Johns Hopkins team responds to my takedown of their pro-COVID vaccine study

In a massive coup, just a few days ago the influential American Journal of Epidemiology, published by Oxford University Press, released my response to a Johns Hopkins study (Kitano et al.) concluding that the COVID-19 vaccines are still worth the risk in the Omicron era. I found quite a bit wrong with the study, noting the very minute stated net benefits, even if ignoring that data for known and unknown risks was omitted. The researchers have now responded. Source. Since AJE would be unlikely to continue the academic back and forth, especially when it would seemingly benefit the unfunded David more than the Big Pharma funded Goliath, here are some of my thoughts on the researchers’ response. Note that they generally seem to attack the low hanging fruit, ignoring the bulk of my critique, and employ mischaracterisations as well.

• While agreeing on the importance of long-term safety studies, they quickly brushed aside Shiraishi et al., implying that that response concerned only a single adverse event whose causality is unknown, ignoring the many other cardiovascular side effects discussed in Shiraishi et al.

• Turning their attention to me, and my mention of counting window issues (as discussed in the JECP ‘series’ that included one of my articles), they again act as if only one was mentioned, brushing off my attempt here with: “Lataster may not have understood the fact that the studies used in our analysis already adjusted these confounding factors such as case counting window.” No explanation is given, this is highly unlikely as counting window issues are very common, and this is impossible since one of the several counting window issues I mentioned as being highly concerning is that adverse effects are only counted for a few months.

• Referring to my thoughts that their “timeframes are inappropriate” they state that for their safety analysis they did consider “adverse events starting immediately after vaccination”. I quoted the part of their original paper where they describe their timeframes word-for-word, and in any case, the end point of their timeframes is still a huge concern. More discussion on that would have been appreciated.

• They bizarrely state that expanding the “timeframes for consideration of vaccine effectiveness” would have improved their results, when we actually have ample evidence now that effectiveness declines to zero, and beyond (less than zero, negative), just a few months after each shot.

• On myocarditis, and why they didn’t include myocarditis deaths in their analysis, they express reservations about using data from a Korean study on their US-focused analysis, as if the vaccines are safer in different countries (though this is possible, since in 2020 apparently the coronavirus knew which citizens were protesting police brutality and which were protesting lockdowns). They go ahead and factor them in anyway, finding “negligible changes” on their overall stated net benefits to vaccination. I found the changes to be significant, particularly for such an already small net benefit, but this can be chalked up to opinion. Notably, they again address just one small part of my critique, myocarditis deaths (and I already noted the window for what counted there in the Korean study was very small), ignoring the rest. What about myocardial damage and long-term implications, including deaths beyond any of the adverse effect counting windows? Crickets.

• Still on myocarditis, they state: “Lataster intentionally selected the study with one of the highest mortality rates of myocarditis with temporal relationship with the vaccination.” I’m not a fan of cries of “Cherrypicking!” This is data that exists and it’s up to them to deal with it. Such data won’t go away because they don’t like it, and nor will their obligations. Imagine a criminal defence attorney saying, “Yeah but you’re cherrypicking the worst things my client, Adolf, has done. 99% of the time he’s been a perfectly safe and effective member of society!”

• On my claim that apart from all these issues the stated net benefits in the study are minute, they merely state that I ‘lack understanding’. This is admittedly subjective. I leave it to you, as ever, to decide if a few hours of extra quality life in young and healthy people is worth it, particularly when these net benefits come from a study that omits data we have and data we don’t yet have (long-term safety data is still necessarily unavailable). And they again mischaracterise (and ignore most of) my critique when they admit that their approach “understates the value of benefits among the very old who are at highest risk of death from COVID-19”, when it was actually the even more minute net benefits in the young and healthy I was more concerned with.

• They notably had no comment on my statement that their work actually reveals that “in the omicron era COVID-19 is now extremely benign”.

• They do take a parting shot, referring to my “lack of expertise in vaccines and epidemiology”, which nicely encapsulates the state of The Science these days. Remember when argumentation and scientific research was about the evidence? And not about punching down, insults, appeals to authority, and other logical fallacies? Pepperidge Farms remembers.

That’s pretty much it. I of course think that my critique still stands, as well as the comments from the other respondents. But I’ll leave it up to you to read the original paper and all the responses and to decide if a risk benefit analysis can be valid when data for known and unknown risks is omitted, not to mention the increasing evidence of negative effectiveness, and to decide if, ignoring all that, the minute net benefits in Kitano et al. merits the ongoing triumphalism around the COVID-19 vaccines.

Okay then.