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US agencies call for pause in Johnson & Johnson vaccine (bbc.co.uk)
456 points by kjakm 22 days ago | hide | past | favorite | 1059 comments

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 understand what the clotting issue is, so it probably makes sense to pause using J&J as long as the mRNA vaccines (Pfizer, Moderna) have not been implicated (which they haven't). OTOH, if this being in the news causes fewer people to get vaccinated, pausing it may be a mistake that will cause more overall deaths.

Now, your risk of dying either from vaccination or Covid19 depends on various demographic factors not accounted for in my math above. But, nonetheless, the risk of dying from the J&J vaccine is really, really, really tiny.

Like, if I knew there was a 0.00009% chance my car were going to explode every time I got in it and started it, I would not be at all nervous about starting my car everyday for the rest of my life. I'm way more likely, even accounting for my age demographic, to choke to death eating dinner tonight (5,051 deaths from choking in the U.S. in 2015 of which 2,848 were older than 74).

Edit: lifetime risk of car exploding assuming I start it every day for 50 years is about 1.6%. Okay, maybe I wouldn't play that game.

It's not just a "blood clot" or some "rare type of blood clot".

This was what I posted in this post about the European Medicines Agency acknowledging the AstraZeneca vaccine (which I was inoculated with) was linked to something never seen before: https://news.ycombinator.com/item?id=26725232

> "Zero surprises here. Both Norwegian and German research teams identified the /actual specific novel antibody/ that causes this /new previously unclassified syndrome/ that was effectively unheard of before the AstraZeneca COVID-19 vaccine existed. Also, both teams are phenomenally talented for identifying this antibody so quickly. Usually it is on “finding a needle in a haystack” level difficulty. BTW, I am probably going to get downvoted but I am definitely not an antivaxxer and I received the AZ vaccine as innoculation for COVID-19."

Do you have any resources to read more about the research teams and their findings? Most of the articles I'm reading are very hand-wavy about the specifics/science and I'd love to actually learn more about the cause and condition.

This one is about how they found out the link for the AstraZeneca vaccine: https://www.theguardian.com/society/2021/apr/13/how-uk-docto...

The Los Angeles Times wrote an excellent article about the Johnson & Johnson (J&J) vaccine situation, in layman's terms [1]. However, journalists need to stop calling it "blood clots" or "rare blood clots", and instead call it a "rare clotting syndrome" that is "novel (new) and previously unclassified". For the AstraZeneca (AZ) vaccine situation, there has also been other good journalism sources here [2][3]. Pay attention to the subsection on [3] stating "Nothing but the vaccine can explain why".

In both cases, the situation is clinically similar to Heparin-induced thrombocytopenia (HIT), although there are very distinct differences. It should not be used as a comparison.

This is a good peer-reviewed journal article on diagnosis and management [4]. This is another article describing the syndrome [5].

I should emphasize that the treatment that is used for this specific syndrome is extremely expensive: intravenous immunoglobulin. I personally take the same medication (immunoglobulin) subcutaneously (under-the-skin) twice per week, for 2 rare immune-mediated neurological diseases affecting my peripheral nervous system. I will require this medication for life. When I lived in the USA (I live in Croatia now), my medical insurance was paying $278,000/year for the medication, under contract. I am not talking about how much the medication was being billed for, which was way higher. So, you heard me right, my insurance paid $278,000/year for this type of medication.

[1] Here’s what we know about J&J’s vaccine and rare blood clots: https://www.latimes.com/science/story/2021-04-13/what-we-kno...

[2] ‘It’s a very special picture.’ Why vaccine safety experts put the brakes on AstraZeneca’s COVID-19 vaccine: https://www.sciencemag.org/news/2021/03/it-s-very-special-pi...

[3] Norwegian experts say deadly blood clots were caused by the AstraZeneca covid vaccine: https://sciencenorway.no/covid19/norwegian-experts-say-deadl...

[4] Diagnosis and Management of Vaccine-RelatedThrombosis following AstraZeneca COVID-19Vaccination: Guidance Statement from the GTH: https://zlmsg.ch/wp-content/uploads/2021/04/2021_Diagnosis-a...

[5] A Prothrombotic Thrombocytopenic Disorder Resembling Heparin-Induced Thrombocytopenia Following Coronavirus-19 Vaccination: https://www.researchsquare.com/article/rs-362354/v1

Can you share some experiences with healthcare and the healthcare payment system in Croatia?

I think we would all be fascinated to hear first hand accounts from someone who's also experienced the abysmal US system.

What does your immunoglobulin cost in Croatia?

Sorry, but this is not relevant to this discussion. I refuse to flood this extremely long thread with details that are not relevant to the readers clicking on this thread. Please see my profile and email me instead, for specific answers.

Just how much it costs mow would probably not be considered flooding though and its probably more informational

It is relevant to the discussion because the AZ and JJ vaccines are for the "rest of the world", so comparative differences in the cost of IG between US and other healthcare systems is relevant.

I'm not the original poster but I'm from Croatia. I've been living in the US for around 10 years now and have a chronic illness that required constant management: Type 1 Diabetes.

I also have a separate issue, Pectus Excavatum, a chest deformity that required me to undertake a fairly difficult surgery called the Nuss Procedure.

I think these two examples do a good job at demonstrating differences between Croatian an US healthcare payment systems. They are very different medical problems.

Diabetes is a chronic illness that requires constant management. I need to inject insulin multiple times a day and require other supplies such as sugar sensors, lancets, needles, and glucose strips. I have a brother who still lives in Croatia and also has Diabetes Type 1. Our treatment plans are almost identical. We take the same medications and need the same supplies.

Managing Diabetes in the US is fairly annoying and expensive. I'm lucky to work in tech which provides me with good pay and insurance but even then my expenses can go up to $200/mo. It is also difficult, sometimes impossible, to get insurance authorization for better insulins that are widely available in Europe. I am on Humalog, or sometimes Novolog, similar insulins but insurance companies only cover a single one, so you have to switch when you change insurances. Newer insulins such as Fiasp, Apidra, or Tresiba, which are newer, quicker to work, and overall "better" are almost impossible to get in the US. I tried multiple times and the insurance never gave me the authorization to use them.

My brother lives in Zagreb, Croatia. He's been a diabetic all of his life. He's using newer insulins such as Fiasp and Tresiba and he doesn't pay anything for them. Literally 0. It's completely covered by the National Insurance. Same goes for all of the supplies like strips and needles, and glucose sensors (which can be pretty expensive in the US). In total he pays $0.00 on diabetes management.

In addition, Diabetes education is terrible in the US. Doctors here will usually tell me that I can eat whatever I want as long as I cover it with enough insulin. This is just awful advice since people are not computers and will never calculate the correct dosage of insulin they need to cover every meal; resulting in bad sugar management and complications that come with it: blindness, limb amputation, and eventually death.

The ONLY way to properly manage diabetes is to be very careful about eating carbs. Not necessarily eliminate them, but come as close to it as possible. This is the way diabetes education works in Croatia. Fix the diet and then use insulin to fix what you can't fix with diet. The result is way better sugar management, and way cheaper treatments. Just the other week I had my checkup here in the US and the doctor told me my blood sugars are "too LOW for a diabetic" (my A1c was 5.9% - still higher than the normal 5.5% for a healthy person). I should change my diet and eat more carbs to raise it up. This is just awful, awful advice and I'm sure it's the result of generally terrible diet in the US.

So overall, healthcare treatment and payment for a chronic illness like Diabetes is just immeasurably better in Croatia. It's not even a contest.

Now, on the other hand.

Pectus Excavatum is a bone deformity. In some cases it's small enough to not present any problems but if it's fairly severe it can cause a lot of cardiovascular issues. Nuss procedure involves implanting multiple steel bars (3 in my case) behind the chest wall in order to force the chest bone out. The bars stay in the body for 3 years and are then removed. Surgery is usually successful and after the bars are removed you are considered "cured". There is nothing more to manage and the rate of complications is very low.

This surgery is complicated. It's most often done on children because it becomes much more difficult to perform it in adults. Video if interested: https://www.youtube.com/watch?v=R8SrRzJqbJ8

As an adult, it's almost impossible to get the surgery performed in Europe. I know there's a center in Italy, and another Netherlands that do perform it, but their rate of success is not great. I've seen a lot of people complain about the results. The place to do it is the United States. Mayo Clinic in Arizona has the absolute world expert on Nuss Procedure and she does surgeries on adult of up to 40ish years of age (I got in at 37, last chance). Her work is absolutely phenomenal and people from all over the world travel to Arizona to do it there. There are also hospitals in Missouri I think and in New Jersey that do it, but I'm less familiar with them.

Now given that there are only a handful of places in the world that perform this surgery on adults, you'd think that the cost of this procedure would be astronomical. In total I paid around $2000 out of pocket. Without insurance it costs around $30k, plus $10k or so for the hospital bed (oh US). Don't get me wrong, it's not cheap, but for something of such difficulty and expertise I expected it to be way more expensive. It's literally impossible to get in most of the world other than the US and it costs less than the price of diabetes supplies for 1 year.

So there you have it. In my opinion the US system is absolutely awful for managing chronic conditions. It's made to exploit you for as much money as possible and even give you bad medical advice that makes sure you're going to need those expensive supplies. On the other hand, the most difficult procedures in the world are sometimes only available in the US, and the price of those is not nearly as high as you'd expect it to be. It's great for acute treatable conditions, and absolutely awful for chronic conditions that require constant management.

I’m the OP. I hope you become a US citizen just in case you need it (not just holding a green card). I agree with your assessment. I also have T1D. My neurologists and endocrinologists (I have 2 of each) are pretty sure one of my (very rare) neuro diseases caused the autoimmunity leading to the T1D diagnosis. The disease I have was discovered in the early 2000s at the Mayo Clinic off of NIH research grant funds. Call me crazy, but the only reason I do not renounce my US citizenship is because the US literally saved my life and others around the world via the NIH funded research discovery.

I've been watching this news story today and every 2 hours there was a new top-post from people:

Covid kills X. Vaccine Kills Y. Everyone is stupid.

Programmers (and I'm one of them) are very black/white thinkers. Very few people on here had said ANYTHING that the radio said today: The pause give us the opportunity to train nurses and doctors to immediately identify the blood clot and make correct recommendations based on that. Typical anti-clotting protocols make this worse. The pause helps us get this communication out.

