Pfizer vaccine approved

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wheelnut
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Re: Pfizer vaccine approved

Post by wheelnut »

irie wrote: Sat Sep 04, 2021 9:43 pm No, as said above, it appears that the net medical benefit to the patient is marginal. That is to say, difficult to assess as being medically either advantageous or disadvantageous.
I think you’ve answered your own question there. If the medical benefits of giving a drug to a patient can’t be quantified then it shouldn’t be given.
it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable.
And that has to be totally irrelevant to the medic giving the jab. They have to believe that’s it’s of a medical benefit to that patient.

The government may decide that it’s the way forward. My point is that if they do then it will go against established medical ethics.
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Re: Pfizer vaccine approved

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Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.
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Re: Pfizer vaccine approved

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Mussels wrote: Sat Sep 04, 2021 10:46 pm Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.
It’s not blinkered at all. You cannot give one person a drug that may cause more harm than benefit to that patient for the benefit of someone else.

It’s nothing to do with being sued, it’s a case of following their own code of conduct.
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Re: Pfizer vaccine approved

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Mussels wrote: Sat Sep 04, 2021 10:46 pm Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.
Doctors are charged with the sole consideration being that of the patient.

Others must consider wider implications.
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Re: Pfizer vaccine approved

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irie wrote: Sat Sep 04, 2021 11:15 pm
Mussels wrote: Sat Sep 04, 2021 10:46 pm Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.
Doctors are charged with the sole consideration being that of the patient.

Others must consider wider implications.
I don't think that's true otherwise they wouldn't be able to refuse abortions.
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Re: Pfizer vaccine approved

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Mussels wrote: Sat Sep 04, 2021 11:42 pm I don't think that's true otherwise they wouldn't be able to refuse abortions.
You’re going to have to explain that one a bit further. Plus I’m not sure doctors do refuse abortions (where it’s legal).

What we’re talking about is using kids as a means to protect adults.
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Re: Pfizer vaccine approved

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wheelnut wrote: Sun Sep 05, 2021 7:40 am
Mussels wrote: Sat Sep 04, 2021 11:42 pm I don't think that's true otherwise they wouldn't be able to refuse abortions.
You’re going to have to explain that one a bit further. Plus I’m not sure doctors do refuse abortions (where it’s legal).

What we’re talking about is using kids as a means to protect adults.
Doctors are allowed conscientious objection to ignore the best interests of their patient (the mother) and preserve the life of another (the foetus). They don't need to justify their actions to ignore the patient.
It's the other way round but shows that the rule is not black & white.
They could also decide it is in a child's best interest that its guardians don't catch covid, if they wanted children to have the vaccine they could have justified it.
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Re: Pfizer vaccine approved

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Mussels wrote: Sun Sep 05, 2021 7:50 am Doctors are allowed conscientious objection to ignore the best interests of their patient (the mother) and preserve the life of another (the foetus). They don't need to justify their actions to ignore the patient.
It's the other way round but shows that the rule is not black & white.
You’re talking about a different thing. Yes a doctor can decline to treat a patient where they disagree with a procedure on moral grounds, effectively referring that patient to another doctor.

That is different from giving an individual patient a treatment that could cause a net harm
They could also decide it is in a child's best interest that its guardians don't catch covid, if they wanted children to have the vaccine they could have justified it.
That’s the crux, we can’t use kids as a means to protect adults. That’s where it goes against current medical ethics.
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Re: Pfizer vaccine approved

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The doctors didn't say vaccines caused net harm, they said the benefit was marginal.
I'd say on an individual level the benefit of the MMR vaccine is marginal, if a child doesn't have it they are still unlikely to suffer from the illnesses it protects against. That's because most others have had it.
I guess the question with the covid vaccine is whether it prevents anyone catching or spreading it, if all it does is reduce symptoms then I agree with the doctors but I don't know if there's enough evidence to support that.
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Re: Pfizer vaccine approved

