Over the past month, fully vaccinated individuals accounted for 29% of cases and 19% of
hospitalizations (In British Columbia, Canada).
We have ~75% of the population vaccinated. So 25% of the people account for 71% of the cases and the case rate amongst vaccinated is significantly lower. What you really want to think about is what that says about the R number difference between those populations because our R is hovering around 1 so the vaccine is making a huge difference.
The study is flawed in many ways. There is no control for any other measures in place. Also looking at the case rate is not the right metric since we don't know the base rate for the comparison, I would want to look at an estimate of R instead.
EDIT: "Notably, Israel with over 60% of their population fully vaccinated had the highest COVID-19 cases per 1 million people in the last 7 days. "
I follow Israel's Covid situations very closely because I have family there and this statement is misleading. The increase in cases in Israel was related to the delta variant arriving, the overall vaccine coverage being low (yeah, 60% isn't enough for Delta) and all restrictions being lifted. And yes, some waning of the effectiveness of the vaccines as well. With the reintroduction of some restrictions (such as vaccine passports e.g.), higher vaccine coverage, and some 3rd booster shots their cases have dropped significantly (by a factor of 8 over a month or so!).
You're looking at presented cases and hospitalizations - a fraction of a fraction of total covid infections. There's no way this accurately reflects R0 (assuming that's what you're talking about - sorry if I'm wrong!). And determining the impact vaccines have on R0 is nearly impossible - there's too many unknown unknowns that would confound it.
For example, if a flu vaccine was administered at the end of a seasonal peak, we'd think the vaccine caused the dropoff because we don't understand seasonality.
We don’t actually care about infections, we care about the things infections cause. A single virus infecting a single cell is an infection, what happens after that depends on the immune system. Antibodies are supposed to stick around briefly after an infection to minimize the risks of reinfection. For near lifetime immunity as provided by the measles vaccine it comes down to memory B cells which drastically speed up the adaptive immune response. Thus reducing the period an infection is contagious and reducing the risks of severe infection.
Note, the above applies both to natural infections and vaccination. Also note many childhood vaccinations are effective for decades.
GP was referring to a limited subset of data that gives an incorrect picture of what the R0 is. I was trying to point out why that data is the wrong set to draw a meaningful number from.
I’m not sure what you’re trying to point out, sorry!
In epidemiology, the basic reproduction number, or basic reproductive number (sometimes called basic reproduction ratio or basic reproductive rate), denoted
R
0
R_{0} (pronounced R nought or R zero),[1] of an infection is the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection.[2] The definition assumes that no other individuals are infected or immunized (naturally or through vaccination). Some definitions, such as that of the Australian Department of Health, add the absence of "any deliberate intervention in disease transmission".
I assume your concerned about transmission, but that’s not a constant when you include vaccinations reducing infection severity.
First let's deal with the nitpicky semantics. R0 is is the basic reproduction number while R generally denotes the effective reproduction number. I am talking about R.
There's indisputable evidence that the vaccination is impacting R. While it's true that the accuracy of estimates for R depends on many factors and certainly there have always been some cases flying under the radar (though that has been studied extensively via antibody studies and other means) proxies like the number of people dying, the number of people hospitalized, while controlling for things like vaccinations are accurate enough to detect this.
Trying to argue confounding factors vs. the observations is IMO very weak. Ofcourse we can't tell anything with certainty in this domain. It seems like the people who want proof here set the bar impossibly high, no proof will ever satisfy them.
> There's indisputable evidence that the vaccination is impacting R.
I think you are misusing the word indisputable, since clearly, people are disputing it.
> While it's true that the accuracy of estimates for R depends on many factors and certainly there have always been some cases flying under the radar (though that has been studied extensively via antibody studies and other means) proxies like the number of people dying, the number of people hospitalized, while controlling for things like vaccinations are accurate enough to detect this.
You just listed a number of proxies that are inaccurate, and/or, generally missing.
Why?
Simply because Covid is highly dangerous to the advanced in age, those that express ACE2, and those with multiple co-morbidities, in particular obese diabetics.
For example, a white male 6' 200 lbs with no comorbidities nonsmoker has the following mortality rate by age:
18: 2.1 per 1M
30: 2.1 per 1M
45: 1.6 per 100K
60: 4.3 per 100K
75: 2.2 per 10k
90: 0.7 per 10k
So, while covid may move through a retirement community like the Death Angel, across a team of 16 year old soccer players most will be asymptomatic, and a few may appear to have a cold.
