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Comment by junofan | Hacker News Reader

I mean I’m as vaccinated as anyone, but the originally reported 95% effectiveness against symptomatic COVID-19 with the monovalent vaccine just doesn’t seem realistic in hindsight. Who knows what complex set of incentives was at play. If you’re running a trial site and your business relies on continued contracts from Pfizer, are you reporting every cough, fever, or headache?

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I wonder if the 95% effectiveness was actually true: against the strains prevalent at the time they ran the trial. But effectiveness against later strains was diminished.

I think this was the original paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745181/

Sample size was 43k people split in treatment and control group. Adding it here for context.

I don't think the claim was 95% against symptomatic covid, it was against hospitalization or death.

The vaccine was tested against the original virus but Omicron was almost a different disease with much more immune escape. We're lucky the vaccine held up as well as it did. This is also why the alternative doctors that wanted everyone to catch covid to build up herd immunity were wrong, but nobody seems to bring them up. These discussions just devolve into the usual polarized political talking points.

Whether the original study said so or not, that is absolutely how it was universally sold to the public. This [1] is a collection of various high profile individuals talking about the efficacy of the vaccines, why that means you won't carry the virus, you won't get sick, and and how that will completely stop the spread of COVID.

It's only as this very obviously failed to be the case that the metric was completely shifted to hospitalization/death. I'd also add this is about the time that the 'public messaging' swapped from talking about efficacy and other topics to outright vitriol and attacks on unvaccinated individuals, which is probably where the politicization of the topic began.

[1] - https://twitter.com/i/status/1472327161352798212

> Whether the original study said so or not, that is absolutely how it was universally sold to the public.

Trust the politics, blame the science?

By "the politics" you're including individuals like Fauci, the head of the CDC, and so on. These are individuals that were perceived as "the science." Beyond this, a peer comment motivated me to look up the original trial results and reporting. And yeah, it was entirely about cases. Here [1] are the data from Moderna. Oddly enough, it seems to have been moved, if not removed, from their website, but fortunately nothing ever dies on the internet.

"There were 11 COVID‑19 cases in the Moderna COVID‑19 Vaccine group and 185 cases in the placebo group, with a vaccine efficacy of 94.1% (95% confidence interval of 89.3% to 96.8%)."

They were claiming it outright prevented COVID, as vaccines generally do. So "the politics" and "the science" were in lockstep on this one. As were they when they seamlessly dropped this narrative and swapped over to hospitalization/death.

[1] - https://web.archive.org/web/20210202223626/https://www.moder...

There is no need to think, you can go read it. There was no indication that it was any help against severe disease, hospitalization, or death. The touted 95% was indeed against some definition of “symptomatic Covid” (a subjective one). In the all cause mortality section, there were more deaths in the vaccine arm than in the placebo arm. (But that was not statistically significant). At any time before 2020, the study would have been laughed at. But scientific standards were thrown out the door in 2020, and have not yet returned. (And … as it turns out from this and similar studies e.g. Ioannidis’ seminal paper showing most research is wrong from 2005 - it wasn’t as good as most people thought in 2020 already)

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