Real-world information on Covid vaccine effectiveness

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For the first time, we have some real-world data about how effective the Covid vaccines are. The good news is that a very small percent of fully vaccinated people get sick. The bad news is that the vaccines aren’t  a three-hundred percent effective suit of armor against serious disease. Or even quite one hundred percent.

Among the 77 million fully vaccinated people in the US, the Centers for Disease Control reports 5,800 Covid cases. That’s somewhere in the neighborhood of 0.0001%. Of that group, 7% were hospitalized and 74 died, and damn it I wish they’d give statistics either entirely in percentages or entirely in absolute numbers to dopes like me could compare them. I can get as far as saying that most of the cases have been either mild or asymptomatic. If you can translate, leave me a comment. Even if your answer’s wrong, I’m not likely to know. 

Infections in vaccinated people are called breakthrough infections, and it would be unusual if they didn’t happen. They were found in all age groups, although 40% were in people who were 60 or older, 65% were in women, and 29% were asymptomatic. 

Irrelevant photo: apple blossoms

So far, they haven’t identified what, if any, risk factors incline vaccinated people toward getting Covid or which (if any) variants are more likely to be involved, but believe me, someone’s staying up late crunching numbers. It’s also not clear how the asymptomatic cases were noticed, since it’s unusual to test fully vaccinated people who show no symptoms. It could be that they were hospitalized for other reasons and a Covid test was run as part of the admissions routine. Whatever the reasons, though, we can assume that the number of asymptomatic infections is an underestimate.

But didn’t they tell us that the vaccines were 100% effective against severe Covid? Yup, they did, and they weren’t lying to us. The odds of a fully vaccinated person getting a severe infection are so small that the sample would’ve had to be insanely large for a case to have surfaced. The people who ran the trial gave us the numbers they had. As real-world information comes in, those numbers change. That’s the annoying thing about the real world. Every so often, it doesn’t line up with our predictions.

I get a rightwing newsletter in my inbox every so often–it’s been interesting so I don’t unsubscribe, although I’m not the person they have in mind–and it’s fond of reporting on cases of people catching Covid after being vaccinated. The tone leans heavily toward See? We told you it didn’t work. If I could, I’d compare that 0.0001% of breakthrough infections with the percentage of unvaccinated people who catch Covid in the US, but we’ll need a person with some minimal mathematical competence to work it out. I asked Lord Google but he was in one of his moods. If you’d like percentages on many unrelated things, I can point you in the right direction. 

The conclusion, if you want one to put in your pocket and take it home, is that the vaccines aren’t 110% effective and we still need to be careful, but we can let go of the anxiety. The numbers are on our side here and the anxiety isn’t helping anyway.

There’s nothing like someone telling you not to be anxious to make you less anxious, is there?

The additional conclusion is, keep the mask. Even if you’re vaccinated, you can still spread the disease. You’re less likely to–if you have an asymptomatic case you’re likely to have a lower viral load–but you can still do some damage. Other people share this world with us. Try not to do them any more harm than you can help.

 

What’s the story on vaccines and blood clots?

The two vaccines that have been linked to very rare incidents of blood clots are based on a single technology–one they share with the Russian Sputnik V vaccine. Basically, they take an adenovirus–that’s a virus that causes colds–deactivate it, and turn it into a chariot for the vaccine to ride in on.

Vaccines are hopelessly vain. They can’t resist a grand entrance. Horses, polished metal catching the sun, noise, dust, cameras. 

The clotting problem seems–and we’re still at the stage of seems–to be related to that damn chariot. 

The clots happen in veins in the brain, in the abdomen, and in arteries, and at the same time the person’s level of blood platelets fall, and those platelets are the beasties that help our blood clot. We end up with blood clots happening at the same time as hemorrhages, which in everyday English means bleeding. That’s kind of like an elevator going up and down at the same time. 

Normally, you’d pour an anticoagulant called heparin into a person with a blood clot forming in scary places, but when you pair the clots with hemorrhages, you can’t do that.

What are the signs that a person’s getting a serious reaction to one of the vaccines? Severe headaches, abdominal or leg pain, or shortness of breath within three weeks after vaccination.

Every article about this says the clots are very rare. 

How rare is very rare? Last I checked, 222 cases had been linked to the AstraZeneca vaccine in Europe and Britain, along with 18 deaths. That’s out of 34 million people who’ve gotten the vaccine. Most of those were in women who were–okay, not young but under 60, which looks younger all the time. In the US, the Johnson & Johnson vaccine has been linked to 6 cases out of 6.8 million people who were vaccinated with it.

So how rare are the clotting problems? About the same as the chance of being struck by lighting in the UK in any year you choose. And that’s in a country that, by comparison with the American Midwest, doesn’t get a hell of a lot of lightning.

The risk of Covid, though, is no small thing. 

