Correlation Between Mask Compliance and COVID-19 Outcomes in Europe

Authors: Beny Spira Published: April 19, 2022 DOI: 10.7759/cureus.24268


Masking was the single most common non-pharmaceutical intervention in the course of the coronavirus disease 2019 (COVID-19) pandemic. Most countries have implemented recommendations or mandates regarding the use of masks in public spaces. The aim of this short study was to analyse the correlation between mask usage against morbidity and mortality rates in the 2020-2021 winter in Europe. Data from 35 European countries on morbidity, mortality, and mask usage during a six-month period were analysed and crossed. Mask usage was more homogeneous in Eastern Europe than in Western European countries. Spearman’s correlation coefficients between mask usage and COVID-19 outcomes were either null or positive, depending on the subgroup of countries and type of outcome (cases or deaths). Positive correlations were stronger in Western than in Eastern European countries. These findings indicate that countries with high levels of mask compliance did not perform better than those with low mask usage.


Universal masking has been introduced during the coronavirus disease 2019 (COVID-19) pandemic at an unprecedented global scale as an important tool to curb viral transmission among potential susceptible persons. Face masks still are one of the most significant and controversial symbols in the fight against COVID-19. Two large randomised controlled trials about mask effectiveness performed during the pandemic came out with mixed results [1,2]. Several studies that analysed the effect of masks on the general population (ecological studies) have concluded that masks were associated with a reduction in transmission and cases [3-7]. However, these studies were restricted to the summer and early autumn of 2020. From March 2020 onwards, country after country instituted some form of mask mandate or recommendation. The stringency of these measures varied among the different countries and they, therefore, resulted in different proportions of mask compliance, ranging from 5% to 95% [8]. Such heterogeneity in mask usage among neighbouring countries provided an ideal opportunity to test the effect of this non-pharmaceutical intervention on the progression of a strong COVID-19 outburst.

Materials & Methods

Study design

This analysis aimed to verify whether mask usage was correlated with COVID-19 morbidity and mortality. Daily data on COVID-19 cases and deaths and on mask usage were obtained for all European countries. The rationale behind the choice of European countries for comparison was fourfold: (1) availability and reliability of data; (2) a relative population homogeneity and shared history of epidemics (comparing countries from different continents may bring too many confounding factors); (3) similar age stratification and access to health assistance; and (4) divergent masking policies and different percentages of mask usage among the different populations, despite the fact that the entire continent was undergoing an outburst of COVID-19 at the time period analysed in this study.

Inclusion criterion

Data were collected from the following Eastern and Western European countries: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czechia, Hungary, North Macedonia, Poland, Romania, Serbia, Slovakia, Slovenia, Belarus, Estonia, Latvia, Lithuania, Republic of Moldova, Ukraine, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, and Northern Ireland. The inclusion criterion was a population size higher than one million people.

Data retrieval

Data on morbidity, mortality, and mask usage were retrieved from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington [8]. Data from IHME were downloaded on 14th February 2022. IHME mask data sources are the Delphi Group at Carnegie Mellon University and the University of Maryland COVID-19 Trends and Impact Surveys, in partnership with Facebook, Kaiser Family Foundation, and YouGov COVID-19 Behaviour Tracker Survey ( Data on vaccination were obtained from Our World in Data (OWID) [9] on 4th April 2022.

Statistical analysis

Data from 35 European countries on morbidity, mortality, and mask usage during a six-month period were collected and analysed. Spearman’s correlation analyses and Shapiro-Wilk normality checks were in JASP (version 0.15; University of Amsterdam, Amsterdam, Netherlands) [10] and linear regressions in Wolfram Mathematica 13.0 (Wolfram Research, Inc., Champaign, Illinois) [11].


This brief communication reports the correlation between the proportion of mask usage in the population and the number of cases (per million) and deaths (per million) from October 2020 to March 2021 in 35 European countries (Table 1). For this analysis, all European countries, including West and East Europe, with more than one million inhabitants were selected, encompassing a total of 602 million people. All analysed countries underwent a peak of COVID-19 infection during these six months (Figures 12). The average proportion of mask usage in the referred period was 60.9% ± 19.9%, slightly higher in Eastern than in Western Europe (62.1% and 59.6%, respectively). However, the level of mask compliance was considerably more homogeneous in East (SD = 13.4%) than in West European countries (SD = 25.4%).

CountryAverage mask usage1Cases/millionDeaths/million
Bosnia and Herzegovina40%430781738
North Macedonia67%520481413
Republic of Moldova66%480451102
United Kingdom62%576891363
Northern Ireland68%545671039
Shapiro-Wilk p-value20.0560.0040.693
Table 1: Proportion of mask usage and the number of COVID-19 cases and deaths per million throughout the 2020-2021 late fall and winter (1st October to 31st March) in Europe.

Percent of the population reporting always wearing a mask when leaving home.

Shapiro-Wilk test for normality.

Figure 1: Mortality from COVID-19 throughout the pandemic in East European countries.

The area between vertical black bars corresponds to the period analysed in this study (1 October 2020 to 31 March 2021). Data were downloaded on 14 February 2022 from Institute for Health Metrics and Evaluation (IHME).

Figure 2: Mortality from COVID-19 throughout the pandemic in West European countries.

The area between vertical black bars corresponds to the period analysed in this study (1 October 2020 to 31 March 2021). Data were downloaded on 14 February 2022 from Institute for Health Metrics and Evaluation (IHME).

Surprisingly, weak positive correlations were observed when mask compliance was plotted against morbidity (cases/million) or mortality (deaths/million) in each country (Figure 3). Neither the number of cases nor the proportion of mask usage followed a Gaussian distribution (Shapiro-Wilk p-values were 0.004 and 0.0536, respectively). A Spearman’s rank test was applied to quantify the correlation between mask usage, cases, and deaths (Table 2). The positive correlation between mask usage and cases was not statistically significant (rho = 0.136, p = 0.436), while the correlation between mask usage and deaths was positive and significant (rho = 0.351, p = 0.039). The Spearman’s correlation between masks and deaths was considerably higher in the West than in East European countries: 0.627 (p = 0.007) and 0.164 (p = 0.514), respectively. This difference could be associated with the fact that the most populous countries are located in West Europe. However, the correlations did not significantly change when the seven countries with populations > 20 million were excluded from the analysis (cases rho = 0.129 (p = 0.513); deaths rho = 0.375 (p = 0.049)). Analyses of other sub-groups, such as countries with populations smaller or higher than six million, higher than 10 million, or higher than 15 million, were also evaluated. None of these tests provided negative correlations between mask usage and cases/deaths.

Figure 3: Correlation between average mask compliance and cases/million (A) or deaths/million (B) in 35 European countries.

Each dot represents a country. The blue line represents the fitted regression line and the areas above and below indicate 1 σσ (yellow), 2 σσ (green), or 3 σσ (red). 

TerritoryMasks x casesMasks x deaths
All Europe0.136 (0.436)0.351 (0.039)*
Eastern Europe10.130 (0.606)0.164 (0.514)
Western Europe20.05 (0.848)0.627 (0.007)*
Table 2: Spearman’s rank correlation coefficient rho (p-value) between mask usage and COVID-19 cases or deaths.

