Here is a fun example of a randomized controlled trial from the British Medical Journal: Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial
What would be the benefit of a placebo study vs studying the differences between vaccinated and unvaccinated populations?
Is the hypothesis that there is some kind of psychosomatic/placebo effect to vaccines, where just the process of getting injected changes outcomes? I find that hard to believe.
nradov · 5h ago
It depends on what type of placebo you use. The adjuvants used in vaccine injections appear to have some effect on the immune system themselves, even without the material intended to promote an immune response against a specific pathogen.
giraffe_lady · 9h ago
Vaccines are already double blind tested with a placebo, but the yearly updates for seasonal vaccines based on a previously tested mechanism are not. The goal of this new requirement is to create delays making it effectively impossible to create annual flu & covid vaccines within these constraints.
The reason the updates aren't currently tested this way is because medical research ethics perspectives on the balance of risk of novel unknown effects vs known risk of withholding effective treatment from the placebo group. https://en.wikipedia.org/wiki/Clinical_equipoise
jljljl · 9h ago
Yeah that makes sense. If there was an update of MMR, and there was a 50/50 chance that your child does not actually get vaccinated against MMR, you’d refuse to participate in the trial.
techpineapple · 9h ago
Maybe they should be double blind. Maybe whether or not your doctor thinks you got the vaccine impacts your later susceptibility.
jljljl · 9h ago
I guess the danger here is that for vaccines that we already know reduce the risk of deadly diseases, you’d either:
Randomly expose patients to the risk of contracting a known debilitating/deadly disease
Or
No one who comes in for the vaccine will consent the trial
jmye · 6h ago
Absolutely unbelievable that someone who knows nothing about medicine is taking a flamethrower to things the provably save lives solely because he’s too stupid to understand the issues.
Anyone supporting RFK should explain to their grandparents why getting and dying from the flu is actually a good thing, this fall.
perilunar · 6h ago
Don't know about the flu, but there has been discussion about the ethics of vaccinating old people against pneumonia. Sir William Osler famously called pneumonia the “old man's friend”, because it kills the elderly without too much suffering.
There might be many reasons to disagree with the research - it’s not peer reviewed for one - but flagging seems to be somewhat antiscience, which is a shame for a forum about software engineering and innovation.
giraffe_lady · 10h ago
> He also claimed that "except for the COVID vaccine, none of the vaccines on the CDC's childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products."
Could not be more obviously building towards flatly banning vaccines. I originally figured it would take 2-3 years to do it but now I think it'll be this year. With his recent comments about autism ("we'll know by september") I suspect the plan is to announce a """discovery""" around then along with a "temporary" emergency ban. And then that's it our children will be dying by the millions again.
> "He's an anti-vaccine activist, a science denialist who is going to do everything he can to tear down the infrastructure in this country of vaccines. Robert F. Kennedy Jr is a dangerous man."
Good shit Dr Paul, thank you. RFK may well turn out to be the single most malign individual of this whole depravity.
Spivak · 10h ago
God the US is so far on the Authoritarian side of the graph that even our "burn down the government deregulate everything" party can't help themselves. Any voter romanticism about having the government have less control over your life surely has to be dispelled by this point. This was the GOPs moment to actually deregulate things in a manner that's good for people and they just said, "we're keeping everything the same, just with conspiracy theories added." I mean it's probably for the best that they're squandering their shot on stupid shit like this but I still wonder if they will ever wake up and realize their position as not the opposition party anymore and that they have to / get to lead — tackle the bigger issues and shape the direction of the country going forward. They won, they owned the libs mission accomplished whatever and now it's their moment to govern and they're still acting like pissed off back seat drivers.
In tech terms they're the principal architects now and they're using that power to get their preferences on minor PR reviews merged.
watwut · 3h ago
I really do not understand why you think "this was the GOPs moment to actually deregulate things in a manner that's good for people".
Nothing about this moment created conditions for such a thing.
There was no support for such a thing and no real promiss to do such a thing. No track record fod GOP proposing good regulation.
Project 2025 was known and not about helping people. The anto vaccine regulations are already a thing in red states.
giraffe_lady · 9h ago
They're doing exactly what they wanted to do and planned to do. To a significant extent these were the goals of the american conservative movement going back decades. This is what leadership means to the right and what it always has. Death and destruction.
techpineapple · 9h ago
I feel like it’s a very strange person that is comforted by all of this. I am super susceptible to nostalgia, but in a nerdy VHS and Afghan blanket kind of way, nothing about any of what Trump is doing makes me think of the good old days. And I long for the good old days!
nailer · 9h ago
Regardless of what you think of RFK, there's no good reason to think more testing of medicine is a bad thing.
