Thread by @drjanaway

So let's talk about the #COVID19Vaccine and #Booster based on the evidence, including #death rates.* This data looks at non-vaccinated vs vaccinated (per dose) and booster (separate study). Links to the evidence are posted at the end of this thread.

Note before starting:

The ASMR (age-standardized mortality rate,) is a unit that compensates for differences between age groups. This is because mortality changes over age band, so it can be misleading not to adjust.

The use of 'person-years' is a unit designed to make sense of the number of people and time under an illness, i.e a measure of incidence and duration. The data used in the first study uses ASMR/100,000 person-years.

In government data ranging from 1/1/21 -10/1/21, the following was found (i have combined the first dose and second dose data for simplicity)

Deaths in unvaccinated: 938.9 p100,000
Had first dose: 302.5 p100,000
Had second dose 40.9 p100,000

This is a huge reduction

By direct comparison, having two doses of the vaccine reduced the risk of death from

938.9 p100,000 to 40.9 per 100,000

With some simple math showing a mortality rate
of 22.9 x lower in those taking 2 vaccines at any time, or 32 x lower if having had a 2nd dose 21 days prior.

This data demonstrates, with certainty, that the vaccines at any stage reduce death rates, but also that if someone had two shots, and this was long ago, the mortality rate would drop even more. So there is your proof that they work. So what about the booster?

First, we must parse that covid has mutated, and thus changes to the spike protein (to which the mRNA vaccine is targetted,) will limit efficacy. Essentially, it has removed some of its markers to hide better. So a booster is needed which targets new areas.

This is what happens with flu every year as it mutates, and tbh every other virus. This is the natural way of things, and we are targetting it 'unnaturally'. If we were to wait for a 'natural' response, a lot of people would die (see 938 above.) This is why we have vaccines.

So with #omicron and the 'booster. Studies are relatively limited, as this is so new. Deaths have a lag behind infection up to a few weeks, so we have to be cautious in our estimations. As with previous mutations, deaths will rise after infections. So if infections increase..

.. deaths will later. This is unfortunate for many reasons, but the statistics may not show this until the deaths happen later, so we need to bear this in mind. We must also bear in mind that the studies are happening NOW.

Going back to August-Sept, an Israeli study, compared over 700,000 people, the majority of which had a booster vs the minority without a booster. The data showed a 90% reduction in mortality with the booster between groups. So, for the majority delta variant, the booster works!

But what about #omicron ? Studies show that the current vaccines may be 4.5x less likely to be wholly effective in those double vaccinated. Even with this is mind, we know it will still show a majority benefit.

Based on modelling data (which obviously is early,) the effect of vaccines in preventing severe illness/admission is reduced around 15% comparing #omicron to delta. Now this data is complicated and based on multiple variations in potential, but the concluding data is:

efficacy against death in omicron:

90days post 2nd vaccine: 84.1%
180 days post 2nd vaccine: 78%
30d post booster: 93.1%
60d post booster: 91.9%
90d post booster: 90.7%

What this shows is

1) vaccine efficiency reduces with time ( as we know)
2) the booster increases the efficiency

Granted, this is modeling data, and people may have concerns about it, but the logical conclusion is based on all data observed (both within and outside modeling..)

Has shown repeatedly that vaccines work against covid 19, reducing mortality significantly and improving resistance as the virus mutates. So hopefully this puts to rest some of the questions and misinformation currently pedaled around.

Sources:

imperial.ac.uk/media/imperial…

ons.gov.uk/peoplepopulati…

Disclaimers:

I am not funded to write this. I have no shares in pharma companies or interest in sales of them. I'm an NHS doctor sat in pajamas during annual leave. I want to see my family next week, that is my motivation for continuing to try and explain this.

I work on a covid psychiatric ward. I also do shifts in the emergency department working with psychiatric cases due to the concerns of the NHS being overwhelmed. My personal interest in this also extends to protecting my patients and colleagues.

Personally, I have no qualms about people expressing their freedom of speech or action, as long as they realise that freedom of action comes with consequence, and if they wish to take responsibility for that within legal limits, fine. But if you infect my grandma, different story

Caveat: I am no expert statistician. I have qualified within degrees and further training that mandate an understanding of statistics as they pertain to treatments in individual and public cases, but I am always happy to be corrected.

There is no value in information asymmetry, it undermines people and makes them susceptible to manipulation. This is also an attempt to remove this asymmetry, to help everyone understand how this works, for better or worse.

Oh and if you want to insult me; try and be original. :P

Further note, efficacy, and efficiency are not the same:

efficacy: under ideal settings
efficiency: real world

efficiency is usually less than efficacy because the real world is not ideal.