since more recent trials and studies are showing that we can also quickly develop (better) vaccines against the flu and malaria, and the success with covid was not an unlikely outcome.
I don’t know when the first year was they they could have designed a successful vaccine against a novel virus in a day and a half, but the odds of that happening just before covid hit are obviously very low, especially since more recent trials and studies are showing that we can also quickly develop (better) vaccines against the flu and malaria, and the success with covid was not an unlikely outcome.
I did not get this part (maybe there’s a missed word or something. Are you implying that they had all tech in place to successfully manufacture such vaccines quickly?
So, to sum up:
mRNA has been studied and used (?) for about 30 years now
Moderna and BioNTech have been around for a while, and their past research has built up their scientific base.
Out of 18 mRNA vaccines developed around the world only 3 made it to clinical trials, and two made it to production
Manufacture? No. Use? Only at lab scale, in animals or a few patients for small studies. Design? Yes, and the design process did not require any additional new tech nor the resources of a large pharmaceutical company.
Yes, old school vaccines have a lot more history behind them and large organizations were more familiar with them and so they were better equipped to get them through trials and scaled up for deployment. But the mRNA vaccines that did make it through seem to be more effective than those old school vaccines.
Of those 18, how many actually failed trials vs. other reasons for not having come to market (didn’t get funding, didn’t have the pre-existing expertise needed, didn’t move fast enough relative to competitors)? Also, four of those 18 were BioNTech, and counting that as a success and three failures seems like a mistake when it’s the same company trying multiple things initially and then proceeding with the best one.
How many old-school vaccine development efforts didn’t pan out, or only got approved because of extensive government support in their countries of origin?
My take is that we have had, for at least a handful of years, the ability to design a new mRNA vaccine against a novel virus in a matter of days, test it in a matter of months, and scale it up in less than a year. Instead, the companies founded to develop that kind of technology had to go in a different direction (targeting cancer), and without the pandemic they would have languished much longer without bringing any mRNA therapeutics to market at all. The pandemic cut through enough bureaucracy that they got a product out and built manufacturing capacity, and now that they have done that, they’re quickly able to repeat that success for other diseases.
I do not expect the pandemic to lead to a flurry of other new traditional vaccines, because those haven’t suddenly gotten easier or cheaper to develop, we just threw more resources at them for covid.
As far as I can tell, if we had had better regulatory and research policy, we could have lived in the world where Moderna or BioNTech had been working on infectious disease mRNA vaccines all along, and launched an improved flu vaccine back in 2016 or so, so that by early 2020 they already had some manufacturing capacity and supply chains in place that they could expand and replicate (with at least the medical community knowing this was a thing that had been used millions of times). I do not believe that that world ever had to have made any technological advances that ours didn’t make, yet they would have been able to mass produce our most effective covid vaccines much, much faster than we did. They would know that they knew how to fight a virus.
Edit to add: I worry that many people (1) think this is what a worst-case-scenario pandemic looks like, and (2) think that next time there’s a new disease, the solution will be to mask up and shut down indefinitely, instead of immediately designing an mRNA vaccine, conducting large trials as fast as possible, and pre-emptively manufacturing hundreds of millions of dose so they’re ready to go ASAP, with an expectation that all relevant regulatory agencies will work round the clock to remove all unnecessary roadblocks to approval.
Suggestion: Pre-register how you imagine a truly safe approval process for a vaccine would look like. Take notes on a piece of paper: How many clinical trials would you expect? How long should they take? If a vaccine successfully passes all trials, how much time should official institutions like the FDA take to review the evidence before they made a decision on whether to authorize use of the vaccine?
Finally, does the process you’ve imagined account for the opportunity cost of delay during an emergency?
Only afterwards, look up how the vaccines were actually approved. For instance, this study (section “Results”) provides an overview of how various vaccines were authorized in the USA, EU, and Canada.
Then compare the actual approval process with what you imagined it should look like. How do they compare?
This suggestion makes it sound like the prior for all vaccinations is the same. The sensible thing to do when faced with a pandemic is to run clinical trials for vaccines with the least risk possible. That means using tried and proven adjuvants. Then you test whether protein domains or whole proteins are more toxic in some animal model and use the thing that’s less toxic.
There’s no good reason to use a new and risky process like the mRNA process. It’s risky because the body starts attacking the cells that produce the antigen and this might be valuable cells all over the body including the brain as polyethylene glycol goes through the blood brain barrier. Adjuvant + Antigen doesn’t let cells produce the antigen so the body won’t kill it’s own cells.
Could it be that so little neurons are killed that it’s safe? Yes, but there’s no reason to take that risk with a speed up approval process.
how much time should official institutions like the FDA take to review the evidence before they made a decision on whether to authorize use of the vaccine?
Without knowing what goes into the evidence review it’s very hard to have an informed opinion on this. If I’m a reviewer at the FDA and see that the vaccine does get measured in the brain up to 25 hours after administration and likely kills a few neurons while none of the measured endpoints in the trial give me a good idea of whether there are effects on cognition, I don’t think the decision whether or not to approve is trivial. It might be that this is a decision that should have done way earlier in the trial process, but it’s very hard from the outside to understand how these things work.
The amount of clinical trials isn’t the prime critieria. What matters is whether the clinical trials look at the relevant outcome metrics for risks.
All the possible long-COVID outcomes you would have guessed based on SARS I long term effects should be measured in the clinical trials for vaccines. Heart health metrics like HRV and lowest night time heart rate should have been measured as an outcome. A mental metric like IQ or maybe something easier to measure should have been an outcome for a drug that crosses the blood-brain barrier.
One reason follow up incidence for CFS, depression should be included in the trials even if that’s not looked at for the first approval.
the body starts attacking the cells that produce the antigen… including the brain as polyethylene glycol goes through the blood brain barrier
How do you know what you think you know? Specifically, regarding the PEG enabling the LNP’s to cross the BBB, and regarding a followup by immune cells that have crossed the BBB?
There are to lines here. PEG gets used to get other medication past the blood brain barrier in pharmaceutical applications where you want to get things past the blood brain barrier. Secondly, for getting the drug approval companies had to measure where in the body the vaccine goes. If you look at the EMA report for the Moderna vaccine it suggests that the vaccine goes into all parts of the body with the expection of the kidneys and that includes with the brain where it can be measured up to 25 hours after the vaccine gets injected.
I sympathize with your warnings, but am unresolved on the forums and means to address them.
The mRNA vaccines are probably riskier than we’re let on to believe, but I see a lot of alternating between normative and descriptive.
