> Hospitalization and death numbers are definitely directly connected

There has never been a RCT which showed covid vaccination reduces mortality. I believe they do but this has not been rigorously shown.

Unfortunately, even though we've had gigantic RCTs on covid none of them showed statistically significant covid-mortality in the unvaccinated population (potentially due to prescreening eliminating people who were at risk of dying), so they weren't able to show any improvement.

Numbers from the population have been suggestive, but unfortunately you can get the same graphs -- an initial spike of reduced mortality with a pronounced fall off in effectiveness -- from a simulation where the vaccine has no effect on mortality at all.

The reason for this is that our stats on the public measure time lagged mortality against current vaccination numbers. People reported dead today actually died a week before and got sick two weeks before that. When the increase in new vaccination is high, you will overestimate the size of the population for the people who died and falsely think the vaccine is more effective than it is. And you end up with your 'per month effect' -- the same statistical error will make the cycle nicely repeat with boosters due to the same population size error for the newly boosted population.

This is the sort of bias that is structurally eliminated in RCT design and hard to avoid in population monitoring.

If anyone wants more details, I assume you’re referencing this recent blog. If you haven’t seen this, you’ll love it because it makes the same argument: https://probabilityandlaw.blogspot.com/2021/12/possible-syst...

Hadn't seen that! but, indeed, it's the same point.

The good thing is you don't need a RCT to see that vaccines are effective against mortality. For this you just have to talk to any clinician who is witnessing this winter wave and let them tell you about the difference in age profile of people on the ICU.

Or you look at incidence and observe that with even higher incidence than last year, we do have reduced mortality overall.

We need all-cause mortality stats from vaccinated vs non vaccinated populations but they won't give us these without fighting for it. For instance, Pfizer's all cause data from their initial trial was higher in the vaccinated group. So they then went and vaccinated the control group thus destroying any chance of long term study in this population.

This is a Human Challenge Trial: have vaccinated participants exposed to either covid or placebo (rhinovirus)! There are heavy ethical dilemmas here, even when using young and healthy candidates. IIRC there was one Human Challenge Study being run in the UK, though they've been awfully quiet for months.