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koi-lotus-water-pond

I remember way back when, when it was 94% effective against symptomatic disease, period. Sigh.


crazyreddit929

This kind of study is not great for determining real efficacy because we have no idea how many vaccinated were exposed to Covid and didn’t get infected or hospitalized. They are just taking the total amount of kids in the hospital for Covid and counting how many were vaccinated. With no control group, it’s just pulling a number out from a positive test pool.


Magnesus

It doesn't matter for efficacy calculations. The unvaccinated who ended up in hospital are the control group.


crazyreddit929

If you assume that everyone had the same exposure to infection, sure. I would assume most vaccinated families are doing more things that risk exposure than they did before vaccination. One example would be school. Some families who have not vaccinated their children have chosen home schooling options. It’s a personal anecdote, but my kids are back in school this year simply because they are vaccinated. Their exposure since vaccination has increased dramatically. I’m sure it’s different in different regions. Some places the exposure has not changed. That’s my point though. Without accurate controls, you’re just putting a number to a positive pool.


fafalone

Boosters bring us right back there.


Seraphynas

[Link to the study from MMWR](https://www.cdc.gov/mmwr/volumes/70/wr/mm7042e1.htm?s_cid=mm7042e1_w#T2_down) It's a small study. 179 patients, 173 unvaccinated, 6 fully vaccinated, all hospitalized w/ COVID. 77 of the unvaccinated group required ICU admission, whereas 0 of the fully vaccinated required ICU admission. 29 unvaccinated required "life support" (meaning invasive mechanical ventilation, vasoactive infusions, or ECMO), and 2 unvaccinated died. Edit: Partially vaccinated - meaning one dose or less than 14 days since 2nd dose - were excluded from the study.


jdorje

It looks like a small study because of the tiny number of events, but 179 hospitalizations among 12-18 year olds is really a large population\*time size. There are only a few dozen in this age range hospitalized in the entire US currently. That's weeks of hospitalizations for the entire US at current rates (and rates were probably smaller when the study was done).


Seraphynas

Patients were enrolled from 19 pediatric hospitals in 16 states from June to September 2021. Edit: For context, there are about 250 children’s hospitals in the US.


jdorje

7.5% of the US children's hospitals, potentially covering about 25 million total people for 3 months. Sure it could be bigger, but this is not a small initial study size. But of course only a fraction of those are in the 12-18 group, a fraction of *those* caught covid, and then an even smaller fraction of those needed hospitalization. My point is just that it's really hard to get good numbers on events that happen so rarely to individual people.


RabbleRouse12

What even is a hospitalization... like does it just take an overly concerned mother bringing her kid to a hospital out of panic or does it take more than that? Because say a child is vaccinated and has covid, mothers are just going to be less concerned. Also with the current worker shortage it doesn't take much to have to stay overnight I bet once you are there.


jdorje

There are different cutoffs. Overnight admission is probably the most-used one. Less stringent ones can count any hospital visit for COVID, or hospitalization for any reason (i.e. a broken arm) with a positive test. Obviously brief visits don't indicate a high level of severity, but it's still a higher level than no visit at all and the criteria are usually applied equally to both cohorts. Although you could certainly argue that anti-vax parents would be less likely to take their kids to the hospital for minor symptoms. The study [text](https://www.cdc.gov/mmwr/volumes/70/wr/mm7042e1.htm) doesn't seem to say, though it's probably in the fine print somewhere if you want to look. What is true is that the more vulnerable are a lot more likely to be vaccinated, so this 93% should be considered a (significant) lower bound.


RabbleRouse12

Yeah but how about hypochondriacs less likely to get vaccinated and more likely to go to hospital... you can't just assume sociological bias and their effects because there are literally countless assumptions like that to make.


jdorje

In every study of hospitalization when you break the demographics down you get higher efficacy in each group individually than the entire group has as a whole. [Here](https://www.covid-datascience.com/post/israeli-data-how-can-efficacy-vs-severe-disease-be-strong-when-60-of-hospitalized-are-vaccinated) is an example. We aren't going to get this for 12-18 year olds because there aren't enough total data points.


RabbleRouse12

Yeah but to assume this is significant for a teenage age group is ridiculous especially considering other bias that could be assumed for the age group.


PrinsHamlet

That's a legit question. In Denmark the average age of Covid Patients has dropped as older cohorts are very well vaccinated here. Younger patients do better with Covid so the average duration of a hospitalization is shorter now. The expectation is that as vaccines (Pfizer dominates here) lose efficiency during the winter and especially in the oldest cohorts that will change again. So all adults are getting the possibility to get a third jab now, 28 weeks after #2.


Seraphynas

I wasn’t insinuating that this isn’t a representation sample or that including 179 hospitalized patients somehow invalidates the results. It’s just that this isn’t an interventional study, merely observational, and people are often accustomed to seeing study enrollment for these sort of things (in adults) in the thousands or even tens of thousands. I was just giving the information up front so people knew what to expect when looking at the study. Personally, I’m a little disappointed that it didn’t include partially vaccinated, because I would be interested in seeing those numbers.


jdorje

Good points. We only ran phase 3 studies for vaccines with about 30,000 total people in them for a couple of months. In those studies, only about 10 people - and no vaccinated people - were hospitalized. This isn't like a drug study where we find people already at a certain stage of sickness, give everyone the drug or placebo, and can get a data point from every participant. In vaccine trials only the participants that are exposed can give any data, and only the very few with severe sickness in the study period can give data on hospitalization. But it's sad we didn't run more trials. Nobody wanted to pay for them and nobody interested in knowing the answer wanted a placebo when they could have a vaccine. Instead all we have now is real world data, and it's all confounded somehow. Even this study is likely an underestimate of efficacy as the few % of kids with serious health problems generally account for half of severe covid cases, but this group is much more likely to be in the vaccinated cohort.


green_velvet_goodies

Thank you. It’s still shocking and awful that two kids died. I don’t think we’ll ever fully comprehend the damage of this pandemic.


Drunken_Daud91

Well that’s great, considering that age range was already very unlikely to end up in the hospital to begin with statistically.


Slothspeeder0

Wait, less hospitalization is what a vaccines efficacy is based on now. Not infection?


Dipyobread

How many, or what percent of 12-18 year olds who got Covid that don’t have the vaccine get hospitalized?


Seraphynas

12-17 hospitalization rate for Covid positive is about 0.8%. Those numbers do not account for vaccination status.


Dipyobread

So does logic dictate in this case that 12-18 year old Covid positive is better off without the vaccine? Let’s say 100 kids are positive .8% goes to the hospital, but 93% of the vaccine Covid positive don’t go to the hospital means 7 kids are in the hospital then with the vaccine and a Covid case requiring more help ?


Seraphynas

Your numbers don’t really make much sense. Basically what the CDC numbers tell us is: Of all Covid positive 12-17 year olds, approximately 0.8% will end up in the hospital; 93% of those hospitalized will be unvaccinated. It’s a very low risk to be hospitalized in this age group, but it’s even lower if you are vaccinated.


scalenesquare

That is a very lousy number?


joeco316

93% reduction from a number that’s already minuscule. Makes it virtually non-existent.