Vinay Prasad is a total huckster, unfortunately. He’s misrepresented data throughout the pandemic.
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@Welcome to FUD @RVABiker, Once you stay around for a bit, you will gain the ability to post links and such. Glad you are adding to discussion.
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He’s probably a great hematologist/oncologist. He is not an infectious disease doc by training and he’s basically one of those people who spends his time being a contrarian about other people’s research.
He fanned fear about myocarditis in kids using iffy statistics and seems to have dug in as a covid contrarian.
Anyways, I think there are a lot of opinions out there right now and this, to me, seems like a reasonable potential association to investigate.
Also, whats’ the harm of being aware of this trend? If doctors know about it, maybe they do a simple T1D autoantibody test when a kid gets discharged from the hospital or sees the doctor for covid-19. Or they get their blood sugar tested at their next physical. Lots of easy interventions that could potentially head off cases of DKA, without much downside.
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As you know the contrarian role is an important one in the scientific community, but my problem is with the new communication channels that allow the scientific debate to spill into the open where people aren’t prepared to understand the typical roles that are played, and of course the slick packaging to try and monetize it. I really wish someone had a way to gain control over this, because the packaging of misinformation and influencing people who don’t look at the research before forming an opinion is going to be the death of us.
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yeah, it’s really disheartening. I’m a contrarian by nature but what’s happening is these people get this platform and then an echo chamber and all this sense of belonging to a “Tribe” and I think it can really get to their heads and compromise their ability to be an honest broker. Not to mention these people may literally be monetizing their platform…
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The authors of the study are actually well aware of some of the limitations Mr Prasad mentions. They’re not hiding anything at all, but his blog post insinuates that they do.
From the CDC article:
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I’m going to rant now.
One of the reasons good science is so difficult is that humans intuitively make these kinds of connections as a matter of course. My guess is because it has tremendous survival value (Ugg ate those strange green berries and got so sick. I won’t eat those berries because they make people sick. …But we now call those berries “grapes.”)
In experimental research it is completely routine to see a behavior, run some experiments to explore the behavior, and come up with an understanding that fully explains the experimental results.
The hard part is to keep going, and apply techniques and effort to find alternative explanations which also fully predict the experimental results, and develop additional experiments that eventually reveal what is actually true. (As a researcher you never want to publish something that turns out to be false, because your career is pretty much over: peers will never believe your results ever again.)
Being smart is merely a prerequisite for doing good research. Reading a lot of the literature to learn the facts of the field is also merely a prerequisite. It takes lots of high-quality training to learn techniques and approaches that enable us to avoid the “clearly true” deductions that actually turn out to be wrong. What’s worse, developing this expertise in one field doesn’t save you from incorrect conclusions in a different field; you don’t yet have the techniques to avoid the pitfalls in the new field, so your mind will draw cause-effect conclusions that turn out not to be true.
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I agree that the role of contrarian is important because if we base population wide decisions on faulty research, we get poor decisions. To me, I found Dr. Prasad’s explanations of the flaws in that study sensible and this is now the second time recently the CDC has released a poorly researched study. Their prior study of a few hundred residents of Kentucky wherein the CDC concluded vaccine immunity was stronger than natural immunity from having recovered from Covid was contradicted by a study in Israel of a population set 10x larger. Also the Cleveland Clinic in a study of their healthcare workers found natural immunity to be strong and durable. Unfortunately, IMO the CDC has really let us Americans down with poor studies and, I think, poor decision-making from those studies that impacts the lives of millions. Drs. like Prasad are not just clinical MD’s, they are professors in the public health arena unafraid to provide a contrarian opinion based on a real analysis - as I think we need more, not less, public debate on these important issues and it seems most folks just want to ‘shut down’ anyone they disagree with these days without listening.
I am well aware of scientific method, research practices, scientific studies ect. Thes do not in any way invalidate anything I have said. Im now done with this topic, i simply posted an article for “something to think about”
Everyone needs to lighten up
I agree that they mentioned these “limitations” but I think we would both agree that these are some awfully substantial limitations, so much so that maybe this particular paper isn’t quite ready ‘for prime time.’
If it gets more parents getting their kids vaccinated, I’m all for it…even if all the questions aren’t answered. I’d prefer to have what info is known and make a decision as a parent, than to know nothing of the possibility existing (based on science…as imature as it may be…it’s still a theory and following the scientific theory).
