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Vaccine Safety in Older Persons

By December 27, 2022Commentary

Readers know I am waging an ongoing battle with those spreading mis-information about vax safety.  The elderly, due to often poor health, may be particularly susceptible to side effects.  This very large study used data on Medicare beneficiaries to examine vax safety in the elderly.  The study looked at 14 potential issues in over 30 million persons, including over 17 million who had been vaxed by January 2022.  This very large real-time database  was used for weekly screening to detect excess event rates.  A variety of data queries were used as multiple checks on potential issues.  An important item to note from a methodological perspective is that these events in the pre-epidemic period showed significant monthly variation, so adjusting for that was key to determining if there actually was a safety signal.

Somewhat surprisingly, there were no safety signals in regard to the Moderna or J & J vax, surprising only because the Moderna vax is a higher dose than Pfizer and the J & J vax has had more reports of issues.  The Pfizer vax initially had a signal, meaning there appeared to be more than the background rate of events, for pulmonary embolism, heart attack and two clotting issues, although the excess rate was small.  On adjustment for the seasonal variation and other factors, only the pulmonary embolism event remained statistically significant, and at a low level.  In addition, the Pfizer vax had a much greater use among nursing home residents and this was not adjusted for which may explain the pulmonary embolism finding.  Other confounding factors also not were included.  There was no time clustering of events in the windows immediately following the vax date.   (Vax Article)

Here is the clear bottom line, for the elderly, this very, very large study shows only one potential safety signal, which likely would be eliminated on further analysis.  So don’t pay any attention to the safety bullshit on the internet.

I would not minimize any risk of any treatment causing adverse events.  These can be serious.  In the elderly population, however, CV-19 has demonstrated its ability to be quite deadly and to cause lingering substantial health issues.  When doing a risk/benefit analysis, unless you are an exceptionally healthy elderly person or have specific high risk factors for a vax adverse event, getting vaccinated likely makes sense, even though the protection may not be extremely long-lasting.  There is a separate issue about whether too many boosters actually impair an immune response to new strains.

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