BNT162b2 Vaccine Booster and Mortality Due to Covid-19 • Hacker News Board

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#41

Post by mint2 » Sat, Dec 11, 2021, 9:07 PM UTC

jimmyearlcarter wrote: post #27

mrtksn wrote: post #18

Earlier quoted context omitted.

Maybe you can consider another vaccine as a booster if this one did not acted well on you? I don't see how the booster is guaranteed to be the final answer as the virus keeps mutating and spreading among the very large unvaccinated population. I personally think that it will become endemic, thanks to the vaccine we would have enough immunity to keep us out of hospital and each time we get the virus it would act as a…

Its actually the 'leaky' vaccine that is causing the problematic mutations. In the same sense that bacteria mutate to evade antibiotics, the virus mutates to evade the vaccine. https://www.youtube.com/watch?v=iwPKnOhJRYg&list=PL2FOgJ3tfG...

Unless those accounts extensively discussed how immune compromised individuals and not evolution across whole populations provided the virus a platform to mutate extensively as that’s the current leading hypothesis of omicron’s origin, then I would recommend understanding those accounts are garbage and should be a big red flag about their motivations

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#42

Post by nkurz » Sat, Dec 11, 2021, 9:09 PM UTC

I'm going to do this as a top-level comment because I think it's important. Throughout this thread, a number of people seem to be misreading the numbers and arguing that the results are unimportant because they show that the booster reduces a tiny risk (0.00298%) to an even tinier one (0.00016%). In general, this is a fine argument to make, but I don't think it's well supported by this paper.

Here is the Results section from the paper: A total of 843,208 participants met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day).

The risk of death is being reported per day, and not per year as many people seem to be assuming. They had 85,000 people in the control arm, and 137 of them died in the less than 2 month timeframe of the study. If you multiply the daily risk by 365 to make it an annual risk, you find the non-boosted (but already doubly vaccinated) group had a slightly greater than 1% chance of dying within a year. By most standards, and compared to most other situations, this is a considerable risk of death. By contrast, the boosted group had a less than .1% chance of dying per year, so it's not just that an elderly study population was already on the verge of death.

So unless you think 1 person out of 100 dying within a year is insignificant, it would be more helpful to point out the potential flaws in the study than to say the results don't matter. Should the data be trusted at all? Is the boosted group really comparable to the unboosted? Did they mishandle/miscount the way people were switched from one group to the other throughout the course of the study? Should those less than 30 years old even care? These are potentially good questions, but it's not reasonable to suggest that the study as printed shows that there is no real benefit to the booster.

(Obviously, if my math is wrong or if I'm misinterpreting the results, please correct me!)

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#43

Post by nonbirithm » Sat, Dec 11, 2021, 9:13 PM UTC

mrtksn wrote: post #18

avalys wrote: post #8

Is it too early to conclude whether booster effectiveness will also wane in 6 months? I had some mild but persistent side effects from the second Pfizer dose (ear ringing and Eustachian tube dysfunction). It's gotten about 98% better - but not 100% - and I'm a bit nervous about the booster given that many people are reporting the side effects are somewhat more intense than the second shot. If the booster is the final…

Maybe you can consider another vaccine as a booster if this one did not acted well on you? I don't see how the booster is guaranteed to be the final answer as the virus keeps mutating and spreading among the very large unvaccinated population. I personally think that it will become endemic, thanks to the vaccine we would have enough immunity to keep us out of hospital and each time we get the virus it would act as a…

I think the media might have unintentionally done themselves in by using the terminology "vaccinated" with no qualifiers in much of the coverage of the virus in the past two years. Soon we might have to be careful to state "vaccinated, but only within the last six months" or "vaccinated, but with the version targeting omnicron". I can't imagine it will be easy for all the existing articles from months ago to be updated now that we have new information.

I feel the same way with masks. If you didn't do enough research, you could easily believe that anything with an N95 certification would be ideal for protective purposes, but plenty of N95 masks have valves which makes them useless for preventing infected individuals from infecting others. There are also cloth masks, gators, and so on. But to many people they all fall under the umbrella of the unspecific term "wearing a mask", and unless you explicitly look up the medical consensus, many sources of information are unlikely to also state "but not those masks."

