The largest side effect of COVID vaccine is to accelerate the COVID-19 pandemic in a short-term (This is not a joke, I am serious)
People all over the world were excited to see the NEJM paper on Israel's mass vaccination result and I was one of them (though I think the BCG Tokyo 172 strain vaccine is safer and more effective).
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Estimated vaccine effectiveness for the study outcomes at days 14 through 20 after the first dose and at 7 or more days after the second dose was as follows: for documented infection, 46% (95% confidence interval [CI], 40 to 51) and 92% (95% CI, 88 to 95); for symptomatic Covid-19, 57% (95% CI, 50 to 63) and 94% (95% CI, 87 to 98); for hospitalization, 74% (95% CI, 56 to 86) and 87% (95% CI, 55 to 100); and for severe disease, 62% (95% CI, 39 to 80) and 92% (95% CI, 75 to 100), respectively. Estimated effectiveness in preventing death from Covid-19 was 72% (95% CI, 19 to 100) for days 14 through 20 after the first dose.
In short, this paper claims the vaccination efficacy would be around 90%. Wow, what a great efficacy! Fast mass vaccination will end the pandemic soon.
Why hadn't we seen a dramatic drop in Israel's country-level data though Israel had been vaccinating its people at a lightning speed?However, I had been wondering why we hadn't seen a dramatic drop in Israel's country-level data though Israel had been vaccinating its people at a lightning speed. The below is a comparison between Israel and Tunisia (no vaccination).
-Israel: more than 80% of elderly are fully vaccinated at the end of Jan— J Sato (@j_sato) March 12, 2021
-Tunisia: no vaccination at all
Where is the vaccination effect? pic.twitter.com/CB0e2c2mo5
I questioned this to the experts but they just said "The NEJM paper is right. Wait for a few more weeks and we'll see a drop." Mmm. This reminds me of the experience with the coronavirus. In Japan, the coronavirus risk is no more than seasonal influenza but we have waited and wasted a whole year.
So, I decided to read the NEJM paper. To be honest, I had not read the NEJM paper as I put more importance on reality than the paper.
With the wisdom of Twitter crowds, two important issues are found. Let me focus on the one issue which is critical and clear.
The NEJM paper arbitrarily excludes 18 deaths data which shows a negative effect of vaccination in the short term, which changes the conclusions significantlyThe paper uses the 1:1 exact matching method which seems to be sophisticated. However, if you look into the detail, you'll find that the paper excludes 18 deaths data which shows a negative vaccine effect arbitrarily.
This critical point is found by @prof_shahar, who is a real expert in this field. We should follow him.
What is the estimated effect on death in Clalit study? (NEJM article)— פרופ' אייל שחר (@prof_shahar) February 26, 2021
Main analysis: Effectiveness 72-84% (41 deaths)
Sensitivity analysis: Effectiveness 44-62% (59 deaths)
Few deaths. Estimated effects only possible for 70+. https://t.co/152loA4x7k pic.twitter.com/xRARnCVdMV
If the 18 deaths data shows a similar trend with the main analysis of 41 deaths, this would not be a big problem, but the reality is that the 18 deaths data shows a negative effect of vaccination; 11 deaths from vaccinated and 7 deaths from unvaccinated. And 18 deaths is 44% of 41 deaths, which would change the conclusion significantly.
I summarized @prof_shahar 's finding/insight on the NEJM paper on Israel mass vaccination, https://t.co/mvFXqmqrIz.— J Sato (@j_sato) March 12, 2021
I think this arbitrary exclusion is critical (intentional?) mistake of the paper, and explains why the reality is so different from the paper. https://t.co/Nk5TdFMlTz pic.twitter.com/7QM3yWTjar
The vaccine efficacy is not around 90% but 50%
The below are the conclusions incorporating the 18 deaths into the analysis.
- The total vaccine efficacy is not around 90% but 50%.
- The vaccine efficacy is smaller for the elderly, probably 30 to 40%. Pfizer and Israel's gov should know the exact figure.
- The largest short-term side effect is to increase COVID-19 mortality risk by 40 to 50% in the two weeks after the 1st dose
The largest short-term side effect: the two-week COVID acceleration by 1st dose
Israel fast mass vaccination may have killed more people with COVID-19 than doing nothingWith this information in mind, let's look at Israel's country-level time-series data.
Israel. No modelling at all on this one. Just hard, cold data straight from the official public source - https://t.co/vyhLgmWHWA. You decide. A new strain twice as deadly for the 80+, 6 times more for the 70-79s, infinitely for the 60-69s? Or something else? pic.twitter.com/p3zjDj6NXt— Joel Smalley (@RealJoelSmalley) February 25, 2021
The FT article below claims that the disparity of 60+ yr cases/hospitalization from 0-59 yr cases/hospitalization trend would be the vaccination effect.
Israel provides first signs of mass vaccination driving down virus cases
I created a chart showing the number of 1st dose vaccination for 60+ yr and 0-59 yr.
Comparing with this chart, I reached the opposite conclusion;
- The relative increase of 60+ yr cases/hospitalization over 0-59 yr cases/hospitalization from late Dec to early Jan is a sign of the two-week COVID acceleration effect by 1st dose of 60+ yr
- The relative increase of 0-59 yr cases/hospitalization over 60+ yr cases/hospitalization from early Jan is a sign of the two-week COVID acceleration effect by 1st dose of 0-59 yr
There are two more countries/regions carrying out fast mass vaccination with Pfizer one; British Gibraltar and Isle of Man
チャートを貼った— J Sato (@j_sato) March 1, 2021
英領マン島でも、新ワクチン（ファイザー）が感染急拡大を着火したと思われる事象が発生— J Sato (@j_sato) March 11, 2021
Two possible causes to skyrocket COVID-19 cases and deaths during the mass vaccination
As Isle of Man had a low prevalence of COVID-19 before vaccination starts, I suspect the Pfizer vaccine can stimulate and cause COVID-19 for those who have SARS-CoV-2 inside their body without any symptoms.
How can Gibraltar and Isle of Man skyrocket COVID-19 cases and deaths during the mass vaccination? I hypothesize the two causes below.
- Stimulating and causing COVID-19 for those who have SARS-CoV-2 inside their body without any symptoms
- Increasing the susceptivity of vaccinated in the two weeks
I don't think only the Pfizer vaccine is causing the two-week COVID acceleration effect by 1st dose. The other vaccines by the other manufactures seem to be causing the same effect looking at UAE, etc.
I really wish everyone look at the real data objectively getting out of the mass hysteria, and make decisions.