Public Health England

New PHE Data Shows Vaccine Effectiveness Against Delta Down to Just 7.6% in the Over-50s, 24% in the Under-50s, as the Vaccinated Continue to Experience Higher Infection Rate

The latest Technical Briefing on the Variants of Concern, number 23, has been published by Public Health England (PHE), so we can update our (unadjusted) estimates of vaccine effectiveness against the Delta variant using the data it includes from sequenced Delta samples from positive PCR test results in England.

As before, we subtract the figures in the latest briefing, now no. 23, from those in briefing 17 to give the figures for the period June 22nd to September 12th. This gives us a picture for the whole Delta surge, which allows for the fact that most of the early reported infections were in the unvaccinated and most of the later reported infections were in the vaccinated (see below). PHE has recently also published the most recent month’s data for all reported infections (not just sequenced Delta ones), which shows lower vaccine efficacy in the most recent four weeks (a new report released on Friday shows this has dropped even further in the most recent week). However, given the apparently delayed infections in the vaccinated, it seems most accurate to look at the figures for the whole surge, not just the last month, when estimating vaccine efficacy against Delta.

We also use figures for proportions of the population vaccinated by age derived from the PHE Covid surveillance reports.

Starting with the over-50s, for the period June 22nd to September 12th, PHE reports 68,445 Delta infections in the double vaccinated and 7,575 in the unvaccinated. PHE figures show that in this period the proportion of the over-50s double vaccinated increased from 87% to 89%, giving a mean of 88%, and the proportion unvaccinated was stable at 9%. Calculating the vaccine effectiveness against Delta infection in the over-50s (1-(68,445/88%)/(7,575/9%)) gives a figure of just 7.6%. This is down from 15% two weeks ago and 24% two weeks before that. This continues to be very different to the estimate in the recent Oxford University study using ONS survey data, a study which I criticised for numerous inconsistent and implausible findings.

With regard to deaths with Covid (within 28 days of a positive test), PHE reports 1,515 in the double vaccinated and 552 in the unvaccinated in the over-50s in this period. This works out (1-(1,515/88%)/(552/9%)) at a vaccine effectiveness against death of 72%, down slightly from 74% using data from the previous briefing. This is a 72% reduction in mortality including any reduced risk of infection, not in addition to it. It continues to be an encouraging figure, albeit lower than earlier studies have suggested, and dropping week on week.

For the under-50s, for the period June 22nd to September 12th, PHE reports 81,718 Delta infections in the double vaccinated and 195,957 in the unvaccinated. PHE figures show that in this period the proportion of under-50s double vaccinated increased from 18% to 42%, giving a mean of 30%, and the proportion unvaccinated decreased from 61% to 50%, giving a mean of 55%. Calculating the vaccine effectiveness against Delta infection in the under-50s (1-(81,718/30%)/(195,957/55%)) gives a figure of 24%. This is down from 27% two weeks ago and 37% two weeks before that, and though higher than in the over-50s, is still very low and much lower than earlier studies (including the trial) indicated.

For deaths, PHE reports 48 in the double vaccinated and 126 in the unvaccinated in the under-50s in this period. This works out (1-(48/30%)/(126/55%)) at a vaccine effectiveness against death of 30%. This is up from 20% two weeks ago and 12% two weeks before that, but is still very low and much lower than in the over-50s. This may be because higher risk people are prioritised for vaccination, or are more likely to consent to it, in the younger age groups, and the rising efficacy may reflect the increase in lower risk people being vaccinated.

These figures are much lower than those commonly quoted and used in modelling, and if they are closer to the truth then they mean the official, self-congratulatory estimates of “100,000 deaths” and “24.4 million infections” prevented by the vaccines are huge overestimates.

By plotting the differences between the reported total Delta cases in the last five briefings we can also get a picture of how they are changing over time in the different age and vaccine-status cohorts. The red and yellow lines in the chart below show that new reported Delta infections in the unvaccinated have continued gently to increase, as have reported infections in the vaccinated over-50s (dark green line). On the other hand, new reported Delta infections in the vaccinated under-50s dropped in the last two weeks, driving an overall drop in reported Delta infections in the vaccinated. This may mark the peak of the Delta surge in the vaccinated, and possibly overall, though the gentle rise in reported infections in the unvaccinated since the start of August adds a smidgen of doubt into that inference.

Why is the ONS Claiming Just 1% of Covid Deaths Are in the Vaccinated When PHE Data Shows the True Figure For August was 70%?

