Ένα ενδιαφέρον άρθρο που δημοσίευσε στον τοίχο του στο facebook ο Σουηδός Μοριακός Βιολόγος Henrik Brändén ( www. henrikbranden.se ) στις 16/11/2020. Το μεταφράζω από τα Σουηδικά στα Αγγλικά:To vaccinate or not to get vaccinated. I will take it!
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I now see news that another American pharmaceutical company, Moderna, has released preliminary analyzes of large-scale phase 3 studies that show that their vaccine is also highly effective. In this case, the figure of 94% protection against infection during the months after vaccination is mentioned. The vaccine is of the same type as Pfizer also recently reported encouraging data from, an RNA vaccine. Both companies flag that they plan to apply for emergency licenses so that the vaccine can be sold and used, even though they have only been tested on large groups of people for a few months, not as usual for a couple of years.
As the studies are very large, we can count on them also capturing rare side effects and side effects. As long as these appear soon after vaccination. However, since the technology with RNA vaccines is fundamentally new and has never before been tested on humans on a larger scale, we can not know for sure if there are any side effects and side effects that come in the much longer term. Which we did not discover, and can not guess.
Theoretically, it feels unlikely. Compared to the other type of new vaccines that are also being developed against covid-19 (where the virus envelopes are allowed to deliver new genes to the body's cells) there are few obvious properties of the vaccine, which could interfere with things in the body, for example by activating the immune system against otherwise, and trigger autoimmunity. Of the two types of vaccine that are being developed, this is why this type I was hoping to come first, because it is with this type that the risk of strange side effects feels lowest.
Still, it IS a problem that the vaccine has not been tested on larger groups of people for more than a few months. It is NOT POSSIBLE to guarantee that it does not turn out to be a late side effect or side effect through any mechanism we today can not even guess. The risk is small, but not non-existent.
And then we end up in the classic problem of how to handle risks when they are small, but the number of people is very large. The aim here is nothing less than to vaccinate the entire world's population.
That problem falls into my eyes in two parts.
What shall I do. And how society should do.
For me, it's pretty obvious.
I am by nature not very worried, and willing to take risks for myself. At the same time, I normally live relatively close to a person 80+, whom I want to be able to meet. The opportunity to feel reasonably sure of not risking infection when I meet her trumps the tiny risk that I would suffer from a rare unknown unspeakable side effect.
In addition, obesity, diabetes and high blood pressure make me close to being considered a risk group. So I also belong to those where also for private health, the risk / benefit analysis of course falls out to take the vaccine. Even clearer with RNA vaccine than with the alternative ghost virus vaccine.
But that does not mean that I think it is obvious that society should encourage everyone to get vaccinated.
For the elderly and others in risk groups, the risk / benefit analysis is even more obvious than for me. For them, the risk of becoming seriously ill and dying is very high if the infection establishes in them. Of course, the initial deliveries of a vaccine will be reserved for them. And with those groups, I think the willingness to get vaccinated is so great ("I finally want to meet people again") that it does not matter much if society calls for vaccination, or just offers it. And there, too, the risk / benefit analysis is so obvious that it may be reasonable for society to urge.
Children, who almost never get a serious illness from being infected with covid-19, would be immediately foolish to vaccinate. Having been infected with the real virus always gives a stronger and longer lasting immunity than a vaccine. Therefore, children are vaccinated against the diseases that endanger the lives of some children - such as measles and rubella. But not against those who are unpleasant but harmless - like chickenpox. On the day when most of the risk groups are vaccinated and immune to covid-19, it does not matter much if a few children walk around sniffing out a few copies of the virus. Infection from children is not common. even if it occurs.
For adults who are outside the risk groups, the question of recommendation is much less obvious. Some of my friends point out that the disease for most adults outside the risk groups is mild, and having had such a mild infection provides much better and more long-lasting protection than a vaccination. If we want a herd immunity that lasts, they believe that it is better that we vaccinate risk groups and then let the infection flow through the rest of the population. No recommendation to vaccinate, then.
On the other hand, we know that even among those who are far from belonging to the risk group, a (small) proportion of those infected with a very serious disease are affected, who kill some, handicap others for months and can cause permanent damage in many different parts. of the body, including the brain. If most adults get vaccinated, they will avoid this risk, and they will reduce the risk of passing the infection on to others who also risk the same. In addition, there is a strong desire around society to be able to put the epidemic behind us once and for all as quickly as possible and return to normal life. Which could be achieved much faster through a rapid general vaccination, than by allowing the infection to spread successively through the population. Arguments for a recommendation.
And then there is that risk, that there could be a problem with the vaccine, which we can not foresee. It carries with it several problems.
One problem is that we cannot quantify it. All of us who work with life sciences professionally probably make the stomach pit assessment that the risk is microscopic that there would turn out to be some completely new kind of side effect, which even comes close to doing as much damage as the vaccine will prevent. But it's like damn just a gut feeling. And I am convinced that the friends who believe in an animated nature who want revenge on us for all the environmental destruction and for the hybris of humanity, make a completely different belly estimate.
And then we come to one of the other problems. That it is very individual how we experience and estimate and weigh risks against each other. We may remember how laughed Johan Norberg was by many when he pointed out something along the lines that with a rational risk analysis we should be more afraid of slipping in the bathtub than for terrorists. It was to mix apples and pears, it was said. And such are we humans. We do not weigh risks rationally, we are safer for some than for others. With different individual preferences.
In particular, we handle situations where we in one scale have a reasonably known risk with a known risk profile (eg 7% risk that the disease becomes so severe that you need hospitalization and 2% risk of dying) and in the other scale there is an unprecedented risk of something you do not even know how serious it is.
Therefore, I am inclined to believe that the most reasonable thing from the part of society in this situation would be to make the assumption that adults outside risk groups are adults who are able to absorb information and can then make independent informed choices. Not big campaigns where everyone is encouraged and convinced to get vaccinated. Just an offer to all adults that if they want, they can get vaccinated at the expense of society: Here are the reasons for getting vaccinated, these are the arguments against it. Here's what you can do if you want to take advantage of the offer.
As I said, I will go and get vaccinated with an RNA vaccine if I get the chance.
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