A friend of mine pointed me in the direction of this blog post by New Zealand’s “Plan B” group. While initially this group opposed the government’s use of lockdowns to manage covid19 outbreaks in this country, they seem to have since moved on to opposing the rollout of vaccines against SARS-Cov-2. And, while they claim to be “injecting evidence into the vaccine spin,” on balance the spin is on their part¹.
Why do I say this? Let me count the ways.
The authors of this Plan B post, Simon Thornley & Gerhard Sundborn, describe the Pfizer/BioNTech vaccine as
the least tested vaccine in living memory
The Phase III randomised controlled trial (RCT) for this vaccine involved 43,000 people – more participants than in pretty much any other vaccine RCT. For example, this large trial of Gardasil involved nearly 19,000 young women. This trial, comparing MMR-II against the earlier MMR, had 996 participants. And in the Pfizer phase III trial, each individual participant was watched closely for 42 days – the same as for volunteers in that MMR-II trial & in fact for most vaccine trials. (This is relatively easy to check at the US Library of Medicine’s clinical trials register.)
Or perhaps it was the speed of development that bothers them, going by this comment:
Plan B had worried that vaccines would take years to pass the usual safety and effectiveness tests. We hadn’t counted on the panic being so strong that usual stages would be curtailed.
Which stages would those be? Animal testing and Phase I, II, & III trials were all completed; the results are presented and discussed in this paper in the New England Journal of Medicine. It didn’t take a great deal to develop the vaccine itself, given that research into mRNA vaccines & their delivery has been ongoing for several decades (see this review paper, for example), and manufacturing the mRNA strand itself could begin once the viral genome had been sequenced (and that information was first available in January 2020). While it’s true that most clinical trials last several years, much of this time is actually occupied in finding funding for each phase, and in enrolling participants – it can take a couple of years just to enlist enough volunteers to obtain statistically reliable data. Neither of those posed a problem this time round: the RCT enrolled those 43,000 people in a matter of a few months.
They go on to refer to a blog post on the BMJ webpage by Peter Doshi, including his statement that “the rate of ‘suspected, but not confirmed’ covid-19 were similar between the two groups: with 1,594 cases in the vaccinated and 1,816 in the placebo.” Doshi felt that the “suspected” cases should have been included in analyses. Virologist John Skylar explains why this is incorrect.
They then say
[since] the primary outcome of the trial is related to mild covid-19 events, we know little about whether the vaccine prevents deaths from the virus.
While this was true at the time that the trial results were published, I am moved to wonder, since we’re 4 months further down the track, why Thornley and Sundborn don’t refer to more recent “real-world” studies. Studies like this paper, also in the NEJM, which describes the impact of Israel’s impressive vaccination rollout. Figure 2 from that paper addresses their concerns very well: it clearly shows that documented infections, symptomatic covid-19, covid-19 hospitalisations, severe disease, and deaths due to covid-19 are all significantly lower in the vaccinated section of the population. The Our World in Data website also provides useful information on both Israel’s vaccine rollout and covid-19 infections, hospitalisations, severe disease & deaths, on an ongoing basis. (In fact, they do this for every country where data are available.)
Or this one, described in correspondence to the editor of the NEJM: it describes the effectiveness of vaccination in the healthcare workers at the University of Texas Southwestern Medical Centre. The vaccine was shown to be effective at preventing infections in both fully- and partially-vaccinated staff compared to non-vaccinated staff, with the flow-on effect of reducing the number of staff in quarantine or isolation and so reducing pressure on the medical/nursing workforce during a surge in hospitalisations. You can dig into the data via this nice interactive infographic.
In other words, the following statement is just wrong: “We simply don’t know whether the vaccine will prevent what really matters: hospital and intensive care admissions and deaths.” The data from Israel indicate that the vaccine does achieve this, and so I have to conclude that if anyone is being disingenuous here, it’s not the government in its promotion of the vaccine.
¹ This wouldn’t be the first time. In a previous post, Plan B claimed that Prof Shaun Hendy (the Director of Te Pūnaha Matatini) had predicted that there would be up to 80,000 deaths from covid19 in NZ, “even with stringent lockdowns in place”. Even a cursory check reveals that he said the opposite (my emphasis): “Modelling showed that, left unchecked, the virus would infect 89 percent of the population and up to 80,000 people would die.”