Wednesday, August 25, 2021

Now This Is Where Medical Experts Are Probably Wrong

Having spent time arguing that one should accept the opinion of medical experts, I am now writing a post disputing medical experts.

The Jerusalem Post just published an article which states as follows:

The Pfizer coronavirus vaccine scored a point in the field of public opinion with an announcement by the American Food & Drug Administration on Monday that it is fully approved. Now, it is likely that many more people will sign up to get the jab, health experts say, in that they will have even more confidence in the safety of the vaccine.
I'm not a health expert, and I'm not qualified to dispute an expert opinion about health. But the health experts cited here are not giving an expert opinion about health. They are giving an opinion about how people in general react to information about science. And that's something which is the domain of psychology, not physical health.
Personally, I think that it is just not going to be true. Yes, a few more people will sign up to get vaccinated. But "many more"? I don't think that is likely at all, and I think that most psychologists and social scientists would probably agree.
The fact is that the vast majority of people rarely make rational decisions based on evidence. There have been countless studies which demonstrate this. Rather, most people primarily based their decisions on such things as emotion, bias, group affiliation and so on, and then use their intellect to rationalize these decisions by deciding which evidence they will consider acceptable.  
To make things much worse, we live in an unfortunate time in which conspiratorial thinking, reception and distribution of misinformation, and distrust of expertise have spread far beyond the fringe circles of conspiracy theorists who believe that lizard people are controlling world events. The majority of Republicans believe that Republican officials conspired to falsify the results of the presidential election! And the internet enables mavericks, including some with credentials, to spread their views widely; it's not easy for the average person to figure out who the real experts even are.

When it comes to Covid and vaccines in particular, the amount of misinformation that people absorb boggles the mind. As noted yesterday, many people have spent over a year believing things that are not only false, but very demonstrably false and even nonsensical. An official approval of the vaccine from the FDA, even with all the consideration that this entailed, isn't going to sway them - not even people who claimed that the reason they didn't take it until now is that it didn't have full FDA approval. They will latch on to the fact that a very very small number of medical experts say that the FDA is wrong or is rushing things. And they will claim that they are able to evaluate this view as being more correct than that of the overwhelming majority of medical experts who say that people should take the vaccine. In the last few days I've heard from MBAs, engineers and housewives who assure me that they are much more qualified to assess the pros and cons of the vaccine than hundreds of thousands of specialized trained medical scientists in this field.

Given all this, why do I spend so much time and energy trying to educate people to identify misinformation and accept the conclusions of mainstream science? I have several reasons for doing this:
  1. Not everyone is totally immune to using evidence and logic to make their decisions.
  2. Even if facts and logic don't convince them immediately, it may plant seeds which bear fruit later.
  3. It's important to strengthen those who draw correct conclusions and make sensible decisions.
  4. This is one of the ways in which I am stupid.
Hopefully the first three reasons have more validity than the last one.
I'd love to be proven wrong about people changing their minds. If you didn't take the vaccine yet, and the FDA approval has changed your mind, please let me know!

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  1. There is almost no point in arguing with Anti-Vaxers, any logical argument you raise is only proof to them that you are part of the Vaccine Conspiracy, and therefore your argument is wrong.

    However there are many unvaccinated people who are not anti-Vax, there are people who simply aren't following the news, and although they must have heard talk about vaccinations, they haven't really been paying attention, even if they received a call from the medical provider, people often get recommendations from their doctor to get a blood test, or check up, or flu shot, and just ignore it.

    There are people who would get the shot, but are just busy and it is not a priority for them

    There are people who don't know where or how to get the shot, maybe because they have language problems, or are not part of a Kupa, or live in an area where the information is less available.

    I assume that many of your readers (including me) have been obsessed with this Pandemic, following developments, regularly checking statistics, and reading as much as we can about how to beat this virus, however as hard as it is to believe, there is a significant percentage of people who just aren't interested - these are the people we should be talking to if there was an easy way to reach them.

