With the risk of starting a flame war, we recently had several well-publicised clinical trials that reported 95% efficacy of some certain modality. Yet, in reality, efficacy as defined in the trial turned out to be closer to 0%.
Instead of investigating what in the design and execution of the trial led to such a discrepancy, the problem was handled by denying there was a problem, changing the goalposts, reporting ad-hoc hypotheses as facts, silencing all critics, and forcing the public to take the modality anyway or lose jobs, school, and freedom of movement.
I can only guess you mean something regarding the pandemic? Do you have links to show things were "closer to 0%?" Sounds more than a touch outlandish. :(
I'm confident we will know even more about things as time goes on. I'm less confident on any nefarious motivations in most of it. Reality is that a lot of people died, and everyone was trying to gain control and an advantage over the situation. Mistakes were certainly made, but I am back to low confidence in thinking that everything was a mistake.
> I'm confident we will know even more about things as time goes on. I'm less confident on any nefarious motivations in most of it. Reality is that a lot of people died, and everyone was trying to gain control and an advantage over the situation.
It's not a matter of being nefarious. They (CDC, FDA, health authorities all over the world) really though it was important, but they've used unacceptable means to enforce their beliefs.
Science dies when PR takes over reality.
If reality disagrees with the trial, you have to debug the rial, and find what in the design or exection went wrong.
> Mistakes were certainly made, but I am back to low confidence in thinking that everything was a mistake.
Silencing critics by health authorities is not a mistake. It is an intentional act to enforce your views.
>Do you have links to show things were "closer to 0%?" Sounds more than a touch outlandish. :(
Take the Pfizer vaccine. The clinical trial's main endpoint was ~95% efficacy in one thing and one thing only, prevention of symptomatic Covid.
Not reduction in mortality, not reduction in serious disease, not infection, and not spread. The only thing the trial tested and reported was prevention of symptomatic Covid. This is also the sole indication in the package insert as approved by the FDA.
In reality, everyone I know got vaccinated and got symptomatic Covd. I mean everyone, no exceptions. The situation is the similar in my entire country and around the world.
Do you know of any studies on the discrepancy? My understanding was that Omicron came out and basically gave the middle finger to everyone's precautions. With what seemed like literally nothing working against it.
The discrepancy is so massive you don't need large studies. You can easily observe yourself.
(a) Make a survey of the people you know and compare their vaccination status to getting symptomatic Covid. Apply a simple statistical test to test whether it is consistent with the trial results.
[Spolier: it is not]
(b) [advanced] what is your best estimate of the vaccine efficacy given your results of the survey in (a).
The measles vaccine has 95% efficacy. You vaccinate and the disease effectively disappears.
> My understanding was that Omicron came out and basically gave the middle finger to everyone's precautions. With what seemed like literally nothing working against it.
Folks don't like comparing to the flu, but in this there are obvious similarities. With obviously similar outcomes on the ability of a vaccine to give sterilizing immunity.
Much to your chagrin, though, I actually can say that among my contacts, getting the vaccine basically led to people not getting symptomatic covid. Folks got what they thought of as a bad cold. Almost flu like, but I know very few, if any, folks that were so bad off that they were symptomatic covid. Most wouldn't have even qualified as having a bad flu. (It is frustrating how many folks underestimate how hard the flu hits.)
Contrast with family members that did not get the vaccine in time, and were hospitalized. It was truly different.
Symptomatic Covid is simply a positive Covid test + any flu-like symptoms. What you're describing is symptomatic Covid. This is what was measured and reported in the trial.
You might say that's not very interesting because it doesn't measure anything of importance. You would be right. That is exactly what critics say before the trials.
The trials were never meant to test whether there would be any mortality benefit, any reduction in serious disease, any reduction in hospitalization, or any effect on infection or transmission.
What they did meausre, turned out to be inconsistent with reality, though.
