From today’s New York Times (with apologies for wonky formatting.)
Preparing vaccines in Rochester Hills, Mich. Emily Elconin for The New York Times
The C.D.C. has begun to publish data on Covid outcomes among people who have received booster shots, and the numbers are striking:
Based on 25 U.S. jurisdictions. | Source: C.D.C.
As you can see, vaccination without a booster provides a lot of protection. But a booster takes somebody to a different level.
This data underscores both the power of the Covid vaccines and their biggest weakness — namely, their gradual fading of effectiveness over time, as is also the case with many other vaccines. If you received two Moderna or Pfizer vaccine shots early last year, the official statistics still count you as “fully vaccinated.” In truth, you are only partially vaccinated.
Once you get a booster, your risk of getting severely ill from Covid is tiny. It is quite small even if you are older or have health problems.
The average weekly chance that a boosted person died of Covid was about one in a million during October and November (the most recent available C.D.C. data). Since then, the chances have no doubt been higher, because of the Omicron surge. But they will probably be even lower in coming weeks, because the surge is receding and Omicron is milder than earlier versions of the virus. For now, one in a million per week seems like a reasonable estimate.
That risk is not zero, but it is not far from it. The chance that an average American will die in a car crash this week is significantly higher — about 2.4 per million. So is the average weekly death rate from influenza and pneumonia — about three per million.
With a booster shot, Covid resembles other respiratory illnesses that have been around for years. It can still be nasty. For the elderly and immunocompromised, it can be debilitating, even fatal — much as the flu can be. The Omicron surge has been so terrible because it effectively subjected tens of millions of Americans to a flu all at once.
For the unvaccinated, of course, Covid remains many times worse than the flu.
I’m highlighting these statistics because there is still a large amount of vaccine skepticism in the U.S. I have heard it frequently from readers in the past week, after our poll on Covid attitudes and partisanship, as well as the “Daily” episode about the poll.
This vaccine skepticism takes two main forms. The more damaging form is the one that’s common among Republicans. They’re so skeptical of vaccines — partly from misinformation coming from conservative media figures and Republican politicians — that many remain unvaccinated.
Look at this detail from the Kaiser Family Foundation’s latest portrait of vaccination: Incredibly, there are more unvaccinated Republican adults than boosted Republican adults.
From a survey of 1,536 adults in Jan. 2022. | Source: Kaiser Family Foundation
This lack of vaccination is killing people. “It’s cost the lives of people I know, including just last week a friend of 35 years, a person I met on one of the first weekends of my freshman year of college,” David French, a conservative writer who lives in Tennessee, wrote in The Atlantic. “I can’t tell you how heartbreaking it is to see person after person fall to a virus when a safe and effective shot would have almost certainly not just saved their life but also likely saved them from even having a serious case of the disease.”
Dr. Peter Hotez, a vaccine expert at the Baylor College of Medicine, estimates that in the second half of last year, 200,000 Americans needlessly lost their lives because they refused Covid vaccines. “Three doses of either Pfizer or Moderna will save your life,” Hotez told me. “It’s the only way you can be reasonably assured that you will survive a Covid-19 infection.” (Young children, who are not yet eligible for the vaccines, are also highly unlikely to get very sick.)
The vaccines don’t prevent only death. Local data shows the risks of hospitalization are extremely low, too. Vaccination also reduces the risk of long Covid to very low levels.
Healthy and anxious
The second form of vaccine skepticism is among Democrats — although many would recoil at any suggestion that they are vaccine skeptics. Most Democrats are certainly not skeptical about getting a shot. But many are skeptical that the vaccines protect them.
About 41 percent of Democratic voters say they are worried about getting “seriously sick” with Covid, according to a Kaiser Family Foundation poll released last week. That’s a very high level of anxiety for a tiny risk.
Here’s the proof that much of the fear is irrational: Young Democrats are more worried about getting sick than old Democrats, even though the science says the opposite should be true.
