Okay, all you fight against the vaccine to the bitter end readers, you can be disappointed in me again. I got a booster today. Already feeling a little tired with some chills, so it is working. I am doing this in the interest of journalism, I am blazing a trail for you. Seriously, at this point looks like the biochemical reaction to another dose is better than after the second dose, so there is hope. If you read the comments, and if you saw some of the emails I get, you would know that a lot of vaxed and unvaxed people get CV-19 and it isn’t a breeze much of the time. Some loyal readers have described pretty harrowing days. I have enough problems without getting CV-19 and if I were laid up, where would you turn for amusement and ranting? I am going to summarize an interesting piece of research in the next CLF part that deals with why the vaccines may not have prompted a great response and it has to do with the dose timing.
But today, my friends, we are gathered once more to marvel at the never-to-be-underestimated incompetence of the Minnesota Department of Health. They think we are dolts because they are constantly looking in the mirror. I KNOW THIS IS LONG, PLEASE READ TO THE END, MAYBE YOU CAN HELP. There was a briefing which covered this as well, but I don’t have the heard to listen and report on it in my booster-addled state. Will do it tomorrow. We got both some more written data and a new database. Both are designed solely to promote the state’s messaging, which is “pay no attention to the man behind the mirror”. Here are the new notes they added about breakthrough infections:
“There are multiple points to consider when reviewing vaccine breakthrough data:
*As more people become vaccinated it is natural to see more cases of vaccine breakthrough (no vaccine is 100% effective). However, vaccines remain highly effective at preventing severe disease, hospitalization, and death.
*Vaccinated people should still take steps to protect themselves and others in certain settings such as indoor public settings and crowded outdoor areas.
*We may be seeing more vaccine breakthrough cases for many reasons including:
*Waning immunity among people vaccinated earliest. These people are also more likely to be older, have comorbidities, or work in a setting that puts them at higher risk for COVID-19.
*The more-transmissible Delta variant may be playing a role that we don’t fully understand yet.
*People are returning to various states of normalcy – this will result in varying levels of disease transmission and test seeking behaviors.
*Vaccination records may be incomplete as a result of reporting errors and delays or problems matching vaccination information with case data. In addition, some entities, including federal organizations, don’t report vaccination information to the state.
*Breakthrough infection is not the same thing as breakthrough disease. Breakthrough infections occur any time a fully vaccinated person tests positive for the SARS-CoV-2 virus, regardless of whether they feel sick. These data report on breakthrough infections, not breakthrough disease.
*Vaccine breakthrough is not a measure of efficacy. There are several studies on vaccine effectiveness: CDC: COVID-19 Vaccine Effectiveness Research.”
Most of this falls into the category of “now you tell us” and “where was this context before”. As always look for what isn’t said. First bullet, notice the absence of “cases” in what vaccines are highly effective against. Second bullet, umm, I think what that means is “don’t count on the vaccines to keep you from getting infected”. Third bullet, second sub-bullet, yeah, I agree that you don’t understand Delta, the research increasingly shows vaccines are just as effective against Delta and Delta is not more infectious than Alpha, the prior dominant strain. Third bullet, third sub-bullet–“its all your fault for not encasing yourself in saran wrap and hiding in your basement and never getting within a mile of another human being.” Fourth bullet, almost my favorite, a clear admission that they are seriously undercounting. They don’t know a bunch of people who are fully vaxed so if those people have infections they can’t match them. This includes any Minnesotan vaxed in Arizona, Florida or most other states. It includes people vaxed in the VA system or other federal health care facilities. That is a very significant portion of the population. And the fifth bullet (coronet flourishes, please), excuuuuse me, you told us that vaccines would end the epidemic, and now you say that getting infected after full vaccination is not a measure of efficacy!!! WTF. This is just bullshit excuse making.
Then we get the new data, which is basically nothing but more detail on per capita rates with some dates and age group breakdowns. You can find it here. (Mn. Breakthrough Data) Dave Dixon is more facile with data sets than I am and he is having the same problem making any sense out of the data. They just keep trying to make you look at per capita rates without giving you a clue of how to figure out the absolute number and the proportion of events in the two sub-populations. Without absolute numbers by date of event, you can’t really figure out what is happening. And not a clue is given as to the number of people considered fully vaxed in a week and the number considered unvaxed. With that you could back into absolute numbers. But they don’t want anyone doing that. Per capita rates are part of the story and do help understand vaccine effectiveness, but they are only part of the story. This is just more garbage that the state is putting out solely to get people to believe that the only issue right now is unvaccinated people. It isn’t.