It's all identity politics at this point. Anyone has anything bad to say about a vaccine and suddenly the anti-anti-vaxxers pop up. Now that Trump criticized the pause I'm sure there's going to be a wildly popular support for this pause.

"Now, your risk of dying either from vaccination or Covid19 depends on various demographic factors not accounted for in my math above. But, nonetheless, the risk of dying from the J&J vaccine is really, really, really tiny."

Unless this is a repeat of AstraZeneca, where many were lamenting the interruption of vaccination and calculating the risk for the entire population of people injected with AZ. Meanwhile, in some countries, the risk of dying from the vaccine for young women was higher than the risk of dying from the virus.

After the concerns about AZ turned out to be justified and AZ being banned for certain age groups you'd think that people would get a clue about unconditional vaccine cheerleading.

> the risk of dying from the vaccine for young women was higher than the risk of dying from the virus

Do you have a good source you'd recommend for this? I couldn't find this bit of info from the first few articles I skimmed.

> After the concerns about AZ turned out to be justified and AZ being banned for certain age groups you'd think that people would get a clue about unconditional vaccine cheerleading.

Who is unconditionally cheerleading which vaccines?

In Norway:

Women < 60 years: 10 deaths from covid-19 in total [0]. Four vaccine-related deaths were reported in young, relatively healthy women. Details on three of the vaccine-related deaths have been published [1]. One of the stories had been made public [2].

The astrazeneca vaccine was put on hold, if not, it's not hard to imagine the number of fatalities surpassing the number of covid-19-related deaths, even when ignoring comorbidities

[0] https://www.fhi.no/en/id/infectious-diseases/coronavirus/dai...

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2104882

[2] https://www.vg.no/nyheter/i/GaOr3l/monica-aafloey-hansen-54-...

Where in [1] does it state that 4 died? There seems to be 2 women who died. Patient 3, a man who were discharged and healthy. Patient 4, discharged, healthy. Patient 5, is unclear I think, wether it survived or deceased.

Edit, please correct me if I'm wrong, it's very important that we don't spread false information regarding this.

Edit 2: There seems to be four, https://www.globaltimes.cn/page/202103/1219441.shtml

Yes, it should have been stated explicitly; three fatalities are reported in the study. The forth was reported in the media [0]. Female, 34 years old, no history of chronic disorders.

[0] https://www.nrk.no/innlandet/helsearbeider-pa-tynset-dode-ti...

In australia for example, where there is currently zero community transmission, and AZ was the preferred rollout for most of the population, assuming only women are vulnerable (not true) about 8m women below 50 (the age for which the government instituted the cutoff for alternatives) so at 1:500,000 risk of some injury (edit - originally said death) that’s 16 people who, ceteris paribus, wouldn’t be at any risk

I think your argument can be better if you qualify your assessment of risk for Australian women with the temporal constraint of "for now". Because transmission is low in Australia they may be better off waiting for a safer choice. However eventually travel will return and it is highly likely that the virus will still be around.

You mean, like 'ceteris paribus'?

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 different type than what these women experienced (pulmonary, not cerebral).

Of course vaccinating the public is extremely important right now. If the risks of clotting really are 1 in a million, it makes sense to re-instate it. I also think that's an obvious conclusion and the people working on this are well aware of the public health trade-off.

I suspect they are working with more information than what's in the press release, and its prudent to give them some time to work through it.

I am so sorry. As somebody who has experienced pulmonary embolism, this is so scary.

Make sure to never forget to take your blood thinning medicine. You absolutely must get the blood clots completely dissolved, and the blood thinner medicine is highly effective at getting rid of it, if you take it.

Clotting happens much more frequently with or without vaccination. The reported cases are a kind of very rare type of clotting. It's easier to spot something unusual going on when mutiple rare events are observed.

In comparison there have been over 2000 deaths reported (US, all vaccines). But death is not unusual and unless one can find a specific link to vaccination that number alone is not alarming. Sometimes we live with known risk, anaphylactic shocks e.g., because they are unavoidable and benefits outweigh risk. But we do what we can to mitigate such risk.

In summary the current pause is triggered by the particular type of clotting, not just any clotting. But your case should contribute to the overall evaluation of the likely cause and risk.

I agree for the US to pause the rollout is likely based on more data than 6 known cases of clotting. Not trying to be conspiratorial but my two cents is the authorities have more data then what is publicly being shared.

Or they are aware that data reporting is spotty - many deaths could have happened and been attributed to other causes. How many heart attacks or strokes happened in those 6 million people? How many of those might have involved undetected clots?

If we assume that only 5% of cases are being detected and reported correctly, then the numbers look quite different.

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.

Thanks. As I've now learned, almost all of these clots originate in the legs and pelvis and then travel to other parts of the body (lungs, brain).

So I think that's why they're telling people to watch for leg pain. I didn't have any issues with my legs, but it's apparently a common symptom to have pain and swelling there.

what were your symptoms that led you to go to the hospital to get checked for clots?

What is someone getting a vaccine as such is supposed to look for?

I got a little out of breath doing simple tasks like walking briskly or picking up my kids, and I had a pain in my back (actually lung) that gradually got worse over a few days.

Eventually the pain was severe enough that I went to the ER.

Looking back, the shortness of breath was a key indicator. It wasn't that I was struggling to breathe or anything, but I felt like I couldn't take a big deep breath easily and that's not normal.

The pain would also get worse at night when I tried to lie down to go to sleep. I thought I had pulled a muscle in my back at first, but it was quite painful.

ok now I'm worried. I got the JJ vaccine 4 weeks ago. Suffered semi bad flu for few hours that night then after felt great. Now some who now me may consider me a hypochondriac but I've felt a tad "off" since the vaccine but kept it to myself. Maybe only 2-3 tiny lightheadedness episodes while walking the dog (nothing major just more of "what was that"), or some very minor chest tightness and stomach bloating feel.

But last week (would have been 3 weeks after shot) I awoke in the middle of the night with pretty a bad chest pain like you describe. Felt like it was in middle of my chest and was quite painful. I had to physically sit up in my bed for about 5 minutes hoping it would subside. I got up and got some water and hoped it didn't get worse as I started contemplating what I should do if it does.

I was so tired though I just propped myself up with pillows and slept sitting up against the headboard because laying down seemed to make it come back worse. I eventually fell asleep and when I woke for the day I still felt a small amount of pain still. Went about my day normally and it seemed to go away later in the day.

I would think I am out of the window by now after 4 weeks to which I am in any danger from what I'm reading on news sites? I've been the gym since that episode and have done cardio fine. My wife suggests I take some low-dose aspirin for next few days.

If you’re having chest pain that’s severe enough to wake you up at night, I would talk to a doctor. It doesn’t have to have anything to do with the vaccine.

I would also not dismiss the nagging feeling in the back of your head that something doesn’t feel right. You know your body more than anyone.

Not to scare you, but I advise following up with a doctor as soon as possible. My 21 year old brother who was otherwise completely healthy suffered a similar short pattern of pain due to blood clots (not related to vaccine) but with severe neck pain for a short time one night.

It went away after that night, he was fine for 3 weeks with no pain or issues, was working out fine, etc. and thought nothing of it.

Suddenly one night went from perfectly fine sleeping to suffering a major stroke due to a blood clot in his brain within a 10 minute period, unable to do anything himself to get help as he lost all motor skills.

He said in retrospect he wishes he had followed up with a doctor on the thing he thought was no longer an issue 3 weeks before.

There are genetic tests they can run, as well, such as to see if you might have factor V Leiden.

Thanks. I’m hoping you’re well now and the clot was treated.

How were you treated for this, and how has recovery been?

They put me on blood thinners right away to prevent future clots and prevent the clots from getting bigger. I’ll be on them for at least a few months.

They then put me on pain meds and supplemental oxygen for a few days and watched me. The pain went away after a few days (I assume when the inflammation went down).

They didn’t actually treat the clots themselves. The body apparently does that itself over the course of a few weeks and months. There are invasive surgical ways to try to break them up but they felt I wasn’t bad enough to risk it since I could sit up and breathe on my own.

They checked my heart for tissue damage and thankfully didn’t find any. So now they’re doing a slew of tests to find the cause (genetics? Cancer? So far tests show cancer is unlikely).

Recovery has been good to be honest. I’m not really in pain. I do get out of breathe very easily but they say that’s normal and should go away in a few weeks as the clots dissipate. The lung damage should heal, I think.

The real danger from more clots to the brain or damaging the heart are prevented by the blood thinners, which are apparently highly effective. So I think I got lucky and I’m glad I went to the ER when I did.

Thanks for sharing and for keeping such a clear mind. My best to you.


110+ million vaccinations in the US and holy goddamn, no major issues. 31 million infections and 550,000+ dead, in a year. Millions of long haul COVID cases. Debilitating lung conditions, brain fog, lasting consequences already from the virus, and you wanna crow about long term consequences of the vaccine. What in the actual roasting hell.

I've noticed you, specifically, posting pro-virus misinformation since the very beginning. Half a million people died, man. I wish you would just spare us your trolling, damn it!


>Stop violating people's human rights to make their own individual medical choices.

What are you even referring to? Literally no one has to get a vaccine if they don't want it. Nobody in the comment chain you're replying in had advocated for forced innoculation. This is 100% already a "their body, their choice" situation.

It's worse than that. They are literally rolling out misinformation--lies, really--to try to convince people to not get vaccinated. Comment history on the topic of COVID is littered with trollish behavior and bonkers-bad reasoning fitting a pattern.

I always provide sources for my facts. See above. The parent comment was an opinion. Meanwhile, you don't have access to a long-term study on any Covid treatment, because not enough time has passed. That's not misinformation. That's math.

Blood clots cause strokes. You have no idea if Covid treatment increases your odds of having a stroke in 10 years. I invite you to study the history of various medical treatments that turned out to have unintended consequences on unsuspecting populations. Good luck either way. Stay healthy and stay free.

Negatives are generally hard to prove.

For example, you can't easily prove that your comment here is not causing me to develop a blood clot if I develop one.

Which is why we try to prove positives: who else has developed a blood clot after reading your comment? Is there any correlation? Anything to suggest there is causation too? What would be the hypothesis.