We have the set of vaccines we have now, and we have Covid circulating. It would be great if we lived in a universe were Covid was less bad or vaccines were mor good…
I just don’t see a lot of “here’s what we should do right now to make the world a better place” that doesn’t involve using the tools the average person has at their disposal.
I just don’t see a lot of “here’s what we should do right now to make the world a better place” that doesn’t involve using the tools the average person has at their disposal.
As Ben points out, people like Zvi are far from advocating using the tools that the average person has it their disposal and only advocate using a subset of them.
The FLCCC protocol is now at 7 tools that are recommended to be used every day. That list doesn’t even include Taffix and at home air filters.
I sympathize with your warnings, but am unresolved on the forums and means to address them.
I do think LessWrong is the forum to speak about what’s true and not only to speak about what’s practical.
I would want my third vaccine dose to be Novavaxx and hopefully not with the spike protein from a year ago but Delta or the varient that’s current at the time.
You don’t need to take prophylatic Ivermectin daily. With Vitamin D I would recommend taking it daily but in theory you can also take it at less frequent intervals.
If people can get Ivermectin legitimately and aren’t taking horse pills or ordering it off the dark web, I don’t see an issue there.
I’m not sure whether there’s much of a quality difference between dark web sources and generic out of the pharmacy.
But all of those have to been taken daily, paid for out of pocket, and none of them are vaccines.
It’s a question of how serious you think COVID-19 happens to be and therefore how serious you want to be to do something about it. If you think COVID-19 isn’t serious enough to do something daily about it, that’s a valid position but you should be clear about that being your position.
So how reasonable is this as a public health policy?
As a public health policy you can give Ivermectin to people for free. Given that it’s cheap enough for the Indians to do that, it should be easier in richer Western countries.
If I were in charge of public health policy I would also say that vaccines can be brought to market by showing that they result in antibody creation in humans and disease prevention in animal studies.
There’s also no need for public health policy to be a one-size-fits-all solution.
I’m not sure whether there’s much of a quality difference between dark web sources and generic out of the pharmacy.
They only way I believe anyone should feel safe recommending it would be if they are sure it’s pharmaceutical grade and quality. Otherwise… it could possibly do more harm than good, or do nothing at all.
It’s a question of how serious you think COVID-19 happens to be and therefore how serious you want to be to do something about it. If you think COVID-19 isn’t serious enough to do something daily about it, that’s a valid position but you should be clear about that being your position.
I don’t see how this is relevant. You could believe Covid is a very big deal and not have the money or means to spend ~50 dollars a month on supplements.
This the question is, even if you did, would this protocol be good enough to prevent catching Covid and transmitting it to someone that’s immunocompromised, for example.
As a public health policy you can give Ivermectin to people for free. Given that it’s cheap enough for the Indians to do that, it should be easier in richer Western countries.
I can? I’m not the FDA, Fauci or WHO. How can I make sure 7 billion people have enough Ivermectin to take several days a week for a year or more and ensure compliance?
I know you didn’t literally mean me, but this is a much harder problem than people make it out to be to coordinate giving the whole world until the pandemic ends, and that’s assuming Ivermectin would be effective here.
There’s also no need for public health policy to be a one-size-fits-all solution.
In general, I agree. Just think were overstating the case for how easy giving everyone seven different supplement regularly and ensuring that they do it… so say nothing about how effective they are compared to vaccines.
If I were in charge of public health policy…
None of us are and none of us will be anytime soon, there’s a lot of discussion like this is plausible.
And there’s no real plan. How would be administer 100 of billions of doses of Ivermectin and ensure people are taking them for months or year?
They only way I believe anyone should feel safe recommending it would be if they are sure it’s pharmaceutical grade and quality. Otherwise… it could possibly do more harm than good, or do nothing at all.
The same is true with a generic that you buy at a pharmacy. It can possibly do more harm than good or do nothing at all. Ranbaxy sold generics for which that’s true and even after the FDA was told about that by a whistleblower it took them years to do something about it.
This the question is, even if you did, would this protocol be good enough to prevent catching Covid and transmitting it to someone that’s immunocompromised, for example.
You can ask the same thing with the vaccines. Vaccines do have the disadvantage that it’s easier for viruses to mutate to escape them. High vaccination rates in the UK and Israel didn’t prevent a rising case count but Ivermectin use (alone) coincides with it in India.
I don’t see how this is relevant. You could believe Covid is a very big deal and not have the money or means to spend ~50 dollars a month on supplements.
Price of supplements is a different issue then whether you have to take the supplement daily.
I can? I’m not the FDA, Fauci or WHO. How can I make sure 7 billion people have enough Ivermectin to take several days a week for a year or more and ensure compliance?
You don’t have the power but you also don’t have the power to set public health policy in other regards.
How would be administer 100 of billions of doses of Ivermectin and ensure people are taking them for months or year?
Public health policy is not about ensuring that people do things outside of totalitarian states. It’s about providing people with options and informing them about the value of various actions.
The same is true with a generic that you buy at a pharmacy. It can possibly do more harm than good or do nothing at all. Ranbaxy sold generics for which that’s true and even after the FDA was told about that by a whistleblower it took them years to do something about it.
Absent a studies comparing the quality of drugs from the dark web vs. the quality of drugs pharmacies, my prior is to assume that drugs from pharmacies are typically safer. Although I agree, yes, it’s not perfect. I have recourse if I discover they’re contaminated or don’t contain the medication advertised. Best I could do on the dark web is leave a mean review and hope the dealer doesn’t find a way to retaliate.
You can ask the same thing with the vaccines. Vaccines do have the disadvantage that it’s easier for viruses to mutate to escape them.
Price of supplements is a different issue then whether you have to take the supplement daily.
Price is a factor in compliance. If you can’t afford supplements, you will be less likely to comply.
You don’t have the power but you also don’t have the power to set public health policy in other regards… Public health policy is not about ensuring that people do things outside of totalitarian states. It’s about providing people with options and informing them about the value of various actions.
This is ultimately why I think this is an unproductive and to some degree dangerously misleading discussion (not just you and me, but also the vaccination vs early treatment and treatment protocols).
I don’t take any joy citing the linked author, but I do feel like we’re on a ship and we’re heading towards and iceberg and everyone is like “what about zinc? what about ivermectin?” And, yes, those are all things that deserve more attention and I’m against censoring discussion of them.
Ivermectin may yet prove to be a miracle drug, and I think the evidence there is promising. I don’t see the downsides to people taking zinc or vitamin d3 at reasonable and effective doses. I don’t see any of it as having the potential to turn the ship around.
