How do I reassure ppl i know about the upcoming covid-19 vaccines?
December 6, 2020 9:09 AM   Subscribe

Difficulty level: for residents of provably authoritarian countries who've been actively pro-democratic and thus reflexively skeptical of govt actions (which is usually warranted). They don't want to be antivaxxers, but they've been susceptible to 'skeptical' claims right now. I'm usually okay with countering the misgivings about the vaccine development turnaround time, but the new one I'm hearing is they're 'not sure' about the mid-term to long-term impact. How should I reply? (I have basic grasp of biology, public health and medical practice)
posted by cendawanita to Science & Nature (17 answers total) 2 users marked this as a favorite
By the time most people are able to get a vaccine, there will be months of data on the people who received the vaccine in the original trials, so that will hopefully provide some assurance. The trials are still ongoing, to monitor for long-term effectiveness and any side-effects (none so far!).

If we don't vaccinate, we will all get COVID eventually, and it would have to be really, really unsafe to be less safe than COVID. Like, >1000x less safe than the worst vaccine we've ever had. The 1976 swine flu vaccine is well-known as a debacle and it caused 450 cases of Guillain-Barre syndrome in the entire US. Which is a really awful result (especially since the flu turned out to be a dud) but receiving it was still much safer than walking around unvaccinated in 2021.
posted by BungaDunga at 9:27 AM on December 6, 2020 [11 favorites]

Of course they're "not sure" about long term effects. There is a greater than zero risk that some bad effect will occur. That is not important. What is important is "how bad are the effects" times "how likely are those effects" vs "how bad are the effects of COVID-19" times "how likely is that".

We are "not sure" about any of the exact values feeding in to that comparison, but by now I think it's pretty clear that the effects of COVID-19 can be quite bad, and are not particularly rare (one in 700 North Dakotans is dead because of it, and that's just the numbers "so far"). It seems real unlikely to me that the vaccine is worse than that.
posted by aubilenon at 9:42 AM on December 6, 2020 [8 favorites]

for residents of provably authoritarian countries who've been actively pro-democratic and thus reflexively skeptical of govt actions (which is usually warranted).

If they look at what actually democratic, non-authoritarian countries are planning to do, would that reassure them?
posted by showbiz_liz at 10:04 AM on December 6, 2020 [2 favorites]

I am pro-vax, but looking forward to more data about these vaccines. My response to vax concerns is to recommend waiting for better data, and to express how much of a blessing vaccines are. I just watched The Big Sick, where the Pakistani-born main character has a smallpox vax scar, despite being pretty young. It reminded me how precious and beneficial vaccines are, and how recent. I knew someone born @ 1960 in China who had polio, and is mildly disabled, which is just so wrong; vaccines existed, but China did not have money or infrastructure or political will. also, I'm nearly at the end of The_Emperor_of_All_Maladies, and reading about genetic manipulation and research on particles and how it is directly saving lives keeps making me cry. Speak the truth, reveal lies, and it will make a difference.
posted by theora55 at 10:19 AM on December 6, 2020 [1 favorite]

I don't even think you need to worry about the science. Break it down to business brass tacks. Something I find helpful: these vaccines are made by companies, not by the government. These companies are very visible, and have shareholders, and those shareholders are also not the government. Some of these companies are very, very big multinational companies with very public safety records. In fact, you've probably taken medicines made by them (if you're ever talking to gentlemen of a certain age, and you want a har har moment, point out that nobody seems to worry about Pfizer's other breakthrough drug, Viagra). These companies are laying their expertise, their fortunes, their reputations, their staff, etc. on the line. So far, tens of thousands of people have volunteered to receive their products. The experiences of those tens of thousands of people is being published for all to see. In the manufacture of medicines, there is nowhere for a company to hide (even though some bad actors have tried, and failed, in the past).
posted by late afternoon dreaming hotel at 10:23 AM on December 6, 2020 [1 favorite]

Response by poster: If they look at what actually democratic, non-authoritarian countries are planning to do, would that reassure them?

Hopefully, but the other layer to the challenge level is that we're asians and they're left-wing enough they have taken historical examples of 'coloniser'/supremacist medical practices to heart.
posted by cendawanita at 10:24 AM on December 6, 2020 [1 favorite]

I think it's really important to let people talk about their concerns about vaccines while at the same time trying to give them good scientific information. I appreciated this Twitter thread (and the one she links to two tweets down) which talks about how many people are vaccine-hesitant for reasons that are legitimate. This woman communicates about science professionally and her point "Any public messaging and conversation around increasing the number of vaccinated people will require [understanding how these people are thinking and feeling]" is worth understanding with empathy.