    Hint, look at the person collecting money at shul, or the guy next to you on the bus, or the person behind you in the supermarket check-out, not all of them are even aware that Israel recommends a third shot and you can get it by walking into a clinic, or maybe they are aware, but don't realize that it can prevent them from getting really sick

  2. There are businesses, universities, and local boards of education, that were uncomfortable with a vaccine mandate prior to full FDA approval. Now that it is fully approved, you already see many more mandates.
    Many people take the vaccine when they feel forced to do so, or when it interferes too much with their day to day living.

    1. I think Nick has hit the nail on the head here -- the effect of the full FDA approval will be most strongly felt in the domain of mandates and / or vaccine passports.

      It may also have the effect of pushing a few hesitant people to finally get vaccinated, but I think this will be very much secondary.

  3. I think this is one of the first post with which I agree (i.e. which confirms my own prejudices).

    I would add that Lockdowns are not exclusively a medical matter either. Doctors are entitled to the same voice as any other citizen.

    We are very used to claims of military necessity spilling over into tyranny. The tyranny of the professional soldier is a trope of history. This is the peculiar 21st century tyranny of the doctor.

    1. "This is the peculiar 21st century tyranny of the doctor."

      No it's not.

    2. I've already posted the video showing the unelected chief medical officer dictating to elected UK parliamentarians what the policy is. Here is the transcript:

      Yet again vexatious and shameless pithy one liners with no regards for the truth.

  4. A decision of a bureaucratic body hardly makes a difference to people who are able to use their own brain. When vaccination euphoria began, we were told- vaccine efficacy is 95%. Wow! And Israel, which was the first country that vaccinated most of population, now is one of the countries with highest infection rate. So, what conclusion should be made: (a) Vaccine surely work (we'll take their word for it), it's just two shots were not enough, we just need 3rd shot and Mashiach will come; (b) Stop enriching big pharma-- 99% of us survive covid as they do flu. Open the country, return o normal life, stop killing economy, just protect vulnerable and make treatment (like monoclonal antibodies IV) and prevention (like Dr.Zelenko protocol) widely available.

    1. And of course, tshuvah, tzedakah and tfila.

    2. Sorry but Lazard logic is sound. I’ve not heard one conspiracist who has made more wrong predictions as the CDC and the WHO. If you have repeated advice from Dr Fauci or the WHO during this pandemic you are guilty of spreading misinformation.

  5. You want to vax fine. But if you do so on the basis of authority, because Dr. Fauci says so, you are no less an idiot than an anti-vax who opposes vaccines because anti-establishment says so.

    1. Let me get this straight. You are saying that the handful of anti-vax "experts" possess no greater authority than the consensus of virtual all the specialists worldwide?

    2. A thousand hechsheirim on one product vs one hechsher is meaningless it doesn't make the product more kosher. If a million experts parrot Fauci without independently verifying it, is worthless. It's not a consensus when millions amplify a message.

    3. And you think that all the specialists worldwide are merely parroting one person?

    4. Can you demonstrate otherwise? Or is this just conjecture?

    5. The difference is that Fauci has data behind his statements -- data available to everyone to check and follow his reasoning. Other countries and jurisdictions have their own health authorities which collect data and make their conclusions as well.

      If there is alignment and consensus around the opinions Fauci expresses, it isn't because he's being held up as some kind of navi.

    6. And you think that all the specialists worldwide are merely parroting one person?

      Oh, Fauci. Let's recall what he said: Don't worry about Covid- worry about Flu, don't wear masks, wear masks, vaccinate and keep wearing masks, don't wear masks if you are vaccinated, still wear masks if you vaccinated, get booster shot... You want to bet what will be next: don't wear mask if you got booster shot, keep getting booster shots every 6 months, still wear masks and keep getting booster shots.

    7. The difference is that Fauci has data behind his statements.

      Data, you say? Israel vaccinated more people per capita that any country in entire world and now has one of the highest infection rates per capita. So, you want to trust Fauci, or trust the evidence? It is attributed to Einstein, but I think it was someone else who said this: Insanity is when you keep doing the same thing and expect different results

    8. Israel hasn't "vaccinated more people per capita that any country in entire world". Many countries are ahead of Israel.

      What Israel did was to get a strong early start, with the most vulnerable people first, then plateau in the low 60%s range.