1 Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czechia, Hungary, North Macedonia, Poland, Romania, Serbia, Slovakia, Slovenia, Belarus, Estonia, Latvia, Lithuania, Republic of Moldova, and Ukraine.

2 Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, and Northern Ireland.

* Statistically significant.


Mask mandates were implemented in almost all world countries and in most places where masks were not obligatory, their use in public spaces was recommended [12]. Accordingly, the World Health Organization (WHO) as well as other public institutions, such as the IHME, from which the data on mask compliance used in this study were obtained, strongly recommend the use of masks as a tool to curb COVID-19 transmission [8,13]. These mandates and recommendations took place despite the fact that most randomised controlled trials carried out before and during the COVID-19 pandemic concluded that the role of masks in preventing respiratory viral transmission was small, null, or inconclusive [1,2,14,15]. Conversely, ecological studies, performed during the first months of the pandemic, comparing countries, states, and provinces before and after the implementation of mask mandates almost unanimously concluded that masks reduced COVID-19 propagation [3-7,16]. However, mask mandates were normally implemented after the peak of COVID-19 cases in the first wave, which might have given the impression that the drop in the number of cases was caused by the increment in mask usage. For instance, the peak of cases in Germany’s first wave occurred in the first week of April 2020, while masks became mandatory in all of Germany’s federal states between the 20th and 29th of April [5], at a time when the propagation of COVID-19 was already declining. Furthermore, the mask mandate was still in place in the subsequent autumn-winter wave of 2020-2021, but it did not help preventing the outburst of cases and deaths in Germany that was several-fold more severe than in the first wave (Figure 2).

The findings presented in this short communication suggest that countries with high levels of mask compliance did not perform better than those with low mask usage in the six-month period that encompassed the second European wave of COVID-19. It could be argued that some confounding factors could have influenced these results. One of these factors could have been different vaccination rates among the studied countries. However, this is unlikely given the fact that at the end of the period analysed in this study (31th March 2021), vaccination rollout was still at its beginning, with only three countries displaying vaccination rates higher than 20%: the UK (48%), Serbia (35%), and Hungary (30%), with all doses counted individually [9]. It could also be claimed that the rise in infection levels prompted mask usage resulting in higher levels of masking in countries with already higher transmission rates. While this assertion is certainly true for some countries, several others with high infection rates, such as France, Germany, Italy, Portugal, and Spain had strict mask mandates in place since the first semester of 2020. In addition, during the six-month period covered by this study, all countries underwent a peak in COVID-19 infections (Figures 12), thus all of them endured similar pressures that might have potentially influenced the level of mask usage.


While no cause-effect conclusions could be inferred from this observational analysis, the lack of negative correlations between mask usage and COVID-19 cases and deaths suggest that the widespread use of masks at a time when an effective intervention was most needed, i.e., during the strong 2020-2021 autumn-winter peak, was not able to reduce COVID-19 transmission. Moreover, the moderate positive correlation between mask usage and deaths in Western Europe also suggests that the universal use of masks may have had harmful unintended consequences.


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Covid Failure

What we did didn’t work. Let’s learn from that.

Authors: PETER VAN BUREN MAY 16, 2022| The American Conservative

We were swindled, fooled, bamboozled, and lied to during the pandemic. The public-health establishment misled the American people about the value of masking, closures, and social distancing. No one has accepted blame. Understanding how badly we failed is not only an inevitable part of the “told you so” process, but, more importantly, a lesson for next time. Just ask the Swedes.

Sweden had zero excess deaths associated with Covid-19. The U.S. had the most excess deaths of all nations. New York had more than Florida. That’s the whole story right there in a handful of words.

Let’s unpack it.

The key element of misdirection in the American swindle was case counts, those running numbers on screens telling us how many Americans had tested positive for Covid. If you’re curious, it looks like some 60 percent of us have had Covid at some point, with most of us experiencing mild or no symptoms.

How high the case numbers went in your neck of the woods depended a lot on the amount of testing taking place. More testing meant more “cases.” For me, when I had a very mild set of symptoms all clearly in line with Covid, I never even bothered to test. Like most people, I just sat around the house for a few days until I got better. My spouse, who had no symptoms, never got tested, either. Neither of us were included in the ever-growing case counts that dominated the headlines for years.

Not that it matters. The case count tells us very little. Hospitalization totals are useful for managing caseload, but often are indicative of protocols like testing patients upon entry to the hospital. Many hospital treatments changed, too. Initially, many Covid-positive people were hospitalized and put on respirators. Before long, many doctors realized infections associated with long-term respirator use were killing people, too.

Eventually, hospitalization numbers went down. That stat, too, only told you so much. Since Covid proved fatal primarily to the elderly, many hospitalizations began with something else only to end with Covid. My own father suffered a blinding, massive stroke, went into hospital, and caught Covid there, to officially die of respiratory failure. I’m not sure if he counted as a Covid death or not.

Now the bad news: Modern medicine cannot cure death. Everybody dies. Most Americans who don’t die earlier in life in accidents typically die after the age of 77. In 2020, heart disease and cancer each killed about double the number of people that Covid did.

The only statistic that really matters then when talking about the roughly two years of the pandemic is “excess deaths,” deaths beyond the usual couple of million that occur every year.

Sweden had zero excess deaths. The U.S. had the most excess deaths of all nations. New York had more than Florida.

Sweden did very little in terms of halting work and school, or forcing masking and social distancing. The U.S. did quite a bit more. The U.S. states known for their Covid “efforts,” particularly New York, had excess deaths worse than or similar to do-little Florida. These states expended an awful lot of effort and angst, and suffered great collateral damage (addiction, suicide, unemployment, social unrest, failing grades), for very little benefit.

And we were lied to by the Covidians. In July 2020, the New York Times stated Sweden’s “decision to carry on in the face of the pandemic has yielded a surge of deaths without sparing its economy from damage. Sweden’s grim result—more death, and nearly equal economic damage—suggests that the supposed choice between lives and paychecks is a false one: failure to impose social distancing can cost lives and jobs at the same time.”

Tsktsk, said the media. And they’re still saying it. Despite Florida having 148 excess deaths per 100,000 to New York’s 248, Politico‘s May 1, 2022, headline read: “Florida lost 70,000 people to Covid. It’s still not prepared for the next wave.”

Much as Florida did, Sweden allowed restaurants, gyms, shops, and most schools to stay open. People went to work; some voluntarily masked, some not. Their decision stood in stark contrast to the U.S., where, by April 2020, the CDC recommended draconian lockdowns, throwing millions out of work and school.

The U.S. is the only major Western nation that still demands a negative Covid test for entry, including for its own citizens. The U.S. is the only nation where every Covid therapeutic, such as new anti-viral drugs that lessen the severity of a positive case, is filtered through the lens of partisan politics.