Symptomatic covid for the first round was far worse than that. Hell, even for later rounds, symptomatic covid was pretty intense. Again, I had family that neglected getting the vaccine and almost died with that decision. We know of many people that neglected the vaccine and did die.
So, if the concern is you are upset a miracle vaccine didn't get developed, you're losing my interest quick. Anyone that got upset that you had a few symptoms is overblowing concerns to a non-useful degree.
> So, if the concern is you are upset a miracle vaccine didn't get developed, you're losing my interest quick.
No, the concern is not that a miracle vaccine didn't get developed. The trial measured and reported whether people who got vaccinated got those "few symptoms" vs people who got the placebo. It claimed 95% efficacy in preventing those "few sysmptoms", but it did not do so in reality.
The concern is that the trial results do not agree with reality. That means that something is wrong in either the design or execution of the trial. It's a bug in the trial, and a bug should be debugged.
But it is easy to see that the "few symptoms" in the trial patients easily proxied to "safer outcomes" in the wild? I seriously cannot underline hard enough that folks that didn't get the vaccine put their lives in extreme risk for basically no reason.
Seriously, the numbers were drastic for vaccinated versus not in hospitalizations alone. To push the narrative that they were wrong to get vaccines out just feels misguided.
If you are pushing that we should continue to get better at trials and reporting? I agree with that. Any harder push there, though, feels nitpicking at best, and I don't see the direction you are hoping to go.
I don't think it's a bug in the trial, but rather evolution at work.
The vaccine worked pretty well against the Wuhan strain, but Covid breeds variants like it was a rabbit. The farther from the strain coded into the vaccine the less effective the vaccine is. It still seems to be pretty good at reducing the severity, though--the unvaccinated are dying at a far higher rate than the vaccinated.
Even in the initial data released by the FDA, Pfizer didn't test all patients for COVID during the trial. In fact, they didn't even test all 'suspected' cases during the trial. In fact, there were more 'suspected but not verified' cases among the test group than the control.
It was junk science from top to bottom, and this assumes any science was conducted at all. According to a whistle blower, the science was fraudulent.
> Folks don't like comparing to the flu, but in this there are obvious similarities. With obviously similar outcomes on the ability of a vaccine to give sterilizing immunity.
And there's quite a controversy whether the flu vaccine is worthwhile becuase of that. The Cochrane systematic reviews are quite scathing.
> Much to your chagrin, though, I actually can say that among my contacts, getting the vaccine basically led to people not getting symptomatic covid. Folks got what they thought of as a bad cold. Almost flu like, but I know very few, if any, folks that were so bad off that they were symptomatic covid.
That's the definition of symptomatic Covid - a positive Covid test + flu-like symptoms (regardless of severity). That is what the trial measured and reported.
(This is in contrast to Asymptomatic Covid which is a positive Covid test but without any symptoms at all)
> Most wouldn't have even qualified as having a bad flu. (It is frustrating how many folks underestimate how hard the flu hits.)
No one I know experience anything close to a bad flu.
> Contrast with family members that did not get the vaccine in time, and were hospitalized. It was truly different.
Around me it was a mild cold to medium flu regardless of vaccination, including people in their 80s and 90s, with all the pre-existing conditions you can imagine. The only exception was a vaccinated friend (late 40s) who got scary chest pains for several days when he contacted Covid. No treatment beyond Paracetamol and Ibuprofen.
> getting the vaccine basically led to people not getting symptomatic covid. Folks got what they thought of as a bad cold.
Am I mistaken in thinking that "bad cold" == symptomatic? Doesn't symptomatic just mean had symptoms? It sounds like you're talking about severe covid.
Not mistaken, but also not useful. In particular, it is hard to tease out folks that did have a common cold from those that had reduced covid. The vast majority of the covid positive folks I knew post vaccine were asymptomatic. Almost apologetic that they tested positive for it, but not at all sick or scared. Even my kids, when they tested positive, were more upset about implications than they were physically ill. (Indeed, for our kids, when they finally tested positive, we didn't see any symptoms from them at all...)
