Pfizer effectiveness dramatic drop vs Delta

[namethatsmell]

If you're looking at the study I saw, the topline number, that initial 2 dose pfizer vaccine efficacy at preventing hospitalization is down to 67%. However, i've read a few interesting threads from statisticians that this data may be a good example of something called Simpson's paradox, where vaccine efficacy appears higher in younger patient and in older patients then if you lump both cohorts together.

The reason for this is that older patients are much more likely to be vaccinated and also more likely to be hospitalized regardless of vaccine status. Younger patients are the opposite, less likely to be vaccinated and less likely to be hospitalized regardless of vaccine status. Thus most hospitalizations will be in vaccinated individuals even if the vaccine is effective. Diving into the data, it appears that right now with delta, vaccine efficacy at preventing hospitalization in people over 50 is 85% and 92% in those under 50.

This data, while much better then the topline number (67% efficacy) still is somewhat concerning given the decline from 98-99% in the initial studies. I know I'll be getting my booster.

Better application of Simpson's paradox: New episodes of The Simpsons keeps being made yet nobody watches









*Couldn't resist this extremely low hanging dad-joke fruit

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[Nephro critical care]

Israel, Once the Model for Beating Covid, Faces New Surge of Infections

 

[Birdstrike]

Iceland also has a very high vaccination rate. Their cases have gone up with delta, but their rate of hospitalizations and deaths was not high.

I know. The rate of hospitalization and deaths is different than the breakdown of what percent of those hospitalizations and deaths are vaccinated or unvaccinated, which is what I was talking about.

 

[RustedFox]

I just overheard a chiropractor say that "facemasks will cause hypoxia with long-term use", and "there's no evidence that they have any effect on transmission rates".

I can't with these people.

Veers, you had it right when you said: "Americans are beyond hope."

 

[Birdstrike]

I just overheard a chiropractor say that "facemasks will cause hypoxia with long-term use", and "there's no evidence that they have any effect on transmission rates".

I can't with these people.

That's nothin'. Hold my beer.

"I can realign your spine to make you immune to COVID," said the Chiro.

 

[RustedFox]

That's nothin'. Hold my beer.

"I can realign your spine to make you immune to COVID," said the Chiro.

Hard stop.

Holy smoke.

How is this not criminal at this point?

I mean, you can get banned from Twitter for being a meanie... but ChiroNonsense is cool.

 

[namethatsmell]

I just overheard a chiropractor say that "facemasks will cause hypoxia with long-term use", and "there's no evidence that they have any effect on transmission rates".

I can't with these people.

Was it Eric?

St. Louis County chiropractor first in US charged under new COVID-19 act

The FTC said Eric Nepute and his company baselessly claimed Wellness Warrior products with vitamin D and zinc were scientifically proven to treat or prevent COVID-19

www.ksdk.com

 

[Birdstrike]

Hard stop.

Holy smoke.

How is this not criminal at this point?

I mean, you can get banned from Twitter for being a meanie... but ChiroNonsense is cool.

I'm not done yet.

"I can bring your sense of taste and smell back after COVID," said the Chiro.

 

[namethatsmell]

I'm not done yet.

"I can bring your sense of taste and smell back after COVID," said the Chiro.

They way things are going this guy will be our next president

 

[Birdstrike]

In Israel, they're now saying at 3rd Pfizer dose bumps the effectiveness to 86% in those over 60.

Source: Reuters

 

[Birdstrike]

Israelis over 40 and teachers are now eligible for a third dose of the Pfizer/BioNTech

Source

 

[Birdstrike]

U.K. - Delta

61% of deaths over age 50, fully vaccinated
24% of deaths under age 50, fully vaccinated

Source: UK Public Health England/Yahoo News

 

[BAM!]

Per UK data from July NEJM publication, Pfizer is 88% effective for the delta variant. Seems pretty good.
Per Israeli preprint data (also July), early vaccinated pts (Jan) were more likely of getting breakthrough cases than late vaccinated pts (Apr). Indicates waning immunity.

Is the US doing a 180 on 3rd booster shots based on an Israeli preprint? What else am I missing?


https://www.nejm.org/doi/full/10.1056/NEJMoa2108891
"With the BNT162b2 [pfizer] vaccine, the effectiveness of two doses was 93.7% (95% CI, 91.6 to 95.3) among persons with the alpha variant and 88.0% (95% CI, 85.3 to 90.1) among those with the delta variant."

https://www.medrxiv.org/content/10.1101/2021.07.29.21261317v1.full.pdf
"Individuals who were vaccinated in January 2021 had a 2.26-fold increased risk (CI 1.80- 3.01) for breakthrough infection compared to individuals who were vaccinated in April 2021 (Figure 1)."

