While most people believe COVID-19 vaccines are safe and their side effects are now clear, a new HarrisX poll conducted for the Deseret News finds a big partisan difference in how people view COVID-19 vaccine safety and effectiveness.
That finding is part of a larger tale about the divides that marked much of the public reaction to the COVID-19 pandemic and the challenges it posed, particularly in the early days when many people were dying, schools and businesses were closing, jobs were vanishing and public health officials sometimes contradicted not just each other, but even themselves.
While overall 59% of those polled are confident the vaccines are safe and their side effects now known, only 44% of Republicans agree, compared to 78% of Democrats and 53% of independents. The other 56% of Republicans and 22% of Democrats say COVID-19 vaccines are not safe and they may have side effects that havent been revealed.
The survey was fielded March 25-26 by HarrisX and included 1,010 registered U.S. voters. The margin of error is plus or minus 3.1 percentage points.
Public health experts believe confusing messaging built distrust early in the pandemic as the unfamiliar illness was ripping through communities, often with lethal results. And some think public shaming attacking those with whom you disagreed or who questioned mandates like the orders to get a vaccine or else, including if you already had COVID-19 played an oversize role that locked people into largely intractable positions.
Dr. Paul Offit, a pediatrician who directs the Vaccine Education Center at Childrens Hospital in Philadelphia and is a voting member of the National Vaccine Advisory Committee, thinks how closely or whether people followed public health vaccine advice has largely hinged on whether individuals had much interaction with a doctor or the health care system.
People who got the vaccine as a general rule were people who were informed about it, said Offit, who noted many people dont have a lot of interaction with health care providers.
Dr. Leisha Nolen, state epidemiologist in the Utah Department of Health and Human Services, said age also played a role. Older people who were hit hardest in terms of severe COVID-19 were at greater risk of death, and more of them were willing to get vaccines.
Offit said because of Medicare, older Americans were also more likely to have a relationship with a health care provider who could answer questions.
Those who were used to getting flu shots were also probably more apt to be comfortable being vaccinated for COVID-19.
But all the experts consulted for this story believe partisan politics made a difference, too.
Folks who questioned the efficacy of vaccines or asked questions about public health pronouncements were sometimes shouted down. And they, in turn, often belittled others who held a different view.
The problem with shaming, according to Han Kim, a public health professor at Westminster College in Salt Lake City, is its a tool that never worked in public health. It might have short-term benefits, but long term, it can cause a serious breakdown in trust toward not only public health, but toward each other.
Disrespect and disdain for open dialogue came from multiple directions, not all political, Kim said. Public health experts shut down people who questioned what health officials saw as science and authority. Politicians used shaming to drive partisan wedges. And lots of folks simply disagreed with each other, each convinced the other was wrong.
I probably participated in this as much as anybody else, Kim admitted in a recent phone call. That, I regret deeply. I think thats going to be something that were going to live with for a while, because overall trust, not only in vaccines, but in public health, has declined dramatically I think.
He said public health isnt effective without trust in the institutions, and in COVID-19, some trust was breached.
Kim said people often expect public health to know all about diseases. But when something new like this comes along, were trying to figure things out. I think we did an extraordinary job of figuring things out in a very short amount of time with COVID-19. The development of vaccines so fast is a perfect example. At the same time, any sort of mixed message definitely breaks down that institutional trust. And unfortunately, our messaging system was not very robust during COVID.
He points to officials saying masks dont work, then reversing and mandating them, as one example.
Its not a challenge unique to COVID-19. Medical advice changes often as more is learned about diseases. But in a pandemic, with the stakes high and lives on the line, reversals create doubt.
Politics had a big effect, said Offit, noting that while that has long been part of vaccine discussion, COVID-19 raised the pitch. Whats always been there, just never to this extent, is the notion of individual freedoms, personal bodily autonomy, individual rights. I dont want the government telling me what to do. There was enormous political pushback to vaccine mandates.
