Particularly the "no increased risk of all-cause mortality". I mean, if we assume the vaccines worked, we'd certainly expect a decreased risk of all-case mortality (because "all-case mortality" certainly includes "covid mortality"). Reading "no increase" seems to imply "it doesn't change anything". Yeah, technically, the sentence does not say that ("no increase" can mean "no decrease" or "no change").
You have to read further below to get what should be the real message on all-cause-mortality: "Vaccinated individuals had [...] a 25% lower risk of all-cause mortality". I think that should've been in the first 1-2 sentences.
Frame it as the safety of the vaccine, not the efficacy of it. If it was about efficacy, it would lead with the 25% lower risk because of COVID safety. But, these days, there are people who think vaccines are dangerous just because, so saying that taking the vaccine or not has equal mortality puts that to rest (or at least does for those who find science real).
A common pattern you'd find in reliable research papers is that authors tend to understate their findings, which in practice strengthens the impact of their conclusions.
The problem is that 25% lower risk of all-cause mortality is too big to be explained solely by the vaccine. The reduction is similar when excluding deaths due to COVID-19, and is probably driven by people who got the vaccine being different in some ways that the observational study isn’t controlling for.
This is a general problem in many technical fields.
People in a technical field, learn to "chunk" complex phrases. Their natural communication style becomes complex. Which makes them hard to understand to those outside of the field. If they want to be understood, the solution isn't to try to educate the world. It is to educate themselves. To learn how to write simply and directly.
Depending on the readability test used, the section up to "Introduction" - which is supposed to be readable - is somewhere between advanced high school and university. See https://www.online-utility.org/english/readability_test_and_... or other free tools to test it. That's bad. The percentage of Americans who can read this text is below the percentage who could read, say, a plain language version written in Spanish. We should expect people to misunderstand. We should not expect this paper to convince.
My take is not quite as charitable as most of the comments, although my objection only barely applies to this particular paper. Biomedical research has long tradition of a very specific type of analysis: hypothesis testing. Roughly speaking, you make a hypothesis and test your data for compatibility with the hypothesis. In this paper, the authors are comparing two hypotheses: (a) there is an increased risk of all-cause mortality or (b) the increase in risk is zero or negative [0]. And the statement you’re quoting from the conclusion section sure sounds like it’s saying that the authors found that the data was consistent with (b) but not with (a).
Researchers love this. There are lots of papers with fancy-named tests with which one can do this analysis. Regulators often demand it.
And it produces papers that are correct in a fairly literal sense but miss the point entirely. For example, “we found no evidence that vaccines increase the risk of autism”. I, too, can look under my bed or study four people and find no evidence of anything at all about vaccines and autism, and I would be more or less justified in making that claim.
And because of this, you need to read papers very carefully to see what you can actually conclude. “No evidence” means a lot more in a large (“high powered”) study than in a small, weak study.
The right way to do this is something like “we looked at such-and-such data and found, with 95% confidence, that the increase in risk of X is <= 0.2%” or even that “the change in risk is <= -25%” (check out that minus sign!). If I look under my bed, I will find evidence that the increased absolute of autism caused by vaccines is <= 100%, and I didn’t need to study anything to confirm that :)
Fortunately, this particular paper has the silly throwaway starting you’re complaining about in a few places but is otherwise mostly on the right track. Quoting from the Results section:
> Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76]), with a similar association observed when excluding severe COVID-19 death. Sensitivity analysis revealed that vaccinated individuals consistently had a lower risk of death, regardless of the cause.
IMO that should have been the headline. The latter sentence there is giving some indication that the result is robust and that the researchers didn’t flub it or get unlucky in quality of their data.
P.S. The fact that the vaccines seemed to reduce the risk is death from causes other than severe covid is interesting. I wonder how much is reducing death from complications of COVID other than “severe covid”, how much is behavioral changes (vaccinated whole socializing more and leaving their houses more), and how much is bizarre off-target effects of the mRNA vaccines. Here’s an example of a surprising off-target benefit that no one understands well:
[0] I think. I didn’t reread it enough times to rule out the other common test: is the data consistent with the hypothesis that the risk didn’t change at all, which is also sadly common. But I’m moderately sure I’m right in the context of this paper.
Personally, I am glad to see it. I definitely got vaccinated as soon as I could, but I was also still nervous as there did seem to be some level of reasonable doubt. I would be happy to see more studies confirm what many consider to be obvious.
Unfortunately, this is an observational study and when you get to the confounding part, they kind of shrug their shoulders and say “well, we included a bunch of covariates that should reduce make the bias go away”, but there’s no causal diagram so we have no idea how they reasoned about this. If you’ve read even something layman friendly like Pearl’s Book of Why you should be feeling nervous about this.
Although from this study the global vaccine output is positive, the personal one seems negative for a lot of people.
Many still got COVID19 and the bleeding issue, but they can't compare to what would have happened without the vaccine.
Notably many for whom the basic understanding of "25% lower risk of all-cause mortality" doesn't mean anything.
- "What is it ? I had 1 chance to 1 million to die but with the vaccine it's 0.75 to 1 million ?"
- "No, out of 22 million vaccinated, 0.4% died but out of 6 million unvaccinated, 0.6% died !"
I think people throw these accusations around way too broadly.
There is a small subset of weirdos who think the Covid/mRNA vaccines contain microchips or were designed kill off some percentage of the population.
But I think there's another, much larger group who might care a lot about their health to the point where they don't even drink from plastic bottles, and who when presented with a novel vaccine which was developed and rolled very quickly were hesitant...
Rightly or wrongly, I think these health-conscious people were concerned during Covid by mainstream media orgs frequently broadcasting what can only be described as pro-vax "propaganda"[1], and in some cases state compelled vaccination.
