Live data from Hacker News

US agencies call for pause in Johnson & Johnson vaccine

bbc.co.uk

831–840 of 1001 posts

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

#831
post #669

Earlier quoted context omitted.

I hear this line being trotted out all over - especially from the "experts" - and I find it nothing short of enraging. There is a difference between saying "an mRNA platform in general might not be safe" and the actual claim real people make which is "this specific vaccine has not existed for more than a year and is being hastily rolled out on the world population via implicit or explicit coercion". The mRNA platform…

It's not dishonest. It's a very adequate answer to the over-simplifying claim above. I.e. there is a difference between a newer and an older platform and there is a difference between an experimental platform and a new platform (that's not experimental but has been in development for a long time). You can always argue for making things slower and experiments longer, the problem is, that there is a pandemic going on w…

> It's not dishonest. It's a very adequate answer to the over-simplifying claim above.

I would disagree that calling it "rushed, experimental, and not necessary for [the original commenter]" is an over-simplifying claim. Indeed I find the "we've done theoretical research with platform X for years" to be the oversimplification. That being said I do agree that there is a difference between an experimental platform and a new platform.

> But again: why would you want to wait for several years in a situation like this when we do have a pretty clear picture of both the worst case risks of the vaccines and the risks of the disease (which are higher than the worst case risks of the vaccines).

Starting with the "higher than the worst case risks of the vaccines" part, FWIW, this is true in general but not for all individuals. For someone like me (20's, active, no major health conditions), the acute side effects of getting a SARS-2 vaccine far outpace the expected level of symptoms from SARS-2 infection itself. (Speaking from a personal risk reduction standpoint only, I don't want to get into the ethics of medical collectivism for the purposes of this discussion). I don't think you would dispute that, but just wanted to mention it because it's because taboo (and indeed you can get actively censored) to say "for my specific health circumstance the vaccine is more dangerous to me".

As for the more general point about understanding the risks of the vaccines and the disease fairly clearly, I would say that we understand the virus far better than the vaccines. Indeed it really saddens me how we've wasted public health dollars on messaging to people that immunity to reinfection is not a thing (when it is most definitely a thing) and to be super spooked about variants despite the fact that SARS-2 is not going to magically mutate away from the spike protein anytime soon (i.e. there's plenty of epitopes for our immune system to work with even for the highly artificial immunity produced by making the body's cells manufacture spike protein exclusively).

I will grant though that we have bounds on how bad short or medium-term adverse reactions could be to the vaccines. Personally I worry less about the (using mRNA as an example here to illustrate a general point) "it's going to turn me into a human GMO" pseudo-argument than I do things like (a) "is the rate at which spike proteins get produced in the body much more of a steep increase followed by a steep dropoff leading to greater potential for acute inflammatory episodes than via naturalistic infection" as well as (b) "could we be over-sentitizing the immune system to react too strongly when it detects spike protein, particularly for those who already had COVID-19 before ever getting the vaccine". If you're not aware, an absurd amount of people who have already gotten COVID-19 and therefore have naturalistic immunity are still getting the vaccine, either because they're "required" to (aka they don't know or want to fight their job's requirements) or more often because they've been brainwashed to think that the variants evade natural immunity which is just a total media-propagated falsehood.

> In the case of SARS-CoV2, they could build a lot on the experiments from SARS-CoV1

Totally agreed and I wish more people knew that the virus causes COVID-19 is called SARS-2 and that it is directly related to SARS-1 (I'm referring to layfolk here). As a separate tangent I wish more people understood that the emergence of SARS-2 means we don't really need to worry about SARS-1 anymore because anyone exposed to SARS-2 will be cross-reactive with SARS-1.

> I've already mentioned this, but if the vaccine candidate doesn't get ready on time because of the above reasons, then you may have to wait for years before you can do a phase3 trial because there will be no people getting infected, so you won't be able to measure the effectiveness.

This is simply not the case for an endemic seasonal respiratory virus. You'll have plenty of cases, especially since we're basically PCR-testing the whole globe (I don't think we should be, to be clear). But I totally agree that the apparent benefit of vaccines declines exponentially as time goes on, particularly with SARS-2 where the fact that it is deadly for the very elderly and harmless for the very young means that yearly recurring mortality is going to essentially vanish after it's propagated through the current world population (as an aside, this fact is one of many reasons why all the hysteria around the virus was absurd from the get-go; amortized over several years the mortality of SARS-2 is entirely unremarkable)

> But again: why would you want to wait for several years in a situation like this when we do have a pretty clear picture of both the worst case risks of the vaccines and the risks of the disease (which are higher than the worst case risks of the vaccines).

Yeah, to conclude I want to bring it back to my earlier point which is that once the virus has propagated through the current world population (more or less), the set of SARS-2-naive individuals will become dominated by the very young, who are not at real risk of COVID-19 and therefore they will develop immunological memory while young when they are incapable of being harmed by SARS-2. This means that recurring yearly mortality will fall off a cliff (albeit, if we keep labelling deaths the way we do we won't see that reflected in the numbers nearly as much as we should). Which is why I think the restrictions and everything else, even if they had worked in places like the US or Europe where they totally failed, were always a bad idea. But the other side of that coin is: yes, insofar as you do think SARS-2 is something worth really freaking out over, we absolutely have to rush the vaccines because if we wait 2 years then there won't be any real COVID-19 deaths left to mitigate.

