Re: Nies’ Covid Column
The recent article by J. Dirk Nies, titled “Increased Risk of COVID-19 Associated with Prior Vaccination,” aims to provide helpful information, yet I found it a somewhat misleading mixture of science and opinion. The title can be easily misinterpreted that getting vaccinated against COVID-19 makes one more likely to get infected. The title—and the article—fail to distinguish between “association” and “causation” as used by scientists. The fact that Covid-19 infection appears more frequently in those vaccinated does not mean vaccination has caused this result. An “association” just means two things happen at the same time. Roosters crow in the morning and people eat breakfast cereal in the morning, but roosters don’t cause that.
Key questions are not addressed in the study, which Dr. Nies correctly acknowledges has not been critically reviewed by other scientists. For example, are those who chose to get vaccinated more likely to be in jobs that bring them in contact with infected people, compared to those who forgo vaccination? The Cleveland Clinic study authors admit to being unable to explain their “unexpected” finding. They note, for example, that: “A simplistic explanation might be that those who received more doses were more likely to be individuals at higher risk of COVID-19.”
I am not arguing that there is no question here worth exploring, only that the conclusion Dr. Nies’s article suggests to the non-scientist is not warranted by the Cleveland Clinic study.
I also want to express concern with some of the language in the article. Dr. Nies comments on the study’s unexpected finding by saying “You read that right!” Later, he cites FDA approval of the bivalent vaccine without a study to determine its effectiveness as a “glaring deficiency” and finds it “astounding” that the Cleveland Clinic would need to do its own study. This ignores the public demand for some means of combating a rapidly-spreading and for many Americans dangerous new viral strain and offers no explanation of the process and science that led FDA scientists to their decision. Emotional language such as this should be avoided in an article that needs to be anchored in objective science.
Still further, Dr. Nies writes that “what I find most disturbing is the possibility that each dose of mRNA vaccine is dampening the human immune system’s response to SARS CoV-2” when this “possibility” and the “dampening” are not verified science. Toward the end of the article, Dr. Nies recommends “we stop shoveling billions of federal tax dollars to makers of these mRNA Covid vaccines.” This seems to me to move even further from valid scientific questions into political advocacy.
To The Editor:
The preprint referenced by Dirk Nies in his column, “Insights for Flourishing: Increased Risk of COVID-19 Associated with Prior Vaccination” is nothing more than an anecdotal report of observations that have not been rigorously researched. The results are therefore not necessarily true or reliable. It’s very surprising Dr. Nies would refer to this paper as “complete” and “cutting-edge medical research” because it is neither.
The authors from the Cleveland Clinic did not report asking their employees, vaccinated and not, whether or how well they followed COVID-19 preventive measures, such as masking, social distancing, avoiding crowded places, and washing their hands. The government made clear that these common-sense measures were required in addition to vaccination for the best chances of avoiding highly contagious COVID.
Thus, without this information, it’s improper to declare—as in Dr. Nies’ chart—that “As vaccine-induced immunity wanes, compared to the unvaccinated” that the “risk of contracting COVID increases with each previous vaccination received”, as if this observation is enough to prove anything about the effectiveness of the vaccines.
It’s quite plausible that vaccinated folks behaved recklessly because they felt protected by their vaccination(s), whereas unvaccinated people felt vulnerable and thus practiced the advised precautions more diligently.
In today’s world, where people are under pressure to publish papers in order to attract clientele or bring in government funds or improve their credibility, numerous unproven studies are published regularly, mainly in the life sciences. It’s disgraceful because it encourages the uninitiated to believe unproven statements, and it allows people with agendas to find papers (that are supposedly scientific) to support their points of view.
To avoid being manipulated, you must learn to look beyond the obvious (i.e., stated information) to see what is missing (in this case, the extremely pertinent information without which valid conclusions cannot be drawn).
Marlene A. Condon
Further Study is Needed
Interpreting scientific publications can be tricky business, and as someone who is an advocate for The Neuroimmune Foundation, I read more than my fair share. So it is with surprise that I read J. Dirk Nies’s interpretation of a recent Cleveland Clinic study in the February issue of the Crozet Gazette. Featuring and emphasizing this particular study—given the range of journal articles available on this topic—can be misleading. These publications do not exist in a vacuum, and sound interpretation is best served by understanding a study’s place in the whole continuum of research occurring at institutions across the globe. This is difficult to do in the context of a local publication with limited space, and in this case, without the benefit of a dedicated immunologist or epidemiologist.
Risk of testing positive for Covid is not the same as having symptomatic Covid or suffering negative effects from Covid. The Cleveland Clinic cites its own study’s limitations in that they did not track severity of illness, nor I would add, did they track incidence of PASC (Long Covid) in their cohort. These are no small matters, and the prominent display of the bar chart in Nies’s article can mislead the reader into thinking the study “proves” vaccination is not in the best interests of the population. Nies does supply caveats in his article, but I fear that nuance is not the default in most public discourse, especially when the subject is Covid-19.
I hope your readers will discuss their personal risk factors with their physicians, as multiple studies show decrease in illness severity with vaccination—and particularly in light of recent studies which show some risk reduction for PASC with vaccination. Long Covid can strike anyone at any age, even with asymptomatic cases. It can disable the young and healthy as readily as the more vulnerable among us. Emerging research also indicates that risks for long-term negative health consequences increase with each Covid infection. Study data on these topics is widely available and should be discussed with physicians when assessing risk.
I also invite your readers to examine first-hand the Cleveland Clinic publication, where they will read many other subtleties and limitations of the research given by the authors, as well as the study conclusion: “ . . . this study found an overall modest protective effect of the bivalent vaccine booster against COVID-19, among working-aged adults. The effect of multiple COVID-19 vaccine doses on future risk of COVID-19 needs further study.”
Further study, indeed. Nies’s advocacy for sunshine, sleep, and exercise while we wait for solutions is helpful, but unfortunately, this virus can decimate even those with the best mental, physical, and spiritual practices. Waning immunity in both the vaccinated and unvaccinated will be disruptive to our daily lives, our long-term health, the workforce, and our society as a whole, unless and until we dedicate the resources to address it.