"Just the Vax, Ma'am"

Yet another obscure cultural reference from the past. For those under the age of 60 or so, here's your explanation. The TV show "Dragnet," a police drama, aired from 1951-59, and was revived from 1967-70. It starred its creator, Jack Webb, as LAPD Sergeant Joe Friday, and the revival stared Harry Morgan, who later starred in M*A*S*H, as his partner, Officer Bill Gannon. (This was back when the police were respected, as they should be.) Anytime Webb was questioning a female witness who might start down a rabbit-hole, he'd say, "Just the facts, ma'am."

Well, the Curmudgeon always seeks the facts, wherever they lead. And most recently he's been seeking facts about the SARS-Cov2 vaccines, hence the double-entendre title of this post, in which I'm going to present some facts about the vax.

Readers may recall that the last post addressed some myths surrounding the Delta variant of the virus. I noted that, when it first hit our shores back in April, it was billed as being more infectious, but less lethal, than earlier variants. Then, the narrative changed to it being not only more infectious, but more deadly. I noted that this is highly unlikely, as cases are rising in many parts of the U.S., but deaths are declining in all of those areas. That remains the case, both here and abroad.

More recently, I've seen several sources - all of which are slanted against the currently available vaccines - that suggest three things: first, that there is no difference in the increase in cases in areas with high vaccination rates vs. areas with low vaccination rates. Second, that the number of infections among vaccinated people indicates that the vaccines are ineffective. And third, that the number of deaths among those who've been vaccinated and are subsequently infected is either a further indication that the vaccines are ineffective, or it's an indication that they're downright dangerous and lead to death if one is infected, or both.

I'm going to debunk all three of these conspiracy theories. I'll use data to debunk the first, a combination of data and math to debunk the second, and some fairly simple math to debunk the third.

But first, some caveats. All along, I've been a skeptic when it comes to this virus, and I've been rather cautious about the vaccines. So, lest anyone think I've reversed position and am now on the Fauci bandwagon (I'm not; for the record, I still believe he's at best a quack and at worst America's Josef Mengele), I'm going to put myself out there and state where I stand on the vaccines.

Essentially, I feel strongly both ways, as one of my board members used to say when I was a CEO. Or, more accurately, I don't feel that strongly either way. So below are my positives and negatives regarding the vaccines.

On the positive side:

• I don't have a huge problem with the mRNA technology. I've read enough about it to understand it well enough to be dangerous, and the technology isn't new, though it's relatively new to vaccines. It actually has some advantages over traditional protein-based vaccines, and we'll probably see future flu vaccines using this technology that will be far more effective than traditionally available flu vaccines. (Sign me up: I got a flu shot in October 2019, and got the flu in February 2020.) Moderna has one such flu vaccine in the works.
• I'm smart enough to not fall for the conspiracy theorists' claims that these are "experimental" vaccines that "haven't been approved for use." They are not experimental; they've been through clinical trials and hundreds of millions of doses have been administered. And while they don't yet have full FDA approval, they do have emergency use authorization, which means they're approved for use - or they wouldn't be used. Remember when the J&J shot was pulled temporarily because some recipients developed blood clots? Then it was discovered that all of those people were women of childbearing age, who were more prone to that reaction. The J&J vaccine was re-authorized, but not recommended for that demographic.
• I'm also smart enough to know that the one-off extreme adverse reactions that I hear about are just that: one-offs. Anomalies. I probably know or know of at least a couple hundred people, from teenagers to people in their 90s, who've gotten the vaccines. Some Moderna, some Pfizer, some J&J. The worst reaction anyone I know had was a day of flu-like symptoms. Most had nothing worse than site soreness, which I get with my annual flu shot. (The shingles vaccine left me feeling like I'd been mule-kicked in the shoulder.) Occasionally someone will tell me of someone they personally know who was very sick from the vaccine, had to be hospitalized, etc. That's one person, or two. Again, I know hundreds who've had no major issues, and most have had no issues at all. These are rare anomalies.
• And I'm smart enough to understand that, while the adverse reactions in the VAERS database are likely underreported, there's also some false reporting in there (documented; one health professional once reported to VAERS that the flu shot turned him into The Incredible Hulk), and that the total numbers are still minuscule compared to the more than 300 million doses administered in the U.S., and more than 3 billion doses worldwide. (I do acknowledge the myocarditis risk in young males, and IMO there is no reason to vaccinate that demographic based on their risk factors. I also acknowledge that, while the adverse incidents are low, they're high enough that any other vaccine with a similar incidence rate would likely be pulled.)
• I don't buy the conspiracy theory that because these were "rushed," scientific corners were cut. What was cut was the usual bureaucratic red tape that ties these things up forever, and for that you can thank Donald J. Trump. Put a businessman in charge, and things get done. I still marvel at how many of my conservative friends praised President Trump for Operation Warp Speed, and now claim that the vaccines developed on his watch are ineffective or deadly or both, while those (including Kamala Harris) who said they wouldn't trust the vaccines because they were developed under Trump, now want them to be mandatory. The Curmudgeon has his political views, but he deals in facts.
• I love to travel, and that Italy trip is still on my bucket list. I also have a Transatlantic cruise booked for next year that departs from Spain. So I figure at some point, I'm going to have to get vaccinated to be able to do the things I want to do. As I've posted before, you trade one freedom for another, and you have to choose what freedoms are most important to you.
• Finally, based on the data I'll present below, I know they work. They reduce both the incidence and the severity of the virus.
  

