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I really wish people would stop referring to the pandemic in past tense. It's still ongoing. The only thing that's over is the emergency designation. The vaccine hesitancy and outright disinformation has been going on for more than a decade. Social media doesn't remove the disinformation even when reported over and over again. We aren't going to gain traction wth the anti-vaccine/anti-science people. My degrees are in psychology and these people are essentially in a cult at this point. They do not listen to reason or facts and the cognitive dissonance they experience is so severe that they rationalize away anything you tell them. Not to mention the rampant Dunning-Kruger that's come out of all this.

Because the facts are that according to the review done of autopsy reports by the NIH, done in 2024, there are only 28 confirmed dealths due at least in part to covid vaccine induced myocarditis. All adults. They all died within a week of getting vaccinated. So we now know that people will not die months or years after being vaccinated for Covid. But you can't convince an anti-vaxxer of that. I have tried for years, even before the pandemic. Everyone needs to read Dr. Peter Hotez's book 'The Deadly Rise of Anti-science'.

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founding
Jun 13·edited Jun 13

Too many snowflakes labor under the fantasy that one's life can be lived risk free.

If only that were so.

Truth, knowledge, and wisdom enable us to discern rational choices to mitigate some of those risks - knowing that some threats are beyond our personal or collective control.

As a public health professional and medical doctor, I know that everything Dr. Panthagani presents it true.

I am fully up to date on all my vaccinations, including COVID and had confirmed COVID twice. (As Ms. Leslie observes, SARS-CoV-2 is still with us; only the emergency phase of the pandemic has come to a close - permanently, we hope.)

I know this is anecdotal, but I had zero side effects from the vaccine, but the COVID infections caused a level of inflammatory response in my trachea that I had never experienced before and was truly alarming.

I am grateful for the vaccine and for the Paxlovid I was prescribed. I truly believe I'm still above ground because of them, because if the inflammation in my trachea was an indication of the natural (untreated) course of the disease, I would not be here to tell the tale. Decreasing serious morbidity and mortality with minimal risk were, are, and always will be the primary goal and benefit of public health / preventative countermeasures.

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Where can I see that review of autopsy reports by the NIH done in 2024? How many autopsies did they review? Were those doing the autopsies actually looking for possible vaccine injuries leading to deaths? Thanks for your reply.

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Good analysis thank you.

With vaccine-hesitant patients I acknowledge their concerns about side effects and adverse events, which are rare and real, while then pointing out that whatever possible side effects one might develop from Covid vaccines/boosters, the actual disease will raise that bet 10 fold and more. Covid re-exposure is a certain, so think flu shots.

And when I’m really trying to persuade someone before backing off for a final time, maybe I’ll counter the statistically likely post hoc fallacy they just told me about with any number of stories of my patients who died of Covid, had lung transplants after Covid, had accelerated dementia after Covid, are physically disabled by long covid post exertional malaise and cognitive damage, aka brain damage.

Is that wrong? Are we on the evidence/scientific side above the power of the story? Is it manipulation when it’s built on a foundation of truth and beneficence?

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author

I think this is a great approach. I'm guessing your question is referring to the second to last paragraph emphasizing kindness and empathy over the post-hoc fallacy -- that was referencing a specific situation, where you're talking to a person who is in the midst of grief because their loved one just died shortly after vaccination. I encounter people with these stories frequently online. In this scenario, where the person is mourning the death of a loved one, they are often not in place to hear about the statistics, and I think trying to force these discussions can often do more harm than good. But if the person is not in a state of grief and is open to listening, I think discussing the post hoc fallacy is very helpful.

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Ryan, if you read the details of any drug, they are all just "poisons with positive side effects"--all treatments have a "number needed to harm" baked in. No harm in a detailed explanation and I give you so much credit for your dedication and compassion.

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When I counsel for vaccines (HPV can present the need for the most education and encouragement), the more information I present, the story of HPV, HeLa cells, informed consent, cervical cancer rates, the process for vaccine approval to share new indications (ie head and neck), everything I know about a vaccine and vaccines in general, I achieve very close to a full acceptance rate.

It’s those who refuse counseling. Refuse discussion, that I cannot move. They are “information resistant”. We just need to keep trying, educating, discussing, and agreed, no cover ups, no sweeping under the rug. Face these things head on. That’s how we win the information fight. With MORE information and information that is complete and accurate.

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Information resistant- yes!

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founding

It seems to me that there is a general mistrust of government and authorities in our culture. Vaccination is a victim of it's success. Being old enough to have had measles, mumps, and chicken pox in addition to having classmates crippled by polio makes me a believer. But many have no exposure to the reality of prevented diseases. Other than calmly, consistently, and respectfully explaining why vaccines are important I have no suggestions. If you have further suggestions please share.