 

[Birdstrike]

Per UK data from July NEJM publication, Pfizer is 88% effective for the delta variant. Seems pretty good.
Per Israeli preprint data (also July), early vaccinated pts (Jan) were more likely of getting breakthrough cases than late vaccinated pts (Apr). Indicates waning immunity.

Is the US doing a 180 on 3rd booster shots based on an Israeli preprint? What else am I missing?


https://www.nejm.org/doi/full/10.1056/NEJMoa2108891
"With the BNT162b2 [pfizer] vaccine, the effectiveness of two doses was 93.7% (95% CI, 91.6 to 95.3) among persons with the alpha variant and 88.0% (95% CI, 85.3 to 90.1) among those with the delta variant."

https://www.medrxiv.org/content/10.1101/2021.07.29.21261317v1.full.pdf
"Individuals who were vaccinated in January 2021 had a 2.26-fold increased risk (CI 1.80- 3.01) for breakthrough infection compared to individuals who were vaccinated in April 2021 (Figure 1)."

We're getting mixed results. But they all agree on one thing: Vaccine effectiveness has dropped with Delta. They disagree on how much. But they all agree it's dropped. Also, several months have passed since they collected this data. The virus is changing daily. And more and more every day, we're hearing about (and some of us are getting) breakthrough cases. Time will tell if the effectiveness keeps dropping and if so, how much. Hopefully, protection against severe disease and death holds, which is most important.

 

[Dred Pirate]

So I received the pfizer vaccine - and will be soon time for the booster - based on this info, part of me wants to get the moderna shot (not even sure if this is a possibility) as a booster vs another pfizer shot - what are your thoughts on this? The dose of the moderna is higher (100 mcg vs 30 mcg), but I am don't think that is a fair comparison (example allegra 180 = loratadine 10) but if they are both essentially the same mRNA - could you infer this?

 

[Dred Pirate]

Just think about what happens if, in theory, we got to a point where 100% of people are vaccinated. 100% of deaths, hospitalizations and cases will be in the vaccinated. It's impossible for it to be otherwise. The closer you get to the population being fully vaccinated, the higher the percentage of pathology in the vaccinated, even if the vaccine is very effective. It's impossible to avoid that, even with the most effective vaccination possible, because the number of vaccinated eventually will outnumber the unvaccinated by such a large amount, their cases outnumber the unvaccinated, even though their risk is much lower.

I've have some slides that prove it if anyone's interested (which is doubtful, lol).

this is why people are so easily manipulated by statistics -I know you know this, but the general population drinks whatever kool-aid that their preferred media source tells them, but you have to look at percentage of each group - if 75% is vaccinated but only contains 25% of the deaths - that is a good thing. Lets say you are 90% vaccinated and now the deaths are 51% in the vaccinated group - one group will say more vaccinated people are dying than unvaccinated, the vaccine doesn't work! While people with have a brain can still see the benefits of vaccination - but explaining that to some of my family who barely graduated high school can be difficult.

 

[RustedFox]

this is why people are so easily manipulated by statistics -I know you know this, but the general population drinks whatever kool-aid that their preferred media source tells them, but you have to look at percentage of each group - if 75% is vaccinated but only contains 25% of the deaths - that is a good thing. Lets say you are 90% vaccinated and now the deaths are 51% in the vaccinated group - one group will say more vaccinated people are dying than unvaccinated, the vaccine doesn't work! While people with have a brain can still see the benefits of vaccination - but explaining that to some of my family who barely graduated high school can be difficult.

Yeah; that's the majority of patients, too.
They cheated their way to a "C" in high-school chemistry, but by God - they know what they need when then come to the ER.

 

[aafisahar]

They either need to build a healthcare system that can handle the problem, or end the problem once and for all.

If you build it in the US, you're going to need return on that dollar and COVID doesn't pay.

 

[Old_Mil]

So I received the pfizer vaccine - and will be soon time for the booster - based on this info, part of me wants to get the moderna shot (not even sure if this is a possibility) as a booster vs another pfizer shot - what are your thoughts on this? The dose of the moderna is higher (100 mcg vs 30 mcg), but I am don't think that is a fair comparison (example allegra 180 = loratadine 10) but if they are both essentially the same mRNA - could you infer this?

Canada has been mixing vaccine types from the first shot to the second for some months. At least moving from the first to the second shot, I've seen no data that would indicate any sort of harmful synergy that puts you at greater risk for side effects by doing this. Given the Mayo data that shows that the Moderna vaccine is more effective than Pfizer's against Delta, if you are going to be vaccinated, this isn't an irrational strategy.

I'm curious to see data coming out of Europe regarding Novavax.

 

[HowlPrenderghast]

Is the Pfizer booster shot a reformulation to account for the variants or simply just a repeat of the first 2 doses?

