You have to be very careful” before tying COVID-19 vaccines to complications, Nath cautions. “You can make the wrong conclusion. … The implications are huge.”
No, you just tell the truth, every time, all the time. This foolish gymnastics where government and public health authorities are putting themselves through because they're scared of potential negative outcomes has resulted in a catastrophic collapse in trust by the public. This itself will have huge implications for any future society-wide initiatives that we may need for the public good.
For reference, here is one counter example from Japan[0][1], where the benefits and risks are communicated clearly. Will crackpots still behave like crackpots? Sure, but crackpots are like that now any way. This "paper over the truth" has damaged credibility amongst a lot of moderates.
PP isn't wrong about communication about vaccine risks being abysmal (in the US at least) or about the erosion of trust in public health agencies and officials. Even those awful "ask your doctor for a reason to take it" drug ads have a lengthy disclosure list of (often serious) potential side effects. Most of the "get the vaccine" ads I've seen have no such disclosure.
It's disappointing, because being forthright about, for example, how many people have died from the vaccines vs. how many lives have likely been saved by them could help the public to assess the overall benefit without discounting the risks. And this should also be sliced by risk groups, such as young or old or people with secondary conditions.
Moreover, vaccine mandates should include compensation for lost work (or school) time not just due to rare side effects but also due to feeling ill after getting the vaccine (or booster, which seems even more likely to make you feel unwell for multiple days.)
I am sorry, my intent was to pinpoint a possible conflict of interest between policy makers and specific policies benefiting specific for-profit entities.
With all due respect, I believe this is a fair point to consider, even though I expressed it in a rather sarcastic way.
That's pretty believable, if long covid is a long term reaction to the spike protein.
It's not like not getting the vaccine would prevent getting long covid in that case though. It does not however explain why getting the vaccine would get rid of long covid though?
Actually, it could. If long COVID is a reaction to the spike, given that infection produces multiple orders of magnitude more protein and that vaccination leads to lesser viral vaccination, it's almost certainly a net positive.
If it's because of latent infection, a vaccine that helps stop infection would reduce the amount of spike protein to zero, which would help.
If it's an autoimmune reaction, vaccines generally provide a different immune reaction than infection, and subsequent immune reaction to infection would be different, so it could improve immune reaction.
"infection produces multiple orders of magnitude more protein and that vaccination leads to lesser viral vaccination"
Do you have a source for this claim? Last time I tried to research this and get a figure for the difference, there was just no way to directly compare dosages. But it turned out that antibody titer is much higher in the vaccinated than the unvaccinated-and-infected, which implies the effect of the vaccine is stronger.
The general rule seems to be that whatever you assume about COVID vaccines, regardless of how basic it may appear to be, will turn out to be riven with conflicting facts when trying to find support for it.
Antibody titers don't imply anything about the relative effect of vaccination versus infection. You have to assay cellular immunity in order to make a meaningful comparison.
But we're not talking about vaccine effectiveness, we're talking about strength of the response provoked in the body. It would be nice if the relationship was as simple as a linear one between antibody levels and clinical outcomes, but as you point out, it's not. The question here is simply which produces more of the toxic spike proteins.
Yes, the antibody titer will be higher with vaccines no matter what, because the virus has some serious immune evasion mechanism and that the vaccine is much more immunogenic.
If you want to estimate the amount of spike produced by the vaccine, we can take the fact that we know the amount of mRNA in the Pfizer vaccine is 30mcg. The mRNA is ~4000 nucleotides long, which gives us a molar mass of 2000kg/mol. So the vaccine actually has 0.015 nanomoles of mRNA which turns out to be around 10^11 mRNA molecules.
Now we know COVID infection produces around 10^12 virions each of which has ~30 spikes, and there are certainly at least 3x more spike protein made that doesn't end up in a virion, so we have ~10^14 spikes from natural infection.
You would thus need each mRNA particle to enter a cell and be transcribed (impossible) and for each mRNA strand to produce 1000 spike proteins, which is very improbable.
So it is very likely that indeed vaccines produce much fewer s proteins than natural infection.
Well, thanks for attempting a numerical and physics based analysis. That's much more than you can find in the (public) documents submitted to regulators. I voted you up as I've been looking for some sort of calculation for a long time.
I have some questions though.
Firstly, I think your analysis would only be true for Pfizer. Moderna has a dose 3x stronger (90mcg equivalent).
Secondly, what exactly is the virus' immune evasion mechanism that the mRNA lacks? I thought it was the other way around - the mRNA is coded with pseudo-uridyl specifically to evade the immune system, but normal viral RNA doesn't use that trick. It would seem to be much more likely that the virus is detected by the immune system than the mRNA particles, specifically designed to evade it.
For a novel argument like this one some citations would really be helpful. Where did you get the number of virions per infection, exactly? Surely this number will vary wildly between patients? What's the CI on that? Where did the 3x number come from?
You say:
"for each mRNA strand to produce 1000 spike proteins, which is very improbable."
Why? From [1] we can read that each dose "consists of around 13,000 billion repetitions of the same 4284 characters". This seems like a huge number of repetitions of the spike protein sequence and this is a highly optimized sequence. They appeared to make great efforts to optimize it well beyond what nature would achieve. I'm not sure how to convert "strand" to "dose" here, but all your numbers and probabilities seem rather hypothetical.
So what we're left with is still something much simpler and easier to measure (antibody levels), which are higher for vaccines, suggesting the body perceived it as a more aggressive invasion. And that's a problem: more antibodies = higher chance of autoimmune disease, at the very least.
> Why? From [1] we can read that each dose "consists of around 13,000 billion repetitions of the same 4284 characters". This seems like a huge number of repetitions of the spike protein sequence and this is a highly optimized sequence. They appeared to make great efforts to optimize it well beyond what nature would achieve. I'm not sure how to convert "strand" to "dose" here, but all your numbers and probabilities seem rather hypothetical
Yes, each repetition is an mRNA strand, so what I wrote is in agreement with that quote. You would need each "repetition" to be translated to 1000+ spike proteins. Of course, the sequence is highly optimized, but it has to be optimized for many things - speed of translation and immunogenicity are much more important than persistence, and persistence is what would allow it to be translated many times. Least of which is because if you produce too many too fast the cell is just going to explode or form syncytiae.
