应对疫苗怀疑 | 统计与故事 第383期 第1部分

三百三十二天。

Three hundred and thirty two days.

这是2020年英国皇家统计学会评选的年度国际统计数据。

That was the International Statistic of the Year in 2020 as identified by the Royal Statistical Society.

这个时间跨度是从科学家于1月11日公布新冠病毒的基因序列，到12月8日成功接种有效疫苗之间的间隔。

That was the length of time between scientists publishing the genetic sequence of COVID nineteen on the January 11 and an effective vaccine being administered on the December 8.

这种疫苗是全球抗疫应对的关键组成部分。

This vaccine was an integral part of the world's pandemic response.

疫苗并不新鲜。

Vaccines aren't new.

在世界卫生组织关于疫苗历史的报告中，爱德华·詹纳医生被公认为1796年成功研制出世界上第一种天花疫苗的人。

In a World Health Organization report describing the history of vaccines, doctor Edward Jenner is accredited with the world's first successful vaccine for smallpox in 1796.

在过去一百年里，科学家们研发出了针对黄热病、百日咳、脊髓灰质炎、乙型肝炎、麻疹、腮腺炎、风疹等多种疾病的疫苗。

In the last one hundred years, vaccines were developed for yellow fever, pertussis, polio, hepatitis B, measles, mumps, rubella, and more.

那么，我们如何知道疫苗是安全有效的呢？

Well, how do we know vaccines are safe and effective?

为什么有些人反对使用疫苗？

Why do some people argue against using vaccines?

今天我们节目邀请到杰弗里·莫里斯医生，帮助我们理解这些问题以及与疫苗相关的其他议题。

On our show today, doctor Jeffery Morris will help us understand these questions and other issues related to vaccines.

我是约翰·贝勒。

I'm John Baylor.

《数据与故事》是由美国统计协会以及迈阿密大学统计系、媒体新闻与电影系联合制作的节目。

Stats and Stories is a production of the American Statistical Association as well as Miami University's departments of statistics and media journalism and film.

我身边的是我的同事，媒体新闻与电影系主任罗斯玛丽·彭宁顿。

I'm joined in the studio by my colleague, Rosemary Pennington, chair of the department of media journalism and film.

今天我们邀请的嘉宾是杰弗里·莫里斯医生。

Our guest today is doctor Jeffery Morris.

莫里斯是乔治·S.

Morris is the George S.

佩珀公共卫生与预防医学教授，同时也是宾夕法尼亚大学佩雷尔曼医学院生物统计、流行病学与信息学系生物统计学部门主任。

Pepper Professor of Public Health and Preventative Medicine and Director Biostatistics Division, Department of Bio Biostatistics, Epidemiology and Informatics at the Perelman School of Medicine, University of Pennsylvania.

他还积极参与了在社交媒体和各种媒体上的科学传播工作。

He also has been actively involved in scientific communication efforts on social media and with various media outlets.

他是安南伯格公共政策中心的杰出研究研究员。

He is a distinguished research fellow at the Annenberg Center for Public Policy.

杰夫，欢迎你来到我们的播客，非常高兴。

Jeff, it's a delight to welcome you to the podcast.

谢谢你，约翰和罗斯玛丽。

Thank you, John Rosemary.

能来参加节目真的很棒，是的，非常荣幸。

It's great, yeah, great to be on.

那么，你是如何开始研究疫苗的呢？

So so how did you first get involved in studying vaccines?

说来有趣，在我的职业生涯中，我其实很少接触这方面的研究。

You know, it's interesting because in my career, I'd never really done much with that.

我之前主要做癌症研究，但真正让我对疫苗产生兴趣的是新冠疫情。

I did most things in cancer research before this, but it was really the pandemic that got me interested in that.

你知道吗，在疫情初期，我们都困在家里，处于封锁状态，一种新的病毒扰乱了我们的生活。

You know, in the early pandemic when we're all kinda stuck at home, locked down, there's this new virus disrupting our lives.

我们完全不知道发生了什么。

We have no idea what's going on.

我只是花时间去跟进不断涌现的数据和文献，弄清楚到底发生了什么。

I just took time to try and keep up with the emerging data and literature to figure out what was going on.

正是这一点让我更多地参与到科学传播中来。

And that's that's what kinda got me involved more in in scientific communication.

但到了年底，大家热议的都是即将问世的疫苗，这些疫苗有望终结疫情，让我们回归正常生活。

But also then, you know, by the end of the year, the big talk was about these vaccines coming that were hopefully going to end the pandemic, get us back to normal.

所以，真正让我对疫苗产生兴趣的，其实是疫情和新冠疫苗本身。

And so that's what kind of got me interested in vaccines, really, the pandemic and the COVID vaccines first.

你知道吗，这三百三十二天的过程，从开始到实际应用，看起来真的非常快。

You know, this this this three hundred and thirty two day thing, that's that seemed really fast, you know, just just to get to go from, you know, to go from start to something that's being applied.

这正常吗？

Is is that typical?

通常开发一种疫苗需要多长时间？

How long does it normally take to develop a vaccine?

是的。

Yeah.

不。

No.

我的意思是，他们能这么快完成简直是个奇迹，因为这非常不典型。

That's I mean, it's a miracle they were able to do it that fast because it's it's very atypical.

你知道，在非紧急情况下，疫苗的典型开发周期可能是十年到十五年，而在快速通道下，可能是五年到七年。

You know, I think the typical timeline for a vaccine in a nonemergency situation might be ten to fifteen years and and in a nonemergency, but in a fast track, maybe five to seven years.

