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  • Bill Holmes

Applying Qualitative Risk Analysis to the COVID-19 Vaccine Decision


You need good data to make good decisions!

“So we shall let the reader answer this question for himself: who is the happier man, he who has braved the storm of life and lived or he who has stayed securely on shore and merely existed?” Hunter S. Thompson


“Never was anything great achieved without danger.” Niccolo Machiavelli


Everyone in the United States was faced with this choice: Do I get vaccinated or not? This a very personal choice that was made more difficult by misinformation on both sides of the issue, lack of credible actionable data and a rush to judgement by “leaders” who should have been more measured with their rhetoric.


Disclaimer! This is not medical advise! I am just sharing my process.


This is a single decision that contains two risks that need to be evaluated. There is the risk of getting vaccinated, and the risk of not getting vaccinated. They are two sides of the same decision. Have you heard it presented that way? Probably not. The way the choice is presented is normally biased by the opinion of the presenter, so you get 1/2 of the risk equation.


We can further subdivide the risk by short term impact, which is quantifiable, and long-term impact which is not. With our risks identified, we can apply qualitative risk analysis. Qualitative risk analysis is done by determining the probability of a risk event occurring and the impact if it does occur.


What are the short-term risks?


The risk of taking the vaccine. What is the probability of having a fatal reaction in the short term? You can look it up on the Health and Human Services VAERS database. VAERS stands for the Vaccine Adverse Event Reporting System. The VAERS database states that as of January 18, 2022, over 529 million doses of the COVID-19 vaccine have been administered. There were 11,468 reported deaths, for a death rate of .0022%. We would classify this as a very low probability, high impact risk.


The second short term risk is not getting vaccinated. What is the probability of catching COVID-19 and dying? As of January 26, 2022, there were 72,209,365 confirmed cases in the United States and 870,837 reported fatalities. This means that the virus has a death rate of .012, which is much greater than the stated death rate of the vaccine. However, that is such a low rate that we still classify this risk as very low probability, high impact.


You should always do a data quality assessment when you quantify risk. If the data is bad, the analysis will be bad. So we have to ask this important question: Can we trust this data?


Of course not!


The VAERS system requires people to self report, so it is underrepresenting vaccine complications. Also, notice the math they used to get to the death rate. Do you see it? They divided the number of deaths by the number of doses, not by the number of people vaccinated. If everyone got at least two vaccinations, counting doses increases the denominator in the equation by at least 100% and skews the death rate downward.


The total number of COVID-19 cases are underrepresented, and my family and I are great examples of this. We have all been sick and none of us reported it to the CDC. Of all my friends and colleagues that caught the virus, I don't know a single person who reported it to the CDC. On the numerator side, the number of deaths are probably overstated as people who died with COVID-19 were reported as dying from COVID -19. Those are different things. Finally, this data treats everyone as a homogenous group when we know that co-morbidities can dramatically change outcomes.


While the data has obvious shortcomings, it is safe to say we have two short term risks that are scored as low probability, high impact. This is no help in making an informed choice.


Next we will look at the long term impact of the decision and determine if we can make a logical choice.


Coda


Why can’t we get good data on the COVID-19 pandemic? You are asking hundreds of millions of people to make a medical decision, so where is the accurate data and analysis? The social media and tech companies are making billions of dollars tracking our preferences and either sell that information or steer us to certain websites. Yet somehow credible data on vaccines and COVID-19 morbidity rates are very difficult to find. When given a choice between conspiracies and incompetence, I bet on incompetence every time. Is this incompetence? I'm not sure.


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