[shajznnckfke]

Is this the worst-case scenario? It doesn’t sound nearly as bad as covid-19.

My concern is that there’s an agency whose job is to minimize the risk of harm from a covid-19 vaccine, but not an agency whose job is to balance the risk of harm from a vaccine with the ongoing harm from not having a vaccine.

[timr]

"Is this the worst-case scenario? It doesn’t sound nearly as bad as covid-19."

This is a case where the media hysteria surrounding the risks of Covid isn't helping anyone. If polling is to be believed, the general public significantly overestimates their personal risk of mortality from the virus:

https://us.beyondbullsandbears.com/2020/07/28/on-my-mind-the...

As noted by the link above, the vast majority of that risk is concentrated in the oldest/sickest people. If everyone in the population is given a vaccine with even a fraction of a percent mortality, it could vastly exceed the risk posed by the virus to younger people.

It would be tragic, for example, to see any serious side-effects from a vaccine in people under the age of 20, who have essentially no risk from infection.

[CydeWeys]

> It would be tragic, for example, to see any serious side-effects from a vaccine in people under the age of 20, who have essentially no risk from infection.

They have little risk of death if they have no comorbidities, but even for a 20 year old, just getting COVID-19 is likely gonna be worse than the side effects from almost any vaccine imaginable. I've had vaccine side effects and I've had COVID and I'd take ten more vaccine side effects over one COVID, please.

There's also the fact that vaccines are never 100% effective and that herd immunity is important, so the 20 year old still needs the vaccine to protect the older people they may run across. So even if the 20 year old is personally somehow guaranteed an asymptomatic, no-damage infection from COVID, they still need the vaccine. Vaccines don't just protect you, they protect everyone else, and a large part of their efficacy in reducing total population mortality is through these herd immunity effects, not just from protecting the individual people who've been vaccinated.

[timr]

"I've had vaccine side effects and I've had COVID and I'd take ten more vaccine side effects over one COVID, please."

I don't know what side-effects you've had from vaccines, but when I talk about risks, I'm not talking about headaches...people actually died from from the 1976 H1N1 vaccine.

[CydeWeys]

... yeah, and way more people are dying from COVID than have ever died from all vaccines put together.

[umanwizard]

> just getting COVID-19 is likely gonna be worse than the side effects from almost any vaccine imaginable

Do you have any non-anecdotal articles that quantify this?

[CydeWeys]

Do you just want to do more research, or are you contending that you think the harm from COVID-19 is actually less than the harm from the most severe side effects of a vaccine we've ever seen?

[timr]

In what age group? The 1976 vaccine actually killed people and gave Guillain Barré to many more, so that's your worst-case outcome. So far, under 20 years of age, the fatality rate for Covid is measured in low-single-digit thousandths of a percent (i.e. under a thousand in the US).

https://www.medrxiv.org/content/10.1101/2020.08.24.20180851v...

[CydeWeys]

Yeah, the worst vaccine mortality rate ever was still not remotely as bad as that, and you're not considering that a vaccine given to a 20 year old is helping to protect all the other people said 20 year old comes into contact with, who will have substantially higher mortality rates from COVID.

[nfw2]

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

Even with experimental concerns like the small sample size, 55% incidence of long-term neurological effects is pretty alarming

[shajznnckfke]

Maybe we should first distribute the vaccine to the elderly, then? It sounds like the trade-off benefits and risk would be different there.

[_ph_]

Not necessarily. Yes, the risk from Covid-19 is larger. But you do not know how well the vaccine works for elderly people. If the protection of the vaccine is relatively low, just vacinating elderly people does not make a huge difference in the outcome, if the general population has a lot of infected people. Vaccination is only partly about protecting the individual and a lot about preventing the spread of disease.

Take Rubella. If you are not pregnat, which means every male, you are at no risk by the disease. But Rubella gets vaccinated against these days as a standard vaccination, as the best way to preent pregnant women to get infected is, to prevent the spread in the population. And it is really nastily infective. When I was in the last year of high school, we had a breakout and to my knowledge, every single pupil in that year got infected.

[timr]

Maybe. You still have to be careful, though: your prior assumption is that older/sicker people are more likely to have side-effects from anything. It's also hard to find big enough groups of old/sick people to do sensitive statistical experiments.

Vaccine development is hard.

[b112]

On top of that, there are cases of many vaccines which are much less effective in the elderly.

While secondary causes are likely causing much of the higher mortality in the elderly, sometimes the immune system is just... not as strong. And yes, that does mean something other than COVID-19 could come along an 'get that person', but... here's my point:

https://www.cda-adc.ca/jcda/vol-66/issue-10/551.html

Hepatitis B surface antigen (HBsAg) induces neutralizing antibodies (anti-HBs) that protect against HBV infection. ... Response to vaccine following a 3-dose series is typically greater than 95% in young, healthy people, although it decreases with age (< 90% response at age 40 and only 75% response at age 60). Other factors such as smoking, obesity and chronic disease decrease vaccine efficacy and may be used to predict risk of nonresponse.6 Adverse events are minimal, although mild injection-site reactions may occur in 20% of recipients.

Quite a few vaccines are like this. Less effective on the elderly. So we could end up with an even larger horror show, with some COVID-19 vaccines.

Such as, it has some bad side effects, AND, doesn't really help the most-at-risk group as much as desired!

What really bugs me is, there are what? Greater than 70 vaccines in development?

Some governments have pre-picked supposed winners. On top of all the other political bull going on, are they going to stick with those winners, regardless of outcome? Or have preferentiality to those specific vaccines?

Because I can imagine some being highly effective and safe, and others being the reverse.

[refurb]

Absolutely. Prioritize those at highest risk of Covid complications (elderly, comorbidities) or those at high risk of exposure (front line healthcare workers).

It will be interesting once vaccines become available. Vaccinating several billion people will have a lot of operational challenges and will likely take upwards of a year to complete.

[SpicyLemonZest]

It's not the worst case, just the worst one that's happened in a vaccine deployed at scale. The dengue vaccine is a famous example of why careful research and approval processes are required; it's effective and not too inherently dangerous, but was found to actually make the disease worse for people who haven't been infected in the past.