THHuxleynew Verified User
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Posts by THHuxleynew

    This event is peak antivax hysteria and uninformed speculation, which TSN for whatever reason seems to want to publicise.


    Why do we not get a proper discussion of the many different mechanisms to catch vaccine side effects, how they work, what are the current definite safety signals, what are the possible ones not yet firmed up, what are the real death rates. That info is all out there and published by the regulators. That would all be interesting. Instead we get this sensationalist hogwash full of innuendo and (real) FUD.


    And the known blood clot issues - it is good to quantify the evidence that now exists - also good to compare it with the much larger risks from blood clots getting COVID. I would not trust these people to quantify anything - just as well we have regulators from many different countries all on the job of doing this.

    I do not know how under reported, but I do noticed that the his collegues told they didn't know how to do this. Now he and his colleuges are probably young and the senior doctors may know and make sure there are good reporting, still I would do a research project to investigate this. To understand this guy, you need to see more of his post. His not an anti vaccer, but he have discovered a lot of overuse of medicins and also discusses problems in the system we setup to do our medics. One thing that is obvious are that the test procedures medicines can be gamed by the medical companies and they do seam to take advantage of this, another fact and my personal pet argument is the disatstrous oversubscription of opioids in USA, But there are more subtle discoveries that he discusses such as doctors seam to be bad at basic probability theory. Also he is very keen on teaching the scientific method and how to read studies properly.

    Yes, my link about him made that clear. I think he is right that drug companies do game trials as much as they can, but has drug companies are evil as too large a thing in his thought processes. Drug companies do what they can to make money and have power. regulators are there to keep things fair. Maybe the regulators should be more powerful, but it is easy to extrapolate from cases of abuse that the whole system is not fit for purpose.


    The opioids thing is a particularly nasty example of what we had in the UK a lot before NICE. Drug companies would give GPs freebies etc and get them to over-prescribe their drugs, or juts prescribe them when the generic equivalents are 1/10th the cost.


    That is aggressive marketing which you always get, and it must be controlled as it was not in the US which I think is generally worse about these things.


    Actually falsifying test results, or hiding safety issues with a vaccine, is not that likely on a very high profile thing like COVID vaccines - where any bad practice is bound to be found out - and the players doing it are major companies.


    And, let me reiterate, our best unfalsifiable info on vaccine safety comes from the mass self-controlled case studies done using UK hospital records. It cannot pick up minor side effects, but will find anything reported to a GP. At least in the UK GPs were very aware of the myocarditis issue, and the blood clot issue.


    Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study
    Objective To assess the association between covid-19 vaccines and risk of thrombocytopenia and thromboembolic events in England among adults. Design…
    www.bmj.com


    Great study, uniquely well controlled and large, it would be nice to do the same thing (the data is all there) on a wider range of conditions.

    Interesting comment on Goetsche


    Peter Gøtzsche and antivaxers: Should a science advocate ever speak at an antivaccine conference?
    Last week, I discussed what at the time I called the strange saga of Peter Gøtzsche and Physicians for Informed Consent. When my post was published, the…
    sciencebasedmedicine.org


    At the time, I speculated that perhaps PIC had invited Gøtzsche to give a talk on the ethics of vaccine mandates with an appeal that played to his well-known and oft-expressed extreme suspicion of big pharma, which he’s likened on more than one occasion to the mafia. I further speculated that perhaps Gøtzsche didn’t know the true nature of PIC, which was astounding to me, After all, all you have to do is to look at PIC’s Twitter feed, Facebook page, and its list of Directors and Advisors to tell right away that it is an antivaccine group. That implies that Prof. Gøtzsche didn’t bother with anything resembling due diligence before accepting PIC’s invitation to speak. In any event, after the Twitterstorm rubbed his face in the antivaccine nature of PIC and how he would be sharing a stage with Robert F. Kennedy, Jr. and a veritable rogues’ gallery of antivaccine cranks, Prof. Gøtzsche wisely decided to back out.


    Of course, at the time, I had no way of knowing if my speculation was correct or not. Indeed, one particularly annoying woman on Twitter repeatedly took me to task as totally irresponsible for having dared to speculate about what had happened, to which I responded that this is not my first rodeo, so to speak. I’ve seen this sort of thing many times before, in which an antivaccine group tries to entice a real scientist to speak at one of its events under false or misleading pretenses, and therefore knew that this was the most likely explanation for how Prof. Gøtzsche was lured into speaking at the PIC workshop. Because of his well-known anti-pharma opinions, he appears to have been an easy mark for such persuasion.