      Read the actual stats -- those getting sick are the elderly and immunocompromised for whom the vaccine was not as effective, and those who never got vaccinated in the first place.

    9. I honestly don't understand the obsession with Fauci. He is a public-health expert, not a prophet. He interprets data and makes recommendations.

      If the data picture changes (as more studies / evidence is collected), his recommendations change. This is how public health works -- practices change as we discover more.

    10. @Joe Q Read news: people are getting covid even after booster shot, let alone after two shots

    11. " Israel... has one of the highest infection rates per capita."

      I'm not going to bother to verify that. Have you actually compared Israel to other countries? I doubt it.
      As I've said before even if you can cite the correct data, you can still misinterpret it.
      The comparison you make may be invalid-
      1) Because you only reference a single point in time. How did Israel do a month ago? Two months ago? On average over the past year? You can compare two students and "prove" the weaker one is better by dishonestly choosing
      a single day when the weak student did better.
      2) There may other factors you're not taking into account. Right now in Israel, government policy is to do little to regulate restrictions and to do even less when it comes to enforcing them. The government has decided to gamble that mass vaccinations with few restrictions is the solution.

    12. "people are getting covid even after booster shot"

      So here you're getting the data correct, but you're misinterpreting it. The article says that 422,000 people were given the booster, and 14 were infected. Two are in hospital.
      So why do you think this statistic "proves" that the booster is useless? Forget about proof- why would the article even make you suspect the booster was ineffective?

    13. David if you think that all the scientists are merely parroting what Dr. Fauci says then you really don't know how science and the scientific community operate.

      It is actually anti vaxxers who parrot what their "experts" say. I've spent a great deal of time looking into all their claims and found them all to be fraudelent, distorted exaggerated etc.

  6. Just so everybody is aware there are people who are anti-vax which means that they never took any vaccinations or won't vaccinate their kids even before covid hit us and then there are people who have been vaccinated and are willing to take anything the media and government pushes, including these, and then there are those like myself who have had all my other vaccines, my children have all been vaccinated but when it comes to covid there's something weird going on. The propaganda of fear, the denial of valid therapies as an option, there's something being oversold to the extreme. The same people who insist on 'my body my choice' as in the right to kill another (unborn) person, now insist you have no choice as to your own body. The fear and suppression of information and medical experts and scientists and virologists who have been canceled and silenced have resulted in a third category, myself included, such people are vaccine hesitant and I am vaccine hesitant because I use my mind I do not just follow the herd I think and I see and I investigate and I find out so before you just label people as the ones who listen and the ones who are anti you should know that there are subtleties and it's not all black and white.

    1. Which "valid therapies" are you referring to? Hydroxychloroquine? Ivermectin? "Natural immunity"? Homeopathy? Bleach? One of the others mentioned here?

    2. Brilliant! Expressed very eloquently! I think most people who have not taken the vaccine, fall under this category.

    3. I thought we addressed "denial of valid therapies" and "suppression of information and medical experts and scientists and virologists who have been canceled and silenced" in the other thread?

      Do you have anything to say about the mountain of evidence showing that ivermectin and hydroxychloroquine are no better than placebo at dealing with COVID?

    4. Therapies are the same ones now authorised and implemented in Florida hospitals:

    5. Monoclonal antibodies are an incredible medical innovation, with lots of advances in recent decades. (Most notably the ability to make them without "sacrificing" enormous numbers of lab animals)

      Monoclonal antibodies are also phenomenally expensive to make and administer, and have no more testing behind them for COVID-19 than vaccines do.

      If your concern is about treatments that have been rushed into use, mAbs won't solve your problem. They've been rushed into use for COVID too.

      If your concern is that COVID vaccines are too complex to be safe, mAbs won't solve your problem either. They are so chemically complex, they make the mRNA vaccine look like a kids' wind-up toy.

      If your concern is that companies are profiting from COVID, mAbs definitely won't solve your problem either. The costs per dose are astronomical, easily 100 times higher than the vaccines.

      I don't think anyone is denying that mAbs are useful -- it's just nonsensical to oppose vaccines (prevention) and instead rely on much more expensive and intrusive treatments.

