How Effective Are Boosters?

  • 7 Jan 2022
  • Reading time 15 mins
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There is an implicit assumption that the way to protect the masses is by everyone having a third vaccination, or booster. But assumptions and facts are not the same thing. As actual data starts to come in a very different picture is emerging. But, before examining the evidence, the first question that has to be asked is what is the purpose of booster vaccinations? Is it to prevent covid infection, spread of infection, prevent hospitalisation, prevent critical covid or to prevent death?

If it were to prevent infection it is not effective. There is no evidence that the vaccinated or boosted are less likely to become infected. The evidence that does exist leans in the other direction – that vaccinated people are more likely to become infected. As a consequence, it is unlikely that they are less likely to spread infection.

There is the addition risk that those vaccinated might ‘ease up’ on protective measures, be it wearing masks, social distancing and self-isolation if infected. This would be hardly surprising given the completely nonsensical ‘rule’ that vaccinated people can enter certain sized gatherings while unvaccinated have to pre-test negative on a lateral flow test. The only logical way to stop spread of infection in gathering is to lateral flow test everyone, regardless of vaccination status. If this is not done, as is currently recommended in some countries and situations, then those vaccinated and unknowingly infected, are going to be more likely to spread infection.

Is Omicron infection a good or bad thing?

Could it actually be better to get infected, presumably with omicron variant, and get over it with built in natural immunity? After all, that tends to be what happens with colds, which are usually coronaviruses. This heretical thought should not be instantly dismissed. After all, based on weekly figures, the percentage of those testing positive has jumped from 4.9% to 8.2% in the last week. This is the first indicator of a ‘third wave’ of infection and the biggest jump since the last wave, at exactly the same time of year. So, infection is clearly spreading. But does this matter?

Coming back to what I think should be the primary goal of vaccination - to reduce hospitalisation, critical covid and death - then these are the critical statistics to keep an eye on. Although there’s a lot wrong with ‘deaths with a positive covid test within 28 days’ the reality is that this hasn’t changed at all. In fact, it’s gone down in the last three weeks, each week recording under 500 deaths compared to the previous 12 weeks, all over 500 and peaking at 796 deaths per week.

Similarly, covid deaths in ICUs, which are a much ‘cleaner’ figure as they can reasonably assumed to actually be deaths from covid, not just ‘with’ covid positivity, are also down. In fact, they are at their lowest since the summer with 110 deaths in the week between Christmas and the New Year. ICU covid deaths account for a third to a quarter of all ‘covid’ deaths so are a very good indication that nothing is happening at the sharp end, which is great news. Is this non-event the calm before the storm given that it takes a couple of weeks from infection to ICU admission? While that is still possible ICU admissions are also down, below 400 a week for the first time since June.

So why, with all this infection around, is nothing happening at the sharp end of either death or ICU admissions for critical covid? Is this evidence that the boosters are working, or that omicron is just so much weaker? They are both good contenders although there are others, not least that the population of the most vulnerable, in care homes, with co-morbidities and other risk factors, was much reduced in the first two waves. Another is that the lateral flow tests are picking up regular colds, which are often coronaviruses, and miscategorising them as ‘covid’.

Of course, there’s a giant and widely ignored elephant in the room as to why colds/covid/coronaviruses kick in in November, December, January and February, then peter away. Could this possibly have someone to do with….lack of sun…lack of vitamin D? It beggars belief that the NHS, PHE and Oxford University’s Big Data Lab have been sitting on data from millions of people regarding their vitamin D status from blood tests and haven’t even bothered to look at its correlation with covid risk. Let’s park that for a moment and look at two possible contributors to the non-event of the ‘third wave’.

Omicron is much weaker

The first is that omicron is much weaker. This is increasingly beyond dispute from a number of studies that are being reported widely in the media. Many virologists and epidemiologists think that covid is doing what any coronavirus does, that is finding a way to live with us without killing us. Research shows the risk of death from Covid for over 70s has decreased by tenfold compared to a year ago. Professor Anthony Brookes, an expert in genetics and health data at the University of Leicester, helped compile the research based on Office of National Statistics, Government and NHS infection reports. In an interview this week with the Daily Express he said “Covid no longer posed a significant threat to “the vast majority of people” He added: “Over the last month the risk has been dropping further thanks to Omicron now accounting for around 95 per cent of cases in England. Omicron is around 4-fold less dangerous – it’s like nature’s vaccine.”

