Younger Americans benefit less from booster shots than older people

https://www.nytimes.com/2022/02/04/health/covid-boosters-older-younger.html

by lxm • 4 years ago

101 141 4 years ago

nytimes.com

mewse• 4 years ago

Booster doses cut the risk of infection in vaccinated people by about half across all age groups.

I’m not convinced the story actually says what the title claims it does.

tedunangst2• 4 years ago

Journalism and statistics, oil and water.

akomtu• 4 years ago

I'd even say journalists don't understand statistics. Without proper math education, they see stats as a game of numbers where the goal is to pick the right numbers to support a desired conclusion. I can't seriously expect a journalist to understand what "2 sigma" means, and even less likely they'd be willing to learn the difference between gaussian and poisson distributions.

QuercusMax• 4 years ago

The title may be correct, if you look at the absolute difference instead of the relative difference.

Making up numbers here, but if 10 out of 100 unvaxed people get sick among the elderly, and 6 out of 100 unvaxed get sick among younger folks, then the vaccine "helps" 5 elderly but only 3 younger folks.

But I agree with you that it's certainly misleading.

josephcsible3• 4 years ago

If infection is less harmful to younger people, less likely in younger people, or both, then cutting the risk of infection by half across all age groups is less beneficial to younger people.

Moto7451• 4 years ago

I see a benefit to not getting sick. Even when it won’t kill you, catching a cold sucks. I have no concern that I’m going to die of Covid but I’ll happily get a booster to avoid getting sick.

My sisters caught Omicron days before their boosters were available and they missed ten days of University and work. The booster doesn’t guarantee you won’t get a breakthrough but every bit helps.

I will offer though that if we’re not seeing a massive public health benefit, as opposed to an individual health benefit, that should factor into how many doses you need when they create vaccination requirements. I don’t think a double dosed 20 year old should be told they can’t eat inside if their risk of death or hospitalization is less than a triple vaccinated 65 year old.

xboxnolifes• 4 years ago

Depends how you look at it: relatives or absolutes. If the infection risk of an 18 year old is 10%, half is 5%. If the infection risk of a 70 year old is 40%, half is 20%. In absolute terms, the younger age group benefits less. This, however, is obvious based on all information we've known since almost the start of the pandemic, and is not useful at all.

Even if younger people stopped getting infected with these numbers, they could never have similar benefit compared to the older cohort.

These titles are designed to get clicks, but they are very "dangerous", for a lack of a better word, because of how often the title will be shared without reading and understanding.

yuliyp4• 4 years ago

The story continued to talk about hospitalization and death rates in people with a standard vaccine course vs also having a booster (units in instances / 100,000 people):

65+ hospitalization: 27.4 -> 4.9 (-82%) 65+ death: 3.6 -> 0.5 (-86%)

50-64 hospitalization: 9 -> 2 (-78%) 50-64 death: 0.4 -> 0.1 (-75%)

They did not break down the 18-49 hospitalization stats, presumably because they are even lower than the 50-64 group (according to the CDC stats linked from the article, < 5 people / 100k in the vaccinated 18-49 group were hospitalized due to COVID-19 in December, and < 1 person / 100k across all 18-49 died from COVID-19, and that number is well under 1 in a million per week for regularly vaccinated, meaning stats are going to be fairly noisy).

alamortsubite• 4 years ago

“The effect of the booster can be seen in the data sets, but it’s far smaller than the effect of vaccination compared to not,” said John Moore, a virologist at Weill Cornell Medicine in New York. “The real problem is the carnage among the unvaccinated.”

Unvaccinated people in every age group are at higher risk of infection, hospitalization and death than those who have been immunized, according to the C.D.C.’s data — a persistent trend ever since vaccines were introduced.

stefan_• 4 years ago

You write an article mixing all kinds of risks together that require careful individual analysis, discuss different kinds of outcomes (hospitalization, death, long covid), discuss different kinds of groups where my first reaction would be to see if the cutoffs are carefully chosen to support the headline - this is a fucking mess. And then you end it all with “The booster policy is the booster policy".