But wait, there’s more, as the Ronco people say (look that up if you don’t get it), look at the notes provided along with the data set. Here is the first set:
“*Fully vaccinated means that at least 14 days have passed since a person completed their COVID-19 vaccination series. A complete series can mean 1 or 2 doses of vaccine have been given, depending on the product. The number of fully vaccinated people will not be the same as the number with a complete vaccination series found on COVID-19 Vaccine Data. Case reporting and vaccine reporting have delays in addition to the time it takes to match case data to the Minnesota Immunization Information Connection. Case counts will typically reflect cases reported one or more weeks ago.
*Note: An error in how vaccine breakthrough data is calculated was fixed on 10/18/21. This is why the total number of fully vaccinated Minnesotans decreased from the prior week’s update.
* Total cases hospitalized includes patients admitted for any reason within 14 days of a positive SARS-CoV-2 test.
* Total deaths (also known as total deaths with laboratory testing) are deaths due to COVID-19 with a positive PCR test (confirmed case) or antigen test (probable case) for SARS-CoV-2, and either COVID-19 is listed on the death certificate or clinical history/autopsy findings that provide evidence that the death is related to COVID-19 without an alternative cause (e.g., drowning, homicide, trauma, etc). *The case overview data covers a longer time period than the tables and graphs below. The case, hospitalization, and deaths data below begins at a later date to capture the time frame when the majority of Minnesotans were eligible to receive vaccine. All data is preliminary and may change as cases are investigated. Case and vaccine totals reflect only the results from laboratory testing and vaccinations that have been reported.”
What you should note is that they find “errors” in their work. So do I. Look at that definiton for a hospitalization, applies to all cases, but clearly includes hospitalizations that have nothing to do with CV-19. Bigger lag on breakthroughs, at least a week longer than with all cases. Dave Dixon tried to use different lags to match proportions accurately, but it is hard without having actual dates of events.
Now we get another set of notes, this one under the charts on cases, hospitalizations and deaths over time:
- “Data within the lag period may change significantly due to delays in reporting and the need to deduplicate and confirm reports.
- Rate per 100,000 people among the vaccinated is calculated as the number of fully vaccinated people who test positive for SARS-CoV-2 (or who are hospitalized after testing positive for SARS-CoV-2, or who died as a result of an infection with SARS-CoV-2) divided by the total number of fully vaccinated people multiplied by 100,000.
- Rate per 100,000 people among those not fully vaccinated is calculated as the number of not fully vaccinated people who test positive for SARS-CoV-2 (or who are hospitalized after testing positive for SARS-CoV-2, or who died as a result of an infection with SARS-CoV-2) divided by the total number of not fully vaccinated people multiplied by 100,000.
- Age-adjusted rates are used to directly compare mortality and disease risk in two groups that have different age compositions. The age composition of the vaccinated population is different from the age composition of the not fully vaccinated population. For example, the vaccinated population in Minnesota is older than the not fully vaccinated population. Older adults are also at greater risk of developing, becoming hospitalized, or dying from COVID-19. Any population that has more older adults will have a higher risk of COVID-19 disease, hospitalization and death. Age adjustment is necessary in order to accurately compare fully vaccinated people to not fully vaccinated people.
- These data only include individuals age 12 and older.”
Why are the headline rates age-adjusted? You can select an age group to look at and compare within that age group. Makes no sense to then adjust the composite rate, and I don’t know what they actually mean, but it is extremely misleading in this context. So give us the unadjusted rates and then explain exactly how you did your age adjustment, so we can check your work, since you acknowledge that you make errors.
Now comes a nice little trick, let’s take out the under 12 age group because they can’t be vaccinated. This might make the unvaxed per capita rate look worse. Have to do some analysis to see if we can figure that out. My suspicion is it does, and that is why they took them out.
And now after you suffered through all those words, here is how you can help. If you look at the new data set and you figure out how to match it up with the table of cases by specimen collection date, or how to figure out what the denominator for the sub-populations is in the fully vaxed and unvaxed per capita numbers, then God bless you and please share with Dave and I. Dave thinks he is pretty much there, but we welcome others’ input. We will keep trying but the state actually doesn’t want us to succeed. But yes, the state is committed to having the absolute best data and being more transparent than anyone. And if you believe that, then go ahead and vote to re-elect the IB.