Population Optimally Immunized after Accounting for Type-Specific COVID-19 Vaccine Waning Intervals: State-Level Prevalence and Trends
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Abstract
BACKGROUND
COVID-19 vaccines exhibit real-world waning effectiveness against SARS-CoV-2 infection within the first 3-6 months after a completed series. Consequently, the main metric tracked by the CDC (percent “fully vaccinated,” with no adjustment for booster status) has become insufficiently informative.
METHODS
We analyzed CDC daily vaccination data to quantify COVID-19 immunization status for 4 mutually-exclusive groups: (1) not immunized; (2) partially immunized ( people who received the 1 st dose of a 2-dose series); (3) immunized with waning immunity (previously immunized people whose booster dose is overdue); and (4) optimally immunized (people who: (a) received the Janssen vaccine <2 months ago or completed an mRNA vaccine series <6 months ago, or (b) received the Janssen vaccine >2 months ago or completed an mRNA vaccine series >6 months ago and received a booster dose.)
RESULTS
The proportion of the total US population who were optimally immunized against COVID-19 fell from a high of 45.3% on July 17 to 29.4% on November 30. During November, the majority of states experienced a worsening trend in the percent of the total population who were overdue for a booster dose, including the 4 largest states, with percentage point increases of 3.5 in New York, 3.4 in California, 2.3 in Texas and 1.7 in Florida.
CONCLUSIONS
Our proposed classification scheme accounts for type-specific vaccine waning intervals, provides an accurate assessment of progress toward national immunization goals, and reveals the urgent need for additional public health mitigation strategies to successfully combat the COVID-19 pandemic in the United States.
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SciScore for 10.1101/2021.12.09.21267295: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations of our study are as follows. Conceptually, the primary limitation of our method is that we assign groups of individuals to the immunized with waning immunity category in a dichotomous fashion, based on time frames that reflect population averages from empirical studies and regulatory time cutpoints (i.e. before or after 2 …
SciScore for 10.1101/2021.12.09.21267295: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations of our study are as follows. Conceptually, the primary limitation of our method is that we assign groups of individuals to the immunized with waning immunity category in a dichotomous fashion, based on time frames that reflect population averages from empirical studies and regulatory time cutpoints (i.e. before or after 2 months for Janssen recepients, and before or after 6 months for Pfizer/Moderna recepients). While these time cutpoints are evidence-based and not arbitrary, they still cannot capture any of the individual variability in the timing of waning vaccine effectiveness, nor do they capture the continuous nature of the process of individual waning immunity at the physiological level. Several other nations have chosen to begin their administration of booster doses at 4 months or 5 months post-completed mRNA vaccine series, based on assessment of the exact same scientific evidence considered by the US FDA and US CDC. Consequently, by implementing a 6-month (for mRNA recipients) transition to the immunized with waning immunity category, instead of an algorithm that reflects possible waning immunity prior to that cutpoint, we take a conservative approach that may underestimate of the true percent of people with waning immunity. It then follows that our method may also overestimate the percent of the population optimally immunized. Simply put, as bad as things look, they may actually be worse. Methodologically, the primary limitation of our approach is the un...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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