What is reduced covid? The ifr for a 30 something was .06%
before vaccines according to the study below.
If my math is correct, thats one 30-something dying for every 1667 infected before vaccines. I don't have hospitalization data handy, but I think "reduced covid" is just what most people had, vaccinated or not. That's not to discount the ones that did get it bad of course, and my condolences for any losses you suffered.
Of course it can still be true that the deaths happened more often in unvaccinated people (did that continue to be true the whole time?), while your individual risk of death was low (the .06 above in my case, and I had a pretty standard cold both times thankfully).
Just look up the hospitalization and death rates for folks vaccinated and not. It is stark in difference.
I had what was probably covid early on. Was like the time I got pneumonia. Asthma attacks in my youth were comparable, if much shorter lived. Getting a positive test case later was something that gave me a fever for a few hours. Scary, due to circumstances. But I was back up and moving in basically no time.
Correpondence published in NEJM regarding the landmark study that found that the first booster dose reduced Covid-related mortality by 90%. It turns out that it also reduced non-Covid-related mortality by a similar amount. So either the booster short is a magic elixir that reduces all deaths, or the boosted, as a group, were healthier at the outset.
In the response of the original authors they mention that
> However, boosters were generally not administered to hospitalized patients who were at high risk for death from any cause.
I think you can guess how it affected the hospitalization and death rates of the boosted vs. the unboosted. For some reason, this was not mentioned in the original study.
And the main point mentioned by the original authors in their response:
> However, a strong, unexplained association between the use of the booster and lower mortality not related to Covid-19 remains.
> During the B.1.617.2 (delta) wave in the United States, similar associations were observed between the use of mRNA vaccines and lower mortality not related to Covid-19 and mortality from any cause.
> Just look up the hospitalization and death rates for folks vaccinated and not. It is stark in difference.
Are those rates an argument against the claim that most people didn't have a bad case, vaccinated or not?
> I had what was probably covid early on. Was like the time I got pneumonia. Asthma attacks in my youth were comparable, if much shorter lived. Getting a positive test case later was something that gave me a fever for a few hours. Scary, due to circumstances. But I was back up and moving in basically no time.
How do you know that your possible second case's low severity is due to the vaccine and not the immunity you would have developed in the first case, or weakening of variants (or some mix of all 3), or even just random chance?
It's hard to ignore personal experience, but it only tells us so much. Like me with my 2 unvaccinated cases having an easy time, I'd be remiss if I generalized that to everyone.
What are you driving at? The rates for vaccinated versus not are a clear indicator that the vaccines helped. Hard to see any other way of interpreting that data.
You are correct that, if I did, in fact, have an early case of covid, I cannot be sure that the vaccine helped me with the later case. So, as far as that goes, my "evidence" is anecdotal at best and can't be taken fully as proof of anything.
You will have a hard time arguing against vaccines with the aggregate evidence above, though.
Sorry, let me clarify. I'm not trying to argue against vaccines.
I entered the thread at
> getting the vaccine basically led to people not getting symptomatic covid. Folks got what they thought of as a bad cold.
I asked for clarity there because it didn't line up with what I understood to be symptomatic covid (have covid and have any symptoms). It sounded like you were really saying the vaccine led to people in your circle not having severe covid.
I believe it is true that the vaccine reduced instances of severe covid. But my point in this thread is that most people already weren't going to have severe covid (based on ifr rates pre vaccine, though hospitalization data would be more useful here).
In other words, "The rates for vaccinated versus not are a clear indicator that the vaccines helped" is true as I understand it, and not something I'm arguing against. It does not contradict "most cases of covid were not severe, vaccinated or not" though.
Ah, fair. I am definitely playing loose in that area.