My god, science reporting in the US is dead.

wolf550e• 4 years ago

Why don't they write/draw a Sankey diagram with something like 1 million people on December 1st 2019, with age bracket percentages, and then draw how some got COVID, some got hospitalized, some died, some got the vaccine, some got a booster, some died from things that are not COVID, all in proportion to how it happened in US population. The width of the flows would make it clear how effective vaccines are.

yuliyp4• 4 years ago

Trying to draw a Sankey diagram that accurately describes what is happening are quite difficult: many of the numbers for those < 65 years old, and especially for those < 50 years old) are so small as to be hard to read: telling 1/1k vs 1/100k in a Sankey diagram doesn't work. They're both 1 pixel wide.

tomrod10• 4 years ago

Sankey doesn't work well because we moved from SIR to SEIR+S with Delta -- meaning that we had breakthrough infections and the potential for waning immunity. Omnicron continues this.

[0] https://en.wikipedia.org/wiki/Compartmental_models_in_epidem...

alea_iacta_est• 4 years ago

2 years in, we don't even have the numbers of people hospitalized from covid or with covid. It's not science reportings that is dead, it's science itself.

nradov6• 4 years ago

Currently about half of COVID-19 patients in hospitals are incidental cases who were admitted for another reason and then tested positive during admission screening.

https://gothamist.com/news/new-preliminary-state-data-shows-...

tomrod10• 4 years ago

There are many people who have these numbers and study them.

Public health officials in the US have both the reported numbers as well as piggy backing on the system set up for influenza monitoring (CLI & ILI).

Simply because not all public reporting is as rich as, say, Illinois or Pennsylvania's, doesn't mean these figures aren't carefully scrutinized -- especially when threatened by political leaning from either side of aisle (such as when the then-current administration pressured the CDC to change and alter reports).

In my experience, hospital operations officers, health information exchanges, and, depending on the state, state HHS agencies don't mess around.

[0] https://www.cnbc.com/2021/04/09/trump-officials-bragged-abou...

pessimizer• 4 years ago

It brings your chances of death from vanishingly small down to undetectable. I didn't think it was personally worth it; I might as well wait until my double vax decays a bit farther, more research is done, and new reformulations specifically targeting new variants that have gone around have been formulated.

As policy it's definitely not worth it. We can pretend that we as a country care about covid, but if we're stressing the importance of patents and boosting our own over vaccinating the world, we don't really care. If we take years to send out masks, we clearly think more about masks as a public declaration of loyalty than disease prevention devices.

I hate that we've split into two groups, one of nationalistic bleach drinkers that don't believe in the germ theory of disease, and the other of nationalistic OCD paternalists. Now I'm expected to believe that there's no level of protection that is enough i.e. evidence that a booster helps is evidence that I should be taking a booster is evidence that everyone should be taking a booster. I'm worried about covid, but I'm worried about things other than covid.

At least the NYT is staying pretty steadily rational about this.

javagram7• 4 years ago

Mass boosting _everyone_ made a lot more sense in the August-November timeframe it was originally proposed and implemented. The booster brought vaccine efficacy against infection back up to 90-95% against the Delta variant. If everyone who came in contact with seniors or almost-seniors was boosted, it would bring down the transmission of the virus (since you can't transmit if you aren't infected) and hopefully prevent those seniors from running the risk of death or serious injury from COVID.

Since the Omicron variant emerged in late November and it bypasses even boosted immunity to infection in somewhere between 30% and 60% of people, as a result we've seen worldwide that vaccination is unable to bring R0 below 1 and stop the spread of the virus.

If we take years to send out masks, we clearly think more about masks as a public declaration of loyalty than disease prevention devices.

The masks being sent out by the US Government seem more like a reaction to the realization that Omicron bypasses vaccine immunity to infection in a massive number of people, who still want some way to protect themselves from the virus. In 2021, the government was attempting to push vaccination as the only way to protect yourself from catching the virus, because social distancing and wearing masks annoys their voters (especially swing/independent voters) and they have an election to win this year. They only sent out masks and tests when the media/people began to demand it after the vaccine failed to stop Omicron.

thoughtstheseus• 4 years ago

Sounds like how we handle the Flu. Those who are more at risk get flu shots. We should prioritize everyday, holistic health as we work toward a more robust society against future viruses.

tomrod10• 4 years ago

Younger Americans mix with older Americans. Decreasing their potential to spread the virus (even if not totally nullified) is a net positive, IMO.

