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.
It's good to point that out, but the first term needs to be multiplied by the chance of getting the virus.
https://newsroom.heart.org/news/myocarditis-risk-significant...
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:
https://www.science.org/content/blog-post/mrna-vaccines-what...
> 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.
The LNPs are most certainly active in the quantities used:
https://www.news-medical.net/news/20221109/Empty-lipid-nanop...
(Also, you don’t have cell walls.)
> 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.
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.
https://newsroom.heart.org/news/myocarditis-risk-significant...
> 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.
https://pubmed.ncbi.nlm.nih.gov/35456309/
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.
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 over the vaccine that is all that matters.