所以，不到一年的时间确实非常快。

So, yeah, less than a year is is remarkably fast.

但鉴于疫情的紧迫性，人们采取了许多措施，使这些步骤比通常情况下快得多。

But but given the urgency of the pandemic, there were a number of things that were done to enable those steps to be completed much more quickly than they usually would.

是的。

Yeah.

我很想多了解一下，因为我知道很多人打了新冠疫苗，但仍然对此感到犹豫，担心疫苗研发速度太快。

And I I would love to hear more of that because I there are a lot of people that I know who have gotten COVID vaccines but then also are still sort of hesitant around that because of this fear that it happened so fast.

为什么它能这么快完成？

Why was it able to happen so fast?

而且，鉴于你一直在关注相关沟通，你觉得在疫苗快速推进过程中，它的传达方式如何？

And I guess given that you've been looking at the communication, how do you feel about how it was communicated as it was being pushed through?

是的。

Yeah.

我想说的一点是，我最初也有类似的担忧，非常怀疑，因为当时我非常担心疫苗研发得太快了。

Well, one thing I can say is, like, I shared concerns, and I was very skeptical initially at first as well because I was very nervous that it was done so quickly.

由于mRNA疫苗主导了市场，而病毒载体疫苗相对较少，我们往往忘记了当时其实有数十种不同的疫苗在同时研发。

And and one thing since the mRNA vaccine sort of dominated in the viral vectors to a lesser degree, we forget that really there were really dozens of different vaccines where they tried all at once.

但这些是第一批成功抵达终点并获得批准的疫苗。

But these were the ones that got to the finish line first and got across.

因此，当时投入了巨大的努力。

So there was just a tremendous effort.

当然，资金方面也提供了前所未有的支持，这在正常情况下是根本不可能的。

And so, of course, funding and there was funding that is never provided on that scale, you know, under normal circumstances that helped.

但仅仅因为疫情的紧迫性，加上这是一种新型病毒，我们知道有人正在死去。

But just the urgency of the pandemic with it being a novel virus, we know people were dying.

我们知道，医院在某种程度上已经超负荷运转。

We know that it was overwhelming hospitals to some degree.

因此，他们意识到了这件事的重要性。

So they recognized the importance of it.

于是，他们尽一切努力加速研发进程。

So they tried to do everything they could to accelerate the development.

也许一个误解是，人们以为很多步骤被跳过了，或者采取了重大捷径。

And one thing that maybe is a misconception is that people think that there were a lot of steps that were skipped and that major shortcuts were taken.

但我认为，实际情况并没有人们通常以为的那么严重。

And I think that's not really as true as people tend to think.

实际上，有些步骤可能被简化了，有些步骤则执行得更快了，但基本的常规步骤还是遵循了，只是在某些方面加快了进度。

That really, there were some steps that maybe were not done as much and steps that were done more quickly, but pretty much the usual steps were followed, but there were some some ways they sped it up.

比如，有几件事。

Like, a couple things.

其中一个早期步骤是确定靶点并开发实际的检测方法。

One one of the early steps is really identifying target and developing the actual assay.

对于mRNA疫苗来说，它们有一个巨大优势：一旦2020年1月确定了病毒序列，mRNA技术就能非常快速地基于新序列开发出疫苗。

With the mRNA vaccines, they had a big advantage because once the sequence was identified in January 2020, the mRNA technology, it's it's very quick to develop something with a new sequence.

在疫情之前几年里，已经有很多相关研究进一步完善了mRNA平台。

And there's been a lot of there were a lot of recent work in the years preceding the pandemic sort of further developing the mRNA platform.

其中很多研究都集中在癌症领域。

A lot of it was in cancer.

当我还在MD安德森癌症中心时，我参与过一些针对癌症疫苗的项目。

When I was at MD Anderson Cancer Center, I worked on some projects with some of those vaccines in cancer.

我认为，之前阻碍它实现的一些技术难题恰好被克服了，所以它已经准备就绪。

And I think some of the technical hurdles to get it to work happened to just be overcome, and so it was kinda ready to roll.

因此，这大大加快了进程，使他们能够迅速开发出可用的方案。

So that that really sped things up where they were able to very quickly have something ready to work.

然后他们做的另一件事是进行临床前测试、一期、二期和三期试验。

Then the other thing they did was there's sort of preclinical testing, phase one, phase two, phase three.

通常这些阶段是串行进行的，中间有间隔，但在这里，他们将这些阶段重叠并合并在一起。

Usually, these are done in a serial fashion with breaks in between, But here, they they overlapped them and put some of them together.

他们把一期和二期合并了。

They put the phase one and two together.

他们在进行一期和二期的同时也开展了临床前研究。

They did the preclinical at the same time as the phase one and two.

然后他们迅速设计了三期试验并立即启动。

And then they very quickly designed the phase three and moved into that.

一旦三期试验开始，三期通常涉及数万名患者。

And then once the phase three started phase three is typically tens of thousands of patients.

这是一个多中心的随机对照试验。

It's a randomized trial with many centers.

组织这样的试验并使其启动需要耗费大量时间。

Takes a huge amount of time to organize this, get it off the ground.

通常，入组速度很慢，但这里他们很快就启动了。

Usually, the accrual is slow, but here they got it off the ground very quickly.

