Thread by @chrischirp

1. THREAD on transparency & JCVI statements on teen vaccination.

This is *not* about the results of the risk benefit analysis but about the fact that 4 weeks after 3 Sept statement, the information we need to interpret & understand their analysis is missing.

14 Tweets (+2)

2. First off - in JCVI code of conduct, openess and transparency are required.

The code states that in any mathematical modelling (which risk/benefit is), the *full assumptions* should be given in sufficient detail to allow *full assessment*.

assets.publishing.service.gov.uk/government/upl…

3. The recommendations also say that the minutes of meetings should be published. While some delay is allowed, there have been NO minutes of JCVI meetings about Covid 19 since a February meeting, published in April.
app.box.com/s/iddfb4ppwkmt…

4. So, for instance, in publishing their priority lists for Covid-19 vax in Dec, JCVI provided full preprints of the modelling and a discusison of considered alternatives (eg priority by occupation) and reducing transmission. Minutes are available.

gov.uk/government/pub…

5. On children, JCVI has released 3 statements: in July, August & September. In their Sept one, they provided risk benefit tables which showed small benefit to healthy 12-15 years from vaccination in terms of hospital and ICU admission.

6. But the detail needed to understand this missing.

First you need estimates of the *risks* of a bad outcome if a teen gets covid. Possible outcomes: Needing hospital or ICU, PIMS, death & long Covid.

Since JCVI only considered healthy kids, need estimates for healthy kids.

7. The estimates used for healthy children are missing for all of these - except for ICU admission but then no denominator is given (per million what? cases, infections or all teens?).

JCVI didn't consider death or long covid as an outcome at all - but no explanation why.

8. Then you need to know what estimates were used for the risk of the vaccine (in this case heart inflammation) and its consequences (e.g. hospitalisation).

JCVI did provide one but not the other.

9. And then - this bit is *crucial* - you need to know what future exposure to Covid is assumed. The risk of the vaccine is the same for the same number of kids vaxxed. BUT its benefit depends on how many cases you prevent which depends on HOW LIKELY kids are to get it.

No info.

10. Finally, you need to know the risk analysis methods - how were all these estimates combined to get to the final risk benefit tables given by JCVI?

No idea.

So basically JCVI give the tables but how they got there is a mystery.

11. So @IndependentSage are asking that JCVI release the underlying information as soon as possible so we can understand it.

*And* make clear their planned method for determining benefit in 5-11 yrs which will be the next decision.

The US CDC did it.
cdc.gov/vaccines/acip/…

12. The UK is an international outlier in its decision on child vax - and its consideration that direct clinical benefit is marginal.

It is right that JCVI publish the detailed analysis and assumptions that underlies its recommendation.

13. And those who say we are at fault for questioning JCVI or their integrity - that's ridiculous.

We aren't questioning integrity - we are asking for the *necessary* information required to *understand* their recommendation. It's just not there.

14. And frankly, just saying "you need to trust them" is no argument. SAGE publish their models, minutes & assumptions. Their docs are excellent & detailed.

Teen vaccination is a v important decision - *everyone* should be asking for this information. /END

Full indie sage statement here
independentsage.org/wp-content/upl…

PS I am going to mute this thread cos I am sure various people will jump into criticise. But so far no denial of any of the actual facts of what info is missing - just along lines of "there's no reason for us to see it". Which doesnt seem v scientific to me.