5 ms·

The reduction in all-cause mortality was independent of covid deaths. Which seems to suggest that there was big differences between the groups other than the v

by zosima 10mo ago

The reduction in all-cause mortality was independent of covid deaths. Which seems to suggest that there was big differences between the groups other than the vaccination. This of course does not change that the vaccine seems mostly safe, but it definitely calls in to question whether the protection against covid death was vaccine-mediated or due to some other difference between the groups. Therefore this paper is moderately strong evidence for the vaccine being safe, but quite weak evidence for the vaccine being efficacious.

lesuorac 10mo ago
Covid hospitalizations where half in the vaccinated group (as % of pop) than unvaccinated. That's extremely desirable when you're in a situation where you have do dedicate whole wings (and then some) of hospitals to a singular disease. Sure, it's not a silver bullet but it's at least stainless steel.
- zosima 10mo ago
  I am speaking about what the paper shows. There are other sources of evidence for efficacy. This paper is not a very strong source of evidence for efficacy due to some obvious uncontrolled difference between groups.
  - _DeadFred_ 10mo ago
    OP's point was more 'How would you measure unvaccinated people that lived because vaccinated people weren't filling the ER, so there were beds/staff to spare'? That unvaxed outcome would need to go in the 'vaxed lives saved' column somehow, or else it looks like 'outcomes were the same either way' because the lives saved from vaccination spill over into the non-vaxed group because the vaccine prevented the healthcare system from melting down.
  - gopher_space 10mo ago
    I wouldn't bother critiquing methodology without current, masters-level experience in the domain. I make incorrect assumptions when I'm even narrowly outside my own lane, and end up asking questions that clearly demonstrate e.g. my inability to parse fig. 4a.
    - zosima 10mo ago
      I wouldn't bother commenting if I were hallucinating figures. There is no figure 4a. If you look at figure 4 in the supplemental material you also see, per your expertise, that covid vaccine protects against traumatic injury. However even adjusting for the protective effect against traumatic injury there is still quite a large protective effect against all-cause mortality. So the beneficial effect of the vaccine is not solely caused by its protective effect against traumatic injury. Or it could be, bold proposition I know, that there is a difference between the groups that both protects against traumatic injury and protects against all-cause mortality, independently of the vaccine.
DebtDeflation 10mo ago
A 25% reduction is huge, even if you account for the fact that people who get vaccines tend to be more health conscious to begin with, when you consider that outside of the very sick and very old Covid has a mortality rate under 1%.
- altcognito 10mo ago
  > Covid has a mortality rate under 1%. I hate it when blanket statements like this creep in. Which Covid? The initial version was definitely more deadly than later versions. What about future covids? Are you willing to guarantee every version of covid from here on out will be less deadly? It is the general case to be true, but it is not some sort of law.
- soperj 10mo ago
  1 out of 100 when billions are getting it is gonna be a large number. Mortality rate has gone down substantially since the vaccines.
  - ceejayoz 10mo ago
    I like to ask people who talk about a 1% mortality rate if they'd go to a football game in a stadium with 100k seats if 1k of those seats randomly had a small bomb attached.
    - deleted 10mo ago
      [deleted]
- deleted 10mo ago
  [deleted]
pygy_ 10mo ago
The vaccinnated group was 1 year older on average, and had mode cardiovascular risk factors. Covid has long term health consequences, and these are proportional to the severity of the acute infection. People who died of a stroke of a heart infarction 6 months down the line were not counted as "covid death", even though covid is known to increase their incidence in the next year.
- deleted 10mo ago
  [deleted]
- pygy_ 10mo ago
  Another factor that may play a role: the people who chose not to take the vaccine may be prone to taking bad decisions more broadly, leading to a higher mortality rate.
  - oldgradstudent 10mo ago
    If true, that means the groups are different in many other aspects other than the vaccine. The study does not control for the differences. No causality can be inferred.
  - disgruntledphd2 10mo ago
    I mean, it's plausibly something around trust in medical authorities which correlates with both vaccine and other treatment refusal.
underlipton 10mo ago
There was a study that showed that cancer patients who receive a MRNA COVID vaccine live longer. This could also be for extrinsic reasons, but IIRC the study considered the reason to be a pronounced immune response that also attacked cancer cells. So there's a chance that the vaccine provokes a general immune response that's protective against a number of mortality-causing issues.
