Lies, Damned Lies, and Vaccine Statistics
drrollergator.substack.comI took the bait, I'm ashamed. I try to keep an open mind, so I read some of it.
The thrust of the article is that vaccines work well at preventing infection, but that if you do get infected, it is _possible_ that you might die at a higher rate. _Possible_ comes from a big spread in the standard deviation of P(death|infected & vaccinated). I didn't check his calculations, I took his numbers at face value and just looked at the charts.
The author uses big standard errors to make claims about what could or could not be true, because the standard errors straddle both favorable and unfavorable statistics for the vaccine.
However when the standard errors are too small for this dubious reasoning, they come out in favor of the vaccine.
The author appears to me to be using motivating reasoning to push an agenda.
Edit: sorry I am not completely right, because I wrote this comment before thoroughly reading the whole article. Sometimes his standard errors come out against the vaccine, and for all I know his math could be right. But I don't want to check the math because I have limited time and I don't care if my death rate goes up given conditions {x, y, z.}
I care if getting the vaccine makes me less likely to get sick and die, which it does, because if you look at all the tables and charts that's exactly what it shows.
It's even worse than that. Aside from deviations, this is a main point in the article:
> The death rate if infected was always going to be higher in the vaccinated groups if most of the vaccinated were those likely to die in the first place.
IOW: Those most likely to die were most likely to get vaccinated. Obviously true, but not interesting - a correlation we need to account for. When you do control for prior risk, the results are as expected, i.e., vaccines make you much safer.
The quoted tweet ("100x") was inaccurate and exaggerated. That's worth briefly correcting. But the lengthy article's points are only minor and pedantic, and do not change what we know, which is that our vaccines are very effective.
Yes. If I read the article correctly, the data in fact say you cannot determine whether the death rate in vaccinated people who become infected is different than in unvaccinated people.
However, 1) it isn't clear if Frieden is working from the same dataset as the author, and 2) a very slight re-wording of the initial statement would make it correct, i.e. "If you are _exposed_ to covid and you've been vaccinated you're about 100 times less likely to die."
There's several reason why even with highly effective vaccines, we might see worse infections when we do see them among the vaccinated. For example, if the vaccines work well, then there should be a bias where we see the most breakthrough infections among those for whom the vaccine doesn't do anything, i.e. people with compromised immune systems. So the people with normal immune systems will make up a much larger percentage of infections among the unvaccinated group, allowing them to drag down the average severity of infections - in the vaccinated group, they've been "removed" since most of them won't get infected, or have mild enough infections that they don't even notice, leaving the immunocompromised as a larger part of the infections that get counted in the statistics, and these infections are thus on average more severe.
> I care if getting the vaccine makes me less likely to get sick and die, which it does, because if you look at all the tables and charts that's exactly what it shows.
The author is actually in the range of an interesting point, even if the article is mostly foolish. If I had a hypothetical vaccine that was in fact composed of neurotoxin and killed the injectee instantly ... it would show 100% effectiveness in the cited tables, because the corpses would be unable to contract COVID. So you can't actually tell if the vaccine reduces your odds of getting sick and dying - we know the current crop are a bit rough and kill people in rare cases.
Covid deaths are so low in the 16-44 category that may be comparable to the vaccine. Although I think the hospitalisation numbers are still quite persuasive in favour of the vaccine.
There is a slippery joint conditional probability here. The article talks mostly of:
Pd1 = Prob(death GIVEN infected AND vaccinated)
vs
Pd2 = Prob(death GIVEN infected AND NOT vaccinated)
Which makes it easy to lose site of:
Pi1 = Prob(infected GIVEN vaccinated)
which is very very small compared to its opposite:
Pi2 = Prob(infected GIVEN NOT vaccinated)
Because Pi1 is so much smaller than Pi2 there are several consequences for Pd1 and Pd2:
- The small counts for "numerator" of Pd1 (zero in some cases) means large uncertainty in the ratio and that the centroid of the distribution is not particularly meaningful. Statistical fluctuations (just one more or one less death) will change Pd1 substantially.
- Statistically significant deviations between Pd1 and Pd2 do not point to a cause.
