Tag: CDC

  • Pfizer for the whole pfamily (now CDC-verified!)

    Pfizer for the whole pfamily (now CDC-verified!)

    In case you missed it amidst the mask discourse: Pfizer was already the “vaccine for cool people,” but this week, it formally became the vaccine for teens. The FDA announced on Monday that it was expanding the Emergency Use Authorization for this vaccine to include children ages 12 to 15, and the CDC followed this up with an official recommendation on Wednesday.

    As Sarah Braner reported when the Pfizer adolescent trial results were released: “In the trial, no participants who received the vaccine contracted symptomatic COVID-19 out of a total of 2,260 participants, marking an efficacy rate of 100%.” So, this formal endorsement was a pretty foregone conclusion, but it’s still good news for the 17 million children ages 12 to 15 in the country.

    Here are a couple more statistics about the 12-15 age group, via the Kaiser Family Foundation:

    • This group accounts for 5% of the U.S. population and 27% of the population under age 16.
    • Nearly half of children in this age group are people of color, including: 25% are Hispanic, 13% are Black, and 5% are Asian.
    • 36% of children in this age group live in a family with incomes below 200% of the Federal Poverty Level.
    Vaccination coverage for the population ages 12 and up, as of May 15. The darker blue a state is, the better its coverage.

    And speaking of adolescent data: on Friday, the CDC diversified its vaccine tracker. In addition to state-by-state views of vaccination coverage for the overall population, adult population, and senior population, the Tracker will now show you vaccination coverage for each state’s population over age 12. Nationwide, 56% of this group has had at least one dose and 44% is fully vaccinated.

    The Vaccinations County View page will show you coverage over age 12 by county, but these data aren’t yet available for easy download in the Community Profile Reports.

    The CDC’s demographic vaccination data, meanwhile, groups adolescents in with (already eligible) 16 to 18-year olds in an under 18 category—so we aren’t yet able to see precisely how many children in this age group are getting vaccinated. This may become a concerning data gap as schools may seek to use 12-15 vaccination rates as an indicator for reopening next fall.

    More vaccine coverage

    • Sources and updates, November 12
      Sources and updates for the week of November 12 include new vaccination data, a rapid test receiving FDA approval, treatment guidelines, and more.
    • How is the CDC tracking the latest round of COVID-19 vaccines?
      Following the end of the federal public health emergency in May, the CDC has lost its authority to collect vaccination data from all state and local health agencies that keep immunization records. As a result, the CDC is no longer providing comprehensive vaccination numbers on its COVID-19 dashboards. But we still have some information about this year’s vaccination campaign, thanks to continued CDC efforts as well as reporting by other health agencies and research organizations.
    • Sources and updates, October 8
      Sources and updates for the week of October 8 include new papers about booster shot uptake, at-home tests, and Long COVID symptoms.
    • COVID source shout-out: Novavax’s booster is now available
      This week, the FDA authorized Novavax’s updated COVID-19 vaccine. Here’s why some people are excited to get Novavax’s vaccine this fall, as opposed to Pfizer’s or Moderna’s.
  • The data behind the CDC’s new mask guidance

    The data behind the CDC’s new mask guidance

    This past Thursday, the CDC announced that, if you are fully vaccinated, the pandemic is basically over for you.

    The announcement surprised everyone—from my parents to COVID-19 scientists—because it appeared to come out of nowhere. Before this week, the CDC’s most recent guidance revisions included an acknowledgment that surface transmission of the coronavirus is very rare and a recommendation that masks might not be necessary outside; both of these conclusions were already well-known in the scientific community. In fact, STAT published an article last week in which Nicholas Florko suggests that the CDC’s COVID-19 messaging has been “overly cautious” and perhaps even “irrelevant for most Americans.”

    So, what led to the announcement on Thursday? The rest of this post will go over the CDC’s evidence for its guidance, taking the epidemiological perspective. Also, as two-thirds of Americans aren’t yet fully vaccinated, I’ll touch on another COVID-19 truism that has garnered some confusion lately: yes, you are significantly safer outside than you are inside.

    CDC graphic on COVID-19 safety, updated with the new mask guidance on Thursday.

    (I need to acknowledge, though, that a. there are certainly outside political and economic forces at play here, and b. the public health perspective on this guidance is far more complicated. For one perspective on the public health side, I recommend this Twitter thread by virologist Angela Rasmussen.)

