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  1. #13841
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by JasonEvans View Post
    Can I ask what we all think of the decision to halt the JnJ vaccine because 6 people out of 7 million got blood clots and 1 person died?

    I really want to hear someone, anyone, argue that this was something less than colossally stupid messaging by the CDC and FDA.

    There is absolutely no question that stopping this vaccine rollout (and the resulting vaccine hesitancy we will see) this is going to cost hundreds, maybe thousands of lives... if every single person in America got the JnJ vaccine, this blood clot problem would (in theory) result in 47 deaths.

    Someone please explain to me how this is not the single stupidest decision by US health experts since, "wearing a mask won't help you, but it helps people around you."
    The fundamental difference is that in the case of the vaccine, somebody was healthy, came to 'us' in a good faith effort to stay healthy, and ended up dying from an intervention that you can't prove would provide any specific benefit to that individual. The American public has very little to no tolerance for adverse outcomes in a public health endeavor.
    If, on the other hand, one of their loved ones were to die of Covid the thought process is that it was an 'act of God,' if you will. It was natural. The person wasn't 'killed' by an intervention meant to protect the general public. That's the way it would be spun, anyway. That it's not about total numbers of deaths or even about numbers of preventable deaths.

    I would be interested in more information about the people who had severe reactions. I wonder how many of them had had Covid previously? I wonder how many were smokers, or were on birth control pills. A lot left to learn.

  2. #13842
    Join Date
    Feb 2018
    Location
    Dur'm
    Quote Originally Posted by JasonEvans View Post
    Can I ask what we all think of the decision to halt the JnJ vaccine because 6 people out of 7 million got blood clots and 1 person died?

    I really want to hear someone, anyone, argue that this was something less than colossally stupid messaging by the CDC and FDA.

    There is absolutely no question that stopping this vaccine rollout (and the resulting vaccine hesitancy we will see) this is going to cost hundreds, maybe thousands of lives... if every single person in America got the JnJ vaccine, this blood clot problem would (in theory) result in 47 deaths.

    Someone please explain to me how this is not the single stupidest decision by US health experts since, "wearing a mask won't help you, but it helps people around you."
    I certainly don't understand the risk assessment, either, even though the media seems to be praising the decision. The article posted earlier on this subject included a graph that showed that risk of clotting is roughly 165,000 in 1,000,000 COVID cases. Let's say that includes a lot of older folks, so the current population is only 10% as likely to get clots (something NOT supported by the data). That lease 16,500 cases. Conservatively estimating that if you don't vaccinate those 1,000,000 people, 10% of them will contract COVID, that's 1,650 clotting cases. Versus 1. 1000 times the risk.

    Is there some health-related reason for this decision that I am not grasping? Because I'm with Jason, here. A pause seems monumentally absurd. Yes, we need to have confidence in vaccine safety, and maybe this won't allow J&J to get full authorization as opposed the current EUA. But stopping people from getting the vaccine? I don't get it.

    Edit: I see rsvman beat me to it, but I still don't get it when it comes to an EUA. I'm sure you'd get people voluntarily avoiding the J&J vaccine based on the announcement, but it still seems absurd to stop distribution. People can make that risk assessment. Heck, if you aren't a female between 18 and 48, there doesn't seem to be any risk at all.

  3. #13843
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    J&J

    Quote Originally Posted by Phredd3 View Post
    I certainly don't understand the risk assessment, either, even though the media seems to be praising the decision. The article posted earlier on this subject included a graph that showed that risk of clotting is roughly 165,000 in 1,000,000 COVID cases. Let's say that includes a lot of older folks, so the current population is only 10% as likely to get clots (something NOT supported by the data). That lease 16,500 cases. Conservatively estimating that if you don't vaccinate those 1,000,000 people, 10% of them will contract COVID, that's 1,650 clotting cases. Versus 1. 1000 times the risk.

    Is there some health-related reason for this decision that I am not grasping? Because I'm with Jason, here. A pause seems monumentally absurd. Yes, we need to have confidence in vaccine safety, and maybe this won't allow J&J to get full authorization as opposed the current EUA. But stopping people from getting the vaccine? I don't get it.

    Edit: I see rsvman beat me to it, but I still don't get it when it comes to an EUA. I'm sure you'd get people voluntarily avoiding the J&J vaccine based on the announcement, but it still seems absurd to stop distribution. People can make that risk assessment. Heck, if you aren't a female between 18 and 48, there doesn't seem to be any risk at all.
    It may be that the FDA took into account the fact that the current supply of the J&J vaccine is quite low, due to the fiasco with the plant in Baltimore. Maybe the FDA thought pausing was no big deal.