For example, it could be that those contributing to Pd1 all got a much higher viral load in order for the virus to break through the vaccine's defenses and high viral loads are known to correlate with death so once vax protection is defeated it is game over. The distribution of viral load exposure may even be the same in the Pd2 case, but for the unvaccinated a lesser load can be fatal. This explanation is consistent with P1d possibly being greater than P2d AND consistent with the given anecdotes of vaccinated tweeters saying covid is just the flu, bro.
The main take away is still: you do NOT want to get this shit and vaccine AND masking will help achieve that goal. And, unless you are a sociopath, you do NOT want to give this shit and vaccine AND masking will help achieve that goal.
To clarify what you're concluding:
It's a given that you do not want to contract COVID-19. Vaccination and wearing a mask will help.
You also do not want to give COVID-19 to others. Again, vaccination and wearing a mask will help.
So this article is just pedantry over a statistical quirk.
The key insight of the article was that errors are reliably ignored or excused when they fit the desired narrative.
It's not hard to see how that would be effective anti-persuasion for persons inclined to have doubts about receiving an emergency authorized intervention. Rigorous honesty[1] would assuredly persuade at least some of those people and thus would raise the population vaccination rate, which I'm sure we all agree is a desirable outcome.
[1] For example, rather than chanting the mantra "safe and effective!" being honest about the tradeoffs and showing that proven risk management strategy indicates vaccination is the mathematically optimal choice.
I think that is a correct summary.
> It's a given that you do not want to contract COVID-19. Vaccination and wearing a mask will help. > You also do not want to give COVID-19 to others. Again, vaccination and wearing a mask will help.
How does that explain delta spread being biggest in highly vaccinated countries?
This is a great post and you can immediately see where they are going with this as soon as he quotes Dr. Tom Frieden.
It makes tons of sense that those who are vaccinated and get infected are more likely to die, simply because it would indicate a failure to develop antibodies and mount an effective immune response to the virus.
That being said I’m not sure such a rant is justified over a tweet like this. Dr. Frieden is more or less correct if you slightly re-word his sentence to: “Getting vaccinated decreases the chance of dying by approximately 100x”.
What I take home from this is that everyone is human, can make simple mistakes, and that we take things written on Twitter far too seriously. I’m sure that Dr. Frieden would not have made such a mistake if he wrote an article that was published somewhere reputable instead of a tweet that could have been sent while waiting for his coffee at Starbucks, or using the toilet.
There is a trade off in communicating science to the public in that using social media, TV, and newspapers reaches more people but almost always distorts the message. I’m not sure how exactly to balance this trade off, but I also think that some amount of responsibility lies with the reader to seek the truth instead of demanding that every sentence they read on the internet be as accurate as a peer reviewed journal.
The author makes a critical mistake when analyzing the BNT/Pfizer clinical trial. Over and over when discussing the results they mention calculating efficacy against "infections" using this data. But this specific clinical trial provided no data about infections. The metric measured was symptomatic COVID-19 disease.
This kind of mistake is understandable, but doesn't really inspire much confidence in a screed about the mistakes others are making in analyzing COVID-19 data.
> The real world data has shown that the death rate among the vaccinated, if infected with COVID, can be 3 to 5.7 times higher1 than the death rate of the unvaccinated.
Okay… but how much less likely are you to get “infected”?
How are you even defining “infected”, here? If virus gets in your body and then your immune system kills it before it does much damage, were you “infected”? If the answer is no, you've got pretty serious selection bias, because you're completely ignoring everyone who was completely protected by the vaccine in the “vaccinated” group, but paying attention to everyone who didn't really need a vaccine in the “unvaccinated” group: basically ignoring all the really-healthy, great-immune-systems, unlikely-to-die people in the “vaccinated” group so, proportionally, the sicker people take up more room. So you can't even say that the vaccine makes things worse for them! If it improves their chances by 100 times, as Dr. Tom said, but the selection bias is only paying attention to the 0.2% least immune people (those who got infected when exposed after vaccination), you'd expect to see a 5× higher death rate even though the actual death rate is 0.99× lower. (Made-up numbers.)