由于兴趣浓厚，入组速度异常快。

There was so much interest that it accrued remarkably fast.

对于他们的主要疗效终点，他们能在几个月内就达到这些目标。

And and for their primary endpoints for efficacy, they were able to reach those endpoints within a few months.

结果如此积极，以至于他们实际上在几个月内就达到了主要终点。

And the results were so positive that they could actually achieve their primary endpoint within a few months.

所以我认为所有这些因素共同促成了快速研发的能力。

So I think all of these factors led to the ability to develop it rapidly.

我认为加速进程的最后一点是，通常在确定生产工艺上会有很长的延迟。

And then the last thing I think that also sped it up is there's usually a long delay in terms of figuring out the manufacturing.

但实际情况是，他们与三期临床试验同步推进生产工艺，以解决各种问题，从而在获批后能更快地投入生产。

But what happened is they were working manufacturing concurrently with the phase three trial to work out the kink so that they could hopefully roll it out more quickly once it was approved.

所以我认为，这种重叠的模式是另一个让他们能更快推进的领域。

So I think that was another area where the overlap allowed them to go more quickly.

嗯，然后，我剩下的问题其实主要是关于这方面的信息传达。

Well and then, you know, my the rest of my question was just sort of the messaging around that.

对吧？

Right?

所以，听到这些，再加上我当时一直关注着这件事的发展，显然，这说得通。

And so I think hearing that and having followed that as it was happening, you know, obviously, like, this makes sense.

显然，没人会在这种规模上推广一种不安全的疫苗。

Like, obviously, you know, no one is gonna share a vaccine that's unsafe on this scale.

但我觉得，关于为什么我们能如此迅速推进的信息传达，作为媒体消费者，感觉并没有很好地传达出来。

But it did feel like the messaging around why we could move so quickly felt like for me as a consumer of media, it felt like it did not get communicated as well as it might have.

我只是想知道，你对这一点怎么看？

And I just, I guess, I wonder what your read on that is.

是的。

Yeah.

我能理解这一点。

I I can see that.

是的。

Yeah.

我觉得本可以做得更好。

I think it probably could have been better.

当我跟进这件事时，就在事情发生的过程中，我听到了他们这样说。

And for my own sake, as I was following it, like, as it was going, I heard them saying this.

所以我点了点头，心想：好吧。

So I kind of nodded my head, and I was like, okay.

原来他们是这样加快进度的。

That's how they're speeding this up.

但我仍然担心，好吧。

But I was still concerned that, okay.

他们会漏掉什么吗？

Are they gonna miss something?

有什么地方马虎了吗？

Is something sloppy?

但他们本可以做得更好。

But they probably could have done a better job.

但我认为，沟通方面更大的问题，以及她在公众中可信度和信任度的下降，更多是因为没有承认当时他们所知的局限性。

But I actually think the bigger problem with communication and maybe some of the things that her credibility and trust in some of the public was more not acknowledging the limitations of what they knew at that point.

比如，从最初的试验中，有一些事情已经得到了充分证实，但在更严重的后果、疫苗预防严重或致命新冠的有效性、保护持续时间是否会减弱、以及对未来的基因变异是否有效等方面，仍然存在很多不确定性。

Like, there were some things that were very well established from that initial trial, but there was still a lot of uncertainty in terms of more severe outcomes, how well it was gonna prevent severe or fatal COVID, how long the protection would last, would it wane, how well it would work with future genetic variants.

此外，尽管安全性数据令人鼓舞，但这是我最近撰写的一篇白皮书中强调的一点：三期试验永远不足以真正确立和发现所有潜在风险。

And then also, even though the safety data was promising, this is one thing I emphasize in a white paper I recently wrote is that the phase three trials are never sufficient to really establish and detect all of the potential risks.

因为像疫苗这样的东西，即使是非常罕见的风险也至关重要，而每组两万人的研究无法检测到十万分之一的风险。

Because something like vaccines, even very rare risks are important to know about, and a study of twenty thousand per arm is not going to detect a one in a hundred thousand risk.

所以我认为，当时存在一些不确定性，比如：

So so I think that there was uncertainty about, okay.

这些疫苗可能存在一些我们尚不清楚的风险，尤其是这种新技术。

There may be some risks from these vaccines, especially with it being a new technology that we don't know about yet.

我认为，许多这些细微之处和局限性可能没有被充分传达，原因是为了鼓励更多人接种疫苗，这有助于公共卫生，或许本意是好的。

And I think that a lot of those nuances and limitations were not communicated perhaps in the name of trying to encourage more people to get the vaccine, which to help public health, which might be a good thing.

但如果在传达时没有透明地说明这些不确定性和局限性及风险，我认为这可能会适得其反，而且我觉得确实如此。

But if it was done in a way that was not transparent about the uncertainties and limitations and risks, I think that's where there was potential for it to backfire, and I think it kinda did.

这似乎确实是任何科学传播中一个持续存在的问题：如何更好地传达不确定性，并解释科学意义上的不确定性与非科学意义上的不确定性有何不同。

That does feel like a kind of perpetual problem when it comes to science communication of any kind is figuring out how to well communicate the issue of uncertainty and explain what that means in a scientific sense versus what it might mean in a nonscientific sense.

对吧？

Right?

在新冠疫情期间，如何有效传达不确定性——既不引发恐惧和怀疑，又能保持诚实——这个问题在这一紧急危机时刻变得尤为突出。

And it feels like in COVID that that issue of, like, how to communicate uncertainty well that doesn't produce fear and skepticism but is honest just sort of came to a head in this very, like, urgent crisis moment.

