Also interesting that there can be a giant asshole running a federal agency into the ground and I've never heard of him until now. Gives some scale to the problem. I also wonder what else is going on in government that falls below the widely reportable threshold.
I can definitely imagine it. It becomes so much easier to not worry about it when you have a comfortable pillow made out of lots and lots of money to rest your head on.
1. That's not what ad hominem means. You can legitimately criticize people for their actions. All I see here are people saying his actions are wrong and incongruous with fact-based science.
2. There's nothing whatsoever wrong about asking questions. It becomes wrong when refusing to listen to the answers and dismissing all the ones you don't like because you don't like the person saying them. Ironically, that's ad hominem.
I think there are two parts of this issue. One is does the vaccine work. The other is should the govt prevent people from having it.
Scepticism is healthy, and I don't begrudge you your scepticism. The scientific consensus can be wrong, especially for issues like this where debates get heated.
But I think that's an argument for 'let people do what they want' rather than 'prevent them from doing what mainstream science seems to think is the best action'.
Vaccine skepticism is on the same level as flat earthism. This is not an insult to your person, but this is the reality of the science. Trading a 0.1 micromort risk once for a 1000 micromort risk over your lifetime is a crazy good deal. Put another way: that's trading ~6 minutes for ~24 days of life. You do that for every vaccine. Some vaccines have worse trades depending on your situation, and some are far better trades.
Note the LOG scale! You can switch to a linear scale, but then you can't even see there are multiple vaccine adverse risk data points, as they all collapse to one dot compared the the huge risks of the diseases they prevent.
>Trading a 0.1 micromort risk once for a 1000 micromort risk
I think like with that person that found their cancer to have some dna from an mrna vaccine in it the issue is when the prominent messaging is that there is no 0.1 micromort risk. There is no risk whatsoever and everyone who says so is a looney.
Immediately you'll have thousands who say i told you so and harden their conviction.
The COVID19 vaccines were the most-discussed vaccines ever. And there was an enormous amount of coverage for the potential side effects. Recommendations were adjusted based on new data.
There was also bad communication on the topic, often when politicians got involved or due to outdated information continued to be repeated. But there certainly was a lot of public discussion about the risks of the vaccines, they were simply vastly outnumbered by the benefits of the vaccines.
It didn't help that the AstraZeneca vaccine was fairly bad all things considered. At roughly 3 micromort according to the latest data it's quite a lot of risk for a modern vaccine actually. Now, compared to getting Covid it's still better. Even for a 10 year old the covid risk is ~20 micromort and we don't recommend vaccines for that group. Which seems a bit bonkers when you consider that trading 20 for 3 is clearly a good choice, it's just that anti-vaccine loonies make politicians scared out of their minds, so they will rather have lots of kids dying than a few kids dying from vaccines.
I suspect the issue is in part also just selfishness.
That 20 is in large part the kid that was brought into the hospital too late if at all. The kid that might have had astma or what have you.
The 3 is potentially yours or one in your family or friend group or community. It is a government mandated death and you might already distrust the gov.
A tragic event vs an authoritarian death inflicted upon you from that perspective.
My grandma is a scientist presumably very familiar with all this stuff but when her partner (not my grandpa) died from a bloodcloth shortly after getting an vaccine she also veered into that territory.
> It is a government mandated death and you might already distrust the gov.
Well.. no. It was a government RECOMMENDED death at the most.
In fact, it's even more stupid. Sweden for example were so deadly afraid of anti-vaxxers that they threw away tens of thousands of doses of AstraZenecas vaccine. The one with 2 deaths per million. At the time it was estimated at 5 per million. Sweden has a population of 10 million. So if we instantly vaccinated the entire population we would see 2 deaths. While this decision to throw away doses was done we lost tens per day. And the government didn't allow those who understood math to take this if they wanted. No. They mandated the deaths. THOSE deaths WERE mandated. For real.
> There is no risk whatsoever and everyone who says so is a looney.
No. Lying about the risks is what got us in this mess. There IS a risk. It's just crazy low. https://boxed.github.io/micromort/?q=vaccine&scale=log These are the real risks. Yellow Fever vaccine is the worst with ~7 micromort risk. That's roughly your baseline risk just by living for 7 hours. It's not a lot, but saying it's zero is false, and lying about shit is how you radicalize people.
Note that Prasad didn't reject their application: he prevented Moderna from even applying. Prasad overrode a phalanx of FDA career scientists who had studied and approved Moderna's study approach and were ready to review it. He did so suddenly and without warning: the FDA up to that point had not raised any concerns about Moderna's trial protocol. He didn't cite any safety or efficacy issues.
This wasn't the only time he stepped in and overrode experts with seemingly no justification. Just the most prominent example.
He's the opposite of data driven. Moderna did in fact include several studies together encompassing over 40 thousand patients over a diverse demographic group. In fact, they designed the study program only after the approval of the FDA was already given for it. It's a perfectly normal drug trial. This guy wanted his name in headlines and so he decided to just go ahead with 'vaccine bad' against the will of literally every expert the FDA employs to make these recommendations.
This guy got fired for a good reason - he's an idiot.
Ah, you're one of those - any disagreement and all you can do is complain about the other person's emotional state. Did you think you were saying something to add value, here? Did you think this was a cutting, insightful comment?
Come on, make your buddies proud, "umadbro" me, next.
Is it reasonable to describe this as a “difference of opinion between scientists”? Per the OP article:
* it was a Trump political appointee who had made a “shocking” decision to not even review the vaccine
* it was despite the objections of the subject matter experts and career scientists
* it was despite the submitted study results being exactly what the FDA had previously approved
* the vote to go the opposite direction of him was unanimous
I mean sure, you could find an odd scientist who doesn't believe in something that 99.999% of scientists agree on, appoint them as the political head of an agency to overrule the 99.999% of scientists, and call that a “difference of opinion between scientists”, but…
You identify the potential bias of only one side here. The revolving door between regulators and industry introduces potential biases of others in the opposite direction.
If Prasad approved of the trial design and later decided it was insufficient then I would see things differently.
I imagine at some point, after earnestly trying to help the American people with real science, these people get tired of working thankless jobs where they're up against monstrous bureaucracy and just want to do something that benefits themselves and their families. Sadly, and in part because our society rarely rewards beneficial work the way it does exploitation, these people find the path of least resistance to be this kind of journey.
We take comfort in fantasizing about a black and white world and condemn others without trying to understand what drove them to act this way. If, perhaps, we could understand the underlying causes we could remove them and prevent as much evil from arising in the future. But we first have to admit that cause and effect is real and applies to human behavior.
Cause? We don't care. Effect? We all are sicker and closer to the grave because these ghouls are preying on us. We don't care about the justifications for murdering the collective for personal gain, its just treason to humanity plain and simple.
I 100% agree that this is terrible, they're doing it for personal gain, and its treason against humanity. All I'm saying is there are underlying causes that drive people to do these things. If we can understand them maybe we can change those causes so it doesn't happen again in the future. I think any sensible person would agree that a future with less of these kinds of experiences is better for everyone.
Is this the one that's a flu/Covid combo? I live in Europe and have been looking forward to it - especially since the flu part covers way more variants than traditionally - no longer a need to depend on flawed predictions as to what variants will be predominant. Also no longer a need for two sore arms.
Interesting. I wonder if the variant limits us now capped by how much you can pack in the vaccine, or how good a on the body does priming for a bunch of stuff at once.