The author uses "evidence of infection" as the definition of infection, and labels all other definitions as misinformation, and writes at length about it as if it was not just a difference in definitions.
Obviously most of the people the author is criticizing are using "exposure that would cause detectable disease in non-immune individuals" as their definition, and I don't know if we have a better word for that.
> The author uses "evidence of infection" as the definition of infection,
So the author makes the implicit assumption that a successful vaccination doesn't prevent evidence of infection, and uses it to argue that vaccines are dangerous… then accuses everyone else of providing numbers without sufficient context?
Edit: no, actually.
> The reason, hidden in plain sight, is that a large number people who were never going to die, are no longer getting infected.
So the author does know… they were just getting spectacle in before explaining. And I do agree with the author's (eventual) point:
> Without careful control and understanding, one might erroneously conclude the Delta variant is is more lethal if you’ve been vaccinated, the vaccine is losing its efficacy, the vaccination is making people weaker, or some combination. While any of those are possible outcomes in this environment, by not being aware of the infection death rate issue from the start, because one is busy spreading misinformation about extra levels of protection that the data do not support, one misses how to properly control for these effects and analyze new data as it comes in.
But I really don't like the article. The author is the only one making those erroneous conclusions in the first place!
> 36 of 84611 in the unvaccinated versus 0 in 1066 in the vaccinated group. 36 in 84611 is roughly 1 in 2350, but we only had 1066 infected in the vaccinated group. There is not enough information to claim the death rate per infection is higher or lower, and that uncertainty is indicated in the graph above. That is worlds away from the relative immortality communicated by the efficacy number 100%.
Okay. But immediately after…
> In fact, if there had been 24 deaths in the vaccinated group the efficacy reported would have been 3%! Because it was looking at rates over time, 24 deaths would have been the death rate over time similar to 36 in the unvaccinated group. But clearly, among those infected, 36 in 84611 is a far lower death rate than 24 in 1066!
If? Now we’re onto hypotheticals. Here is an idea, you have so few because they were vaccinated!
Also the mental gymnastics of saying: “it’s better to not be vaccinated in case you get covid because you are less likely to die” is worthy of a mental gymnastics olympics gold medal.
I understand that the CDC guy may have worded things differently but directionally he is right.
But, again, one cannot just ignore the hypotheticals of Dr. Gator when it provides validation for your anti-vaxx stupid attitude.
In the “ What the numbers really showed” you use the lack of vaccinated sample size to justify something for the unvaccinated, but then immediately use that small number to your advantage to say “if 24 people had died then the vaccinated would have a higher death rate”. It’s disingenuous and doesn’t show anything.
Also if the vaccine prevents contraction then it should be counted as preventing death/hospitalization, but obviously those numbers aren’t obvious. Seems to me the vaccine IS preventing contraction so you would need to account for that wouldn’t you?
yes. the “if” maneuver for the mental gymnastics gold! cannot believe i wasted my time reading this pedantry
This article does actually make an interesting point, but its graphs are all bunk.
The vaccine works by priming the immune system to work quickly against a disease. It is quite likely that if someone develops symptoms despite their body being at peak alert for coronavirus then they are in trouble. The graphs bear that out, and do not alarm me. If we only select for cases where the person is physically susceptible enough for the virus to break through the vaccine protections to cause an infection it makes sense that the cases will be on average worse.
But there is an interesting point here that if the vaccine were killing people (eg, heart inflammation problems have been detected in some cases) then the "COVID-19-related-death" stats, etc, would be highly misleading. It would be more interesting to see all-cause mortality and the cited tables don't do that.
The case for the vaccine sells itself.
Why do professionals get in the business of exaggeration when it serves no useful purpose than to provide excuses and doubt to the hesitant.
Also. Often when officials state things with exaggerated and unwarranted certainty, take it with a grain of salt.
PS why isn’t Twitter marking such as misinformation? My guess, it fits their narrative, so it gets a pass.
There's a natural predilection for some people that, when presented with bullshit (in this case "5g mIcROchIPS"), go in the complete opposite direction and start spewing bullshit themselves, but based on the opposite underlying truth.