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Mussels wrote: Sun Sep 05, 2021 8:11 am The doctors didn't say vaccines caused net harm, they said the benefit was marginal.
I'd say on an individual level the benefit of the MMR vaccine is marginal, if a child doesn't have it they are still unlikely to suffer from the illnesses it protects against. That's because most others have had it.
I guess the question with the covid vaccine is whether it prevents anyone catching or spreading it, if all it does is reduce symptoms then I agree with the doctors but I don't know if there's enough evidence to support that.
They say;
As evidence shows that COVID-19 rarely causes severe disease in children without underlying health conditions, at this time the JCVI’s view is that the minimal health benefits of offering universal COVID-19 vaccination to children do not outweigh the potential risks.
https://www.gov.uk/government/news/jcvi ... ung-people

It does seem to help stop transmission, but not anywhere near as much as was hoped.

I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?
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Re: Pfizer vaccine approved

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My guess is that by/during winter the goalposts will have been moved by a double whammy of Covid and 'flu.
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Re: Pfizer vaccine approved

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wheelnut wrote: Sun Sep 05, 2021 8:35 am
I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?
Governments (and advising scientists) will take more into account than the SAGE review did. They may consider longer term factors of disrupted education for example. eg obesity and wealth are linked, education and subsequent wealth are linked. Reducing disruption to education has many potential benefits for children that look beyond the '60 children per million may suffer side effects' analysis.

Economically, reducing disruption to education reduces disruption to the labour force and enables some families to keep earning which again can impact beneficially on a child's well-being.

It's not an a+b=c problem, which may explain why several major governments have gone ahead with vaccination.
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Re: Pfizer vaccine approved

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Count Steer wrote: Sun Sep 05, 2021 9:45 am
wheelnut wrote: Sun Sep 05, 2021 8:35 am
I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?
Governments (and advising scientists) will take more into account than the SAGE review did. They may consider longer term factors of disrupted education for example. eg obesity and wealth are linked, education and subsequent wealth are linked. Reducing disruption to education has many potential benefits for children that look beyond the '60 children per million may suffer side effects' analysis.

Economically, reducing disruption to education reduces disruption to the labour force and enables some families to keep earning which again can impact beneficially on a child's well-being.

It's not an a+b=c problem, which may explain why several major governments have gone ahead with vaccination.
All valid concerns, but not relevant to a doctor who is making a decision to give a treatment to a patient where the approving body have decided that the risks outweigh the benefits.

For other countries , I think, but could be wrong, that they have approved the use saying that the medical benefits outweigh the risks.
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Re: Pfizer vaccine approved

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wheelnut wrote: Sun Sep 05, 2021 10:32 am
For other countries , I think, but could be wrong, that they have approved the use saying that the medical benefits outweigh the risks.
As CS says, that probably depends upon how narrowly/widely "medical benefits" are considered.
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Re: Pfizer vaccine approved

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wheelnut wrote: Sun Sep 05, 2021 10:32 am
All valid concerns, but not relevant to a doctor who is making a decision to give a treatment to a patient where the approving body have decided that the risks outweigh the benefits.
The remits of JVCI and SAGE are not all encompassing and do not consider all risks and benefits. Only the ones within their allocated scope.
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Re: Pfizer vaccine approved

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As evidence shows that COVID-19 rarely causes severe disease in children without underlying health conditions, at this time the JCVI’s view is that the minimal health benefits of offering universal COVID-19 vaccination to children do not outweigh the potential risks.

I'd want to know if they mean -

Potential risks to the child from the vaccine

or

Potential risks to the child from the virus


If it's the first I would understand not doing it.

If it's the second, well, surely that's like the MMR. You probably won't have an issue and if you don't get it you probably won't get the virus BUT the more kids that have the vaccine then the fewer people will get the virus

(I think I've written that how I mean it!!)
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Re: Pfizer vaccine approved

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Noggin wrote: Sun Sep 05, 2021 12:09 pm
As evidence shows that COVID-19 rarely causes severe disease in children without underlying health conditions, at this time the JCVI’s view is that the minimal health benefits of offering universal COVID-19 vaccination to children do not outweigh the potential risks.

