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This is a brilliant insight into vaccine efficacy. A recent COVID vaccine appeared to have 43% efficacy, but in reality had 71%. Efficacy was underestimated because vaccines both prevent asymptomatic infections and convert symptomatic to asymptomatic infections!
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medRxiv
@medrxivpreprint
Vaccine efficacy against naturally asymptomatic infections: A novel estimand for quantifying vaccine effects medrxiv.org/cgi/content/sh #medRxiv