There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory‐confirmed influenza were analysed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under‐investigated.
A total of 2840 participants completed the survey between December 18 and 23, 2021. 51% (1383 of 2840) of the participants were female and the mean age was 47 (95% CI 46.36–47.64) years. Those who knew someone who experienced a health problem from COVID-19 were more likely to be vaccinated (OR: 1.309, 95% CI 1.094–1.566), while those who knew someone who experienced a health problem following vaccination were less likely to be vaccinated (OR: 0.567, 95% CI 0.461–0.698). 34% (959 of 2840) reported that they knew at least one person who had experienced a significant health problem due to the COVID-19 illness. Similarly, 22% (612 of 2840) of respondents indicated that they knew at least one person who had experienced a severe health problem following COVID-19 vaccination. With these survey data, the total number of fatalities due to COVID-19 inoculation may be as high as 278,000 (95% CI 217,330–332,608) when fatalities that may have occurred regardless of inoculation are removed.
Knowing someone who reported serious health issues either from COVID-19 or from COVID-19 vaccination are important factors for the decision to get vaccinated. The large difference in the possible number of fatalities due to COVID-19 vaccination that emerges from this survey and the available governmental data should be further investigated.
Although rare, a statistically significant association between BNT162b2 vaccination and myo/pericarditis and AKI was observed. While the association between BNT162b2 and myo/pericarditis has been confirmed internationally, further research is required to understand the association of AKI. BNT162b2 was not found to be associated with most of the AESIs investigated, providing reassurances around the safety of the vaccine.
Published 20 December 2010
If peer review was a drug it would never be allowed onto the market,’ says Drummond Rennie, deputy editor of the Journal Of the American Medical Association and intellectual father of the international congresses of peer review that have been held every four years since 1989. Peer review would not get onto the market because we have no convincing evidence of its benefits but a lot of evidence of its flaws.
Yet, to my continuing surprise, almost no scientists know anything about the evidence on peer review. It is a process that is central to science – deciding which grant proposals will be funded, which papers will be published, who will be promoted, and who will receive a Nobel prize. We might thus expect that scientists, people who are trained to believe nothing until presented with evidence, would want to know all the evidence available on this important process. Yet not only do scientists know little about the evidence on peer review but most continue to believe in peer review, thinking it essential for the progress of science. Ironically, a faith based rather than an evidence based process lies at the heart of science.
Following the availability and use of the updated (bivalent) COVID-19 vaccines, CDC’s Vaccine Safety Datalink (VSD), a near real-time surveillance system, met the statistical criteria to prompt additional investigation into whether there was a safety concern for ischemic stroke in people ages 65 and older who received the Pfizer-BioNTech COVID-19 Vaccine, Bivalent. Rapid-response investigation of the signal in the VSD raised a question of whether people 65 and older who have received the Pfizer-BioNTech COVID-19 Vaccine, Bivalent were more likely to have an ischemic stroke in the 21 days following vaccination compared with days 22-44 following vaccination.
Four outcomes met the threshold for a statistical signal following BNT162b2 vaccination including pulmonary embolism (PE; RR = 1.54), acute myocardial infarction (AMI; RR = 1.42), disseminated intravascular coagulation (DIC; RR = 1.91), and immune thrombocytopenia (ITP; RR = 1.44). After further evaluation, only the RR for PE still met the statistical threshold for a signal; however, the RRs for AMI, DIC, and ITP no longer did. No statistical signals were identified following vaccination with either the mRNA-1273 or Ad26 COV2.S vaccines.
This early warning system is the first to identify temporal associations for PE, AMI, DIC, and ITP following BNT162b2 vaccination in the elderly. Because an early warning system does not prove that the vaccines cause these outcomes, more robust epidemiologic studies with adjustment for confounding, including age and nursing home residency, are underway to further evaluate these signals. FDA strongly believes the potential benefits of COVID-19 vaccination outweigh the potential risks of COVID-19 infection.
