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I have some misgivings about calling the mRNA vaccines 'near miraculous' for elderly patients.

Have looked everywhere for serious data on this question and have come up with nada.

Meanwhile it is clear that many elderly, double-vaccinated patients are dying in many countries - from the UK to the Netherlands to Italy - where hospital and nursing home staff sometimes take the risk of speaking out.

The standard mantra is that 'these are old people, and of course many are going to die regardless.'

Quite true. But where is the data that mRNA vaccines have truly and significantly reduced all-cause mortality in the elderly?

As I've said, have looked hard, but am still hopeful of finding it.

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My thoughts, exactly. Since it is impossible to un-vaccinate someone, there is no way to know how those vaccinated elderly would have fared without the vaccine.

Love this article, though!

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Thanks for this. How about the repeated hyping of each new variant as being uniquely devastating, only for time to show these claims were overblown?

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Nice piece, John. Only one minor quibble— a study that looks back at data is called “retrospective”, not “observational”. Often, these 2 occur together, but not always.

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Thanks DJC. I really appreciate the correction. To my readers, Dr. Cohen is absolutely correct. I will correct the text.

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I appreciate this especially given your background. I would like to hear your thoughts about the effectiveness of various medicines (supplements also?) as treatment for C19 vs possible long term risks of serious side effects from the vaccine. Thank you.

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"The mRNA vaccines are so good, that any adult can simply take the free shots, and boom, they are protected from severe COVID-19." Yes, until this Delta variant came along. Now the MRNA vaccine effectiveness seems to be around 65% or less against Delta. Not enough information yet. That also needs to be incorporated into people's decision to get the vaccines. And how do we know myocarditis is rare in the vaccinated? Have large groups of vaccinated people of all ages been given heart scans before and after vaccination over months to look for any amount of inflammatory changes? Or only the ones who have developed symptoms, like young Army guys who do rigorous physical training all day and so would likely be the first to get symptoms caused by inflammation? Also, young people in general are more active than older folks. Can one have some heart inflammation without experiencing symptoms? Is anyone in the medical field asking these questions?

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"effectiveness" can be:

- preventing positive PCR tests even if asymptomatic

- preventing symtoms

- reducing spread

- preventing "severe disease" or "hospitalization"

- preventing permanent disability

- preventing death

Pop quiz: which does your 65% refer to?

It's one thing to lump the last three together to get an initial understanding of what's going on. It's unacceptable for decision-making to lump the whole list together, as the science beat often does: I would accept a vaccine with 0% effectiveness on the first two points and even prefer it to a vaccine with 95% effectiveness if the adverse reactions were fewer or the immunity lasted longer, so long as it was about as good as the competition on the bottom four points.

The third point is difficult. Suppose the vaccine works great except for the third point. Would you rather do a "booster" or gain immunity through spread of "cases" that have been rendered harmless by the hypothetical vaccine? That's another reason John's comment is so important: "unlike other communicable diseases, people do not have to depend on others being vaccinated. The mRNA vaccines are so good, that any adult can simply take the free shots, and boom, they are protected from severe COVID-19."

I think it's basically never okay to lump the whole list together, to the point of being misinformation because it will change the take-home message to one that's false in our reality. Whoever collected the stat usually has enough information to know it's false. It's the job of the science beat to preserve the actionable part of information as they simplify things which they're not doing when they lump the whole list together. If they fail in this way it should affect how much you trust their guidance in the future.

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Thank you John. I believe there should be accountability for those journals who authorized such low quality articles. I am sure they were knowledgeable of the flaws and yet decided to continue with the fear mongering. This is completely irresponsible, dangerous and destructive. So much people have suffered because of these lies. Among other things they fed the government with lies that further fueled the restrictive measurements that so much harm has caused to small businesses and schools.

With no accountability these people will feel more empowered to continue such behaviour.

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Many unanswered questions remain. What or who were the sources of the decision to choose early intubation as a treatment for COVID-19? Should those people be held accountable? Why? Why not?

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"It short, it too, was a mess." Perhaps that should be "In short,"?

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Thank you Dr M.

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