America is plummeting down the global vaccination league table

https://www.economist.com/graphic-detail/2021/08/04/america-is-plummeting-down-the-global-vaccination-league-table

by pseudolus • 5 years ago

35 108 5 years ago

Can someone explain to me why the vaccine is safe even though it’s “experimental”. I got it, but I have family members that I’m trying to convince and their biggest fear is that it’s going to hurt them long term.

psychometry2• 5 years ago

Whereas actually getting covid won't hurt them long term (assuming it doesn't kill them)...? What a ridiculous argument. Not sure what you should tell them, honestly.

ceoloide5• 5 years ago

Treating others as ridiculous won't help with the convincing. Reason doesn't always work when strong emotions are at play.

However, I am no psychologist nor an influencer, I too don't know what can be done to overcome the impasse. I'd be curious to know what strategies work.

sokoloff• 5 years ago

At some point, you might not be able fully reason them out of a position they didn’t reason their way into, but I’d appeal to “what mechanism would show no negative response for 6+ months but then start showing negative outcomes later?”

If there was a significant risk in the short-term, we’d be seeing those cases already.

At some point, you throw up your hands, wave, and wish them luck.

sudosysgen• 5 years ago

It's actually been significantly over a year since the trials. Wild, I know.

ceoloide5• 5 years ago

This is truly a very common sentiment. Independent of the approved status, the common phrase is "how can we know it won't have long term effects that are unknown now?".

Psychological effects of past medical disasters that caused irreversible harm and went under the authority's radar shouldn't be discounted, many people cling to that to justify their fear of the unknown.

So how do we set up a discourse that takes this type of fear into account? What are the tricks or strategies to help people overcome their fears?

minikites7• 5 years ago

the common phrase is "how can we know it won't have long term effects that are unknown now?".

If this was truly the fear, we would see these types of people wearing masks religiously. But we don't, which means it's not a medical fear, it's a political one.

jjoonathan• 5 years ago

The stickler: attention bias.

The more time you spend thinking about a possible negative outcome, the more likely your intuition will believe that negative outcome to be. This affects everybody, even people who ought to know better, like scientists. It's a shockingly strong effect, too.

If you don't couch your logical discourse inside a procedure that translates its outcome directly into action (like an approval process), attention bias is almost guaranteed to override the outcome, no matter how good your reasoning. Since better reasoning takes more time, this leads to the unfortunate circumstance where better, deeper arguments are less likely to be effective that shorter, weaker arguments.

ianai2• 5 years ago

Over a billion people have taken them without significant problems. Probably way more than any trial for any treatment before or well into the future.

msandford• 5 years ago

I have heard reports of people having long covid-like symptoms from the vaccine and needing treatment. That may not be significant to some folks, but to others it might well be. I'm not saying that their evaluation is correct, BTW, but I think it's difficult to make the argument that the vaccine is 100.0000% upside.

Even if the rate of people having these long covid-like symptoms is lower than that of people who get covid it's still not riskless even though the risks are lower.

effie20• 5 years ago

To make an assessment of safety, what is the number of people who have taken them and got significant problems?

It is very hard to find this number. I know a person who got bad reaction to the vaccine, heart and brain aches. Their doctor turned them down, saying "that's normal, that's what vaccine does" a didn't even do ECG. How many people got treated this way?

vwcx• 5 years ago

In their minds, is the greater risk a side effect from the vaccine popping up years from now or the debilitating effect of long-term COVID symptoms? Because right now, we're seeing hundreds of thousands of people not dying from Covid, but still suffering for more than a year with no end in sight to their symptoms.

Also curious if their fear of long-term vaccine side effects has been their line since April? I'm seeing a few anti-vaxx friends switching to this line of anti-reason in the last few weeks, now that the FDA approval is right around the corner.

breckenedge• 5 years ago

That’s been my experience too. I asked one holdout I know, and she said she was waiting to see what effect the vaccine had on us, even though many of us have been vaxxed for six months or more. She’s so afraid of the vaccine that she gave up income due to loss of employment.

alkonaut4• 5 years ago

It’s not experimental. It was. It was given emergency approval which sounds dramatic - but isn’t. Now the vaccines have been given to hundreds of millions with few adverse effects.

