I will get downvoted... but really, 60% of the hospitalizations come from vaccinated population, does that really count as "incredibly effective"? Is that really what people were hoping for when Pfizer & Moderna announced 94%+ effectiveness?

In addition to the clear example of Simpson’s paradox presented here: https://www.covid-datascience.com/post/israeli-data-how-can-... , I offer you the following intuition: if only 4 people in Israel were unvaccinated and 2 were in the hospital with 2 vaccinated patients, would you consider the vaccine effective? It’s important to look at the right numbers.

I didn't say that the vaccine isn't effective. I'm saying this is nowhere near "incredibly effective".

The post you cited is helpful. However, it is confusing the definition of efficacy. There were debates on what the efficacy meant when Pfizer and Moderna reported their high numbers. But there was *NO* definition saying that 94% efficacy means 94% of vaccinated people won't get SERIOUSLY sick. Most commonly, it meant either (1) 94% people will have lower chance of getting COVID (i.e. getting tested positive)[1], or (2) 94% people will have a lower chance of getting sick [2].

Now the post you cited essentially says 94% people won't get SERIOUSLY sick. This just proves that neither (1) or (2) above is true.

[1] https://www.livescience.com/covid-19-vaccine-efficacy-explai... [2] https://time.com/5945177/covid-19-vaccine-effectiveness/

Both [1] and [2] predate Delta so I don't know what you're on about.

Not to mention recently discovered waning immunity. So [1] and [2] could definitely have been true at the time.

Did the root comment say this is "INCREDIBLY" effective before Delta? Why is it so hard to understand what I'm trying to convey here? It's not "INCREDIBLY" effective now.

Now waning immunity - did Pfizer or Moderna warn the world about it? Did they warn us about potential variants? Absolutely no, right? They posted the high numbers to pump their stock price. Vaccines are effective to some extent. But those two companies are not credible.

The other important piece of information is that vaccinations were not given out homogeneously.

The older and more vulnerable were vaccinated FIRST and at a higher rate, so seeing more of them hospitalized now 6 months later with a variant is not unexpected.

What it really means, is that those same patients would probably be in the morgue, not the hospital if it wasn't for the vaccine.

Pro-vaxxer will not answer your original question. The fact is it is not incredibly effective now as Pfizer and Moderna effectiveness have drop to 70%+ and 40%+ respectively from their earlier 95%. 60% are hospitalize that means it is severe that warrant hospitalization. If it is incredibly effective, "hospitalization" for vaccinated should be under a few percentage point. Take a look at historical smallpox and polio vaccination. Now that is incredible effective. Vast majority of pro-vaxxer aren't aware of old stats, while predominantly getting over excited by media outlet or their less informed doctors acquintances. To be fair, those vaccines originally targeting earlier variant of Covid. Now you have Delta, likely Delta+ and Lambda or some more deadlier version of variants, the vaccine can only go down in effectiveness in coming 6mths. In fact, you should be hearing people getting those vaccines died due to immunity waning in coming 6mths. Expect booster shots and annual jabs just like flu shots.

“Pro-vaxxed” aka people who believe in science and social responsibility.

Also, the effectiveness is lower against variants like delta, and does naturally decrease over time. If we had higher vaccination rates, the spread of covid would be significantly reduced, and variants wouldn’t be such a large problem.

Also also, MRNA vaccines — EVEN AT 70% — far outperform existing vaccines like the one for seasonal influenza.

Also also also, where the hell are you getting 40% for moderna’s VE? I’d love to see a citation.

Oh, regarding “old stats” like the effectiveness of the smallpox vaccine: Surprise! No controlled studies on its effectiveness. Surprise! It has significantly more risk (both in terms of the danger of the adverse side effects and their incidence).

I’m guessing you’re not an epidemiologist?

The Simpson's paradox seems to refer to something else:

https://twitter.com/_MiguelHernan/status/1428014414666420230

You're getting down voted because you're falling into a statistical fallacy. For example, If 100% of the population was vaccinated, by definition 100% of those in the hospital would be vaccinated. That gives you no information on the effectiveness of the vaccine itself.

Can we stop calling everything an "fallacy" when you're just trying to say he's wrong? That aside what you're saying doesn't address the issue at all. You have a clear relation between two groups and an outcome and those relations clearly show that it was a bad choice to pretend we can lockdown until a miracle cure happens.

Let's put it this way, did you expect the outcome to be what it currently is? We have MORE deaths with Covid than we had at the same time last year. Is that what you would have predicted when the great results of the trials were published?

