5 ms·

I've seen numbers from germany that suggest across all vaccines manufactured the risk is roughly 1/8500 (~0.00011) for severe adverse events, while Ioannidis so

by toolz 6y ago

I've seen numbers from germany that suggest across all vaccines manufactured the risk is roughly 1/8500 (~0.00011) for severe adverse events, while Ioannidis somewhat recently published a systematic review finding the global IFR roughly 0.0014 for covid - so it would seem the vaccine risk is about an order of magnitude lower than covid, but I do think it's a tough and important question to consider because many people are at much higher risk for covid (which mean others are much lower) and there are a great deal of asymptomatic people that may already have better immunity than these vaccines can provide. Unfortunately I'm not expecting much calm rational debate on the nuances of getting the vaccine. This whole pandemic has felt like an emotional rollercoast void of logic. (and please don't take my vaccine numbers as an authoritative risk assessment - there's a lot that goes into assessing such a number and I don't want to sound like I'm confident those numbers are correct)

raphlinus 6y ago
I recommend the Meyerowitz-Katz and Merone survey of IFR [1] over Ioannidis. The tl;dr is an IFR estimate 0.68%. Consensus in the epidemiology community is that Ioannidis has become a politicized hack, consistently pushing lowball estimates. Of course, your argument is still valid even with the lower estimate, I just think it becomes more complicated. Unfortunately, this case is quite a bit more complicated because COVID fatalities are heavily weighted to older ages, while this purported VIPIT is appearing largely in younger, otherwise healthy people. [1]: https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4 https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v... [2]: https://sciencebasedmedicine.org/what-the-heck-happened-to-john-ioannidis/ https://sciencebasedmedicine.org/what-the-heck-happened-to-j...
- Gibbon1 6y ago
  > The tl;dr is an IFR estimate 0.68% What's funny, not amusing is the Chinese said they thought the IFR was about 0.7% back in Feb 2020. Lots of people decided to not believe that for reasons. But here we are. And yet people still refuse. For 'reasons'
- daanlo 6y ago
  Thank you. Very interesting read. I have never understood some of the low IFR estimates. If you look e.g. at numbers for New York State. They have had 50.905 covid related deaths (https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/) and roughly 20.000.000 inhabitants. That sets a pretty clear lower boundary on IFR of 0.0025. And clearly not everyone in New York State has had covid.
  - toolz 6y ago
    picking one of the hardest hit areas in the world doesn't set a lower boundary on IFR.
reader_mode 6y ago
> so it would seem the vaccine risk is about an order of magnitude lower than covid If you get infected, or did you account for the risk of getting covid in the first place ? And with all that COVID has easily identifiable risk factors that impact the probability of severe outcome by order of magnitude, do vaccine side effects have comparable risk predictors ? So, from where I'm standing, if you're young, healthy and able to avoid high risk COVID areas you're much better off skipping vaccination till they figure out the risk factors or vaccinate enough higher risk groups that it's no longer an issue.
brutos 6y ago
I would advice to interpret the IFR reported by the Ioannidis paper with an extreme amount of caution. One of the authors criticized (which is quite an understatement) by Ioannidis went into a detailed rebuttal in [1]. A second thread [2] also gives a very detailed analysis of issues with the paper. [1] https://twitter.com/GidMK/status/1376304539897237508 https://twitter.com/GidMK/status/1376304539897237508 [2] https://twitter.com/AtomsksSanakan/status/1375935382139834373 https://twitter.com/AtomsksSanakan/status/137593538213983437...
- toolz 6y ago
  I'd personally be extremely cautious of a rebuttal in a twitter thread rather than a professional rebuttal which is how these sorts of things should be sorted out in the scientific world. A twitter thread to rebut a peer reviewed paper actually makes me sad that this is where scientists go during a period where we need their input more than any other time. Also, fwiw I followed antibody testing studies for the better part of a year and anything over 0.004 IFR was rare. I was surprised to see it as low as 0.0014 from this review expecting close to 0.002-0.003 but 0.0068 is incredibly high.
  - brutos 6y ago
    That's a valid, but still weird take to me. Academic publishing takes a very long time. Every paper I was involved in took many months from submission to eventual publishing (completely ignoring the time it takes to prepare a submission). Ioannidis published something extremely controversial (if not even flawed) and one of the main authors he attacked responded with a lengthy explanation so that this manuscript would not remain unchallenged. I found that aspect way more important than the venue of response. Would you prefer to leave Ioannidis' work unchallenged for potentially months instead?
    - toolz 6y ago
      I've seen multiple published (not peer reviewed) rebuttals published in academic papers within a week or two during this pandemic. Not everything published needs to be peer reviewed before going before a wider audience - twitter simply isn't the platform for generating useful dialog - maybe for any context, but certainly not in an academic context. edit: do you recall the paper that made waves in the U.S. claiming covid causes heart damage? That paper was published and editted prior to peer review based on criticism multiple times within a week or two IIRC - the appropriate way to handle conflict in science isn't by trying to get twitter to chime in and make things personal. Ioannidis "attacks" were unprofessional - in my mind, though, they were absolutely not on the level of trying to call out an author on twitter.

