Because the risk of e.g. dying of myocarditis from the virus still exceeds the risk of dying of myocarditis from the vaccine.
Particularly with the mRNA vaccines there isn't much in the vaccine that isn't in the virus already.
There has to be a name for this fallacy. It is like we're living in the dark ages where contracting covid is just "God's will" and it doesn't count in risk assessments, while no matter how small the risk is of the vaccine that is all that matters.
It's definitely not a standard name, but I call kind of reasoning error "active/passive bias": we're generally much more afraid of risks that manifest from action (mauled by a shark while swimming, getting in a car crash) than inaction (dying of obesity, getting hit by a car on the sidewalk).
In the case of COVID-19: you have to actively get the vaccine, meaning that people overweight its risks relative to the risks latent in not getting it.
I think you're right, and an additional factor is that the vaccine is tangible and certain where the virus is invisible and may or may not be present in any given situation (and in unknown quantity).
At its core it may be more that people can't think past binary logic. Either something works or it doesn't work. Either something is perfectly safe or it is too risky. But that doesn't address why they don't apply the same logic to the virus itself (although there are some people on the flip side who still do).
> Particularly with the mRNA vaccines there isn't much in the vaccine that isn't in the virus already.
I don’t find this compelling at all. At the very least, the mRNA vaccines have the lipid nanoparticles themselves, and LNPs are quite clearly biologically active.
And the mRNA gets delivered to cells that would not be infected by the actual virus. One might imagine that such cells would be targeted to at some some extent by CD8+ T cells that learn to recognize spike protein. As far as I can tell, there is nothing published examining what actually happens, but you certainly don’t end up with massive death of muscle cells when vaccinated. See, for example, the comments here:
The lipid nanoparticle itself is basically a cell wall and it fuses with your cell wall and deploys its payload. There isn't a lot there. It isn't like the adenovirus capsid that binds to PF-4 and causes the clotting disorders in J&J and ChAdOx1. It would have to be something related to ALC-0315 and/or ALC-0159 and be active in the very tiny quantities which are administered. Those are lipids and it is most likely that they're eventually just disassembled.
> One might imagine that such cells would be targeted to at some some extent by CD8+ T cells that learn to recognize spike protein.
This is exactly what we want to see happen, and you're going to get CD8+ T-cells from the virus as well (and if you don't, then you're going to get very extremely ill).
The tissue distribution is a reasonably good point, but that should be considered in light of the evidence that the virus itself likes to hide out in places like the gut and that liver and gut activation after vaccination may be protective. And if that argument is wrong, that would be an argument to try to produce nasal mRNA vaccines.
And at this point we do have a really massive amount of data on the safety and efficacy of the mRNA vaccines and we're having to sift the data very closely to find effects lower than one in million. Other vaccines perform worse. I think it probably is because we're getting closer and closer to minimalism.
> This is exactly what we want to see happen, and you're going to get CD8+ T-cells from the virus as well (and if you don't, then you're going to get very extremely ill).
No. What you want to see is protection from the virus, hopefully prevention of infection entirely, hopefully long lasting, hopefully in a form that the virus can’t easily evolve its way out of. And you want this with as little in the way of side effects as practical.
You might think this would happen with an appropriate antibody response or an appropriate CD8+ response or some combination or something else. That’s a hypothesis that may or may not be correct.
But saying that you want your T cells attacking your muscle cells after a vaccine seems absurd. Maybe you can tolerate that (as people apparently can), but I can’t imagine it’s desirable. As far as I can tell, the actual desired means to get CD8+ T cells is for antigen-presenting cells to present pieces of the protein in question attached to MHC1 on their surface, along with the appropriate signals to nearby T cells to encourage them to develop into the right kind of T cell. Your muscle cells are not those antigen presenting cells!
> And at this point we do have a really massive amount of data on the safety and efficacy of the mRNA vaccines … Other vaccines perform worse.
I’m a fan of Covid vaccines too, but this feels like drinking the Kool-Aid. The chickenpox vaccine is effective. The measles vaccine is effective. The tetanus vaccine is pretty effective.
The current crop of monovalent Covid mRNA were highly effective from a week or so after the second dose out to quite a few months against variants closely enough related to the original. [0] Otherwise they are, frankly, far from highly effective. The bivalent vaccines, as far as I can tell, look decent in terms of immunogenicity, but haven’t really been studied well for efficacy against actual infection.
So maybe these mRNA vaccines achieve a form of minimalism, and maybe they’re better than other Covid vaccines, but on the scale of vaccines overall, they’re not great.
[0] Compare to the chickenpox vaccine. In actual randomized trials, they were nearly completely effective even in patients exposed to chickenpox a few days before vaccination. The two-dose series appears to protect recipients for life, or at least decades, strongly enough that epidemic chickenpox is gone in the US. And that continues to work despite chickenpox surely being reintroduced by visitors from abroad on a regular basis and from older infectious shingles patients. That is an effective vaccine.
> Because the risk of e.g. dying of myocarditis from the virus still exceeds the risk of dying of myocarditis from the vaccine.
There's several studies that have shown myocarditis from the virus is indistinguishable from previously-measured myocarditis in the population in general - that the virus isn't actually causing any. At least one of them included vaccine-caused myocarditis and showed it's several times higher.
> People who were infected with COVID-19 before receiving any doses of the COVID-19 vaccines were 11 times more at risk for developing myocarditis during days 1-28 after a COVID-19 positive test.
If we're just going to quote stuff at each other...
> Post COVID-19 infection was not associated with either myocarditis (aHR 1.08; 95% CI 0.45 to 2.56) or pericarditis (aHR 0.53; 95% CI 0.25 to 1.13). We did not observe an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from COVID-19 infection.
But also your source is kind of bad. It doesn't have an unvaccinated control group, so from that research there's no way to know if what they found was virus or vaccine related. But they did find an age and sex based correlation which lines up with other sources saying the vaccines are bad for young men:
> The risk of COVID-19 vaccine-associated myocarditis was higher in men younger than age 40 after a first dose of an mRNA vaccine or after a second dose of any of the 3 vaccines.
That isn't relevant because there is no evidence that the vaccine reduces your risk of suffering from myocarditis after infection. (It isn't even necessarily true, but that is a separate matter).
> The risk of COVID-19 infection-related myocarditis risk was cut in half among people infected after vaccination (received at least one dose of a COVID-19 vaccine).
Based on the original strain. Not that I would want to argue. There are several nations that do not recommend vaccination for younger people. They could be wrong of course, but to be so certain about science of a rapidly changing virus and wave away methodological difficulties, like measuring myocarditis without an autopsy, strikes me as scientifically naive, perhaps bordering on religiosity.
Particularly with the mRNA vaccines there isn't much in the vaccine that isn't in the virus already.
There has to be a name for this fallacy. It is like we're living in the dark ages where contracting covid is just "God's will" and it doesn't count in risk assessments, while no matter how small the risk is of the vaccine that is all that matters.