by Vinay Prasad M.D., The Pulse:
An important paper came out yesterday, but not for the reason the authors think.
Redelmeier and colleagues find that unvaccinated people are more likely to end up in a motor vehicle accident (MVA) than vaccinated people.
Let me be clear: it is ridiculous to think that lipid wrapped mRNA spike template could lower car accidents, so the only plausible explanation is that people who get vaccinated are more precautious: they may drive less, more safety, in cars that have more safety features, etc. This finding only tells you that the 2 groups are not comparable. They are different in ways other than vaccination.
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The authors know that these groups are different. Their own Table 1 shows differences in age, etc. They claim however, that the association persists despite adjustment for these factors. (though they don’t have distance driven)
What does that tell us?
The proper take aways are:
- People who choose to get vaccinated are different than those who choose not to, and available covariates cannot capture all these differences.
- Ergo, all vaccine effectiveness studies are confounded. They have the healthy vaccinee effect. Especially at young ages. (see forrest plot).
- Ergo, data for vaccinating kids and young adults is likely confounded. Since the CDC did not demand RCT data showing severe disease reductions at these ages, and rely on observational data, those should be questioned.
- There is no good data to vaccinate children and boost young adults. This is a crisis of evidence.
But that’s not what they conclude. Let me tell you what they suggest we do:
- “Primary care physicians who wish to help patients avoid becoming traffic statistics, for example, could take the opportunity to stress standard safety reminders such as wearing a seatbelt, obeying speed limits, and never driving drunk”
This is ridiculous. The authors have no evidence that this intervention will help, and in particularly, that it works preferentially in unvaccinated (i.e. why not just tell everyone). They are making things up, and that is shameful.
2. “The observed risks might also justify changes to driver insurance policies in the future.”
This one is just plain sad. They want to leverage this information to discriminate yet again against unvaccinated without evidence or understanding that this discrimination may even further vaccinate hesitance and create more animosity to authority.
Overall, the paper has one useful fact in it. Vaccinated people are different, and that is why we need RCTs to support perpetual boosters and cannot rely on observational data, but the authors are so misguided— they instead cling to their worldview, and would have us tell unvaccinated people to drive slow, and, by the way, let me raise your insurance rates.
Their recommendations are very likely futile, discriminatory and harmful. They are so convinced of their worldview (vax good, unvax’d are scum), they miss the facts in front of their own eyes.
Unvaccinated people are not a monolith— and some are likely even making a correct decision (young, healthy person who had covid! Why vax?)— papers like this reflect a failure of medicine to focus on what matters.
We wanted unvaccinated older people to get vaccinated in first half of 2021. Everything else was trivial. Boosting teenage boys and vaccinating babies has no RCT data, and observational studies will be confounded, and only a misguided person would pursue those policies.
