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The US vaccine effect: rapid rollout starts to bear fruit

The rapid rollout of Covid-19 vaccines across the US is starting to work, according to a Financial Times analysis of official data that shows the number of deaths and hospital admissions are falling more quickly among older people than in the wider population.

The US has overseen one of the fastest vaccination programmes in the world, administering more doses than any other country and vaccinating a large proportion of its population.

Older people and those in nursing homes were first in line for vaccinations, resulting in a rapid decline in Covid-19 hospitalisations and deaths among these groups in the past few weeks. The declines in these groups has been faster than in the rest of the population, which has also seen a broad-based reduction since the winter peak.

Tom Frieden, the former director of the US Centers for Disease Control and Prevention, said: “Vaccines are already saving thousands of lives in the United States. Rapid declines in the number and proportion of deaths among nursing home residents are the direct result of vaccines saving lives.”

The US has suffered more in terms of overall fatalities than any other country from Covid-19, with over 500,000 deaths. But it has also proved more successful at vaccinating large numbers of people, having now administered nearly 33 doses per 100 people.

The first groups to be vaccinated have been healthcare workers and those working and living in nursing homes, which states started inoculating in December, as soon as the US drugs regulator authorised the first vaccine

The US has suffered more in terms of overall fatalities than any other country from Covid-19, with over 500,000 deaths. But it has also proved more successful at vaccinating large numbers of people, having now administered nearly 33 doses per 100 people © Octavio Jones/Getty Images

In the first month of the rollout, an estimated 78 per cent of nursing home residents were vaccinated, according to a study last month by the CDC. Since then that number has continued to rise, according to those working in the sector, who say they think that in many homes almost all residents have now received at least one shot.

Government data show that cases and deaths among nursing home residents started to fall around a week after the rollout began, even as both cases and deaths across the country as a whole continued to climb.

Chart showing the US’s vaccine effect: cases and deaths have fallen earlier and further among nursing home residents, the first to be vaccinated in the US

In the following two months until the end of February, cases among nursing home residents dropped 96 per cent, while deaths fell 87 per cent. 

During the same period, cases among people aged 18-54, the least likely group to have been vaccinated, fell by 72 per cent, while deaths dropped by 80 per cent.

Chart showing the US’s vaccine effect: the decline in cases and deaths is no longer slower among older groups than younger ones

Ruth Katz, senior vice-president of policy at LeadingAge, which represents care homes across the country, said: “The safest place in the country to be right now as far as Covid-19 goes is a nursing home. Many homes have vaccination rates among their residents up in the 90 [per cent range].”

Older people in general have also experienced a steeper decline in Covid-19 cases and deaths, with most states offering the vaccine to all over-65s earlier this year. The CDC changed its guidance in mid-January to urge states to offer the vaccine to all over-65s and those with underlying conditions, although many states had already begun to do so.

A vaccination site in Inglewood, California, as people with pre-existing health conditions are granted access to a vaccination © Mike Blake/Reuters

Government data show hospitalisations have fallen by 90 per cent among people aged 85 and above since the winter peak, considerably more than the 72 per cent drop among people aged 18-49. The gap opened up in the weeks after the vaccination rollout kicked into gear.

The recent fall in Covid-19 rates among older Americans is not only more rapid than among younger people, it is also more rapid than was seen in the aftermath of the country’s second wave in August, in another sign of the impact of the vaccines.

Evidence of the US “vaccine effect” follows similar data from European countries and Israel that have shown coronavirus rates falling faster among vaccinated groups than non-vaccinated ones.

In the UK, cases among the over-80s are down 95 per cent, while deaths in that age group have fallen 93 per cent. Among people aged 18 to 69, cases have come down slightly less, by 91 per cent, while deaths have fallen 87 per cent.

Israel has now administered more than 100 doses per 100 people, and has vaccinated the vast majority of its elderly population. Almost no Covid restrictions are in place, and infections are down to 3 per cent of those who are getting tested.

In the US, many states are now widening vaccine eligibility and, as a result, cases, hospitalisations and deaths have begun to fall more quickly among younger people, thereby closing the gap with older age groups. 

Leana Wen, a public health professor at George Washington University, said: “A lot of states are now opening things up because there were so many different categories of eligible people that it was slowing things down.”

But even as the rollout continues with nearly 2.5m doses a day being given out on average, according to data from Bloomberg, the political row over mitigation efforts remains alive.

A server works at a bar in a restaurant in Pearland, Texas. Earlier this month, Texas and Mississippi announced an end to all Covid-related restrictions, including mask mandates © Go Nakamura/Bloomberg

Earlier this month, Texas and Mississippi announced an end to all Covid-related restrictions, including mask mandates, moves that were condemned by US President Joe Biden as examples of “Neanderthal thinking”

While cases continue to fall in most places, a recent rise in certain states has triggered concerns that more transmissible, and potentially more lethal variants, may be taking hold. Rochelle Walensky, the head of the CDC, said earlier this week that she expected the B.1.1.7 variant, which ripped through the UK this winter, to become the dominant variant in the US by early April.

Despite this, doctors are cautiously optimistic that the continued acceleration of the vaccine programme will continue to bring case and death rates down. Frieden, the former CDC director, said: “Targeted vaccination of those over 65 is already driving death rates down, and I expect that this decrease will continue.”


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