third dose

Triple-Jabbed Over-30s Have Higher Infection Rates Than the Unvaccinated, UKHSA Data Show

This week’s UKHSA vaccine surveillance report has landed – and this week a change. In the (in)famous Table 12, which shows rates of infections, deaths and hospitalisations per 100,000 by vaccination status, the data have suddenly switched to giving rates for triple-jabbed rather than two-or-more doses, meaning we no longer have continuity with our previous data. So sudden was the change in fact, that the report itself has not kept up with it, and the notes under the table still say the rates are for “people who have received either two doses of a COVID-19 vaccine or in people who have not received a COVID-19 vaccine”.

The change means we have to start over in our week-by-week comparisons, so the infection rates by age for this period are depicted above and the unadjusted vaccine effectiveness figures are depicted below.

Below is how the total reported infections for the period break down by vaccination status (in this chart vaccinated means one or more doses). While the chart doesn’t take into account the different numbers of people vaccinated and unvaccinated, with over 70% of infections in the vaccinated it does show that the outbreak is predominantly in vaccinated people.

Below is what our previous chart would look like if we just added the new data in, but the trend in the past week is obviously nonsense as they’ve changed the parameters. Still, it gives an indication of the difference between the double and triple jabbed, and note that all but the under-30s are still negative (meaning higher infection rates in the vaccinated than unvaccinated), and the under-30s are still low. Also, the over-70s declined since last week anyway, despite the switch to triple-jabbed only. Makes you wonder what the data for two-or-more doses would have shown.

Fourth Vaccine Dose Makes No Difference, Study From Israel Shows, as Infections and ICU Admissions Surge

A fourth dose of Covid mRNA vaccine is not effective against Omicron infection, preliminary research from Israel has shown. Health Policy Watch has more.

“Despite a significant increase in antibodies after the fourth vaccine, this protection is only partially effective against the Omicron strain, which is relatively resistant to the vaccine,” lead researcher Prof Gili Regev-Yochay, told a media briefing on Monday.

Some 154 health workers at Sheba Medical Center received their fourth Pfizer shot two weeks ago. A week ago, 120 health workers received a shot of Moderna following three doses of Pfizer one week ago.

They were matched with a control group of around 6,000 health workers who have been being followed by the hospital since the start of Israel’s vaccination campaign in December 2020. 

According to Regev-Yochay, the third dose resulted in “much higher antibodies, neutralisation and the antibodies were not just higher in quantity but also in quality” than the second dose – but the fourth vaccine did not show significant antibody increase.

“Maybe there are a few more antibodies but not much more compared to the third dose,” said Regev-Yochay.

Last week, she told Israeli Prime Minister Naftali Bennett that there had been a five-fold increase in antibodies in people who took the fourth dose, but she later told a radio station that “the amount of antibodies returns to the level it was after the third vaccine, not more. It’s nice, but it’s not what we expect from a booster”.

In addition, around the same percentage of hospital workers who received the fourth dose caught the virus as those who didn’t get the fourth booster. 

With the UKHSA reporting three-dose protection against Omicron at under 50% after 10 weeks, this suggests a limit to what repeated shots of the same vaccine can achieve.

The findings come as Israel experiences a large surge in reported infections and ICU admissions, despite 65% of the country being at least double-dosed, 46% being triple-dosed, and some even quadruple-dosed. It will be interesting to see how this translates into deaths (how many of them are incidental admissions?), and what this might tell us about Omicron and vaccines.

Vaccine Effectiveness Against Hospitalisation Plummets in Omicron Surge, Data Shows

The most striking point from this week’s UKHSA Vaccine Surveillance report – with data for the four weeks ending January 9th – is the sharp decline in unadjusted vaccine effectiveness (calculated from raw data, so not adjusted for potential confounders such as risk factors and testing behaviour) against hospitalisation (see above). The decline is particularly sharp for under-50s, with 18-29 year-olds dropping to 38% (meaning the hospitalisation rate was 38% lower among the vaccinated (two or three doses) than the unvaccinated). The sharpness of the drops coincides with the age groups with the lowest third-dose coverage (see below), which suggests it may be a waning effect accelerated by Omicron and offset by boosters.

Third doses in England (UKHSA)

Another possible explanation is that it is an artefact of the high number of incidental hospital admissions in recent weeks, with more than half of Covid hospital admissions being treated primarily for something else. Given vaccines offer little to no protection (or worse) against infection, they will offer the same lack of protection against incidental hospital admission as Omicron spreads in hospitals or is found in those admitted for other reasons. The difference by age may arise because infection rates in those under 50 are currently much higher than in those over 50. In truth, it is likely to be a bit of both, but without data specifically on those being treated primarily for Covid it’s difficult to get to the bottom of which is making the biggest difference.