In addition to leaving our economy in shambles, America’s Covid strategy apparently did not consider the age disparity in excess deaths. Globally, most Covid deaths occured among persons age 77 and older. People exposed to Covid in their 70s have twice the mortality rate of those exposed in their 60s, and 3,000 times that of Covid-exposed children. But everyone was made to wear a mask as though everyone were at equal risk of Covid, and without solid evidence that mask mandates significantly lower viral spread in the community.

The data were clear in China from the early days of the pandemic. Death rates for elderly Chinese in the early days of the pandemic, who were not social distancing, and elderly Americans, who were social distancing, were very similar. Swedish intensive-care-admission rates showed sharp declines after early pandemic peaks despite a lack of state-imposed shutdowns.

Age-specific solutions were needed for a virus with age-specific effects. We ignored or overlooked the data. We are paying for that mistake now. Savings lives or saving the economy? Both, please. Ask the Swedes.

America’s pandemic response was wrong across the board. Its failure is attributable in part to red-blue politics and a pathetic desire for control by Democratic governors.

It was also exacerbated by Americans’ underlying health, which is worse than most other developed countries. Our underlying health woes are exacerbated by income inequality and high rates of poverty, and maddening levels of obesity, diabetes, and “deaths of despair,” especially among the underclass. Black Americans were hit harder by Covid than white Americans. The poor were hit harder than the well-to-do.

Whatever we did, whether we masked or locked down or stayed open and maskless, we still would have suffered because of these underlying issues. Fixing the next pandemic means fixing America first.

Vaccinated Up to 15X MORE LIKELY Than Unvaxxed to Develop Heart Inflammation Requiring Hospitalization: Peer Reviewed Study

Authors:  Julian Conradson Published April 25, 2022 at 4:14pm

A new study out of Europe has revealed that cases of heart inflammation that required hospitalization were much more common among vaccinated individuals compared to the unvaccinated.

A team of researchers from health agencies in Finland, Denmark, Sweden, and Norway found that rates of myocarditis and pericarditis, two forms of potentially life-threatening heart inflammation, were higher in those who had received one or two doses of either mRNA-based vaccine – Pfizer’s or Moderna’s.

In all, researchers studied a total of 23.1 million records on individuals aged 12 or older between December 2020 and October 2021. In addition to the increased rate overall, the massive study confirmed the chances of developing the heart condition increased with a second dose, which mirrors other data that has been uncovered in recent months.

From the *peer-reviewed study, which was published by the Journal of the American Medical Association (JAMA):

“Results of this large cohort study indicated that both first and second doses of mRNA vaccines were associated with increased risk of myocarditis and pericarditis. For individuals receiving 2 doses of the same vaccine, risk of myocarditis was highest among young males (aged 16-24 years) after the second dose. These findings are compatible with between 4 and 7 excess events in 28 days per 100 000 vaccinees after BNT162b2, and between 9 and 28 excess events per 100 000 vaccinees after mRNA-1273.

The risks of myocarditis and pericarditis were highest within the first 7 days of being vaccinated, were increased for all combinations of mRNA vaccines, and were more pronounced after the second dose.”

Also mirroring other data, the study confirmed that young people, especially young males, are the ones who are suffering the worst effects of the experimental jab. Young men, aged 16-24 were an astounding 5-15X more likely to be hospitalized with heart inflammation than their unvaccinated peers.

But it isn’t just young men, all age groups across both sexes – except for men over 40 and girls aged 12-15 – experienced a higher rate of heart inflammation post-vaccination when compared to the unvaxxed.

From The Epoch Times, who spoke with one of the study’s main researchers, Dr. Rickard Ljung:

“‘These extra cases among men aged 16–24 correspond to a 5 times increased risk after Comirnaty and 15 times increased risk after Spikevax compared to unvaccinated,’ Dr. Rickard Ljung, a professor and physician at the Swedish Medical Products Agency and one of the principal investigators of the study, told The Epoch Times in an email.

Comirnaty is the brand name for Pfizer’s vaccine while Spikevax is the brand name for Moderna’s jab.

Rates were also higher among the age group for those who received any dose of the Pfizer or Moderna vaccines, both of which utilize mRNA technology. And rates were elevated among vaccinated males of all ages after the first or second dose, except for the first dose of Moderna’s shot for those 40 or older, and females 12- to 15-years-old.”

Although the peer-reviewed study found a direct link between mRNA based vaccines and increased incident rate of heart inflammation, the researchers claimed that the “benefits” of the experimental vaccines still “outweigh the risks of side effects,” because cases of heart inflammation are “very rare,” in a press conference about their findings earlier this month.

However, while overall case numbers may be low in comparison to the raw numbers and thus technically “very rare,” the rate at which individuals are developing this serious condition has increased by a whopping amount. When considering the fact that 5-15X more, otherwise healthy, young men will come down with the condition – especially since the chances of Covid-19 killing them at that age are effectively zero (99.995% recovery rate) – it’s downright criminal for governments across the world to continue pushing mass vaccinations for everyone.

Dr. Peter McCullough, a world-renowned Cardiologist who has been warning about the long-term horror show that is vaccine-induced myocarditis in young people, certainly thinks so. In his expert opinion, the study does anything but give confidence that the benefits of the vaccine outweigh the risks. In “no way” is that the case, he says. Actually, it’s quite the opposite.

From McCullough, via The Epoch Times:

“In cardiology we spend our entire career trying to save every bit of heart muscle. We put in stents, we do heart catheterization, we do stress tests, we do CT angiograms. The whole game of cardiology is to preserve heart muscle. Under no circumstances would we accept a vaccine that causes even one person to stay sustain heart damage. Not one. And this idea that ‘oh, we’re going to ask a large number of people to sustain heart damage for some other theoretical benefit for a viral infection,’ which for most is less than a common cold, is untenable. The benefits of the vaccines in no way outweigh the risks.”

It’s also worth pointing out that the new study’s findings could be an indicator as to what is driving the massive spike in the excess death rates in the United States and across the world. Correlating exactly with the rollout of the experimental mRNA Covid-19 vaccines, people have been dying at record-breaking rates, especially millennials, who experienced a jaw-dropping 84% increase in excess deaths (compared to pre-pandemic) in the final four months of 2021.

With all the data that has been made available up to this point, there is no denying that the vaccine is at least partially to blame for the spike in severe illness and death, if not entirely. Nevertheless, the CDC, Fauci, Biden, and the rest of the corrupt establishment continue to push mass vaccines, just approved another booster jab (with plans for another already in the works), and are licking their chops to unleash another round of Covid hysteria and crippling restrictions come this fall.

HHS Secretary Becerra Claims COVID Vaccines ‘Kill People Of Color’ At ‘Twice The Rate Of Whites,’ Vows To ‘Work’ Harder To Get More People Vaccinated

Authors: Alicia Powe Published April 19, 2022

After months of mandates forcing people to get two and three doses of COVID-19 vaccines to keep their jobs attend, school, travel and enter indoor venues, the federal government admits the experimental gene modification shots are killing people.