650• 4 years ago

The booster for omicron reduces spread potential?

empthought• 4 years ago

Of course it does, that’s how vaccines work.

javagram7• 4 years ago

The article notes "Booster doses cut the risk of infection in vaccinated people by about half across all age groups."

You can't transmit if you aren't infected.

fungiblecog• 4 years ago

Younger people benefit less from booster shots than older people

There fixed it for you

jurassic• 4 years ago

I’m 34 and healthy. Each of my shots and the booster gave me severe flu-like side effects (chills, body aches, etc). I’ve lost 5-6 days over the last year to recovering from these side effects. Given my low risk from the actual virus, I don’t see myself getting another booster. I’m not anti-science, but there needs to be significant ROI for that level of discomfort and time lost to recovery.

CoryAlexMartin3• 4 years ago

I was 28 when I got the Johnson and Johnson vaccine last April. I had bad flu-like symptoms for a week, which was followed by 3 months of lethargy, among other things. I can't even begin to imagine how much time I lost from that. Needless to say, I opted not to get a booster.

michaelmrose5• 4 years ago

I'm not aware of anyone having bad flu like symptoms for a week or 3 months of lethargy from J and J. Are you sure you didn't actually get covid? On balance that seems substantially more likely.

josephcsible3• 4 years ago

Needless to say, I opted not to get a booster.

You're lucky if opting out is a practical choice for you. For a lot of people now, opting out means being expelled from your school or fired from your job.

SOLAR_FIELDS2• 4 years ago

I was 30 when I got COVID in October of 2020. I spent 6 months recovering from the illness with symptoms ranging from myocarditis to Reynauds syndrome. As I type this message, pain erupts in my right lung as I inhale. If I had the vaccine available to me at that time maybe I wouldn’t be experiencing a constant reminder of my illness every time I inhale.

enraged_camel• 4 years ago

You spent 5-6 days over the last year recovering from side effects, but you don't really know what the alternative would have been. You may be healthy and relatively young, but without the vaccine shots you would most likely have had much more severe symptoms.

toolz5• 4 years ago

You're gonna need to provide some citation that young, no comorbidity individuals have "most likely" more severe symptoms when they have 2 doses vs 3.

kishinmanglani• 4 years ago

“Most likely”? According to what data?

In fact, the data suggests otherwise. They would have most likely had mild symptoms if any at all.

vvanders4• 4 years ago

Given my low risk from the actual virus ...

It's not about your risk, it's about transmission to other people that have a much higher risk profile.

[edit] Thanks for the downvotes, confirms that people care less about others than experiencing any inconvenience themselves.

christophilus3• 4 years ago

Everyone transmits the virus. The vaccines don’t do much in that regard, though from what I’ve read. They do a good job of preventing severe disease.

vmception2• 4 years ago

That will always be true, and how true that is now is way lower than when nobody was vaccinated. There was only upside, now there is not only upside for a merely marginal potential optimization for higher risk profile people. The current variants are weakened versions of the virus that they are essentially the vaccine.

christophilus3• 4 years ago

40, but same story. I just got over Omicron last week. It was roughly the same experience I had when I got the first Moderna shot. I rarely get the flu, and never get a flu shot for the same reason— the shot guarantees me a week of flu symptoms. At some point, I’ll be far enough along the risk curve to warrant that annual unpleasantness, but I’m not there yet.

micromacrofoot• 4 years ago

isn’t it possible that your experience with omicron was only similar to the shot reaction because you had some immunity?

ajross3• 4 years ago

Per the article, the ROI is a 2-4x reduction in hospitalization risk vs. a vaccinated-but-unboosted individual. Given that the side effects of the mRNA vaccines have essentially zero hospitalizations[1] and no deaths[2], that seems like a good deal to me.

I mean, it's true anecdotally that the immunization is worse that the disease. It was true for my family at least (four Omicron cases, all extremely mild). But it's not true for everyone, and some of those people are going to die. I regret nothing.

