A year and a half into the pandemic, Americans are more confused than ever about the risks they face, and that goes for experts and lay people alike. Cases and hospitalizations are going up in almost every state, but the messages we’re getting are mixed about the risks to the fully vaccinated.
The New York Times recently reported that in a limited number of states that do such reporting, 12% to 24% of people hospitalized for Covid-19 are fully vaccinated. We’ve heard that the vaccine is wearing off fast in Israel, where Covid-19 is in a raging surge, and that in the U.K., the majority of recent deaths have been among the vaccinated. And yet the Centers for Disease Control has used data from Los Angeles County to produce the more reassuring statistic that unvaccinated people are 29 times more likely to be hospitalized than the vaccinated.
Part of the problem is that numbers can be spun different ways, depending on whether the object is to persuade people to get the vaccine or to persuade the vaccinated to wear masks in public. The other part of the problem is that the data are much more limited than they should be.
That leaves the public with many unanswered questions. Should we wait till we get a third shot before we go back to having social lives? How much will a booster help? Are vaccines wearing off or is it just that they’re not quite as good at protecting people from the delta variant?
In May, the CDC stopped tracking infections among vaccinated people unless they were hospitalized. It was reasonable given that what matters most is, of course, severe disease and death, and resources are limited.
But the lapse in data-gathering was worse than that, said Eric Topol, a physician who is director of the Scripps Research Translational Institute in La Jolla, California, and the author of a recent piece in the Guardian titled “America is flying blind when it comes to the Delta variant.” It turns out that hospitalized people haven’t been systematically tracked either, beyond limited local data used for studies.
“We now have over one hundred and two thousand hospitalized Americans, and we have no idea what proportion are vaccinated or not vaccinated,” Topol told me.
For everyone admitted to a hospital, even in the most overwhelmed states, it should be a simple matter to record ages, whether the patients were vaccinated, which vaccine they received and when. It’s the kind of data Americans might assume was used to back the recent decision to recommend boosters to everyone eight months after our initial shots. When I looked into the booster rationale for a previous column, I found that there was no expert consensus on whether the efficacy of vaccines was waning over time or whether we’re seeing the effects of the more contagious delta variant coupled with people reverting to more typical social lives.
Right now, we’re relying on data out of Israel for recommending boosters, but it would be much better for the U.S. to have its own data than to try to extrapolate from the experience of other countries. If the unvaccinated are really 29 times more likely to be hospitalized, why are boosters so urgent?
It’s hard to judge whether we save more lives by giving all Americans booster shots, or by shipping our excess vaccine doses overseas where they can help protect us from another, more dangerous variant emerging in a country with a low vaccination rate, the way delta emerged from India’s monstrous spring surge.