Lots of criticism of new booster plans, much of it re: how much of ⬇efficacy # s are due to confounding vs truly ⬇effectiveness. To me, it seems incontrovertible that vax effectiveness is ⬇significantly, though amount of drop – particularly vs severe cases – is unclear.(1/7🧵)
I'm in support of the new booster plans. This is anecdotal, but in past week I've heard of 2 fully vaxxed people in 70s who died of Covid. With Delta & waning vax effectiveness, this will happen. Even if failure to wear masks contributed to the cases, that'll happen too. (2/7)
We can make two types of errors here: acting too early and acting too late. Given that it'll take 4-6 months to roll out boosters to 200M people, I think we need to skate to where the puck is going. To my reading, the evidence we have regarding waning vax effectiveness... (3/7)
... is already strong & likely to get stronger over time. (Sure, we might have a reprieve after Surge 4 ends, only to be slammed by a 5th surge in the winter). I continue to feel that the "we should send these shots abroad" narrative... (4/7)
... is viscerally appealing but largely unrealistic. And while some unvaccinated people might see boosters as another reason not to get shots 1 & 2, I worry more about unvaxxed people seeing rising cases of severe breakthrough infections & wondering if vaccines truly work. (5/7)
I appreciate that – like so many in Covid – this is another tough choice, one involving real tradeoffs in the face of some uncertainty. But weighing everything we know, and taking an educated guess about where the puck will be in the late fall, it seems like a good call. (6/7)
We should think hard before authorizing boosters for healthy young people – more data will help. For now, I favor decision to proceed in higher risk groups. I'll certainly get my shot when my turn comes. My guess is that many who are critiquing the new policy will as well. (7/7)
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