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Getting a Covid jab is safer than taking aspirin (pursuit.unimelb.edu.au)
26 points by shankarro 1812 days ago
5 comments

I don't understand how ostensibly smart people keep making the same error, time and time again.

First, they see the other tribe's worst members making false claims, engaging in fearmongering, or worse.

Then they consider the direct opposite position. In this case, it's "vaccines are dangerous" vs "vaccines are completely safe."

Then, they cherry pick analytical frames which validate the latter position.

And of course, along the way, box themselves into claims they can't possibly make.

And when reality sets in that the truth is actually less clean than either side presents, it further erodes trust in the side of the discussion that is considered the establishment or consensus.

Rinse repeat.

In this case, here's where the merit of the "other team's" view can be drawn from:

- These vaccines have not been deployed long enough, in comparison to other drugs, to make strong claims regarding their long term effects.

- These vaccines have been deployed in a system of unprecedented scope and scale, so this will act as a magnifier on any such long term effects.

- There are valid theoretical mechanisms being discussed for such side effects to emerge in the long term, and clear disincentives to collect data on them in the short term.

- They are in response to a disease which has evidence to support the idea there is a very broad spectrum of potential impacts depending on a person's individual age/BMI/etc.

Therefore, it is unfair to suggest that an individual who sees themselves as low risk to COVID, and potentially exposing themselves to a yet-to-be-fully-understood drug, does not have a valid dilemma in the choice around vaccines. It is a genuine dilemma that we should do our best to help provide the best information around.

For many, the choice is more obvious. For some, less so. But claiming the choice is always obvious is a recipe for the erosion of trust I mentioned since we ought to expect it to be the case that some long term side effects manifest, at which point any person who has allowed themselves to slip into claims falsified by that discovery will have any other things they said of merit bucketed as being untrustworthy.

My wife has a "light" autoimmune condition. She is very sensitive to this topic. She was strongly recommended by several doctors to not be vaccinated. Not because of the short term possible effects but because of the unknown possible undocumented side effect which could be "triggered" in a distant future.
That doesn't sound grounded in science?
If she were 70, it would not be a conversation topic (she would have been vaccinated as the benefits would considerably outweigh the probability of risks short, medium and long term). But as she is young, there is a big question mark. And as it is not an exact science and nobody knows...
How is saying there is insufficient data to make a conclusion not grounded in science?
Public expectations of science:

1) resolves every question

2) in a socially acceptable way (in other words, says what society "knows" is right, and we know from history how "right" society was historically. We consider ourselves, of course, as uniquely right. Just like every other society did, except they were wrong about it)

3) in a simple enough way for idiots to understand, without nuance

4) without criticizing the people involved in making or executing the decision

And people will happily publish, support and even base legislation on bullshit if it upholds the above requirements.

Needless to say, actual science does not follow any such principles. Plenty of questions aren't resolved, or can only be resolved when oversimplified. There is plenty of "antisocial" science. E.g. average racial and sexual differences in intelligence are real, and known to be at least in part biological. Stating that while there are more intelligent women than men in a random group of 100 of each, but that the smartest and dumbest individuals in the group are still almost always men is not accepted. Or stating that an abused child (whether it's bad parents, bad schools, bad environment or kidnapping) will very likely become an abuser themselves and helping this child will likely make it worse is not accepted. And we all know what happens when one points out that a politician has made a 180 without the science changing.

That’s a great analysis, but I think there is one more aspect which needs to be considered. The decision should not be purely individual, since there is a tragedy of the commons aspect. To any individual, the risks of Covid are relatively low, and the long term risks of the vaccine are hard to know, so personally choosing not to get the vaccine seems reasonable. Yet if every individual makes that same calculation, we won’t reach herd immunity, and the risk to everyone will go up as a consequence. This is one of those situations were each individual making the best choice for themselves doesn’t result in the best result for everyone.
I agree that is a factor I did not explicitly cover but is part of the choice involved as an individual. I think this is modulated somewhat by the fact that at this point anyone who wants a vaccine has got one, other than kids. So at some point it should be a marginal concern when weighing the personal risks against the network effects you will be accelerating.
But the risks to everyone won't go up. Before anyone gets the vaccine, the risks of covid are relatively low. That risk won't go up. It may not go down, but it won't go up.
Sure, as long as we continue to keep restaurants and bars closed and wear masks and social distance, the risk will remain low. How long is it realistic to keep doing that?
Your reasoning is flawed..