I'm very pro-vax, but I remember at the time (2021) being a bit torn on what I should do. I was in my twenties and already contracted Covid. Did it really make sense for me to take a vaccine when my risk was so low and there were some reports that young men were suffering from myocarditis post-vaccination?
I guess what I'm saying is that I think most reasonable people who may have initially been nervous about the vaccine can look at data like this and feel much more comfortable with the risk profile today. This is exactly the kind of data a lot of people (including myself) wanted when their governments were trying to force them to take these newly developed vaccines.
In my mind it's those on the extreme pro-vaccine and extreme anti-vaccine side in 2021-2022 that were the ones lacking critical thought. The reality was that as a society given the absence of long-term data like this, we were taking a calculated risk. Because even if mRNA vaccines slightly increased all-cause mortality that wouldn't mean the vaccine rollout was a bad thing... Similarly chemo probably great for you either and I'm sure people who undergo chemo unnecessarily suffer from increased morality risk. But if you have cancer or if you're in the middle of a pandemic risk calculations change a little.
It seems like the antivaxxers, and many people in general, seem to just think that whatever they hear from their friends and family and favorite TV talking heads, whether it has any research behind it or not, is automatically and magically true. So that even if the only real research that exists contradicts it, they just assume that the research must be the result of some kind of error or conspiracy.
I find that incredibly frustrating and dangerous, but as far as I can see, it's the way it is.
"bUT wE StILl DoN't KnoW tHe LOnG TeRM EffECts oF ThE VacCInES."
I swear these folks will be on their death beds 50 years in the future claiming this. There will be no amount of evidence or time that matters to them.
Someone can prove me wrong, and tell me exactly what evidence would convince them that the vaccines are safer than the alternative.
This is the wrong attitude to take to the problem.
While I grant there were many who were disposed to be irrational skeptics, lots of skepticism was generated by dishonest messaging, coercive mandates, and punitive limitations on dissenting speech. Institutions took an end-justifies-the-means strategy, and many smelled a rat.
Even now, online, you see right wing users continuing to lament over vaccine injuries, and on the left, long COVID. Ironically the injuries are often similar. They are, of course, both right.
Worse it will be used to produce even more disinformation. Most of the stuff I've encountered takes studies like this, misrepresents or outright lies about the findings and includes a link (sometimes working) to the paper which nobody consuming the slop will ever check.
“Doesn’t kill you” is the absolute bare minimum and a very low bar. Because the vaccines were so rushed, it’s still reassuring, but not at all a testament to the safety of mRNA vaccines.
The more interesting studies will be about non-lethal adverse reactions. Changes to menstruation, heart problems, lymph node swelling to name just a few.
>Vaccinated individuals were older than unvaccinated individuals (mean [SD] age, 38.0 [11.8] years vs 37.1 [11.4] years), more frequently women (11 688 603 [51.3%] vs 2 876 039 [48.5%]) and had more cardiometabolic comorbidities (2 126 250 [9.3%] vs 464 596 [7.8%]).
This is interesting because of "supposed" cardiovascular effects of the vaccine that many folks were worried about. Even more confounding is the gender differences. You'd think skewing women would skew away from cardiovascular issues.
An alternate interpretation is that the at risk cardio unvaccinated died of COVID for some reason.
The increase in myocarditis from the vaccine is well-documented. (And very small.)
COVID causes myocarditis too (even for young people unlikely to die from COVID itself), at much higher rates. So you only need a 20% chance of contracting COVID for the vaccine to be net positive in the least obviously positive age group.
Your cite reads to me like a statement on the available data, which is interesting in its own ways but can be corrected for when it's irrelevant to the hypothesis.
> Sensitivity analysis revealed that vaccinated individuals consistently had a lower risk of death, regardless of the cause
This sounds like a red flag to me if you're trying to isolate the COVID vaccine as something safe. Table 2 data showed less drownings, less car crashes, less falls, less deaths related to chromosomal abnormalities... How can there not be a confounding variable or two here?
It's obviously almost all confounders, since COVID mortality is low now and choosing to obtain the vaccine correlates strongly with other medical and non-medical factors affecting all-cause mortality. The point is that no adverse effect from the vaccine offsets that confounding beneficial effect. More covariates would shrink the confounding effect, but they did the best they could with their dataset.
That confounding effect turned out to be massive, which is bad news for anyone hoping to tightly bound the vaccine risk. It's good personal news for anyone in the vaccinated group, just more as to their general life choices than as to COVID.
One thing I don’t get: the study excludes the first 6 months after vaccination to avoid immortal-time bias. But if people died right away due to the vaccine (hypothetically), wouldn’t this design exclude those deaths?
>As unvaccinated individuals were alive between their random index date and November 1, 2021, corresponding to a maximum duration of 6 months, starting follow-up from the index date would have introduced immortal time bias. Therefore, we initiated the study of long-term mortality 6 months after the index date, while mortality within 6 months after vaccination was analyzed separately using SCCS models. While the SCCS models are well-suited for short-term vaccine safety studies, they are less appropriate for long-term mortality, particularly due to limited control periods among vaccinated individuals, and age differences within the same individual across risk or control periods, as age is by far a major risk factor for death. For both analyses, we introduced the calendar period as an adjusting factor to account for the infection dynamics, baseline mortality trends, and the varying propension to get vaccinated.
I have to admit I checked the author on this paper. No surprise it is from outside of the US. It's hard to imagine a US institution releasing a scientific study that directly contradicts the administration's viewpoints out of fear of reprisal via loss of funding or even shakedowns.
I just hope this doesn't elicit some unhinged Truth Social post about evil Frenchmen trying to poison our bodies.
It goes the other way too. It's hard to imagine a {EU,German,whatever} institution releasing a scientific study that directly contradicts the administration's viewpoints out of fear of reprisal via loss of funding or even shakedowns.
I've been using this prompt on articles that generate debate. Like microservices, or jwt's. It brings up some interesting points for this article...