Unadjusted vaccine effectiveness against infection continued to decline in older age groups and in under-18s this week, presumably due to the waning of the third and second doses. It is negative in all over-18s, meaning the infection rate is higher in the vaccinated than the unvaccinated; in the 18-70s it is lower than minus-100%, meaning the vaccinated are more than twice as likely to have an infection. It did however rise slightly in the 18-50s this week, from a very low base. UKHSA continues to claim this extraordinary data is a result of confounders such as different risk factors and testing behaviour between vaccinated and unvaccinated. However, the agency still has not published any data on these confounders (e.g. testing behaviour and co-morbidities by vaccination status), despite being asked repeatedly, nor made any attempt to estimate adjusted vaccine effectiveness based on this data. If you would like to ask it to do this you can email its head Mary Ramsay here (Twitter here).

Coronavirus is Nowhere Near Endemic, Says WHO

The coronavirus is “nowhere near” endemic, the World Health Organisation has said, and will not reach this point until it is “stable” and stops triggering unpredictable waves of infection that don’t “rely on external forces being placed in order to maintain that stability”. The Telegraph has the story.

Speaking at a press conference on Tuesday Dr. Catherine Smallwood, a senior emergency officer at WHO Europe, said it’s still too soon to suggest the world is moving into an endemic phase of COVID-19 – in spite of assertions from politicians in countries including the U.K. and Spain. …

“In terms of endemicity, we’re still a way off,” Dr. Smallwood told journalists. “Endemicity assumes that there’s stable circulation of the virus, at predictable levels with predictable waves of transmission… that doesn’t rely on external forces being placed in order to maintain that stability. But what we’re seeing at the moment, coming into 2022, is nowhere near that… we can’t just sit back and see a stable rate of transmission,” she said. 

“We still have a huge amount of uncertainty, we still have a virus that’s evolving quite quickly and posing quite new challenges. So we’re certainly not at the point of being able to call it endemic. It may become endemic in due course, but pinning that down to 2022 is a little bit difficult at this stage.”

At the weekend the Cabinet Minister Nadhim Zahawi said he believes the country is “witnessing the transition of the virus from pandemic to endemic”, while Spain’s Prime Minister this week urged Europe to consider the possibility of treating COVID-19 as an endemic illness, such as flu. 

But Dr. Smallwood warned governments “to hold back on behaving as if it’s endemic before the virus is actually behaving as if it’s endemic”.  She added that widespread vaccination uptake on an equitable basis will be “very very key in moving toward this scenario”. 

Worth reading in full.

Note the multiple fantasies in this alarmist statement. “Widespread vaccination uptake on an equitable basis will be ‘very very key in moving toward this scenario'” – even though we already have very widespread vaccine take-up and infection rates are as high as ever.

Endemicity requires stability that “doesn’t rely on external forces being placed in order to maintain that stability” – even though there is no evidence “external forces” (i.e., interventions) have done anything to limit the spread of the virus.

Endemicity “assumes that there’s stable circulation of the virus, at predictable levels with predictable waves of transmission” – even though there’s nothing predictable about existing endemic viruses like those which cause colds and flu.

So what’s the idea now? Vaccines don’t stop the spread, restrictions don’t stop the spread, hardly anyone is getting very sick and health services can cope, but for some reason we still have to stay on an emergency footing and not move on from the pandemic?

Meanwhile, Pfizer CEO Albert Bourla has said that a vaccine for Omicron will be ready in March and the company has begun manufacturing the doses. He also admitted that two doses are no longer any good against severe disease – though he may have had other motives for implying more doses of his product are necessary for protection. The Independent has the story.

End Covid Vaccination Campaign, Says Ex-Head of Vaccine Taskforce

Covid should be treated as an endemic virus similar to flu, and ministers should end mass-vaccination after the current booster campaign, Dr. Clive Dix the former Chairman of the U.K.’s vaccine taskforce has said. The Guardian has the story.

With health chiefs and senior Tories also lobbying for a post-pandemic plan for a straining NHS, Dr. Clive Dix called for a major rethink of the U.K.’s Covid strategy, in effect reversing the approach of the past two years and returning to a “new normality”.

“We need to analyse whether we use the current booster campaign to ensure the vulnerable are protected, if this is seen to be necessary,” he said. “Mass population-based vaccination in the U.K. should now end.”