While vowing to ramp up biomedical tyranny and the effort to get more Americans vaccinated, U.S. Health and Human Services Director Xavier Becerra Experimental claimed the “safe and effective” mRNA shots are killing people with dark skin at a much higher rate than those with light skin.

“By the way, we know that vaccines are killing people of color — blacks, Latinos, indigenous people — at about two times the rate of white Americans,” Becerra explained during a digital “White House Convening on Equity” seminar on April 14.

After months of mandates forcing people to get two and three doses of COVID-19 vaccines to keep their jobs attend, school, travel and enter indoor venues, the federal government admits the experimental gene modification shots are killing people.

While vowing to ramp up biomedical tyranny and the effort to get more Americans vaccinated, U.S. Health and Human Services Director Xavier Becerra Experimental claimed the “safe and effective” mRNA shots are killing people with dark skin at a much higher rate than those with light skin.

“By the way, we know that vaccines are killing people of color — blacks, Latinos, indigenous people — at about two times the rate of white Americans,” Becerra explained during a digital “White House Convening on Equity” seminar on April 14.

After acknowledging the lethality of COVID shots, Becerra explained that approximately 80 percent of the American public is vaccinated.

But the government needs to “work” harder to vaccinate Americans who have refrained from getting inoculated, he argued.

“So, on vaccines, last year, we saw that about two-thirds of white American adults had received at least one shot of vaccine,” Becerra said. “That was just barely over 50 percent for black Americans and Latinos at that particular time. So, again, we’ve got to work.

“Today, a year later, over 80 percent of white American adults have received at least one shot. Over 80% of black American adults have received at least one shot. Over 80 percent of Latino Americans have received at least one vaccine shot.”

While HHS acknowledges the deadly effects COVID vaccines have on minority communities, the Center for Disease Control and Prevention’s Vaccine Adverse Effects System confirms the COVID shots are killing more people than any other vaccine in history.

According to VAERS, only 421 vaccine-related deaths in 2020 prior to the administration of the mRNA shots. In 2021, the number of people who dies after getting vaccinated precipitously spiked with at least 21,914 people died after receiving the COVID shots.

As yet, 5689 people died after receiving a COVID vaccine in 2022.

Meanwhile, the CDC is deploying fleets of federally funded “pandemic” buses to minority communities across the nation to persuade unvaccinated Americans into getting jabbed.

As reported, the CDC’s PANDEMIC (Program to Alleviate National Disparities in Ethnic and Minority Immunizations in the Community) deploys teams of health care workers into minority communities to educate people about why they need to be vaccinated.

According to PANDEMIC grant program materials, PANDEMIC’s goal is to reach groups that may experience “immunization disparities” in racial and ethnic minorities, residents of rural communities, migrant farmworkers, Native Americans, Hispanics, Blacks, and people identifying as part of the LGBTQ community and boost vaccination rates in areas chosen for having “high vaccine-hesitancy rate. ”

“If people aren’t sure [that they want the vaccine], then we have educational materials, and our community health workers and the extension agents will talk to them about their particular questions and try to answer their questions and their concerns. And then…[we] immediately give them the vaccine,” explained Catherine Striley of the University of Florida, who helps oversee the PANDEMIC project.

Pfizer Hired 600 Employees Due To ‘Large Increase In Adverse Event

Authors: Zachary Stieb The Epoch Times  March 9, 2022

Pfizer hired 600 employees in the months after its COVID-19 vaccine was authorized in the United States due to the “large increase” of reports of side effects linked to the vaccine, according to a document prepared by the company.

Pfizer has “taken multiple actions to help alleviate the large increase in adverse event reports,” according to the document. “This includes significant technology enhancements, and process and workflow solutions, as well as increasing the number of data entry and case processing colleagues.”

At the time when the document—from the first quarter of 2021—was sent to the U.S. Food and Drug Administration (FDA), Pfizer had onboarded about 600 extra full-time workers to deal with the jump.

“More are joining each month with an expected total of more than 1,800 additional resources by the end of June 2021,” Pfizer said.

The document was titled a “cumulative analysis of post-authorization adverse event reports” of Pfizer’s vaccine received through Feb. 28, 2021. It was approved by the FDA on April 30, 2021.

The document was not made public until the Public Health and Medical Professionals for Transparency sued the FDA after the agency claimed it needed decades to produce all the documents relating to the emergency use authorization granted to the company for the vaccine.

Under an agreement reached in February, the FDA must produce a certain number of pages each month.

The analysis of adverse event reports was previously disclosed to the health transparency group, but certain portions were redacted (pdf), including the number of workers Pfizer onboarded to deal with the jump in adverse event reports.

“We asked that the redactions on page 6 of this report be lifted and the FDA agreed without providing an explanation,” Aaron Siri, a lawyer representing the plaintiffs, told The Epoch Times in an email.

After the document was produced, the FDA determined that the three redactions on that page “could be lifted,” an FDA spokesperson told The Epoch Times via email.

The redactions had been made under (b) (4) of the Freedom of Information Act, which lets agencies “withhold trade secrets and commercial or financial information obtained from a person which is privileged or confidential.”

The unredacted version of the document also now shows that approximately 126 million doses of Pfizer were shipped around the world since the company received the first clearance, from U.S. regulators, on Dec. 1, 2020. The shipments took place through Feb. 28, 2021.

It was unclear how many of those doses had been administered as of that date.

Pfizer did not respond to emailed questions, including how many workers it has onboarded to deal with adverse events.

The companies that manufacture the other two COVID-19 vaccines that U.S. regulators have cleared, Moderna and Johnson & Johnson, did not respond when asked if they have seen an increase in adverse events and if they have hired more employees to deal with reports.

The number of post-vaccination adverse event reports to the Vaccine Adverse Event Reporting System, jointly run by the FDA and the Centers for Disease Control and Prevention, has spiked since the vaccines were first cleared.

Problems linked to the vaccines include heart inflammation, blood clotting, and severe allergic shock.

Federal officials say the vaccines’ benefits outweigh the risks, but some experts are increasingly questioning that assertion, particularly for certain populations.

Protection by a Fourth Dose of BNT162b2 against Omicron in Israel

Authors: Yinon M. Bar-On, M.Sc., Yair Goldberg, Ph.D., Micha Mandel, Ph.D., Omri Bodenheimer, M.Sc., Ofra Amir, Ph.D., Laurence Freedman, Ph.D., Sharon Alroy-Preis, M.D., Nachman Ash, M.D., Amit Huppert, Ph.D., and Ron Milo, Ph.D. April 5, 2022 DOI: 10.1056/NEJMoa2201570 NEW ENGLAND JOURNAL OF MEDICINE



On January 2, 2022, Israel began administering a fourth dose of BNT162b2 vaccine to persons 60 years of age or older. Data are needed regarding the effect of the fourth dose on rates of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and of severe coronavirus disease 2019 (Covid-19).


