
I enjoyed the
['Never vaccinated' vs 'Ever vaccinated' mortality rate illusion](https://wherearethenumbers.substack.com/p/never-vaccinated-vs-ever-vaccinated)
substack by Norman Fenton. It includes a short video explaining how survivor or
survivorship bias can lead to massively exaggerated claims of vaccine efficacy
and safety. As it happens, I am currently experimenting with explainer video
production, so I thought I could create a similar video, using a different
example. Here is the result:

<VideoPlayer src='vaccination' />

Of course, the example provided is extremely simple to simplify the
calculations. But the effect of these simplifications does not invalidate the
conclusions:

- That the vaccination progresses linearly or not is irrelevant. As shown in the
  video, the important issue is that we should analyse infections considering
  the time spent by the individuals taking part in the study in each estate:
  vaccinated and unvaccinated. For that reason, observational studies need to
  use the concept of person years to estimate the effect of interventions.
- A constant rate of infection is unrealistic, but the reality is even worse.
  Vaccination took place in many countries during periods in which the rate of
  infection was maximum. As a result, the overestimation of the vaccine
  effectivity would be even higher using real data than what I show on the
  video.
- I have considered no age variation in the vaccination and infection rates.
  This is a serious limitation of the exercise, but many studies I have seen
  share this limitation.
- Finally, I worked with the concept of infections rather than deaths. This
  simplifies enormously the explanation. The bias introduced by not considering
  deaths is small if the mortality rate is small (as it is the case for covid).
  This is my first attempt at using the method of explainer videos to support
  the messages in this blog. For that reason, I really appreciate any feedback
  regarding whether you find the video instructive and understandable.

  Note: The video uses an artificial voice created with
  [11ElevenLabs](https://beta.elevenlabs.io) using the free tier.



In the
[previous post of this series](/posts/on-skepticism-about-covid-19-vaccines-i/),
I presented in a chronological order the emerging evidence of the failure of the
vaccines, using information that was readily available and published by
mainstream sources.

In this post, I argue that the mass vaccination campaigns was a massive
government failure, sharing all the characteristics common to failed policies.

## Vaccines are a complex medical intervention

As
[previously documented on this blog](/posts/covid-19-impressions-eighteen-months-after/),
I never considered vaccines a viable exit strategy for covid. For that reason,
when vaccines become available on December 2020 under an Emergency Use
Authorization (EUA), I remained skeptical.

Vaccination is a medical intervention, and a particularly troublesome one since
it directly contradicts the ethical medical principle of not harming the
patient: "first do no harm" (_primum non nocere_). We can say that all medical
interventions have at least the potential to harm patients, but with vaccines it
is not a potential risk, it is a certain risk.

One very important difference between vaccines and other medical interventions
is that we don't wait until the disease manifests. This results in a completely
different risk-benefit analysis. When someone already has a disease, it is
easier to justify an intervention than when we are simply preventing a future
disease. As with any other prophylactic intervention, safety is more important
than efficacy.

Another important aspect is that **vaccines need necessarily to provoke an
infection** in an otherwise sane individual in order to be effective. Otherwise,
they would not trigger the immune system and the vaccination would be useless.
This distinguishes vaccines from all other preventive treatments. In fact,
vaccines are **a wager in which we bet that the protection gained against a
future real infection is higher than the certain short-term risks imposed by the
intervention itself**.

Having said that. I am, and have always been **extremely favorable to the
concept of vaccines**. I have considered them one of the most significant
exponents of the human ingenuity and it is a testament to our rationality that
we accept being inoculated with an attenuated form of a disease in order to
become immune to it.

One reason humanity has accepted vaccinating our little children is that
vaccination campaigns, at least recently in the Western world, have been
conducted mostly following strict safety principles. Of course, there have been
some controversies. In particular, those related to the polio vaccination
campaigns in the 1950s and 1960s. Ironically, the control of polio, which has
been one of the greatest vaccine successes in History also involved some of the
worst mistakes<Tip>Because of the covid vaccination fiasco I have been reading
about recent vaccination trends and there are worrying signals that public
health authorities have been pushing questionable vaccines at a growing pace, so
the previous safety principles that were used in the past might have changed in
the last years</Tip>.

