Do the common complaints about vaccine testing, where it concerns "killed" viruses or replicated viral proteine, apply to mRNA vaccines though? Are, based on how they work, certain worries about safety still relevant here? — Benkei
It's very different and very new technology.
Any new pharmaceutical can have totally unexpected consequences. It's possible we discover entirely new pathways to mess-up the human body over the long term that no current expert could even dream of today, thanks to this vaccine. Experts may say the risk is small, but the consequence distributed over hundreds of millions of people is extremely big. As mentioned previously, "side-effects" can only be detected in the short term if they have clear symptoms and correspond to something we understand. The purpose of phase-4 trials is to catch the things no one thought was in any way likely or even possible. There can be many 1 in 1000 terrible long term side-effects that no one currently understands and therefore no one currently can check, and that will not appear as a discernible signal in current statistics. 40 000 seems like a lot of people, but if there are lot's of weird 1 in 1000 consequences it's far from sufficient quantity to find these things, even if there are symptoms (doctors will not be able to make a causal inference to the vaccine, and many 1 in 1000 events will simply not appear anyways, just from statistics, not to mention the populations not even represented, or not in any statistically significant way, within the 40 000).
Keep in mind there are many long term problems that have no short term symptoms. If the vaccines cause cancer for instance, it could literally be a decade before that's clear
independent of how many people we vaccinate. Likewise impacts on fertility.
Keep in mind also, impacts may not be acute to certain individuals but spread out, and widely distributed affects (not acute in any one patient) are even harder to detect but may have greater consequence.
Of course, western leaders and with no doubt pharmaceutical companies are completely willing to exchange future cancers
no matter how many there may end up being against ending the pandemic and fixing the economy. However, this is because they are evil people; there is no rational basis to take such a risk. Not to say some proxy experiments have been made to be more than less confident the vaccines don't cause cancer, but every pharmaceutical that ends up causing cancer had similar evidence (and these kinds of proxy experiments can only be accelerated to a point, keep in mind).
The chance of dying of coronavirus along with developing "long Covid" is on the order of 1 in 1000 or greater for most people (i.e. IFR estimates are in the 0.1 - 0.2 range, including vulnerable populations, so for the healthy populations it can go all the way to 1 in 100 000 risk for young healthy profiles).
Therefore, giving healthy people the vaccine is an extremely big experiment without any assurance that it is smaller risk than actual Covid for the healthy population.
This can just be a catastrophe, leading to more demand on the health system and not less to deal with these problems while the vaccine program may not stop transmission anyways, so the Covid situation maybe unchanged.
@Isaac has good comments on why real effectiveness (at stopping the pandemic) is not proven; to summarize, the phase 3 trials didn't even attempt to prove the vaccines will decrease transmission or decrease hospitalizations. The vaccines may end up increasing both. That governments and the media insist we assume and promote the idea the vaccines are effecting at ending the pandemic is completely absurd as no scientist involved in the trials is even making such a claim (they sometimes explicitly state they basically have no idea if transmission or hospitalizations will end; censorship has officially started of criticizing the vaccines, which would include simply repeating the actual claims of the creators of the vaccines).
The effectiveness numbers are at reducing symptoms, mainly in the healthy population that is at minimum risk anyways. People on reddit like to claim that reducing symptoms reduces transmission, but this is an unverified hypothesis; the vaccine could result in a small number of people having no symptoms but being infectious for extended periods of time (a sort of shingles type situation where the immune system manages but never gets rid of the virus nor stops the virus being infectious; there is currently nothing that would exclude such a possibility). For the vulnerable that are likely to end up in hospitals we may discover the vaccine actually makes their cases worse and not better, causing sever immune reactions (cytosine storms). And of course, not to mention mutations, both present and future, which may not simply defeat the vaccine but outcomes maybe worse for vulnerable vaccinated people and even healthy people; there's an assumption that "oh, well, it maybe like the flu and we must vaccinate each year"; terrible assumption considering vaccinating against the flu doesn't stop the flu, vaccines for the flu are based on historic patterns that don't exist for coronavirus (we have no basis on which to predict the dominant coronavirus strain or strains next season), and coronavirus is nothing like the flu so maybe that strategy wouldn't even work even if it was possible.
Keep in mind (lot's to keep in mind), that without the vaccine statistics makes the dominant strains likely to remain the dominant strain through the network effect. However, put pressure on the dominant strain and other strains that already exist may flourish if they have a mutation that defeats the vaccine. Competent scientists would have collected as many strains as possible to then actually test at least in laboratory (rather than just say there's no reason to assume a new strain will defeat the vaccine and so we shouldn't worry ... yet .. I guess?) while distributing the trials over as wide a range geographically as possible, to at least have some basic tests.
In other words, not only may these vaccines not work they could make the situation worse while collapsing all trust in health authorities and the "gov'ment".
Of course, if we really go deep into the biology we may decide the risks are small (I am not offering any calculations of the risks I'm talking about, just pointing out there are many of them, no evidence they don't happen and therefore it's a big gamble) and so, though even if we conclude risks are small they would remain possible and perhaps still unreasonable when multiplied by hundreds of millions of people and the governing and social consequences if things go wrong, nevertheless unlikely.
In which case, the likely situation is still not "good". The current vaccine programs are too little and too late to affect this winter season; coronavirus has demonstrated strong seasonal tendency and so will anyways go down in the spring and it will be difficult to know if the vaccine is working or not, and if we will be hit by a third wave next season anyways, whether due to the vaccines not working or new strains defeating the vaccine.
The virus is now well mixed in the population and so social distancing no longer really matters. Full isolation would be needed now to significantly reduce cases which was reasonable to do as part of containment strategy (which I advocated for in the spring) but is no longer possible once containment is irrelevant (no where to "contain" the virus to).
The alternative is of course to let the strong do what they will and the weak to suffer what they must (i.e. what is happening now because there is no longer any other alternative). Although it may seem at first reasonable to take a massive risk on the long term health and fertility of the young and healthy population, very quickly it is of uncertain ethical foundation; of course, this is now the policy so we'll see what happens. In any case, getting to the morally wrenching point is due to a large criminal negligence of our leadership. Therefore, whatever happens, Nuremberg type trials should be held and our western leadership hanged.
Abandoning containment was in essence undertaking a genocide against the poor either out of neglect or to protect the stock-market (which has done very well indeed, so the policy has succeeded). If we are better than the Nazi's we will employ the same legal standards and consequences for those responsible.
If we do not, we are no better than the Nazi's, merely their heirs.