The purpose of this study is to determine the ECG parameter change and the efficacy of ECG screening for cardiac adverse effect after the second dose of BNT162b2 vaccine in young population. In December 2021, in cooperation with the school vaccination system of Taipei City government, we performed a ECG screening study during the second dose of BNT162b2 vaccines. Serial comparisons of ECGs and questionnaire survey were performed before and after vaccine in four male-predominant senior high schools. Among 7934 eligible students, 4928 (62.1%) were included in the study. The male/female ratio was 4576/352. In total, 763 students (17.1%) had at least one cardiac symptom after the second vaccine dose, mostly chest pain and palpitations. The depolarization and repolarization parameters (QRS duration and QT interval) decreased significantly after the vaccine with increasing heart rate. Abnormal ECGs were obtained in 51 (1.0%) of the students, of which 1 was diagnosed with mild myocarditis and another 4 were judged to have significant arrhythmia. None of the patients needed to be admitted to hospital and all of these symptoms improved spontaneously. Using these five students as a positive outcome, the sensitivity and specificity of this screening method were 100% and 99.1%, respectively. Conclusion: Cardiac symptoms are common after the second dose of BNT162b2 vaccine, but the incidences of significant arrhythmias and myocarditis are only 0.1%. The serial ECG screening method has high sensitivity and specificity for significant cardiac adverse effect but cost effect needs further discussed. What is Known: • The incidence of cardiac adverse effects was reported to be as high as 1.5 per 10 000 persons after the second dose BNT162b2 COVID-19 vaccine in the young male population based on the reporting system. What is New: • Through this mass ECG screening study after the second dose of BNT162b2 vaccine we found: (1) The depolarization and repolarization parameters (QRS duration and QT interval) decreased significantly after the vaccine with increasing heart rate; (2) the incidence of post-vaccine myocarditis and significant arrhythmia are 0.02% and 0.08%; (3) The serial ECG screening method has high sensitivity and specificity for significant cardiac adverse effect.
Extensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired t test; P<0.0001).
Immunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine–induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause.
Commentary from Wall Street Journal Article: ‘Experts’ Are Fueling Distrust in Vaccines
An article in the American Heart Association’s journal Circulation last week found a link between myocarditis in teens and higher circulating levels of vaccine spike proteins in the blood. The authors found no correlation with vaccine antibody or T-cell responses, suspected by many as the cause of myocarditis.
Nearly half of Americans think COVID-19 vaccines may be to blame for many unexplained deaths, and more than a quarter say someone they know could be among the victims.
The latest Rasmussen Reports national telephone and online survey finds that (49%) of American Adults believe it is likely that side effects of COVID-19 vaccines have caused a significant number of unexplained deaths, including 28% who think it’s Very Likely. Thirty-seven percent (37%) don’t say a significant number of deaths have been caused by vaccine side effects, including 17% who believe it’s Not At All Likely. Another 14% are not sure.
∗ Across 31 systematically identified national seroprevalence studies in the pre-vaccination era, the median infection fatality rate of COVID-19 was estimated to be 0.034% for people aged 0–59 years people and 0.095% for those aged 0–69 years.
∗ The median IFR was 0.0003% at 0–19 years, 0.002% at 20–29 years, 0.011% at 30–39 years, 0.035% at 40–49 years, 0.123% at 50–59 years, and 0.506% at 60–69 years.
∗ At a global level, pre-vaccination IFR may have been as low as 0.03% and 0.07% for 0–59 and 0–69 year old people, respectively.
∗ These IFR estimates in non-elderly populations are lower than previous calculations had suggested.
This study explores the effect of in-person schooling on youth suicide. We document three key findings. First, using data from the National Vital Statistics System from 1990-2019, we document the historical association between teen suicides and the school calendar. We show that suicides among 12-to-18-year-olds are highest during months of the school year and lowest during summer months (June through August) and also establish that areas with schools starting in early August experience increases in teen suicides in August, while areas with schools starting in September don’t see youth suicides rise until September. Second, we show that this seasonal pattern dramatically changed in 2020. Teen suicides plummeted in March 2020, when the COVID-19 pandemic began in the U.S. and remained low throughout the summer before rising in Fall 2020 when many K-12 schools returned to in-person instruction. Third, using county-level variation in school reopenings in Fall 2020 and Spring 2021—proxied by anonymized SafeGraph smartphone data on elementary and secondary school foot traffic—we find that returning from online to in-person schooling was associated with a 12-to-18 percent increase teen suicides. This result is robust to controls for seasonal effects and general lockdown effects (proxied by restaurant and bar foot traffic), and survives falsification tests using suicides among young adults ages 19-to-25. Auxiliary analyses using Google Trends queries and the Youth Risk Behavior Survey suggests that bullying victimization may be an important mechanism.