When effective, vaccines are a great solution. Unfortunately, they are not
adequate for all contagious diseases. In particular, respiratory viruses have
proved very elusive to the development of safe and effective vaccines.

After decades of promotion of the annual influenza vaccines by public health
authorities, there is a considerable
[gap between vaccination policies and the evidence of their benefits](https://europepmc.org/article/PMC/1626345).

I have a completely _unproven theory_ about the convenience of vaccination for
mild respiratory viruses, but I don't want to contaminate this series that is
based on facts, not opinions. It might be the subject of a future post, though.

In what respects to coronaviruses, there are no vaccines for any of the four
common coronaviruses that regularly infect humans. That is an immense red flag
that has been flaming against the 'vaccination solution' since the beginning of
the crisis.

In summary, vaccines might be good when they exist, but they are also risky and
we should handle them with the most exquisite care, advancing at a very slow
pace to prevent errors. And when they don't work, we should not force them on an
unsuspecting public.

Unfortunately, as with everything covid, the public discourse about the vaccines
has become so politicized as to lose any contact with rationality. New dogmas
have substituted ideas that used to be common basic knowledge. And these dogmas
cannot be challenged because of ideological reasons that have no relation with
public health considerations.

## What would a pro-vaccine skeptic do regarding the novel vaccines?

The news of the authorization of the first mRNA vaccine for covid impressed me.
The technology behind mRNA vaccines looked truly exciting, offering many
possibilities for fast development of vaccines and other therapeutic
interventions.

Also, at first sight, mRNA seemed safe. Rather than using an attenuated live
virus or a _'dead'_ virus, these new vaccines are based on a short-lived
molecule to instruct our cells to produce an antigen (the covid spike protein).
What could go wrong?<Tip>Yes, I am being ironic</Tip>

So, even if vaccines for covid never convinced me, I thought that the new
vaccine technology could at least prove useful for other use cases.

My wife was much more skeptical than me initially. She thought that biology is
complex and messy, and we know very little of what really happens at the
cellular and molecular level<Tip>That is why we have to do randomized trials,
because we have no way to predict what will happen until we try</Tip>. So I
hastily conceded her point and decided that only time would tell if these
vaccines were safe.

### What about the other vaccines?

There were two other vaccines authorized in Europe and the United States
(Johnson & Johnson - Janssen and AstraZeneca). They used a different mechanism
to introduce the genetic material inside the cells, an adenovirus incapable of
reproduction, but they had a similar mechanism of operation; instructing cells
to produce the covid spike protein.

These two vaccines were much more disputed since the beginning. Regulators such
as the CDC in the United States and the European Medicines Agency warned of
adverse effects. See how the CDC
[does not recommend the Janssen vaccine](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html),
after authorizing it, and a summary of the
[AstraZeneca early doubts and disputes](https://www.cnbc.com/2021/03/25/astrazeneca-covid-vaccine-all-the-issues-and-problems-the-shot-has-faced.html).

As shown in the following table, four other vaccines were developed in Russia
and China. Two of them using adenoviruses and the remaining two traditional
inactivated viruses.

<Picture src="covid-vaccines.svg" alt="Authorized vaccines for covid" />

In retrospect, it is not clear why public health authorities focused their
criticism on the two non-mRNA "occidental" vaccines, given that the other two
had similar problems. Nor why they completely neglected the "non-occidental"
vaccines, even accepting that Russia and China could be considered at the time
not a reliable source of covid related technology. It is also remarkable that no
pharmaceutical company outside China undergone traditional inactivated virus
vaccines.

According to
[Our World in Data](https://ourworldindata.org/grapher/covid-vaccine-doses-by-manufacturer),
as of April 7, 2022 the mRNA vaccines accounted for 97% in the United States and
89% in the European Union. Thus, the campaign against non-mRNA vaccines carried
out by regulators in the United States and the European Union has been rather
successful.

Because of their absolute prevalence, I have focused on the mRNA vaccines in my
research. But I suspect that most of what I discuss in this series of posts also
applies to the other vaccines.

### The decision to not vaccinate

Fortunately, living in Spain and being under 65 there was no rush. I would not
get offered the vaccine for a few months. So I had the luxury of waiting and
see.

