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sradman | 4 years ago

There is not strong evidence supporting a 3rd booster dose in immunocompetent people. We have partly seen a misinterpretation of the Israeli data [1] and specifically the single low effectiveness value that appears to be the result of Simpson's Paradox [2]. Dr. Fauci reported this single value decline from the high nineties to the high seventies on Andy Slavitt's podcast [3]. Pfizer's CEO has promoted this same data, Israel's 3rd dose campaign is well under way, and Fauci's public statements are a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that the Canadian numbers do not yet support a general 3rd dose booster but, like the UK, a longer 2nd dose interval due to a First Doses First (FDF) strategy may be a factor.

The 3rd dose is safe and will probably provide a small benefit to the recipient as Shane Crotty described in TWiV 802 [5]. The downside is that these doses are in short supply globally where they could make a significant difference.

[1] https://www.covid-datascience.com/post/israeli-data-how-can-...

[2] https://en.wikipedia.org/wiki/Simpson%27s_paradox

[3] https://lemonadamedia.com/podcast/dr-fauci-answers-your-bigg...

[4] (YouTube ~3.5min @36m45s) https://youtu.be/93Rnjmr7iCk?t=36m45s

[5] https://www.microbe.tv/twiv/twiv-802/

discuss

order

tguvot|4 years ago

with regards to misinterpretation of israeli data, it's more like miscalculation of israeli data:

1) his calculated efficiency for different age groups is up to 40%+ higher compared to numbers that released by israeli ministry of health in official presentations. when asked about it, he said that he doesn't know how they calculate it and this is his numbers

2) his calculations from the beginning included people that got booster shot. Kinda hard to base statistics about efficiency of two doses when you get inside it data about people who got three

sradman|4 years ago

I think the misinterpretation is mainly by the media and the general public. When most of your population is vaccinated and most of the serious disease is in the unvaccinated, you need to report by rate and vaccination status as the Ontario Science Table [1] now does (rather than absolute case numbers).

Simpson's Paradox is more of a data artifact that you have to be aware of. I didn't know about this statistical anomaly before but the takeaway is that if you see a effectiveness percentage decrease from 97% to 77% then you should also check that the value in each age cohort because each individual cohort may surprisingly be above 90%. The Israeli data might be fine but I want to see the "age corrected" range rather than a single effectiveness number.

The bottom line is that we will get good data moving forward from the Israeli 3rd dose program with other quality data sets soon to follow from the U.S., UK, Canada, Singapore, etc.

What we have not yet seen is any good evidence that the vaccinated are contributing to spread, though in the Fauci interview he indicated that the R(t) in the unvaccinated was non-zero. This is an important question, IMO.

[1] https://covid19-sciencetable.ca/ontario-dashboard/#riskbyvac...

nullc|4 years ago

> a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that

...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

Someone1234|4 years ago

> ...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

What you stated did not occur.

What did happen was that the FDA and CDC got into a procedural slap-fight, and because the CDC gave advice first and the White House signaled public acceptance of that advice before the FDA's panel had a chance to finish two people resigned in protest.

Let's break down why the post above is erroneous:

- "Biden administration seems to have asked" no factual basis.

- "authoring this report" they never authorized a report, that's what they were protesting.

- "report saying that the evidence didn't support the widespread use of boosters" since the FDA's Office of Vaccines Research and Review hasn't published a report you cannot state what is in the report.

What did occur is that the two resigning panelists published a review in The Lancet[0] where they essentially said they felt more data was needed to approve boosters and that the WH approval on the CDC's recommendation was premature (although they also said their view may not match the FDA's view as a whole so YMMV what the final FDA report says).

By the way I actually agree with the two FDA panelists on this one, and think the WH jumped the gun. But regardless of my feelings the "Biden had vaccine experts resign to push through the booster" comment above is problematic.

[0] https://www.nytimes.com/2021/09/13/health/fda-coronavirus-bo...

SamBam|4 years ago

Link?

uselesscynicism|4 years ago

I'm fairly convinced that the pharmaceutical companies want Uncle Sam to buy and mandate 350 million shots per year and that's why the boosters are being pushed and combined with flu shots, while Dear Leader figures out the best way to dictate the health choices of his subjects without so much as first having Congress vote on it.

coolgeek|4 years ago

Is this a parody account? Because you've nailed it