This same phenomenon is easily witnessed in other contexts, including politics (Q-Anon vs. zany Kremlin theories), and science (climate change deniers vs. climate doomsday seers).
I'm unsure what the cause or solution to this is, but I think sage advice would be to approach always assume the worst for your side of the story. Don't try and stretch data to fit your worldview. If your position doesn't hold up under the harshest scrutiny that you can give it, it's not a position worth holding.
This article fails to mention the BY FAR most significant benefit of the vaccine which is: achieving herd immunity
We should be as accurate as possible with when talking about vaccine but throwing around statics(or should we say "Vaccine Statistics") like:
> "the death rate among the vaccinated, if infected with COVID, can be 3 to 5.7 times higher than the death rate of the unvaccinated."
is not exactly providing the big picture context needed for a productive social discussion.
The article suggests focusing "real efficacy". Before the vaccine program started there were ~4000 deaths per day in the US, now there are ~100. Clearly it is very effective at reducing death.
Even the NYT is willing to admit that the drop started in January, before vaccination can really be credited for it.
Herd immunity can be achieved with natural immunity + inoculation + therapeutic/chemo prophylaxis. The only time in history where natural immunity has been considered insufficient for the goal of herd immunity is 2020+. WHO went as far as changing their definition of herd immunity last year to exclude natural immunity (check the way back machine).
Leaky vaccines can also cause mutation pressure on viruses, but the only acceptable public position is that the unvaccinated are causing the more virulent strains.
Propaganda from the top down to sell more (in patent) pharmaceutical products, with force and public shame. Think about this for a moment: someone at WHO identified their herd immunity definition on their website and willingly modified it to exclude natural immunity. Ask yourself how that is in any way scientific or appropriate. It is scientific gaslighting and the only explanation is a desire to sell more vaccines.
If we took your suggestion and let everyone get natural immunity, in the US alone this would cause 2.5 million deaths (not considering new mutations). This is unacceptable to any sane person, and does not require a massive global conspiracy propaganda campaign to convince people of.
https://www.king5.com/article/news/health/coronavirus/verify...
You realize you are posting an article from September 2020 that claims that COVID has a death rate north of 3%, which we now know to be wildly untrue, right?
Christ almighty, the vaccines-are-the-only-solution crowd is statistically illiterate and lazy. Just embarrassing.
Not only are you numbers unsound, but your position is only true if you accept the false dichotomy of “vaccines or nothing”. Prophylaxis options are available, but they’re out of patent, so they’re ignored and torpedoed by your holy CDC and WHO high priests who live in the pockets of big pharma.
>your holy CDC and WHO high priests who live in the pockets of big pharma.
Even you are wrong. Because they are not in the pockets, but they are the big pharma. They are the marketing arms of big pharma that are just a much more convincing version of the person in a lab coat in a toothpaste commercial. They just appear to do enough good stuff to not blow their cover, just like an undercover cop might go along with the baddies just enough to not blow their cover.
So if you think CDC/WHO can be "fixed" by changing the funding, you would be very wrong.
>Before the vaccine program started there were ~4000 deaths per day in the US, now there are ~100. Clearly it is very effective at reducing death.
Changing the way you categorise death can do wonders..
> Q Can you talk about your concerns about deaths being misreported by coronavirus because of either testing or standards for how they’re characterized?
> DR. BIRX: So, I think, in this country, we’ve taken a very liberal approach to mortality, and I think the reporting here has been pretty straightforward over the last five to six weeks. Prior to that, when there wasn’t testing in January and February, that’s a very different situation and unknown. There are other countries that if you had a pre-existing condition and let’s say the virus caused you to go to the ICU and then have a heart or kidney problem — some countries are recording that as a heart issue or a kidney issue and not a COVID-19 death. Right now, we’re still recording it, and we’ll — I mean, the great thing about having forms that come in and a form that has the ability to mark it as COVID-19 infection — the intent is, right now, that those — if someone dies with COVID-19, we are counting that as a COVID-19 death.
Now, imagine if, after vaccine rollout, we counts those deaths as cause by a heart condition. Boom. Drop in covid deaths! Vaccines worked! Hail pharma!