这似乎是一个非常典型的例子，凸显了我们亟需学会如何妥善处理这一挑战。

And it felt like it was a really potent example of that struggle and the need to figure out how to do that well.

我觉得你说得非常好。

I think I think that's well said.

我觉得你一针见血，因为我认为这始终成立，因为科学总是充满细微差别。

I think, you can nail on the head, because I think this is always true because science is always nuanced.

不确定性始终存在。

There's always uncertainty.

很多时候，这种信息在公众传播中被忽略了，因为那些没有接受过科学思维训练的人，很难应对不确定性。

And a lot of times that gets lost in the public messaging because people that aren't trained to think as scientists, I think it's hard for them to manage the uncertainty.

人们更希望看到非黑即白的结论。

They people wanna think a little more black and white.

疫苗有效。

Like, the vaccine works.

疫苗能阻断传播。

The vaccine stops transmission.

疫苗会终结疫情。

The vaccine will end the pandemic.

人们就是希望这样想。

People wanna think that way.

疫苗是安全的，但其中的细节总是更复杂。

The vaccine is safe, but the nuances are always more complex.

我们科学家喜欢讨论这些细节，但有时我们会让人感到无聊，或者让人困惑。

And and we scientists like talking about the nuances, but then sometimes we bore people or sometimes we confuse people.

是的

Yeah.

因此，我认为这就是信息传达如此困难的原因，也是我部分参与科学传播和媒体合作的原因。

And so that's, I think, why the messaging is difficult, and that's part of why I've gotten involved a little bit in scientific communication and working with media.

因为我理解简化信息的必要性，但我觉得我们应当更好地保留更多的细微差别和不确定性，或许更应相信公众能够理解比我们想象中更复杂的内容。

Because I understand the need to simplify the message, but I think we need to do a better job of retaining more of the nuance, more of the uncertainty, and maybe trusting the public to understand a little bit more complicated things than we do.

因为我认为，这跟我作为教师的本能有关，我把它视为一种挑战：好吧。

Because I think and that's part of the teacher in me that I sort of take it as a challenge to say, okay.

这很复杂，但我一定要让这个人理解它。

This is complicated, but I'm gonna get this person to understand it.

我认为他们可以做到。

I think they can.

因为我认为，我们可以通过与人们产生共鸣的方式传达复杂的原理，帮助他们理解。

Because I think we can relate complex principles in ways that resonate with people and get them to understand it.

因此，我认为我们可以通过更多地向公众普及一些科学，甚至是统计流行病学的细微差别，让他们能够识别出哪些内容被误解了，或者更好地理解这些细微差别。

So that's where I think we can educate the public a little more about some of the scientific, even statistical epidemiological nuances so that they can recognize when things are misinterpreted or they can understand the nuances a little better.

所以这是我一直在尝试做的事情，但我不知道自己是不是在努力中走得有点太远了。

So that's something I've tried to do, but I don't know if I'm I probably am trying to push it too far in my, you know, my efforts.

但总的来说，我认为我们需要找到更好的方法来做到这一点。

But overall, I think that that's something, you know, we need to figure out how to do better.

我们生活在一个受过良好教育、信息灵通的社会，人们能够接受像成年人一样的对话。

We have a very educated, informed society, and people can handle being talked to as adults.

我们不需要像对孩子一样跟他们说话。

We don't need to talk to them as children.

是的。

Yeah.

对。

Yeah.

当你谈到这一点时，我突然想到各种不同的素养，比如科学素养、数据素养、统计素养。

You know, just as a, as you were talking about that, I found myself thinking about different types of literacies, whether it was scientific literacy, data literacy, statistical literacy.

你选一个最喜欢的吧。

You pick your favorite one.

还有，你提到的那个问题，比如疫苗的有效期能持续多久？

And and just this the story that the you mentioned this the question about, well, you know, how long does a vaccine's effectiveness last?

我觉得我能理解这种困惑，比如说：‘我小时候打过疫苗了。’

And, you know, I think that there's I can can well imagine the confusion of saying, oh, I was vaccinated this as a kid.

现在就不需要再打了，或者我最近刚打过，接下来七年都不用再打。

Now I don't have to do it again, or I was vaccinated recently and I don't have to do it for another seven years.

但当你面对一种新出现的疾病时，却被告知：‘你得在六个月后再打一次？’

And the idea that that you're starting out with something for this recent disease and you go, well, you know, I have to do this again in six months?

或者我得……你知道的？

Or I have to you know?

这些挑战在于，人们要理解：对于不同的疾病和相应的干预措施，它们的效果并不都是一样的。

There there are these these kind of challenges to try to process the fact that that with certain diseases and certain kind of interventions for them, they don't all just work the same.

所以，要讲清楚这个故事真的很难。

So that that's a that's a hard hard story to tell.

我觉得确实如此，因为人们普遍认为疫苗是小时候打的，能终身免疫，不会再得这种病。

I I think it is because I think people think vaccine, yeah, is something you get as a child and you have lifelong immunity, and you're not gonna get to the disease.

而且，你知道，这有点过于简单了。

And, you know, and that's a little bit simplistic.

我认为对于某些类型的病毒，即使你感染了，比如新冠病毒就是如此。

And I think for for certain types of viruses, even if you get infected, like and this is true of SARS CoV two.