An expert (can’t remember) explain why one shouldn’t be afraid of long term adverse effects of the vaccine: basically it has only two periods of operation: short term you can be affected by anything in the shot which contains all kinds of lipids and stuff used to create a vaccine. You can be allergic to one of these substances, for example. But if you didn’t have a short term effect from the vaccine, the long term effect is just the immune response. Nothing else. That immune response would come from the disease too. There is just no mechanism that would create a long term adverse effect. BUT there are tons of ways in which the virus could!

You should ask the vaccine sceptic which long term effect they would rather have: the virus or the vaccine. Because it’s not about getting vaccine or not at this point. It’s about getting immune from the vaccine or from the disease. There just is no benefit of getting immune from the disease.

tialaramex2• 5 years ago

It was given emergency approval which sounds dramatic - but isn’t.

In New Zealand since they had elimination they didn't do emergency approval. They expedited their normal process, but since there were literally no people dying in New Zealand of COVID-19 they weren't losing anybody by waiting for their medicines agency to complete all the steps it would usually take at the pace necessary.

They're currently vaccinating their general population, having at first prioritised health workers and those at the border who might meet infected people in the course of their duties.

Obviously things look a bit different when you've got people dying every day, but the vaccine is the same, so if you'd be more confident that it was assessed without worrying about all the people dying meanwhile, New Zealand did that. Months ago.

taf2• 5 years ago

I really like this line of reasoning. The aspect of it that plays into a question I have is if we get immunity from both the vaccine and the virus - what is the total percentage of population that has had both? Also lots of fear about the variants - seems vaccinated or infected - the new virus can infect… I’m really curious to know whether an updated vaccine is in the works- not just a booster of the same vaccine ?

optimiz3• 5 years ago

Have we resolved why a cohort of younger folks were getting myocarditis? That is not something you want to get as a teenager when your body is developing.

Have gotten the shot, but have heard this question from parents and it is completely reasonable IMO.

azth2• 5 years ago

It doesn't help that people are not only discouraged from asking questions (the whole premise of science), but are dubbed labels and ostracized when they have genuine concerns. This, in the face of evidence of actual side effects like myocarditis and other effects, doesn't help the cause at all.

alfl• 5 years ago

Build a function of unknowns that gives probability of a “bad outcome”, plug in the ranges of the best data you can find for the unknowns.

Compare this to the probability of getting Covid (~100%) and having a “bad outcome”.

This let me confidently say things like, “getting vaxxed is 2-5x safer than not” and ending the argument (whatever the actual figures were when I got vaxxed).

The real answer isn’t technical though —- we need public health authorities to learn post-Internet PR. I’m cribbing Eric Weinstein here.

basseq• 5 years ago

And yet[1]:

75% of unvaccinated adults are "not worried about getting seriously sick"...

50%+ are not worried "about the Delta variant worsening the pandemic"...

50%+ say "getting vaccinated is a bigger risk than getting infected", and...

75% don't think the vaccines are effective.

So definitely a "PR problem" is those figures differ from reality. But you read these figures, and the outcome is obvious: "I'm not going to get seriously sick, the long-term effects of the vaccine are unknown, and the vaccine doesn't work anyway... so why should I get it?"

[1] https://www.kff.org/coronavirus-covid-19/poll-finding/kff-co...

effie20• 5 years ago

The procedure you are describing is difficult to do formally for most people, so they estimate it intuitively, like you did.

And since individual data and personal values and political stances are involved, they got a different result from yours.

minikites7• 5 years ago

If someone isn't vaccinated by now, I don't think the FDA "approving" it is going to make a difference, they've made their choice. We need to start shipping our supply of vaccines to nations that need them so we can give them to people who actually want them.

JCM9• 5 years ago

The general public has a very hard time rationalizing and making decisions based on risk assessments. People get nervous on US commercial air carriers even though this is by all measures currently the safest form of transport in the history of transportation. Literally safer than walking down the street.

As for the vaccine, the fallacy of most people’s logic here is thinking that not getting the vaccine equates to risk avoidance. In fact based on all we know it’s quite the opposite. The risk of not getting the vaccine vastly outweighs any potential risk of getting the vaccine. With the Delta variant if one isn’t vaccinated it’s increasingly very likely you’ll get COVID. The short and long term impacts of COVID are well known to have a high risk of being severe. From a risk standpoint it’s a no brainer.