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founding

I was in pediatric practice in the early 1960s. I took care of children who died from measles and had post chicken pox ataxia. Also took care of children who had had polio. When "Sabin on Sunday" arrived the lines to get vaccinated were blocks long. I did not know anyone who did not get their children and themselves vaccinated. There was no social media and few or no people talking about side effects. It is sad to see the change from acceptance of medical advice to the disbelief of science currently so pervasive.

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@Dr Kessler: I used the same approach when discussing preventive health care - repetition and expression of concern on each routine visit. That was the approach with smoking cessation counseling. Not so much as nagging as reminding the patient of the importance to do so. As for vaccine hesitancy, I reminded patients about penicillin anaphylaxis as a reality for a very small number of recipients. Death from penicillin (or peanuts in others) happens, but penicillin and its analogs remain in the pharmacopoeia. (And Jif peanut butter remains as popular as ever).

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It is a statistical probability that following vaccination, a recipient won the lottery.

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This article talks about Facebooks posts being "flagged." What does"flagged" mean? Those posts were censored, removed from Facebook? Those posts had something added to the bottom of them by Facebook?

What is "disinformation" is often disputed. Professional "fact checker" organizations have expressed bias in the favor of the institutions funding them. They tend to forget things they said were true when those statements were later found to be false when they made them.

One example is Snopes. Snopes will not allow the Internet Archive- the way back machine - to record web pages of Snopes. That way it's much harder to prove that Snopes made false statements. It's Orwellian.

Public health has lost a lot of public confidence due to government policies regarding COVID shots and other coercive pandemic policies. Data on adverse effects was kept secret until judges forced the government to share it. So that naturally causes suspicion.

Has there been a loss of confidence in public health happening in other nations? I've not read about that. Other advanced nations never recommended COVID shots for children. Other nations raised the age for COVID shots higher than their initial recommendation after experience with the shots and COVID had died down. Other nations never recommended COVID shots for 6 month old infants, or required them for certain people. If a legal immigrant family wants to be accepted into the U.S. they are forced to get COVID shots for themselves and all their children, down to the age of 6 months.

In the U.S., until recently a visitor from another country was denied entry into the U.S. without proof of COVID shots. If did not matter if they tested negative for COVID and did not have COVID. At the same time immigrants merely had to make an asylum claim at the border and they were let into the country without having to get any COVID shots. The government did not give COVID shots to these immigrants when they had access to them. Thus, a huge number of people entered the country without COVID shots and some them had COVID. These nonsensical policies also caused doubt about public health in the U.S.

Here in the U.S. COVID shots and all the boosters are recommended for everybody down to 6 months of age. But the public is not clamoring for new booster shots like they did the original shots in 2021. Millions of doses of COVID shots have expired unused worldwide. The reason enthusiasm for COVID shots has abated is not due only to vaccine skepticism found on social media. Many people experienced bad side effects, or know people who did experience them or died suddenly. The effect of COVID shots on the rise of excess death rates is now resulting in news stories in mainstream media.

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Canada recommended coVid vaccines for children, and there has been large uptake. Canada has a higher vaccine uptake than the US, and a much lower death rate from coVid.

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Facebook and other "social media" (or however we refer to them today), the internet in general, and the epidemic of Dunning-Kruger are IMHO the main contributors to problem. Before I left academic medicine, I saw it coming when patients would come in with their new-found "knowledge" about drugs gained from surfing the web. I worked diligently to educate them about how drugs are approved and how labels are negotiated between the drug company and the FDA. The brighter among them (and I was at a flagship military medical center) got it immediately. The rest eventually did. But now every Thelma, Doris, and Harriet knows far better than her child's pediatrician what is best for her child. Facts, education, and training just don't matter anymore. doG help us.

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founding
Jun 13·edited Jun 13

Thank you, Dr. Panthagani. This sort of lay-the-facts-on-the-table truth telling is rare - except in Your Local Epidemiologist!

The broader societal subtext for your insights regarding mis- and disinformation contains several elements:

1) Unprecedented access to and proliferation of light-speed communication;

2) "Journalism," from network news, to prestigious newspapers, to Jill or Joe Blow bloggers has become a revenue source. Just capture the largest audience possible by whatever means;

3) The emergence of "meta-news," that is, stories about other stories rather and stories about the facts surrounding an event. Your article is a prime example of what meta-news is NOT: you go to the heart of the crucial questions and provide fact-based, honest answers. BRAVA!

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Jun 13·edited Jun 13

the Phase 3 trials for the covid shots were garbage. Only lasted a few months, with a 0.8% absolute risk reduction for symptomatic covid and no mortality or hospitalization benefit shown. In fact, 6 more people 6 died in the vax cohort vs. placebo in the Pfizer trial.

So anyone claiming these shots save lives is full of sh*t. Nobody knows. My advice is to stop lying to the public about the efficacy of pharmaceutical products and don't coerce, mandate, and shame people into taking them.

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The primary anti-vaxx arguments used against the pertussis vaccine in the 80’s and 90’s were based on coincidental deaths that were from SIDS. Those were never easy conversations because people do not think statistically and recency bias is very compelling.