But right now as of August 16th at ~5:45pm mountain time what we have to turn the ship around that we know works are vaccines. Yes, the side-effects are probably worse than claimed. And, yes, the public health apparatus in the US sucks for a million reasons, one of which is that they talk to us like children when it comes to vaccine safety. But all the evidence I’ve seen is that this is better than the alternative.
Since I haven’t seen other proven solutions for quickly and reliably turning the ship around, comparatively everything else seems like a distraction.
If you had infinite time and resources, you’d ideally test for all conceivable outcome variables when designing clinical trials for anything. Of course there’s always a chance that something was missed in the trials, but it certainly matters what that chance is. Do we have reason to believe it to be non-negligible, now that more than enough people have been vaccinated for even the tiniest of risks to manifest themselves?
In any case, if someone is specifically worried about the novel mRNA vaccines, they can take one of the classically produced vaccines instead.
There’s no good reason to use a new and risky process like the mRNA process.
… there’s no reason to take that risk with a speed up approval process.
… What about the higher efficacy of the mRNA vaccines?
(I also tried to look up a timeline of manufacturing volume by vaccine type, but unfortunately couldn’t find anything useful. I had had the impression that the mRNA vaccines had been quicker to manufacture.)
An omniscient being could make a full cost-benefit analysis on this kind of stuff, but we have to reason under uncertainty, and things certainly don’t look so clear-cut to me.
Do we have reason to believe it to be non-negligible, now that more than enough people have been vaccinated for even the tiniest of risks to manifest themselves?
How would we notice if the lowest night heart rate goes up for everybody who takes the vaccine by one point?
How would you notice if the IQ of everyone who takes the vaccine goes down by one point?
How would we notice if 0.5% gets a depression half a year after receiving the vaccine? (Brain trauma doesn’t produce depression immediately but has lag time)
If someone gets a depression half a year after receiving the vaccine, why would they think that they should tell VEARS about it?
We know that the mRNA vaccines produce some brain damage, because we find the vaccine in the brain and the it gets cells to produce the antigen and then the immune system kills those cells. What we don’t know is how much damage that it. If the damage would be enough to reduce IQ by an average of 10 points we likely would notice. I don’t think we would have noticed if it’s 1 point.
Myocarditis that’s strong enough to produce clinical effects seem to happen enough that it’s flagged as a risk to investigate. Most cases of myocarditis caused by the vaccine are likely not strong enough to be clinically noticeable. If someone has myocarditis that raises their lowest nightly heartrate by one, they are not going to put anything into VAERS. As a patient non-clinical side-effects matter.
Look at a discourse of side-effects of something like microplastic. Such a discourse takes decades to come to good conclusions about what the side-effects are.
… What about the higher efficacy of the mRNA vaccines?
I don’t think there’s evidence that shows mRNA vaccines outperforming Novavaxx currently. Even if two doses of Novavaxx would give less immunity there’s less risk in simply giving more shots.
Novavaxx uses a patented adjuvant instead of a well tested one, but it’s the choice that’s available for classically produced vaccines.
I think you can make a good argument that in the shitty situation we are in it still makes sense to get vaccinated but pretending that we have strong evidence of lack of side-effect stretches it because we have not studied relevant outcomes to an extend where we would see the effects.
Epistemically, this kind of argument reminds me of god-of-the-gaps or shrinking parameter spaces in string theory. That doesn’t make the argument wrong, but it means that I don’t really see a fruitful way to engage with it.
I suppose that if one’s prior is that this kind of risk is negligible, the argument will sound unconvincing, whereas if it sounds plausible a priori, then lack of such studies seems concerning? Let’s leave it at that. Though I could be convinced otherwise if I learned that this concern was taken seriously by a significant fraction of doctors or other public health professionals.
Though I could be convinced otherwise if I learned that this concern was taken seriously by a significant fraction of doctors or other public health professionals.
If you learn anything about a rationalist is that knowing things is hard. If you look at the replication crisis we see that it’s hard to know things even when there are studies that intend to measure an outcome.
Claiming strong evidence for something should require evidence and not just lack of concern.
Why is the prior that a drug that causes brain damage should have a negliglible risk of causing brain damage that’s relevant reasonable?
How is it a god-of-the-gaps argument to ask for checks to see whether the brain damage is large enough to cause problems? If you haven’t check claiming you have strong evidence that there are no side-effects seems to me very unfounded.
I had a doctor tell me that removing a rib of me is no problem because there’s no evidence that it produces any problems. While that evidence isn’t in the clean form that doctors like, I do feel like it makes the some things in my body more complicated.
I don’t have the expertise or training to evaluate detailed medical claims myself. I wasn’t even able to find sources for the blood-brain-barrier thing (neither claims nor rebuttals), except for this thread on askreddit which I was too exhausted to peruse. In any case, at this point the discussion is not about medicine but about epistemology.
I have not yet been convinced that the vaccine causes brain damage. I think that at the very least, that argument requires sources for both a link between mRNA vaccines and an inflamed brain, and for the claim that this is an exceptional occurence / that this is something worse than what happens in e.g. an average fever.
I guess my prior is that bodies are pretty robust, and that most contrarian claims are wrong. Identifying correct contrarians is hard.
My god-of-the-gaps comment was directed at what I perceived as a complex hypothesis which looked like it was (over?)fitted to the available evidence. In such a situation, one can’t falsify the hypothesis without new evidence, even though one figures there should be plenty evidence regarding most conceivable side effects by now.
I do agree about the issues with doctors, though. I have had several suboptimal encounters with the medical system, which have left me rather unimpressed with medical care (diagnosis in particular). I have an essay draft on this topic, but it’s going to be a long while until I get to it.
The EMA is the EU equivalent of the FDA. When they approved the drug the wrote a report indicating all the risk related information about the COVID-19 Vaccine from Moderna.
In it they say:
Low levels of mRNA could be detected in all examined tissues except the kidney. This included heart, lung, testis and also brain tissues, indicating that the mRNA/LNP platform crossed the blood/brain barrier
The fact that your sources don’t tell you about this tells you how much they are interested in having a serious discussion about side-effects.
Generally, there are a lot of possible side-effects a drug could potentially have.
There are many situations where people claim to know more then they actually know for political reasons. A claim like “I know that the mRNA that’s found in the brain produces significant problems” is one that needs a lot more evidence then one that says “It possible that this happens but we don’t know”.
You have presented evidence that the mRNA vaccines “cause brain damage” to, let’s say, the same extent as drinking a glass of wine “causes brain damage”. That is, you can trace a sequence of events likely to kill at least one brain cell.
