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*.
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.
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.
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
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.
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Quick thread on current Covid situation in England and Long Covid.
I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.
TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.
This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.
Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....
TLDR: worrying only about NHS & social care is missing the point
let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.
The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.
Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.
TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots
This was spotted quickly and studied. Vax monitoring did its job. 3/9
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*
It is to do with changes in case reporting and NOT hospital testing
2/6