The ONS has published a new study on Covid deaths which purports to show how few vaccinated people die of Covid. Here’s how the Telegraph reported the headline claim: “Only 59 fully vaccinated people without serious health conditions died from COVID-19 out of more than 50,000 deaths in England this year, new figures from the Office for National Statistics (ONS) show.”

The Telegraph report continues:

In the first study of deaths by vaccination status, the ONS found that around 99% of COVID-19 deaths between January 2nd and July 2nd 2021 were in people who had not had two doses.

Overall 640 (1.2%) of deaths were in those who had received both vaccine doses, but the ONS said many of those could have been infections picked up before the second dose. 

Just 256 deaths (0.5%) were considered true “breakthrough” infections where the second dose had long enough to work, but still did not offer protection. 

However, the average age of those “breakthrough” infections was 84 and the majority (76%) were classed as “extremely clinically vulnerable”. Just 59 did not have serious medical conditions.

These statistics appear remarkable – until you realise what they’ve done. Although the data is presented as “this year” in fact the cut-off date is July 2nd. That is significant because it is just before the Delta surge got going. This means the data all comes from the Alpha surge, when almost no-one was vaccinated and tens of thousands of Covid deaths were reported, and from the quiet spring and early summer when many were vaccinated but almost no-one died (see chart below).

Robert Peston Shocked by Lack of Debate on Vaccine Effectiveness – Before Caving to Critics and Apologising for Questioning Vaccine Effectiveness

I wrote earlier in the week about the latest vaccine data from Public Health England (PHE) and how it shows that in the last month reported infection rates have been higher in the double vaccinated than in the unvaccinated for those aged 40-79 – up to 38% higher in some age bands.

Usually, data like this that casts the vaccines in a bad light is not reported by major media outlets – they tend to stick only to reporting on the press releases from actual studies rather than presenting implications from real-world data, which means they typically include whatever spin and ‘adjustments’ the researchers have added.

Unusually, this time Robert Peston decided to report on the new PHE data for ITV News. Inspired it seems by the fact that he has just had Covid despite being double-vaccinated, he wondered how many others had experienced similar, and was surprised to find in the data that it was actually very common.

He remarks: “I am surprised these statistics have received so little attention and have occasioned so little debate.”

Why is he surprised, though, when the fact is PHE has been publishing statistics like these for months showing that the infection rate in the vaccinated has been rising. Most journalists haven’t reported on them before, including Peston (who seems unaware of them, given that he is discovering this data for the first time), so why would they start now? Particularly when the vaccine surveillance report they come from specifically warns readers against using the raw data to estimate vaccine effectiveness and refers them to the published studies summarised higher up. Nothing to see here, is the message.

If Peston was unsure why other journalists weren’t reporting on this data, he soon found out, as the Twitterati piled on him for daring to cast the vaccines in a negative light. Many accused him of failing to recognise that this was just because the large majority of people over 40 were vaccinated, so of course they had more infections – which only made themselves look foolish as Peston was clearly quoting rates by vaccination status (the proportions of the vaccinated and unvaccinated who were infected), so this was accounted for. The statistics show the double vaccinated have higher rates of infection than the unvaccinated – that was his point.

Vaccines Have NEGATIVE Effectiveness in the Over-40s, as Low as MINUS 38%, Shows New PHE Report

Public Health England (PHE) published their latest weekly vaccine surveillance report on Thursday. Usually these just summarise other studies so are not particularly interesting, but this week something new appeared that has been widely asked for but elusive: data on cases, hospitalisations and deaths broken down by age and vaccination status.

Although the fortnightly technical briefings on the variants of concern have a breakdown of sequenced Delta cases broken down by vaccination status and into the over-50s and under-50s, this is the first time PHE has published general data on all cases (not just sequenced ones) split up by age and vaccination status.

The data comes from the Second Generation Surveillance System (SGSS), the relationship of which to the Government dashboard data is unclear, though the figures are similar. It reports 722,728 cases in the reporting period, compared to the dashboard figure of 727,010 by specimen date, so this seems comprehensive. On the other hand, it includes 6,605 hospitalisations, whereas the dashboard has 21,242, more than three times as many, though this may be due to how it counts hospitalisations (“Cases whom [sic] presented to emergency care (within 28 days of a positive specimen), resulting in overnight inpatient admission”). It has 2,381 deaths, against the dashboard’s 2,496, so again this is most of them.

It is just data for the past month, August 9th to September 5th. We can use it to calculate a rough estimate of unadjusted vaccine effectiveness in different age cohorts for this four-week period.

