7 ms·

"The Phase 3 clinical trial of BNT162b2 began on July 27 and has enrolled 43,661 participants to date, 41,135 of whom have received a second dose of the vaccine

"The Phase 3 clinical trial of BNT162b2 began on July 27 and has enrolled 43,661 participants to date, 41,135 of whom have received a second dose of the vaccine candidate as of November 13, 2020." Wow so there was an ivermectin study with 44k people? Where is it? I agree that it should be able to be studied and probably used. But what's going on is that people are looking for an ALTERNATIVE to the vaccine... which is detrimental when the vaccine is proven to be our best tactic against death/serious illness.

bluGill 5y ago
> Wow so there was an ivermectin study with 44k people? Where is it? There wasn't. Once you eliminate the studies that made up their data it is clear ivermectin doesn't work in the few studies that are left so nobody would bother doing a big study.
__blockcipher__ 5y ago
Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v... > During the blinded, controlled period, 15 BNT162b2 and 14 placebo recipients died; during the open-label period, 3 BNT162b2 and 2 original placebo recipients who received BNT162b2 after unblinding died. None of these deaths were considered related to BNT162b2 by investigators. There was actually one more death in the experimental group, albeit that's not significantly significant. So some combination of the following must be true: (1) The vaccination is effective at reducing COVID mortality, but COVID mortality for people in the trial was such a joke that eliminating 95% of COVID mortality doesn't actually change one's risk of dying in a non-negligible manner (2) The vaccination is effective at reducing COVID mortality, which does spare lives, but it ends up killing just as many from adverse events / side effects (3) The vaccine isn't effective and they doctored the numbers. My money is mostly on (1) with a sprinkling of (2), personally. --- And since people like to be binary thinkers, this is where I mention that I'm not an Ivermectin shill and as a medical nihilist I'm strongly skeptical of treatments in general. And while I haven't looked at the IVM data very much at all, what I have seen is incredibly weak evidence at best, as well as a bunch of really crappy associative arguments from the IVM crowd ("Africa uses IVM and Africa has less COVID mortality than the US!" as if that proves anything) To quote (slightly paraphrased) the great Jacob Stegenga: > If we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, then our confidence in medical interventions ought to be low.
- phonypc 5y ago
  >Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: Is the implication that we should have expected it to? The study endpoints are clearly "vaccine efficacy (VE) against laboratory-confirmed COVID-19 and safety data".
  - __blockcipher__ 5y ago
    I think most people would have expected it to. Whether that's a reasonable expectation or not is up for debate. But yeah, many if not most people in the US were convinced that COVID was a threat so severe that it warranted completely uprooting life as we knew it. A sizeable minority of people are convinced that COVID vaccination is so important that people should be coerced into it by almost any means necessary. So I think understanding that we don't have a single randomized controlled trial that actually shows a reduction in all-cause mortality when given this intervention is pretty important. It's a general principle of medicine (or at least, it used to be) that the important outcomes are the actually clinically relevant outcomes. Did people die less? Did they achieve a better quality of life? When you get into proxy metrics you get to this weird place where you can show that something is insanely effective for proxy metric X, and yet it makes no difference (or is even deleterious) in thing-you-actually-care-about Y.
    - phonypc 5y ago
      This study not finding an effect it wasn't designed to isn't incompatible with the more hyperbolic interpretations of the threat of COVID / the importance of vaccination. Did we need RCTs demonstrating a reduction in all-cause mortality for polio or measles vaccines before it became blindingly obvious that they were a good idea?
- j-wags 5y ago
  I initially skipped over this post because it appeared to be written in bad faith [1]. But I gave it another shot and read the linked paper, and I agree with the summary. Thanks for pointing this out -- your post has changed my understanding of the vaccine's effectiveness. For skeptical readers - The linked paper is a medrxiv preprint, with authors from several locations. Many of the authors list affiliations with Pfizer, and the last author is an MD at Pfizer. This seems to be a required report from the ~6-month point of a clinical trial. There really are 14 and 15 all-cause deaths reported in the placebo and treatment groups, respectively. The causes of death for each group are in table S4 [2]. The incidence of COVID in the treatment group is much lower than in the placebo group. I'm surprised by these results because I would have expected to see significantly lower mortality in the vaccine group. One possible reason for this surprising result is that only a small fraction of people - even in the placebo group - caught COVID at all. I'm not sure how to account for possible missed infections but Figure 2 of the main text indicates that 0.08% of the placebo group became CASES (which I think means something like "person felt bad enough to see a medical professional, who then diagnosed them with COVID"), and the table in Figure 2 indicates that there were 1034 "occurrences" out of ~22,000 people in the placebo group (which I read as "~5% confirmed infections"). So, it's possible that the beneficial effect of the vaccine is still hidden in the statistical noise since there have been so few infections in the placebo group. It's also possible that some people _were_ harmed by receiving the vaccine (see table S4 [2]), so there's a fixed harm upfront to the vaccine group, which may eventually be surpassed once more of the placebo group gets infected. Thanks for posting this! [1] I really do appreciate you making this post, and it helped me learn something. I would have been more willing to read it initially if it had excluded the phrases "such a joke", "since people like to be binary thinkers", "crappy associative arguments", "to quote the great...". It seems like there's a silent majority of HN lurkers that are interested in all perspectives, and really are open to quality arguments like this, but might dismiss this post before reading it because of the choice of phrases. [2] Link to supp material PDF is on this page: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.supplementary-material https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v...
LMYahooTFY 5y ago
>Wow so there was an ivermectin study with 44k people? Where is it? Perhaps I should have spoken more precisely, but I don't get the impression you're trying to seriously consider whether ivermectin is useful. https://ivmmeta.com/ https://ivmmeta.com/ Preemptively, if you're interested in picking apart why one RCT can't be compared in any way to a collection of studies, only some of which are RCTs, I'm not. > But what's going on is that people are looking for an ALTERNATIVE to the vaccine *some people You're effectively strawmanning, and choosing not to engage with the actual doctors who don't advocate this. Which is practically all of the ones I can find. But by all means, please link me all of the doctors stating we should use ivermectin as an alternative. I'll bet I can link a lot more that aren't. The website I linked above even explicitly states this in bold, on the front page. >which is detrimental when the vaccine is proven to be our best tactic against death/serious illness. The trial you're citing seems to indicate there was no observed effect on mortality.

