5 ms·

Long-term Covid-19 booster effectiveness: a population-based cohort study

32 points by t0bia_s 3y ago

graeme 3y ago
Important to note that effectiveness is a relative term. One thing they ought to track in these studies is infections in both the boosted group and control group. Effectiveness can wane for multiple reasons: 1. Antibodies want 2. Variants shift and the booster is less effective 3. The control group caught covid and gained immunity If your control group gets infected and gains immunity, the booster will seem less effective. But it wasn't waning, unlike causes #1 or #2. The study period ends Oct 2022. 2022 was the year most of the population caught sars-cov-2 at some point.
superkuh 3y ago
I know we're only supposed to comment on the articles but I've tried 3 different computers, 4 browsers, and two IP addresses and I still just get a blank white page. Even with all javascript enabled, etc. The Lancet jumped the shark in late 2019 and has only been getting worse. Their website is literally not performing it's function to distribute text. At least I could still get the full article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079373/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079373/ "Booster effectiveness relative to primary series was 26·2% (95% CI 23·6–28·6) against infection and 75·1% (40·2–89·6) against severe, critical, or fatal COVID-19, during 1-year follow-up after the booster." That's not as bad as I thought it would be. The intramuscular's humoral) immunity against severe disease in the body serum and organs holds up pretty well. The protection against infection, which relies on upper respiratory mucosal immunity that injections into the arm don't give, are predictably low. I really wish the USA was still funding vaccine research so that some of these intranasal booster trials could be sped up. I haven't heard much about India's approved iNCOVACC intranasal role-out (starting this past ~feb), but the papers on it's effectiveness against infection should be out soon.
- mikeyouse 3y ago
  Must be your settings - Do you have a misconfigured PiHole or something? it works perfectly fine for me.. direct link to the PDF maybe? https://www.thelancet.com/action/showPdf?pii=S1473-3099%2823%2900058-0 https://www.thelancet.com/action/showPdf?pii=S1473-3099%2823...
- George83728 3y ago
  Odd. The lancet link loads fine for me with all javascript (including first party) disabled. In my experience, disabling all javascript fixes websites more often than it breaks them (most javascript only exists to create nuisances), so I leave it all disabled by default.
  - Workaccount2 3y ago
    Same experience, firefox with noscript blocking everything, page loads fine.
- abracadaniel 3y ago
  https://web.archive.org/web/20230525154103/https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00058-0/fulltext https://web.archive.org/web/20230525154103/https://www.thela...
- purpleblue 3y ago
  What does 26.2% effective mean in this context?
  - Scoundreller 3y ago
    Against infection, which: > Incidence of infection was defined as the first PCR-positive or rapid antigen-positive test after the start of follow-up, regardless of symptoms. > all rapid antigen tests conducted at health-care facilities (appendix p 9). SARS-CoV-2 testing is widely available and performed extensively in Qatar, mostly for non-clinical reasons.1, 12 Most infections are diagnosed not because of symptoms, but because of routine testing (appendix p 3). So they’re even capturing non-symptomatic infections, which you may not really care about. If a booster turned a symptomatic infection into a non-symptomatic infection, it would still be captured here and make it look like a booster failure. Not sure how well Qatar captured symptomatic infections.
  - fauxpause_ 3y ago
    Relative effectiveness. It means you were 26% less likely to get COVID vs those with the vaccine but no booster
mikeyouse 3y ago
It's astonishing how successful the vaccines turned out to be given the circumstances in which they had to be developed.
- canadiantim 3y ago
  Still too early to tell
  - mikeyouse 3y ago
    Lol no. They've saved millions of lives and trillions of dollars with no downside except in the minds of weirdo antivaxxers that p-hack their way into obviously false beliefs.
    - dangwhy 3y ago
      Doesn't africa have really low vaccination rate at like less than 25% in most countries?
      - mikeyouse 3y ago
        Contra dozens of studies showing the effectiveness and number of deaths averted in countries with strong public health reporting and organization, the existence of lower rates of disease in some African countries with low vaccine uptake is persuasive to you?
