I have absolutely no inside-understanding of how vaccines work, and I don’t know whom I could trust right now, given how much political pressure, twisted incentives and increased polarization (due to the crazy anti-vaccine movement) there is. My risk model treats all the available vaccines as “drug that was developed under political and financial pressure and whose trials ended much sooner than is normally the case”.
My risk model treats all the available vaccines as “drug that was developed under political and financial pressure and whose trials ended much sooner than is normally the case”.
I think we can do better than that, even in the current information climate. Drugs can be almost anything and have almost any goal. Vaccines are a pretty narrow class of treatment that are attempting to do one thing- give you an immune memory that will trigger if infected by a disease. They do that by exposing you to some part of the disease. The natural cap of badness of that attempt is giving you the disease itself- anything more needs an explanation.
Some examples off the top of my head where a vaccine caused effects you wouldn’t get from the disease itself (not all of which rendered the vaccine net negative):
certain adjuvants encouraged cancer (e.g. some pet vaccine)
the vaccine triggered an immune overreaction that left people worse off if actually infected (there was an STD vaccine that did this, and I believe SARS-1)
Allergy to something else in the vaccine (e.g. eggs in the flu vaccine).
Of these, we’d expect #3 to show up nigh immediately upon immunization, and is not dependent on how many people were exposed to actual covid, so we have a fairly large sample size. I vaguely recollect that where #2 was a factor, it was pretty universally true, not a rare reaction- so the sample size is probably large enough for that too.
This is complicated by the fact that at least one of the covid vaccines is using an entirely new mechanism. This could leave us vulnerable to certain problems like the adjuvants, that take a long time and large sample size to catch.
Certainly some people are very sensitive and medically excused from vaccines- but those people are pretty screwed if they catch the actual disease too. The only reason not getting the vaccine is viable for them is herd immunity.
I’m not an expert and I haven’t looked into this very long. But there are mechanistic models that can help us predict the risk here, and I think it’s a mistake to use the entire collection of FDA-monitored treatments as a reference class.
My risk model treats all the available vaccines as “drug that was developed under political and financial pressure and whose trials ended much sooner than is normally the case”.
And what other drugs do you believe have been in that reference class? Without that, it doesn’t tell you much. All drugs are developed under financial pressure.
Direct finanical motivations seems to be even less strong in this case. Big Pharma is more in it for the goodwill then for the profits. If you read market analysis like How much could Pfizer make from a COVID-19 vaccine?:
And while there will be massive COVID-19 vaccine sales, he actually doesn’t see pharmaceutical companies in general making significant profits off of them in the long run.
[...]
So why race to be first? Conover said other incentives, along with profit, would include a company being able to generate goodwill with governments and patients.
And what other drugs do you believe have been in that reference class?
I don’t know.
Without that, it doesn’t tell you much.
I disagree. It allows me to shift those products from the category “drugs backed by the authority of academia and years of rigorous research” to “drugs that you take because important people and your echo chamber say that you should”.
I must admit, I’ve had some lingering doubts about drug testing before. But I never investigated those because it would take me too much time to gather the necessary knowledge to even distinguish whom to trust (especially since I find biology completely uninteresting—my high school teacher made sure of that). But I’m certain that the incentives of researchers and administrative bodies are more aligned with telling the truth in the case of ordinary drugs, than they are in case of Covid vaccines.
Direct finanical motivations seems to be even less strong in this case.
Thank you. I do not believe the guy quoted in the article because I don’t know his incentives, but that prompted me to look up the stock price of Pfizer and to my untrained eye it doesn’t look like investors believe the company will reap great profits from this. This strikes out my concern about financial incentives. The other concerns (about political pressure and lowered scrutiny) remain.
What’s the model under which the vaccine is more dangerous than the virus it’s based on? That’s not unknown, but it would be quite weird.
I have absolutely no inside-understanding of how vaccines work, and I don’t know whom I could trust right now, given how much political pressure, twisted incentives and increased polarization (due to the crazy anti-vaccine movement) there is. My risk model treats all the available vaccines as “drug that was developed under political and financial pressure and whose trials ended much sooner than is normally the case”.
I think we can do better than that, even in the current information climate. Drugs can be almost anything and have almost any goal. Vaccines are a pretty narrow class of treatment that are attempting to do one thing- give you an immune memory that will trigger if infected by a disease. They do that by exposing you to some part of the disease. The natural cap of badness of that attempt is giving you the disease itself- anything more needs an explanation.
Some examples off the top of my head where a vaccine caused effects you wouldn’t get from the disease itself (not all of which rendered the vaccine net negative):
certain adjuvants encouraged cancer (e.g. some pet vaccine)
the vaccine triggered an immune overreaction that left people worse off if actually infected (there was an STD vaccine that did this, and I believe SARS-1)
Allergy to something else in the vaccine (e.g. eggs in the flu vaccine).
Of these, we’d expect #3 to show up nigh immediately upon immunization, and is not dependent on how many people were exposed to actual covid, so we have a fairly large sample size. I vaguely recollect that where #2 was a factor, it was pretty universally true, not a rare reaction- so the sample size is probably large enough for that too.
This is complicated by the fact that at least one of the covid vaccines is using an entirely new mechanism. This could leave us vulnerable to certain problems like the adjuvants, that take a long time and large sample size to catch.
Certainly some people are very sensitive and medically excused from vaccines- but those people are pretty screwed if they catch the actual disease too. The only reason not getting the vaccine is viable for them is herd immunity.
I’m not an expert and I haven’t looked into this very long. But there are mechanistic models that can help us predict the risk here, and I think it’s a mistake to use the entire collection of FDA-monitored treatments as a reference class.
And what other drugs do you believe have been in that reference class? Without that, it doesn’t tell you much. All drugs are developed under financial pressure.
Direct finanical motivations seems to be even less strong in this case. Big Pharma is more in it for the goodwill then for the profits. If you read market analysis like How much could Pfizer make from a COVID-19 vaccine?:
I don’t know.
I disagree. It allows me to shift those products from the category “drugs backed by the authority of academia and years of rigorous research” to “drugs that you take because important people and your echo chamber say that you should”.
I must admit, I’ve had some lingering doubts about drug testing before. But I never investigated those because it would take me too much time to gather the necessary knowledge to even distinguish whom to trust (especially since I find biology completely uninteresting—my high school teacher made sure of that). But I’m certain that the incentives of researchers and administrative bodies are more aligned with telling the truth in the case of ordinary drugs, than they are in case of Covid vaccines.
Thank you. I do not believe the guy quoted in the article because I don’t know his incentives, but that prompted me to look up the stock price of Pfizer and to my untrained eye it doesn’t look like investors believe the company will reap great profits from this. This strikes out my concern about financial incentives. The other concerns (about political pressure and lowered scrutiny) remain.