Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

US agencies call for pause in Johnson & Johnson vaccine

bbc.co.uk

Post reply on HN
Print view View original

241–250 of 1001 posts

Re: US agencies call for pause in Johnson & Johnson vaccine

#241

Post by shmel »

ceejayoz wrote: post #2

Six cases in seven million administered doses. One death. Meanwhile, hormonal birth control causes clots in 1/1,000 women. No one blinks an eye. The vaccine hesitancy this engenders is likely gonna kill more than that one person. https://twitter.com/NateSilver538/status/1381936112311148548 > Public health bureaucrats have some weird habits in how they reason under uncertainty and how they communicate to the public. I…

Why is it relevant? So far nobody forces me to take birth control and threatens for exclude me from the society if I refuse to do so (UK wants to require vaccine passports to go to cinema, for example). Nobody paints me as stupid anti-vaxxer if I just say I don't want to take BC pills. Nobody tells me that I won't be able to travel unless I agree to take BC.

Re: US agencies call for pause in Johnson & Johnson vaccine

#242

Post by ravenstine »

dragonwriter wrote: post #153
ravenstine wrote: post #123

I'm trying to understand why this isn't ridiculous, and I'm not sure what that reason could be. The disease left to its own accord has the potential to kill millions (someone please correct me on this). Why would we pause a vaccine because 6 people in 7 million got blood clots? Why would we do that and risk fueling anti-vaccine viewpoints? I'm baffled, but perhaps I'm a fool.

> Why would we pause a vaccine because 6 people in 7 million got blood clots? Because J&J isn’t the only vaccine in the inventory, and the others don’t have that problem (or, IIRC, the same level of other adverse reactions), and because: > Why would we do that and risk fueling anti-vaccine viewpoints? What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especiall…

> What risks fueling anti-vaccine viewpoints is ignoring adverse impacts which are known and plowing forward, especially giveb that people often don’t have a choice of which vaccine they are administered.

Your point about other vaccines being available is totally valid and sound, but... what is our standard here, then? For absolute-zero people to die of any vaccine we produce? What if it was 1 person who got a blood clot? It probably sounds like I'm being pedantic, but I'm serious in that I want to know why people find it reasonable to pull an otherwise effective vaccine because of this. It just doesn't seem worth it to tell everyone that the vaccine is dangerous enough that it had to be pulled entirely.

Ignoring adverse impacts definitely fuels anti-vaccine sentiment, but so does giving people concrete evidence that the vaccine can possibly kill people, possibly leading them to be resistant to getting any COVID vaccine at all until they're forced to get it. I mean, if I were at all skeptical of getting a COVID vaccine, and I was told the J&J vaccine was so dangerous they had to pause it, why would I get any of the more experimental vaccines knowing that they also have the potential to kill me but we don't even know yet because they're experimental?

I don't think people on HN realize the full magnitude to which the public can be timid and irrational. It just doesn't seem worth it to me for us to possibly fuck up the rollout of vaccinations when we are facing a possible 4th wave of COVID and more virulent variants.

Let's compare some numbers here.

The number of known blood clot cases with the J&J vaccine seems to be 6 in 7 million. That's a ~0.00000085% chance of getting a blood clot caused by the vaccine, give or take a zero since I suck at math and calculators refuse to not use scientific notation. According to the CDC, around 100,000 people die of blood clots in the United States every year, and the US population is 308,401,808, meaning that Americans have a ~0.0003% chance of dying of a blood clot in their lifetime. The only concerning factor as far as I can tell is that the people who got the blood clots were women under 50.

I mean, fine, if that's a risk profile we are averse to, then so be it. I don't really understand that.

Re: US agencies call for pause in Johnson & Johnson vaccine

#243

Post by barsonme »

myrandomcomment wrote: post #230

Okay so I want to make something very clear here. The rule is to put it very very simply, is you can ship any drug that is approved but you have to list the side effects. This drug was approved under an emergency order and this side effect was not listed. This will get paused long enough for the side effects to be updated and then used again. The arguments about “well the birth control pill has a higher risk” are usi…

I don’t understand why you have to pause then restart. Just update the side effects as you go. Or pause for the affected groups.

Re: US agencies call for pause in Johnson & Johnson vaccine

#244

Post by Ericson2314 »

Well this seems stupid.

The thing I'm trying to understand is whether Johnson & Johnson and AstraZeneca are meaningfully different. All the media just assumes they are (until proven equivalent), but is the genetic code publicly known so we can compare? The Pfizer and Moderna ones are extremely similar. Now, I imagine the adenovirus ones have an order of magnitude more genetic material, but is the code publicly know to compare?

As far as I can tell, they both should have been approved ages ago, if only to depress prices and get more redundancy.

Re: US agencies call for pause in Johnson & Johnson vaccine

#245

Post by krooj »

HillRat wrote: post #201
johnnyapol wrote: post #190

Earlier quoted context omitted.