Look at this article and point out any wording that seems meant to push a certain viewpoint. Note anything important the author leaves out, downplays, or overstates, including numbers that seem cherry-picked or lack context. Clearly separate basic facts from opinions or emotional language. Explain how people with different viewpoints might read the article differently. Also call out any common persuasion tactics like loaded wording, selective quotes, or appeals to authority.
I'm a bit uneasy about so many people being pro-science and still falling into all the fallacies scientific method tried to address.
Disclaimer: I'm pro vaccine, I do think Covid vaccines saved a lot of lives. I still think the risk is relatively low even after getting an onset of auto-immune disease 3 days after the shot (diagnosis confirmed 2 years after it started after mRNA booster) and sister in law getting another auto-immune months after the vaccine (also confirmed diagnosis by now).
I did read the article and while deaths from Covid were clearly lower in vaccinated group, the sample selection has signs of various problems, starting from representation (why significantly more disadvantaged groups in unvaccinated group), to results like external causes of mortality 25% lower in the vaccinated group. 32% lower deaths from transport crashes - clearly healthy/selection bias.
Such studies bring nothing to pro-science crowd and give anti-vaccine propaganda another advantage.
I don't consider myself an anti-vaxxer. But I do have doubt in vaccines especially mRNA vaccines nowadays, and I wish these studies do more than just this.
I have 4 kids, and 3 of them got vaccinated for the covid (1 is a baby 2 years old) for the very first time with Delta. They struggle for weeks to recover, they get tired, they seem to have heart related symptoms. Eventually, those went away after months. The baby has never had covid (no vaccine). I then have never covid vaccinated them, and they have never been sick with covid even though my wife and I caught covid after our 3rd vaccine shots. We didn't do any isolation, we share things and direct contacts with them. They might have had Covid but very mild, the quick tests never showed positive.
My wife got blood clot issue that I saw blood coming out from her skin.
I struggled many months with the vaccines with weird fatigues (I'm normally very healthy in my late 30s). My gut biome seemed to change and I became quite sensitive to some food (milk proteins mostly, not just lactose intolerance)
My mom who lived in a different country got 3 shots and she struggled with heart condition for more than a year, Drs couldn't find the reason why. It was difficult for her to do anything with strength. She finally recovered after 1+ year.
There're many real and true stories like mine, I really have no idea what these studies saying anymore.
I'm having a hard time following your second paragraph, but I don't see where you're questioning the cause of these issues to be covid itself instead of the vaccines?
That's my biggest problem with the "I now have X problem after the vaccine" crowd; quick to blame the vaccine, but they never question whether it was the virus itself that caused it.
My dad is one of these people and it infuriates me to no end that he defaults to "vaccine bad" and not his irresponsible behavior during the height of the pandemic which caused him to get very sick from the virus itself. Nor the fact that he had a very visible lyme disease rash 20 years ago and refused to get treatment because "MDs bad". He's quick to blame his neurological disease on the covid vaccine though, so frustrating.
It’s sad that these days anytime health studies or recommendations come out I half to make sure it’s not from an official US government source.
But to be honest even before the current shit show I was taking recommendations from foreign health departments when it came to COVID.
I got a booster shot after getting the J and J vaccine before it was officially recommended by the CDC because I saw other countries’ health departments publishing data about it. I can’t remember whether it was Isreal, the UK or the EU.
Findings: In this cohort study including 22.7 million vaccinated individuals and 5.9 million unvaccinated individuals, vaccinated individuals had a 74% lower risk of death from severe COVID-19 and no increased risk of all-cause mortality over a median follow-up of 45 months. Findings In this cohort study including 22.7 million vaccinated individuals and 5.9 million unvaccinated individuals, vaccinated individuals had a 74% lower risk of death from severe COVID-19 and no increased risk of all-cause mortality over a median follow-up of 45 months
They define unvaccinated as anyone in the study who didn't get their first dose by Nov 2021. That feels like a pretty tight window to me. I don't think they checked to see if those "unvaccinated" people got vaccinated during the 4 year followup, especially given the mandates that forced people to get them.
It's the full vaccination rate; as of Dec 1 2021 it was 69.89%. A month later (i.e. those Nov folks are getting their second dose) it's 74%; latest number on the chart is 78.44%.
How would they calculate 4 year all-cause mortality on people who got vaccinated after Nov 2021? In case you haven't looked at a calendar recently, it's December 2025 now.
Am I right in reading "Figure. Estimation of All-Cause Mortality at 4 Years in Vaccinated Compared With Unvaccinated Individuals Using Weighted Cox Models: Main and Stratified Analyses" to show that vaccines were more beneficial to the 18-29 age group than any older group? Isn't that unexpected?
This isn't an RCT and COVID mortality is no longer high, so the effect on all-cause mortality is almost entirely confounders. So that result just means people 18-29 who chose to get the COVID vaccine have other characteristics that result in the much lower mortality from non-COVID causes.
I'm not sure why. The top causes for that age group are usually non-medical, accident, suicide, or homicide. We might speculate those would anticorrelate more strongly with the prudence that leads people to get the vaccine than unavoidable medical causes, but looking at the V, W, X, and Y causes from Table 2 that doesn't seem to be true. I guess it could be true but only for the 18-29 group (and if it's not then what causes are responsible?), since they don't break that down by age.
The "problem" is that vaccine recipients are so much healthier overall than non-recipients that the vaccine would have to be spectacularly unsafe to offset that. So this analysis doesn't actually tell us much, but it's consistent with all other evidence that the vaccine is safe.
Honestly, the thing I find more interesting is the "Social Deprivation Index" where vaccinated individuals were 21% "most social" and 19% "least social" while unvaccinated individuals were 15% "most social" and 27% "least social".
There are obvious negative and positive ways to interpret this but I don't actually know the correct one.