Download the PDF: https://www.nber.org/system/files/working_papers/w30795/w30795.pdf
RNA vaccines are efficient preventive measures to combat the SARS-CoV-2 pandemic. High levels of neutralizing SARS-CoV-2-antibodies are an important component of vaccine-induced immunity. Shortly after the initial two mRNA vaccine doses, the IgG response mainly consists of the pro-inflammatory subclasses IgG1 and IgG3. Here, we report that several months after the second vaccination, SARS-CoV-2-specific antibodies were increasingly composed of non-inflammatory IgG4, which were further boosted by a third mRNA vaccination and/or SARS-CoV-2 variant breakthrough infections. IgG4 antibodies among all spike-specific IgG antibodies rose on average from 0.04% shortly after the second vaccination to 19.27% late after the third vaccination. This induction of IgG4 antibodies was not observed after homologous or heterologous SARS-CoV-2 vaccination with adenoviral vectors. Single-cell sequencing and flow cytometry revealed substantial frequencies of IgG4-switched B cells within the spike-binding memory B-cell population (median 14.4%; interquartile range (IQR) 6.7–18.1%) compared to the overall memory B-cell repertoire (median 1.3%; IQR 0.9–2.2%) after three immunizations. Importantly, this class switch was associated with a reduced capacity of the spike-specific antibodies to mediate antibody-dependent cellular phagocytosis and complement deposition. Since Fc-mediated effector functions are critical for antiviral immunity, these findings may have consequences for the choice and timing of vaccination regimens using mRNA vaccines, including future booster immunizations against SARS-CoV-2.
Norway, Sweden and Iceland had the lowest relative cumulative excess mortality.
- Between the week ending 3 January 2020 (week 1 2020) and the week ending 1 July 2022 (week 26 2022), the UK’s relative cumulative excess mortality was 3.1% above the average of 2015 to 2019; this was over a third less than the cumulative excess mortality in the week ending 18 June 2021 (week 24 2021; the period of the previous article), at 5.8%.
- The UK had the 16th highest relative cumulative excess mortality of the 33 countries analysed (UK, its constituent countries, and 28 European countries), and 15th highest of 28 countries when constituent countries are removed.
- The majority of European countries analysed (25 of 33) experienced above average relative cumulative excess mortality for the whole period, with eight countries showing relative cumulative mortality below average.
- Bulgaria had the highest relative cumulative excess mortality at 18.2% above average, followed by Poland (13.3% above average) and Romania (12.2% above average); Norway had the lowest with 4.1% below average, followed by Sweden (4.0% below average) and Iceland (3.9% below average).
- The majority of European countries (22 of 33) had higher relative cumulative excess mortality in those aged 65 years and over compared with those aged under 65 years.
- The UK had the fifth highest relative cumulative excess mortality rate in those aged under 65 years (8.3% above average); in those aged 65 years and over in the UK, the cumulative excess mortality rate was the 19th highest (2.2% above average).
- Overall, 19 of the 33 European countries had a decrease in their relative cumulative excess mortality rates since the last release (week ending 18 June 2021), including the UK and constituent countries; the largest decrease was in Czechia (5.4 percentage points lower), whereas the largest increase was in Cyprus (5.4 percentage points higher).
The bivalent COVID-19 vaccine given to working-aged adults afforded modest protection overall against COVID-19, while the virus strains dominant in the community were those represented in the vaccine.
The Johns Hopkins Center for Health Security, in partnership with WHO and the Bill & Melinda Gates Foundation, conducted Catastrophic Contagion, a pandemic tabletop exercise at the Grand Challenges Annual Meeting in Brussels, Belgium, on October 23, 2022.
The extraordinary group of participants consisted of 10 current and former Health Ministers and senior public health officials from Senegal, Rwanda, Nigeria, Angola, Liberia, Singapore, India, Germany, as well as Bill Gates, co-chair of the Bill & Melinda Gates Foundation.
The exercise simulated a series of WHO emergency health advisory board meetings addressing a fictional pandemic set in the near future. Participants grappled with how to respond to an epidemic located in one part of the world that then spread rapidly, becoming a pandemic with a higher fatality rate than COVID-19 and disproportionately affecting children and young people.
Participants were challenged to make urgent policy decisions with limited information in the face of uncertainty. Each problem and choice had serious health, economic, and social ramifications.