It's not a choice of "take vaccine, have risk" or "don't take vaccine and not have risk."

It's take vaccine - with an unknown long term risk, or risk covid where there are also strong signs of long term side effects. There has been research showing infertility effects, there is research showing permanent brain alternations in even some mild cases. And yes, nothing of this is fully proven yet, and we don't know how impactful it is, but the signals are there.

it's not an error, it's a goal
I feel like you're trying to hedge the argument and being fair to both sides but honestly one side is wrong and you're just going to have to decide which one it is.
False. It could very well turn out that mRNA vaccines specifically have long term side effects with other medications or underlying conditions we do not yet understand, which would, for example, warrant the choice of not using them in children, who present low risk to COVID. This may not mean not vaccinating overall, but it could determine which vaccine to choose from the selection of mechanisms. Not mRNA vaccines in general, but this specific mRNA vaccine, which causes your body to synthesize this specific protein.

edit to respond to your deleted comment: the falsifiable claim you made is that one side is right and the other is wrong, when it could be both sides are wrong for different reasons. and I was eagerly vaccinated in February, given COVID was plausibly a life-threatening illness to me given underlying lung damage.

We know that the disease itself has long term effects and they are showing up. We don't have any evidence yet that there are any long-term side effects to any of the vaccines. There have been some that of course have had heart problems or death, but those are rare, and are heavily outweighed by the benefits of the vaccine.

I guess I hear your point that we should defer to knowledge as it is gained, and that's a good point for sure.

The issue becomes clearly in focus if you consider the question of what to do about children. They do not have the same risks of COVID, nor its long term effects, in its current form. If they did, we'd be in a much deeper crisis and (valid) panic about COVID than we already are.

Under those assumptions, and the ones I've stated, it becomes clear at the very least this is a difficult question. This doesn't mean we can't form good priors, but it does mean that anyone discounting that process by claiming it is self-evident beyond a reasonable doubt is the kind of behavior we should push back against given it will ultimately cause more problems than it solves.

I haven't heard that children are any less susceptible to long-term effects of covid-19. In fact I've mostly heard the opposite that they are just as at risk of long-term side effects of the disease as anyone else.
The AstraZeneca vaccine is not mRNA based (which is the vaccine the article is talking about).
> Therefore, it is unfair to suggest that an individual who sees themselves as low risk to COVID, and potentially exposing themselves to a yet-to-be-fully-understood drug, does not have a valid dilemma in the choice around vaccines.

Especially if the person has already had Covid, since natural immunity is arguably comparable to vaccine protection, and vaccine side-effects are arguably more pronounced in those who have already had the infection.

Short-term reaction side effects are not the same as any potential long-term side effects. The long-term effects of being infected with the disease are definitely known to be worse than any unknown potential long term side effects that are suspected so far of the vaccine.
>The long-term effects of being infected with the disease are definitely known to be worse than any unknown..

Seems an indefensible statement. You can't possibly know how 'bad' the unknown is, its unknown.

I guess I was speaking to all of the guesses that people have so far as to what any long-term effects may be... I haven't heard anything that seems plausible that is worse than the organ failure that the disease itself can produce. There's a lot of Cronenberg style ideas about what could potentially happen across generations but I think all of that comes from just a complete misunderstanding of what mRNA is. But I haven't heard any long-term side effects of the vaccine that seem plausible so far.
The people talking about mRNA are largely confused except those who are talking about the potential cytotoxicity of the spike protein, it leaking into the bloodstream, and the potential short and long term consequences if that is happening with any non-zero probability (given the scale of the deployment.)
You misunderstood. I'm talking about those who have already been infected.
Right. We know that they will have long-term effects that people who were vaccinated and never contracted it won't get is all that I'm saying. We simply don't know about any long-term effects of the vaccine though, so it is unfair to even begin to speculate or compare the two.
The only point I'm making is that for those who have already had Covid, taking the vaccine is mostly downside, since it won't offer any more protection than they already have from being infected, and it has the potential, however small, for side-effects. I'm saying nothing about comparing vaccine side-effects to Covid effects.
You're missing the point. The question being raised is if it is a smart decision to get the vaccine after you know you've already contracted COVID.
The author's argument is based on the assumption that taking aspirin results "in around one death per 10,000 people".

The cited study [1] does not say that. Those results are specifically for "a fifty-year-old male" (see p. 638), not the general population.