bluGill 5y ago

> Wow so there was an ivermectin study with 44k people? Where is it? There wasn't. Once you eliminate the studies that made up their data it is clear ivermectin doesn't work in the few studies that are left so nobody would bother doing a big study.

__blockcipher__ 5y ago

Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v... > During the blinded, controlled period, 15 BNT162b2 and 14 placebo recipients died; during the open-label period, 3 BNT162b2 and 2 original placebo recipients who received BNT162b2 after unblinding died. None of these deaths were considered related to BNT162b2 by investigators. There was actually one more death in the experimental group, albeit that's not significantly significant. So some combination of the following must be true: (1) The vaccination is effective at reducing COVID mortality, but COVID mortality for people in the trial was such a joke that eliminating 95% of COVID mortality doesn't actually change one's risk of dying in a non-negligible manner (2) The vaccination is effective at reducing COVID mortality, which does spare lives, but it ends up killing just as many from adverse events / side effects (3) The vaccine isn't effective and they doctored the numbers. My money is mostly on (1) with a sprinkling of (2), personally. --- And since people like to be binary thinkers, this is where I mention that I'm not an Ivermectin shill and as a medical nihilist I'm strongly skeptical of treatments in general. And while I haven't looked at the IVM data very much at all, what I have seen is incredibly weak evidence at best, as well as a bunch of really crappy associative arguments from the IVM crowd ("Africa uses IVM and Africa has less COVID mortality than the US!" as if that proves anything) To quote (slightly paraphrased) the great Jacob Stegenga: > If we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, then our confidence in medical interventions ought to be low.