In the US, until very recently, there were four variants in the vaccine: two Influenza A and two Influenza B. But one of the B variants seems to have gone extinct during the COVID pandemic, and now the vaccine is just two A and one B.
So in at least two fields in which the US still leads (biomedical research, AI), government action is actively harming their ability to compete because of ideological or political reasons.
> While unanimous support from the advisors is a positive sign for the vaccine’s fate, the FDA ultimately decides whether to grant approval. The agency has set a deadline for a decision by August 5.
They'll just ban it again. Science got a temporary victory but I predict it won't matter.
The Covid vaccines have saved an estimated 14 million to 20 million lives.[1]
The trust was not eroded by scientists, it was eroded by politicians pushing lies. I'm still to this day hearing lies & misinformation repeated about the vaccines.
The subversion of scientific expertise to replace it with podcasters and political sycophants is one of the biggest disasters of the current years.
The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).
I don’t know. Seems like the Orban government was funneling an awful lot of money to CPAC. You know, one of Putin’s closest allies. Not sure it’s genuinely home grown.
The amount of "foreign" money in US politics is absolutely dwarfed by the amount of "local business" money. The US government is being dismantled by its corporations, many of which are home grown.
Certainly both are happening, to one degree or another. Hostile influence campaigns are having some effect but I would give homegrown the most credit. Given the general bumbling of the Putin/Orban governments of the world I doubt they are overly competent in this one area. Most of the physical sabotage operations that have been uncovered in Europe weren't very sophisticated; even if they are still dangerous.
Americans are incredibly pissed about all sorts of things, both valid and absurd, and have a long track record of picking bad options as a fix.
And, following the similar pattern of “accusation in a mirror”, is the exact same thing they accused scientists of doing during the previous administration.
Which (conveniently) both justifies aggressively “fighting back” against the fictitious conspiracy and waters down any criticism as a “both sides” partisanship thing that can be cynically dismissed as business as usual in DC instead of a seismic shift in federal scientific policy to conform to arbitrary political mandates.
> The subversion of scientific expertise to replace it with podcasters and political sycophants
> The very concept of merit has been destroyed ...
It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.
I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.
Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.
These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])
There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.
How is discussion on HN different from the leadership levels at FDA?
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
That is a good question, and I'm sure many of the people at UCSF are asking similar questions. However, his sort of misconduct is not the type that would usually violate tenure protections. Beyond the minor CV fibbing, without some evidence that he actually, say, solicited a bribe from Moderna, it's unlikely that he can face any sort of official sanction.
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
For normal research universities, like UCSF, the titles of Professor and Associate Professors have tenure. Assistant Professors are tenure-track, meaning that they have the chance to get tenure. Prasad has the title of Professor.
One can make the argument that Prasad has his title of Professor due to the stature he gained with his ill-founded contrarianism and subsequent notoriety. He was promoted in 2022 at the somewhat astonishing age of 39, at a time when his actual scientific output was not particularly high
The whole thing is kind of fascinating. Some of his "skeptic" fellow travelers like Cifu and Mandrola still carry water for him. Presumably he has a champion in Bob Wachter who also likes to fly the "contrarian" flag.
COVID really brought out a lot of crazies from UCSF and Stanford
One way they should balance in a functioning society is that while tenure would protect you from negative repercussions within the walls of an academic institution, a Congress with any semblance of seriousness and care toward the American people would ensure you never set foot inside a policy-making institution.
> he is so sloppy with major decisions of life and death
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
Far more significantly, the FDA regulates what is allowed to be marketed as treatment at all, an influence that extends heavily into what types of validation studies are performed, etc.
Such decisions, what treatments are available, are far more widespread and momentous than any individual decision between a doctor and a single patient, because they affect all conversations between doctors and patients.
> It sounds like you’re taking an expansive view of this government agency’s mandate
It sounds like you don't know what the FDA does in practice. It is not my supposed "view" it is the basic factual reality of the FDA for decades and decades. (And if you are asking for my view, I believe it has the appropriate level of control of the industry, having developed products directly under their regulation. My personal experience with the FDA, and the experience of all the people I know in similar situations, has been with a very astute and scientifically meritous institution, that worked hard to make sure that products see fair and rapid evaluation. At least, up until what I have seen under Vinay Prasad.)
The FDA regulates which drugs make it to market which is itself an extremely powerful force (excessively so) on conversations between you and your doctor.
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
> Decisions with enormous health implications, enormous financial implications, are made at FDA.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
> Mention you work on drug development for big pharma to the random person and they think you're evil
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
Prasad, to the extent he had a reputation before, was for critiquing the scientific practice as inadequate, which would hope that he'd bring the idea of rigor to his stint at the FDA. Instead, we see quite the opposite:
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
Nah, by 2021 Prasad's reputation had gone into the shitter
I actually think he's just grifting and the notoriety he achieved went to his head. His pre-2020 takes were better reasoned and at least worth engaging with. I could see his takes shifting with popular misinformation ideas in real time as it contributed to his success
IMO this is worse than if he were just wrong. I think he knows better, but then he talked himself into a box, and doesn't have the people and political skills to survive on a bigger stage.
Imagine being able to shut down discussion at the FDA because a few anonymous randos pushed a "flag" button when they saw something they disagreed with.
They were actually clear about this, it's only your feelings that don't matter, not feelings in general.
In their minds there are two classes of people, and all of politics and law is about establishing the hierarchy. For the in group, the law is meant to protect and not bind, and the out group for which the law exists to bind but not protect.
It's clear in the language about "criminals" too. Actual convictions and clear corruption in the in group politicians? That's A-OK. An immigrant that is showing up for an official hearing? Time to be whisked away and treated with cruel and unusual punishment, whether or not their bureaucratic forms were filled out perfectly. (In particular I'm thinking of the immigration raid where South Korean professionals were helping to set up a battery factory and treated with chains as if they were violent criminals)
At HN, most people are here to learn, here to understand more.
There's a substantial "learn and understand" cohort, but there are other factions. At the start of the pandemic, there were 2 posters explicitly here to proselytize Trump style conservatism. I'm reasonably certain there was an anti-vaxx voting ring 2020-22, and I suspect there's remnant Elon fanboy and MAGA coordinated voting.
So you don’t agree with their point and saw fit to draw out a response that fingerpoints at the the side that’s over the intolerance of the non-scientifically bound members of society? Great high horse fam.
One thing that's particularly frustrating about all this is that any conversation with the growing contingency of distrustful people has been made very difficult by what I would call poor, avoidable, and illiberal decisions made by the federal government during COVID. (TBF, decisions during a crisis are always hard.)
Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.
Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")
In the age of social media, I think the study of public health needs to consider more seriously the effects of viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.
Having lived through it myself, I found the government’s actions extremely mild when compared to something like what ICE has been up to. Zero people were directly killed by authorities because of Covid noncompliance.
From my perspective, it’s hysteria borne out of the difference in requirements for urban health policy vs. rural health policy, and the fact that rural people quite often travel through urban areas (e.g. airports).
Talk to anyone from Wyoming and ask what Covid was like during the worst days, and then talk to an ER doctor who worked in New York City.
Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.
Were there a few scandals? For sure, I will not deny that. But I have the distinct urge to invent time travel for the hemmers, hawers, and devil’s advocates and transport them to New York Presbyterian in April of 2020.
Edit: I also have to credit rightwing media, of course, for capitalizing on the opportunity to manufacture a wedge issue that every American had an armchair opinion of. Chicken and egg, of course, but media ghouls will be media ghouls.
> Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.
Doesn't that cut both ways, though? Controls needed to keep densely populated areas safe aren't always necessary in low density areas like Wyoming. Yet some of those controls affected the livelihood of many people in areas of the country that are often poorer than those in dense urban areas.
And, yes, if a rural person is traveling to an urban area, they would have to abide by the same rules. Same as an urban person traveling to a rural area should be able to relax some of the restrictions they had to deal with. But it was mostly all or nothing, helping the divide grow even larger.
> And, yes, if a rural person is traveling to an urban area, they would have to abide by the same rules. Same as an urban person traveling to a rural area should be able to relax some of the restrictions they had to deal with.
Isn’t this precisely what organically happened? Again, there were no federal agents armed with guns and pepper spray roaming the nation, enforcing Covid compliance. Rural bars, restaurants, stores pretty much all remained open the whole pandemic minus the couple of weeks where we weren’t sure if it was thousands or millions of people who would die.
People were “forced” to wear masks, which again, in practice, meant that once you got a certain number of miles away from an urban center there was no enforcement.
Plenty of Americans never got vaccinated. Their travel was restricted. Fair trade off all things considered. Urban people shouldn’t be forced to eat (i.e. live) where rural people shit (i.e. gallivant around as a disease vector).
> Yet some of those controls affected the livelihood of many people in areas of the country that are often poorer than those in dense urban areas.
This is very bad faith. The rural poor were completely unaffected by Covid measures. I traveled to Kentucky throughout Covid for hiking and pretty much never saw a mask. The rural poor also were unaffected by travel restrictions because the rural poor do not travel.
I swear the only acceptable policy for some people would have been no policy at all. Any active policy would have eroded “trust in institutions”.
I was more middle of the road. I live in a rural red red state. Then during COVID people would yell at my dying of cancer mother on chemo for wearing a mask while grocery shopping. Eventually the stores had to set special hours so people like her could shop without harassment. My politics have been greatly impacted. I was shown there is no compassionate conservative, that is just cover for 'fuck everyone who is not me and my in group'. Or if there are compassionate conservatives, they don't care to step in an impose compassion, so they might as well not exist. My mom died afraid to go shopping in her own community because she would be verbally abused. My politics are never going back.
Zero patrons inside the stores cared/did anything. A business structuring things to prevent a scene is not compassion in my mind, just like pride awareness by businesses wasn't actual pride awareness.
Deciding whether someone's helpful actions or lack thereof is good or bad based on your perception of their internal mental state seems pretty fraught. How do you know why the business implemented this? How do you know what the other patrons felt about it? Do you regularly pick fights with psychopaths in public?
If a woman is being harassed, especially an old one, yes, I have always stepped in. That used to be a part of me I thought was conservative. But it doesn't appear to actually be a trait they hold.
I'm not litigating my mothers treatment here. I am expressing the damage done.
I am so sorry that happened to you and your mom. We've become so tribal there's very little space for compassion for the vulnerable as we are positioned to fight tooth and nail.
I lived in Manhattan in April 2020 and specifically know doctors who worked in the ER at Mt. Sinai. I think the vaccine mandates, to the limited extent there were any, were not paternalistic in a way that was unreasonable.
I would not say shutting down all discussion about a topic (lab origin) that ends up getting vindicated is a minor scandal. It's something everyone observed that erodes trust at a national level.
> I would not say shutting down all discussion about a topic (lab origin) that ends up getting vindicated is a minor scandal.
“Shutting down all discussion” - lol. I mean this is grossly hyperbolic. Were social media companies coordinating with the government to slow disinformation? Yes. Was it applied too broadly? Maybe. But describing it as “shutting down all discussion” is a disservice to people who don’t know as much as you and I do.
And yes, in the grand scheme of things, it is a minor scandal. Have you watched the news recently? Save your energy for issues that matter.
Harris lost by a couple percentage points in few key states. Perhaps the news you are talking about wouldn't be happening if trust in institutions hadn't fallen so low.
I don't think whataboutism is helpful here. I think the FDA was broadly well-intentioned, and this administration is not. But this article isn't about ICE.
You're right, this article is about the Trump administration going out of their way to pick political appointees who go out of their way to make us sicker in such a despicable way that even they cannot justify it.
It's wild to me that we keep talking about Biden/Kamala as if they are the ones responsible for the lost in trust in institutions when we have a Republican party and Fox news that blast that the government can do nothing right for the last 3 decades of my life.
Sure, the Democrats can do a LOT better for the common folk, but it's so misplacing the blame as to be mind boggling.
What I often hear is that it's not useful to blame conservatives, but conservatives can live 90% of their political lives by blaming others, shifting the blame even for things they actively choose to do on their own.
People reject science because of misinformation spread by conservatives?! Oh that's the scientists fault for not doing a better job of countering the conservatives!
"Lab leak" may or may not be true, but it's (a) going to be extremely hard to find evidence for given time and China, and (b) .. ultimately irrelevant? Are there people who think "COVID was a bioweapon and therefore we shouldn't mask up and get vaccinated"?
There are many people who say they view any sort of paternalistic behavior with suspicion. But one obvious example of paternalistic behavior would be banning vaccines that people want to receive based on vague concerns of unproven harm. An even better example might be creating a site called realfood.gov, instructing the American people that only some kinds of food are "real" and you should ideally only eat "real" food.
So if someone says they oppose paternalism in public health and yet supports the Trump administration's public health efforts, I'm not sure how to avoid the conclusion that they're lying.
They’re pushing back against the parent comment’s suggestion that it’s a reaction to government “paternalism” in general and much closer to just “paternalism I don’t agree with”.
It seems reasonable to me too. It's good and proper for the government to tell people that certain foods are better than others, even when the bad foods are popular. Eating a pile of candy every day isn't a personal lifestyle choice we're required to respect and encourage; it's bad for people who do it and bad for society to have lots of people doing it.
What I don't see is how anyone could argue this isn't paternalism.
That might be true for some of them, but unfortunately I know a few anti vaxxers who also happen to be atheists. They just believe all the various conspiracy theories about vaccines.
If you were able to trace some of these conspiracy theories to their source, you'd find some of these religious folks behind them. Any category of person could potentially fall for them, including atheists.
Both VRBPAC and CDC's ACIP did remarkably good work during the pandemic under enormous pressure - what specific complaints do you have? They got safe and effective vaccines out there fast, did a really reasonable job of balancing the cost benefit w.r.t. side effects of both j&j's and the somewhat elevated myo/pericarditis risk from moderna's vaccine in young men, etc.
Be specific?
(I have complaints - I thought Dr. Meissner was wrongheaded about opposing allowing EUA to extend to pediatric populations. But the committee as a whole functioned well and balanced the urgency of the situation with the need for voluminous data.)
(i must preface that this block was 100% trying to extract payment, like it was documented some coubtries did even during covid, but)
even the lead researcher of mrna vaccines before covid said she would not consider mrna vaccines safes outside of the covid emergency. and this study focus on effectiveness, not side effects.
so while turning away from science for politics is as bad as pushing it irresponsible for commercialization.
Is this good because flu vaccines are an educated guess as to what will be circulating because it takes so long to culture them all and this will shorten the manufacturing time so the educated guess can take place later in the process (and be more accurate)?
I thought mRNA vaccine was approved by FDA as an emergency measure for Covid. Doesn't it usually take around 10 years of assessment long term effects to approve a vaccine for general use? Especially for a new family of vaccines like mRNA?
