DB, the email you sent through the website does not have an email address I could use to respond, but obesity is far and away the number one risk factor for serious CV-19 disease, with diabetes, hypertension and others playing a role.
People occasionally ask me for research cites for statements I make. Everything I say is based on research that is summarized in these posts. You can use the search function of the blog to find topics. And as you know, there are frequent charts and tables of data that also are the basis for my conclusions. Read the research summaries and you will know what I know. And I always link to the actual underlying research paper, so you can read it for yourself and come to your own determination about what it says.
The big jump in reported cases in Minnesota on Tuesday is from several days so while there is a bit of an uptick, it is misleading. Jumps later in the week do reflect a slight tick up from low numbers. And the CDC’s revised mask guidance, aside from being idiotic, is the clear sign that we have peaked nationally in the recent case bump. Cases will be heading down now for sure. Government is always slow and late. Remember the euphemistic “pause” in Minnesota early last winter; the IB put that in place after active cases had already peaked.
And we were blessed with a second press briefing this week by our friends at the DOH. I haven’t had the stomach to watch it yet but will post separately when I do. These incompetent boobs can put out a brief today on vaccine “equity” but can’t give us information to demonstrate the effectiveness of vaccines.
I am beyond fed up with the lies and misinformation being spread by Alex Berenson and others about vaccine effectiveness, which only feeds terrorism and hysteria and panic and sure enough, mask mandates and lockdowns. Not going to back down from calling out crap whoever spreads it on whatever issue.
Minnesota isn’t the only place where a lot of hospitalizations aren’t really for CV-19, but are listed as such even though people were admitted for another reason and happened to test positive. This story from the UK says that in that country, only 44% of admissions are for people with already diagnosed CV-19. Now it is possible that some of the other 56% who were identified on admission could end up being treated for CV-19 and needing hospitalization, but I doubt it is very many. (UK Hosp.)
A lot of vaccine related research today, so let’s get cranking. Okay, everyone is getting all worked up about how vaxed people can get infected. My reaction is so what else did you expect, vaccination does not stop exposure and occasional infection, and tell me when their outcomes are as bad or worse. This study looked at infections in vaccinated health care workers in Israel. (NEJM Article) Big caution is this was pre-Delta, mostly Alpha infections. Among 1479 fully vaccinated persons (fully vaxed was 11 days post last dose, so not really fully vaxed) 39 infections occurred. In 37 the index case was an unvaccinated person and the other two cases were not traced. The median time to infection was 39 days after last dose, so many were not fully vaxed. The positivity rate among this group was 2.6%, substantially lower than in the community at the same time. Two-thirds of the cases had no or mild symptoms, there were no hospitalizations or deaths. There was no secondary transmission from any of these vaccinated cases. Several cases were clearly low “positives” although 74% had a test result with a cycle number under 30 at some point. The researchers called this a high viral load but that is not accurate given that most studies show many tests in that range don’t culture viable virus. Most interesting was that the level of neutralizing antibodies was correlated with infection; those who developed low levels following vaccination were most likely to be infected.
Here is another vaccine study, this one from Sweden, a cohort study involving the working age population and the Pfizer vaccine. (Medrxiv Paper) This was a study of over 800,000 people, 26,000 of whom had been vaccinated with at least one dose. Vaccine effectiveness was estimated at 42% within 7 days or more after one dose and 86% 7 days or more after the second dose. For people in the unvaxed group, prior infection was associated with a 91% effectiveness against reinfection. I just want to remind people that the effectiveness may appear to decline over time solely because any time you start with a percent of a set group, each additional event lowers the percent. It is a little deceptive and why more information about each “case” in a vaxed person is important.
Another Pfizer vax study from the US, Europe, South America and South Africa. (Medrxiv Paper) This was a randomized trial involving placebo, so good design and unusual in the vaccine world because of ethical concerns. Over 45,000 people over the age of 12 were included in the study. Vaccine effectiveness was 91% against infection and 97% against serious disease through 6 months of followup. But effectiveness was highest in the two months following second dose and began to tail off slightly. Not unexpected, see my note below and remember the issues with PCR testing. Few serious adverse events were recorded.
Finally, a study from Qatar looking at vaccination by mRNA vaccine among both previously uninfected and infected cohorts. (Medrxiv Paper) The intent was to compare whether vaccination was more effective in those with no prior infection or with a prior infection. However, a caveat would be that only detected infections were included, so could make the difference from infected versus uninfected seem stronger than it is, but see the next sentence. Oddly, for the Pfizer vaccine, prior infection appeared to boost vaccine effectiveness, while not so much for the Moderna one. This was tentatively attributed to a much higer dose of Moderna and a longer period between the doses, see the summary below. Rates among the vaccinated were far lower than in the unvaxed population at a time when incidence in Qatar was quite high. In fact, the absolute number of infections was very low.
A lot of basic research could be done to help improve vaccine efficacy. This study examined pre-existing T cell responses in non-infected persons to CV-19. It found differences in the presence of those T cells among younger and older adults, with older persons having fewer spike-oriented T cells and more membrane ones. The presence of these pre-existing cross-reactive T cells is a partial explanation for susceptibility to disease and infection and may help guide vaccine development, particularly for the elderly. (Medrxiv Paper)
And this paper also is helpful in vaccine rollout. It examined the effect of a basic parameter–the schedule of multi-dose vaccinations. (Medrxiv Paper) The study involved both an mRNA and an adenovirus vaccine given to adults 50 or older. More people showed evidence of antibodies with a longer passage of time, and the antibody levels were higher if the time interval between doses was longer. I believe this is due to the length of time it takes for B memory cells to reach their full adaptive immunity level. Previously infected people tended to have a stronger response to the first dose. This is valuable research for maximizing effectiveness through the dosing schedule.
Remember when Alex Berenson was trying to convince us that the mRNA vaccines would kill us all, using VAERS data which is completely unreliable? Here are a couple of actual studies on side effects. This one looked at what I will simplistically call blood clots. There is no question that some people likely suffered a blood clot disorder following vaccine administration. But how different was the rate from that occurring in the general population or as importantly, from that occurring after CV-19 infection? (Medrxiv Paper) Over 600,000 people in each of groups with one dose or two doses of the vaccine, and over 190,000 people with prior CV-19 infection were included and compared to a reference population of over 7 million people. The rates of clotting disorders was the primary outcome. The background rate over 21 days is about 2.15 events per 100,000 people. The study was done in a large Spanish health system. In the 21 days following vaccination with a first dose, the event rate was 5.65 and in the 21 days after a second dose it was 7.23. The risk was about twice as great in men but did not differ materially by age. So vaccination was associated with an increased risk of clotting issues, but the rate of clotting disorders among people with CV-19 was far higher, 32.5, so if you are doing your risk/benefit analysis, take that into account.
And myocarditis has been identified as a risk factor from vaccines in young people, especially young males. The thrust of this study was again to identify myocarditis rates following CV-19 infection for comparison purposes. (Medrxiv Study) Now not a lot of young people get CV-19, so the absolute numbers are quite low, but the per million rate of myocarditis following CV-19 infection in younger males, depending on age subset, was from 240 to around 900. (I left out the high end of the range, to be very conservative.) Among females it was 73 to 700 per million. These rates in CV-19 patients are multiples of myocarditis rates among vaccinated people of this age, but again the absolute numbers in CV-19 patients are quite low.