5,000-year Life-Expectancy needed for COVID injections to be cost-effective in Children
Re-analysis with updated data
In a previous Substack, I estimated that kids would need to live for 600 years in order to make COVID injections cost-effective for them as a means of saving a life-year at a cost which is not over twice the median personal income.
It turns out I was wrong, and by a lot.
The actual remaining life that kids would need to have, in order for COVID injections to be cost-effective medically, is in the thousands.
Here are the steps to find out if an intervention is cost-effective:
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estimate disease spread (e.g., annual incidence among those susceptible)
estimate disease lethality/virulence (e.g., infection fatality rate)
estimate the absolute risk reduction (untreated vs. treated), or ARR
get a number needed to treat (NNT) or number needed to vaccinate (NNV) to prevent the occurrence of one adverse outcome, such as death
estimate the cost of getting the treatment out to people so as to save a year of life
compare that “cost-per-life-year-saved” to twice the personal income
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Vaccine effectiveness against severe symptoms is lower in kids than in adults, and after the second month, drops to 20% to 40%:
In terms of severe outcomes, such as hospitalization (or death), vaccine effectiveness is below 40% after Month 4 post-dose:
If a vaccine schedule were one dose per year, average vaccine effectiveness against hospitalization would be far below 40%. If a vaccine schedule were one dose every 6 months, then average protection against hospitalization would be around 40%:
Using those two levels of average protection, along with new data on the COVID IFR, you can crudely estimate the number you’d need to vaccinate to prevent one death:
[click image above to enlarge it]
In the annual schedule, spread was assumed to be 25%, a 25% annual attack rate. But with 12-months between doses, average vaccine effectiveness against severe outcomes such as hospitalization and death is estimated from CDC data at only 20%
In the 6-month schedule, spread is reduced by half and vaccine effectiveness is doubled — so that the differences wash out, and it leads to the very same NNV.
This means — under the assumptions about spread, IFR, and vaccine effectiveness — that it costs about $333 million in childhood vaccines to save a life, which is possibly the least cost-effective medicine which has ever been used on a wide scale.
After finding out how many myocarditis cases you’d get in 6.7 million injections (ie, what it takes to save a life) — and assuming that just under 1% of myocarditis cases are fatal — then you’d have negative efficacy.
You’d have a “treatment” which causes “net harm” to those who take it. Further sensitivity analysis regarding changes in the spread, IFR, and vaccine effectiveness will be forthcoming.
Note: This is the kind of analysis which should have been performed by the CDC before they voted to put COVID injections on the childhood immunization schedule. It appears that regulators have been captured by private interests, and that that has prevented the CDC from doing the right thing.
Reference
[CDC presentation showing that vaccine effectiveness is always below 40% before 150 days post-dose (before 5 months have passed since your last dose)] — Updates on COVID-19 Vaccine Effectiveness during Omicron. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-09-01/04-covid-link-gelles-508.pdf
[new study showing that COVID was never worse than bad flu for the non-elderly] — Age-stratified infection fatality rate of COVID-19 in the non-elderly informed
from pre-vaccination national seroprevalence studies. https://www.medrxiv.org/content/10.1101/2022.10.11.22280963v1.full.pdf
[study showing how to properly estimate cost-effectiveness for medical interventions (use twice the income as the cutoff cost for saving a life-year)] — Economic foundations of cost-effectiveness analysis. https://pubmed.ncbi.nlm.nih.gov/10167341/
[median household income is $71,000] — U.S. Census Bureau, Median Household Income in the United States [MEHOINUSA646N], retrieved from FRED, Federal Reserve Bank of St. Louis; https://fred.stlouisfed.org/series/MEHOINUSA646N
[128 million total US households] — U.S. Census Bureau, Total Households [TTLHH], retrieved from FRED, Federal Reserve Bank of St. Louis; https://fred.stlouisfed.org/series/TTLHH
[264 million US civilians (2 per household)] — U.S. Bureau of Labor Statistics, Population Level [CNP16OV], retrieved from FRED, Federal Reserve Bank of St. Louis; https://fred.stlouisfed.org/series/CNP16OV
[evidence-based medical practice requires estimation/publication of ARR] — Using absolute risk reduction to guide the equitable distribution of COVID-19 vaccines. https://ebm.bmj.com/content/ebmed/early/2022/03/27/bmjebm-2021-111789.full.pdf