@margbrennan @FaceTheNation @CDCgov @KFF @ASTHO @AmerMedicalAssn Public health experts always knew this was going to be the hardest vaccine distribution in history. And we need to understand that while federal planning and funding/ support are critical, most of the work happens at the state and local level. 1/?
@margbrennan @FaceTheNation @CDCgov @KFF @ASTHO @AmerMedicalAssn I used to run a State Health Department. You absolutely cannot bypass the state or you will have chaos. But you also have to recognize that not all states have the local partnerships in place to reach the most vulnerable communities. 2/?
@margbrennan @FaceTheNation @CDCgov @KFF @ASTHO @AmerMedicalAssn One of the things we need to do is learn from places like West Virginia. They are blowing away much larger, better funded, & healthier states. So sometimes it IS about leadership, and we need to share best practices and put some friendly pressure on poor performers w the data. 3/
@margbrennan @FaceTheNation @CDCgov @KFF @ASTHO @AmerMedicalAssn And finally, I love the partnerships with the local pharmacies. Many people go to and trust their pharmacy more than a hospital or the "government." Local partnerships are KEY. 4/4 @CVSHealth

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More from @JeromeAdamsMD

19 Feb
@margbrennan @FaceTheNation @CDCgov Great question. Life expectancy decreased 2.7 years for the non-Hispanic black population (74.7 to 72.0). It decreased by 1.9 years for the Hispanic population (81.8 to 79.9) and by 0.8 year for the non-Hispanic white population. 1/?
@margbrennan @FaceTheNation @CDCgov The first thing we need to do is collect, analyze, & share the data. @CDCgov is now doing this (I've been calling for it for a while so I'm glad to see it). @KFF and others are also putting demographic data out there. Once we have the data, we can identify gaps and targets. 2/
@margbrennan @FaceTheNation @CDCgov @KFF You can check out cdc demographic data at their website. But so far only about 50% of states report.

covid.cdc.gov/covid-data-tra…
Read 4 tweets
16 Feb
I’ve been calling for ⁦@CDCgov⁩ to publish demographic data on vaccinations (eg race, gender, and age breakdowns on who is- and who isn’t getting vaccinated), and I’m happy to see it’s finally on their website. VERY revealing- Check it out. 👇🏽

covid.cdc.gov/covid-data-tra… Image
Blacks make up 12% of US population, but less than 6% of vaccinations. Hispanic Americans are 18% of US population, but les than 9% of vaccinations.

Whites seem to be over represented in vaccinations, but so are asian Americans and native Americans. Image
Some fascinating vax data on age and gender- there is a large over representation among women who’ve gotten vaccinated, and among 50-64 year olds who’ve gotten the shot. Does this represent a healthcare worker bubble? Better access? Less hesitancy/ more willingness? 🤔 ImageImage
Read 4 tweets
15 Feb
Lots of debate about what this means. Here’s my take:
- Fewer sick and dying is good, no matter why
- It shows we CAN control the virus
- Like an MMA fight our opponent is stunned- if we keep at we can win- If we let up, we could get knocked out... npr.org/2021/02/15/968…
Is it herd immunity? Well it’s complicated. Herd immunity is a threshold that depends on the setting. On a National level, it could take > 250 million vax + infected (ie 80%). For individual encounters, all it takes it’s one person with immunity to slow/ stop spread...
So with the possibility of 100 million plus infected and recovered in US (some estimate 3-4 x as many who’ve tested positive have actually been infected and have antibodies) and almost 40 million vaccinated, some degree and type of herd immunity is likely helping ⬇️ spread.
Read 5 tweets
11 Feb
I respectfully disagree w @DrTomFrieden here- or at least contend his hypothesis (and that of MANY other experts is incomplete). If you flooded the market right now with vaccine, data suggest they’d continue preferentially going to affluent whites, and you’d increase disparities.
The math is in fact unforgiving. Overall supply is the most important rate-limiting step- IF YOU ARE WHITE. If you’re a minority (and therefore on average at higher risk), there are other significant “rate limiting” factors, like hesitancy and location.
https://t.co/bLc83DtTOA
I greatly respect Dr. Frieden’s work, but this is the blind spot (and unintentional but real perpetuation of bias) I continue to see in public health. We often talk of equity, but when we have a chance to drive the conversation, we often prioritize averages > inequities.
Read 4 tweets
7 Feb
If you care about health equity and haven’t seen this @KFF #COVID19 data, it’s shocking, and a must read.👇🏽

In NJ for example, blacks = 12% of population, 16% of deaths, but only 4% of vaccinations...

Latest Data on COVID-19 Vaccinations Race/Ethnicity kff.org/6f5f223/
Hispanics are 21% of NJs population, 19% of deaths, but only 6% of #COVID19 vaccinations.

And not just NJ- these trends hold up for all other states.

This IS systemic bias (and institutional racism) playing out in real time. @CDCgov @POTUS should be reporting & addressing!
I see a story here or a tweet there, but there really needs to be @WhiteHouse press briefing dedicated solely to discussing actions/ solutions- not just casually mentioning it as an issue. Resources and accountability are key.
Read 5 tweets
31 Jan
The bottom line on vaccine efficacy against #COVID19 variants, as well as comparing one vax to another:

ALL of the vaccines are still more effective vs all strains of covid than the flu shot is vs flu strains in many years.

And 50% more likely to live still better than 0%!
We can’t allow our collective judgements to be clouded by the amazingly high (and to be frank unexpected) 90% plus efficacy of the mRNA #COVID19 vaccines against the original viral variants.

The original bar for most scientists as well as @US_FDA was > 50- 60%.
In other words, judged by original/ pre- mRNA standards, the current efficacy of all the current vaccines against all the current strains would’ve been widely touted and welcome news if they’d been the first across the finish line/ to get authorization.
Read 5 tweets

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