[ Question ]

Why has no one compared Covid-19 and Vaccine Risks?

by Niklas Lehmann1 min read4th Jun 202118 comments


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Currently, hundreds of millions of people face the choice to 

(1) get vaccinated against Covid-19 (maybe choosing between different vaccines)


(2) do nothing

Given the fact that both the vaccines and contracting Covid-19 pose risks (in a sense that they may lead to significant reduction of quality of life), it is natural to approach the question whether to go with (1) or (2) from a decision-theoretic perspective. In other words, it is not obvious which of the two (or more) options listed above is the best option considering only self-interest. 

Take e.g. me, I expect to live for at least 50 more years (likely much longer). I am almost exclusively interested in irreversible long-term effects or death rates. It absolutely blows my mind that given the number of people in my situation, after a couple hours of research I have not found much information to support my decision. 

There is: 

  • some information regarding potential long-term effects of Covid-19 infection
  • Excellent data regarding my exposure and likelihood of Covid-19 infection
  • Excellent data on reversible short-term effects of vaccination (which are negligible) and short-term mortality

What is totally missing is: 

  • Predicted long-term effects of vaccination
  • A handy comparison of predicted long-term effects from vaccination and Covid-19 infection

I get that there is sparse data regarding the long-term effects of getting vaccinated. But certainly predictions can and therefore should be made. 

What I would have liked to find is a risk calculator that takes into account the most important variables and compares expected loss of quality of life from multiple scenarios. It would be fine if these could be heuristically expressed as e.g. odds of dying + odds*degree of permanent neural impediment due to the choice. 

Does someone have an idea what to do about this? Any information would be much appreciated and surely helpful for many.



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6 Answers

Besides the short term side effects we currently don't have "predicted long-term effects of vaccination". For practical concerns rounding that number down to zero is the best way to think about it given that COVID-19 comes with significant chance of long-term negative effects. 

This is my confident understanding as well. All who say 'long term effects' are purely basing this on the 'we don't know there aren't such effects' style of argument and nothing more, when there's every reason to believe that if there were such effects we would see signs of them by now and no plausible mechanism for long term effects. 

Whereas Covid-19 definitely does have substantial long term negative effects reasonably often for those who don't die - as OP notes, the estimates are loose, but Long Covid is definitely a thing. 

I would rate 'possibility of unknown long term side effects we have no reason to expect whatsoever' to be much less of a reason to not get vaccinated than 'you might feel bad for a day after getting it' even with a long term orientation. It's that small.  

3ChristianKl12dIt's also the nature of unknown unknowns that you can't include them in the kind of risk calculator that the OP asks for.
1Jonathan_Graehl12dIs only 1/3 of Long Covid sufferers actually having had covid definitely a thing, too? I think it is (or maybe antibody tests give many false positives?)

Thank you very much for your educated inputs. This definitely nudged me much closer to getting vaccinated. 

If you aren't vaccinated you WILL be infected eventually.  

If case counts continue to decline, there will be a significant number of people who are never exposed.

6CellBioGuy12dI expect it to return as an endemic seasonal virus, especially in areas of low vaccination uptake, with continued antigenic drift allowing occasional mild infection of those with immune memory after enough time has passed. It's the first infection of a naive set of lungs that matters though.

How much lower is the chance of being 'infected eventually' if you keep current on your annual (or whatever it ends up at) corona vaccination booster?

3CellBioGuy12dI actually care a lot less about 'never getting it' now, since I will never have to deal with that first burn though me when I have never seen anything like it at all since I am vaccinated. Any memory is good, even in the face of drift or waning. I couldn't tell you if there will be updated boosts over time. If so, they'll certainly help...

In order to weigh about the possibility of long term effects of the MRNA covax (Pfizer, Moderna), we need some plausible categories of mechanism; my understanding is that a known-harmful spike protein is produced in some quantity (surely dose dependent; why do they dose large people the same as small?) which may cause some clots or other harms acutely, but then days later spike levels are back to zero at which point there's nothing more to worry about except lingering cancer type damage that won't heal fully, and autoimmune (more likely in case of response to covid exposure than broadly own-tissue-attacking which we'd have seen already after 100m doses). I've heard no specific evidence that the spike insult or the MRNA mechanism would cause either but those are the categories of risk as I see it, FWIW.

Why do you think there is any risk of long-term loss of quality of life from the vaccine? There just isn't a reason to think there is a risk there. Your only finding one side because there is only one side.

Since I (or for that matter most people) do not understand the working mechanisms of the vaccines completely, I can not rule out the chance of significant long-term effects.

1River3dI'm no microbiologist either. I can't cite a paper to tell me there's no risk of heart disease from pumping my own gasoline. But I also don't have a model of the world that suggests any connection between pumping gasoline and heart disease, so I don't worry about it. Most things don't cause most other things. So just on priors, there's no reason to worry about this.

Any such evaluation should be accompanied by an evaluation of the risk(s) to others around you should you decide to not get vaccinated. You can do the relative weighing of the two risks yourself, but the weighing should be done.

There are no known long-term effects of vaccination, for any vaccine administered in history. Ever. That's why you should not be worried about that. 

Dr. Fauci's short answer here: https://twitter.com/SajjadFazel/status/1353122257615409158?s=20 , I am sure you can also find a long-form version or a relevant paper.

That seems a bit overconfident. Immunity is one supposed long-term effect. Death is another long-term effect though obviously infrequent in approved vaccines.

Apart from the things Jonathan mentions, the Pandemrix vaccine used for swine flu seems to have caused narcolepsy in rare cases.

Note that Fauci in that video is talking about delayed effects, not long-term effects.