I have a few follow-ups from last week regarding COVID-19 cases and vaccines. First, it seems that the cases of Ingham and Kent Counties are increasing, as are hospitalizations, although so far we are well below the surges of last spring. Second, there is new security data for the Pfizer vaccine outside Israel. Because the Israelis have something akin to a real health care system, they can track large numbers of people and create post hoc control groups. This type of data is not as good as prospective, randomized, blinded trials, but it includes a huge number of people who are living their lives for real. In short, Pfizer’s vaccine is remarkably safe, and although the vaccine is linked to an increase in myocarditis, there is much less myocarditis in people who are vaccinated than in people who contract COVID-19.
Also this week, the CDC released a study linked to third boosters advertised for people eight months after their mRNA vaccination. The fundamental trend behind the call for the third shot is an 85% reduction in vaccine effectiveness for frontline workers within 120 days of their vaccine, compared to a vaccine effectiveness of 73% for frontline workers. frontline workers more than 150 days after their vaccination. Careful readers of this study will notice that the confidence limits for these two means overlap. This means that there is a declining trend in efficacy, but the data from this study does not yet meet the definition of statistical significance used in biology.
These studies are complex. You may remember my discussion of another CDC report last week, or you read the CDC Retirement Homes Study from the previous week. Many different variables could contribute to the decrease in the apparent effectiveness of the vaccine: the delta variant is more transmissible and is peaking in many states now, masking behavior has declined this summer, the economy has opened up to several ways and heat waves may have pushed people indoors where transmission is more likely.
All of these variables likely act to accentuate any apparent decrease in vaccine efficacy in the community and confuse studies trying to discern whether the time is right for boosters. The data is very complex, and I understand why policymakers have decided to go ahead with third injections of these very safe vaccines for people who are eight months past their vaccination date. We would expect vaccine efficacy to decrease over time, and it would be good to prepare for boosters before there is a major difference in efficacy. This is especially true for those on the front lines most likely to be exposed to COVID-19.
If we’re going to do any reminders, I think we have an ethical duty and a practical interest in expanding vaccination around the world. People in so many countries are struggling to get their people vaccinated. Certainly, if we have enough vaccines to give boosters, we can have enough vaccines to help protect more of the poor and vulnerable around the world. At a practical level, more dangerous and transmissible variants can originate from any location in the world with significant transmission of SARS-CoV-2. And global immunization is how we protect everyone from the risk of more dangerous variants.
I’m proud that MSU adopted a vaccination mandate earlier this summer, and the deadline for faculty, staff and students to get vaccinated is Tuesday, August 31. You can certify and document your vaccination at Website Together we will. There are exceptions for medical and religious reasons, but the College of Human Medicine will not assign unvaccinated students to clinical activities.
We are still planning the Gran Fondo’s returning to Grand Rapids on September 18th. We are tracking cases in Kent and Ottawa counties, discussing with county health departments, and communicating with hospitals in Grand Rapids regarding the city’s COVID-19 situation. We do our best to keep up with CDC Tips on external events. As an example, we try to make sure there is a distance before and after the ride, registration documents are mailed rather than using pickup lines on site, and we have eliminated registration on site to, once again, avoid queues. We will cancel if need be, but so far like outdoor fall sports we are ready. We are closely monitoring security issues. Register before August 30 for 12, 25, 40 or 80 mile trips in support of skin cancer research.
In other news, Rebecca Knickmeyer, PhD, received a $ 5.5 million NIH award to lead the greatest of its kind world study understand the impact of genetics on early brain development and neurological disorders such as autism, schizophrenia and attention deficit hyperactivity disorder. Congratulations, Rebecca!
As you all know, Barbara Forney is leaving CHM for the Bureau of Health Sciences with a small share of retirement as part of the transition. We take this as a moment to integrate business and faculty development with our academic human resources and staff teams. This will create a new unit that we call the Office of Faculty and Personnel Administration (FASA) headed by our indomitable Associate Dean, Nara Parameswaran. People have worked very well together, and I think that will make us more efficient and better coordinated.
As a teaser for next week – be sure to see former CHM and former Dean Marsha Rappley, MD on the Town hall at noon on September 3!
Please protect those around you by wearing a mask when you are indoors in public, and protect yourself and others by getting vaccinated.
Serve people with you,
Aron Sousa, MD