[sradman]

There is not strong evidence supporting a 3rd booster dose in immunocompetent people. We have partly seen a misinterpretation of the Israeli data [1] and specifically the single low effectiveness value that appears to be the result of Simpson's Paradox [2]. Dr. Fauci reported this single value decline from the high nineties to the high seventies on Andy Slavitt's podcast [3]. Pfizer's CEO has promoted this same data, Israel's 3rd dose campaign is well under way, and Fauci's public statements are a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that the Canadian numbers do not yet support a general 3rd dose booster but, like the UK, a longer 2nd dose interval due to a First Doses First (FDF) strategy may be a factor.

The 3rd dose is safe and will probably provide a small benefit to the recipient as Shane Crotty described in TWiV 802 [5]. The downside is that these doses are in short supply globally where they could make a significant difference.

[1] https://www.covid-datascience.com/post/israeli-data-how-can-...

[2] https://en.wikipedia.org/wiki/Simpson%27s_paradox

[3] https://lemonadamedia.com/podcast/dr-fauci-answers-your-bigg...

[4] (YouTube ~3.5min @36m45s) https://youtu.be/93Rnjmr7iCk?t=36m45s

[5] https://www.microbe.tv/twiv/twiv-802/

[tguvot]

with regards to misinterpretation of israeli data, it's more like miscalculation of israeli data:

1) his calculated efficiency for different age groups is up to 40%+ higher compared to numbers that released by israeli ministry of health in official presentations. when asked about it, he said that he doesn't know how they calculate it and this is his numbers

2) his calculations from the beginning included people that got booster shot. Kinda hard to base statistics about efficiency of two doses when you get inside it data about people who got three

[sradman]

I think the misinterpretation is mainly by the media and the general public. When most of your population is vaccinated and most of the serious disease is in the unvaccinated, you need to report by rate and vaccination status as the Ontario Science Table [1] now does (rather than absolute case numbers).

Simpson's Paradox is more of a data artifact that you have to be aware of. I didn't know about this statistical anomaly before but the takeaway is that if you see a effectiveness percentage decrease from 97% to 77% then you should also check that the value in each age cohort because each individual cohort may surprisingly be above 90%. The Israeli data might be fine but I want to see the "age corrected" range rather than a single effectiveness number.

The bottom line is that we will get good data moving forward from the Israeli 3rd dose program with other quality data sets soon to follow from the U.S., UK, Canada, Singapore, etc.

What we have not yet seen is any good evidence that the vaccinated are contributing to spread, though in the Fauci interview he indicated that the R(t) in the unvaccinated was non-zero. This is an important question, IMO.

[1] https://covid19-sciencetable.ca/ontario-dashboard/#riskbyvac...

[tguvot]

i know. as i said he miscalculated efficiency for age cohorts. israeli data for most age ranges is 45 to 25 percent lower than his calculated 95%-99%+ efficiency. So maybe, as paradox it's nice, but as calculation go, they suck. and now everybody running around with this site as proof that there is no need in booster because efficiency is still 95%

[sradman]

Do you have a link to the full age cohort effectiveness numbers? I didn't think these numbers were published yet, if they are or don't exhibit Simpson's Paradox then the question is what accounts for the discrepancy with the UK and Canadian data and the immunological lab research done by Shane Crotty and Rockefeller [1].

[1] https://www.microbe.tv/twiv/twiv-717/

[tguvot]

There were presentation with numbers stratified by age, but I can't find it now. Unfortunately I still can't figure out how to track down everything that ministry of health releases over there. Closet one that I found is this one https://www.gov.il/BlobFolder/reports/vpb-12082021/he/files_... . Look at slide 7.

Also, if you we are talking about Simpson's Paradox, we need to go deeper. As you can see at same slide, vaccine efficiency going down, the further you get away from second shot. Hence, age cohort effectiveness is useless. You need age/vaccination time frames to judge real efficiency

[nullc]

> a strong indicator that the U.S. will follow the same path. British Columbia's Dr. Bonnie Henry indicated yesterday [4] that

...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

[Someone1234]

> ...an even stronger indicator is that the Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign following them authoring this report saying that the evidence didn't support the widespread use of boosters as a public health measure.

What you stated did not occur.

What did happen was that the FDA and CDC got into a procedural slap-fight, and because the CDC gave advice first and the White House signaled public acceptance of that advice before the FDA's panel had a chance to finish two people resigned in protest.