Now, on the negative side:

• I'm still a bit leery about any long-term auto-immune effects. At this point, we just don't know.
• I still maintain that my odds are about the same, given my age, condition, and where I live, whether I get the vaccine or not. So if there's any question at all, why get it?
• I'm hopeful that the more traditional protein-based Novavax vaccine, which has completed Phase 3 trials in the U.S. with very good results (over 90% efficacy overall, and 100% efficacy against moderate and severe disease), will be approved by the end of the year. Yes, I'm somewhat okay with the mRNA technology, and even recognize some benefits of it. But I'm used to the more traditional vaccines. I get the flu shot annually, because young kids are at particular risk from the flu, and I'm around my grandkids. (I'm never around anyone in the high-risk category for this virus, so the "get it for them" argument doesn't apply.) And I got the shingles shots. Before my first trip to Africa, I got stuck like a human pin-cushion. So I'm no anti-vaxxer (actually, I have no use for those people). But those were all traditional, proven vaccines that have been around for a long time, with full FDA approval.
• Finally, the government, health officials, and many doctors keep changing the narrative and outright lying regarding the vaccines, adverse events, the risks of the Delta variant, etc., all in a full-court press to get people vaccinated. They'll lie, coerce, threaten, scare, discriminate, you name it - any tactic to get those needles in people's arms. And when anyone - especially the government, and especially THIS government - is that desperate to get me to do something ... well, I'm that much more reluctant to do it.

So much for my position, which isn't much of a position at all. On to the data.

I looked at the recent trend in cases compared with the trend over the same number of days one month ago, for every state in the U.S., plus D.C. (aka "the swamp"). I calculated the percent change, noting that some states showed increases of up to 300%, while some showed decreases of as much as 74%. Generally speaking, the states with the biggest increases have low vaccination rates, and the states that showed improvement have high vaccination rates. Of course, a robust study would normalize for other influencing factors: population density, tourism rates (daily visitors), the law of large numbers, etc. But I could see those factors through observation, and it's clear that the vaccines have been effective in preventing recent spikes in states with higher vaccination rates.

Here's a stark example: Joplin, MO has the highest SARS-Cov2 hospitalization rate in the U.S. as of this writing. Daily cases are up 71% over the last 14 days, at 76 per 100,000 population, which is about 11x the U.S. rate. The counties surrounding Joplin, in what's known as the "Four-State Region" of Southeast Kansas, Northeast Oklahoma, Northwest Arkansas, and Southwest Missouri, are experiencing similar spikes. The hospitalization rates for those counties and Joplin are up 40-64% over the last 14 days. The vaccination rates in those counties are all under 30%, and are among the lowest in their respective states. Some counties are under 20%. Anecdotally, the hospitalizations in Joplin are among those not vaccinated.

There is a correlation between the vaccination rate and the recent case trend. The vaccines are effective in preventing the recent upticks in cases that we've seen in a number of states. They work. Period.

On to the infections among vaccinated people, and here I'm going to turn to UK data. As of July 6, cases in the U.K. were up 72% vs. the prior week. By mid-June, 97% of cases were Delta infections. (In my last post, I explained this phenomenon, and how Delta would eventually "crowd out" other strains of the virus.) The U.K. also has one of the highest vaccination rates in the world: 63% of the population is fully vaccinated, and 85% of adults have gotten at least one shot.