The mandates were the right thing to do in a public health crisis unfolding in real time, hospitals overrun to the point that nonemergency surgeries were canceled and people were 12 times more likely to be hospitalized or die in 2021 if you werent vaccinated than if you were, Offit said. By 2022, it dropped to six times more likely because there was more natural protection out there, including natural immunity. Look at it from a doctors point of view: Here you are, working double shifts, all hands on deck. People come into the hospital with an option to get a vaccine, which is free and dont yet theyre perfectly willing to avail themselves of the hospital service, the treatment part but not the preventive part.
A mandate should not have been needed, Offit added, but he acknowledges those mandates were tough. People were fired from their jobs.
Nolen, Utahs state epidemiologist, said contradictory public messaging didnt help.
I think there were a lot of things that impacted if people got vaccines and a lot of voices telling them different things, she told the Deseret News. It was really unfortunate we got such confusing messaging from different leaders, different organizations, different community groups. I think it made it hard for people to know who to trust and who to lean to when they were making those choices for themselves and their families.
Utahs version of the national Behavioral Risk Factor Surveillance Survey showed political philosophy had at least some influence on who took the vaccine or planned to, she said. In public health, we really dont want that. We want to do whats right for everybody without political sway to it.
Nolen and Kim both believe that public health experts learned from COVID-19 that how a message is presented really matters. Officials had figured people would follow their advice.
Instead, they learned that public health needs to work with different communities to make sure we talk in a way that resonates with them, that highlights their values. And we all have different values, said Nolen. We all have different risks and to tell someone to just do this because of the science of it isnt going to work. Hopefully, public health has learned through this pandemic that we need to think more actively about how were talking about things to whatever population were talking to.
Another challenge is how the public health system works, Kim said. The Centers for Disease Control and Prevention is set up to provide information, but much power rests with state and local health departments, so sometimes messages are very mixed.
The good news, according to Nolen, is that COVID-19 has been around a while, knowledge has grown and those giving the public message are more clear about the diseases mechanics and what people should know.
Kim agrees. We learn more from our mistakes than from our successes, he said. I wish everyone had more patience and understood science and, again, didnt think so black and white, but it seems to be the environment we live in.
Offit differed with many of his peers on the question of natural immunity for COVID-19. He voted not to mandate vaccines for people whod recently had COVID-19 infection. He was outvoted.
Its certainly true that if youve been naturally infected, youre going to be protected against at least severe disease. Vaccinated or naturally infected or both, you develop an antibody response against at least mild disease for about three to six months. You also develop memory cells: memory B cells which make antibodies and memory T cells which can kill a virus and are much longer lived, he said.
The question then is how much longer lived. A year? Two? 10? I think well find out. Offit said he had three doses of vaccine, the last in November 2021 and had COVID-19 once. He has no health problems, so he figures he has plenty of memory T cells to protect him from severe disease. I dont know how long, but well see.
Experts have long told the Deseret News that not knowing who had COVID-19 unless it was lab confirmed or how long natural immunity lasts drove vaccine mandates. Most people who got sick dealt with it at home without lab confirmation.
Kim sees another issue: One could argue natural immunitys better than vaccine-induced immunity, other than the fact that you actually have to get the disease, which is never a good thing. I would prefer a vaccine than to actually get the disease.
In the poll, more men view the vaccine as safe, the side effects known, compared to women, 62% versus 56%.
The survey also found age differences. The vast majority of people 65 and older view the vaccines as safe (71%). Thats true for 54% of those ages 18-34, 52% of those 35-49 and 59% of those 50-64.
Hispanics in smaller shares are convinced the vaccines are safe and side effects known at 52% compared to both whites and Blacks, which each come in around 60%.
More than two-thirds of those with a four-year college degree or more believe the vaccines are safe, compared to 54% of those with less education.
By income, theres more doubt among people with household incomes below $75,000 (57% say safe) compared to those with higher incomes (62% say safe).
Southerners are more skeptical than other regions of the country. Theyre divided about 50-50, compared to those in the West (67% say safe), Northeast (64%) and Midwest (60%).