If you're social you're more likely to care about those around you. Vaccines are also important for protecting vulnerable people in the community, so they were doubly motivated that way.
>"Exposure Exposure was defined as receiving a first mRNA dose between May 1 and October 31, 2021. Individuals who were unvaccinated by November 1, 2021, were assigned a random index date based on vaccinated individuals’ vaccination dates."
What?? So any first mRNA dose before May 1st and after Nov 1st 2021 was not considered an adequate exposure? Why are they only defining exposure as the initial dose being administered within a six-month period for a vaccine that was released (A) before that; and (B) still continually offered - though in much lower capacities?
Looking forward to reading your work, please do link it when it's available as there's no point in arguing for or against something that we don't yet have access to.
so anyone who didn't get vaccinated before Nov. 2021 is considered unvaccinated? if they got the same dose the "vaccinated" group got on Dec 1st 2021 they're still... unvaccinated? and this is the control for this study? am i missing something? im sure there are a ton of valuable findings in this study, but that seems like a flaw.
also, this is only tangentially related, but why is everyone so keen to defend big pharma? i thought we were supposed to hate them? they made billions off vaccines.
remember martin shrkeli? he claimed he raised the price of a drug for a rare disease to make it commercially viable and he was crucified for it. less than 5 years later, a virus breaks out of a town with a lab dedicated to experimenting with (i.e. weaponizing) viruses and big pharma decided to convert to altruism when we needed them most? shrkeli's company made $65M in total off that (which a court ruled all of which had to be returned)... thats not even rounding error for pfizer, who sold $35B+ worth of mrna vaccines in 2021 alone.
if the guy who invented Daraprim came out and told us shkreli was a scumbag, we'd have believed him. but the mRNA guy comes out and he gets eviscerated. i get it, it's not 1:1, but still.
i'm not saying its all a hoax or a conspiracy, but "there doesn't need to be a formal conspiracy when interests converge". in the U.S., federal funding was given to anyone "treating" COVID. had COVID and got hit by a bus? that was a COVID death. and a check to the hospital from uncle sam.
i don't think the vaccine killed 17M people, and i think there are definitely grifters on the skeptic side, but that doesn't discount skepticism as a whole. and i dont think this study vindicates anything completely either.
> so anyone who didn't get vaccinated before Nov. 2021 is considered unvaccinated?
The answer is in the first paragraph of the "Design, Study Populations, and Outcomes" section:
Exposure to COVID-19 vaccination was defined as the administration of a first dose of an mRNA vaccine between May 1 and October 31, 2021 (inclusion period), which was the mass vaccination period for adults in France, who primarily received mRNA vaccines. Multiple vaccinations in exposed individuals were not considered. The unvaccinated group was defined as individuals who remained unvaccinated as of November 1, 2021. Individuals vaccinated before May 1, 2021 (12.0%), or who received a first dose of another (ie, non-mRNA–based) COVID-19 vaccine during the inclusion period (1.4%) were excluded.
> why is everyone so keen to defend big pharma? i thought we were supposed to hate them?
Are we? Says who? Certainly there are bad actors who profit off of the misfortune of others. There are also brilliant people who work hard to bring about access to lifesaving treatments. There have certainly been examples of fraud in the past, and there have also been examples of truly amazing public health benefits.
Do I personally think the US health system could be better structured to disincentivize the former and promote the latter? Definitely! Is that evidence of a global conspiracy? Nope.
> had COVID and got hit by a bus? that was a COVID death
is it not possible that the kind of person who would've had negative side effects from an mrna vaccination already died from covid itself prior to wide rollout? presumably anyone who had any sort of minor illness during covid would be predisposed to get the vaccine, whereas anyone both lucky enough to be spared of that and ignorant of the vaccine would have their own illness due to the way this was designed. in addition anyone who for whatever reason didn't want to get the vaccine who didn't at this point would actually be uniquely at risk due to the combination of likelihood of getting covid plus disposition for an anti-health attitude.
I feel like you could have the same conclusion if you had groups that were people who go to the doctor vs people who do not in the same time period
they go into this themselves:
> It seems reasonable to assume that by early November 2021, 3 months after the introduction of the mandatory health pass39 (delivered when fulfilling one of these conditions: a negative COVID-19 test result, proof of COVID-19 vaccination, or a certificate of recovery from a COVID-19 infection) to enter and exit France as well as to access restaurants, theaters, and nonurgent hospital consultations, the majority of unvaccinated individuals were reluctant to get vaccinated.
> A study aimed at characterizing patient hesitancy toward COVID-19 vaccination showed that categorical refusal of vaccination was associated with prior noncompliance with vaccination recommendations, a lower educational level, and a less severe perception of COVID-19.41
in any case i've yet to see a slam dunk study showing any negative effect of vaccination.
These are fair questions. I guess I'd first say that there were studies on reactogenic/immunogenic effects coincident w/ the original rollout. But perhaps more importantly, this study conditions on the time frame, meaning that it applies to all participants, and should thus not affect the risk ratio. I think knowing the current hazard risk ratio is more scientifically/medically valuable than the previous one (even if I'm skeptical that it has changed significantly for reasons other than noise)
This is rather weird. Mortality in immediate connection with the vaccine (index time) would not have been captured here. I would hesitate to draw any conclusion from this paper.
> For all individuals, vaccinated or not, follow-up time zero began 6 months after the index date.
> The main causes of death were cancer (769 and 853 cases per million in vaccinated and unvaccinated individuals, respectively), external causes of mortality (493 and 597 cases per million, including, among others, unintentional injuries, such as transportation crashes, falls, and drownings, as well as suicides or self-inflicted injuries) and diseases of the circulatory system (282 and 367 cases per million) (Table 2). Vaccinated individuals had a lower risk of death compared with unvaccinated individuals regardless of the cause of death.
I don't think mRNA vaccination is likely to cause an increase in all-cause mortality. But this study is clearly comparing two radically different populations, and could not show a mortality increase from mRNA vaccination even if one existed.