    It turns out that I was (mostly) correct. We now have an explanation. So why not just tack the now known explanation onto the end of my original post as an update? Simple. The explanation provides a pretext to discuss a rather interesting issue: Is it ever worthwhile for a science advocate to speak to a pseudoscience organization? First, though, let’s examine what we now know.

    More from Stefan's antivax-slanted but partly sensible link


    The idea that herd immunity can only be reached with vaccines is perhaps the most laughable idea to be heavily promulgated during the pandemic, at least to everyone with even a little knowledge of immunology and history. Eighteen months in to the pandemic, most countries are at or on the cusp of herd immunity, regardless of how effective they have been at vaccinating their populations. There is no need to force the remaining 15-30% of the population to take a vaccine they don’t want. The end of the pandemic is in sight.


    I agree, except when that 15% - 30% clog up hospitals and create scare stories about not enough ICU beds, as well as making it impossible for hospitals to do any other work including cancer screening etc.


    That happened in the UK before we were well vaccinated.

    Peter Goetzche argued in his book, “Deadly medicines and organized crime”, that no-one should take a new drug that’s been on the market for less than seven years, in light of the fact that it often takes that long for dangers to become known and dangerous drugs to be pulled off the market. In recent months, we’ve learned that the Astra-Zeneca vaccine can cause deadly blood clots in the brain, and we’ve learned that the Pfizer and Moderna vaccines can cause myocarditis. The authorities say that these events are extremely rare, based on the number of events that are reported to the authorities. But this ignores the fact that most adverse events don’t get reported.

    In recent weeks, I’ve personally seen multiple cases of myocarditis that occurred days after vaccination. When I’ve suggested to colleagues that we should report them to the authorities as possible vaccine side effects, the response I’ve been met with has been roughly this: “oh, yeah, maybe that’s a good idea… I don’t know how to do that”. I’ve reported the cases I’ve handled personally, but my guess, based on this reaction, is that most other cases have not been reported. Obviously, if you believe that what actually gets reported is an accurate estimate of the reality, then you will grossly underestimate the case rate.


    Just a comment. I agree, non-serious side effects will be under-reported by frontline doctors who do not keep up with things - I am sure there are lots of those. However serious side effects (and myocarditis is serious - normally - though not when vaccine induced) will get to hospitals and specialists who know all about VAM. And in the UK, every GP knows about VAM, every patient gets told about it in a leaflet they get when vaccinated.


    So I think it highly unlikely that serious myocarditis cases are under-reported.


    The bottom line is, as from that self-control study that cannot be fudged and compared vaccine AEs with COVID AEs on all 30M UK patients vaccinated in given timeframe where everyone seriously ill end up properly recorded in hospital, we know vaccine-induced myocarditis is a much smaller problem than COVID-induced myocarditis, and we know its magnitude. So if you reckon everyone will get one of the other it is pretty clear what to do.

    Good critical discussion


    A good discssion and a nice post with a good tone. Some things may be wrong such as we now know that India has an enormously underreported deaths statistic so that claiming heard immunity in India was good is cynical in hindsite. What really surprise

    me is that it is probably very common that we underreport issues with drugs. Still we have the medical records so post suggest for a research project that investigate how common myocarditis is by looking at medical records and combine with the vaccine database. All data is still there, Just that we need to dig it up. Kind of understand Wyttenbachs frustration and I start to understand now the logic with the tragic event of Semmelwise. He also mentions that there is a high presure to conform in sience now, would like to understand what the preprint that was rejected actually was, this is an annectote and could or could not be a real concern. Alarm bells and investigation is however prudent. I agree with that putting a unessesary high pressure on covid to mutate is maybe not so good. We hopefully the virus will not evolve to be more nasty but he has a good point that we re plying with fire. Also I am wonderning if he is not underestimating that delta is not the same as the earlier strains and that the statistics is different now with respect to how nasty it is. But still a nice post that will make you think.

    It raises a lot of interesting issues but gets some wrong.


    Sure, much we don't know, but by now much we do.


