Is it? I don't remember reading about that in NIH training on control groups. I'm pretty sure when your plan is to distribute 1 billion vaccines, holding out 0.000015 for a placebo control group is a sensible "ethical" tradeoff. Especially if, I don't know, everyone *volunteered* and agreed to those terms when signing up! And especially if, I don't know, all the data they had to date showed no increase in death rate?

That's ridiculous -- of course benefits can outweigh psychological side-effects. Usually you'd want those benefits to accrue to the person suffering the side-effects, but living in a civilized society means accepting that sometimes the good of the many outweighs the pain of the few. If a vaccine for a deadly, highly communicable disease can completely stop transmission then I think it's perfectly ethical to require everyone to accept it or isolate from those willing to do so.

That's why we have the vaccine trials.

They're the very last step in testing a vaccine. And there really is no other option: if the end result is going to a vaccine given to small children, at some point you're going to have to give it to some small children and see what happens. The only way around it is to not vaccine children at all... which doesn't seem great from an ethical standpoint given the number of lives that have been saved by vaccines.

Did you consider the law of unintended consequences?

That doesn’t actually seem right though. You have control groups at least through all phases of trials to make sure “the treatment works”. That’s literally the point of the control.

Especially now that we know the vaccines don’t completely work to stop infection or prevent symptoms or spread.

I’m all for the vaccines, but it seems crazy that they didn’t even wait until phase3 was over for a new type that has never been tested on humans before.

If the argument is “the control petiole were at risk”, they should have been told their vaccine was placebo and ask for volunteers to remain in control, seems like flat out offering them real shot defeats the point, doesn’t it?

It is not a technicality.

There are no drugs, procedures, medical devices, or vaccines without adverse effects. It is always and everywhere a tradeoff between benefits and harms. If you intentionaly terminate a trial (breaking blindness is effectively terminating it), you cannot trade off the harms and benefits because you have no idea if there are harms, or whether the benefits last.

There were drugs, devices, procedures, and even vaccines, whose massive harms were only apparent years after they were approved.

I think the insidious and repugnant effect of this line of thinking is that it subverts the body autonomy and free will that every human being should enjoy.

The issue isn’t only risk, rather it’s individuals deciding based on their own judgement, which may involve their own evaluation (informed or not) of risk.

The public health establishment is set on presenting the illusion that people have absolutely no choice but to take a vaccine that was rapidly developed using novel technology.

In my opinion, this is unethical. No human being should be coerced or propagandized into taking drugs or medicine of any type.

The only responsibility of government should be presenting boring information about the vaccine to be used by people to decide what they’d like to do. But it’s very clear that society at large is set on propaganda and conformity in the pursuit of technocratic policy goals.

It’s precisely this well-intentioned pursuit of end goals augmented by the certainty of science that allowed the eugenics of the 1920s. And it seems like a century later we think we’re immune to that pernicious illusion afforded by science.

This is the attitude I am talking about. As I said earlier, I agree treatment options are not a substitute for vaccination. Why does being pro-vaccine necessitate being hostile to treatment options?

First off, Some people can't get vaccinated, and some vaccinated still get ill.

Second, for those who refuse to get vaccinated (as ill advised as it may be), don't we want them to have the 2nd best health outcome possible? Don't we want to minimize healthcare burden and social harm?

It seems like there is a large contingent of the population that want these people to suffer and die, and root for treatments to fail. Some sort of vindictiveness where folks are willing to sacrifice the public interest and their own to spite the vaccine-resistant.

That is effectively coercing people to undertake a medical procedure for their own or for society’s good. The ethics of doing that should be concerning, considering the social and ethnic makeup of the vaccine hesitant, and the checkered history of coercive medical intervention.

I’d much rather see the carrot used than the stick.

Can you show me where this is demonstrated?

>A study were all the participants are exposed on purpose to the disease is very difficult to justify, with or without control group.

I agree, solid scientific study on vaccines is nearly immoral.

So from a dispassionate scientific perspective, it seems reasonable to state the science on vaccines is not settled.

That signals they may have conflict of interest. For example accidentally finding a treatment that works, could mean huge loss for vaccine business.

(Just to be clear, I am not anti-vax. I got vaccinated myself and I believe there is no better option right now, however, trying to limit doctors in finding other means sounds extremely fishy)

You might elicit sympathy for your plight if you had lab confirmed robust preexisting natural immunity which was being ignored, or you were a young man at great risk of myo/pericarditis, or severely allergic to vaccine ingredients. However, as you merely stated an obvious falsehood, that the vaccines are experimental, you get no sympathy from me. What do you think you’re going to discover that the ~100,000 phase I-III test subjects and billions of people who already got vaccinated haven’t already discovered?

Exactly. And some would. But most would not. Just like every other randomized control study. It boggles the mind to say "let's tell everyone they got the placebo, because some people might leave". That does not follow logic.

> plot to hide the long-term inefficacy of their vaccines is absurd.

What part of that is absurd?

At the time the control groups were destroyed, there was no evidence that the vaccines were saving lives (https://www.fda.gov/media/144434/download — 7 deaths in placebo group; 7 in control group). Now, if you got tens of billions of dollars based on those early results, wouldn't you have *strong* incentives to shut things down, and not wait for the long-term verdict? What would you have to gain if 2 years in, the placebo group continued to have just as few deaths as the vaccine group?

Are you saying that the idea that humans respond to incentives is absurd?

As I understand it, medical ethics isn’t about utilitarianism, or else we’d skip the rats and monkeys and just go straight to testing on the poor for money. They don’t seem to prioritize minimizing the opportunity cost of avoiding bad outcomes. Their guiding principle seems to be avoiding giving harmful treatment.

Meanwhile some healthcare workers at my partner’s facility are skeptical about whether the vaccine was rushed (I think they’re crazy, for the record). But there’s real risk if enough of the public doesn’t trust the vaccine. I’d bet that kind of angle is part of why they focus on “do no harm” instead of “minimize cumulative regret.”

Well the study is funded by the vaccine makers. So we can toss it out before it's even conducted.

Same goes for anything done by parties who have equated taking the vaccine with moral righteousness. If there are serious health risks it will only be found by a skeptic with a lot of perseverance.

> In this circumstance as well, taking a chance is worth it.

Nope nope nope nope. This is the literal example of survivor bias. You can't look at the results and use them to inform prior behaviour. The vaccine could have had catastrophic side effects.

It won't work because for every such group, there will be 10 groups with high conflict of interest that can counter any finding of your hypothetical group, and journals with conflict of interests will reject the findings of that group, but instead give high visibility to the reports of high-conflict of interest groups..

Quickly no one will dare to research the said topic.

Rigorous testing is all well and good, but we do know how many errors crop up in scientific papers, right? A lot.

The gold standard of testing is double-blind, randomized, placebo controlled studies and this is only done sometimes for vaccines, as far as I aware.

I believe there are certain circumstances such as no safe and effective already existing vaccine, or where there's a certain kind of benefit to the injected population, where vaccines are generally allowed to go through this double-blind, randomized, placebo controlled studies (the gold standard of testing) and certain circumstances where they do not go through such rigorous testing.

I believe this ethic stems from Jonas Salk's decision during the development of the Polio vaccine where the ethical call was made to not do double-blind, placebo controlled testing due to the desire to prevent damage to human lives that could be prevented by not using a placebo.

I invite fact-checking on everything stated.

why should they be? if the scientists determined that the vaccine is of marginal benefit to them compared to the risks, then they don’t need it. the fact that they want it because the tv told them it’s the right thing to do is irrelevant.

i guess “following the science” only applies when the science agrees with the predetermined status quo