I'd want to know if they mean -

Potential risks to the child from the vaccine

or

Potential risks to the child from the virus


If it's the first I would understand not doing it.

If it's the second, well, surely that's like the MMR. You probably won't have an issue and if you don't get it you probably won't get the virus BUT the more kids that have the vaccine then the fewer people will get the virus

(I think I've written that how I mean it!!)
It's the first. The JCVI have come to the conclusion that the potential harm from the vaccine side effects outweigh the potential adverse effects of the virus in kids. Therefore, under the ethics principle that you cannot give drugs to one person for the benefit of another, it's going to be difficult for a medic to administer it to a (healthy) kid.
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Re: Pfizer vaccine approved

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irie wrote: Sun Sep 05, 2021 10:45 am As CS says, that probably depends upon how narrowly/widely "medical benefits" are considered.
Count Steer wrote: Sun Sep 05, 2021 11:51 am The remits of JVCI and SAGE are not all encompassing and do not consider all risks and benefits. Only the ones within their allocated scope.
The remit is the medical risks/benefits involved in giving a vaccine to a particular group. And when it comes to administering or not administering a drug that's a wide enough scope. You cannot give a drug to an indivudual that has been determined may cause a net harm in order to solve some of the side effects of a pandemic. It's basic, simple principle of medicine that the government are obviously struggling to get around.
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Re: Pfizer vaccine approved

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wheelnut wrote: Wed Sep 08, 2021 2:30 pm
irie wrote: Sun Sep 05, 2021 10:45 am As CS says, that probably depends upon how narrowly/widely "medical benefits" are considered.
Count Steer wrote: Sun Sep 05, 2021 11:51 am The remits of JVCI and SAGE are not all encompassing and do not consider all risks and benefits. Only the ones within their allocated scope.
The remit is the medical risks/benefits involved in giving a vaccine to a particular group. And when it comes to administering or not administering a drug that's a wide enough scope. You cannot give a drug to an indivudual that has been determined may cause a net harm in order to solve some of the side effects of a pandemic. It's basic, simple principle of medicine that the government are obviously struggling to get around.
Because the above defines neither the exact scope of what is meant by "medical risks/benefits", nor exactly what is meant by "a particular group", it is generalised to the point of being meaningless. Which of course is what it is meant to be.
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Re: Pfizer vaccine approved

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irie wrote: Thu Sep 09, 2021 5:09 pm
wheelnut wrote: Wed Sep 08, 2021 2:30 pm
irie wrote: Sun Sep 05, 2021 10:45 am As CS says, that probably depends upon how narrowly/widely "medical benefits" are considered.
Count Steer wrote: Sun Sep 05, 2021 11:51 am The remits of JVCI and SAGE are not all encompassing and do not consider all risks and benefits. Only the ones within their allocated scope.
The remit is the medical risks/benefits involved in giving a vaccine to a particular group. And when it comes to administering or not administering a drug that's a wide enough scope. You cannot give a drug to an indivudual that has been determined may cause a net harm in order to solve some of the side effects of a pandemic. It's basic, simple principle of medicine that the government are obviously struggling to get around.
Because the above defines neither the exact scope of what is meant by "medical risks/benefits", nor exactly what is meant by "a particular group", it is generalised to the point of being meaningless. Which of course is what it is meant to be.
Also, "The committee* instead suggested ministers ask the four chief medical officers of the UK to examine wider factors such as the potential impact of disruption to schools".

I assume that the MHRA have approved vaccine for 12 to 15 year olds otherwise the JVCI would have had nothing to consider.

*JVCI (who said they could not recommend it based on purely clinical considerations ie they just ducked).
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