As I have documented on the
[previous post](/posts/on-skepticism-about-covid-19-vaccines-i/), before I had
to decide, there was enough information available that suggested that my wife
was right after all and the mRNA vaccines were not safe.

So, by February 2021, I had already decided that I was going to pass on the
vaccination, unless the future proved that the initial safety related data was
misleading. Maybe I could contemplate getting jabbed during the Summer (the best
moment to be low on defenses). But to be frank, most probably I would not,
because, as I have said, I doubt vaccination is a good treatment for a disease
like covid that is mild for most people.

My decision was a direct application of the precautionary principle regarding
novel medical interventions. The vaccines had not undergone a proper evaluation
of risks. There had not been enough time for that. In that situation, unless you
face an imminent risk of death or serious injury, you do not subject yourself to
a new medical intervention lacking a proper safety profile.

The story should have ended here. In February 2021 **there was enough
information to rule out massive vaccination as the preferred way to control the
covid medical crisis**. Around that time, regulators should have reassessed the
ongoing vaccination campaigns, reserving the vaccines for the population at the
higher risk from covid, monitoring closely the adverse side-effects and the
temporary immune suppression, with a view to **stop completely the vaccination
altogether** if they proved to be a concern, as they would.

Unfortunately, I was in a minority. People were still getting jabbed as if there
was no tomorrow, and the covid circus was in full parade mode.

The authorities silenced the side effects and gave no advice regarding the
increased post-vaccination risk. For example, the
[pamphlets produced by the CDC](https://www.cdc.gov/coronavirus/2019-ncov/downloads/vaccines/5534-VaccinationPoster_WhatToExpect.pdf)
were a joke:

- Regarding side effects, they recommended _'drinking a lot of water'_ and
  _'dressing lightly'_. In addition, they affirmed that **'You should get the
  second shot even if you have side effects after the first shot, unless a
  doctor tells you not to'**.
- Regarding the immune suppression. Pamphlets did not even mention it. They
  simply warned that vaccines would take time to _'fully protect'_ the
  vaccinated, without the implication that they rather increased the short-time
  risk.

I don't believe I have ever seen an example of public authority recklessness in
the past that is comparable to this.

## The regulatory vicious circle

That authorities were actively hiding the initial problems caused by the
vaccines raised all my alarms. The vaccination exercise had but all the symptoms
of a failed public policy. As such, it would enter, inexorably, into the vicious
circle experienced by all faulty policies<Tip>Arguably, the vaccines were the
second (or maybe third) turn of the previously established vicious circle of
trying to combat covid using social engineering methods, but on this post I am
focusing on vaccines</Tip>.

<Picture
  src="policy-vicious-circle.svg"
  alt="Faulty policies vicious circle"
  width="500"
/>

From the moment I decided the vaccines were not a good option, I kept looking at
the data that was emerging, comparing it with what the authorities and their
loudspeakers were saying. With each turn of the vicious circle, it became more
clear that the vaccines were failing and their proponents were perfectly aware
of it. I have documented this process in the
[previous post of this series](/posts/on-skepticism-about-covid-19-vaccines-i/).

### The elimination of the control group

In my previous post, I describe some fallacies that were used to trick the
population into compliance with vaccination:

- Vaccines were sold as safe and effective, implying that they offered
  substantial and durable protection and prevented secondary infections.
- The necessity of achieving a high proportion of the population vaccinated to
  end the pandemic, even after it was patent that vaccines did not prevent
  secondary infections.

With respect to the first fallacy, I hope this series of articles debunk the
safety and efficacy of the vaccines sufficiently.

Regarding the second one, arguably the most insidious, I need to examine it
carefully, because it is the key to understand the perversion of the regulatory
vicious circle.

First, the motives:

When there was undeniable evidence that the vaccines were not working as
intended during the Summer of 2021 (_"Harms become impossible to hide"_) it was
necessary to acknowledge it (_"A real problem is identified"_) and amend the
policy to accommodate the problem caused by the previous policy (_"A faulty
policy is introduced"_).

