Lies, damn lies, and statistics: covid booster edition

photo by Jimmy Yeh, CameraShyInLA Photography www.instagram.com/camerashyinla

What if I told you that getting a COVID booster reduced your chance of death from COVID by 90%?

Sounds pretty good.

What if I told you that getting a COVID booster reduced your chance of death from any cause by 90%?

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Sounds great!

Except, wait, wat? Is the COVID booster magic or something? How does it reduce the cause of death by 90%? Does it cure cancer? Liver disease? Heart attacks?

Dr. Vinay Prasad, one of the heroes who arose during the pandemic, asked this very question. Prasad is a professor at UC San Francisco (I know, right?), and he has been a bulldog on ensuring that the scientific conversation around COVID is, well, scientific. Prasad obviously was attacked viciously for his insistence that science be scientific.

He is neither pro- nor anti-vax–he thinks some should get it and others shouldn’t, based upon various factors–and he has been relentless in sorting out the good science from the crap.

There is a lot of crap.

In a piece just published in the New England Journal of Medicine he does a takedown of a widely cited study from Israel on booster effectiveness. That study was one of the key pieces of evidence that “convinced” (they were going to do it no matter what) the US government to push COVID boosters.

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In simplified form, the study claimed that COVID boosters reduced deaths from COVID by 90%. Great news!

Only Prasad took a deep dive into the research and discovered that deaths from all causes in the boosted group were about 90% lower, suggesting that some other factor was involved. Prasad couldn’t get the underlying data about the patients, but clearly, something was wrong with the population groups. Some non-random factors.

And boom! It looks like there is one: much of the non-boosted population was people in hospitals who did not receive the booster due to life-threatening conditions. This comes straight from the researchers’ response to Prasad.

The policy in Israel prioritized the administration of boosters to persons in the community setting who were at the highest risk. However, boosters were generally not administered to hospitalized patients who were at high risk for death from any cause. Therefore, we explored hospitalization for any cause as an additional risk factor. The results, which are shown in Table S1 in the Supplementary Appendix (available with the full text of this letter at NEJM.org), indicate that hospitalization was significantly associated with mortality not related to Covid-19 (hazard ratio, 9.1; 95% CI, 8.1 to 10.2; P<0.001), and adjustment for hospitalization slightly modified the estimated association between receipt of the booster and mortality not related to Covid-19 (hazard ratio for death among participants who received the booster, 0.27; 95% CI, 0.24 to 0.31).

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Their findings indicated that there was likely some benefit to high-risk people who took the booster, but nothing like 90%, and possibly zero. The samples were simply not randomized. Everybody was at high risk in the first group, but the people in the second group were at high risk for all deaths anyway.

This isn’t how science and medicine are supposed to work.

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John Sexton 8:00 PM | December 13, 2024
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