      - unmole 3y ago
        Africa also has a population that is very young: A combination of both high birth rates and low life expectancy. I'm not sure what point you're trying to make.
        Scoundreller 3y ago
        Yup. 60% of the continent’s population is under 25. > All of the world's top 10 youngest countries by median age are in Africa, with Niger in first place with a median age of 15.1 years. https://en.m.wikipedia.org/wiki/Youth_in_Africa https://en.m.wikipedia.org/wiki/Youth_in_Africa
HaroldBolt77 3y ago
It may be statistically significant improvement but I doubt that most rational, informed patients would consent to an experimental genetic therapy that reduced the likelihood of a flu-like illness by as little as 2.2% within a year. I would be especially curious to know: -if this was extrapolated, do the cohorts' infection rates eventually meet -extrapolating further, would the boosted cohort rate even exceed the control, especially as natural immunity increases more quickly in the control -the rate and seriousness of vaccine side-effects within the boosted cohort -the cumulative rate and seriousness of vaccine side-effects with annual boosters -serious injury and mortality from the vaccine in the boosted group vs serious injury and mortality from the disease in the control group
- fauxpause_ 3y ago
  [flagged]
  - HaroldBolt77 3y ago
    You need an account to comment on HN, yes.
TurkishPoptart 3y ago
>>Booster effectiveness relative to primary series was 26·2% (95% CI 23·6–28·6) against infection Sorry, maybe I'm an idiot, but what does this mean? "Effectiveness against infection" - does that mean that 26% of participants who got the booster did not contract corona-19?
- fauxpause_ 3y ago
  > For example, an effectiveness of 40% means that incidence of infection in the three-dose cohort was 40% less than that in the two-dose cohort. It’s a relative hazard ratio. % less likely to get COVID vs. the cohort with just the vaccine
fwlr 3y ago
While I don’t at all doubt the public health advantages of the Covid vaccine, I do have one reservation about the whole thing that I feel was never properly addressed: when I was growing up, I was taught the reason we make vaccines mandatory is because they confer herd immunity; that is, if 90% of people cannot catch or spread the disease because they are vaccinated, the other 10% are conferred protection as well because there aren’t enough remaining vectors for a disease to spread (any potential chain of infections peters out quickly rather than continuing). This reasoning made a lot of sense to me and I accepted mandatory vaccinations on that basis. I do feel that a kind of “bait and switch” happened where the Covid vaccine was initially presented as mandatory for the same reason, but then “prevents infection” was replaced with “significantly lowers the harm from infection”, and thus the new motivation for making it mandatory was “it stops the public health system from collapsing by dramatically lessening the cost and impact of each infection”. While that is a very good thing, it is still the case that we lost the original ‘herd immunity’ justification for mandatory vaccination, but never re-litigated the mandatory aspect of it on this new basis. I’m unsure that “keeping the public health system afloat” actually justifies mandating medical decisions for individuals. I urge you before responding to note that I am unsure - it might have justified mandatory treatment, I was quite open to believing it did, but it remains an uncomfortable fact for me that we went ahead and kept it mandatory without anyone making those arguments. (Posting this because that’s what this study shows: a small effect on preventing infection and a very large effect on reducing the severity of infection)
- alienicecream 3y ago
  [flagged]
  - smellyshaft1 3y ago
    [flagged]
- deleted 3y ago
  [deleted]
- taeric 3y ago
  My understanding is that herd immunity can be seen differently for different things. As such, it gets really tricky really quickly, as some folks will be talking about the kind of immunity you can have for things like Measles, while others will be talking about Flu and such. That is to say, a whole shit ton of talking past each other. My own view is that looking at population level metrics usually means that you can't really view the individual level metrics at the same time. Way too easy to see confounding increases in personal risks from some protection that oddly leads to more damage at the population level.

