A couple of commenters have noted that I seem to be very frustrated and too pointed in regard to vaccine doubters. That may be true, but there is a good reason for it. There is an immense amount of misinformation being spread about vaccines, and if that misinformation keeps people who could benefit from being vaccinated from doing so, that is not a good thing. People are making political statements and acting on beliefs and talking about distrust of government. Those are not substitutes for rational decision-making. I try to report on the research and data as it comes, including everything I can on vaccine effectiveness and safety. I understand FDA processes pretty well, having run a clinical trials organization and being involved in drug development for many years. I understand how vaccines work and I have realistic expectations about how a respiratory virus vaccine would work. I have tried to explain that and set those expectations since before the vaccines were actually approved for use. The data and research so far tell me that the vaccines are safe and are effective against serious disease. So yes, I get a little tired of having to respond to “what about long-term safety studies” and other relatively uninformed remarks and I am definitely fed up with the conspiracy crap. I have been as critical as anyone about government messaging and distrust of public health experts who have become politicized, but I can also read the research and data and come to my own conclusions. And those conclusions are what I share with you.
And while I vehemently disagree with Alex Berenson on vaccines, there is no way he should be suspended from Twitter. It is unconscionable that these large social media companies are purporting to be deciders about what is accurate, particularly given that they are totally ideological and political organizations. I am hoping that Alex sues and I have offered to provide financial support for that if he needs it. And we need a total change in how these entities are regulated. If they want to be responsible for content, then they can take the liability that goes along with that.
I like to start off with bad news. The terror campaign associated with attempts to suppress the virus led many people to avoid needed health care. This study from Canada attempted to assess the likely toll of this missed care in regard to cancer. It estimated that from 2020 to 2030, over 20,000 additional cancer deaths would occur, and many of these are younger persons than typically die from CV-19, so I believe that alone would be higher toll in years of life lost that was caused by the virus, which in Canada right now has only caused around 26,000 deaths. (Medrxiv Paper)
This article from England details data regarding hospitalizations in that country. (UK Article) I am trying to locate the actual data but according to the article many current hospitalizations attributed to CV are not for treatment and many stays for CV are very short. By August 15, 43% of Delta-infected persons had actually been admitted for another reason and 60% were discharged within one day of admission. Unvaxed persons were disproportionately rsponsible for hospitalizations.
And this study from the US looks at hospitalizations among vaxed and unvaxed persons. Unvaxed persons were far more likely to be hospitalized when infected. Breakthrough hospitalizations were concentrated among the elderly, especially in LTC facilities, and those with poor health status. By July, 16% of hospitalizations were breakthroughs, but again, this is a result of high percents of vaxed persons in the population. I have documented the same phenomenon in Minnesota. And in July, unvaxed persons had ten times the hospitalization rate. And I want to note again, that since vaxed people are more likely to have asymptomatic infections, this probably understates the protective effect of vaccination. And once again, data was not available on the unvaxed who might have been infected, so the protective effect of vaccination may be understated. (Medrxiv Paper).
I think some of the most meaningful data and analyses that could be done right now are comparisons between breakthrough infections after vaccination and reinfections among unvaxed but previously infected persons, properly adjusted for all confounders. I suspect that such analyses, if properly done, would show that the reinfection rate is lower than the breakthrough infection rate, indicating that adaptive immunity via infection is at least as strong as adaptive immunity after vaccination. One reason I think this may be true is that the vaccines are not as optimal as they could be since they only create a response to spike protein. This study examines reinfection rates among NBA players and staff, who were required to undergo regular testing. (JID Study) Out of 768 infected persons, over a 6 month period only 7 experienced reinfection, less than 1%. These persons were all asymptomatic or mildly infected and viral loads were far lower than for primary infections.
It appears that vaccine protection from infection lessens over time. This study from Qatar looked specifically at that issue. The country has a high vaccination rate and good data gathering infrastructure. The study period was from January 1 to August 15. Effectiveness against any infection reached a peak at around 72% around five weeks after vaccination and declined thereafter. Effectiveness against serious illness or death reached 94% and stayed at that level for the 6 month maximum followup period. One thing this suggests to me is that other aspects of the immune response than antibodies are involved in protecting against serious illness. (Medrxiv Paper)
This was another study comparing antibody development from vaccination versus infection. One of the findings again is the variability in measurements from different assay types. But over a year, antibody strength, while declining in the infected patients still remained relatively high, whereas in vaccinated persons the antibodies were initially much higher than in infected persons, but began to decline within a three month period. (Medrxiv Study)
And this study looked at the effectiveness of prior infection or infection plus vaccination against variants. It found that patients with prior infection or vaccination had a fairly good response against the variants, but that response was boosted by subsequent vaccination. (Medrxiv Paper)
Okay, here is a study from Mongolia of all places, but it looked at four different vaccines including a Russian and Chinese one. (Medrxiv Paper) The Chinese and Russian vaccines prompted less strong antibody development. There was less neutralization of variants. Prior or subsequent infection coupled with vaccination appeared to prompt the strongest antibody development. Breakthrough infections appeared more correlated with the development of low antibody levels, as opposed to infection by a variant.