> Prasad was also behind the rejection of a closely watched gene therapy for Huntington’s disease made by UniQure
This guy is a disaster. But really it's not just him. It's the entire organizational structure that puts him, or any other one person, in the position that they have the power to do this. There is simply no one qualified.
We need to have expert scientists to set up trials and review the design of the trials and conduct the analysis of the data. This is something that is generally objective and not able to be done without skills and experience. But then you have to make a decision based on those results. And the decision is some sort of risk reward trade off. While science can quantify what that tradeoff is, which path to take is fundamentally outside of the scope of science.
Trade offs are not objective determinations at all because they are based on subjective preferences. And therefore it makes no sense to force it into a one size fits all approval or denial by some centralized body. The only rational approach to such a trade off is to allow each individual to choose for themselves. The only person's opinion on whether the risk justifies the reward for the experimental Huntington's disease treatment is the patient's. The best we can do with science is to use it for its intended purpose to produce good data for him to make his choice.
So we need CDC approval for the vaccine to be provided to everyone at no cost. But it sounds like if only the FDA approves, the vaccine will be available to anyone willing to pay. Is that correct?
“it’s been 5 years since i’ve taken up smoking and i didn’t die yet, therefore cigarettes are perfectly safe and anyone who disagrees with me doesn’t understand science” - average educated internet science expert
Something I have never understood about the "big pharma makes fake/unnecessary/harmful vaccines" narrative is how folks who believe in it (including those in this comment section) understand these companies' incentives.
In the United States, pharma companies make money when insurance companies (and the government, but less so than in many other nations) buy their product to give to patients. In practice, very few people are paying for vaccines out of pocket.
Insurance companies in particular hate, hate, hate giving anybody money for any reason. They will not pay for something unless you beat them over the head with how well it works. And if they don't believe you, they'll do their own analyses. Better to blow a few million on a study than spend a few billion on unnecessary treatments. (This is the same reason that there's a car-insurance funded highway safety institute crash-testing cars.)
And yet, every year, they insist on making the flu and COVID vaccines free and pushing it on as many people as possible! I guarantee you if you call your insurance company and ask if they think you should get a flu or COVID vaccine, or any vaccine, really, they'll say, yes please.
Why would they do that if these vaccines were going to cost them money by a) being useless or b) being harmful? There is simply no incentive!
The reason everybody wants you to get the damn shot is that the shots work, and the downside risks of them are smaller and cheaper than the downside risks of the things they prevent. Capitalism would make it very difficult to repeatedly sell vaccines that don't work, or hurt you; you might get away with it once, but after that, the reward's just not there.
I don't know how one responds to that, if one distrusts vaccines, other than to suggest a much larger and more complex evil conspiracy than is plausible to most people.
Flu vaccines aren't immunizing vaccines. They protect against specific strains, and half the time they immunize against a strain that doesn't become widespread and do very little or nothing to protect you. They have side effects which vary widely in severity depending on the specific vaccine.
This article has no data about why mRNA flu vaccines will improve these outcomes, and has no data about the risk/benefit ratio or how it was calculated. It doesn't even cite the "studies" it mentions. It's a remarkably bad article written for low information readers by a low information author.
Not everyone is duplicitous, and it’s not surprising that the experts on a technology work at a company that creates the technology. I assume you’d think the study was valid if the Moderna staff were testing a Pfizer vaccine?
He does have a point though, would you trust a study on how there is no long term side effects from smoking published by scientists that works for a tobacco company?
I agree that not everyone is duplicitous, but how would you know which one is and which one isn’t?
After the lies and misinformation we now know we were fed during the COVID era, you would have to be insane to blindly trust this group again, especially the hacker news astroturf squad that's downvoting my comments. Hard data studies only from independent researchers, preferably double blind placebo controlled, and sterilizing vaccines only, not these leaky "get your booster this week before it mutates again" treatments.
Are you remotely qualified to understand said data? Or do you, as you did below, just want an easy opportunity to swipe at things you know you lack expertise to understand?
If Prasad thought this needed more research then it needed more research. He and the people he works with have written dozens, maybe hundreds now, of reports that expose studies that lack the rigor for definitive results, have misleading endpoints, have imbalanced arms etc. I get that anything that would slow vaccines down has somehow become political and lots of people would gladly accept the pharmaceutical companies word on things. This is a blindness due to political leanings and not evidence based. If Prasad says it needs more and better data I'd put money on it needing it.
How much death and suffering does this guy have on his conscience?
I’m so curious how someone goes from being a professor to a science denier? I simply can’t imagine that journey.
Also interesting that there can be a giant asshole running a federal agency into the ground and I've never heard of him until now. Gives some scale to the problem. I also wonder what else is going on in government that falls below the widely reportable threshold.
It's like saying that one of the seagulls at the beach is particularly noisy.
How much death and suffering does this guy have on his conscience?
His what now?
Results are fuzzy. He has a nice Malibu compound to go to after this lived experience
The suffering is the point.
I can definitely imagine it. It becomes so much easier to not worry about it when you have a comfortable pillow made out of lots and lots of money to rest your head on.
Death and suffering are “natural.”
These people are all delusional ideologues. If reality does not match the ideology, reality must be wrong.
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1. That's not what ad hominem means. You can legitimately criticize people for their actions. All I see here are people saying his actions are wrong and incongruous with fact-based science.
2. There's nothing whatsoever wrong about asking questions. It becomes wrong when refusing to listen to the answers and dismissing all the ones you don't like because you don't like the person saying them. Ironically, that's ad hominem.
I think there are two parts of this issue. One is does the vaccine work. The other is should the govt prevent people from having it.
Scepticism is healthy, and I don't begrudge you your scepticism. The scientific consensus can be wrong, especially for issues like this where debates get heated.
But I think that's an argument for 'let people do what they want' rather than 'prevent them from doing what mainstream science seems to think is the best action'.
Vaccine skepticism is on the same level as flat earthism. This is not an insult to your person, but this is the reality of the science. Trading a 0.1 micromort risk once for a 1000 micromort risk over your lifetime is a crazy good deal. Put another way: that's trading ~6 minutes for ~24 days of life. You do that for every vaccine. Some vaccines have worse trades depending on your situation, and some are far better trades.
Look at these stats: https://boxed.github.io/micromort/?q=vaccine&scale=log&sel=v...
Note the LOG scale! You can switch to a linear scale, but then you can't even see there are multiple vaccine adverse risk data points, as they all collapse to one dot compared the the huge risks of the diseases they prevent.
> Vaccine skepticism is on the same level as flat earthism
Their bio: "Christian // Father // Husband // Veteran"
>Trading a 0.1 micromort risk once for a 1000 micromort risk
I think like with that person that found their cancer to have some dna from an mrna vaccine in it the issue is when the prominent messaging is that there is no 0.1 micromort risk. There is no risk whatsoever and everyone who says so is a looney. Immediately you'll have thousands who say i told you so and harden their conviction.
The COVID19 vaccines were the most-discussed vaccines ever. And there was an enormous amount of coverage for the potential side effects. Recommendations were adjusted based on new data.
There was also bad communication on the topic, often when politicians got involved or due to outdated information continued to be repeated. But there certainly was a lot of public discussion about the risks of the vaccines, they were simply vastly outnumbered by the benefits of the vaccines.
