1/ We're now five months into the rollout of the #Covid vaccines - enough time to make some judgments of how they're working in the real world.

So let's talk honestly about the good, the bad, and the ugly. (I promise, no prion variants or shedding.)

2/ The good: At this point I think we have to agree the mRNAs are broadly effective at full protection. The Israeli and British data are too strong.

This assessment comes with two big caveats. Broadly effective does NOT mean 95% effective in the population most at risk...

3/ People are still dying in Israel (the equivalent of about 250-300 a week in the US) - and we are seeing breakthough infections and deaths here. Still, even 80% long-term effectiveness in the elderly would be a huge win for them and really end the death counting...

4/ The even more important caveat is that we do not know how long the protection will last. The companies are suggesting annual shots will be needed, which doesn't say much about their confidence. And we don't know if the side effects of a 3rd (or 10th!) shot will be tolerable...

5/ Nonetheless, the fear of January and February - that the vaccines simply wouldn't work in the elderly - has not panned out. And that is without doubt good news.

Okay, onto the bad: the vaccines DO cause a short-term spike in cases when they are first dosed.

6/ I don't think this is arguable either. It's been true essentially everywhere. If the vaccines offer 10 years of protection, I think the advocates have a case for ignoring the bump; but if they tap out after six months it is more relevant to the overall cost-benefit analysis...

7/ So it is still too early to tell how important a problem this will be.

Now the ugly.

Pharmaceutical therapies are supposed to be BOTH safe and effective. See that first word? SAFE? Effectiveness isn't all that counts.

And VAERS and EUDRA are throwing up massive red flags...

8/ The number of side effect reports, including death reports, is off the charts compared to other vaccines. The vaccine advocates can make excuses for this (anyone can report to VAERS, etc), but none of them begin to explain what we are seeing...

9/ Worse, the reports fall into a pattern. Many are strokes, embolisms, and other clotting and cardiac events - often in young people at low risk for such events. And researchers have raised concerns the Sars-Cov-2 spike protein can by itself raise the risk of such problems...

10/ The primary response from the vaccine advocate community has been

A) To point to the size of the clinical trials and the lack of cardiovascular safety signals in them

B) To argue that the spike proteins are largely contained near the injection site

11/ But neither of those answers is convincing. Not enough people under 40 were enrolled in the trials to be sure of catching serious risks, if they're age-stratified. How do we know? Because the trials DIDN'T catch the clotting problems of the @astrazeneca @jnjnews vaccines...

12/ The question if the spike proteins are contained locally near the injection site is complex and technical, above my pay grade. I do not claim to have an answer. But I will say European regulators reported "mRNA could be detected in all examined tissues except the kidney."

13/ That's in here, on page 47. So some mRNA is getting distributed through the body. Is enough spike protein leaking to matter? Again, I don't know. But the flat denials sound A LOT like the last year's denials that the virus could have come from a lab.

https://www.ema.europa.eu/en/documents/assessment-report/covid-19-vaccine-moderna-epar-public-assessment-report_en.pdf

14/ The VAERS reports have other strange side effect clusters. Tinnitus is one. Does that make sense pharmacologically? Could it be related to the LNP shell around the mRNA? I don't know. Neither does anyone else.

But what I do know is that these are worth investigating...

15/ And that safety matters. But safety and effectiveness are opposite ends of the seesaw. We can tolerate considerable risk for a treatment for a disease that kills 10% of the people it infects (like #SARSCoV2 in 90 year olds)...

16/ But basically no risk for a treatment for a disease that kills so few people that accurate mortality figures can't even be offered (like #SARSCoV2 in 12 year olds).

So, five months and hundreds of millions of shots along, we know pretty much what we did in December...

17/ These vaccines make sense for people at high risk from #Covid (especially the elderly); their side effect profile should worry anyone at low risk (especially the young); and a lot of people in the middle have a choice that's harder than the media wants to pretend.

END