32 points by t0bia_s 3y ago

Important to note that effectiveness is a relative term. One thing they ought to track in these studies is infections in both the boosted group and control group. Effectiveness can wane for multiple reasons: 1. Antibodies want 2. Variants shift and the booster is less effective 3. The control group caught covid and gained immunity If your control group gets infected and gains immunity, the booster will seem less effective. But it wasn't waning, unlike causes #1 or #2. The study period ends Oct 2022. 2022 was the year most of the population caught sars-cov-2 at some point.

superkuh 3y ago

I know we're only supposed to comment on the articles but I've tried 3 different computers, 4 browsers, and two IP addresses and I still just get a blank white page. Even with all javascript enabled, etc. The Lancet jumped the shark in late 2019 and has only been getting worse. Their website is literally not performing it's function to distribute text. At least I could still get the full article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079373/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079373/ "Booster effectiveness relative to primary series was 26·2% (95% CI 23·6–28·6) against infection and 75·1% (40·2–89·6) against severe, critical, or fatal COVID-19, during 1-year follow-up after the booster." That's not as bad as I thought it would be. The intramuscular's humoral) immunity against severe disease in the body serum and organs holds up pretty well. The protection against infection, which relies on upper respiratory mucosal immunity that injections into the arm don't give, are predictably low. I really wish the USA was still funding vaccine research so that some of these intranasal booster trials could be sped up. I haven't heard much about India's approved iNCOVACC intranasal role-out (starting this past ~feb), but the papers on it's effectiveness against infection should be out soon.

mikeyouse 3y ago
Must be your settings - Do you have a misconfigured PiHole or something? it works perfectly fine for me.. direct link to the PDF maybe? https://www.thelancet.com/action/showPdf?pii=S1473-3099%2823%2900058-0 https://www.thelancet.com/action/showPdf?pii=S1473-3099%2823...
George83728 3y ago
Odd. The lancet link loads fine for me with all javascript (including first party) disabled. In my experience, disabling all javascript fixes websites more often than it breaks them (most javascript only exists to create nuisances), so I leave it all disabled by default.
- Workaccount2 3y ago
  Same experience, firefox with noscript blocking everything, page loads fine.
abracadaniel 3y ago
https://web.archive.org/web/20230525154103/https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00058-0/fulltext https://web.archive.org/web/20230525154103/https://www.thela...
purpleblue 3y ago
What does 26.2% effective mean in this context?
- Scoundreller 3y ago
  Against infection, which: > Incidence of infection was defined as the first PCR-positive or rapid antigen-positive test after the start of follow-up, regardless of symptoms. > all rapid antigen tests conducted at health-care facilities (appendix p 9). SARS-CoV-2 testing is widely available and performed extensively in Qatar, mostly for non-clinical reasons.1, 12 Most infections are diagnosed not because of symptoms, but because of routine testing (appendix p 3). So they’re even capturing non-symptomatic infections, which you may not really care about. If a booster turned a symptomatic infection into a non-symptomatic infection, it would still be captured here and make it look like a booster failure. Not sure how well Qatar captured symptomatic infections.
- fauxpause_ 3y ago
  Relative effectiveness. It means you were 26% less likely to get COVID vs those with the vaccine but no booster

mikeyouse 3y ago

It's astonishing how successful the vaccines turned out to be given the circumstances in which they had to be developed.