Younger people, he said “now have a higher risk of dying from a car crash in a whole year, than they do from Covid-19. Since their serious Covid risk is already very low, it is hard to identify any good reason for imposing or coercing youngsters to take on the known risks of vaccination.” Other experts agree. Professor Paul Hunter, an expert in infectious disease at the University of East Anglia said: “There is no doubt the illness we are seeing now is less severe than at the start. We are seeing a big shift towards covid becoming the common cold due to a range of factors including prior infection and vaccines. There is a point where we have to ask why are we testing and isolating people who just have a common cold? We could bring down our isolation requirements to five days from a positive test – after five days there is no real advantage in isolating people. By Easter I think we could end mass testing and test only in hospitals unless things turn out worse than we expect.”

Will boosters make any real difference?

While Omicron is clearly less life-threatening, we’re told that the key and critical public health action is to get a booster. But is this stopping infected people tipping over into critical covid and death?

There’s a simple and ‘real-life’ way to gauge this, and that is the percentage of those being admitted into intensive care units, which is where the majority of critical covid patients end up or die, that are vaccinated or unvaccinated. One could go a bit deeper and look at double vaccinated versus triple or ‘boosted’ and unvaccinated but this data doesn’t really exist yet.

What has become available in the past month, on a weekly basis, from the very reliable source of the Intensive Care National Audit Research Centre (ICNARC) who receive detailed information from all adult ICUs across the country, is the percentage of those with covid in ICUs that have or have not been double vaccinated.

Before examining this, there’s a little background to understand. Approximately 87% of the adult UK population has been double vaccinated. (Two thirds of these have since been triple vaccinated). Therefore, if vaccinations did nothing to reduce your risk of admission, 87% of those admitted to ICU would be expected to be vaccinated, reflecting the general percentage in the adult population. If, on the other hand, vaccination was 100% effective then you’d expect that 0% of those admitted would be vaccinated.

From May to mid December those at least double vaccinated made up 61% of those in ICU. According to ICNARC the percentage of admissions of vaccinated people in October and November was 52% vaccinated, thus with 48% being unvaccinated. This is very different to the talk in the media that up to 90% in hospitalised covid patients are unvaccinated.

I asked a statistician, Phil, to work out what this actually means to your reduction of risk of ICU admission if vaccinated. His calculation showed that “vaccination has reduced my actual real-world risk by 0.03%, which is 1 in 3,230”. So, over 3,000 people have to be vaccinated for one less ICU admission, based on the ICNARC figures.

In the last week of results it appears that the percentage of admissions from vaccinated people is very slightly reducing. Maybe the boosters are kicking in? But, however you do the maths it is unlikely that the ‘numbers needed to vaccinate’ to get one less ICU admission is going to go below 2,000.

Meanwhile, a study in the Internal Medicine journal of the American Medical Association compared the outcome of vaccinated and unvaccinated people in the US and reported that about 84% of outpatients were vaccinated, with 16% requiring hospitalization compared to about 77% of outpatients who were unvaccinated, 23% of which were hospitalized. The details of this study are shown in this report.

Other studies even suggest that omicron attacks the vaxed much more than unvaxed, suggesting worse than zero effectiveness. For example an article in The Indian Express [Out of 34 Omicron cases at Delhi hospital, 33 are fully vaccinated | Delhi News (indianexpress.com) ] reports: "Out of 34 Omicron cases at Delhi hospital, 33 are fully vaccinated". This would make a fully vaxed person 47.5 times more likely to be hospitalised for omicron in Delhi.

Leaving aside these recent studies and reports, if we stick with UK official figures and, for example, vaccinate a million, at a cost of £100 each (each vaccination costs £22 + maybe £11 cost of administration), this totals £100 million and would be expected to keep a maximum of 500 people out of ICU. In other words it costs somewhere between £200,000 and £300,000 to keep one person out of ICU with a vaccination strategy.

Before considering obvious alternatives, there’s a flip side that needs to be considered which is the ‘numbers needed to harm’. How many people do you need to vaccinate for one person to become critically ill or die? On the basis of MHRA yellow card reports they say ‘The MHRA has received… 1,889 UK reports of suspected Adverse Drug Reactions in which the patient died shortly after vaccination.’ With 47 million double vaccinated that’s 40 deaths per million vaccinated.

(Now this will be disputed in both directions, both as under-reporting would increase the number of actual deaths and ‘association’ doesn’t mean cause, thus not all deaths will be shown to be caused by vaccination.) But the most recent study on one cause of death and disability, myocarditis and pericarditis (heart inflammation) from the Oxford University group shows a doubling of risk in those vaccinated. There have been 1,434 cases reported to the MHRA up to Christmas, with the majority occurring in the 18-39 year olds. Most resolve but some have resulted in death and ongoing disability. So, one cannot deny that there is both an increased risk of death and disability. (Those pro-vaccination will argue that it is less than the risk of death or disability if you get covid, which may be true, but it assumes that the vaccination will stop this risk entirely, which it clearly doesn’t.)