    Our first category of evidence: the mRNA vaccines work really well. It’s no surprise that the Pfizer and Moderna vaccines are both exceptionally capable of protecting people against the coronavirus, but a couple of recent studies really hammer this home:

    • In this recent study from Israel, the Pfizer vaccine demonstrated 97% effectiveness against symptomatic cases and 86% effectiveness against asymptomatic cases among about 6,700 healthcare workers who were regularly tested for COVID-19.
    • According to this MMWR report from the CDC, the Pfizer and Moderna vaccines were 94% effective in preventing COVID-19 hospitalization for fully vaccinated seniors (over age 65), demonstrating how well the vaccines protect against severe disease. Plus, the vaccines were 64% effective in preventing hospitalization for partially vaccinated seniors.
    • Another MMWR report, released this past Friday, demonstrates that the mRNA vaccines were 94% effective at preventing symptomatic COVID-19 in U.S. healthcare workers. A single shot of Pfizer or Moderna ws 82% effective at preventing symptomatic COVID-19.
    • A study from the Cleveland Clinic, a medical research center based in Cleveland, Ohio, studied COVID-19 cases among its caregivers after vaccines were made available; the Clinic found that a whopping 99.7% of those workers who tested positive for COVID-19 had not been fully vaccinated. Only 0.3% were breakthrough cases. Meanwhile, 99.75% of COVID-19 patients that the Clinic treated during the study’s time frame were not fully vaccinated.
    • According to the CDC’s breakthrough case data, out of about 122 million fully vaccinated Americans, less than 1,400 people have been hospitalized or have died due to COVID-19. That’s 0.001%. (The CDC’s breakthrough reporting focuses on severe outcomes rather than cases, as these cases may be difficult to systematically identify outside of studies.)

    Second evidence category: the vaccines work against variants.

    • It’s important to note here that, when I say “vaccines work,” it’s not an all or nothing situation. A vaccine might protect you against severe COVID-19 disease or death (the primary goal), but not against an asymptomatic case that allows you to transmit the virus to someone else.
    • All the COVID-19 vaccines currently on the market protect us against severe COVID-19 disease and death—whether you’re infected with an older version of the coronavirus or with a variant. 
    • For a couple of the variants, that protection might not be quite as secure. Studies on B.1.351 (the variant first identified in South Africa), P.1 (identified in Brazil), and B.1.617 (identified in India) have all demonstrated lower vaccine effectiveness. But again, lower effectiveness here still means protection for the majority of people who get vaccinated.
    • And one big advantage of mRNA vaccine technology is, the Pfizer and Moderna vaccines may easily be adjusted to protect against particularly concerning variants. Moderna recently reported promising data for two booster shots designed to protect specifically against B.1.351 and P.1.
    • If you’d like a more detailed rundown of the vaccine v. variants battle, check out this article by STAT’s Andrew Joseph.

    Third evidence category: U.S. cases are way down.

    • As I noted in today’s National Numbers post: cases have dropped by 50% in the last month. And beyond that, cases have dropped from a peak of 250,000 new cases per day in January to under 40,000 new cases per day now.
    • During this time frame, most states did not impose lockdowns or other restrictions on the level of what we saw in spring 2020. So, these drops can primarily be attributed to the vaccines.
    • We still do not have much evidence showing how well the vaccines protect against asymptomatic transmission and infection, but the evidence we have so far is promising, as Apoorva Mandavilli explains in the New York Times. (One major study investigating this question in college students is currently underway.)
    • Still, the massive case drops—occurring even as B.1.1.7 and other more contagious variants spread through the country—indicate that the vaccines must be doing some work to stall coronavirus spread from one person to another. This supports the CDC’s argument that vaccinated Americans can take off their masks in public without worrying about spreading a latent coronavirus to someone else.

    Fourth evidence category: outdoor transmission is incredibly low.

    • Earlier this week, the New York Times’ David Leonhardt provided a compelling argument for why, though the CDC said “less than 10%” of COVID-19 transmission occurs outside, the true number is actually much lower. In fact, fewer than 1% (and possibly even fewer than 0.1%) of COVID-19 cases happen due to someone getting infected outside.
    • As I’ve previously reported, there is not a single recorded superspreading event that took place solely outside. This includes the large Black Lives Matter protests last summer. (A few superspreading events have both outdoor and indoor components.)
    • A new study from researchers at Drexel University specifically examined COVID-19 transmission in parks, and found no correlation between the number of people using a park and the number of COVID-19 cases in the surrounding ZIP code. The research suggests that you should feel safe at your local park, even if it seems a bit more crowded and less mask-adherent than it did a few months ago. I spoke to Franco Montalto and Bita Alizadehtazi, two authors on this study, who emphasized that “it’s important to get outside,” take advantage of the green infrastructure in your neighborhood, and feel safe while doing so.