    Ignoring what it says about what governments say (it depends which country you are in):


    (1) True, deaths at any time depend on infection rates which vary enormously. And people tend only to look at deaths

    (2) False, the vaccine maybe does not do much good against other strains. We have good figures for VE against delta. VE against infections is not great but still a bit worthwhile in terms of reducing infections. Delta is so infectious it will not be stopped by vaccines alone, practically. VE against serious infection and death is excellent against delta and stays very good for at least 6 months, after which a booster shot puts it back to excellent. By excellent I mean 20X less chance of serious disease. We don't know exactly how immunity decays from vaccination over long times.


    Those two facts are enough. It does not matter that you need people to get covid as well to achieve herd immunity. If they are vaccinated first the death toll is 5X - 20X less. Younger people have lower risks anyway, but also have higher relative protection from the vaccine. Which is not the point - absolute reduction in risk is what matters.


    Once everyone who is going to catch COVID has done so, then COVID becomes a less severe disease, especially if we have the right drugs to reduce long COVID etc.


    Vaccines reduce death getting to that nice place, and also delay it, so that more drugs are well understood thus further reducing harm.


    The tone of that link is more "vaccines are a hysterical over-reaction". They do at the margins reduce R which is why governments are keen on them for young people. They also reduce small absolute risks for young people, which is why doctors are keen on them (at least from say 15 up). But mainly they reduce hospital burden and getting very high fraction of vaccinated in older (> 40) age groups is essential for countries wanting hospitals to operate normally and keep their population alive. You still need vaccination below that - for hospitals - because otherwise a very high peak in infections and hospitalisation can still occur, even though the individual risks are small for younger ages. And small does not mean 0.


    THH

    Is covid-disease acquired immunity better?


    From FM1's post above (but still limited data):


    (1) Overall; yes, if you get the disease seriously. No if you get a mild case

    (2) You get IgN + IgS - however IgN wanes over time and for most people disappears after 12 months. Vaccines (at the moment) give you lots of IgS.

    (3) there seems evidence that Covid IgS response wanes slower than vaccine IgS response. But really we do not yet have enough info.

    (4) vaccine + COVID immunity not surprisingly is better than either individually.


    "Natural" infection:


    No pain, no gain.

    Pharma insiders think natural immunity is better, the vaccines are failing, and they are silent about things like myocarditis for money.

    Personally I think it is anti-vaxxers are silent about myocarditis. it is one of the many big risks from COVID disease, nasty because it kills even healthy children.


    And the vaccine surveillance reports mention myocarditis the whole time. As do the very relieved US doctors treating child vaccine induced myocarditis patients and finding it much more benign than disease-induced (typical) myocarditis.


    Navid - i suspect you need to get out more.


    Portsmouth girl, 15, dies of Covid on day she was due jab
    Jorja Halliday, from Portsmouth, was due to have her coronavirus vaccination on the day she died.
    www.bbc.co.uk

    Intersting interview and also: And his blog I find no fact checking against him, so he seems like a good guy. He seam to be honest and a very good source of critical thinking. His not against vaccines but he is critical of aspects how we handle them. Still the only negative posts I find about him is lacking facts so really I can't judge him from the negative side. He is also good at linking to sources. I think my ex wife who is a medical doctor soon, agrees with many of his conclusions. Personally I agree that it is weird that we do not do a cost benefit analysis and that we are risking putting young people under the bus because we have just have a focus on covid deaths e.g. mostly very old people with few years left with mostly low quality of life. On the other hand he seam to have dramatized the swedish later actions a little too much. I did not find the second wave different from the first one, in my sphere there was zero collateral damage from more stricter measures.

    I agree, I've always seen lockdown as a political and (very natural) emotional reaction. But then people are emotional. If no lockdown the flooding of hospitals with too many patients is big news and prevents life as normal anyway, so even if you want to stay normal people's reaction to reported deaths will prevent that.


    Anyway, in the developed world we are now past that. With the vaccines no-one needs to lockdown. We still need to be a bit careful if we are to keep hospitals working properly, and that is all. Rules are adjusting to that new reality.

    I've taken the bet that the vax gives me better odds.

    It is not eitehr / or.


    You can catch COVID after vaccination and it will boost your immunity further, + it will on average be a lot less severe. ADE effects seem second order to non-existant thank God.