Using the Israeli Ministry of Health database, we extracted data on 1,252,331 persons who were 60 years of age or older and eligible for the fourth dose during a period in which the B.1.1.529 (omicron) variant of SARS-CoV-2 was predominant (January 10 through March 2, 2022). We estimated the rate of confirmed infection and severe Covid-19 as a function of time starting at 8 days after receipt of a fourth dose (four-dose groups) as compared with that among persons who had received only three doses (three-dose group) and among persons who had received a fourth dose 3 to 7 days earlier (internal control group). For the estimation of rates, we used quasi-Poisson regression with adjustment for age, sex, demographic group, and calendar day.


The number of cases of severe Covid-19 per 100,000 person-days (unadjusted rate) was 1.5 in the aggregated four-dose groups, 3.9 in the three-dose group, and 4.2 in the internal control group. In the quasi-Poisson analysis, the adjusted rate of severe Covid-19 in the fourth week after receipt of the fourth dose was lower than that in the three-dose group by a factor of 3.5 (95% confidence interval [CI], 2.7 to 4.6) and was lower than that in the internal control group by a factor of 2.3 (95% CI, 1.7 to 3.3). Protection against severe illness did not wane during the 6 weeks after receipt of the fourth dose. The number of cases of confirmed infection per 100,000 person-days (unadjusted rate) was 177 in the aggregated four-dose groups, 361 in the three-dose group, and 388 in the internal control group. In the quasi-Poisson analysis, the adjusted rate of confirmed infection in the fourth week after receipt of the fourth dose was lower than that in the three-dose group by a factor of 2.0 (95% CI, 1.9 to 2.1) and was lower than that in the internal control group by a factor of 1.8 (95% CI, 1.7 to 1.9). However, this protection waned in later weeks.


Rates of confirmed SARS-CoV-2 infection and severe Covid-19 were lower after a fourth dose of BNT162b2 vaccine than after only three doses. Protection against confirmed infection appeared short-lived, whereas protection against severe illness did not wane during the study period.

During late December 2021, with the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant, the prevalence of confirmed infection rose sharply in Israel. Some of the contributing factors were increased immune evasion by the variant1 and the passage of more than 4 months since most adults had received their third vaccine dose. In an effort to address the challenges presented by the omicron variant and to reduce the load on the health care system, on January 2, 2022, Israeli authorities approved the administration of a fourth dose of the BNT162b2 vaccine (Pfizer–BioNTech) to persons who were 60 years of age or older, as well as to high-risk populations and health care workers, if more than 4 months had passed since receipt of their third dose. The real-world effectiveness of the fourth dose against confirmed infection and severe illness remains unclear. In this study, we used data from the Israeli Ministry of Health national database to study the relative effectiveness of the fourth dose as compared with only three doses against confirmed infection and severe illness among older persons in the Israeli population.



For this analysis, we included persons who, on January 1, 2022, were 60 years of age or older and had received three doses of BNT162b2 at least 4 months before the end of the study period (March 2). We excluded the following persons from the analysis: those who had died before the beginning of the study period (January 10); those for whom no information regarding their age or sex was available; those who had had a confirmed SARS-CoV-2 infection before the beginning of the study, determined with the use of either a polymerase-chain-reaction (PCR) assay or a state-regulated rapid antigen test; those who had received a third dose before its approval for all older residents (i.e., before July 30, 2021); those who had been abroad for the entire study period (January 10 to March 2; persons were considered to be abroad 10 days before traveling until 10 days after their return to Israel); and those who had received a vaccine dose of a type other than BNT162b2.

For persons who met the inclusion criteria, we extracted information on March 4, 2022, regarding SARS-CoV-2 infection (confirmed either by state-regulated rapid antigen test or by PCR) and severe Covid-19 (defined with the use of the National Institutes of Health definition2 as a resting respiratory rate of >30 breaths per minute, an oxygen saturation of <94% while breathing ambient air, or a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen of <300) during the 14 days after confirmation of infection. During the study period, infections were overwhelmingly dominated by the omicron variant.3 We also extracted data regarding vaccination (dates and brands of first, second, third, and fourth doses) and demographic variables such as age, sex, and demographic group (general Jewish, Arab, or ultra-Orthodox Jewish), as determined by the person’s statistical area of residence (similar to a census block4).


The study period started on January 10, 2022, and ended on March 2, 2022, for confirmed infection and ended on February 18, 2022, for severe illness. The starting date was set to 7 days after the start of the vaccination campaign (January 3, 2022) so that at least the first four-dose group (days 8 to 14 after vaccination) would be represented throughout the study period (Fig. S1 in the Supplementary Appendix, available with the full text of this article at The end dates were chosen to minimize the effects of missing outcome data due to delays in reporting PCR or antigen test results and to allow time for the development of severe illness.

The design of the study was similar to that of a previous study in which we assessed the protection conferred by the third vaccine dose as compared with the second dose.5 We calculated the total number of person-days at risk and the incidence of confirmed infection and of severe Covid-19 during the study period defined for each outcome. For persons who received the fourth dose, treatment groups were defined according to the number of weeks that had passed since receiving that dose, starting from the second week (8 to 14 days after vaccination). These four-dose groups were compared with two control groups. The first control group included persons who were eligible for a fourth dose but had not yet received it (three-dose group). Because persons who received the fourth dose might have differed from those who had not according to unmeasured confounding variables, a second control group was defined as persons who had received a fourth dose 3 to 7 days earlier (internal control group). This control group included the same persons as the four-dose groups, but during a period in which the fourth dose was not expected to affect the rate of confirmed infection or severe illness. The membership in these groups was dynamic, and participants contributed risk days to different study groups on different calendar days, depending on their vaccination status.


The study was approved by the institutional review board of the Sheba Medical Center. All the authors contributed to the conceptualization of the study, critically reviewed the results, approved the final version of the manuscript, and made the decision to submit the manuscript for publication. The authors vouch for the accuracy and completeness of the data in this report. The Israeli Ministry of Health and Pfizer have a data-sharing agreement, but only the final results of this study were shared.


Using quasi-Poisson regression, we estimated the rates of confirmed infection and severe Covid-19 per 100,000 person-days for each study group (included as factors in the model), with adjustment for the following demographic variables: age group (60 to 69 years, 70 to 79 years, or ≥80 years), sex, and demographic group (general Jewish, Arab, or ultra-Orthodox Jewish). Because incidences of both confirmed infection and severe illness increased rapidly during January 2022, the risk of exposure at the beginning of the study period was lower than at the end of the study period. Moreover, the fraction of the population in each study group changed throughout the study period (Fig. S1). Therefore, we included calendar date as an additional covariate to account for changing exposure risk.6 The end of the study period for severe Covid-19 was set to 14 days before the date of data retrieval (March 4), allowing at least 14 days of follow-up time for the development of severe illness. To ensure the same follow-up time for severe Covid-19 in all persons, we considered only cases of severe illness that developed within 14 days after confirmation of infection. The date used for counting events of severe Covid-19 was defined as the date of the test confirming the infection that subsequently led to the severe illness.