    This evidence brings us to what The Atlantic’s Drew Thompson calls the “Two Commandments of COVID-19”:

    1. COVID-19 is an indoor aerosol disease.

    2. Vaccination protects you; more vaccinations protect everyone.

    Speaking just for myself: I am fully vaccinated, but I fully intend to keep wearing a mask in stores, on the subway, and even outside when I’m in a large crowd of people. This is partially because my state still has a mask mandate in place, but also because there are still a lot of people in my community who aren’t yet vaccinated—and I don’t want to pose a risk to them, no matter how small that risk may be. (In Brooklyn, where I live, 41% of the population has had at least one dose and 33% are fully vaccinated, according to city data.)

    Suffice it to say, the CDC makes recommendations about COVID-19 safety. It doesn’t issue requirements. I made a personal masking decision for myself, based on the community where I live; I hope this article helped you understand the science behind the guidance change so that you can do the same. And if you have questions—my inbox is always open.

    More vaccine coverage

    • Sources and updates, November 12
      Sources and updates for the week of November 12 include new vaccination data, a rapid test receiving FDA approval, treatment guidelines, and more.
    • How is the CDC tracking the latest round of COVID-19 vaccines?
      Following the end of the federal public health emergency in May, the CDC has lost its authority to collect vaccination data from all state and local health agencies that keep immunization records. As a result, the CDC is no longer providing comprehensive vaccination numbers on its COVID-19 dashboards. But we still have some information about this year’s vaccination campaign, thanks to continued CDC efforts as well as reporting by other health agencies and research organizations.
    • Sources and updates, October 8
      Sources and updates for the week of October 8 include new papers about booster shot uptake, at-home tests, and Long COVID symptoms.
    • COVID source shout-out: Novavax’s booster is now available
      This week, the FDA authorized Novavax’s updated COVID-19 vaccine. Here’s why some people are excited to get Novavax’s vaccine this fall, as opposed to Pfizer’s or Moderna’s.
    • COVID-19 vaccine issues: Stories from COVID-19 Data Dispatch readers across the U.S.
      Last week, I asked you, COVID-19 Data Dispatch readers, to send me your stories of challenges you experienced when trying to get this fall’s COVID-19 vaccines. I received 35 responses from readers across the country, demonstrating issues with insurance coverage, pharmacy logistics, and more.
  • COVID source shout-out: CDC’s vaccine blue

    COVID source shout-out: CDC’s vaccine blue

    As anyone who follows me on Twitter could likely tell you, I love to make fun of the CDC’s vaccination dashboard. The agency uses the color blue like it’s going out of style, with heatmap-style charts that range from teal to a dark, indigo shade for states that have administered the most vaccine doses relative to their populations.

    I have no problem with the color blue. But the CDC doesn’t always update its color categories in time with increasing vaccination rates, which can lead to charts like this:

    Or this:

    This week, the agency’s dedication to blue got even more intense, with this graphic shared in the White House COVID-19 briefing on Friday:

    Much as I love to make fun, though, I have to admit that I do love the vaccine blue. Or, more accurately, I love what the blue represents: a darker shade means more people getting vaccinated, more people protecting themselves and their communities from the coronavirus.

    Dr. Walensky tapped into this sentiment during Friday’s briefing, when she said: “Now that everyone is eligible to receive a vaccine, please help turn your county toward more protection and a darker shade of blue. The healthier our families are, the healthier we will be as a nation.”

    Dark blue! More vaccines! Let’s go! (Now, can we send some of our extra doses to India, please?)

  • J&J is back on the menu

    After 10 days, the pause on the J&J vaccine has been lifted. According to CDC Director Rochelle Walensky, there have been about 1.9 cases of severe blood clotting per million people who had received the J&J vaccine. It has been re-authorized for use in people aged 18 and older, now with an addendum to the label and fact sheet warning of the risk of blood clots: 

    It’s important to note that at time of writing (April 24) only some states have already resumed its use. (These are Arizona, Colorado, Connecticut, Louisiana, Maine, Massachusetts, Michigan, Missouri, Nevada, New York, Tennessee, Texas, Indiana, and Virginia.) However, this is coinciding with a larger trend of states ordering fewer vaccine doses.

