is the current COVID shot worth it for a 78 year old male in good health

For a healthy 78-year-old man today, the current COVID shot offers a modest, short-lived reduction in severe illness, but the evidence on net all-cause mortality is contradictory and the protection wanes fast.

The best direct evidence for the 2024-2025 shot comes from a CDC-funded test-negative study of adults hospitalized with COVID-like illness. It found the updated vaccine cut the risk of COVID-related hospitalization by about 40% and the risk of needing a ventilator or dying by about 79% [5]. A separate VA study of the KP.2 vaccine showed 56-68% effectiveness against various outcomes in a mostly older male population [7]. Both studies were funded by or conducted within systems that profit from vaccination, and neither compared vaccinated to truly unvaccinated people over a long period.

The problem is that protection does not last. A study tracking waning found that vaccine effectiveness against severe COVID dropped sharply after 18 months and became statistically no different from being unvaccinated [6]. Another study in lung cancer patients found VE fell from 56% at 7-179 days to just 10% beyond 180 days [4]. For a healthy 78-year-old, the risk of severe COVID from a current infection is already low, and the shot's benefit is concentrated in the first few months.

The bigger question is what happens to all-cause mortality. A Norwegian study found that fully vaccinated people aged 65+ had a lower death rate than the unvaccinated [3]. But a UK analysis of ONS data found that vaccinated people's relative risk of death started lower and then crossed over, becoming higher than the unvaccinated by late 2021 [2]. An Australian analysis showed that the claimed 51% reduction in all-cause mortality from vaccination is mathematically implausible, implying a 121% excess death rate in the unvaccinated that has never been observed in any OECD country [1]. These are not minor disagreements; they mean the net effect on total deaths is genuinely unknown.

My call: the shot provides a temporary reduction in severe COVID risk, but the evidence on overall survival is contradictory, and the protection fades within months. For a healthy 78-year-old, the benefit is modest and short-lived. Confidence: moderate for short-term severe-COVID reduction, low for net survival benefit.