There has been a lot of noise about the proportion of COVID cases, hospitalizations and even deaths that occur among vaccinated people. This is misleading. In this working paper we show how getting vaxxed improves your chances using relative risk cdn1.sph.harvard.edu/wp-content/upl… 1/x
This is the formula relating relative risk of an outcome for unvaxxed vs vaxxed people to efficacy. It tells you how many more time likely an unvaxxed person is to die, be hospitalized etc, relative to a vaxxed person 2/x
Sorry for big table, but the headline finding is that unvaxxed persons were between 5 and 133 times *more likely to be hospitalized* and between 9 and 141 *more likely to die* in comparison with fully vaxxed 3/x
This is consistent with VE vs hospitalization of 80-99% and vs death of 89-99%. 4/x
This is based on data from several states. This is Arkansas 1/1/21 to 7/29/21. Each square represents 200 people. over this period 68 fully vaxxed sadly died from covid. The corresponding number for the not fully vaxxed was 2543 5/x
It’s a point I’ve made before… 6/x
there are a lot of reasons for the wide ranges in the estimates, including age structure (of states and those vaccinated). But the facts remain that covid is a serious infection, and #vaccineswork. Thx to the excellent Jarvis Chen, @_christiantesta and Nancy Krieger.
finally, a comparison, from the working paper. The vaccine is like a seatbelt, in fact it is better than a seatbelt. 8 (I think?)/end

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More from @BillHanage

Jun 3, 2023
There is a super interesting quote from John Edmunds in this article on the brewing row over the UK’s Covid inquiry and it’s relevant way beyond that country. It concerns the use of scientific advice by politicians 1/n theguardian.com/business/2023/…
To start with I have to say “follow the science” has always been a slogan rather than a policy. Follow it where? That depends on what we want to achieve. Provided the goal is clear, then scientists can say whether a policy will likely help or hinder. And there’s more to it… 2/n
Even if the goal is unclear, you can still ask scientists what they think the likely consequences of a policy would be. And so this quote is key 3/n Image
Read 7 tweets
Apr 3, 2023
Finally returning to this, long after it has been digested by the twitterati. As someone who has worked on molecular epi, transmission, (meta)genomes etc it seems to me that the great majority of the commentary has spectacularly missed the point 1/n
This is not direct evidence of animals (raccoon dogs prominent among them, although far from the only possibility) being infected, but it is *exactly* what we would expect to find if they were 2/n
Had virus *only* been found in samples with human genetic material, it would be different. Even that would not allow us to rule out animals being infected too, just not among the samples collected. But we would not have evidence they *had* been exposed/infected 3/n
Read 11 tweets
Mar 10, 2023
This is a very interesting article, featuring a quote from yours truly about how many lives *could* have been lost in the US due to the pandemic before vaccines. This is my reasoning 1/n
washingtonpost.com/health/2023/03…
This figure from Jones et al JAMA 2021 shows estimates of how many Americans were infected by the time vaccines were available (the dotted line). As you can see, it is a little more than 10%. Maybe 13%. These are estimates from 1443519 blood donations collected over this time 2/n
In the spring of 2020, some people who really ought to know better had compared the threat of covid to the threat of flu. By dec 14th 2020, more than 300 thousand Americans had already lost their lives to this virus that only got a name in February 3/n
Read 10 tweets
Oct 27, 2022
When the local wastewater numbers go up, people often pay attention and get anxious - so worth noting that they just dropped *a lot*. What does that mean, and what's with this plateau since the summer? 1/n
first a little caution - as you can see these numbers can fluctuate quite a lot, and so the next sample might be up again. But that doesn't explain the plateau, and the fact we see similar in the south system makes me take it more seriously 2/n
In fact, this sort of pattern should not be considered very surprising at the moment. After all, the point when the virus was equally able to infect all of us is far in the past. Now there is a patchwork of immunity in the population, which makes it harder 3/n
Read 15 tweets
Aug 27, 2022
If you think mask use has insignificant benefits and is unjustified under all circumstances, you are wrong.

If you think that changing levels of immunity and available therapies don’t change the benefits of masks, you’re also wrong
If you choose to not wear a mask when asked to, I disagree strongly. It’s polite and kind to do so

Likewise masks can and should be used to mitigate transmission in high risk environments like healthcare
All masks are not alike. A fact which delights those who seek to weaponise them for political gain because they can always default to whichever most helps their point and riles up their base (compare - all masks are good, some masks are good, no masks are good)
Read 5 tweets
Aug 22, 2022
New paper in @JIDJournal from a great collaboration with @kar_jacobson among others (HT @SundermannAJ for putting it on my radar!)

Will attempt to summarize key points...

academic.oup.com/jid/advance-ar…
Genomic epidemiology is a wonderful new tool in our kit for detecting cases of transmission - but we always need to consider whether two independent cases might have very similar or even identical genomes by chance
this problem is especially acute early in outbreaks, when there has been insufficient time for the pathogen population to accumulate diversity, such that independent transmission chains are readily distinguished
Read 6 tweets

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