UKHSA Efficacy Stats Death Watch: Week 48

We’re republishing a post this morning by the German Substacker who calls himself ‘Eugyppius’. Looks like he’s been kicked off Twitter – shock! You can subscribe to his Substack email newsletter here.

Not much has changed in the UKHSA Week 48 Covid vaccine surveillance report. Cases by vaccination status:

We see continued improvement in infection rates in the 80+ vaccinated cohort, extending to the those in their 70s as well. This is very likely down to the booster campaign, and it’s more or less what we’d have expected: the vaccines provide protection that after some months appears to decay to the point of negative efficacy. The boosters then bring you back into positive territory, for a time. 

Of course the offending numbers are still greyed out:

While UKHSA objections to the reliability of the relative rates apply to every second column reporting “rates among persons not vaccinated”, you’ll notice they only grey out the statistics that are unfavourable to the vaccines. The other columns, which according to their own arguments are equally unreliable, can be printed in ordinary typeface. 

The new 60-day death rate by vaccination status also shows a slight improvement in the vaccinated 80+ bracket. They’re now doing slightly better than unvaccinated 70 year-olds: 

Finally, the death numbers:

Higher Infection Rates in Vaccinated Not an Artefact of Wrong Population Data, New Analysis Shows

Back in October, when the critics rounded on the UKHSA for publishing vaccine data that didn’t fit the narrative, front and centre of their complaints was the claim that they were using poor estimates of the size of the unvaccinated population, and thus underestimating the infection rate in the unvaccinated. Cambridge’s Professor David Speigelhalter didn’t hold back, writing on Twitter that it was “completely unacceptable” for the agency to “put out absurd statistics showing case-rates higher in vaxxed than non-vaxxed” when it is “just an artefact of using hopelessly biased NIMS population estimates”.

To the UKHSA’s credit, while it conceded other points, it never gave in on this one, sticking to its view that the National Immunisation Management System (NIMS) was the “gold standard” for these estimates. It pointed out that ONS population estimates have problems of their own, not least that for some age groups the ONS supposes there to be fewer people in the population than the Government counts as being vaccinated.

How can we know which estimates are more accurate? A group of experts has applied analytical techniques in order to estimate the size of the unvaccinated population independently of ONS and NIMS figures. Using three different methods, experts from HART found that estimates from all three methods were in broad agreement with the NIMS estimates, whereas the ONS estimate was a much lower outlier.

Vaccine Effectiveness Remains Negative in 30-79 Year-Olds, Government Data Shows, Despite Boosters Starting to Kick In

The latest UKHSA Vaccine Surveillance report came out yesterday, allowing us to update our estimates of unadjusted vaccine effectiveness. Last week I noted that vaccine effectiveness was stabilising, and this week we can see it rising in the older age groups. Despite this, it is still negative for those aged 30-79, highly so for 40-69 year-olds, and barely positive in the over-80s and 18-29 year-olds.

Part of the reason for the recent rises in the older age groups may be the boosters that have been rolled out since September 20th – you can see a staggered stabilising and then rise across the age groups in the graphs above and below. This means that we are no longer seeing clean data for double-vaccinated versus unvaccinated, as some are triple-vaccinated. The UKHSA report doesn’t include figures for ‘dose three’ and appears to include the triple-jabbed in its ‘received two doses’ category, though oddly does not clarify either way.

The report still claims of course that its data is too biased to be used to estimate vaccine effectiveness, and lists the usual reasons. We await any actual data on the differences between vaccinated and unvaccinated populations, such as testing rates, seroprevalence and prior Covid positives, that would help to account for these biases.

While the raw data shows infection rates often much higher in the double-vaccinated than the unvaccinated, and a number of studies have shown negligible vaccine effectiveness after six months, the official line is that the vaccines remain positively efficacious. Test-negative case-control studies are often used to demonstrate this, which we criticise here. A recent UKHSA study on boosters put the pre-booster effectiveness at 44.1% for AstraZeneca and 62.5% for Pfizer, five months after dose two. Such estimates must be considered upper bounds, given the biases in the case-control design that seem consistently to inflate vaccine effectiveness estimates.

