I’ve had some queries that make me think that a brief meta-blog entry might be in order. I’m still fielding a lot of coronavirus queries, not all of which by any means make it up here to the blog. And at the same time, I’m also getting a lot of suggestions that are more in the classic mode: interesting science and drug-discovery stuff that has nothing to do with the pandemic.
Readers have probably already noticed that there have been more of the latter recently. That’s going to continue. I am still going to write about big coronavirus issues, but in the end, this is not a Covid-19 site, and thank God. No doubt I’ll shed some of the readers that I’ve picked up over the last year or so, people who are looking for more pandemic-focused material. That’s fine. Such posts are still going to show up here, but you may or may not want to go through multiple posts on organic chemistry, chemical biology, drug discovery and development issues in general, and so on before another comes back around.
On the other hand, you might find some of those interesting – who knows? I’ve picked up a lot of regular and semi-regular readers over the years who started out reading the blog for other reasons than the ones that have kept them around. And that’s fine, too, more than fine when you get right down to it. Over the years, I’ve tried to vary the topics that come up so that if someone finds themselves uninterested in a given post, that they can be pretty sure that the next one won’t cover the same area and will be worth checking out. That rotation got thrown out the window over the last few months, of course, but at the same time there was certainly a lot of interest in All Things Coronavirus, so I didn’t let that bother me.
But at this point, the way out of the pandemic seems clear. The vaccines work. We have to produce and distribute huge amounts of them around the world. If and when we are able to do that, I really believe that the pandemic has excellent chances of being over. Really over. There are a number of things that can go wrong with that, of course, and one of the big ones would be the emergence of a variant that truly evades the immune response brought on by the current vaccines. I am very hopeful that this will not happen, but neither am I willing to bet the future of the world on that hope, either. We need to get the population of the world vaccinated, to knock things down and lower the chances that such a variant can come up.
The corollary to all that is that yes, I believe that the vaccines both work and are safe enough to roll out into billions of people. It has not escaped my notice that there are people who disagree with that statement. With both parts of it, and especially the second. But at this point I would like to quote a long reply I gave deep in the comments section of this post, which I suspect few people saw (and I don’t blame them!)
. . .I’m getting so many questions from people who are nervous and skeptical about taking the vaccines, and these seem to be coming from several different sorts of people. Some of them are looking for ways to feel better about making the decision to get vaccinated, while others are looking for reasons *not* to take it. And addressing all these objections as a series is not necessarily doing much good.
I’m fond of saying that you can’t use reason to argue someone out of a position that they did not arrive at by reason. And some of the objections I’m getting are coming more from the emotions, and can’t really be dealt with by a step-by-step quoting of medical rationales with recourse to literature references. It’s the wrong tool for the job.
If you’re looking for complete assurance that nothing bad will happen, I can’t give it to you. But that goes for any medical intervention at all. Take antibiotics: if you have never taken a beta-lactam, I cannot assure you that you will not be one of the rare people who will have a strong (possibly fatal) anaphylactic reaction to them. If you take a fluoroquinolone instead, I cannot promise you that you will not be one of the people who have a bad reaction in the joints and tendons. If you opt for clindamycin instead, I cannot promise you that you will not then get a strong (perhaps deadly) C. difficile infection in your gut – that happens, too, on rare occasions. The same goes for any other therapy, for any other disease.
But the paper you cite isn’t talking so much about rare idiosyncratic side effects, as much as something that should affect (unless I mistake their language) a large number of people taking any of the Spike-protein-producing vaccines. But the real-world data aren’t showing it. Now, one response to that it “Well, you haven’t waiting long enough”. But from what we know about the pharmacokinetics of the vaccines, the people who were vaccinated earlier this year should be *long past* producing Spike protein by now. And we’re seeing no such effects in them. The authors say “long term” effects need to be watched for, but “long term” is in the eye of the beholder. Coronavirus infection itself can bring on lung trouble far more quickly – shouldn’t we have seen something by now? I find it very difficult to believe that a one-time pulse of Spike protein alone sets people on an irreversible course towards pulmonary hypertension, etc.
So I think that the hypothesis advanced in the paper has not panned out. Most medical hypotheses don’t, even ones that are backed up by far more reasoning and far more data than this one. It’s not a crazy paper, but it’s not irrefutable either, not by a long shot. Over the last 30 years, I have learned that even my best ideas get brushed aside by real-world data, and I don’t take it personally. But this argument will not be persuasive to someone who is worried about the idea of getting a coronavirus vaccination in general. They either will not accept this response, or will wave it aside and move on to the next objection: “Well, what about this? Can we be sure that this other thing won’t happen?” It never stops.
If we continue to see no signs of lung damage for another month, will that put you more at ease? Three months? Six? A couple of years? You will need to pick the point at which you will feel convinced. For some people there isn’t one. For my part, I found the clear and present danger of the coronavirus outweighed any objections to the vaccines that I could come up with.
That was in response to a question about a particular paper, but the general points apply. I am deliberately not turning this site into a Whack-a-Mole exercise dealing with a series of objections to some of the coronavirus vaccines, or all of the coronavirus vaccines, or all vaccines for anything ever, or germ theory in general, or ontology and the knowability of any facts whatsoever. If you believe that the coronavirus vaccines are going to start scything down the human population Any Day Now, there’s not much I can do for you. Build that bunker, stock up on potable water, dried beans, and potatoes. Meanwhile, I very strongly believe that the rest of the world will be working its way out of this horrible pandemic.
I’ll still be writing on major issues relating to the coronavirus and the therapies and vaccines against it. But any attempt at blow-by-blow coverage is over here, and has been over for weeks. Please feel free to hang around and pick up some weird knowledge about science and drug research; some neat stuff comes up every once in a while. At the other end of the scale, though, all I can say is enjoy the spuds.