I mean this was the statement i originally had a quibble with


Feels like it is reasonable to say this is an overstatement given we haven’t even deployed it yet

So can you define works for me now?

I ask because Filthy's definition of works won't be attained in this country, not anytime soon. It feels like you're setting up some goalposts that will not be met with no fault to the vaccine or the mRNA work.

Seems like it's virtually impossible for this to be in the top 1000 in a "value over replacement science" kind of way. A vaccine was achieved in the timeframe that was stated and it looks like there are multiple viable vaccines which seems like evidence against a vaccine being that exceptional of an achievement.

If its just something exceptional because modern science is good then whatever. Yeah every (time frame) will have greater achievements.

I was thinking about what things count as science. People would say this counts (I would too) but it doesn't fit at least some definitions of science. And people would probably say implementing a successful track and trace program (possibly including adjustments for human behavior) ISNT science, but based on this year it's functionally harder to do (at least in western countries).

A most valuable scientific achievement draft could be interesting.

I don't know. I guess its hard to say. The flu vaccine seems to range anywhere from like 25-60% effective on a year when they guess the strain right, and I think the estimates are that it saves a few thousand people a year in the US. If that is the kind of success we can expect from this I wouldn't rate it up there with any kind of all time advancement. And I think most people would say the flu vaccine "works" (even though I would not).

And that is to say nothing of possible long term side effects which we know nothing about--I find that a bit worrisome for something that seems to be a completely brand new technology.

I'd agree flu efficacy would not be "working" in regards to this. Good news is the efficacy we've seen is not even in the same ballpark. I'd wager every dollar I could borrow that its orders of magnitudes more effective than the flu vaccine (for now, there are certainly concerns about length of immunity and it seems likely this may become an annual thing, but those questions will be answered later). The cumulative incidence curves are incredible between placebo and intervention, better than we've ever seen with the flu (to my knowledge, could be missing a year or something). Of those in the intervention group nearly all the cases were within 7 days of administration. A tiny % increase happened after the first week (while placebo group increased every step of the way). Furthermore, this was only the first of two doses! Immunity increased with the second.

As far as the long term effects, sure, I addressed that, but I understand if thats not compelling to you. There are always risks involved whenever any medical intervention is administered. That being said, if someone doesn't get it they should definitely do absolutely everything in their power to not get COVID because every argument for side effects of this work for COVID as well.

I really think it's underrated just how insane it was to get this to market doing what it does in the timeframe it does. This is part of why I asked how you define works, because we may not even recognize the benefits when half the country doesn't get it, we don't still quarantine sick, etc. Just making this happen in this manner is historical despite the fact we probably don't deal with it right and don't recognize the benefits people hope, some magical wand that makes everything like it was a year ago.

Thanks for the discourse, enjoy chatting with you.

Yeah you may be more researched on just how good this vaccine is expected to be, chim.

Some of the concerns I heard were that similar to the flu, covid would mutate and we would wind up with many many strains (already moving in that direction perhaps?) such that repeated vaccinations would be required--far more often than annually--to have any hope of protection

To go further into the discussion I feel would get messy because the current state of discussions on vaccines allows basically zero nuance. Either you think every vaccine is the best thing in the world and the more vaccines the better and keep them coming or you are a batshit anti-vaxxer who thinks vaccines cause autism and are part of a mind control experiment and you shouldn't get any.

I am much closer to the former than the later--vaccines are one of the miracles of (relatively) modern science and there is a good argument that vaccines (if we take them as a whole) have saved more lives than just about any advancement in human history. I am vaccinated, I plan to have my kids vaccinated, and I believe everyone should do the same. And I believe continued research is warranted and should be funded. I think Cuba has one of the most respectable and successful medical systems in the world, and I mostly agree with their approach to somewhat mandatory vaccine schedule.

However, I do believe that like with many things in capitalism, pharma companies have gone a bit off the deep end in the vaccination campaign. I think to some extent people treat vaccines as if they have absolutely no possible downside and I don't fully agree. Vaccines also need to have probably the most rigorous exploration of drawbacks given they are something being given to (usually) healthy people. An example I often use is insulin--the amount of money that has gone into continually developing more and more "advanced" forms of insulin since I got diabetes over 20 years ago to me is crazy. Sure there have been a few upgrades that I liked, but it is to the point where companies are just making new "versions" of insulin to make money and protect patents. They can keep doing "developments" forever just to keep charging more and more money etc.

