This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
CDC has released a report today finding preliminary association between the Pfizer vaccine and stroke for those over 65 years of age.
Another drop in the bucket - or is the bucket spilling out the top now?
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/bivalent-boosters.html
Pfizer is associated significantly with strokes - CDC is keeping us in the dark about the exact data.
They then list multiple studies that did not replicate this finding for the BIVALENT vaccine - well of course, this vaccine was testing on mice, and then deployed without long term testing. Do they have monovalent data they are not mentioning?
EDIT: Is it possible monovalent risk benefit analysis is simply using a different pathogen, and now with the advent of Omicron, this is a medical update saying this level of strokes is no longer worth the benefit vs the current pathogen? Food for thought.
This contradicts what Paul Offit's opinion is, which was posted in the NEJM. Paul Offit believes we should not give bivalent boosters to young healthy patients.
https://www.nejm.org/doi/full/10.1056/NEJMp2215780
It would be much more shocking to announce a chance to the vaccine campaign, than to keep the current inertia the same. I think we are seeing a communication strategy developing to deliver the population into accepting yearly mRNA vaccines - instead, they will be directed to other worthwhile candidates for vaccination - IF pharma companies can even deliver those.
In my eyes: mRNA vaccines are dangerous, so you need to determine how dangerous the pathogen presenting is. I see a great use case for mRNA developing for Airborne Ebola Zaire strains (90% mortality) or other disease of similar magnitude. Simply put: your vaccine should not significantly increase cardiovascular risk. It should be absolutely negligible. 1 in a million, whereas these vaccines might be 1 in 100,000.
Why? This seems to me like you picked "an order of magnitude safer than what it allegedly is" and if the alleged rate of danger were different, you would have picked a different goal. Unfortunately I can't easily find the serious side effect rate for various common medicines, but https://www.medsafe.govt.nz/consumers/Safety-of-Medicines/Medicine-safety.asp says that a "very rare" side effect means one that happens to 1/10,000 people or less.
I find these numbers to be particularly confusing in light of how dangerous COVID itself is. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02867-1/fulltext#seccestitle140 says that at age 65, the IFR for COVID is about 1.7%, 1,700 times higher than your alleged risk of the vaccine and 17,000 times higher than what you claim the risk should be.
And according to https://www.cdc.gov/stroke/facts.htm, the baseline rate of ischemic stroke in the US is slightly over 2 per 1,000 people, again much higher than the alleged risk of the vaccine. For those of age 65, it seems to be slightly higher, increasing quickly with age: https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.120.031659
For additional context, to have a 1 in 1 million risk of dying while driving, you would have to drive less than 100 miles (overall rate is about 1.5 deaths per 100 million vehicle miles in the US, according to https://en.wikipedia.org/wiki/Transportation_safety_in_the_United_States, although I think that number is outdated and is even higher now).
No medicine is completely safe, but this seems like a real no-brainer to me.
Vaccines have to be more good than bad. Almost all of them are. The covid vaccines get a wee bit murky in that regard when you get to younger age cohorts - especially younger male cohorts. There's a lot of good evidence that for young males in particular the virus carries fewer side effects than the mRNA vaccines, especially the 2nd dose of said vaccines. For older age groups I think you'd have to show pretty awful side effects for vaccination not to be worth it - so, for instance with over 65s you'd have to really have some bad frequency of side effects since they're so vulnerable to covid.
The other issue at hand here is efficacy, however. If the bivalent booster has risks but doesn't ultimately protect anyone any better than the 2x shots they already had (or 3x with the original booster) then there's really no good argument for them. The FDA lost two of its most experienced vaccine regulators over the Biden admin's "boosters for all" push, which wasn't based on any data whatsoever - we don't have any data showing that a 30 year old vaccinated woman will have further reduced mortality and morbidity with a booster shot or a bivalent booster. Most other countries, where their medical systems are more tuned towards cost and efficacy, have only authorized boosters for elderly people and those with severe immunocompromise (cancer patients). The US chose to push a one-size-fits-all policy with boosters, with zero evidence, and so...when a safety signal like this bubbles up it looks even worse than it would have if they'd pursued more evidence based recommendations.
More options
Context Copy link
https://www.nature.com/articles/s41467-022-35653-z
Here's one estimate. I would never base policy on one study, usually that's something the CDC would do.
This is data from a year ago. We are talking about how the bivalent booster is associated with ischemic strokes, especially held against the risk of omicron.
Let's stick to relative risk? This is not useful.
Agreed. But we have to go places, like schools, small business, and our places of worship. So no one proposes stopping driving. I'm proposing stopping the EUA novel biotechnology vaccination campaign.
Which it is not by the very report you are using. You've jumped from "The CDC reported a signal which they investigated and found nothing" to "The vaccine is associated with strokes" as though that were proven and established.
Why not go the whole hog and say the vaccine causes women to ride broomsticks to the meeting with the Devil? You are determined the vaccine is bad and then go looking for straws to build your house with, instead of looking at established risks and then forming an opinion.
Definite side-effects of getting the vaccine that have been established: muscle pains, fever, diarrhoea, mild allergic reaction.
Possibility of more serious side-effects: anaphylactic reaction
If you want to argue that the risk for young men is too high as compared to the risk of contracting Covid and the effects of that illness, you have a valid case there. You do not have one for general scare-mongering.
Fair, I'm not going to rip off my wallpaper over elderly and at risk people receiving bivalent vaccines - precisely because I have a calculation of their quality life years remaining, that is very different from younger healthy people.
The exact people who benefit from a covid vaccine have less quality life years to live than those who do not.
