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Comment by jkhdigital | Hacker News Reader

> thanks to widespread vaccination of the elderly, however fast this disease spreads it will ultimately inflict a much, much smaller death toll than earlier waves, because vaccination has probably eliminated 90 percent or more of the country’s total COVID-19 mortality risk.

This claim does not appear to be grounded in any factual basis: A double-blind randomized trial for an mRNA vaccine with 44k participants showed nearly identical all-cause mortality in vaccinated vs. placebo groups after six months [1]. The delta wave will almost certainly be less fatal, but there is no evidence to indicate that widespread vaccination is the primary causal factor, or even a contributing factor, for the reduced mortality.

[1] https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v...

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That is a dramatic misrepresentation of that preprint. The number of deaths is small enough that it is hard to draw inferences from it, and that was not the endpoint of the study. Rather, the key finding is a vaccine effectiveness of 97% against severe disease.

A preprint that did address deaths[1] found a vaccine effectiveness of 98.7% against death. This is not consistent with your claim of "no evidence."

[1]: https://www.medrxiv.org/content/10.1101/2021.04.21.21255873v...

That preprint is not an RCT. The study I cited is an RCT. And the RCT shows no effect on deaths.

And yes, it does show a dramatic effect on infections and serious illness. This is great, and we should shout it from the rooftops! But a journalist writing that vaccines are the reason Covid mortality will drop 90% is projecting, not reporting facts.

> This claim does not appear to be grounded in any factual basis

No factual basis in that paper but you seem to be saying "no factual basis at all" which is flat-out wrong, indeed basing such a claim on one paper is disingenuous: Absence of evidence in 1 chosen paper is not evidence of absence in general.

You only have to compare the linkage between cases and deaths in UK waves 1 and 2, with the much lower level of deaths for comparable numbers of cases in wave 3, to see the "much, much smaller death toll" staring you in the face.

Your chosen paper is also largely irrelevant before we even get there; it's about mRNA vaccines, whereas the UK's program has leaned heavily on AZ, which is not.

While this is a literal interpretation of all-cause mortality from the paper, I’m not sure this is the right take away.

There was such a dramatic reduction in overall cases in the vaccination group that deaths are probably more statistical noise in both groups than being tied to covid one way or another.

Currently deaths and cases have diverged dramatically in the population and this might be more indicative of the real world vaccine performance as it pertains to reducing death.

In this study the vaccine reduced Covid-19 infection rates by like 90%, and essentially eliminated severe cases. This is great!

But the same number of people died in each group. So vaccines do not reduce Covid-19 mortality, period. Does this mean vaccines are a waste of time? No, of course not! It just means we should be precise and correct in the claims we make based on statistics, and not fudge them to say things that sound good but are not true.

EDIT: Fair enough, I'm making the same sloppy mistakes... this study doesn't say anything, positive or negative, about vaccine effects on mortality. But it certainly doesn't support the journalist's claim. It does support the claim that vaccines dramatically reduce infection rates and severity, which is great and reason enough to get vaccinated.

I don’t follow the logical leap. It’s clear the paper doesn’t demonstrate a difference, you’re right.

I do think it’s disingenuous to say that the vaccine categorically doesn’t prevent deaths, if it can prevent infections that would lead to deaths, that’s a good outcome. Additionally, the real world performance in the general population is showing a massive divergence in deaths and cases in elderly populations after the coverage of vaccines. That may be from some other variable and not vaccines, but I’m not sure that I would be able to suggest an alternative cause.

Did I categorically say that the vaccine doesn't prevent deaths? I simply cited a study which shows no effect, and scolded the journalist for making a claim that doesn't seem to have solid scientific support. I'm not making a statement about vaccines, I'm making a statement about journalists playing fast and loose with science.

> That may be from some other variable and not vaccines, but I’m not sure that I would be able to suggest an alternative cause.

This is why we do science. Your lack of imagination about causal relationships is not evidence for or against any particular causal relationship.

You did categorically state it: “So vaccines do not reduce Covid-19 mortality, period.”

You also missed my nuance, but that’s not surprising at this point.

2 people in the placebo group died with a covid infection and 1 in the vaccinated group. That is way to little data to even remotely make such a bold claim.

Or, if I follow your flawed logic, Covid vaccines reduce mortality by 50%!

The bold claim is the journalist in this article who said that vaccines are the reason we should see a 90% reduction in mortality. That is an optimistic projection, not a fact-based statement. That's all. Christ, people think I'm anti-vaccine just for being pedantic about science reporting...

So, now that we have seen a 90% reduction in mortality ... ?

Pasting the rebuttal to that point from the comments of the linked paper:

Those are all-cause death. The number of covid-related deaths were 2 in the placebo and 1 in the vaccine arms. There simply weren't many covid deaths during this part of the trial (probably because most of the participants were <55 years old).

Median age was 51, so seems like there would have been at least a decently sized cohort over 55 (although I don't have to actual data to confirm).

But anyways, my original point was that the journalist is being dishonest by claiming that vaccination among the elderly is the reason mortality should drop by 90% compared to prior waves. This RCT certainly doesn't provide any evidence to support that statement, and it is the largest study of its kind so the only conclusion I can make is that the journalist is just projecting without facts.

> vaccination among the elderly is the reason mortality should drop by 90% compared to prior waves.

What exactly do you mean "should" ? It has. It did.

This does not seem like a useful source to draw this conclusion. 14/15 persons of both group died, but I do not see whether it was related to Covid. edit: 2 unvaccinated people with covid died 1 vaccinated. Point stands.

45.000 people is simply too small a number to draw such a conclusion. However, we are currently collecting a large amount of worldwide data, and that shows very strong reduced mortality and hospitalization on the vaccinated population. This is much higher quality data to draw conclusions on.

> A double-blind randomized trial for an mRNA vaccine

Sorry, what is the relevance of this trial to the parent story about the UK?

The vast majority of the UK's elderly and at-risk people got the first vaccines available there - the AstraZeneca jab, which is not a mRNA vaccine.

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