Frame it as the safety of the vaccine, not the efficacy of it. If it was about efficacy, it would lead with the 25% lower risk because of COVID safety. But, these days, there are people who think vaccines are dangerous just because, so saying that taking the vaccine or not has equal mortality puts that to rest (or at least does for those who find science real).

The problem is that 25% lower risk of all-cause mortality is too big to be explained solely by the vaccine. The reduction is similar when excluding deaths due to COVID-19, and is probably driven by people who got the vaccine being different in some ways that the observational study isn’t controlling for.

A common pattern you'd find in reliable research papers is that authors tend to understate their findings, which in practice strengthens the impact of their conclusions.

It's interesting that they leave things at 18-59. Do they later stratify into 18-28, 29-38, 39-48, 48-58?

This is a general problem in many technical fields.

People in a technical field, learn to "chunk" complex phrases. Their natural communication style becomes complex. Which makes them hard to understand to those outside of the field. If they want to be understood, the solution isn't to try to educate the world. It is to educate themselves. To learn how to write simply and directly.

Depending on the readability test used, the section up to "Introduction" - which is supposed to be readable - is somewhere between advanced high school and university. See https://www.online-utility.org/english/readability_test_and_... or other free tools to test it. That's bad. The percentage of Americans who can read this text is below the percentage who could read, say, a plain language version written in Spanish. We should expect people to misunderstand. We should not expect this paper to convince.

Eh, it's an important point. "It made COVID things much better, and it didn't make other unrelated things worse."

Because this whole paper is bullshit and is a bias confirmation report

It assesses persons "who were alive on November 1, 2021"

That tantamount to saying "for people alive January 1st 1950, the Second World War was not a significant cause of mortality"

Can you see how ridiculous that sounds?

It's a shame that sibling comment got flagged to death, it was hilarious!

Unfortunately, this is an observational study and when you get to the confounding part, they kind of shrug their shoulders and say “well, we included a bunch of covariates that should reduce make the bias go away”, but there’s no causal diagram so we have no idea how they reasoned about this. If you’ve read even something layman friendly like Pearl’s Book of Why you should be feeling nervous about this.

Personally, I am glad to see it. I definitely got vaccinated as soon as I could, but I was also still nervous as there did seem to be some level of reasonable doubt. I would be happy to see more studies confirm what many consider to be obvious.

Unfortunately, one of the only things that is proven to convince vaccine skeptics is when someone from their community dies of a preventable illness.

This is a great book on this topic: https://www.amazon.com/Anti-vaxxers-How-Challenge-Misinforme...

Ultimately, natural selection might do it.

you never get a second chance to make a first impression

FDA is imposing stricter vaccine protocols due to children deaths linked to Covid-19 vaccine-related myocarditis [1].

[1] https://www.the-independent.com/news/world/americas/us-polit...

It seems like the antivaxxers, and many people in general, seem to just think that whatever they hear from their friends and family and favorite TV talking heads, whether it has any research behind it or not, is automatically and magically true. So that even if the only real research that exists contradicts it, they just assume that the research must be the result of some kind of error or conspiracy.

I find that incredibly frustrating and dangerous, but as far as I can see, it's the way it is.

Yeah maybe forcing people to get them triggered some kind of skepticism, how about that

This is the wrong attitude to take to the problem.

While I grant there were many who were disposed to be irrational skeptics, lots of skepticism was generated by dishonest messaging, coercive mandates, and punitive limitations on dissenting speech. Institutions took an end-justifies-the-means strategy, and many smelled a rat.

Even now, online, you see right wing users continuing to lament over vaccine injuries, and on the left, long COVID. Ironically the injuries are often similar. They are, of course, both right.

Exactly this. Science and evidence is not high on the list of priorities for most skeptics.

Exactly. The "skepticism" was always the point, always the tail wagging the dog.

I think people throw these accusations around way too broadly.

There is a small subset of weirdos who think the Covid/mRNA vaccines contain microchips or were designed kill off some percentage of the population.

But I think there's another, much larger group who might care a lot about their health to the point where they don't even drink from plastic bottles, and who when presented with a novel vaccine which was developed and rolled very quickly were hesitant...

Rightly or wrongly, I think these health-conscious people were concerned during Covid by mainstream media orgs frequently broadcasting what can only be described as pro-vax "propaganda"[1], and in some cases state compelled vaccination.

I'm very pro-vax, but I remember at the time (2021) being a bit torn on what I should do. I was in my twenties and already contracted Covid. Did it really make sense for me to take a vaccine when my risk was so low and there were some reports that young men were suffering from myocarditis post-vaccination?

I guess what I'm saying is that I think most reasonable people who may have initially been nervous about the vaccine can look at data like this and feel much more comfortable with the risk profile today. This is exactly the kind of data a lot of people (including myself) wanted when their governments were trying to force them to take these newly developed vaccines.

In my mind it's those on the extreme pro-vaccine and extreme anti-vaccine side in 2021-2022 that were the ones lacking critical thought. The reality was that as a society given the absence of long-term data like this, we were taking a calculated risk. Because even if mRNA vaccines slightly increased all-cause mortality that wouldn't mean the vaccine rollout was a bad thing... Similarly chemo probably great for you either and I'm sure people who undergo chemo unnecessarily suffer from increased morality risk. But if you have cancer or if you're in the middle of a pandemic risk calculations change a little.

