Five different COVID vaccine trials: 75,000 trial subjects, zero deaths or hospitalizations

A cheery reminder from David Leonhardt that not all vaccines are created equal, but in the case of COVID they’re equal enough. Consider this a gloss on Friday’s post about the “disappointing” Johnson & Johnson vaccine. It may not be as effective as Pfizer’s or Moderna’s but it’s performed just as well as those two in clinical trials at its core task, which is keeping people alive.

Same goes for Novavax and AstraZeneca, the other two vaccines to have completed phase three trials. Across all five, in a population of trial subjects the size of a small city, there wasn’t a single death from COVID.

Which is not to say that no one in the real world who’s received both doses has died of the disease. More on that in a moment.

Of the roughly 75,000 people who have received one of the five in a research trial, not a single person has died from Covid, and only a few people appear to have been hospitalized. None have remained hospitalized 28 days after receiving a shot.

To put that in perspective, it helps to think about what Covid has done so far to a representative group of 75,000 American adults: It has killed roughly 150 of them and sent several hundred more to the hospital. The vaccines reduce those numbers to zero and nearly zero, based on the research trials.

Zero isn’t even the most relevant benchmark. A typical U.S. flu season kills between five and 15 out of every 75,000 adults and hospitalizes more than 100 of them.

I’m going to trust Leonhardt’s math there about the fatality rate. If he’s right, and if in fact we need to vaccinate another 200 million Americans or so in order to reach herd immunity, then if we could fully vaccinate everyone tomorrow we’d save … more than 650,000 lives by doing so.

A decent return on our vaccine investment, I hope we’d all agree.

Is it fair to expect, though, that no one who gets vaccinated for COVID will end up dying of the disease? The best evidence we have right now to answer that question is what’s happening in Israel, where around a third of the population has received its first dose and some 19 percent or so have received both doses. Has Israel seen any deaths among the vaccinated population? Turns out it has — but it’s really, really, fluky:

Israeli Ministry of Health (MoH) figures show 531 over-60s, out of almost 750,000 fully vaccinated, tested positive for coronavirus (0.07%).

And far fewer fell ill, with 38 becoming hospitalised with moderate, severe or critical disease – a tiny proportion…

There were three deaths in vaccinated over-60s – although it is possible they contracted the infection earlier, before their immunity had time to build.

Maybe the virus was already in their systems and replicating before the vaccines were administered. Even if not, that’s 0.3 fatalities among 75,000 people, a minuscule number compared to the 150 or so American adults being killed in a similar-sized population according to Leonhardt. And note that this isn’t a sample of the general Israeli population; it’s a sample of people over 60, a cohort that’s a bit more vulnerable to fatal outcomes from COVID. The vaccine has turned deaths among senior citizens and near-senior citizens into a freak occurrence in the Jewish state.

Here’s a data point that’s a bit confounding, though. Per the above, infections are exceedingly rare among vaccinated people; since Israel has only nine million people or so, we would expect something like 6,300 total infections for the duration of the pandemic if every Israeli could be vaccinated immediately. And yet, despite nearly 20 percent of the population having received both shots, Israel’s still having a tougher time of things on a per capita basis than we are:

The only explanation, it seems, is that the 80 percent who still haven’t been fully vaccinated are being slammed at the moment, creating a strange bifurcation in which many senior citizens are now basically home free while middle-aged and younger Israelis are in the thick of an ordeal. The country just extended its national lockdown in order to try to mitigate the ongoing spread, in fact. The problem: Apparently the highly contagious British variant is “spreading wildly” there, boosting daily case counts paradoxically even as the country continues its pace-setting vaccination program. Moderna and Pfizer are confident that their vaccines are fully effective against the British variant, which would seem to be borne out by the minuscule infections and deaths among the over-60 crowd. With the British variant circulating, the numbers among senior citizens should be spiking. Instead they’re collapsing among those who’ve been vaccinated.

In lieu of an exit question, read this interesting NYT piece about people who’ve had COVID getting the vaccine. Because they already have a measure of antibodies in their system, the first dose of the vaccine triggering further antibodies is generating somewhat nastier side effects — to the point where doctors are starting to think that those who’ve had the disease should only get one dos, not two.