Persons who received four doses were assigned to groups according to the numbers of weeks that had passed since receipt of the fourth dose; for each outcome, we estimated the incidence rate in each of these four-dose groups and in the two control groups. We calculated two rate ratios for each treatment group and each outcome: first, the ratio of the rate in the three-dose group to that in each four-dose group; and second, the ratio of the rate in the internal control group to that in each four-dose group. Note that the higher this rate ratio is, the greater the protection conferred by the fourth dose of vaccine. In addition, adjusted rate differences per 100,000 person-days during the study period were estimated with a method similar to that used in our previous analysis.7 Confidence intervals were calculated by exponentiating the 95% confidence intervals for the regression coefficients, without adjustment for multiplicity. Thus, the confidence intervals should not be used to infer differences between study groups.

To check for possible biases, we performed several sensitivity analyses. First, we estimated the rate ratios for confirmed infection using an alternative statistical method that relied on matching (similar to that used by Dagan et al.8), as described in detail in the Supplementary Appendix; this approach could not be applied to the analysis of severe Covid-19 because of the small case numbers. Second, we examined the results of using data on infections confirmed only by PCR testing and excluding data on those confirmed by state-regulated antigen testing. Third, we repeated the analyses with data from the general Jewish population only. Fourth, we analyzed the data while accounting for the exposure risk over time in each person’s area of residence. Fifth, we analyzed the data while accounting for the time of vaccination since the third dose. Further details of the sensitivity analyses are provided in the Supplementary Appendix.



Figure 1.Study Poplation.Table 1.Demographic and Clinical Characteristics of the Persons in the Study Groups.

A total of 1,252,331 persons met the criteria for inclusion in the study (Figure 1). The total number of events and person-days at risk in each of the study groups, along with the distribution of covariates used in the analysis, are shown in Table 1, which provides statistics aggregated across weeks since receipt of the fourth dose from the second week onward. The information for each treatment group according to the week since receipt of the fourth dose is provided in Table S1. Overall, the distributions of covariates in the aggregated treatment groups are similar to those in the internal control group. As compared with the three-dose group, the aggregated four-dose groups and the internal control group included more person-days over the age of 80 years (24.9% and 25.1%, respectively, vs. 16.2%) and more person-days from the general Jewish population (94.2% and 93.7% vs. 84.4%). Those in the three-dose group had a larger number of risk days than did those in the aggregated four-dose groups (31.0 million person-days vs. 23.9 million person-days) but had more confirmed infections (111,780 vs. 42,325) and more severe cases (1210 vs. 355).


As shown in Table 1, the unadjusted rate of confirmed infection was 177 cases per 100,000 person-days in the aggregated four-dose groups, 361 cases per 100,000 person-days in the three-dose group, and 388 cases per 100,000 person-days in the internal control group. The unadjusted rate of severe Covid-19 was 1.5 cases per 100,000 person-days in the aggregated four-dose groups, 3.9 cases per 100,000 person-days in the three-dose group, and 4.2 cases per 100,000 person-days in the internal control group.Table 2.Results of the Quasi-Poisson Regression Analysis of Confirmed SARS-CoV-2 Infection.Table 3.esults of the Quasi-Poisson Regression Analysis of Severe Covid-19.Figure 2.Adjusted Rate Ratios for Confirmed Infection and Severe Illness.

The results of the quasi-Poisson regression analysis are summarized in Table 2 for confirmed infection and in Table 3 for severe illness. Figure 2 provides a graphical representation of the results for both confirmed infection and severe illness.

The adjusted rate of confirmed infection was lower in the four-dose groups than in the two control groups. The adjusted rate among persons in the fourth week (22 to 28 days) after receipt of the fourth dose was lower by a factor of 2.0 (95% confidence interval [CI], 1.9 to 2.1) than that in the three-dose group and was lower by a factor of 1.8 (95% CI, 1.7 to 1.9) than that in the internal control group. The adjusted rate of confirmed infection (after rounding) in the fourth week after the fourth dose was 171 cases per 100,000 person-days (95% CI, 165 to 177), as compared with 340 cases per 100,000 person-days (95% CI, 337 to 343) in the three-dose group and 308 cases per 100,000 person-days (95% CI, 299 to 317) in the internal control group (Table S2). In the analysis of adjusted rate differences, the group in the fourth week after the fourth dose had 170 fewer confirmed infections per 100,000 person-days (95% CI, 162 to 176) than the three-dose group, and 137 fewer confirmed infections per 100,000 person-days (95% CI, 125 to 148) than the internal control group. From the fifth week (29 to 35 days) onward, the rate ratio for confirmed infection started to decline. The adjusted rate of infection in the eighth week after the fourth dose was very similar to those in the control groups; the rate ratio for the three-dose group as compared with the four-dose group was 1.1 (95% CI, 1.0 to 1.2), and the rate ratio for the internal control group as compared with the four-dose group was only 1.0 (95% CI, 0.9 to 1.1).

The rate ratios comparing the control groups with the four-dose groups were larger and longer-lasting for severe Covid-19. For persons in the fourth week after receipt of the fourth dose, the adjusted rate of severe illness was lower by a factor of 3.5 (95% CI, 2.7 to 4.6) than that in the three-dose group and was lower by a factor of 2.3 (95% CI, 1.7 to 3.3) than that in the internal control group. The adjusted rate of severe Covid-19 (after rounding) in the fourth week after the fourth dose was 1.6 cases per 100,000 person-days (95% CI, 1.2 to 2.0), as compared with 5.5 cases per 100,000 person-days (95% CI, 5.2 to 5.9) in the three-dose group and 3.6 cases per 100,000 person-days (95% CI, 3.0 to 4.5) in the internal control group (Table S2). The adjusted rate differences were 3.9 fewer cases per 100,000 person-days (95% CI, 3.4 to 4.5) and 2.1 fewer cases per 100,000 person-days (95% CI, 1.4 to 3.0) than the three-dose group and the internal control group, respectively. Severe illness continued to occur at lower rates in the four-dose groups than in the control groups in later weeks after receipt of the fourth dose, and no signs of waning were evident by the sixth week after receipt of the fourth dose (Figure 2).


The results of the matched analysis of confirmed infection were similar to the results obtained in the main analysis (Fig. S3). In addition, restricting the quasi-Poisson regression analysis to the general Jewish population, adding as a covariate the exposure risk over time in each individual’s area of residence, or adding as a covariate the time since administration of the third dose did not substantially change the results of the main analysis (Figs. S4 and S5).

As described in the Supplementary Appendix, the testing policy in Israel was changed in early January 2022 (before the study period) for persons younger than 60 years of age. Even though the testing policy for the study population (persons ≥60 years of age) did not change, we tested the possible effect of the type of diagnostic test used to confirm infection by repeating the analysis counting only infections confirmed by positive PCR tests. This resulted in only very minor changes to the estimated level of protection conferred by the fourth dose (Figs. S4 and S5). In addition, we compared the testing rate and test type (PCR or antigen) among persons who received the fourth dose as compared with those who received only three doses and found the differences to be of limited extent (Fig. S2).