> Secondly, what exactly is the virus' immune evasion mechanism that the mRNA lacks? I thought it was the other way around - the mRNA is coded with pseudo-uridyl specifically to evade the immune system, but normal viral RNA doesn't use that trick. It would seem to be much more likely that the virus is detected by the immune system than the mRNA particles, specifically designed to evade it.
Normal viral RNA is encapsulated in a virus. There is no need for pseudouridine because there won't be RNA in the open for the immune system to react until after infection. The vaccines need it because they want to create immune response to the spike instead of the mRNA and to lead to higher delivery. This, instead of leading to immune evasion, prevents the immune system from reacting to the wrong thing, which makes the vaccine more effective.
The immune evasion capability of the virus is completely different from pseudouridiliation, and are actually detrimental. It interferes with many signaling molecules necessary to the immune system, and induces the immune system to act as if it wasn't a virus but instead a parasite to some extent. This causes the immune system to react very inefficiently and erratically, causing responses that are damaging to the body, and also affects antibody formation. It can also induce T-cell exhaustion
The virus also has more proteins than simply the S protein, which means that the immune system may initially focus on other parts of the virus.
Then there is the fact that the lipid carrier as well as mRNA itself is highly immunogenic, even with pseudouridine. This means that for the same amount of spike protein, the vaccine will create a very strong and immediate immune reaction.
I went with the higher estimates because Delta (and thus Omicron) have much higher viral loads. This is on the order of 1000x, but I only took 100x more than the lowe bound to be very conservative. If you want to be accurate, you can multiply the number of spike protein from the virus that I wrote by 100x : https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8375250/
As you can see, it is normal that we would see a higher number of antibodies from the vaccine.
> more antibodies = higher chance of autoimmune disease, at the very least.
Absolutely not. What matters for autoimmune diseases isn't the amount of antibodies, but the type of antibodies. Vaccines only have one out of a dozen proteins in the vaccine and in only one conformation and one form, while the virus has all of those proteins in many conformations and will accumulate hundreds of mutations leading to even more antigens. So at the same amount of antibodies we expect a higher chance of autoantibodies from natural infection.
As for why they didn't send this to regulators, why would they? They have empirical data from trials that show this didn't happen, and the regulators didn't ask for it.
As for the 3x, viral assembly is a haphazard process. Virus proteins very often don't come together right - for some viruses the vast majority of virions are incomplete. I'm not aware of data on it for COVID except that the vast majority of virions that do have RNA (and not all do) are incomplete and can't infect, (see the number of virions paper), so for every RNA containing virion there is almost certainly much more than 3x as many spike proteins as if it was a complete virus. 3x is just a very conservative estimate.
Not all of it. A certain fraction of the lipid membranes wont ever get to a cell intact. A good fraction of mRNA will be damaged and won't be viable. Etc, etc.., the long and short of it is that much less than 100% of the RNA will actually make it to a cell.
Maybe I misread your post if your claim was that not every mRNA strand enter the cell. apologies.
That said, this type of mass analysis is deeply flawed.
It ignores the difference between mRNA weight and spike protein weight. I believe this lowers the ratio as the mRNA is more massive than the spike protein encoded.
On the other side, it ignores the number of of times each mRNA strand is transcribed to protein. It also ignores the adjuvant effect of the lipid nanoparticle, which amplifies the immunogenicity of the protein mass.
That said, I think the entire discussion of mass is a gross oversimplification to the question of comparing possible long covid autoimmune conditions between vaccination and natural infection. There is soo much more going on: rates of immune response, differences in intensity, differences in immunogen proteins, ectara.
Overall, I think it is an open question. It seems plausible that vaccination could cause long covid in some cases, especially given that it has been show capable of causing autoimmune multisystem inflammatory syndrome. It is also plausible that it could be used to address long covid, by attenuating the immune response or some other mechanism.
I'm not doing mass analysis. That's why I divided by the molar mass of the mRNA strand. I'm comparing the number of virions to the number of mRNA strands. I already corrected for what you mentioned.
> It also ignores the adjuvant effect of the lipid nanoparticle, which amplifies the immunogenicity of the protein mass.
If you think long covid is caused by the immune reaction, this is all moot, as I said in the original post. It's very possible longcovid is autoimmune, but it's possible it's not.
I saw mrna strand vs spikes, so this at least leaves out transcription cycles. I point this out now not to be argumentative, but simply because I'm curious. My understanding was that it was not one to one.
Also for the sake of curiosity, what are the non immunogenic theories? Some sort of persistent damage from the spike count?
Yes, I also took into account transcription cycles - it would take 1000+ transcriptions per mRNA strand to break even.
But yes, persistent damage from spikes is a non immunogenic theory. There are also theories of persistent infection and viral damage to various organs, as well as exhaustion of the immune system, etc..., and of course it could be a sum of any.
In the last few days several major publications have had articles discussing the grey areas of the covid response in ways that didn't seem acceptable recently. It feels like we've made a cultural shift from pandemic to endemic, and fear has much receded. HN readers are flagging these topics less heavily too. It's encouraging.
Let’s hope so, because this quote from the article scares the hell out of me:
> Other researchers note the scientific community is uneasy about studying such effects. “Everyone is tiptoeing around it,” Pretorius says. “I’ve talked to a lot of clinicians and researchers at various universities, and they don’t want to touch it.”
The minute we are no longer allowed to ask questions either through external censorship or pressure to internally censor, is the day we start declining to our demise as a species.
You realize a main reason they are reticent is because anything they say would get grasped upon and misinterpreted and blown up on the internet, And that it would be unbearable for a vaccine researcher to know their words, even if twisted online, caused people to die needlessly.
Also the latest cia report on the Havana syndrome was that only a few dozen are unexplainable and could be an attack, all the hundreds of others reporting symptoms later were explainable by preexisting conditions, stress, and anxiety.
