The counterfactual world still never develops this vaccine...
This is a good point. I think the counterfactual world I was thinking of was one in which the world is as it was, but this vaccine proposal/Stöcker acts as an exogenous shock and makes some part of the German population take a vaccine earlier. But you’re right that there is also a counterfactual where this exogenous shock isn´t needed at all.
You touch on a few points on your second paragraph; to respond to a few:
Impossibility of trust. Presumably this affects different groups differently, and his political inclination might have made people sympathetic to right-wing conspiracy theories more likely to take his particular vaccine, where in actuality they instead where one of the most vaccine-hesitant groups. This seems fine to me.
Differential impact on immigrants: Specifically, having an intervention which differentially helps nonimmigrants seems fine by me. It’s particularly salient to me here that a) immigrants wouldn’t be harmed by someone else taking this vaccine, b) in fact they might be helped if it reduces the spread. You can also make things clearer by pairing this with a second intervention to make vaccines more appealing to immigrants in particular, but I don’t think this is necessary to make it a Pareto improvement.
Origins of requiring control and rigor on vaccines. I agree that past disasters are a reason to impose controls and rigor on vaccine development.
Wisdom of requiring long randomized trials before allowing people to take vaccine candidates. I disagree that past disasters were a strong enough reason in the face of a disease of uncertain long-term effects and a professor of immunology who created Euroinmun offering an alternative.
I don’t think that it’s the possibility that Stöcker might have only allowed people of certain immigration status to take it or the possibility of differential impact on people that like or dislike his politics that huw was drawing attention to.[1] Rather it’s the point that medically qualified people with some interesting views have conducted some incredibly ugly experiments in the past, particularly in Germany, which is one of the reasons why you don’t get to run unlicensed medical experiments on the general public just because you’re a doctor.
From the limited coverage I’ve seen haven’t seen any reason to believe that the decision to try to stop Stöcker to offer a vaccination claimed to be a COVID cure whilst its efficacy was essentially untested had anything to do with his politics (and if it did, I think the direction of causality is more individual becomes increasingly politically radical ⇒ individual being less willing to cooperate with bureaucrats than the other way round). I don’t think there’s been any serious suggestion that he actually intended to harm people, con people or exclude migrants from receiving the vaccine. But improperly prepared or ineffective vaccines delivered in good faith can potentially cause a lot of harm too.[2]
It may be the case that German bureaucracy is particularly inflexible (it does have that reputation!) [3]but there is a happy medium between considering potential positive impact of shortening standard approval processes[4] and not letting someone bypass regulations to inject people with a solution claimed to be a pandemic cure because they have relevant qualifications and claim to have validated it’s safe and works on five people.
Yes, the COVID pandemic was an exceptional circumstance, but even or perhaps especially with COVID there are plenty of plausible circumstances where skipping the approval process results in more deaths than approval delays, including circumstances where the substance is harmless but ineffective but leads to behavioural change due to false beliefs about immunity.
Ultimately Stöcker is extremely well qualified, but so are a non-zero number of the quack cure promoters (for the record, I’ve also read a credible, critical source suggest his vaccine is plausibly effective, fairly unlikely to be harmful and not dissimilar to the approved Novavax COVID vaccine in approach so it’s probably unfair to put him in the “quack” bracket. But I think it’s fair to say that if his essentially untested approach to preventing COVID symptoms did actually work in the general population, it’s the exception amongst untested “COVID cures”). And the RCTing a parachute analogy isn’t appropriate here, because the “cure” plausibly leads to more deaths than the problem. So even the most streamlined drug approval process isn’t going to look like letting doctors say or do what they want in a pandemic if they have a vaguely plausible method and let natural selection sort out whether they’re right.
afaik Stöcker made no attempt to qualify who did and didn’t receive his vaccine and no matter how strongly he might feel about the topic of immigration, I’m sure he’s aware that vaccinating immigrants benefits German citizens too...
If you Google “Lubeck vaccine” you’ll see fewer references to Stöcker and more to a grisly story from many years earlier about how a contaminated batch of the otherwise notably safe and effective BCG immunization killed over a quarter of babies injected with it.
I agree that doctos with interesting views have done experiments without the consent of patients in the past.
I agree that, with low enough state capacity, if you can’t differentiate between Stöcker and a crank, you might want to ban all of them. However, I could also see the case for a) not banning anything, and letting the population learn to differentiate cranks vs non cranks over a few generations, or b) developing more state capacity so that you can in fact differentiate between these.
I’m not sure whether I agree on the direction of causality. Opaque bureaucratic decision ⇒ politics takes a role also makes sense to me.
I think it’s very unlikely that his actual vaccine was worse than the disease, and so the RCT-ing a parachute analogy is valid.
I also think that in saying “not letting someone bypass regulations to inject people with a solution claimed to be a pandemic cure because they have relevant qualifications and claim to have validated it’s safe and works on five people” you’re skipping over the part where you can have a mechanistic understanding of why and how vaccines work.
Basically, agree that if you squint, this looks like other things that could be bad, and that if the state can only squint, it might want to apply violence to prevent it. But that doesn’t seem like the only alternative to me.