The survey found big differences in uptake of vaccines, sometimes based on politics, but more commonly on age. The youngest cohort, 18-34, is more likely to say theyre unvaccinated (29%) than those 65 and older (12%). Overall, 28% of Republicans say they are not vaccinated, comparable to 26% of independents, but a far cry from 12% of Democrats. More women (24%) than men (29%) say they have never had a COVID-19 vaccine. Overall, 28% have never been vaccinated.
About one-third overall got a booster in the past six months.
The survey found 3 of 10 Democrats have had at least four COVID-19 shots, compared to 1 in 4 Independents and 1 in 7 Republicans.
How much of the uptake is really about politics or ideology? Experts admit theyre still not sure, since other factors also made a difference
Nolen said that most public health experts, herself included, expect COVID-19 to move to the flu model, with a seasonal vaccine to protect folks. That depends, of course, on whether there are drastic mutations to the virus that make it more dangerous again.
I think if things continue where its a slower mutation with nothing dramatic, it will be a yearly dose that will be updated for the most recent viruses, she said. If we have a big, dramatic change, we might need to get another booster thats going to be specific to that really dramatic version.
DEAR DR. ROACH, I just read an article stating that the Centers for Disease Control and Prevention is now recommending that seniors 65 and up get an additional COVID vaccine. The article says that the current version is highly effective. I got my last Moderna vaccine in October 2023. Should I get another? -- J.L.I.
ANSWER: The downside of another COVID vaccine is small for the vast majority of people. The benefit is that they can increase their protection against COVID, especially severe COVID, which is the kind that puts people in the hospital.
I strongly recommend another vaccine this spring for those at a high risk, including those who are over 65 with additional risk factors like diabetes, heart, or lung disease, and those who live in a nursing home. The benefit for 65-year-olds who have been fully vaccinated so far and are otherwise healthy is small. People who are considerably older -- in their 80s or more -- would also benefit from an additional vaccine this spring, even if they are otherwise healthy.
The data are becoming clear that an annual vaccine for COVID-19 is effective. While it isnt yet proven, it may be that higher-risk people can benefit from getting vaccines twice a year. In my opinion, those at a very high risk, such as the people I mention above and people with immune system disorders, should take an extra vaccine now.
DEAR DR. ROACH: Would you recommend the most reliable literature source(s) for vitamin and supplement information and interactions? For instance, health magazines give these examples of supplement information:
-- J.L.
ANSWER: The problem with health magazines is that reliable information can be interspersed with information that isnt so reliable. Sometimes a claim is hopeful and based on experimental or animal data; sometimes it is demonstrably false, either by error or to sell an advertisers supplements. For the examples you mention above, vitamin D (D2 or D3) improves absorption of calcium and magnesium, but this doesnt mean that you need them. I dont recommend them unless theyre prescribed.
Piperine absolutely increases the absorption of curcumin, which is the most active ingredient in turmeric. This increases both effectiveness and toxicity. Zinc and iron compete for absorption, so they should not be taken at the same time; if you are deficient, they should be separated. However, neither pine bark nor L-arginine had a benefit on coronary disease in clinical trials.
The first literature source that I recommend is MedlinePlus.gov, which is curated by the National Library of Medicine. It is also part of the National Institutes of Health. Most of the answers above can be found there. Some large institutions, like Johns Hopkins and the Mayo Clinic, have highly reliable information about many medical subjects.
Your local pharmacist is another source, as is your own physician, but some questions require either special expertise or the time and ability to look up the answers.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2022 North America Syndicate Inc.
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Many younger people in high-income New York City neighborhoods accessed COVID-19 vaccinations before they were eligible, risking the lives of older people in low-income areas by pushing them down the queue, according toresearch in the Journal of Urban Health.
Led by researchers at the University of Witwatersrand in South Africa and Columbia University, the study used linked data from the Census Bureau and New York City Health.
Starting on December 14, 2020, New York administered vaccines to high-risk hospital workers, expanding to adults 70 years and older on January 4, 2021, 60 and older on March 10, 50 and older on March 23,and those 30 and older on March 30.