And if you’re inclined to roll the dice by going unvaccinated, the risk of having a blood clot after a bout of Covid is 8 times higher than after getting the AstraZeneca vaccine. The risk of clots after Covid is 100 times higher than after a normal infection.

 

Covid immunity and prior infections

And vaguely related to that is the news that having had Covid doesn’t give young people full protection from another bout of it. That’s from a study of 3,000 healthy U.S. Marines who were between 18 and 20 years old and unless the regulations have changed since last I looked had radically and irrelevantly short hair.

Even though the marines had antibodies, they didn’t have the level of protection that the vaccine offers: 10% got reinfected. That compares with 50% who hadn’t had an earlier infection, although in the previously infected group 84% of the infections  were asymptomatic or mild compared to 68% in the previously uninfected group.

The numbers of infections and reinfections were higher than would be likely outside of a military base because of the cramped living conditions and close contact.

The advice to people who’ve recovered from Covid is to boost your immunity with a vaccine.

48 thoughts on “Real-world information on Covid vaccine effectiveness”

  2. Unfortunately, thanks to Emmanuel Macron, half of Europe seems to think they’d be better off not being vaccinated – I’ve been told by people in Germany that people are reluctant to be vaccinated, and Sweden’s apparently throwing out stocks of vaccine which have gone off because people book appointments and then don’t turn up!

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  3. As you say the risk of blood blot is the same as getting struck by lightning, I’ll take my chances with the vaccine (the 1st dose made me very ill) rather than covid. Still the newspapers have stories about the very rare side effects in them. I don’t understand the right wing view….look at Brazil and India, that’s where “boosterism” get you.

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    • Really. It’s so completely crazy. I wonder if, having staked out a position that this was nothing but hype and fear mongering, they can’t find a way to back down, even as their countries crumble around them.

      Although in fairness, I don’t know what position Modi’s taken on Covid. I had the sense that he took it seriously–they did a severe if poorly thought-through lockdown very early on, and the country’s a major producer of at least some of the vaccines. I wouldn’t cut Modi slack on many things, but I doubt he belongs in the same category as Bolsonaro.

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      • India did very well to start with and then they let everyone think it was “all over” (remember GB last summer?) and allow campaigning for upcoming elections and big religious festivals to take place…massive wave of infections has resulted. I dont know a lot about what is happening in Brazil – I guess there are regional governors but Bolsonaro keeps mucking things up (in much the same way like Trump did). Talking of Trump, I read somewhere that he & Melania got vaccinated but chose not to be photographed having it done! He cares more about appearing strong than the welfare of his followers, obviously.

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        • I did see a headline about Trump getting vaccinated–and his followers being offended. I can’t think what a person would have to do inside their head to make it possible to follow him through all his twists and turns. Interesting about India and the religious festivals. I wonder if they involved a lot of people traveling. Chile also opened up too quickly–and it looks like we will as well. Again.

          I would so love to be wrong about that prediction.

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  4. You mentioned a r/w newsletter from the US. This is the problem. the US passed 200 million first doses, probably 100 million fully vaccinated. That is only about 30% fully vaccinated and 60% one dose. There are problems with people not showing up for their shots appointments. This is a bad sign. The last 20% or more is needed for herd immunity and those are the r/w vaccine skeptics mentioned in the newsletter. They will continue to get infected and die, and worse the virus will continue to mutate in them with a possibility of mutating into a resistant strain that will start killing vaccinated people! Then boosters are needed but again the anti-vaccers will not take them either and then more mutations and so on and so on for perpetuity! Far UVC needed everywhere people meet!

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    • Many things are needed, I think, all of them working together. I wouldn’t close the door on any of them. I do agree about the anti-vax problem, which isn’t being helped by the hysteria over the J&J and AZ vaccine clots, rare as they are. And I say that as someone scheduled for a second AZ dose this weekend–I’m not wishing it on other people. We need every tool out of the toolbox it we’re going to win this.

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      • Vaccines for infections many people don’t even notice are always going to be a hard sell. The good news is that COVID-19 is not actually serious for very many people. If it were to mutate into a form that killed people who had meaningful life expectancies, or even caused more discomfort than a new pair of shoes, interest in the vaccine would increase.

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        • I hear what you’re saying, but it really depends on whether people are willing to consider not just themselves but also their relatives, their neighbors, their coworkers. Strangers. Their society. Their economy. And I do believe that people are capable of that level of consideration.

          On top of that, the invulnerability of younger people has been oversold. A surprising number of them are coming down with long Covid after mild cases of the disease. Covid really is an unpredictable beast. Draw a card out of that deck and you have no way of knowing in advance what you’ll end up with.

