Monday, September 06, 2021

Speaking Of Science And The Necessity Of Large Randomized Sample Data

The CDC stopped tracking breakthrough infections that didn’t cause hospitalization or death after April 30, then pointed to low figures for earlier pre-Delta breakthrough cases to justify their position that these were so rare and mild they needn’t be tracked. 

They made that decision before they knew if those vaccinated could transmit the virus, suggesting this was unlikely. It wasn’t. Weeks later, they knew and announced the Delta variant was proliferating, yet did not change their guidance on breakthroughs.

In July strong evidence accumulated that breakthrough cases were easily spread, found in clusters, and growing in number, as in Provincetown. Unlike the US, Israel studied waning immunity early and began widely administering 3rd doses. 

The CDC said there wasn’t yet evidence to support 3rd jabs (evidence they’d declined to collect), then abruptly changed guidance for the immune-compromised—before submitting the evidence they’d said they were waiting for. 

Meanwhile, data from states tracking breakthroughs told a different story: cases were rising, occurred in clusters, most were symptomatic, and for the most vulnerable, could require hospitalization and cause death.

Looking at the following site I calculate about 4% of breakthrough infections go into the hospital compared to 5% of unvaccinated infections...lower but not by all that much.

Why don't we have this data for other states? Going further, why do we lack so much data on breakthrough cases?

What percentage of breakthrough infections are going into the hospital and how does that compare to infections among un vaccinated people?  

How do we know that the issue we are seeing with breakthrough infections is not waning immunity but the Delta variant getting by the vaccine?

Where is data on reinfection rates with Delta? Are those who had COVID already better protected? If breakthrough infections are milder (not convinced based on the Wisconsin data), do they convey better protection than a booster?

We will never know what percentage of breakthrough infections are going into the hospital, because the public health officials, including the CDC, are only tracking breakthrough infections that result in hospitalization or death.

While I'm not an epidemiologist, I would *really* prefer that the public health officials track *all* breakthrough infections. And, that they track *all* cases among unvaccinated individuals.

How else will they, or we, know which vaccines are most efficacious, and for how long? Are we just to wait for data from much smaller countries like Israel?

Israel did not have randomized studies of the third dose.  They did not wait for Pfizer studies. Pfizer just submitted its randomized study data, which should trump observational data from Israel.  It is important to know which groups actually obtain benefit from the neo-vaccinoid booster. 

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