That hindsight is at least marginally closer to 20/20 than foresight.
Lotta people just continue on operating from the assumption that we knew the severity of COVID upfront which… we didn’t. It was very severe and it appeared even more so (as is well within the bounds of possibility of a novel pathogen).
It’s so hard to talk about this without being labelled a “vaccine denier”.
We all knew the initially claimed protection rates were overstated, it was acknowledged as a limitation in the initial study protocol but ignored by politicians and media.
For the validation trials, due to the time / resource requirements (we didn’t have PCR capacity) testing for seroconversion/positivity was only done on symptomatic patients and not at a routine time interval. This type of testing is well known to result in overestimating treatment effects (you’re missing all the people who didn’t self declare symptoms and get tested by not having strictly adhered testing intervals) and there’s zero doubt “94% protection” was an overestimate (even by the original Pfizer study authors). By how much, we’re not sure, and we absolutely needed something in a time of uncertainty and it was the right decision at the time given available resources and pandemic pressures.
As evidence has accumulated, we’re realizing the vaccine effects and COVID mortality (particularly post Delta) are vastly overstated.
I have not seen a CT chest with the “cardboard lung” appearance of COVID-19 pneumonia or ECMO patients since December/Jan 2022, and I was reporting inpatient chest imaging in the largest ECMO center in Ontario at multiple points during the pandemic.
The “sniff test”, suggested things were changing (like population drift with a ML model). And the issue with the vaccine rollout is we went back to “science based medicine” rather than the currently accept “evidence based medicine” where lab tests like neutralization assays were being extrapolated into clinical outcomes. Medicine moved away from this type of reasoning for a reason, you really need to look at higher level outcomes to know what’s actually going on. You can rationalize many treatments on a scientific level (as was done for anti malarial drugs at some point) but it usually ends up invalid.
What’s being proven true now, is that we overestimated both COVID mortality due to confounding effects of co-admission (how many inpatients are there BECAUSE of COVID not with it) as well as the effectiveness of vaccines, particularly at later stages in the pandemic. They probably worked well for COVID 1.0 up to Delta at preventing serious illness but that quickly dropped.
I don’t buy the evidence to support current vaccination recommendations with the bivalent (esp. young and healthy), and you can see many institutions have dropped that requirement (only the initial 2 dose series was ever mandatory at my place)
I agree that vaccinating young and healthy people with the bivalent vaccine doesn't have much data supporting it.
The rest of your claims are dubious at best. Yes COVID deaths are going down, but that's because the most vulnerable are already dead and most everybody has a prior infection now. All the vaccine studies up to the bivalent booster used clinical outcomes. Most COVID deaths are "from" COVID, not with COVID, so this distinction is not particularly meaningful... Nobody is arguing that 100% of deaths are attributed perfectly.
Basically the vaccine recommendations up to the bivalent booster (ie 3 shots of the original vaccine for all age groups) were obviously correct and have overwhelmed data supporting them. The bivalent booster is a bit more complicated, but don't pretend that invalidates everything from the past 1.5 years.
First, what time point are you talking about though? Covid has been Jan 2020 to present and the variants arguably represent different diseases. Certainly they have different morbidity and mortality supported by science and evidence (e.g. at some point around omicron it became an upper airway infection).
Two, what’s the clinical outcome you’re referring to? How is attributable death determined? I’m not aware of any evidence to say the most COVID deaths since July 2022 are due to COVID. Particularly as we are not seeing the same clinical signs/changes with the newer variants as we were before.
What is the overwhelming data? There are a lot of observational studies reporting relative risk reduction. What’s the absolute risk of someone < 40 dying or being hospitalized due to omicron? Medical coding is horrendous and these questions are hard to answer with accuracy. I would be cautious with the strength of your statement, this is an ongoing field of study.
As I stated, the initial vaccination recommendation made sense, but when those recommendations were made they were not supported by strong evidence (largely because you can’t obtain evidence in an active pandemic).
I’m not anti-vax, and I support the initial recommendations, particularly given the context in which they were made. There is probably equal quality evidence on whether the booster was actually effective vs triggering temporary immune response boosting short term outcomes when I last updated myself on the literature in the fall (most of the studies measure out to 3 months, which is what we would expect from temporary immune boosting due to exposure). What are the long term risk reductions and is there lasting immunity to support the booster?
Is it sensible to divert human resources to boosters if the effect only lasts a few month and the ARR is minimal? Keeping in mind that diverting nurses to vaccination resulted in cancellation of elective ORs. These are important questions.
Now is the time to do more careful and objective analyses, not to shame or critique Dr. Fauci and co but to inform future decision making.