I do not see any 'radical difference' in the numbers. Individuals who choose not to get vaccinated are likely to be less informed and more reckless in other aspects of managing their health and their lives in general, so the relatively small difference between the populations is perfectly understandable.
We should not forget, that in most countries people who were unvaccinated came under severe social pressure. They often lost their jobs or got banned from social circles. You were basically rendered an outcast by not being vaccinated. So taking the vaccine did not only affect your immune system, but also gave you a higher social status. And there are plenty of studies that show that a lower social status significantly impacts mortality, with lower status linked to higher death rates. This may explain the lower all cause mortality among vaccinated people.
For vaccines like the measles vaccine where it can entirely stop the spread in a vaccinated population this can be true until enough people think this way that measles starts spreading in your vicinity.
But with Covid-19 vaccination wasn't able to eliminate its spread so it mostly is about protecting yourself rather than protecting others.
NB: most people choosing not to take it in France tend to fall into the medically at risk, stubborn, or, "so far down the rabbit hole that you probably can't trust these people to make sensible life choices" groups.
(This alone being a good reason why this 'control' group had a slightly higher all cause mortality at 6months)
Remember, France was one of the wonderful countries where you couldn't legally shop or work if you were deemed to be 'not at risk' && 'unvaccinated' and achieved a very high rate as a result biasing the control group. (This is a purely statistical statement)
And for reference, I do think the vax is dangerous in terms of massive populations and we don't have mass graves due to mRNA problems (although several large cancer blips). In the same way in countries with low vaccination rates we don't have mass graves at 10% population or higher. Cv19 was always going to kill and an untested treatment is likely to kill those who were at risk.
(I'm willing to bet in the case of cv19 the ones who were hit hardest would have been hit badly by either vector, virus or mRNA. But we'll pretty much never be able to prove or disprove that...)
I'm sure both extremes will jump to the rallying cry of "2 more weeks..." So yes of course I'm wrong, I only worked on analysing early 'data' and pulling apart the models so what do I know.
Some comments were deferred for faster rendering.
hannob|2 months ago
Particularly the "no increased risk of all-cause mortality". I mean, if we assume the vaccines worked, we'd certainly expect a decreased risk of all-case mortality (because "all-case mortality" certainly includes "covid mortality"). Reading "no increase" seems to imply "it doesn't change anything". Yeah, technically, the sentence does not say that ("no increase" can mean "no decrease" or "no change").
You have to read further below to get what should be the real message on all-cause-mortality: "Vaccinated individuals had [...] a 25% lower risk of all-cause mortality". I think that should've been in the first 1-2 sentences.
eddieroger|2 months ago
groestl|2 months ago
simonster|2 months ago
btilly|2 months ago
People in a technical field, learn to "chunk" complex phrases. Their natural communication style becomes complex. Which makes them hard to understand to those outside of the field. If they want to be understood, the solution isn't to try to educate the world. It is to educate themselves. To learn how to write simply and directly.
Depending on the readability test used, the section up to "Introduction" - which is supposed to be readable - is somewhere between advanced high school and university. See https://www.online-utility.org/english/readability_test_and_... or other free tools to test it. That's bad. The percentage of Americans who can read this text is below the percentage who could read, say, a plain language version written in Spanish. We should expect people to misunderstand. We should not expect this paper to convince.
ceejayoz|2 months ago
purpleflame1257|2 months ago
amluto|2 months ago
My take is not quite as charitable as most of the comments, although my objection only barely applies to this particular paper. Biomedical research has long tradition of a very specific type of analysis: hypothesis testing. Roughly speaking, you make a hypothesis and test your data for compatibility with the hypothesis. In this paper, the authors are comparing two hypotheses: (a) there is an increased risk of all-cause mortality or (b) the increase in risk is zero or negative [0]. And the statement you’re quoting from the conclusion section sure sounds like it’s saying that the authors found that the data was consistent with (b) but not with (a).
Researchers love this. There are lots of papers with fancy-named tests with which one can do this analysis. Regulators often demand it.
And it produces papers that are correct in a fairly literal sense but miss the point entirely. For example, “we found no evidence that vaccines increase the risk of autism”. I, too, can look under my bed or study four people and find no evidence of anything at all about vaccines and autism, and I would be more or less justified in making that claim.
And because of this, you need to read papers very carefully to see what you can actually conclude. “No evidence” means a lot more in a large (“high powered”) study than in a small, weak study.
The right way to do this is something like “we looked at such-and-such data and found, with 95% confidence, that the increase in risk of X is <= 0.2%” or even that “the change in risk is <= -25%” (check out that minus sign!). If I look under my bed, I will find evidence that the increased absolute of autism caused by vaccines is <= 100%, and I didn’t need to study anything to confirm that :)
Fortunately, this particular paper has the silly throwaway starting you’re complaining about in a few places but is otherwise mostly on the right track. Quoting from the Results section:
> Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76]), with a similar association observed when excluding severe COVID-19 death. Sensitivity analysis revealed that vaccinated individuals consistently had a lower risk of death, regardless of the cause.
IMO that should have been the headline. The latter sentence there is giving some indication that the result is robust and that the researchers didn’t flub it or get unlucky in quality of their data.
P.S. The fact that the vaccines seemed to reduce the risk is death from causes other than severe covid is interesting. I wonder how much is reducing death from complications of COVID other than “severe covid”, how much is behavioral changes (vaccinated whole socializing more and leaving their houses more), and how much is bizarre off-target effects of the mRNA vaccines. Here’s an example of a surprising off-target benefit that no one understands well:
https://www.science.org/content/blog-post/mrna-vaccines-and-...