    6. As someone who spent a significant amount of time looking at the claims of antivaxxers regarding this vaccine I can tell you that there is a lot of false information going around some of it even being spread by doctors. This has resulted in many people deciding against taking the vaccine which is why 99% of the people dying from covid these days are unvaccinated.

  7. This comment has been removed by the author.

  8. "To make things much worse, we live in an unfortunate time in which conspiratorial thinking, reception and distribution of misinformation, and distrust of expertise have spread far beyond the fringe circles of conspiracy theorists who believe that lizard people are controlling world events."

    This isn't entirely the fault of the conspiracy theorists, considering we live in a time in which so many of our leaders are grossly incompetent if not worse. I imagine you've been reading the news this past week or two. And specifically as regards this virus, I can point you to, oh, the guy in charge of such things in the UK.

    A lot of people fell down on the job here, or worse. A lot of people have been doing that for *decades*. And like it or not, that sort of behavior breeds conspiratorial thinking. Unjustified, in my opinion, but certainly understandable.

    Maybe if, say, medical "science" wasn't so busy selling anti-science, politicized claptrap like "people with cervixes" the last couple of years, people would be more receptive.

  9. Very apropos, today's Jesus & Mo. Motivated reasoning:

  10. Here is a reason not to worry about potential "long term effects" of the vaccine.

    Do you worry about potential "long term effects" of anything else? Of all the industrially processed food and junk food you eat, and feed to your kids? Which are filled with hundreds of ingredients you couldn't understand even if you were a chemist? And of which the ingredients are constantly being changed, without long-term seven-year studies?

    No, you don't worry? If so, you shouldn't worry about the vaccine either.

    1. Not a sensible comparison.

      The long term effects of the things you mentioned are known, and known risks can be managed. And many sensible parents absolutely do restrict the amount of processed food their children consume. Keeping kosher helps, as availability of the processed food is far lower (not many kosher 'ready meals' available) but NO salami allowed in my house.

      The long term effects of the vaccine are completely unknown.

    2. Wrong. The long term effects are not known, as the ingredients are constantly being changed, and thousands of new products constantly developed, every year.

    3. Who has ever tested longterm effects of food ingredients rigorously? This is very difficult to actually test.

    4. No vaccine ever tested has ever caused side effects past 2 months.

    5. @Moshe: It would be very difficult to cause side effects after 2 months considering the components of vaccines are cleared from the body by then.

      It is interesting that the same folks who claim special mystical powers to the body and its natural immunity to clear away Covid also think the body decides not to clear out the stuff you inject into it in a vaccine.

  11. This is where you have let yourself be had Dr Nathan, the premise of your article is that Pfiser is fully approved and based on that the mayor of New York and many others in the media are saying ok now the kids can get the vaccine and go back to school. But I suppose I cant blame you as you trust the J Post, but as we know the media is basically fake news and have to read the source information directly, not the way they present it.

    So here are the facts:

    As of August 23rd, it has been widely reported that the Pfizer drug has now been fully approved by the FDA to be used to vaccinate against Covid19. Up until that time, it was authorized for emergency use.

    Lo and behold, on the FDA's own website, it is shown that the Pfizer drug is still under Emergency Use Authorization. Here's text from page 2 of the link:

    "On August 23, 2021, having concluded that revising this EUA is appropriate to protect the public health or safety under section 564(g)(2) of the Act, FDA is reissuing the August 12, 2021 letter of authorization in its entirety with revisions incorporated to clarify that the EUA will remain in place for the Pfizer-BioNTech COVID-19 vaccine for the previously-authorized indication and uses, and to authorize use of COMIRNATY (COVID-19 Vaccine, mRNA) under this EUA for certain uses that are not included in the approved BLA (biologics license application)."