In the first 3 months of COVID-19 vaccine availability, low-income neighborhoods with higher percentages of people 65 years and older had lower vaccine coverage (average vaccination rate, 52.8%; maximum coverage, 67.9%) than higher-income areas (average vaccination rate, 74.6%; maximum coverage in the wealthiest quintile, 99%). Over the year, low-income areas also had higher death rates.
If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.
Despite limited vaccine availability, many younger peopleespecially in high-income neighborhoodsjumped the queue to get vaccinated before they were eligible(average coverage, 60% among residents 45 to 64years in the most affluent quintile).A year later, when vaccines were broadly available, older residents' median vaccine uptake was 87%, including in the poorest area.
"Our analysis provides clear evidence of why U.S. policymakers must target their distribution approach to providing access to lifesaving technologies in short supply, focusing first on those most at risk of severe morbidity and mortality," lead authorNina Schwalbe, of Columbia University, said in a Columbianews release.
The greatest risk factor for COVID-19 death was older age, the authors noted.
"When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups," they wrote. "If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower."
Consumers love having choices, even when it comes to vaccines, according to new research from the University of Oregon.
In studies conducted during the height of the pandemic, researchers found Americans are more willing to vaccinate against COVID-19 if theyre allowed to choose between multiple vaccine brands rather than being assigned to one. As vaccination rates for preventable, infectious diseases like measles decline in the United States, the findings could help improve public health policy and the way that vaccines are presented.
What psychologists call the pleasure of choice may be a simple, though partial, solution to increasing vaccine uptake for many different diseases, saidEllen Peters, director of theCenter for Science Communication Research in UOsSchool of Journalism and Communication. When multiple options exist, people feel empowered if theyre given a choice and, as a result, like the option they chose more than if they didnt have the chance to make the decision themselves.
Thats the scenario we faced with COVID-19 vaccines, said Peters, also a professor in psychology. Whether it's choosing Coke over Pepsi or one outfit over another, there's a pleasure from choosing that causes people to feel more positive about what they get.
Peters and her colleagues conducted two separate online surveys in December 2020 and June 2021 to study Americans real-time perceptions of the COVID-19 vaccines during their authorization and roll-out. Their findings[LO1] published Thursday, April 11, 2024, in theJournal of Applied Research in Memory and Cognition.
Unlike with the common flu shot, Americans had the unusual opportunity to decide between different vaccines for COVID-19, said Brittany Shoots-Reinhard, asenior research associate at the Center for Science Communication Research andresearch assistant professor of psychology at Ohio State University. Multiple pharmaceutical companies were racing to rapidly develop a vaccine, which left room for extensive discussion on the relative merits of the various brands, she said.
To confirm if people were more likely to consider vaccination if given a choice among multiple vaccines, the researchers first surveyed Americans in early December 2020, when the Pfizer COVID-19 vaccine was given emergency-use authorization, with Moderna close behind. They presented all participants with information on both vaccines, including their risks and effectiveness, but half had the option to choose their preferred vaccine while the other half was assigned one.
Of those given a choice, 44 percent of participants reported being likely or certain to get vaccinated compared to 23 percent of those told which one they would get.
The pleasure of choice also seems to encourage vaccination among unvaccinated people. The researchers conducted a similar survey in June 2021, after the Johnson & Johnson vaccine was also authorized, to assess vaccine and booster shot perceptions between unvaccinated and vaccinated individuals. Having a choice among Pfizer, Moderna andJohnson & Johnson vaccines increased vaccine and booster intentions in both groups.
The pleasure of choice is often discussed with consumer products, but its not really something we think about with health care decision-making, Shoots-Reinhard said. There hasn't been a lot of research where you get to choose a vaccine and, in this case, simply being offered one of the better vaccines didnt increase vaccine willingness. It really was offering options and allowing choice that gave vaccination intentions a boost.
The pleasure of choice, however, is not a magic bullet to improving vaccine uptake, the researchers warn.
Highlighting the pleasure of choice is only a partial solution, Peters said. It's not going to be the only thing needed to convince people to get vaccines. But it did work across our studies with vaccinated and unvaccinated populations. So, when multiple kinds of vaccines exist, providing a choice may make a difference.