Blaming the failure of the vaccines on the unvaccinated offered two key
advantages: First, it preserved the idea that the previous policy was sound, but
its implementation was insufficient. Second, it transferred the blame from the
real culprits (the public health authorities that had implemented a bad policy)
to the sector of the population that was most dangerous to the _vaccinators_.
Unvaccinated had defied the authority (and had to be **punished**) and were the
control group that showed that the vaccines had failed (and had to be
**eliminated**).

Then, the basis:

Trying to follow the convoluted rationale used to blame the unvaccinated is
almost impossible, because it defies logic at every stage. But I will try my
best.

Certainly, the concept of _herd immunity_ implies that a minimum percentage of
the population achieves immunity. These immune individuals act as a shield that
protects the vulnerable sectors of society and starve the virus of susceptible
hosts.<Tip>This is absolutely true, and indeed, it has been precisely my point
since I started this blog</Tip>.

Thus, to achieve herd immunity and end the pandemic, we need to vaccinate as
much as possible. _Quod erat demonstrandum_.

This reasoning is so wrong when applied to the covid mRNA vaccines that it is
embarrassing that the authorities used it, and that many people failed for it.

First, as I mention in my previous post, it is immoral to use common good
arguments to justify the imposition of known risks on anybody to protect others.
It is a very worrying sign that governments imposed mandatory vaccination
policies but that a sizeable portion of the population of western countries
complied with them and approved these policies is even more worrisome.

In particular, I find particularly abhorrent the extension of vaccination to
children. I have little doubt that the treatment they have suffered during this
nightmarish two years will be remembered for a long time, and we will be justly
vilified for accepting it.

Second, the vaccines do not prevent secondary transmissions. Therefore, they are
incapable of participating in herd immunity. Period.

Third, recovered individuals also achieve immunity (natural immunity). Yet,
natural immunity was neglected. Contrary to the established procedure for any
other vaccine of not vaccinating recovered individuals, a bizarre argument was
used; that vaccines provided better protection than natural immunity.

That is absolutely false. It is impossible for any vaccine to provide a better
protection than a successful recovery. In the case of mRNA vaccines, as opposed
to 'dead' or 'live attenuated' vaccines it is even worse, because the vaccinated
have only been exposed to a portion of the virus, the spike protein, while the
recovered have been exposed to the whole virus<Tip>And this causes other
problems, that are discussed elsewhere</Tip>.

Vaccines are useful not because they provide a _better protection_, but because
they provide an _inferior protection_ without the risks inherent to a true
infection. Subjecting recovered patients to the known and unknown risks
associated with the vaccination, with no benefits for them or the community, was
reckless and criminal.

### The disaster was predictable and inevitable

What is important to note is that once the authorities decided to promote an
untested vaccine technology, the rest of what has happened was almost
inevitable. **Because of the vicious cycle, faulty policies always provoke
enormous harms to society, orders of magnitude higher than the problems they
intend to solve**.

Different groups have tried many therapies and procedures since the initial
outbreak of covid. Most have failed, but it was worth the try. And when an
option fails, we move ahead and try something else. **That is the only way to
win in a pandemic**.

The bet on the mRNA vaccines had tiny odds of winning to begin with. In fair
competition with alternative interventions and with no political pressure,
vaccines would have shown they were less safe and effective than other
prophylactic or therapeutic procedures and quickly discarded.

Instead, governments, medical organisations and the complicit media fixated on
vaccines, while dismissing all other alternatives. **That is the surest way to
lose in a pandemic**.

When the COVID crisis started it was fashionable to argue that
[there are no libertarians in a pandemic](https://www.theatlantic.com/politics/archive/2020/03/trump-socialism-and-coronavirus-epidemic/607681/).
The vaccination fiasco, following the previous ones, has demonstrated that
**governments should be restrained in a pandemic**.

## The results of the mass vaccination campaigns

We can be sure that vaccines have failed. But to what extent?

To answer that question, we need to explore their benefits, measured in lives
saved, against their costs and their potential risks. And this is precisely what
I am going to do in the next article on this series.

If you have reached this point. I thank you very much.



On my last post related to the Covid crisis
[Covid impressions, eighteen months after](/posts/covid-19-impressions-eighteen-months-after/)
I presented a review of my initial impressions regarding the Covid crisis and
its unprecedented management.

