COVID19 mini-update, May 7, 2021: The Lancet paper on efficacy of Pfizer in Israel; Germany says, “patents are not the bottleneck, production capacity is”

(1) My homeland has effectively been a country-sized Phase IV trial for Pfizer. Analysis of the efficacy of the vaccine on this mass scale has been circulating in preprint form, but now the paper has been published after peer review in The Lancet.

Haas, E. J.; Angulo, F. J.; McLaughlin, J. M.; Anis, E.; Singer, S. R.; Khan, F.; Brooks, N.; Smaja, M.; Mircus, G.; Pan, K.; Southern, J.; Swerdlow, D. L.; Jodar, L.; Levy, Y.; Alroy-Preis, S. Impact and Effectiveness of MRNA BNT162b2 Vaccine against SARS-CoV-2 Infections and COVID-19 Cases, Hospitalisations, and Deaths Following a Nationwide Vaccination Campaign in Israel: An Observational Study Using National Surveillance Data. Lancet 2021.

DOI: https://doi.org/10.1016/S0140-6736(21)00947-8 [Paper appears to be Open Access]

(These funny links you see are called DOIs, or Digital Object Identifiers, in scholarly publishing: they are maintained at a central database by the various publishers, and are meant to be link rot-proof permalinks to scholarly papers. They can also be looked up in CrossRef.org and you will get all the human-readable “metadata” like authors, title, journal name,… with a single click.)

The figures are actually similar to what was reported in earlier studies, but the uncertainty intervals have shrunk drastically because, well, we’re talking a sample of millions now, not 30,000 or so participants in a Phase III trial.

The moneygraf from the abstract:

During the analysis period (Jan 24 to April 3, 2021), there were 232 268 SARS-CoV-2 infections, 7694 COVID-19 hospitalisations, 4481 severe or critical COVID-19 hospitalisations, and 1113 COVID-19 deaths in people aged 16 years or older. By April 3, 2021, 4 714 932 (72·1%) of 6 538 911 people aged 16 years and older were fully vaccinated with two doses of BNT162b2. Adjusted estimates of vaccine effectiveness at 7 days or longer after the second dose were 95·3% (95% CI 94·9–95·7; incidence rate 91·5 per 100 000 person-days in unvaccinated vs 3·1 per 100 000 person-days in fully vaccinated individuals) against SARS-CoV-2 infection, 91·5% (90·7–92·2; 40·9 vs 1·8 per 100 000 person-days) against asymptomatic SARS-CoV-2 infection, 97·0% (96·7–97·2; 32·5 vs 0·8 per 100 000 person-days) against symptomatic COVID-19, 97·2% (96·8–97·5; 4·6 vs 0·3 per 100 000 person-days) against COVID-19-related hospitalisation, 97·5% (97·1–97·8; 2·7 vs 0·2 per 100 000 person-days) against severe or critical COVID-19-related hospitalisation, and 96·7% (96·0–97·3; 0·6 vs 0·1 per 100 000 person-days) against COVID-19-related death. In all age groups, as vaccine coverage increased, the incidence of SARS-CoV-2 outcomes declined. 8006 of 8472 samples tested showed a spike gene target failure, giving an estimated prevalence of the B.1.1.7 [“British”] variant of 94·5% among SARS-CoV-2 infections.

Summarizing in table form:

Effectiveness against:percentageconfidence interval
Any level of SARS-CoV-2 infection95.394.9 — 95.7
Asymptomatic COVID-1991.590.7 — 92.2
Symptomatic COVID-1997.096.7 — 97.2
Hospitalization for COVID-1997.296.8 — 97.5
Severe or critical COVID-1997.597.1 — 97.8
Death related to COVID-1996.796.0 — 97.3
Effectiveness of Pfizer two-vaccine regime in Israel (mostly B.1.1.7 epidemic)

Lots more in the paper itself, which is not paywalled: https://doi.org/10.1016/S0140-6736(21)00947-8

(2) The recent proposal to make COVID19 vaccines patent-free is predictably raising the ire of the pharmaceutical industry. And here we have the topsy-turvy situation that statist Germany is telling the US, “not so fast!” and “beware of unintended consequences”. Also, more pertinently perhaps, “it is not intellectual property that’s the bottleneck, but production capacity”.

The EU, and especially European Commission chair, the German Ursula von der Leyen — learned this to their chagrin with the Oxford/AstraZeneca fracas. The low per-dose cost and permissive IP of that vaccine helped them little when the factories couldn’t churn out the doses fast enough. (It reminds me a little bit of “free healthcare” not being very useful if you have a 6-month wait for a specialist and a 2-year wait for surgery.)

(3) I have had my differences with Paul Mirengoff at times, but on this one he’s dead on target. It is a good reminder that (a) most journalists, and nearly all opinion journalists, are innumerate, and the exceptions rarely have more than the most superficial understanding of statistics; (b) while the “woke left” is setting new benchmarks in intellectual dishonesty every day, they sadly do not have a monopoly. I have to keep reminding myself that one can be a expert in one area of human endeavor and a complete fool in another outside one’s expertise.

Let me sign off with a little musical balm for the soul, courtesy of Franz Liszt and Paul Barton. Have a good weekend and, for my coreligionists, shabbat shalom

Concert Etude S.144 Nr. 3 in Db major, “Un Sospiro”

2 thoughts on “COVID19 mini-update, May 7, 2021: The Lancet paper on efficacy of Pfizer in Israel; Germany says, “patents are not the bottleneck, production capacity is”

  1. The papers from the even larger UK phase VI trial should be fascinating. Particularly since it allows comparison between three(? four?) different vaccines

  2. The surprise for me in the Lancet study is that there was almost no loss of efficacy in the 85+ age group. There has been talk about their immune response not being strong enough for the vaccines to work as well, but this shows that’s not actually true.

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