KeepFlying · 9h ago
If we had infinite time and resources and pecpuld pause disease for the duration of the trial, then I'd agree with you.
Without that we delay treatment, increase costs, and slow research. And people die while we wait.
Test what's most likely to be a problem, and avoid wasting resources proving what we already know.
nailer · 8h ago
> Without that we delay treatment, increase costs, and slow research. And people die while we wait.
This is for new vaccines: we're not halting administration of existing vaccines. And the time taken for testing new vaccines seems reasonable for safety purposes, as it would be for any other medicine.
clipsy · 7h ago
"New vaccines" in this case includes, as an example, influenza vaccines that use the same mechanism that has already been proven safe and effective and which need to be developed and deployed in the (short) time between determining the most likely influenza strains for the year and the beginning of flu season.
If annual influenza vaccines cannot be approved in time for flu season and flu deaths increase significantly over the years to come, would you consider that justifiable?
nailer · 6h ago
That’s a good question. No I wouldn’t consider it justifiable. I think newer versions of existing vaccines shouldn’t qualify as ‘new vaccines’.
The article mentions ‘
four years ago is unacceptable so it sounds like they want to retest new versions every four years, rather than every new version.
clipsy · 5h ago
> The article mentions ‘ four years ago is unacceptable so it sounds like they want to retest new versions every four years, rather than every new version.
Your choice of quote makes it seem like you are misunderstanding or deliberately misrepresenting the article. In more context:
> "As we've said before, trials from four years ago conducted in people without natural immunity no longer suffice. A four-year-old trial is also not a blank check for new vaccines each year without clinical trial data, unlike the flu shot which has been tried and tested for more than 80 years," Nixon said in a statement he had earlier sent to The Washington Post. "The public deserves transparency and gold-standard science — especially with evolving products."
This states that a Covid vaccine passing the placebo-controlled study requirement 4 years ago will not suffice to accept updated versions of the same Covid vaccine -- not that vaccines and/or delivery mechanisms will only need to be tested every 4 years. More concisely: it's an upper bound, but not a lower bound.
Edit: Fixing up some grammar.
nailer · 1h ago
> This states that a Covid vaccine passing the placebo-controlled study requirement 4 years ago will not suffice to accept updated versions of the same Covid vaccine
Yes. That is what the comment you were replying to states.
> More concisely: it's an upper bound, but not a lower bound.
You can’t say it’s any bound at all. Maybe more than two milliseconds old (less than four years) is unacceptable, maybe 16 millennia (more than four years) is unacceptable. They’re just thinking about four years as being unacceptable. Which sounds reasonable.
giraffe_lady · 9h ago
Medical research ethical standards disagree:
> An ethical dilemma arises in a clinical trial when the investigator(s) begin to believe that the treatment or intervention administered in one arm of the trial is significantly outperforming the other arms. A trial should begin with a null hypothesis, and there should exist no decisive evidence that the intervention or drug being tested will be superior to existing treatments, or that it will be completely ineffective. As the trial progresses, the findings may provide sufficient evidence to convince the investigator of the intervention or drug's efficacy. Once a certain threshold of evidence is passed, there is no longer genuine uncertainty about the most beneficial treatment, so there is an ethical imperative for the investigator to provide the superior intervention to all participants.
Here's the 2021 flu vaccine, that'll be $500. Good news, we verified it won't turn you into a unicorn.
add-sub-mul-div · 8h ago
What if what you think of RFK is that he's clearly throwing up roadblocks to delay or prevent vaccines (ideologically) that the actually legitimate medical community is already on top of testing appropriately?
nailer · 1h ago
But they’re not on top of testing:
> "except for the COVID vaccine, none of the vaccines on the CDC's childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products."
jmye · 6h ago
What, specifically, is your experience in medicine, and specifically epidemiology and current vaccine testing?
Given the answer is clearly and obviously “none”, why do you think you’re qualified to have any opinion at all?
nailer · 1h ago
What research have you made to refute the statement that more testing of medicines is a good thing? Please link to the published studies you have authored.
In case you are new to adult discourse, many people, including yourself have opinions on matters that they are not experts in.
Despite the question above, you are in fact allowed to have opinions on whether there should be more or less testing of medicine.
The same way you have opinions about geopolitics despite the fact that you don’t sit on private committees or serve in the military.