I do think it's very important to be clear what your statistics are saying, and everyone has done a pretty poor job of being clear about that.
But in this case, what people really want and need to know is how well the vaccine is going to prevent them from dying.
They don't care about the difference between "Prevent dying from covid" and "prevent dying from covid once you have covid". The latter simply doesn't matter to them until they have covid, and then it's too late for the vaccine. That statistic is meaningless to the general public.
People only want to know if the vaccine can help them not die. And it absolutely can because it helps prevent getting infected in the first place.
Edit: I just realized the statistic that people want: "How likely are you to die from Covid if exposed to it, vaxed vs unvaxed." Not if you get it. Just if you're exposed to it. And since we don't run tries where we deliberately expose people to viruses, it's going to be a hard number to get.
Here's what I'm failing to understand.
According to most major studies coming out (including this one: https://www.imperial.ac.uk/news/227713/coronavirus-infection...), with the advent of delta variant, the vaccinated have about a 50% less chance of getting infected than unvaccinated people.
If we assume the vaccine offers no additional protection against hospitalization/death given that one is already infected (which is what the author seems to be arguing), then what we should be seeing is 67% of hospitalized COVID patients are unvaccinated, yet we're seeing the rate closer to 97%. So there's obviously something going on here, and the most likely culprit would be that the vaccine does offer protection against hospitalization/death, contrary to the author's argument.
The post is conflating vaccine efficacy and effectiveness which are two different epidemiological measures.
It also fails to consider the false positive and false negative rates inherent in these studies. In particular, lots of asymptomatic cases in the vaccinated arm are not caught by efficacy studies (false negatives). So claiming that low death rates are solely a result of reduced infection(as opposed to fighting off infections better) is also a conclusion made hastily.
Death rates and symptomatic cases are much measured much more accurately, and claiming that effectiveness studies have little point once there's vaccine efficacy is available underestimates the challenges of epidemiology.
But the overall point that statistics are hard to understand, easily misused in online arguments is a valid point.
@dang and other moderators: Please unflag this.
Please don't. The article is pedantic silliness that can be, will be, and has been interpreted to mean "vaccination increases your risk of dying from COVID". Far from decreasing vaccine stupidity, it's increasing it. The article has negative value.
100 people, unvaccinated, all contract covid, 10 die. That's 10%. 100 people, vaccinated, 10 contract covid, 1 die, That's 10% based on the number whom contracted covid. Not based on the number of vaccinated vs unvaccinated.
Not directly related to the article, but - I am extremely disappointed that this article was flagged. It certainly displays the general inability for people to openly analyze ideas and narratives that (at first glance) appear to go against their beliefs. I feel like this type of censorship across platforms is only adding ammunition to the persecution complex of those who are already skeptical of the vaccine.
I don't believe everything that is posted on the internet.
One really has to ask why some one cares to write such a long blog post instead of simply publish the analysis to Lancet if it is so new and overlooked. Does the author expect to get careful reviews? I would care if I am publishing something that easily can also be misguide policy makers. If the author is correct from my understanding one should see more deaths and more hospitalised relative to the incidence in countries with high vaccination rates. We do see the opposite afaik. Did I get something wrong? But isn't that the claim: now mostly thoseppl just do not get infected which never would have died anyways?? Can someone please enlighten me, but there seems to be a major flaw in that analysis.
what about Lies, Damned Lies, and Cloroquine Statistics?
Sounds like you've got a great post to write.
This post was flagged. I just vouched for it. I read the whole thing. As far as I can tell, it is accurate.
There is not a single comment pointing out any error or misinformation or lie or damned lie.
Unless somebody can show that the data and/or interpretation are wrong, it should not be flagged.
I flagged it because of the inflammatory title in no way bears the weight of the rather simplistic claim this article writes conspiratorially at length to make:
The evidence that vaccination reduces the severity or decreases mortality of COVID-19 infection is not as strong as the evidence that vaccination prevents COVID-19 infection entirely.