Moreover, while choice makes people feel only more positive toward their chosen option, they also feel more negative toward the rejected options. If those options remain viable, however, that should be noted in public health messaging, the researchers said.
Anytime people are offering choices, it should be emphasized that those rejected options may nonetheless be good options for you later, Peters said. The pleasure of choice is all yours, but keep in mind these vaccine options will be around for a while and you may prefer a different option down the line. For example, although the single-dose Johnson & Johnson vaccine was less effective than Pfizer and Moderna, it might have been good for someone who didnt have the time to go back for multiple doses later.
To see how vaccine education can be further improved to reduce hesitancy, Peters and Shoots-Reinhard also looked at how to best present vaccine safety and side effectsin a 2022 paper. They noticed that current vaccine messaginginforms people of the potential side effects but often leaves out how likely they are to occur.
When presenting online survey participants with the numerical likelihoods of experiencing side effects from hypothetical vaccines,70 percent of those who got the numbers reported being likely to vaccinate compared to only 54 percent who didn't get that information.
Although the COVID-19 landscape has greatly changed since 2020 and 2021, and therefore this research cannot be exactly replicated today, the pandemic presented a rare opportunity to study a highly evolving, global health emergency that affected and continues to affect so many people.Vaccines are an important public health tool that go beyond the coronavirus, and the findings are a silver lining in how vaccine efforts in the U.S. can be improved for future epidemics, the researchers said.
Its about giving people more and better information and allowing them more control over their lives, Peters said. We want people to get the information they're missing and be able to make their own informed decisions.
By Leila Okahata, University Communications
This project was supported by the National Science Foundation.
Add hyperlink to paper on pub date 4/11/24[LO1]
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Researchers from NDORMS and the University of Oslo have successfully replicated findings from recently published international studies on the effectiveness of COVID-19 vaccines to prevent long COVID and post-acute complications.
The new study, published in The Lancet Respiratory Medicine, is a part of a project to assess the "impact of COVID vaccination to prevent long COVID" led by Professor Daniel Prieto Alhambra and Dr. Annika Jdicke. Using data from Estonia, Spain and the UK including 20 million patients, the first pieces of work were published in The Lancet Respiratory Medicine and Heart.
Both studies showed that COVID-19 vaccination reduced the risk of long COVID and post-acute complications. The analyses were done using federated analytics (analysis that is performed on multiple, often geographically, separated datasets) on the the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).
The research team in Norway led by Professor Hedvig Nordeng and Dr. Nhung Trinh have recently mapped data from several nationwide linked health registries covering primary and secondary care events, vaccinations, and communicable disease notifications into OMOP CDM as part of the European Health Data and Evidence Network. They applied the publicly available scripts and successfully replicated the findings from Estonia, Spain and UK.
COVID-19 vaccines reduced the risk of developing long COVID symptoms across all study cohorts by 36%. Although post COVID-19 thromboembolic and cardiovascular complications were rare, they also found a reduced risk for post-COVID ATE (arterial thrombosis) during the acute phase and for heart failure and VTE (venous thromboembolism) during the post-acute phases in older people following vaccination.
Dr. Jdicke commented, "We are very excited to see that the Norwegian vaccine effectiveness results are supporting our previous findings of a reduction in risk of long COVID, and post-COVID cardiac and thromboembolic complications."
Trinh, Researcher at PharmaSafe research group, at the University of Oslo, said, "We are glad that our study provides reassuring evidence on the COVID-19 vaccination effectiveness. I really believe that OMOP Common Data Model and federated analytics are the future of real-world evidence research. Extensive efforts are required at the harmonization phase but once the data are in OMOP format, several studies relying on multinational data can be conducted very efficiently."
Professor Alhambra added, "This work demonstrates the value of federated analytics based on the OMOP CDM to make real-world evidence reliable and reproducible."
Nordeng, head of the Pharmacoepidemiology and Drug Safety research group at the University of Oslo, concurs, "This study showcases the efficiency of our data analytical pipeline at the University of Oslo using the OMOP common data model.