You can have opinions about tech products without having written their source code or even writing any of your own.
https://www.bmj.com/content/363/bmj.k5094
Is the hypothesis that there is some kind of psychosomatic/placebo effect to vaccines, where just the process of getting injected changes outcomes? I find that hard to believe.
The reason the updates aren't currently tested this way is because medical research ethics perspectives on the balance of risk of novel unknown effects vs known risk of withholding effective treatment from the placebo group. https://en.wikipedia.org/wiki/Clinical_equipoise
Randomly expose patients to the risk of contracting a known debilitating/deadly disease
Or
No one who comes in for the vaccine will consent the trial
Anyone supporting RFK should explain to their grandparents why getting and dying from the flu is actually a good thing, this fall.
e.g.: https://www.sciencedirect.com/science/article/abs/pii/S02644...
There might be many reasons to disagree with the research - it’s not peer reviewed for one - but flagging seems to be somewhat antiscience, which is a shame for a forum about software engineering and innovation.
Could not be more obviously building towards flatly banning vaccines. I originally figured it would take 2-3 years to do it but now I think it'll be this year. With his recent comments about autism ("we'll know by september") I suspect the plan is to announce a """discovery""" around then along with a "temporary" emergency ban. And then that's it our children will be dying by the millions again.
> "He's an anti-vaccine activist, a science denialist who is going to do everything he can to tear down the infrastructure in this country of vaccines. Robert F. Kennedy Jr is a dangerous man."
Good shit Dr Paul, thank you. RFK may well turn out to be the single most malign individual of this whole depravity.
In tech terms they're the principal architects now and they're using that power to get their preferences on minor PR reviews merged.
Nothing about this moment created conditions for such a thing.
There was no support for such a thing and no real promiss to do such a thing. No track record fod GOP proposing good regulation.
Project 2025 was known and not about helping people. The anto vaccine regulations are already a thing in red states.
Without that we delay treatment, increase costs, and slow research. And people die while we wait.
Test what's most likely to be a problem, and avoid wasting resources proving what we already know.
This is for new vaccines: we're not halting administration of existing vaccines. And the time taken for testing new vaccines seems reasonable for safety purposes, as it would be for any other medicine.
If annual influenza vaccines cannot be approved in time for flu season and flu deaths increase significantly over the years to come, would you consider that justifiable?
The article mentions ‘ four years ago is unacceptable so it sounds like they want to retest new versions every four years, rather than every new version.
Your choice of quote makes it seem like you are misunderstanding or deliberately misrepresenting the article. In more context:
> "As we've said before, trials from four years ago conducted in people without natural immunity no longer suffice. A four-year-old trial is also not a blank check for new vaccines each year without clinical trial data, unlike the flu shot which has been tried and tested for more than 80 years," Nixon said in a statement he had earlier sent to The Washington Post. "The public deserves transparency and gold-standard science — especially with evolving products."
This states that a Covid vaccine passing the placebo-controlled study requirement 4 years ago will not suffice to accept updated versions of the same Covid vaccine -- not that vaccines and/or delivery mechanisms will only need to be tested every 4 years. More concisely: it's an upper bound, but not a lower bound.
Edit: Fixing up some grammar.
Yes. That is what the comment you were replying to states.
> More concisely: it's an upper bound, but not a lower bound.
You can’t say it’s any bound at all. Maybe more than two milliseconds old (less than four years) is unacceptable, maybe 16 millennia (more than four years) is unacceptable. They’re just thinking about four years as being unacceptable. Which sounds reasonable.
> An ethical dilemma arises in a clinical trial when the investigator(s) begin to believe that the treatment or intervention administered in one arm of the trial is significantly outperforming the other arms. A trial should begin with a null hypothesis, and there should exist no decisive evidence that the intervention or drug being tested will be superior to existing treatments, or that it will be completely ineffective. As the trial progresses, the findings may provide sufficient evidence to convince the investigator of the intervention or drug's efficacy. Once a certain threshold of evidence is passed, there is no longer genuine uncertainty about the most beneficial treatment, so there is an ethical imperative for the investigator to provide the superior intervention to all participants.
> https://en.wikipedia.org/wiki/Clinical_equipoise
> "except for the COVID vaccine, none of the vaccines on the CDC's childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products."
Given the answer is clearly and obviously “none”, why do you think you’re qualified to have any opinion at all?
In case you are new to adult discourse, many people, including yourself have opinions on matters that they are not experts in.
Despite the question above, you are in fact allowed to have opinions on whether there should be more or less testing of medicine.
The same way you have opinions about geopolitics despite the fact that you don’t sit on private committees or serve in the military.
You can have opinions about tech products without having written their source code or even writing any of your own.