When do we know enough?


Recall that the test for the vaccines on children from 5-11 in the US “only” tested 2,400 children. Is that enough? I wish the group had been longer but then the test would have taken longer.

Some people argue that the test of 2,400 is inadequate because the group should have been much larger. Much larger would be nice. But right now it is the best test we have. Parents can say the test is not big enough and we will wait for a larger test.  We must always remember that doing nothing is making a choice too. These parents are choosing the status quo. That also has risks, because there are no decisions that involve no risks when it comes to taking or not taking vaccines.

Such parents have to remember that a significant number of children die from Covid-19 if parents do nothing as they have been doing up to now. Until now they had no choice. Now they do. Canada just approved the vaccine for children aged 5-11. Now doing nothing is a choice. Is it the best choice?

I would suggest we rely on the best test we have. That test shows the vaccine is 91% effective in preventing serious disease in children. The evidence is not perfect, but that is a significant benefit for the vaccine. Parents who don’t allow their children to take the vaccine are depriving them of vaccine that best available shows that it would really help 9 out of 10 children improve their odds of avoiding serious illness.

We have to chose one or the other. We cannot make a choice to take no risks, because such a choice does not exist. People who do nothing are also taking a risk. Is it a smaller risk? Why?

Dr. Paul Offit used the example of the polio vaccine which most of us are too young to remember. Oldsters like I remember. It was a very dangerous disease that really scared a lot of young children like me in the mid-fifties. I was overjoyed when a vaccine was approved, and I could take it. I was so overjoyed I remember it about 65 years later.

Dr. Salk produced the vaccine with a team of scientists that he led.  In their scientific tests 200,000 people got the vaccine and 200,000 people got a placebo instead.  During the time of the tests 16 people died in the placebo group. None died in the other group where they got the vaccines. Dr. Salk was horrified that 16 people died in his view unnecessarily because he wanted to give the vaccines to them but couldn’t.

When it comes to risk, we must always ask what human price are we willing to pay for knowledge. There is always a price to pay for human knowledge. Sometimes the price is high, as it was for the 16 people who got the placebo instead of the vaccine. Please note I am not advocating for no tests of new drugs!  I also remember the thalidomide drug that devastating children around the world because it had not been adequately tested. It is a difficult decision to make when testing has gone on long enough. I understand that the recent testing for the Covid-19 pills were so successful the FDA  scientific team overseeing the tests cut short the testing because it was so overwhelming beneficial they did not want to withhold it any longer. .

When it comes to risk we have to ask ourselves when do we know enough to make a decision, because often, not making the decision, is actually making a decision. Sometimes that decision is the wrong one and people suffer needlessly.

We can never stop worrying about and analyzing risks. But we should listen to science. Not uncle Ernie.


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