[1] I haven't seen numbers but haven't heard of any

[2] This one is attested.

umvi• 4 years ago

2-4x reduction doesn't mean anything unless you know the original risk probability. For a low 30s person that isn't obese... The original risk is already probably a tiny number. It's like saying because an anti shark ointment that makes you break out in itchy rashes reduces your risk of getting attacked by a shark by 2-4x, therefore everyone at the beach should use it.

michaelmrose5• 4 years ago

You also can't fairly compare vaccinated omicron cases + vaccination vs vaccinated omicron cases.

The proper comparison is vaccinated omicron cases + vaccination vs unvaccinated covid.

morpheuskafka• 4 years ago

I am inclined to agree with this. Getting one booster as an extra precaution was one thing (and in my case definitely made sense because my primary series was J&J, which is said should have been two dose to begin with).

Getting one every 6-12 months for an indeterminate number of years needs to be based on more than just a general precautionary instinct.

tcbawo• 4 years ago

I would love to know if anyone has looked at data from identical twins re: vaccine side effects and succeptibility to Covid reactions. It seems like a strong reaction to the vaccine might correlate to a strong viral reaction. Are there any studies that refute or corroborate this?

kyriakos3• 4 years ago

Identical twins rarely have the same immune system, part of the immune system develops with our exposure to pathogens which is unlikely to be the same for both twins.

armchairhacker• 4 years ago

Yeah but you're almost guaranteed to catch the virus at least once, and even if your symptoms aren't severe, they're likely to be worse had you not been vaccinated. 5-6 days of discomfort from vaccination may have saved you 5-6 days or more of discomfort from covid.

roenxi• 4 years ago

But presumably now he's had 5-6 days of discomfort, the vaccine antibodies will get flushed out and at some point he's going to get COVID and suffer 5-6 days of discomfort from COVID anyway. These first generation vaccines are a bit harsh which would make sense given that they were rushed through. It is unclear if they are suitable for frequent use given the side effects.

COVID isn't going away, everyone's going to catch a couple of varients in the next 60 years assuming they live that long.

0xB31B1B2• 4 years ago

The main issue IMO is that the original dose schedule of 2 doses 1 month apart is stupid, goes against pretty much all of our first principles understanding of immunology, and was driven by a regulatory need for a short time window for testing/deployment (it’s quicker to test a vaccine w 1 month window than one with 6 month window), not due to science. The optimal dosing schedule is more likely to be once mRNA vaccine and a second one 6 months later. Source: family member is a chief scientist at a few drug discovery startups. Most people will have a durable immune response with the schedule above.

lamontcg2• 4 years ago

No, the second dose greatly increases the efficacy against hospitalization and death in the short term. It wasn't "stupid" or "not due to science".

It optimized for maximum vaccine efficacy at around the 5 week timepoint.

Canada took a slightly longer dosing schedule to get more people their first doses faster due to having less available doses. But they didn't go with a 6 month interval either, and there's a difficult calculus there where it isn't at all obvious that one choice is "stupid".

With Delta slamming into India and a lot of doses available in the USA the short schedule got the bulk of the population as immunized as possible.

There's a whole lot of hindsight bias going in trying to claim that was just dumb or unscientific. It probably did save some lives in the summer of 2021 because we did have the doses in this country. Someone who got vaccinated in early April would have only been getting boosted then in early Oct 2021 and that would have been after 75% of the Delta wave had already passed. Second doses clearly needed to be going into arms sooner than 6 months and you can only figure out what timing might have been in optimal in retrospect when you know what the virus was going to do.

It is correct that it didn't allow time for the immune response to mature before the boost and that is the rationale for the third shot. And for anyone getting vaccinated now, particularly young people a 6 month schedule of 2 doses may make more sense (although you always have to look at that 6 month interval and do the calculation on what the risk is of getting COVID during that interval -- at this point though presumably a person who isn't vaccinated isn't very concerned about that and probably has already been exposed at some point).

yen223• 4 years ago

I am also 34 and relatively healthy. When I got my Pfizer booster, I had a mild muscle ache for about half a day, and nothing else.

newsbinator2• 4 years ago

Same here: mild muscle ache for the Pfizer booster. If I didn't know I'd had the booster the previous day, I would have attributed it to falling asleep on a lumpy part of my comforter or something, assuming I'd even noticed it at all.

