The vaccines were never tested to prevent transmission, only symptomatic disease, and those who knew the science expected, from the outset, that we would see some number of such cases, and that they would be, overwhelmingly, mild. But Delta appears to have changed things. Not everything: The vaccines are working to suppress severe outcomes from COVID infection — according to a New York Times analysis, by more than a factor of 100 for some states, and at least fivefold for even the states where the effect has been most muted. That is, by the standards of historical vaccines, game-changingly well. But most of the data in that analysis comes from before the arrival of the Delta variant, and during the current surge there does seem to be considerably more “leakage” in the protection that vaccines offer against pandemic spread than has widely been acknowledged. While more severe breakthrough cases remain, in relative terms, very rare, we may be seeing a rise in those numbers with Delta, as well.
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“We’re seeing a lot more spread in vaccinated people,” agreed Scripps’s Eric Topol, who estimated that the vaccines’ efficacy against symptomatic transmission, which he estimated to be 90 percent or above for the wild-type strain and all previous variants, had fallen to about 60 percent for Delta. “That’s a big drop.” Later, he suggested it might have fallen to 50 percent, and that new data about to be published in the U.S. would suggest an even lower rate. On Wednesday, a large pre-print study published by the Mayo clinic suggested the efficacy against infection had fallen as far as 42 percent.
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“I think the problem we have is people — whether it’s the CDC or the people that are doing the briefings — their big concern is, they just want to get vaccinations up. And they don’t want to punch any holes in the story about vaccines. But we can handle the truth. And that’s what we should be getting.”
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Almost all of these calculations about the share of breakthrough cases have been made using year-to-date 2021 data, which include several months before mass vaccination (when by definition vanishingly few breakthrough cases could have occurred) during which time the vast majority of the year’s total cases and deaths took place (during the winter surge).This is a corollary to the reassuring principle you might’ve heard, over the last few weeks, that as vaccination levels grow we would expect the percentage of vaccinated cases will, too — the implication being that we shouldn’t worry too much over panicked headlines about the relative share of vaccinated cases in a state or ICU but instead focus on the absolute number of those cases in making a judgment about vaccine protection across a population. This is true. But it also means that when vaccination levels were very low, there were inevitably very few breakthrough cases, too. That means that to calculate a prevalence ratio for cases or deaths using the full year’s data requires you to effectively divide a numerator of four months of data by a denominator of seven months of data. And because those first few brutal months of the year were exceptional ones that do not reflect anything like the present state of vaccination or the disease, they throw off the ratios even further. Two-thirds of 2021 cases and 80 percent of deaths came before April 1, when only 15 percent of the country was fully vaccinated, which means calculating year-to-date ratios means possibly underestimating the prevalence of breakthrough cases by a factor of three and breakthrough deaths by a factor of five. And if the ratios are calculated using data sets that end before the Delta surge, as many have been, that adds an additional distortion, since both breakthrough cases and severe illness among the vaccinated appear to be significantly more common with this variant than with previous ones.
...
Unfortunately, more accurate month-to-month data is hard to assemble — because the CDC stopped tracking most breakthrough cases in early May, before the Delta wave had begun, and the states maintaining their own databases often update them irregularly and, in some cases, according to idiosyncratic logic — but over the last week, I’ve tried.
Breakthrough COVID-19 Cases May Be a Bigger Problem (nymag.com)
This is a story written by a very pro-vaccine journalist. He firmly believe that the vaccines are one of the most effective tools we have to fight this pandemic.
He does, however, also recognize several things that i've been saying...
1. There is increased spread in the vaccinated with the delta variant.
2. Many of the studies/data being presented is distorted due to the timing of the data presented. Year-to-date Covid data is being coupled with current vaccination rates and presenting a wholly distorted picture of effectiveness. Additionally, much of what is being presented is from before delta became the predominant strain.
3. Those presenting the data at the CDC and government aren't being fully transparent in the information being presented - not due to some insidious plan, but to increase vaccine acceptance.
...
“We’re seeing a lot more spread in vaccinated people,” agreed Scripps’s Eric Topol, who estimated that the vaccines’ efficacy against symptomatic transmission, which he estimated to be 90 percent or above for the wild-type strain and all previous variants, had fallen to about 60 percent for Delta. “That’s a big drop.” Later, he suggested it might have fallen to 50 percent, and that new data about to be published in the U.S. would suggest an even lower rate. On Wednesday, a large pre-print study published by the Mayo clinic suggested the efficacy against infection had fallen as far as 42 percent.
...
“I think the problem we have is people — whether it’s the CDC or the people that are doing the briefings — their big concern is, they just want to get vaccinations up. And they don’t want to punch any holes in the story about vaccines. But we can handle the truth. And that’s what we should be getting.”
...
Almost all of these calculations about the share of breakthrough cases have been made using year-to-date 2021 data, which include several months before mass vaccination (when by definition vanishingly few breakthrough cases could have occurred) during which time the vast majority of the year’s total cases and deaths took place (during the winter surge).This is a corollary to the reassuring principle you might’ve heard, over the last few weeks, that as vaccination levels grow we would expect the percentage of vaccinated cases will, too — the implication being that we shouldn’t worry too much over panicked headlines about the relative share of vaccinated cases in a state or ICU but instead focus on the absolute number of those cases in making a judgment about vaccine protection across a population. This is true. But it also means that when vaccination levels were very low, there were inevitably very few breakthrough cases, too. That means that to calculate a prevalence ratio for cases or deaths using the full year’s data requires you to effectively divide a numerator of four months of data by a denominator of seven months of data. And because those first few brutal months of the year were exceptional ones that do not reflect anything like the present state of vaccination or the disease, they throw off the ratios even further. Two-thirds of 2021 cases and 80 percent of deaths came before April 1, when only 15 percent of the country was fully vaccinated, which means calculating year-to-date ratios means possibly underestimating the prevalence of breakthrough cases by a factor of three and breakthrough deaths by a factor of five. And if the ratios are calculated using data sets that end before the Delta surge, as many have been, that adds an additional distortion, since both breakthrough cases and severe illness among the vaccinated appear to be significantly more common with this variant than with previous ones.
...
Unfortunately, more accurate month-to-month data is hard to assemble — because the CDC stopped tracking most breakthrough cases in early May, before the Delta wave had begun, and the states maintaining their own databases often update them irregularly and, in some cases, according to idiosyncratic logic — but over the last week, I’ve tried.
Breakthrough COVID-19 Cases May Be a Bigger Problem (nymag.com)
This is a story written by a very pro-vaccine journalist. He firmly believe that the vaccines are one of the most effective tools we have to fight this pandemic.
He does, however, also recognize several things that i've been saying...
1. There is increased spread in the vaccinated with the delta variant.
2. Many of the studies/data being presented is distorted due to the timing of the data presented. Year-to-date Covid data is being coupled with current vaccination rates and presenting a wholly distorted picture of effectiveness. Additionally, much of what is being presented is from before delta became the predominant strain.
3. Those presenting the data at the CDC and government aren't being fully transparent in the information being presented - not due to some insidious plan, but to increase vaccine acceptance.