如果你今天感染了，康复后就会有一定的免疫保护。

If you get infected today, you you have some immune protection once you recover.

这很好。

So that's great.

但你可能在不到一年的时间内再次感染新冠。

But you might get you might get COVID nineteen again in less than a year.

所以，这种保护并不会持续你的一生。

So, like, that protection doesn't last the rest of your life.

它可能只持续一年左右。

It might only not it might only last a year.

既然自然感染本身都不能提供持久的免疫力来防止再次感染，我们又为何期望疫苗能永久有效呢？

So why would we expect vaccines to somehow be permanent if the infection itself does not provide permanent immunity against reinfection.

当病毒快速变异并且以非常高效的方式传播时，要完全阻止和预防它们是非常困难的。

And when we have viruses that mutate quickly and that spread certain ways that are very efficient, it's just really hard to just completely stop and completely prevent them.

我们希望减轻它们的影响，使它们不致人死亡，不让人住院，并且希望尽可能减缓传播。

We wanna mitigate them so they don't kill people, so they don't put people in the hospital, and hopefully, we can slow the spread.

但我们可能永远无法完全阻止传播。

But we may never stop the spread.

我们可能永远无法让病毒彻底消失，但也许这也没关系。

We may never make the virus ever go away, but maybe that's okay.

我们可以学会与周围存在的各种病毒共存。

We can learn we we learn to live with all kinds of viruses that are around us.

但问题是，我们能否减轻这些病毒带来的严重风险？

But the question is, can we mitigate the serious risks from that?

你正在收听《统计与对话》，我们正在与杰夫·莫里斯讨论疫苗的有效性以及应对与疫苗使用相关的误导信息。

You're listening to Stats and Stories, and we're talking with Jeff Morris about vaccine effectiveness and countering misleading information related to the use of vaccines.

你知道，有一个问题是，为什么最近人们对疫苗有如此强烈的抵触情绪？

You know, one one question is, why has there been such a pushback against vaccines, particularly recently?

是的

Yeah.

这是个好问题。

It's a good question.

我的意思是，我认为随着时间的推移，一直都有某些群体对疫苗持怀疑态度，质疑疫苗是否过多，或者疫苗是否造成了未被承认的伤害。

I mean, I think that over time, there's always been, you know, groups of people that have been vaccine skeptics and wondering whether there's too many vaccines or whether vaccines are causing damage that's not being acknowledged.

我认为这种情况已经持续了几十年，但我认为疫情确实让这种观点获得了更多支持，某种程度上变得更加主流，并迅速蔓延开来。

And I think that's that's been around for decades, but I think the pandemic really helped that to gain much more support and maybe become more mainstream in some ways and really take off.

所以，我认为我们之前谈到的一些问题，比如人们对疫情期间政府应对措施的不满——首先是严格的防控措施，然后是对疫苗的担忧，人们可能觉得政府在解释疫苗已知和未知的信息时不够透明。

So I think some of the issues we were talking about related to people, you know, being upset about the government response during the pandemic, like, first, the strict mitigation, and then with the vaccines that people were concerned about, maybe, you know, people feeling like they weren't being transparent about explaining everything that was known and unknown about the vaccine.

接着，当出现像强制接种和疫苗通行证这样的措施时，人们感到被迫接受自己并不安心的事情，这会激发强烈的情绪。

And then when when there's something like mandate mandates and vaccine passports where people feel forced to take it when they're not comfortable, that raises the emotion.

我认为这加剧了人们对新冠疫苗的诸多担忧。

And I think that contributed to a lot of a lot of concern about the COVID vaccines.

我认为在疫情期间，很多人会说：看。

And I think a lot of people during the pandemic would say, look.

我不是反疫苗的。

I'm not anti vaccine.

你知道，我支持所有其他疫苗，但我就是反对新冠疫苗。

You know, I I support all the other vaccines, but I'm just anti COVID vaccine.

但有趣的是，我认为有一部分对新冠疫苗感到失望的人，在过去几年里逐渐转向对所有疫苗或至少更多种类的疫苗产生怀疑和担忧。

But what's kind of interesting is I think a subset of people that became disillusioned with COVID vaccines have sort of progressed in the last couple years to being skeptical and concerned maybe about all vaccines or at least a larger class of vaccines.

我认为这很大程度上是疫情中一些动态自然发展的结果。

And I think a lot of that has naturally come out of some of the the dynamics of the pandemic.

但接着想到RFK，他过去几十年一直以某种方式作为活动家，通过儿童健康防御组织关注疫苗可能带来的危害。

But then I think also with RFK, who's really spent the last couple decades as, you know, kind of a crusader in some ways, again, you know, about potential vaccine harms through the Children's Health Defense Organization.

当他成为卫生与公众服务部部长时，我认为这进一步将这些观点带入了当前政府主流和广大公众的视野。

When as he became the director of HHS, I think that's, again, brought these ideas more into the mainstream of the current administration and for a large part of the public.

而我们看到的一些变化仍在持续引发这些问题并推动变革。

And then some of the changes that we've seen going on are continuing to raise these questions and make changes.

因此，我认为在某种程度上，这些观点已经与某些政治团体和政治立场联系在一起，使得这些人现在会以不同的方式看待这些观点，甚至更倾向于相信它们。

So I think that in some ways, these ideas have become connected to certain political groups and political viewpoints so that those people will now look at these ideas in a different way and perhaps lend more credence to them.