Let's break down why the post above is erroneous:

- "Biden administration seems to have asked" no factual basis.

- "authoring this report" they never authorized a report, that's what they were protesting.

- "report saying that the evidence didn't support the widespread use of boosters" since the FDA's Office of Vaccines Research and Review hasn't published a report you cannot state what is in the report.

What did occur is that the two resigning panelists published a review in The Lancet[0] where they essentially said they felt more data was needed to approve boosters and that the WH approval on the CDC's recommendation was premature (although they also said their view may not match the FDA's view as a whole so YMMV what the final FDA report says).

By the way I actually agree with the two FDA panelists on this one, and think the WH jumped the gun. But regardless of my feelings the "Biden had vaccine experts resign to push through the booster" comment above is problematic.

[0] https://www.nytimes.com/2021/09/13/health/fda-coronavirus-bo...

[nullc]

> - "authoring this report" they never authorized a report, that's what they were protesting.

You are commenting on a HN story which is literally linking directly to the document they authored.

I hope you will delete your misguided and grossly uncivil comment in the time that the site lets you do so, and consider offering another response when you've actually read the article that you're commenting on!

> the FDA and CDC got into a procedural slap-fight, and because the CDC gave advice first

The CDC statement is here: https://www.cdc.gov/media/releases/2021/s0818-covid-19-boost... you can see that it is unambiguously conditional on FDA approval: "We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines".

> "Biden had vaccine experts resign to push through the booster" comment above is problematic.

This is a false and fabricated quotation, which I did not say at any point. Your inclusion of it makes it extremely hard to see your comment as a good faith attempt to communicate.

[Someone1234]

> You are commenting on a HN story which is literally linking directly to the document they authored.

You're conflating the timeline and facts a lot. Here is what you stated happened above:

- FDA panelist published a report -> Biden admin asked them to resign -> they resigned.

Here is what actually happened:

- CDC published a report -> WH accepted the CDC's report -> WH signaled moving forward with boosters -> FDA panelists who never got to publish resign -> FDA panelists author review paper in The Lancet critical of boosters (what this article is about) -> [Future] FDA publish their official recommendation

The timelines are completely different (e.g. resign before Vs. after publication), what we're talking about being published is different (e.g. FDA official report Vs. Lancet review), and the whole "asked to resign" is nowhere to be seen.

> This is a false and fabricated quotation, which I did not say at any point.

You said this verbatim:

> Biden administration seems to have asked two multi-decade long FDA vaccine approval experts to resign

You haven't defended or sourced that. Want to go ahead and do that rather than acting offended by my shorthand characterization of it?

[SamBam]

Link?

[nullc]

https://thehill.com/opinion/healthcare/571022-to-boost-or-no...

https://www.politico.com/news/2021/08/31/biden-booster-plan-...

https://endpts.com/breaking-in-a-major-blow-to-vaccine-effor...

These are authors of this report.

[SamBam]

You said

> Biden administration seems to have asked

Nowhere is that reported, or even suggested, in the links you posted.

Two researchers resigning in disagreement is seriously, seriously different from the administration forcing people out.

One is researchers protesting decisions by their own senior leadership. The other is the administration censoring scientific disagreement.

[uselesscynicism]

I'm fairly convinced that the pharmaceutical companies want Uncle Sam to buy and mandate 350 million shots per year and that's why the boosters are being pushed and combined with flu shots, while Dear Leader figures out the best way to dictate the health choices of his subjects without so much as first having Congress vote on it.

[coolgeek]

Is this a parody account? Because you've nailed it

[NDizzle]

I don't know how the Israel data is being misinterpreted.

https://pbs.twimg.com/media/E_F6vV0XoAMbaNO?format=jpg&name=...

https://imgur.com/a/fzMdPFE

I guess ignoring data to push an agenda can be defined as "misinterpretation", fair enough. Carry on.

[adevx]

It's telling that linking to factual hard data is being downvoted.

[ipv6ipv4]

It’s not hard data. It’s nonsense. There are so many confounding factors that comparing Israel and Sweden is non-sensical.

Hard data is easily available directly from the horse’s mouth [1].

As of today, in Israel, for age 60+, per 100K population. Unvaxxed are 4.5X more likely to be seriously ill compared to 2 shot vaccinated and 40X compared to 3 shot.

For under 60. The same ratios per 100K are 3x and 10x.

1. https://datadashboard.health.gov.il/COVID-19/general