    Our Fascist FUD'er

    Just a side comment. it is ironic, and funny, that W should call me a fascist FUDer given my political views (a bit left of centre, strongly against any form of autocracy or strong man government). And as for FUD again I am much less full of doubt than I was at the start, now we know so much more. And also less fearful: the promise of vaccines + drugs is looking pretty good for beating COVID in teh devloped world. In the young developing world, they will I guess catch COVID, but have a 10X demographic advantage over us with an effective IFR of 0.1% not 1%. Tragic if you are old there and die, but on population level it looks like just one other serious cause of mortality. Alongside malnutrition, poor access to clean water, malaria, etc, etc.

    The official figure for prior covid infections is lower than my ballpark at 18% vs my 27% (and therefore even less kind to W).


    However, there are reasons for that which do not invalidate my figure:


    PHE monitors the proportion of the population with antibodies to COVID-19 by testing
    samples provided by healthy adult blood donors aged 17 years and older, supplied by
    the NHS Blood and Transplant (NHS BT collection). This is important in helping to
    understand the extent of spread of COVID-19 infection (including asymptomatic
    infection) in the population and the impact of the vaccine programme. 250 samples from
    every geographic region in England are tested each week using 2 different laboratory
    tests, the Roche nucleoprotein (N) and Roche spike (S) antibody assays. This dual
    testing helps to distinguish between antibodies that are produced following natural
    COVID-19 infection and those that develop after vaccination. Nucleoprotein (Roche N)
    assays only detect post-infection antibodies, whereas spike (Roche S) assays will detect
    both post-infection antibodies and vaccine-induced antibodies. Thus, changes in the
    proportion of samples testing positive on the Roche N assay will reflect the effect of
    natural infection and spread of COVID-19 in the population. Increases in the proportion
    positive as measured by S antibody will reflect both infection and vaccination. Antibody
    responses reflect infection or vaccination occurring at least 2 to 3 weeks previously
    given the time taken to generate an antibody response.
    In this report, we present the results using a 4-weekly average, of testing samples up to
    10 September 2021, which takes account of the age and geographical distribution of the
    English population. Overall, the proportion of the population with antibodies using the
    Roche N and Roche S assays respectively were 18.9% and 97.8% for the period 16
    August to 10 September (weeks 33 to 36) (Figure 3). This compares with 18.5% Roche
    N seropositivity and 97.6% Roche S seropositivity for the period of 19 July to 13 August
    (weeks 28 to 31).
    The continuing increase in seropositivity using the Roche S assay reflects the growing
    proportion of adults who have developed antibodies following vaccination. .
    Figure 4a and 4b show the proportion of the population with antibodies by age group.
    Recent increases in N seropositivity has been observed in some age groups. Roche N
    seropositivity has increased slightly in the 30 to 39 year olds from 20.2% in weeks 29 to
    32 to 21.9% in weeks 33 to 36. Similarly, small increases were observed in individuals
    aged 60 to 69 from 11.4% in weeks 29 to 32 to 13.0% in weeks 33 to 36. Roche N
    seropositivity is plateauing across all other age groups.
    The pattern of increases in Roche S seropositivity which are observed follow the roll out
    of the vaccination programme with the oldest age groups offered vaccine first (Figure
    4b). Roche S seropositivity increased first in donors aged 70 to 84 and has plateaued
    since week 13, reaching 99.3% in weeks 33 to 36.


    We know (FM1's recent post above) that IgN response from covid infection wanes over 12 months so that figure will be less than my 27% figure. In fact the two figures look about right to me. The IgN negative covid infection guys will still have some protection from IgS response (the same as the vaccine, which only delivers IgS). Of course it is all a matter of how large is that response, and it wanes over time from both vaccine and covid infection (faster from vaccine) however it is also pushed much higher initially by vaccine.

    May be once try to use real UK data not a hospital of your choice. I used vaccination report 38.


    The error you do is always the same. You divide vaxx_ICU/totalvaxx what is wrong. 50% of the totalvaxx are not protected by the vaccine. These lucky people are protected by an infection. So this group size must be divided by 2!


    What normal people interests: What do I get from vaccine not from a vaccine + infection....


    You have not yet acknowledged your poor maths here (ignoring base rates).


