Relative Risk Reduction (RRR) versus Absolute Risk Reduction (ARR) & Number Needed to Treat (NNT); example shows how FDA, CDC, NIH, Fauci, Francis Collins, Bourla (Pfizer), Bancel (Moderna) misled us
by Paul Alexander
These people in pharma, for drugs and vaccine etc. and the alphabet agencies lie e.g. FDA, on the benefits of drugs and medical devices and vaccine etc. They lie to you the public using RRR & not ARR
There is an important distinction between RRR and ARR and the vaccine makers and CDC and FDA uses this to deceive you in your decision making. Allows the FDA and Pfizer etc. to claim either drug or vaccine makes no real difference in absolute terms but is very substantial in relative terms, but you NEED the absolute difference. NOT relative difference. So you are misled every single day by these pharma and FDA and CDC liars! When you take the harms and toxicity and costs (if prohibitive) and burden of taking a drug etc. and it is too high compared to a modest (very small absolute benefit e.g. a drug may result in a reduction in stroke of 0.2% yet drug may cause intestinal bleeds, so a small benefit yet with a harm that you may not place high value on and may not want to experience), you will likely opt not to take it. This is why they lie to you by stating the relative difference which really is the difference in two numbers relative to each other. That is all. You must ask always ‘is the benefit they report worth the cost’? And you need the ARR to make that judgement. Not the inflated RRR.
So for the Pfizer vaccine, they got EUA based on a declared RRR of 95% but ARR of 0.7%. A 0.7% ARR is not that impressive, correct? But you did not know this. It was hidden from you. Moreover, it is way more nuanced than that for this risk gets even small (or benefit) when you tease the data apart by subgroups who have differential risk of course, age-groups have differential risk too in terms of acquiring COVID. So you cannot even report the RRR is 95%, you need to give that data by groups and age-bands etc. The vaccine makers did not do this and FDA did not demand this. We were deliberately deceived. We need always age-risk stratified results for optimal trustworthy informed decision-making. For example, in young children and teens etc., the ARR will be very very negligible as their risk is very low. ARR risk also may differ by setting, geography etc.
There were roughly 20,000 subjects in the vaccine arm and placebo control arm each of the Pfizer trial (initial legacy trial) and I believe roughly similar for Moderna. There were 162 events reported in the placebo arm in Pfizer trial and 8 events in the vaccine arm for a RRR of 95%. Pfizer and FDA and CDC only presented the RRR of 95%. Yet this was 0.7% for the ARR which I will show you how you get this shortly.
Let’s say we have a disease in the population with a baseline risk of 0.0002% and a drug A reduces that baseline risk to 0.0001%, then the RRR versus the ARR is as follows:
RRR= (baseline (or control rate) - event (experimental rate) / baseline (or control rate)) x 100% =
(0.0002 - 0.0001 /0.0002) x 100 = 50%
ARR = baseline (or control rate) - event (experimental rate) =
0.0002-0.0001 = 0.0001%
Thus the RRR is 50% and the ARR is 0.0001%
But 0.0001% ARR means almost nothing to you and you will likely say not interested in that drug. The benefit is so small. But you are never told this ARR, you were told the 50% RRR and you said ‘hey, that’s so large, I want that drug’.
Same RRR result if we used 2% baseline and experimental is 1%, then this will be RRR of 50% and ARR now of 1% (RRR = (2-1/2) x 100% =50%, ARR = 2-1=1%). Same RRR but ARR differs as it is the absolute difference.
Point is that we do not need to know the RRR which is the reduction in two numbers relative to each other, and the ARR is the absolute difference. We needed to know the latter, ARR. We also may use the number needed to treat (NNT) to help in interpretation of the benefit or harms and the NNT = 100/ARR
In short, you want the NNT to be as close to 1 as possible e.g. you would treat 1 person with drug to get the desired effect (benefit e.g. save a life) and not 1 million to save one person so to speak.
So if we used the example of 0.0002% as baseline, then on average, 1,000,000 patients would have to receive experimental treatment (instead of control treatment) for one additional patient to NOT have the study outcome (100/ARR of 0.0001).
If we used the example of 2% as baseline example, then 100 patients would have to receive experimental treatment (instead of control treatment) for one additional patient to NOT have the study outcome (100/1).
Bottom line is RRR should not be used as Pfizer and Moderna did and CDC and NIH and Fauci et al. have done. They knew that if the ARR which is the correct measure was presented, then no one would want the vaccine with an ARR of 0.7% with a NNT of 100/0.7% = 142
So we were lied to by Bourla (CEO) of Pfizer, Bancel (CEO) of Moderna, Fauci, Redfield, Hahn, Francis Collins, Walensky, Marks, Woodcock, Birx etc., it is that simple.