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

#832
post #303

Earlier quoted context omitted.

The rules do not exist to manage risk. They exist to strike a balance between ethics and risk in emergency situations. If you’d like to change them going forward, feel free to advocate. I think it’s best we stick with our current rules this round.

We've changed the rules for every single part of life and society because of this massive emergency, with no idea what the long-term consequences of doing so might be. I'm not sure why the FDA should be excluded.

The change in life is supposedly temporary restriction of freedoms for emergency reasons. Maybe it is wrong but governments have that power and people accept it.

Imposing political pressure on experts and forcing them to approve against their judgment would be a horrible corruption of these regulator institutions.

Maybe the expert regulator think that the bar should be lowered. But then they should come forward. This should not be ordered by politicians or their handlers.

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

#833

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…

Thank you for this explanation. I've been wondering this myself especially when it comes to methylation.

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

#834
post #702

The risk of dying from a blood clot after receiving the J&J vaccine is six in 6,800,000 (6.8M). The world population is 7,900,000,000 (7.9B). If everyone on the planet got the J&J vaccine tomorrow, and if it is the cause of the clots, then 6,971 people would die from the vaccine. Yesterday, Covid19 killed 8,803 people (according to worldometers). We don't want anyone to die from vaccination, and we don't fully unders…

But you are having conflate for deaths from each of things. Rates in dying are not homogeneous in J&J vax versus corona. J&J vax maybe is received by many younglings who are not risking death so much from Corona for benefit of old. It is not yet being known for if J&J vax is having any greater risk for older people or younger people. So calculus is maybe not so simple. If I are healthy young person maybe it is not a…

This is an excellent point, and exactly the reason why the UK decided to stop administering the AstraZeneca vaccine to people under 30. Not sure why you're being downvoted.

For people under 30, particularly women, the risk of blood clots from AZ is higher, while at the same time the risk from coronavirus infection is lower. When there are alternative vaccines available with no evidence of similar side effects, it makes sense to temporarily stop administering AZ/J&J to those groups to investigate if there are any risk factors we can use to predict and protect those who may be most vulnerable to side effects. (It has been suggested that young women on certain types of birth control are at highest risk of blood clots after AZ.)

That said, as some have pointed out, the risk of blood clots is still thought to be very low, even for women under 30, and anti-vax groups as well as the vaccine hesitant may see this news as a sign that it's not safe for anyone to take any vaccine. However, I don't think we as a society should actively try to conceal news or research about vaccine safety so that people don't worry. In my opinion, people have a right to know, and efforts to conceal concerning information often backfire, producing more public distrust.

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

#835
post #640

Earlier quoted context omitted.

I hear this line being trotted out all over - especially from the "experts" - and I find it nothing short of enraging. There is a difference between saying "an mRNA platform in general might not be safe" and the actual claim real people make which is "this specific vaccine has not existed for more than a year and is being hastily rolled out on the world population via implicit or explicit coercion". The mRNA platform…

J&J is not mRNA platform, it uses an adenovirus platform.

Thanks. To avoid repeating myself: https://news.ycombinator.com/item?id=26799734

TL;DR you can probably s/mRNA/adenovirus vector/g although I will grant that adenovirus vector seems less "experimental" than mRNA does

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

#836
post #310

Earlier quoted context omitted.

Government over-reactions to COVID19 have been disastrous. There would have been an economic hit for sure but things would have returned to near normal by August 2020 if they had respected freedom (or if people had disobeyed in mass).

Yeah. The US is apparently already at ~50% antibodies, not counting vaccination. So, there’s a floor on the upside of the vaccine: It did no more than halve deaths. We’re in the middle of a surge, and it looks like most of the remaining 50% will end up catching covid before being vaccinated, so the percentage saved by vaccination will continue to drop. The ideal strategy without hindsight was conventional wisdom: Pro…

> The ideal strategy without hindsight was conventional wisdom: Protect the vulnerable and stiff upper lip for the rest.

China, Vietnam, Australia and New Zealand used strict lockdowns to eliminate community spread, and then largely opened things up again. People in those countries have been able to live much more normal lives than people elsewhere during the pandemic. With hindsight, that was clearly the correct strategy: eliminate the virus, then reopen and keep a hawk eye out for any new cases.

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

#837
post #828
post #702

The risk of dying from a blood clot after receiving the J&J vaccine is six in 6,800,000 (6.8M). The world population is 7,900,000,000 (7.9B). If everyone on the planet got the J&J vaccine tomorrow, and if it is the cause of the clots, then 6,971 people would die from the vaccine. Yesterday, Covid19 killed 8,803 people (according to worldometers). We don't want anyone to die from vaccination, and we don't fully unders…

If there is solid evidence that a vaccine will kill people, it should not be used. It's intolerable that people die taking a prophylactic. It's much, much worse to kill someone with a vaccine than to allow that person to perhaps die of a virus. Thankfully, in this case, sanity prevailed.