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#44

Post by mrtksn » Sat, Dec 11, 2021, 9:29 PM UTC

nonbirithm wrote: post #43

mrtksn wrote: post #18

Earlier quoted context omitted.

Maybe you can consider another vaccine as a booster if this one did not acted well on you? I don't see how the booster is guaranteed to be the final answer as the virus keeps mutating and spreading among the very large unvaccinated population. I personally think that it will become endemic, thanks to the vaccine we would have enough immunity to keep us out of hospital and each time we get the virus it would act as a…

I think the media might have unintentionally done themselves in by using the terminology "vaccinated" with no qualifiers in much of the coverage of the virus in the past two years. Soon we might have to be careful to state "vaccinated, but only within the last six months" or "vaccinated, but with the version targeting omnicron". I can't imagine it will be easy for all the existing articles from months ago to be updat…

It’s a mass communication, not precise scientific communication.

It will keep evolving as the situation evolves.

I think, the danger lies in the fact that everything said by scientists on the media is oversimplification and technically wrong as a result of the simplification attempt. This can erode credibility significantly.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#45

Post by angelzen » Sat, Dec 11, 2021, 9:45 PM UTC

kelnos wrote: post #12

angelzen wrote: post #5

Given that boosters are an attempt to counteract waning vaccine vaccine effectiveness, there are two fundamental questions: 1. Do boosters work at all? 2. Do boosters wane over time, just like the original shots did? They answer only 1. They didn't even attempt to shed light on 2, which is a serious letdown. Given known waning vaccine effectiveness, at a minimum claims on booster effectiveness should be bracketed by…

How could they answer #2? Boosters have only been a thing for, what, a couple months now?

"We've measured the position of iron balls thrown at different speeds from a 56m tall tower and found they were 90% likely to be found flying in the air."

This is technically correct, yet fundamentally misleading. The same statement, bracketed by time since triggering event:

"We've measured the position of iron balls thrown at different speeds from a 56m tall tower, 0.1 seconds after throwing, and found they were 90% likely to be found flying in the air."

Even better, show the plot of position by time, or at least clarify you are merely doing a point-in-time measurement. Time is a fundamental component of the vaccine effectiveness equation.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#46

Post by sterlind » Sat, Dec 11, 2021, 10:00 PM UTC

avalys wrote: post #8

Is it too early to conclude whether booster effectiveness will also wane in 6 months? I had some mild but persistent side effects from the second Pfizer dose (ear ringing and Eustachian tube dysfunction). It's gotten about 98% better - but not 100% - and I'm a bit nervous about the booster given that many people are reporting the side effects are somewhat more intense than the second shot. If the booster is the final…

Countering this anecdata with my own: I have several rare diseases and I'm quite disabled. I didn't get noticeable effects from my first two Pfizer doses (at least nothing I could distinguish from my chronic illness), while the third gave me flu-like symptoms for 2-3 days. I was happy about this because it told me it was working, and I returned to my (crappy) baseline afterwards with no lingering effects.

I wonder if you just happened to get ear ringing coincidentally around the time you got your second dose, and connected the dots even though it might not be causally related.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#47

Post by sharken » Sat, Dec 11, 2021, 10:02 PM UTC

ulnarkressty wrote: post #19

avalys wrote: post #8

Is it too early to conclude whether booster effectiveness will also wane in 6 months? I had some mild but persistent side effects from the second Pfizer dose (ear ringing and Eustachian tube dysfunction). It's gotten about 98% better - but not 100% - and I'm a bit nervous about the booster given that many people are reporting the side effects are somewhat more intense than the second shot. If the booster is the final…

Same here, no vertigo before in my life - had it for both doses, longer the second time, still not 100% recovered. I even voluntarily filled in my info on the Pfizer side-effects page, but didn't hear anything back. Did you manage to find out what exactly goes wrong with the inner ear after the vaccine? Still, regarding the study, it appears that taking the booster would be the better choice, considering most of us w…

The vertigo effect you describe, was that right after each dose, or at a later point.

