David Wallace-Wells writes:

In mid-September, King County, Washington, in which ­Seattle is located, released an eye-popping slide about vaccine efficacy and breakthrough prevalence: Vaccines had reduced the risk of infection from COVID sevenfold, county data showed, and reduced the risk of hospitalization and death 41-fold and 42-fold, respectively.

These ratios, though bigger than those found in other studies released in recent weeks, are nevertheless in line with an obvious emerging consensus in the data: Vaccines do clearly reduce transmission and dramatically reduce hospitalizations and deaths, making the threat of severe outcomes to the vaccinated much more like the risk associated with other, far more quotidian diseases. A recent Centers for Disease Control and Prevention study of Los Angeles found a 29-fold reduction in hospitalization from vaccines early this summer, for instance, and another quasi-national study suggested an average 11-fold reduction in mortality risk overall.

But in small type, King County included some other data that paint what seems at first blush like a very different picture: Fully 25 percent of deaths were among vaccinated people, the county reported. How can this be? If the vaccines are so effective that they reduce mortality 42 times over, how could the vaccinated account for such a large proportion of the deaths? The answer is actually quite simple: the overwhelming age skew of the disease, which — in the time of vaccines, breakthrough cases, and Delta — we are still, as a public, hugely underestimating and which is governing the post-­vaccine pandemic landscape as clearly as it did the pre-vaccine landscape. And while encouraging further vaccination remains by far the best tool we have in fighting the pandemic to an endgame détente, we should also be clear along the way about the continuing risks to the vaccinated elderly and what might be done to protect them. [Continue reading…]