"It marks an exciting milestone, opening avenues for our involvement in a new era of rapid and robust federated real-world studies on disease history, drug utilization, drug safety, and vaccine effectiveness. This study is an excellent start of this collaboration."
This study strengthens the findings on the effectiveness of COVID-19 vaccination in preventing long COVID and post-acute complications. It also confirmed the usefulness of federated analytics and OMOP CDM that can be easily applied across national borders.
More information: Nhung TH Trinh et al, Effectiveness of COVID-19 vaccines to prevent long COVID: data from Norway, The Lancet Respiratory Medicine (2024). DOI: 10.1016/S2213-2600(24)00082-1
Journal information: Lancet Respiratory Medicine
The hunt for a signal of excess sudden cardiac deaths among young people after COVID-19 vaccination left Oregon health officials empty-handed, they reported.
Investigators searched death certificates for Oregon residents 16-30 years old who died from cardiac or undetermined causes of death from June 2021 to December 2022 and tried to match these deaths with mandatory statewide records of mRNA COVID vaccination, according to Juventila Liko, MD, and Paul Cieslak, MD, both of the Oregon Health Authority's Public Health Division in Portland, in the CDC's Morbidity and Mortality Weekly Report.
Among the 24 male decedents with an mRNA COVID-19 vaccination record, two died within 100 days of having received the vaccine: one recorded as dying of congestive heart failure attributed to hypertension, and the other had an undetermined cause of death.
As for the 16 female decedents logged as having received at least one mRNA COVID-19 vaccine dose, just one died within 100 days of vaccination. The immediate cause was recorded as undetermined, albeit related to chronic respiratory failure with hypoxia attributed to mitral stenosis.
Meanwhile, out of the 1,292 identified deaths of young people in the state, COVID-19 was cited as the cause for 30.
"These data do not support an association between receipt of mRNA COVID-19 vaccine and sudden cardiac death among previously healthy young persons. COVID-19 vaccination is recommended for all persons aged 6 months to prevent COVID-19 and complications, including death," study authors concluded.
Oregon residents over 16 years of age became eligible for COVID-19 vaccination on April 19, 2021. That month, reports of myocarditis after COVID-19 vaccination, particularly among young male vaccine recipients, began to appear in the voluntary Vaccine Adverse Event Reporting System (VAERS).
This rare complication had not been reported in clinical trials leading to the authorization of the Pfizer/BioNTech and Moderna mRNA vaccines (Comirnaty and Spikevax, respectively).
Multiple studies subsequently described myocarditis associated with COVID vaccines as mostly mild. Detailed records showed that affected vaccine recipients tended to be men and boys who were typically able to recover after a few days in the hospital.
Nevertheless, skeptics remained concerned about possible vaccine-related cardiac fatalities in teenagers and young adults. These fears were flamed by reports of sudden deaths among professional athletes and cardiovascular events in this age group in 2022.
The present study from Oregon did not show evidence of these risks.
Liko and Cieslak acknowledged that their analysis did not account for any potential vaccine-associated cardiac deaths occurring more than 100 days after COVID vaccination. Additionally, Oregon's population may be too small to detect rare events such as sudden cardiac death among young people.
Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow
Disclosures
Liko and Cieslak had no relevant disclosures.
Primary Source
Morbidity and Mortality Weekly Report
Source Reference: Liko J, Cieslak PR "Assessment of risk for sudden cardiac death among adolescents and young adults after receipt of COVID-19 vaccine -- Oregon, June 2021-December 2022" MMWR 2024; DOI: 10.15585/mmwr.mm7314a5.
The United States (US) Centers for Disease Control and Prevention (CDC) said on Thursday (Apr 11) that Covid vaccines were not associated with sudden cardiac death among previously healthy young people. Since vaccines from Pfizer and Moderna were authorised in late 2020, anti-vaccination groups in the country blamed the shots for fatal heart problems in young athletes.
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In a statement, the CDC said that vaccination has been associated with myocarditis in adolescents and young adults, and concerns have been raised about possible vaccine-related cardiac fatalities in this age group.