Where are the "damn lies"? We're talking about splitting hairs in the interpretation of twitter posts that evidence does support. It's interesting, but exactly this kind of inflammatory language is what I will always flag on HN, whether it be about COVID or VIM vs. EMACs.
No, the point is not what you claim. The point is that facts matter and we shouldn’t lie about them, for a variety of reasons.
From the article:
> The person who incorrectly assumes that “with the vaccine, even if I get infected I am less likely to die than I would be without the vaccine,” will be more likely to engage in behavior that risks infection. They may become the “it’s just a flu bro” of the vaccinated.
> If the lack of observed layered protection were made more explicit then people may choose to still wear masks and social distance, to further reduce their exposure in addition to vaccination. They may choose to go to fewer social events. This in turn would reduce the infection rate, and reduce the probability a mutation that evades vaccination finds a host to practice on. (While writing this article, the White House changed its masking recommendation for the vaccinated)
I am not 100% on HN policies regarding flagging / renaming threads, but I do see articles get renamed on a fairly regular basis without getting flagged into dead status first? Is there not a mechanism to suggest a different title without getting it pulled entirely?
I think the click bait title is a good knee-jerk reaction test, and I would suspect a fair number of folks flagged the thread without reading the full article. In the spirit of open discussion and intellectual honesty, this seems like a failure.
A more descriptive title would probably be for the best, though.
The post has been up for an hour. The people who will write those comments pointing out errors are probably taking their time to read it and write those comments.
So, to be clear, you're simply assuming that this article is false because... reasons?
> There is not a single comment pointing out any error or misinformation or lie or damned lie.
The article was posted 1 hr ago. Assuming some time to notice the article, then something like 30 minutes to read it and write a response, you'd not expect to see many comments pointing out the problems in the first hour.
Nobody has to prove it's wrong. Analysis of studies is months of work in very specific domain knowledge. You're not going to find good rebuttals to medical data reviews in a comments section unless there's glaring issues and you happen to attract the attention of someone that knows better. Those people are generally not in comment sections, but working 80 hours a week.
So, you are rejecting the medical studies done by the UK and Israel on the effectiveness of the vaccines because... why exactly?
You should do research into "logical fallacy" and "intellectual dishonesty" before commenting on the internet. I never said I rejected those medical studies, I am saying the review of those studies, is, in itself, difficult to refute without a lot of time and domain knowledge. That's true of any complex topic.
Agreed. I also read it carefully, and could not seen any inaccuracies.
Thanks for vouching for it.
Posts like this are often flagged. Makes one wonder.
My theory - pandemic is mostly a religious event. Mind that much of world religions is mostly anti-epidemic advice presented as God's commands (with some world creation myth and some moral advice on top). So people are prone to react with religious fervor in response to each epidemics.
And since the main purpose of religion is dividing people on Us vs Them (Us - clean and moral, Them - stained and evil) this is exactly what is happening with pandemic. Plus some overzealous virtue signaling.
Rational arguments and rational people are doomed to fail in the circumstances.
I think this is only a religious debate in the US where Trump tied it directly to a certain identity people desperately want to maintain or distance themselves from.
I've never heard it referred to as a religious debate in the US. When I hear about anti-vaxxers complaining, it's from a perceived freedom (not religion) standpoint. Maybe there are exceptions for some religious minorities, but I have yet to hear them.
The religion in this case is US partisanship, which somehow the vaccine seems to be getting sucked into.
Agree on the US partisanship, disagree on the religious angle (except to agree that religion could potentially be used, on a small scale (e.g. local churches), to disparage the vaccine).
On another note, I enjoy open debate regardless of the subject, and I appreciate that there are arguments against the vaccine (though I am vaccinated myself).
Not sure if you’re a native English speaker, so commenting explicitly just to help out. “Religious” does not only refer to supernatural beliefs, at least in American English. US partisanship has escalated to a level where it can be easily referred to as “religious.”
Many clearly prioritize it over their official “religion” as you can see with Christians bending over backwards to support Trump even when it puts them in direct opposition to the teachings of Christianity.
> And since the main purpose of religion is dividing people on Us vs Them
Wow, that's so misguided. No, it's not the main purpose of religion.