Know the Absolute Risk Reduction of the COVID-19 Vaccines! Part 1

Addendum October 23, 2021: A new article about the Pfizer Booster shot can be read here: The Absolute Risk Reduction of the Pfizer Biontech Booster Shot

The absolute risk reduction of the COVID-19 Vaccines are:

• Pfizer–BioNTech – 0.84 %
• Moderna – 1.2 %
• Gamaleya (Sputnik) – 0.93 %,
• J&J – 1.2 %
• AstraZeneca – 1.3 %.

Intrigued? Read on.

You probably have heard the numbers showing the vaccine efficacy of COVID-19 shots by now.

• Pfizer–BioNTech 95%
• Moderna 90%
• Gamaleya (Sputnik) 90%,
• J&J 67%
• AstraZeneca 67%.

Vaccine efficacy is another name for relative risk reduction (RRR). The relative risk (RR) ratio of attack rates with and without the vaccine. It is used in vaccine research to compare results between vaccine trials.
RRR sounds impressive because of the high numbers, which is why it is used in press releases to disseminate news agencies. Medical representatives also tell physicians these numbers. But if RRR is presented alone, it introduces a reporting bias, and RRR only means half of the story.

The FDA requires that RRR be reported together with the absolute risk reduction (ARR). That’s because the ARR is more relevant to the person getting the vaccine. The ARR is the difference between attack rates with and without a vaccine and considers the whole population. ARR tells us about the effectiveness of that vaccine-related to an individual.

Let’s unpack these RRR and ARR. The following is from Outcome Reporting Bias in COVID-19 mRNA Vaccine Clinical Trials published in Medicina.

For the COVID vaccines, the Relative Risk ratio is the number of people who got COVID-19 in the Experimental group over the Placebo or Control group. See figure below.

In the figure above, the number of people who got COVID among the 100 vaccinated is, or Experimental event rate (EER) is 1/100 or 1%.

The Control group on the right side did not get the vaccine. Among them, two people got COVID-19. The Control Event Rate (CER) is 2/100 or 2%.

The Relative Risk Reduction (RRR) or Vaccine reduction relative to placebo risk formula is ARR (0.01)/CER (0.02) = RRR 0.5 (50%)

The formula for the absolute risk reduction (ARR) or vaccine risk reduction is
CER 0.02% – EER 0.01% = ARR 0.01 (1%). ARR for this example means that the vaccine reduced the risk of getting the disease by only 1%.

Now that we know how the RRR and ARR are derived…

What is the absolute risk reduction of the current COVID-19 vaccines?

• Pfizer–BioNTech – 0.84 %
• Moderna – 1.2 %
• Gamaleya (Sputnik) – 0.93 %,
• J&J – 1.2 %
• AstraZeneca – 1.3 %.

Source: [1]

They’re pretty low, aren’t they? But wait, there’s more!

Number Needed to Vaccinate

The ARR can be used to calculate the number needed to vaccinate (NNV). NNV is answering the question, How many people need to be vaccinated to prevent one case of COVID-19? The ideal answer should be one. The formula is 1/ARR.

• Pfizer–BioNTech – 117
• Moderna – 76
• Gamaleya (Sputnik) – 80
• J&J – 84
• AstraZeneca – 78

Source: [1]

The Pfizer NNV number means that only one will benefit among 117 people vaccinated with the Pfizer–BioNTech BNT162b2 mRNA vaccine. The rest may still get COVID-19.

If you only know Pfizer’s numbers, the relative risk, you will think that the NNV is close to one since it is 95% vaccine efficacy! But that 95% RRR relates only to the vaccine trial and not to the person who will get the vaccine. That’s why it is essential to know the ARR and NNV.

The numbers presented are study numbers. What about the actual numbers since the vaccination campaign started?

Real World ARR and NNV

So far, the only available data is the Israeli mass vaccination using the Pfizer-Biontech shots. The RRR is 94%, similar to the phase 3 trial (95%). However, the ARR is only 0.46%, with an NNV of 217. The ARR is much lower than the Pfizer study showed, and the NNV is 1.8 times higher.

Parting thoughts

We are awash in propaganda from the particular interest that makes billions from the vaccination. Knowing absolute risk reduction is a valuable tool that anyone can use to weigh the risks and benefits of getting an FDA-unapproved vaccine.

If you like this article, you will also enjoy,  Absolute Risk Reduction of the COVID-19 Vaccines. Part 2

Knowledge about Covid-19 is rapidly evolving, and information may update as new studies are made. Stay current by subscribing. Feel free to share.

Don’t Get Sick!

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References:

[1] Piero Olliaro, Els Torreele, Michel Vaillant. COVID-19 vaccine efficacy and effectiveness—the elephant (not) in the room. The Lancet. April 20, 2021. DOI:https://doi.org/10.1016/S2666-5247(21)00069-0

[2] Brown RB. Outcome Reporting Bias in COVID-19 mRNA Vaccine Clinical Trials. Medicina. 2021; 57(3):199. https://doi.org/10.3390/medicina57030199

[3] Dagan N Barda N Kepten E et al. BNT162b2 mRNA COVID-19 vaccine in a nationwide mass vaccination setting. N Engl J Med. 2021; (published online Feb 24.)
https://doi.org/10.1056/NEJMoa2101765

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