Whether or not there are actual side effects to the vaccine like the story here, there will be hundreds or thousands of people who are like the ones from the Havana syndrome report. It’s a stressful anxiety filled time. Their symptoms are real, but the cause they attribute them to is misplaced.
Doubt it. Scientists are not afraid of making mistakes, that happens all the time. They are afraid of losing funding and the fastest way in 2022 to lose funding is to suggest something outside the political and social acceptability narrative.
Look, in the article it literally quoted a main reason being any spurious result would be grasped on and lead to death. One is welcome to believe whatever affirms ones narrative regardless of facts, but that doesn’t make the narrative true.
> >” Probing possible side effects presents a dilemma to researchers: They risk fomenting rejection of vaccines that are generally safe, effective, and crucial to saving lives. “You have to be very careful” before tying COVID-19 vaccines to complications, Nath cautions. “You can make the wrong conclusion. … The implications are huge.” ”
That’s your opinion, but in the article there is a quote saying scientist law are literally afraid of making a mistake and it being grasped on by the anti vax crowd and taken for something it is not.
>” Probing possible side effects presents a dilemma to researchers: They risk fomenting rejection of vaccines that are generally safe, effective, and crucial to saving lives. “You have to be very careful” before tying COVID-19 vaccines to complications, Nath cautions. “You can make the wrong conclusion. … The implications are huge.” ”
In Australia there is finally some attention to the police/government response of last year. One man was grabbed from behind by a police officer, lifted and slammed face first in to the ground. This kind of stuff was not politically correct to discus back then because people were panicking but now looking back, this was all too far.
That was exactly one of the key worries expressed by Robert W Malone(quite relevant expert to say the least), who is not even anti-vaxx, but argued that people should have informed consent over their health, but the censors thought othervise.
All the hysterics in the comments over censorship and suppression.
Wake up.
1. This is an article proving that people still have a voice.
2. The article shows a tiny fraction of those who got vaccines are experiencing major adverse side effects that are not yet explained.
3. If you told someone that there was a 1 in 100,000 chance this could make their life worse they rationally would still take the vaccine. The only people this affects are the irrational.
Should people have informed consent? Yes. Does that mean you have to outline in excruciating detail every single rare chance that there is the remotest possibility of happening to them? Maybe, but I'd argue humans are terrible with statistics and worse with action: it's better for everyone and for each individual to know there are infinitesimal risks and huge, immediate benefits.
Which is exactly what has been said. Long covid from vaccines is a new tiny risk that needs to be studied. But if you don't want long covid the best way to avoid it is still to take a vaccine. It's not a choice here: it's just mathematically provable.
If you can prove me mathematically that I am better off with the vaccine I will take it. Seriously. I believe I have sufficient background in math and I am willing to pick up extra if needed.
I could give you background info on me (age, health, covid status etc) but you said you could prove it for all possible hn commenters so I'd keep my privacy.
Long COVID-like symptoms or not, the protection afforded by COVID vaccines still clearly outweighs the negatives. This holds true especially for at-risk populations.
Well, then like with any other trade-off, we need to quantify and refine:
* How much does the vaccination status reduce the chance of death/hospitalization?
* How does it differ among age groups?
* How does it change over time (not 2 doses vs. booster, but by time since the last dose)?
* How does it affect the transmission rates? Given how many people are critical to masks/vaccines, you can easily find volunteers to do transmissibility tests in 2 buildings of comparable layout.
* What about comorbidities? How does the benefit of losing extra weight compare to an extra vaccine dose?
* What about suicides and the mental health in general?
* How often are new variants expected to appear and what is the estimated vaccine efficiency against them?
* What about the treatments? Can they be scaled up to be more affordable?
Considering and openly discussing these factors could help our society find a reasonable compromise, but we are not doing that. We are pushing a single solution that benefits a small economic group at the expense of everyone else, and are recruiting the general population to wage a holy war against the dissenters. I don't like this at all.
> * How much does the vaccination status reduce the chance of death/hospitalization?
> * How does it differ among age groups?
> * How does it change over time (not 2 doses vs. booster, but by time since the last dose)?
> * What about comorbidities?
> * What about the treatments? Can they be scaled up to be more affordable?
Addressed extensively in the scientific literature. I don't know how you can seriously claim otherwise unless you've been out of the loop for over a year.
> * How does it affect the transmission rates?
How would you go about testing it though? The difficulty is that the viral load is lower (which should reduce transmission probability) but the probability that the person will quarantine also is lower (which should have the opposite effect), and how these things balance in the real world is like guessing.
> * How often are new variants expected to appear
Nobody knows but yes there is open discussion about how new variants come about.
> * What about suicides and the mental health in general?
Don't know what this is getting at regarding vaccines.
I would appreciate some links. All I could find from brief googling looks more like a sales pitch than an unbiased study. Looking at absolute hospitalization prevention numbers without controls, making no distinction between incidental COVID vs. hospitalized for respiratory symptoms, and other tricks that belong to a used car salesman's arsenal, rather than a scientific context. And the disclaimers how "no, no, no, I'm not against the vaccines" remind me of the mandatory praises to Allah you would find in the papers originating from certain Middle Eastern countries.
Shouldn't introducing controls make vaccines look even better, because the old are more likely to be vaccinated?
Suppose 100% of old people and 0% of young people are vaccinated. Even if the vaccines are moderately effective, most of the deaths would be in old people, giving the false impression that they don't work.
> I would appreciate some links.
UK Surveillance Report. Most of the bigger countries have published data.
The only ever double blind RCT of the Pfizer vaccine (that done by Pfizer themselves) found 24% increase in all cause mortality (21 in vaccine arm vs 17 in placebo arm, each group 22,000 of reasonably health mostly 20-50 year olds)
Death with Covid is the baseline requirement (although, ideally, we look at death by Covid, even though that's methodologically difficult) for the above data to have any meaning for the question of whether vaccines work.
Suppose there's 0 Covid cases over the study period. Then this is exactly the result we expect to see. Approximately half the deaths being among the vaccinated, and half the deaths being among the unvaccinated. Because there's going to be heart attacks and so on in the two cohorts over the study window.
