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How can the Lancet publish a letter with a) such basic statistical omissions and b) no editing whatsoever
Like everyone operating in bad faith, they compare % of cases in fully vaccinated people to unvaxinated people, without talking about relative vaxination rates. Of course you're going to get more raw numbers infections of people who have been vaccinated (especially with waining immune effects as time passes) if you vaccination rate is 90%+.
Here's the IMO right way to look at it:
https://kingcounty.gov/depts/health/covid-19/data/vaccinatio...
Unvaccinated people in King County are 7x more likely to catch covid, 38x more likely to end up in the hospital, and 24x more likely to die. The raw numbers don't matter in the context of arguing about effectiveness except to ensure you have a large enough sample to make statistical inferences with.
Additionally, there is no mention of the waning efficacy of the vaccine. The efficacy rate drops from ~94% to ~45% after 6 months w/ Pfizer & Moderna). The assertion: "It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission..." completely ignored the very obvious fact that a large percentage of the vaccinated population is entering a low efficacy phase leading up the booster (which actually surpasses the efficacy of the initial 2-dose regimen
https://twitter.com/ryanlcooper/status/1461889784369008641
). The number of breakthrough cases is on the rise as a result of the vaccine's decreased efficacy (
https://ehrn.org/articles/breakthrough-covid-19-cases-on-the...
). It seems intentional, or grossly negligent to use their words, to omit this information.
Still, it would seem negligent to bifurcate the population into (vaccinated = low transmission; unvaccinated = high transmission) when the reality is exactly as you describe - a forever variable efficacy rate across the board (transmission, infection, hospitalization, death) thanks to the waning effects of the vaccine + new variants.
Having 30,000 vaccinated people pack into a basketball game can't be accepted in good faith when countries are trying to ban unvaccinated people from air travel, working in offices, working in healthcare settings with proper precautions, etc. when vaccination isn't a switch for forever lasting 95% immunity.
Hopefully we can get to a point where a vaccine or something else can put an end to this, but until then telling a large group with variable levels of protection that are they safe is enabling the spread of the virus.
There is no prospect of stopping the spread. Almost everyone will be exposed eventually and no infection control measures can prevent that. Fortunately the vaccines are pretty effective at preventing deaths, and there are other good treatments as well.
https://www.medpagetoday.com/opinion/vinay-prasad/94646
I really do not understand how any of that is relevant, it seems both you and OP are grasping at straws.
The article’s conclusion was “It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission when deciding about public health control measures.”.
If anything, waning vaccine protection is an argument _for_ that conclusion.
And it’s particularly irresponsible at the moment, because our hospitals in Germany are so clogged with mostly unvaccinated Covid patients that my father-in-law is having to just suffer with a hernia because that repair surgery is “elective”. It’s been rescheduled twice, and they’ve not bothered to give him a new date after the last cancellation.
Things are somewhat better in Denmark, but hospitals and their staffing have been neglected for many, many years.
And it seems that no political party wants to remedy the situation, it's more about image and public profile nowadays.
King County's data is misleading. They admit that there are practically zero unvaccinated people in the county in the age groups at highest risk of death, and they artificially inflate their numbers. The red box on your link links to a document that describes them claiming that at least 5+% of these age groups are unvaccinated, even when they are not. Relevant quote:
"To resolve these issues, we have added a "continuity correction" to our estimates of the size of the unvaccinated population, to ensure that it would not become unrealistically small. To do this, we assume that we will not reach 100% vaccination and that at least 5% of each age group, race/ethnicity group, and zip code will always be unvaccinated."
In the last 30 days (chosen because the only other stat includes time before vaccines were available), 80% of deaths (50/62) in King County were in people over the age of 60 [1]. The dashboard in your link states that "Over the past 30 days, people who are not fully vaccinated are 24.3 times more likely to die due to COVID-19 related illness than people who are fully vaccinated" [2]. These are the number of people who have been vaccinated compared to the total population of the age group, as well as how many died in each group in the last 30 days [3]:
60-69 y/o: 218.4k residents, 218.8k vaccinated partially, 207.6k vaccinated fully, 13 deaths.
70-79 y/o: 124.2k residents, 136.5k vaccinated partially, 129.0k vaccinated fully, 17 deaths.
80+ y/o: 59.9k residents, 70.3k vaccinated partially, 65.0k vaccinated fully, 20 deaths.
Using the 24.3 times more likely to die ratio mentioned above, this means that, assuming the relative risk is constant across age groups, 2 people over 60 who died were vaccinated, and the other 48 were unvaccinated. Considering the ridiculously small population of unvaccinated people in this age group, the deaths per unvaccinated population rate (unadjusted) is insanely high, far higher than the pre-vaccine availability death rate. This does not smell right.