[0] I think. I didn’t reread it enough times to rule out the other common test: is the data consistent with the hypothesis that the risk didn’t change at all, which is also sadly common. But I’m moderately sure I’m right in the context of this paper.
exceptthisthing|2 months ago
It assesses persons "who were alive on November 1, 2021"
That tantamount to saying "for people alive January 1st 1950, the Second World War was not a significant cause of mortality"
Can you see how ridiculous that sounds?
drcongo|2 months ago
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dalbaugh|2 months ago
jchw|2 months ago
laichzeit0|2 months ago
jquaint|2 months ago
This is a great book on this topic: https://www.amazon.com/Anti-vaxxers-How-Challenge-Misinforme...
stackedinserter|2 months ago
Edit: OTOH that pill will reduce your chance to suffer even more or even die, which is a good thing ofc
whynotmaybe|2 months ago
Although from this study the global vaccine output is positive, the personal one seems negative for a lot of people. Many still got COVID19 and the bleeding issue, but they can't compare to what would have happened without the vaccine.
Notably many for whom the basic understanding of "25% lower risk of all-cause mortality" doesn't mean anything.
- "What is it ? I had 1 chance to 1 million to die but with the vaccine it's 0.75 to 1 million ?"
- "No, out of 22 million vaccinated, 0.4% died but out of 6 million unvaccinated, 0.6% died !"
add-sub-mul-div|2 months ago
trts|2 months ago
rich_sasha|2 months ago
kypro|2 months ago
There is a small subset of weirdos who think the Covid/mRNA vaccines contain microchips or were designed kill off some percentage of the population.
But I think there's another, much larger group who might care a lot about their health to the point where they don't even drink from plastic bottles, and who when presented with a novel vaccine which was developed and rolled very quickly were hesitant...
Rightly or wrongly, I think these health-conscious people were concerned during Covid by mainstream media orgs frequently broadcasting what can only be described as pro-vax "propaganda"[1], and in some cases state compelled vaccination.
I'm very pro-vax, but I remember at the time (2021) being a bit torn on what I should do. I was in my twenties and already contracted Covid. Did it really make sense for me to take a vaccine when my risk was so low and there were some reports that young men were suffering from myocarditis post-vaccination?
I guess what I'm saying is that I think most reasonable people who may have initially been nervous about the vaccine can look at data like this and feel much more comfortable with the risk profile today. This is exactly the kind of data a lot of people (including myself) wanted when their governments were trying to force them to take these newly developed vaccines.
In my mind it's those on the extreme pro-vaccine and extreme anti-vaccine side in 2021-2022 that were the ones lacking critical thought. The reality was that as a society given the absence of long-term data like this, we were taking a calculated risk. Because even if mRNA vaccines slightly increased all-cause mortality that wouldn't mean the vaccine rollout was a bad thing... Similarly chemo probably great for you either and I'm sure people who undergo chemo unnecessarily suffer from increased morality risk. But if you have cancer or if you're in the middle of a pandemic risk calculations change a little.
[1] https://www.youtube.com/watch?v=Mq76QSlRiPo
garyrob|2 months ago
I find that incredibly frustrating and dangerous, but as far as I can see, it's the way it is.
xracy|2 months ago
I swear these folks will be on their death beds 50 years in the future claiming this. There will be no amount of evidence or time that matters to them.
Someone can prove me wrong, and tell me exactly what evidence would convince them that the vaccines are safer than the alternative.
rkapsoro|2 months ago
While I grant there were many who were disposed to be irrational skeptics, lots of skepticism was generated by dishonest messaging, coercive mandates, and punitive limitations on dissenting speech. Institutions took an end-justifies-the-means strategy, and many smelled a rat.
Even now, online, you see right wing users continuing to lament over vaccine injuries, and on the left, long COVID. Ironically the injuries are often similar. They are, of course, both right.
tjpnz|2 months ago
anthem2025|2 months ago
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drcongo|2 months ago
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exceptthisthing|2 months ago
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ekianjo|2 months ago
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liveoneggs|2 months ago
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spyrja|2 months ago
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on_the_train|2 months ago
bilekas|2 months ago
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andreygrehov|2 months ago
[1] https://www.the-independent.com/news/world/americas/us-polit...
blub|2 months ago
The more interesting studies will be about non-lethal adverse reactions. Changes to menstruation, heart problems, lymph node swelling to name just a few.
sa-code|2 months ago
> study including 22.7 million vaccinated individuals and 5.9 million unvaccinated individuals
These are the important bits for the non medical folks
lentil_soup|2 months ago
"vaccinated individuals had a 74% lower risk of death from severe COVID-19 and no increased risk of all-cause mortality"
gwerbret|2 months ago
Also significantly: "vaccinated individuals consistently had a lower risk of death, regardless of the cause."
blindriver|2 months ago
colingauvin|2 months ago
This is interesting because of "supposed" cardiovascular effects of the vaccine that many folks were worried about. Even more confounding is the gender differences. You'd think skewing women would skew away from cardiovascular issues.
An alternate interpretation is that the at risk cardio unvaccinated died of COVID for some reason.
theptip|2 months ago
COVID causes myocarditis too (even for young people unlikely to die from COVID itself), at much higher rates. So you only need a 20% chance of contracting COVID for the vaccine to be net positive in the least obviously positive age group.
Scaevolus|2 months ago
It's very hard to interpret this data given the massive confounder of "antivaxxers are suspicious of healthcare and take more risks".
athrowaway3z|2 months ago
Your cite reads to me like a statement on the available data, which is interesting in its own ways but can be corrected for when it's irrelevant to the hypothesis.
ucoclddau|2 months ago
This sounds like a red flag to me if you're trying to isolate the COVID vaccine as something safe. Table 2 data showed less drownings, less car crashes, less falls, less deaths related to chromosomal abnormalities... How can there not be a confounding variable or two here?
tripletao|2 months ago
That confounding effect turned out to be massive, which is bad news for anyone hoping to tightly bound the vaccine risk. It's good personal news for anyone in the vaccinated group, just more as to their general life choices than as to COVID.
relaxing|2 months ago
gaborcselle|2 months ago
biophysboy|2 months ago
ceejayoz|2 months ago
Yes. That's what we have plenty of other studies for, including the clinical trials that led to the vaccines being approved in the first place.
jandrese|2 months ago
I just hope this doesn't elicit some unhinged Truth Social post about evil Frenchmen trying to poison our bodies.