    Of course, that doesn't into account the public messaging aspect of this.

  4. #13844
    Quote Originally Posted by MChambers View Post
    I think it's a horrible overreaction. They'll probably release the vaccine next week, but the damage will be done in terms of public opinion.
    I just listened to the NY Times' Daily podcast yesterday in which they discussed the same effect from messaging on the AZ vaccine in Europe.

  5. #13845
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    Yep

    Quote Originally Posted by Duke79UNLV77 View Post
    I just listened to the NY Times' Daily podcast yesterday in which they discussed the same effect from messaging on the AZ vaccine in Europe.
    Here's what Your Local Epidemiologist has to say, in part:

    5. “Will this seriously impact the US vaccine campaign and delay our return to normal?”

    Yes, it will seriously impact the US vaccine campaign. I think, though, in terms of hesitancy (like we’ve seen in Europe) rather than in terms of availability. So, yes it will delay our return to normal. If the CDC and FDA decide (after scientists review the evidence) that JJ cannot be distributed (which I highly doubt will be the case- from what it sounds like the benefits still outweigh risk), then this will also delay availability of vaccines. We will know more tomorrow.

    https://yourlocalepidemiologist.subs...good-questions

  6. #13846
    Join Date
    Nov 2007
    Location
    Vermont
    I think folks are being a bit harsh with respect to the J&J pause...correct me if I'm wrong, but all the vaccines are currently being administered under an emergency use authorization, right? As such, taking precautions would seem to be prudent.

  7. #13847
    Quote Originally Posted by rsvman View Post
    The fundamental difference is that in the case of the vaccine, somebody was healthy, came to 'us' in a good faith effort to stay healthy, and ended up dying from an intervention that you can't prove would provide any specific benefit to that individual. The American public has very little to no tolerance for adverse outcomes in a public health endeavor.
    If, on the other hand, one of their loved ones were to die of Covid the thought process is that it was an 'act of God,' if you will. It was natural. The person wasn't 'killed' by an intervention meant to protect the general public. That's the way it would be spun, anyway. That it's not about total numbers of deaths or even about numbers of preventable deaths.
    Sounds like the famous trolley problem in ethics.

    We are more willing to accept greater adverse outcomes caused indirectly through inaction, than fewer adverse outcomes caused directly through action.
    I supposed we have evolved with that bias because the cause and effect can be less clear in the former case.

    (though the specific trolley example is a counter-example; in fact, my intuition would be that the efficacy of pushing the "fat man" to stop the trolley from hitting the larger group of people is HIGHLY uncertain. It's mentally hard to accept the premise that it would definitely work, and thus such a push is likely to result in one extra death.

  8. #13848
    Join Date
    Nov 2007
    Location
    Raleigh, NC
    Quote Originally Posted by budwom View Post
    I think folks are being a bit harsh with respect to the J&J pause...correct me if I'm wrong, but all the vaccines are currently being administered under an emergency use authorization, right? As such, taking precautions would seem to be prudent.
    I think people are (understandably) too focused on the immediate picture. I suppose there isn't much hope of winning over anti-vaxxers anyway, but there certainly won't be if a year from now it comes out that they knew the vaccines were increasing the rate of blood clots but sat on it because they didn't want to deter people from getting vaccinated. Even if the numbers are small, there is some long term institutional credibility at stake there and that matters if you think we might ever need a national vaccination program again.

  9. #13849
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by cspan37421 View Post
    Sounds like the famous trolley problem in ethics.

    We are more willing to accept greater adverse outcomes caused indirectly through inaction, than fewer adverse outcomes caused directly through action.
    I supposed we have evolved with that bias because the cause and effect can be less clear in the former case.

    (though the specific trolley example is a counter-example; in fact, my intuition would be that the efficacy of pushing the "fat man" to stop the trolley from hitting the larger group of people is HIGHLY uncertain. It's mentally hard to accept the premise that it would definitely work, and thus such a push is likely to result in one extra death.
    There is another version of the trolley problem in which you just pull a switch that redirects the train to where a single person is lying and if you don't pull the switch 5 or 6 people get killed. I agree that the issue is fundamentally similar.

