It's Possible to Promote the Vaccine Without Resulting to Hyperbole
On the Noble Lie that the Vast, Vast Majority of Covid Deaths are Among the Unvaccinated
Often when listening to radio or reading articles discussing Covid related matters the hosts/authors will go to pains to inform their audience that they are vaccinate and support vaccination of adults, especially those at high risk. This is fine. There is certainly a segment of the population who aren't yet vaccinated who would still benefit from the shot. My major critique of these appeals for vaccination is that they often resort to hyperbole when describing the benefits of vaccination.
By now most of the calls for vaccination are not made at preventing cases, the vaccine’s ability to prevent infection is weak and fleeting. Now the calls for vaccination are that it’s offers a personal benefit against hospitalization and death. The problem is that all too often one will hear the claim made that the “vast, vast majority” of the daily reported Covid deaths are among the unvaccinated. This statement is simply untrue, and provably false when you look at the raw numbers. (I will provide multiple sources below) It's possible to expound on the benefits of vaccination without having to dramatically overstate reality and spread “Noble Lies”. The vaccine offers multiple fold protection against death from Covid, that should be enough, but the vaccines aren't a magic drug that removes all Covid risk.
In fact, vaccinated individuals make up the majority of the Covid deaths being reported currently. In the US these raw number reports are very hard to come by, but where they do exist they show that this winter a bare majority of the Covid deaths were among the vaccinated. The numbers from other countries, which are reported more transparently, are even more clear in showing this trend.
A layman might ask, if over half the deaths are in the vaccinated, then how is the vaccine working? This is called the "Base Rate Fallacy". Before you do any analysis you must adjust for population rates, and more than half of the population is vaccinated. The Covid data website Our World in Data has a great summary page which describes the Base Rate Fallacy in the context of Covid vaccines. The key is that to determine vaccine efficacy you need to compare the rates of deaths between vaccinated and unvaccinated, not just the total number. That website includes the diagram below:
The diagram shows a hypothetical situation where 83% of a population is vaccinated with a vaccine that is 80% effective at preventing death. This is not a perfect analog for our real world situation, but it's good enough for comparison. Under this scenario as you can see the vaccine lowers your odds of death by 5X and yet you still end up with half the deaths among the vaccinated due to the fact that such a large segment of the population is vaccinated.
This simple adjustment still undersells the vaccine, since those at higher risk have disproportionately higher vaccination rates. Failing to adjust for age and health status will land you into Simpson's Paradox, where the overall trend (lower Covid death rates among the vaccinated) is obscured by other trends (high Covid risk among higher age groups). The link below gives a great primer on how Simpson’s paradox effects Covid data.
In the US we are rarely shown the raw numbers, since our Public Health Betters assume the public to be innumerate rubes who can't navigate through these statistical paradoxes. Instead the wizards at the CDC hide all the numbers behind a black box and show us a graph like this:
If you look at this graph you would assume that in January well over 90% of the Covid deaths in the US were among unvaccinated individuals. You have to read the graph's fine print to discover that this graph is not based on raw data, but has multiple adjustments all behind a black box.
This fine print, which define how the CDC age adjusts to determine incidence rates, and how the CDC determines and categorizes vaccination status has profound implications. It would be deserving of it’s own post. Luckily the intrepid Clayton Cobb, who runs the twitter account @Hold2LLC, recently published a fantastic article which does a great job of clearly and methodically laying out the current issues with our government data. This article should be front page news in every major newspaper in the country. It's definitely worth a read.
So we see what the CDC provides, and how it potentially obscures the underlying data. How does this compare to the raw data?
The New York City Health Department doesn't advertise the raw numbers on Covid death vaccination status, but it's on their publicly accessible GitHub! Updates to their Weekly-Breakthough.csv file haven't occured on 12 days... and the data is backfilled with all Covid deaths assumed to be unvaccinated until a vaccine match is found. Looking back to December and early January where the data has stabilized shows that roughly half of the deaths are in the vaccinated:
Minnesota's data is also made publicly available and over a similar time period they are showing a similar trend:
It's hard to find this data in many other places in the US. It's certainly out there being recorded, but it's kept under lock and key to keep it from us statistical rubes. The NY Times is actually picking up on this, reporting that:
"The [CDC] has been reluctant to make [information on vaccine breakthroughs] public, ... because they might be misinterpreted as the vaccines being ineffective"
And they aren't the only Health Agency deciding that it's better to hide the raw data and leave the public to just trust the health experts. Scotland used to publish a weekly report on all things Covid. In their last report it showed that fully 84% of the 359 Covid deaths in Scotland between December 25th and January 21 were in vaccinated individuals...
The link above is from Archive.org. If you tried to use the actually link you get this:
Apparently Scotland decided to pull their reports over concerns it would be misrepresented by "anti-vaxxers"...
But there are still other countries publishing raw data:
The UK publishes excellent weekly Covid surveillance reports. In their latest report they show that over the last month 91% of the country's 3,412 Covid deaths were in vaccinated individuals.
One more for good measure. Denmark, a country which recently dropped basically all Covid measures, publishes raw data on breakthrough cases and hospilizations, in Danish!... Based on their latest report, currently only 251 of Denmark's 1,657 hospitalized patients with Covid are unvaccinated. Just 15%! While we don't have the raw numbers on Covid deaths we can infer from this that the vast majority of Covid deaths in that country are also among vaccinated individuals.
These might seem like a shockingly high number. But two things can be true at once:
The vaccines can be helpful and critical to prevent death if you are in a high risk group.
Since most Covid deaths are among the very frail, who are nearly all now vaccinated, this still leads to a large number of deaths.
For some context, using the data above Public Health Scotland still calculates that the vaccine is 40% to 70% effective against Covid mortality, and even higher with a booster dose. This means all else being equal a person would be about 2 to 4 times less likely to die from Covid if they get vaccinated. That's the way I would sell the vaccine. Why not reduce your risk by 4x? I wouldn’t sell the vaccine by propagating a "Noble Lie” that everyone dying right now is unvaccinated because it simply isn't true.
Again, none of this data is presented to claim the vaccines don't work, or that people shouldn't get the vaccine, especially if they are older (over 50) or have health conditions, especially obesity. The data is provided to make it clear that any blame placed on the unvaccinated for the ongoing Covid deaths or "full hospitals" is misplaced, and to make clear that the selling of the vaccine as a cure that ends your chances of dying from Covid is just over selling it.
I believe it's better for the public to see the data, and make judgments for themselves, not to have it hidden away and interpreted for them by “The Experts” who clearly don't trust the public. It's this exact lack of trust that has been so detrimental throughout this entire pandemic, in particular to vaccination efforts.
Anyway, 0 and 2…
It's not enough to just compare % of deaths to % of populations when the population that is getting vaxxed might be different than the population that is not getting vaxxed. As an example of this, please see here:
https://inumero.substack.com/p/best-predictor-of-covid-deaths-in?utm_source=url
This is why double-blind trials that balance the populations are so important. Unfortunately, the trials we had were too short to capture the waning efficacy of the vaccines. More & more, I don't believe we have a good estimate of the VE. I don't know how we correct this at this point.