During the COVID-19 pandemic sizeable groups of unvaccinated minorities persist even in countries with high vaccine access1. Consequently, vaccination became a controversial subject of debate and even protest2. Here, we assess whether people express discriminatory attitudes in the form of negative affect, stereotypes and exclusionary attitudes in family and political settings across groups defined by COVID-19 vaccination status. We quantify discriminatory attitudes between vaccinated and unvaccinated citizens in 21 countries, covering a diverse set of cultures across the world. Across three conjoint experimental studies (N=15,233), we demonstrate that vaccinated people express discriminatory attitudes towards the unvaccinated, as high as the discriminatory attitudes suffered by common targets like immigrant and minority populations3,4.5. In contrast, there is an absence of evidence that unvaccinated individuals display discriminatory attitudes towards vaccinated people, except for the presence of negative affect in Germany and United States. We find evidence in support of discriminatory attitudes against the unvaccinated in all countries except Hungary and Romania and find that discriminatory attitudes are more strongly expressed in cultures with stronger cooperative norms. Prior research on the psychology of cooperation has shown that individuals react negatively against perceived free-riders6,7 including in the domain of vaccinations8,9. Consistent with this, the present findings suggest that contributors to the public good of epidemic control (i.e., the vaccinated) react with discriminatory attitudes against perceived free-riders (i.e., the unvaccinated). Elites and the vaccinated general public appealed to moral obligations to increase COVID-19 vaccine uptake10,11 but the present findings suggest that discriminatory attitudes including support for the removal of fundamental rights simultaneously emerged.
Published June 2019
C40 is delighted to publish this pioneering piece of thought leadership, The Future of Urban Consumption in a 1.5°C World. The report demonstrates that mayors have an even bigger role and opportunity to help avert climate emergency than previously thought. But to grasp that opportunity, city leaders need to be even more entrepreneurial, creating and shaping markets and engaging in sectors that may not previously have been considered within the domain of city government, and working out how to support their citizens and businesses in achieving a radical, and rapid, shift in consumption patterns.
Our early warning safety system is the first to identify-four new statistical signals for modestly elevated risks (RR less than 2) of four serious outcomes of AMI, PE, DIC, and ITP following BNT162b2 vaccination. This FDA and CMS COVID-19 vaccine safety study is one of the largest studies of elderly persons aged 65 years and above including approximately 34 million doses administered to more than 17 million Medicare insured persons. Our surveillance monitoring did not detect statistical signals for the mRNA-1273and Ad26 COV2.S vaccines for any of the 14 monitored outcomes.
Analysis from The Epoch Times can be found here: Pfizer’s COVID-19 Vaccine Linked to Blood Clotting: FDA
Published: 27 March 2017
The paper presents a simple framework for the analysis of the macroeconomic implications of de-cashing. Defined as replacing paper currency with convertible deposits, de-cashing would affect all key macroeconomic sectors. The overall macreconomic impact of de-cashing would depend on the balance of growth-enhancing and growth-constraining factors. Starting from a traditional saving-investment balance, the paper develops a four-sector macroeconomic framework. It is purely illustrative and is designed to provide a roadmap for a systematic evaluation of de-cashing. The framework is disaggregated into the real, fiscal, monetary, and external sectors and potential implications of de-cashing are then identified in each sector. Finally, the paper draws a balance on possible positive and negative macroeconomic implications of de-cashing, and proposes policies capable of augmenting its economic and social benefits, while reducing potential costs.
Following the onset of the COVID-19 pandemic, several countries faced short-term fertility declines in 2020 and 2021, a development which did not materialize in Scandinavian and German-speaking countries. However, more recent birth statistics show a steep fertility decline in the aftermath of the pandemic in 2022. We aim to provide data on the unexpected birth decline in 2022 in Germany and Sweden and relate these data to pandemic-related contextual developments which could have influenced the post-pandemic fertility development. We rely on monthly birth statistics and present seasonally adjusted monthly Total Fertility Rates (TFR) for Germany and Sweden. We relate the nine-months lagged fertility rates to contextual developments regarding COVID-19 mortality and morbidity, unemployment rates, and COVID-19 vaccinations.
The seasonally adjusted monthly TFR of Germany dropped from 1.5-1.6 in 2021 to 1.3-1.4 in 2022, a decline of about 14 %. In Sweden, the corresponding TFR dropped from about 1.7 in 2021 to 1.5-1.6 in 2022, a decline of almost 10 %. There is no association of the fertility trends with changes in unemployment, infection rates, or COVID-19 deaths. However, there is a strong association between the onset of vaccination programmes and the fertility decline nine months after of this onset. The fertility decline in the first months of 2022 in Germany and Sweden is remarkable. Common explanations of fertility change during the pandemic do not apply in its aftermath. The association between the onset of mass vaccinations and subsequent fertility decline indicates that people adjusted their behaviour to get vaccinated before becoming pregnant, as societies were opening up with post-pandemic life conditions. Our study provides novel information on fertility declines in countries previously not affected by any COVID-19 baby bust. We provide a first appraisal of the COVID-19-fertility nexus in the immediate aftermath of the pandemic.