pama 10mo ago
The simple explanation is that the causal agent for the excees of the non-covid deaths is the same SARS-CoV2 virus, but death comes later and not at the acute phase of the disease.
- Chris612 10mo ago
  If the vaccine was randomly administered among the study population, I'd buy this as the simple explanation. Not sure it follows so cleanly with the actual study setup
  - pygy_ 10mo ago
    There is plenty of evidence beside this study.
jmull 10mo ago
> but quite weak evidence for the vaccine being efficacious That’s directly contradicted by the results of the study. E.g., “Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76])…” It’s pretty clear a lot of unvaccinated people who died of covid would be alive today had they gotten vaccinated. (I would point out the current yearly vaccine they are putting out is potentially a different story since covid is changing and so is the vaccine. I’d talk to my dr about whether to get that or not.)
stocksinsmocks 10mo ago
I don’t think it’s possible to know anything conclusive about the safety for a few decades and a generation or two of affected kids can be observed. Given that finding harm would embarrass important aristocrats, I don’t think that evidence would ever be found in the foreseeable future. That mRNA and lipid nano particles were never found to be safe until the exact moment of crisis is awfully convenient for its investors. I say decades because of the study below. Certainly, the authors could have published it for engagement bait or malice or some reason. https://www.gavinpublishers.com/article/view/detection-of-pfizer-biontech-messenger-rna-covid19-vaccine-in-human-blood-placenta-and-semen https://www.gavinpublishers.com/article/view/detection-of-pf...
- vineyardmike 10mo ago
  Where do you get decades? That study says 200 days.
  - stocksinsmocks 10mo ago
    You really aren’t going to know how this MRNA in egg and sperm cells are going to affect offspring until you have offspring to observe. Effects like wolbachia could take multiple generations to observe.
    - velcrovan 10mo ago
      mRNA can't cause wolbachia. Wolbachia is a bacterium that actually lives inside cells and gets transmitted through eggs to offspring. it's a persistent organism that reproduces. There's not a way for mRNA to grow bacteria. mRNA is just a molecule that breaks down, and the mRNA in these vaccines is extremely fragile and temporary. Once injected it enters whatever cells are nearby (muscle cells)and ribosomes read it to produce the inert spike protein. The mRNA itself is gone within hours. Your cells have enzymes specifically designed to break down RNA because cells naturally produce and dispose of mRNA constantly as part of normal function. The mRNA in vaccines never enters the cell nucleus where DNA is stored, so it can't integrate into your genome or affect reproductive cells in that way. And it doesn't replicate itself either. And millions of babies have been born to vaccinated parents by now. If the effects you are talking about were even possible they would definitely have shown up by now.
disgruntledphd2 10mo ago
I think that's mostly fair, but given that we can't randomly assign vaccine administration this sort of study is the best we're gonna get. Like, the major takeaway is that the vaccine is safe, I think that we've already established that it works to reduce Covid hospitalisations.
rainsford 10mo ago
Obviously there are confounding variables besides vaccination status, but I find it pretty compelling that the decrease in COVID mortality among the vaccinated group was significantly larger than the decrease in all-cause mortality of that group. This suggests whatever the difference was between the two groups, besides vaccination, either had a much larger impact on COVID than other causes of death or that the vaccine had some positive impact. One example of the former explanation I could imagine is that people who got vaccinated against COVID were probably also more likely to take other preventative measures, like wearing a mask or avoiding larger crowds of people. Those precautions would be more likely to be effective against a contagious disease like COVID but less likely to protect them against some other causes of death like heart disease. I'm not sure how likely I find that as an explanation compared to the alternative that the vaccines provide at least some level of protection. My observation was that widespread measures specifically meant to defend against COVID, like masking and social distancing, largely went away well before the end of the time period covered by this study, at least in the US. Amusingly, I suspect the anti-vax contingent would likely be bothered by data suggesting anything the COVID vaccinated group was doing differently protected against COVID, since their position seems to largely be that not only is the COVID vaccine useless, but so are any other measures meant to reduce the spread.

