The most powerful graph that I have seen of the pandemic.

This calls for a rethink of vaccination strategy.

Note the sharp demarcation around age 40-45.

Vaccination of this 40+ segment needs priority.

Below that age, it could even be made optional. Here’s why👇

(Thread)
Although vaccines were launched with a hope of stopping transmission and further waves, we have seen that high % vaccination coverage does not stop subsequent waves. This is because they are ineffective in providing mucosal immunity; virus is silently spreading in communities.
2/
At the same time, we have found that vaccines are not 100% benign products as is often suggested by certain academics.

They have failed to acknowledge the small but significant number of serious and fatal outcomes is that occurred - particularly among younger individuals.

3/
There has been a clear attempt to downplay the risks, under various guises. Using statistics to trivialise success, and attributing complications to other causes. Families who suffered these complications have been ignored, and have understandably felt cheated by the system.

4/
Before I go on to discuss the merits of vaccines as of today, let me take a moment to state the solemn fact that for a family who suffered death as a result of vaccination, it is NOT trivial.

For the academics who push mandates, they might just be a statistic.

5/
One can argue that a “small %” of deaths & complications are “acceptable”, but we must never forget that for the family who lost a loved one, it is always a 100%. For those who are left with a deficit, it is a 100%.

This does not mean that vaccines are ineffective products.

6/
Published data of such adverse outcomes will invariably undercount/underestimate these risks, simply because it is impossible “prove” that the event was caused by vaccine.

I recall writing about reinfections last year & being ridiculed that “it was impossible” as “no proof”

7/
“Proof” is a curtain behind which it is easy to hide. When many of us reported reinfection, they asked us for peer reviewed publication. A peer reviewed complication was not possible because genomic sequences needed to be done in both instances - which is next to impossible.

8/
Thus, reinfections, though common, were ignored; this led to an impression that immunity against this virus was the sterilising type.

Absence of proof is not proof of absence.

This fit the vaccine narrative that it was possible to “vaccinate our way out of the pandemic”.

9/
After the vaccines were launched, in the initial months, infections were few; this led to a false sense of security. This was from high level of Antibody lasting ~3 months.

Some nations decided to discard all other precautions, claiming that they “conquered the pandemic”.

10/
At the same time, reports of adverse outcomes from vaccines came in, most of which were crushed claiming “lack of proof”. Academics where afraid to admit this, claiming that it will ‘fuel vaccine hesitancy’. A good no. of these were indeed spurious (incidental) associations.

11/
As the publications finally came in, it was clear that a very small no. of individuals did have serious complications, some of which were fatal.

This is not to state that vaccines should not be given, but that they must be treated on the same platform as other medications.

12/
All medical interventions have their share of side effects, for instance antibiotics, painkillers, surgeries, general anaesthesia, CT scans, chemotherapy.

In fact it is unscientific to claim or suggest that adverse outcomes do not happen, or to misrepresent the numbers.

13/
Now is the time to put all the facts on the table.

Which include:

1. Vaccines are effective at preventing deaths
2. Vaccines are not very effective at preventing infections or spread
3. Deaths do not occur equally at all ages
4. Serious outcomes occur, but are very rare

14/
5. Certain serious vaccine related outcomes are disproportionately seen among younger age groups, who are by default at the lowest risk of mortality from COVID-19, see graph above.

The following revisions may be considered to existing strategies, in view of the above facts.

15/
1. Vaccination must be prioritised for older adults- particularly those above 40.

2. Two doses are necessary to generate sufficient protection against severe disease and death

3. Among those who had prior infection, one dose will suffice.

16/
4. Among people under 40, greater emphasis on non-pharmaceutical interventions will result in lower spread of virus.

This can (and must) be done without compromising livelihood.

17/
5. Among younger people, vaccination can be even made optional, with emphasis for people who are at greater risk of either exposure, or for developing complications because they have a significant medical condition. Forcing people to take vaccines is not acceptable anymore.

18/
The reason is that beyond the initial few months, vaccines are ineffective at preventing transmission - regardless of what the “blind proponents” continue to say.

We have seen that in countless outbreaks around the world that occurred among fully vaccinated individuals.

19/
Vaccines, as I have written many months ago, function effectively like a helmet ⛑

Helmets do not prevent accidents; but in the event of an accident, they improve one’s chance of survival.

Now let’s look at the helmet at analogy in three contexts.

20/
If we look at the road, the people who need the helmet the most are the two wheeler riders.

They are at greatest risk of dying - because they fall at a high speed.

They definitely need a helmet; ignoring this recommendation puts them at great peril.

21/
The next level of risk will be the cyclists, but they fall at a lower speed and are at lower risk of death. While helmets are definitely recommended, we see many cyclists choosing not to wear them.

The decision to wear or not can be left to the individual or while racing.

22/
The third level are pedestrians. Theoretically, they can also fall by tripping on a pavement or a banana peel. If they were wearing a helmet, yes - they are less likely to die from that fall.