Sorry, I think I'm confused, it sounds like all-cause mortality is not the important number to be looking at in your opinion? The person you responded to reports more deaths in the vaccinated group. But you were querying about Covid deaths. Why would you ignore the larger all cause death and concern yourself only with Covid deaths?
Suppose someone offered you a pill. They say with certainty that you can trust that it will prevent you from dying of Covid but increase your likelihood of dying of something else by so much that your overall likelihood of dying actually increases. Is that some pill you'd want to take?
edit: I just finally got your point about a period with zero covid cases. Kind of makes sense, but how could you ever use that to make a claim about a vaccines effectiveness if there is known zero challenge?
If the difference was statistically significant, sure. But it isn't, is it?
~50% of the time, the vaccinated group will have more deaths by chance, even if the vaccine is safe - assuming either little to no community spread during the study, or a small study of young people.
All this result shows is that the vaccine isn't effective at preventing car crashes, which is something we already knew.
There are 4 deaths from cardiac arrest in the vaccine arm, vs. 1 in the placebo; and 1 death from covid vs. 2 in the placebo.
Taken altogether, especially with what we now know about myocarditis/pericarditis risk from the vaccine, non trivial input. And I don't know if you're aware, but the original (dec 2020) approval basically rested on 4:1 placebo:vaccine severe cases. It was approved based on statistically insignificant data, but somehow the same counts of death is not even interesting.
Depending on your model, 21:17 may or may not be statistically significant. I didn't see any "official" modeling of that, especially given that "no deaths were attributed to the vaccine" - if your model says something can't happen, it obviously can't statistically happen .....
There is one "death" (which might as well be a car crash) out of the 29=(15+14) causes listed. All others are medical.
It is not close to statistically significant. Here are two monte carlos under different assumptions which checks how often we expect 21 or more deaths by chance under the null hypothesis of no-effect on non-Covid mortality (i.e., that the vaccines are safe).
##
>>> import numpy
>>> import random
>>> N_vaccine_deaths = []
>>> for j in range(500):
... x = []
... x = [0 for i in range(46000)] + [1 for i in range(38)] # 38 deaths, ~46000 non-deaths
... random.shuffle(x)
... N_vaccine_deaths += [np.sum(x[0:int(len(x)/2)])]
>>> N_vaccine_deaths = np.array(N_vaccine_deaths)
>>> p = np.sum(N_vaccine_deaths >= 21)/len(N_vaccine_deaths )
>>> p
0.296
>>> x = []
>>> for i in range(5000):
... x += [sum([random.random() < (38/46000) for i in range(int(46000/2))])]
>>> p = np.sum(np.array(x) >= 21)/len(x)
>>> p
0.3446
Even just looking at cardiac deaths only and it turns out to be statistically insignificant with a p-value around 0.2. And this is actually p-hacking since we didn't prespecify and lock-in that hypothesis before the study began.
> And I don't know if you're aware, but the original (dec 2020) approval basically rested on 4:1 placebo:vaccine severe cases. It was approved based on statistically insignificant data, but somehow the same counts of death is not even interesting.
I don't see how this is relevant. That was a long time ago and we didn't have much data, hence low statistical power, and the need to make a decision with an incomplete picture. We now have much more data from over 20 countries, and are able to draw more conclusive and confident conclusions about efficacy.
Simulation is much appreciated, even if I would use a different method (but I didn’t have the time, so I’ll accept yours)
We do not have efficacy data from 20 countries. E.g. israeli data which I am intimately familiar with is incredibly biased to show vaccine efficiency. Official data touted based on observational data showed 95% efficiency, while at the same time airport data which is the only place with unbiased testing showed about 60%.
(That data is biased by demographics, but not by sampling).
As you said, there’s no statistically significant RCT data showing vaccines are dangerous, but also no RCT data showing they are effective in preventing severe disease. Statistical significance cuts both ways.
> E.g. israeli data which I am intimately familiar with is incredibly biased
Can you expand on this? Why is the data biased by demographics? Is this data biased in the same way as the other countries that show a 90% effectiveness?
As I argued above, there is a bias that's working against vaccines, given that a larger proportion of old people are vaccinated which leads to an understatement of their effectiveness.
> while at the same time airport data which is the only place with unbiased testing showed about 60%
Link?
> [there's] no RCT data showing they are effective in preventing severe disease
Only because they haven't done an RCT that could possibly pick that up, probably because of some ethical argument that giving people a placebo may cause them to behave more recklessly (which I would disagree with).
> Is this data biased in the same way as the other countries that show a 90% effectiveness?
Well, Israeli MOH rules are basically that unvaccinated people must test at least twice a week to continue normal life, whereas vaccinated people need not test even while showing symptoms, even when being admitted to a hospital ; This had variation over time (e.g., since Jan 2021, approx 8 months only unvaccinated had to test on hospital admission, and 4 months everyone), but that's the gist.
Furthermore, upon exposure to a verified case, the vaccinated can do a home test, and self report that they are negative, and not quarantine - whereas the unvaccinated must quarantine, and test in an offical supervised test, twice in a 7-day period in order to finish quarantine after 7 days, or spend 14 days in quarantine if they do not want to test. (This was shortened to 5 days last week, and also had some variations over time, but same gist).
There are many other biases. It's kind of ridiculous.
I don't know exactly how other countries run these things, but I suspect it's similar in other places, though the details differ.
>> while at the same time airport data which is the only place with unbiased testing showed about 60%
> Link?
It's biased by economical demographic traits, because the people who actually fly are not a representative sample; But since everyone who lands gets tested, there is no bias such as the ones I described above. (Well ... there is; a vaccinated person tests once on arrival and that's it; an unvaccinated person must test again in 10 days, and if positive in the 10-days after arrival is considered to have been postiive on arrival -- but compared to the above, this is a "small" bias).
> Only because they haven't done an RCT that could possibly pick that up,
Well, yes, but there isn't one. As I said, it cuts both ways - they haven't done a test that's powered enough to show vaccine ACM is worse than placebo ACM. Is that the only reason it doesn't exist? Maybe yes, maybe not. Cuts both ways.
Well there's no such bias in Australia, AFAIK. Everyone has the same testing requirements.
