COVID-19: Answering Some Common Anti-Vaxxer Issues

by Raywat Deonandan, PhD
Epidemiologist & Associate Professor
University of Ottawa
(I add my credentials to these COVID-19 blog posts in case they get shared. I want readers to know that my opinion is supposedly an educated and informed one)

Some months ago, a friend sent me a long list of anti-vaccination concerns she was encountering in her workplace. I promised I would address some of them in this space. But life got in the way –deaths in the family, moving house, my busy job, etc– and that project fell by the wayside.

So today, I will try to answer some of those concerns, though I fear my response might be too late to be useful to that colleague. Nevertheless, it’s always a good idea to have a record of such things.

I do want to make it clear, though, that I’m not interested in having an argument here. These kinds of posts always end up attracting abusive personalities in the comments section; and, frankly, I don’t have the patience for that nonsense anymore. So if that is your inclination, your comment will be deleted and your IP address blocked.

So let’s get to it.

We begin with this “Open Letter to Dr. Bonnie Henry, Adrian Dix, and Premier John Horgan” by a BC-based anti-vax group called Vaccine Choice Canada. The letter asks some questions and offers its own (incorrect) answers to those questions. So I will go through them briefly in turn.  (Briefly because I am a very busy man and I don’t have the staff or resources or time that a well-funded organization like “Vaccine Choice Canada” possesses. And as I write this, a busy toddler is racing around my feet, so typing and child-minding are a challenging set of balls to juggle.)

The letter’s first issue….

1. “Why are you aggressively pressuring 12 through 19-year-old children to get the experimental COVID-19 vaccine when NO DEATHS have occurred in this age group due to COVID-19…”

This obsession with deaths never fails to amuse and exasperate me. Prior to vaccination, COVID offered a general IFR (infection fatality ratio) of ~1%, with expected increase by age and by non-vaccination status. That’s actually a very big number when you compare it to other serious diseases. I’ve covered this before here and here and here. So I won’t belabour it again.

Yes, risk of COVID death among young people is low. But there’s more to vaccination than avoiding death. This anti-vaxx letter was written before the rise of Delta and Omicron variants, when vaccines were quite good at preventing infection and transmission. So vaccinating young people protected the community. But today, that ability has been compromised. But the ability to prevent hospitalization is still very good. Why wouldn’t you want to keep your kid out of the hospital?

Let’s not forget, though, about Long COVID.  The CDC estimates that 1 in 5 adults who got COVID met the definition of Long COVID. We don’t have good data about younger people, but there’s no reason to assume they would be appreciably different.

When the letter was written, vaccination greatly reduced the chances of getting infected, thus the chances of Long COVID. Today, breakthrough infections are common. But guess what? Getting 2 or 3 doses has been shown to reduce the risk of Long COVID, even among breakthrough infections.

2. “PCR TESTING –Invalid test used to create fear based on 90%+ false positives.”

This is just nonsense. It’s very telling that the anti-vaxxers no longer crow about this point, as it’s been invalidated many times. I’ve written about it here already.

Similarly, the next point in the letter uses their questioning of PCR to question the validity of COVID case definition, which of course then allows them to question whether the epidemic is occurring at all.  That set of argumentative dominoes crumble when you realize that PCR testing continues to be quite valid.

3. “What science or information are you relying upon when you say in your health orders that unvaccinated individuals are at higher risk than vaccinated persons of being infected with and transmitting COVID-19?”

Remember, this anti-vaxx letter was written in the early days of the Delta era.  Back then, there was very strong evidence that vaccination reduced transmission. Rather than bore you with all the data, here’s a summary quote from the Alberta Health Services, “COVID-19 Scientific Advisory Group Evidence Summary and Recommendations” from 2021: “Studies so far show that COVID-19 vaccination reduces the risk of the vaccinated person spreading COVID-19, by preventing infection in most but not all recipients, and if they test positive, they seem to be less likely to spread infection to their close contacts.”

They cited studies showing that for wild-type SARS-CoV-2 (the original Wuhan strain), the Pfizer and Moderna vaccines are most effective from approximately 3 weeks after the second dose (61%-97% effective against asymptomatic, 94% against symptomatic infection). That’s pretty good.

With Omicron, the situation is more complicated. But as I wrote here, four doses of COVID vaccines do measurably reduce infection and therefore transmission, even in the Omicron era.