[1] https://www.youtube.com/watch?v=Mq76QSlRiPo

Worse it will be used to produce even more disinformation. Most of the stuff I've encountered takes studies like this, misrepresents or outright lies about the findings and includes a link (sometimes working) to the paper which nobody consuming the slop will ever check.

The comments from @exceptthisthing here perfectly illustrate the comprehension and reasoning levels of the vaccine sceptic.

I give you this pill that makes you suffer for a year, but you will not die in 4 years. If it's safe to you, then alcohol and smoking are safe too.

Edit: OTOH that pill will reduce your chance to suffer even more or even die, which is a good thing ofc

“Doesn’t kill you” is the absolute bare minimum and a very low bar. Because the vaccines were so rushed, it’s still reassuring, but not at all a testament to the safety of mRNA vaccines.

The more interesting studies will be about non-lethal adverse reactions. Changes to menstruation, heart problems, lymph node swelling to name just a few.

"Skeptics" is a very kind term for these people. I bet my life if you polled these people, they have not read any material on the matter.

I can understand skepticism, notably from a woman I know that had many unwanted bleeding and it seems she was not alone : https://pmc.ncbi.nlm.nih.gov/articles/PMC12407584

Although from this study the global vaccine output is positive, the personal one seems negative for a lot of people. Many still got COVID19 and the bleeding issue, but they can't compare to what would have happened without the vaccine.

Notably many for whom the basic understanding of "25% lower risk of all-cause mortality" doesn't mean anything.

- "What is it ? I had 1 chance to 1 million to die but with the vaccine it's 0.75 to 1 million ?"

- "No, out of 22 million vaccinated, 0.4% died but out of 6 million unvaccinated, 0.6% died !"

Thank you!

And this bit:

"vaccinated individuals had a 74% lower risk of death from severe COVID-19 and no increased risk of all-cause mortality"

> These are the important bits for the non medical folks

Also significantly: "vaccinated individuals consistently had a lower risk of death, regardless of the cause."

They define unvaccinated as anyone who wasn't vaccinated by Nov 2021. What if they got vaccinated afterwards?

>As unvaccinated individuals were alive between their random index date and November 1, 2021, corresponding to a maximum duration of 6 months, starting follow-up from the index date would have introduced immortal time bias. Therefore, we initiated the study of long-term mortality 6 months after the index date, while mortality within 6 months after vaccination was analyzed separately using SCCS models. While the SCCS models are well-suited for short-term vaccine safety studies, they are less appropriate for long-term mortality, particularly due to limited control periods among vaccinated individuals, and age differences within the same individual across risk or control periods, as age is by far a major risk factor for death. For both analyses, we introduced the calendar period as an adjusting factor to account for the infection dynamics, baseline mortality trends, and the varying propension to get vaccinated.

> But if people died right away due to the vaccine (hypothetically), wouldn’t this design exclude those deaths?

Yes. That's what we have plenty of other studies for, including the clinical trials that led to the vaccines being approved in the first place.

The increase in myocarditis from the vaccine is well-documented. (And very small.)

COVID causes myocarditis too (even for young people unlikely to die from COVID itself), at much higher rates. So you only need a 20% chance of contracting COVID for the vaccine to be net positive in the least obviously positive age group.

> First, individuals who choose vaccination may differ from those who do not, potentially introducing confounding bias.

It's very hard to interpret this data given the massive confounder of "antivaxxers are suspicious of healthcare and take more risks".

I'm not sure what you're trying to say.

Your cite reads to me like a statement on the available data, which is interesting in its own ways but can be corrected for when it's irrelevant to the hypothesis.

As others have mentioned that data is captured in other studies and isn't the point of this paper

These are fair questions. I guess I'd first say that there were studies on reactogenic/immunogenic effects coincident w/ the original rollout. But perhaps more importantly, this study conditions on the time frame, meaning that it applies to all participants, and should thus not affect the risk ratio. I think knowing the current hazard risk ratio is more scientifically/medically valuable than the previous one (even if I'm skeptical that it has changed significantly for reasons other than noise)

The guy who says HIV is caused by poppers?

That's a year into its availability in France. Anyone who didn't have their first dose by then probably wasn't getting a dose.

You can see that in this chart (click the 5Y range): https://ycharts.com/indicators/france_coronavirus_full_vacci...

It's the full vaccination rate; as of Dec 1 2021 it was 69.89%. A month later (i.e. those Nov folks are getting their second dose) it's 74%; latest number on the chart is 78.44%.

This is crazy, I knew there would be BS like this in the study

if you were among persons "who were alive on November 1, 2021"

This study demonstrates that it benefits the individual (and therefore the population).

Not getting measles, polio, etc… seems like a pretty big benefit to the individual.

If you really missed the personal "benefit" of mortality or morbidity there are many ways you could make up for that.

Vaccines benefit both! Not dying or even really getting sick from preventable but horrific diseases is a huge benefit to the individual!

Is the personal expense not dying or getting less sick or something?

How? Not dying from preventable diseases seems like a pretty good deal for the individual.