You are right that vaccines are not proven to be perfectly safe (and to be honest, none of them are even with longer testing time). But you are still muddying the waters by throwing these "prove a negative" statements.

The risk with coronavirus vaccines today is that the risks are not fully known (unlike with other, more established, vaccines for other diseases). Risks of getting coronavirus is also not fully established, though we know it can be pretty severe.

It would be only natural to expect some similar immune response from COVID and vaccines causing similar issues in the body, but that's totally hypothetical until proven to be the case.

Data so far points that it's much less likely for someone to develop issues from a vaccine than from COVID itself (roughly 10000 less likely at least), so it's up to the individual to assess if they are less likely to contract COVID and get serious symptoms, or get serious symptoms out of vaccination.

> roughly 10000 less likely at least

No source.

Also statistically unknowable at this point. But a 34 and under year old already has less than a 1 in 100K chance of dying from Covid. That is to say, an under 34 year old is more likely to die of murder than die of Covid. Anywhere from 4-10x more likely in the U.S. depending on the city.


We never really exposed general population of under 34s to unmitigated coronavirus (perhaps March/April 2020 in USA or Sweden in 2020 is closest we got to it), but even that is uncontrolled for people deciding to reduce exposure to other people on their own.

"10000 less likely" was derived from 1 in 6 million compared to a global death rate of roughly 2%, then allowing for roughly an order of magnitude error: not scientific at all, I agree.

Taking your numbers as undisputable while not acknowledging that they are as uncertain as "the other side" is a bit dishonest in my opinion.

Accepting your stats here, but what about consequences other than death? A friend in their late 30s just had to relearn how to walk and was in a coma for weeks after getting COVID. Months later he still isn't able to work full time.

Care to provide your source for people being vaccinated against their will?

Literally nothing in that link suggests anybody will be forced to get a vaccine against their will.

Imagine having to do 10 year studies on any drug before releasing it.

Isn't that the average for a new drug?

"The full research, development and approval process can last from 12 to 15 years."

"If the FDA gives the green light, the investigational drug will then enter three phases of clinical trials:

Phase 1: About 20 to 80 healthy volunteers to establish a drug's safety and profile, and takes about 1 year. Safety, metabolism and excretion of the drug are also emphasized. Phase 2: Roughly 100 to 300 patient volunteers to assess the drug's effectiveness in those with a specific condition or disease. This phase runs about 2 years. Groups of similar patients may receive the actual drug compared to a placebo (inactive pill) or other active drug to determine if the drug has an effect. Safety and side effects are reviewed. Phase 3: Typically, several thousand patients are monitored in clinics and hospitals to carefully determine effectiveness and identify further side effects. Different types and age ranges of patients are evaluated. The manufacturer may look at different doses as well as the experimental drug in combination with other treatments. This phase runs about about 3 years on average."


Your longest phase there is 3 years. The length of observation of any individual in that phase will be less.

If you had had observations of subjects lasting 10 years - your overall process would be much much longer than 10-12 years.

Fine, then what issue do you have with my comment? Pressuring or rushing to inject people who have no statistical risk is just adding to the overall risk equation

And when I hear rumblings of vaccine passports and all this nonsense in the news and I see some people's general attitude towards Covid vaccination: you're either for it or you're a flat earthling neophyte.

At any rate, point I'm trying to make:

There's less than 3700 deaths for Under 34 year olds in the United States, from Covid19 [1].

And that number will go down with every year that passes from here on out, because a broader percentage of that demographic already has herd immunity. In fact, there's much more important health problems to focus on for those demographics. Suicide, heart disease, homicide, car accidents, liver disease, diabetes, etc.

Population under 34: 148M Covid19 deaths under 34 in first year of existence, with no immunity in population: 3710

Flu & pneumonia deaths for pop under 34 in 2018 was 1857 [3].

Odds of dying of Covid19 under 34 in first year of its existence: .0025%

Odds of long-term consequences from RNA therapy from AZ, J&J, or Pfizer treatment: ???

Unknown. It could increase your odds of having a stroke at in 10 years. No one knows. If it's causing blood clots, that's a distinct possibility.

[1] https://www.heritage.org/data-visualizations/public-health/c... [2] https://www.statista.com/statistics/241488/population-of-the... [3] https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_dea...

Some issues with your comment chain:

- these are vaccines, they aren’t gene therapy (ie they aren’t changing cellular DNA)

- saying a portion of the population has herd immunity is non-sensical. Either there’s herd immunity (virus can’t spread bc everyone has antibodies) or there isn’t. It happens at specific thresholds of population exposure/antibody presence that varies based on the R of the virus. It was estimated at ~70% for the ‘original’ virus and with the UK/SA variants now looks to be north of 80%.

- even with exposure, there are case reports of reinfect ion which makes sense in the history of coronaviruses which aren’t considered to provide long term immunity (ie antibody titre falls off and may not provide immunity in some short term horizon, ie 18 months)

- therefore, return to normal relies on elimination of community spread, by herd immunity, which likely will require vaccination; which will hopefully provide longer term immunity than infection with the virus itself (not sure on the evidence on this)

I agree that population that has low statistical risk shouldn’t be pressured into vaccination, and I see the dangers in vaccine passports etc.

To another point you made, regarding long term risks and generally the history of misguided attempts by the medical community to do something that has severe deleterious longer term effects that were unforeseen: I am signicantly less concerned about the risk of ie long term stroke risk being raised in this population, because the emerging evidence points to a HITTs-like antibody mediated condition.

In Heparin induced thrombocytopaenia and thrombosis, removal of trigger removes long term risk and I would think that no further antibody triggering thrombosis should be produced after the acute period in those affected (and indeed in that very large fragment of the population who don’t develop CVTS or vaccine mediated thrombosis, which does seem confined to those who had vaccine via adenovirus vectors), then it should be a non-issue because the autoantibody was never produced in the first place and there are no memory cells there ready to pump it out again at antigen presentation.

Of course, I qualify this with its possible, and you’re free to dismiss my confidence, but we have a plausible mechanism that is relatively well understood so I think the risk of there being long term risks is very low

It's quite true that nobody knows the long-term consequences of these vaccines (which I don't think it is accurate to call gene therapies), but likewise you have no idea what the long-term consequences of COVID exposure are either - it's not a simple die/survive binary as some people have mild symptoms but develop chronic problems.

You obviously have strong feelings about this because you came into the thread with big broad claims, but you seem to be taking disagreement from others very personally.

>Fine, then what issue do you have with my comment?

It's pretty obvious if you read my comment. You said, "Stop violating people's human rights", and I said nobody's rights are being violated. Putting it to you as clearly as possible, your rights are not being violated until you are being strapped into a chair and having a vaccine forced into you, and that's simply not going to happen.

Some regions may adopt a "passport" system for the relative short-term but even then, you still do not have to get a vaccine if you don't want to. You just may have to wait a little bit longer than the vaccinated to get back to participating in certain things, but you would still be exercising your right to not get vaccinated.

It's as simple as that, and has nothing to do with the rambling that followed your question.

> It's pretty obvious if you read my comment

I meant the original comment where you levied a personal attack against me. I stated my opinion in earnest. I've been posting on HN for better part of a decade, and you levy a personal assault on me. At any rate, I want you to understand: it's perfectly ok, and perfectly acceptable for there to be people in the world who have different opinions than you, and that does not make them a troll.

The above was my rationalization, with sources that you probably didn't bother to read, for my original comment where you made the personal attack and assaulted my character. At any rate, this conversation is done. Stay healthy and stay free, my friend.

> I meant the original comment where you levied a personal attack against me.

I think you mean me. What I actually wrote was:

> Comment history on the topic of COVID is littered with trollish behavior and bonkers-bad reasoning fitting a pattern.

And I stand by that statement. You've had a long history of rolling out dubious arguments and posting inflammatory misinformation with a deliberate agenda to minimize COVID from the very beginning, the whole damn year. I have no idea why. Your comments on other topics seem reasonable and level-headed, but your COVID trolling is just off the charts. I wish you would just stop it. The world hasn't even processed the trauma of going through millions of deaths, we're finally seeing the light at the end of the tunnel, and we got you out here just making more noises again, with driveby doubt mongering. Every. damn. time. Only with one more zero on the death counts each time. Please, just can it, dude. What are you hoping to accomplish? Talking people out of getting vaccines? You're afraid that you need to take a vaccine, because it's just the sniffles, or something? Fuck off with that already, the world's been on fire for a year. People I know have died. Friends of mine have long COVID. Friends of mine are doctors, nurses, who have seen thousands die. Fuck off with your stupid "gene therapy" fear mongering, on exactly the wrong thing, in exactly the wrong direction, at exactly the wrong time.

It concerns me that you are so keen on citing data in your comments, yet you are unable to notice that my username is not the same username that called you a troll.

My first comment in this thread was where I told you that your rights were not being violated. My second comment was my clarification. This is my third. There have been no personal attacks directed toward you from me - if you feel differently, please highlight where you feel I attacked you.

I urge you to pay better attention.

This is false. MRNA vaccines have no relation to gene therapy. MRNA is not turned into DNA by the body, and is fully gone from the body within a couple days. As such, there are no possible long term effects related to the vaccine being MRNA vs traditional protein based vaccines.

> No one has any clue as to their long term side effects. The under 30 odds of death for Covid-19 are statistically zero percent.

Can't you flip that around? No one has any clue as to the long term side effects of Covid-19. The under 30 odds of death for getting the vaccine are statistically zero percent.

They are vaccines and you should update your knowledge. Herd immunity needs to happen or our economy and health will be suffering for years. The chance of complications is also basically zero. If you want to chicken out and not get one that's fine, but don't spread disinformation. The mRNA vaccine is not gene therapy. Again you are spreading misinformation with that. Stop reading right wing trash sites and read some science sites.

> 6 obvious deaths that we're aware of.

1 death. The other cases are severe blood clotting but still alive by my understanding.

That's literally one-in-6-million chance of death with regards to this blood-clotting issue. A vanishingly smaller chance than the 1-in-40,000 (or 150-in-6-million) a healthy young person has of dying of COVID19.

So 1 death, 5 severe reactions related to blood clotting. Definitely a cause of concern, but lets not overplay the stats here.

This just another "Trolley problem": 150-people (even youngsters) would die from COVID19 vs the 1-person who died from the J&J vaccine.