"In April 2021, cases of myocarditis after COVID-19 vaccination, particularly among young male vaccine recipients, were reported to the Vaccine Adverse Event Reporting System," it added.
To assess the above possibility, investigators searched the death certificates of people from Oregon between the ages of 16 and 30 years who died between June 2021December 2022 for cardiac or undetermined causes of death.
For the identified decedents, records in Oregon's immunisation information system were reviewed for documentation of COVID-19 vaccination received at 100 days or less than 100 days before death.
Of the 1,292 identified deaths, Covid was cited as the cause for 30, the CDC said.
Also watch |COVID pandemic anniversary: How a virus led to collapse of global health system | WION Decodes
"For 101 others, a cardiac cause of death could not be excluded; among these decedents, immunization information system records were available for 88, three of whom had received an mRNA (Messenger RNA) COVID-19 vaccination within 100 days of the death," it said.
The CDC pointed out that of the 40 deaths that occurred among people who were vaccinated against the virus, three occurred at 100 days or less than 100 days after inoculation.
"Two of these deaths were attributed to chronic underlying conditions; the cause was undetermined for one. No death certificate attributed death to vaccination," the health body further said.
Despite the improved supply of COVID-19 vaccine starting by late 2021, coverage in the African Region increased slowly. Regional coverage with a primary series reached 32% in 2023, with 38% of the population receiving 1 dose. Among the subset of countries that reported coverage for high-risk groups, 48% of health care workers and 52% of older adults received a primary series. Variation in coverage among countries was substantial. Four (9%) of the 47 countries in the region achieved the WHO target of 70% primary series coverage in the total population in 2022 (Liberia, Mauritius, Rwanda, and Seychelles); 29 (62%) countries reported primary series total population coverage <40%. Eritrea has not introduced COVID-19 vaccines, and Burundi delayed introduction in the general population and focused on vaccination of health care workers.
Several reasons likely account for low coverage with COVID-19 vaccines, including limited political commitment, logistical challenges, low perceived risk of COVID-19 illness, and variation in vaccine confidence and demand (3). Country immunization program capacity varies widely across the African Region. Challenges include weak public health infrastructure, limited number of trained personnel, and lack of sustainable funding to implement vaccination programs, exacerbated by competing priorities, including other disease outbreaks and endemic diseases as well as economic and political instability. The total population for each country was used as the denominator for vaccination coverage calculations. However, the eligible population for COVID-19 vaccination differed among countries; most countries targeted persons aged 16 or 18 years, but some countries vaccinated persons aged 5 years. In countries with large populations aged <18 years, meeting coverage targets was not possible (7).
Vaccination of high-priority groups remains critical for optimizing the impact of COVID-19 vaccines (4). Morbidity and mortality are highest among older adults and those with comorbidities (5), yet only two countries in the African Region have achieved >70% coverage among older age groups. The low coverage emphasizes the importance of targeted approaches to generate demand and address population concerns and of new delivery strategies to reach high-priority groups.
In May 2023, the public health emergency of international concern was officially declared over by WHO (8). In October 2023, SAGE recommended using a simplified primary vaccination series of a single dose of any COVID-19 vaccine and updated recommendations on revaccination for high-priority groups (5). SAGE recommended the continued prioritization of high-risk groups as described in the updated SAGE roadmap (5). The recommendations also reinforced the need for sustainable programs and COVID-19 vaccination integration into primary health care and other relevant services. The aim was to optimize resources and build sustainable immunization delivery platforms throughout the life course in alignment with the Immunization Agenda 2030 goals (9).
In November 2023, the Regional Immunization Technical Advisory Group for the African Region endorsed the SAGE recommendations, encouraging countries to continue COVID-19 vaccination as aligned with national priorities (10). Many countries in the African Region are integrating COVID-19 vaccination into their routine health services and exploring new entry points for vaccinating high-priority populations as part of primary care and other relevant services, including through multiantigen periodic intensified routine immunization activities.
