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Old 12-06-2021, 06:50 PM   #5153
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Join Date: Apr 2007

Originally Posted by blankall View Post
Once again, the biggest factor is likely just that some people will get severe disease no matter what due to co-morbidities. For example, my aunt has Lupus and has been vaccinated, but cannot produced anti-bodies because she's on immune suppressing drugs.

So if you have X percentage of the population that is going to get severe disease, the more effective the immunity, the higher the percentage of people who do get a breakthrough case that will become severe. For example, if you had extremely effective vaccine you would see fewer breakthrough cases in total and, therefore, a higher proportion of those breakthrough cases would have those co-morbidities that always lead to severe cases.
If that's what was driving it, then you would expect the booster group to have a high ratio of severe cases since a) it provides superior protection to immunity from infection (at least within the time window of this study), and b) it's very heavily slanted towards people with comorbidities. Yet despite that, the ratio is virtually identical to the 2-dose group (3 dose vs 2 dose):

16-39: 0.087% vs 0.052%
40-59: 0.64% vs 0.62%
60+: 6.2% vs 8.1%

The effect V mentions above matches my personal experience too. The 10-15% of the population who remains unvaccinated at this point are far less likely to seek testing for mild cases than the rest of the population.

I do see what you're saying; something that allows more mild cases while retaining protection against severe disease will tend to have a lower rate of severe cases vs. something that provides high protection for both. But I think the demographic and test-seeking behaviors of the groups are too different to not play a role in the outcome. The data from the entire pandemic illustrates that.
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