Computerized decision model provides evidence vaccinated is better than not

By Chuck Gibson (Information from U.C. News) 

CINCINNATI, OH (July 20, 2021) – For many the battle rages on: should I get the COVID Vaccine, or not?  Which one? 

COVID-19 samples used in research (File photo)

We couldn’t get the vaccination solution fast enough. It seemed everyone, not just here in the U.S., but all across the world was screaming for a vaccination to end the COVID-19 pandemic. In a vaccine, we found hope. Politics aside, decisions were made at the highest level of our U.S. government early in 2020 to fund the necessary research immediately to develop a vaccination to protect the people against COVID-19 infection and slow, if not stop, the spread of the deadly disease. 

Pharmaceutical companies like Moderna, Pfizer, Johnson & Johnson (J&J), and Astra-Zeneca focused research and resources on developing an effective vaccine as quickly as possible. With no funding impediments, it wasn’t long before vaccines from Pfizer, Moderna and others were being tested in nationwide studies. The University of Cincinnati Health and Medical research teams were chosen to participate and help conduct the studies. They recruited volunteers from the public to have the vaccine administered and monitored the results. Ultimately, the results were reported as remarkably good. First Pfizer, and then just days later Moderna reported efficacy rates exceeding 90-percent success. Soon after, they received Emergency Use Authorization (EUA) to distribute and inject the vaccine to be administered to the public. First it was the elderly and most vulnerable , and eventually in phases, the vaccine was made available to everyone 12 years of age and older. 

The debate continues today. Despite the original outcry for the development of a vaccine, many now eligible for the vaccine have thus far chosen not to be vaccinated. Make no mistake, those who argue against it because it has not yet received the full approval of the Food & Drug Administration (FDA), who oversees such approval decisions, are not wrong. There is a difference between and EUA and full approval by the FDA. The point is less than 50% of the total U.S. population has been vaccinated according to Center for Disease Control (CDC)  data thru July 19, 2021. The percentage of U.S. population over 12 years of age with at least one dose increases the number to nearly 57%. Even when you look at the their numbers for those over 65 years of age, it remains less than 80% who have had at least one dose of the vaccination administered. The debate rages on. 

rFor weeks, if not months, the Federal Government and State Governments along with the National Institutes of Health (NIH) and the CDC have waged a campaign encouraging people to be vaccinated as soon as possible. There have even been incentivized campaigns with monetary rewards for being vaccinated. Arguments are made for vaccination to protect against new, maybe deadly, COVID variants. Some argue the results are conclusive for getting the vaccination. Some the opposite and still more who say the arguments are inconclusive either way. Many critics claim it is all somehow politically motivated. One thing is clear today. this debate is not going to subside soon. One other thing appears cleat today, those in the health research field are looking for definitive answers. Here is the latest from the University of Cincinnati, Division of General Internal Medicine Dr. Mark Eckman, MD. 

Mark Eckman, MD Director and Professor U.C. Division of General Internal Medicine. (Photo Credit Colleen Kelley)

FROM U.C. NEWS: Vaccine hesitancy is increasingly impacting the health of large segments of the American population as the COVID-19 pandemic enters its second year.

Researchers at the University of Cincinnati College of Medicine have developed a computerized decision analytic model to compare projected outcomes of three vaccine strategies: a patient opts for a messenger RNA vaccine, a patient decides to get an adenovirus vector vaccine or the patient simply forgoes a vaccine altogether. 

Pfizer and Moderna produce mRNA vaccines while Johnson & Johnson manufacture an adenovirus vector vaccine. The decision analytic model uses a metric of quality adjusted life expectancy that accounts for both survival and quality of life as affected by hospitalization, COVID-19 disease and long-term post-infection complications on a patient, also commonly known as long-haul syndrome, explains Mark Eckman, MD, director and professor in the UC Division of General Internal Medicine and lead author of the study.

The model simulated the health outcomes for a 65-year-old and found the patient would gain a net of 7.4 days — an extra week of life — if the person received the mRNA vaccine versus opting to not vaccinate at all.  Of the two strategies that include receiving a vaccine, both yield virtually equivalent results, with the mRNA vaccine demonstrating a minimal gain of roughly one day of life compared with the J&J vaccine. – Eckman

The study findings are available online in the scholarly journal Medical Decision Making Policy & Practice. Other co-authors include Richard Lofgren, MD, President and CEO of UC Health, and faculty members in the UC Department of Internal Medicine: Margaret Powers-Fletcher, PhD, assistant professor; Jennifer Forrester, MD, associate professor; Carl Fichtenbaum, MD, professor and George Smulian, MD, professor.

“The important point is that both types of vaccines are better than no vaccine,” said  Eckman, also a primary care physician at UC Health, the UC affiliated health system that teaches and trains residents, medical students and other students in health care professions. “If we take a public health perspective by multiplying that gain over the vaccine eligible population, it results in a large net benefit for the nation.”

Dr. Margaret (Maggie) Powers-Fletcher, PHD co-investigatorr on the Moderna Vaccine study conducted by U.C.. Health (Provided)

Eckman says if the U.S. extends the per person benefit to the remaining unvaccinated and eligible population (individuals 12 years old and up) in the country, the aggregate benefit would be 3.92 million quality-adjusted life years for those receiving an mRNA vaccine. If the aggregate benefit were calculated using the J&J vaccine it would result in a net benefit of 3.38 million quality-adjusted life years.

“Since we did not have time to perform a clinical trial to study this question of vaccination, we developed a computer model to simulate outcomes of the strategies mentioned, using the most up-to-date and best data available,” Eckman said. “Our analysis showed that both vaccines yield virtually equivalent results. The take-home message is that receiving either type of the vaccine is better than not getting vaccinated at all.”

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