phonypc 5y ago
>Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: Is the implication that we should have expected it to? The study endpoints are clearly "vaccine efficacy (VE) against laboratory-confirmed COVID-19 and safety data".
- __blockcipher__ 5y ago
  I think most people would have expected it to. Whether that's a reasonable expectation or not is up for debate. But yeah, many if not most people in the US were convinced that COVID was a threat so severe that it warranted completely uprooting life as we knew it. A sizeable minority of people are convinced that COVID vaccination is so important that people should be coerced into it by almost any means necessary. So I think understanding that we don't have a single randomized controlled trial that actually shows a reduction in all-cause mortality when given this intervention is pretty important. It's a general principle of medicine (or at least, it used to be) that the important outcomes are the actually clinically relevant outcomes. Did people die less? Did they achieve a better quality of life? When you get into proxy metrics you get to this weird place where you can show that something is insanely effective for proxy metric X, and yet it makes no difference (or is even deleterious) in thing-you-actually-care-about Y.
  - phonypc 5y ago
    This study not finding an effect it wasn't designed to isn't incompatible with the more hyperbolic interpretations of the threat of COVID / the importance of vaccination. Did we need RCTs demonstrating a reduction in all-cause mortality for polio or measles vaccines before it became blindingly obvious that they were a good idea?
j-wags 5y ago
I initially skipped over this post because it appeared to be written in bad faith [1]. But I gave it another shot and read the linked paper, and I agree with the summary. Thanks for pointing this out -- your post has changed my understanding of the vaccine's effectiveness. For skeptical readers - The linked paper is a medrxiv preprint, with authors from several locations. Many of the authors list affiliations with Pfizer, and the last author is an MD at Pfizer. This seems to be a required report from the ~6-month point of a clinical trial. There really are 14 and 15 all-cause deaths reported in the placebo and treatment groups, respectively. The causes of death for each group are in table S4 [2]. The incidence of COVID in the treatment group is much lower than in the placebo group. I'm surprised by these results because I would have expected to see significantly lower mortality in the vaccine group. One possible reason for this surprising result is that only a small fraction of people - even in the placebo group - caught COVID at all. I'm not sure how to account for possible missed infections but Figure 2 of the main text indicates that 0.08% of the placebo group became CASES (which I think means something like "person felt bad enough to see a medical professional, who then diagnosed them with COVID"), and the table in Figure 2 indicates that there were 1034 "occurrences" out of ~22,000 people in the placebo group (which I read as "~5% confirmed infections"). So, it's possible that the beneficial effect of the vaccine is still hidden in the statistical noise since there have been so few infections in the placebo group. It's also possible that some people _were_ harmed by receiving the vaccine (see table S4 [2]), so there's a fixed harm upfront to the vaccine group, which may eventually be surpassed once more of the placebo group gets infected. Thanks for posting this! [1] I really do appreciate you making this post, and it helped me learn something. I would have been more willing to read it initially if it had excluded the phrases "such a joke", "since people like to be binary thinkers", "crappy associative arguments", "to quote the great...". It seems like there's a silent majority of HN lurkers that are interested in all perspectives, and really are open to quality arguments like this, but might dismiss this post before reading it because of the choice of phrases. [2] Link to supp material PDF is on this page: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.supplementary-material https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v...

LMYahooTFY 5y ago

>Wow so there was an ivermectin study with 44k people? Where is it? Perhaps I should have spoken more precisely, but I don't get the impression you're trying to seriously consider whether ivermectin is useful. https://ivmmeta.com/ https://ivmmeta.com/ Preemptively, if you're interested in picking apart why one RCT can't be compared in any way to a collection of studies, only some of which are RCTs, I'm not. > But what's going on is that people are looking for an ALTERNATIVE to the vaccine *some people You're effectively strawmanning, and choosing not to engage with the actual doctors who don't advocate this. Which is practically all of the ones I can find. But by all means, please link me all of the doctors stating we should use ivermectin as an alternative. I'll bet I can link a lot more that aren't. The website I linked above even explicitly states this in bold, on the front page. >which is detrimental when the vaccine is proven to be our best tactic against death/serious illness. The trial you're citing seems to indicate there was no observed effect on mortality.