The media doesn’t help here at all. One person has a reaction from the vaccine and they’re all over it. Meanwhile thousands more die from not getting the vaccine. Opting out of the vaccine increases your risk, not decreases it.

tedmcory77• 5 years ago

"The general public has a very hard time rationalizing and making decisions based on risk assessments. People get nervous on US commercial air carriers even though this is by all measures currently the safest form of transport in the history of transportation. Literally safer than walking down the street."

I've thought about this a lot; for me, it's not the mortality rate that bothers me the most.

It's the method of passing. Having been in a plane experiencing a serious issue it was a lot scarier because of the duration than the traffic accidents I've seen which were basically over immediately.

ceoloide5• 5 years ago

This seems to nail it based on my experience.

At least anecdotally, the people I know that are vaccine-averse have the same fear of airplanes, etc.

It might just be the way they reason, fixating on worst-case outcome instead of a more balanced view.

effie20• 5 years ago

The risk of not getting the vaccine vastly outweighs any potential risk of getting the vaccine.

Read again and think a little about this statement. First, it is biased: risk of getting vaccinated is "potential", but the other risk is not denominated this way. Second, this risk comparison is obviously not true for every person.

In fact, both risks are individual and depend on several factors and weights of those factors, and those weights depend on person's values. You didn't mention data you are basing this statement on and for which combination of those factors and weights it is true.

Also, besides the risk analysis, getting the vaccine is a political decision for many people. Most people I know got it to avoid repression from state and to get preferential treatment from authorities when travelling. Other people refuse the vaccine because they don't trust the source, the evangelist and the administrator.

You can't mandate or dictate people's political stances nor medical treatments. That's a definition of totalitarian power.

Meanwhile thousands more die from not getting the vaccine.

You meant to say some people died because they refused the vaccine and then got killed by COVID. Yes this is sad but those people died as free people.

danShumway• 5 years ago

Short version:

- Full FDA authorization takes time

- We know a lot more about how these vaccines work than other vaccines so we're less nervous about them, but that doesn't mean full FDA authorization doesn't still take time

- Since temporary authorization was granted, a huge number of people have gotten the vaccine, which gives us a lot of confidence since we effectively have a lot of case studies to look at. However, doesn't change anything about the fact that full FDA authorization still takes time.

- If Covid wasn't Covid, even knowing the above we might not have allowed temporary authorization, but we're managing relative risk, and the risk for nearly every population from Covid dwarfs the risk that there's a side effect from the vaccine that's worse. But, FDA authorization still takes time, it's not based on how dangerous the alternative is, so full authorization is still only gonna happen once enough time has elapsed for the vaccines to be evaluated using the normal process.

----

I don't know if this will help with your family in specific, but I like to compare this to a change on a piece of software in an enterprise environment. Knowing for certain that the change is safe requires the change to be deployed on production hardware via a production build and run through a full set of full-stack tests, and then ideally monitored for a week to see if anything else jumps out as a regression.

So one day, imagine we notice a critical bug that's causing data loss for customers. I can argue:

- The change to fix this bug is in a part of the code that is well understood, all of our developers have looked it over and agreed that it's unlikely to have side effects.

- We've hotpatched this fix to multiple sites that were affected, and tested internally, and everything seems to be working well. We do have this code running in production for some customers, but we have not seen side effects.

- The risk of one of our customers randomly losing their data because of the bug is far higher than the risk of the fix causing additional problems, and it would be foolish for us to leave our customers in a state where they might lose data suddenly.

All of those are good arguments for bypassing the full set of tests and deploying the fix immediately (which is basically what the FDA did with the emergency authorization). BUT I still can't accurately claim that my fix has passed the full set of testing requirements. Independently of hot-patching sites and rolling out the critical fix, I also still want to run the full test suite and monitor the production hardware for a while longer.

That's basically where we are with the vaccine. We'd be foolish not to be deploying it now, but we still can't pretend or shortcut the process and just say that it's fully authorized (even though basically no one is expecting the authorization process to fail at this point). It hasn't passed the full test suite and sat on production hardware for a week yet. However, the risk of an issue at this point is small enough that for the vast majority of adults (even middle-aged and below), the risk of Covid complications are higher than the risk of vaccine complications.