If we include the general population (instead of focusing on the youngest and healthiest of us): COVID19 mortality rate is 1%ish, or 60,000-people-per-6-million.

Three quick points:

You have to multiply the IFR by the odds that the person gets COVID to begin with. In countries where there's no community transmission (Australia) or in countries where it's possible to kill the virus just by vaccinating the at-risk population combined with shut-downs, the multiplier should be pretty small. Even in countries that have handled it badly, it still might be only a 1/3 or 1/2 chance of catching it. So as a young healthy person my chances of dying from COVID are probably less than 1/100000.

I bring this up because I think it misses the actual point. Even if the vaccine had a 1/100000 chance of death or major complications, I would still take it. Because my life is not the only one that matters. Killing the virus is likely (in this country) to require most people who are physically capable (including the young) of taking the vaccine. My taking on a 1/100k risk with the vaccine vs a 1/100k risk without the vaccine is worth it, because for most other adults, the risk is much greater than 1/100k if the population doesn't get vaccinated.

Fortunately, I don't think pausing J&J is necessarily the wrong decision, even given the argument I just made. AFAIK it's the least common of the three vaccines, and so there should not be many "missing" vaccinations that result from the pause. The fact that taking a risk is justified does not mean that pointless risk is justified.

It's not clear to me that the J&J vaccine's supply is large or critical enough that it's going to make that much of a difference (yet). If the supplies of the Moderna and Pfizer vaccines are such that most people with J&J appointments can just get one of the others instead, that's really not that big a deal.

Walk-ins might be affected, though, but I'm not sure what percentage of the total daily vaccinations are walk-ins vs. appointments.

And as a sibling mentions, the general risk of dying from COVID-19 is not 150 in 6M, because the probability of getting (symptomatic) COVID-19 needs to be factored into that figure. I would not be surprised that if that probability drops to under 1 in 6M after accounting for that, though of course the symptomatic infection risk differs based on demographics.

One thing that I am worried about, though, is that this might make people trust all the vaccines less in general. My girlfriend and I had J&J appointments for this Friday; fortunately we were able to get a walk-in Moderna shot today, but the issues with the J&J vaccine did give her a little anxiety even about the Moderna vaccine. I think that (and worse) might be pretty common, and isn't unreasonable.

It’s actually one obvious death we’re aware of—the other five are still alive. Though that doesn’t change the calculus much.

yeah, and how many got "non-severe" clots? Obviously, it isn't a binary situation like: you are 100% OK vs you are dead from clot.

I wish people applied this much caution to the virus. Who knows what cancers it causes 10 years down the road.

Do any corona-family viruses cause cancers that we know of?

I don't know. But HPV and Herpes definitely can. Here's some more:


It takes quite a long time to prove the link between a viral infection and a cancer that develops decades later, so it'll be a while before we know for sure.

I think that given the fact that we've been getting sick from corona-family viruses for years with no suspected link to cancers, this should be of relatively low concern, barring any specific information.

There are other potential longer term side effects that at least seem to have some emerging data to back them up, which seem more concerning to me.

How would we even know? In order to tell if coronaviruses caused cancer, we'd need to be keeping track of which people had ever been infected with one of them and how many of them ended up with cancer, and we're not. It'd just fall into the background level of cancer incidence otherwise. Hell, we haven't even figured out if they're the main cause of Kawasaki disease yet, and that's a fairly spectacular and dangerous condition affecting children. There's some evidence that some common viruses in the family might be really deadly to elderly people, but that doesn't seem to have been researched much either. There's a lot we just don't know.

This isn't actionable information, though. There are no good ways to mitigate all unknown potential risks, because the mitigations have risks themselves.

You mean proteins if you're talking modern/pfizer. It's literally triggered by one protein that matches a protein on the covid membrane. Everything in life is a chance, just stepping out and getting some sun puts you at risk for skin cancer yet still people have been doing it for a couple million years.

Well, consider that a lot of people who aren't applying as much caution to the virus itself just don't think it's that big a deal. Either they think their infection risk is low, or they expect they'll be asymptomatic, or think that even symptomatic infections aren't that bad. Through that lens, it makes sense to be wary of taking a vaccine with possibly-dangerous side effects when they don't believe the virus it protects against is all that bad.

I don't agree with the premise behind this reasoning, but I can see how it'd come about.

We have 17 years of SARS-CoV-1 patient data. We're even using their antibodies to treat COVID-19.

8000 infections of SARS worldwide. It took how many hundreds of millions of HPV infections and cancers to detect the link?

There is already plenty of evidence some people who survive the virus end up with lasting lung damage.

While this is not cancer, for those poor souls, a lifetime spent struggling to breathe is not much better.

I agree but only because about 5% of the vaccines currently distributed are J&J in the USA. The others will more than make up for it I'm sure. I think when we hit the wall and the supply outstrips the demand in the next few weeks as we approach 60-65% vaccinated and qanon and hippy antivaxxers are unwilling, I bet in month there will be so many open spots that they'll start cutting back manufacturing unless Biden convinces Moderna and Pfizer to keep going full speed ahead and we say distribute to Mexico/Central America/South American countries (like we ought to do).

Some experts have said that it's probably an immune reaction to the adenovirus which is used as the delivery mechanism in the vaccine. Wouldn't the side effects therefore be limited to the first weeks after the injection only?

You'd have to compare that to the chances of the long term effects of COVID causing issues down the line, which I'm willing to heavily bet is much more likely given what we've seen so far.

There's already been large scale phase 3 trials, and we've deal with vaccines for decades, they're not entirely novel and unknown each time.

The phase 3 trial for JnJ/Janseen had only ~44k participants whereas here we are talking on the order of ~1 per million (that are reported as of today)

> we've deal with vaccines for decades

I don’t think that’s accurate in this case. The type of vaccine that J&J released had up until months ago only ever been deployed in animals.

IIRC pigs had a problem with corona viruses that we solved”

The J&J is not a heap of dead virus like the common ones we have had forever. But a live harmless (we think) virus dolled up to look like Rona Corona.

Live harmless vaccines aren't anything new. Some of the TB vaccines from the 60s are of that variety. Live virus vaccines have safely been used for at least the past 5 decades. Stop spreading bullshit.

Ok. Well, perhaps you aren’t actually aware of what the J&J is. I enjoyed the part about spreading bullshit though, good one.

No, there have been no previous live viruses that have been genetically modified to look like other viruses (embedding Covid spike proteins) injected in humans before three months ago in any scale.

We have treated animals with exactly this however, including pigs against piggy rona.

I recommend reading the whole post next time, not just stopping at “live virus”.

This is what worries me. I have had the AZ vaccine. Will I be at risk of this syndrome every time I am exposed to coronavirus? In other words, is the risk cumulative?

6 deaths? I thought it was 1 death and 5 serious injuries?

I went to the emergency room for earth shattering headaches (no history of headaches like this) after getting the J&J vaccine last week. I mentioned I’d got the vaccine and asked if it was possible the two were linked. The doctor did everything but actually roll his eyes and thought that the headache being caused by the vaccine was ridiculous.

I bet if I went today he wouldn’t be so dismissive.

Actually, I bet he'd be even more dismissive.

That's odd, as headache is a common symptom for many vaccines (or pretty much any medicine).

a thunder clap headache is also a symptom of a stroke.

...which is a kind of blood clot.

Would he somehow check for blood clots? What could that doctor have done?

My family history includes some "adventures" with blood clots/PE's.

Typically they investigate with multiple tools - a CT scan, a D-Dimer blood test, and often an ultrasound to check blood flow in limbs etc.

He did order a CT scan on my head and neck. Luckily no stroke or anything like that.

Give you blood thinners like aspirin?

Did you report it to VAERS?

Did you have a blood clot? Temporal proximity doesn't necessarily mean "cause", usually just a coincidence.

I did not, thankfully. I went to a follow up appointment and it seems there are several potential causes so I’m working on figuring out proper therapy with my doctor.

>The risk of dying from a blood clot after receiving the J&J vaccine is six in 6,800,000 (6.8M)

that we know of.

I suspect the lack of understanding about what is happening, and what other knock-on effects there might be is what is behind this.

If a wing falls off of one airplane in a million, we still stop and try to figure out what happened because as far as we know, wings are not supposed to fall off any airplanes, so there's something about the system we need to learn more about.

But airplaines are engineered by humans, we know everything about how they are supposed to work until the last bit of physics.

We don't have the same absolute understanding of mechanisms with vaccines. Therefore, I am not sure we can use this metaphore to suggest that it is the right choice in this terrible time to stop vaccinations, causing slowdowns to happen and scepticism to spread in the population that is bombarded by the press which creates an echo chamber repeating over and over superficial news.

I personally don't expect a vaccine, nor any medicine in general, to be supposed to have absolutely zero incidence of possible negative side effects.

>stop vaccinations

We aren't stopping vaccinations. We are stopping this vaccine. For the moment. To gather more information. Which is precisely the kind of responsible behavior that we need, if we want people to be less skeptical of the vetting process for these vaccines.

>We don't have the same absolute understanding of mechanisms with vaccines.

Wouldn't this support more caution, not less?

>But airplaines are engineered by humans, we know everything about how they are supposed to work until the last bit of physics.

>We don't have the same absolute understanding of mechanisms with vaccines.

Having even less knowledge about how vaccines and our immune systems work seems like reason to be even more cautious, not less cautious.

Especially considering the fact that autoimmune disorders have been on the rise for decades, and we don't know why.

> Especially considering the fact that autoimmune disorders have been on the rise for decades, and we don't know why.

Could it be that we are simply diagnosing them better?

Just throwing it out there as a plausible explanation since autoimmune disorders are commonly diagnosed based on a multitude of symptoms none of which definitely indicates an autoimmune disorder independently; similarly, I find it highly likely the rise in cancer diagnosis to be at least partially linked to better diagnostics too.

Every day, 300 people in USA get a blood clot. It's not wanted, but it's expected.


I had wondered about this as well - in the pool of people who have gotten the J&J vaccine, how many would we expect to have developed a blood clot under normal circumstances anyway?

That's exactly what they'll be studying to see if it's statistically relevant. They're being super cautious. Some would say over cautious but I think it's fine since J&J is currently only 5-10% of the vaccine supply going out. Which means a slight slow down in vaccine supply but not as big a deal as AZ in Europe since that is their main supply.