You haven’t shown any evidence that mRNA vaccines do anywhere near enough damage with anywhere near enough probability to be cause for concern.
The fact that the EMA report says what it does but doesn’t say anything at all like “the risk of brain damage is a downside to using these vaccines” seems to me to indicate that the people who wrote that report don’t think that what they found about small numbers of lipid nanoparticles crossing the blood/brain barrier is cause for concern. This means that either they don’t think brain damage would be a problem (which seems … unlikely), or else they don’t think the danger is substantial enough to be worth worrying about.
The comments from user yesitsnicholas in the Reddit thread linked above by MondSemmel seem to be (1) written by someone who actually knows something about this stuff, and (2) very confident that there’s no danger to speak of.
Now, whether or not yesitsnicholas is an expert, I am not, and maybe I’m failing to recognize the dangers here. I’m willing to be persuaded. Do you have any evidence that goes beyond “look, at least one lipid nanoparticle will get into the brain and that may lead to the death of at least one brain cell”?
I am not disagreeing with the narrower point that what we know at present about the safety of COVID-19 vaccines—or, in fact, pretty much any drugs—or in fact, pretty much anything at all—is not enough to be very confident that there aren’t very small adverse effects. Or indeed very small beneficial effects; we wouldn’t have noticed if getting the Pfizer vaccine raises your IQ by one point, either. Identifying very small effects is difficult.
But you go further and say e.g. that there was no point in trying novel approaches (with, therefore, more scope for wholly unsuspected adverse consequences) like mRNA vaccines. But available evidence suggests that the mRNA vaccines happen to be the most effective against COVID-19. A policy for which we can see with hindsight that it would have stopped us finding the most effective vaccines is, it seems to me, not obviously correct. “But for all we know Novavax’s vaccine is just as good as the mRNA ones”, I hear you say. Maybe it is. But it’s still in trials and the Pfizer and Moderna vaccines have been widely available and widely used for months.
We can calculate the upper bound of risk from the document you provided. Moderna says 2% of plasma level of LNP ends up in the brain. There are 10 billion LNP in each shot of Moderna vaccine and at most 10% goes into general circulation unless nurse made a mistake and put it in your vein. So, 2% of one billion is 20 million LNP, that is the maximum that will end up in a person’s brain following a vaccine shot. So, maximum 20 million brain cells are at stake after each shot. Not all of them will be neurons.
I have similar thoughts about the approval process, though much less coherent.
From a citizen (non-medical education) level of knowledge, I wonder how we should go about reaching a decision regarding getting a jab.
Though I am obliged to say, where I and my SO currently live (Lithuania and Russia) it will soon become not a “whether”, but “which” in a month due to regulations.
I think that COVID-19 is bad enough, that even with the risks as described I still got a shot of the BionTech vaccine three weeks ago.
If there’s a real free choice I think the answer is currently Novavaxx as it’s the classic adjuvant + antigen combination. Evidence suggests that it has less average side-effects and it doesn’t get your body to kill it’s own cells. Not getting your body to kill it’s own cells means that certain immune responses are not triggered but the trials we have shows Novavaxx to have comparable effectiveness to the other vaccines.
Could you explain how you arrived at the safety conclusion? Wait, let me explain why I myself am getting overwhelmed (maybe I start from the wrong viewpoint).
There is an unprecedented need for a vaccine, and a few companies / people have got an opportunity to get extremely rich fast (and so they have). I cannot seem to get it out of my head how media and papers are all unanimous in supporting the vaccine. How do we discern honest from swayed / funded unjustly?
Last February, you could still find articles / papers like this:
Now it’s all just “safe and effective”.
One more red sign in my head: there’s a vaccine for a previously unknown virus made with completely new technology (granted, mRNA wasn’t discovered yesterday, but it’s never been used like this before), in an astonishingly short time, which is also safe and effective. How probable would this sound to someone completely ignorant of all the media and the whole Covid-19 thing?
Please note, I am not an angry antivax. I am confused and seeking answers.
The only thing that people can be really sure of, for all patients, and all disease conditions, in general, is that some things are NOT safe (like: literal poison or just peanuts for someone allergic to peanuts) and something are NOT effective (like: homeopathy or chemotherapy for something other than the relevant kind of cancer).
The entire concept of a legal declaration that a drug is totally Safe(tm) and totally Effective(tm) is basically just marketing.
The thing that actually makes things safe and effective is that the doctor diagnoses you correctly and prescribes the right thing at the right dose without causing complications FOR YOU. Sometimes some problems happen despite the best guesses and efforts (because every human is a snowflake), and this is just how biology is: extremely complicated in general.
(
Something to note is that antibiotics and vaccines are insanely more important than heart valve replacements and boob jobs, in terms of making life for humans possible under modern conditions. For basically all of human history cities were net death traps, full of disease, where the excess people born in the country went to have sub-replacement numbers of kids and then die of smallpox or whatever. If we can’t make new communicable disease treatments fast enough… this is what cities will go back to.
However the REST of medicine is often nigh unto homeopathy itself?
Perinatal care, and gunshot trauma treatment, and setting bones, and insulin for type I diabetics work, but these are unusual.
A lot of stuff “treats” the thing you went in for… while causing a new problem. Making all cause mortality go down is HARD. This paper argues that ignoring all cause mortality is fine. I think it is fine if the goal is to give people quite a bit of make-believe-medicine that causes them to feel cared for and helps doctors pay off their med school debts.
Keep in mind: something like 80% of the dollars spent in medicine are spent in the last few months or weeks of life, and they are often miserable, and pointless, and not what anyone sane would want for themselves or their loved ones… but many people are not sane
)
The real experiments are the early patients. If the patients are smart and have a good doctor and the cost-benefit-analysis for THAT patient in THAT situation pencils out… then the risks are worth the benefits and you take the bet and get your outcome. Then the doctor learns something.
That’s how medicine gets better in real life. The more clinical experience that builds up, the better a judicious clinician can make this determination. To pretend otherwise is crazy.
There have been a LOT of people taking the vaccine. Empirically, it seems to help more than it hurts. For a very large “clinical N”.
Personally, I think that the thing that happened was: Moncef Slaoui (and Kushner?) did an end run around The Evil Ones?
Clinical practice reveals, over and over and over, that things approved by the FDA as “safe” actually weren’t “safe” and should maybe be recalled (or maybe they were safe if used properly and doctors weren’t using them properly, and so someone decided that rather than let people get hurt, and rather than purge the doctors of incompetence, they should purge the legal drugs of things that were being mis-used a lot)?