The findings in this report are subject to at least three limitations. First, immunization coverage estimates are based primarily on administrative data, which might contain inaccuracies resulting from errors in recording doses administered or in population estimates. Second, although reporting is highly encouraged, in 2023, many countries stopped reporting COVID-19 vaccination data because of competing priorities. In addition, fewer than one half of the countries are reporting doses administered among high-priority groups, including doses for health care workers and older persons. Finally, population estimates for high-priority groups are available only in some countries in the African Region, making assessing coverage challenging.
The African Region has low COVID-19 vaccination coverage. Community engagement is needed to better understand drivers of vaccine confidence and develop more targeted strategies to improve vaccine demand (4). Integration of COVID-19 vaccination into routine immunization and primary health care services would help build sustainability and support recovery of routine immunization services (9). Strengthening adult immunization platforms would contribute to pandemic preparedness and global disease prevention goals (4). To protect vulnerable populations and prevent additional COVID-19 morbidity and mortality in the African Region, progress must continue to be made in vaccination of priority populations at highest risk for disease.
Oregon Heath Authority study reports no link between Covid-19 vaccine and cardiac deaths
PORTLAND, Ore. (KATU)
A study from the Oregon Health Authority (OHA) found that there is no link between the Covid-19 vaccine and cardiac deaths.
OHA says this study comes after several reports of athletes suffering from cardiac arrest.
Officials investigated nearly 1,300 deaths among Oregonians ranging between the ages of 16 and 30 that occurred over 19 months during 2021 and 2022.
The reports states that of the 40 deaths that occurred among persons who had received an mRNA COVID-19 vaccine dose, only three occurred within 100 days after vaccination. However, two of the deaths were attributed to chronic underlying conditions, and the cause was undetermined for one.
The study showed none of the deaths that happened within 100 days of getting a mRNA vaccine were attributed to vaccination.
An OHA doctor recommends the COVID-19 vaccination for people over six months old.
Nevertheless, Cieslak said, it is clear that the risk, if any, of cardiac death linked to COVID-19 vaccination is very low, while the risk of dying from COVID-19 is real. We continue to recommend COVID-19 vaccination for all persons 6 months of age and older to prevent COVID-19 and complications, including death, says Paul Cieslak, M.D.
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A spring Covid booster is being offered to those most at risk from the virus.
Some pharmacies have also started selling the jab privately.
From Monday 15 April, the NHS will take bookings from eligible groups:
The NHS is sending texts, emails, NHS App messages or letters to those who are eligible, but you do not have to wait for the invite.
Those at highest risk are being invited first.
You will generally be invited to have your booster around six months after your last dose, but you can have it after three months.
Spring vaccinations will be available until 30 June.
Vaccines from four different companies are in use across the UK: Pfizer-BioNTech, Moderna, Sanofi/GSK and Novavax.
Those getting the spring booster will be given an mRNA vaccine made by either Pfizer or Moderna. Both have been updated to help protect against more recent strains of Covid.
People are advised to take whichever they are offered, as all provide protection against severe illness or death.
Similarly, if you qualify but missed an earlier booster dose, you can have another jab this spring to catch up.
If you have a severely weakened immune system, your doctor may advise you to have an extra dose three months after the spring booster.
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A number of high street chemists and private clinics have started selling and administering Covid vaccines directly to the public.
They range in price from around 45 to 99.
You need to be aged 12 or above, and have not had a Covid vaccine in the previous three months. You also need to talk to a health professional to check that it is suitable.
A protein-based booster vaccine made by Novavax, which works differently to the Pfizer and Moderna mRNA jabs, should be available to buy soon.
It also recommends waiting if you have a high temperature or feel otherwise unwell with any illness.
But there's no need to wait if you have recently recovered from Covid and feel well.
The vaccines do not infect people with Covid and cannot cause positive test results.
They are part of the body's normal immune response to vaccination, and tend to resolve within a day or two.
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It has also been listed as a rare possible side effect of the Novavax vaccine, after a very small number of cases were reported during clinical trials.
Patients with serious allergies should talk to their healthcare professional before being vaccinated.
