In a week without major pandemic news, it seems that the medical and lay media have found time to speculate about how this pandemic might end. Of course this is premature, we hardly know what to expect next month, let alone the years to come. It does give me an excuse to make some observations on current goings-on.
Medical Pundits Aren't Reading the Literature Carefully
I was flabbergasted when I learned of major news media outlets like NPR and Wall Street Journal giving voice to poorly-informed opinions related to COVID-19 vaccination of young children. In one, a mother who also is an adult infectious diseases physician expounded on her plan to deliberately spread out the interval between vaccine doses for her child because she had concluded a longer interval between doses resulted in longer-lasting immunity. In explaining her rationale, she seemed to have discounted the fact that she was guessing on extrapolation of studies in adults in entirely different settings and vaccines, not to mention the fact that only a 3-week interval has been studied for the Pfizer vaccine in younger children. We simply don't know what spreading out intervals will do, although this is certainly something to be studied particularly if we need to incorporate regular COVID-19 vaccination within the regular pediatric well-child visit schema. I absolutely support this mother's right to make decisions about her child's healthcare, but is it necessary to promote this poorly substantiated thought to the general public?
Worse was another piece where the authors cherry-picked superficial data from some pretty dense discussions at FDA and ACIP to reach similarly unfounded views regarding risks and benefits of pediatric COVID-19 vaccines. It appeared they hadn't read the source documents but rather looked at some slide presentations from Pfizer to point out presumed holes in CDC recommendations. A deeper dive to look at detailed briefing documents from FDA as well as discussion of 6 different vaccine risk/benefit scenarios, all concluding benefits exceed risks of vaccination in the 5-11 year-old age group, seems to refute their editorial points. Anyone could correctly accuse me of cherry-picking my discussions for this blog, but this is always informed by careful analysis of the original source documents.
Bottom line? Reading an opinion written by pundits in a respected media source doesn't guarantee you are reading an evidence-based conclusion.
I Will Be Safe When Everyone Else is Safe
Earlier in the pandemic we talked about herd immunity and ending SARS-CoV-2 transmission. That happy ending doesn't seem likely now; talk to a white-tailed deer in Iowa about it. Just don't get too close.
Many of us in the US are guilty of not giving enough voice to the global situation. We are all very pleased with availability of vaccines including boosters in our country, even though our immunization rates pale beside what less-resourced countries have accomplished. Let me point you to 2 sources to give you a view of the "pan" in this pandemic.
First is a great data source from Our World in Data. This site, updated daily, gives both quick and detailed looks at progress (or lack thereof) for COVID-19 vaccination across the globe. Note from the first map the horrific gaps in coverage in some countries, as well as the relatively poor showing in the resource-rich US. I probably don't need to remind you of how isolated outbreaks can become global problems very quickly. Remember Ebola?
Second is an article appearing recently in the BMJ that looked at life expectancy and premature mortality from the pandemic in 37 upper-middle and high income countries utilizing corrections for population age spectrum and other factors not often considered in this type of report. The US was second-worst to Russia in changes in life expectancy for populations, far worse than countries at the other end of the analysis such as Iceland, Denmark, Norway, South Korea, Taiwan, and New Zealand. Although all of those countries have differing circumstances, we can learn much from study of their mitigation strategies.