>A slight slow down is a euphemism for people dying.

We apparently don't know that, which is why they are pausing to examine the safety of the vaccine.

We don't know what? We know that if a slow down causes a delay in people getting vaccines, there will be people dying from COVID.

Not if the vaccine isn't safe.

For the record, I'm not coming down on one side or the other of this argument, just pointing out what the calculus they seem to be operating under is.

OTOH, if this being in the news causes fewer people to get vaccinated, pausing it may be a mistake that will cause more overall deaths

This is the reason people lost trust in the medical community during COVID.

Yes, the fact that they are being this cautious is a good thing for public trust. We have other vaccines as well. I rather have this level of transparency then blindly tell people to get JJ and we will figure out edge cases later.

Is it that good? There are places where lots of people are refusing to get the vaccine if they hear it's Astra-Zeneca, because of all the overblown nightmarish news around it. I can tell you for example that in Italy there are examples of regions where 80% of people refuse.

I understand the need for being cautious and for transparency. Actually, I would like to have even more transparency and actual scientific data and numbers from the news. That would help the public understand better why certain decisions are made.

(Maybe my main problem is just with mainstream press, not much with stopping vaccinations per se. I'd just like to know more and be told by politicians: we are listening to scientists, these are the data, this is how numbers compare to the incidence of other side effects for well known medicines and to the numbers of daily deaths and long term problems caused by COVID, and the decisions are taken because X > Y).

> refusing to get the vaccine if they hear it's Astra-Zeneca, because of all the overblown nightmarish news around it

Here is a small problem with this that makes me also consider if I want to take a shot with AZ even if I registered for it months ago waiting for my place:

Before EU started discussing the issue with statistical signifiant number of cases of blood clots in vaccinated population UK Reported 5 cases of blot clots in vaccinated population.

After EU talked second time to suspend vaccination with AZ lo and behold UK discovered that it missed in previous months to report 25 more cases.

Now should I trust any of these agencies that they are telling the truth? I am starting not.

But I had a mild COVID and I am sure after experiencing those symptoms that I really want a vaccine. I am not willing to experience a reinfection.

I was scheduled for JnJ vaccine tomorrow but late in evening I got a text that my appointment is cancelled. I was conflicted all day about whether to keep my appointment or cancel it. I am sort of relieved that someone else made this decision for me and honestly makes me feel good about getting another vaccine. This assures me if there were or are any issues with any other vaccines, our regulators would have paused those vaccines too.

Also I was able to get another appointment for Moderna vaccine next week. So I just have to spend another 4 weeks or so social distancing. It is better than developing blood clots, imo.

It's even worse than that. Many other countries are now following suite and also pausing roll-outs. I'm here in the 3rd world (South Africa) and we really need to get our vaccinations going, so now the government has "paused" their non-existent vaccine program with winter on the way (and after pretty hectic easter celebrations).

Another factor to consider is that COVID is contagious but blood clots are not. The multiplicative (if not exponential) nature of COVID spread makes this a no brainer that the vaccine should be reinstated (and just monitored).

I suspect that what's happening is that these institutions don't think in consequentialist point of view. They are not comfortable with diverting the trolley even if the math checks out.

Nit pick sorry:

> Now, your risk of dying either from vaccination or Covid19 depends on various demographic factors

Your risk of dying, or other health injury, depends on your personal health factors specifically.

Demographic is the statistical data of a population.

Also, there is a clot risk for with COVID [1] that's much higher than the vaccine. The clot risk is the reason I've been indoors this whole pandemic, so I'll happily take my these ridiculously better chances with the vaccine.

1. https://www.cnbc.com/2021/04/13/blood-clots-more-likely-from...

Per Wikipedia: there are 7.3 deaths per 1 billion km driven in the USA. About 7 million J&J doses have been delivered. One person has died as a result of blood clots thought to be related to the vaccine.

If we assume an average of 32km round trip to get to a vaccination site (~10 miles each way). Statistically speaking at least one person has died driving in their car to get the vaccine. The same number as from the vaccine.

I couldn't find good stats on serious injuries per km driven, but I suspect it's an order of magnitude higher than deaths per km. Your risk of dying on your way to get the vaccine is the same as your risk of dying from the vaccine. You are, almost certainly, far more likely to be seriously injured on your way to get the vaccine than you are from the vaccine.


>> Yesterday, Covid19 killed 8,803 people (according to worldometers).

I'm certainly not denying Covid19, but I do take all the statistics with a grain of salt. It's important to understand that those people died with, not necessarily of Covid19. Also, why are so many positive tested persons without any signs of illness? I wonder what numbers would result in testing every death for other viruses.

The best, maybe only number we can properly compare is the total death rate. In doing so we see that Covid19 causes additional deaths, but it is far from as severe as the media and politics suggest.

The number of excess deaths in the world is quite similar to the number of known COVID deaths. In fact, excess deaths is the higher number. It's very likely that the number of COVID deaths is currently underestimated, as spread of other infectious diseases has been drastically diminished by the lockdowns.

With all due respect to the statistics lessons that usually follows news like this, if you are one of the 6,971 or the 8,803 for that matter, these numbers are not as comforting as you might imagine. It's like the time I was unemployed and I kept hearing from the government about how low the unemployment rate was.

I can avoid getting into my car and running that risk. It’s still there and can happen, but I can opt to not drive my car.

The vaccine is eventually going to be mandated to go back to the office, go places, etc.. That’s a risk that you can’t avoid and will have to take.

I’m all for vaccinations and get them when needed, I’m still not comfortable for vaccines that have not been approved. Right now, they all have emergency approval and not overall approval. According to the cdc, vaccines need at least ten years of data to be considered safe for use. We’re only a little over a year into the development of the vaccine. Not really safe in my eyes.

> if this being in the news causes fewer people to get vaccinated, pausing it may be a mistake that will cause more overall deaths.

Except for that the government covering up the MMR investigation instead of doing it openly is what caused the anti-vaxx movement in the first place. Compare that with the public rallying around J&J after their Tylenol recall.

0.00009% over a 30 year period means you have about a 1% chance of being blown up by starting your car. that's about the odds of catching HIV while having unprotected sex with someone who is HIV positive (depends on a lot of factors though).

Error, mismatched units. The 30 year odds of HIV due to unprotected sex is far higher.

point being, even if it was just 1 time, had you performed that action you would be very worried I presume.

The 6 are only those we know of. There could be others, because these cerebral blood clots can happen two weeks after receiving the vaccine.

As we analyze the data, and see if more data comes in the next two weeks, we'll have a better sense of the risk.


> Proclaiming that there could be others is worthless without quantifying what you're willing to accept.

If it can be isolated to certain groups, then those groups could be offered alternatives. The UK did something like that, and it worked well for them. It's not just about an overall number - it's about how effectively this risk can be reduced.

> Just saying to wait is a decision that will kill people.

J&J was a very small proportion of vaccines. There is plenty of extra supply from Moderna and Pfizer in the US, so you'll need a citation that this will kill people.

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 beneficent risk for taking.

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.

Also if you live somewhere like Australia or NZ which is vaccinating but has largely wiped out community COVID. It makes sense to have a bit more caution in such places as long as the mRNA vaccine can still be used. Australia suspended the AstraZeneca vaccine for that reason, but I believe we're using it again now after some analysis.

It's been continued with adequate consultation. I was supposed to have my AZ this morning (however had to postpone) as part of the 1b category. 35 yo male. I'm ok with getting it but i would kind of like the pfizer one coz i'm a nerd and the pfizer vaccine has more science in it.

I read one of the six died. Has there been a news update that all six have died?

It's six bloot clots, and only ONE death, not six deaths:


People don't think like that.

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?

If airbags kill someone who didn't crash their car, that model of car/airbag should be recalled. If a vaccine kills someone, people should stop taking that vaccine.

The point here is simple. It's worse for someone to die of a vaccine than for someone to die of the coronavirus. How much worse is up for debate, but it's a significant factor and napkin math has to take that into account or it's morally bankrupt.

I think I see your point but the probabilities are an important factor, as well as the freedom to choose based on being well informed. Unfortunately at this stage we don’t have sufficient information to provide solid information to make an informed choice.

If there’s (hypothetical overly high numbers here) a 10% chance of dying from a disease or a 1% chance of dying from the vaccine from that disease, I want the vaccine and would like the freedom to do so. But if a new vaccine is coming out and soon after we see a 1% death rate from it, now I’m gonna want to hold off and take my chances with the disease because that 1% may turn out to be as high as or greater than 10% down the track when more is known.

The main complexity here is just like the early days of coronavirus - until things have played out for a while you can’t have confidence about the extent of the harm and that’s true for both the disease (which we now have over a year of information about) and the vaccines (which we have a month or two of in-the-wild info so far).

Unfortunately, your comments exclusively address a hypothetical scenario. Even if there were solid evidence that "a vaccine will kill people," the likelihood of that occurring currently appears to be orders of magnitude less than the likelihood of having the same occur from actually having COVID. [0]

As someone else pointed out here, you're about as statistically likely to die in a car wreck on your way to get the vaccine than you are to have (not die from) a blood clot from it.

[0] https://www.beckershospitalreview.com/cardiology/blood-clots...

If a hypothetical vaccine could save a million lives, but kills 10 people who get vaccinated, are you arguing that it shouldn't be administered?

Yes. Let justice be done, though the world perish.

There's solid evidence that foods kill people.

100% of people who eat food eventually die.

For certain foods, some people die very quickly from immune reactions.

My comment is more or less ridiculous, but I'd like to understand why an effective vaccine that is dangerous to a few people is different than peanuts, which are dangerous to a few people (many of whom discover this by consuming peanuts).

Why is everyone worried about blood clots, and not that the J&J vaccine has a crap-tastic efficiency of 66.3%?

Would you want the chef at your local takeout to be vaccinated to 66.3% efficiency? or 94%?

Why was this vaccine even approved, instead of just having J&J produce the same vaccine Pfizer and Moderna are making, which would be in the best interest of the world? Is this some utterly idiotic capitalism bullshit that prevents J&J from making a 94% vaccine as well?

Why can't we just take $100B out of the $1T military budget, throw it at Pfizer and Moderna to shut up their patent lawyers, and then hand the formula to J&J to become a 3rd factory for a good 94% mRNA vaccine?

