COVID Transmissions fro 1-18-2021
A shorter newsletter in honor of Dr. Martin Luther King, Jr.
Good morning and welcome to COVID Transmissions.
It has been 427 days since the first documented human case of COVID-19.
In honor of Martin Luther King Day in the US, today’s newsletter will be abbreviated.
I do have a couple of items today that I think are important that we discuss today.
As usual, bolded terms are linked to the running newsletter glossary.
Keep the newsletter growing by sharing it! I love talking about science and explaining important concepts in human health, but I rely on all of you to grow the audience for this:
Now, let’s talk COVID.
Deaths in Norway after vaccination
At latest report, 29 people have died in Norway after receiving the Pfizer COVID-19 vaccine. Please note how I phrased this, because the meaning is often missed. These individuals died after vaccination. This does not mean they died because of vaccination. I think this has been reported in an overly sensational way by the press in some cases, so I want to walk through what this means. Let’s start by remembering that millions of people around the world have receive this vaccine at this point. 29 is a very small fraction of that population.
You can read a bit about the situation here: https://www.nytimes.com/live/2021/01/17/world/covid-19-coronavirus/norwegian-officials-emphasize-vaccines-safety-after-nursing-home-deaths
I understand that by this point, some of the deaths have been traced to vaccine adverse events, but we need to probe this a little further to really understand it. The Norwegian government has been prioritizing vaccination of older individuals in nursing homes—as have many countries. In this case, it appears that quite a few terminally or otherwise severely ill patients were vaccinated. These patients either died of their illnesses, or were not able to handle the vaccine as a result of them—at least, this is the current thinking. That’s very serious, as is any death, and I am hopeful that this will provide important information to the medical community about who is healthy enough to receive this vaccine.
It’s worth noting, though, that this doesn’t seem to have happened in any other country. It is possible that the guidelines for vaccine eligibility in Norway were not the same as in other countries, and particularly frail patients were vaccinated there but not in other countries. Or it is possible that Norway is capturing this kind of event more accurately than other countries.
I think if we have learned anything here, it is that very old patients with severe or terminal illnesses are not always appropriate candidates for vaccination. In most countries, there are guidelines that prevent or modify the use of vaccines in patients in this sort of condition. I don’t know if those guidelines exist in Norway for this particular vaccine.
Really, either way, this does not apply to most people, though, and that’s an important take-home message. These events have been noticed only in specific patient populations in Norway. If you are someone over the age of 75 with a very severe or terminal medical condition, you should always consult with your doctor about your condition before getting a vaccination.
If you are anyone, of any age, that’s also probably good advice anyway.
What am I doing to cope with the pandemic? This:
Taking the day off for MLK day
To further honor the day, I would like to share with you a link to his daughter, Bernice King’s, twitter feed, which I’m sure will contain appropriate content today: https://twitter.com/BerniceKing
Last week, I mentioned someone named Peter Doshi who wrote some inaccurate things about vaccine trials. Because Doshi is an editor at BMJ with an impressive title in his other work as a professor, I thought that he was an experienced pharmaceutical scientist operating in good faith.
Thanks to information from reader Carl Fink, I have learned that he is not. In fact, he appears to be unqualified in pharmaceutical science, with training in anthropology and history rather than in science. He has used these credentials to serve as an expert witness in antivaccine lawsuits, I have now learned. I must conclude that his arguments are made in bad faith out of sympathy to unscientific antivaccine positions.
Here is Carl’s comment that helped to fill me in:
Huh. David Gorski pointed me to this:
Doshi is borderline antivax, apparently.
As it turns out, Dr. Gorski also wrote about this, asking why Doshi is still an editor at the BMJ. And, thanks also to Carl, who shared that COVID Transmissions issue with him, Dr. Gorski linked to my words about Doshi as well. This appears to have led a few new readers to this newsletter, so I’d like to welcome you!
I’d also like to link Dr. Gorski’s post, which provides additional perspective: https://respectfulinsolence.com/2021/01/15/why-is-peter-doshi-still-an-editor-at-the-bmj/
At this point I think it’s actively harmful that Peter Doshi is given a platform by the BMJ. On the other hand, I am glad that this episode has helped connect more people with this newsletter and hopefully with good information about COVID-19.
You might have some questions or comments! Send them in. As several folks have figured out, you can also email me if you have a comment that you don’t want to share with the whole group.
Join the conversation, and what you say will impact what I talk about in the next issue.
Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.
Part of science is identifying and correcting errors. If you find a mistake, please tell me about it.
Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.
No corrections since last issue.
See you all next time.
Always,
JS
The New York Times morning briefing quoted a New England Journal of Medicine vaccine FAQ (https://www.nejm.org/covid-vaccine/faq): “If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!"
That doesn't match my understanding from what you've said here. Can you think of any examples of vaccines that prevent disease without providing sterilizing immunity? If not, what is it about SARS-CoV-2 that makes you think our priors from previous vaccines might not apply?
Hey, John, have you written about antivirals? A diet of all vaccine essays is probably getting dull, and I find it disappointing that we still have no effective antiviral medications against SARS-CoV-2. (No, I don't think that remdesivir is actually doing anything.)