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PaperclipPerfector  1d ago (text post)   1649 thread views

Small-Scale Question Sunday for February 23, 2025

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

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Agree. And I'm willing to vaccinate myself for purely pro-social reasons with no benefit to myself, provided they are safe and effective.

That said... don't you think this reasoning makes it more likely that people are lying about vaccines risks? For example, let's say you had data that suggested vaccines are 1) good for society but 2) bad for individuals, you might lie for the greater good.

This isn't something I've given much thought before, but even on reflection, I don't think it makes much difference.

The most controversial vaccine is that for Covid. Even then, my impression (memory fades) is that the vaccines were lauded as being more effective than they turned out to be. I don't recall seeing evidence back then, that people were lying out of their teeth, they interpreted unclear, insufficient or ambiguous evidence as proof that vaccines would cut the pandemic short. They didn't, they reduced mortality, but not the spread of Covid.

I can't think of any other vaccine that was remotely as controversial, and my presumption is that the FDA and medical associations, normally do a decent cost-benefit analysis before advocating them. I know NICE does, in the UK.

my impression (memory fades) is that the vaccines were lauded as being more effective than they turned out to be

The vaccines were lauded as being more effective than they had already turned out to be. Pfizer's efficacy was something like 93% in the initial study, and e.g. Biden oversimplified that as badly as "You’re not going to get COVID if you have these vaccinations."

They also turned out to be less effective than thought, with that 93% dropping to like 68% after only 6 months, which was enough to take us from "well some vaccinated people still get it but as long as we can push R<1 we can..." to "screw it, it's endemic now", even before Omicron changed the math further.

I'm not sure if this is "people were lying out of their teeth" rather than "voters aren't smart enough to avoid black-and-white thinking so they don't insist their president be smart enough either", but I think the takeaway is that you can probably trust independently repeated and reviewed studies of vaccine effects and you probably can't trust most popular interpretations of those studies.

Thank you.

I'm not sure if this is "people were lying out of their teeth" rather than "voters aren't smart enough to avoid black-and-white thinking so they don't insist their president be smart enough either", but I think the takeaway is that you can probably trust independently repeated and reviewed studies of vaccine effects and you probably can't trust most popular interpretations of those studies.

That seems like an eminently sensible take, though I can only reiterate that COVID was uniquely politicized, and by the time the typical vaccine reaches market (let alone when it becomes part of a national schedule), the evidence is very strong.

by the time the typical vaccine reaches market (let alone when it becomes part of a national schedule), the evidence is very strong.

Flu vaccines? Even people wanting you to take them usually stick to a pitch like "it doesn't work every year, but... can't hurt, can it?" IME. (possibly moving on to "you wouldn't want to kill grandma, would you?")

Flu vaccine? Well, if you want to single it out, then I'd be obliged to say that unless you're sickly, old, or work in healthcare, the benefits are largely a wash when compared to the minimal risk the typical annual flu strain otherwise presents. That would be the case even if the vaccine was perfectly safe. I'm on record saying the same thing, if someone wants to dig years deep into my profile.

If someone doesn't want to get it, no biggie. Hell, even I've missed shots that were offered to me for free because I didn't think it mattered enough.

Sure, that's a reasonable position -- thing is, it's not really aligned with what the public health people say. Hence the burnt credibility.

Don't know if we have data on this (because it's ultimately small potatoes by expensive research standards) but healthcare lore and anecdote in the U.S. is that the flu vaccine 100% reduces severity of illness and down time.

Worth it in my book for a mild owie.

All it takes is one real visit by the flu and then you get the point.

Note that this is very rough napkin maths, but I estimate that the average flu shot provides ~ 0.0015 to 0.003 QALYs per shot.

In other words, about a day's worth of perfect health per shot. This probably does matter at the population level, I think it comes to about $10k to $20k per QALY, which isn't bad at all, but per shot, it's rather negligible on an individual basis.

Being healthy for half a day versus having a rather sore arm (and a small additional risk of flu for a few days) is what it boils down to, and I will confess that I can't be bothered most of the time. If someone shows up with a shot and asks me to take it (my grandpa was a stickler about literally doing that), I'd go for it. If it posed even a trivial inconvenience, I wouldn't lose sleep over missing it.

I've had the flu maybe a dozen times (at least counting respiratory infections worse than the average cold) and covid 4+ times (that's how many times I tested positive, and eventually I stopped bothering). None of them were bad enough to overcome my general laziness these days.

Unless you're already sick, immunocompromised, or old, I think you wouldn't really notice the difference between getting a shot and not bothering.

Unless you're already sick, immunocompromised, or old, I think you wouldn't really notice the difference between getting a shot and not bothering.

Clearly I'm in this description and I don't like it.

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