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Another important variable. Journalism relies upon anecdotes.

As human beings we did not evolve to understand the laws of large numbers...i.e., statistics.

Instead, we evolved to respond to a rustle in the bushes. We didn't collect data on thousands of rustles.

Our nervous systems respond, powerfully, to anecdotes. Even when statistics are buried in an article, people don't respond.

How do we overcome this? I don't see how. Our nervous systems aren't built for it. We could required 3-4 classes in statistics for everyone, maybe, but boy I'd had to be the teacher.

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"hate" to be the teacher.

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In addition to statistics, many people don't like uncertainty or the concept of a moving target, both of which are essential concepts in science. After listening to the grueling congressional "hearing" (which implies listening, a skill that was completely absent on one side) of Dr. Fauci, it was clear to me that context and nuance will not move the needle. Americans want yes and no answers now! Perhaps that is why the current iteration of AI tools are content to hallucinate, as long as they deliver something that seems plausible.

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I'm aware of 2 health care professionals who have newish auto immune conditions and their physicians are attributing them to Covid vaccines--hard to know if it's causal or temporal.

Thank you for this great analysis.

As the promise of Covid vaccines was over-stated and turned into "prevents death/hospitalization/wanes quickly--and they have side effects, and the "current" vaccine is always a variant that has left the scene, it's hard to feel enthusiastic, and yet it's the strongest tool we at risk people have. I find that I now view other vaccines with more skepticism: the Guillian-Barre safety signal with the RSV vaccines.

The very upper middle class suburb near my house is seeing an outbreak of pertussis. My grandchildren have to scramble to get annual Covid vaccines. Poor messaging and this amplification of risk coupled with absolute denial of adverse outcomes has fueled vaccine skepticism and aversion.

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How many times have these health care professional had covid? It's the covid infections, even vaccinated, that cause long covid symptoms like new auto-immune diseases. Covid attacks all major systems and can kill off your previous immunity from other vaccines and can cause auto-immune disorders. There have only been 28 confirmed deaths from covid vaccine induced myocarditis and they all died within a week of vaccination. Developing auto-immune disorders are not side effects of the covid vaccine anywhere. Doctors and the CDC's denial of Long Covid up until recently has been highly problematic. People atriubuting things to the vaccines that they should be attributing to repeat covid infections is even more problematic.

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I am the biggest vaccine supporter. I receive and advocate for all vaccines (from a very educated perspective). However, it is well established that there are immune triggers to autoimmune conditions. They can be infectious, stress- sleep, diet, emotional, as well as vaccines. The way I think about it, may not be 100% precise, is that if a vaccine for an infection can be a trigger for either the start of an autoimmune condition or a flare, what does the actual infection do? Maybe worse.

As a person with one such condition, I noticed from when I was just a child the connection. As an adult I was very aware of the connection. As a physician I anticipate flares with each illness or vaccine I need to get. It does not stop me from receiving all the boosters. I am first in line in spite of this, because of this.

It’s not a reason to not vaccinate, perhaps it’s the argument to indeed vaccinate. We cannot suppress and need to approach it head on to avoid distrust.

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Measles can cause immune amnesia, but this has not been shown with covid:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668147/

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Exactly! When one person self attributed their condition to vaccination, I replied that there are so many confounding issues, I don't see the causality.

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You wrote: "Covid attacks all major systems and can kill off your previous immunity from other vaccines and can cause auto-immune disorders."

I've not see that before - that COVID can kill off previous immunity from other vaccines. Do you have a source for that you can share? If COVID can kill off previous immunity, does that mean people should get many vaccines again if they get COVID?

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The linked article contains the studies.

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founding

I have an adult daughter with an autoimmune problem who was not vaccinated and got long covid. After 36 months she got vaccinated and two months later recovered completely.

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How are we going to deal with the absolute dearth of basic science and math education? How many people have never even heard the phrase "correlation does not imply causation" much less understand the basic premise involved? I'm not sure how any approach is going to work when so many people don't possess the fundamental knowledge to evaluate risk vs reward and that there are no risk-free interventions in medicine.

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William, you are so right. Causation/correlation, pre-test probability, etc. etc. I am discouraged that the lay public, with the relatively new, online access to so much information, feels they can “do their own research.” Yikes!

One of our problems is lack of trust in experts/doctors/the CDC/politicians/ etc.

I long for the old days when we knew what we didn’t know, and knew whom to trust! (Like Walter Cronkite :-))

Steve Playe

Steve Playe

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This all makes me think of stranger danger abductions. Like adverse vaccination responses, stranger abductions are statistically very rare. Yet we went from free range parenting to helicopter parenting in a generation. The headlines made it seem like it was an epidemic of abductions, changing parental behavior.

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Would you not drive to the grocery store because of fear of an injury accident?

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I appreciate the carefully laid out reasoning and would bet that, these principles have been true since the anti- vaccination movement started after Jenner discovered cowpox vaccine for smallpox.

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