PHE Data Update: Vaccine Effectiveness Just 15% in Over-50s, 27% in Under-50s. Deaths Cut by 74% in Over-50s, But Just 20% in Under-50s

The latest Technical Briefing on the variants of concern, number 22, has been published by Public Health England (PHE), so we can update our (unadjusted) estimates of vaccine effectiveness against the Delta variant using the data it includes from sequenced Delta samples from positive PCR test results in England.

As before, we subtract the figures in briefing 22 from those in briefing 17 to give the figures for the period June 22nd to August 29th. We also use figures for proportions of the population vaccinated by age derived from the PHE Covid surveillance reports.

Starting with the over-50s, for the period June 22nd to August 29th, PHE reports 47,874 Delta infections in the double vaccinated and 5,748 in the unvaccinated. PHE figures show that in this period the proportion of the over-50s double vaccinated increased from 87% to 89%, giving a mean of 88%, and the proportion unvaccinated was stable at 9% (Note: not 10% as I stated previously). Calculating the vaccine effectiveness against Delta infection in the over-50s (1-(47,874/88%)/(5,748/9%)) gives a figure of 15%. This is the same as the figure I calculated two weeks ago, though now using the more accurate figure of 9% rather than 10% for the proportion unvaccinated. This means that it represents a decline (using 9% for the previous calculation would give a VE of 24%). This continues to be very different to the estimate in the recent Oxford University study using ONS survey data, a study which I criticised for numerous inconsistent and implausible findings.

With regard to deaths with Covid (within 28 days of a positive test), PHE reports 1,004 in the double vaccinated and 399 in the unvaccinated in the over-50s in this period. This works out (1-(1,004/88%)/(399/9%)) at a vaccine effectiveness against death of 74%, down slightly from 75% using data from the previous briefing (even with the change to 9% unvaccinated). This is a 74% reduction in mortality including any reduced risk of infection, not in addition to it. It continues to be an encouraging figure, albeit lower than earlier studies have suggested, and dropping week on week.

For the under-50s, for the period June 22nd to August 29th, PHE reports 58,714 Delta infections in the double vaccinated and 160,143 in the unvaccinated. PHE figures show that in this period the proportion of under-50s double vaccinated increased from 18% to 39%, giving a mean of 28%, and the proportion unvaccinated decreased from 61% to 51%, giving a mean of 56%. Calculating the vaccine effectiveness against Delta infection in the under-50s (1-(58,714/28%)/(160,143/56%)) gives a figure of 27%. This is down from 37% two weeks ago, and though higher than in the over-50s, is still very low and much lower than earlier studies (including the trial) indicated.

For deaths, PHE reports 37 in the double vaccinated and 93 in the unvaccinated in the under-50s in this period. This works out (1-(37/28%)/(93/56%)) at a vaccine effectiveness against death of 20%. This is up from 12% two weeks ago, but is still very low and much lower than in the over-50s. This may be because higher risk people are prioritised for vaccination, or are more likely to consent to it, in the younger age groups.

These figures are much lower than those commonly quoted and used in modelling, and if they are closer to the truth then they mean the official, self-congratulatory estimates of “100,000 deaths” and “24.4 million infections” prevented by the vaccines are huge overestimates.

By plotting the differences between the reported total Delta cases in the last four briefings we can also get a picture of how they are changing over time in the different age and vaccine-status cohorts. The red and yellow lines in the chart below show that new Delta infections in the unvaccinated have started to increase again, but not by as much as those in the vaccinated (for this purpose, all who are at least 21 days after their first dose), which have continued to surge. A majority of new infections (57,565 out of 94,148, or 61%) are now in the vaccinated. This means that the recent increase in reported infections in England is being driven primarily by infections in the vaccinated. The fainter lines show the trends in the over- and under-50s, indicating that in both age cohorts new Delta infections in the vaccinated now outnumber those in the unvaccinated, and that new infections in the vaccinated over-50s are increasing particularly fast. This helps to explain the declining vaccine effectiveness estimates given above.

The Fatal Flaw in PHE’s New Study Claiming Delta “Doubles Risk of Hospitalisation” Compared to Alpha

A new study from Public Health England (PHE) and Cambridge University was published in the Lancet last week, claiming to find that the Delta variant “doubles a patients’ risk of hospitalisation compared to the Alpha variant”, as the Telegraph reported (as did the BBC).

Reviewing over 40,000 sequenced positive PCR test results from England between March 29th and May 23rd, 2021, the researchers found that 2.2% of Alpha infections (764/34,656) and 2.3% of Delta infections (196/8,682) were hospitalised within 14 days of their first positive test. However, once they adjusted for factors such as age, ethnicity and vaccination status they found the risk of hospitalisation from Delta more than doubled compared with Alpha (a 2.26-fold increase).

