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Wednesday, May 26, 2021

Covid Vaccine Safety and Efficacy In Israel

The anti-vax group America's Frontline Doctors are promoting an article by Hervé Seligmann claiming that "the Pfizer vaccines, for the elderly, killed during the 5-week vaccination period about 40 times more people than the disease itself would have killed". The article makes a basic mistake that invalidates its main claim.

First, Seligmann makes an apples-to-oranges mistake by comparing Israeli vaccinations from Dec 19 to Feb 11 with a baseline of "death rates per day for unvaccinated are estimated for the 303 days from March 1 to December 20". (Ignore his mistake of saying "death rates per day", he meant "per-day death rates".) A big problem with that baseline is that the vaccinations were just getting started as Israel suffered a third wave of deaths that dwarfed the deaths from March 1 to Dec 20. That's like saying that aiming firehoses at a burning building must be the reason why more people trapped in the burning skyscraper died after the fire trucks arrived versus before.

The first drop of water from a firehose doesn't immediately extinguish a fire, and it's well-known that it takes several weeks for COVID-19 vaccines to reach full efficacy. During that time, it's expected that just-vaccinated people will be more vulnerable to COVID-19 than when the 2nd dose has been given its two weeks to fully kick in. 

Also, note that the earliest vaccines in Israel were given to the most vulnerable populations -- just as the third wave was heading for its peak. Seligmann's data conveniently ends at Feb 11, just as COVID-19 deaths per million in Israel were about to plummet. Israel reached 50% fully-vaccinated on Mar 16, and the data since Feb 11 indicate the exact opposite of the increased COVID-19 death risk that Seligmann claimed.

Indeed, thanks to Israel's data-intensive healthcare system, we now have detailed data on how COVID-19 differentially impacts unvaccinated people there. Studies published in Nature and the New England Journal of Medicine confirm the success of the Pfizer vaccine in Israel.

P.S. Table 1 in Seligmann's article strangely labels the first column as "community". Maybe this is a language/translation problem, but nowhere does he explicitly say that this column counts COVID-19 cases among people who have received vaccine injections but are not fully vaccinated. So for his denominator, he chose

  • a vaccine-recipient population that is known to be skewed toward the most vulnerable, and
  • systematically excluded its members once their vaccine reached effectiveness, and
  • ended his data window just as Israel's death rate was about to plummet.
The meaning of his "community" column was only clarified after I finally found this detailed debunking of Seligmann written in German. (The Google translation is amazing, and actually reads more like native English than Seligmann's own paper.)
Update 12pm: Who debunks the debunkers? The German article makes a false claim here:

But ratios obviously matter more here than absolute numbers. The death rate among vaccinated COVID-19 victims was 709/54588 = 1.3%, while the rate among unvaccinated during the same period was 1566/368826 = 0.425%. However, note that the Pfizer vaccine efficacy in the 21 days between doses 1 and 2 is 52%. So to make the comparison fair, the denominator for the vaccinated case should include all the cases that the vaccine averted. This doubles the denominator, making the relevant 1-dose COVID-19 death rate be 0.65%.   That's only 50% higher than the unvaccinated COVID-19 death rate. That could potentially be explained by the fact that in Israel the vaccine was targeted early to the most vulnerable populations.
Israel's COVID-19 death graph above, with 2.5 months more data than the table above, shows that vaccines do not lead to more deaths from COVID-19. Some anti-vaxers have made a different claim: that vaccines will cause a spike in non-COVID-19 deaths. However, that claim is so far similarly contradicted by the excess-death data from the three countries that are making the most use of the most efficacious vaccines:

In the U.S., U.K., and Israel as of April 11, 156M distinct people had received a vaccine so far, while the population-weighted excess deaths among them had already become negative (as Israel's population is only 9M). As of yesterday, a total of 207M distinct people in those 3 countries have received a vaccination. When will all those "death jabs" ever cause the de-population that some anti-vaxers say the vaccine is engineered to do?
My prediction: in 2021-2023 there will be hysteresis pressure toward negative excess deaths in the U.S. because many of the pandemic deaths were among Americans likely to die in the coming years. Any spikes in excess deaths will be traceable to new variants that might develop, especially in the virus playground consisting of the world's unvaccinated people. But such spikes should be manageable, as emerging data suggests that the existing vaccines have some efficacy against variants. And since our most effective vaccines are based on the new nimble mRNA technology, it will be straightforward to create booster vaccines for problematic variants.

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