For the majority of people who are not physicians or epidemiologists, the COVID-19 vaccine among other things has brought on new challenges in terminology.
Lesson 1: Efficacy and effectiveness are not the same thing.
Efficacy is the degree to which a vaccine prevents disease and this is key under ideal and controlled conditions like in clinical trials when youre comparing a vaccinated group to a placebo group. You have very defined and selected populations, said Dr. Russell Faust, Oakland County Medical Director.
Effectiveness is how the vaccine protects in the real world.
Now were talking hundreds of thousands or millions vaccinated, were talking anybody goes except its 16 and up right now. Were talking wide demographics, wide geographic areas, wide geographic areas with other endemic diseases, other endemic viruses, were talking about different countries, were talking about people taking different medications, who have different diseases and different ailments, Faust said. Were talking about observational study now in the real world. This is effectiveness.
In most cases when people sign up for a vaccine they are unsure of whether it will be Pfizer, Moderna or Johnson & Johnson. Vaccine shopping is not recommended most specialists agree that any of the three are good.
If you Google any of the three you will find different numbers for efficacy and effectiveness. Dont let your head spin.
On Monday, the Centers for Disease Control and Prevention released some of the first real-world evidence that mRNA vaccines like Pfizer and Moderna are 90% effective at preventing COVID-19 infections, even asymptomatic cases.
The CDC study featured data from nearly 4,000 healthcare workers, first responders, and essential workers across six U.S. states. By getting both vaccine doses (and then allowing those shots two more weeks to take effect) they were about 90% less likely to catch COVID-19, despite their continued, consistent exposure to the coronavirus on the job.
Lets be really clear about this. Everybody wants 100% effectiveness. Thats what you want, thats what I want. I want to get a vaccine where in the real world the success rate of it, the effectiveness is, 100% to guarantee I'm never going to get this disease, Faust said.
That is not going to happen.
Even vaccines that have what would be considered low effectiveness in the real world prevent deaths of hundreds of thousands of people every year, according to Faust.
The flu vaccine is only 40-50% effective in the real world, but it saves tens of thousands of lives in the U.S. alone, maybe hundreds of thousands, Faust said. Even with a 40% or 50% or 60% effectiveness in the real world, I would be delighted. If I get a 20-percent effective flu vaccine in a year I'm jumping for joy.
There are some years that the flu vaccine is not even 20% effective.
So while it may sound good that the COVID-19 vaccines reached 90% or 95% or 97% efficacy in trials, it is not the real world.
What I really care about in public health is I care about the effectiveness of a vaccine of keeping people from being severely infected where theyre transmitting to others and being admitted to the hospitals and ending up in the ICU, Faust said. I care about that where were shutting down our hospitals remember last March, April, May a year ago it was like warzone medicine. Thats what I care about. If a vaccine prevents that and I can keep people alive thats what I care about the most.
The Pfizer and Moderna vaccines are over 90% effective against severe COVID-19 disease. Johnson & Johnson is over 85% effective in preventing severe COVID-19 disease, according to Faust.
That doesnt mean Johnson & Johnson is a lesser vaccine. Pfizer and Moderna ran their clinical trials almost a year ago when there were no variants.
When were comparing the published numbers were talking apples and oranges because of the different clinical trial times and honestly theyre different clinical trials. Not only different times but Johnson & Johnson went out of their way to run clinical trials in places where variants were known to be popping up, Faust said. I see that as very forward thinking, very progressive and frankly noble that they would stick their necks out like that and expose themselves to a potential failure its totally possible those clinical trials would show horrible results because they knew the variant was everywhere and yet they did very well.
So basically the effectiveness of the three vaccines is about the same.
If one is 90% effective that means once a person is fully vaccinated that the chances of catching the virus are about 10%.
In other words, its much safer to be vaccinated, yet still theres a chance of getting COVID. Thats why masks and social distancing remain important.
No theyre not 100% safe. You cant be fully vaccinated and go out and throw caution to the wind, Faust said. Were in the 25th mile of a 26-mile marathon. This is not the time to stop running. This is not the time to get crazy and get yourself exposed and get sick.