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        • I’m not saying that to discourage anyone who lives with a very vulnerable person from doing what they can to protect that person. I do think that, for most of us, vaccine choices should be made based on the risks and benefits to the individual vaccinated. I’d consider being among the first to test a new vaccine if I were thirty years older, or had cancer, or were living with someone who was or did. Meanwhile, I did quarantine and I’m sort of fond of my “hometown pride” mask, but I read that vulnerable people in some countries can’t get vaccine for coronavirus. They are welcome to my share.

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          • I do agree that vaccination in other countries is crucial, but we also need to think of this not in terms of the small circle around us but the community as a whole. We really do all need to protect each other. And the more infections there are–even the mild or asymptomatic ones–the more chances the disease has to mutate, to become more dangerous. The variant running through Brazil seems to be infecting younger people. I don’t think anyone can consider themselves safe.

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  6. One of the reliable doctors on the news said the incidence and types of blood clot are akin to those most often seen in connection with birth control medicines
    so it is not an issue exclusively with the vaccine..

    There is a movement ongoing to convince people who are “vaccine hesitant” to get vaccinated…appealing to them to protect their families and others, testimonies from folks who were hesitant and are now glad they were vaccinated, etc. Another point one of them came up with is that soon the only Covid victims may all be Trump voters. That should win them the Darwin Award.

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    • If it could only be limited to a self-selecting group–. Yes, the Darwin Award.

      I expect a lot of people can be won over that way. Hope the program peels away enough of the folks in the middle.

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  7. Here in BC, Canada, we’re experiencing a “third-wave”. The vaccination roll out has been so slow. Travel within communities is restricted and restaurants/pubs are all closed. Our number are growing on all fronts….including ICU and death. Done.

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    • Oh, hell, I hadn’t known. I tend to follow the complete disaster states–Brazil and India at the moment. Others (in my overwhelmed state) fall off my radar. Even with vaccination, though, new waves are possible: See Chile, and I’m not convinced we won’t have one here as well, what with opening this that, and other and not being careful about international traffic. Have you been vaccinated yet?

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      • Hey Ellen. I haven’t been vaccinated yet. Still waiting. there’s shortages of the vaccine itself. It’s like a frikken gong show. I’m lucky as I work from home and have no issues but many of the staff of restaurants/pubs/hotels etc all laid off. But, we have a flipping building boom and houses are selling like pancakes (that’s a really stupid saying….I wonder where it came from…hmm maybe it’s hotcakes…whatever. still stupid)
        Houses are selling for over asking price and being snapped up. It’s nuts.
        Canada just banned flights from India and Pakistan for the next 30 days.

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        • Britain’s put India on the red list, restricting travelers and imposing a quarantine, but only after waiting a few days to make sure it’s not effective. Grrrr.

          I always heard it as hotcakes, but as soon as you changed it to pancakes I could hear what a strange saying it is. Funny, I never gave it a thought before that.

          And finally, yes, I hear what you’re saying about people who are laid off. Are they getting any money to help them get through this, or have they just been dumped?

          May the vaccine make its way to you soon. And to all.

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          • Hey Ellen. Hotcakes/Pancakes…all good. Makes me want to source out some maple syrup.
            India now banned here. Took way too long for the Federal govt to move on banning international travel. sigh….
            Canadain Gov’t has been fairly generous with helping people and speeding up processes. A lot of social programs in place for the populations.
            Hardest thing is the uncertainty I think. It’ll all come together. My hubby gets jabbed next week and I’ll probably get done a few weeks after.
            Thanks for the chat. I like your brain.

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            • I’m trying not to make a joke about my brain being the only one I have, so I’ll settle for a passing reference to it and the pretence that I didn’t make the joke.

              Travel bans seem to be hard for governments to impose, although in our current mess I can’t see any way around them. They’re quick enough to do it, though, when they see some refugee population or a group of people they’re scared of.

              I’m glad the jabs are moving in your direction.

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  10. A young lady I know of, in her mid twenties received the J & J vaccine 3 weeks ago, and right after the vaccine has been on a steady decline starting with severe arm and shoulder pain, then tingling and burning in her hands and feet.. She went to her doctor and he declared she just had arthritis. Nothing about the vaccine. I wonder how often this happens, where any connection is denied?

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    • Not all doctors are well informed. Not all doctors (as my partner’s fond of reminding the world) graduated at the top of their class. So it’s entirely possible. It’s also possible that something else is happening and that the timing’s accidental. I hope she’s able to see a different doctor.

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  11. I’m beginning to get nervous that too many people in the US are going to refuse the vaccine for us to reach herd immunity. As far as I can tell, it’s the only country in that situation

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  12. Dear Ellen,
    I just now remembered that I wanted to thank you! Deep in fatigue-land after the second vaccine shot, I was delighted to catch up on reading your posts last week, one post after the other. I kept reminding myself to comment and thank you….but I fell asleep again. So, thank you Ellen for such wonderful and hilarious reading on a down-day! It was terrific…..

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