I think vaccines go in that direction. This probably requires a larger discussion and perhaps my expectations for nuance are too high.

But to your other point about long term side effects from covid. I would love to see some more time and money invested into treatment options for things like covid. We are always going to have respiratory ailments that need treating. And the idea of just taking 10s of vaccines each year to combat more and more random viruses that crop up just isn't a sustainable model and that is sort of where we are headed. We need to approach things more holistically. Find ways to make people healthier so their own body can recover when they get sick.

I mean certainly there is something to the fact that some people get covid and don't even ever know it and others are hospitalized for a week. And I'm not just talking about an obviously old at risk person. You have one health 25 year old who doesn't even notice they have it and another who is running a fever and coughing for 10 days and loses their sense of taste and smell for 3 months. Something is going on there. And I'm not ready to say it just comes down to dumb luck. Of course the approach I am suggesting you can't monetize and patent, so there are not billions of dollars being thrown at it.

Anyways kind of rambling.

Bird,

I don’t disagree with much you posted. Hell, I live in the Nutrition world and teach non medical interventions. It’s not like I’m some friend of pharma. My research is more public health focused, but preventative and better approaches to holistic health is my world.

We are going to have more zoonotic disease spread. Overpopulation and relationship with animals make it inevitable. We need to seriously shift our approach and research aims.

That doesn’t take away from the efficacy of this vaccine, though, and the incredible processes to make it happen. The data is available. There’s no question it works for what the intention was. It’s one of the most effective trials ever, the data is amazing.

What you’ve read about mutation is a real concern and we don’t know what the future holds there. If the mutation proves this vaccine ineffective long term, that means being infected by COVID doesn’t protect you anyways and we are in for a world of trouble. If we don’t get the 8 months or whatever or protection at least it’s going to be a bad future for sure.

Anyways, I mostly agree with your overall concerns. We need better ways to address things and more zoonotic diseases are coming. Medical interventions can’t always be the answer. We need to be more proactive in both understanding and prevention. What they did with this vaccine and the level of efficacy is still absolutely historical though.

And what we do with insulin in this country should have people in prison.

I should note I was referring to Pfizer.

Astrazeneca I feel much less comfortable with the safety and the efficacy because their methods don't give a ton of confidence. They also made errors in dosing and manufacturing.
Pfizer had much more power in their study as they have a larger sample size AND better efficacy.

I think people will trust Astrazeneca more, because its more traditional and not the mRNA method. It appears to be less effective, though. It also might create a weird scenario because those who are actually against vaccines typically cite adjuvants as a risk factor for the vaccine, and the mRNA vaccine doesn't use those same processes.

Going to be interesting to watch and see what happens with it all.

Good posts chim—i think we are mostly on the same page.

But does it concern you that pharma companies are conducting their own studies while at the same time demanding indemnification from the government as a condition of producing this vaccine?

Our entire medical system concerns me. The fact that if an individual comes to me with an A1C of 6.2 and I have to say "Sorry you're only prediabetic, I can't bill for my services, our system requires me to tell you to come back when you're actually diabetic" is absurd. We could deal with Type2 Diabetes so much more effectively if we could intervene when someone becomes prediabetic. Not who we are, though. We hate preventative and are only allowed to provide services when someone reaches a diagnostic level where it is hard to help. It's awful.

More directly - sure, our reward system creates motivation for people to act unethically. Our government makes this whole issue worse, not better. I can't speak for all companies and all vaccines, but I know some of the people who have worked on some of them. While a company is looking out entirely for their financial benefit the scientists involved are truly dedicated to addressing this problem. Despite the systemic problems, I am confident that the data we've seen are accurate. With the Pfizer vaccine I'm confident the methods were sound and are producing reliable data. I noted the Astrazeneca exception because I'm not as compelled by their methodology and some of the errors they've had.

Your concern is definitely part of the risk evaluation calculation, though.

If you care at all I can try to speak more to Moderna when we have something beyond a press release. They've yet to release the actual data, and my fawning over Pfizer was data driven, not company press release. Moderna is claiming more efficacy, but we still don't have the data.

Sorry for Being rude to Iamnotawerewolf. I get mad over little things but don’t stay that way. Thanks for talking to me IANAW.

I guess my question would be "why demand indemnification if the data is sounds?"