Negative Vaccine Effectiveness Isn’t a New Phenomenon – It Turned Up in the Swine Flu Vaccine

This is a guest post by Mike Hearn, a software engineer who between 2006-2014 worked at Google in roles involving data analysis.

The Daily Sceptic has for some time been reporting on the apparent negative vaccine effectiveness visible in raw U.K. health data. Despite some age ranges now showing that the vaccinated are more than twice as likely to get Covid as the unvaccinated, this is routinely adjusted out, leading UKHSA to un-intuitively claim that the vaccines are still highly effective even against symptomatic disease. A recent post by new contributor Amaneunsis explains the Test Negative Case Control approach (TNCC) used by authorities and researchers to adjust the data, and demonstrates that while a theoretically powerful way to remove some possible confounders, it rests on an initially reasonable-sounding assumption that vaccines don’t make your susceptibility to infection worse:

A situation where this assumption may be violated is the presence of viral interference, where vaccinated individuals may be more likely to be infected by alternative pathogens.

Chua et al, Epidemiology, 2020

Amanuensis then compares results between the two different statistical approaches in a Qatari study to explore whether violation of this assumption is a realistic possibility and concludes that the multi-variate logistic regression found in their appendix supports the idea that viral interference can start happening a few months after initial vaccination.

What other angles can we explore this idea through? One way is to read the literature on prior epidemics.

The Flaw at the Heart of the UKHSA’s Vaccine Effectiveness Study

There follows a guest post by Daily Sceptic reader ‘Amanuensis’, as he is known in the comments section below the line. He is an ex-academic and senior Government researcher/scientist with experience in the field, who says he is “a bit cross about how science has been killed by Covid”. It was originally posted on his Substack page, but I thought it was such an excellent analysis of the UKHSA’s favoured test-negative case-control approach and its problems – especially why it seems consistently to exaggerate vaccine effectiveness – that Daily Sceptic readers should be treated to it too.

There has been much consideration in recent months about the effectiveness of the Covid vaccines, and this leads to thoughts about how vaccine effectiveness is calculated in the first place. The trouble with any attempt to calculate vaccine effectiveness is bias – that is, are the vaccinated and unvaccinated similar enough to make the calculation, or, rather, can we remove any bias to get an unbiased estimate.

As an example of bias, in the early days of the Covid vaccinations the majority of the vaccinated were old, and the unvaccinated were young – so if there was an effect of age then we’d get a biased result simply by comparing overall case rates (per 100,000) in the vaccinated versus the unvaccinated groups. In this case the bias might be resolved by splitting the analysis into different age groups, but what about other factors? Most of all, what is the bias associated with willingness to become vaccinated (maybe the vaccinated are in general more likely to be the healthy ones, say)?

Some time ago, statisticians came up with a really great way to remove rather a lot of the ‘difficult’ bias – it is called the Test Negative Case Control approach (TNCC).  With this approach you don’t simply count infections, but compare the rates of infections amongst those who get tested – more specifically, you compare the ratio of positive to negative results in the vaccinated against the positive-to-negative ratio in the unvaccinated groups.

The great thing about this method is that it automatically compensates for many behavioural effects in the vaccinated compared with unvaccinated groups – so, say the unvaccinated are half as likely to go and get tested compared with the vaccinated, the TNCC should remove most of this effect. Of course, many demographic things are of interest (particularly the impact of age and gender), so you’ll usually separate out these variables, but the advantages of the TNCC method remain.

Anyway, pretty much every study on Covid vaccine effectiveness makes use of TNCC – it gives such a powerful and unbiased estimate.  You can read more about it in this review article.

Oh, but what’s this I see in that paper?

Why Are the UKHSA’s Estimates of Vaccine Effectiveness Consistently Far Higher Than Other Studies?