And then hand that formula to the rest of the world including Brazil, India, China, and other recent new COVID hotspots so that the virus doesn't boomerang back to the US in an evolved form?

At least that's what I would do if I was president.

This is not full story. 65% efficacy against symptomatic COVID-19 but 100% efficacy against death and hospitalization due to COVID-19. So there is real benefit to it.

This is a leaky vaccine, which is actually a big health risk. You remove selection pressure for lack of virulence, so more fatal strains can spread more easily. Definitely not a good thing.

I know about Marek's disease in chickens, but has a leaky vaccine ever caused a virus to evolve like that in humans?

Would there be anything in particular about the study of that case which would not be valid in humans? I've seen articles/studies from before Covid that suggest this sort of thing could be a concern in humans, but no reported cases of it happening. On the other hand, we don't exactly have a control group, so there's not a good way to tell.

Yes, but 65% efficacy still means that 1/3 of the vaccinated people will continue to be spreaders, which doesn't sound great, especially if that allows the virus to spread and evolve into a harsher variety.

At this stage, getting as many people to near 100% death avoidance and with some immunity is the goal.

We're not at a stage yet when we can play favorites. It'll be a long time before we have the supply to prefer one over the other (except maybe in the US where there will be enough mRNA vaccines to go around).

Not necessarily. Efficacy measures are about protection from hospitalisation or death if you contract COVID. It doesn’t imply loss of viral shedding. There’s a vox video on YouTube that explains this...

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 would never test positive on a PCR test but could still spread covid. The odds that this is how the vaccines work seems very small, relative to the number of times this argument that "we don't know yet" is getting repeated.

It just seems strange to me that so many people are hung up on pointing out that this small possibility is still a possibility. It seems more likely that this will drive more people to skip the vaccine, since they're being told they can't even go back to normal once vaccinated, than anything else.

I don't think the fact that you might be still spreading covid when vaccinated is enough of a reason to continue lockdown. As long we are continually getting people vaccinated, we should be fine for returning to normal.

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.

> Aren't the efficacy numbers from the phase 3 trials based on giving periodic PCR tests to everyone that was participating in the trials?

For most trials, no. You have to look at each individual study, but most commonly, they only test after people show specific symptoms.

Keep in mind that a door handle is completely immune to Covid and can be spreading it.

Only for a few hours though, not 2 weeks+, and viruses don't mutate on a doorknob. Someone who got vaccine and falls in the ineffective category will likely not die but will be a spreader for a few weeks, with some nonzero probability of mutation, and that times 1/3 of the population that got the vaccine would give the virus a lot of opportunity to mutate.

According to some experts, Covid-19 can endure on certain surfaces for as long as six days.

Okay, but until they're done studying, maybe let's just make more of the 94% vaccine using J&J's facilities?

You do realize that different manufacturing facilities are not interchangeable? They're not a rack of x86 servers.

Lol if the people that don't get it and it's more or less a cold it's not a big deal. If you go to the hospital your chances of dying from it go up astronomically. How can you miss that most basic of points?

If nothing else, the logistics of transporting J&J make it a lot better in a lot of cases. Pfizer in particular needs to be transported super-cold, and Moderna needs to be frozen as well. J&J can be handled much more like a flu shot.

That said, I'm smarting a bit (even though I understand why) that the fully vaccinated guidelines cover 2 weeks after J&J, while it's looking likely the mRNA vaccines give you better protection even 2 weeks after the first shot. (You really do want the second... the 6-month Moderna study shows you get about 10x the antibodies from the second one, which means the protection lasts much longer if nothing else.)

The percentage efficacy can be misleading, it is not a like-for-like comparison.


The limits of mRNA vaccine manufacturing are that it's a new process and the technology and supply chain required to produce it are very hard to get right. Derek Lowe does an excellent job of debunking the simplistic "Why don't they share the design" argument here:


Do your research dude. It basically results in essentially 100% non-hospitalization which is the big deal, not whether you get a fever and cough a bit. I can't imagine how anyone would miss that little factoid if they read at all about the J&J vaccine before saying it's useless. Again do a little reading.

> Why is everyone worried about blood clots, and not that the J&J vaccine has a crap-tastic efficiency of 66.3%?

See "Why you can't compare Covid-19 vaccines":


You're welcome.

> "Why is everyone worried about blood clots, and not that the J&J vaccine has a crap-tastic efficiency of 66.3%?"

The J&J vaccine is marketed as a single-dose vaccine, unlike the others which all require two doses to reach their reported efficacy. Single-dose is a massive advantage which will greatly speed up vaccination progress, especially in developing countries.

And 66% seems pretty good for a single dose.

> And then hand that formula to the rest of the world including Brazil, India, China, and other recent new COVID hotspots so that the virus doesn't boomerang back to the US in an evolved form?

Such a vaccine would also have two doses and require intense refrigeration which are the primary issues blocking it... additionally many of those jurisdictions might not accept a US vaccine. China, maybe, since they admitted their own vaccines aren't working super well. Russia doesn't have anything wrong with its vaccine but the Kremlin admitted no one is taking it, apparently because they don't believe in covid.

> China, maybe, since they admitted their own vaccines aren't working super well.

Despite what the press has reported, that's not really what happened. In a conference talk on vaccines, the head of China CDC made a general statement about what to do about "low vaccine efficacy." That's been blown up in the Western media into an "admission" that all Chinese vaccines supposedly have low efficacy.

It doesn't even make sense to talk about the efficacy of "Chinese vaccines." Chinese vaccines run the gamut, from inactivated whole virus to protein subunit to adenovirus vectors. There's even a Chinese partner to Biontech, which is going to manufacture the latter's mRNA vaccine.

It's kinda funny how Sputnik-V felt like a rushed publicity stunt... and later on it turned out it might actually work.

> Why was this vaccine even approved, instead of just having J&J produce the same vaccine Pfizer and Moderna are making, which would be in the best interest of the world? Is this some utterly idiotic capitalism bullshit that prevents J&J from making a 94% vaccine as well?

Exactly. There should be no place for vaccine profiteering, especially now that we have two extremely good vaccines. But in the interest of pharma profits, instead of cooperatively manufacturing the best vaccines, unburdened by patent hurdles, instead we have massive amounts of public funding going to pharma corps so that they can make profits off this medical crisis. Truly shameless.

"The incidence of cerebral venous thrombosis (CVT) varies between studies, but it is estimated to be between 2 and 5 per million per year. A recent study in the Netherlands with comprehensive ascertainment suggested a much higher incidence." https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.116.0...

So the six reported cases in 6.8 million vaccinations seems low. Glad I read about all this because I got the J&J vaccine 12 days ago. No noticeable side effects so far. I exercise a lot and did a 5 mile hike four days ago that resulted in a slightly strained a calf muscle. I have been taking it easy the past few days, meaning sitting and reading a lot more than usual. So after learning about the blood clotting, have started exercising the legs frequently. My optimistic thinking is that even if the vaccine does cause an increased risk of CVST that risk can be eliminated via exercise.

It will be most interesting to learn if those six cases involved people at high risk, if they exercise regularly, etc.

If you’re doing the calf exercises to ward off a DVT, (and not to just stretch your strained calf!) you may be barking up the wrong tree.

The preliminary theories (backed by the thrombocytopaenia) are that, if there’s a vaccine induced thrombosis with thrombocytopenia, it is probably immune-mediated (similar to HITT - heparin induced thrombocytopenia and thrombosis).

And then there’s some weird thing that makes them form in your venous sinus.

But there were also reports of more typical blood clots (ie DVTs), the first European Medicines Agency advisory (0) said that this was within the level of noise (im now talking AstraZeneca, so apologies for shifting vaccine as generally they should be considered separately until the evidence catches up, although everyone is quickly drawing parallels between them)

(0) https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazene...

Ps apologies for not referencing around HITTs and theories around antibody-mediation for CVT. Basically it’s all pretty noisy anyway at the moment and so my here-say from the medical tea rooms is as good a gossip as any, as long as everyone is aware that no one really has any definitive idea what may be going on yet

Agreed, I don't think anyone knows clearly what is happening. Some additional points that are related.

Thrombocytopenia has been a known complication of adenovirus vectors that researchers have worked to overcome in recent decades.

These incidents mirror HITT (women are at higher risk for HITT) and seem to be happening in the timeperiod where IgG titers spike post vaccination.

To me this indicates it's not unlikely something with the adenovirus vectored vaccines (J&J, AZ) is causing this issue. And because this thread seems to have gone to hell, I'll add that I support doing subgroup specific risk calculations and allowing vaccinations to proceed where it makes sense.

https://jvi.asm.org/content/81/9/4866 https://ashpublications.org/blood/article/109/7/2832/125650/... https://pubmed.ncbi.nlm.nih.gov/17148587/

Just want to add that this is not a new theory and has been circulating in medical circles for roughly a month [1]. There is also the hope that when it happens it can be diagnosed and treated.

[1] https://twitter.com/LJohnsdorf/status/1371721321336475651 (in German)

Good take.

Arterial clots with thrombocytopenia is incredibly rare. Additionally the PF4 activity in these patients is very abnormal and appears to be to immune mediated. Lots of science and focus going into the mechanism around this now. The other recent NEJM articles around clots associated with the other adenovirus COVID vaccines are likely a similar phenomena.

2-5 per m per y is an incidence over the entire year. Assuming a uniform distribution over the 365 days, then the probability of getting it "on that day" becomes a probability of 1-2 per billion.

So the reported cases of are not comparable. They are really, really high.

And while I agree about the relative risk vs covid, again this is not a fair comparison. For many people who are isolating, then a person never leaving the house has a very low risk from covid, both personally and transmitting it. You are not asking people to exchange a very small risk from the vaccine vs a very high risk from covid. You are asking them to exchange a very small but roulette-like risk from the vaccine, versus a presumably equally small if not smaller risk from covid due to their circumstances.

Note, what I am "not" saying is that peoples shouldn't be vaccinated. I'm just saying artificially trivialising the risk further using bad math isn't doing anyone any favours.

"So the six reported cases in 6.8 million vaccinations seems low."

No, because those 6 cases are something more like "1 per day" rather than "per year". Or maybe "per week". But either way, you need to multiply the "per year" base rate by a large number to get the base rate for "coincidentally happened immediately after a particular event", for some definition of "immediately".