If the reality were even half this, say one death or long-term disability in 50,000 vaccinated, then using our example of a million people vaccinated we’d expect 20 would die or be disabled as a consequence of the vaccine compared to 500 who would be admitted to ICU, of which approximately 30% are dying (much less if the ICU uses intravenous vitamin C, but still few do). So that’s 150 lives saved and 20 lives lost due to vaccination. Overall, vaccines would be expected to save 130 lives at a cost of £100 million.

However you cut the figures, and I’m trying to be as vaccine friendly as possible, any intelligent person has to ask if this is really the most cost–effective way of keeping people out of hospital with critical covid? Our government scientists should be asking what else could be done to stop people tipping into critical covid and keeping people out of hospital other than masks, social distance and lockdown, which many argue has done more harm than good and is, in any event, a failure of public health prevention. You know what I’m going to say: vitamin C and vitamin D. I did the maths on this back in the March issue of COVID NEWS for those who want to dig deeper.

So in our example group of a million people, of which perhaps 20,000 are expected to become infected, One quarter, that is 5,000 people, would be expected to develop critical covid and are hospitalised. Of those 5,000, if treated with high dose vitamin C in hospital, according to existing studies, only 20% or 1,000 end up in ICU of which 10%, that is 100 die, which is better than what you’d expect with vaccines. What of the cost? If 5,000 people are treated for 5 days with 10 grams of vitamin C that’s 250,000 grams – or 25 kilos. At £20 a kilo that’s £500. Add on some admin and call it £1,000 compared to £200,000 for a lesser effect with vaccination.

Alternatively, vitamin C could be given earlier, upon infection, as has been done in China and Uttar Pradesh in India. Then 20,000 people are given a supply of vitamin C, costing £4,000 – still a fraction of the cost of vaccination. Would this reasonably be expected to stop one ICU admission? That’s all a vitamin C strategy would need to achieve to equal the current effectiveness of vaccination. I’m sure a similar situation would exist if one was to give everyone 3,000iu of vitamin D in the winter.

But there’s another plus side to the vitamin C and D strategy which is that it would have lots of knock on benefits that would keep people out of hospital from other infections including flu and pneumonia, and other vitamin-related health conditions.

It seems to me we have a highly ineffective public health strategy, apparently designed to reduce the number of people going into hospitals, backed up by an unnecessary threat of layers of lockdown, primarily because the public health strategy is so ineffective.

There are now 18 relevant clinical studies of vitamin C and covid acknowledged by NICE and their RAPID C-19 expert group, whose purpose is to advise doctors on safe and effective treatment for covid and probably a similar number on vitamin D.

Yet, despite what has to now be undeniable evidence hospitals and ICUs are not being encouraged to test and correct vitamin deficiencies, and the majority are still not treating covid patients properly with the life-saving combination of intravenous vitamin C, vitamin D, ivermectin, steroids (often given at too low a dose) and anti-coagulants. Also, the public are not being erncoraged to take vitamin C upon infection and vitamin D on a daily basis at a dose of at least 1,000iu in the winter.

But even more deep-rooted is the simple fact that our National Health Service is a disease service, and Public Health England, set up to prevent disease in recognition of the NHS’s failure in this regard, has failed to tackle the cause of the diseases that are driving people into hospital in the first place, thus using up NHS resources.

So, as is true every year, the NHS ends up overloaded in winter, coincidentally when sunlight and vitamin D stores disappear and dietary vitamin C intake reduces. A simple example of this is type-2 diabetes, which causes over 500 deaths a day, more than 28-day deaths ‘with covid’. Yet, no-one even mentions a ‘sugar lockdown’. With 700 new diagnoses of type-2 diabetes, a reversible disease, every single day simply tackling this disease with the same government enthusiasm given for the covid vaccination roll-out has had would had more impact on premature deaths than covid. A similar story can be told for the other diseases that consume NHS resources, such as dementia and cancer, paid for from your taxes.

So, my conclusion, especially if you are under 70 and in reasonably good health, is that having a booster isn’t going to make any real difference to your risk of developing serious covid symptoms; isn’t going to protect others from getting it from you; isn’t going to significantly ease the NHS’s burden, and certainly not less than keeping your vitamin D status good and taking high dose vitamin C (and zinc) upon infection; but does have a small but real risk of harming you or giving you significant adverse reactions for a few days, perhaps greater than getting covid, and does have a very small risk of killing you.

 

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