In retrospect, it was probably a mistake to take off the mask. But what are you going to do? David Flint and his wife had to visit her father in the Bronx. Flint’s wife is her father’s home health assistant, and the older man has just returned home from foot surgery. For over an hour, they all sat there around the bed – Flint, his wife and his sister-in-law. It’s a long time to wear a mask if it’s not all. “After a while, I picked it up,” Flint said.
Flint has already been vaccinated against COVID-19, so he assumed he would be immune. As a social worker in New York who provides home care services to dying people, he was one of the first people in the country to receive the vaccine. When he sat down in his father-in-law’s bedroom on January 19, he was completely vaccinated for a week. The odds were in his favor.
But the odds are fickle. In a game of chance, not everyone can win, even if the chances of winning are great. Flint rolled … and he lost on January 25, diagnosed with a mostly symptomatic case of COVID-19. This in itself was not a shock. He knew that some people would still get the virus, despite the vaccination. Even the famous “95 percent effectiveness” of mRNA was really a measure of how well the vaccines are prevented symptomatic incidents. But Flint did not expect to be one of the people who slipped through the cracks. More importantly, however, he expected someone to care. “I thought there would be a mechanism,” he said. But no one asked him about his vaccine status when he was tested. There was nowhere to submit the information to his doctor. And that was the part that Flint confused. “Doesn’t anyone want to know?” he asked.
Yep, they have to. And they do. Efforts are already underway to gather information that will help scientists understand how effective COVID-19 vaccines are in the real world. But “How well do vaccines work?” and “Should we count every vaccinated person who catches the disease?” are two different questions.
This complication begins with some basic facts about the efficacy of the Pfizer and Moderna vaccines currently available in the US. According to scientists, there is a difference between “effectiveness” and “effectiveness”. Efficiency is the 95 percent figure you get from a clinical trial. The effectiveness is the number if you vaccinate millions more people, some of whom will be older or sicker or more exposed to a virus than participants in the experiment. It is a measure that covers all the turmoil of real life, including that vaccines will not always be administered in the ideal ways, said dr. Kelly Moore, deputy director of the Immunization Action Coalition, said. Prevention to inform the public about vaccines. ‘You have people who forget to come back for a second dose or let you come back. “Maybe there’s a dosing error or a storage problem,” she said. And this is even before you start researching whether new variants such as the B.1.1.7 – which was originally found in the UK, but which is expected to be dominant in the US in March – are more resistant to the vaccines than the variants against which the vaccinations were tested back in the fall.
The CDC will monitor actual COVID-19 vaccine efficacy in multiple studies and use different methodologies at different sites at different times. Some studies – such as one that follows groups of vaccinated and vaccinated healthcare professionals over time – are already underway.
Other studies are just off the ground. One CDC effort will use an existing system created to track the effectiveness of flu vaccines. At five medical research centers – in Michigan, Pennsylvania, Texas, Washington and Wisconsin – every person who comes with a cough or other respiratory symptoms can become a participant. All will be tested for COVID-19. Those who test positive are the cases; those who test negative become the controls. Researchers will then compare the vaccination rate between the two groups. However, these studies have only just begun because you can not study the vaccine until people actually start getting it.
‘This is only possible when the vaccine is rolled out to larger sections of the population. Wash only now in Wisconsin, ”said dr. Ed Belongia, director of the Marshfield Clinic Research Institute’s Center for Clinical Epidemiology and Population Health – the Wisconsin flu vaccine effectiveness research center – said on Feb. 11. “You can not learn anything if only 1 percent of the population is vaccinated. ”
The CDC follows several approaches to this, because the real world has something that is easier to control in a clinical trial: randomization. Unlike in the lab, you can not choose people to get the vaccine while you are denying it. In addition, people do not just randomly report for clinical trials, and this affects the results. People who want to participate in a study may in some ways differ from the population as a whole. Doing different types of studies comparing groups in different ways can reduce the uncertainty in the overall results.
But none of these efforts will study the efficacy of the vaccine by counting all the cases like Flint. There is CDC research has aimed to do this, but it is not about the efficacy of the vaccine. Instead, the project, a partnership with state health departments, is intended to see trends in who the vaccine is is not work for.
The methods to detect the effectiveness of the vaccine are not new, even if the virus is. Scientists are studying the effectiveness of the vaccine after the introduction for each new vaccine that comes out, says dr. Katherine Fleming-Dutra, a member of the vaccine efficacy and evaluation team in the CDC’s COVID-19 response. And that research is very important for the prevention of diseases.
As part of an effort to eradicate measles in the United States, for example, scientists began following the decades-old vaccination against measles in the 1980s. According to Walter Orenstein, professor and co-director of the Emory Vaccine Center at Emory University, they learned that one dose of this vaccine does not cut it. In 1989, the CDC and the American Academy of Pediatrics began recommending that everyone receive two doses. If you did not look closely, it would have been easy to miss that a second dose was needed. The first dose of measles vaccine is 93 percent effective. But the disease spread so easily and quickly that 93 percent were not completely well enough, Orenstein said. With the second dose, the vaccine becomes 97 percent effective in preventing measles.
The flu vaccine, meanwhile, goes through this process annually. Therefore, there is the network of research centers for the CDC to study COVID-19. The system shows the results of the effectiveness of flu vaccine twice a year, and preliminary results can be compiled with as little as a month or two of data. But that does not mean we will have results on COVID-19 vaccines so quickly. Since the entire public health system has struggled to explain over the past year, the flu and COVID-19 are not the same animal – and no one I spoke to was willing to estimate how long the results for COVID-19 will last. does not last.
This is because a number of complications will make it more difficult (and possibly longer) to do the same types of studies for COVID-19. The seasonal flu, for example, has predictable annual checkpoints at this point. Vaccines begin to roll out in the fall. In December or January, as the flu cases really started to increase, everyone who was going to be vaccinated was, and the proportion of Americans who were vaccinated is about the same from year to year. With COVID-19, scientists are looking at a disease that has a high incidence in some places and not in others, as well as introducing brand new vaccines.
There are other challenges to detecting the effectiveness of COVID-19 vaccines, says Emily Martin, professor of epidemiology at the University of Michigan and co-director of the Michigan Influenza Center. The flu networks have long trusted people to come to a doctor about their breathing symptoms. This is where they are enrolled for the studies. But the expansion of COVID-19 tests has largely taken place outside of doctors’ offices, and those test centers leave a record of negative (or positive) diagnoses or not.
When the information finally comes in, it will likely show us that David Flint did not contract COVID-19 alone after receiving two doses of the vaccine. But these studies can also bring good news. This is because the most delicious of vaccines is: “How well does it work?” is not just about individuals. For example, when researchers studied the effectiveness of pneumococcal vaccines, they found that the disease rate falls among older people, even if only children are vaccinated. This is because children were the main carriers of the disease. Once they stopped contracting it, so did their grandparents.
And vaccine effectiveness is not just about how many people are positive. One thing we have learned from flu vaccine studies is that the vaccine can reduce the severity of the disease, even if you still catch it after vaccination. These studies will help us to find out what is also going on with COVID-19. Things like that matter. After all, when Flint got COVID-19, he just had a sore throat. However, his non-vaccinated relatives were worse off.