This is the fundamental lie of the FDA: they REALLY can’t do, during clinical trials, what they claim to do, and they get in the way of the people who MIGHT be able to do it for real eventually by just trying shit and repeating what works.
I’m not entirely against trying random shit on consenting old people who are going to die anyway.
SUPPOSE that things are hopeless… then why NOT try something that is likely to fail? It MIGHT work?
The right argument against such experimentation is more complicated and more about economics than medicine: how many bits of information about what parameters of various biological systems are you really buying when you try something new in medicine and is that worth it to whoever is footing the bill compared to their alternative uses for the same money.
However, the FDA also forbids this in general. Experiments should be as cheap as possible to get as many of them as possible. And it is NEVER cheap right now!
In order to try such an experiment you’d first file a New Drug Application (NDA) which is like $1M a pop.
So you can’t just notice that you have a weird disease, and are basically gonna die no matter in the near future for a predictable cause… and then “just try something that your doctor thinks MIGHT work based on first principles medical reasoning and wikipedia”. You you have to get permission from people in DC first.
Sometimes I wonder if they are INTENTIONALLY holding off medical innovation in general because like… abortion and transsexuality and cures for venereal diseases are already out of pandora’s box… what else is in there? Maybe immortality? Maybe EXPENSIVE immortality? So maybe they are outlawing “medical innovation in general” to the best of their ability? And they pretend that their destruction of medical innovation is actually in support of “safe and effective and scientific” medical innovation because… they think we’re dumb enough to believe their lies? (And maybe they are right?)
So, turning off some of the dumber laws momentarily enabled us to invent a new and effective vaccine.
And this isn’t surprising to me because science works. The thing in the US that’s broken is our political economy, not our actual physical sciences (yet).
In terms of safety, the argument for LONG TERM safety of this vaccine technology is not, and never could be, empirical. To verify the safety empirically you’d… have to wait a long time for results.
Instead the thing you do is… guess. Just like with masks. Based on reasoning about reality?
So far as I’m aware the key idea here is Kariko’s work with things like pseudouridine. That’s what made this new kind of mRNA vaccine work where the old mRNA vaccines had unacceptable side effects.
Honestly, it doesn’t seem totally impossible to me that having a lot of this in your body might do… something? (Keep in mind though: water is poison at the right dose.)
But it empirically hasn’t done much yet now that it has been rolled out to millions. Like with masks… you reason about reality directly to the best of your ability, and ask for peers to check your thinking?
One central comforting thing for me (if you click through to Kariko) is that the clever chemistry ALREADY EXISTS in our bodies. Human biology makes chemical adjustment to the backbone and microstructure of mRNA, then looks for these adjustments actively. Then viruses either have to also attempt this (which is very hard for many of them) or else the lack of these adjustments in certain cellular compartments can work as a trigger of certain kinds of “kill it all with fire” immune reactions.
So the current clever mRNA vaccines are giving “viral code” with “human-like chemical signatures” to dodge this reaction, and thereby sneak viral protein manufacturing instructions “deeper into our cell’s machinery with less trauma” for at round of protein manufacturing, in a way that gives us “pieces of virus” (for our immune system to learn to recognize), but no second generation of virus (to be an actual infection), while avoiding some innate immune side effects.
I personally think it would be foolish to say that it can’t possibly hurt in any way ever at all. The best medicine is the ancient stuff like aspirin (ie the active ingredient in willow bark tea which is 4000 year old medical tech with mentions in Sumerian and Egyptian texts). Time allows information to accumulate <3
I just think that the bet seemed to be worth it. I have two doses of Pfizer. I got them as fast as I legally could because the testing on the old people seemed like “enough” basically? Also both parents got the vaccine, and presumably they have the same genes as me more or less, so if they didn’t specifically have a reaction then I wouldn’t either most likely?
Empirically: pretty safe and decently effective (for N>millions) over months against the strains that are out there right now.
Theoretically: clever and probably pretty similar to what human bodies already have in them.
Surprisingly: generated “unusually fast” because heroes started ignoring a bunch of catastrophically stupid laws.
This essay of yours might be worth its own post :)
Your comment got me thinking about the probability of what I described once again:
Such miracles only happen in people’s imagination.
Previously, I noticed one simple explanation: the vaccine is not as safe / effective.
Now I realize there’s another: the mRNA vaccines are not that new, they simply never made it public before. Just something that dawned on me.
I’ll study the links and get back here. Thank you for your time and effort!
Early papers on mRNA therapeutics date back to the late 1980s/early 1990s, with a number of small scale tests and trials starting by the late 1990s. Making custom arbitrary mRNA has been affordable/feasible since at least the mid-2000s. BioNTech was founded in 2008, and Moderna was founded in 2011, which means the relevant tech at that point was already far enough along to warrant founding companies that were going to need a lot of funding to bring anything to market. But instead of making vaccines targeting infectious diseases, they both mostly targeted cancer immunotherapy. I assume that’s because those are the treatments they were able to get funding for, even though it’s a much harder problem technically.
I don’t know when the first year was they they could have designed a successful vaccine against a novel virus in a day and a half, but the odds of that happening just before covid hit are obviously very low, especially since more recent trials and studies are showing that we can also quickly develop (better) vaccines against the flu and malaria, and the success with covid was not an unlikely outcome.
I did not get this part (maybe there’s a missed word or something. Are you implying that they had all tech in place to successfully manufacture such vaccines quickly?
So, to sum up:
mRNA has been studied and used (?) for about 30 years now
Moderna and BioNTech have been around for a while, and their past research has built up their scientific base.
Out of 18 mRNA vaccines developed around the world only 3 made it to clinical trials, and two made it to production
9 “old-school” vaccines made it through the trials
This does sound somewhat realistic: old tech is better-known and had more successful attempts at.
Manufacture? No. Use? Only at lab scale, in animals or a few patients for small studies. Design? Yes, and the design process did not require any additional new tech nor the resources of a large pharmaceutical company.
Yes, old school vaccines have a lot more history behind them and large organizations were more familiar with them and so they were better equipped to get them through trials and scaled up for deployment. But the mRNA vaccines that did make it through seem to be more effective than those old school vaccines.
Of those 18, how many actually failed trials vs. other reasons for not having come to market (didn’t get funding, didn’t have the pre-existing expertise needed, didn’t move fast enough relative to competitors)? Also, four of those 18 were BioNTech, and counting that as a success and three failures seems like a mistake when it’s the same company trying multiple things initially and then proceeding with the best one.
