I'm reposting some of my thoughts below to try and genuinely see is someone has an answer to the question:
From a utilitarian perspective, why weren't these all approved for the elderly in Q2 2020?<p>In other words, its May 2020 and you have the option to ban vaccines or allow vaccines for the elderly, what do you pick?<p>We know the following about vaccines generally:
-Vaccines have an extremely high success rate, 33% of vaccines make it through all trials to approval. 50% after phase 1 is complete.
-The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS, or Pandemrix, where 1 in 18400 got narcolepsy. (1)(2)
-Vaccine candidates have 85% chance of making it from phase III to approved (phase III is supposed to be the efficacy check), in other words we expect about a 15% chance that the vaccine is not effective, most of the tests are about safety.<p>We know the following about COVID:
-Unknown long term side effects, reasonably likely to be worse than the worst vaccines ever, but unknown.
-The IFR for those over 75 is about 4.6% now(1). Earlier in the pandemic it was about 11.6%(2).
-If you assume that people have a 10% chance of contracting the disease, you can say that those over 75 would have approximately a 0.46% chance of dying (4.6 in 1,000 dead) if they don't get the vaccine. This seems to be a conservative estimate.<p>So if you have to decide whether to ban a vaccine or not in May 2020, and you assume with 100% confidence that this vaccine was tied for the "worst side effects ever", for example it turns out to be as bad as Pandemrix, then you would expect 1 in 18400 to get something like narcolepsy if you give them the vaccine.<p>Using the IFR and 10% number above, you assume that not giving the vaccine would leave 84.64 dead for the same population. (85x by volume).<p>I don't know your opinion of "how much worse is death versus narcolepsy?". If you believe death is 10x worse than narcolepsy, then by severity and volume, taking a vaccine with the worst side effects ever would seem about 850x better than not taking it (in elderly populations). Earlier in the pandemic, when IFRs were over 2x as bad, this was well over 1,000x better.<p>I mean, the numbers so dramatically favor vaccination that I don't get it at all. Why is this not approved already? Why does it take the FDA 3 weeks to even discuss the matter of approval when this made sense to approve in May? Why did all governments opt to ban the vaccines versus allow them?<p>Sources:
(1) <a href="https://en.wikipedia.org/wiki/Pandemrix" rel="nofollow">https://en.wikipedia.org/wiki/Pandemrix</a>
(2) <a href="https://www.cdc.gov/vaccinesafety/concerns/concerns-history.html" rel="nofollow">https://www.cdc.gov/vaccinesafety/concerns/concerns-history....</a>
(3) <a href="https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v7" rel="nofollow">https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v...</a>
(4) <a href="https://www.nature.com/articles/d41586-020-02483-2" rel="nofollow">https://www.nature.com/articles/d41586-020-02483-2</a>