Additionally, the results are from an "aspirin therapy simulation", not real world data [2]. How the researchers ended up with their model parameters, is unknown.

Did the author even read the studies?

[1] https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.26.3.6...

[2] https://pubmed.ncbi.nlm.nih.gov/15590881/

It's worth noting that the risk of death stated for AstraZenica in this article, one in two million, surely relies on proper and rigorous reporting of the causes of deaths. As a thought experiment, let's say someone aged 65 happens to die one month after having received the first dose of the vaccine. Are we sure that the local coroner will check whether the vaccine had anything to do with their death if there is some more "obvious" cause of death like an underlying health condition? Are we sure to the level of one in two million? It would only take 18 misattributed deaths to make that risk 10x higher.

I'm not trying to start an argument over vaccines but it sincerely seems to me like there might be large error bars on the assertion that the risk of death from the vaccine is one in two million. And I expect aspirin is still far riskier than the vaccine so the central headline doesn't change. I'm probably missing something here so would welcome input from others. Hopefully Hacker News is a mature enough place to discuss this with level heads.

EDIT: 2 minutes after posting, first downvote. Maybe my previous sentence was too hopeful?

And what about the other way around? What is the chance that a 65 year old randomly dies of something that could be misattributed to the covid vaccine. It would only take 2 misattributions for the risk to be zero.
Indeed, and that doesn't change my point (though I'm not accusing you of saying that it should). Do we believe accuracy in such accounting - at least in Australia - is error-proof to at least one in a million? Could it be 10x better or worse? 100x? Where's the line? I actually have no idea where you would even begin to work out the accuracy of such a number. For aspirin too, for that matter.
Yes it is very true that not very many people understand risk enough to effectively compare it amongst other risks.
And it is also true that no one can effectively compare risks when the assumptions can not yet be relied upon
Was going to go back and edit my (now flagged) post in this thread since after seeing a few videos of the MSM my subcutical vitriol didn't sit well after a thought hit me. Figure'd I'd post this. Feel free to flag it too, these opinions are my own and not that of HN, I own them.

So the issue with MSM reporting and this specific article is the habitation of publishing without applying basic principles of news literacy first. Editorials and Opinion pieces are all too often confused with stories of fact, and Questions about interests, data, and how conclusions are all often buried or require way too much time to discover and determine or we are asked to take it at face value. I won't say what puppies the MSM have killed but I will say in the last couple of years, they've killed a few publicly; the overton bubble has begun boiling and the Frog is wondering which pot is actually safe at this point. In this article I have to click on 6 or so links and read seperate articles to find out what was proposed here is an opinion piece, then do google searching. I shouldn't have to proove out the authors statement myself.

And that has become a bad habit for many people, and it's infested the education system. The net impact of that is to destroy the capacity of a country to utilize reputation and sound reporting and lets be really honest here, there are institutions that even in this pandemic and well before it have prooven trustworthy.

I would reccomend anyone reading this that REALLY doesn't like what I'm saying to assume I'm full of it but do yourself a favor. Take a news literacy course.

Well, at least I'm consistent - I avoid taking aspiring needlessly just as I avoid pointless vaccination. The mental circuitry feels the same in both cases - Strong belief that the body will successfully defend itself. I mean, what was the point of all that evolution if it couldn't?
The fact that your immune system will overreact to the virus is probably the main reason to be vaccinated.
> The fact that your immune system will overreact to the virus

It's not a fact, first of all. Second, the vast majority do not suffer that reaction or anything remotely close to it.

For the majority Covid is equivalent to getting a mild cold, or less. Now that's actually a fact, derived from the rather enormous trove of data we have on outcomes at this point.

Cytokine storm is one of the major contributors to death from the disease. From my reading then is pretty much the definition of your immune system overreacting and starting to destroy your body.

The immune system generally walks a line between being absolutely worthless and killing you.

Edit: Oh I see my use of the word will is leading you astray. "Will" as in that your immune system will be overreacting if you are a case that results in death.

> The immune system generally walks a line between being absolutely worthless and killing you.

And that's your strong belief which steers you towards getting vaccinated.

See, in my mind, my immune system is highly effective. Not only did it protect me through all the big "scary" diseases the media went on and on about like swine flu, avian flu, etc., but it has also flawlessly protected every single one of my ancestors since billions of years ago.

The only thing I've been hospitalized for was salmonella. Fun times (not).