 

[Arcan57]

Is the Pfizer booster shot a reformulation to account for the variants or simply just a repeat of the first 2 doses?

Repeat.

 

[HowlPrenderghast]

Repeat.

Ok. I was thinking the booster shot would atleast be re-engineered to account for the delta variant atleast.

 

[southerndoc]

Ok. I was thinking the booster shot would atleast be re-engineered to account for the delta variant atleast.

Already has; likely will be early next year before it's approved. I'm getting a booster as soon as it's available and repeating it with the Delta booster as soon as it's available.

 

[Arcan57]

Ok. I was thinking the booster shot would atleast be re-engineered to account for the delta variant atleast.

I think it depends on the goal. Preventing infection is going to need a re-engineered vaccine (or a much higher vax compliance than we're ever going to get). The current formulations still seem to be doing well against prolonged hospitalization/death.

 

[Birdstrike]

Already has; likely will be early next year before it's approved. I'm getting a booster as soon as it's available and repeating it with the Delta booster as soon as it's available.

I think it depends on the goal. Preventing infection is going to need a re-engineered vaccine (or a much higher vax compliance than we're ever going to get). The current formulations still seem to be doing well against prolonged hospitalization/death.

Current public policy, appears to be to let COVID Delta-variant burn through the U.S. population. Here's why I think that.

We've already seen multiple variants cycle through: Alpha, Beta, Gamma, now Delta. Delta wasn't even dominant until it exploded in India 3 months ago. A new variant gains dominance every few months. By the time Pfizer's delta specific vaccine is done in 2022, it'll likely be obsolete with a new variant likely in dominance. Pfizer, the CDC and FDA know that.

Yet Pfizer's CEO keeps saying, "We can have a delta (or other variant) specific vaccine ready in 90 days, if asked to." [1, 2] But no one, CDC, FDA, US government included, has asked, at least not publicly. Why not?

Why let Delta burn through the US population until sometime in 2022, when they could have a Delta-specific vaccine out 3 months after it surged in India, which would be now? I suspect it's because the current vaccines, despite waning protection against spread, still seem to be offering protection against COVID hospitalizations and deaths.

They've chosen to let Delta rage, while Pfizer works on it's obsolete-upon-arrival Delta-specific vaccine, having turned down the option to have one in 90 days. That might change if suddenly we see decreasing protection against severe and fatal COVID, in the vaccinated. But for now, they're letting it burn, baby burn.

 

[turkeyjerky]

Pfizer and Moderna can reap the stock market benefits of claiming they have a ready made process for creating variant-specific boosters while selling already manufactured vaccine doses to the US gov't for multiples of what they could get in India.

 

[Arcan57]

This whole process is f'ed. COVID isn't deadly enough to make successfully make the argument to capital that spending the resources to eradicate it is worthwhile. It's not destabilizing enough for governments to collaborate on a world-wide scale. The countries that would have the wealth to make a huge dent in disease burden can't even get their s%#@ together domestically or carry the flag of authoritarianism when they reach abroad. It's the climate debacle but compressed into 2 years rather than 20-30.

 

[Birdstrike]

This whole process is f'ed. COVID isn't deadly enough to make successfully make the argument to capital that spending the resources to eradicate it is worthwhile. It's not destabilizing enough for governments to collaborate on a world-wide scale. The countries that would have the wealth to make a huge dent in disease burden can't even get their s%#@ together domestically or carry the flag of authoritarianism when they reach abroad. It's the climate debacle but compressed into 2 years rather than 20-30.

It seems to me a worldwide industry has been born revolving around COVID. There's a tremendous amount of money being made dependent upon around managing the problem. It's always concerning when managing a crisis is likely to be more profitable than eradicating that crisis.

The same goes for the fact that this, like other crises, has brought certain people a tremendous amount of power. Relying on people who're attracted to positions of power, to give up new found power, is also a very uncomfortable place to be.

 

[dchristismi]

Kinda like clipboard nurses and water at your workstation?
I mean right there we have a whole industry created to justify its own existence...

 

[Birdstrike]

Kinda like clipboard nurses and water at your workstation?
I mean right there we have a whole industry created to justify its own existence...

Yes, identical, only different in scale.

 

[MaximusD]

RSV is now circulating out of season. With worldwide lockdowns and social distancing, have we put evolutionary pressure on other viruses to select for high R naughts? Will the influenza that starts circulating again soon have higher R naughts? Law of unintended consequence?

Or it’s just spreading easily because it’s endemic pattern of relative immunity and seasonality was broken and it’s following an epidemic pattern all over again. What evidence of R0 selectivity do you have?

