As the issue of anti-vax sentiment is a big issue for many countries around the world and undoubtably is costing lives, I would think that questions like this need not be asked via the media.
You trust experts to lie to the public (at the very least through omission) for their own good.
No thanks. Your attitude is a significant part of our current political dysfunction. Public servants have been replaced by self-promoters and technocrats who share nothing except contempt for the man on the street.
In the tech world, we've got responsible disclosure for security holes. That's essentially what's being proposed here - let AZ have 24h to at least come up with a response. The article includes a line saying "AstraZeneca did not immediately respond to a Reuters request for comment", which sure sounds like "we sent their PR an email, then hit publish an hour later".
We've already seen issues in recent weeks with the blood clots issue, where the initial breathless media coverage gives way to "the regulators took a look and it seems fine, it's about the normal level of them, and the pause probably killed many more than the clots ever did".
Lay people - including reporters - are really bad at teasing apart normal "how the sausage is made" from "there's an actual issue here", especially with anti-vax propagandists ready to leap on anything with even a hint of confusion.
> "DSMB externalisations of concerns are deeply unusual for multinational pharma companies and suggest an extraordinary high level of friction between the DSMB and the sponsor,' Citi analysts said in a note."
It sounds like they're not getting the type of collaboration they want from AZ, so they've raised the stakes.
> Lay people - including reporters - are really bad at teasing apart normal "how the sausage is made" from "there's an actual issue here", especially with anti-vax propagandists ready to leap on anything with even a hint of confusion.
Exactly this. Journalists and laypeople are specialists in making mountain out of molehills
But it's said when specialists also do that (with the suspension of the vaccine when the thing it is preventing has a 1000x chance of causing the same problem)
Let's make a distinction between "the tech world" and some substance we're injecting into people en masse.
In all likelihood the AstraZeneca vaccine is perfectly fine. But we should have this conversation in public. If people "come to the wrong conclusions," that's fine. It's the price we pay for an open society.
1. If there's a serious issue with the vaccine and we kept it quiet, the consequences would be catastrophic. Not only in terms of public health but also in terms of public trust. Even a small chance of this outcome far, far outweighs the number of people who will die due to people wrongly deciding not to get the AZ vaccine.
2. We have a moral obligation to have conversations in public that involve the safety of injecting substances into people. Regardless of "cost benefit analysis," people simply have a right to be privy to these conversations. It's better for things to go worse and respect this right than for things to go better and not respect it.
Remember that many public vaccination programs are relying on healthy people taking on risks to protect others. Right now, more people are being harmed by polio vaccinations than by wild polio: https://www.the-scientist.com/news-opinion/polio-vaccination...
I think that is a perfectly acceptable trade-off given the the long-term goal of eliminating polio entirely. I also think it's totally ok to ask people to bravely face a risk to help others (a fairly small one in this case). I even think it can be ok to ask minors, and parents, to take on those risks in some circumstances, and I think polio elimination is one of them. But it's a trade-off that must be done openly, with consent.
You expressed concern about anti-vaxxers, correct? If it turns out the AZ vaccine doesn't work very well, that's a boost to them, especially if the conversation occurred in private. Perhaps that will result in more people dying in the long run due to decreased trust in institutions.
When you play this utilitarian game, you can kick the consequences can down the road forever, which is why it's better to think of these arguments in more immediate terms.
That's not "in more immediate terms". It involves peering into the future and it implies the belief that we can perform a cost benefit analysis and therefore remove the moral and political elements from decision making.
When I say immediate, I'm talking about this:
> 2. We have a moral obligation to have conversations in public that involve the safety of injecting substances into people. Regardless of "cost benefit analysis," people simply have a right to be privy to these conversations. It's better for things to go worse and respect this right than for things to go better and not respect it.
I would rather have more people die in an open society than less people die in a closed one.
The reason there's so much skepticism of public health authorities is because they repeatedly mislead the public.
Right now, for example, Dr Fauci tells people who have been vaccinated to wear two masks. That's because he wants the unvaccinated to keep wearing theirs, lest they see others without masks. But it's nonsense and lay people know it. So they see this and think Fauci is mad, deceptive, or something else that can't be a reason to trust him. And that's how public health figures lose the trust of the public and create millions of skeptics of vaccines, masks, social distancing, etc.
No, the double masking recommendation comes from studies performed that demonstrate a better fit, especially with the cloth masks that are in widespread use.