But, to the science angle of them, it's worth understanding a little about how the whole thing works, but also how it doesn't work (there's no genetic tracking, you're not getting "live virus," many famous people you have heard of and may respect have been getting it, here's how many people have already been tested) and letting it percolate over time. Also maybe worth untangling how the local public health authorities are linked to government in that country (they may be tightly linked but they may not be) or how much the vax companies are linked to government (same) to try to instill more confidence. And, as aubilenon says, there are some unknowns but what we DO know about COVID makes potential vaccine likely side-effects seem manageable.
posted by jessamyn at 10:26 AM on December 6, 2020 [2 favorites]

Honestly, a lot of this is emotional, and you might find that it's a bit whack-a-mole. That is, you think you've talked round this particular point, but another argument crops up. Perhaps it's worth asking what would persuade them that they should get vaccinated on schedule?
posted by plonkee at 10:51 AM on December 6, 2020 [1 favorite]

So I have tendencies towards feeling this way and have doctors in my family that feel similarly. Despite being pro vaccines generally - I have all the necessary ones plus lots of extra "wacky" ones for travel purposes. Aubilenon's argument is the one that shifted my thinking the most (probably helps that it does acknowledge that the feared risk of vaccine having side effects is not non-existent).

Just my two cents.
posted by cacao at 11:04 AM on December 6, 2020 [4 favorites]

Two good blogs to look at for debunking antivaxx stuff are Skeptical Raptor and Science Based Medicine. Both recently have published articles on the science behind the RNA vaccine.
posted by kathrynm at 11:32 AM on December 6, 2020 [1 favorite]

The fast-tracked development and approval processes of these vaccines, plus the political pressures that have been put on everyone involved, also make me more uneasy than I would be otherwise. One of the things that make me worry less is that I don't expect to even have the possibility of getting the vaccine until some 6-12 months from now, which is a lot of time for additional statistics to be gathered and any problems to come to light.

(This also means that hopefully the more the time for vaccination approaches, the more people they know personally will feel comfortable about the vaccine and even start getting it themselves. I've found that "everyone else thinks it's okay"-type of thinking has a surprisingly big influence on my own opinions, even when I'm aware of it and try to counter it.)

And while I too have vague worries about long-term side effects, thinking about it more carefully makes me ask myself what exact effects I'm worried about and what the mechanism of action for those effects could be. It turns out I can imagine some scenarios with bad side effects, but they're all things that would come up in the shorter term and that I should be aware of by the time I can take the vaccine. But I'm having a hard time thinking of specific sleeper side effects that wouldn't be observable until months later. In other words, while I have no trouble imagining vague problems, forcing myself to go from vague to specific brings to light the unlikelihood of such problems - other than the possibility that the protective effect won't last that long, which doesn't have to do with whether the vaccine is safe.

One country-specific concern is tracking the official process by which the vaccine is acquired and distributed, since there have been warnings that fake vaccines could find their way into some supply chains.
posted by trig at 12:48 PM on December 6, 2020

the new one I'm hearing is they're 'not sure' about the mid-term to long-term impact.

I guess I am one of the people you are talking about, if you look at a recent comment I made on the blue (not sure if that's okay to link here, so not linking for that reason). In sum, I am extremely pro-vaccine after having and losing an immuno-compromised child. My child and I get all the vaccines the CDC and our doctors recommend (i.e. we use mainstream doctors who follow the CDC schedule), including annual flu. Even if it were made available to me, I will not get the Covid vaccine immediately. I don't say I will never get it. My concerns are not related 5G, mind control, tracking devices, or thinking it will give me Covid. My concerns are about it being rushed to market and subtle long term effects going undiscovered because of the rush to solve the present emergency.

So I guess I'll answer how you could persuade me. First, you would have to be more reliable in my eyes than my sister-who-practically-raised me who is a nurse with a child working in public health-epidemiology (who is in fact involved with administration of vaccine trials), and who does not feel it is safe enough for her reproductive-age children to get the vaccine until there is a chance for observation for any longer-term side effects.

1. Short/medium term: You could demonstrate to me beyond a shadow of a doubt that creation, storage, delivery, etc. of the vaccine is consistely, reliably safe such that I needn't fear something similar to the Cutter incident where children vaccinated against polio got polio from a vaccine where the inactivation of the polio virus was defective. Some died. (Note, I also had an Uncle whose life was horribly impacted by polio, the long term effects of which ultimately killed him prior to my birth.)

2. Long term: You could persuade me with strong , reliable evidence that the vaccine won't have an as-yet-unanticipated side effect that will shorten my life span, my child's life span, impact his health or genetics, impact his reproductive capacity.

Here are things that won't reassure me:

* Presidents or other people in leadership getting it, especially if they don't have young children relying on them and definitely if they haven't lost a child.
* People who have been through child loss are slightly more persuasive, but again not if they don't have young children relying on them now.
* Saying "it can't be worse than Covid" when that's pure speculation or reflective of confidence rather than evidence. Of course it could be worse than Covid! Covid can be an entirely asymptomatic infection! Defective vaccines rushed to market have killed people. Yes, I know this is a different type of vaccine. No, that alone is not persuasive. Just because cars (one kind of thing) kill people and an avalanche (entirely other type of thing) isn't a car doesn't mean avalanches can't also kill people. Clunky analogy I admit.
* Being told that Covid could harm or kill us too - yes, it could, and that's why we've continued to be extensively careful about mask wearing, staying home, washing hands, avoiding crowds etc. I pulled my kid from school for the year to homeschool even though my district is doing in-person school. We are healthy and have no factors that heighten Covid risk. I am not implying we couldn't get Covid (I know careful people have gotten it), but on balance my concern level is low. Not nearly high enough to justify injecting something that has had less than a year of testing.
* Being told that the chance of a defective vaccine or long term side effect is low, when you don't know what the chance actually is and again you're just speculating confidently. The chance of my daughter being born with the disease that claimed her life was vanishingly low, let me tell you. And we will probably never know what weird random thing triggered the 22nd chromosome genetic mutation that caused it.