It didn't help that the AstraZeneca vaccine was fairly bad all things considered. At roughly 3 micromort according to the latest data it's quite a lot of risk for a modern vaccine actually. Now, compared to getting Covid it's still better. Even for a 10 year old the covid risk is ~20 micromort and we don't recommend vaccines for that group. Which seems a bit bonkers when you consider that trading 20 for 3 is clearly a good choice, it's just that anti-vaccine loonies make politicians scared out of their minds, so they will rather have lots of kids dying than a few kids dying from vaccines.
I suspect the issue is in part also just selfishness.
That 20 is in large part the kid that was brought into the hospital too late if at all. The kid that might have had astma or what have you.
The 3 is potentially yours or one in your family or friend group or community. It is a government mandated death and you might already distrust the gov.
A tragic event vs an authoritarian death inflicted upon you from that perspective.
My grandma is a scientist presumably very familiar with all this stuff but when her partner (not my grandpa) died from a bloodcloth shortly after getting an vaccine she also veered into that territory.
> It is a government mandated death and you might already distrust the gov.
Well.. no. It was a government RECOMMENDED death at the most.
In fact, it's even more stupid. Sweden for example were so deadly afraid of anti-vaxxers that they threw away tens of thousands of doses of AstraZenecas vaccine. The one with 2 deaths per million. At the time it was estimated at 5 per million. Sweden has a population of 10 million. So if we instantly vaccinated the entire population we would see 2 deaths. While this decision to throw away doses was done we lost tens per day. And the government didn't allow those who understood math to take this if they wanted. No. They mandated the deaths. THOSE deaths WERE mandated. For real.
> There is no risk whatsoever and everyone who says so is a looney.
No. Lying about the risks is what got us in this mess. There IS a risk. It's just crazy low. https://boxed.github.io/micromort/?q=vaccine&scale=log These are the real risks. Yellow Fever vaccine is the worst with ~7 micromort risk. That's roughly your baseline risk just by living for 7 hours. It's not a lot, but saying it's zero is false, and lying about shit is how you radicalize people.
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Note that Prasad didn't reject their application: he prevented Moderna from even applying. Prasad overrode a phalanx of FDA career scientists who had studied and approved Moderna's study approach and were ready to review it. He did so suddenly and without warning: the FDA up to that point had not raised any concerns about Moderna's trial protocol. He didn't cite any safety or efficacy issues.
This wasn't the only time he stepped in and overrode experts with seemingly no justification. Just the most prominent example.
I think it's good he's gone.
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> Don't create accounts routinely. HN is a community—users should have an identity that others can relate to.
https://news.ycombinator.com/newsguidelines.html
Is there a similar story behind that huntingtons therapy?
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He's the opposite of data driven. Moderna did in fact include several studies together encompassing over 40 thousand patients over a diverse demographic group. In fact, they designed the study program only after the approval of the FDA was already given for it. It's a perfectly normal drug trial. This guy wanted his name in headlines and so he decided to just go ahead with 'vaccine bad' against the will of literally every expert the FDA employs to make these recommendations.
This guy got fired for a good reason - he's an idiot.
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The toxicity leveled when there is a difference of opinion between scientists is astounding.
This is not a "difference of opinion" and framing it as such is intentionally and egregiously dishonest.
More histrionics.
Ah, you're one of those - any disagreement and all you can do is complain about the other person's emotional state. Did you think you were saying something to add value, here? Did you think this was a cutting, insightful comment?
Come on, make your buddies proud, "umadbro" me, next.
Is it reasonable to describe this as a “difference of opinion between scientists”? Per the OP article:
* it was a Trump political appointee who had made a “shocking” decision to not even review the vaccine
* it was despite the objections of the subject matter experts and career scientists
* it was despite the submitted study results being exactly what the FDA had previously approved
* the vote to go the opposite direction of him was unanimous
I mean sure, you could find an odd scientist who doesn't believe in something that 99.999% of scientists agree on, appoint them as the political head of an agency to overrule the 99.999% of scientists, and call that a “difference of opinion between scientists”, but…
You identify the potential bias of only one side here. The revolving door between regulators and industry introduces potential biases of others in the opposite direction.
If Prasad approved of the trial design and later decided it was insufficient then I would see things differently.
I imagine at some point, after earnestly trying to help the American people with real science, these people get tired of working thankless jobs where they're up against monstrous bureaucracy and just want to do something that benefits themselves and their families. Sadly, and in part because our society rarely rewards beneficial work the way it does exploitation, these people find the path of least resistance to be this kind of journey.
Or perhaps he never did give a fuck?
We take comfort in fantasizing about a black and white world and condemn others without trying to understand what drove them to act this way. If, perhaps, we could understand the underlying causes we could remove them and prevent as much evil from arising in the future. But we first have to admit that cause and effect is real and applies to human behavior.
Cause? We don't care. Effect? We all are sicker and closer to the grave because these ghouls are preying on us. We don't care about the justifications for murdering the collective for personal gain, its just treason to humanity plain and simple.
I 100% agree that this is terrible, they're doing it for personal gain, and its treason against humanity. All I'm saying is there are underlying causes that drive people to do these things. If we can understand them maybe we can change those causes so it doesn't happen again in the future. I think any sensible person would agree that a future with less of these kinds of experiences is better for everyone.
Dude just stop.
This seems a lot more plausible to me
Is this the one that's a flu/Covid combo? I live in Europe and have been looking forward to it - especially since the flu part covers way more variants than traditionally - no longer a need to depend on flawed predictions as to what variants will be predominant. Also no longer a need for two sore arms.
No, this one is just flu.
Interesting. I wonder if the variant limits us now capped by how much you can pack in the vaccine, or how good a on the body does priming for a bunch of stuff at once.
In the US, until very recently, there were four variants in the vaccine: two Influenza A and two Influenza B. But one of the B variants seems to have gone extinct during the COVID pandemic, and now the vaccine is just two A and one B.
So in at least two fields in which the US still leads (biomedical research, AI), government action is actively harming their ability to compete because of ideological or political reasons.
They seem to be doing some interesting things to their reputation as military superpower peace keeper too.
Sounds like at least one step toward putting science back in charge.
> While unanimous support from the advisors is a positive sign for the vaccine’s fate, the FDA ultimately decides whether to grant approval. The agency has set a deadline for a decision by August 5.
They'll just ban it again. Science got a temporary victory but I predict it won't matter.
It won't. Many people here in the US don't believe in science any more and they definitely think mRNA technology is some kind of conspiracy.
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Pushing those vaccines saved hundreds of thousands of lives.
The Covid vaccines have saved an estimated 14 million to 20 million lives.[1]
The trust was not eroded by scientists, it was eroded by politicians pushing lies. I'm still to this day hearing lies & misinformation repeated about the vaccines.
[1]: https://en.wikipedia.org/wiki/COVID-19_vaccine
The subversion of scientific expertise to replace it with podcasters and political sycophants is one of the biggest disasters of the current years.
The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).
It is not a disaster. It is a part of carefully orchestrated attack on Western democracies by enemy states.
This stupidity is home-grown. Blaming "enemy states" is deflection - the quicker we understand that the quicker we can get to fixing this mess.
I don’t know. Seems like the Orban government was funneling an awful lot of money to CPAC. You know, one of Putin’s closest allies. Not sure it’s genuinely home grown.
The amount of "foreign" money in US politics is absolutely dwarfed by the amount of "local business" money. The US government is being dismantled by its corporations, many of which are home grown.