He said ministers should urgently back research into Covid immunity beyond antibodies to include B-cells and T-cells (white blood cells). This could help create vaccines for vulnerable people specific to Covid variants, he said, adding: “We now need to manage disease, not virus spread. So stopping progression to severe disease in vulnerable groups is the future objective.”

A rare moment of sanity at a time when policy seems increasingly to be driven by something other than the evidence. May it signal a change in the wind.

Worth reading in full.

Vaccine Effectiveness Plummets to as Low as Minus-151% as Omicron Cancels Out Boost From Third Doses

Omicron bites hard in the UKHSA Vaccine Surveillance report this week, as unadjusted vaccine effectiveness against infection (calculated from the raw data) plummets across all age groups in the month ending January 2nd 2022. The revival in some age groups from the third doses has now been almost completely cancelled out, as all age groups above 18 years go negative again. Those in their 40s hit a new low of minus-151% (negative vaccine effectiveness means the vaccinated are more likely to be infected than the unvaccinated; a vaccine effectiveness of minus-100% means the vaccinated are twice as likely to be infected as the unvaccinated). There is a sharp drop for under-18s for the first time as well, with unadjusted vaccine effectiveness more than halving in a fortnight, collapsing from 79% to 38% (there was no report last week due to the Christmas holiday).

To underline the pointlessness of vaccine passports and mandates for preventing spread, I have plotted in the chart below the proportions of infections in the unvaccinated and vaccinated for the month ending January 2nd (in this chart ‘vaccinated’ includes all who have received at least one dose; in the other charts in this post ‘vaccinated’ means at least 14 days after a second dose). It shows that 72% or nearly three quarters of infections in that four-week period were in the vaccinated (65% in the double or triple vaccinated) and only 22% in the unvaccinated. That is certainly not an epidemic of the unvaccinated; almost the opposite, in fact.

Omicron has also had an impact on unadjusted vaccine effectiveness against hospitalisation, with sharp declines occurring particularly in the younger age groups with lower booster coverage. The decline in 18-29 year-olds is particularly steep, dropping to just 50%, meaning double vaccination is only halving the risk of hospitalisation (though keep in mind this is unadjusted vaccine effectiveness based on raw data, not taking into account any potential confounders in either direction).

We Can’t Vaccinate the Planet Every Six Months, Says JCVI Chief

Professor Sir Andrew Pollard, the head of Britain’s vaccine body, has said fourth jabs should not be offered until there is more evidence as he warned that giving a new dose to people every six months was “not sustainable”. In an interview with the Telegraph the Chairman of the Joint Committee on Vaccination and Immunisation (JCVI) also said there was no point in trying to stop all infections, and that “at some point, society has to open up”.

Speaking to mark the first anniversary of the AstraZeneca jab rollout last January, Sir Andrew said: “The worst is absolutely behind us. We just need to get through the winter.”

He wants lockdowns to be consigned to history, adding: “At some point, society has to open up. When we do open, there will be a period with a bump in infections, which is why winter is probably not the best time.

“But that’s a decision for the policy makers, not the scientists. Our approach has to switch, to rely on the vaccines and the boosters. The greatest risk is still the unvaccinated.”

Sir Andrew cautioned against blindly following Israel and Germany, which have given the green light to a second set of boosters to all over-60s.

“The future must be focusing on the vulnerable and making boosters or treatments available to them to protect them,” he said. 

“We know that people have strong antibodies for a few months after their third vaccination, but more data are needed to assess whether, when and how often those who are vulnerable will need additional doses.”

Vaccines can rapidly be adapted to fight new variants, but he said: “We can’t vaccinate the planet every four to six months. It’s not sustainable or affordable. In the future, we need to target the vulnerable.”

Worth reading in full.

UAE Bans Citizens From Leaving Country Without Third Vaccine Dose

The United Arab Emirates has announced a ban on citizens who have not had three doses of a Covid vaccine from travelling abroad. In a notable tightening of the country’s vaccine passport travel regime, medical exemptions will apply but there is no option of a negative test. The BBC has the story.

Officials said the exit ban, which comes into force on January 10th, would not apply to those who are medically exempt from receiving the vaccine.

It is the latest country to announce new curbs amid a rise in infections.

Many countries impose strict restrictions on unvaccinated people before they are allowed in.

This varies from a requirement for a negative Covid test before travel to mandatory quarantine upon arrival.

More than 90% of the population in the UAE has been fully vaccinated against COVID-19. About 34% had received the booster jab as of December 24th, according to Our World in Data.

