Data Snapshot: Updated Covid-19 vaccine and booster rates, by age.
Older people did well on the primary series. But something in the data concerns me.
Older people got the memo. Two years ago, we rolled out the Covid-19 vaccine. It was a moment of pure triumph for science and technology. It was even a moment of triumph for public enterprise. A safe and effective vaccine had been developed, tested, authorized, and rolled out in under a year. The vaccines would not have been possible but for public investment and Operation Warp Speed—which combined private sector innovation with public support and, eventually, infrastructure.
Early on, uptake was impressive, especially among the highest-risk groups. Here’s where we are, as a nation today:
The data speak loudly. The fact that 95% of US residents ages 65-74, and 91% of those ages ≥75 have been vaccinated says a lot. First, it shows the public understood what the Covid-19 threat meant to seniors in particular. Second, it highlights a success in public health.
Just a few months before the vaccine was rolled out, public sentiment had been mixed at best on the vaccines. By the time the rollout began though, enthusiasm was high, especially among older Americans. Overall, more people were eventually vaccinated than polls suggested might in the fall of 2020.
Two years on and we have the bivalent booster—half ancestral strain, half Omicron. Clearly, interest is lagging now. Young people may not benefit for very long, so interest there is understandably ho-hum. But older people are far more likely to have important benefits from boosting which—even if temporary—makes it both worthwhile and the correct strategy. The most common cited reason most adults have not gotten a bivalent booster? They don’t even know they can. (Here’s who is eligible.)
But what disturbs me most in the graph above is how low the primary series vaccination rate for children <2 years of age is. I have to say: 4% is just paltry, especially because infants <1 are at a higher rate for Covid-19-related hospitalization than most non-geriatric adults. If you look at pediatric Covid mortality, a large fraction of the deaths occurs in infants ages 0-1.
To get those numbers to zero, there are two strategies:
First, we must shore up primary vaccination rates in infants. Infants become eligible for Covid vaccination at age 6 months. As I’ve written, my baby girl was vaccinated as soon as she reached that age. The safety and efficacy data are there. (Vaccinating my infant gave me peace of mind which has allowed me to alter my personal risk tolerance for Covid.)
Second, we must allow and encourage third trimester boosters during pregnancy. This protects the mother during the late stages of pregnancy (one of the highest-risk times for all reproductive-age adults, if not the most dangerous time for that demographic), and antibodies transfer to the fetus, and last several months after birth. Along with two leaders in Ob-Gyn, I wrote about the CDC’s need to allow and encourage this last year. I hope in 2023, it’ll happen.
If we vaccinate more 6-month-old infants and we boost more people during the third trimester of pregnancy, infant Covid mortality will plummet—and with it, pediatric Covid mortality overall.
Thanks to Benjy Renton for curating Data Snapshot.
"If you look at pediatric Covid mortality, a large fraction of the deaths occurs in infants ages 0-1."
Two considerations:
1) I feel this statement lacks context, as it gives impression there are a lot of pediatric Covid deaths which I don't see represented in the data. For 2021 there were 29, 711 total deaths ages 0-14. Of those, 287 were recorded as Covid representing just under 1% of all pediatric deaths. Yes, roughly 32% of those were in the 0-1 cohort, but this group already accounts for 70% of all pediatric deaths, so the early infant mortality rate would likely explain this considering....
2) there are zero excess deaths in this age cohort*, so could it be that this is a group where deaths are "with covid" instead of "because of covid"? How could Covid vaccinations lower all-cause mortality in groups where there is no increase in annual deaths? This also applies to ages 1-14 as well, once you back out the increases in accidental deaths, the baseline is unchanged for 2020 and 2021 (appears the case for 2022 but too early for Wonder).
This applies to other countries as well, so unlikely it's dependent on healthcare model.
* From Wonder:
Year // Deaths Age <1 // Ages 1-14 [excludes accidental deaths]
2019 // 19,392 // 5,902
2020: // 18,142 // 5,668
2021 // 18,347 // 5,955
CDC posted detailed files of the cause of death by age groups for 2020 and 2021 earlier this week:
https://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm#Mortality_Multiple
I just started downloading the files and am going through them now. Might help in answer the question I posed yesterday - are these "with Covid" or "because of Covid".
Thought you might be interested too, maybe pass on to one of your analysts to go through them?