Will there be a new SARS-COV2 variant by mid-2023 against which 3 doses of Pfizer's BNT162b2 barely reduces death rates?

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resolved Jul 4

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The market will resolve YES if, by 30 June 2023, there is a new strain of SARS-CoV-2 that:

1. Is estimated to have caused >1 million cases globally.

2. The WHO does not classify as a sub-type of an existing variant (e.g. Omicron).

3. Our best estimate is that a 3-shot regimen of Pfizer's 2020 mRNA vaccine is <10% as effective at preventing death as it was against the Omicron B.1 strain — an effectiveness currently estimated at around 94%.

All 3 conditions will be evaluated by Rob Wiblin using common sense and considering nearby available evidence if necessary (e.g. the effect of Moderna's mRNA vaccine, effect on hospitalization, effect of 4 shots rather than 3, etc).

If uncertain, resolution may be briefly delayed while we wait on relevant research.

Jul 29, 6:45pm: ~~Will there be a new widespread coronavirus variant by mid-2023 that renders Pfizer's original mRNA vaccine largely useless?~~ → Will there be a new SARS-COV2 variant by mid-2023 against which 3 doses of Pfizer's BNT162b2 barely reduces death rates?

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predicted NO

@RobertWiblin: Resolves NO

bought Ṁ10 of YES

Why is "2. The WHO does not classify as a sub-type of an existing variant (e.g. Omicron)." present as a criterion? Surely you care only about vaccine efficacy, not the taxonomy/ancestry of the variant.

@WilliamEhlhardt Second this. What’s the point of that condition?

Is there any evidence the vaccine wasn’t largely useless? Produced almost no change in TFR: https://twitter.com/Humble_Analysis/status/1550277921452896257?s=20&t=y_IbZp0MImboqjjVGKhEAA

Vaccine was released on evidence that it decreased infections for a matter of weeks in healthy middle-aged people. (No evidence for other groups and actually increased mortality. Since then, mortality has been up among under-44s with “unexplained deaths”, down in middle aged, and up in elderly. And consistently trials show sometimes negative efficacy of the vaccine a few quarters out. With again no actual mortality evidence.)

@Gigacasting Then how do you explain this data https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status ?

> Vaccine was released on evidence that it decreased infections for a matter of weeks in healthy middle-aged people. > (No evidence for other groups and actually increased mortality. Uh... https://www.pfizer.com/science/coronavirus/vaccine/about-our-landmark-trial shows a large number of people across age groups, including age 56+, in the trial population. And people talked a lot about vaccine efficacy against severe disease and death. The first study google result I got for vaccine efficacy against death was https://www.cdc.gov/mmwr/volumes/71/wr/mm7112e1.htm which says "VE [Vaccine efficacy] against IMV [invasive mechanical ventilation] or in-hospital death was 90%". The next was https://www.science.org/doi/10.1126/science.abm0620 which says during Delta, "For age <65 years, vaccine effectiveness against death (VE-D) was 81.7%... For age ≥65 years, VE-D was 71.6%." And it says VE-D lowered over time. So I think that's good evidence that vaccines both were highly effective and that the effectiveness reduced moderately over time with the new variants.

predicted NO

Forgot to add this to the first point - https://www.nejm.org/doi/full/10.1056/nejmoa2034577 Table 3 has the data broken down by age groups. It found 90%+ VE in all age groups, although with wider confidence intervals for the very old groups, still clearly effective in 65+.

predicted NO

One more issue, IMO point 1. is meaningless to whether or not a vaccine is useful: if the vaccine does not prevent infection and we end up having one billion cases in 2023, but every single one of those cases is asymptomatic (so 0 deaths and 0 hospitalizations), I would still consider that vaccine very useful. Also, right now cases are very difficult to keep track of and likely underestimated because people are doing tests at home and not reporting them, or not testing, or having less severe infections (due to the vaccine and the current strain) that are not reported. It is much better to state a number of deaths instead of a number of cases.

predicted NO

The terminology "largely useless" might not be the most appropriate. It is very likely that the original vaccine will still provide substantial protection against death if you use it as a booster in the summer of 2023 (let's say more than 50% effective). However, we will probably not be using the original vaccine because we will be using one specialized in Omicron. Therefore people with only a 3-shot regimen of original vaccines by mid-2023 would be people whose last shot was around early 2022 and for whom the vaccine protection has already waned. So conditions 1-3 are asking whether or not we will be requiring an additional booster (perhaps with a modified vaccine) to be well protected. The original vaccine is not "largely useless" as it will likely be fundamental so that you acquire strong immunity with just an extra shot.

predicted NO

@jorge Thanks edited the wording of the headline question

bought Ṁ10 of NO

In point 3 you are saying <10% as effective at preventing death as it was against B.1, current mRNA vaccines are at least 90% effective against death (https://www.cdc.gov/mmwr/volumes/71/wr/mm7112e1.htm), so do you mean vaccine effectiveness of 9% or less? Could you change point 3 and say exactly what would you consider as the effectiveness threshold?