Unlike maybe some people out there, I sincerely do await scientific evidence and the increased confidence from longer term observation. These initial trials have showed us that it works and that is freaking amazing, vaccines are amazing and I am glad we have them. I am also glad that we have lots of evidence to indicate that the risks of short- or long-term side effects or vaccine reactions are incredibly low, and I look forward to having that evidence for this vaccine too.
posted by MustangMamaVE at 2:04 PM on December 6, 2020 [7 favorites]

Just a small point to drop in - the RNA vaccines don't carry attenuated virus so you can't get Covid from them. However, the fact that they are RNA vaccines is what worries me a bit because it's new.

However, what I really came to share was I heard quite a long discussion of this on CBC lately and the expert they had said that the testing cycle overall, so far, is actually fairly normal.

What's not normal is that the drug companies didn't wait for results to move forward which they usually do not for data, but for for financial reasons. So they were manufacturing enough for the phase 3 trial before phase 2 was complete, which put them at financial risk, but they didn't cut corners on the actual phases themselves. I have not evaluated this discussion myself but I pass it on.

That said, it seems pretty evident you can't see long-term effects until it's been long-term. It's just that the idea that we would "normally" have longer term data is a little bit of a squidgy bit. We would because the manufacturing would be taking longer, but it doesn't mean that the testing would be that rigorous. That's what I understood anyway.
posted by warriorqueen at 2:30 PM on December 6, 2020 [4 favorites]

For me, people keep talking about what are the long term effects...but do we have any idea what those COULD actually be? Or is it just fear? I haven't heard any concrete long term effects we are supposed to be worried about.
posted by tiny frying pan at 2:41 PM on December 6, 2020 [1 favorite]

Response by poster: Hi, thank you all so much, and i don't want to make it chatfilter but I just want to respond to MustangMamaVE's comment, in that as I haven't really been on mefi long enough lately to go thru a lot of the longer commented posts because I don't have the bandwidth to temporally follow the discussions and the ensuing rhythm and consensus as they tend to develop. So i haven't seen her comments at all.

But, her points are what I'm trying to address rather than the standard antivaxxer, and to that end, if i can have more assistance in imagining/projecting the likely side effects as mentioned by tiny frying pan, i think also would be helpful, as I'm not trying to sound dismissive because these are people i respect but 2020 has made them even more partial to medical catastrophizing (in large part due to having only lay understanding of the process - eg i had to explain to one uncle that even the smallpox vaccine doesn't have long-term immunity for the body, because at the time the reports that indicated the projected immunity window for the covid-19 vaccine became a sticking point for him).

ETA: sry sry, but if it's helpful, for my country in particular we're looking at receiving the pfizer one and the sinovax one.
posted by cendawanita at 6:32 PM on December 6, 2020

Derek Lowe’s blog In The Pipeline Has been an invaluable resource for me throughout the pandemic. He has written a ton of posts about the vaccine development process, the different types of vaccines currently being trialed, and some great summaries explaining the trial results. He’s a chemist in the pharmaceutical industry, so may have bias towards drugs in general being effective treatments, but doesn’t seem to hesitate to call out bad science or poor reporting of results when he sees them.

The most recent post is on false side effects and seems quite relevant to your question. An excerpt:

We’re talking about treating very, very large populations, which means that you’re going to see the usual run of mortality and morbidity that you see across large samples. Specifically, if you take 10 million people and just wave your hand back and forth over their upper arms, in the next two months you would expect to see about 4,000 heart attacks. About 4,000 strokes. Over 9,000 new diagnoses of cancer. And about 14,000 of that ten million will die, out of usual all-causes mortality. No one would notice. That’s how many people die and get sick anyway.

But if you took those ten million people and gave them a new vaccine instead, there’s a real danger that those heart attacks, cancer diagnoses, and deaths will be attributed to the vaccine. I mean, if you reach a large enough population, you are literally going to have cases where someone gets the vaccine and drops dead the next day (just as they would have if they *didn’t* get the vaccine).

posted by Jawn at 7:01 PM on December 6, 2020 [4 favorites]

Maybe talking about medicine and vaccine approval in general might be helpful. The EU has a standard process that it follows, as does the US. Trials are done in a certain way, the same way for vaccines that you friends/family have had. Although this vaccine has been quick, it builds on about 20 years research into coronaviruses in general, so when this one came up, it had a massive headstart. They approve a new flu virus vaccine each year - it's not completely new from scratch but they have to tailor it each year. It feels like this is very out of the ordinary, but it's not *very* out of the ordinary.
posted by plonkee at 5:57 AM on December 7, 2020 [2 favorites]

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