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Great to see that vaccine hawks are alive and well, at least!
The western vaccine studies are exactly as trustworthy as the Chinese ones, for exactly the same reasons -- nobody has yet been able to suggest to me a convincing mechanism by which a vaccine does ~nothing to prevent infection and yet is significantly protective against severe outcomes. Are you up for that?
Yes, science has an answer for that: protection against severe outcomes appears to be mainly due to T cells, which take too long to react to an infection to clamp it down enough to never be detectable. T cells react to infected cells so there's no mechanism for them to prevent an infection, but when we say "prevent infection" we actually mean "prevent detectable infection", so it's imaginable that some T cell-virus interaction could fit that definition, although that does not seem to ever be the case for SARS-CoV-2 and other human coronaviruses. (I haven't listened to the episode yet, but a recent paper found that some people's T cells are effective enough to significantly decrease the chance they will get symptoms from SARS-CoV-2.) Antibodies and memory B cells (which produce antibodies after detecting a previously seen infection) are also involved and may be more important in other viruses---and are easier to study so they get more press---but do not appear to be the primary part of the immune system preventing severe disease from SARS-CoV-2, although the short boost in antibodies from the vaccines are what caused the temporary protection from infection that was observed with the vaccines.
My information comes from listening to the podcast This Week in Virology, which is a group of virology researchers discussing papers. Specifically, you can look in their archives for episodes tagged t cells. Although it's a podcast, each episode has a summary page of what was discussed and links to the papers. They recommend using the YouTube speech-to-text feature if you want a transcript.
But the original vaccine worked fairly well at preventing infection by the original strain -- the antibodies/b-cells/t-cells/whatnot all recognized the spike protein produced when you ingested the vaccine, provoking an immune response that made you less likely to get noticeably sick at all. (although the impact on transmission is up for debate I guess)
Why does this aspect not work anymore with Omicron? Why does the updated vaccine not work the same way? Why are other vaccines not like this?
Seemingly-unrelated-but-actually-quite-relevant question: Why do you find the Chinese vaccine efficacy statistics untrustworthy?
Multiple comments in this thread were taking for granted that all official information out of China is a lie. I was assuming we were including their vaccine studies in that. It seemed simpler to just cut out that part of the discussion.
There's at least two things going on here:
Because the protection from infection was always a misinterpretation of the data (I haven't actually listened to them but there's TWiV T cell episodes dated August 2020 and they've been patting themselves on the back for getting the story right from the start). It's a little complicated because there's two separate things going on at the same time that can be difficult to disentangle: the virus is changing over time and protection from infection (which only applies to a sufficiently similar virus anyway) decreases over time.
Antibodies are the reason why once you've gotten a virus, your immune system actually clears it out completely (for most viruses, if your immune system is actually functioning right) and you don't get that virus again soon. But antibody levels fall quickly (on the order of months). Maybe not to zero, but to low enough that within about 3-6 months, they're no longer high enough to protect you from infection by a coronavirus. A likely evolutionary explanation for this is that many viruses mutate fairly quickly, so keeping the antibodies around for an old version of a virus is not super useful (it's also possible antibodies against coronaviruses specifically go away faster because the immune system somehow recognizes it as virus likely to mutate, but that's purely speculation my part). The balance is that the immune system keeps around memory B cells which can ramp up production of known antibodies if a sufficiently similar infection is detected, but that takes on the order of days to produce a significant level of antibodies.
For the first about two years of the pandemic (i.e. pre-Omicron), SARS-CoV-2 didn't mutate to evade immunity much, probably because it had plenty of naive hosts to target, so there was limited selection pressure for immune evasion, so antibodies against the original strain in the vaccine remained fairly effective, but, importantly, this was irrelevant 3-6 months after a person's most recent vaccine dose / significant virus exposure, since those antibodies would have gone away by then. So the initial 90%+ protection from infection numbers were on people who were very recently vaccinated with a strain closely matching the circulating strain. Now there both are multiple circulating strains and they are changing too quickly to develop and distribute a vaccine before it changes enough that the vaccine effectiveness against infection would be significantly reduced. Additionally, Omicron seems to actually be better at evading the immune system, not just better at evading immune memory from insufficiently similar strains of SARS-CoV-2, so the best case is not as good.
The bivalent vaccines did provide some protection from infection: see this study (mentioned briefly in this episode of TWiV) which found it reduced the chance of a PCR positive when BA.4/5 (i.e. the strain it was targeted against) was dominant by 29%, when BQ was dominant by 20% (but with the 95% confidence interval going down to 6%), and when XBB was dominant not at all. So, uh, it's doing something, but nothing to write home about, even if you were somehow able to come up with a new vaccine every 3 months, 29% protection from infection just isn't worth it, especially when protection from severe disease remains strong.
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