Whats needed to get back to normal is herd immunity. Faust prefers the term community immunity since, after all, we are not cows.
We need to vaccinate as many people as possible, as rapidly possible. Its not just the U.S., also as much of the global population vaccinated as possible, he said.
Understand even if were 100% vaccinated across the U.S. and the rest of the world is unvaccinated, every time someone gets infected with this virus it is mutating. During an active infection, variants are being produced. The risk is that as infections continue around the world the risk is there may be a variant that pops up that is frankly unaffected by your vaccine immunity or by your immunity if youve already had COVID-19, Faust said.
A variant may pop up thats completely immune to your vaccines and then we start all over again wildfire pandemic moving through our population. We need everybody vaccinated to put a stop to this pandemic, he added.
And then he offered a reminder.
We can also do it with masks, this is not rocket science. We can stop transmission person to person by wearing masks and distancing. Yes, I want to get everybody vaccinated so we can go back to a normal life but you know we can also put an end to this pandemic simply by wearing masks and distancing, Faust said.
Scaling Up Covid-19 Vaccination in Africa Lessons from the HIV Pandemic | NEJM nejm.org
A national survey shows 4 out of 5 unvaccinated Maine adults still plan to get the COVID-19 vaccine, one of the highest rates among states and a positive sign as the state hopes to achieve population-level immunity from the deadly virus.
The survey, conducted by the U.S. Census Bureau over two weeks in early March, suggests demand for the vaccine in Maine remains high even though state officials raised concerns this week about some appointments going unfilled after Maines vaccine supply increased.
Overall, just shy of 80 percent of Maine adults surveyed who had not yet received the vaccine said they definitely or probably would get it, compared to only 73.5 percent of unvaccinated adults nationally. Maine was 10th in the nation as rates varied widely by state, ranging from as high as 88 percent in Massachusetts and Vermont to as low as 46 percent in Wyoming.
The survey found the most enthusiasm in the youngest and oldest Maine adults. About 85 percent of unvaccinated Mainers under the age of 40 said they definitely or probably planned to get the vaccine. The most hesitant group was Mainers between the ages of 40-54, only 53 percent of whom said they would definitely get the vaccine while 17 percent said they would definitely not.
Maines vaccine rollout has largely been based on age, so many of the older people enthusiastic about the vaccine have already had the chance to get it. The state extended eligibility to people in their 50s last week. Teachers and child care workers are also eligible to be vaccinated now, while all adults over the age of 16 are set to become eligible April 19.
As of Wednesday, more than 426,000 first doses of the Moderna and Pfizer vaccines had been administered in Maine, along with nearly 266,000 second doses and Johnson & Johnson vaccines.
There is not yet scientific consensus on what share of the population needs to be vaccinated to achieve so-called herd immunity for coronavirus, though most estimates have suggested it is at least 70 percent, which would require 950,000 Mainers to be fully vaccinated. If it were 80 percent, the number would be closer to 1.1 million Mainers or the states entire adult population, as a vaccine has not yet been approved for use in children younger than 16.
Among Mainers who said they were probably or definitely not going to get vaccinated, the most commonly cited reason was concern about side effects, followed by distrust of the government or vaccines. Experts agree that the side effects of the vaccine such injection site soreness, chills, fatigue and a low-grade fever are mild compared to symptoms of the coronavirus. Severe allergic reactions to the vaccine are extremely rare, and providers in Maine monitor patients after each dose to ensure treatment can be administered in the event of a reaction.
Nirav Shah, director of the Maine Center for Disease Control and Prevention, encouraged Mainers in their 50s to get vaccinated on Tuesday after the state received a record 68,000 doses, leaving many appointments unfilled this week. Maines supply is expected to increase again next week, although federal allocations to pharmacies are not yet known.
Shah noted that the unfilled appointments did not necessarily reflect hesitancy, but could be due to a mismatch between when and where vaccines were available and peoples schedules, noting Mainers in their 50s are more likely to be working during the week compared to previously eligible groups.
