Wednesday, 30 June 2021

Analysis of COVID-19 vaccine death reports from the Vaccine Adverse Events Reporting System (VAERS) Database

 

 

There have been multiple conflicting claims made about the safety of the COVID-19 vaccines that were rolled out world-wide from Dec 2020. However, there is no universally agreed system for reporting either deaths or serious side-effects for which these vaccines may have been the cause or a contributory factor, and hence, as a result, there are concerns about variability in the quality of reports and the credibility of the sources submitting them. Reports can be submitted by physicians involved in administering the vaccine or helping treat side effects that may have consequentially arisen, clinical and non-clinical health service employees, or pharmaceutical professionals involved in the investigation. Likewise, lay people, such as the patient or their family and friends, may have submitted a report independently of medical carers. It has been suggested that a third category of submission may have been made by members of anti-vaccine, or other groups, motivated by ill-intent, who may exaggerate case numbers reported. Critics of safety reporting cite the fact that lay people, or those with malign intent, may form the bulk of reports and hence statistics on side effects must therefore be exaggerated because they come from non-credible sources. Set against this, research suggests that as few as 1% of the true adverse reactions ever get formally recorded.

In early April 2021 Scott McLachlan and colleagues downloaded the 2021 Vaccine Adverse Events Reporting System (VAERS) dataset (this is the US dataset) with the aim of analysing these reports to determine the range and frequency of health problems potentially caused by the vaccines as well as the quality of the reports and, by inference, the credibility of the reporters lodging them. 

For each patient cited in a report, a clinically trained reviewer manually examined the report to determine its source and clinical credibility and to identify and record medical history, current illness, and symptoms. Each was then checked by a second reviewer. This process is ongoing, as there are 1644 deaths in the April VAERS deaths dataset that have been reported in patients who had recently received their first or second COVID-19 vaccination, and over 28,000 serious adverse events that did not result in death. 

McLachlan and colleagues have today published an interim report that presents the results of their analysis of the first 250 reported deaths that have been reviewed and coded by the team

They identified health service employees as the reporter in at least 67% of the reports, while pharmaceutical employees were identified as the reporter in a further 5%. Lay people were identifiable as the reporter in only 28% of the reports. This suggests an intention for clinical applicability and usefulness and goes some way towards addressing the common disclaimer that many VAERS reports are made by aggrieved family members and anti-vaxxers, both with an axe to grind. 

With regard to analysing the likely role of the vaccine in the reported deaths, the sample is heavily biased because these were all people vaccinated very early in the programme when only the elderly, those with significant or chronic health conditions and frontline health service staff were being vaccinated. The analysis shows that the patients can be grouped into three main types: 

  1. those where the vaccine was most likely not a factor; 
  2. those where the vaccine may have been a factor; and 
  3. those where the vaccine was the most likely factor in their deaths. 

Despite the sample bias, they found that in 34 of the 250 deaths (14%) a vaccine reaction could be ruled out as a contributing factor in their death; these were all patients either already bedridden and expected to die from a serious medical condition like lung cancer, or were described as at end of life or receiving palliative hospice care. For 203 of the 250 (81%) the vaccine may have been a factor in their death; however, many of these patients had one or more chronic or age-related comorbid conditions. Finally, for at least 13 of the 250 deaths (5%) the vaccine was the most likely cause of death; these patients had strong reactions soon after vaccination and died either on the same day, or during the next couple of days.

The full report:

McLachlan,  S,  Osman, M,  Dube, K, Chiketero, P, Choi, Y, and Fenton N (2021) "Analysis of COVID-19 vaccine death reports from the Vaccine Adverse Events Reporting System (VAERS) Database",  http://dx.doi.org/10.13140/RG.2.2.26987.26402 

See also: 

The problem with ALL studies so far into the risks and/or benefits of Covid-19 vaccines

Saturday, 26 June 2021

Simpson's paradox in the interepretation of Covid fatality rates for vaccine effectiveness

Some people are looking at today's Public Health England report and concluding the Case Fatality Rate for Delta positive cases is much higher for vaccinated compared to unvaccinated. But this is an instance of Simpson's paradox as shown by this table:
 
 
 
In both age categories the rate among vaccinated is lower; but, when the numbers are aggregated the fatality rate for the vaccinated is much higher. And it is simply because a much greater proportion in the older age group (in which most deaths occur) are vaccinated compared to the younger age group.
 
