Jean Fisch

I am a bit lost for words in this case: I still can't believe that such a huge pack of seasoned statisticians did not see this basic problem ... so maybe, I miss something? :-)

I have no idea what you are talking off so the answer to your question is

No, I haven't addressed that paper

Would you have a link? No guarantee that it will trigger an interest though ;--)

A picture says more than 1,000 words?

So here the evolution of natural deaths excl covid for the <65 vs. all possible linear trends of the last decade

I see claims about "there was lots of excess in France among the young" on the back of the French study of vax vs. non vax

There is none except for covid ... and external causes

So if you believe vaccines make people do stupid things, you have your confirmatory chart ;-)

So, the study remains interesting but, unfortunately, there are elements in there which make its interesting results (in terms of differential between vaxed and unvaxed) a bit shaky

It's unfortunate but there is nothing one can do

END

Also, the fact that possibly 20% of the vaxed have not have had any interaction with healthcare in 2020 (and are hence not taken into account in the study) could mean that these possibly healthier people could tilt the difference even more between vax and unvax ... or not, who knows?

6/

The post-freeze point (end Nov 2021) vaccination uptake means that 20% in the unvaxed group are actually vaxed

This will affect the differential vaxed / unvaxed calculation(ie potentially making it artificially smaller)

5/

These factors are not per se "killer arguments" but they add confusion

The vaccination uptake (point A) figure in the open data of Santé does not specify "residents"

But it would mean that millions of doses in France given to working age people were non residents

4/

C) Size of the vaxed pop excluded from the study:
- Per Santé publique, 30.5m 1st doses were administrated to 18-59yo by Nov 21
- Yet, the study identified only 22.8m people meeting the criteria, in particular "interaction with healthcare in 2020"
-> 7m (very healthy?) people were not included

3/

B) Post-Nov 21 vax uptake:
- Per Santé Publique open data, 1m 18-59yo took up covid vaccination from Dec 1, 2021 to Jun 26, 2023
- So this means that of the 4.9m which were unvaxed in France End Nov 2021, 20% ended up vaxed after all despite being classed as unvaxed in the study

2/

Next interesting / puzzling / frustrating things about the French vaxed vs unvaxed study of 18-59yo

A) Data consistency: End Nov 2021, France had
- 30.5m vaxed (Santé Publique open data)
- 35.1m residents (INSEE)
so ~4.9m 18-59yo unvaxed
Yet the study identified 5.9m unvaxed in their system

1/

Wow, I didn't realize that the Epi-Phare press release actually focuses on the "no increase in mortality in vaxed" message

It's a great study but it is not designed to say anything on the mortality impact on of C19 vaccines

This is very very disappointing...

www.epi-phare.fr/actualites/c...

Let me take an example: The French study found that vaxed are 25% less likely to die than unvaxed

If this figure was 30% pre-vax, it would concerning

If it was 25%, there would be no concern

We don't know how high that figure is: Hence we can't conclude on vax impact (either way)

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What this (and other similar studies) show is that any comparison of vaccinated to unvaccinated is bound to find a health differential

But unless you know the health differential BEFORE vaccination, you cannot deduce anything on the impact of vaccination ... because you miss the comparative

What this French study showed is something known and best analysed so far by a national study of Denmark

Unvaccinated are intrinsically less healthy even after correcting for known factors because they seek less healthcare

Here a walk-through

bsky.app/profile/jean...

So just to leave no doubt: This warning is about METHOD not RESULT!

There is zero sign of any unexplained excess mortality in France beyond covid, flu and heat vs. expected deaths from pre-pandemic trends in France

Vaccines therefore cannot have generated any topline visible mortality

Quick warning: The @epiphare.bsky.social study on vax/unvaxed mortality in France is very interesting

However, it does not show "covid vax does not increase mortality" as claimed by its president

For that, one would need to know the relationship of mortality BEFORE VAX and this is not available

COVID-19 mRNA Vaccination and 4-Year All-Cause Mortality Among Adults in France This cohort study uses the data from all adults aged 18 to 59 years living in France on November 1, 2021, to evaluate whether there is an association of receipt of an mRNA COVID-19 vaccine with long-t...

Link to the study jamanetwork.com/journals/jam...

So the study is very interesting as it confirms
- a structural vaccinee bias beyond corrections
- a likely covid vaccine efficacy upon infection against death of up to 66%

But it also shows that there is still work ahead to determine the true efficacy of respiratory vaccines

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Jean Fisch on X: "Netherlands did a mortality by vax status analysis with being vaxed is as of the day of the 2nd dose (ie without delay) As with ONS - Covid mortality rate is much higher in the unvaxed - but unvaxed also see higher non-covid mortality But the ratio of the two is always 2-4⤵️ https://t.co/wrsKU4Af2h" / X Netherlands did a mortality by vax status analysis with being vaxed is as of the day of the 2nd dose (ie without delay) As with ONS - Covid mortality rate is much higher in the unvaxed - but unvaxed also see higher non-covid mortality But the ratio of the two is always 2-4⤵️ https://t.co/wrsKU4Af2h

It should have made a separate analysis of the impact of this choice and show the impact over time

What is likely to happen is what was seen in The Netherlands, ie a short-term peak of those very ill who got a dose and then a flattening out

9/

x.com/Jean__Fisch/...

However, the study has one limitation in my eyes:

It did exclude those 18-59 vaccinated early (it only took those vaxed as of May 2021)

I fully understand the reason: Early were people at high mortality risk and so it's the right approach overall

But

8/

The study also show that the diff in mortality is also bigger with overall respiratory mortality (50-60% instead of 25%)

Is this because people who are covid vaxed are also flu vaxed? Or is the vaccinee bias magnified on respiratory mortality?

This needs clarification

7/

Over 4 years, one can reasonably assume that the exposure to covid was roughly equal between vaxed and unvaxed

Hence, it looks as if vaccination reduced the (relative) covid risk by up to 66%

Why "up to"?

6/

But the study also found that the vaccinated had a much lower risk of mortality from covid (75% lower), ie 3x lower than the general lower mortality risk, and this over 4 years

5/

This of course affects any vaccine efficacy study

Vaccine efficacy cannot be deduced from a comparison of results between those who choose to vaccinate and those who don't, even after correcting for the usual confounders

Yet this is still what is done worldwide

4/

The study did correct for all the usual confounders (age, health factors, etc.) and yet, despite doing all the things we know of, there is clearly some residual health differences between those who choose to vaccinate and those who don't

3/

What is interesting is that this study looks at vaxed vs never vaxed differences over a long period of time and on the working age population

And it confirms something suspected from previous studies: A structural health bias generated by the covid vaccine self-selection

2/

This super interesting factor-adjusted pop level study compared 4-year mortality of working aged ever and never vaxed in France

Result
- Confirmation of a healthy vaccinee bias: 25% lower mortality among vaxed
- A 75% lower covid mortality

This indicates a RR of 66% but only potentially

1/

Yes, clearly, in fact the French study confirms that Danish study (done on the seniors) on the working population

I am about to post a thread about it so give me 1 minute ;-)

Quick add-on: Switzerland and Denmark (which also updated their data today) now also show a slight uptick