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COVID-19 vaccine “95% e ective”: It
doesn’t mean what you think it Your e-mail here Subscribe

means!
Posted on December 15, 2020 by Learning Machines in R bloggers | 0 Comments

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When people read this many assume that it means that
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journalists get it wrong! If you want to understand what it
COVID-19 vaccine “95% e ective”: It doesn’t
really means, read on!
mean what you think it means!

Let us take the example of the German biotech company R – Sorting a data frame by the contents of a

BioNTech which developed its mRNA vaccine BNT162b2 in column

cooperation with pharmaceutical giant P zer. First of all,

let me make it very clear that this is an extraordinary Sponsors
achievement and I am hopeful that it will prove to be a real game-changer in the ght
against this horrible virus. I stress this because nowadays you cannot be cautious
enough not to be instrumentalized by all kinds of strange people who have an interest in
downplaying this devastating pandemic.

Now, what does a so-called e cacy rate of 95% mean? Let me start by stating what it
doesn’t mean: it doesn’t mean that 95 out of 100 vaccinated persons will be protected
from COVID-19, nor does it mean that it will reduce the severity of the illness in case you
contract the virus despite being vaccinated.

To understand the real meaning let us go through the press release of P zer:

Primary e cacy analysis demonstrates BNT162b2 to be 95% e ective against COVID-

19 beginning 28 days after the rst dose;170 con rmed cases of COVID-19 were
evaluated, with 162 observed in the placebo group versus 8 in the vaccine group

What P zer did was to select about 43,000 voluntary participants where about half
received the vaccine and the other half (= the control group) received only a placebo,
without any active substance. After about a month after the rst dose (i.e. one week
after the second dose), they started to count the number of con rmed COVID-19 cases
for each group: in the placebo group 162 cases were con rmed, whereas in the vaccine
group only 8 cases appeared.

To get to the 95%-number the following calculation was performed:

(1 - 8/162) * 100
## [1] 95.06173

So the 95% is the relative risk-reduction in infections, it doesn’t tell us the absolute
probability of not getting infected despite being vaccinated!

We already covered relative vs. absolute risk reductions (and its dangers) in this blog.
There we saw that personograph plots (also called Kuiper-Marshall plots) are an excellent
way to communicate risks.

Let us start by illustrating the con rmed COVID-19 cases in the placebo (= control) group
for a better manageable group size of 2,500…

library(personograph) # first install from CRAN

## Loading required package: grImport
## Loading required package: grid
## Loading required package: XML

n <- 2500
inf_wo_vac <- 20 / n

data <- list(first = inf_wo_vac, second = 1-inf_wo_vac)

personograph(data, colors = list(first = "red", second = "lightgrey"),
fig.title = "20 of 2500 infected without vaccine",
draw.legend = FALSE, n.icons = n, dimensions = c(25, 100),
plot.width = 0.97)

…and now for the vaccine group of the same size:

inf_w_vac <- 1 / n

data <- list(first = inf_w_vac, second = 1-inf_w_vac)

personograph(data, colors = list(first = "red", second = "lightgrey"),
fig.title = "1 of 2500 infected despite of vaccine",
draw.legend = FALSE, n.icons = n, dimensions = c(25, 100),
plot.width = 0.97)

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I think that those plots really put matters in perspective.

The main problem is that vaccine studies cannot directly measure what we really want to
know: the e ectiveness of the vaccine in the real world, i.e. how well it protects us from
contracting the disease. Therefore they use e cacy as a proxy instead, i.e. relative risk-
reduction of infections in the two study groups. This can give a good indication of the
order of magnitude of the real-world e ect but is not the same!

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