How many old-school vaccine development efforts didn’t pan out, or only got approved because of extensive government support in their countries of origin?
My take is that we have had, for at least a handful of years, the ability to design a new mRNA vaccine against a novel virus in a matter of days, test it in a matter of months, and scale it up in less than a year. Instead, the companies founded to develop that kind of technology had to go in a different direction (targeting cancer), and without the pandemic they would have languished much longer without bringing any mRNA therapeutics to market at all. The pandemic cut through enough bureaucracy that they got a product out and built manufacturing capacity, and now that they have done that, they’re quickly able to repeat that success for other diseases.
I do not expect the pandemic to lead to a flurry of other new traditional vaccines, because those haven’t suddenly gotten easier or cheaper to develop, we just threw more resources at them for covid.
As far as I can tell, if we had had better regulatory and research policy, we could have lived in the world where Moderna or BioNTech had been working on infectious disease mRNA vaccines all along, and launched an improved flu vaccine back in 2016 or so, so that by early 2020 they already had some manufacturing capacity and supply chains in place that they could expand and replicate (with at least the medical community knowing this was a thing that had been used millions of times). I do not believe that that world ever had to have made any technological advances that ours didn’t make, yet they would have been able to mass produce our most effective covid vaccines much, much faster than we did. They would know that they knew how to fight a virus.
Edit to add: I worry that many people (1) think this is what a worst-case-scenario pandemic looks like, and (2) think that next time there’s a new disease, the solution will be to mask up and shut down indefinitely, instead of immediately designing an mRNA vaccine, conducting large trials as fast as possible, and pre-emptively manufacturing hundreds of millions of dose so they’re ready to go ASAP, with an expectation that all relevant regulatory agencies will work round the clock to remove all unnecessary roadblocks to approval.
Suggestion: Pre-register how you imagine a truly safe approval process for a vaccine would look like. Take notes on a piece of paper: How many clinical trials would you expect? How long should they take? If a vaccine successfully passes all trials, how much time should official institutions like the FDA take to review the evidence before they made a decision on whether to authorize use of the vaccine?
Finally, does the process you’ve imagined account for the opportunity cost of delay during an emergency?
Only afterwards, look up how the vaccines were actually approved. For instance, this study (section “Results”) provides an overview of how various vaccines were authorized in the USA, EU, and Canada.
Then compare the actual approval process with what you imagined it should look like. How do they compare?
This suggestion makes it sound like the prior for all vaccinations is the same. The sensible thing to do when faced with a pandemic is to run clinical trials for vaccines with the least risk possible. That means using tried and proven adjuvants. Then you test whether protein domains or whole proteins are more toxic in some animal model and use the thing that’s less toxic.
There’s no good reason to use a new and risky process like the mRNA process. It’s risky because the body starts attacking the cells that produce the antigen and this might be valuable cells all over the body including the brain as polyethylene glycol goes through the blood brain barrier. Adjuvant + Antigen doesn’t let cells produce the antigen so the body won’t kill it’s own cells.
Could it be that so little neurons are killed that it’s safe? Yes, but there’s no reason to take that risk with a speed up approval process.
Without knowing what goes into the evidence review it’s very hard to have an informed opinion on this. If I’m a reviewer at the FDA and see that the vaccine does get measured in the brain up to 25 hours after administration and likely kills a few neurons while none of the measured endpoints in the trial give me a good idea of whether there are effects on cognition, I don’t think the decision whether or not to approve is trivial. It might be that this is a decision that should have done way earlier in the trial process, but it’s very hard from the outside to understand how these things work.
The amount of clinical trials isn’t the prime critieria. What matters is whether the clinical trials look at the relevant outcome metrics for risks.
All the possible long-COVID outcomes you would have guessed based on SARS I long term effects should be measured in the clinical trials for vaccines. Heart health metrics like HRV and lowest night time heart rate should have been measured as an outcome. A mental metric like IQ or maybe something easier to measure should have been an outcome for a drug that crosses the blood-brain barrier.
One reason follow up incidence for CFS, depression should be included in the trials even if that’s not looked at for the first approval.
How do you know what you think you know? Specifically, regarding the PEG enabling the LNP’s to cross the BBB, and regarding a followup by immune cells that have crossed the BBB?
There are to lines here. PEG gets used to get other medication past the blood brain barrier in pharmaceutical applications where you want to get things past the blood brain barrier. Secondly, for getting the drug approval companies had to measure where in the body the vaccine goes. If you look at the EMA report for the Moderna vaccine it suggests that the vaccine goes into all parts of the body with the expection of the kidneys and that includes with the brain where it can be measured up to 25 hours after the vaccine gets injected.
https://pubmed.ncbi.nlm.nih.gov/17068976/ does suggest that immune cells can cross into the CNS and are active there. I don’t think it’s studied to what extend they do this here.
I sympathize with your warnings, but am unresolved on the forums and means to address them.
The mRNA vaccines are probably riskier than we’re let on to believe, but I see a lot of alternating between normative and descriptive.
We have the set of vaccines we have now, and we have Covid circulating. It would be great if we lived in a universe were Covid was less bad or vaccines were mor good…
I just don’t see a lot of “here’s what we should do right now to make the world a better place” that doesn’t involve using the tools the average person has at their disposal.
As Ben points out, people like Zvi are far from advocating using the tools that the average person has it their disposal and only advocate using a subset of them.
The FLCCC protocol is now at 7 tools that are recommended to be used every day. That list doesn’t even include Taffix and at home air filters.
I do think LessWrong is the forum to speak about what’s true and not only to speak about what’s practical.
I would want my third vaccine dose to be Novavaxx and hopefully not with the spike protein from a year ago but Delta or the varient that’s current at the time.
I’d also like RaDVaC to be funded better.
I think we’re all on board with D3. In terms of the risk-benefit analysis. If this is what you’re talking about.
https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Alliance-I-MASKplus-Protocol-ENGLISH.pdf
I would say that for most other things on the list.
If people can get Ivermectin legitimately and aren’t taking horse pills or ordering it off the dark web, I don’t see an issue there.
*with the standard caveats that particular people may have contraindications, etc.
But all of those have to been taken daily, paid for out of pocket, and none of them are vaccines.
So how reasonable is this as a public health policy?
You don’t need to take prophylatic Ivermectin daily. With Vitamin D I would recommend taking it daily but in theory you can also take it at less frequent intervals.
I’m not sure whether there’s much of a quality difference between dark web sources and generic out of the pharmacy.