by toolz 6y ago

raphlinus 6y ago

I recommend the Meyerowitz-Katz and Merone survey of IFR [1] over Ioannidis. The tl;dr is an IFR estimate 0.68%. Consensus in the epidemiology community is that Ioannidis has become a politicized hack, consistently pushing lowball estimates. Of course, your argument is still valid even with the lower estimate, I just think it becomes more complicated. Unfortunately, this case is quite a bit more complicated because COVID fatalities are heavily weighted to older ages, while this purported VIPIT is appearing largely in younger, otherwise healthy people. [1]: https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4 https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v... [2]: https://sciencebasedmedicine.org/what-the-heck-happened-to-john-ioannidis/ https://sciencebasedmedicine.org/what-the-heck-happened-to-j...

Gibbon1 6y ago
> The tl;dr is an IFR estimate 0.68% What's funny, not amusing is the Chinese said they thought the IFR was about 0.7% back in Feb 2020. Lots of people decided to not believe that for reasons. But here we are. And yet people still refuse. For 'reasons'
daanlo 6y ago
Thank you. Very interesting read. I have never understood some of the low IFR estimates. If you look e.g. at numbers for New York State. They have had 50.905 covid related deaths (https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/) and roughly 20.000.000 inhabitants. That sets a pretty clear lower boundary on IFR of 0.0025. And clearly not everyone in New York State has had covid.
- toolz 6y ago
  picking one of the hardest hit areas in the world doesn't set a lower boundary on IFR.

reader_mode 6y ago

> so it would seem the vaccine risk is about an order of magnitude lower than covid If you get infected, or did you account for the risk of getting covid in the first place ? And with all that COVID has easily identifiable risk factors that impact the probability of severe outcome by order of magnitude, do vaccine side effects have comparable risk predictors ? So, from where I'm standing, if you're young, healthy and able to avoid high risk COVID areas you're much better off skipping vaccination till they figure out the risk factors or vaccinate enough higher risk groups that it's no longer an issue.

brutos 6y ago

I would advice to interpret the IFR reported by the Ioannidis paper with an extreme amount of caution. One of the authors criticized (which is quite an understatement) by Ioannidis went into a detailed rebuttal in [1]. A second thread [2] also gives a very detailed analysis of issues with the paper. [1] https://twitter.com/GidMK/status/1376304539897237508 https://twitter.com/GidMK/status/1376304539897237508 [2] https://twitter.com/AtomsksSanakan/status/1375935382139834373 https://twitter.com/AtomsksSanakan/status/137593538213983437...

toolz 6y ago
I'd personally be extremely cautious of a rebuttal in a twitter thread rather than a professional rebuttal which is how these sorts of things should be sorted out in the scientific world. A twitter thread to rebut a peer reviewed paper actually makes me sad that this is where scientists go during a period where we need their input more than any other time. Also, fwiw I followed antibody testing studies for the better part of a year and anything over 0.004 IFR was rare. I was surprised to see it as low as 0.0014 from this review expecting close to 0.002-0.003 but 0.0068 is incredibly high.
- brutos 6y ago
  That's a valid, but still weird take to me. Academic publishing takes a very long time. Every paper I was involved in took many months from submission to eventual publishing (completely ignoring the time it takes to prepare a submission). Ioannidis published something extremely controversial (if not even flawed) and one of the main authors he attacked responded with a lengthy explanation so that this manuscript would not remain unchallenged. I found that aspect way more important than the venue of response. Would you prefer to leave Ioannidis' work unchallenged for potentially months instead?
  - toolz 6y ago
    I've seen multiple published (not peer reviewed) rebuttals published in academic papers within a week or two during this pandemic. Not everything published needs to be peer reviewed before going before a wider audience - twitter simply isn't the platform for generating useful dialog - maybe for any context, but certainly not in an academic context. edit: do you recall the paper that made waves in the U.S. claiming covid causes heart damage? That paper was published and editted prior to peer review based on criticism multiple times within a week or two IIRC - the appropriate way to handle conflict in science isn't by trying to get twitter to chime in and make things personal. Ioannidis "attacks" were unprofessional - in my mind, though, they were absolutely not on the level of trying to call out an author on twitter.