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hannob 3 hours ago

I found the intro very confusing, tbh.

Particularly the "no increased risk of all-cause mortality". I mean, if we assume the vaccines worked, we'd certainly expect a decreased risk of all-case mortality (because "all-case mortality" certainly includes "covid mortality"). Reading "no increase" seems to imply "it doesn't change anything". Yeah, technically, the sentence does not say that ("no increase" can mean "no decrease" or "no change").

You have to read further below to get what should be the real message on all-cause-mortality: "Vaccinated individuals had [...] a 25% lower risk of all-cause mortality". I think that should've been in the first 1-2 sentences.

eddieroger 3 hours ago | parent | next [-]

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).

zosima 2 hours ago | parent | next [-]

The reduction in all-cause mortality was independent of covid deaths.

Which seems to suggest that there was big differences between the groups other than the vaccination.

This of course does not change that the vaccine seems mostly safe, but it definitely calls in to question whether the protection against covid death was vaccine-mediated or due to some other difference between the groups.

Therefore this paper is moderately strong evidence for the vaccine being safe, but quite weak evidence for the vaccine being efficacious.

pygy_ 2 hours ago | parent | next [-]

The vaccinnated group was 1 year older on average, and had mode cardiovascular risk factors.

Covid has long term health consequences, and these are proportional to the severity of the acute infection.

People who died of a stroke of a heart infarction 6 months down the line were not counted as "covid death", even though covid is known to increase their incidence in the next year.

an hour ago | parent [-]
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lesuorac 2 hours ago | parent | prev | next [-]

Covid hospitalizations where half in the vaccinated group (as % of pop) than unvaccinated. That's extremely desirable when you're in a situation where you have do dedicate whole wings (and then some) of hospitals to a singular disease.

Sure, it's not a silver bullet but it's at least stainless steel.

zosima 2 hours ago | parent [-]

I am speaking about what the paper shows.

There are other sources of evidence for efficacy. This paper is not a very strong source of evidence for efficacy due to some obvious uncontrolled difference between groups.

gopher_space 6 minutes ago | parent | next [-]

I wouldn't bother critiquing methodology without current, masters-level experience in the domain. I make incorrect assumptions when I'm even narrowly outside my own lane, and end up asking questions that clearly demonstrate e.g. my inability to parse fig. 4a.

_DeadFred_ 23 minutes ago | parent | prev [-]

OP's point was more 'How would you measure unvaccinated people that lived because vaccinated people weren't filling the ER, so there were beds/staff to spare'?

That unvaxed outcome would need to go in the 'vaxed lives saved' column somehow, or else it looks like 'outcomes were the same either way' because the lives saved from vaccination spill over into the non-vaxed group because the vaccine prevented the healthcare system from melting down.

jmull an hour ago | parent | prev | next [-]

> but quite weak evidence for the vaccine being efficacious

That’s directly contradicted by the results of the study. E.g.,

“Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76])…”

It’s pretty clear a lot of unvaccinated people who died of covid would be alive today had they gotten vaccinated.

(I would point out the current yearly vaccine they are putting out is potentially a different story since covid is changing and so is the vaccine. I’d talk to my dr about whether to get that or not.)

stocksinsmocks an hour ago | parent | prev | next [-]

I don’t think it’s possible to know anything conclusive about the safety for a few decades and a generation or two of affected kids can be observed. Given that finding harm would embarrass important aristocrats, I don’t think that evidence would ever be found in the foreseeable future. That mRNA and lipid nano particles were never found to be safe until the exact moment of crisis is awfully convenient for its investors.

I say decades because of the study below. Certainly, the authors could have published it for engagement bait or malice or some reason.

https://www.gavinpublishers.com/article/view/detection-of-pf...

vineyardmike 42 minutes ago | parent [-]

Where do you get decades? That study says 200 days.

stocksinsmocks 32 minutes ago | parent [-]

You really aren’t going to know how this MRNA in egg and sperm cells are going to affect offspring until you have offspring to observe. Effects like wolbachia could take multiple generations to observe.

velcrovan a minute ago | parent [-]

mRNA can't cause wolbachia. Wolbachia is a bacterium that actually lives inside cells and gets transmitted through eggs to offspring. it's a persistent organism that reproduces. There's not a way for mRNA to grow bacteria.

mRNA is just a molecule that breaks down, and the mRNA in these vaccines is extremely fragile and temporary. Once injected it enters whatever cells are nearby (muscle cells)and ribosomes read it to produce the inert spike protein. The mRNA itself is gone within hours. Your cells have enzymes specifically designed to break down RNA because cells naturally produce and dispose of mRNA constantly as part of normal function.

The mRNA in vaccines never enters the cell nucleus where DNA is stored, so it can't integrate into your genome or affect reproductive cells in that way. And it doesn't replicate itself either.

And millions of babies have been born to vaccinated parents by now. If the effects you are talking about were even possible they would definitely have shown up by now.

pama an hour ago | parent | prev | next [-]

The simple explanation is that the causal agent for the excees of the non-covid deaths is the same SARS-CoV2 virus, but death comes later and not at the acute phase of the disease.

Chris612 an hour ago | parent [-]

If the vaccine was randomly administered among the study population, I'd buy this as the simple explanation.

Not sure it follows so cleanly with the actual study setup

pygy_ an hour ago | parent [-]

There is plenty of evidence beside this study.

underlipton 2 hours ago | parent | prev | next [-]

There was a study that showed that cancer patients who receive a MRNA COVID vaccine live longer. This could also be for extrinsic reasons, but IIRC the study considered the reason to be a pronounced immune response that also attacked cancer cells.

So there's a chance that the vaccine provokes a general immune response that's protective against a number of mortality-causing issues.

