A sober discussion of vaccine risks

I appreciated the sobriety of this discussion in Apollo’s Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live by Nicholas Christakis. I’m increasingly worried that we’re entering a situation where an understandable desire to avoid fuelling anti-vaccine sentiment (something which has the potential to undermine a vaccine-led resolution of Covid-19) will create a reticence to talk about the fact that vaccines do have risks, with the inevitable blowback in terms of public attitudes if/when problems emerge with the current vaccine roll out. From pg 235-236:

Another crucial factor is safety. The usual rate of serious complications for approved human vaccines is approximately one out of a million recipients. The seasonal flu vaccine might kill one out of ten million people to whom it is given, a figure that is clearly offset by the thousands of lives saved annually by the vaccine. But no matter how many lives a vaccine saves, safety is a serious issue, especially in some populations (like children) who face relatively less risk of getting or succumbing to COVID-19. Some vaccine candidates for other coronaviruses actually made the infections worse in animal testing, in part by worsening the natural way the animal’s body attempted to fight off the infection. Another risk is that if the wrong kind of immune response is elicited, the body might attack itself in what is known as an autoimmune reaction. This happened with the flu vaccine in 1976, when many patients developed a kind of paralysis (from which most people recovered) known as Guillain-Barré syndrome. Rushing to bring a vaccine to market could also cause other sorts of safety problems in its manufacturing. Infamously, this happened in the Cutter Incident during the early launch of the polio vaccine, in 1955. When the polio vaccine was made available, mass vaccination days were organized by local communities. More than 120,000 children received a batch of the vaccine in which the process of inactivating the live virus was incomplete. Within days, there were reports of children developing paralysis, and the mass immunization program was abandoned within a month. Investigation showed that two batches of the vaccine, manufactured by Cutter Laboratories, had the live virus, resulting in symptoms in forty thousand people, permanent paralysis in fifty-one, and death in five; and this does not include cases of the virus spreading to other children. This episode was described as a perfect storm of sloppy company practices, greed, and lax federal oversight—leading to a tragedy for the victims.

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