Let's forget vaccine effectiveness (VE) against hospitalization, because as far as Israel is concerned you may be right.
What about VE against mortality? How could this data be biased? I always focus on VE against mortality, since it's the least prone to bias. (EDIT: I see your link to Fenton & Neil, I will discuss below)
> [Airport testing]
That's interesting, but there are other explanations for this.
For example, natural immunity in a large % of the 'unvaccinated' population by the time that this study was done.
Another explanation could be old people self-selecting into the vaccinated population. That will again make vaccines seem weaker than they are in reality, especially in their ability to prevent infection.
I also note that the RCT which you like showed strong VE against infection (against an old variant).
> Is that the only reason it doesn't exist?
Probably yes? And if not, it's probably some other basic explanation, such as Pfizer not wanting to waste their own money on a trial if the FDA didn't require it. They are for profit, after all. Is there a need for some deeper reason? Occam's Razor.
> Fenton & Neil's work
Interesting.
Maybe this bias existed in that ONS report at a particular time period, I didn't read the full report, it's quite long. Maybe this bias exists in all the data sets being reported by different countries. It's possible.
But what about the VE against mortality in countries that have plateued vaccination rates, where such a bias is going to be minimal? Wouldn't we find evidence of a sharp drop in VE over a rolling 4-8 week window? Can anyone show me this happening to any of the big countries?
If someone can show me that - and the data public in a number of countries, so it should be possible to show - I will probably change my mind.
> What about VE against mortality? How could this data be biased?
At least two ways:
(a) Fenton & Neil trick in the blog posts I linked - it applies to any measure. Note that people who died in the first 28 days post original shot are considered unvaccinated, despite all tests showing very significant antibody response in 12 days.
(b) Ignoring all cause mortality. Taken ad absurdum: Inject cyanide. 100% efficiency against corona death. Step back from absurdum: it's possible the vaccine induces "silent covid" by generating the spike but failing the PCR tests -- so that, in fact, as far as mortality goes, it is equivalent to getting sick, but as far as testing goes, it's never attributed to covid.
> That's interesting, but there are other explanations for this.
Yes, there's always other explanations for everything. You reach your conclusions because of your prior, which is "the vaccine is effective, let's see how and why". Which is fine, but you should acknowledge your prior rather then assume it is universal. I have a less informative prior, and the data is much less convincing under that prior.
> They are for profit
And have already paid billions of dollars in fines for past "for profit against health" actions. BMJ editor Peter Doshi has shown -- as soon as they've published -- that equally valid interpretations of Pfizer's own data can show 29% effectiveness. Now, there are two ways to interpret the data - one shows 95% effectiveness against mild disease (and no information about severe disease), and one shows 29% against mild disease (and no information about severe disease). Which one do you expect a for-profit company to champion?
> But what about the VE against mortality in countries that have plateued vaccination rates, where such a bias is going to be minimal? Wouldn't we find evidence of a sharp drop in VE over a rolling 4-8 week window? Can anyone show me this happening to any of the big countries?
It is, in fact, the current narrative, that vaccine efficiency drops significantly after 4 months or so, and that's why a booster shot is needed (Israel has already been administering the 4th shot for a month, Fauci is talking about doing same in the US). It is strictly in the negative territory for mild disease now, still positive (but dropping) for severe disease and mortalitly. Some of it is blamed on immune escaping variants, but the dropping VE is seen everywhere. Don't have the links handy, but that's why they are boosting, officially.
But the RCT showed that vaccine safety isn't a big part of the picture, so all-cause mortality won't be relevant. The difference in non-Covid deaths was statistically insignificant. Yes the mRNA vaccines are more likely to cause myocarditis than Covid itself, but so far I haven't seen evidence that it has translated into a big source of mortality. (It may have, I guess?)
> [rest]
Let's ignore VE against mild disease for now. I just want to nail down VE against death, which is less susceptible to sampling bias, manipulation, and so on.
We should be able to easily answer this question conclusively by finding 1 or 2 countries where vaccine administration has plateued (which is actually most countries now), and simply measuring the VE against death over the last 8 weeks. Has anyone something like that?
My guess is that the VE is still very high, which is fairly conclusive evidence that the vaccines work at preventing death from Covid and that VE against death can't all be explained by the Fenton & Neil trick. And since the vaccines were shown to be safe in the RCT, that is proof that they work at preventing death itself - especially in older populations where the risk of Covid is higher and the risk of myocarditis is lower.
> [vaccine immunity is in the] negative territory for mild disease now
IIRC, this was just a 5000 sample study in one European country, and the result was inconsistent between Delta and Omicron. Or has this finding been replicated? (I don't want to get into the weeds on this question, though, since I want to talk about VE against death).
> vaccine efficiency drops significantly after 4 months or so
On mobile and no time, but I’ll say this now: I agree we should look at death, as that’s not subject to sampling bias.
I disagree we should look at Covid death exclusively - that IS subject to attribution bias. I look (and have, in the last two years) only at all cause mortality.
Israel and the US have both experienced increase in all cause death in 2021 that is not attributed to either Covid or vaccines. What is it then? No one seems to know (cdc classifies it under “not sure”). Very significant excess (40% or so) in young ages in Israel, only in 2021, at times that correlate to big vaccine drives with a 1-2 months shift. No cause data yet.
The RCT was not powered enough to show safety or extreme lack of it. The celebrated safety paper (based on biased Israeli data), Balicer, Lifsitz et al is statistical garbage with a predetermined result (lumps 16-60 age group when it was already known 16-24 myocarditis risk is 1:4000 and at 50 assumed to be 1:100000, for example)
My interpretation is that the rushed approval missed some safety issues. The vaccine is likely worth it for >60 or people with comorbidities. For young healthy people …. The data doesn’t say that, and does say “something is weird”
So, we agree that vaccines prevent significant numbers of Covid deaths, as presumably shown by VE against death after the plateau of the vaccination drive.
We're now discussing the extent to which vaccines are killing lots of people. Your data in support of this is unexplained excess deaths in the US and Israel in 2021.
I remember seeing something here on HN about Israel's excess deaths implying vaccines caused deaths and thinking it was bogus. Please send me the link again.