Lionga|2 months ago
albeebe1|2 months ago
Look at this article and point out any wording that seems meant to push a certain viewpoint. Note anything important the author leaves out, downplays, or overstates, including numbers that seem cherry-picked or lack context. Clearly separate basic facts from opinions or emotional language. Explain how people with different viewpoints might read the article differently. Also call out any common persuasion tactics like loaded wording, selective quotes, or appeals to authority.
pjc50|2 months ago
You could at least paste the points here.
CrossVR|2 months ago
purpleKiwi|2 months ago
oxag3n|2 months ago
Disclaimer: I'm pro vaccine, I do think Covid vaccines saved a lot of lives. I still think the risk is relatively low even after getting an onset of auto-immune disease 3 days after the shot (diagnosis confirmed 2 years after it started after mRNA booster) and sister in law getting another auto-immune months after the vaccine (also confirmed diagnosis by now).
I did read the article and while deaths from Covid were clearly lower in vaccinated group, the sample selection has signs of various problems, starting from representation (why significantly more disadvantaged groups in unvaccinated group), to results like external causes of mortality 25% lower in the vaccinated group. 32% lower deaths from transport crashes - clearly healthy/selection bias.
Such studies bring nothing to pro-science crowd and give anti-vaccine propaganda another advantage.
unknown|2 months ago
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blackqueeriroh|2 months ago
sdo72|2 months ago
I have 4 kids, and 3 of them got vaccinated for the covid (1 is a baby 2 years old) for the very first time with Delta. They struggle for weeks to recover, they get tired, they seem to have heart related symptoms. Eventually, those went away after months. The baby has never had covid (no vaccine). I then have never covid vaccinated them, and they have never been sick with covid even though my wife and I caught covid after our 3rd vaccine shots. We didn't do any isolation, we share things and direct contacts with them. They might have had Covid but very mild, the quick tests never showed positive.
My wife got blood clot issue that I saw blood coming out from her skin.
I struggled many months with the vaccines with weird fatigues (I'm normally very healthy in my late 30s). My gut biome seemed to change and I became quite sensitive to some food (milk proteins mostly, not just lactose intolerance)
My mom who lived in a different country got 3 shots and she struggled with heart condition for more than a year, Drs couldn't find the reason why. It was difficult for her to do anything with strength. She finally recovered after 1+ year.
There're many real and true stories like mine, I really have no idea what these studies saying anymore.
y-c-o-m-b|2 months ago
That's my biggest problem with the "I now have X problem after the vaccine" crowd; quick to blame the vaccine, but they never question whether it was the virus itself that caused it.
My dad is one of these people and it infuriates me to no end that he defaults to "vaccine bad" and not his irresponsible behavior during the height of the pandemic which caused him to get very sick from the virus itself. Nor the fact that he had a very visible lyme disease rash 20 years ago and refused to get treatment because "MDs bad". He's quick to blame his neurological disease on the covid vaccine though, so frustrating.
jibal|2 months ago
But you write anti-vax comments filled with the usual anti-vax post hoc ergo propter hoc fallacies.
raw_anon_1111|2 months ago
But to be honest even before the current shit show I was taking recommendations from foreign health departments when it came to COVID.
I got a booster shot after getting the J and J vaccine before it was officially recommended by the CDC because I saw other countries’ health departments publishing data about it. I can’t remember whether it was Isreal, the UK or the EU.
xracy|2 months ago
basisword|2 months ago
blindriver|2 months ago
ceejayoz|2 months ago
You can see that in this chart (click the 5Y range): https://ycharts.com/indicators/france_coronavirus_full_vacci...
It's the full vaccination rate; as of Dec 1 2021 it was 69.89%. A month later (i.e. those Nov folks are getting their second dose) it's 74%; latest number on the chart is 78.44%.
triceratops|2 months ago
sixQuarks|2 months ago
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ubercow13|2 months ago
tripletao|2 months ago
I'm not sure why. The top causes for that age group are usually non-medical, accident, suicide, or homicide. We might speculate those would anticorrelate more strongly with the prudence that leads people to get the vaccine than unavoidable medical causes, but looking at the V, W, X, and Y causes from Table 2 that doesn't seem to be true. I guess it could be true but only for the 18-29 group (and if it's not then what causes are responsible?), since they don't break that down by age.
The "problem" is that vaccine recipients are so much healthier overall than non-recipients that the vaccine would have to be spectacularly unsafe to offset that. So this analysis doesn't actually tell us much, but it's consistent with all other evidence that the vaccine is safe.
lesuorac|2 months ago
There are obvious negative and positive ways to interpret this but I don't actually know the correct one.
CrossVR|2 months ago
misiti3780|2 months ago
ceejayoz|2 months ago
HaZeust|2 months ago
What?? So any first mRNA dose before May 1st and after Nov 1st 2021 was not considered an adequate exposure? Why are they only defining exposure as the initial dose being administered within a six-month period for a vaccine that was released (A) before that; and (B) still continually offered - though in much lower capacities?