    The J&J vaccine’s return is probably good news for the rest of the world as well. Combined with the AstraZeneca vaccine, the J&J vaccine was supposed to be one of the big players in the global fight against COVID-19. But the U.S. pause raised concerns for vaccine diplomacy and the global rollout—J&J had also paused its European distribution, South Africa announced they were putting J&J distribution on a temporary hiatus, and Australia said it wouldn’t purchase any J&J doses. Resuming distribution in the U.S., which can act as a bellwether for which vaccines are seen as desirable abroad, might allay concerns about safety abroad.

    More vaccine coverage

    • Sources and updates, November 12
      Sources and updates for the week of November 12 include new vaccination data, a rapid test receiving FDA approval, treatment guidelines, and more.
    • How is the CDC tracking the latest round of COVID-19 vaccines?
      Following the end of the federal public health emergency in May, the CDC has lost its authority to collect vaccination data from all state and local health agencies that keep immunization records. As a result, the CDC is no longer providing comprehensive vaccination numbers on its COVID-19 dashboards. But we still have some information about this year’s vaccination campaign, thanks to continued CDC efforts as well as reporting by other health agencies and research organizations.
    • Sources and updates, October 8
      Sources and updates for the week of October 8 include new papers about booster shot uptake, at-home tests, and Long COVID symptoms.
    • COVID source shout-out: Novavax’s booster is now available
      This week, the FDA authorized Novavax’s updated COVID-19 vaccine. Here’s why some people are excited to get Novavax’s vaccine this fall, as opposed to Pfizer’s or Moderna’s.
  • Did you know that you, a plebeian, can search through VAERS?

    Did you know that you, a plebeian, can search through VAERS?

    You’ve probably heard about the Johnson & Johnson debacle by now. (Here’s an explainer on NYT’s The Daily and another one with more scientific background from Roxanne Khamsi at The Atlantic if you’re still confused.)

    If you attended or read about the April 14 emergency ACIP (Advisory Committee on Immunization Practices) meeting discussing the pause, you probably heard “VAERS” a lot. VAERS stands for “Vaccine Adverse Event Reporting System.” It’s used as a “national early warning system to detect possible safety problems in U.S.-licensed vaccines,” it’s been around for much longer than the COVID-19 vaccines or even COVID-19, and it’s how regulators are examining the data about possible complications related to the Johnson & Johnson COVID-19 vaccine. And as the cherry on top, the data is open to the public through the WONDER search engine. So what’s there?

    The search procedure is VERY customizable, and there’s even a video teaching you how to do it. You can narrow your search by symptoms, vaccine type, vaccine products, date that the event was reported, and more. For my cursory search, I, like a lot of people, was curious about the results for the Johnson & Johnson COVID-19 vaccine, so I just narrowed my search to “COVID-19 Vaccine Janssen.” 

    Here are my results, sorted by most common symptoms:

    These are the most common results, but the list keeps going after that with rarer side effects as you go down. It quickly became clear that this is not a perfect system, with some slightly nonsensical reports and strange distinctions. I was certainly left wondering how “SARS-COV-2 test negative” ended up as an adverse effect. (Seems like that’s what you want? Either way, there were 59 of these reported. Good for those 59 people—or that one person with a very sore nose.)

    Also notable were “Feeling abnormal” (213 reports), “Irritability” (10 reports) and my personal favorite, “No adverse event” (58 reports). It’s fairly obvious that not all of these adverse events were directly caused by the vaccine. Indeed, while the list can be fun to poke through and somewhat illuminating in what keeps popping up (headache, chills, pain, pyrexia/fever), finding the most common symptoms seems to be its main use.

    J&J distribution is paused right now because there were 6 cases of cerebral venous sinus thrombosis (CVST) combined with low platelets in a group where that is not common, and symptoms manifested between 6 and 13 days after vaccination. However, you can’t see that from this dataset. It doesn’t even seem like this dataset is fully updated—right now, there’s only one case of CVST recorded. (It was last updated on April 10.) The dataset also doesn’t actually say when the person got vaccinated and when the event was reported—just frequency. 

    In the April 14 emergency ACIP meeting, Dr. Tom Shimabukuro of the CDC COVID-19 Vaccine Task Force cited the 6 reports as of April 12, so it looks like the public dataset hasn’t been updated while the people actually making decisions are working with updated data. It doesn’t mean that this dataset isn’t useful, it just means that one should act with caution before using it to draw any conclusions. 

