I bet you’ve read that the new COVID-19 vaccines are not 100% perfect, so employing the Nirvana fallacy, must be avoided. That’s just not how one should look at medical data – whether examining vaccine safety and effectiveness or the usefulness of chemotherapy in treating cancer.
No medical procedure is perfectly safe or perfectly effective. Physicians and scientists never make those kinds of claims. In evidence-based medicine, benefits are weighed against risks based upon peer-reviewed published data.
I always like to say that when a physician reduces a fracture of the arm or leg, there is a small, but statistically significant chance of dying from something like a clot forming that goes to the heart or lungs. However, if you don’t reduce the fracture, there is a might higher chance of dying or permanent disability. Yet, I doubt that anyone would refuse the procedure despite the inherent risk.
Unfortunately, the bad math of the anti-vaccine world means that any risk that is not absolute 0% is rounded up to 100%, and vaccine effectiveness that is not absolutely 100% is rounded down to 0%. Yet, I’m sure if they had a broken arm, they would have the fracture reduced immediately.
This article is going to take a look at the Nirvana fallacy and how it relates to the acceptance of the COVID-19 vaccines.
What is the Nirvana fallacy?
Essentially, the Nirvana fallacy is a logical fallacy that is an attempt to compare a realistic solution with an idealized one, and dismissing or even discounting the realistic solution as a result of comparing to a “perfect world” or impossible standard, such as “perfectly” safe and effective COVID-19 vaccines.
This reasoning ignores the fact that the solutions are often good enough to meet any reasonable standard of safety and effectiveness. Furthermore, the fallacy often focuses on one single standard of an idea or thing without regard to the other qualities that may be important in evaluating that thing or idea.
In addition, the Nirvana fallacy can lead someone to ignore an unbiased evaluation of risk versus benefit analysis. One could focus on the risk, demanding that it be completely eliminated, even if the benefit far outweighed the cost.
I like to say that the Nirvana fallacy states that “if it’s not perfect, it must be worthless manure.”
The Nirvana fallacy and COVID-19 vaccines
It appears that some people who are refusing COVID-19 vaccines are employing the Nirvana fallacy – they want 100% certainty that the vaccine is safe and effective. But as I wrote above, evidence-based medicine utilizes the best-published evidence to determine the best choice for the patient.
In this case, we need to utilize the best evidence about the safety and effectiveness of the COVID-19 vaccines and compare it to the best evidence about the risks of COVID-19 itself.
I’ve written several times about the safety of the COVID-19 vaccines. Yes, they seem to very rarely cause adverse effects like myocarditis, blood clots, or allergic reactions. However, large studies have shown that other than a very small increase in myocarditis in one age group, most adverse events don’t appear to be different than what would be observed in an unvaccinated population.
This doesn’t mean I’m saying that the vaccine is 100% safe, but I am saying that serious adverse events are extremely rare and not too serious.
As for effectiveness, the research has shown that the vaccines are extremely effective ranging from 67% up to 95% depending on the vaccine and the outcome being measure. And the vaccines are showing mostly good evidence that supports its effectiveness in preventing hospitalization from the Delta variant of SARS-CoV-2.
So, this doesn’t mean the vaccine is 100% effective, but no vaccine is. And no medical procedure is unless it’s pseudoscientific nonsense pushed on the internet about horse dewormer.
But let’s look at the science behind the risks of COVID-19 itself so that we can do a proper risk-benefit analysis.
Complications from COVID-19 may include pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure, septic shock, and death. Cardiovascular complications may include heart failure, arrhythmias (including atrial fibrillation), heart inflammation, and thrombosis, particularly venous thromboembolism. Approximately 20–30% of people who present with COVID-19 have elevated liver enzymes, reflecting liver injury.
Neurologic manifestations include seizure, stroke, encephalitis, and Guillain–Barré syndrome (which includes loss of motor functions). Following the infection, children may develop a pediatric multisystem inflammatory syndrome, which has symptoms similar to Kawasaki disease, which can be fatal. In very rare cases, acute encephalopathy can occur, and it can be considered in those who have been diagnosed with COVID-19 and have an altered mental status.
And of course, the case fatality rate for the USA is around 1.6%, similar to most developed nations. That means you have a 1.6% chance of dying from the disease, although it can be lower or higher depending on your age and other comorbidities.
You might think that’s a low risk, but let’s compare it to other risks you might take every day:
- You have a 0.2% annual risk of dying of heart disease.
- A 0.18% annual risk of dying of cancer.
- A 0.012% annual risk of dying in a motor vehicle accident.
- A 0.004% annual risk of dying from a firearm.
These are all remarkably low risks, although they should not be trivialized in any way. But we wear seat belts to keep from dying in a motor vehicle accident. We exercise and take medications to reduce our risk of heart disease.
The risk-benefit analysis of COVID-19 vaccines is overwhelmingly on the side of benefit. In today’s world, if you are unvaccinated, you have a greater risk of dying from COVID-19 than just about anything else that could happen to you by just going about your day.
And despite the improper and unethical misuse of the Vaccine Adverse Events Reporting System (VAERS) database, there are no confirmed cases of any deaths from the COVID-19 vaccine. That doesn’t mean I think that there have been none or there will be none, but there is robust evidence that vaccines have only been linked to less than 10 deaths.
Of course, at the time that I wrote this article, there have been over 4.5 million deaths from COVID-19.
Unless you love the Nirvana fallacy, COVID-19 vaccines are demonstrably safe and effective, the benefits of them far outweigh the risks of the disease that they prevent.
Get the COVID-19 vaccine. Protect yourself, your loved ones, and the world around you from this deadly disease.
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