canadiantim 3y ago
Still too early to tell
- mikeyouse 3y ago
  Lol no. They've saved millions of lives and trillions of dollars with no downside except in the minds of weirdo antivaxxers that p-hack their way into obviously false beliefs.
  - dangwhy 3y ago
    Doesn't africa have really low vaccination rate at like less than 25% in most countries?
    - mikeyouse 3y ago
      Contra dozens of studies showing the effectiveness and number of deaths averted in countries with strong public health reporting and organization, the existence of lower rates of disease in some African countries with low vaccine uptake is persuasive to you?
    - unmole 3y ago
      Africa also has a population that is very young: A combination of both high birth rates and low life expectancy. I'm not sure what point you're trying to make.
      - Scoundreller 3y ago
        Yup. 60% of the continent’s population is under 25. > All of the world's top 10 youngest countries by median age are in Africa, with Niger in first place with a median age of 15.1 years. https://en.m.wikipedia.org/wiki/Youth_in_Africa https://en.m.wikipedia.org/wiki/Youth_in_Africa

HaroldBolt77 3y ago

It may be statistically significant improvement but I doubt that most rational, informed patients would consent to an experimental genetic therapy that reduced the likelihood of a flu-like illness by as little as 2.2% within a year. I would be especially curious to know: -if this was extrapolated, do the cohorts' infection rates eventually meet -extrapolating further, would the boosted cohort rate even exceed the control, especially as natural immunity increases more quickly in the control -the rate and seriousness of vaccine side-effects within the boosted cohort -the cumulative rate and seriousness of vaccine side-effects with annual boosters -serious injury and mortality from the vaccine in the boosted group vs serious injury and mortality from the disease in the control group

fauxpause_ 3y ago
[flagged]
- HaroldBolt77 3y ago
  You need an account to comment on HN, yes.

TurkishPoptart 3y ago

>>Booster effectiveness relative to primary series was 26·2% (95% CI 23·6–28·6) against infection Sorry, maybe I'm an idiot, but what does this mean? "Effectiveness against infection" - does that mean that 26% of participants who got the booster did not contract corona-19?

fauxpause_ 3y ago
> For example, an effectiveness of 40% means that incidence of infection in the three-dose cohort was 40% less than that in the two-dose cohort. It’s a relative hazard ratio. % less likely to get COVID vs. the cohort with just the vaccine

fwlr 3y ago

While I don’t at all doubt the public health advantages of the Covid vaccine, I do have one reservation about the whole thing that I feel was never properly addressed: when I was growing up, I was taught the reason we make vaccines mandatory is because they confer herd immunity; that is, if 90% of people cannot catch or spread the disease because they are vaccinated, the other 10% are conferred protection as well because there aren’t enough remaining vectors for a disease to spread (any potential chain of infections peters out quickly rather than continuing). This reasoning made a lot of sense to me and I accepted mandatory vaccinations on that basis. I do feel that a kind of “bait and switch” happened where the Covid vaccine was initially presented as mandatory for the same reason, but then “prevents infection” was replaced with “significantly lowers the harm from infection”, and thus the new motivation for making it mandatory was “it stops the public health system from collapsing by dramatically lessening the cost and impact of each infection”. While that is a very good thing, it is still the case that we lost the original ‘herd immunity’ justification for mandatory vaccination, but never re-litigated the mandatory aspect of it on this new basis. I’m unsure that “keeping the public health system afloat” actually justifies mandating medical decisions for individuals. I urge you before responding to note that I am unsure - it might have justified mandatory treatment, I was quite open to believing it did, but it remains an uncomfortable fact for me that we went ahead and kept it mandatory without anyone making those arguments. (Posting this because that’s what this study shows: a small effect on preventing infection and a very large effect on reducing the severity of infection)

alienicecream 3y ago
[flagged]
- smellyshaft1 3y ago
  [flagged]
deleted 3y ago
[deleted]
taeric 3y ago
My understanding is that herd immunity can be seen differently for different things. As such, it gets really tricky really quickly, as some folks will be talking about the kind of immunity you can have for things like Measles, while others will be talking about Flu and such. That is to say, a whole shit ton of talking past each other. My own view is that looking at population level metrics usually means that you can't really view the individual level metrics at the same time. Way too easy to see confounding increases in personal risks from some protection that oddly leads to more damage at the population level.