    The CDC clearly agrees with me, as they make you check a box stating that you’ve read the disclaimers like “reports may include incomplete, inaccurate, coincidental and unverified information” and “the number of reports alone cannot be interpreted or used to reach conclusions about the existence, severity, frequency, or rates of problems associated with vaccines” before they show you the goods in WONDER.

    There’s also a 17-page “VAERS Data Use Guide” which of course I found when I was almost done writing this up. Despite the limitations of the actual public dataset, I was extremely impressed by how much guidance that’s provided. I haven’t had my hand held this much while sifting through data in ages (I was very much on my own while going through the Global.Health database) and it really shows how much they want this data to be used with care. So I give serious props for solid and effective guidance on how to communicate this data—I just wish there was more data to communicate. 

    But WONDER isn’t the only way to sift through all the data. You can also download CSV files of every event reported (supposedly) back until 1990. That’d be a bit much for one post, but next week we might see what’s there.

    More vaccine news

    • Sources and updates, November 12
      Sources and updates for the week of November 12 include new vaccination data, a rapid test receiving FDA approval, treatment guidelines, and more.
    • How is the CDC tracking the latest round of COVID-19 vaccines?
      Following the end of the federal public health emergency in May, the CDC has lost its authority to collect vaccination data from all state and local health agencies that keep immunization records. As a result, the CDC is no longer providing comprehensive vaccination numbers on its COVID-19 dashboards. But we still have some information about this year’s vaccination campaign, thanks to continued CDC efforts as well as reporting by other health agencies and research organizations.
    • Sources and updates, October 8
      Sources and updates for the week of October 8 include new papers about booster shot uptake, at-home tests, and Long COVID symptoms.
    • COVID source shout-out: Novavax’s booster is now available
      This week, the FDA authorized Novavax’s updated COVID-19 vaccine. Here’s why some people are excited to get Novavax’s vaccine this fall, as opposed to Pfizer’s or Moderna’s.
  • CDC says 80% of teachers and childcare workers are vaccinated, fails to provide more specifics

    CDC says 80% of teachers and childcare workers are vaccinated, fails to provide more specifics

    This past Tuesday, April 6, the Centers for Disease Control and Prevention put out a press release that I found heartening, yet confusing.

    “Nearly 80 percent of teachers, school staff, and childcare workers receive at least one shot of COVID-19 vaccine,” the release proclaims. These vaccinations include “more than 2 million” people in these professions who received doses through the federal retail pharmacy program and “5-6 million” vaccinated through state programs, all of whom received shots before the end of March.

    This CDC release is exciting because occupational data—or, figures tying vaccination counts to the jobs of those who got vaccinated—have been few and far between. As I wrote last month, state and local health departments have been unprepared to track this type of data; even getting states to report the race and ethnicity of their vaccinated residents has been a struggle.

    While you may need to be a teacher or fit another essential worker category in order to get vaccinated in your state, your provider may require you to show some proof of eligibility without recording that eligibility status anywhere. Meanwhile, school districts and local public health departments might be wary of surveying their local teachers to see who’s been vaccinated. Madeline Will explains the issue in EdWeek:

    Yet many vaccination sites do not collect or report occupation data, and many districts are not tracking vaccination rates themselves. Some district leaders say they’re wary of asking employees if they’ve gotten vaccinated because they don’t want to run afoul of any privacy laws, although the U.S. Equal Employment Opportunity Commission has said that employers can ask whether employees have gotten a COVID-19 vaccine.

    This brings us to the question: how did the CDC get its 80% figure? The agency’s press release is frustratingly unspecific; it’s all of 282 words long, with just one paragraph devoted to what a data journalist like myself would call the methodology, or the explanation of where the data come from.

    Here’s that explanation:

    CDC, in collaboration with the Administration for Children and Families, the Department of Education, and our non-federal partners, conducted surveys of Pre-K-12 teachers, school staff, and childcare workers at the end of March. CDC received almost 13,000 responses from education staff and nearly 40,000 responses from childcare workers. The responses closely matched available national race/ethnicity and demographic data on this specific workforce.

    Let’s unpack this. The CDC worked with two other federal agencies to conduct a survey of this high-priority occupation group, including 13,000 school staff and 40,000 childcare workers. The agency then extrapolated the results of this 53,000-person survey to estimate that 80% of Americans in these occupations have been vaccinated overall. While the CDC doesn’t provide any detail on how workers were chosen for the survey, the press release notes that responses match demographic data for this workforce, indicating that agency researchers did collect race, ethnicity, and other demographic information for those they surveyed.