    I'd like you to do that so others can have more confidence figures you post will not always be wrong. The base rate adjustments here are large factors - in this case 10X or more.


    Now, you are elaborating on these figures, claiming a more complex model. True, there are many other factors that can account for the raw figures apart from VE.


    However your suggestion that 50% of people in the UK have caught Coronavirus is unwarranted, even if all kept immunity. From FM1's link above what we know about natural immunity is:

    (1) even amongst diagnosed cases (not all those asymptomatic silent ones) antibody protection wanes over 8 months and 30% have no IgN response by then. 70% none by 12 months.

    (2) response is higher the more severe the infection: therefore those silent cases will have lower response, and response that lasts less long.


    Nevertheless covid infection derived immunity is a big help. So, how many people actually have it in the Uk?


    If you count silent infections obviously cases don't work. However from the ONS survey we know the ratio now of infections to cases. There are about 60% more infections than actually recorded as cases.


    If we assume that same ratio throughout the pandemic we get a total number of infections as:


    7.8M / 67.2M * 1.6 = 27%


    Those 27% will (obviously) be skewed away from the people who have been vaccinated, since once vaccinated your risk of infection goes down.


    Finally we are double counting. There is a small correction here due to the vaccinated + pre-infected group. There is a correction the other way due to the unvaccinated prior covid infection group.


    If your idea is we should all get COVID without vaccination and then be safe - just say it.


    For most of us, the risk we want to reduce is that you run when you catch COVID for the first time. Anti-vaxxers talk about natural immunity (it sounds wholesome) forgetting to mention that it comes from COVID disease, and to get lots of it you need to have got through severe COVID disease. No pain, no gain.


    In summary -

    • ignoring base rates (which W is still doing) is a 10X or more error.
    • prior infection is a small correction - a lot less than the 50% you suggest, but even that would be only a small correction in comparison with 10X base rate maths error
    • In any case prior infection reduces ICU rates for unvaccinated as well as vaccinated - and reduces those for unvaccinated more than vaccinated both because the reduction in relative risk is larger and because more unvaccinated people will have been infected than vaccinated. So without more careful analysis we cannot even say which way this adjustment will go. I suspect it is actually on the side of increasing, not reducing, the adjusted VE.


    All of these figures have second order effects which are quite difficult to quantify. You cannot simply look at raw figures and whenever you don't like them invoke second order effects without careful analysis showing them likely as large as the main effect. in this case the factor of 10X which W conveniently ignores is much larger than an optimistic factor of 1.5X from second order effects.


    I believe W is capable of doing simple maths and stats, which is why I continue with this. I think he can learn. Although, as with many anti-vaxers, he will just abandon arguments that no longer work and move onto the next bogus argument. I don't bother to correct most of them - I have limited time here. it is soul destroying and repetitive answering the antivax stuff, although as here looking in detail at the numbers always interests me.



    THH

    You live in fantasy land. All country statistics I analyzed show in average a ratio of 1 double vax and 4 unvaxx in ICU. So the real protection is max 4x.



    the protection offered from the vaccine is determined by the relative probability of ending up there if vaccinated versus if not vaccinated. Defined as:


    (vaccinated in ICU / population vaccinated) / (unvaccinated in ICU / population unvaccinated)


    rearranging we get


    (vaccinated in ICU / unvaccinated in ICU) X (unvaccinated population / vaccinated population)


    Wyttenbach 1/4 (4X protection) ----------------------- Base rate ratio (Wyttenbach ignores).


    The Base rate ratio is higher in countries with high vaccination rate. It is weighted by age according to risk, so high vaccination rates for > 60 (for example) => higher base rate ratio.


    In the vaccine terror countries this base rate adjustment is particularly high. In the UK it is around 90% fully vax to 10% not fully vax or a base rate ratio factor of 1/9 - and higher than that when fully risk adjusted - the higher risk age groups are very highly vaccinated. We think. It is probably one of the reasons why Wyttenbach so misestimates vaccine protection in those countries and comes out with those ludicrous statements.


    thus if the UK had this same average 1/4 ratio it would mean a protection of better than 36X.