    Also from the end of page 4 and continuing to the middle of page 5:

    "Having concluded that the criteria for issuance of this authorization under Section 564(c) of the Act are met, I am authorizing the emergency use of Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19, as described in the Scope of Authorization section of this letter (Section II) and subject to the terms of this authorization. Additionally, as specified in subsection III.BB, I am authorizing use of COMIRNATY (COVID-19 Vaccine, mRNA) under this EUA when used to provide a two-dose regimen for individuals aged 12 through 15 years, or Page 5 – Pfizer Inc. to provide a third dose to individuals 12 years of age or older who have undergone solid organ transplantation or who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. I. Criteria for Issuance of Authorization I have concluded that the emergency use of Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19 when administered as described in the Scope of Authorization (Section II) meets the criteria for issuance of an authorization under Section 564(c) of the Act, because: A. SARS-CoV-2 can cause a serious or life-threatening disease or condition, including severe respiratory illness, to humans infected by this virus; B. Based on the totality of scientific evidence available to FDA, it is reasonable to believe that Pfizer-BioNTech COVID‑19 Vaccine may be effective in preventing COVID-19, and that, when used under the conditions described in this authorization, the known and potential benefits of Pfizer-BioNTech COVID‑19 Vaccine when used to prevent COVID-19 outweigh its known and potential risks; and C. There is no adequate, approved, and available alternative to the emergency use of Pfizer-BioNTech COVID‑19 Vaccine to prevent COVID-19.

    Source :

    Based on this, I trust you will modify your article to reflect the truth of what has actually been released.

    1. Not happening, biggest donors to the museum are these very same vaccine worshipers!

    2. Here is the Press Release from the FDA, as posted on their website.

      It took about 12 seconds to find it

      Of course it is possible that the FDA did not approve the vaccine and they are just saying that they did to support a Museum in Beit Shemesh

    3. elie,

      Read this to see why you're dead wrong.

    4. Elie - at the same exact link you provided, just 1 paragraph earlier than where you began citing, you will see that the relevant vaccine has received an approval for age 16+. The paragraphs you are citing are referring to other categories.
      This does seem like a deliberate misrepresentation in your part, as you cite multiple paragraphs making it like you read the entire letter. Still, we can give you some benefit of the doubt that you missed that paragraph.
      Based on this, I trust you will modify your comment to reflect the truth of what has actually been released.

    5. Marvin,
      You've done us a service by introducing the readers of this blog to Orac. But why bother? I don't need Orac's expertise here- I can read the FDA's press release myself. I can also read Jpost, CNN. NPR and the others. Elie read the same material and decided:
      1) The FDA did not "upgrade" the EUA to approval. This is untrue. Approval for 16+, EUA continues for 12-16s & vulnerable.
      2) The mainstream media failed to report this. This is untrue. CNN, NPR & the JPost all reported that the EUA remains in effect for 12-16s.

      If the deniers can't comprehend a JPost article (I doubt they're purposely lying- and if they were lying, I doubt they be brazen liars!), why they comprehend Orac?_

    6. "This does seem like a deliberate misrepresentation in your part"

      I doubt it. He didn't understand what he read.

    7. elie - Antivaxers like you are really a serious example of "The blind leading the blind."

      Someone who completely misunderstood and misrepresented the FDA press release and then shared their ignorance with you. You were duped by it because you have similar levels of ignorance, cannot discern what you are reading, and simply accept the explanation of an ignorant fool.

      Either that or you shared your own original thoughts here (which I doubt because I've seen this confusion spread elsewhere), and thus you are demonstrating your ignorance of FDA regulatory matters.

      The vaccine was approved for ages 16 and up. That was the first indication Pfizer filed a BLA for. (Also was the first indication to receive EUA, originally).
      For ages 12-15, it remains under EUA, so those people do not lose access because of this approval.

      FDA had previously stated there will be some mixture and residual EUA status to keep access for different populations. So not a surprise at all.

      A BLA is always for a specific patient population, ie "indication." It is not blanket approval for a drug/vaccine for all uses and people. If approved, it gets a label for specific indication.

      In the future, Pfizer will file an sBLA for the age 12-15 population.
      They will also apply for EUA for under 12's first, and only later apply for full approval for under 12's with an sBLA.

      It's really not complicated, but you just don't know what you're talking about.

