Well, maybe not dazed, but then I couldn't have a movie reference. Every outbreak manual I know of stresses the importance of clear messaging from authorities. That's been lacking with the booster roll out.
How Can You Follow the Science When It Doesn't Provide Answers?
That's probably the underlying problem brought to light at the recent FDA/VRBAC and ACIP/CDC meetings discussing COVID-19 vaccine booster plans. I commented a bit last week on the first meeting, but the ACIP/CDC meeting and its aftermath really shook things. up. I was able to attend most of the proceedings, especially the meatier parts and the discussions. At the risk of over-simplifying an extremely complex issue, the current data just don't answer the question of whether boosters now will have any great benefit for individuals receiving them or any impact in calming or preventing surges. The only likely benefit is for the "elderly," (yes, it still irks me that I fall into that category) and even that isn't entirely conclusive. Thus we are down to risk/benefit discussions that suggest moving towards the riskier side of the scale at younger ages. My 35-year-old son, also a healthcare provider, received his Pfizer primary series last January. He asked me if I thought he should get a booster and I was able to respond generally yes, with some caveats about potential rare myocarditis risks. As pediatric healthcare providers, the patients asking our advice are likely to be in the 18-25 age range where potential benefits to the individual seem to be very low, so even small risks start to become a consideration. Look at Dr. Thornburg's great explanation of immunity and SARS-CoV-2 as well as Dr. Oliver's presentation, slides 46 and 47 in particular, for a good discussion on risks and benefits for different ages and circumstances.
As for me, about 8 months out from completing my primary Pfizer series, I suppose I will get the booster when it is offered to me, but no big deal if I have to wait a bit. I will be getting my flu vaccine soon.
More School Studies
MMWR published 3 Early Release articles on September 24. They don't necessarily tell us anything new but are important because the all suggest that masks, along with other mitigation strategies, still are highly effective in the delta variant era.
Two of the studies were headed by CDC with help from other institutions. One looked at pediatric COVID-19 cases from July 1 - September 4, 2021, in counties with and without school mask requirements. After the start of the school year, the increase in daily case numbers was much higher in the counties without school mask requirements compared to those with mask requirements. The other study looked at mask use effects on school closures and learning modality changes from August 1 - September 1 and again found evidence in support of mask requirements.
The third study was limited to Maricopa and Pima counties in Arizona and carried out in July and August. These counties comprise 75% of the state's population, and the study concluded that the odds of a school-associated COVID-19 outbreak was 3.5 times higher in schools without a mask requirement compared to those with mask requirements implemented early in the school year which began in July.
All of these studies have significant limitations; it is very difficult to control for all of the potential confounding variables. However, masking requirements in schools, coupled with multi-layered infection control measures, still work extremely well in the delta era. We all need to concentrate on that, as well as trying to vaccinate the unvaccinated.