Steve Valeika DVM PhD
@zoonotic1.bsky.social
DVM (UGA 01) | PhD (UNC 08) | Small Animal Vet | Recovering Academic | Infectious Disease Epi | ID and Public Health consultant for the Veterinary Information Network | Board member for Buncombe County Health Dept. | Family Guy | Son of an immigrant
both scales of measurement are important to report, and they give different information about individual and population level effects. Just like we teach in the first couple of weeks of every intro epi class… 4/4
February 15, 2026 at 3:27 PM
both scales of measurement are important to report, and they give different information about individual and population level effects. Just like we teach in the first couple of weeks of every intro epi class… 4/4
But, increasing the efficacy of the vaccine by 26% is still a very large relative effect on performance. Certainly makes a difference to individuals, especially high risk. And could increase vax rates because poor efficacy is a common reason people skip the vaccine. Circling back to my first comment
February 15, 2026 at 3:27 PM
But, increasing the efficacy of the vaccine by 26% is still a very large relative effect on performance. Certainly makes a difference to individuals, especially high risk. And could increase vax rates because poor efficacy is a common reason people skip the vaccine. Circling back to my first comment
The most I can assume is that based on results, risk of infection is 3% in vaccinated, which is usually about 45% of population. So with absolute risk difference of 1%, we would expect this vaccine to only prevent 44k cases. So maybe absolute public health impact is not massive at current vax rates
February 15, 2026 at 3:27 PM
The most I can assume is that based on results, risk of infection is 3% in vaccinated, which is usually about 45% of population. So with absolute risk difference of 1%, we would expect this vaccine to only prevent 44k cases. So maybe absolute public health impact is not massive at current vax rates
Actually I made an incorrect assumption. I don’t know what the reductions in death would be because the baseline risk for that would be deaths in those vaccinated with the standard vaccine, not total deaths. So the impact on deaths will be lower. 1/4
February 15, 2026 at 3:27 PM
Actually I made an incorrect assumption. I don’t know what the reductions in death would be because the baseline risk for that would be deaths in those vaccinated with the standard vaccine, not total deaths. So the impact on deaths will be lower. 1/4
Totally agree. I replied with the below screenshot to the post you deleted. (And I do realize that the punishment for ignoring the public health impact of absolute measures of effect is a beating with the old Rothman and Greenland before they slimmed it down. 😂)
February 14, 2026 at 10:59 PM
Totally agree. I replied with the below screenshot to the post you deleted. (And I do realize that the punishment for ignoring the public health impact of absolute measures of effect is a beating with the old Rothman and Greenland before they slimmed it down. 😂)
Didn’t take it as an argument against absolute effects. Clearly both scales as well as knowledge of baseline rate is going to give the clearest picture.
February 14, 2026 at 10:54 PM
Didn’t take it as an argument against absolute effects. Clearly both scales as well as knowledge of baseline rate is going to give the clearest picture.
Ahh. Gotcha. I took it to be an argument in context about Mandrola focusing on what most people would think is a negligible absolute difference of <1%, ignoring that this would actually have a big impact on flu. And that the relative effect of VE is super important to report as well.
February 14, 2026 at 10:54 PM
Ahh. Gotcha. I took it to be an argument in context about Mandrola focusing on what most people would think is a negligible absolute difference of <1%, ignoring that this would actually have a big impact on flu. And that the relative effect of VE is super important to report as well.
I’m not arguing against the risk difference. But 26% fewer influenza deaths, so somewhere between 8-10k deaths, seems like a win to me.
February 14, 2026 at 10:40 PM
I’m not arguing against the risk difference. But 26% fewer influenza deaths, so somewhere between 8-10k deaths, seems like a win to me.
I’m talking specifically about flu
February 14, 2026 at 10:37 PM
I’m talking specifically about flu
Great point. Both measures give useful information, and they can mean different things at individual vs population level. Potentially 26% (likely higher) fewer flu deaths is a big impact and massive public health win.
February 14, 2026 at 10:15 PM
Great point. Both measures give useful information, and they can mean different things at individual vs population level. Potentially 26% (likely higher) fewer flu deaths is a big impact and massive public health win.