As I say at the beginning of the post, after learning much more about infectious
diseases and epidemiology and having analysed the results of the successive
insane measures adopted to cope with the Covid crisis, I believe I have
confirmed that my initial intuition was essentially right.

I understand much better the complex dynamics of the interactions of viruses and
their human hosts to see why the recipes arising from millions of years of
evolution provide much better results than half-baked social engineering
theories, commercial interests and authoritarian ideologies.

In a nutshell, humans and viruses (especially the less harmful respiratory
viruses) live in an ecological equilibrium that is best mediated by the human
immunological system at the individual level and by the phenomenon of _herd
immunity_ at the population level.

Contrary to what we would like to think, modern medicine does not _cure_
infectious diseases. We cure ourselves through our own immunological system.
Viruses constantly develop new tricks to foul our immunological system, but they
only succeed if they can increase their infectiousness without increasing their
lethality. Killing the host is usually not the best strategy for the survival of
viruses that are transmitted human-to-human and indeed, the fewer symptoms
produced by an infection on the host (the less severity), the better chances
that the host will infect other humans (increasing their potential
infectiousness).

Unfortunately, some individuals have a compromised immunological system and
cannot cope with an infection. With respiratory viruses, this does not require a
specially lethal variant of the virus, but is rather caused by the fragility of
the individuals or the malfunction of their immunological systems, for example
due to auto-immune disorders.

In these cases, at the population level, frail people can still be protected by
being shielded by sane individuals that become immune after successfully
clearing a previous infection. This is what is known as _"herd immunity"_.

Contrary to what you might have heard, herd immunity is not an _strategy_ but
the inevitable outcome of the laws of epidemiology.

We call this state of ecological equilibrium after reaching herd immunity as an
_endemic_ virus. As populations evolve, with new births entering the pool, older
(or sick) people losing their capacity to fight the virus, and the virus itself
mutating to reinfect otherwise immune individuals, both viruses and humans can
coexist for thousands of years. Every season<Tip>For reasons that are not
completely understood, every type of respiratory virus is more active during a
particular and characteristic season, so each year the different families of
viruses become active in a predictable succession</Tip> new variants develop, a
variable proportion of the population gets infected and an even smaller
proportion of these infected, unfortunately die or suffer severe harms caused
directly by the virus or by their own immunological response to the infection.

SARS-CoV-2, the virus responsible of COVID-19 is a new virus that has entered
the pool of respiratory virus that will affect us for the next thousands of
years (unless medicine advances considerably from its current baseline, which
might or might not happen). It has a lethality, which is in the same order of
magnitude of other existing respiratory viruses, i.e. in the 0.1 to 0.3% range.

The situation in which a new virus (or a sufficiently changed virus) enters a
population is what is called an _epidemic_. The main difference in an epidemic
is that there is less acquired immunity in the population<Tip>This is what seems
to have happened with Covid. There was some cross-immunity, because it is
closely related to other existing endemic coronaviruses, but it was definitely
lower than other established viruses, at least outside of Asia</Tip>.

During the initial epidemic phase, after a new virus enters a population, until
the population acquires immunity through successfully recovering from infection,
the number of deaths (the _fatality ratio_) is much higher than what the same
virus will cause in the future when it becomes endemic, for at least six
reasons:

1. As mentioned above, the **lethality of epidemic viruses is higher than that
   of the future endemic variants**, because the virus has not yet experienced
   the evolutionary pressure that decreases its severity and increases its
   infectiousness in order to enhance its chances of survival and spread in the
   long term

2. Since there is no acquired immunity initially (or is very small), the
   **proportion of people susceptible to infection is higher**, up to 100% of
   the population

3. Sane individuals (which are usually more active, get infected first and
   recover quickly) are **not able to shield the fragile population** initially,
   resulting in a higher proportion of fragile people (with a higher fatality
   ratio) getting infected

4. The most **effective treatments** to mitigate the symptoms of the disease
   caused by the virus might **take some time to be developed and implemented**,
   resulting in a higher mortality

5. Hospitals and doctors might get overwhelmed, resulting not only in direct
   deaths caused by the virus, but potentially indirect deaths caused by the
   **sanitary collapse**

6. Even if not collapsed, hospitals and institutional care homes become the most
   important **focus of infection**, because they are the only places in which
   individuals that are sick are able to infect effectively others (who are in a
   general bad shape and thus more susceptible to develop complications from the
   infection). When the virus becomes endemic, most sick individuals stay at
   their own home, thus removing themselves from society and limiting their
   capacity to infect others.