DebtDeflation 2 hours ago | parent | prev [-]

A 25% reduction is huge, even if you account for the fact that people who get vaccines tend to be more health conscious to begin with, when you consider that outside of the very sick and very old Covid has a mortality rate under 1%.

soperj 2 hours ago | parent | next [-]

1 out of 100 when billions are getting it is gonna be a large number. Mortality rate has gone down substantially since the vaccines.

ceejayoz 2 hours ago | parent [-]

I like to ask people who talk about a 1% mortality rate if they'd go to a football game in a stadium with 100k seats if 1k of those seats randomly had a small bomb attached.

2 hours ago | parent [-]
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altcognito 2 hours ago | parent | prev | next [-]

> Covid has a mortality rate under 1%.

I hate it when blanket statements like this creep in.

Which Covid? The initial version was definitely more deadly than later versions.

What about future covids? Are you willing to guarantee every version of covid from here on out will be less deadly? It is the general case to be true, but it is not some sort of law.

18 minutes ago | parent | prev [-]
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a_cardboard_box 2 hours ago | parent | prev [-]

Yes, but they incorrectly called it all-cause mortality under Findings. "Mortality" on it's own would be fine. "Mortality from other causes" would be better.

simonster an hour ago | parent | prev | next [-]

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.

hannob 31 minutes ago | parent | next [-]

Yeah, but there's a plausible explanation for this: Likely, people who get vaccinated also are more likely to do other things to improve their health.

TheBigSalad an hour ago | parent | prev | next [-]

Could it mean that lots of Covid deaths are being attributed to other things?

bluGill an hour ago | parent | prev [-]

If you don't get the covid vaccine you probably do other risky things. Not get other vaccines, don't see the doctor about various issues...

groestl 2 hours ago | parent | prev | next [-]

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.

btilly 2 hours ago | parent | prev | next [-]

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.

ceejayoz 3 hours ago | parent | prev | next [-]

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

hervature 2 hours ago | parent [-]

Looking at Table 2 and as the name suggests, COVID is included in "all-cause" mortality. Your statement does not follow because it could have made COVID outcomes better yet "all-other" causes worse for a neutral "no increase in all-cause". If you look at Table 2, you can see that the vaccinated group is less mortality in all diseases. That being said, as much as I think this is over-stated, this is very much a correlation thing because we all know that unvaccinated individuals live their lives differently compared to vaccinated individuals. Even accounting for similar statistics, the one group is prone to higher death rates not because they are unvaccinated but because of the reason they are unvaccinated.

ceejayoz 2 hours ago | parent [-]

Read again.

> After standardizing the characteristics of vaccinated individuals to those of unvaccinated individuals, we observed a 25% lower standardized incidence of all-cause death in vaccinated individuals compared with unvaccinated ones…

> Vaccinated individuals had a lower risk of death compared with unvaccinated individuals regardless of the cause of death.

> All-cause mortality was lower within 6 months following COVID-19 vaccination, regardless of the dose administered, compared with the control periods...

hervature 2 hours ago | parent [-]

You should read my statement again.

If COVID vaccines reduces COVID deaths by 100% and increase everything else by 0.01%, you will still have a reduction in "all-cause" mortality yet your chances of dying by anything else has increased. I already said Table 2 does not show this is happening and in fact vaccinated individuals have better outcomes across the board. However, people are drawing this conclusion (even though they are correct) incorrectly without looking at the data.

ceejayoz 2 hours ago | parent [-]

> If COVID vaccines reduces COVID deaths by 100% and increase everything else by 0.01%…

But you already agreed this is not the case, in your comment:

> If you look at Table 2, you can see that the vaccinated group is less mortality in all diseases.

binary132 41 minutes ago | parent [-]

GP is saying that indicates there is some other factor involved in reducing all-cause mortality, since it is probably reasonable to believe the mRNA vaccines were not improving mortality rates of other diseases, and that therefore the sampling of these populations is not random.

See this comment: https://news.ycombinator.com/item?id=46164643

purpleflame1257 2 hours ago | parent | prev | next [-]

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

ceejayoz 2 hours ago | parent [-]

Looks like they do, yes.

> A stronger association was observed among individuals aged 18 to 29 years, although the underlying reasons remain unclear and warrant further investigation.

an hour ago | parent [-]
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exceptthisthing 3 hours ago | parent | prev | next [-]

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?

biophysboy 2 hours ago | parent | next [-]

No, because the same conditional is applied to both participant groups. Its good to specify a time frame.

2 hours ago | parent | prev | next [-]
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hervature 2 hours ago | parent | prev | next [-]

While you are being downvoted, this is actually an astute observation. However, your point is working against you in this case. If the vaccine was actually deadly, the unvaccinated individuals who survived the pandemic would be having better health outcomes. This is not what they found. If they included the pandemic in this study, the deaths by COVID would be much worse in the unvaccinated group.

an hour ago | parent [-]
[deleted]
dwroberts 2 hours ago | parent | prev | next [-]

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

That’s a nonsense comparison because the thing they are studying is the vaccine, not COVID itself. The vaccine was available at minimum, what, end of 2020? Exposure being defined as first dose May-October 2021 does not seem unreasonable at all (and probably not arbitrarily chosen right - it’s probably something to do with the availability of data)

gus_massa 2 hours ago | parent | prev [-]

It's a good observation, but I expect that even considering only people alive in 1950, survivors of the Hiroshima bombing or concentration camps (or a few other events), still have long term problems that increase mortality.

drcongo 3 hours ago | parent | prev [-]

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

SketchySeaBeast 2 hours ago | parent [-]

I honestly wonder if it's better to flag and downvote into oblivion rather than to engage in good faith. The sibling didn't seem like they were trolling, just misguided, and shutting down discussion doesn't allow for any reflection.

I suppose the problem is that it was unlikely to be productive.