It’s a question of how serious you think COVID-19 happens to be and therefore how serious you want to be to do something about it. If you think COVID-19 isn’t serious enough to do something daily about it, that’s a valid position but you should be clear about that being your position.
As a public health policy you can give Ivermectin to people for free. Given that it’s cheap enough for the Indians to do that, it should be easier in richer Western countries.
If I were in charge of public health policy I would also say that vaccines can be brought to market by showing that they result in antibody creation in humans and disease prevention in animal studies.
There’s also no need for public health policy to be a one-size-fits-all solution.
They only way I believe anyone should feel safe recommending it would be if they are sure it’s pharmaceutical grade and quality. Otherwise… it could possibly do more harm than good, or do nothing at all.
I don’t see how this is relevant. You could believe Covid is a very big deal and not have the money or means to spend ~50 dollars a month on supplements.
This the question is, even if you did, would this protocol be good enough to prevent catching Covid and transmitting it to someone that’s immunocompromised, for example.
I can? I’m not the FDA, Fauci or WHO. How can I make sure 7 billion people have enough Ivermectin to take several days a week for a year or more and ensure compliance?
I know you didn’t literally mean me, but this is a much harder problem than people make it out to be to coordinate giving the whole world until the pandemic ends, and that’s assuming Ivermectin would be effective here.
In general, I agree. Just think were overstating the case for how easy giving everyone seven different supplement regularly and ensuring that they do it… so say nothing about how effective they are compared to vaccines.
None of us are and none of us will be anytime soon, there’s a lot of discussion like this is plausible.
And there’s no real plan. How would be administer 100 of billions of doses of Ivermectin and ensure people are taking them for months or year?
The same is true with a generic that you buy at a pharmacy. It can possibly do more harm than good or do nothing at all. Ranbaxy sold generics for which that’s true and even after the FDA was told about that by a whistleblower it took them years to do something about it.
You can ask the same thing with the vaccines. Vaccines do have the disadvantage that it’s easier for viruses to mutate to escape them. High vaccination rates in the UK and Israel didn’t prevent a rising case count but Ivermectin use (alone) coincides with it in India.
Price of supplements is a different issue then whether you have to take the supplement daily.
You don’t have the power but you also don’t have the power to set public health policy in other regards.
Public health policy is not about ensuring that people do things outside of totalitarian states. It’s about providing people with options and informing them about the value of various actions.
Absent a studies comparing the quality of drugs from the dark web vs. the quality of drugs pharmacies, my prior is to assume that drugs from pharmacies are typically safer. Although I agree, yes, it’s not perfect. I have recourse if I discover they’re contaminated or don’t contain the medication advertised. Best I could do on the dark web is leave a mean review and hope the dealer doesn’t find a way to retaliate.
I’ve heard this repeated often, but I haven’t seen evidence of it. How much as measles changed since we began vaccinating people for it? How about polio? How about smallpox? The evidence that I’m aware of also seems to be against this.
Price is a factor in compliance. If you can’t afford supplements, you will be less likely to comply.
This is ultimately why I think this is an unproductive and to some degree dangerously misleading discussion (not just you and me, but also the vaccination vs early treatment and treatment protocols).
I don’t take any joy citing the linked author, but I do feel like we’re on a ship and we’re heading towards and iceberg and everyone is like “what about zinc? what about ivermectin?” And, yes, those are all things that deserve more attention and I’m against censoring discussion of them.
Ivermectin may yet prove to be a miracle drug, and I think the evidence there is promising. I don’t see the downsides to people taking zinc or vitamin d3 at reasonable and effective doses. I don’t see any of it as having the potential to turn the ship around.
But right now as of August 16th at ~5:45pm mountain time what we have to turn the ship around that we know works are vaccines. Yes, the side-effects are probably worse than claimed. And, yes, the public health apparatus in the US sucks for a million reasons, one of which is that they talk to us like children when it comes to vaccine safety. But all the evidence I’ve seen is that this is better than the alternative.
Since I haven’t seen other proven solutions for quickly and reliably turning the ship around, comparatively everything else seems like a distraction.
If you had infinite time and resources, you’d ideally test for all conceivable outcome variables when designing clinical trials for anything. Of course there’s always a chance that something was missed in the trials, but it certainly matters what that chance is. Do we have reason to believe it to be non-negligible, now that more than enough people have been vaccinated for even the tiniest of risks to manifest themselves?
In any case, if someone is specifically worried about the novel mRNA vaccines, they can take one of the classically produced vaccines instead.
… What about the higher efficacy of the mRNA vaccines?
(I also tried to look up a timeline of manufacturing volume by vaccine type, but unfortunately couldn’t find anything useful. I had had the impression that the mRNA vaccines had been quicker to manufacture.)
An omniscient being could make a full cost-benefit analysis on this kind of stuff, but we have to reason under uncertainty, and things certainly don’t look so clear-cut to me.
How would we notice if the lowest night heart rate goes up for everybody who takes the vaccine by one point?
How would you notice if the IQ of everyone who takes the vaccine goes down by one point?
How would we notice if 0.5% gets a depression half a year after receiving the vaccine? (Brain trauma doesn’t produce depression immediately but has lag time)
If someone gets a depression half a year after receiving the vaccine, why would they think that they should tell VEARS about it?
We know that the mRNA vaccines produce some brain damage, because we find the vaccine in the brain and the it gets cells to produce the antigen and then the immune system kills those cells. What we don’t know is how much damage that it. If the damage would be enough to reduce IQ by an average of 10 points we likely would notice. I don’t think we would have noticed if it’s 1 point.
Myocarditis that’s strong enough to produce clinical effects seem to happen enough that it’s flagged as a risk to investigate. Most cases of myocarditis caused by the vaccine are likely not strong enough to be clinically noticeable. If someone has myocarditis that raises their lowest nightly heartrate by one, they are not going to put anything into VAERS. As a patient non-clinical side-effects matter.
Look at a discourse of side-effects of something like microplastic. Such a discourse takes decades to come to good conclusions about what the side-effects are.
I don’t think there’s evidence that shows mRNA vaccines outperforming Novavaxx currently. Even if two doses of Novavaxx would give less immunity there’s less risk in simply giving more shots.
Novavaxx uses a patented adjuvant instead of a well tested one, but it’s the choice that’s available for classically produced vaccines.
I think you can make a good argument that in the shitty situation we are in it still makes sense to get vaccinated but pretending that we have strong evidence of lack of side-effect stretches it because we have not studied relevant outcomes to an extend where we would see the effects.