 
However, it is worth noting, the following:
  • in the <50 age group there is little difference in fatality rate between the vaccinated and unvaccinated
  • the data that is completely missing is that relating to deaths (or serious adverse reactions) of vaccinated v unvaccinated people who were NOT classified as having the Covid. So there is no information on vaccine risks contained in this data.
In fact we have general concerns about the usefulness and validity of all the studies and data published so far into the effectivness and risks/benefits of Covid-19 vaccines. These concerns are discussed here: probabilityandlaw.blogspot.com/2021/06/why-al

So the above should certainly not be considered an argument in favour of the vaccine - n fact, we will shortly be producing a report about deaths and adverse reactions from the vaccine. However, it is important to call out misrepresentation of data on ‘both sides’ of the argument.




Friday, 25 June 2021

The problem with ALL studies so far into the risks and/or benefits of Covid-19 vaccines

 Vaccination, Doctor, Syringe, Medical, Health, Needle

Here are some indisputable facts about the challenge of assessing the ‘efficacy’ – in particular, benefits and risks, of Covid-19 vaccines: 

  • Without an independent clinical assessment or post-mortem we can never be sure that the vaccine was the main or even a contributory factor if a person suffers an ‘adverse reaction’ or death after receiving the vaccine. 
  • All measures of ‘effectiveness’ used so far rely on comparing numbers of ‘Covid-19 cases’ of vaccinated v unvaccinated people where a ‘case’ is defined by a positive PCR test. But PCR tests are unreliable and so we can never be sure if a person does or does not contract Covid-19. Moreover, there is no uniformity in testing strategies between unvaccinated and vaccinated people. 
  • Even if we could accurately measure the true number of Covid-19 ‘cases’ over time, we can never be sure of the main cause of any change in numbers (vaccines, lockdowns, heard immunity, seasonality, etc).
  • The notion of whether or not there are ‘excess deaths’ (or excess illnesses) depends on multiple subjective criteria about previous years’ of data which may be incomplete. Moreover as with trends in case numbers, we can never be sure of the main cause of ‘excess deaths’.

It follows that any study that claims to demonstrate benefits and/or risks of Covid-19 vaccines which assumes to know some or all of the following in its data is potentially flawed: 

  • a death/illness was or was not caused by the vaccine 
  • the difference in Covid-19 incidence for vaccinated v unvaccinated by using PCR testing
  • decreasing or increasing ‘cases’ was or was not caused by the vaccine 
  • there is a known number of ‘average’ deaths that should be ‘expected’

Until we have longer term data (especially on deaths for both vaccinated and unvaccinated) these problems can only be avoided by more independent clinical assessment, and a much more rigorous vaccine reaction yellow card reporting system. If Covid-19 'cases' really need to be considered to evaluate effectiveness then only those where there is a clinical diagnosis with illness and symptoms should be counted.  If Covid-19 is as dangerous as is generally assumed, then, in the longer term, the only criterion we need to determine if vaccines work and are safe is if the proportion of deaths and serious illnesses among the vaccinated is lower than that among the unvaccinated. 

For the longer term analysis we can completely ignore: a) whether or not a death/illness is due to Covid-19; b) the notion of what is/not a Covid ‘case’; c) any previous years’ data. We just need to know the following national (or large area) data for a few fixed time periods (initially we could even ignore the serious illness data):

 


Vaccinated

 

Unvaccinated

Age

Total

Deaths

Serious Illness

 

Total

Deaths

Serious Illness

<18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

>85

 

 

 

 

 

 

 

If the (proportional) number of deaths/illnesses overall are less in a vaccinated age group than the corresponding unvaccinated age group, then the vaccine is saving more lives than it is killing. It’s as simple as that. No more and no less. 

A full cost-benefit analysis should also add the cost of the vaccination programme (e.g. by using standard formulas that equate amounts of spending on healthcare with number of lives saved). 

See also: Is the Pfizer vaccine as effective as claimed?

Thursday, 17 June 2021

NFL Covid-19 protocols: a glimpse into the future restrictions for all unvaccinated - and a problem for studies into vaccine effectiveness


These are the new Covid-19 protocols for NFL players. Eventually these kinds of differences will apply everywhere. 

Apart from the civil liberties issues, the fact that only unvaccinated will be routinely tested also means that data on vaccine effectiveness will be massively biased because the vast bulk of people being tested will be asymptomatic unvaccinated people. When real infection rates are low (as they are now) this bias will exaggerate vaccine effectiveness because almost all new 'cases' will be asymptomatics (i.e. unvaccinated) - most of which will be false positives.  Yet, if infection rates are high the bias could underestimate vaccine effectiveness as the proportion of symptomatics among those tested will be higher for the vaccinated. 

We raised this issue of how different testing strategies for unvaccinated compared to vaccinated compromised the big Pfizer study in Israel .......... and are still waiting for a response from The Lancet 

Links