It would be interesting to know more about this side effect.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#48

Post by timr » Sat, Dec 11, 2021, 10:12 PM UTC

actually_a_dog wrote: post #26

timr wrote: post #17

Earlier quoted context omitted.

> I'll take a 90% lower mortality rate any day. Really? Any day? Read the part you quoted carefully: the death rate in the control group is 3 per 100,000. And if you read the rest of the paper, you'll see that the study population was entirely over age 50. Remember that the risk of death from Covid-19 goes up exponentially with age -- something like 90% of all fatalities are over age 50 [1]. If you're in the typical…

Yes. Any day, and twice on Sunday. If 90% of COVID deaths in the US could have been prevented (in fact, many could have been)[0][1], that cuts this whole thing down to a very bad flu season, comparable to the 1957 flu pandemic [3]. Would you rather not cut your risk by 90%? Edit: Incidentally, I have been hit by cars while walking 3 times. No injuries, luckily, since they were very low speed impacts. Why are you seem…

> Would you rather not cut your risk by 90%?

Depends entirely on the cost vs. the benefit. As I said, a 90% relative reduction is meaningless without knowledge of the baseline risk.

And once you know the baseline risk, you can do the math instead of just reacting emotionally.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#49

Post by timr » Sat, Dec 11, 2021, 10:23 PM UTC

nkurz wrote: post #32

timr wrote: post #17

Earlier quoted context omitted.

> I'll take a 90% lower mortality rate any day. Really? Any day? Read the part you quoted carefully: the death rate in the control group is 3 per 100,000. And if you read the rest of the paper, you'll see that the study population was entirely over age 50. Remember that the risk of death from Covid-19 goes up exponentially with age -- something like 90% of all fatalities are over age 50 [1]. If you're in the typical…

Your comparison points are great, but I think you are misreading the quote: "Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day)." The death rate of the control group is .16 vs 2.98 per 100,000 people per day . If you annualize this by multiplying by 365 to make it comparable to you…

That's fair. You can't annualize a daily risk by multiplying by 365 (volatility must be taken into account), but the broader point that annual vs. daily risks are different orders of magnitude is well-taken. Unfortunately, I don't have any examples of risks that low measured on a daily basis.

> over 1000 deaths per 100,000 people per year for the double vaccinated but not boosted.

We know this isn't even close to true by looking at aggregate numbers. For example, a truly conservative back-of-the-napkin calculation: 800k deaths in the US @ 50M reported cases (which we know is low by a factor of at least 2...) -> 1600 per 100,000. And many of those (half?) happened prior to vaccines; many now happen in the unvaccinated population. It's fairly obvious that 1000 per 100,000 is much too high an estimate.

(...and this isn't even the correct number to compare...what you really want is absolute risk per person, which will be far lower than the risk if you get infected, which is what I've estimated above. If you do that calculation, you get ~240 per 100,000 in the US over the entire pandemic. That's somewhere between the annual risk of dying in an accident (1 in 700) and the annual risk of dying from cancer (1 in 500).

Generalizing from the sample in the study is problematic for a bunch of different reasons -- not the least of which is that it's an older group of people -- but I didn't want to get caught up in a debate about IFR estimates.

Re: BNT162b2 Vaccine Booster and Mortality Due to Covid-19

#50

Post by spurgu » Sat, Dec 11, 2021, 10:39 PM UTC

nkurz wrote: post #42

I'm going to do this as a top-level comment because I think it's important. Throughout this thread, a number of people seem to be misreading the numbers and arguing that the results are unimportant because they show that the booster reduces a tiny risk (0.00298%) to an even tinier one (0.00016%). In general, this is a fine argument to make, but I don't think it's well supported by this paper. Here is the Results sect…

The study is somewhat skewed since its comprised of people 50+ years old, which have a significantly higher risk to begin with compared to young healthy adults.

Edit: Removed false/misleading bit.