    So, here’s my big question: is the CDC planning to release more detailed results from this survey? And if not… why?

    As we’ve noted in past CDD issues, teacher vaccination can go a long way towards inspiring confidence in school reopening programs, in school staff and parents alike. And that confidence is needed right now: February results of the Department of Education’s school COVID-19 survey, released last week, demonstrate that even though the majority of U.S. schools are now offering in-person instruction, only about one-third of students are learning in the classroom full-time. (More on those findings via AP’s Collin Binkley.)

    If the CDC released results of this vaccination survey for individual states and demographic groups, local public health and school district leadership may be able to see how their populations compare and respond accordingly. If, say, Texas is vaccinating fewer teachers than New York, Governor Greg Abbott can make a speech telling his state to step it up.

    And those states where a higher share of teachers have been vaccinated can use the information to inform school opening plans. The CDC’s press release doesn’t specify what share of that 80% vaccinated represents partially versus fully vaccinated school and childcare workers (which would also be useful data!), but even a workforce that was partially vaccinated at the end of March may be ready for in-person work by the end of April.

    All this is to say: show your work, CDC! Give us more detailed data!

    It’s also important to note, though, that while teachers are in the spotlight, they aren’t the only occupation for whom vaccination data should be a priority. Many staff in long-term care facilities have been unwilling to get vaccinated even though it would be a highly protective measure for the seniors they care for, Liz Essley Whyte wrote in late March at The Center for Public Integrity.

    The federal program that partnered with pharmacy chains to get LTC residents and staff vaccinated is now winding down, Whyte reports, even though some states still have a lot of LTC workers left who need shots. In seven states and D.C., less than a third of staff are vaccinated.

    Whyte writes:

    Low vaccination rates among staff at these facilities mean that workers continue to have greater risk of contracting COVID-19 themselves or passing the virus to their patients, including residents who can’t be inoculated for medical reasons. Low staff uptake can also complicate nursing homes’ attempt to reopen their doors to visitors like Caldwell, who are striving for some sense of normalcy.

    The Centers for Medicare & Medicaid Services are hoping to improve data on this issue. This agency proposed a new rule this week that would require nursing homes to tell the CDC how many of their health care workers are vaccinated against COVID-19, POLITICO reported on Friday. This rule would enable the CMS to identify specific facilities that are faring poorly and take appropriate action. And, if such data are made public, it would be easier for both reporters and families of nursing home residents to push for more LTC worker vaccinations.

    Still, privacy concerns continue to be a barrier for more detailed vaccination data of all types. Some of the big pharmacy chains that are administering huge shares of shots are requiring vaccine recipients to share their emails or phone numbers when they register for an appointment—then saving that data to use for future marketing. Getting patient contact information is an easy way to ensure people actually show up for their appointments, but when it’s a private company collecting your phone number instead of your public health department, it’s understandable that people might be a bit concerned about giving any information away.

    More detailed data standards, along with communication between governments and vaccine providers, could have saved the U.S. from the patchwork of vaccination data we’re now facing. But instead, here we are. Asking the CDC to please send out a longer press release. Maybe with a state-by-state data table included.