> The findings of these simulations should neither be generalized to the effectiveness of all medical procedure masks or cloths masks nor interpreted as being representative of the effectiveness of these masks when worn in real-world settings.
I think complaints are justified when CDC officials turn around and do exactly what their report says not to do: interpret the findings as being representative of real-world settings. A year in and with trillions spent, our evidentiary standard should be higher.
How, exactly, are you proposing we get the data on "real-world settings" without trying out the approach that's been lab-validated? Barring evidence in the "this might be dangerous" direction, those lab results certainly appear to support recommending people adopt the practice.
Turning this sort of CYA language that's standard in medical research into a scary gotcha is exactly the sort of propaganda the anti-vax folks engage in all the time.
I believe clinical trials are the gold-standard mechanism by which specific questions about interventions may be answered. I’m not pointing out a “scary gotcha.” I’m pointing out an omission identified in the linked work.
Lab confirmation of double masking can be performed in an afternoon. A clinical trial is going to take tens of thousands of self-reporting "I wore two" people for months or longer, plus difficulties with all sorts of confounding variables.
I'm very comfortable with a tentative recommendation based on the lab data for a non-dangerous intervention. If we get observational data a year from now confirming it, even better.
Because while we have conclusive data that states "the vaccine will keep you out of the hospital", we do not yet have the data that lets us conclusively say "you can't get and spread the virus if you're vaccinated".
I don't think experts are lying to the public, I think they have questions and it's correct they should ask them. But you can do that with a phone call or an email. When you make a press release you're not asking a question you're making a statement. And the statement the media makes and then the statement the public choose to hear are beyond your control. To use the old analogy, there are consequences to yelling fire in a crowded theater.
I’m not sure what you mean by this sentiment. If there were issues, questions need to be asked. Anti-vax is a problematic issue, but you can’t solve that with hiding facts or causing doubt.
As someone who had been a part of FDA interactions, it’s not being communicated via the media. I have no doubt there were conversations between the FDA and AZ prior to the press release.
I assume that whatever the discussion, it wasn’t going to get resolved quickly so the FDA informed AZ they could not sit on the information and would have to make a public statement.
The actual final data analysis isn’t done (AZ mentioned this in their press release). It sounds like they did an initial analysis of the final data, it looked similar to the Feb interim data, so they said “good enough, go with 79% in the press release” and the FDA was like “wait a second, that wasn’t the agreed upon final data”.
The backlash from people finding out about a quiet discussion can be just as bad. If they favor openness then they don't lose points for secrecy.
And it's clear enough that literal anti-vax people don't need a real reason. It's hesitancy that is the addressable issue, which is going to be better addressed by building trust than by saying what sounds right.
I'm a huge proponent of vaccinations but this attitude is very concerning. I see it too with J&J, where we have data showing lower efficacy rates and no data on long term avoidance of chronic side-effects of COVID (such as chronic pain and fatigue, organ damage, clots, etc), only data on hospitalization rates (which yes, are on par with other vaccines). And if you dare question any of this, you're immediately shut down and told to shut up. It just makes me trust J&J even less. I'm young and healthy, my biggest risk is not hospitalization but the long term side effects, do not suppress this and do not act like it's wrong to question these things in an informed and intelligent manner.
You appreciate that this attitude, that is, that things must be hidden or people might get worried, is exactly why some do not trust the new Covid vaccines?
I'd say that hiding potential issues with a vaccine, where regulations have already been eased to speed up its rollout, is about as damning as it can be.
Ah, OK. I wouldn't characterize the use of a preexisting regulatory channel that is present exactly for this purpose as "easing" but it is a perfectly fair position to take. Thanks!
At least where I am (UK), yes. They added to article 174 of the Human Medicines Regulations, allowing an unlicensed vaccine to be advertised in some circumstances, as well as allowing a broader range of people to administer the vaccine, and provided legal protection in law to the developers of the vaccine in case of any issues.
This is in addition to the existing powers of article 174, which allows an unlicenced medicine to be rolled out in exceptional circumstances.
No, not silly, but potentially justified, in the case of a pandemic. However, these changes obviously increase the risk to the recipient of the vaccine. There's a higher chance of something going wrong with the actual injection, as a broader spectrum of people are administering it (where I live, there was a call for volunteer vaccinators in the local paper), and also very little legal recourse if something is found to be harmful with the vaccine itself.