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That depends what you mean by prime time. It can’t be used to support very strong conclusions.
Vinay Prasad could matter-of-factly have written that. Instead he chooses a conspiratorial tone as if he by himself uncovered some dirty secret, while in fact the limitations are mentioned in the article.
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And his observations and the way he declared them will serve no other purpose than to have more people NOT get vaccinated…which is why we are where we are right now.
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@RVABiker So, I am not sure which CDC study you’re looking at, I am familiar with the Israel data which to me shows pretty clear evidence of waning of vaccine effectiveness, which is why we need boosters. CDC may have published certain studies but on their summary page they include all the relevant data: Science Brief: SARS-CoV-2 Infection-induced and Vaccine-induced Immunity | CDC
In general it’s tricky to compare these groups over time as that they are not homogeneous and they change with each new variant, how long they’ve been vaccinated or had immunity from infection, what the rules are in the places they live, etc. For instance, in my city, an unvaccinated person is by default exposed to LESS risk than a vaccinated person – by law. They cannot eat indoors, go dancing, go to a gym, go to a bar, or be anywhere that you have to take off a mask in public. So the only people doing those high risk activities here were vaccinated people. And unsurprisingly, they showed a relatively higher rate of infection compared to the unvaccinated as compared to elsewhere, where unvaccinated people were allowed to do more in public.
I think the issue with CDC research is that it’s epidemiological data and a lot of that data is crummy/incomplete because, unlike Israel, we don’t have a centralized health system with a single medical records system, but rather a gazillion small things that are not coded uniformly or tracked in a way that’s helpful for data analysis. In fact, researchers often have to pay for these datasets.
This is why some of the best clinical trial data has come out of the U.K. – they can run very sophisticated, but statistically robust trials because they have a huge dataset and know a lot of information about all of their participants.
Also, Dr. Prasad is not a public health professor. He is a blood and cancer specialist. He does do some informatics-like research where he evaluates the claims of clinical trials and the evidence base for certain medical recommendations. I know him of him because he’s from our city and have been listening to him talk for the past two years. I think his framing can have a detrimental effect on the discourse. Comparing anything in our public health response to the Nazis is just non-starter and inflames discourse in pointless ways, for instance.
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Also, i think you’d be shocked at how much research has these types of limitations. What we “know” in most of medicine is on pretty shaky ground. So this is pretty in line with a lot of research we have. Not fabulously done but it would have been published in another journal for sure.
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Yes, that’s the Israeli study I was referring to and how natural immunity is superior to vaccine immunity and, better yet, natural immunity plus at least one vaccine seems to be the best. Unfortunately our CDC doesn’t apparently choose to recognize natural immunity as being sufficient even though there are these multiple studies which confirm this.
Anyway, regarding Prasad, here’s what Google says and you can draw your own conclusions:
People also ask
Who is Vinay Prasad MD MPH?
Vinay Prasad MD MPH is a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco. He runs the VKPrasad lab at UCSF, which studies cancer drugs, health policy, clinical trials and better decision making.
So as I see it, biostatistics professor and health policy are the types of insights I’m looking to him for… YMMV
Interesting conversation, especially for this forum. From the little I know of the CDC (mostly from the Michael Lewis Covid book), their general bias is to hold off on publishing something until they have all their bases covered - they are quite conservative.
Given their conservative bias, I take their assertion of a link between juvenile covid and diabetes more seriously. I know many others do not. Dr Prasad is just taking chip shots - criticisms that are plausible but rather general, applying to many studies like this.
My limited statistical background comes with such basic tools as what we used to call “ordinary least squares”, where researchers try to control for all sorts of data to get at the “true” effect of one thing on another. My understanding of the history of this OLS technique was that it was originally developed by researchers doing work on smoking and lung cancer, because the “correlation” between the two was so consistent and obvious and many nay-sayers were saying “no, it’s because of age or height or birthplace” and so the researchers “controlled” for all of these things to show that the connection between smoking and lung cancer was a causal one. But the basic, simple correlation between smoking and cancer was very obvious in the raw data, before controlling for all sorts of other things.
In a large sample such as the one that the CDC used, the differences in diabetes onset across populations (those with juvenile covid and those without) is pretty huge. Yeah, there may be other factors, but it reminds me of the smoking / cancer data.