It's reports within 3 weeks, so something like 18 per million per year.. The larger danger is any interaction with an automobile to get to the appointment.

They also appear to cluster in young women and one young man (from the phase 3), do it’s quite probable that the “6 million” is not representative.

Using 1 per year is useless unless it's adjusted to a ratiometric form like percentage or per capita

My wife says this is not about exercise, while living a healthy lifestyle is good, apparently this specific condition causes clots to form in the brain itself as a result of low platelets.

CVST with Thrombocytopenia is the name.

Similar to AZ, all six were women between the ages of 18 and 48.

20% male (1 patient) in this report https://www.nejm.org/doi/full/10.1056/NEJMoa2104882

I think with numbers that small it’s hard to tell if it hat 1 male is purely a coincidence or not. Also I don’t know if percentages are useful either.

seems like they were all young women. so let’s say young women make up 1/4 of those vaccinated.

for them it’s more like 1/250k

That’s what I keep saying! People are saying it’s 1 in a million chance, but unless all the people who got the vaccine were women than it’s not. The instance could be far higher but it’s not possible to know without knowing how many were given to men vs women

But not _young_ women. We may be seeing something legitimate.

John Campbell suggested on his video the other day that perhaps this is happening because some injectors are not aspirating. What that means is that when an intramuscular injection is given you want to ensure that it goes into the muscle and not into a vein. So the proper way to do this is for the person doing the injection to first pull out the syringe (after it's been stuck into the arm) a bit to make sure there's no blood coming out. Then if not, the vaccine is pushed in. If blood is seen then a new site has to be chosen. Apparently Denmark has included aspiration in their directions for usage of the AZ vaccine.

Medical professionals are often taught these days that aspiration is not necessary for IM injections, particularly in commonly used sites such as the delts.

From the CDC [1]: Aspiration before injection of vaccines or toxoids (i.e., pulling back on the syringe plunger after needle insertion but before injection) is not necessary because no large blood vessels are present at the recommended injection sites

[1] https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/admi...

This lines up exactly with what Dr. Daniel Griffin talked about in the most recent clinical update podcast for TWIV [1]. Apparently aspirating makes the shot more painful, because the needle is in the body longer, and serves no benefit as long as the vaccinator is putting it in the right location.

1: https://www.microbe.tv/twiv/twiv-741/ (towards the end)

"no large blood vessels are present at the recommended injection sites"

That's a bold statement. Sure, no large blood vessels may be present at the recommended injection site on an average human, but it's well known there is more divergence in anatomy than they necessarily teach about in primary school, and vaccines are supposed to go in basically everyone.


As a set of examples, not the whole gamut of such possibilities: https://health.howstuffworks.com/human-body/parts/reversal-o...

Your first class may not teach this, but you'd get to it eventually if you kept taking classes. (Then again, your first class may at least mention this sort of thing at some point.) What the "average human" is is not what all humans are. There's all sorts of things like, the stuff in that link, major nerve clusters having additional or missing separations, extra separated or fused bones, major veins and arteries not being quite in the usual location... look close enough and you'll find something on everybody that doesn't match the "standard human anatomy".

Still, even if it gets close to a small vessel it might be problematic

Maybe we'll need to do it for AZ. Or maybe subcutaneous?

That's interesting to know. When I got my Pfizer jab, the lady said "oops, I did it wrong" and blood came out. She didn't jab me again though and I just assumed it was good to go. Should she have done it again at a different site? I was told elsewhere that it doesn't make the vaccine any less effective, but I'm curious what others on here think now...

As I understand it the concern isn't effectiveness so much as potential for side effects. An intramuscular injection is meant to stay pretty much in a small area of muscle tissue. If it goes into the vein the vaccine then travels into tissues all over the body.

That’s not really true, we give lots of drugs IM because the muscle is highly vascular so it generally shoots out all over the body really quickly. Ie want to take down a patient with Ice (crystal meth) induced psychosis? IM. Also, it’s hard to miss most of the time.

If you want something to sit around for a long time, you go for less vascular areas. (Ie insulin for diabetics, subcut abdominal fat)

IM is preferred because of the vascularity which helps in the immune response (ie quick immune response, antigen distributed around the body) as well as any immune reaction confined to the muscle rather than, say the skin. (0) is a quick and dirty on mechanisms of administration.

To your earlier point about ‘into’ a vein, I’d never heard of Dr Campbell before you mentioned him, he seems to have great credentials, but I can’t easily explain why an accidental IV administration of an IM vaccine would cause CVST, my gut is that it’s a bit of a hand wave but who knows.

(0) https://www.forbes.com/sites/quora/2017/11/07/why-arent-vacc...

IV injection of adenovirus gene therapy vectors is well known to cause thrombocytopenia.

Right, thanks, I wasn’t aware.

Time periods seem off (5-14hrs) in mouse models compared to what’s being seen here though, which seems more like an immune reaction rather than a response to the antigen/delivery system

That makes no sense of course. You’re innoculating the whole body, especially bone marrow and lymph nodes, not a small area of muscle.

If this were the case it would be odd that this is happening a.) in a consistent subset of women 18-38 b.) that it would emerge in a 1-shot regimen rather than a 2-shot regimen, because it would seem more likely that any one individual would experience this more frequently with 2 chances for human error rather than 1

The Pfizer & Moderna 2-shot vaccines use mRNA instead of an adenovirus vector. The AZ vaccine is 2 shot, but also uses a similar adenovirus vector - the bloodclot issue has also been seen in the AZ vaccine which has led to some countries in Europe not allowing it for women under 60.

I would assume the guidelines for aspirating would be the same across all of these vaccines, though? If so the original point still stands regardless of adenovirus vs. mRNA

Yes, we know that. But what does adenovirus vs mRNA have to do with aspirating an injection? Does the adenovirus become more dangerous when accidentally placed in a blood vessel?

with only 6 people you can't really say that since it's such a tiny sample size. If it's 6 women then you're starting to get to a pattern worth testing.

Injecting IM solution into a blood vessel is excruciating and you and the provider would notice it immediately if it happened. It is likely to cause an embolism and possibly kill you, but I don't think it would be unnoticeable and then cause a thrombus multiple days later.

There are also not a lot of major vessels near common injection sites, for this reason. It's possible and rather common to nick a surface capillary or something, and those can bleed quite a lot, but a vein or artery would be totally different. Swelling, horrible pain, likely a cough.

Source: inject myself with intramuscular estrogen every week.

hah, I inject myself with estrogen subcutaneously. it gets absorbed quicker which causes peaks and troughs, but I get to use a smaller needle (25g x 5/8") and I don't have to worry so much about bruising or locating the right sites.

I should ask about subq. My current regimen gives me a lot of anxiety, even though I know it's pretty safe.

Any theory on why this is occurring needs to have a solid explanation for why women under 55 are suffering this effect more than anyone else. Does John Campbell have one?

Perhaps because younger veins and capillaries are easier to accidentally inject into?


> Apparently Denmark has included aspiration in their directions for usage of the AZ vaccine.

Great, so not only will I have to wait 2-3 months to get vaccinated..

They'll also stick the needle in and pull out a few times just to sure I'm really feeling it!!!

Sorry, but I really hate needles :/

So this past year the government has been willing to let unemployment, suicides and drug overdoses jump due to isolation and loneliness caused by lockdowns, child abuse to skyrocket and mental health to plumment due to schools being kept closed, all because we needed to stop covid at any cost. Now one person dies out of almost 7 million who received the vaccine, and we need to stop administering the J&J vaccine "out of an abundance of caution"? I'm starting to think more and more that the shitty decisions regarding covid in the past year were because it was an election year.

The CDC only tracks actual suicides, not attempts. Suicidal thoughts and attempts are up: https://www.aappublications.org/news/2020/12/16/pediatricssu...

Besides, in the CDC table, "unintentional injuries" is up by way more than suicides are down. This includes things like car accidents, and is a little suspicious, like suicidal behavior led to a death that wasn't classified as suicide. Also note that the table is "deaths with covid or presumed covid", not "deaths by covid": https://jamanetwork.com/journals/jama/fullarticle/2778234


everyone is at home, so perhaps there's less people alone long enough to commit suicide?

As did unintentional injury, which was due to overdoses.

Alcohol and drug abuse is way up as well, that will have long term ramifications.

It is not stopped. It is paused for a few days while updated training is rolled out.

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: Protect the vulnerable and stiff upper lip for the rest. That would have more than halved casualties.

With the benefit of hindsight, a 3 month shutdown while hospitals got their acts together (combined with protecting the vulnerable) would have roughly quartered the remaining deaths, but at far lower cost than the full shutdown.

This was predicted by some of the old-guard epidemiologists, which is why they were against the shutdown in the first place.

The cancel culture folks lumped them in with MAGA anti-vaxxers (I blame both sides) and got them censored by the big platforms. Here we are, with 100,000’s unnecessarily dead, trillions squandered, and many careers, businesses and educations ruined.

I suspect roughly zero people have learned a lesson from this. Hopefully I’m overly cynical.

CDC data shows that more like 25% of Americans have antibodies to COVID, so your number is off by a factor of two. [https://covid.cdc.gov/covid-data-tracker/#national-lab]

Additionally, you make a few glib statements that don’t really check out - you say give hospitals three weeks to prepare - how? There’s been a lot made of hospitals getting ready, but for the most part, the limiting factor for covid treatment has been how many icu care teams are available. More ventilators don’t help much if there’s nobody to use them. Second, I’m not sure how you protect senior citizens when everyone else, including the people who provide their care, is swimming in a soup of COVID.

Like a while bunch of places did in March and April last year: build emergency capacity during what was supposed to be only a short several-week lockdown. Instead, when the capacity went mostly unused during the lockdown, it was quietly dismantled and lockdowns continued.

Also, we knew by April last year that ventilators were a bad choice: Doctors were jumping to it because of a specific weird symptom (blood oxygen levels impossibly low), but they had to keep turning the ventilators to higher settings to get an effect - to the point it was causing further lung damage. There's a bunch of less damaging ways to get more oxygen into a patient they'd been shifting to: https://www.statnews.com/2020/04/08/doctors-say-ventilators-...

> With the benefit of hindsight, a 3 month shutdown while hospitals got their acts together (combined with protecting the vulnerable) would have roughly quartered the remaining deaths, but at far lower cost than the full shutdown.