This is a good point. I think the counterfactual world I was thinking of was one in which the world is as it was, but this vaccine proposal/Stöcker acts as an exogenous shock and makes some part of the German population take a vaccine earlier. But you’re right that there is also a counterfactual where this exogenous shock isn´t needed at all.
You touch on a few points on your second paragraph; to respond to a few:
Impossibility of trust. Presumably this affects different groups differently, and his political inclination might have made people sympathetic to right-wing conspiracy theories more likely to take his particular vaccine, where in actuality they instead where one of the most vaccine-hesitant groups. This seems fine to me.
Differential impact on immigrants: Specifically, having an intervention which differentially helps nonimmigrants seems fine by me. It’s particularly salient to me here that a) immigrants wouldn’t be harmed by someone else taking this vaccine, b) in fact they might be helped if it reduces the spread. You can also make things clearer by pairing this with a second intervention to make vaccines more appealing to immigrants in particular, but I don’t think this is necessary to make it a Pareto improvement.
Origins of requiring control and rigor on vaccines. I agree that past disasters are a reason to impose controls and rigor on vaccine development.
Wisdom of requiring long randomized trials before allowing people to take vaccine candidates. I disagree that past disasters were a strong enough reason in the face of a disease of uncertain long-term effects and a professor of immunology who created Euroinmun offering an alternative.
I don’t think that it’s the possibility that Stöcker might have only allowed people of certain immigration status to take it or the possibility of differential impact on people that like or dislike his politics that huw was drawing attention to.[1] Rather it’s the point that medically qualified people with some interesting views have conducted some incredibly ugly experiments in the past, particularly in Germany, which is one of the reasons why you don’t get to run unlicensed medical experiments on the general public just because you’re a doctor.
From the limited coverage I’ve seen haven’t seen any reason to believe that the decision to try to stop Stöcker to offer a vaccination claimed to be a COVID cure whilst its efficacy was essentially untested had anything to do with his politics (and if it did, I think the direction of causality is more individual becomes increasingly politically radical ⇒ individual being less willing to cooperate with bureaucrats than the other way round). I don’t think there’s been any serious suggestion that he actually intended to harm people, con people or exclude migrants from receiving the vaccine. But improperly prepared or ineffective vaccines delivered in good faith can potentially cause a lot of harm too.[2]
It may be the case that German bureaucracy is particularly inflexible (it does have that reputation!) [3]but there is a happy medium between considering potential positive impact of shortening standard approval processes[4] and not letting someone bypass regulations to inject people with a solution claimed to be a pandemic cure because they have relevant qualifications and claim to have validated it’s safe and works on five people.
Yes, the COVID pandemic was an exceptional circumstance, but even or perhaps especially with COVID there are plenty of plausible circumstances where skipping the approval process results in more deaths than approval delays, including circumstances where the substance is harmless but ineffective but leads to behavioural change due to false beliefs about immunity.
Ultimately Stöcker is extremely well qualified, but so are a non-zero number of the quack cure promoters (for the record, I’ve also read a credible, critical source suggest his vaccine is plausibly effective, fairly unlikely to be harmful and not dissimilar to the approved Novavax COVID vaccine in approach so it’s probably unfair to put him in the “quack” bracket. But I think it’s fair to say that if his essentially untested approach to preventing COVID symptoms did actually work in the general population, it’s the exception amongst untested “COVID cures”). And the RCTing a parachute analogy isn’t appropriate here, because the “cure” plausibly leads to more deaths than the problem. So even the most streamlined drug approval process isn’t going to look like letting doctors say or do what they want in a pandemic if they have a vaguely plausible method and let natural selection sort out whether they’re right.
afaik Stöcker made no attempt to qualify who did and didn’t receive his vaccine and no matter how strongly he might feel about the topic of immigration, I’m sure he’s aware that vaccinating immigrants benefits German citizens too...
If you Google “Lubeck vaccine” you’ll see fewer references to Stöcker and more to a grisly story from many years earlier about how a contaminated batch of the otherwise notably safe and effective BCG immunization killed over a quarter of babies injected with it.
It also has one of the world’s biggest pharmaceutical industries, so the problem isn’t insurmountable...
Something which itself wasn’t uncontroversial, both amongst actual professionals and politically motivated promoters of vaccine hesitancy.
I agree that doctos with interesting views have done experiments without the consent of patients in the past.
I agree that, with low enough state capacity, if you can’t differentiate between Stöcker and a crank, you might want to ban all of them. However, I could also see the case for a) not banning anything, and letting the population learn to differentiate cranks vs non cranks over a few generations, or b) developing more state capacity so that you can in fact differentiate between these.
I’m not sure whether I agree on the direction of causality. Opaque bureaucratic decision ⇒ politics takes a role also makes sense to me.
I think it’s very unlikely that his actual vaccine was worse than the disease, and so the RCT-ing a parachute analogy is valid.
I also think that in saying “not letting someone bypass regulations to inject people with a solution claimed to be a pandemic cure because they have relevant qualifications and claim to have validated it’s safe and works on five people” you’re skipping over the part where you can have a mechanistic understanding of why and how vaccines work.
Basically, agree that if you squint, this looks like other things that could be bad, and that if the state can only squint, it might want to apply violence to prevent it. But that doesn’t seem like the only alternative to me.