New Study: Vaccines Less Effective or Just Rewriting History With Faulty Models?

I've fallen behind on posting here in favor of Substack. So let's catch up!

Am I WRONG About COVID vaccines??

A new study published through JAMA was highlighted in #MedPage Today. The headline was that the #COVID-19 vaccines were less effective than previously thought and didn’t need to be given to anyone under 60. I was curious, until I saw who the authors were. I was actually surprised that MedPage even bothered to platform two people who consistently spread disinformation over the last 5 years and caused harm while doing so, but I guess it probably earned clicks. Let’s take a look at the authors, the faulty assumptions made for the papers mathematical model, and also why these COVID contrarian papers consistently get it wrong.

The video was a bit too long for Substack, so instead you get the script!

They’re trying to rewrite the pandemic.

There’s a new comparative effectiveness study in JAMA Health Forum that claims that vaccinations had a limited benefit outside of people over 60, so its authors think vaccines don’t need to be given to everyone. Is this true?

Let’s look at the source. The lead author is a man named John Ioannidis, a physician from Stanford, who, early on in the pandemic, I think April 2020, predicted that the US would see only 40,000 deaths. That number would quickly be surpassed on our way to 1.2 million deaths (which is still probably an undercount). Since then he’s been trying to claw back his reputation.

It also was published with invited commentary by Monica Gandhi, a UCSF physician who repeatedly tried to make claims that that kids weren’t affected by COVID and that the end of the pandemic was just around the corner, and consistently got it wrong just about every time.

Neither of these people are reliable sources of information on vaccine effects or recommendations given their overly contrarian bias. Now, if you’ve seen my videos you know I’m very pro-vaccine, but I have also been realistic about the evidence we have and how effective it is and how much we need more than just individual vaccination to protect against COVID-19.

Let’s also look at the timing. Back in May, FDA head Marty Makary and CBER Director Vinay Prasad published an editorial in NEJM in which they proposed a new “framework” for COVID vaccines where they would only be administered to those 65 and older or with certain comorbidities. It was vague about that second part. They claimed they were aligning our vaccine recommendations to be closer to those of Europe, and then proceeded to incorrectly summarize the guidelines from various European countries. Most evidence-based physicians and scientists criticized them roundly for it.

So, from the people who brought you the AI-generated fake citations of the MAHA report, comes a real paper led by fellow COVID contrarians that somehow supports their conclusions. The timing is a little too good.

The paper itself is based on a mathematical model - that’s not inherently bad. That’s how they’ve done other analyses of how many lives the COVID vaccines saved, so this isn’t that different. But what matters is what you put into the model.

This paper makes some iffy assumptions. Infection fatality rate is noted as quite low - well below 1% (0.000003 in ages 0-19, 0.00506 in ages 60-69). However, Jean Fisch on BlueSky did a great little analysis in a thread where she looked at John Ioannidis’s paper from 2023 on infection fatality rate pre-Omicron and all of the data points show a infection fatality rate greater than 1%. Applying the estimates in this 2025 paper, she notes that the studies from which they pull the IFR use COVID deaths from broad international databases that likely greatly underestimate death numbers because of significant underreporting (she compared them to individual national registries). So if you’re dramatically reducing the IFR of COVID, of course that’s going to dramatically decrease the number of lives saved.

The other major flaw that persists as part of every COVID contrarian’s analysis: death. Is. Not. The. Only. Bad. Outcome.

The COVID vaccines were tested for reduction in severe illness and hospitalization, and prevention of death followed that. However, prevention of severe illness and hospitalization are important in and of themselves. We have also found that even milder illness with COVID-19 can lead to post-acute sequelae of COVID-19, or “Long COVID”. Symptoms can be everything from a lack of smell or, maybe worse, a permanent bad smell sensation, to requiring supplemental oxygen for your weakened lungs, to increased cardiac disease and heart failure. Less COVID infections/severity mean less long COVID.

And finally, kids aren’t automatically immune and despite what certain economists who don’t know how to stay in their lane like to claim, you should not treat them like “a vaccinated grandparent.” There have been a substantial amount of pediatric hospitalizations and deaths due to COVID (though based on what Kennedy, Jay Bhattacharya, Mehmet Oz, and Marty Makary say, you would think that a bunch of dead kids isn’t a big deal). Further, we know that asymptomatic spread of COVID happens, and I had MANY elderly patients who got infected by their grandkids or nephews/nieces.

This infection is not benign for so many people. John Ioannidis and Monica Gandhi are trying to fudge data to justify their previous incorrect conclusions. We don’t do that here.