Thursday, September 21, 2023

Breakthrough Infections and the elderly

A breakthrough infection is when a vaccinated person still gets the disease. Study suggests that the elderly are LESS affected by breakthrough infections. The study authors were Chinese but their data was international, not Chinese

Published in the journal of Infectious Disease by Jing et al., “SARS-CoV-2 vaccine breakthrough infection in the older adults: a meta-analysis and systematic review,” as the durability challenges of the COVID-19 vaccines lead to waning vaccine effectiveness, associated breakthrough infections tend to rise.

The study authors, affiliated with the Tianjin University of Traditional Chinese Medicine in the northern coastal metropolis of about 14 million people, come to the bombshell conclusion contrary to popular understanding: elderly persons face far less risk for breakthrough infection than is popularly understood, and that the risk of severe COVID-19, hospitalization and death due to breakthrough infection remains perhaps even lower risk than for breakthrough infection alone.

Do these findings alter the risk-benefit calculus for vaccination? Could these results be because of vaccination or natural Immunity? These are important questions. While TrialSite doesn’t anticipate that this important meta-analysis will be picked up by mainstream press in the West the outcomes, limitations aside, are important for further consideration.

The study, published in BMC infectious Diseases and represented by corresponding author Xiaohui Jing with the Tianjin University of Traditional Chinese Medicine in Tianjin, China raises significant questions. Much of the data generated by U.S. public health sources points to far more COVID-19 risk associated with older individuals. Yet this study out of China points to an opposite conclusion.

The Study

Designed as a systematic review or meta-analysis, from November 2, 2022, the study team reviewed 30 studies published across English language journal platforms from PubMed and Embase to Cochrane Library and Web of Science. Employing the use of a random-effects model the team calculated pooled estimates of the prevalence and occurrences of COVID-19 breakthrough infections in elderly persons.

Mindful of the influence of bias, the study team employed use of funnel plots, Egger’s regression test, as well as sensitivity analyses while following standard guidelines for this class of study-- Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

The Results

The study authors report across 30 publications reveals a pool prevalence of COVID-19 breakthrough infection among the elderly at 7.7 per 1,000 individuals (95% CI, 4.0-15.0), with pooled incidence equaling 29.1 per 1000 person-years (95%CI 15.2–55.7).

The China-based researchers take away from their meta-analysis that the prevalence and incidence of SARS-CoV-19 breakthrough infection in older adults was low. But more eye opening was the finding associated with the risk of hospitalization, severe disease and death associated with the elderly and breakthrough infections, which was even lower than the risk of breakthrough infection.

Study Limitations

Jing and colleagues disclosure a handful of limitations including 1) study data restricted to publications in English, 2) the inclusion of studies with a sample size greater than 500 may result in the loss of small eligible studies; 3) Lots of heterogeneity was observed in the included studies; 4) most of the studies included in this study were observed within six months of vaccination; 5) some studies provided little information about the potential influencing factors such as vaccine type, vaccine dose, gender, prior infection, time from vaccination to breakthrough infection, comorbidity, and lifestyle of the included older adults on the prevalence and incidence of COVID-19 breakthrough infection and finally 6) It was also impossible to conduct meta-analyses among some groups due to the less information from studies assessing those factors. Clearly more research is required.


Supreme Court Issues Pause on Banning Biden Administration from Contacting Social Media Platforms

In early September, a federal appeals court in New Orleans ruled that the White House, the Federal Bureau of Investigation (FBI) and social media companies to remove content or posts the Biden administration considers to be misinformation. This included posts about COVID-19.

The court ruled the government had most likely overstepped the First Amendment by urging major social platforms to remove the content the Biden administration thought was misleading.

The decision came down from a three-judge panel for the Fifth Circuit in New Orleans, ruling that the White House and the Surgeon General had “coerced the platforms to make their moderation decisions by way of intimidating messages and threats of adverse consequences” and “significantly encouraged the platforms’ decisions by commandeering their decision-making processes.” The court also found the FBI used coercion in its interactions with the social media companies which took down 50% of the online posts the bureau’s agents deemed “troublesome”.

A theme generally considered to be a pattern during COVID-19: that the Biden administration was directly, or indirectly censoring Americans, attacking any critical voices not concurring with the standard pandemic narrative.

The New Orleans panel upheld a decision by a lower court judge declaring that the government pressured Facebook, Google, X (Twitter) and YouTube into censoring posts related to COVID-19 and allegations of election fraud.

But the Fifth Circuit judges also put a 10-day injunction, or hold, on the lower court’s ruling in order to give the Justice Department, which is defending the Biden administration, a chance to appeal to the Supreme Court. And, last week the highest court in the land responded.

Temporary Hold

Last Thursday, the U.S. Supreme Court temporarily put on hold an order restricting the ability of President Joe Biden's administration to encourage social media companies to remove content it considers misleading, including about the Covid-19 pandemic. The order was issued by Conservative Supreme Court Justice Samuel Alito, and it pauses the lower court ruling until September 22.

In their filing against the lower court ruling, the Justice Department said, “The court cited no precedent for that boundless theory, which would allow any state or local government to challenge any alleged violation of any constituent’s right to speak.” Additionally, the Justice Department said, “The Fifth Circuit’s decision contradicts fundamental First Amendment principles. It is axiomatic that the government is entitled to provide the public with information and to ‘advocate and defend its own policies.’”

Missouri AG Plans to Oppose Appeal

A spokesperson for Missouri Attorney General Andrew Baily said he plans to oppose the administration's Supreme Court appeal. "We are rooting out this censorship enterprise and will hold any wrongdoers accountable," Bailey said in a statement. Missouri and Louisiana were the original plaintiff’s in the lawsuit claiming the administration threatened the social media platforms with antitrust enforcement and reforms to tech platforms’ liability shield, known as Section 230 of the Communications Decency Act, if they didn’t comply with the government’s takedown requests.

The Justice Department said there was no coercion beyond the private and public appeals to companies by officials. “Rather than any pattern of coercive threats backed by sanctions, the record reflects a back-and-forth in which the government and platforms often shared goals and worked together, sometimes disagreed, and occasionally became frustrated with one another, as all parties articulated and pursued their own goals and interests during an unprecedented pandemic,” the Department of Justice said in their filing.

TrialSite’s main news website, on the topic of censorship has experienced continuous problems, not directly because the website is independent, but indirectly as groups such as News Guard have attempted to challenge content, all clearly labeled as opinion, on the TrialSite platform.

Also, TrialSite content has been censored on social media platforms such as YouTube. For example, a documentary about Ivermectin, balanced, objective and not taking any sides, was deleted by the subsidiary of Google. Another example when the nation of Slovakia authorized on an emergency basis the use of ivermectin during the COVID-19 pandemic, Facebook deleted the TrialSite post even though the article was based on a formal government ruling. It was as if facts didn’t matter.

Censorship is alive and well in America during the age of COVID-19.




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