所以我认为所有这些因素共同作用，但我觉得疫情确实在帮助这些观点在更多人中传播和扎根方面发挥了作用。

So so I think all of those dynamics together, but I think the pandemic definitely played a role in sort of helping these ideas grow and take root in more people.

你发表了一篇刊登在《美国流行病学杂志》上的文章，探讨了与新冠疫苗及疫苗有效性相关的各种热门观点和谬误。

You have a article with the American Journal of Epidemiology that was examining some of the hot takes and fallacies that were circulating in relation to COVID-nineteen vaccines and vaccine effectiveness.

当你谈到这些推动疫苗相关世界观的政治人物时，我不禁想听听你的看法：与此同时，社交媒体已成为一个极具影响力的平台，谣言、叙事和观点在这里广泛传播，即使人们试图纠正，错误的理解也可能迅速走红。我想知道，在传播疫苗有效性信息、缓解部分疫苗怀疑论观点方面，社交媒体究竟构成了多大的问题？

As you're talking about this and the political figures that are pushing this kind of worldview around vaccines, I wonder what your thoughts are because at the same time social media has become this very potent space where myths and narratives and ideas get spread really widely and often you know a misguided take on something can go viral even as people try to correct it and I wonder how much of a problem is social media when it comes to trying to communicate about vaccine effectiveness and and sort of mitigate some of these more vaccine skeptic views.

是的。

Yeah.

不是。

No.

我觉得这是个大问题，社交媒体在其中扮演了重要角色。

I I think it's a big thing, and I think social media is a big part of it.

但我认为这甚至比社交媒体更广泛，如果我们回溯历史，比如我是个X世代的人。

But I think it's even broader than social media that like, if we think back historically, like, I'm a Gen Xer.

我成长的时候，电视只有三个频道，新闻就在那里，还有本地报纸。

And as I grew up, we had, like, three channels on TV, and you had the news there, and you had your local paper.

我小时候连《今日美国》都没有。

You didn't even have USA Today when I was a kid.

所以每个人都在看同样的新闻。

And so everybody was getting the same news.

我们有不同的观点，但我们都看到同样的内容。

And we have different views, but we were all seeing the same things.

不管是不是完整或全面的故事，人们当然可以质疑，但我们都看到的是同一件事。

Whether it was complete or the full story, you know, people could question, but we were seeing the same thing.

但随着时间推移，互联网让所有信息都通过社交媒体变得触手可及，而现在人工智能会了解你是谁，并为了营销目的，只给你想听的内容。

But over time, the the Internet made all this information available on social media, and now AI gets to know who you are and for marketing purposes, gives you what you wanna hear.

所以这实际上加剧了极化现象，制造出巨大的回音室，人们只能接收到机器人认为他们想听的信息。

So it it really just exacerbates sort of the polarization and creates these enormous echo chambers where people get fed information that the bots think is what you wanna hear.

因此，这往往会让人对现实产生扭曲的认知，因为他们看到的一切都在强化他们的观点。

And so what it what that tends to do is it can give people a distorted sense of reality because everything they see is reinforcing their view.

而那些与他们观点相悖的信息，他们往往很少看到。

And the the things that contradict their views, they don't tend to see as much.

因此我认为，这导致了更广泛的两极分化，甚至超出了疫苗这一议题。

And so I think it leads to greater polarization just more broadly even outside of this issue of vaccines.

但当涉及到疫苗这些议题时，我认为这是一个严重的问题，因为很多人，包括我自己，当疫苗最初获批时，确实有一些合理的疑问。

But then when it comes to these questions about vaccines, I think it's a tremendous problem because a lot of people have legitimate questions, like me included, when they were especially when they were first approved.

我确实有一些真正的批评意见。

And and I definitely have some genuine critiques.

我看到确实存在真正的风险。

I see that there are genuine risks.

因此，在这种环境中，当有些人想把事情推向更极端时，就会为一些人制造出一个有利的环境，让他们提出可能非常夸张、甚至不实的主张，但这些主张仍会获得大量追随者，并在社交媒体上被转发和传播。

So I think in that environment where there's other people that wanna take it much further, then it creates a ripe environment for people to make claims that that are maybe even very dramatic, maybe untrue, but they'll still gain a tremendous following and get forwarded on social media and and spread.

然后，很多人会倾向于相信这些说法，因为它们强化了他们的疑虑。

And then a lot of people will tend to believe it because it's reinforcing their doubts.

所以，是的，我认为这是一个巨大的问题。

So, yeah, so I think that's that's a huge problem.

老实说，这正是让我在疫情期间更深入参与社交媒体的原因。

And, honestly, that's kind of what got me involved to get more involved in social media during the pandemic.

一开始，我只是发了一些社交媒体帖子，但后来我创建了一个博客，coviddatascience.com。

That first, I just did some social media posts, but then I created a blog, coviddatascience.com.

我的目标是利用自己作为生物医学科学家和统计学家的专业知识，通过数据和新兴研究来评估证据，运用科学原则进行批判性分析，并发布关于数据真实反映的可靠信息。

And that was really my goal was to try and use my expertise as a biomedical scientist and statistician to evaluate the emerging evidence using the data and the emerging studies and to critically assess them using scientific principles and try and put out reliable information about what the data shows.

同时，作为这一努力的一部分，反驳我认为缺乏数据支持的主张。

And then as part of that, to counter claims that I think are not supported by the data.