The good news is that most timetables I've seen expect full authorization to be finished for Pfizer between September and December. I would not advise anyone to wait for that, but hopefully when it happens that will decrease vaccine hesitancy.

mschuster912• 5 years ago

Can someone explain to me why the vaccine is safe even though it’s “experimental”.

The COVID vaccines are a trade-off... possible but unlikely long-term consequences vs. definitive and massive long-term side effects of catching COVID.

Australia and New Zealand aside, if you are not vaccinated you will get COVID eventually.

philliphaydon• 5 years ago

Why do you say “australia and New Zealand aside”? Getting vaccinated doesn’t prevent you getting covid… it just prepares your immune system to fight it if you do get it.

II2II• 5 years ago

I suspect the argument about long term effects is intentionally misleading. It will be impossible to convince most of those people about long term effects until the long term has come to pass. The chart in the article even alludes to that, with < 15% saying they'd get vaccinated if there was full FDA approval. That is likely as close as we'll get to a statement of there being no long term effects in the near future.

As for "shortcuts" being taken in the approval process, the normal process is intended for situations where there is less urgency. The combination of a high infection rate and relatively high mortality rate has a large social impact and it has a large economic impact, regardless of whether anything is done to mitigate spread. The provisional approval is necessary, it still reflects high standards for safety, and it does not imply a lack of safety.

Edit: for clarity.

effie20• 5 years ago

relatively high mortality rate

Can you quantify that? How many people died from COVID vs. cancer or transport accidents?

staticassertion3• 5 years ago

Just explain how the vaccine works. I think a lot of people seem to not really understand it, which makes it this mystery fluid being injected into them. You don't need to get too detailed.

The vaccine contains mRNA, which is basically like DNA (in layman terms). The mRNA is from covid and it's what gives it its 'spiky' structure. When the mRNA is injected your body uses it to generate those spikes - that's just a normal function of your body. Your immune system learns how to attack those spikes, and so it'll recognize covid in general. mRNA is very short-lived so it breaks down, the end result being that your body gets some covid proteins for a little while and your immune system cleans them up.

I think a really simplistic breakdown like this goes a long way to helping people feel comfortable. They're no longer wondering "what's in this thing? how does it work?" and instead it's like "oh ok yeah, I have at least an extremely basic understanding of DNA, and this is just a tiny little piece of DNA stuff that breaks down super fast".

formerly_proven• 5 years ago

As I understand it, mRNA vaccines are considered safer "by design" than other types of vaccines, because mRNA is so short-lived and the body has no way of replicating mRNA, and each piece of mRNA is only translated a few times, so the number of proteins a shot of mRNA vaccine creates is very specific. Because the mRNA can be made to only produce a very specific component of the virus, there is basically no risk for a real infection to develop, because there isn't a real pathogen, in contrast to some other vaccines which contain modified/weakened pathogens.

basch• 5 years ago

I honestly think focusing on mRNA is basically missing the forest for the trees.

It's like trying to describe how safe a substance in a shot is by describing the needle. mRNA is HOW you deliver the spike protein. But the safety of the vaccine is related to WHAT the mRNA creates. If it were a human protein, we would all develop auto-immune diseases of some sort.

mRNA vaccines are the cleanest, and in a round-about way, simplest delivery mechanisms, (simple in that there arent as many precursor steps as something like a viral vector vaccine and simple in that its not a full attenuated virus) but its what they deliver that the conversation should be about.

analog312• 5 years ago

I ask what are the long term effects of covid. Allowing covid to spread throughout society is also an experiment.

effie20• 5 years ago

True. One which unfortunately we can't stop with vaccines. Even if vaccines were 100% effective (which they are not), we would have to violate constitution and humans rights of millions to really exterminate the virus with vaccines. That's unthinkable (the consequences would make the whole COVID situation a boring detail of history). The COVID is here like flu, cold is, can't get rid of it, we should let it exist and go on with our lives.

lb0• 5 years ago

Those ""longterm"" fears to me are just an excuse.