Considering these six factors, it is very easy to understand the recommended
practices to handle epidemics of respiratory viruses before 2020. These
practices were focused on maintaining a functional society, providing good
information to the population, and preventing the collapse of the public health
infrastructure.

In conclusion, the key to handle an epidemic caused by a new pathogen is **to
build the population immunity as soon as possible to reach the endemic state,
preferably by having healthy people getting infected first** (resulting in the
minimum possible casualties), so that the virus loses lethality naturally and
the recovered immune individuals shield the population at risk.

At the same time, old-fashioned pharmaceutical and other medical interventions
have to be developed and tested to mitigate the effects of the virus on the
susceptible population until the epidemic phase ends.

This is almost the opposite of what has been tried during the Covid panic,
resulting in a **complete disruption of the economy** while causing a **higher
number of direct and even higher number of indirect deaths**, most of which will
happen in the future, because of delay or complete elimination of the treatment
of anything non-covid for the last two years.

I plan to write in more detail about each of these factors that drive epidemics
in the future, so keep tuned in ...



As I mentioned on my [first post](/posts/welcome-to-stupid-econ), I started the
blog as my personal reaction to the surprising public reaction to the covid
crisis. In some ways it seemed to confirm some ideas I have maintained in the
past, but for the most part it was abolutely inexplicable. I simply could not
(still can't) make sense of what was happening (and is still happening).

So, I tried to write long and comprehensive posts to explain why the crisis was
being mismanaged, what would be more appropriate ways to analyse the situation
and mitigate its effects, and above all, the reasons that motivated that
authorities, experts, mass media and the general public acted like they did.

I did not finish any of these posts.

As it turns out, writing about something you don't understand is not conducive
to the state of mind required to pursue a new creative endeavor (i.e. start
writing regularly for a new blog).

Therefore, I have decided to stick to my original plan and focus on matters
which are more mature in my mind. As a bonus, the exercise maybe can help me
understand what has happened in the world in the last 20 months and what the
future holds.

Also, I have decided to self host my blog rather than contine using
[Wordpress.com](https://wordpress.com). I believe it will help in the long run,
but it means that the blog platform will be initially very limited.



I am not an economist. In fact, I have not had any formal economic education,
although I have been professionally involved in micro-economic analysis for most
of my career as a financial analyst and independent corporate finance advisor.

That is why I decided to use the word “stupid” in the title of my blog. I will
not present sophisticated economic analysis and I do not intend to do any
cutting edge demand-side economical research. Instead, I will try to present
common sense thoughts on some ideas used in the economic science that I believe
are commonly misunderstood, not only by the general population but also by
pundits, politicians and even by mainstream economists.

For most of my life I have been puzzled by the fact that some very basic errors,
which I believe are self-evident, and were successfully rejected centuries ago
by economic scholars, are still maintained and continue to harm humanity.

In the last years, and specially after the Great Recession of 2008, my concerns
have but increased. Until then, I believed that people were harming themselves
unnecessarily, by letting other people take advantage of them, but that the
general improvement of the economic conditions more than compensated the harm.

Lately I am increasingly fearing that the stupid behavior of the most opulent
society known in history might be on the brink of destroying the very conditions
that have made humanity really prosper for the first time since the homo sapiens
species evolved on earth.

That’s why I have decided to start this blog. I want to discuss some very basic
ideas that are misunderstood by the general population. Sometimes because they
are not intuitive, but mostly because there is a well organized propaganda
apparatus that wants us to believe that good is bad.

Maybe I will not convince anyone with my arguments. I don’t mind. That is not my
intention.

What I want is to discuss with other people that do not agree with me. I want to
understand why they think what they think.

I want to learn.


Posts about other items

Vaccine efficiency video

On skepticism about COVID-19 vaccines - II

On skepticism about COVID-19 vaccines - I

Some epidemiological considerations about respiratory viruses

Back to blogging ... I hope

Welcome to StupidEcon