因此，我的目标之一是进入这个领域，提出问题，帮助人们更仔细地审视他们所相信和传播的内容——这些主张真的有数据支持吗？

And so that was part of my goal to try and, you know, get into that space and raise questions and and try and help people to look more carefully at these things they're believing and seeing does the data really support this claim that you're believing and forwarding.

你知道吗，你的一些文章让我特别注意到一点，那就是研究经常被误解。

You know, so one of the things that struck me with with some of the the writing that that you've done is is the how often you'll see that studies are are essentially misinterpreted.

基本上，人们会说：看。

That that basically people are saying, look.

数据显示，接种疫苗的人越多，该社区的死亡人数就越多。

The data shows you that the the more people that are vaccinated, the more the more deaths you observe in that community.

这种现象确实存在，但这种看法相当天真，因为它没有控制那些熟悉良好研究设计和分析的人会注意到的其他因素。

So it's there but that's kind of a naive assessment because it's not really controlling for factors or other things that someone that knows something about good study design and analysis would be sensitive to.

你能举一两个这样的例子，说明这种情况是如何发生的，以及你是如何拆解这种错误论点的吗？

Could could you talk through at least an example or two where that occurred and and how you kind of deconstruct kind of this false argument?

是的。

Yeah.

当然。

Sure.

从大方向来看，这正是公众理解起来特别困难的地方：有时候，那些看似简单、直观、清晰的东西其实是错误的。

And and the big picture of this that and this is what's really tricky with the public is that sometimes what seems very simple and intuitive and clear is wrong.

对。

Yeah.

而真相往往更加复杂。

And the truth is more nuanced.

但由于不信任，当有人试图解释这种复杂性时，听起来就像在回避问题，试图掩盖显而易见的事实。

But then because of the distrust, when you someone tries to explain the nuance, it sounds like they're double talking and trying to cover up what is plainly true.

我认为这种动态使得情况变得棘手。

And I think that dynamic makes it tricky.

但是，是的，我的意思是，很多出于善意、非常聪明的人误解了我们所看到的很多内容。

But but, yeah, I mean, a lot of stuff, very well meaning people, very intelligent people misinterpreted a lot of what we saw.

而且，再次强调，我们正处于一个开放数据和开放互联网的时代。

And, again, we're in sort of an open data age and an open Internet age.

因此，所有这些数据都是可获取的，这很好，但这也意味着人们会做出天真的总结并做出断言，然后这些内容会被广泛转发。

So all this data is available, which is great, but that also means that people will do naive summaries and make claims, and it will get forwarded.

我知道有几个例子引发了我自己的博客文章，而这些文章本身也走红了。

So I know there were a couple examples that that are that led to blog posts that I I did that I think kinda went viral themselves.

但其中一个例子发生在2021年，当时疫苗已经推出约六个月，有报道称约60%的住院新冠患者是已接种疫苗者。

But one of them was, like, in in 2021 where the vaccines have been out about six months, there were reports that about sixty percent of the hospitalized COVID patients were vaccinated.

于是人们就说，因此疫苗根本不起作用。

And so people were saying, well, therefore, the vaccines can't be working.

60%，这已经超过一半了。

Like, sixty percent, that's more than half.

所以接种疫苗的人反而更糟糕。

So the vaccinated are worse off.

当我看到这个时，以色列已经在网上公布了这些数据，而且确实属实。

And so when I saw this, Israel had shared this data on the web, and indeed it was true.

当时住院的感染者中，有百分之六十是接种过疫苗的。

Sixty percent of those that were currently hospitalized infections were vaccinated.

但当我更仔细地查看数据时，我们发现当时以色列百分之八十的成年人已经完全接种了疫苗。

But then when I looked at the data more carefully, we saw that eighty percent of the adults in Israel were fully vaccinated at that time point.

因此，当你实际计算接种者和未接种者中严重感染的比率时，会发现接种者的住院感染率比未接种者低了百分之六十七。

So when you actually then compute the infection the the severe infection rate in the vaccinated and unvaccinated, actually, the vaccinated had a sixty seven percent lower rate of of hospitalized COVID infections than the unvaccinated.

所以这百分之六十让人误以为接种者状况更差，但实际上，作为一个整体群体，他们的风险低了三分之二。

So the sixty percent made it look like the vaccinated were worse, but actually, they were, as a entire group, two thirds better.

这被称为基础比率谬误：当你比较两个群体时，如果其中一个群体规模大得多，那么仅看事件的绝对数量，规模更大的群体看起来状况更差，即使其事件发生率实际上低得多。

So that's something called the base rate fallacy, where if you compare two groups and one group is much bigger, then if you just look at the actual number of events, the group that is bigger looks like it's doing worse even if its rate of that event is much lower.

所以当时发生的就是这种情况。

So so that was what was going on.

但更微妙的是，根据我们听到的信息，风险降低百分之六十七其实已经相当令人失望了。

But then there was even something more subtle there because from what we were hearing, sixty seven percent lower risk would be very disappointing.

当时我们预期的效果应该接近百分之九十，这基于我们所听到的信息以及其他一些数据。

We expected something more like ninety percent at that time based on what we were being told and what what some other data showed.

但有趣的是，这指的是所有年龄组的接种人群总体情况。

But what's interesting is that's all vaccinated across all age groups.

因此，以色列将数据按50岁及以上和50岁以下进行了划分，发现老年人群的接种率确实更高。

And so Israel had split it into those 50 and those 50, and the older people were simply more vaccinated.