Certainly both are happening, to one degree or another. Hostile influence campaigns are having some effect but I would give homegrown the most credit. Given the general bumbling of the Putin/Orban governments of the world I doubt they are overly competent in this one area. Most of the physical sabotage operations that have been uncovered in Europe weren't very sophisticated; even if they are still dangerous.
Americans are incredibly pissed about all sorts of things, both valid and absurd, and have a long track record of picking bad options as a fix.
it's not enemy states, it's a reactionary attack from within.
Really reminds me of the Russia leadership portrayals in Chernobyl.
It's basically Lysenkoism
And, following the similar pattern of “accusation in a mirror”, is the exact same thing they accused scientists of doing during the previous administration.
https://en.wikipedia.org/wiki/Accusation_in_a_mirror?wprov=s...
Which (conveniently) both justifies aggressively “fighting back” against the fictitious conspiracy and waters down any criticism as a “both sides” partisanship thing that can be cynically dismissed as business as usual in DC instead of a seismic shift in federal scientific policy to conform to arbitrary political mandates.
That’s exactly what it is.
> The subversion of scientific expertise to replace it with podcasters and political sycophants
> The very concept of merit has been destroyed ...
It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.
I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.
Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.
These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])
There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.
How is discussion on HN different from the leadership levels at FDA?
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
> Vinay Prasad is a fraud
What’s with him being allowed to continue to practice at the University of California [1]?
[1] https://vinayakkprasad.com/
That is a good question, and I'm sure many of the people at UCSF are asking similar questions. However, his sort of misconduct is not the type that would usually violate tenure protections. Beyond the minor CV fibbing, without some evidence that he actually, say, solicited a bribe from Moderna, it's unlikely that he can face any sort of official sanction.
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
> not the type that would usually violate tenure
How can one tell whether he has tenure?
For normal research universities, like UCSF, the titles of Professor and Associate Professors have tenure. Assistant Professors are tenure-track, meaning that they have the chance to get tenure. Prasad has the title of Professor.
One can make the argument that Prasad has his title of Professor due to the stature he gained with his ill-founded contrarianism and subsequent notoriety. He was promoted in 2022 at the somewhat astonishing age of 39, at a time when his actual scientific output was not particularly high
The whole thing is kind of fascinating. Some of his "skeptic" fellow travelers like Cifu and Mandrola still carry water for him. Presumably he has a champion in Bob Wachter who also likes to fly the "contrarian" flag.
COVID really brought out a lot of crazies from UCSF and Stanford
I really wonder what's up with that. Also remember the crazy Stanford guys.. did something flip in their brain or were they just always like that?
Would you say Prasad’s public-health misconduct rises to the level where creating a statutory change to what permits firing under tenure makes sense?
I would say that the US has had enough destruction of institutions and few enough institutional protections of individuals.
I can dislike someone’s stance while at the same time recognizing that others benefit from the same protections.
If protections are reduced, the process will be weaponized.
> If protections are reduced, the process will be weaponized
This is a valid concern. So is moral hazard from a lack of accountability. I’m trying to figure out how those balance.
One way they should balance in a functioning society is that while tenure would protect you from negative repercussions within the walls of an academic institution, a Congress with any semblance of seriousness and care toward the American people would ensure you never set foot inside a policy-making institution.
> he is so sloppy with major decisions of life and death
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
Far more significantly, the FDA regulates what is allowed to be marketed as treatment at all, an influence that extends heavily into what types of validation studies are performed, etc.
Such decisions, what treatments are available, are far more widespread and momentous than any individual decision between a doctor and a single patient, because they affect all conversations between doctors and patients.
> It sounds like you’re taking an expansive view of this government agency’s mandate
It sounds like you don't know what the FDA does in practice. It is not my supposed "view" it is the basic factual reality of the FDA for decades and decades. (And if you are asking for my view, I believe it has the appropriate level of control of the industry, having developed products directly under their regulation. My personal experience with the FDA, and the experience of all the people I know in similar situations, has been with a very astute and scientifically meritous institution, that worked hard to make sure that products see fair and rapid evaluation. At least, up until what I have seen under Vinay Prasad.)
The FDA regulates which drugs make it to market which is itself an extremely powerful force (excessively so) on conversations between you and your doctor.
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
> Decisions with enormous health implications, enormous financial implications, are made at FDA.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
> Mention you work on drug development for big pharma to the random person and they think you're evil
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
I’m curious why you claim he’s a fraud, I just learned about him from this thread.
Prasad, to the extent he had a reputation before, was for critiquing the scientific practice as inadequate, which would hope that he'd bring the idea of rigor to his stint at the FDA. Instead, we see quite the opposite:
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Linked in this article is the "truly evil" decision requiring sham brain surgery in the placebo arm for a Huntington Disease trial https://arstechnica.com/health/2026/06/truly-evil-fda-reject...
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
Nah, by 2021 Prasad's reputation had gone into the shitter
I actually think he's just grifting and the notoriety he achieved went to his head. His pre-2020 takes were better reasoned and at least worth engaging with. I could see his takes shifting with popular misinformation ideas in real time as it contributed to his success
IMO this is worse than if he were just wrong. I think he knows better, but then he talked himself into a box, and doesn't have the people and political skills to survive on a bigger stage.
> Lied on his CV about being on a highly prestigious council
You called this “minor CV fibbing” above. If he was lying about this when he applied for tenure, wouldn’t that be Cause?
This is usually modulated by whether the fib is about something "material".
In fact, he probably would have had the same decision with or without the claim which is the essence of "not material".
My own personal take is that the lying is crucial, however.
Totally agree. I’m an outsider—from finance, where I thought the bar was already low. I’m asking if this a material fib or commonplace in medicine.
People making decisions at the FDA should also be actively learning and understanding more all the time.
That should be their primary objective.
Imagine being able to shut down discussion at the FDA because a few anonymous randos pushed a "flag" button when they saw something they disagreed with.
Apparently, the ‘fuck your feelings’ crowd DOES care about some ‘feelings’
They were actually clear about this, it's only your feelings that don't matter, not feelings in general.
In their minds there are two classes of people, and all of politics and law is about establishing the hierarchy. For the in group, the law is meant to protect and not bind, and the out group for which the law exists to bind but not protect.
It's clear in the language about "criminals" too. Actual convictions and clear corruption in the in group politicians? That's A-OK. An immigrant that is showing up for an official hearing? Time to be whisked away and treated with cruel and unusual punishment, whether or not their bureaucratic forms were filled out perfectly. (In particular I'm thinking of the immigration raid where South Korean professionals were helping to set up a battery factory and treated with chains as if they were violent criminals)
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At HN, most people are here to learn, here to understand more.
There's a substantial "learn and understand" cohort, but there are other factions. At the start of the pandemic, there were 2 posters explicitly here to proselytize Trump style conservatism. I'm reasonably certain there was an anti-vaxx voting ring 2020-22, and I suspect there's remnant Elon fanboy and MAGA coordinated voting.
I'd love to be proved wrong on these things.
Oh they are still here, last time I had a good chuckle was the group arguing that The Pope Is A Democrat. "You know your brain is pickled when..."
So you don’t agree with their point and saw fit to draw out a response that fingerpoints at the the side that’s over the intolerance of the non-scientifically bound members of society? Great high horse fam.
One thing that's particularly frustrating about all this is that any conversation with the growing contingency of distrustful people has been made very difficult by what I would call poor, avoidable, and illiberal decisions made by the federal government during COVID. (TBF, decisions during a crisis are always hard.)
Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.
Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")
In the age of social media, I think the study of public health needs to consider more seriously the effects of viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.