  12. It's hard to resist the temptation to call the other side morons. Very, very hard! In my heart I confess to nothing but contempt for those individuals I still see voluntarily wearing masks. In my heart, I do think you believers in the so-called "vaccine" are gullible and grossly uninformed at best, and fools at worst. But like Jules (Samuel Jackson) said at the end of Pulp Fiction, "I'm trying, Ringo. I'm trying." In the last post I tried to have a civil discussion with a few interlocutors. אולי יש תקוה. I am sure I will fail in this resolution a dozen times between now and RH, and will thus be as big a hypocrite as our professor Slifkin here, only at least I'll be self aware enough to recognize it. But I'm trying, Ringo, I'm trying.

    1. What does this mean:

      "I still see voluntarily wearing masks"

      Given that masks save lives, I am surprised that anyone who values human life is not wearing a mask while near other people in an indoor setting.

      Some people are not wearing masks because they don't understand basic science, others feel that the minimal discomfort of a paper is more important than the life of at risk people around them.

      Which category are you? (or do you wear a mask)

    2. It's frustrating for us, too, to see the shtus being repeated over and over again -- all of the provably false claims that, even when refuted, you continue to make, about COVID, the vaccine, its side-effects, etc.

      In a way, your comments give me chizuk that the data-driven approach to COVID is the right one -- in the sense that, since you are only able to support your proposed approach with blatant falsehoods, no reasonable person would take it seriously.

    3. IS it a coincidence that the same people who fight vaccines are also against mask wearing?
      Is there anything that those people think they can do to prevent disease? Or is all medical advice immediately suspect?
      But suspect is the wrong word. If masks were merely suspect, they wouldn't provoke that reaction. It seems that if medical advice is A, the only option is A-, the precise opposite.

      As a wise wag once said, if we got the government to pass a law making it illegal to jump off a cliff, we would have a neat line of 'non-conformist' libertarians ready to jump off.

  13. Rabbi Slifkin, this is where you and others forget two important things. 1. Public Health experts (like myself, with 20 years of university training in medicine, public health science, AND behavioural science) actually do study and are expert in social psychology - particularly as it relates to vaccine hesitancy. 2. How uniquely unusual Haredi Jews, and right wing Americans are in terms of conspiracy and anti-vax beliefs. They are outliers in every way. While there are crazy people in other OECD countries, they truly are on the margins. In Canada, I have yet to personally know a single anti-vaxx conspiratorial thinker who is not a Haredi Jew or an American. They are out there - for certain - but they are ashamed and in the shadows. Bottom line: the full FDA approval will actually move a LARGE number to the vaccine camp. In Canada, that means another 10% - a tall order, and hugely impactful. The US? The global public health community just looks on them with pity.

  14. "How uniquely unusual Haredi Jews, and right wing Americans are in terms of conspiracy and anti-vax beliefs."

    pre or post-covid? e.g. Bobby Kennedy Jr. is no right-winger. There are plenty of alternative medicine wackos on the left.

    In the covid era, covid denialism preceded anti-covid-vax. And why was covid denialism to a great degree an American phenomenon? Trump & the Trump deranged left. He correctly saw the pandemic as a threat to the economy and thus his re-election. So he did what he could to make the pandemic go away. That included the successful vaccine drive, but also questionable policies. So the left took advantage of the crisis and poisoned the scientific debate (to the extent that it was actually scientifically debatable,) with politics. They then revealed their own crass expediency when they poo-poohed covid in their support of mass BLM protests. That of course evoked a response from the right & otherwise sane right-wingers went psychotic. (And yes, supporting BLM protests was also psychotic.)

    You don't have those factors elsewhere- an election in a split country- and left-wing hypocrites. Sober minds should see above such partisan bickering & concentrate on the science. But that requires sobriety. I'm not sure the left would have done better if they had been in power. (Think the Corbyn brothers)

    I'm not sure how widespread conspiracy thinking exists in the Charedi world beyond the US. I'm not even sure it made inroads in Satmar, where they didn't need conspiracy as an excuse for their recklessness. Xenophobia, rather than paranoia might be at play there. There is no authority but the rebbe- no respect is due to scientific authority- after all, no respect was due to Rav Henkin or Rav Moshe Feinstein.
    In Israel you had reckless non-compliance among Charedim (but it was not universal.) And yet, when it came to vaccinations the Charedim were more or less on board.
    So I'm not sure (non-American) Charedim are particularly conspiratorial in their thinking here.


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