As for US excess deaths, why can't this just be Covid? Does every state test every death?
Also, the RCT wasn't underpowered. On what basis do you make that assertion? If the vaccines were killing a large number of people, it should've shown up in the RCT. The only way the RCT could have been underpowered is if the vaccines only kill so few people, that you need a gigantic sample size in order to tease out that small effect. That's what underpowered means. Unless you think the vaccine is only killing people after a long period of time (but that would be a separate issue to being underpowered)?
If the car crashes in the treated group are high enough, you have to start asking if there is a mechanism where vaccination side effects are the cause.
This is why you don't drive or operate heavily machinery with certain drugs.
> The unvaccinated get admitted to the ICU at staggering rates compared to the vaccinated.
Without breaking that down by age group, we are no better informed. Emotive words like "staggering" without mentioning the data, is unhelpful.
It's common knowledge that elderly and unhealthy/vulnerable represent most ICU beds. I think it was Italy or Greece who have mandated the jab for over 60's. This sounds like an expert has formulated a policy that matches the challenge: that the 60+ age group are filling the hospital beds. If only more countries could formulate measured, level-headed responses to match the reality of the pandemic.
It's not commonly known whether younger unvaccinated people who end up in ICU, are there because they're unvaccinated vs existing health condition. That comes down to individual hospitals and doctors reporting efforts. What we hear in media reports is a broad mashing of data, reduced down to an oversimplified message that unvaccinated people are filling the hospitals. When in fact, it's more likely that unvaccinated people from a specific age and health status group, are filling hospital beds.
Age group impacts illness and hospitalization but not tremendously so. Deaths under 65 weren't tracked b/c signal to noise ratio didn't meet their criteria.
At anectotal level. Everyone I know that isn't vaccinated (no hard liners, just skeptics) did never attract COVID. While many vaccinated I know already had their second infection.
What exactly are the staggering rates? What if you exclude 60+ year-olds, overweight, smokers and immunocompromised?
From what I can hear in Canada, unvaccinated make about 10% of population and about 50% hospitalizations, that makes the vaccine reduce your chances by about 5x. But they are already vanishingly low for young healthy people. So what if we vaccinated the older folks, promoted healthy BMI, and created 20% more hospital beds? Or how does a vaccine 1 year ago compare to natural immunity from 1 year go? Or how much exactly of the taxpayer money is going to the Big Pharma as opposed to building new hospitals and training new staff?
> Or how much exactly of the taxpayer money is going to the Big Pharma as opposed to building new hospitals and training new staff?
I’m not necessarily disagreeing with your overall premise, but the idea that politicians in countries round the world can/will just snap their fingers and magic new hospitals, staff, and infrastructure into existence seems idealistic in the extreme.
We’re living in a world where the opposite is true: for a variety of reasons (depending on the country you examine) hospitals are run close to capacity during normal times - which is why they struggle so much when there’s a new wave of COVID infection. This seems to be the economic reality of healthcare, whether you’re talking about successful ‘socialised’ models, successful privatised models, or failing examples of any kind.
Many staff are exhausted, demoralised, and underpaid, and there’s a trend to people leaving the profession - and there’s a 3 to ~7-10 year lead time to deliver a new meaningfully-trained healthcare professional.
Choosing to change this trend around the world, versus a few bucks spent per person on a vaccine every year or so…?
<< From what I can hear in Canada, unvaccinated make about 10% of population and about 50% hospitalizations, that makes the vaccine reduce your chances by about 5x
When 50 % of the total hospitalizations are 10 % of the entire population(unvaccinated pop.), the vaccinated 90 % need to be reduced to an equal 10 % too(1/9 * 90 % = 10 %), which means it reduces your chance by 9x not 5x
You are right. On the other hand, we are not trying to increase the vaccination rate from 0% to 100%, it's more about convincing the remaining 10% to go, so the effect on the actual hospital utilization would be much lower. Plus, we don't know the hospital bed number per age (how many actual 30-year-olds are the problem?) and whether Omicron has a different picture.
So, in my mind, the amount of guesswork that's currently on the table warrants a tax-paid advertising campaign, but all censorship and forced vaccination measures do much more harm than good.
> Long COVID-like symptoms or not, the protection afforded by COVID vaccines still clearly outweighs the negatives.
I don't think it's that simple to make such a blanket statement anymore. In much/most of the developed world, over half the population has already received 2 doses of vaccine and the conversation is moving from "What about the people who choose to remain unvaccinated?" to "Are you fully vaccinated with just 2 doses?" and "How many boosters do we give and how frequently do we give them?" We've gone from thinking that we might need a booster a year to advising people to get boosters just months after a previous jab.
In light of omicron, the cost/benefit analysis is not anywhere near as clear anymore, especially when it comes to these boosters. There's also the issue that risk varies by magnitudes of order between age and comorbidity risk groups, and overall risk of severe outcomes is lower for all groups with omicron.
From the article:
> She says she has preliminary evidence that vaccination can lead to microclots, although in most cases they go unnoticed and quickly disappear—an effect she and a colleague saw in their own blood and that of eight other healthy volunteers, which they sampled after their vaccinations.
This highlights the fact that there's a ton we still don't know. What if there are subclinical effects of vaccination that have the potential to affect people's health in negative ways, either in the near term or long term? Even small changes in uncommonly tested biomarkers can be clinically meaningful over longer time periods.
Perhaps it's reasonable to argue that made the right decision early on by accepting these unknown risks in light of the efficacy of the vaccines at preventing hospitalization and death pre-omicron. But is it reasonable to do that with never-ending boosters when the currently dominant strain is proving to be far less virulent in all groups? Is it still reasonable to push for vaccination and boosting of children and younger and middle-aged adults who are otherwise healthy and at significantly less risk than older, unhealthy groups?
If we just blindly accept that the cost/benefit analysis of vaccination always favors vaccination, how would we ever know that we've crossed a line where that is no longer the case?
The cost-benefit of vaccination doesn’t always favor vaccination, which is why we mandate the polio vaccine but not the dengue fever vaccine, because the latter comes with attendant risks relative to the potential benefit.