I'm not saying your calculus is wrong but this does make an assumption that all clots are created equal and I don't believe that is the case. The specific issue being observed is "cerebral venous sinus thrombosis (CVST)" in combination with "low levels of blood platelets (thrombocytopenia)" per the Joint CDC and FDA statement (1). Low blood platelets means anti-clotting treatments can pose a substantial bleeding incr…

And we know adenoviruses interfere with the coagulation cascade through FX binding, so it’s well worth taking a pause and taking a closer look into what’s going on. With two well-tolerated and safe mRNA vaccines in the market, we can afford — to a degree! — to put Ad-based vaccines through additional scrutiny, especially since they’re likely to be the primary vaccine type on a global level.

Sorry, what’s the effect adenoviruses have on FX? I’m a male with a mild hypercoag disorder and history of DVT. Am scheduled to get the JJ vax today and will be skipping and seeking out mRNA instead.

Re: US agencies call for pause in Johnson & Johnson vaccine

#246

Post by carnivalWilson »

laplacesdemon48 wrote: post #103

Both the AstraZeneca and J&J vaccines use an adenovirus to deliver DNA instead of mRNA wrapped in lipid (like Moderna & Pfizer). Everywhere I read about the J&J vaccine, I see something like "the DNA vaccine doesn't alter your DNA". Can somebody please clear this up? As far as I understand, the mRNA just stays in the cytoplasm of the cell and gets used up by the ribosome to create spike proteins. The adenovirus vecto…

I'm a bioengineer. Everyone that gives an answer mostly ignores epigenetics and the fact that RNA can permanently alter the _shape_ (or conformation) of how your DNA is tightly wound up. For example, RNA can direct methylation of DNA and alter histones, which can lead to transgenerational epigenetic effects on gene expression and phenotype [1]. The fact is, molecular cell biology is incredibly complex and the models we have are just that, models. Saying that these mRNA strands don't affect the genome long-term may be correct, but this is an educated guess based on theoretical models. There's a reason why FDA approvals traditionally took 10+ years, we normally verify our educated guesses empirically.

It almost certainly won't have long-term affects, but it may not be trivial to identify if mRNA vaccines have been altering epigenetics.

[1] https://en.wikipedia.org/wiki/RNA-directed_DNA_methylation

Re: US agencies call for pause in Johnson & Johnson vaccine

#247

Post by SpicyLemonZest »

endisneigh wrote: post #219
endtime wrote: post #214

Earlier quoted context omitted.

I don't see your point. The J&J vaccine also presumably prevents much more blood clot-related harm than it's causing. OP is pointing out that we seem to have weirdly high standards for COVID vaccines vs. stuff we're used to. Also, how does Bayes' Theorem apply to your comment?

There's no "high standard" to begin with. J&J is paused because there are alternatives that don't have clotting to the same degree. A comparison with birth control makes no sense. Is there some magical birth control that's used orders of magnitude more (Pfizer) and orders of magnitude safer with respect to blood clotting and also prevents pregnancy? No? Then the comparison is stupid.

The primary concern people have here isn't the review, it's the immediate withdrawal. People who had appointments to get the J&J vaccine will now go vaccine-less until they can be rescheduled, even if they would have been happy to take it knowing about the blood clots.

Re: US agencies call for pause in Johnson & Johnson vaccine

#248

Post by ravenstine »

ed_balls wrote: post #220
ravenstine wrote: post #206

Earlier quoted context omitted.

Isn't that as true, if not greater, for the mRNA based vaccines, despite them not having that observed side effect? For all we know, everyone's butts might fall off because of them in the future. (yes, I'm being somewhat facetious)

My understanding is the that AstraZeneca and J&J are also new tech. Vector-based and mRNA are different than attenuated (weakened) form of the virus which is used in most vaccines. (I'd be good if someone with more knowledge could comment)

Yes, you are right. Both are experimental / new tech.

Re: US agencies call for pause in Johnson & Johnson vaccine

#249

Post by clon »

cblconfederate wrote: post #210

Is there an understanding of why the vaccines cause the clots?

As for the AZ vaccine, we are still learning: https://www.nejm.org/doi/full/10.1056/NEJMoa2104840

The paper details several cases (and index case in more detail) as well as a plausible mechanism behind the thrombotic events. Even better, there are some therapeutic possibilities as well arising from the heparin induced analogue condition.

Re: US agencies call for pause in Johnson & Johnson vaccine

#250

Post by stevenwoo »

cblconfederate wrote: post #210

Is there an understanding of why the vaccines cause the clots?

The theory is that it is the same reaction that a tiny percentage of people have to heparin (AZ vaccine in this study but mechanism presumably the same) There is a treatment but imperative that doctor knows that this is the cause for appropriate response. https://www.nejm.org/doi/full/10.1056/NEJMoa2104840
Post reply on HN