4. What source are you looking at when you declare that the variant(s) are being caused by unvaccinated individuals?

Well, first of all, the scary new variants first pop up in countries and populations with low vaccination rates. That’s a sign. Remember, as well, that Alpha, Beta and Gamma all emerged before we had widespread vaccination. So clearly, vaccination did not drive the creation of those variants.

That alone should allow us to put this “issue” to bed. Variants don’t need vaccinated people to emerge, and since vaccination, all the variants of consequence have emerged in populations with low vaccination rates. Ipso facto…

5. Where is the transparency for the current statistics and details regarding counts of vaccine-related injuries and deaths

Now we enter conspiracy theory territory…. that the big bad pharma-funded government is deliberately hiding news of all the vaccine-injured people amongst us.

Think about it. In Canada, close to 90% of the population over 5 has received at least one dose. That’s 32 million people. If the vaccine were as dangerous as these people claim, there should be millions of people filling our hospitals with vaccine injuries. Where are they?  Since we see no sign of them, the only explanation is that “they” are deliberately hiding them.

Despite the letter’s claim, most provinces are very transparent with their vaccine adverse reaction (AE) data. Public Health Ontario publishes summaries regularly, as with this document: “Adverse Events Following Immunization (AEFIs) for COVID-19 in Ontario: December 13, 2020 to July 17, 2022.

Their report notes that an AE was filed for 0.06% of all doses administered. But a filed AE does not mean that an AE actually occurred, only that one was suspected by the person filing it; investigation would happen later, to determine whether the AE was in fact caused by vaccination or was coincidental. But even if it was real and causal, 0.06% is miniscule.

Importantly, among those 0.06%, 94.4% were non-serious, like pain or a transient fever.  That means that the suspected rate of serious AE was more like 0.0003%… which is vanishingly small.

Which brings us to one of the most insidious anti-vaxx tools….

6. The VAERS Database

VAERS (Vaccine Adverse Event Reporting System) is the US surveillance system for suspected vaccine AEs. Many governments have attempted to shut it down, but the anti-vaxx lobby keeps stopping that process.  Why do they want to shut it down? Because, frankly, it’s more trouble than it’s worth. The British system, called “Yellowcard“, suffers from the same maladies.

Here is the very important nuance about VAERS, directly from the website:

“The Vaccine Adverse Event Reporting System (VAERS) is a passive reporting system, meaning it relies on individuals to send in reports of their experiences. Anyone can submit a report to VAERS, including parents and patients.”

Anyone can submit a report. More on that below.

As a result, VAERS is not meant for rigorous statistical analysis, since so many reports are, in a word, horseshit. The intent was for VAERS to be a registry for suspected AEs to be later investigated for causal relationships, not for actual trends and risk factors to be extracted. And of course, there’s an OpenVAERS version that makes VAERS data readily available to people without the requisite expertise to parse this information with nuance.

Unsurprisingly, “30 percent of OpenVAERS referral traffic comes from Gateway Pundit, a far-right website that often publishes fake news and conspiracy theories.”

Famously, Dr James Laidler once successfully filed a VAERS AE claiming that his flu vaccine turned him into the Incredible Hulk. You know what? CDC had to ask Dr Laidler’s permission to have the obviously parodical submission removed; that’s how hard it is to remove fake data.

To be clear, VAERS is useful. For example, it once detected an important safety signal for the rotavirus vaccine. It’s just that its democratic nature is being abused. As one researcher put it, “It’s the worst possible data that you could possibly imagine.”

McGill University has a nice summary of why VAERS has likely outlived its usefulness. There are lots of other dissections of how anti-vaxxers have duplicitously misused VAERS data. Here’s a good one.

7. But there are more infected vaccinated people than there are infected unvaccinated people!

I want to end this post by reminding us all of the ongoing problem that so many vaccine hesitant people have with understanding the simple math surrounding the base rate fallacy.  If you don’t know what that is, I wrote about it here earlier this year.

Basic innumeracy has been one of the greatest challenges in combatting misinformation during this pandemic. Layer on top of that the inability of so many people to understand the limitations in assessing causality, and you can see how so many inexpert people are ripe for recruitment by insidious, disingenuous, or just shallow-thinking anti-vaxx misinformation merchants.

All of this is just so exhausting.