I'm still trying to decide if "severe adverse events" from the Pfizer vaccine or "severe COVID" is worse. There is a 4:1 ratio that spooks me. According to the study protocol (page 373 of the PDF), "severe COVID" didn't require hospitalization, only a positive lab test, fatigue or nasal congestion, plus HR >= 125 bpm. It can also be worse, but frequency probably clusters at the mild end. In the follow-up study (Appendix, Table S3) there were 112 more severe adverse events for the vaccine vs. the placebo, and 29 fewer cases of severe COVID. I'd rather have HR >= 125 bpm and some fever than any of the side effects in their severe form (pain, redness, swelling, fever, fatigue, headache, chills, vomiting, diarrhea). The 4:1 odds make this trade-off even worse. I've heard the counter argument from an MD that she sees a lot more COVID patients in the hospital than ones with vaccine side effects. But maybe the side-effects are just attributable less clearly to the vaccine, or people are more likely to tough them out?

Protocol from here: https://www.nejm.org/doi/full/10.1056/NEJMoa2034577 Other data from the supplement: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1