Having lived through it myself, I found the government’s actions extremely mild when compared to something like what ICE has been up to. Zero people were directly killed by authorities because of Covid noncompliance.
From my perspective, it’s hysteria borne out of the difference in requirements for urban health policy vs. rural health policy, and the fact that rural people quite often travel through urban areas (e.g. airports).
Talk to anyone from Wyoming and ask what Covid was like during the worst days, and then talk to an ER doctor who worked in New York City.
Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.
Were there a few scandals? For sure, I will not deny that. But I have the distinct urge to invent time travel for the hemmers, hawers, and devil’s advocates and transport them to New York Presbyterian in April of 2020.
Edit: I also have to credit rightwing media, of course, for capitalizing on the opportunity to manufacture a wedge issue that every American had an armchair opinion of. Chicken and egg, of course, but media ghouls will be media ghouls.
> Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.
Doesn't that cut both ways, though? Controls needed to keep densely populated areas safe aren't always necessary in low density areas like Wyoming. Yet some of those controls affected the livelihood of many people in areas of the country that are often poorer than those in dense urban areas.
And, yes, if a rural person is traveling to an urban area, they would have to abide by the same rules. Same as an urban person traveling to a rural area should be able to relax some of the restrictions they had to deal with. But it was mostly all or nothing, helping the divide grow even larger.
> And, yes, if a rural person is traveling to an urban area, they would have to abide by the same rules. Same as an urban person traveling to a rural area should be able to relax some of the restrictions they had to deal with.
Isn’t this precisely what organically happened? Again, there were no federal agents armed with guns and pepper spray roaming the nation, enforcing Covid compliance. Rural bars, restaurants, stores pretty much all remained open the whole pandemic minus the couple of weeks where we weren’t sure if it was thousands or millions of people who would die.
People were “forced” to wear masks, which again, in practice, meant that once you got a certain number of miles away from an urban center there was no enforcement.
Plenty of Americans never got vaccinated. Their travel was restricted. Fair trade off all things considered. Urban people shouldn’t be forced to eat (i.e. live) where rural people shit (i.e. gallivant around as a disease vector).
> Yet some of those controls affected the livelihood of many people in areas of the country that are often poorer than those in dense urban areas.
This is very bad faith. The rural poor were completely unaffected by Covid measures. I traveled to Kentucky throughout Covid for hiking and pretty much never saw a mask. The rural poor also were unaffected by travel restrictions because the rural poor do not travel.
I swear the only acceptable policy for some people would have been no policy at all. Any active policy would have eroded “trust in institutions”.
Dead people don’t buy products either.
I was more middle of the road. I live in a rural red red state. Then during COVID people would yell at my dying of cancer mother on chemo for wearing a mask while grocery shopping. Eventually the stores had to set special hours so people like her could shop without harassment. My politics have been greatly impacted. I was shown there is no compassionate conservative, that is just cover for 'fuck everyone who is not me and my in group'. Or if there are compassionate conservatives, they don't care to step in an impose compassion, so they might as well not exist. My mom died afraid to go shopping in her own community because she would be verbally abused. My politics are never going back.
> they don't care to step in and impose compassion, so they might as well not exist.
Is this not what the store owners did?
Zero patrons inside the stores cared/did anything. A business structuring things to prevent a scene is not compassion in my mind, just like pride awareness by businesses wasn't actual pride awareness.
Deciding whether someone's helpful actions or lack thereof is good or bad based on your perception of their internal mental state seems pretty fraught. How do you know why the business implemented this? How do you know what the other patrons felt about it? Do you regularly pick fights with psychopaths in public?
If a woman is being harassed, especially an old one, yes, I have always stepped in. That used to be a part of me I thought was conservative. But it doesn't appear to actually be a trait they hold.
I'm not litigating my mothers treatment here. I am expressing the damage done.
But, by your definition, the liberal take of government-mandated compassion would also not be compassion.
I am so sorry that happened to you and your mom. We've become so tribal there's very little space for compassion for the vulnerable as we are positioned to fight tooth and nail.
I lived in Manhattan in April 2020 and specifically know doctors who worked in the ER at Mt. Sinai. I think the vaccine mandates, to the limited extent there were any, were not paternalistic in a way that was unreasonable.
I would not say shutting down all discussion about a topic (lab origin) that ends up getting vindicated is a minor scandal. It's something everyone observed that erodes trust at a national level.
> I would not say shutting down all discussion about a topic (lab origin) that ends up getting vindicated is a minor scandal.
“Shutting down all discussion” - lol. I mean this is grossly hyperbolic. Were social media companies coordinating with the government to slow disinformation? Yes. Was it applied too broadly? Maybe. But describing it as “shutting down all discussion” is a disservice to people who don’t know as much as you and I do.
And yes, in the grand scheme of things, it is a minor scandal. Have you watched the news recently? Save your energy for issues that matter.
Harris lost by a couple percentage points in few key states. Perhaps the news you are talking about wouldn't be happening if trust in institutions hadn't fallen so low.
I don't think whataboutism is helpful here. I think the FDA was broadly well-intentioned, and this administration is not. But this article isn't about ICE.
You're right, this article is about the Trump administration going out of their way to pick political appointees who go out of their way to make us sicker in such a despicable way that even they cannot justify it.
It's wild to me that we keep talking about Biden/Kamala as if they are the ones responsible for the lost in trust in institutions when we have a Republican party and Fox news that blast that the government can do nothing right for the last 3 decades of my life.
Sure, the Democrats can do a LOT better for the common folk, but it's so misplacing the blame as to be mind boggling.
All models are wrong but some are useful. Blame is rarely a useful model because solutions require internal locus of control not external
What I often hear is that it's not useful to blame conservatives, but conservatives can live 90% of their political lives by blaming others, shifting the blame even for things they actively choose to do on their own.
People reject science because of misinformation spread by conservatives?! Oh that's the scientists fault for not doing a better job of countering the conservatives!
You see it all over this thread too.
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Lab origin theory was never vindicated. Even if it was should we not study viruses that can affect humans to be able to create vaccines?
"Lab leak" may or may not be true, but it's (a) going to be extremely hard to find evidence for given time and China, and (b) .. ultimately irrelevant? Are there people who think "COVID was a bioweapon and therefore we shouldn't mask up and get vaccinated"?
There are many people who say they view any sort of paternalistic behavior with suspicion. But one obvious example of paternalistic behavior would be banning vaccines that people want to receive based on vague concerns of unproven harm. An even better example might be creating a site called realfood.gov, instructing the American people that only some kinds of food are "real" and you should ideally only eat "real" food.
So if someone says they oppose paternalism in public health and yet supports the Trump administration's public health efforts, I'm not sure how to avoid the conclusion that they're lying.
What’s the problem with realfood.gov? I just read the entire landing page and it seems reasonable to me
They’re pushing back against the parent comment’s suggestion that it’s a reaction to government “paternalism” in general and much closer to just “paternalism I don’t agree with”.
It seems reasonable to me too. It's good and proper for the government to tell people that certain foods are better than others, even when the bad foods are popular. Eating a pile of candy every day isn't a personal lifestyle choice we're required to respect and encourage; it's bad for people who do it and bad for society to have lots of people doing it.
What I don't see is how anyone could argue this isn't paternalism.
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That might be true for some of them, but unfortunately I know a few anti vaxxers who also happen to be atheists. They just believe all the various conspiracy theories about vaccines.