    Actually I do not have figures for the UK. I have this:


    Almost 90% of patients admitted to Intensive Care Units in north east London are not fully vaccinated - NHS North East London CCG
    Between July and September 2021, 203 patients with Covid-19 were admitted to intensive care units (ICU) across north east London (NEL). Of these, 90% (181)…
    northeastlondonccg.nhs.uk


    90% unvaccinated in ICU. But in the north east london vaccination levels are probably a lot lower. If it were the same as for the UK > 90%, then we have > 80X protection against ICU admission over that period.


    There are a few other issues here, correlation is not causation, but the error got from ignoring base rates is the same. Wyttenbach makes it, and other similar errors, all the time here.


    Similarly the ecological arguments that ivermectin works ignore the context (but that is a whole load of things, not just simple base rates). It is depressing there is so much bad understanding of science and maths at this most basic level.


    THH

    Correlation is not causation. But, particularly here, where infection rate depends on history of past R values.


    For example, a country with no COVID control measures would have a higher faster peak than one that did (where control is vaccine, lockdown, etc).


    Therefore after say 12 months (given just one wave) it would have herd immunity and a much lower rate than a neighbouring country with control methods.


    We then have complications: multiple variants - spread of variants in different countries at different times, effects of vaccination and lockdowns, fact that without very complete vaccination there is not much effect on R, fact that some countries 9or states) have naturally higher spreading rate, and the rate influences the infection level which infuences political response to it, etc.


    The association here is meaningless.


    What is meaningful is that COVID control measure do not get rid of COVID. Lockdowns slow it down but this is only a delaying tactic. Vaccine (unless it gets R < 1, something current vaccines are not likely to do with delta) also only slow it down.


    Of course vaccines have the effect that with a high ifection rate you can still have low hospital demand and deaths, as in the UK, and life as normal.


    You do not need population epidemiology to see this!


    You might think that delaying is pointless but it might prove worthwhile. if a drug comes along that halves death rate, then by delaying an epidemic peak you have saved 50% of your population. And by flattenning peaks you prevent hospitals from overflowing and therefore have enough intensive care beds.


    In the early days of the pandemic delaying was justified by let us wait till we have the vaccine. With a fully 9and recently) vaccinated population you have 20X fewer deaths coming from an epidemic peak and the same amount less of heath resource use. It turns a disaster into a nasty version of winter flu.


    Maybe the US politics does not see things like this - i'm sorry - but as the most prolific vaccine warrior here it is how I (and any aware sane person) would see things.


    One thing though. the UK has a high infection rate (and has been consistently high). It is nowhere near herd immunity from natural infection. It has static 9juts) infection numbers from combo of 20% now natural immunity and 80% vaccine immunity.


    Both these types of immunity wane so in terms of infection rate it is still a delaying action.


    luckily we have advantages in the future:

    • Even though resistance wanes, vaccination, or, better, vaccination + infection, reduces disease severity. (Infection alone does that too, but you need very high rates to gte enough people infected for that to help at population level)
    • New drugs are coming online. If ivermectin works that will e known in a few months. Molnupiravir may make a big difference - it is a well-targeted smart anti-viral. There are many other possibles.
    • We will eventually get better vaccines, though maybe as with Flu need shots every year.


    So a holding action, keeping people alive for now while not needing lockdown, is not a bad idea.


    You can tell from my posts here that while I detest people who are ideological and push anti-vaccine memes for some intellectual reason - not able to see the big picture - i agree that any simple-minded anlysis of the complex interation between epidemic control, epidemics, and population health and freedom will fall down.


    It is just that at the moment vaccines are so obviously the most powerful available measure, I can't understand why anyone would not acknowledge that.


    And although vaccines (like drugs) have risks - COVID vaccines more so than most others - the relative risks of vaccines and COVID a long way way favour vaccines. Unfortunately people don't look at risks mathematically. They vcount memes, and think no smoke without fire, and if aware of risks will tend not to get vaccinated because the vaccine risk is immediate on vaccination, the COVID risk is uncertain and in the future.


    that leads naturally to personal decisions which are strongly against personal interests. It is why i'm sympathetic with governments who (unlike me) simplify things and say the vaccines are safe. That is true - as a simplification. And any more accurate message will misinform people who react to ideas rather than cruching all the numbers and coming to a calm informed decision. There are lots of those reactors around.