NASHVILLE, Tenn. (WKRN) Should you be required to get a COVID-19 vaccination? Thats the question lawmakers are debating.
Its a conversation happening around the world and Tennessee is now advancing a bill that would restrict governmental entities from requiring a coronavirus shot.
Were not here to argue whether or not vaccines are good or bad were not here to argue the science behind COVID, were simply saying we are against a government mandate to a medical treatment especially without a religious exemption, said Gary Humble, organizer of the rally.
Currently, there is not a requirement for COVID-19 shots to be taken in Tennessee.
The approved U.S. vaccines have shown the doses are effective against severe illness and death.
The amended bill passed the Senate Health and Welfare committee by a party line vote 8-1.
The supply of Covid-19 vaccines in the U.S. is increasing with each week, and the pace of vaccinations is picking up. States are opening up eligibility for the vaccines sooner, too, allowing more Americans an opportunity to get the shot.
And yet with so many people getting vaccinatednearly 30% of all Americans have had at least one shot, according to the Centers for Disease Control and Preventionthe number of new Covid-19 cases is on the rise.
Nationally, the seven-day average in cases has risen in recent weeks from over 53,000 cases a day to 65,000 cases. Thats down from the peak in early January, when the number of cases being recorded was more than 250,000, according to a Wall Street Journal analysis of Johns Hopkins University data. But an average of 65,000 cases is still considered high by epidemiologists, and is close to the height of the countrys second surge in July of 2020.
Federal officials have for weeks cautioned about a fourth surge of infections, saying that the U.S. is on a path to follow some other European countries that have seen recent spikes. CDC Director Rochelle Walensky spoke about her recurring feeling of impending doom at a White House press briefing Monday.
In interviews with epidemiologists and public-health officials across the country, common themes emerged that explain the rise in cases. Many cited a mixture of increase in infections among younger people, pandemic fatigue, mixed messaging on public-health measures with the rollback of restrictions, and the spread of more contagious variants.
MADISON, Wis. (WBAY, WEAU) - 3 out of 10 people in the state of Wisconsin have received a COVID-19 vaccine.
The latest data from the Wisconsin Department of Health Services show 1,765,007 Wisconsin residents have received at least one dose, which is 38,488 more than reported the day before.
These include 1,040,039 people who are fully vaccinated, which is 26,426 more people since Tuesdays report. These can include vaccinations over the past couple days as vaccinators reports are still coming in to the DHS.
In all, vaccinators in the state have administered 2,813,475 shots of the Pfizer, Moderna or Johnson & Johnson vaccines.
By our calculations, the state is averaging 53,572 shots a day over the past 7 days (the record 7-day average set last week is 55,790 shots per day).
Percentages that received and completed their vaccinations so far, by age group:
Wednesday, the Wisconsin Supreme Court ruled the Evers administration exceeded its authorities with continual health emergencies during the COVID-19 pandemic, effectively striking down the statewide mask mandate (see related story). However, masks can still be required in municipalities that issued their own mask orders and in private businesses, including stores and restaurants (see related story).
Health officials says we cant led our guard down yet against the coronavirus. Wearing masks -- which have to be over the nose -- maintain 6 feet from anyone who isnt from your household, even visiting friends and relatives; and wash your hands more frequently or use sanitizer.
Tuesday, Gov. Evers announced everyone age 16 and older will be eligible for the vaccine starting next week on April 5, regardless of health condition or where they work. Making more teens and young adults eligible for the vaccine could help against virus outbreaks weve seen in our area and nationwide blamed on people of high school and college age getting together without wearing a face mask over their nose or social distancing. While these age groups are less likely to suffer serious effects of the coronavirus developing into COVID-19, they can be asymptomatic and spread the disease to more vulnerable people.