As far as the evolving science on what has to happen, well, it’s a rapidly changing situation. If someone had said at the start of the vaccine schedule, “hey, there’s going to be an incredibly infectious strain in late 2021 that will render vaccines much less effective”, maybe they would have mandated three shots up front. But they didn’t know that, and so when the first round of vaccine trial results came back with a 90%+ efficacy rates, I remember there were people arguing that those numbers were TOO effective, and we should reduce the volume of the second dose or remove it entirely in order to vaccinate more people. Good thing we didn’t do that.
As far as the whatabouts - great, yes, therapeutics are great. More therapeutics. But focusing on omicron’s reduced level of severe cases misses the point of vaccination, which is that we don’t only vaccinate for ourselves, we do it to try to reduce spread in the community. We vaccinate to try to make it less likely that new variants that are better at escaping immune response arise. Maybe if everyone had embraced vaccination we wouldn’t be close to 2k dead/day.
> As far as the evolving science on what has to happen, well, it’s a rapidly changing situation. If someone had said at the start of the vaccine schedule, “hey, there’s going to be an incredibly infectious strain in late 2021 that will render vaccines much less effective”, maybe they would have mandated three shots up front. But they didn’t know that, and so when the first round of vaccine trial results came back with a 90%+ efficacy rates, I remember there were people arguing that those numbers were TOO effective, and we should reduce the volume of the second dose or remove it entirely in order to vaccinate more people. Good thing we didn’t do that.
But then governments and businesses started to mandate the vaccines, even though they had no clear vision of the future, while there already were signs of lowered efficacy and side effects. It's all cool as long as it is voluntary with a focus on risk/benefit ratios, but as of now, people are demonizing others who want to wait for a clearer picture. Since all that new science regarding efficacy, side effects and natural immunization is bubbling up now, I am sure that anyone who tried to force the vaccine on others will be deemed pretty reckless soon.
Who would support Rwanda-style forced vaccinations for example?
I encourage everyone eligible to protect themselves by getting vaccinated but there is no reliable evidence that will make it less likely for new variants to arise. The current thinking is that variants are most likely to evolve in immunocompromised patients who experience prolonged infections. Vaccination is less effective for patients with defective immune systems.
Increasing vaccination in the population overall reduces the velocity of spread and reduces the likelihood that an immunocompromised person will have the opportunity to have one of those long-term infections that create variants. It also gives the world time to create therapeutics that might be able to treat immunocompromised individuals with Covid and do the same. It’s not only about individual protection.
“ Over the next decade, give or take a few years, every single person on earth has a date with this virus. We will all be exposed, and the virus might replicate in some of our respiratory mucosa.”
Exposed, not infected, though even if they did say infected, a 10 year timespan is better than a 2 year timespan.
It's not that clear unfortunately. Consider that all-cause death rate is a lot higher in the under-40s vaccinated than the under-40s unvaccinated (UK recently released stats on this):
That simply shouldn't be happening. The death rate gets 4x higher over last summer, it's an enormous difference. Even if you think there's some statistical or other problem causing this it cannot be said things are "clear" when such basic data has gone in the wrong direction.
The bias runs in the opposite direction: the vaccinated are supposed to be more healthy, not less, because people on death's door aren't being vaccinated at all.
Although this comment is a cliche and it's been already shown to be incorrect in another reply, I'd like to also point out that any such new data that surfaces will likely change the risk/reward ratio for subsets of the population or in regard to boosters.
This doesn’t seem like the case at all, considering, you know, the fact that they don’t really definitely mitigate anything.
In my experience (and this is anecdotal) there’s no rhyme or reason as to why this virus affects some people more than others. You can try to tell me why, but it would ask me to betray what i’ve witnessed (or lack thereof) over the past two years.
The data isn’t reliable nor convincing, so i’m not sure how you’re in the definitive “experimental jab better than nothing” camp.
Beyond the vaccination factor, it's clear that this virus affects obese people more than others. Regardless of what you might have witnessed the data is crystal clear on that point.
"Compared with the unvaccinated, fully vaccinated people overall had a much lower chance of testing positive for the virus or dying from it, even through the summer’s Delta surge and the relaxation of pandemic restrictions in many parts of the country." (https://www.nytimes.com/interactive/2021/10/28/us/covid-brea...)
Vaccination definitely mitigates hospitalization and death.
It's starting to seem like the group who had it and recovered are ignored by the media. At least now the CDC is saying this group has more durable protection than the vaccinated.
Can you help me understand the focus of your comment?
Should the current group who have recovered take the side-effect risks, or is the CDC note about reduced susceptibility to infection something to consider when making a decision about the first vaccine shot?
There was an article just one or two days ago that indicated that vaccination prevents against hospitalization something like many multiples of times greater protection than recovery from prior infection.
There is always a risk to inject something to a healthy person. But we just hope the risk is low enough so many do it for themselves and others. It is hard call. Let the study and “experiment” continue.
Why is this flagged? Why expressing any vaccine-related concerns has suddenly become a thought crime with an army of volunteers ready to shoot the messenger?
How can we possibly hope to resolve the pandemic in a way that benefits the ordinary people, if any discussion or questioning of the party line is not allowed anymore? Have I suddenly woken up back in the USSR?
Because there are two sides that think they know what’s best and they both use the pretense that ‘science’ has the one true answer. That causes a problem when some research shows their one true answer is wrong.
Real science doesn’t have to censor other opinions.
Because it causes unneeded worry until the studies actually show causation rather than weak correlation and there is so much misinformation out there already. The general public seems to have no concept of what statistics actually mean outside of "so all i'm hearing is there's a chance so now I'm going to decide to not get a vaccination because there is a chance even if the chance covid kills me is far higher"
>Because it causes unneeded worry until the studies actually show causation rather than weak correlation and there is so much misinformation out there already.
You know, the studies can show anything other than the party line only if there is
a culture of questioning the party line. Otherwise, the scholars are publishing praises to planned economy and condemning the "rotting West" while the plebs are queueing for bread. That was the fucking state of affairs in the USSR for decades, and the only reason the West didn't sink that low is that it had the culture of questioning the narrative, that so many people today are trying to destroy.