> If there is solid evidence that a vaccine will kill people, it should not be used.

Don't all vaccines have some extremely low but nonzero probability of killing someone?

> It's intolerable that people die taking a prophylactic.

What do you think about airbags in cars?

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

#838

Earlier quoted context omitted.

6 obvious deaths that we're aware of. The risk of the vaccines is in their novelty and morbidity. An abundance of caution is required in this instance. It would be very bad to discover that there's a vanishingly small chance of blood clots within the first 3 months but a significant chance when paired with other events over the following decade.

So I created a new account for this to avoid linking personal information... I had blood clots in my lungs last week a few days after getting the J&J vaccine. I'm an otherwise totally healthy man in my 30s, no preconditions. The hospital reported it to the vaccine reporting agency, which I assume is reviewing all this information. I'm not sure if they considered my case when making this decision. My clots were differ…

The PR release tells people to watch for pain in their legs. So I think it’s possible and likely that clots are not only cerebral but arterial and venous.

But, IDK and I’m super skeptical they’re willing to halt vaccine and take this hit for 6 known cases. My guess is 6 deaths they’re willing to acknowledge and a few more cases that will come out.

But again, I know nothing and I would’ve expected their stock price to take a hit today.

Hope you get better soon.

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

#839
post #755

Earlier quoted context omitted.

The different efficacy rates of the vaccines do not directly imply anything about spreading covid. A vaccinated person can have no symptoms of covid and still be spreading (This may or may not be true). Folks are still studying how effective the vaccines are at preventing spread.

> A vaccinated person can have no symptoms of covid and still be spreading Aren't the efficacy numbers from the phase 3 trials based on giving periodic PCR tests to everyone that was participating in the trials? And not just based on people self-reporting symptoms? It would be very surprising if there were a new kind of asymptomatic carrier that emerged only for people having taken certain vaccines in which they woul…

Depends on the particular trial, but the clinical trial data used to get FDA approval usually measures symptomatic cases, which is a combination of coronavirus symptoms and positive PCR test.

There's some additional data which indicates Pfizer and Moderna are likely to limit transmission, but from my understanding it's not as ironclad as the symptomatic cases data.

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

#840

Earlier quoted context omitted.

This comment is a prime example of why we’re in this mess with vaccine denial in the first place. You’re either not allowed to say anything negative about vaccines, or you’re an anti-vaxxer who thinks your kids will get autism and 5G chips. It’s so cult-like. We should be honest about the (low) risks and benefits of vaccination without turning it into a political campaign of shame and bullying, and trust people to ma…

IMO, no - I'm saying that folks risk management is completely out of wack. The chance the disease kills you is 1 in 100. The chance that the vaccine kills you is 1 in 7 000 000. One is bigger than the other. By, like, a lot. The government's response is to pacify anti-vaxxers.

> The chance the disease kills you is 1 in 100

It's 6 in 1000 if you listen to the CDC; personally I think the real number is closer to 3 in 1000. That's not too far off from what you said but I prefer being more explicit rather than using such a fuzzy resolution.

And just to be explicit, that's the general IFR, the IFR for, say, people in their 20's, or even people in their 40's, is a fraction of that.

---

Anyway, your point about risk management is somewhat true, but it is much more true if you apply that logic to the general public's fear of SARS-2 in the first place. I can't find it in my notes but surveys that have asked people what their chance of dying is if they catch the virus, are off by MULTIPLE orders of magnitude. And young people rank their individual risk of death higher than old people do (both estimate too high, even the old people), presumably due to them being more "plugged in" to "the system" so to speak.

Personally speaking, since I'm in my 20's, almost everyone I know who has gotten the vaccine has done so because they believe outright falsehoods about the virus that have been propagated not just by the media but by our so-called health experts themselves.

For example, I have multiple friends who had PCR-confirmed COVID-19, recovered months ago, and still got the vaccine. In the times I've probed at them to see why, they muttered some vague things about "the variants" and essentially said that the variants bypass naturalistic immunity which is just completely false.

I know for a fact that my likelihood of an acute adverse reaction (the all-too-common "feeling like death for a day" reaction) is far higher than the likelihood of comparable symptoms from SARS-2 infection. So I'm not getting the vaccine, and I'm not embarrassed to say so. For many people, the risks of the virus are less than risks of the vaccine; however, much less people than you would think. We don't have good enough data yet but I'd bet it crosses over somewhere in the 40's or 50's age range.

There's a huge difference between being an "anti-vaxxer" in the true sense of the word - i.e. you think all vaccines are inherently bad, period - and being someone who takes the same attitude towards vaccines that we do towards drugs: no drug is inherently safe; rather drugs that are proven to be safe are safe. By extension, no vaccine is inherently safe; vaccines that are proven to be safe are safe.

The latter statement is my personal view of it, and unfortunately such a statement can get you banned from social media platforms if you get unlucky.

This binary way of dividing the world into "anti-vaxxer" vs not, "AIDS denialist" vs not, etc is not just oversimplified but is intentionally done to suppress dissent. I refuse to participate in such a culture and I humbly implore you to do so as well.

Post reply on HN