It’s because they think that 100% of the harms from the pandemic were from the response rather than the virus. And not just the public health response, but the response of HCW’s who put their lives on the line too. And also 👇
It’s extra crazy because if they were to truly institute an actual plan of focused protection a la GBD, it would require an incredibly complex and granular level of detail and planning—beyond them just saying the words “focused protection” over and over with no actionable details.
February 13, 2026 at 8:28 PM
It’s because they think that 100% of the harms from the pandemic were from the response rather than the virus. And not just the public health response, but the response of HCW’s who put their lives on the line too. And also 👇
It’s extra crazy because if they were to truly institute an actual plan of focused protection a la GBD, it would require an incredibly complex and granular level of detail and planning—beyond them just saying the words “focused protection” over and over with no actionable details.
February 13, 2026 at 8:19 PM
It’s extra crazy because if they were to truly institute an actual plan of focused protection a la GBD, it would require an incredibly complex and granular level of detail and planning—beyond them just saying the words “focused protection” over and over with no actionable details.
It would be refreshing if he was talking about his past addictions in explicit terms, how he overcame them, and how he is using his position to help others recover. Instead this administration has massively cut evidence-based treatments, and he is stating this to further his germ theory denialism.
February 13, 2026 at 2:31 PM
It would be refreshing if he was talking about his past addictions in explicit terms, how he overcame them, and how he is using his position to help others recover. Instead this administration has massively cut evidence-based treatments, and he is stating this to further his germ theory denialism.
Glad you got the reference. In the hundreds of arrested development gifs available none were from that one.
February 12, 2026 at 6:15 PM
Glad you got the reference. In the hundreds of arrested development gifs available none were from that one.
Needs either a codpiece or Jean shorts to be authentic.
February 12, 2026 at 6:07 PM
Needs either a codpiece or Jean shorts to be authentic.
Yeah. For 20 years the only “new developments” were things like 1/2 ml vaccines or the transdermal FeLv vaccine that you shot into cats with a device that sounded like a gunshot. Pure hype. That’s why I’m kind of psyched about this one. It’s actually new.
February 12, 2026 at 4:28 PM
Yeah. For 20 years the only “new developments” were things like 1/2 ml vaccines or the transdermal FeLv vaccine that you shot into cats with a device that sounded like a gunshot. Pure hype. That’s why I’m kind of psyched about this one. It’s actually new.
Spell check changed “transfect” to “transfer” up there.
February 12, 2026 at 2:55 PM
Spell check changed “transfect” to “transfer” up there.
Finally, you can use the replicon without packaging it in a viral vector at all. It can be packaged in LNPs, endosomes etc. the saRNA means that a single replicon generates up to 10^6 copies of the gene. Rabies vaccine was immunizing with 1 ug of LNP-replicon in a human trial.
February 12, 2026 at 2:54 PM
Finally, you can use the replicon without packaging it in a viral vector at all. It can be packaged in LNPs, endosomes etc. the saRNA means that a single replicon generates up to 10^6 copies of the gene. Rabies vaccine was immunizing with 1 ug of LNP-replicon in a human trial.
…on a single plasmid, there were rare instances of the VSPs and GOI swapping leading to replication competent vectors. Doesn’t happen with the 2 plasmid method. Also, the VSPs are from an attenuated VEEV strain that is already used as a vaccine in horses. 2/3
February 12, 2026 at 2:54 PM
…on a single plasmid, there were rare instances of the VSPs and GOI swapping leading to replication competent vectors. Doesn’t happen with the 2 plasmid method. Also, the VSPs are from an attenuated VEEV strain that is already used as a vaccine in horses. 2/3
They’ve been studying these since 1987. The replication issue is pretty well worked out. They transfer cells with two plasmids, one with the replicon (polymerase plus GOI), the other with vital structural proteins. Magic of molecular biology creates non replicating vector. When they put everything…
February 12, 2026 at 2:54 PM
They’ve been studying these since 1987. The replication issue is pretty well worked out. They transfer cells with two plasmids, one with the replicon (polymerase plus GOI), the other with vital structural proteins. Magic of molecular biology creates non replicating vector. When they put everything…