As someone that has had access to a regional hospital system's covid counts, I can assure you that this is not a disease of the very young and fit.
Our surveillance numbers around covid antibodies is incredibly low because it is only a tiny percentage of the population that is getting tested for antibodies. There are more people being tested for active infections, than there are for antibodies.
You're making it sound like the people looking at this are idiots. Of course this is tracked across age groups. Look at the BC data where it's broken down by age.
Also are you suggesting that the relative portion of the population in certain age groups has changed dramatically? Because otherwise you can still look at the aggregate as indicators.
Sorry if I'm misusing the work indisputable. English is not my mother tongue. Looking at the dictionary I also don't think it means what you think it means. Someone can dispute anything. We could say gravity is indisputable but someone can come and say there's no gravity. People say the earth is flat. Possibly in this day and age nothing is indisputable.
From where I stand, given the evidence, the people who say something like "vaccination has no impact on R" are not far from people claiming the earth is flat. I mean maybe the earth is flat. Even the guy who responded to me saying I was wrong then changes his mind on that.
> From where I stand, given the evidence, the people who say something like "vaccination has no impact on R" are not far from people claiming the earth is flat. I mean maybe the earth is flat. Even the guy who responded to me saying I was wrong then changes his mind on that
Judging from the statistics of high vaccination rate countries like Israel vs Sweden,[1] there are a few important questions to respond with such as:
Which vaccine, formulated against which variant?
Vaccinated When?
Against which infectious variant?
At what point was herd immunity hit?
Overall, it appears as though Sweden's approach was better as they are not having a 3rd wave, they hit herd immunity, because natural immunity > vaccination, they have more durable results against future variants, etc.
I'm not disputing whether we should vaccinate some that are old, or have comordibidities, or want to get it. But, pushing a leaky vaccine across a large population is a license to get mutations and cause new variants in a large population. In effect, adapting the virus to target the vaccinated.
I agree all these factors matter. But you're not really commenting on the question at hand.
But since you dragged me into a different debate, Sweden has 66% of the population vaccinated. So if they did so great on herd immunity why are they vaccinating? Is 66% of their population old and/or with co-morbidity? So clearly the Swedish disagree with the idea that you should only vaccinate the old or those with comorbidity? Are there any good examples of countries that are open, not vaccinating, and are doing well? I honestly lost track of what Sweden has been doing exactly but I think even early on the portrayal that they're just acting normally was wrong, they relied on recommendation rather than enforcement... and I think they did worse than their peers.
Sense check: most variants of concern emerged in countries prior to mass vaccination.
Short version: why would vaccine-induced immunity provide materially different selection pressure to naturally-acquired-via-infection immunity? Neither are 100% effective, and will therefore allow immune-escape mutations through.
> "Not all vaccines prevent infection. Some, known as leaky vaccines, prolong host survival or reduce disease symptoms without preventing viral replication and transmission. Although leaky vaccines provide anti-disease benefits to vaccinated individuals, new research by CIDD’s Andrew Read, David Kennedy and colleagues at the Avian Oncogenic Virus Group in the United Kingdom, and The University of New England in Australia, has demonstrated that leaky vaccines can make the situation for unvaccinated individuals worse. Leaky vaccines work by enhancing host immunity to a particular pathogen, without necessarily blocking or slowing viral replication. The result is that infected but vaccinated individuals have extended survival, allowing highly virulent pathogen that would normally reach an evolutionary dead-end in a dead host, can transmit. The evolutionary consequences of high virulence are thus reduced and these pathogens can be selectively favored as a result of leaky vaccination."
[1]
> "Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek's disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts."