I am always skeptical that's why I'm asking for proof before people go off telling people who only absorb rather than filter their information. If I own a business (like hackernews/facebook/reddit) and I see people spreading "what if" information that has a very weak basis I'm well within my rights to shut that down if I know about it. Those free thinkers can go listen to Joe Rogan, C2C, or Infowars if they want fringe opinion/weak correlation
I'm just happy this is the top comment now. During these last two years, you were treated like a mad conspiracy theorist if you felt the vaccines were dangerous to the human body.
I think i prefer the mystery of human consciousness, but it would be interesting to snapshot the mind of a person that votes up or down on this story and explore the root system of that action.
You really think that this article is trying to exaggerate the dangers of the covid vaccine? Even when the headline starts with “In rare cases”
An excerpt from the article:
Probing possible side effects presents a dilemma to researchers: They risk fomenting rejection of vaccines that are generally safe, effective, and crucial to saving lives. “You have to be very careful” before tying COVID-19 vaccines to complications, Nath cautions. “You can make the wrong conclusion. … The implications are huge.”
Even when the article explicitly qualifies it claims and actively encourages the reader to not exaggerate the claims?
I don’t think OP is “feigning confusion” but rather that people have a knee jerk reaction to anything to do with the risks of the covid vaccine.
HN thrives on the community and its discussion. And when there's little merit in the discussion threads because most have turned or started toxic it doesn't. So sometimes stuff may be flagged for the overall dynamics of a submission - maybe some sort of anti-"eternal September" reaction of the old user base. Especially certain political topics from 2016 to 2021 had this issue and Covid sometimes as well.
HN is not just a discussion board, it also serves as a place to get caught up on the latest happenings around the world. Hence hacker news. Flagging a news article for removal just because the readers have no civility is untoward.
If anything, it is the community and moderation teams responsibility to ensure toxic comments are downvoted or removed.
If you decide to never allow anything “controversial” on HN, it is an easy backdoor for bad actors to get articles they don’t like flagged. All they have to do is make comments inciting controversy or astroturf the comments from both sides.
Threads turn toxic because people treat eachother like the enemy. We constantly fail to respect the other person when he or she has a different point of view.
I think you're right and in vaccine discussions you see this the most I'd argue.
If your way of life is changed in a way you disagree with, e.g. forced vaccine or Use of Corona passport, then discussion can get heated and the respect is lost.
In this article i find it unprofessional to flag it, i would sincerely hope that Hacker News is better than that.
It should be the merit of the article and not politics that decide if something gets flagged or not.
The state of things is that highly vaccinated countries like mine are experiencing the biggest baddest infection and death rate yet. This isn't the outcome projected when they were nagging, blackmailing, and propagandizing us every day for 2 years about reaching "80% vaccination".
The public did what they were told, and more. We're now above 90% vaccination, but apparently that isn't enough. We need blunt, symbolic tactics now, such as kicking unvaccinated athletes out of the country to "send a message" about vaccination. Desperate measures including mass-behavioral manipulation and psychological tactics dripping in political spin.
> a very strong anti-vaccine narrative chomping at the bit
You're kidding yourself if you think narratives and "chomping at the bit" is exclusively the domain of the anti-vaxxer, and not exercised by those pushing and enforcing mandates.
Which country? Because in many countries, even though Omicron infections are up at least 10x (can't measure it, don't have the labor capacity for it :)), hospitalizations and deaths are down.
I was responding to someone who accused the parent comment of "feigned confusion". They seemed to be justifying the flagging of the story as an "overreaction but understandable" measure to counter anti-vax narratives.
Fighting one form of propaganda with another form, is not a game I'd ever participate in. Why would anyone? Surely we want practical measures that suit the changing conditions of a pandemic, rather than broad immovable "rules are rules" policies.
> hospitalizations and deaths are down
Depending on how you look at it. End of the day where I live...(Jan 18, 2022):
> "Victoria has declared an unprecedented system-wide ‘code brown’ emergency across all its Melbourne hospitals and six in the regions as it buckles under COVID-19 pressures."
> "Mr Merlino said hospitalisations in NSW, where the Omicron outbreak is a couple of weeks ahead of Victoria, continue to increase by about 100 people per day."
> "The number of people in ICU also decreased, by two to 127, although 43 people are now on ventilation, an increase of five."
It's not a binary argument. The vaccine prevents serious illness for many people. I thought that was a given by now. Elderly people who weren't vaccinated previously, are now vaccinated.
Any drop in hospital admission rates would also be from the less severe Omicron variant; vaccination of elderly and vulnerable; and more people managing their illness from home. At the beginning, many were panicking and rushing to hospital with a headache. They were still reported as covid hospitalisations, even though their hospital admission consisted of basic monitoring then discharged soon after.
Flagging the article is just wrong when there is merit to it.
As for the vaccine preventing deaths and hospitalizations, i hope most can agree that is a fact.
When that is said, then we have always had the flu which also causes many deaths and hospitalizations. With Omicron the flu and Corona are now equals regarding deaths and hospitalizations.
Where i come from that is what you can learn from the data.
So when the flu doesn't cause restrictions and is now similar to Corona, then restrictions should be dropped. That is my viewpoint.
Flagging stories on the possible dangers of COVID-19 vaccines is extremely counter-productive for the goal of combating anti-vaccine narratives. It totally discredits the pro-vaccine narrative for many people, even if it shouldn't.
No, you just tell the truth, every time, all the time. This foolish gymnastics where government and public health authorities are putting themselves through because they're scared of potential negative outcomes has resulted in a catastrophic collapse in trust by the public. This itself will have huge implications for any future society-wide initiatives that we may need for the public good.
For reference, here is one counter example from Japan[0][1], where the benefits and risks are communicated clearly. Will crackpots still behave like crackpots? Sure, but crackpots are like that now any way. This "paper over the truth" has damaged credibility amongst a lot of moderates.
[0]https://pbs.twimg.com/media/FIm_mrZXEAYUuLq?format=jpg&name=...
[1]https://pbs.twimg.com/media/FIm_meqX0AUH6jh?format=jpg&name=...