The AIDS Vaccine Conference begins today in Paris, and so we are treated to this AIDS vaccine op-ed in today's Times on the topic of that recent study we've been ignoring. It's not a crazy argument that the writer-who is Mr. Let's Make a Vaccine Foundation-is making: that we shouldn't dismiss that Thai AIDS vaccine study, even though it didn't actually work.
Or, to be fair: "The trial partners initially announced that the vaccine combination reduced the risk of infection by 31.2 percent in a statistically significant analysis." Basically, they gave this non-vaccine to 8000 Thai people. 51 one of those got HIV, as opposed to the 74 in the placebo group. I think that's what we call "potentially significant." Like, with a disclaimer. Maybe it was! Maybe we will find out! (Also? None of this has to do with whatever idiocy this is about vaccines and getting ill and sentence fragments and random thoughts. These vaccines aren't made from HIV.) Anyway so this op-ed is basically like "WHY WON'T ANYONE LISTEN TO THIS STUDY!" And it's like, dude, you are probably in Paris today, listening to the results of this study actually, why don't you do the paying attention for us? Then this op-ed devolves into a series of hedged and tiered arguments. IF the study this, and WHEN people that, and "Even if" the study "has no real benefit...." I don't know. The nail in the coffin? When you write on the HuffPo Health Section (eek) and also refer to "fanatical AIDS activists" I presume you are either working for the Cheneys or some obscure right-wing foundation.
What this guy needs are helpers!
Choire, you seem somewhat upset and wired yourself.
I am about to purchase a new espresso machine, so I will be joining you in your condition soon.
This past Thursday, I was fortunate enough to be someone's guest at an ADARC fundraiser. ADARC is one of the leaders in the work toward a vaccine and is the group responsible for the "triple-play" meds cocktail that is pretty much the reason that AIDS is no longer wiping out populations. Drs. David Ho and David Baltimore both spoke and mentioned the Thai study positively. Is it the "at-last" vaccine? No. Is it an approach that brought light to a different receptor that could possibly lead to the eventual vaccine? Yes, and as such, it is, maybe, a stepping stone.
Also learned that night:
- Lucy Liu is a really good person.
- Bill Clinton is just amazing.
- People are doing huge things with their lives, and I'm merely a dilettante. (Seriously, it was/is humbling.)
I think we've been trained to expect vaccines to be 100% effective, making a mere 30% reduction in risk seem dubious. The vaccines we get as kids are presented as really powerful things - shots that will protect you for life (or until the next booster shot) from diseases that would otherwise strike at any time. In fact, none of these vaccines are perfectly effective, and a substantial amount of their protective effect is due to herd immunity.
A vaccine that reduced risk of infection by 30% could still greatly reduce the incidence of HIV infection, if it was administered to a substantial proportion of the population. It therefore doesn't seem all that unreasonable to trumpet these results as a big deal. Or at least, it's fairly unreasonable to say at this stage that "it didn't actually work." The trick with statistical significance is that it's just an arbitrary threshold. It sucks that the vaccine doesn't seem to be strongly effective, but these results are promising enough to merit further study (in the real sense, not the padding-out-the-conclusion-section sense), regardless of where you draw that threshold.