Where was this "full shutdown" you speak of? Not anywhere in the US. In Wuhan, and some other Asian countries, sure.

Didn't we kind of have the 3 month shutdown-lite you're referring to? Mid-March through about June for most places were at varying levels of shutdown in the US. But recall things started opening up in June of 2020. And cases started rising again into July.

> The US is apparently already at ~50% antibodies, not counting vaccination.

Citation? That seems like about 3X the most optimistic numbers I've heard from credible sources.

As for shutdown vs shutdown lite: No; the economy didn’t completely reopen in July. The recommendations from March 2020 were for more strict targeted shutdown protocols, but over a shorter duration (Strict reverse quarantines for nursing homes, but only for a few months for example.). The idea was to get less vulnerable groups to herd immunity faster. I’m saying a general, country wide shutdown for three months, concurrently with a strict targeted lockdown for about 5-6 months would have been more effective and cheaper (and, we’d have been done by last August, as the parent of my other post suggested.)

Source for 50%: Wall street journal. We were above 33% (based on random sampling, not confirmed cases) a few months ago.

This one from Feb predicted herd immunity a bit too early. They ran one with updated numbers last week, but I can’t find it:


And then we had excess deaths in NY State because Governor Cuomo FORCED nursing homes to take in infected patients! And then he gave immunity to the whole industry from liability if they didn’t take precautions.

And he became the darling of the media and even won an Emmy.


As someone with a family member working in a hospital who still couldn't get reliable PPE after 3 months, I feel that you live in an entirely different universe than I do. Would that we would have lived in a country where PPE for nurses, physicians, and hospital workers were prioritized in summer 2020. Hah. Hospitals were not in a position to get their own; I saw them jockeying for shipments from China and Korea and it's just ludicrous to expect people to get their PPE in bidding wars that involve calling in favors from the chief cardiologist's wife's uncle who owns a factory in China.

You can't really protect the vulnerable, especially when the vaccines wasn't developed. Any source for the 50% antibody claim?

> You can't really protect the vulnerable, especially when the vaccines wasn't developed.

If true, then social distancing, masks, and lockdowns couldn't have done anything for the rest of us for the past year either.

The argument for "protect the vulnerable" is that these precautions could be more targeted and so, hopefully, more effective.

I suspect a lot of folks learned (in the US) is that if you have a president who politicizes a pandemic and shits the bed on leadership, the populous is screwed.

Let's not pretend that rational discourse was ever an option, and the media isn't the place for blame.

I don't know. Seems like a sane, sober, professional, mature, and objective media would go quite far in moderating the overheated partisan rhetoric from politicians.

No, in the age of social media and the internet, the media is no longer a check or filter on partisan rhetoric from politicians.

Putting aside that these claims are presented without any evidence, “most” of 50% of the US population is a minimum of 82M people. ~31M have contracted COVID so far. That we’re going to see almost 3x the number of cases, concentrated in half the population, as we enter summer, and with 3-4M vaccines administered per day, is a pretty bold claim.

> 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.

2/4 of those examples are affluent island nations with low population densities.

Another one of those examples has been actively censoring covid information from the start, and thus cannot be trusted.

As for Vietnam, it is an interesting case, and we don't have enough data to rule out cross reactivity or other factors playing a role.

Extrapolating these data points to the entire world with wildly varying sociological, biological, environmental, and countless other factors and saying this is clearly the correct (and implicity achieveable) strategy for all 8 billion people on the earth is at best hypothetical.

> As for Vietnam, it is an interesting case, and we don't have enough data to rule out cross reactivity or other factors playing a role.

They took shit seriously and everyone prepared the minute news reached them of a possible pandemic. A good friend of mine is from VN and he was shipping PPE back home to his parents around August or October of 2019.

I think most Americans don't realize how common pandemics have been in east Asia. To them, it's like preparing for any other natural disaster. It's like comparing the Michiganders response to a blizzard to that of Texans.

>how common pandemics have been in east Asia.

This is why we need more data about cross reactivity playing a role in the relatively favorable health outcomes in Asia and Africa compared to the rest of the world.

> 2/4 of those examples are affluent island nations with low population densities.

Australia and NZ have densely populated cities, and what does being an island have to do with anything? Countries can close their borders. In fact, Australian states closed their borders to one another.

> Another one of those examples has been actively censoring covid information from the start, and thus cannot be trusted.

You don't have to trust the government. Just ask people you know in China what's going on there. Things have been mostly open for a year now, with no sign of the virus (outside of a few localized outbreaks, which have been dealt with through local lockdowns and blanket testing of the population). China is not the black box that many people think it is.

> As for Vietnam, it is an interesting case, and we don't have enough data to rule out cross reactivity or other factors playing a role.

Vietnamese people are not somehow immune to SARS-CoV-2. They're susceptible, just like everyone else.

> Extrapolating these data points to the entire world

This is the wrong way to think about this. These aren't data points generated by some semi-random process. They're countries that effectively implemented a strategy that we know should work, based on the basic principles of epidemiology. The virus is spread between people who are in close proximity to one another. If you drastically reduce contacts between people, the virus has far fewer chances to spread, and the epidemic recedes. If you do that long enough, you get down to a small enough number of cases that you can trace every single one and snuff out the virus completely. After that, you have to have strict measures at the border in order to catch imported cases, and you have to do regular testing in the population to make sure you don't miss the beginnings of any new outbreak.

There's nothing to "extrapolate." The strategy works because of very basic principles of how the virus spreads. The only question is whether each county has the organizational capacity and societal will to carry this strategy out.

>question is whether each county has the organizational capacity and societal will to carry this strategy out.

Indeed, that's a critical question to the long term success of the strategy.

If the world is unable to put 8 billion people in solitary confinement (nevermind the disastrous effects that would cause) indefinitely until the virus is eliminated (nevermind the fact that we are incapabale of validating if it was actually completely erradicated), the virus is only going to pop back up.

There is no evidence of such a strategy working at scale across the world.

The scientists on the covid team at the WHO have said as much: lockdowns should only be used as a last resort to buy time to scale up health care resources. Should we listen to those scientists?

It's not indefinite. The longest lockdown in China was 76 days, in Wuhan. Elsewhere, it was significantly shorter. Because they had a strict lockdown early on, they have been living with far fewer restrictions than most of the world for about a year now.

> the virus is only going to pop back up.

It does indeed pop up every once in a while, because the borders can never be 100% sealed. There have been outbreaks in Beijing, Qingdao, border towns in Heilongjiang and Yunnan, and elsewhere. But the government is understandably on high alert, and these outbreaks were caught early enough to be stopped with local lockdowns, coupled with blanket testing of the population (i.e., testing everyone in a city in a few days).

There was a brief "second wave" in China this winter, in which an outbreak managed to spread to several cities, but it was ended with relatively short lockdowns and mass testing. The number of new infections per day peaked around 100.

The basic lesson here is that you can both have near-zero case counts and let people live their lives almost as normal if you first act decisively to bring cases to zero, by using temporary, strict lockdowns, quarantines and mass testing.

> There is no evidence of such a strategy working at scale across the world.

China is the largest country in the world, so I'd call that "at scale." Vietnam is larger than any EU country. We're not talking about San Marino or Monaco here.

> The scientists on the covid team at the WHO have said as much: lockdowns should only be used as a last resort to buy time to scale up health care resources. Should we listen to those scientists?

A lot of recommendations will be reevaluated after the pandemic is over. Nothing like this has happened in 100 years.

> The cancel culture folks lumped them in with MAGA anti-vaxxers (I blame both sides)


Something close to a full shutdown was done in China, etc., not Florida.

> returned to near normal by August 2020

The problem is the virus, not the government reaction to it. Personally, I tend to think governments under-reacted in most Western countries. I'm not sure how things would have returned to "normal" if the virus was raging out of control. A good precentage of people would see the deaths and still avoid going out to shop or whatever. I'm assuming you mean by "normal" that people would return to some normal pattern of economic activity - and even if 10 or 20% of people changed their behavior that would still impact the economy.

> A good precentage of people would see the deaths and still avoid going out to shop or whatever.

That seems hard to believe, since significantly more people die every year of all causes than could possibly have died of Covid, even if every single person in the world caught it. Most people probably wouldn’t have noticed anything was different.

> even if 10 or 20% of people changed their behavior that would still impact the economy.

Maybe so, but the economy is not the only or even the most important casualty of our Covid response. The importance of human social gatherings, the freedom to leave one’s home and go wherever one pleases, the education of children, and so on cannot be measured in economic terms.

> The problem is the virus, not the government reaction to it.

Places where there were very few or only brief restrictions, like Serbia, Belarus, or Florida, largely avoided the issues I described above with only a small or in some cases unmeasurable increase in all cause mortality for 2020.

It's not at all hard to believe. All the people in my family, for instance, have changed grocery habits and stopped discretionary shopping in stores essentially entirely. Why? Many are older and have risks yet also have full lives and want to live to play with their grandkids. We prioritized gathering with each other cautiously over spending money shopping and changed habits immediately (I started working from home March 12, before any US guidance).

Sweden is an interesting example. Comparing Sweden and Finland, for instance, older people essentially cloistered themselves in Sweden because they had no trust that they'd be safe in society, and their spending dropped by a higher amount than old people in Finland, who changed their habits less due to the swift and more stringent government response? My old-person family members in Finland were able to keep shopping, going to church, and having birthday parties with many families due to that response (as opposed to in the US where we limited ourselves to gatherings with max 3 households and did everything masked or outdoors due to several people still working on site).

Perhaps you live in a very different place. You certainly interpret statistics quite differently given your example of Florida.

The behavior changes you are describing are incredibly regional. For much of the US, we're already back to "near normal" and have been for ages.

How many dead people would that "normal" have been worth to you?

If, instead, people had behaved responsibly in mass and we had used the time we got from that to establish coherent contact tracing and testing, things would have returned to normal by August as well, only without many the deaths your way would cause.

> How many dead people would that "normal" have been worth to you?

A lot

Or if they just followed the plan for this exact scenario that was handed to them by the last administration, if we're talking about the US, where more than half a million people died preventable deaths.

I'd argue that the "response" at the Federal level was a massive under-reaction. Months of denial didn't seem to work out so well.

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