I'm all pro-vax but what? Lol.
kachapopopow|2 months ago
edit: tl;dr: covid-19 mRNA vaccine was effective and did not contribute to increased deaths.
exceptthisthing|2 months ago
stefantalpalaru|2 months ago
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greaterGoods|2 months ago
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toxicplanes1|2 months ago
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bigrightmiss|2 months ago
also, this is only tangentially related, but why is everyone so keen to defend big pharma? i thought we were supposed to hate them? they made billions off vaccines.
remember martin shrkeli? he claimed he raised the price of a drug for a rare disease to make it commercially viable and he was crucified for it. less than 5 years later, a virus breaks out of a town with a lab dedicated to experimenting with (i.e. weaponizing) viruses and big pharma decided to convert to altruism when we needed them most? shrkeli's company made $65M in total off that (which a court ruled all of which had to be returned)... thats not even rounding error for pfizer, who sold $35B+ worth of mrna vaccines in 2021 alone.
if the guy who invented Daraprim came out and told us shkreli was a scumbag, we'd have believed him. but the mRNA guy comes out and he gets eviscerated. i get it, it's not 1:1, but still.
i'm not saying its all a hoax or a conspiracy, but "there doesn't need to be a formal conspiracy when interests converge". in the U.S., federal funding was given to anyone "treating" COVID. had COVID and got hit by a bus? that was a COVID death. and a check to the hospital from uncle sam.
earlier this year (MIT got duped)[https://www.lesswrong.com/posts/M2GzdAGbxwinERSEt/a-widely-s...] by a second year student when no one critiqued his fraudulent AI research. its a reminder that skepticism is an important part of the feedback loop.
i don't think the vaccine killed 17M people, and i think there are definitely grifters on the skeptic side, but that doesn't discount skepticism as a whole. and i dont think this study vindicates anything completely either.
rcv|2 months ago
The answer is in the first paragraph of the "Design, Study Populations, and Outcomes" section:
Exposure to COVID-19 vaccination was defined as the administration of a first dose of an mRNA vaccine between May 1 and October 31, 2021 (inclusion period), which was the mass vaccination period for adults in France, who primarily received mRNA vaccines. Multiple vaccinations in exposed individuals were not considered. The unvaccinated group was defined as individuals who remained unvaccinated as of November 1, 2021. Individuals vaccinated before May 1, 2021 (12.0%), or who received a first dose of another (ie, non-mRNA–based) COVID-19 vaccine during the inclusion period (1.4%) were excluded.
> why is everyone so keen to defend big pharma? i thought we were supposed to hate them?
Are we? Says who? Certainly there are bad actors who profit off of the misfortune of others. There are also brilliant people who work hard to bring about access to lifesaving treatments. There have certainly been examples of fraud in the past, and there have also been examples of truly amazing public health benefits.
Do I personally think the US health system could be better structured to disincentivize the former and promote the latter? Definitely! Is that evidence of a global conspiracy? Nope.
> had COVID and got hit by a bus? that was a COVID death
There's a good analysis of that here: https://www.astralcodexten.com/p/the-evidence-that-a-million...
TLDR is that all-cause death increased in line with the reported covid deaths which strongly refutes the "had covid got hit with a bus" theory.
websiteapi|2 months ago
I feel like you could have the same conclusion if you had groups that were people who go to the doctor vs people who do not in the same time period
they go into this themselves:
> It seems reasonable to assume that by early November 2021, 3 months after the introduction of the mandatory health pass39 (delivered when fulfilling one of these conditions: a negative COVID-19 test result, proof of COVID-19 vaccination, or a certificate of recovery from a COVID-19 infection) to enter and exit France as well as to access restaurants, theaters, and nonurgent hospital consultations, the majority of unvaccinated individuals were reluctant to get vaccinated.
> A study aimed at characterizing patient hesitancy toward COVID-19 vaccination showed that categorical refusal of vaccination was associated with prior noncompliance with vaccination recommendations, a lower educational level, and a less severe perception of COVID-19.41
in any case i've yet to see a slam dunk study showing any negative effect of vaccination.
biophysboy|2 months ago
zosima|2 months ago
> For all individuals, vaccinated or not, follow-up time zero began 6 months after the index date.
bmau5|2 months ago
emtel|2 months ago
> The main causes of death were cancer (769 and 853 cases per million in vaccinated and unvaccinated individuals, respectively), external causes of mortality (493 and 597 cases per million, including, among others, unintentional injuries, such as transportation crashes, falls, and drownings, as well as suicides or self-inflicted injuries) and diseases of the circulatory system (282 and 367 cases per million) (Table 2). Vaccinated individuals had a lower risk of death compared with unvaccinated individuals regardless of the cause of death.
I don't think mRNA vaccination is likely to cause an increase in all-cause mortality. But this study is clearly comparing two radically different populations, and could not show a mortality increase from mRNA vaccination even if one existed.
deepspace|2 months ago
jansan|2 months ago
biophysboy|2 months ago
jibal|2 months ago
llmslave|2 months ago
arnoooooo|2 months ago
tcoff91|2 months ago
jandrese|2 months ago
Symmetry|2 months ago
But with Covid-19 vaccination wasn't able to eliminate its spread so it mostly is about protecting yourself rather than protecting others.
thrance|2 months ago
codyb|2 months ago
pfdietz|2 months ago
rob_c|2 months ago
Remember, France was one of the wonderful countries where you couldn't legally shop or work if you were deemed to be 'not at risk' && 'unvaccinated' and achieved a very high rate as a result biasing the control group. (This is a purely statistical statement)
And for reference, I do think the vax is dangerous in terms of massive populations and we don't have mass graves due to mRNA problems (although several large cancer blips). In the same way in countries with low vaccination rates we don't have mass graves at 10% population or higher. Cv19 was always going to kill and an untested treatment is likely to kill those who were at risk.
(I'm willing to bet in the case of cv19 the ones who were hit hardest would have been hit badly by either vector, virus or mRNA. But we'll pretty much never be able to prove or disprove that...)
I'm sure both extremes will jump to the rallying cry of "2 more weeks..." So yes of course I'm wrong, I only worked on analysing early 'data' and pulling apart the models so what do I know.
CrossVR|2 months ago
How convenient for you...