A study investigating the effectiveness of COVID-19 vaccines has been published after initially being withheld from a government health journal. The research, released by JAMA Network Open, shows vaccines are about 55% effective against COVID-19-related hospitalizations and reduce emergency department and urgent care visits by 50%.
Such findings align with previous research affirming the efficacy of COVID-19 vaccines. The public took notice when Trump administration officials chose not to include it in a Centers for Disease Control and Prevention (CDC) publication. They questioned the design, suggesting it might lead to biased results. However, many health experts argue this design has long-standing reliability and remains crucial for current vaccine assessment.
In an accompanying commentary, Natalie Dean, a biostatistics expert from Emory University, emphasized the importance of continuing to publish vaccine effectiveness estimates as virus strains evolve.
The study was initially set for release in the CDC’s Morbidity and Mortality Weekly Report. Approval came from the Office of Science, but acting CDC Director Jay Bhattacharya flagged it, explained Althea Grant-Lenzy, CDC’s chief science officer. Authors were free to submit the study to outside journals, which they chose to do.
The study employed a “test-negative design” methodology. Researchers evaluated patients hospitalized or visiting emergency rooms with respiratory illnesses, checked their vaccination status, and compared the odds of positive COVID-19 tests among vaccinated and unvaccinated individuals. Esteemed journals, such as Pediatrics and New England Journal of Medicine, commonly use this methodology.
Critics like Bhattacharya argue this method can be skewed by assumptions, previous infections, and patient behaviors. Conversely, supporters assert it accounts for care-seeking differences and minimizes prior infection bias since so many Americans have contracted the virus. No perfect alternative exists, and none has been proposed by U.S. Health and Human Services for efficiently gauging real-time vaccine effectiveness.
The CDC hosted a forum highlighting the method’s advantages and drawbacks. A panel, including Natalie Dean, underscored its strengths, although Martin Kulldorff offered criticism. A co-author of the Great Barrington Declaration, Kulldorff argued against including diverse disease cases in such studies, asserting the need for longer-term evaluations. In response, someone in the crowd pointed out the unique challenge of conducting longer studies during a pandemic.
The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation, though the AP holds sole responsibility for the published content.
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