The authors took the opportunity to use the results to stress the importance of being vaccinated, noting that only two per cent of those hospitalised were double vaccinated. However, this data is out of date, as more recent data from the main Delta surge suggests that vaccine efficacy against Delta infection may be as low as 15%.

The finding that Delta is more than twice as serious as Alpha is surprising as official data shows that hospitalisations have been much lower with Delta than Alpha. Data in the PHE technical briefings on the variants of concern shows that between February 1st and August 15th, 2.9% of sequenced Alpha infections resulted in an overnight hospital stay, compared with 1.9% of sequenced Delta infections. Technical Briefing 21 (the most recent) acknowledges this but adds that “a more detailed analysis indicates a significantly greater risk of hospitalisation among Delta cases compared to Alpha (see page 50 of Variant Technical Briefing 15)”.

Technical Briefing 15 quotes the findings, then in pre-print form, which are now published in the Lancet study (I criticised an earlier version of the claim here).

March 29th to May 23rd, the study period, is notable for being a period of low prevalence in England, when there were only around 2,000 reported infections a day (compared to a peak of around 50,000). In the over-60s in that period there were only 100-200 reported infections per day.

Latest PHE Data Shows Vaccine Effectiveness Down to Just 15% in the Over-50s, 37% in the Under-50s. Deaths Cut by 76% in Over-50s, But Just 12% in Under-50s

Public Health England (PHE) has released a new technical briefing on the variants of concern, number 21, and this allows us to update our estimate of (unadjusted) vaccine effectiveness against the Delta variant using the data it provides on confirmed Delta cases.

We subtract the figures in briefing 21 from those in briefing 17 to give the figures for the period June 22nd to August 15th. We also use figures for proportions of the population vaccinated by age derived from the PHE Covid surveillance reports.

Starting with the over-50s, for the period June 22nd to August 15th, PHE reports 29,282 Delta infections in the double vaccinated and 3,915 in the unvaccinated. PHE figures show that in this period the proportion of the over-50s double vaccinated was stable at 88% and the proportion unvaccinated was 10%. Calculating the vaccine effectiveness against Delta infection in the over-50s (1-(29,282/88%)/(3,915/10%)) gives a figure of just 15%, down from 17% using data from the briefing two weeks ago. This is very different to the estimate in the recent Oxford University study using ONS survey data, a study which I criticised for numerous implausible findings.

With regard to deaths with Covid (within 28 days of a positive test), PHE reports 602 in the double vaccinated and 280 in the unvaccinated in the over-50s in this period. This works out (1-(602/88%)/(280/10%)) at a vaccine effectiveness against death of 76%, down slightly from 77% using data from the previous briefing. This is a 76% reduction in mortality including any reduced risk of infection, not in addition to it. It’s an encouraging figure, albeit lower than earlier studies have suggested.

For the under-50s, for the period June 22nd to August 15th, PHE reports 36,855 Delta infections in the double vaccinated and 125,394 in the unvaccinated. PHE figures show that on June 20th 61% of under-50s were unvaccinated while 18% were double vaccinated. On August 15th those figures were 52% unvaccinated and 35% double vaccinated. Taking the average of these gives 56% unvaccinated and 26% double vaccinated for the period. Using this to calculate the vaccine effectiveness against Delta infection in the under-50s (1-(36,855/26%)/(125,394/56%)) gives a figure of 37%. This is higher than in the over-50s, but still very low and much lower than earlier studies (including the trial) indicated.

For deaths, PHE reports 27 in the double vaccinated and 66 in the unvaccinated in the under-50s in this period. This works out (1-(27/26%)/(66/56%)) at a vaccine effectiveness against death of just 12%. Why this would be so much lower than in the over-50s is unclear, but it’s worth bearing in mind that these are small numbers of deaths which may make the estimate unreliable.

These figures are much lower than those commonly quoted and used in modelling, and if they are closer to the truth then they mean the official, self-congratulatory estimates of “100,000 deaths” and “24.4 million infections” prevented by the vaccines are huge overestimates.