    From the vaccine "trust" standpoint, it is a no-win situation. If they put a pause on it, they can say, "See? Vaccines are safe because we are keeping a very close eye on everything that is happening and protecting you from harm when we find a problem," which is true, but the message that might be heard is simply, "The J&J vaccine causes horrendous blood clots; it must be very dangerous." So while attempting to assuage fears of the general public, they may actually be stoking the fire.

    On the other, hand, if they DON'T put a pause on the vaccine, people would just say, "Look! The vaccine is killing people and nobody is doing anything about it! This is why you can't trust vaccines and the people who support them."

    So, like I said, it's really a lose-lose.
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  10. #13850
    Join Date
    Nov 2007
    Location
    Raleigh, NC
    Quote Originally Posted by rsvman View Post
    There is another version of the trolley problem in which you just pull a switch that redirects the train to where a single person is lying and if you don't pull the switch 5 or 6 people get killed. I agree that the issue is fundamentally similar.

    From the vaccine "trust" standpoint, it is a no-win situation. If they put a pause on it, they can say, "See? Vaccines are safe because we are keeping a very close eye on everything that is happening and protecting you from harm when we find a problem," which is true, but the message that might be heard is simply, "The J&J vaccine causes horrendous blood clots; it must be very dangerous." So while attempting to assuage fears of the general public, they may actually be stoking the fire.

    On the other, hand, if they DON'T put a pause on the vaccine, people would just say, "Look! The vaccine is killing people and nobody is doing anything about it! This is why you can't trust vaccines and the people who support them."

    So, like I said, it's really a lose-lose.
    But as you illustrate, those people are a lost cause (they're going to find issue with the vaccine either path you take). There are some people who are swayable though, and I think they are more likely to be swayed by the appearance of caution than by an attempt to sweep adverse reactions under the rug (even if it sways them to "I don't want J&J but I'll take one of the others). I also still think the long term credibility (which will impact more than just the vaccine skeptics) remains the more important consideration.

  11. #13851
    Quote Originally Posted by rsvman View Post
    The fundamental difference is that in the case of the vaccine, somebody was healthy, came to 'us' in a good faith effort to stay healthy, and ended up dying from an intervention that you can't prove would provide any specific benefit to that individual. The American public has very little to no tolerance for adverse outcomes in a public health endeavor.
    If, on the other hand, one of their loved ones were to die of Covid the thought process is that it was an 'act of God,' if you will. It was natural. The person wasn't 'killed' by an intervention meant to protect the general public. That's the way it would be spun, anyway. That it's not about total numbers of deaths or even about numbers of preventable deaths.

    I would be interested in more information about the people who had severe reactions. I wonder how many of them had had Covid previously? I wonder how many were smokers, or were on birth control pills. A lot left to learn.
    I wondered the same thing. I'm only an accountant so I'm happy to see my question has the backing of someone I respect. I hope that, if they are able to determine an outside factor, that is emphasized when they release the vaccine for continued use.

  12. #13852
    Join Date
    Feb 2018
    Location
    Dur'm
    Quote Originally Posted by Acymetric View Post
    But as you illustrate, those people are a lost cause (they're going to find issue with the vaccine either path you take). There are some people who are swayable though, and I think they are more likely to be swayed by the appearance of caution than by an attempt to sweep adverse reactions under the rug (even if it sways them to "I don't want J&J but I'll take one of the others). I also still think the long term credibility (which will impact more than just the vaccine skeptics) remains the more important consideration.
    Just to be clear, I don't think anyone was suggesting that adverse reactions should be hidden in any way. They HAD to make an announcement. What they didn't have to do is pause the delivery. Add that to the list of EUA caveats you have to go through as a patient, but keep cranking the vaccines out there. Some people will refuse the J&J because that's how these things work. But many people still want the J&J if that's what's available, and there's very little reason not to let them have it.

    If there are identifiable factors discovered later, so much the better, of course. But it's called an EMERGENCY Use Authorization for a reason. This is still an emergency, to the tune of ~60,000 new cases per day.

  13. #13853
    Join Date
    Feb 2007
    Location
    Greenville, SC
    Quote Originally Posted by rsvman View Post
    There is another version of the trolley problem in which you just pull a switch that redirects the train to where a single person is lying and if you don't pull the switch 5 or 6 people get killed. I agree that the issue is fundamentally similar.