by zosima 10mo ago

lesuorac 10mo ago

Covid hospitalizations where half in the vaccinated group (as % of pop) than unvaccinated. That's extremely desirable when you're in a situation where you have do dedicate whole wings (and then some) of hospitals to a singular disease. Sure, it's not a silver bullet but it's at least stainless steel.

zosima 10mo ago
I am speaking about what the paper shows. There are other sources of evidence for efficacy. This paper is not a very strong source of evidence for efficacy due to some obvious uncontrolled difference between groups.
- _DeadFred_ 10mo ago
  OP's point was more 'How would you measure unvaccinated people that lived because vaccinated people weren't filling the ER, so there were beds/staff to spare'? That unvaxed outcome would need to go in the 'vaxed lives saved' column somehow, or else it looks like 'outcomes were the same either way' because the lives saved from vaccination spill over into the non-vaxed group because the vaccine prevented the healthcare system from melting down.
- gopher_space 10mo ago
  I wouldn't bother critiquing methodology without current, masters-level experience in the domain. I make incorrect assumptions when I'm even narrowly outside my own lane, and end up asking questions that clearly demonstrate e.g. my inability to parse fig. 4a.
  - zosima 10mo ago
    I wouldn't bother commenting if I were hallucinating figures. There is no figure 4a. If you look at figure 4 in the supplemental material you also see, per your expertise, that covid vaccine protects against traumatic injury. However even adjusting for the protective effect against traumatic injury there is still quite a large protective effect against all-cause mortality. So the beneficial effect of the vaccine is not solely caused by its protective effect against traumatic injury. Or it could be, bold proposition I know, that there is a difference between the groups that both protects against traumatic injury and protects against all-cause mortality, independently of the vaccine.

DebtDeflation 10mo ago

A 25% reduction is huge, even if you account for the fact that people who get vaccines tend to be more health conscious to begin with, when you consider that outside of the very sick and very old Covid has a mortality rate under 1%.

altcognito 10mo ago
> Covid has a mortality rate under 1%. I hate it when blanket statements like this creep in. Which Covid? The initial version was definitely more deadly than later versions. What about future covids? Are you willing to guarantee every version of covid from here on out will be less deadly? It is the general case to be true, but it is not some sort of law.
soperj 10mo ago
1 out of 100 when billions are getting it is gonna be a large number. Mortality rate has gone down substantially since the vaccines.
- ceejayoz 10mo ago
  I like to ask people who talk about a 1% mortality rate if they'd go to a football game in a stadium with 100k seats if 1k of those seats randomly had a small bomb attached.
  - deleted 10mo ago
    [deleted]
deleted 10mo ago
[deleted]

pygy_ 10mo ago

The vaccinnated group was 1 year older on average, and had mode cardiovascular risk factors. Covid has long term health consequences, and these are proportional to the severity of the acute infection. People who died of a stroke of a heart infarction 6 months down the line were not counted as "covid death", even though covid is known to increase their incidence in the next year.

deleted 10mo ago
[deleted]
pygy_ 10mo ago
Another factor that may play a role: the people who chose not to take the vaccine may be prone to taking bad decisions more broadly, leading to a higher mortality rate.
- oldgradstudent 10mo ago
  If true, that means the groups are different in many other aspects other than the vaccine. The study does not control for the differences. No causality can be inferred.
- disgruntledphd2 10mo ago
  I mean, it's plausibly something around trust in medical authorities which correlates with both vaccine and other treatment refusal.

underlipton 10mo ago

There was a study that showed that cancer patients who receive a MRNA COVID vaccine live longer. This could also be for extrinsic reasons, but IIRC the study considered the reason to be a pronounced immune response that also attacked cancer cells. So there's a chance that the vaccine provokes a general immune response that's protective against a number of mortality-causing issues.

pama 10mo ago

The simple explanation is that the causal agent for the excees of the non-covid deaths is the same SARS-CoV2 virus, but death comes later and not at the acute phase of the disease.