WEDNESDAYS VACCINATION TOTALS
WISCONSIN ALLOCATED: 3,002,745 ADMINISTERED: 2,813,475
PFIZER: 1,484,696 MODERNA: 1,269,862 JOHNSON & JOHNSON: 58,791
FIRST DOSE: 1,765,007 (30.3%) FULLY VACCINATED: 1,040,039 (17.9%)
EAU CLAIRE CO. FIRST DOSE: 34,169 (32.7%) FULLY VACCINATED: 23,218 (22.2%)
CHIPPEWA CO. FIRST DOSE: 19,869 (30.7%) FULLY VACCINATED: 12,965 (20.1%)
LA CROSSE CO. FIRST DOSE: 41,580 (35.2%) FULLY VACCINATED: 25,313 (21.4%)
DUNN CO. FIRST DOSE: 11,016 (24.3%) FULLY VACCINATED: 6,947 (15.3%)
CASES AND DEATHS
The Department of Health Services (DHS) reported 10 more deaths from COVID-19, the second straight day in double digits. The 7-day average held steady at 4 because eight days ago there were also 10 deaths which are no longer counted in the average. The death rate has been 1.15% of coronavirus cases for over three weeks.
Wisconsin reported an astounding 17,539 coronavirus test results, the first time weve seen testing over 10,000 since February 25, and the most results in a single day since November 21. We dont know the reason for the state having this many test results at this time. These only include people who are being tested for the first time or tested positive for the first time.
There were 563 positive tests in that batch, which is a mere 3.21% of the results.
Wisconsins average for new cases fell to 471, after rising to 501 yesterday, because last week Tuesdays 776 new cases are no longer counted in that 7-day average.
New cases were found in 57 of Wisconsins 72 counties. Another two counties (Forest and Kewaunee) had their case numbers revised.
New deaths were reported in Dodge, Kenosha, Lincoln, Milwaukee, Outagamie, Washington and Waukesha counties. The state revised death totals in Racine County.
The positivity rates 7-day average looking at all tests, including people whove been tested multiple times, held at 2.8% for a second day. Its been rising since March 11 after it reached a low of 2.0%.
Since February 5, 2020, the state reports:
County-by-county case and death totals will be updated later in this article.
HOSPITAL READINESS
Within the past 24 hours, the DHS says 67 people were admitted for COVID-19, two more than Tuesday. The 7-day average is 49 new COVID-19 patients per day. The state says 4.8% of all coronavirus cases have resulted in hospitalization.
According to the Wisconsin Hospital Association (WHA), there are 233 currently hospitalized COVID-19 patients in 136 hospitals across the state, a decrease of 17 from Tuesday. There are 59 in ICU, which is seven fewer in the ICU than the day before. Changes in daily hospitalizations take discharges and deaths into account.
WEDNESDAYS COUNTY CASE AND DEATH UPDATES (counties with new cases or deaths are indicated in bold) *
Wisconsin
Adams 1,626 cases (+3) (10 deaths)
Ashland 1,200 cases (+2) (16 deaths)
Barron 5,524 cases (+7) (76 deaths)
Bayfield - 1,079 cases (19 deaths)
Brown 30,695 cases (+31) (232 deaths)
Buffalo 1,327 cases (+1) (7 deaths)
Burnett 1,232 cases (+2) (22 deaths)
Calumet 5,601 (+5) (46 deaths)
Chippewa 7,183 cases (+6) (93 deaths)
Clark 3,168 cases (+1) (58 deaths)
Columbia 5,176 cases (+4) (56 deaths)
Crawford 1,677 cases (17 deaths)
Dane 42,069 (+32) (288 deaths)
Dodge 11,558 cases (+2) (159 deaths) (+1)
Door 2,522 cases (+8) (21 deaths)
Douglas 3,750 cases (30 deaths)
Dunn 4,394 cases (+11) (30 deaths)
Eau Claire 11,247 cases (+20) (105 deaths)
Florence - 430 cases (12 deaths)
Fond du Lac 12,082 cases (+9) (104 deaths)
Forest - 936 cases (State revised, decrease of 1) (23 deaths)
Grant 4,737 cases (+9) (83 deaths)
Green 3,364 cases (+11) (16 deaths)
Green Lake - 1,536 cases (18 deaths)
Iowa - 1,952 cases (+2) (11 deaths)
Iron - 567 cases (21 deaths)
