XFool wrote:One point that has been brought up on here is the amount of time a vaccine has been in use before it can be declared "safe" to use.
I am thinking two things. Firstly, how "long" would be considered long enough to show a vaccine is demonstrably "safe"? Five years? Ten years? Twenty-five years?
Secondly, in order to establish such a long record of safe use, any vaccine would have to be in use for that length of time to be established as safe!
It's worth noting that although yes, it can take 10-15 years for new drugs to get approved, most of that time isn't spent "testing" - and compared to "normal" drugs, vaccines have two disadvantages and one advantage.
A lot of the total time taken involves paperwork going to and fro between people's desks, and a lot of that hold up is just a question of the resources available. It was even worse for new vaccines as historically they've not been a great moneymaker, so they tended to find themselves at the back of the queue behind all the ulcer drugs etc. That wasn't the case with Covid - there was the cash to get round any roadblock, everything was in the priority lane.
Perhaps the biggest problem with vaccines is patient recruitment. With a "normal" drug that is trying to "cure" a disease, it's fairly easy to find a population of people with the disease, split them into two or more groups and give one the drug and the other a placebo. If you're testing an acne drug then you just need to go to a few schools and you will have more than enough kids with acne for your statistics to work. Whereas it's different if you're testing a vaccine to prevent a disease in the first place, assuming that the disease is too nasty to deliberately infect people with then it can be quite hard to find a population where it's sufficiently likely that they will get it that you can see what difference a vaccine makes.
For instance, historically there was one case of monkeypox every 6 months in the UK - how do you test a vaccine in that population? Even now where there's an "outbreak", only 1 in 20,000 people have caught it this year. Even big drugs trials only have a few thousand people, but you could have 100,000 people in one arm of the trial, during an outbreak, and yet you'd only expect 5 of them to catch it in 6 months - how do you tell if the vaccine is really having an effect in such low numbers? And yet it's hugely complicated, costly and above all time-consuming to organise a trial with at least two arms of 100k people, never mind just motivating people to take part in a trial of a vaccine for something so obscure.
So again that was one way in which Covid was not a normal vaccine trial, it was being tested at a time when millions of people were catching the disease, and there was no shortage of volunteers prepared to answer the call and allow themselves to be recruited. That made a massive, massive difference in how quickly one could tell if it worked or not.
On the flip side, one good thing about vaccines is that problems tend to show up quickly. If you're testing an Alzheimer's drug, you could be waiting 5-10 years to see if your patients go gaga or not. Vaccines are not like that - the effect of a vaccine depends on an immune response, which ramps up quickly and then fades away, so any problems generally show up during that initial immune response, within weeks if not days or hours.
One another comment - something that's bedevilled the Covid debate is that people from allied fields tend to jump in and comment regardless of how much they actually know about the matter at hand, when outsiders might think "Oh, (s)he works on X, she must know about the Y under discussion" when the reality is that even though X appears related, the detail of Y is so different that knowing about X is irrelevant. In fact it works the other way, that the people closest to the field but outside it, know enough about X to know how little they know, whereas the less expert just breeze in obliviously. So you'll get media bookers going down a list of increasing ignorance, with the people who know 70% about X or 60% about X declining until they get down to the people who know 20% about the subject, who don't realise how little they know. And then they're the ones who get on telly or who start YouTube channels.
I feel a bit the same way. I may have done a PhD on mechanisms of infection, but I know enough to know how badly placed I am to judge the trustworthiness of the trials. However at least I speak the same language as the immunologists and it was striking at the time how they had a consensus that although extra time would be nice, the accelerated approach was the right way to go in the circumstances and they were happy with the safety profile that came out of the trials. And then of course we've had billions of people receive the jabs without significant problems. Although as someone who had long Covid for a year before getting jabbed for the first time, I don't have too much time for those who seek to draw conclusions about vaccine safety from half-baked analysis of a population in which infection with this nasty, persistent virus is rife.
