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The 4th Shot: The Flawed Research

Anew preprint has been offered as proof that the 4th dose save lives. Here is the key figure, death from Covid-19 for people who got the 4th dose vs. those who only got 3 doses.

By Vinay Prasad

At first glance it looks amazing, but you can already see why it is bogus. Look again. Do you see it?

The curves already start to split between day 5 and day 10!

By Day 15, they are clearly apart! These time-points are too early to save a life from Covid-19. First, the vaccine takes 7-10 days to even lower rate of SARS-Cov-2 acquisition. Then to see the effect you would still have to wait till covid kills someone. Curves should be superimposable the first month or so for the outcome of death from Covid, and they would be if this were a randomized trial.

Instead it tells you the groups must be fundamentally different in a way they are not adjusting for. There are hints of that in the paper.

People who rush to get the 4th dose have higher socioeconomic status, and are less likely to be Arab. These indicate broader patterns of differences, including behavior, that are impossible to adjust for. 

In short, you cannot infer 4th vs 3rd dose reliably from these sorts of studies. Also there are downsides to more doses of the old, ancestral mRNA, such as original antigenic sin, which may hurt people when the Omicron on novel mRNA sequence booster comes out. Such people may keep mounting strong immune response to original spike, and not the modification.

In order to justify Pfizer’s billions & boosting huge chunks of the population, we need randomized trials. Pure and simple.

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