My understanding is the Moderna booster, being a 1.5x dose, often results in stronger side effects that knock a person out more often.

afarviral• 4 years ago

Same (pfizer) and this was the typical reaction in friends and family. A couple had minor flu-like symptoms for an afternoon but nothing like some have described here (days of "agony" etc), totally unheard of in my circles.

tunesmith• 4 years ago

You didn't mention the risk of other people getting it from you. Each shot has lessened that risk considerably. That alone can be worth it - it only takes so many generations (person passing to person) for one person's infection to cause a death in another.

nradov6• 4 years ago

I encourage everyone eligible to protect themselves by getting vaccinated, but that won't stop widespread community transmission. Everyone will be exposed to the virus.

https://www.medpagetoday.com/opinion/vinay-prasad/94646

throwaway932489• 4 years ago

It's a nice thing to do on the individual level but I don't think it's right to coerce people into the vaccine on this basis.

An interesting reversal of this: https://www.nhs.uk/conditions/vaccinations/chickenpox-vaccin...

"Being exposed to chickenpox as an adult (for example, through contact with infected children) boosts your immunity to shingles."

"If you vaccinate children against chickenpox, you lose this natural boosting, so immunity in adults will drop and more shingles cases will occur."

It's seemingly not the primary justification the vaccine isn't offered, but I wonder if, to cut to the core question, those who are pro/anti vaccinating the low-risk to protect the high-risk feel the same way when it's flipped.

dnissley• 4 years ago

Same - I put off getting the booster until this past week and even though it's a half dose I still lost a day and a half to it.

jeeeb• 4 years ago

FWIW. I’m also in my mid-30’s and relatively healthy.

I had a mild reaction to vaccination and lost no time to it.

I also recently caught COVID. I had severe fever, headache, muscle ache and chills. I still get much more tired after mild exercise, like a long walk, than I did before.

Vaccination certainly didn’t stop me from catching COVID but it likely did help me avoid a more severe outcome.

I don’t believe in forcing it on others but I would strongly recommend it.

ornornor2• 4 years ago

I had 3x Moderna. The last two shots made me feel like shit for 36h and 24h respectively. It wasn’t fun but ok.

A friend of mine, same age, is in a couple where he isn’t vaccinated and she is (Pfizer). Of course he got sick last month and contaminated her because they live together.

He had to take 10 days off and felt like shit the whole time, unable to do anything. She kept working because since sh was vaccinated she had very very mild symptoms that didn’t hinder her.

Anecdotal evidence is anecdotal, and you don’t even mention what vaccine you got.

What I’m considering doing for the next booster is to check how many antigens I still have before deciding if I take the booster when it’s due or wait a bit longer (barring a virulent mutation that would change the decision making).

In any case, I’ll take 24–36h of flu like symptoms (without having an actual virus damaging my body) any day over 7–10 days of agony like my friend went through.

nradov6• 4 years ago

Which antigens are you referring to? If you mean antibody titers, that doesn't actually tell you much about your immunity level. In practice cellular immunity is more important, but it's not easy to assay.

https://peterattiamd.com/covid-part2/

xivzgrev• 4 years ago

Why is the only measure of success deaths and hospitalizations?

As a younger person it has been my observation that vaccinated folks are more likely to get break through cases 6+ months after vaccine / booster. Speaking for myself I got COVID almost exactly six months after being fully vaccinated.

These break thru cases, while not life threatening, are nonetheless NOT fun, may lead to long haul symptoms, and put others at risk.

I personally would like to see boosters available every 5 months for those who want it

tremon• 4 years ago

In NL, the general recommendation [0] is that children shouldn't be given a booster shot since the benefits are marginal. Children (or their parents) may still ask for one and they won't be denied, but it's not automatic. My attempt at translating the report conclusion:

The direct health benefit from the booster shot for 12-17-year olds is very limited, even for high-risk individuals. Break-through infections with the Omicron variant are very mild and the chance of hospitalization for vaccinated teens is minimal. Similarly, the risk of developing MIS-C due to infection is deemed very small. Moreover the booster shot also carries the (very rare) risk of developing myocarditis. The European Medical Agency also has not officially weighed the booster benefits against the risks for teens, making its use effectively off-label.