The latest UKHSA Vaccine Surveillance report was released yesterday. It has a new section entitled “Vaccine effectiveness publications” which lists the relevant UKHSA and PHE publications, and which may well have been added in response to the emails of Daily Sceptic readers asking for an update on the UKHSA vaccine effectiveness study.

The top item in the list is the latest from their ongoing test-negative case control study – or rather the update-before-last, as for some reason the link goes to a pre-print from September, which then redirects you to a newer version published on October 6th. In any case, this means I was incorrect to state that there had not been an update using data since May, as these papers had somehow flown under my radar (for which, sincere apologies). In fact, the latest update uses data up to September 3rd, so still two months behind and including nothing from the autumn, but it’s certainly better than stopping in spring.

The chart below shows the estimates over time for the two main vaccines, indicating declining effectiveness.

It is immediately apparent, however that these estimates are significantly above those found in other studies. The new study claims, for example, that the AstraZeneca vaccine remains 47% effective after 20 weeks (five months), when a recent Swedish study found it was down to zero (or lower) after four months. It puts Pfizer at 70% effective after 20 weeks (five months), when the Swedish study put it at 47% after four to six months, and zero after seven months. A Qatari study similarly found the Pfizer vaccine effectiveness down to around zero after five to seven months (these figures are all for symptomatic infection). The UKHSA acknowledges the Qatari study and says it is in line with its own findings in terms of showing decline, but doesn’t discuss why its own study still found substantial protection when the other did not.

The suspicion is that there is something wrong with the design of the UKHSA study that means it is coming up with inflated vaccine effectiveness estimates owing to biases that it is failing to adjust for (and may not be able to). That was certainly the inkling I got in May when I analysed the study design when it first came out with data up to February 19th.

Exclusive: UKHSA Admits it is Monitoring Current Vaccine Effectiveness But Not Publishing It. What Has it Got to Hide?

The UKHSA has admitted for the first time that it is undertaking internal analysis “every week or two” to monitor the current real-world performance of the vaccines but not publishing the results.

In an email seen by the Daily Sceptic, Dr Mary Ramsay, Head of Immunisation at the UKHSA, admits that her agency is continuing to undertake regular analysis of vaccine effectiveness but, despite publishing a weekly Vaccine Surveillance report, is not publishing the estimates.

The Vaccine Surveillance reports have recently been criticised by the U.K Statistics Authority and others for including data which shows infection rates in the vaccinated running at more than double the rate in the unvaccinated. Critics have argued this gives a misleading impression that the vaccines are ineffective or worse. They say it is really a result of problems with the population estimates and systemic differences between vaccinated and unvaccinated populations.

The UKHSA has responded by altering the presentation of its data to draw attention to these limitations and make clear that, in its view, the data should not be used to estimate vaccine effectiveness.

However, it has not published an update of its own estimates of vaccine effectiveness using data more recent than May 2021. This means it has not updated its estimates with data from the summer and autumn, a period when its raw data shows infections in the vaccinated outpacing those in the unvaccinated.

In a recent post I encouraged readers to contact Dr Ramsay to ask her to publish an update of her agency’s study of vaccine effectiveness. In a reply to one reader, seen by the Daily Secptic, Dr Ramsay made the stunning admission:

Infection Rates More than Twice as High in the Vaccinated, New UKHSA Data Shows, as Agency Dismisses Own Data as ‘Biased’. But Why No New VE Estimate Since May?

The latest UKHSA Vaccine Surveillance report was released Thursday, and its authors are now bending over backwards to keep their critics happy. Following a telling-off this week from the U.K. Statistics Authority, the UKHSA’s Head of Immunisation, Mary Ramsay (pictured above), published a blog post explaining what they’ve done to appease their detractors, while the report now states no fewer than four times, twice in bold typeface, that “these raw data should not be used to estimate vaccine effectiveness”. Ramsay grovels:

To make our data less susceptible to misinterpretation, the U.K. Health Security Agency has worked with the UK Statistics Authority to update some of the data tables and descriptions in the report, specifically around rates of infection in vaccinated and unvaccinated groups. In our commitment to transparent and clear data, we regularly review our publications to ensure they reflect the current situation within the pandemic, and we will continue to work with our partners at the statistics bodies, to ensure our reporting is as scientifically robust as possible.