If you were able to trace some of these conspiracy theories to their source, you'd find some of these religious folks behind them. Any category of person could potentially fall for them, including atheists.
“Scientific expertise” was already sold out to politics as we saw during covid. The further degradation to podcast bros is the cherry on top.
Both VRBPAC and CDC's ACIP did remarkably good work during the pandemic under enormous pressure - what specific complaints do you have? They got safe and effective vaccines out there fast, did a really reasonable job of balancing the cost benefit w.r.t. side effects of both j&j's and the somewhat elevated myo/pericarditis risk from moderna's vaccine in young men, etc.
Be specific?
(I have complaints - I thought Dr. Meissner was wrongheaded about opposing allowing EUA to extend to pediatric populations. But the committee as a whole functioned well and balanced the urgency of the situation with the need for voluminous data.)
(i must preface that this block was 100% trying to extract payment, like it was documented some coubtries did even during covid, but)
even the lead researcher of mrna vaccines before covid said she would not consider mrna vaccines safes outside of the covid emergency. and this study focus on effectiveness, not side effects.
so while turning away from science for politics is as bad as pushing it irresponsible for commercialization.
Is this good because flu vaccines are an educated guess as to what will be circulating because it takes so long to culture them all and this will shorten the manufacturing time so the educated guess can take place later in the process (and be more accurate)?
I thought mRNA vaccine was approved by FDA as an emergency measure for Covid. Doesn't it usually take around 10 years of assessment long term effects to approve a vaccine for general use? Especially for a new family of vaccines like mRNA?
> Prasad was also behind the rejection of a closely watched gene therapy for Huntington’s disease made by UniQure
This guy is a disaster. But really it's not just him. It's the entire organizational structure that puts him, or any other one person, in the position that they have the power to do this. There is simply no one qualified.
We need to have expert scientists to set up trials and review the design of the trials and conduct the analysis of the data. This is something that is generally objective and not able to be done without skills and experience. But then you have to make a decision based on those results. And the decision is some sort of risk reward trade off. While science can quantify what that tradeoff is, which path to take is fundamentally outside of the scope of science.
Trade offs are not objective determinations at all because they are based on subjective preferences. And therefore it makes no sense to force it into a one size fits all approval or denial by some centralized body. The only rational approach to such a trade off is to allow each individual to choose for themselves. The only person's opinion on whether the risk justifies the reward for the experimental Huntington's disease treatment is the patient's. The best we can do with science is to use it for its intended purpose to produce good data for him to make his choice.
For context, it’s a seasonal flu vaccine, the title is a bit unclear.
So we need CDC approval for the vaccine to be provided to everyone at no cost. But it sounds like if only the FDA approves, the vaccine will be available to anyone willing to pay. Is that correct?
This would be a much more useful headline if it said "vote to approve Moderna's mRNA flu vaccine".
“it’s been 5 years since i’ve taken up smoking and i didn’t die yet, therefore cigarettes are perfectly safe and anyone who disagrees with me doesn’t understand science” - average educated internet science expert
Something I have never understood about the "big pharma makes fake/unnecessary/harmful vaccines" narrative is how folks who believe in it (including those in this comment section) understand these companies' incentives.
In the United States, pharma companies make money when insurance companies (and the government, but less so than in many other nations) buy their product to give to patients. In practice, very few people are paying for vaccines out of pocket.
Insurance companies in particular hate, hate, hate giving anybody money for any reason. They will not pay for something unless you beat them over the head with how well it works. And if they don't believe you, they'll do their own analyses. Better to blow a few million on a study than spend a few billion on unnecessary treatments. (This is the same reason that there's a car-insurance funded highway safety institute crash-testing cars.)
And yet, every year, they insist on making the flu and COVID vaccines free and pushing it on as many people as possible! I guarantee you if you call your insurance company and ask if they think you should get a flu or COVID vaccine, or any vaccine, really, they'll say, yes please.
Why would they do that if these vaccines were going to cost them money by a) being useless or b) being harmful? There is simply no incentive!
The reason everybody wants you to get the damn shot is that the shots work, and the downside risks of them are smaller and cheaper than the downside risks of the things they prevent. Capitalism would make it very difficult to repeatedly sell vaccines that don't work, or hurt you; you might get away with it once, but after that, the reward's just not there.
I don't know how one responds to that, if one distrusts vaccines, other than to suggest a much larger and more complex evil conspiracy than is plausible to most people.
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Better medicine is better.
Flu vaccines aren't immunizing vaccines. They protect against specific strains, and half the time they immunize against a strain that doesn't become widespread and do very little or nothing to protect you. They have side effects which vary widely in severity depending on the specific vaccine.
This article has no data about why mRNA flu vaccines will improve these outcomes, and has no data about the risk/benefit ratio or how it was calculated. It doesn't even cite the "studies" it mentions. It's a remarkably bad article written for low information readers by a low information author.
Hard pass until I see some hard data.
What do you mean by "immunizing vaccines"?
In the first sentence, you say that flu vaccines are not and in the second you admit they are.
Maybe you meant that their coverage is not comprehensive. If so, that's what you should say.
mRNA flu vaccines have substantial potential advantages in terms of the ability to target a wider spectrum of variants and faster time to manufacture.
> faster time to manufacture.
In other words: improved responsiveness when loading a flu season.
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The word you're looking for is "sterilizing."
Wow... that took me several, uh, seconds to find.
https://www.nejm.org/doi/full/10.1056/NEJMoa2516491
There's your hard data.
Thanks. 10 our of 13 of the researchers work for Moderna or another pharma company. That "study" might as well be a marketing brochure.
Not everyone is duplicitous, and it’s not surprising that the experts on a technology work at a company that creates the technology. I assume you’d think the study was valid if the Moderna staff were testing a Pfizer vaccine?
He does have a point though, would you trust a study on how there is no long term side effects from smoking published by scientists that works for a tobacco company?
I agree that not everyone is duplicitous, but how would you know which one is and which one isn’t?
After the lies and misinformation we now know we were fed during the COVID era, you would have to be insane to blindly trust this group again, especially the hacker news astroturf squad that's downvoting my comments. Hard data studies only from independent researchers, preferably double blind placebo controlled, and sterilizing vaccines only, not these leaky "get your booster this week before it mutates again" treatments.
> Hard pass until I see some hard data.
Are you remotely qualified to understand said data? Or do you, as you did below, just want an easy opportunity to swipe at things you know you lack expertise to understand?
Are you suggesting that a governing body can recommend a medicine to the public without requiring publicly available scientific data first?
I'm suggesting that people like OP who demand "hard data" are frequently the people least equipped to understand it in any way.
Why, on earth, do you think I would be suggesting anything about governing bodies?
More deaths in the new study group for this product. More overall adverse reactions for the new product.
Here's the top-line comparison:
Healthcare encounter:
new: 80 (0.4)
existing: 120 (0.6)
Each group had roughly 20k participants, mostly white.
No actual control group, no independent third party study. Junk.
What is the baseline?
If Prasad thought this needed more research then it needed more research. He and the people he works with have written dozens, maybe hundreds now, of reports that expose studies that lack the rigor for definitive results, have misleading endpoints, have imbalanced arms etc. I get that anything that would slow vaccines down has somehow become political and lots of people would gladly accept the pharmaceutical companies word on things. This is a blindness due to political leanings and not evidence based. If Prasad says it needs more and better data I'd put money on it needing it.
> This is a blindness due to political leanings and not evidence based.
Your comment reeks of that as well.