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vaccine-effectiveness

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Estimating vaccine effectiveness from observational data — test-negative designs, cohorts, and bias control.

skills/vaccine-effectiveness/SKILL.md

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## Overview

vaccine-effectiveness covers how to estimate how well vaccines work in the real world (as opposed
to efficacy in trials): the test-negative design, cohort and case-control approaches, and the
biases — confounding by health-seeking behavior, time-varying confounding, depletion of
susceptibles — that make naive estimates misleading.

VE = 1 − (risk in vaccinated / risk in unvaccinated), usually as 1 − odds ratio or 1 − hazard
ratio. Simple formula, treacherous estimation.

## When to use

- Test-negative design studies (the workhorse for influenza, COVID VE).
- Cohort VE studies from EHR/registry data.