So why are people still getting the virus? It's a simple matter of data and math. The vaccines have an efficacy rate of about 90%. If you've gotten one dose, it's about 70% or so. So, with a population of about 67 million, if 42 million people are fully vaccinated, and 10% of those might get infected, that's more than 4 million that could get infected. Frankly, it's surprising there aren't far, far more of these "breakthrough" infections. There've been about 800,000 new cases in the U.K. since the end of May; that's less than 20% of what we'd expect with a 90% efficacy rate. So the vaccines are actually performing better than advertised, at least so far.

And average daily deaths have increased, but from about 7 in late May to about 30-40 of late. That's a very small percentage, still, of the significant spike in cases they've seen recently, which is worst than the spike last fall, and second only to the January spike. This may be another indication that the Delta strain is less lethal. It may be related to the fact that most unvaccinated people tend to be younger, and thus have a better chance of surviving the virus in general, barring any co-morbidities. It may be due to improved treatment or earlier hospitalization.

However, it has been reported - and the conspiracy theorists have jumped on this - that among 92,000 Delta cases logged through June 21 in the UK, there were 117 deaths, and that 50 of those deaths, or 46%, were among people who were fully vaccinated.

This led to the hypothesis that the virus doesn't prevent death, and actually may cause it if you're vaccinated and get infected. This is utter nonsense, and simple math bears it out.

I've already noted that the vaccine has a less than 100% efficacy rate, so there will be breakthrough infections. Among those fully vaccinated in the UK, 35% are over the age of 65. The elderly (as well as those whose immune systems are weak or compromised) are more likely to contract the virus if exposed.

But, more importantly, they're more likely to die if infected. Let's say the vaccine reduces an 80-year-old's risk of dying by 95%. That 80-year-old's risk of dying is still likely going to be higher than the risk faced by an unvaccinated 20-year-old. Add in any co-morbidities for those older individuals (and most older folks have more co-morbidities than younger people), and the risk factors increase even more.

Another reason for this phenomenon is that, as more of the population is vaccinated, there are fewer unvaccinated people for the virus to infect. So if the pool of vaccinated people is larger than the pool of unvaccinated people, as it is in the UK, at some point breakthrough infections resulting in death among the elderly vaccinated population will equal or even exceed deaths from infections of younger, unvaccinated individuals. Assume a country reaches 100% vaccination. At 90% efficacy, all infections would be breakthrough infections resulting from less-than-perfect efficacy, and all deaths would be among the most vulnerable of those infected, as was the case before the vaccines were even created.

So what about those 50 deaths among fully vaccinated people in the UK? All of them were in people aged 50 and older. And that age group represents 70% of the vaccinated UK population.

It's simple math, people. No conspiracy here. The vaccines do not cause death if you get infected.

None of this takes away from the fact that the vaccines reduce the likelihood of infection, and the likelihood of death if infected. It's just that if you're already in the high-risk groups - and we all know by now what they are - you still have some likelihood of death. As I've posted before, the average age of U.S. deaths from this virus is the same as the average age of U.S. deaths annually from all causes. And the average age of death is higher than U.S. life expectancy! Once I pass my expiration date, I'm going to savor and be thankful for every precious minute - but I'll also know that I'm on borrowed time, and that something's bound to get me.

Public Health England estimated the fatality rate for the Alpha variant, which first hit the UK late last year, at 1.9%. It estimates the fatality rate for the Delta variant at around 0.3%. This is attributable to improved treatment - and yes, the high vaccination rate in the UK.

Don't get me wrong, I'm still on the fence. But I'm no conspiracy theorist. The vaccines work, at least up to their proven efficacy rate. The case vs. vaccination rate data prove this. And they don't cause death if you get a breakthrough infection, but if you're in a high-risk group, you may die if you get infected, even if you're vaccinated. But your chances are still better than if you're not, so if I were in a high-risk group, I'd be getting off the fence.

I'll leave you with some food for thought regarding conspiracy theories in general. A true skeptic is skeptical of everything, not just stories or sources with which he or she disagrees, or which don't fit his or her preferred narrative. A true skeptic questions everything, fact-checks everything, and looks at the data for himself. Only then does he accept something as true or false.

In scripture, 2 Timothy 4 says, "For the time is coming when people will not endure sound teaching, but having itching ears they will accumulate for themselves teachers to suit their own passions." That time is here, and there are itching ears - and false teachers - on both sides of every issue. Don't scratch that itch.