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Curious and Concerned's avatar

Sayer, let me see if I properly understood how the average person would get a grasp on the true value of the vaccine in the paper you cited. You wrote, “The relative risk reduction is 46%. The absolute risk reduction is five one-thousandths of one percent. These are the same number, expressed two different ways, and one of them is systematically chosen for the headline while the other is systematically buried.”

You are saying that the Absolute Risk Reduction (ARR) is the proper statistic to use to show the clinical value of the outcome. (That’s what I understand; and the math is pretty simple).

For the untrained, how is the NNT (Number Needed to Treat) calculated, that is, the number of individuals that you need to treat to achieve a clinical benefit for one person? Per the Medical Advisory Board website, The NNT is calculated by taking the inverse of the Absolute Risk Reduction (ARR). The formula is: NNT = 1/ARR.

The figures for the ARR in the paper you are discussing are:

The ARR is calculated as 5/1000 x 1/100 or .005 x .01 = 0.00005

Then the NNT is calculated as 1/.00005 = 20,000

So the bottom line would be this. You would need to vaccinate 20,000 individuals to avoid or eliminate one case of the cancer being studied. This number is so high that it begs the question of how valuable, how reliable and how significant the reduction of HPV infection actually is.

To take a next step from what you offered…For the real social value, you would have to weigh this “benefit” to one person against adverse events caused by the vaccine in all of those 20,000 individuals. Are those events even tracked? In theory they should be. On top of that, so many other factors can come into play in a test subject’s life over such a long trial period that it’s incredibly difficult to say that only the vaccine and the virus are important factors. And that is nearly impossible.

Did I get this right?

JLE's avatar

The powers that be just keep on sucking...

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