'I do not buy that the (J&J vaccine) pause was a good idea': Nate Silver

538's Nate Silver on whether the move to resume the Johnson & Johnson vaccine will increase vaccine hesitancy.

[thetruth]

I care about my family, my friends and fellow citizens that's why I got vaccinated.

[ccbowers]

My initial feeling was the same as Nate's, but I changed my mind a bit. Although the overall figures were 1:500, 000 to a million, the concern was throught to be greater in a subgroup of people who also have a lower risk from COVID, i.e. younger adult women. A combined higher risk of harm from vaccine and lower risk of COVID could have changed the recommendation for them. Especially with other vaccine options.

Another aspect is that the pause was not expected to affect the supply of vaccine to the point it would impact vaccine administration. It was always thought to be temporary, with possibility of changing recommendations.

The other part of the decision is a PR one. If the risk ended up being higher, and there was no pause done, the other 20/20 hindsight people would be pounding the message of unsafe vaccine and unsafe/corrupt public health organizations.

There was a risk and potential harm regardless of their decision. This hindsight criticism would have occurred on many other different channels if they didn't pause.

[Ferrousbull]

I like Nate, but this is classic Dunning-Kruger. Nate does not have any expertise in vaccinations, public health, or medical ethics. This was a tough call, and may have been the wrong one, but a couple public opinion polls don't cover the complexity of this issue. We really should look at the cost of the vaccine pause and polls will be helpful evidence, but making a call on this decision without fulling understanding the underlying issues is not helping anyone.

[malliksss]

I disagree. The current use of vaccines is not done after a detailed trial. It only got emergency use authorization. This is because we had no time to do the detailed trials. Pause was necessary to ascertain if it was indeed 1 in 500, 000 or more. Those who get hesitant will come back. But who would have been responsible if there were indeed 1800 cases instead of 18 and their intensity was at different levels. So Nate data analytics is not all 😉

[JeoJetsonmusic]

Wow I’m glad 538 is making a video about this because I thought the pause was a terrible decision

[WISEYOUN]

I agree with Nate Silver for three reasons.

First, the risk differential between CoVID-19 and the J&J vaccine is huge. The numbers that Nate gave are conservative, i.e. 1:500, 000 of cerebral sinus thrombosis due to the J&J vaccine worldwide and 1:500 Americans dying from CoVID-19. Fewer than 1:500, 000 people had the complication and, if the complication were treated properly, the mortality rate is close to zero. This suggests that the risk dying from CoVID-19 from not taking the vaccine is much more than 1000x greater than the risk of getting this complication. That alone is a very strong argument for not “pausing” the vaccine.

Second, over 2000 people are dying from CoVID-19 per day in India alone and probably more than double that per day dying from CoVID-19 around the world from not having been vaccinated. The “pause” likely allowed the virus to kill many thousands more people during the week. Some people might say the J&J vaccine is not preventing all CoVID-19 infections and that other vaccines are available. However, millions of J&J vaccinations per day could have been give during the “pause”. If the pause stopped 10 million vaccines from being given and the vaccine could have prevented 0.2% of vaccinated people from dying from CoVID, that the “pause” likely have killed over 200, 000 people.

Third, US vaccine hesitancy, already very high at 37% before the pause, rose to over 50% at the end of the one week “pause”. More concerning, the number of vaccines given per day in the US declined from 3.4 million doses per week to less than 3.0 million doses during the week of the pause. At present, only 28% of the US are fully immunized and about 50% are partly immunized with the first of two shots. This pause may have discourage hundreds of millions of people from getting their first or second dose of vaccine, significantly slowing down the rate of vaccination, potentially killing million more people.

The one week pause of the J&J vaccine was imposed “out of an abundance of caution”, according to CDC director Rochelle Walensky. In my opinion, the withholding of the J&J vaccine was not carefully thought out and likely killed thousands of people, much more than any possible complication from the J&J vaccine. There was no need to stop giving the vaccine while the evaluation was going on. In fact, the implication that a “pause was necessary” to evaluate the data is false. The evaluation was going on before, during, and after the “pause”. Why was a pause necessary, other than for public relations?

The claim that the vaccine was an “emergency” approval, suggesting that it was inadequately tested for safety, is misleading. All the vaccines were tested in large scale phase III trials for 30, 000 - 40, 000 participants. The JNJ vaccine was tested in more people and in more countries than any of the other vaccines. By the way, the JNJ vaccine not only had less morbidity and mortality than then the control group but none of the patients that received that vaccine had to go into hospital. The European Medicine Agency, the equivalent of the FDA for Europe, approved the J&J vaccine and only required a warning of a possible risk.

[tylerhackner]

I disagree with Nate. I feel like the people who says this impacted their decision weren’t going to get it in the first place

[keithbajema]

I know someone who got the Pfizer vaccine who says they might not have after the J&J pause. It even made me uneasy about getting my second shot. It can be weird how news affects people.

[LucioFercho]

Why is Tim Burton's Penguin asking me to subscribe?

[TheRiskyBrothers]

I think there's a lot of hindsight bias going on here. We've only got the sample size of one, where the pause was enacted, but the vaccine was safe. Without a pause, the integrity of the CDC might have been called into question among the unvaccinated population, lowering confidence in any government health measures. It's easy for a keyboard doctor to say that a safe vaccine shouldn't have been paused after the fact, but if there's one thing that would have killed dead any chance of vaccinating the whole population, it's ignoring a harmful vaccine. The administration's political opponents would have decried it as the worst thing a president's ever done without a shred of self-awareness.

Granted, we're near the territory of only people with low trust in government/social institutions being yet to be vaccinated. This might just be a bit of a Kobayashi Maru situation where there isn't an outcome that decreases vaccine hesitancy among antivaxxers.

Bad use of confidence interval.

[g.g.]

WHY IS USA NOT BANNING FLIGHTS FROM INDIA?

[TrimutiusToo]

Contamination was a bigger problem though

[uhoh]

Another subject about which Nate Silver has no clue, but is happy to opine upon.

[Anthonycheesman]

They were in a bad spot regardless but pausing it for that short amount of time wasn't worth it they should have just kept going.

[josephlunderville]

That's a deeply flawed analysis! You can't compare different messaging assuming the vaccine was safe, because the point of the pause was that the CDC didn't know for sure the vaccine was safe. You have to compare against scenarios where the vaccine was particularly unsafe in some way despite clinical trials -- say a manufacturing problem that affected specific doses, or an interaction with a specific underlying condition or drug.

[deeman]

I agree, especially with respect to men. Men did not appear to have any extraordinary side effects. An abundance of caution is an Excuse for incompetence. We reward incompetence in America!

[tigerfishdivisionlancey]

God if that isn't the most over dramatic, irritating intro music I have ever heard! This is news, not a goddamn sports game.

[IanZainea]

would it have been better to not pause and just let the (admitedly very small) risk be out there... idk. Might have been worse the other way. We will never know.

[Markd]

damn nate keep the twitter fights off youtube!!!

[tweeker]

Nate Silver should stick with sports betting.