By plotting the differences between the reported total Delta cases in the last three briefings we can also get a picture of how they are changing over time in the different age and vaccine-status cohorts. The red and yellow lines in the chart below show that new Delta infections in the unvaccinated have stayed largely flat over the past fortnight, but those in the vaccinated (for this purpose, all who are at least 21 days after their first dose) have surged, so that a majority of new infections (44,038 out of 76,117, or 58%) are now in the vaccinated. This reveals that the recent modest increase in positive cases in England is being driven primarily by infections in the vaccinated. The fainter lines show the trends in the over- and under-50s, indicating that in both age cohorts new Delta infections in the vaccinated now outnumber those in the unvaccinated. This helps to explain the declining vaccine effectiveness estimates given above.

Public Health Scotland Admits That the Majority of People Hospitalised and Testing Positive for Covid Are Vaccinated

The latest Covid report from Public Health Scotland has gone back to adding data normally after last week where a backlog was added without any kind of helpful differentiation between the normal data and the one-off additions. This means we can resume our effort to get a rough estimate of how well the vaccines are preventing death.

Here’s the data so far presented by week.

In the bottom right table I have ignored the week July 16th-22nd, when the backlog was added, to get two weeks’ worth of data covering July 9th-15th and July 23rd-29th. Focusing just on the over-50s (for which vaccination rates are now stable), we can see that there were 14 deaths in the unvaccinated added in those two weeks and 60 deaths in the double vaccinated. Using our rough estimates from last time of vaccine coverage in the over-50s of 7% unvaccinated and 91% double vaccinated, this gives a (roughly estimated) vaccine effectiveness against death in those two weeks of 67% (1-((60/91%)/(14/7%)). This is up from 46% from one week’s data last time, and heading closer to the estimate from PHE data of 77%. This is perfectly respectable and will (if correct) be contributing to reducing the death toll from COVID-19, but is notably much lower than the up-to-99% effectiveness against death currently estimated by PHE in their official reports.

Another point of note from the latest PHS report is that it shows that the majority of both new positive cases and hospital admissions are in vaccinated people. According to the report, in the four weeks up to August 6th, “48.1% of COVID-19 positive PCR cases were in unvaccinated individuals” and “46.8% of COVID-19 related acute hospital admissions were in unvaccinated individuals”. There are confounders of age and the proportion of the population vaccinated, of course, but even so this shows that any attempt to claim that the majority of current infections or hospitalisations are in unvaccinated people is misleading.

The growing share of the vaccinated in new infections and hospitalisations also appears to be confirmation of the phenomenon noted from PHE data earlier this week, where infections in the unvaccinated peaked and declined ahead of those in the vaccinated. This phenomenon warrants further investigation.

PHE Data Confirms That New Infections Peaked and Dropped in the Unvaccinated Before They Did in the Vaccinated

Back in early July I noted that data from the ZOE Covid Symptom Study was showing that new infections in the unvaccinated were peaking and falling while those in the vaccinated were still surging.

This was not a phenomenon noted elsewhere and prompted questions about whether it showed that the vaccines were delaying infection, or whether it was primarily an age-based phenomenon. Unfortunately, before anyone was able to investigate further, within a couple of weeks ZOE had ‘updated‘ their methodology and in their new data the phenomenon had oddly disappeared.

Alarming Data from PHE Shows the Fatality Rate in the Vaccinated Under-50s is 57% Greater Than in the Unvaccinated

Yesterday I wrote about the new data from Public Health England that allows us to make a (rough) calculation of vaccine efficacy during the Delta surge. Using data from technical briefings 17 and 20 I calculated that vaccine efficacy against infection with the Delta variant in the over-50s was a disappointing 17%. Vaccine efficacy against mortality was a better (if lower than expected) 77%.

The Daily Expose also published a piece looking at the new PHE data and argued that it showed vaccination was actually increasing the risk of hospitalisation and death. Their analysis did not break the results down by age, however, and so did not take into account that most of the infections are in the young, who are less vaccinated, and most of the deaths are in the old, who are much more vaccinated. That’s why my analysis focused on the over-50s, and when you do that you find the vaccines reduced mortality during the Delta surge in that age group by around 77%.

The Daily Expose article helpfully drew attention to the fact that in a recently published document, the Government advisers on SAGE themselves appear to admit that the vaccines do not prevent infection and transmission. In paragraph eight, they write:

While we feel that current vaccines are excellent for reducing the risk of hospital admission and disease, we propose that research be focused on vaccines that also induce high and durable levels of mucosal immunity in order to reduce infection of and transmission from vaccinated individuals. This could also reduce the possibility of variant selection in vaccinated individuals.

This being the case, why is SAGE not advising the Government to cease all aspects of the vaccination programme based on the idea of reducing transmission and protecting others (vaccine passports, the coercion of young people, vaccination of children and so on) as its members clearly don’t believe that these things are backed up by sound scientific evidence?