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founding

Anecdotally, I think part of the problem might be from the conversations between vaccinated people. I work at a hospital where we all got it extremely early, opting to just hit everyone instead of trying to tier employees. Just as a natural outcome of allotments, some of us were Pfizer and some were Moderna. And every time someone mentioned they had their shot, the questions would start: oh, were you Pfizer or Moderna? Did you have any reactions? How was your first shot vs. second? Etc.

And I get why it happened in our internal space; after a year of being run ragged by pandemic, we've got something proactive happening and we want to obsess over it the same way people can't shut up about the options they chose for their new car or whatever. The problem is that a lot of people went on to give the blow by blow to their friends, who didn't have that same context of "We're all imminently getting vaccinated, we're all going to take what we're offered, and this is really just an excuse to talk about vaccines some more". So I'll overhear phone calls of "Oh, all of the *really* bad side effects I've heard about were Pfizer" (and naturally, I've heard the same phone call about Moderna) when it's a Pokemon Red to Pokemon Blue situation and no one here really *cares* in the sense of strongly wishing they'd had the other one.

So yes, agree that choice isn't worth the anxiety here, but I think a lot of people are feeling catharsis talking about what they've received, which is probably contributing to the perception of meaningful difference.

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author

Totally agree. It's a feeling of being in control, having something to do. And I'd be fine for it if it wasn't also causing so much anxiety. I feel like this is how I sometimes stare at the ketchup aisle. Too many choices! Just give me some ketchup, heh.

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I do wish the vaccines were not associated with Brand names. I believe this influences a society already pushed towards a consumer viewpoint ("really, you have to buy this kind of olive oil...") to apply this behavior where it is entirely inappropriate.

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We are unfortunately getting articles like this too: https://www.theatlantic.com/health/archive/2021/03/pfizer-moderna-and-johnson-johnson-vaccines-compared/618226/ - and while I agree that letting people know about complexity is important, this article adds so much noise and much less nuance than it seeks.

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That article was so incompetent that I couldn't finish and wanted to scream at something. Yes, much noise was added.

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founding

The question about choosing different vaccines that are on offer gets a little more complicated in places where vaccines other than Pfizer, Moderna and J&J are being given out. Especially Russian/Chinese and India’s locally made Covaxin. (India is also giving AstraZeneca one.)

All these vaccines have disputed or non-published/peer reviewed Phase III trials study results.

For example, The Lancet published a peer reviewed article about high efficacy of Russia’s Sputnik vaccine but The New Yorker (Feb 1) had a story raising doubts of the data they used, putting the whole thing under a cloud.

Who do you trust? Are we seeing politics overriding science when it comes to different vaccines? Remember it took the US several months to clear way for the oral polio vaccine (though it was an American who discovered it, but was popularised by the Soviet Union.)

But whatever pros and cons of this argument, what this is leading to is every time you tell someone over 60 to get vaccinated, at the back of your mind there is a fear of that unknown linked to reports raising doubts of its dangers. This is what doctors who were recommending treatments for complex issues probably faced. But now it is becoming a burden you and I have to carry.

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On the other hand, perhaps for some people, having choices, rather than causing anxiety, helps them feel like they're in control, making them happier about their decision? Someone may prefer a vaccine for reasons we don't think are particularly sound, but if the result is that they get vaccinated, it's all good.

We might compare this with the marketing trick of letting people pick between three choices, good, better, and best.

The flipside of "all vaccines are excellent" is that it doesn't matter what they pick or why they pick it, as long as they get vaccinated, and all available vaccines get used.

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author

I think that is exactly right. It feels like we're participating in something important. People like that, of course, and marketers do use those feelings. There is always a "most expensive" wine to steer towards the upper-priced one, and there is the egg we add to the pancake mix (could have come in powder form but we need something to do...). And so on. Of course, in this particular case, the differences do matter but mostly in terms of the planners, not the receivers: J&J is easier, logistically and should go to poorer countries and/or mobile teams within countries and the other two are more suitable for centralized administration. Maybe we will learn something more about the differences in the long run... For now, it doesn't feel like it's worth the fretting.

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Confidence in vaccines is not helped by the need to launch into the lives & habits of T-cells.

If you want to go that road, then I'll ask if any studies have looked at whether foreign mRNA crosses the placenta. Do you want to go there? 🤔

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