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The French On The Risks Of Vaccination

Covid 19

The Precautionary Principle can be taken too far. This being a common complaint about modern politics and politics and regulation as done by the European Union. Here we’ve a French application of the same mistake:

Earlier on Monday, Beaune, a close ally of the French president Emmanuel Macron, also defended the EU’s record, adding that the UK’s apparent success had “nothing to do with Brexit”. He claimed the UK strategy had involved risks that France’s public would have found intolerable.

He said: “The British are in an extremely difficult health situation. They are taking many risks in this vaccination campaign. And I can understand it, but they are taking many risks.”

In his critique of the British rollout, Beaune cited the UK’s decision to extend the gap between the initial and booster jabs to up to 12 weeks, twice the maximum gap recommended by the World Health Organization, and its dependence on the Oxford/AstraZeneca vaccine.

He said: “They have spaced – and the scientists have told us not to – they have massively spaced the two injections apart … They mainly depend on one vaccine, AstraZeneca. The European authority will tell us tomorrow, but Germany has already told us about doubts regarding the effectiveness in people above 65.

“The UK has used the vaccine in this age group. So I understand that if they are in a difficult health situation, they take additional risks, but I do not think our citizens would accept if we took all those risks despite the recommendations of our scientists.”

Adults would understand that the correct risk calculation is not to compare the use of the vaccine – even which vaccine – against the perfect use of the vaccine. But to compare the varied possible, given real world constraints, uses or not uses of the vaccine/s.

Yes, obviously, if we had the full two doses of the perfect vaccine then the correct action is to give everyone their two doses, three weeks apart, as fast as arms can be lined up.

But that’s not actually the world we’re in. We’re in one where none of the vaccines are perfect. Further, we’ve supply constraints upon the vaccines. So, we now want to discuss how do we best reduce the death toll from infections, the wider costs from lockdowns, given that constraint we’ve got with the vaccine availability?

Answer – get as much protection as we can from our limited supplies of vaccine. Single injections to more people by delaying the second dose. Using whatever vaccines come to hand – at least those that have a reasonable if not perfect effect.

To argue the opposite, that we should spend that limited supply on double doses over 3 weeks is to be making the perfect the enemy of the good. Or, another description of the same thing, to be taking the Precautionary Principle too far.

Yes, clearly, it would be better if we could but insisting upon it given real world constraints is to lose lives through the delay. Which is, of course, the general problem with a rigid insistence upon the Precautionary Principle. It all sounds great, don;t do anything until we know that it’s safe. But that’s not reality, nothing is ever safe, just some things are safer.

Or, in one of those central economic lessons, there are no solutions, only trade offs.

It may even be that French public opinion insists upon being on the wrong side of this divide. That they disregard their countryman’s – Bastiat – insistence to look at the hidden. But if that is the cause here then we’re well out of political union with them, aren’t we? For who would want to be tied to the decision making process of people who are wrong?

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The Mole
The Mole
7 months ago

There is also the fact that they seem to be mixing up lack of evidence with evidence of lacking. My understand is that there is simply insufficient test data to show how effective the AstraZenica vaccine is in over 65s because they didn’t have sufficient over 65s in the tests. There is no evidence that it will suddenly stop working in everybody who is 66 and above, but experience has shown as people get older the effectiveness of most (all?) vaccines decrease, so it might only be 60% effective rather than 90%. It isn’t really a question of risk, I… Read more »

HJ777
HJ777
7 months ago

In fact, second doses were given only three weeks after the first in trials for a specific reason – trial results were, understandably, wanted as quickly as possible and three weeks was the minimum period considered likely to produce an enhanced vaccination effect. However, there are many two-dose existing vaccines for other diseases available and with those it is normal to delay the second dose for three months or more because this has been found to produce an even better long term vaccination result. So it is entirely possible that delaying the second dose will improve results further (albeit at… Read more »

John B
John B
7 months ago
Reply to  HJ777

‘ So it is entirely possible that delaying the second dose…’

And entirely possible it won’t. Which is why we have the scientific process to provide empirical evidence instead of guesswork.

And because some médicaments work with a particular dose regime, it may not be assumed all will be effective with the same regime. Plenty of deaths are caused by people who ignore stated dose.

HJ777
HJ777
7 months ago
Reply to  John B

But this possibility (and it is no more than a possibility) needs to be balanced against the fact that if you give the second dose much sooner, many people will not receive the first dose until much later.

The government has a 4-man panel of experts on vaccines advising it and they were unanimous in their view that more lives would be saved by prioritising giving the first doses to as many people as possible as quickly as possible.

Bloke in North Dorset
Bloke in North Dorset
7 months ago
Reply to  HJ777

Yes, and the priority is protecting the health care system and reducing deaths not getting the best outcome for the individual.

With that priority in mind with 1m doses its better to give 1m single doses at 60% efficacy that 500k doses at 90% or even 95% efficacy.

All else being equal.

Nigel Sedgwick
7 months ago
Reply to  John B

@John B, with whom I often agree.

The issue here is possibility versus probability. I’m sure you can appreciate that difference.

Then we get to: sum over circumstances(probability times cost or benefit). I suspect you’re good on that too; however, confirmation would be appreciated.

Keep safe and best regards

Balam
Balam
7 months ago

I think this is THE main difference between left and right: the left they act as if things were the way they should be, and the right make to do with what there is.

Principles vs compromise (seen from the left), idealists vs pragmatists (seen from the right).

John B
John B
7 months ago

Well the French have changed the dose regime from 3 weeks to 5 weeks, so clearly it’s a moveable feast, which is ‘risky’. None observation of the dose regime used in Human Clinical trials and recommended by the manufacturer means nobody has a clue about ‘effective’ – it’s just wishing. Sterile water will likely work as well if we wish it so. The purpose of vaccination is prevention of spread of a disease, dangerous for the whole population, not as a treatment for a small, vulnerable cohort that has about 12 months left on their life-clock. Vaccinating the dying is… Read more »

john77
john77
7 months ago
Reply to  John B

The vast majority of the elderly being prioritised have a lot more than 12 months left on their life clock. Looking at a slightly out-of-date actuarial tables (current ones would show a more favourable picture) an 80-year-old woman has a better-than-evens chance of living for *ten* years, an 80-year-old man has a better-than-evens chance of living for seven years and a 31% chance of living for ten years. It is arguable that the decision to lock down cost more than it gained, depending on what value you put on children’s education versus elderly human lives, but debates based on facts… Read more »

Smithy
Smithy
7 months ago

On Spectator TV Professor David Salisbury, interviewed by Andrew Neil, said that the longer gap between the first and second dose would improve efficacy.

Nigel Sedgwick
7 months ago

Well, for HJ777 (with whom I also often agree) as well; John B too – and others interested: We are also getting to the issue of acknowledged ignorance. Please also take than as lack of information; and also (acknowledged) lack of precision in the information we do have. All of these things can be coped with better than most people do: that is by a combination of seat of the pants approximation of the PDFs (probability density functions) that are viewed as important. But what we cannot deal with is the discontinuities in any of the distributions and functions, probability… Read more »

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