If there was ever any doubt that there is no termination condition for the vaccine program, then the recommendation to approve it for children as young as five has resolved that error in logic. In truth, everyone knew it would be approved regardless of the results of Pfizer’s well-manipulated study. The basis for the recommendation only proves what we already knew: most people are scientifically illiterate.
We have all encountered person x that mentions a study proved y; as if a single study proves anything. The truth is there are few studies performed without errors. Frankly, it is difficult and sometimes impossible to eliminate bias. Good papers attempt to take a full accounting of what may be wrong with their work and suggest how it could be improved or expanded in the future. This type of paper is skeptical of itself even when the conclusions seem robust. Bad papers purposefully inject bias into the way data is collected and find results that match their preordained conclusions. This type of paper is absolute in their conclusions even when they seem shoddy. Person x does not care whether a paper is good or bad, rather, they select for the conclusion that aligns with their prejudice.
Toby Roger’s excellent analysis of the most recent Pfizer study points out some of the points which should have invalidated the results if we truly were following the science, yet the previous studies had many of the same red flags and they were still pushed through. The only question that remains is why even bother to do a study at all? It seems like an unnecessary transaction cost from a Coasean perspective since there is absolutely nothing that would have changed the FDA recommendations. Other countries will soon receive the same recommendations from regulators. Canadian health authorities have already mapped out how the vaccine will be distributed when it is inevitably approved.
In any case, it is clear that the regulators are either not doing benefit cost analysis, or, when they do as in the case of the Scandinavian limitations to Moderna’s vaccine, these analysis are only taking into account a single variable: age. Furthermore, the benefits are generally overstated and the costs understated. Does anyone truly believe that the waning effect of vaccinations or the use of boosters were considered when these vaccines were originally approved? Does anyone think they are considering these factors now? They are extremely important because a vaccine that lasts for a lifetime has significantly different benefits than one that lasts for 6 months.
Anyone choosing to get the vaccine, then, should be doing their own benefit cost analysis because the regulators, and more importantly family doctors, have ceded their role in doing so. Unfortunately, there are limitations to this as so many deaths with the virus have been treated as deaths from the virus, so any benefits will likely be overstated. Likewise, adverse events are poorly understood, especially long-term adverse events, so costs will likely be understated. Even so, we can get a rudimentary idea of whether it makes sense to get vaccinated by considering what we know.
We must remember that the vaccine is time-variant and a full accounting of this fact has never been performed. The reason that the first 14 to 21 days of the vaccine do not count is because people actually get the virus at a faster rate during this period, but one should not be deceived and think that it is effective after this period. In fact, in order to overcome the initial immune system suppression, one has to look at both the point where the vaccinated and those without the vaccine are equally likely to get the virus. Then, one has to account for the increased likelihood to get the virus by the vaccinated individuals prior to that point and discount it into the future. Let me explain.
Consider the simple case where a vaccinated person is equally likely to get the virus as an someone without the vaccine. Let’s say that point occurs 16 days after receiving the vaccine. In the first 15 days, the vaccinated person was 5% more likely to get the virus in any given day. Afterwards, the vaccinated person is 5% less likely to get the virus than the person without the vaccine (5% used for example purposes only). Thus, the breakeven point is not after 16 days, but after 31 days. By then, the second vaccine will have been given, which means in this case there may be no benefits at all to the first dose with only potentially negative adverse events.
The second dose will follow the same trend where the vaccinated individual has less immunity than if they had just stuck with the first dose, but it will eventually offer better protection. Let’s say the breakeven point is 20 days after the second dose. For the next 5 months, the vaccine will offer this level of protection but it will slowly degrade to near zero by the 6th month. In sum, 7 months after receiving the first vaccine, a booster will be required. The process repeats ad infinitum.
Interestingly, the chance of acquiring natural immunity from the virus continues to increase as there is little evidence that natural immunity degrades. Thus, over time, thr benefits of receiving doses or boosters should continue to drop. If you have natural immunity before taking the vaccine, only the risks of adverse events from the vaccine remain.
Let’s ignore boosters for simplicity. The benefit from the vaccine then becomes the total relative risk reduction from the entire period. Not from three months out as the Pfizer trials want people to believe. Because the relative risk reduction degrades over time and the first dose may only be given at the breakeven point (and thus, offers no benefits at all), this might work out to a true relative risk reduction of 50% (as an example) for a six month period.
But relative risk reduction is not absolute risk reduction. That is to say, the chance of getting the virus over a 6 month period may be vanishingly small depending on natural immunity in the population, time of year, et cetera. What if, say, in a population of 200,000 people (100,000 vaccinated; 100,000 without the vaccine), 1000 people without the vaccine get the virus. A 50% relative risk reduction means only 500 vaccinated individuals will get the virus. Yet, that is only an absolute risk reduction of 0.5%. In other words, the vaccinated individual is risking adverse events for a 0.5% less chance to get the virus.
The chance of having a serious outcome from getting the virus will be even lower. If there is a 5% chance of having a serious outcome from the virus (this is an exaggeration), then only 25 serious outcomes will be prevented, maybe only a few deaths. Depending on the age range of this population, these numbers may be lower or higher. For example, if the population is high school or college students, there is not likely to be any difference in deaths and little difference in serious outcomes. Furthermore, virus risk can be mitigated by our actions, like hand washing and avoiding sick people. The risk from adverse events cannot be mitigated. While some of those receiving the vaccine may be more predisposed to having an adverse event, it is impossible to tell beforehand who will have one.
Again, assuming high school or college students, the risk of myocarditis may be 1 in 5000 (or higher). Thus, in order to save no deaths and few serious outcomes, the vaccinated population will have 40 more cases (20 per dose) of myocarditis. If you add in a rate of approximately 25 in 100,000 having anaphylaxis, the chance of stroke, blood clots, GBS, and all the other adverse events, and there is no way it makes sense for this population to get the vaccine. That is without even acknowledging long term adverse events.
You can extrapolate this little example out to other age groups, levels of underlying conditions, chances of catching the virus, and so on and so forth. Even to yourself.
Now, you may say that the chance of getting the virus is much higher. But how much? And if so, how much of the population already acquired natural immunity? Because remember, those people that have should never get the vaccine. People from New Zealand, for example, which seen little spread of the virus, have essentially taken on all of the costs without any benefits because there is no virus risk. They will continue to add to the costs of getting the vaccine in anticipation that one day they will have a virus risk.
Maybe that makes sense in the short term, but at what point are the costs too much? The costs from the vaccine will continue to accumulate and, as a larger proportion of the population acquires natural immunity, the benefits will continue to fall even if you think the benefits outweigh the costs right now. Eventually, natural immunity is the only way to stop accumulating vaccine costs. There is no end in sight unless some magic pill comes along that is just as effective.