As I noted last week, the UKHSA does not accept the criticism of its population estimates levelled by, among others, David Spiegelhalter, who declared that using them was “deeply untrustworthy and completely unacceptable”.

The agency instead takes the view that the problem is systemic biases in the data which mean it “should not be used” to estimate vaccine effectiveness. But as I have noted repeatedly, those biases just mean that the estimate will be of unadjusted vaccine effectiveness, which is a perfectly legitimate quantity to estimate and has its uses, particularly when looking at trends or when there is reason to think the biases may be relatively small. (For instance, a recent vaccine effectiveness study in California adjusted its raw data for 22 different factors but in almost all cases the adjustments were tiny.)

The UKHSA report itself correctly gives the definition of vaccine effectiveness: “Vaccine effectiveness is estimated by comparing rates of disease in vaccinated individuals to rates in unvaccinated individuals.” The U.S. CDC, likewise, states the definition as “the proportionate reduction in disease among the vaccinated group”. The CDC distinguishes “vaccine efficacy”, estimated from controlled studies, from “vaccine effectiveness”, which is used “when a study is carried out under typical field (that is, less than perfectly controlled) conditions”. It is therefore not appropriate for the UKHSA, a Government agency, to insist that its data “should not be used” to estimate vaccine effectiveness, which is a false statement and amounts to attempted Government censorship of scientific enquiry.

Hide the Vaccine Failure: UKHSA Caves to Pressure and Removes Chart Showing Higher Infection Rates in the Vaccinated – as Effectiveness Hits New Low of Minus-132%

It appears the critics finally got to the U.K. Health Security Agency (UKHSA). The new Vaccine Surveillance report, released on Thursday, has been purged of the offending chart showing infection rates higher in the double-vaccinated than the unvaccinated for all over-30s and more than double the rates for those aged 40-79.

In its place we now have a table similar to the one below that I have been producing for the Daily Sceptic each week (though without the vaccine effectiveness estimates), and a whole lot more explanation and qualification.

Here are our updated charts of unadjusted vaccine effectiveness over time from real-world data in England.

Pressure Mounts on the UKHSA to Stop Publishing Data Showing Infection Rates Higher in the Vaccinated

The Prime Minister may have acknowledged reality and stated that being double vaccinated “doesn’t protect you against catching the disease, and it doesn’t protect you against passing it on” but others appear to remain in denial.

On Sunday I asked whether now that the PM had let the cat out of the bag the media would start reporting properly on the UKHSA data showing higher infection rates in the vaccinated than the unvaccinated. It appears the answer is no, at least if the Times‘s Tom Whipple is any indication.

In a typically mean-spirited piece – in which anyone who doesn’t agree with his favoured scientist of the hour is smeared as a conspiracy theorist and purveyor of misinformation – Whipple quotes Cambridge statistician Professor David Spiegelhalter, who heaps opprobrium on the U.K. Health Security Agency (the successor to PHE) for daring to publish data that contradicts the official vaccine narrative. Spiegelhalter says of the UKHSA vaccine surveillance reports:

This presentation of statistics is deeply untrustworthy and completely unacceptable… I cannot believe that UKHSA is putting out graphics showing higher infection rates in vaccinated than unvaccinated groups, when this is simply an artefact due to using clearly inappropriate estimates of the population. This has been repeatedly pointed out to them, and yet they continue to provide material for conspiracy theorists around the world.

This is the graphic he is presumably referring to.

If Professor Spiegelhalter has a source for his claim that higher infection rates in the vaccinated are “simply an artefact” of erroneous population estimates then he doesn’t provide it.