The omicron variant is genetically divergent from the ancestral SARS-CoV-2 strain for which the BNT162b2 vaccine was tailored. The results presented here indicate that as compared with three vaccine doses given at least 4 months earlier, a fourth dose provides added short-term protection against confirmed infections and severe illness caused by the omicron variant. The incidence rate for confirmed infection was lower by a factor of 2 and the rate of severe disease lower by a factor of 3 among persons in the fourth week after receiving the fourth dose than among eligible persons who did not receive the fourth dose.

Comparing the rate ratio over time since the fourth dose (Figure 2) suggests that the protection against confirmed infection with the omicron variant reaches a maximum in the fourth week after vaccination, after which the rate ratio decreases to approximately 1.1 by the eighth week; these findings suggest that protection against confirmed infection wanes quickly. In contrast, protection against severe illness did not appear to decrease by the sixth week after receipt of the fourth dose. More follow-up is needed in order to evaluate the protection of the fourth dose against severe illness over longer periods.

Although our analysis attempts to address biases such as confounding, some sources of bias may not have been measured or adequately controlled for — for example, behavioral differences between persons who received the fourth dose and those who did not. For severe illness, differences in the prevalence of coexisting conditions could potentially have affected the results; however, this information is not recorded in the national database, and therefore we did not adjust for such differences. Differences in coexisting conditions could also be associated with differential treatment with antiviral drugs such as ritonavir-boosted nirmatrelvir, which could have affected the results. To address some of these biases, we compared the rate of confirmed infection and severe illness within the group of people who received the fourth dose. Estimates of the rate ratio during the first days after vaccination could include the effect of transient biases (Fig. S6). These potential biases include the “healthy vaccinee” bias,9 in which people who feel ill tend not to get vaccinated in the following days, which leads to a lower number of confirmed infections and severe disease in the four-dose group during the first days after vaccination. Moreover, one would expect that detection bias due to behavioral changes, such as the tendency to perform fewer tests after vaccination, is more pronounced shortly after receipt of the dose.

Thus, we compared the rates of confirmed infections and severe illness at different weeks after the fourth dose, from the second week onward, with the rates on days 3 to 7 after its receipt, a period during which the transient biases would have diminished but before the vaccine would be expected to have affected the rate of the outcomes of interest.6 The rate ratios obtained for confirmed infections were very similar to those obtained when comparing the treatment groups with the persons who did not receive a fourth dose. For severe illness, the rate ratios relative to the internal control group were lower than the rate ratios relative to the three-dose group. Even when the internal control group was the basis for comparison, the rate ratios for severe illness were still higher than those for confirmed infection and did not show signs of waning immunity.

In addition, several sensitivity analyses were performed to assess the robustness of the results to further potential biases. First, we performed the analyses using data only from the general Jewish population, since the participants in that group are more common in the population that received the fourth dose. Second, we included in the model the risk of exposure in the person’s area of residence. The results of these analyses were similar to the results of the main analysis.

Overall, these analyses provided evidence for the effectiveness of a fourth vaccine dose against severe illness caused by the omicron variant, as compared with a third dose administered more than 4 months earlier. For confirmed infection, a fourth dose appeared to provide only short-term protection and a modest absolute benefit. Several reports have indicated that the protection against hospital admission conferred by a third dose given more than 3 months earlier is substantially lower against the omicron variant than the protection of a fresh third dose against hospital admission for illness caused by the B.1.617.2 (delta) variant.1,10,11 In our study, a fourth dose appeared to increase the protection against severe illness relative to three doses that were administered more than 4 months earlier.

Covid infections in Britain are rising again, and 90 percent of the dead are vaccinated. Have mRNA jabs ruined our chance at herd immunity?

Authors: Alex Berenson

New figures from Britain raise bright red flags about the direction of Covid in wealthy countries that used mRNA and DNA shots to attempt to defeat the coronavirus last year.

Hospitalizations and deaths remain stubbornly high and overwhelmingly occur in vaccinated people. In February, 90 percent of the 1,000 Britons who died each week of Covid were vaccinated.

New infections are not only far higher than they were before the Omicron variant emerged, they are rising again after a brief fall in February. And even boosters appear to offer no protection against hospitalizations in younger people.

British data are crucial both because Britain vaccinated and boosted early and because its datasets are far more complete and less politicized than those in the United States.

Day by day, week by week, the figures are becoming more worrisome. They hint that mRNA and DNA shots may have slowed if not completely halted the natural progression to herd immunity that occurred in earlier respiratory virus epidemics.

In fact, Britain now reports 99 percent of adults have antibodies to Covid, mostly as the result of vaccination. That level is far higher than epidemiologists believed would be necessary to support herd immunity. Yet Covid infections, hospitalizations, and deaths continue unabated. Almost 12,000 Britons are now hospitalized with Covid, more than at this time last year.

The most stunning chart is this one. Each week the British government releases a “surveillance report” which includes Covid deaths by vaccine status.


In the four weeks ending February 27, 397 unvaccinated Britons died of Covid, compared to 3,512 who were vaccinated. Using a broader definition, which may include more incidental deaths unrelated to Covid infections, the numbers are even worse, with 5,871 vaccinated people dying compared to 570 unvaccinated. (The United States does not publicly provide this data; it is not even clear American public health authorities collect it comprehensively.)

The report also shows for the first time that adults under 50 are now just as likely to be hospitalized for Covid whether they are boosted or unvaccinated. The report does not provide a similar hospitalization estimate for people who were vaccinated but unboosted, but based on the raw numbers it does provide, those rates are the highest of all.

Meanwhile, new Covid infections have nearly doubled in Britain in the last two weeks, and now top 60,000 a day. British media outlets have connected the rise to Britain’s “freedom day” on Feb. 24, which marked the legal end of Covid restrictions.

But Britain had already been moving toward normality throughout February, and cases were falling sharply. It is not clear that the legal end to restrictions made much difference behaviorally.

Britain is not alone.

Though elite media outlets have sharply deemphasized reporting on Covid, the epidemic continues unabated in advanced countries. In Europe and the United States, overall death and hospitalization rates remain high as the epidemic enters its third spring. Meanwhile, in South Korea and Japan, which largely avoided serious problems before mRNA vaccinations and the Omicron variant, infections are soaring and deaths following.

In contrast, many poorer countries that used older “inactivated virus” vaccines, or have low overall vaccination rates, have seen their coronavirus epidemics progress in a more traditional pattern.

Infections have risen and then fallen rapidly in distinct seasonal waves. Omicron has not caused off-the-charts spikes in new infections – probably because previous immunity from natural infection is far broader and more valuable against Omicron than vaccine-generated protection.

Here’s India, for example:

India no doubt undertests for Covid cases compared to Western countries, but the pattern is clear. Meanwhile, with a population one-twentieth as large, Britain now has more reported Covid deaths, more than 10 times as many infections, and shows no signs of emerging from its epidemic.


When the mRNA jabs began to become available in December 2020, vaccine advocates predicted that poor countries that lacked access to them would face the misery of unceasing Covid epidemics, while wealthy nations would emerge quickly.

Public Health Scotland COVID-19 Winter Statistical Report

As at 17January 2022 Publication date: 19 January 2022

The latest public health data published by the Scottish Government reveals that the COVID-19 “age-standardized case rate” is at its highest among the double-jabbed ‘fully vaccinated’ – and it isn’t particularly close.