In general, I think the data is fine...it is the conclusions being drawn from the data that I think go too far. It is how short the tests have been. We have data that shows that the vaccine will not causes serious adverse affects in the short term in a statistically significant portion of the population. But that is all that data shows, correct?

I think the pharma companies want indemnification because they know the conclusions you can draw from the studies they have done are limited.

I don't know why or how that all played out, not going to try to guess what happened. I'm happy to read any sources that try to explain what may have happened. My best guess is they told the governments they wanted another year or so to fully test it, and governments asked them what likely outcomes were and explained the science, and then governments said don't worry about liability, we've made the decision that the benefit outweighs potential costs. I 100% understand you may feel uncomfortable with that because lol companies and lol government. My personal analysis (some of which is to follow) will have my family getting vaccinated the day we qualify.

To the other points -

The data shows:

-very high efficacy, I do not believe this is debatable. The sample, statistical power, and methodology was very sound.
-You're correct in saying we know about short term reactions, but also mechanistic possibilities at a cellular level. We definitely know it doesn't impact DNA (the first MAJOR concern), since it doesn't enter the nucleus. It promotes a protein to be created by signaling activity in the ribosome. This is what creates the immune response.

As far as I know they aren't claiming anything else, so I'm not sure "the conclusions being drawn from the data... go too far" unless you mean media and others response to it. If Pfizer is claiming long term 100% safety, they are out of line and I fully agree with you.

At a cellular level here is the long term concern from what I understand (and I readily admit I have a middling understanding here, we're getting a little outside my scope) - the mRNA doesn't enter the cell correctly, becomes destroyed, and maybe something happens. mRNA is not as stable as DNA so can be destroyed fairly easily. The odds this actually has downsides to recipient are very small, as more than likely it will just be destroyed and amino acids recycled. The "something happens" is the question for long term, but it's really hard to find a plausible mechanism that something actually happens. This method, from a mechanistic standpoint (which I admit are not always congruent with human outcomes) seems *far* safer to me than any other vaccine method we've used.

A much larger concern to me is that it doesn't enter the cell right, the protein is not created, and immunity doesn't happen. Someone goes around with no knowledge they aren't vaccinated, and get sick. This was my major pause with this method, but the efficacy data is very strong.

I agree with your overall concerns, as noted. How many years after vaccine would you consider that we could call it safe? With such limited downsides (much more limited downside than traditional vaccines due to ingredient combinations), I'm worried we wait for "the long run" until its way too late.

I've enjoyed this chat, it's nice to talk to someone with skepticism that isn't all "5g is going to brain control you Bill gates for dictator". Thanks for the reasonable and nuanced discussion.

India opted not to authorize AstraZeneca yet waiting for more data. I do feel much less comfortable with that vaccine (as noted).

Anyways, Bird, your long term concerns are fair. There’s always risk with intervention and this is a novel method. It’s up to each person to evaluate their risk profile - though when we don’t achieve herd immunity due to insufficient vaccinations (I’m not placing blame, people are free to evaluate their own risk) it’s not a deficiency of the vaccine. It’s just a tool like the rest of them.

today was the first day the official death count from covid in the usa was higher than the death count from 9/11

3242 died from covid today in usa

Communism?

Text is a beast. We're good, homey.

If it's safe for 90% of the people who take it, 10% are going to be angry.

Government (public) indemnification, assuming it's that and not total liability shielding like we did in Georgia for Return To Work, is a sensible risk pooling policy.

Pwns get that demarcation **** out of here

I think our governments are making a large mistake not prioritizing health care workers families in an earlier wave of vaccine options.

We don't actually know yet if any of this prevents a silent spread, where the individual is protected, but could still infect others. This becomes a little less important when vaccinations are widely adopted (though as I've noted who knows if they will be) - but right now this is *vitally* important.

I would think the families of front line health care workers should be prioritized over other health care workers who can work remotely.

Another question I have is with "teachers" in phase 2 of most state rollouts. Do University faculty count? I'd like them to for selfish reasons, but I also think that is a mistake. I can work remotely for much longer than others.

wait, chim are you saying that people who are vaccinated might be protected from getting sick from covid, but they might still get infected, have no symptoms, and spread it to other people?

It's possible, the trials were not powered (or even designed) to test that. I think it's unlikely, but we don't know yet.

When in doubt of something like that, we should be more precautious about front line health care worker families imo.

Just another reason vaccine isn't magic and we still have a lot of public health best practices we need to follow for some time.