I have track record of making predictions on Metaculus.com . And yeah, the new variants were a suprise. We were expecting sars-cov-2 to evolve slower than influenza. I think this will still hold. But from my experience with generic algorithms I also knew that evolution happens the quickest after some breakthrough, when the new solution is not yet optimal. The issue is that we don't know what optimum looks like for this virus.

Besides that experts were also telling us that immunity from vaccine will likely fade.

Why even stop smoking if it does not stop 100% of all cases of cancer?

The more people are vaccinated the less people will become infected and will be spread the virus at any time. The less people are spreaders the less breakthrough infections can happen. It is a feedback loop and not really hard to understand.

>Why even stop smoking if it does not stop 100% of all cases of cancer?

If the intend to ban smoking in a population was to reduce the incidence of lung cancer, and the incidence does not drop after smoking ban, then ban was useless.

On the other hand if it does drop, and the death toll drops by a lot (like in Israel) ... then you're argument is akin to:

"Why stop hitting people with cars when the people hit don't die in 100% of cases ?"

My understanding is that the vaccines are mainly here to avoid you to die or to require severe ventilation and, based on the available studies, they are doing the job.

The hospitalisation rates are way lower than any previous wave but the law of big numbers still apply at some point... And the Delta variant is clearly a game change here.

Finally, Israel is in a peculiar position because they have vaccinated - relatively speaking - quite a while ago so protection migh be indeed waning and the overall % is not that high (pretty surprised tbh).

> they are doing the job.

As per https://spectator.com.au/2021/08/most-covid-patients-at-isra...

>Dr Kobi Haviv, medical director of Herzog Hospital in Jerusalem, stated that the majority of coronavirus patients in an Israeli hospital are fully vaccinated, including those with severe disease.

>Dr Haviv further specified that: “95% of the severe patients are vaccinated,” adding “85-90% of the hospitalizations are in fully vaccinated people” and the hospital is “opening more and more COVID wards.” This has led him to conclude that “the effectiveness of the vaccine is fading out.”

Note that I am not point out the fact that 95% is vaccinated. But that they are still overwhelming the hospitals, so it seems that your point no longer hold.

Also from the same article

> In other words, the TGA never saw or requested the patient data from Pfizer and simply accepted their reporting of their study as true.This means that when the head of the TGA John Skerritt said that “the safety evidence is pretty thorough” on February 6, his words would ring hollow to most Australians who have assumed, rightly or wrongly, that the TGA had actually looked at the patient data before granting any such approval. As noted by Doctors for Covid Ethics on its website, it is currently not known whether any of the major government agencies around the globe (FDA, MHRA or EMA) has independently verified, or attempted to verify, Pfizer’s data, before proceeding with provisional/emergency authorisation of Pfizer’s mRNA therapy vaccine.

It is possible indeed that the Pfizer vaccine is not particularly efficient against Delta but, at the same time, Israel is only one country among a growing list of countries facing a new wave of Covid and what we can see over there does not show up (yet?) in other countries such as the UK or France.

Even if Dr Haviv is correct and the protection offered by the Pfizer vaccine is only valid for 7/8 months, many lives have still been saved in the meantime (Israel got almost no cases and deaths in Q2 2021 for example).

I guess more data is required to see how it goes but it is ackowledged that not all the vaccines have lifetime effects and some only work against specific variant (like the flu one).

To finish, I would like to reiterate that the Delta variant is a game changer so a quote from February needs to be taken with a grain of salt because the situation has changed completely since then.

And with their track record...

"Pfizer Violation Tracker"

https://violationtracker.goodjobsfirst.org/parent/pfizer

> So even if 100% vaccination does not stop surges in covid hospitalisations, vaccines won't be considered ineffective, right?

Umm, of course?

If we had a vaccine for e.g. the flu, that cut hospitalizations in half, we would call that effective. Or maybe not - effective here is a very vague word. We'd more correctly say "this vaccine reduces hospitalizations by 50%".

If it were a particularly bad flu season and literally everyone got the flu (as well as everyone getting vaccinated), hospitals would be overwhelmed, because cutting in half isn't enough. But that wouldn't change the base fact - this hypothetical vaccine cut hospitalizations in half.

The original standard the CDC decided to use before we had data on any of the vaccines was that 50% protection would be the threshhold for "effective"; although I am not sure what level of infection they were planning on measuring (e.g. the vaccines appear more effective at preventing severe disease than symptomatic, and symptomatic than asymptomatic).

Well you're just making up a scenario with no numbers and then asking what people will consider so it's impossible to answer you in any constructive way.

>the rate of serious cases among unvaccinated people over age 60 (178.7 per 100,000) was nine times more than the rate among fully vaccinated people of the same age category, and the rate of serious cases among unvaccinated people in the under-60 crowd (3.2 per 100,000) was a little more than double the rate among vaccinated people in that age bracket.