    I worry here that some might be reators - in the sense that the weight of scientific sounding posting here is strongly on the antivax side of the argument. No matter that the quality of those posts is rubbish - that fact is not obvious and probably not believed by many here. So then the pro-vax side wins arguments only when i spend a lot of time in detail rebutting, dredging up detailed subgroups stats, a even then because some here will ignore anything contrary to their views you have to dollow logical arguments carefully to see the real pro-vax resolution.


    It is why the internet advice is not to engage with anti-vax memes intellectually and instead engage with the feelings people have that lead them to find such memes attractive. I agree with the psychology there but I like the stats, I am not much interested in PR, so it is not what i do.


    Unfortunately it is what the other side (TSN is pre-eminent in doing this well) does. These are not however two sides arguing equally. For example:


    • ivermectin is clearly not a good bet. That does not mean it has no effect - any drug could have some effect. The evidence so far is not on its side, and there has now been a lot of evidence. I have seen no evidence of suppression - far from it - the political campaign means that many big trials are looking at it - to be fair there are not that many viable repurposed drugs to look at. Many people react to the way moist of the ivermectin hype comes from people with an anti-vax agenda. That is true, but as with all such arguments it should be ignored. What should not be ignored is the overall result of those meta-analyses, and also the level of bias uncovered in the low quality pro-ivermectin trial results.
    • remdesivir is of only marginal use - it seems. I agree that it got regulatory approval relatively easily because it was backed by money, but the evidence for it while not great is a bit better than the evidence for ivermectin (mainly because positive not negative lab results, and less real-world negative evidence). one weird factor allowing it to keep regulatory approval is that people can't black market it - its approval does no harm.
    • molnupiravir is interesting because there is so little real world evidence for or against, and the lab evidence is great. So I am staying very hopeful, but not counting chickens there. I'm not clear about safety profile.
    • the let us have a cocktail that will save us view is one I bought into early in this story. It seems very reasonable. I'd still want to have a good diet, and in terms of immune system the biggest easy intervention is take lots of exercise build up muscle mass (which I would be rubbish at doing). But you can see from here that people view a cocktail of possibly beneficial but most likely of no benefit drugs as providing large levels of protection. That is a misjudgement.
    • And, finally, the vaccine good or bad arguments. it amazes me that they are still being waged when the evidence is so stacked on one side. people maybe want to see how governmnets might have cut corners, be underestimating risks. All possible. But personally, when the risk balance is so strong, it is silly to care about a 10% adjustor. The arguments over personal risks for children are interesting. I thought the US was quick to approve vaccines for them. that is lucky for the rest of the world, we now have so much safety info that judgements can be made. The argument there is mostly about whether vaccines should not go to old people in other countries because they would have a much larger effect there. If you are a 15 year old in Portsmouth dying of COVID who would definitely not die had you been vaccianted earlier that seems a poor argument. But then anecdotes do not make good whole population governance.
    • The vaccine infection data (efficacy against infection). It is sort of irrelevant, given what the current vaccines do and don't achieve. But the mRNA vaccines give you about 50% infection protection some time after second dose. Info from israel shows very strong benefit 2 - 4 weeks out from a booster dose (factor of >10X better protection from infection). How that wanes - we will find out - but that it is so good initially means boosters work. They also provide some 10X better protection against serious illness than vaccine 6 months old, which itself provides some 5X better than no vaccine. So you can see why personally I'm glad (for selfish reasons) we have them in the UK for over-50s.
    • The vaccine safety equation. I find myself scared of needles, etc. But realistically more scared of a COVID infection that does such nasty things to all the organs in your body. The amounts of foreign substance from vaccinations are so minuscule - and much smaller than the amount of nasty foreign RNA you get from a COVID infection. People see natural immunity as somehow less risky because of no artificial stuff. But, in terms of somatic effect, COVID RNA and generated proteins is much more nasty both in terms of quality (more different foreign things) and quantity (millions of times more of it, reproducing, infusing cells throughout the body with powerful immune-twisting chemicals) than the little bits of COVID proteins made by the vaccines. And the mRNA vaccine itself has level 1000s of times lower than the small bit of foreign protein it makes. Vaccines remain dangerous because allergic reactions to foreign stuff is what our bodies sometimes do, even tiny amounts. But allergic reactions get worse with larger quantities, and infections provide that. Which is why that Portsmouth 15-year-old dies of COVID myocarditis.