In the same publication they make the following claims regarding booster effectiveness (for all age groups, not specifically teens):

- full protection (only asymptomatic infection) drops to 50-75% within four weeks, drops further to 25-40% after three months.

- protection against hospitalization due to Omicron is around 90%, drops to 75% after three months.

- vaccinated but not-boostered people still have 70-80% protection against hospitalization due to Omicron in the first six months, drops to 60% efficacy after that.

- Against the Delta variant, non-boostered people still have above 80% protection against hospitalization even after more than six months.

The citations for these claims are from NL,UK,IS and US, but only two have a hyperlink. If someone wants to hunt them down, they're cites 10,21,23,24,25,36,37 in the PDF linked from [0].

[0, in Dutch]: https://www.gezondheidsraad.nl/organisatie/vaccinaties/docum...

[25] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4011905

[37] https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e3.htm?s_cid=mm...

oakasokww• 4 years ago

It should be proof enough I feel it necessary to make a throwaway to even comment on this because it's so easy to get marked "anti-science" for being a skeptic.

This article (typical of NY Times, honestly) is editorialized. There are so many questions to ask:

Booster doses cut the risk of infection in vaccinated people by about half across all age groups. The gap between unvaccinated and vaccinated groups was much greater. The numbers most likely reflect only symptomatic cases, and may be different for asymptomatic infections, Dr. Barouch noted.

To this day I have not seen a single study that controls for the obvious confounders. In particular, people who get vaccinated are likely "safer" in general. They most likely work out more, they most likely care about their health, they most like wear masks, and most likely listen to their doctor unquestioningly. ALL of these are confounders that MUST be controlled for in order for any study on booster efficacy to meet the bar of actual science, and not this pseudo-scientific idol worship we have right now.

Some people have worried about persistent symptoms even after a mild bout of Covid. But a recent study suggested that the risk of so-called long Covid is highest among people with one of four predisposing factors, including Type 2 diabetes and the presence of autoantibodies.

Weird, just recently we were hearing long covid is unavoidable even with vaccination in some cases. This was never mentioned. Yet another ultra low quality "studies say" post written by a non-scientist.

In those age groups, vaccination itself — two doses of the Moderna or Pfizer-BioNTech vaccines, or one dose of the Johnson & Johnson vaccine — decreased the risk of hospitalization and death so sharply that a booster shot did not seem to add much benefit.

Indeed, despite my area being pretty well boosted we still had a massive peak in cases. Without a doubt the "journalists" spun it as a catastrophe that is the unvaccinated's fault. Well, if 80% of my location is vaccinated, do you think a positive rate of 38% can only be because the unvaccinated? I suppose if you listen to MSM like NY Times and the mouthpieces at the CDC you'd probably believe so.

This calls into question the vaccine effectiveness in general. Which have the same problem, confounders are everywhere and no one is controlling for them. It's far easier to sell fear than science, because science takes time.

One day we'll get actual information. Until then we're stuck with these faux-journalistic pieces that are just cleverly dressed up op-eds with reddit-tier "studies say" bait.

oneoff786• 4 years ago

To this day I have not seen a single study that controls for the obvious confounders. In particular, people who get vaccinated are likely "safer" in general. They most likely work out more, they most likely care about their health, they most like wear masks, and most likely listen to their doctor unquestioningly. ALL of these are confounders that MUST be controlled for in order for any study on booster efficacy to meet the bar of actual science, and not this pseudo-scientific idol worship we have right now.

Clinical trials give people a placebo. The efficacy is well established.

Weird, just recently we were hearing long covid is unavoidable even with vaccination in some cases. This was never mentioned. Yet another ultra low quality "studies say" post written by a non-scientist.

Some study suggesting something does not imply consensus. There has never been a consensus that long covid is unrelated to disease severity.

Indeed, despite my area being pretty well boosted we still had a massive peak in cases. Without a doubt the "journalists" spun it as a catastrophe that is the unvaccinated's fault. Well, if 80% of my location is vaccinated, do you think a positive rate of 38% can only be because the unvaccinated? I suppose if you listen to MSM like NY Times and the mouthpieces at the CDC you'd probably believe so.

Seems almost purposefully obstinate in how you try to refute a claim about metrics of hospitalizations and death with a fact about new cases.

Younger Americans benefit less from booster shots than older people

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