No vaccine (or please tell me one) ever showed any "long term" effects in that sense that bad things showed up > 3 months after the vaccination, actually almost all side-effects happen instantaneously.

The reason talking about "long term" side effects is that you usually need to reach very high numbers on your studies to e.g. correlate one in a million side effect to a medication, and thus need very "long term" studies.

However, for those vaccines we are now MUCH beyond these numbers already! That is also what people mostly don't get in general right now: (In the very beginning maybe yes, but now not anymore)

Those studies are NOT! pushed anymore with shortcuts and exceptions, the contrary, because due to the pandemic situation the necessary numbers (get x people of test persons infected) were so quickly passed now.. similar now for those side effects. It just doesn't make any sense to pull that argument anymore (though science vs belief is hard).

And if you are really like "Meh.. but these totally new mRNA vaccines will grow me horns" => Comparing mRNA vs old-school vector vaccines is maybe like comparing LDC TVs of today vs old tube TVs that even bombarded you with little xrays... it is just such a technology jump.. and if you are into the topic and really concerned about that this mRNA will inject something into your cells/genes.. then you actually should be much more afraid of vector vaccines or just some viruses out there like Corona doing the same but much more reliably..

jansan• 5 years ago

Well, there is the Dengvaxia controvery:

https://en.wikipedia.org/wiki/Dengvaxia_controversy

manwe150• 5 years ago

There was once a concern that certain vaccines predisposed you to diabetes or autism. Those studies took years to run (need to follow through adulthood), though in the end could not find a correlation.

munch117• 5 years ago

Pfizer-BioNTech has been approved in the EU since December 2020. Fully approved that is, not experimental, not emergency use.

That it's still on emergency use in the US is puzzling. But as anyone who's been through a formal approvals process knows, these things can drag out forever. Approving bodies are all about CYA, they just don't like to commit to anything being satisfactory.

effie20• 5 years ago

Not true. It has conditional marketing authorization.

https://www.ema.europa.eu/en/medicines/human/EPAR/comirnaty#...

Also it is in pharma's interest to have this as long as possible. They like their immunity from prosecution.

MR4D• 5 years ago

It isn’t “experimental”, rather, it has “emergency use” authorization.

Frankly, these vaccines have tons of data behind them, with the exception of long-term results [0].

Here’s how I would frame it: would you rather take a chance on a vaccine or getting Covid? Remember, Covid has many worse short term effects than the vaccine, and long term effects from it are truly understood yet either. So the vaccine is the more rational choice, despite the unknowns.

Hope that helps.

[0] https://www.fda.gov/emergency-preparedness-and-response/coro...

Majromax• 5 years ago

Here’s how I would frame it: would you rather take a chance on a vaccine or getting Covid?

I refuse to get any virus that has not passed rigorous Stage 3 and Stage 4 safety trials. Worse yet, this so-called Delta variant has been rushed into production without even the most basic studies, even though it's clearly not the same thing as the original virus!

loicd5• 5 years ago

I don't understand why people are so obsessed over potential long term effects of vaccines while completely ignoring the potential long term effects of covid. There are no examples of vaccines with long term side effects. On the other hand, there are viruses like HPV that despite producing essentially no symptoms cause cancer in the long run. Sars-cov-2 is a new virus. Nobody knows its long term effects. Even asymptomatic covid cases may have damage to their lungs. Given how contagious covid is, the choice really is between covid and the vaccine, and the vaccine definitely looks like the safer choice.

effie20• 5 years ago

I don't understand why people are so obsessed over potential long term effects of vaccines while completely ignoring the potential long term effects of covid.

I don't know anyone obsessed but: the issue is present. The rollout was quick and we don't have 10 years of data and the pharma got their immunity. If pharma isn't confident in safety of their product, it's safe to assume they know or are afraid that some significant percentage of nasty cases will happen.

There are no examples of vaccines with long term side effects.

https://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_sy...

If there can be bad effects like GB syndrome as far as in 6 weeks, there can be longer term effects as well.

With COVID vaccines it hasn't been very long yet. Standard studies of vaccines take 10 or more years. I like that cautious approach.

Sars-cov-2 is a new virus. Nobody knows its long term effects.

Yes, the same as for vaccines. Hopefully we will know in the future.