[2]
> "Over the past fifty years, Marek’s disease—an illness of fowl—has become fouler. Marek’s is caused by a highly contagious virus, related to those that cause herpes in humans. It spreads through the dust of contaminated chicken coops, and caused both paralysis and cancer. In the 1970s, new vaccines brought the disease the under control. But Marek’s didn’t go gently into that good night. Within ten years, it started evolving into more virulent strains, which now trigger more severe cancers and afflict chickens at earlier ages. Andrew Read from Pennsylvania State University thinks that the vaccines were responsible. The Marek’s vaccine is “imperfect” or “leaky.” That is, it protects chickens from developing disease, but doesn’t stop them from becoming infected or from spreading the virus. Inadvertently, this made it easier for the most virulent strains to survive. Such strains would normally kill their hosts so quickly that they’d die out. But in an immunised flock, they can persist because their lethal nature has been neutered. That’s not a problem for vaccinated individuals. But unvaccinated birds are now in serious trouble. This problem, where vaccination fosters the evolution of more virulent disease, does not apply to most human vaccines. Those against mumps, measles, rubella, and smallpox are “perfect:” They protect against disease and stop people from transmitting the respective viruses. “You don’t get onward evolution,” says Read. “These vaccines are very successful, highly effective, and very safe. They have been a tremendous success story and will continue to be so.”" [3]
> "Vaccination elicits immune responses capable of potently neutralizing SARS-CoV-2. However, ongoing sur-
veillance has revealed the emergence of variants harboring mutations in spike, the main target of neutralizing
antibodies. To understand the impact of these variants, we evaluated the neutralization potency of 99 indi-
viduals that received one or two doses of either BNT162b2 or mRNA-1273 vaccines against pseudoviruses
representing 10 globally circulating strains of SARS-CoV-2. Five of the 10 pseudoviruses, harboring receptor-
binding domain mutations, including K417N/T, E484K, and N501Y, were highly resistant to neutralization.
Cross-neutralization of B.1.351 variants was comparable to SARS-CoV and bat-derived WIV1-CoV, suggest-
ing that a relatively small number of mutations can mediate potent escape from vaccine responses. While the
clinical impact of neutralization resistance remains uncertain, these results highlight the potential for variants
to escape from neutralizing humoral immunity and emphasize the need to develop broadly protective inter-
ventions against the evolving pandemic." [4]
> "HIV patient had COVID for over 7 months, infection mutated over 30 times....It is noted that patients who have HIV are not more susceptible to contracting a coronavirus infection than those without, nor does it worsen the medical implications of the infection. Additionally, the fact that the disease stays present within the body of immunosuppressed patients for longer periods of time compared to healthier individuals could mean that HIV patients could be an incessant source of transmission and mutations of the coronavirus - almost like a factory of variants." [5]
If you have high viral transmission against a less effective variant, of course you will have natural selection of a virus for greater transmissibility within that specific environment. If the environment is now a conventional spike antibody human environment, this will promote changes to the spike, and, changes to the overall virus.
Furthermore, when you have a leaky vaccine distributed to a large population where viral spread is still occuring, you promote genetic transfer between viruses that are mutually infecting patients, as well
This is science 101, unless you disbelieve in adaptation?
> There's indisputable evidence that the vaccination is impacting R
> Ofcourse we can't tell anything with certainty in this domain
Which one is it?
I'm sorry - there are issues with nearly all the links and data you've provided, but I don't have the time to go through them with you.
I agree with you that the vaccine is very likely impacting R. I don't agree that it is enough to matter yet - we could vaccinate everyone and covid would still spread. The vaccines will keep people from dying. Any more benefit than that is still unclear.
You're contradicting yourself. You're saying you agree with me the vaccine is very likely impacting R yet you're saying it doesn't help. Which one is it?
We have lots of places, such as where I live, where the number of deaths and hospitalizations and daily cases is about level. Since you agreed with me vaccinations impact R you can also agree with me that going from 75% vaccinations to 100% vaccinations is going to cause that level trajectory to go down? What is your projection?
As to your question "which one is it" there is no conflict. The evidence is indisputable yet there is no certainty. Simply because in this domain there is no certainty. It's not a math proof. It is by far the most likely thing that's happening. I mean maybe aliens are curing people to coincide with the different levels of vaccinations but I've yet to hear some reasonable hypothesis how in place like where I live where seasonality dictates higher rates, restrictions have been relaxed, and there is clear correlation between higher vaccination rates and reduced other metrics (change in new cases/day, hospitalizations, deaths). I think if you disagree with the obvious you should at least offer some other hypothesis supported by some data.
>You're contradicting yourself. You're saying you agree with me the vaccine is very likely impacting R yet you're saying it doesn't help. Which one is it?
When it comes to exponential growth, the difference in practice between an exponent of 1.5 vs 2 is negligible.
Over the past month, fully vaccinated individuals accounted for 29% of cases and 19% of hospitalizations (In British Columbia, Canada).
We have ~75% of the population vaccinated. So 25% of the people account for 71% of the cases and the case rate amongst vaccinated is significantly lower. What you really want to think about is what that says about the R number difference between those populations because our R is hovering around 1 so the vaccine is making a huge difference.