But do pedestrians really need to wear a helmet expecting to take a fall?

23/
In the above metaphor, people over 40 represents two wheeler riders, young adults are the cyclists and children are the pedestrians.

I am aware that this yes contrary to many recommendations but it is time that we started thinking in this direction.

24/
Why? Because this pandemic is not going away, reinfections & breakthrough infections will continue to occur, we need to prioritise those who are likely to develop bad outcomes.

Risk benefit analysis is not the same for all age groups. It is time we acknowledged that.

25/25
*peer reviewed publication
*trivialise risks
*optional/voluntary is the implied meaning

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More from @RajeevJayadevan

30 Oct
Vaccine effectiveness DOES NOT decline even after 6 months

Study from Sweden with wrong conclusions of “waning protection” against severe & symptomatic disease (see my annotations on the table)

Also illustrates the fallacy of observational studies

1/16

papers.ssrn.com/sol3/papers.cf…
The study looked at vaccinated and and vaccinated people in Sweden and looked at the event rates up to 9 months.

They calculated vaccine effectiveness at regular intervals until past six months. The authors conclude erroneously that vaccine effectiveness drops to (zero).

2/
The traditional method of calculating effectiveness is to compare the outcomes in the vaccinated & vaccinated groups and see the percentage difference between the two.

Eg. If 10 events happen in the unvax group and only 1 event occurs in the vax group, effectiveness is 90%.

3/
Read 21 tweets
29 Oct
Breakthrough infections “naturally boost” immune response.

First detailed description of immune response following breakthrough infections. This is a study on a subset of 35 people (infected vs uninfected) from the Provincetown Massachusetts outbreak, US.

See thread 👇

1/
The study compared 14 fully vaccinated individuals who got symptomatic COVID-19.

They were compared to 21 fully vaccinated individuals who were not infected during this outbreak.

469 individuals were infected in the outbreak that occurred in July.

2/
Details of the outbreak: Among the 469 people who were infected, 3/4 were fully vaccinated.

Five people were hospitalised, four of whom were fully vaccinated.

There were no deaths.

See earlier tweet for details, Will link below.

Main findings from this study👇

3/
Read 9 tweets
10 Oct
Vaccinated people have higher infection rates than unvaccinated - among all age groups over 30.

This is data from Public Health England. Rate is per 100,000.

Original graphs from PHE attached, reference link on thread.

Thanks @tlowdon

1/5
At the same time, vaccinated individuals are less likely to be admitted to hospital, or die from COVID-19.

The reported death protection is likely to be an underestimation, because vaccination preferentially occurs among people who have more background illnesses.

2/
The question is why the rate of infection is higher among vaccinated people.

It is obvious by now that vaccines aren’t very good at stopping the virus from entering the nose or throat, particularly past the initial few weeks of high antibody titres.

3/
Read 7 tweets
10 Oct
Comparison of immune response of vaccination with natural infection

1. Memory cells remains stable in number over the first 5 to 6 months in both groups

2. Memory cells continue to evolve with increased somatic mutation & emergence of unique clones

1/

nature.com/articles/s4158…
3. After natural infection, neutralising breath of memory antibodies increases with time, not much increase noted in the vaccine group.

4. We do not know yet if a third dose (or breakthrough infection) after 2-dose vaccination will generate more memory B cells

2/
5. In both groups (natural infection & vaccine), affinity maturation increased 3-7.5 fold at 5-6 months.

6. In the vaccine group, affinity increased 4.5 fold, while in natural infection it increased 11.2 fold at 5-6 months

3/
Read 9 tweets
10 Oct
Opinion of an immunologist about COVID-19 in children.

He believes that children must be vaccinated before attending school in person.

While that is his opinion as an immunologist, there are several pitfalls here.

I had done a detailed thread earlier. Will link it below.👇
Whether Children should be vaccinated before attending school is a topic where not everyone agrees upon.

In other words this is not a binary topic; which means that a “yes or no” answer is not relevant.

That is why the opinion of doctors who take care of patients matter.

2/
Experience in my part of India on the ground has overwhelmingly stated the following facts.

1. Regardless of what immunology says, the chance that a child will fall sick from COVID-19 is so rare - it is much rarer than chance of death from many routine things in life.

3/
Read 13 tweets
8 Oct
Vaccination of healthy children not necessary before opening schools, writes @DrLahariya

1. Severe disease risk close to zero (exceptions don’t define policy)
2. Current vaccines not very effective in blocking virus infection in nose

1/

theindiaforum.in/article/reopen… @TheIndiaForum
When we view the outside world while standing in the ICU, it is easy to be tricked into believing that the whole world is falling severely ill.

It is true that a tiny % of children fall ill, but that % is less than 0.008 (Kerala) and is ~made up of children with comorbidity.
2/
Which is why if we only look at the severely ill children, we will not be able to see the massive denominator of healthy children who were not affected significantly by the virus.

3/
Read 14 tweets

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