Thread by @ewanbirney

I've recently navigated some COVID19 vaccine conversations with friends and friends of friends and wanted to give my take on why I - and you - should be confident to take them. Structured here as a Q&A:

(Context: I am a human genetics/computational biology expert; I know virus experts and clinical trials experts but I am not one myself; I am a trial participant on one COVID vaccine trial, the Oxford / AZ one).

Is the vaccine really safe? Surely if it has been done so quickly they've cut some corners?

They really are safe. Basically no corners were cut, but things were overlapped in terms of getting the next phase studies up and running so that if the phase before said yes, the very next day the next phase could kick in.

Normally there is at least 6 months (can be longer) between phases, with lots of money raising in particular for vaccines as they are not such a money spinner for companies (sadly); COVID19 broke all the money raising rules (everything was pre-funded as well)

How safe is safe? How can you be sure?

As one of the Phase II/III trials people I am one person who took a bit more risk on safety to ensure really high levels of safety. The vaccine will have been injected into >20,000 (often more) people in trials and followed up over >6 months before it passes safety

One aspect of vaccine trials is that you need large numbers in each trial to work out if it works at protecting against disease because infection is pretty rare (just really bad when you get it). But everyone on the trial helps understand safety.

Is it *completely* safe?

No, but it is very safe; nothing in life and medicine can be completely safe, but of the things you do, this is safe. You will most likely do many riskier things each day than take this vaccine

Aren't the companies going to make a lot of money? Isn't there a massive incentive to pretend that these work better than they do?

The whole clinical trial thing is set up to prevent the fundamentals of cheating; in particular the randomisation in the trial of who got the vaccine or who got the "sham" treatment (placebo) is only know to a tiny set of people, not allowed by involved in anyway with the company

Given how well the vaccines work (ie, the numbers who got disease on the sham treatment to the vaccine treatment) its basically impossible for people to fake this result.

I don't like the idea of injecting something to help me; is it not better to get it "naturally"?

Basically no. When you get it naturally there is a chance of this runaway bad immune reaction in your body, leading to the disease of COVID19. In someways it is not the virus which is the disease, it is our bodies' response to the virus.

The vaccines are harmless, but educate your immune system both that this is a bad thing (so it reacts more promptly) but also probably not to overreact.

We don't really know all the details - the human immune system is fearsome complex - but we do know the vaccines prevent the disease

I really don't like needles. Is there another way to get the vaccine?

I'm afraid not. I don't like needles either - I have to look away too!

I don't like going to hospitals on principle.

Fair enough, but most likely you will get vaccinated somewhere else anyway.

If I am young, healthy - do I *need* to get the vaccine?

In most places you most likely wont be forced, but it is likely that by getting the vaccine you will prevent the virus from using you to spread. So - even if you wouldn't get ill (and you might. There is a horrible other disease called LongCOVID from this) you'd still be helping