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week of August 18, 2022

Minimizers claim victory

The claim:

Changing CDC guidance has folks who minimized COVID and never liked vaccines proclaiming that they were right all along.
 

The facts:

COVID minimizers have long claimed that vaccines either don't work or are inferior to natural immunity when it comes to limiting transmission, and see new guidelines as proof that they were correct. They are missing a couple of key points, however.

When the COVID vaccine was first introduced near the end of 2020, there had only been about 20 million COVID cases in the United States, with fewer than 35 million cases (about 10% of the population) by mid-year 2021. At that time, vaccination was very successful at preventing infection of those circulating variants of COVID, which also limited transmission. While natural immunity did help protect some of those who had previously had COVID, obtaining natural immunity meant having COVID and being a potential vector of disease. By the end of the year 2021, it was estimated that 34% of people in the United States had been infected.

As Omicron emerged in early 2022, not only did we discover it was even more contagious to those without any immunity, we discovered that it was able to evade immunity for both those vaccinated and those who had previously been infected. Boosting both of these populations helped bring immunity levels up at similar rates, again showing that vaccination including boosters was superior to simply natural infection. By April 2022, an estimated ~60% of people in the United States had been infected.

The most recent Omicron wave of BA.5 was the most contagious yet, with a number of breakthrough infections and reinfections of COVID occurring as soon as 28 days after a previous infection As of July 2022, The Institute of Health Metrics and Evaluation at the University of Washington estimates that over 80% of people in the United States has had COVID at least once. 

With these new variants, the landscape has changed significantly. The vaccine, once very protective against COVID disease in its entirety, now allows breakthrough infections while still protecting against severe disease and the worst complications of COVID.

At this point, the CDC feels that the variants have changed the calculus of transmission enough that guidelines could also adapt. The new guidance doesn't mean that vaccines never worked. It just means that enough people have some form of immunity through vaccination or previous infection that the CDC feels it should now focus its efforts on reducing serious illness as opposed to limiting transmission in general.

Monkeypox transmission, cont.

The claim:

We continue our series on "Just How is Monkeypox Spread" with a discussion of asymptomatic transmission. Is it a thing?
 

The facts:

In a recent STI screening of 200 men who had no symptoms, 13 tested positive for monkeypox. Two of those 13 developed symptoms about a week later. While 8 of the 13 were also HIV positive, all had undetectable levels of the monkeypox virus in their system, and all but one had what is considered a healthy immune system. Asymptomatic infection of monkeypox has been previously documented in areas of Africa where monkeypox is endemic.

What we don't know yet, however, is if asymptomatic (or presymptomatic) infection can lead to transmission.  If it can, we need to potentially evaluate the strategy of vaccinating primarily those who have come in contact with a known patient.

Eyes on measles

The claim:

We don't need to worry about measles any more because it's all just COVID and monkeypox. Right?
 

The facts:

Since April of 2022, 80 children in Zimbabwe have died of measles. While 10 years ago, Zimbabwe could boast a 97% vaccination rate for measles, those numbers have slipped to about 85% in 2020. The Ministry of Health has documented 1,036 suspected cases and 125 confirmed cases since April, blaming church gatherings of a religious sect that discourages vaccination.

Measles is very contagious; about 90% of people exposed who are not immune will become infected. Because it is so contagious, the threshold for community immunity (the percentage of people who need to be immune to a disease to prevent transmission in a community) is about 95%. The good news is that the measles vaccine is very effective: 2 doses of the MMR vaccine provides about 97% effectiveness in preventing measles.

It's NIAM

National Immunization Awareness Month! We have been helping folks get the word out about the good vaccines do in our communities. Give us a boost by becoming a monthly donor!
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