The Government says the aim is to prioritise “health and safety” but it’s not clear how requiring triple vaccination to leave the country will protect the country from importing infections. It suggests the aim may be more to incentivise third dose take-up than actual infection control.

Worth reading in full.

Vaccine Effectiveness Drops Below Zero in 18-29 Year-Olds for First Time – But Boosters Appear to be Helping

The latest UKHSA Vaccine Surveillance report, containing data for the month ending December 12th, brings mixed news on the vaccines. First the bad news. Unadjusted vaccine effectiveness based on the raw reported infection rates is still negative for all aged between 18 and 70 (see above). In fact, it’s gone negative for the first time in 18-29 year-olds, down to minus-10.1%, after a sharp drop in the last week. A negative vaccine effectiveness means the infection rate per 100,000 people is higher in the vaccinated than the unvaccinated. This means that vaccine passports and vaccine mandates will be ineffective at preventing transmission, and indeed it implies that the vaccinated are actually a higher transmission risk than the unvaccinated. Far from protecting the vaccinated from the unvaccinated, then, as much current policy seems intended to do, perhaps the unvaccinated should be wary of the company of the vaccinated. For those in their 40s in particular, unadjusted vaccine effectiveness is minus-119%, meaning the vaccinated are more than twice as likely to be carrying the virus as the unvaccinated.

The goods news, however, is that the boosters appear to be having a significant impact. Unadjusted vaccine effectiveness has been rising in the older age groups for some weeks, and is now solidly positive in the over-70s, albeit at a not-very-impressive 39.5% in 70-79 year-olds and 53.3% in the over-80s. That this rise is likely due to the third doses is indicated by the fact it has occurred in staggered fashion in each age group, apparently in line with when boosters were rolled out.

What appears to be the case to the casual eye has been put more rigorously to the test by Dr. Richard J. Booth, a retired civil servant with a Ph.D. in mathematical statistics. In a new piece published by the Daily Sceptic today, Dr. Booth undertakes statistical analysis to compare the booster rollout rates in each age group with the changes in the relative reported infection rates to see if there is any correlation over time. He explains:

It occurred to me that since the third doses have been deployed at different rates in the different age groups, it might be possible to observe, and analyse, a ripple of decreasing infection rates from older to younger people over the last few weeks. So I developed a statistical model for infection rates, including a value dependent on the week (because the epidemic progresses at a rather unpredictable rate from week to week), and a week-dependent value proportional to the number of people who two or more weeks earlier had had the third dose compared with the number having had at least the first dose. I divided out the infection rate data by its value in the first week, to put the different age ranges on the same footing.

He concludes that what appeared to be the case is validated by his model, and the booster rollout correlates well with the changes in relative infection rates.

I conclude that though three doses of vaccines may have been effective from the outset, statistical support for that proposition via these sources did not become apparent until week 44’s data was published, when nearly half of over 80’s had had boosters two or more weeks earlier, but has been sustained since then. Of course, ‘statistical support’ is not a cast-iron proof, as correlation is not causation and there might be ‘unknown unknowns’ at work. Nevertheless it is highly suggestive that the prior statistical work on Covid vaccines is vindicated here.

While not all readers will follow every detail in Dr. Booth’s thorough and technical article, it is well worth checking out.

Plans for “Booster” Covid Vaccine Roll-Out Coming Within Weeks

Health Secretary Matt Hancock says that plans for a “booster” Covid vaccine roll-out in the autumn will be set out in the coming weeks. BBC News has the story.

The Health Secretary said ministers were waiting for results from trials of different combinations of vaccines.

It comes after doctors and NHS trusts said planning for a booster rollout must start now as it will involve bigger challenges. 

They said many questions needed answering, including how long immunity from the original Covid jab lasts.

The issue of whether children will be vaccinated also still remains, health leaders said.

“We are currently trialling which combinations of jabs are the most effective,” Mr Hancock told BBC Breakfast. 

“In the next few weeks, when we get the clinical data through on what’s the most effective combinations to have… then we’ll set out all the details for the booster programme for the autumn.”

Among the ongoing trials is the U.K.’s Cov-Boost trial, which is testing different combinations of third doses across England. 

A senior Government source said the U.K. would also benefit from new vaccines from Novavax and Valneva, which are awaiting approval from the U.K.’s medicines regulator. 

So far, nearly 60% of U.K. adults have had two jabs of the vaccine, meaning they are fully vaccinated, and more than four in five adults have had their first dose.

People have been rushing to get their vaccines in recent days, with more than one million jabs booked on Friday and Saturday in England after vaccinations opened to all over-18s.

Worth reading in full.