Even asymptomatic covid cases may have damage to their lungs. Given how contagious covid is, the choice really is between covid and the vaccine, and the vaccine definitely looks like the safer choice.

COVID is very contagious if you believe that positive PCR test means you have COVID. Of course, that's not how disease in general is diagnosed; symptoms are the telltale of sickness, and based on those, COVID is not that bad. Of course, there is the possibility that prolonged presence of virus in these OK persons will wreak havoc with their health in the coming years. But this is hypothetical now and not enough to scare major part of the population.

nokcha• 5 years ago

Two points:

1. The fact that the vaccine only has "emergency-use authorization" rather than full FDA approval is best explained by the fact that the FDA is a dysfunctional bureaucracy motivated primarily by CYA rather than rational cost-benefit analysis.

2. The vaccine isn't 100% absolutely safe, but neither is anything else in life. The proper question to ask isn't whether the vaccine is safe in some absolute sense, but whether it is safer than going around unvaccinated. The evidence indicates that getting vaccinated is significantly safer than regularly breathing the same air as other people while unvaccinated. And although healthy non-elderly people are unlikely to outright die of COVID-19, there is evidence that infection often causes long-term effects, including cognitive deficits [1, 2].

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

[2] https://thezvi.wordpress.com/2021/07/29/covid-7-29-you-play-...

effie20• 5 years ago

1. Maybe true, but there is also the interesting fact that pharma wanted and got immunity, so it is in pharma's interest to prevent the full authorization;

2. You missed the fact that risks depend on personal data, factors, weights of those factors. Also, cheap treatments are available and effective which push the risk of bad COVID to such small number it's immaterial to most anti-covidism people (a political stance).

furstenheim• 5 years ago

This looks a lot like evolution in real time.

thenoblesunfish• 5 years ago

Your comment could be read two in ways:

1) People refusing to get vaccinations are more likely to die, which will affect the human gene pool. 2) The coronavirus itself is going to evolve faster (creating new variants) because of more replication in the unvaccinated human population.

I'd be cautious about the first one - we have a long history of getting things wrong in this area. The second one is pretty undeniable (this is how we got the Delta Variant, I think), and it makes the (often reasonable) "their bodies, their choice" argument harder.

minikites7• 5 years ago

it makes the (often reasonable) "their bodies, their choice" argument harder.

This argument is in no way reasonable when talking about a contagious disease. It's not about your body, it's about society. They steadfastly believe they don't owe anything to society, whether it's getting a vaccine or wearing a mask.

melenaboija• 5 years ago

Is not evolution always in real time?

effie20• 5 years ago

While this is a process that is believed to be happening, it is very hard to observe in real time. It takes comparing data between decades and more to notice changes in composition of animal bodies.

MagnumOpus• 5 years ago

No, almost all people who die unvaxxed are past reproductive age. For evolutionary fitness, it doesn't matter if you die a dumbass at 55 as long as you spawned loads of offspring beforehand.

warlog• 5 years ago

The figure and message are a bit misleading:

Plummeting down a rank curve conveys that America (and the headline) suggests the country is getting worse in absolute terms. But more Americans are vaccinated now than before, so it is absolutely better than it was before.

Thanks to the rest of the world for also getting vaccinated. When any country surpasses the US current per centage, the US drops a full rank point. But it's not getting less vaccinated, it's not getting worse.

freemint• 5 years ago

suggests the country is getting worse in absolute terms.

No, it doesn't. What makes you think that?

mngnt• 5 years ago

I only read up to the paywall, but I think a more truthful title would be "Countries around the world overtaking USA in vaccination rate". Tells the truth and still is catchy enough. Plus, it is in tune with the article, which doesn´t claim Americans got un-vaccinated.

tzs• 5 years ago

The variation within the US is striking. The NY Times interactive vaccination tracking page [1] has this neat visualization comparing the states [2].

For those unfamiliar with US geography, the way the graphs for each state are arranged matches the geographical layout of the states within the country, so if you've seen other maps of the US showing how something varies with location you can match those with the vaccination rate graphs and see interesting correlations.

[1] https://www.nytimes.com/interactive/2020/us/covid-19-vaccine...

[2] https://imgur.com/a/MkKaoyY

America is plummeting down the global vaccination league table

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