Jackson - 2,579 cases (+1) (26 deaths)
Jefferson 8,047 cases (+11) (105 deaths)
Juneau - 3,038 cases (21 deaths)
Kenosha 14,974 cases (+5) (304 deaths) (+1)
Kewaunee 2,304 cases (cases revised -2 by state) (24 deaths)
La Crosse 12,412 cases (+6) (80 deaths)
Lafayette - 1,499 cases (+2) (6 deaths)
Langlade - 1,943 cases (+1) (32 deaths)
Lincoln 2,947 cases (+3) (60 deaths) (+2)
Manitowoc 7,359 cases (+3) (68 deaths)
Marathon 13,886 cases (+14) (184 deaths)
Marinette - 4,001 cases (+1) (65 deaths)
Marquette 1,328 cases (21 deaths)
Menominee - 789 cases (11 deaths)
Milwaukee 100,722 (+116) (1,260 deaths) (+2)
Monroe 4,378 cases (+1) (34 deaths)
Oconto 4,314 cases (49 deaths)
Oneida - 3,502 cases (+4) (69 deaths)
Outagamie 19,884 cases (+28) (199 deaths) (+1)
Ozaukee 7,854 cases (+6) (81 deaths)
Pepin 817 cases (+1) (7 deaths)
Pierce 3,621 cases (+4) (35 deaths)
Polk 4,029 cases (+2) (44 deaths)
Portage 6,542 cases (+3) (66 deaths)
Price 1,175 cases (+1) (7 deaths)
Racine 20,673 cases (+13) (336 deaths) (State revised, decrease of 1)
Richland - 1,272 cases (15 deaths)
Rock 14,782 cases (+19) (164 deaths)
Rusk - 1,273 cases (16 deaths)
Sauk 5,483 cases (+8) (44 deaths)
Sawyer - 1,571 cases (+5) (23 deaths)
Shawano 4,607 cases (+1) (69 deaths)
Sheboygan 13,264 cases (+21) (133 deaths)
St. Croix 6,775 cases (+18) (47 deaths)
Taylor - 1,810 cases (+5) (23 deaths)
Trempealeau 3,460 cases (+2) (38 deaths)
Vernon 1,875 cases (38 deaths)
Vilas - 2,193 cases (39 deaths)
Walworth 9,043 cases (+12) (135 deaths)
Washburn 1,354 cases (+4) (18 deaths)
Washington 14,065 cases (+7) (141 deaths) (+2)
Waukesha 42,031 cases (+56) (501 deaths) (+2)
A list of available vaccine providers will pop up, with links to contact each one. Keep in mind that different providers use different methods to sign up people for vaccine appointments. If a person encounters a process that seems confusing or time consuming, they can try another provider.
DENVER Starting Friday, anyone over 16 in Colorado can get a COVID-19 vaccine.
For many, that vaccination will provide a path to normalcy and a pre-pandemic way of life.
However, many are wondering whether businesses will be able to require proof of vaccination.
Everyone wants to feel safe and this is the easiest way to prove that, said Steve Herr, the General Manager of the Staples store in Glendale.
Herrs store has been busy laminating COVID-19 vaccination cards. Staples stores nationwide are offering the service free of charge right now.
Today it was probably close to 45 of them alone, he said.
Airlines, stadiums, and cruise ships could soon start requiring proof of vaccination. Even Red Rocks has explored the idea.
I think the industry as a whole is looking at how this might play out, explained Brian Kitts, with Denver Arts and Venues. Bluntly though, I dont think theres enough time or technology to get this going for this season.
However, implementing such a system is easier said than done.
Christian Hadigree is the Dean of the School of hospitality at Metropolitan State University in Denver.
She believes airlines and many foreign countries will likely start requiring proof of vaccination, especially for international travel, but says implementing such a system is easier said than done, especially at restaurants, stadiums, and in the workplace.
In the United States I cant see Kansas saying you have to have a passport to come to our state. I also think were going to see lawsuits. When are you infringing on rights to privacy? Do I have a right to be out in public engaging in these services? We are the freest country on the planet and the more you try to limit that, the more challenges youll have from the population as a whole,Hadigree said.