For those reasons, along with the lack of any information as to whether the vaccine has a meaningful effect on reducing transmission, I have decided that the risk (relative to the reward) to me is too high.
On its face the UK has administered doses to over 25MM people thus far I believe (remarkably hard to find the exact number to date from an official source with a simple google!) and unless you are among the oldest on HN or in remarkably poor health most of those people would likely be at much high risk of complications than you would. If complications were anything but extremely rare there would be many, many cases by now.
Additionally, perhaps you are better equipped than I to know, but I believe you could control for any risk you perceive (which I think is ridiculous, but to each his own) from having someone inexperienced administering the vaccine by getting it from your GP.
As for the transmission of COVID-19, if you require absolute proof that vaccination will prevent all transmission then you are setting your bar far too high and your position is indefensible.
To start the presumption is that it is very likely that vaccination will at the very least reduce the likelihood of transmission because while there are viruses like Measles that can still be transmitted in such circumstances those cases are the exception to begin with.
Furthermore evidence is building that vaccination against COVID-19 prevents people from carrying loads of the virus that can be transmitted, if you are quite as committed to this line of argument as you seem to be I am sure you can find the published and pre-pub studies out there. I am confident that if you went about booking yourself an appointment for a month from now by the time your appointment were actually up you'd have lots more evidence to avail yourself of - and you'd always have the option of declining at the time!
"Data analysis in a study by the Israeli Health Ministry and Pfizer Inc found the Pfizer vaccine developed with Germany’s BioNTech reduces infection, including in asymptomatic cases, by 89.4% and in syptomatic cases by 93.7%."
"More research is needed to draw a definitive conclusion, but the studies are among the first to suggest a vaccine may stop the spread of the novel coronavirus and not just prevent people getting ill."
At least do me the favor of reading the link; "two Israeli studies" is in the very first sentence, and the second study is published:
> A separate study by Israel’s Sheba Medical Center published on Friday in The Lancet medical journal found that among 7,214 hospital staff who received their first dose in January, there was an 85% reduction in symptomatic COVID-19 within 15 to 28 days with an overall reduction of infections, including asymptomatic cases detected by testing, of 75%.
> As shown in Figure 1A, the percentages of persons who became infected differed according to vaccination status, with infections in 234 of 8969 nonvaccinated employees (2.61%; 95% confidence interval [CI], 2.29 to 2.96), 112 of 6144 partially vaccinated employees (1.82%; 95% CI, 1.50 to 2.19), and 4 of 8121 fully vaccinated employees (0.05%; 95% CI, 0.01 to 0.13) (P<0.01 for all pairwise comparisons).
> The effect of vaccination on the preservation of our workforce has been dramatic. We observed a greater than 90% decrease in the number of employees who are either in isolation or quarantine.
So's letting malicious actors permanently obliterate the reputation of one of the vaccines before we can get the data in to know if there's actually an issue. Media headlines are a really sucky way to do data science.
I have yet to see any evidence of malicious actors. There are anti-vaxxers, but they have a genuine belief as far as I can tell. They're not just here to watch the world burn for fun.
I also don't see a prevailing reason why one of the vaccine companies would want to sabotage AZ. They're all at maximum production afaict, and AZ had worse efficacy than Moderna already. If it were corporate sabotage, I would expect them to target one of the superior mRNA vaccines.
AZ is also the one that screwed up here. If they can't submit correct efficacy data, people should be concerned. That raises serious doubts about their internal organization, and looks like we may be relying on government safety regulations to ensure the vaccine is safe. Which were relaxed for this vaccine.
I didn't see a lot of people saying we should keep letting Boeing's MAX keep flying until we could be totally sure that it wasn't just an unlucky streak of drunk pilots. I also don't see a lot of people saying that we should give Boeing lead time to get a PR spin on their latest disaster.
> Media headlines are a really sucky way to do data science.
I agree. They're also the only way that most people are going to encounter this information, which I would argue they have a right to know. I hope that they'll make rational decisions based on the evidence available, but I'd rather they made poor choices with the evidence than good choices without it.
> this attitude, that is, that things must be hidden or people might get worried, is exactly why some do not trust the new Covid vaccines?
People don’t trust the vaccine because a lot of them are scientifically illiterate and paranoid. That someone on the Internet sees benefit in hiding something doesn’t factor into the equation. It’s an emotional response, not a fact-based one.
yes we should unquestionably accept everything told to us by the holographic spokespeople of corporations on the tv, after all they always have our best interests in mind