    From the vaccine "trust" standpoint, it is a no-win situation. If they put a pause on it, they can say, "See? Vaccines are safe because we are keeping a very close eye on everything that is happening and protecting you from harm when we find a problem," which is true, but the message that might be heard is simply, "The J&J vaccine causes horrendous blood clots; it must be very dangerous." So while attempting to assuage fears of the general public, they may actually be stoking the fire.

    On the other, hand, if they DON'T put a pause on the vaccine, people would just say, "Look! The vaccine is killing people and nobody is doing anything about it! This is why you can't trust vaccines and the people who support them."

    So, like I said, it's really a lose-lose.
    From what I have seen during the pandemic my prediction would be:

    Pause vaccination - some minor anger at stopping, more anger at vaccine deaths. Feeds into the "vaccine rushed" anger.

    Don't pause vaccination - major anger at vaccine deaths and at the decision not to pause. Feeds into the "government doesn't care if vaccines kill us" anger.

    It's a lose-lose choice, but the argument can be made that not pausing poisons the "well of trust" more.

  14. #13854
    I’m glad I’m not making those decisions.

    That being said I think the pause boosts vaccine credibility among reasonable people. Unreasonable people - who knows how they process info?

    (Not speaking to Jason’s and others comments about whether it was correct decision - just to the long term cred part.)

  15. #13855
    I really think they need to involve marketing folks in some of their announcements. Saying that, although the number of people developing blood clots is less than happens among smokers or women on birth control or those that actual have contracted Covid, they want to take a pause in the distribution of the vaccine while they look at the cases to see if it can be determined if factors other than the vaccine were part of the reason for developing blood clots.

    The way it was done seems to tie it directly to the vaccine instead of indicating that there could be other issues involved that caused the clots and it just happened to occur in close proximity to the time the vaccine was received. It is already tied to women in specific age groups from what I've seen but what else is involved? Do they smoke, are they on a particular birth control, etc. - remind people of the difference between causation and correlation. The majority of people are probably not going to go looking for details and they don't have access to the expertise we have in this thread.

  16. #13856
    Join Date
    May 2007
    Location
    Winston-Salem, NC
    Mods please go ahead and add this to the sticky Vaccine hesitancy reasons (ok not really, but I really did have someone tell me this and they were serious).

    beastvaccine.jpg

    This thread deserves a vaccine hesitancy laugh today, right?

  17. #13857
    Join Date
    May 2007
    Location
    Winston-Salem, NC
    Quote Originally Posted by richardjackson199 View Post
    Mods please go ahead and add this to the sticky Vaccine hesitancy reasons (ok not really, but I really did have someone tell me this and they were serious).

    beastvaccine.jpg

    This thread deserves a vaccine hesitancy laugh today, right?
    devildeac, when did you get a Sorrento?

  18. #13858
    Join Date
    Sep 2007
    Location
    Undisclosed
    Quote Originally Posted by richardjackson199 View Post
    devildeac, when did you get a Sorrento?
    Better than his Aztek:

    BC41FD19-FBB9-4D6F-875E-0581B9BBCD06.jpg

  19. #13859
    Join Date
    Feb 2007
    Location
    Watching carolina Go To HELL!
    Quote Originally Posted by richardjackson199 View Post
    devildeac, when did you get a Sorrento?
    Quote Originally Posted by OldPhiKap View Post
    Wait a minute! My ex drove a 2002 Pontiac Aztec 2002-2004. I thought it was a nice vehicle and drove well. People said it was ugly, I didn't. It was just ahead of its time! It looks very similar to 90% of today's small/mid size SUVs - Toyota, Lexus, Honda, Hyundai, Kia, Ford, GM, et al.
    Ozzie, your paradigm of optimism!

    Go To Hell carolina, Go To Hell!
    9F 9F 9F
    https://ecogreen.greentechaffiliate.com

  20. #13860
    Join Date
    Sep 2007
    Location
    Undisclosed
    Quote Originally Posted by OZZIE4DUKE View Post
    Wait a minute! My ex drove a 2002 Pontiac Aztec 2002-2004. I thought it was a nice vehicle and drove well. People said it was ugly, I didn't. It was just ahead of its time! It looks very similar to 90% of today's small/mid size SUVs - Toyota, Lexus, Honda, Hyundai, Kia, Ford, GM, et al.
    Nothing against Azteks! My reference was to the iconic Aztec driven by Walter White in Breaking Bad (both pictured). A poor effort at humor.

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