 

[deleted1114045]

Or it’s just spreading easily because it’s endemic pattern of relative immunity and seasonality was broken and it’s following an epidemic pattern all over again. What evidence of R0 selectivity do you have?

My evidence would be a dramatic increase in the already super infectious delta variant. It has become the second most infectious virus in modern history, in addition to RSV circulating at higher than normal rates at this time of year.

Vaccines Are Pushing Pathogens to Evolve | Quanta Magazine

Just as antibiotics have bred resistance in bacteria, vaccines can potentially lose their effectiveness over diseases they controlled. Researchers are working to head off the evolution of new threats.

www.quantamagazine.org

 

[DoctwoB]

My evidence would be a dramatic increase in the already super infectious delta variant. It has become the second most infectious virus in modern history, in addition to RSV circulating at higher than normal rates at this time of year.

Vaccines Are Pushing Pathogens to Evolve | Quanta Magazine

Just as antibiotics have bred resistance in bacteria, vaccines can potentially lose their effectiveness over diseases they controlled. Researchers are working to head off the evolution of new threats.

www.quantamagazine.org

Delta became rampant in countries with low vaccination rates. It wins natural selection by being more transmissible then other variants, vaccine or no vaccine.

Though if Dr. Weasley here is right, then the solution is we all just have to lick everyone we meet. If distancing makes viruses more transmissible then we must get as close as possible to make them less transmissible. That is why my hospital has mandatory make out sessions every lunch break.

Edit: If the latter is true, then I'm quite certain the existence of toddlers and daycares and the infinite negative selective pressure they apply disproves your theory.

 

[deleted1114045]

Delta became rampant in countries with low vaccination rates. It wins natural selection by being more transmissible then other variants, vaccine or no vaccine.

Though if Dr. Weasley here is right, then the solution is we all just have to lick everyone we meet. If distancing makes viruses more transmissible then we must get as close as possible to make them less transmissible. That is why my hospital has mandatory make out sessions every lunch break.

Edit: If the latter is true, then I'm quite certain the existence of toddlers and daycares and the infinite negative selective pressure they apply disproves your theory.

I’m not following your reasoning. Daycare situations, where children lick everything they touch, swap spit/fecal matter/snot all day long, would not put a selection pressure on viruses to have large Ro’s as a virus doesn’t have to have large Ro’s to spread effectively in these situations. It would select for viruses that give very minor illnesses as if they had major illnesses, they would look too bad and their parents wouldn’t send them to daycare.

 

[DoctwoB]

I’m not following your reasoning. Daycare situations, where children lick everything they touch, swap spit/fecal matter/snot all day long, would not put a selection pressure on viruses to have large Ro’s as a virus doesn’t have to have large Ro’s to spread effectively in these situations. It would select for viruses that give very minor illnesses as if they had major illnesses, they would look too bad and their parents wouldn’t send them to daycare.

It is extrapolating from your point. If distancing places selective pressure that increases Infectiousness, then Daycare makes transmission so easy that Ro would not require selective pressure and would decrease in favor of selection for other factors.

in reality I was being facetious and think your point is ridiculous. Selection occurs for all organisms at all times. For any virus increased infectiousness and Ro is selected for, regardless of masks, distancing, or vaccines. Because any strain that is more infectious will out compete the others for hosts all else being equal. What allowed Delta to happen is that pressure combined with unchecked replication in hundreds of millions of hosts, giving near infinite chances for mutation.

 

[deleted1114045]

It is extrapolating from your point. If distancing places selective pressure that increases Infectiousness, then Daycare makes transmission so easy that Ro would not require selective pressure and would decrease in favor of selection for other factors.

in reality I was being facetious and think your point is ridiculous. Selection occurs for all organisms at all times. For any virus increased infectiousness and Ro is selected for, regardless of masks, distancing, or vaccines. Because any strain that is more infectious will out compete the others for hosts all else being equal. What allowed Delta to happen is that pressure combined with unchecked replication in hundreds of millions of hosts, giving near infinite chances for mutation.

For the sake of the world, I hope my point proves to be ridiculous. You are saying that environmental conditions don’t exert an evolutionary pressure? That would be really awesome. In the meantime, vaccinations rates worldwide are frustratingly low, and unlikely to improve a whole lot. Look at Africa! A giant COVID vaccine desert! Like you said, this ensures infinite chance of mutation, but with the evolutionary pressure of a vaccine that still allows minor illness, making the disease perpetually ubiquitous for the forseeable future. The virus will continuously ping pong back and forth between vaccinated and unvaccinated populations, and between populations that socially distance and those that don’t. To my mind, this is like taking an incomplete course of antibiotics. It selects for resistance… resistance to social distancing and resistance to vaccination. Please show me where my reasoning is wrong. I really want to not believe this.