From a survey of 1,536 adults in Jan. 2022. | Source: Kaiser Family Foundation
The most plausible explanation for this pattern is political ideology. Younger Democrats are significantly more liberal than older Democrats, according to the Pew Research Center (and other pollsters, too). Ideology tends to shape Covid views, for a complex mix of often irrational reasons. The more liberal you are, the more worried about Covid you tend to be; the more conservative you are, the less worried you tend to be.
I know that many liberals believe an exaggerated sense of personal Covid risk is actually a good thing, because it pushes the country toward taking more precautions. Those precautions, according to this view, will reduce Covid’s death toll, which truly is horrific right now. In a later newsletter this week, I will consider that argument.
For now, I’ll simply echo the many experts who have pleaded with Americans to get vaccinated and boosted.
Answers and convenience
What might help increase the country’s ranks of vaccinated? Vaccine mandates, for one thing — although many Republican politicians, as well as the Republican appointees on the Supreme Court, oppose broad mandates. Private companies can still impose mandates on their employees and customers.
Without mandates, the best hope for increased vaccination is probably community outreach. While many unvaccinated Americans are firmly opposed to getting a shot, others — including some Democrats and independents — remain agnostic. If getting a vaccination is convenient and a nurse or doctor is available to answer questions, they will consider it.
“I cannot count how many people I’ve spoken to about the Covid vaccine who have been like, ‘No, I don’t think so. No,’” Dr. Kimberly Manning of Emory University told The Atlanta Journal-Constitution. “Then I run into them two weeks later and they tell me they got vaccinated.”
Related: “You have to scratch your head and say, ‘How the heck did this happen?’” Dr. Anthony Fauci told Michael Barbaro on today’s episode of “The Daily,” about the partisan gap in Covid attitudes. Fauci also predicted that people who were anxious about Covid would become less so as caseloads fell.
In Times Opinion, James Martin, a Jesuit priest, argues that schadenfreude over vaccine skeptics’ suffering warps the soul.
To summarize some encouraging vaccine news in today’s New York Times:
All five vaccines with public results have eliminated Covid-19 deaths. They have also drastically reduced hospitalizations. “They’re all good trial results,” reports Caitlin Rivers, an epidemiologist at Johns Hopkins University. “It’s great news.”
Don’t focus on the relatively minor differences among the vaccine results. The available data is very encouraging — including the vaccines’ effect on the virus’s variants.
Coronaviruses have been circulating for decades if not centuries, and they’re often mild. The common cold can be a coronavirus. The world isn’t going to eliminate coronaviruses — or this particular one— anytime soon.
We don’t need to eliminate Covid-19 for life to return to normal. We need to downgrade it from a deadly pandemic to a normal virus.
All five vaccines — from Pfizer, Moderna, AstraZeneca, Novavax and Johnson & Johnson — look extremely good. Of the roughly 75,000 people who have received one of the five in a research trial, not a single person has died from Covid, and only a few people appear to have been hospitalized. None have remained hospitalized 28 days after receiving a shot.
For perspective, in 75,000 American adults, Covid has killed roughly 150 and sent several hundred more to the hospital. The vaccines reduce those numbers to zero and nearly zero, based on the research trials. A typical U.S. flu season kills between five and 15 out of every 75,000 adults and hospitalizes more than 100.
When you read that the Johnson & Johnson vaccine was 66 percent effective or that the Novavax vaccine was 89 percent effective, those numbers are referring to the prevention of all illness. Researchers count mild symptoms as a failure.
What about the highly contagious new virus variants that have emerged in Britain, Brazil and South Africa? There is no evidence yet that it increases deaths among vaccinated people. Two of the five vaccines — from Johnson & Johnson and Novavax — have reported some results from South Africa, and none of the people there who received a vaccine died of Covid.
The vaccines still provide considerable protection against the variant, though less than against the original version. Some protection appears to be enough to turn this coronavirus into a fairly normal disease in the vast majority of cases.
Any of the five vaccines can save your life. If you have to choose between getting the Johnson & Johnson vaccine now or waiting three weeks to get the Moderna or Pfizer vaccine, the experts say: Get what you can, as soon as you can. Don’t risk three more weeks of exposure.