From the article. Emphasis is mine.

The under-60 part doesn't really count as the age of vaccinated people is generally higher than the age of unvaccinated people. I trust the over-60 data to represent the efficiency of the vaccine against the Delta variant better.

The question is: What's the difference between un-/vaccinated people >60? Why aren't they vaccinated? Different opinions? Health-related reasons? Without this information, it's tough to draw conclusions.

Why would their opinions matter?

As for health, I think you might be alluding to pre-existing conditions? Can you elaborate on how you would see this affecting the result?

Extreme example: Person A with perfect health gets vaccinated. Person B undergoes palliative care and chooses not to get vaccinated. Person B's routine SARS-CoV-2 PCR test is positive and they're therefore classified as a hospitalized/severe case.

It's a miracle that Israel even offers age-stratified hospitalizations data. But it's still not enough.

Do you really think scenarios like this could account for skewing the data by a multiple of 9? Come on.

>Without this information, it's tough to draw conclusions.

Oh please. This data overwhelmingly shows that vaccinated people (>60) have better outcomes than non-vaccinated people(>60). The only debate is by how much.

No, it was an extreme example to better express the issue: We do not know why they're not vaccinated. We do not know their medical history. This isn't a randomized controlled trial.

More realistic example: According to this study [1], 4.0% of US citizens (>80) are immunocompromised. We know that ~5.8% of Israelis (>80) are not vaccinated. Is it possible that the unvaccinated in this age cohort have more serious pre-existing conditions and therefore had a way higher chance of being hospitalized? We don't know.

Is it wrong to ask for better data? We're capable of extracting the smallest detail from a person randomly scrolling through a news feed but we can't get proper stats on hospitalized people? Come on.

[1] https://academic.oup.com/ofid/article/3/suppl_1/1439/2635779

None of the reasons you cited come anywhere near to reasonably accounting for a nine-fold difference. You're really reaching. If you can't take something away from a 9x difference (vaxed vs. non-vaxed) I don't what to tell you.

Better data would be great, but based on your anti-vax, anti-lockdown, anti-science, comment history I'm not convinced that would be enough for you.

I'm not interested in debating people with an obvious idealogical agenda, so good day to you.

Since I'm an anti-science woman on a quest to spread my anti-vax agenda, I've taken a look at the raw data.

We're talking about 137 unvaccinated & 268 vaccinated patients >60 with severe disease (What kind of disease? Who cares, am I right?)

So, based on this enormous (!) sample size with one (!) confounding factor (#FuckMedicalHistory), we conclude that of course there is an undeniable nine-fold difference.

Why are we even doing randomized controlled trials? Just observe 137 & 268 patients retrospectively and frame critics as ideologues. A final word from an anti-vax activist:

> Conversely, there was concern that observational data obtained from nonrandomized studies after vaccine deployment could yield unreliable answers. Observational studies are subject to substantial biases and are much less amenable to unambiguous interpretation. Their limitations are of particular concern during this public health emergency, because vaccinated and unvaccinated people will differ in their risk of exposure to infection and of serious disease, partly because of fluctuating attack rates and because during early phases of vaccine deployment, vaccinees may well be at particular risk of infection. In these circumstances, even carefully analyzed observational studies can yield misleading answers about safety and efficacy. In addition, unrelated events that occur by chance after vaccination may be incorrectly attributed to the vaccine, and such anecdotes may be deliberately promulgated by groups opposed to vaccination. [1]

[1] https://www.nejm.org/doi/full/10.1056/NEJMp2033538

in principle you shouldn’t be downvoted if you’re adding to the conversation, and whilst i don’t agree with your overall thesis, i think you have a valid concern.

the OP’s statistics line up with the assertion that vaccines are certainly effective. if they weren’t, we’d expect to see similar proportions of vaccinated peoples hospitalised with covid.

certainly, the vaccines have lost some of their efficacy. it can probably be attributed to “slow” rollout, and - probably more significantly - vaccine hesitancy/denial. israel’s high rollout percentage is relatively meaningless in the global context, unfortunately. the virus has more chances to interact with vaccinated individuals. in a similar fashion to not finishing antibiotics, it was inevitable that the virus would mutate to overcome the existing vaccines at some level.

at this point, our only hope is that vaccines will at least make the virus less lethal. it’s not the ideal outcome, but given everything that’s happened thus far, i think it’s the best we can hope for.

There is not a single known variant that provably escapes vaccine protection. It is not inevitable and it has not happened yet.

Waning immunity has nothing to do with the virus mutating, it is just how the immune system works.