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I think one of the issues with advertising natural immunity is the assumption that goes into that. One has to assume you don’t end up on a ventilator and/or die in the pursuit of gaining that natural immunity and the antibodies that come from having covid. Since two people who meet the exact same criteria…age, weight, lifestyle, etc, can have drastically different reactions to covid.
I think to advertise natural immunity would serve to have less people vaccinated.
My thoughts on that anyway.
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and here’s my beef with the CDC succinctly summed up by the WSJ Editorial Board in this Editorial. Unfortunately they do not follow the science as much as they claim:
OPINION | REVIEW & OUTLOOK
How Fauci and Collins Shut Down Covid Debate
They worked with the media to trash the Great Barrington Declaration.
By
Dec. 21, 2021 6:47 pm ET
The Editorial Board Follow
In public, Anthony Fauci and Francis Collins urge Americans to “follow the science.” In
private, the two sainted public-health officials schemed to quash dissenting views from
top scientists. That’s the troubling but fair conclusion from emails obtained recently via
the Freedom of Information Act by the American Institute for Economic Research.
The tale unfolded in October 2020 after the launch of the Great Barrington Declaration, a
statement by Harvard’s Martin Kulldorff, Oxford’s Sunetra Gupta and Stanford’s Jay
Bhattacharya against blanket pandemic lockdowns. They favored a policy of what they
called “focused protection” of high-risk populations such as the elderly or those with
medical conditions. Thousands of scientists signed the declaration—if they were able to learn about it. We tried to give it some elevation on these pages.
That didn’t please the lockdown consensus enforced by public-health officials and the
press. Dr. Collins, the director of the National Institutes of Health until Sunday, sent an
email on Oct. 8, 2020, to Dr. Fauci, the director of the National Institute of Allergy and
Infectious Diseases.
“This proposal from the three fringe epidemiologists . . . seems to be getting a lot of
attention – and even a co-signature from Nobel Prize winner Mike Leavitt at Stanford.
There needs to be a quick and devastating published take down of its premises,” Dr.
Collins wrote. “Is it underway?”
These researchers weren’t fringe and neither was their opposition to quarantining
society. But in the panic over the virus, these two voices of science used their authority to
stigmatize dissenters and crush debate. A week after his email, Dr. Collins spoke to the
Washington Post about the Great Barrington Declaration. “This is a fringe component of
epidemiology,” he said. “This is not mainstream science. It’s dangerous.” His message
spread and the alternative strategy was dismissed in most precincts.
Dr. Fauci replied to Dr. Collins that the takedown was underway. An article in Wired, a
tech-news site, denied there was any scientific divide and argued lockdowns were a straw
man—they weren’t coming back. If only it were true. The next month cases rose and
restrictions returned.
Dr. Fauci also emailed an article from the Nation, a left-wing magazine, and his staff sent
him several more. The emails suggest a feedback loop: The media cited Dr. Fauci as an
unquestionable authority, and Dr. Fauci got his talking points from the media. Facebook censored mentions of the Great Barrington Declaration. This is how groupthink works.
Appeared in the December 22, 2021, print edition as ‘How Fauci and Collins Shut Down Debate.’
Countries like China lock down their citizens when it’s convenient (Australia too?). Countries like Sweden do not - where would you rather live? I know what my preferred choice is.
So one of our reporters was talking to a researcher who mentioned that vaccination is better at preventing hospitalization. When you test antibody levels in post-infection and post-vaccination people, there is more variability in the post-infection group. Many produce a very strong antibody response while others produce a much weaker one. In part, this is because when you are infected with the whole virus, it also coopts your body to make proteins that reduce the immune response, the better to replicate undetected.
Meanwhile, if you’re vaccinated, you’re only shown the spike, which does not come along with all the immune-system muting proteins, so it induces a more consistent antibody response. (On the flip side, you could imagine getting to see the “whole” virus might induce a better T-cell response or ability to recognize newer variants.)
I’m not sure if this researcher was basing that conclusion on this CDC study or what, but it was an interesting comment. It’s certainly smaller than the Israeli data but they do control for a variety of things, including time to last shot in addition to age, etc. and this one focuses on hospitalization only.
In fact, it’s hard to dispute the data coming out of NYC with omicron; hospitalizations in the vaccinated are rising very modestly while the unvaccinated are seeing their hospitalizations rise sharply. See Table 2 here. Of course, it could be omicron getting every last “true” susceptible – those who have never seen the spike in any form. But clearly a lot of those sick people have been infected previously.
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