Epistemically, this kind of argument reminds me of god-of-the-gaps or shrinking parameter spaces in string theory. That doesn’t make the argument wrong, but it means that I don’t really see a fruitful way to engage with it.
I suppose that if one’s prior is that this kind of risk is negligible, the argument will sound unconvincing, whereas if it sounds plausible a priori, then lack of such studies seems concerning? Let’s leave it at that. Though I could be convinced otherwise if I learned that this concern was taken seriously by a significant fraction of doctors or other public health professionals.
If you learn anything about a rationalist is that knowing things is hard. If you look at the replication crisis we see that it’s hard to know things even when there are studies that intend to measure an outcome.
Claiming strong evidence for something should require evidence and not just lack of concern.
Why is the prior that a drug that causes brain damage should have a negliglible risk of causing brain damage that’s relevant reasonable?
How is it a god-of-the-gaps argument to ask for checks to see whether the brain damage is large enough to cause problems? If you haven’t check claiming you have strong evidence that there are no side-effects seems to me very unfounded.
I had a doctor tell me that removing a rib of me is no problem because there’s no evidence that it produces any problems. While that evidence isn’t in the clean form that doctors like, I do feel like it makes the some things in my body more complicated.
I don’t have the expertise or training to evaluate detailed medical claims myself. I wasn’t even able to find sources for the blood-brain-barrier thing (neither claims nor rebuttals), except for this thread on askreddit which I was too exhausted to peruse. In any case, at this point the discussion is not about medicine but about epistemology.
I have not yet been convinced that the vaccine causes brain damage. I think that at the very least, that argument requires sources for both a link between mRNA vaccines and an inflamed brain, and for the claim that this is an exceptional occurence / that this is something worse than what happens in e.g. an average fever.
I guess my prior is that bodies are pretty robust, and that most contrarian claims are wrong. Identifying correct contrarians is hard.
My god-of-the-gaps comment was directed at what I perceived as a complex hypothesis which looked like it was (over?)fitted to the available evidence. In such a situation, one can’t falsify the hypothesis without new evidence, even though one figures there should be plenty evidence regarding most conceivable side effects by now.
I do agree about the issues with doctors, though. I have had several suboptimal encounters with the medical system, which have left me rather unimpressed with medical care (diagnosis in particular). I have an essay draft on this topic, but it’s going to be a long while until I get to it.
The EMA is the EU equivalent of the FDA. When they approved the drug the wrote a report indicating all the risk related information about the COVID-19 Vaccine from Moderna.
In it they say:
The fact that your sources don’t tell you about this tells you how much they are interested in having a serious discussion about side-effects.
Generally, there are a lot of possible side-effects a drug could potentially have.
There are many situations where people claim to know more then they actually know for political reasons. A claim like “I know that the mRNA that’s found in the brain produces significant problems” is one that needs a lot more evidence then one that says “It possible that this happens but we don’t know”.
You have presented evidence that the mRNA vaccines “cause brain damage” to, let’s say, the same extent as drinking a glass of wine “causes brain damage”. That is, you can trace a sequence of events likely to kill at least one brain cell.
You haven’t shown any evidence that mRNA vaccines do anywhere near enough damage with anywhere near enough probability to be cause for concern.
The fact that the EMA report says what it does but doesn’t say anything at all like “the risk of brain damage is a downside to using these vaccines” seems to me to indicate that the people who wrote that report don’t think that what they found about small numbers of lipid nanoparticles crossing the blood/brain barrier is cause for concern. This means that either they don’t think brain damage would be a problem (which seems … unlikely), or else they don’t think the danger is substantial enough to be worth worrying about.
The comments from user yesitsnicholas in the Reddit thread linked above by MondSemmel seem to be (1) written by someone who actually knows something about this stuff, and (2) very confident that there’s no danger to speak of.
Now, whether or not yesitsnicholas is an expert, I am not, and maybe I’m failing to recognize the dangers here. I’m willing to be persuaded. Do you have any evidence that goes beyond “look, at least one lipid nanoparticle will get into the brain and that may lead to the death of at least one brain cell”?
I am not disagreeing with the narrower point that what we know at present about the safety of COVID-19 vaccines—or, in fact, pretty much any drugs—or in fact, pretty much anything at all—is not enough to be very confident that there aren’t very small adverse effects. Or indeed very small beneficial effects; we wouldn’t have noticed if getting the Pfizer vaccine raises your IQ by one point, either. Identifying very small effects is difficult.
But you go further and say e.g. that there was no point in trying novel approaches (with, therefore, more scope for wholly unsuspected adverse consequences) like mRNA vaccines. But available evidence suggests that the mRNA vaccines happen to be the most effective against COVID-19. A policy for which we can see with hindsight that it would have stopped us finding the most effective vaccines is, it seems to me, not obviously correct. “But for all we know Novavax’s vaccine is just as good as the mRNA ones”, I hear you say. Maybe it is. But it’s still in trials and the Pfizer and Moderna vaccines have been widely available and widely used for months.
We can calculate the upper bound of risk from the document you provided. Moderna says 2% of plasma level of LNP ends up in the brain. There are 10 billion LNP in each shot of Moderna vaccine and at most 10% goes into general circulation unless nurse made a mistake and put it in your vein. So, 2% of one billion is 20 million LNP, that is the maximum that will end up in a person’s brain following a vaccine shot. So, maximum 20 million brain cells are at stake after each shot. Not all of them will be neurons.
Thank you for detailed comments!
I have similar thoughts about the approval process, though much less coherent.
From a citizen (non-medical education) level of knowledge, I wonder how we should go about reaching a decision regarding getting a jab.
Though I am obliged to say, where I and my SO currently live (Lithuania and Russia) it will soon become not a “whether”, but “which” in a month due to regulations.
I think that COVID-19 is bad enough, that even with the risks as described I still got a shot of the BionTech vaccine three weeks ago.
If there’s a real free choice I think the answer is currently Novavaxx as it’s the classic adjuvant + antigen combination. Evidence suggests that it has less average side-effects and it doesn’t get your body to kill it’s own cells. Not getting your body to kill it’s own cells means that certain immune responses are not triggered but the trials we have shows Novavaxx to have comparable effectiveness to the other vaccines.
Interesting information, thanks. However, the choice is as follows (numbers indicate available units):
1. Moderna (4990)
2. Comirnaty (Pfizer) (25111)
3. Vaxzevria (AstraZeneca) (6073)
4. Janssen (3611)
The viral vector technology has previously been used for Ebola, right? What do we know about that?
UPD: apparently, we might get Novavax sometime soon. I might want to wait for that.