[zosima]

The reduction in all-cause mortality was independent of covid deaths.

Which seems to suggest that there was big differences between the groups other than the vaccination.

This of course does not change that the vaccine seems mostly safe, but it definitely calls in to question whether the protection against covid death was vaccine-mediated or due to some other difference between the groups.

Therefore this paper is moderately strong evidence for the vaccine being safe, but quite weak evidence for the vaccine being efficacious.

[pygy_]

The vaccinnated group was 1 year older on average, and had mode cardiovascular risk factors.

Covid has long term health consequences, and these are proportional to the severity of the acute infection.

People who died of a stroke of a heart infarction 6 months down the line were not counted as "covid death", even though covid is known to increase their incidence in the next year.

[pygy_]

Another factor that may play a role: the people who chose not to take the vaccine may be prone to taking bad decisions more broadly, leading to a higher mortality rate.

[lesuorac]

Covid hospitalizations where half in the vaccinated group (as % of pop) than unvaccinated. That's extremely desirable when you're in a situation where you have do dedicate whole wings (and then some) of hospitals to a singular disease.

Sure, it's not a silver bullet but it's at least stainless steel.

[zosima]

I am speaking about what the paper shows.

There are other sources of evidence for efficacy. This paper is not a very strong source of evidence for efficacy due to some obvious uncontrolled difference between groups.

[stocksinsmocks]

I don’t think it’s possible to know anything conclusive about the safety for a few decades and a generation or two of affected kids can be observed. Given that finding harm would embarrass important aristocrats, I don’t think that evidence would ever be found in the foreseeable future. That mRNA and lipid nano particles were never found to be safe until the exact moment of crisis is awfully convenient for its investors.

I say decades because of the study below. Certainly, the authors could have published it for engagement bait or malice or some reason.

https://www.gavinpublishers.com/article/view/detection-of-pf...

[vineyardmike]

Where do you get decades? That study says 200 days.

[rainsford]

Obviously there are confounding variables besides vaccination status, but I find it pretty compelling that the decrease in COVID mortality among the vaccinated group was significantly larger than the decrease in all-cause mortality of that group. This suggests whatever the difference was between the two groups, besides vaccination, either had a much larger impact on COVID than other causes of death or that the vaccine had some positive impact.

One example of the former explanation I could imagine is that people who got vaccinated against COVID were probably also more likely to take other preventative measures, like wearing a mask or avoiding larger crowds of people. Those precautions would be more likely to be effective against a contagious disease like COVID but less likely to protect them against some other causes of death like heart disease.

I'm not sure how likely I find that as an explanation compared to the alternative that the vaccines provide at least some level of protection. My observation was that widespread measures specifically meant to defend against COVID, like masking and social distancing, largely went away well before the end of the time period covered by this study, at least in the US.

Amusingly, I suspect the anti-vax contingent would likely be bothered by data suggesting anything the COVID vaccinated group was doing differently protected against COVID, since their position seems to largely be that not only is the COVID vaccine useless, but so are any other measures meant to reduce the spread.

[disgruntledphd2]

I think that's mostly fair, but given that we can't randomly assign vaccine administration this sort of study is the best we're gonna get.

Like, the major takeaway is that the vaccine is safe, I think that we've already established that it works to reduce Covid hospitalisations.

[jmull]

> but quite weak evidence for the vaccine being efficacious

That’s directly contradicted by the results of the study. E.g.,

“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])…”

It’s pretty clear a lot of unvaccinated people who died of covid would be alive today had they gotten vaccinated.

(I would point out the current yearly vaccine they are putting out is potentially a different story since covid is changing and so is the vaccine. I’d talk to my dr about whether to get that or not.)

[pama]

The simple explanation is that the causal agent for the excees of the non-covid deaths is the same SARS-CoV2 virus, but death comes later and not at the acute phase of the disease.

[Chris612]

If the vaccine was randomly administered among the study population, I'd buy this as the simple explanation.

Not sure it follows so cleanly with the actual study setup

[underlipton]

There was a study that showed that cancer patients who receive a MRNA COVID vaccine live longer. This could also be for extrinsic reasons, but IIRC the study considered the reason to be a pronounced immune response that also attacked cancer cells.

So there's a chance that the vaccine provokes a general immune response that's protective against a number of mortality-causing issues.

[DebtDeflation]

A 25% reduction is huge, even if you account for the fact that people who get vaccines tend to be more health conscious to begin with, when you consider that outside of the very sick and very old Covid has a mortality rate under 1%.

[soperj]

1 out of 100 when billions are getting it is gonna be a large number. Mortality rate has gone down substantially since the vaccines.

[altcognito]

> Covid has a mortality rate under 1%.

I hate it when blanket statements like this creep in.

Which Covid? The initial version was definitely more deadly than later versions.

What about future covids? Are you willing to guarantee every version of covid from here on out will be less deadly? It is the general case to be true, but it is not some sort of law.