Also, the graphs on that dashboard (by default) aren't raw deaths divided by population; they are adjusted by age because, in their words, "when considering rates, it’s important to standardize, or control, for age. For example, older adults are both more like to be vaccinated than younger people and more likely to have underlying health conditions that may decrease the protection they get from vaccination and increase their risk for being hospitalized or dying if they get COVID". I think this is a fair adjustment to make, but King County did not do age standardization in the past, and the only dashboard that does it today is the vaccination status one. Since the number of unvaccinated people in the age groups with the vast majority of deaths is "adjusted" from the real counts, which show that there are more people vaccinated than the most recent census, it is impossible to accurately perform age standardization. There is no raw data on the site with vaccination status attached, so it is impossible to see what effects their adjustments have had.
[1]
https://kingcounty.gov/depts/health/covid-19/data/daily-summ...
Go to the "Demographics" tab, select "Deaths" from the drop down, and select the "Last 30 Days" radio button.
[2] Exact quote comes from clicking the "Relative Risk trend" box below the "death" ratio on your dashboard.
[3]
https://kingcounty.gov/depts/health/covid-19/data/vaccinatio...
Select "Demographics", and "10 year age groups" from the dropdown.
That’s irrelevant in regard to the conclusion: the vaccinated still get sick and spread it, so they should wear masks and get tested. At least the latter is illogically the opposite of what’s happening in e.g. Germany.
July: 65% vax/35% unvax, 17%/83%, 17/65 = 0.26, 83/35 =
2.37
October: 85%/15%, 60%/40%, 60/85 = 0.7, 40/15 = 2.67
In other words, vaccinated seniors were more likely to develop Covid in October, several months after most of them were vaccinated, than they were in July, but still WAY less likely than unvaccinated seniors, whose likelihood appears to have increased a bit over that timespan.
So yes, being vaccinated does not mean you’re free to act like we did two years ago. It does mean that you’re still far less likely to catch and pass on Covid than your unvaccinated peers, just not as vanishingly unlikely as you were before your immunity started wearing off. I’d love to see these same numbers now that a lot of older Germans have gotten their boosters.
> So yes, being vaccinated does not mean you’re free to act like we did two years ago.
When are you free to do that? Covid is never going away, there's nothing else to wait for.
Is the answer to that just never?
The answer to that is to make the decision for yourself and then move to an appropriate area of the world where the policies match your decision.
Some areas will stick to this for a very long time because it's now part of an identity for many people.
"just move to another area of the world"
This idea should have a name at this point. It's trotted out as a fix for some otherwise intractable problem without any hint of irony that practically nobody has the means to accomplish this. I see it brought up as a solution to so many problems its hilarious.
I don't understand the headline (and the article text doesn't clear it up): "the epidemiological relevance of COVID-19 vaccinated individuals is increasing"... does that mean that people who are vaccinated are getting Covid more than they used to? Like a lot more? More than unvaccinated people? Either it doesn't say or I don't follow the medicalese well enough to interpret it.
I had the same initial reaction and did some googling to see if it was a term of art, but couldn't find anything to support my hypothesis.
I am interpreting "relevance" here as meaning that it's a factor in the epidemic. Increased relevance means vaccinated people are increasingly a factor in (i.e., contributing to) the spread of COVID-19.
I don't think its anything wild. Summarized: Don't discount the impact of vaccinated people spreading disease.
> Either it doesn't say or I don't follow the medicalese well enough to interpret it.
You can't interpret it because our current leaders don't want you to understand it.
- Fauci has refused to cooperate with Senate oversight questions. Since he has a conflict of interest in funding 26 Chinese virology labs, including WIV, he should resign.
- OSHA is forbidden from releasing workplace covid stats
- after 18 months, the CDC has not released any data on the effectiveness of paper/cloth masks. Other countries have either found none, or 5% to 10%.
- the CDC has not provided a clear message on whether it is spread via droplets or aerosols, so nobody knows how to improve building ventilation.
People are calling this the biggest coverup of all time.
Something to keep in mind is the rate of people near death from other serious diseases who will not be willing, or might not be given the vaccine, because of their already compromised immune system and weakened state.
If you have terminal cancer, with a few weeks to live are you even going to bother to take the vaccine? If you end up in the hospital in your last few weeks before death, good chance you will get covid there too. This is why I'm skeptical. Even if you show twice the rate of vaccinated dying. We are talking about such small numbers 30 vs 60 / 100,000 that its not at all clear its just not selection bias.
The requirement to have two doses to be counted as vaccinated could also be hiding a spike in deaths after the first vaccine. Its possible to have a graph that goes up, than goes down. Meaning the first vaccine shot kills of the very weak. Some people with compromised immune systems are not able to mount a proper immune response to any vaccine.
The very sick people admitted to the hospital that are immediately vaccinated on admission, than then live on survive the first dose of the vaccine, will be a subgroup of those healthier ones anyway.
Most of the dying from Covid are sick 80 year olds with comorbidities. You could probably ask these people to tie their shoe laces on hospital admission, and show far better statistical outcomes. Then go on to claiming teaching people to tie shoes laces saves lives. When in fact you're just doing a fitness test.
Dr Christina Parks testimony for Michigan HB4471
She explains the effects that this study now confirms.