  • Featured sources, April 4

    • Vaccination data update: Two more states are now reporting vaccinations by race/ethnicity. New Hampshire has reported the figures in one of the state’s recent daily updates, which include vaccination data on a weekly basis. And South Dakota has added race/ethnicity to the vaccines tab of its dashboard. As always, you can find detailed annotations on state and national vaccine data sources (updated yesterday) on the COVID Data Dispatch website.
    • KFF COVID-19 Vaccine Monitor: The Kaiser Family Foundation released the latest update for their Vaccine Monitor, an ongoing survey project to track public attitudes and experiences with COVID-19 vaccines. In this update, published this past Tuesday, KFF reports that 62% of those surveyed say they’ve already gotten a shot or plan to do so as soon as possible, while 17% want to “wait and see” how the rollout goes. That “wait and see” share is down from previous reports.
    • CDC Provisional Mortality Data for 2020: This past Wednesday, the CDC released death counts for 2020. As we’ve discussed before, mortality data tend to be reported with a lag compared to other types of public health numbers due to the complex processes involved with tallying up death certificates. About 3.3 million deaths occurred overall in 2020, according to these new data; this was a 16% increase from 2019. COVID was the third leading cause of death that year, accounting for 345,000 lives lost.
    • Federal COVID-19 Chart Gallery: Peter Walker, former data visualization co-lead for the COVID Tracking Project, has put together a new Tableau gallery using data from the CDC COVID Tracker and HHS Protect. The gallery includes many chart formats that CTP fans may recognize, such as national views, four-pane views, and regional comparisons. More charts are coming!
    • Pfizer COVID-19 Clinical Trials: An interactive, searchable map from Pfizer lets you look up vaccine trials around the world. For each trial, you can see the location, the trial’s phase, who’s eligible to join, and a link out to more information on ClinicalTrials.gov. Trials are happening in the U.S., the U.K., Spain, and Japan.
    • mRNA sequence for the Moderna vaccine: A group of scientists at Stanford used small amounts of Moderna vaccine left after all doses were extracted from vials to sequence the mRNA in that vaccine, then posted the sequence publicly on GitHub. The full sequence takes up two pages. You can read more about the scientists’ work and their decision to post the sequence in Motherboard.
    • Pulse of the Purchaser 2021 Report: This new report from the National Alliance of Healthcare Purchaser Coalitions examines how employer attitudes to healthcare have shifted during the COVID-19 pandemic. The report presents results from a survey of 151 major employers, representing diverse industries and sizes; it includes attitudes towards COVID-19 vaccines, telehealth, equity, and other healthcare topics.

  • Hey CDC, when dashboard?

    Hey CDC, when dashboard?

    As dedicated CDD readers may remember, one of President Biden’s big COVID-19 promises was the creation of a “Nationwide Pandemic Dashboard” that would be a central hub for all the information Americans needed to see how the pandemic was progressing in their communities.

    The Biden administration sees the CDC’s COVID Data Tracker as that dashboard and plans to continue improving it as time goes on, White House COVID-19 Data Director Cyrus Shahpar said in an interview with The Center for Public Integrity last month. But a new report from the Government Accountability Office suggests that the CDC’s tracker has a long way to go before it becomes the centralized system that Americans need.

    The Government Accountability Office, or GAO, is a federal watchdog agency that evaluates other federal agencies on behalf of Congress. Its full report, released last Wednesday, is over 500 pages of problems and recommendations, ranging from the Emergency Use Authorization process to health care for veterans.

    But, as COVID Tracking Project leader Erin Kissane pointed out on Twitter, there are some real data bangers starting in the appendix:

    Here are a few of those data bangers:

    • Recommending that the federal government provides more comprehensive data on who gets a COVID-19 vaccine. The GAO specifically wants to see more data on race and ethnicity, so that the public can gauge how well vaccination efforts are reaching more vulnerable demographic groups. The agency also notes the challenge of finding occupational data on vaccinations, something we’ve bemoaned before at the CDD.
    • Calling out the lack of public awareness for federal data. Some experts the GAO interviewed noted that “the public may be more aware of non-federal sources of data on COVID-19 indicators (e.g., the COVID Tracking Project, Johns Hopkins) than sources from the federal government,” in part because those non-federal sources started providing public data earlier in 2020. The federal agencies need to step up their communications game.
    • Stating the need for central access to federal data. The GAO describes how the HHS lacks a central, public-facing COVID-19 data website, while the CDC’s COVID Data Tracker fails to provide access to the full suite of information available from the HHS. Specific missing data pages include COVID-19 health indicators and vaccine adverse events.

    Overall, the GAO says, the agency recommends that “HHS make its different sources of publicly available COVID-19 data accessible from a centralized location on the internet.” One would think this is a pretty straightforward recommendation to follow, but HHS reportedly “neither agreed nor disagreed” with the assessment.

    While there’s a lot more to dig into from this report, it is only part of a long evaluation process to improve federal data collection and reporting. The new report is part of a GAO effort that started last March, reports POLITICO’s Sarah Owermohle:

    The latest report is part of nearly yearlong effort by GAO to track the federal pandemic response after a directive in the March 2020 CARES Act. The watchdog first called on CDC to “completely and consistently collect demographic data” including comprehensive results on long-term health outcomes across race and ethnicity, in September. It later criticized the government’s lack of “consistent and complete COVID-19 data” in a January report.

    I, for one, am excited to see what the GAO does next—and how the federal public health agencies respond.