超过百分之九十的老年人已经接种，而百分之八十以上的未接种者都集中在年轻群体中。

So over ninety percent of the older people were vaccinated, and more than eighty percent of the unvaccinated were in the younger group.

所以，如果你将人群按年轻和年老分开，再计算重症新冠的发生率，会发现年轻人中接种者患重症新冠的可能性降低了百分之八十五。

So if you just split the groups into the younger and older and computed the severe COVID rate, then actually in the younger people, they were eighty five percent less likely to have severe COVID.

对于老年人来说，如果接种了疫苗，患重症新冠的可能性则降低了百分之九十二。

The older people were ninety two percent less likely to have severe COVID if they were vaccinated.

因此，最初看起来像是接种组表现更差的数据，实际上反而显示出强烈的保护作用，风险可能降低了近百分之九十。

So what initially looked like it was saying the people in the vaccinated group did worse looked like, if anything, there was a strongly protective effect, perhaps even ninety percent reduced risk.

这就是年龄混杂效应的一个例子，甚至更微妙的一种现象，叫做辛普森悖论。

And so that's an example of age confounding and even something really subtle called Simpson's paradox.

所以当我发布这篇帖子时，这是我第一篇走红的帖子。

So so when I I did a post on this, and this is my first post that went viral.

我发布的第二天，这篇帖子被下载了近百万次，意大利、西班牙和德国的主要报纸都刊登了文章，讨论我的博客帖子，因为人们都在疑惑这怎么可能成立。

I got downloaded almost a million times and newspapers in the next day after I posted it in Italy, in Spain, and in Germany, their main newspapers printed an article on my blog post talking about this because people were wondering how this could be true.

之后有很多人告诉我，他们用这个例子来说明辛普森悖论，因为人们对这60%感到非常困惑。

And and then I got a lot of people that have told me they use this as an example of Simpson's paradox because people were really perplexed about the 60%.

但当你以非常基础的方式拆解分析时，就能看出人们为什么会误解这些数据。

But when you break it down, even in a very basic way, you can see how people would misinterpret the data.

所以，你知道，打破信息茧房、运用科学方法、检验你所相信的东西，这些都是非常重要的理念。

So, you know, this is this idea of breaking out of out of echo chambers and using the scientific method and kinda testing what you believe, these are all really important messages.

如果你要建议公众更批判性地看待各种说法，你有什么建议可以分享吗？

If you're gonna if you're gonna advise the public to to kind of con be be more critical consumers of claims, do you do you have a piece of advice or two you might share?

这是个好问题。

That's a good question.

我的意思是，这取决于具体情境，因为这里面有很多陷阱。

I mean, I think it depends on context because I think there's a lot of potholes.

但我在自己的沟通中强调的一点是观察性数据。

But one thing emphasize in my own communications is observational data.

从观察性数据中得出因果结论非常困难。

It's really hard to draw causal conclusions from observational data.

所以当你看到观察性数据时，必须非常、非常谨慎。

So when you see observational data, you have to be very, very careful.

那些看起来非常简单、对你来说非常直观的总结，可能完全是错误的。

And you can't what looks like a really simple summary and is really intuitive to you can be completely wrong.

你可能会得出完全相反的错误结论，而这既困难又微妙。

And you might draw the total opposite wrong conclusion, and and it's difficult and subtle.

因此，我最大的警告就是对这一点保持谨慎。

And and so that's my biggest warning is to just be cautious about that.

在我的一些博客文章中，现在我更多地转向了Twitter（X）平台，我会尝试突出那些我反复看到的问题，帮助关注我或看到我帖子的人自己识别出来。

And then in some of my, you know, blog posts, and now I've switched more to Twitter, x, doing things, but I try to highlight some of the things I see over and over again to try and help the people that follow me or see my posts be able to recognize it on their own.

我认为在某种程度上，这取得了一些成效，因为我看到人们自己提出这些担忧，说：‘哦，不。’

And I think to some degree, there's some success in that because I see people raising these concerns on their own saying, oh, no.

这是辛普森悖论，或者说是，哦，不。

This is Simpson's paradox or, oh, no.

这是基础比率谬误。

This is bait rate base rate fallacy.

所以我觉得这有点帮助。

So I think it helps a little bit.

好的。

Alright.

好吧，我担心我们今天这期《统计与故事》的时间到了。

Well, I'm I'm afraid that's all the time we have for this episode of stats and stories.

杰夫，非常感谢你今天加入我们。

Jeff, thank you so much for joining us today.

真的非常感谢。

So much.

当然。

Sure.

谢谢。

Thank you.

非常感谢。

Appreciate it.

《统计与故事》是美国统计协会与迈阿密大学统计学系、媒体新闻与电影系的合作项目。

Stats and stories is the partnership between the American Statistical Association and Miami University's departments of statistics and media journalism and film.

您可以在Spotify、Apple Podcasts或其他您收听播客的平台收听我们。

You can listen to us on Spotify, Apple Podcasts, or other places you can find podcasts.

如果您想对我们节目提出意见，请发送邮件至statsstories@amstat.org，或访问statsandstories.net了解更多信息。

If you'd like to share your thoughts on our program, send your email to statsstories@amstat.org, or check us out at statsandstories.net.

别忘了收听《统计与故事》的后续节目，我们将探讨统计背后的叙事以及叙事背后的统计。

Be sure to listen for future editions of stats and stories where we discuss the statistics behind the stories and the stories behind the statistics.