Let's not dismiss concerns that PHE report some vaccinated groups getting infected at higher rates than unvaccinated.
First, even if vaccines significantly reduce chance of infection (high vaccine effectiveness), real world data may not reflect this for several reasons ...
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Vaccinated may behave differently to unvaccinated, e.g. taking more risks &/or ignoring low level symptoms.
Also, there may be population differences, e.g. previously infected with very high levels of immunity could be less likely to get vaccinated ...
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Irrespective of the reasons, if real world infection rates among vaxed are higher (or not much lower) than unvaxed, vaccines may still be helpful in reducing hospitalisations & deaths but there should be serious questions about vaccine passports, sacking carers etc. ...
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The big issue raised about the PHE Vaccine Surveillance reports is the use of NIMS population data to calculated rates amongst the unvaccinated. When ONS data are used, the estimated rate for unvaccinated becomes much higher. However …
… 1. Using NIMS population has problems, but so does using ONS estimates.
PHE make a case that NIMS is better particular for older age groups. It is not enough just to assume the ONS population are correct, it is an issue that needs exploring …
… 2. Vaccinated people over 80 seem to be getting infected at higher rates than unvaccinated whichever population denominator is used. There may be good reasons for this but these need exploring …
… 3. Over time, the rates reported by PHE seem to be becoming more unfavourable or (for <40 &/or if using ONS population) less favourable to the vaccinated. Again, there may be good explanations for this, but it raises important questions …
… 4. PHE don't report rates for one-dose vaccinated, but best estimates suggest rates are very high for some age groups.
This is another important issue that needs attention, given 12-17s are only getting one dose … hartgroup.org/pick-your-deno…
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I think the following are reasonable conclusions so far from PHE vaccine surveillance data:
• For 80+, vaccinated seem to be getting infected at a higher rate than unvaccinated.
• There is uncertainty over relative infection rates for 40+ & under 80 ...
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• Vaccinated in all age groups are getting infected at significant rates and
• over time, the relative advantage of vaccinated seems to be decreasing.
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Clearly still lots to understand, but enough in the data at least to raise questions about likely benefits of sacking unvaccinated carers/vaccine passports.
Rather than dismissing concerns, let's try to understand better what is going on.
More questioning not less please!
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Update to various Covid-19 indicators for England:
• Deaths up again (data to 9 Sept) but looks like will turn back down from tomorrow.
• Admissions coming down faster now.
• Positive tests also falling quite fast, both school age & others.
• Triage & Zoe steady.
What is particularly encouraging for future hospitalisation and deaths data is that positive tests are at long last falling steadily in the 60+ and 90+ groups ...
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Encouraging also that school age rates are decreasing *despite* (!) no masks.
Mass school testing makes interpreting trends a little tricky, but no obvious signal from the positive tests data of any significant increase in infections after schools opened in England ...
The Govt seem to have authorised vaccinating 12-15 year olds on the basis of modelling suggesting the programme will avoid the loss of about 15 minutes schooling per pupil over a 6 months period.
... 1. No vaccinated children have been previously infected.
But we know a high % of children have been infected & hence already have high immunity. Allowing for this wd mean estimated schooling saved is much lower even than 15 mins /pupil.
As far as I can see and quite remarkably, the modelling uses vaccine effectiveness estimates vs unvaccinated but not previously infected.
Their mid-point VE is 55%, close to 57% in the Oxford study which definitely has not previously infected as the reference group ...
... those previously infected have a high level of immunity. There may be an additional effect from vaccines, but it will much, much smaller for this group ...
.. the higher the % of children previously infected, the lower will be potential school absences prevented. Knowing this % is essential to the modelling but I can't find any reference to their estimate of this ...
We know vaccine passports:
• are unethical & discriminatory.
• are unlikely to have any beneficial effect on infections.
• will create huge costs to firms & individuals.
• will entrench anti-vax sentiment.
but how bad is the problem they are actually trying to solve?
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The Govt says they want to introduce vaccine passports for nightclubs, football matches & other crowded events as they think, otherwise, those will cause big rises in infections …
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Well, since 19 July, we have been running an experiment:
England opened all these events in full & with no legal obligation for vaccine passports/tests.
We've had full sports stadia for #100, T20, Tests, Premier league etc, packed nightclubs & loads of festivals …
The new Lancet Infectious Diseases study finds vaccination reduces risk of infection relative to unvaccinated who have not previously been infected (they don’t compare risk to unvaccinated with a previous infection) but ... thelancet.com/journals/lanin…
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crucially the study also finds “increased incidence of asymptomatic or minimally symptomatic infection in vaccinated participants”
The researchers warn of the potential risk this creates from vaccinated workers like carers who interact with vulnerable people ...
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i.e. to the extent asymptotic transmission occurs, vaccinated carers who get infected may pose a bigger risk to residents than unvaccinated.
More evidence the Government's policy of sacking unvaccinated carers may have all sorts of unintended consequences ...