  • National numbers, April 4

    National numbers, April 4

    In the past week (March 27 through April 2), the U.S. reported about 435,000 new cases, according to the CDC. This amounts to:

    • An average of 62,000 new cases each day
    • 133 total new cases for every 100,000 Americans
    • 1 in 754 Americans getting diagnosed with COVID-19 in the past week
    • 9% more new cases than last week (March 20-26)
    Nationwide COVID-19 metrics as of April 2, sourcing data from the CDC and HHS. Posted on Twitter by Conor Kelly.

    Last week, America also saw:

    • 34,600 new COVID-19 patients admitted to hospitals (10.6 for every 100,000 people)
    • 6,200 new COVID-19 deaths (1.9 for every 100,000 people)
    • An average of 3 million vaccinations per day (per Bloomberg)

    “I’m gonna pause here, I’m gonna lose the script, and I’m gonna reflect on the recurring feeling I have of impending doom.”

    You’ve probably seen headlines with this quotation, something CDC Director Dr. Rochelle Walensky said at the White House COVID-19 briefing on Monday before launching into an impassioned plea to “just hold on a little while longer.” Still, I recommend watching the full video, if you haven’t yet. I watched it live, and was struck by Dr. Walensky’s drive to avoid any more people sent to the hospital with COVID-19, any more unnecessary deaths.

    The pandemic’s current state puts public health leaders like Dr. Walensky in a challenging position. New cases continue to rise, with states like Michigan, New York, New Jersey, and other parts of the northeast seeing more concerning spikes. While a 60,000-cases-per-day average may seem small compared to the numbers we saw this winter, it’s comparable to the summer surge that devastated much of the country. And our still-improving genomic surveillance system is finding more and more cases caused by variants.

    Yet at the same time, millions of people are getting vaccinated—a new record was set just yesterday, with 4 million doses reported in one day. The weekly average is now at 3 million new doses each day. Not four days after that briefing when Dr. Walensky warned of impending doom, the CDC put out a travel guidance that many took as a license to book post-vaccination plane tickets. (It’s not, though by the way some have described it, you could be forgiven for thinking that way.)

    Those who’ve been vaccinated may find it hard to believe another surge is coming. But we can’t let down our guard yet! About three in ten Americans have received at least one vaccine dose—that’s far from herd immunity.

  • New, more local data from the CDC

    New, more local data from the CDC

    The CDC made two major updates to its COVID-19 data this week.

    First: On Tuesday, the agency published a new dataset with more granular information on COVID-19 cases. Like previous case surveillance datasets, this new source compiles cases shared with the CDC, along with anonymized information on their symptoms, underlying medical conditions, race/ethnicity, and other variables. The new dataset is notable because it includes detailed geographic data, going down to the county level.

    After months of no state-by-state demographic data from the federal government, we now have county-by-county demographic data. This is a pretty big deal! It’s also a pretty big dataset; it includes about 22 million cases (out of a total 30 million U.S. cases to date).

    Of those 22 million cases, race is available for about 13 million cases (58%) and ethnicity is available for about 10 million cases (47%). The dataset will be updated monthly, so we may see better completion with further updates. I haven’t had time to do much detailed analysis of the new dataset yet (hell, I haven’t even managed to get it to load on my computer), but I’m excited to dive into it for future issues.

    Second: Vaccination data at the county level are now available on the CDC’s COVID Data Tracker, as of Friday. No, not in the vaccinations section—you need to go to the County View section, then select “Vaccinations” in the dropdown menu. Click on a specific county (or select it using dropdown menus), and you’ll be able to see data for that county.

    County-level vaccination data from the CDC. Screenshot taken on March 27.

    At the moment, only three data points are available: total fully vaccinated population, fully vaccinated population over age 18, and fully vaccinated population over age 65. Also, data are missing for Texas, New Mexico, and select other counties. Still, this a great start for more standardized vaccination data at the national level. (Can we get more demographic data next?)

    These county-level vaccination data aren’t downloadable directly from the CDC’s tracker, but the COVID Tracking Project is archiving the data at the Project’s public GitHub. The New York TImes has also built an interactive map with the data, which you can find on their vaccine tracker.

    It’s worth noting that I found out about both of these updates via tweets from the White House COVID-19 Data Director, Cyrus Shahpar. I’m on both the CDC’s press list and the White House press list, and I watch nearly every White House COVID-19 press briefing, so it seems a little odd that I’m getting the news from Twitter.

    (Not that I don’t love Cyrus’ daily tweets! I just wonder about the PR strategy here. Also, Cyrus, if you’re reading this, that interview request I sent back in January still stands.)