Chris612 10mo ago
If the vaccine was randomly administered among the study population, I'd buy this as the simple explanation. Not sure it follows so cleanly with the actual study setup
- pygy_ 10mo ago
  There is plenty of evidence beside this study.

jmull 10mo ago

> but quite weak evidence for the vaccine being efficacious That’s directly contradicted by the results of the study. E.g., “Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76])…” It’s pretty clear a lot of unvaccinated people who died of covid would be alive today had they gotten vaccinated. (I would point out the current yearly vaccine they are putting out is potentially a different story since covid is changing and so is the vaccine. I’d talk to my dr about whether to get that or not.)

stocksinsmocks 10mo ago

I don’t think it’s possible to know anything conclusive about the safety for a few decades and a generation or two of affected kids can be observed. Given that finding harm would embarrass important aristocrats, I don’t think that evidence would ever be found in the foreseeable future. That mRNA and lipid nano particles were never found to be safe until the exact moment of crisis is awfully convenient for its investors. I say decades because of the study below. Certainly, the authors could have published it for engagement bait or malice or some reason. https://www.gavinpublishers.com/article/view/detection-of-pfizer-biontech-messenger-rna-covid19-vaccine-in-human-blood-placenta-and-semen https://www.gavinpublishers.com/article/view/detection-of-pf...

vineyardmike 10mo ago
Where do you get decades? That study says 200 days.
- stocksinsmocks 10mo ago
  You really aren’t going to know how this MRNA in egg and sperm cells are going to affect offspring until you have offspring to observe. Effects like wolbachia could take multiple generations to observe.
  - velcrovan 10mo ago
    mRNA can't cause wolbachia. Wolbachia is a bacterium that actually lives inside cells and gets transmitted through eggs to offspring. it's a persistent organism that reproduces. There's not a way for mRNA to grow bacteria. mRNA is just a molecule that breaks down, and the mRNA in these vaccines is extremely fragile and temporary. Once injected it enters whatever cells are nearby (muscle cells)and ribosomes read it to produce the inert spike protein. The mRNA itself is gone within hours. Your cells have enzymes specifically designed to break down RNA because cells naturally produce and dispose of mRNA constantly as part of normal function. The mRNA in vaccines never enters the cell nucleus where DNA is stored, so it can't integrate into your genome or affect reproductive cells in that way. And it doesn't replicate itself either. And millions of babies have been born to vaccinated parents by now. If the effects you are talking about were even possible they would definitely have shown up by now.

disgruntledphd2 10mo ago

I think that's mostly fair, but given that we can't randomly assign vaccine administration this sort of study is the best we're gonna get. Like, the major takeaway is that the vaccine is safe, I think that we've already established that it works to reduce Covid hospitalisations.

rainsford 10mo ago

Obviously there are confounding variables besides vaccination status, but I find it pretty compelling that the decrease in COVID mortality among the vaccinated group was significantly larger than the decrease in all-cause mortality of that group. This suggests whatever the difference was between the two groups, besides vaccination, either had a much larger impact on COVID than other causes of death or that the vaccine had some positive impact. One example of the former explanation I could imagine is that people who got vaccinated against COVID were probably also more likely to take other preventative measures, like wearing a mask or avoiding larger crowds of people. Those precautions would be more likely to be effective against a contagious disease like COVID but less likely to protect them against some other causes of death like heart disease. I'm not sure how likely I find that as an explanation compared to the alternative that the vaccines provide at least some level of protection. My observation was that widespread measures specifically meant to defend against COVID, like masking and social distancing, largely went away well before the end of the time period covered by this study, at least in the US. Amusingly, I suspect the anti-vax contingent would likely be bothered by data suggesting anything the COVID vaccinated group was doing differently protected against COVID, since their position seems to largely be that not only is the COVID vaccine useless, but so are any other measures meant to reduce the spread.