If 100% of all people are vaccinated that 100% of all hospitalization would be from vaccinated people. That says nothing about effectiveness of the vaccines.

78.8% of the population we're talking about here are vaccinated.

58% from TFA, or [62.84% currently](https://ourworldindata.org/covid-vaccinations)

I got vaccinated over 6 months ago. I'm getting my booster later today. It seems that those who were vaccinated more recently are more likely to be protected against delta as well.

Booster? Where do you live?

> I will get downvoted... but really,

Can we pelase just automatically downvote all posts starting like this?

Don't you mean the remaining 21.2%?

Oops. Yes.

I mean, don't you feel like this at least somewhat changes your conclusion then? Yes, the vaccines are quite effective, but now it means that the unvaccinated are only doubly overrepresented in new cases, which at least changes the calculus in my mind.

The vaccinated folks are mostly old people and people with comorbidities, and the unvaccinated are mostly young and healthy people, so you're not comparing like for like.

More data here: https://twitter.com/jsm2334/status/1427465003007942659?ref_s...

I think it's still concerning that 60% of hospitalizations are vaccinated patients. Even if 79% of the population is vaccinated.

The vaccinated folks are mostly old people and people with comorbidities, and the unvaccinated are mostly young and healthy people, so you're not comparing like for like.

Best case, the Pfizer vaccine is 95% effective at preventing serious illness and death. This has been known since the beginning.

If you vaccinate 100% of the total population, you'll find that 100% of hospitalised and dead patients have been fully vaccinated.

TL;DR: This is only concerning if one doesn't properly grasp statistics. Most of us (self included) fail at this.

I do properly grasp statistics, and your conclusion is unwarranted. If 79% of people are vaccinated, then if hypothetically 79% of the hospitalized people were vaccinated, it would mean the vaccine had absolutely 0% effectiveness.

The fact that only 60% of the hospitalized are vaccinated means the vaccine is more effective than nothing (and the data on death is even better), but as time goes on it becomes clearer the vaccines are not the silver bullet many of us thought they would be.

> If 79% of people are vaccinated, then if hypothetically 79% of the hospitalized people were vaccinated, it would mean the vaccine had absolutely 0% effectiveness.

Incorrect. The vaccinations are targeted at the most vulnerable not distributed uniformly so this is not exactly right.

Just to be clear, I agree with your point that there is a difference in vaccinated vs. unvaccinated population (e.g. average age).

But when you say "targeted" at the most vulnerable, I'm not sure how true that is. There's a pretty big push to get everyone vaccinated, including populations that have been reluctant to get vaccinated until now.

You're misrepresenting the situation. As the article says, only 58% of the population is vaccinated. Only 78.8% of the eligible population is vaccinated.

I'm pro-vaccination, but there's no sugar coating the fact that %60 of hospitalizations are of previously vaccinated people.

I don't know much about mRNA vaccines, but do mRNA vaccines induce sterilizing immunity?

It's a statistical effect called Simpson's Paradox. The 60% is nothing to be worried about.

https://www.covid-datascience.com/post/israeli-data-how-can-...

https://twitter.com/jsm2334/status/1427465566210695178

The Simpson's Paradox seems to refer to something else:

https://twitter.com/_MiguelHernan/status/1428014414666420230

If you go by what Simpson wrote, then maybe it is a different paradox. If you go by what most people are being taught the Simpson's paradox is, then no. Ultimately it's besides the point. The conflict is resolved by better statistics.

If 100% of people were immunized then 100% of hospitalizations would be vaccinated people. This doesn’t mean vaccines aren’t effective.

I’m not saying all vaccines are ineffective. I’m wondering if mRNA vaccines are effective long term since they don’t produce sterilizing immunity.

Not sure what “sterilising immunity” is but the vaccines appear to reduce likelihood you will get Covid (not completely make you immune). If you then get it you are much less likely to end up in ICU or die, you may go to hospital though.

Natural immunity is also incredibly effective. How many of the unvaccinated are recovered patients with natural immunity?

That's news to me, I seem to remember news stories from last year that people were being infected multiple times and the immunity from having endured COVID-19 was not actually that good. Quickly trying to look this up with 'covid-19 reinfection' as query (trying to avoid confirmation bias in that search), the top hit on DDG is the USA CDC which writes:

> Among Kentucky residents infected with SARS-CoV-2 in 2020, vaccination status of those reinfected during May–June 2021 was compared with that of residents who were not reinfected. In this case-control study, being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated. --https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

Reinfection occurs much more frequently if you don't get vaccinated, if I am reading this right. Not sure I'd call "natural" immunity "also" or "incredibly" effective.