The vaccine has a novel, not totally understood method of mRNA translation, and then goes through another not completely understood process of protein folding, and then enters the immune system (not completely understood). The pharmacokinetics of the nano lipid particle are not characterized or understood. And there is a concerning signal of a blood clot appearing in patient's brains.
I am not scare mongering, I am being highly critical, since I'm not the one defending the novel RNA transfection vaccines.
When they run trials for new vaccines, they will compare them to the harms that the RNA transfection vaccines caused, and the new vaccines are going to look amazing. My guess is they will use protein-adjuvanted methods.
More options
Context Copy link
More options
Context Copy link
I didn't ask for an estimate, I asked why 1 per 1 million is the higher tolerable level of risk.
Why does it being a year old matter? Even if the IFR is a few times lower, it's still much, much, much higher than what you're talking about.
Do you plan on explaining why or are you just going to make assertions?
It's entirely possible to build towns and cities that don't require you to drive literally everywhere, but no one seems to care about the risk from driving when designing cities or choosing where to live. At least, not at the magnitude you're talking about: 100 miles could be saved in 2 months by moving 1 mile closer to work, but does anyone care about that? Not in the slightest. A minuscule improvement in civil design would save orders of magnitude more lives than eliminating all risk from vaccines, with lots of other positive side effects to boot.
This entire post of yours is just one big isolated demand for rigor.
1 in one million, compared to 1 in 100,000, in our current data collection environment, is a good signal to keep track of if you are considering your options to receive a covid-19 vaccine. Perhaps you can take J&J, Novavax, or Covaxin and maintain protection against SARS-2.
The IFR is lower and vaccines are not denting hospitalization or death rates as they plummet from their previous heights (mass naïve infection). Most people have had a much better inoculation than a monovalent vaccine - they've had a SARS-2 infection.
Well, because a stroke as a cardiovascular event, I'm interested in the dynamic between mRNA vaccination and your cardiovascular system. A stroke, downstream of pathology, will offer valuable information when it goes above the baseline.
Well, you are demanding rigor, and yet I feel like this is a complex claim. Even a city would involve having people driving to bring supplies and transportation towards these centers - a mandatory risk.
We should be paving our public serology with only the best, most well understood vaccines that we are capable of developing and testing and passing on in our limited lifetimes. There is a broader umbrella of rigor that I am requesting to be frank.
A lot of the rigor I'm demanding will also take time, more time than has been allotted for these Bivalent updates. The first injectable, multi-transcriptional (unknown if combined or separated) mRNA vaccine to market has shown an unexpected safety signal.
...why? What makes it a good signal? Again, compared to the baseline number of strokes, you probably would not ever be able to detect these increases. If you wouldn't seriously consider the risk of driving 1000 miles, why would you seriously consider this risk?
Do you have some data for these claims? I've seen them, but I've also seen the opposite (e.g. that vaccine provides a better immune response than previous infection). Case and hospitalization rates are certainly nowhere near their high of a year ago (https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html) but if the virus is mutating to become more contagious and less severe over time, and vaccines aren't actually effective, you should still see a high case count.
What valuable information? How does this answer my question?
I'm not really sure what you are trying to say. There are plenty of alternatives to using large motor vehicles in city centers, near pedestrians. Also, deliveries of goods represent a tiny fraction of all trips taken in populated areas, so you can still have those while reducing personal car trips. Urban design is a complex topic, but so is medicine. Do you want me to recommend you some urbanist sources?
This seems like a much weaker conclusion than:
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
Absurd safety standards for medicine are the norm. Lots of things with side effects and uncertain cost-benefit profiles (like lockdowns themselves!) are acceptable when if they happened to take the form of a pill or injection they'd be ten different kinds of illegal.
It is the norm, but even by those standards it feels inconsistent. I agree that many other policies are handled too cavalierly, but that's not really a good argument against what appears to be a legitimately safe vaccine.
I'm arguing in favour of the vaccine. It has a much better safety profile than a lot of things - it's just because it happens to take the form of medicine that we want a frankly ridiculous safety standard.
More options
Context Copy link
It's an EUA vaccine approved for an emergency. I think if you want to say "legitimately safe vaccine," it would be easier if Pfizer or Moderna could actually distribute an FDA approved and LABELLED as approved "Comirnaty" or "Spikevax" vial of vaccine.
Isn't this what they are already doing, or are you engaging in legal hair-splitting of the type about "the FDA issued approval labels for the original vaccine but the boosters are only recommended"? So if they're only "recommended" or "authorised" but not "approved" this means they're dangerous? There's a whole article about the difference between "approved" and "authorised" here.
You may have a point somewhere buried beneath all the scare-mongering, but it's hard to discern. Maybe less "The vaccine has been proven to cause strokes!" when no such thing has been established would make your case better.
The irony here is that people have been complaining the full FDA approval process takes too long and a modified version (say, where drugs are trialled for a shorter period and the FDA approves them but you take them at your own risk, or that drugs legal in the EU shouldn't have to go through the same process in the USA for approval) would be better to get drugs to market and treating patients faster.
You can't please everyone!
Your response didn't address the crux of FDA and EUA labelling. The entire power structure of our country, legal recourse and all, rests along these lines. Sorry to bring Foucault into the mix, but he's the ultimate nightmare of a public health pandemicist.
https://www.comirnaty.com/
Is this not VERY different from the medical advice given to people getting the EUA? Mix and match the first vial you can even get your hands on?
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
I am much more worried about real, physiological implications of nanoparticle technology uptake. Not simple safety standard concerns (those already seem tattered).
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link