    That is the trouble. Anecdotes make great anti-vax stories. The W - my uncle caught COVID and was fine story sort of sounds convincing even though a moment's thought will show you that it is expected, and zero evidence. W probably believes it is good evidence - that is the way human brains work.


    THH

    Is COVID-19 associated with risk of thrombotic events?

    Yes. In addition, of course to hospitalization and death risks (which have gone down since the onset of the pandemic), the disease itself could pose more risk for blood clotting-related events than the vaccine, according to one study. But no one can definitively declare the risk profile answer here.

    Just one blatant misinformation from TSN. Do you think the person writing this is not aware of the literature, or deliberately over-egging vaccine risks relative to COVID? I don't know.


    The risk profile from blood clotting events from COVID and from vaccines is well summarised in that self-controlled study of 20 million UK people.


    You can see precisely what are the relative risks (they are much higher for COVID infection than for vaccine). And this type of study, self-controlled, is uniquely free of any possible confounders.


    Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study
    Objective To assess the association between covid-19 vaccines and risk of thrombocytopenia and thromboembolic events in England among adults. Design…
    www.bmj.com


    Objective To assess the association between covid-19 vaccines and risk of thrombocytopenia and thromboembolic events in England among adults.

    Design Self-controlled case series study using national data on covid-19 vaccination and hospital admissions.

    Setting Patient level data were obtained for approximately 30 million people vaccinated in England between 1 December 2020 and 24 April 2021. Electronic health records were linked with death data from the Office for National Statistics, SARS-CoV-2 positive test data, and hospital admission data from the United Kingdom’s health service (NHS).


    Participants 29 121 633 people were vaccinated with first doses (19 608 008 with Oxford-AstraZeneca (ChAdOx1 nCoV-19) and 9 513 625 with Pfizer-BioNTech (BNT162b2 mRNA)) and 1 758 095 people had a positive SARS-CoV-2 test. People aged ≥16 years who had first doses of the ChAdOx1 nCoV-19 or BNT162b2 mRNA vaccines and any outcome of interest were included in the study.

    Main outcome measures The primary outcomes were hospital admission or death associated with thrombocytopenia, venous thromboembolism, and arterial thromboembolism within 28 days of three exposures: first dose of the ChAdOx1 nCoV-19 vaccine; first dose of the BNT162b2 mRNA vaccine; and a SARS-CoV-2 positive test. Secondary outcomes were subsets of the primary outcomes: cerebral venous sinus thrombosis (CVST), ischaemic stroke, myocardial infarction, and other rare arterial thrombotic events.


    Results The study found increased risk of thrombocytopenia after ChAdOx1 nCoV-19 vaccination (incidence rate ratio 1.33, 95% confidence interval 1.19 to 1.47 at 8-14 days) and after a positive SARS-CoV-2 test (5.27, 4.34 to 6.40 at 8-14 days); increased risk of venous thromboembolism after ChAdOx1 nCoV-19 vaccination (1.10, 1.02 to 1.18 at 8-14 days) and after SARS-CoV-2 infection (13.86, 12.76 to 15.05 at 8-14 days); and increased risk of arterial thromboembolism after BNT162b2 mRNA vaccination (1.06, 1.01 to 1.10 at 15-21 days) and after SARS-CoV-2 infection (2.02, 1.82 to 2.24 at 15-21 days). Secondary analyses found increased risk of CVST after ChAdOx1 nCoV-19 vaccination (4.01, 2.08 to 7.71 at 8-14 days), after BNT162b2 mRNA vaccination (3.58, 1.39 to 9.27 at 15-21 days), and after a positive SARS-CoV-2 test; increased risk of ischaemic stroke after BNT162b2 mRNA vaccination (1.12, 1.04 to 1.20 at 15-21 days) and after a positive SARS-CoV-2 test; and increased risk of other rare arterial thrombotic events after ChAdOx1 nCoV-19 vaccination (1.21, 1.02 to 1.43 at 8-14 days) and after a positive SARS-CoV-2 test.

    Conclusion Increased risks of haematological and vascular events that led to hospital admission or death were observed for short time intervals after first doses of the ChAdOx1 nCoV-19 and BNT162b2 mRNA vaccines. The risks of most of these events were substantially higher and more prolonged after SARS-CoV-2 infection than after vaccination in the same population.