For specifics in my circle, I really only have my immediate family and some coworkers as direct evidence. Among those, I don't know anyone that got symptomatic anything if they were vaccinated. We had plenty of colds, but only tested positive during a time when that wasn't going through the family. (We only tested due to kid's having contacts that got covid.)
So, to that end, only vaccinated person in the family that ever had symptoms was me. And, as I said, it was super quick. Such that I can't say for sure the kids didn't have symptoms overnight that we just didn't see.
Pulling it back to "most cases overall were not severe," is tough, though. If that is somehow indicative that the vaccines didn't help me, that would also imply that they didn't help the population at large. And the data just doesn't agree with that.
Is that where you are asking? Or did I avoid the question?
I'm just trying to make the point that the vaccines helped at a population level (going from .06% to .0006% or whatever IFR is real numbers when you're talking about the whole world), but I think people overestimate the impact it had on them individually.
And it's easy to see why they would! Given the environment at the time (daily press conferences, scary news articles, demonization of the unvaccinated, mandates) I think it's easy to believe that the vaccine saved you from a death sentence if you get vaccinated and then have an easy case.
It's easy to not notice that in a room of 1667 infected unvaccinated 30 year olds (I don't know how old you are, just using that as an example), maybe over a thousand of them would have had a similar case that you did, and only one of them would have died.
On that, I think I'm in violent agreement with you. In particular, I actually was annoyed with how much stress folks put pre-teens through regarding vaccination. I had friends that were terrified of doing anything with their toddlers before they got vaccinated, despite the odds still being higher for the parents with a vaccine than the kids without. It was truly baffling.
For my part, I suspect it helped me. Childhood asthma and general obesity being what they are. I was almost certainly in elevated risks for my age group. To your point, my age group was still moderate risks, all told.
It seems that Pfizer basically rammed the vaccine through because it prevented covid with 95% efficacy for a couple months and made the case that it was too effective to continue the study.
We now know that antibodies from Pfizer decrease significantly and quickly after a couple months, so it seems very likely that Pfizer knew this as well and decided that after two months was the perfect time to conclude their study and start selling vaccines.
No. The trial was intended to conclude when they had sufficient data to get an acceptable confidence interval. It was to be periodically reviewed to see how it was faring against that yardstick.
They ended up tossing one of the intermediate reviews because it was overtaken by events--the objective was met, spend the time on analyzing that data rather than the now-irrelevant intermediate review.
The test did nothing towards establishing how long the protection lasted--they can't have rushed it through based on that being short because they had no measurement of it then.
You simply can't measure time effects in medicine other than by observing them. If you want to know what protection is like after a year you have to wait a year and then measure it. (This is also why we saw repeated changes to the shelf life of the vaccine--the vaccine makers simply didn't have the time to establish what the true shelf life was and thus could only claim what they had measured. Note that this is pervasive in medicine--stored properly most drugs are effective far beyond the stated shelf life. It's just the manufacturers have no reason to spend the money to certify this.)
And in blaming Pfizer you show your bias--why did every vaccine maker do the same thing at the same time??
If anything I'll blame Pfizer for making a weak vaccine. Moderna chose to go with a higher dose that appears to provide slightly more protection at the cost of more side effects at the time.
To the governments, who have no money but from tax payers.
This I think was the most egregious marketing lie in recent history. That everyone who was jumping up and down for their vaccine was under an impression it was free.
The same people rabbling all day about "transfer of wealth" saw no issue there.
I don't have a stance on covid or vaccines that is terribly unique. But that most people overlooked the massive economic reasons to move in the direction that it did, annoys me.
Downvoted for not parroting Democratic Bay Area values. We will be contacting all FAANG companies and everyone listed in Crunchbase to let them know your an anti-vaxxer.
Instead of investigating what in the design and execution of the trial led to such a discrepancy, the problem was handled by denying there was a problem, changing the goalposts, reporting ad-hoc hypotheses as facts, silencing all critics, and forcing the public to take the modality anyway or lose jobs, school, and freedom of movement.