The update also showed the sharp negative efficiency was maintained throughout double vaccinated rates for hospitalizations and deaths over the past four weeks.


Since the start of the Coronavirus-19 (COVID-19) outbreak Public Health Scotland (PHS) has been working closely with Scottish Government and health and care colleagues in supporting the surveillance and monitoring of COVID-19 amongst the population. As part of our continuous review of reporting, as of 08 December 2021 Public Health Scotland has implemented changes to the COVID-19 Weekly Report to support the reader in drawing insights from a wider range of existing metrics around COVID-19 and winter pressures.

Caution should be used when making comparisons between metrics; each metric is calculated independently and may cover different time periods or cohorts of the population. The consolidated report will include the following content weekly: COVID-19

• Summary of tests and cases
• Contact Tracing
• Hospital and ICU admissions
• Testing in care homes
• COVID-19 vaccination status cases, hospitalisations and deaths
• Covid-19 vaccination uptake summary
• Ad-hoc reporting on topics such as: Covid-19 and Vaccination in pregnancy, Equality
reporting etc.

Hospital/ Wider System Pressures

• Unscheduled Care
• Waiting Times
• Delayed Discharges

Additional charts for a number of variables related to COVID-19 service use in the NHS, including some metrics previously presented in the weekly COVID-19 report, are available to view in our interactive dashboard. These include breakdowns by age, sex and deprivation. The variables currently available on the dashboard include:

• Positive cases per day and cumulative total
• COVID-19 hospital admissions
• COVID-19 patients admitted to ICU admissions
• COVID-19 related contacts to NHS24 and the Coronavirus Helpline
• Community Hubs and Assessment Centers
• Scottish Ambulance Service incidents
• Contact tracing
• Health care workers
• Care homes
• Targeted community testing
• Travel outside of Scotland
• Quarantine Statistics
• NHS Protect Scotland App
• Lateral Flow Device (LFD) Testing 5

The Public Health Scotland COVID-19 Daily Dashboard publishes daily updates on the number of positive cases of COVID-19 in Scotland, with charts showing the trend since the start of the outbreak. From 26 February 2021 the Daily Dashboard also includes daily updates on vaccinations for COVID-19 in Scotland.

There is a large amount of data being regularly published regarding COVID-19 (for example, Coronavirus in Scotland – Scottish Government and Deaths involving coronavirus in Scotland – National Records of Scotland). This report complements the range of existing data currently available.

To View The Current COVID-19 Report for Scotland Click Link Below:

COVID-19 vaccine surveillance report Week 3

Latest UK Data Shows Covid Infection RATE Among the Triple Jabbed (Boosted) Is HIGHER And RISING FASTER Than The Unvaccinated Across ALMOST EVERY Age Group

20 January 2022

Executive summary
Four coronavirus (COVID-19) vaccines have now been approved for use in the UK. Rigorous
clinical trials have been undertaken to understand the immune response, safety profile and
efficacy of these vaccines as part of the regulatory process. Ongoing monitoring of the vaccines
as they are rolled out in the population is important to continually ensure that clinical and public health guidance on the vaccination program is built upon the best available evidence. UK Health Security Agency (UKHSA), formerly Public Health England (PHE), works closely with the Medicines and Healthcare Regulatory Agency (MHRA), NHS England, and other government, devolved administration and academic partners to monitor the COVID-19 vaccination program. Details of the vaccine surveillance strategy are set on the page COVID-19: vaccine surveillance strategy (1). As with all vaccines, the safety of COVID-19 vaccines is continuously being monitored by the MHRA. They conclude that overall, the benefits of COVID-19 vaccines outweigh any potential risks (2).

Vaccine effectiveness

Several studies of vaccine effectiveness have been conducted in the UK against different
COVID-19 variants. Vaccine effectiveness against symptomatic disease with the Omicron
variant is substantially lower than against the Delta variant, with rapid waning. However,
protection against hospitalisation remains high, particularly after 3 doses.

Population impact

The impact of the vaccination program on the population is assessed by taking into account
vaccine coverage, evidence on vaccine effectiveness and the latest COVID-19 disease surveillance indicators. Vaccine coverage tells us about the proportion of the population that have received 1, 2 and 3 doses of COVID-19 vaccines. By 16 January 2022, the overall vaccine uptake in England for dose 1 was 68.9% and for dose 2 was 63.6%. Overall vaccine uptake in England in people with at least 3 doses was 48.4%. In line with the program rollout, coverage is highest in the oldest age groups.

We present data on COVID-19 cases, hospitalizations and deaths by vaccination status. These
raw data should not be used to estimate vaccine effectiveness as the data does not take into account inherent biases present such as differences in risk, behavior and testing in the
vaccinated and unvaccinated populations. Vaccine effectiveness is measured in other ways as
detailed in the ‘Vaccine Effectiveness’ section. Based on antibody testing of blood donors, 98.7% of the adult population now have antibodies to COVID-19 from either infection or vaccination compared to 24.1% that have antibodies from infection alone.

COVID-19 vaccine surveillance report – week 3- 4

Vaccine effectiveness

Large clinical trials have been undertaken for each of the COVID-19 vaccines approved in the
UK which found that they are highly efficacious at preventing symptomatic disease in the
populations that were studied. The clinical trials have been designed to be able to assess the
efficacy of the vaccine against laboratory confirmed symptomatic disease with a relatively short follow up period so that effective vaccines can be introduced as rapidly as possible. Post implementation real world vaccine effectiveness studies are needed to understand vaccine effectiveness against different outcomes (such as severe disease and onwards transmission), effectiveness in different subgroups of the population and against different variants as well as to understand the duration of protection. Vaccine effectiveness is estimated by comparing rates of disease in vaccinated individuals to rates in unvaccinated individuals.

Below we outline the latest real-world evidence on vaccine effectiveness from studies in UK
populations. Where available we focus on data related to the Omicron variant which is currently dominant in the UK. The findings are also summarized in Table 2.

Effectiveness against symptomatic disease

Vaccine effectiveness against symptomatic COVID-19 has been assessed in England based on
community testing data linked to vaccination data from the National Immunisation Management
System (NIMS), cohort studies such as the COVID Infection Survey and GP electronic health
record data. After 2 doses of AstraZeneca vaccine, vaccine effectiveness against the Omicron
variant starts at 45 to 50% then drops to almost no effect from 20 weeks after the second dose.
With 2 doses of Pfizer or Moderna effectiveness dropped from around 65 to 70% down to
around 10% by 20 weeks after the 2nd dose. 2 to 4 weeks after a booster dose of either the
Pfizer or Moderna vaccine, effectiveness ranges from around 65 to 75%, dropping to 55 to 65%
at 5 to 9 weeks and 45 to 50% from 10+ weeks after the booster. Vaccine effectiveness
estimates for the booster dose are very similar, irrespective of the primary course received (3).
Vaccine effectiveness is generally slightly higher in younger compared to older age groups.

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