Last week we saw more encouraging news on vaccination efforts, despite missteps by AstraZeneca in reporting its efficacy data. AstraZeneca later released more complete data, which reassuringly continued to show a high level of effectiveness.
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About our “The COVID-19 Crisis” series
U.S. vaccination numbers rise
The vaccine effort in the United States has ramped up nicely. Last weekend we hit 3 million doses on both Saturday and Sunday, and we’re at an average of 2.5 million a day over the last week. The federal government will send out 27 million doses of vaccine this week — so the challenges of vaccination are going to change rapidly.
We’ll continue to face the problem of having enough people, places and infrastructure to schedule and administer shots, and we’ll still have to pay attention to offering easy access to disadvantaged communities. By May, the biggest vaccination challenge will be convincing those in doubt to take the shot.
The rapidly expanding vaccine supply makes it more likely that employers will get access to vaccines from state and local public health authorities. Recent Medicare increases in payment to providers from about $28 a shot to $40 a shot for administering the vaccine will help us get even more doses into arms, and many commercial carriers are also increasing their allowed amount.
Employers consider vaccination policies
Willis Towers Watson just completed our 2021 Emerging Trends survey of 446 employers with 6.3 million total employees. The survey shows increasing employer efforts to communicate about COVID-19 vaccination and develop policies and procedures, and little action yet on vaccine mandates.
Few employers (4%) are currently offering financial incentives, and these are almost always $200 or less. More employers (15%) are offering time off for those who get vaccinated, with a full third doing so, planning or considering this. Most offer between one to four hours of paid time off, and 10% report they are providing additional leave for those who have adverse reactions to the vaccine; over a quarter are providing, planning or considering this.
No respondents reported that they are currently requiring proof of vaccination for returning to the workplace; 3% said they were planning this, and 20% are considering this action.
U.S. cases remain at a worrisome plateau, with over 50,000 cases most days. We continue to have about 30,000 patients hospitalized, and the number of cases in Michigan has more than doubled in the last two weeks. Increases in case rates in Brazil and Europe fueled by more contagious variants are cause for concern. We’re tantalizingly close to getting the pandemic under control, but more adherence to masks and distancing and getting people vaccinated right now will be critical to ensure we continue our very positive progress.
The seven-day moving average on March 27, 2021 was 60,425.
Source: Centers for Disease Control and Prevention
Confusion but clarification of AstraZeneca vaccine efficacy
AstraZeneca released the most recent information on its COVID-19 vaccine last week, addressing concerns from the Data and Safety Monitoring Board (DSMB) that it had not included some of the cases that had been identified most recently. The headlines:
- 76% overall efficacy in preventing any symptomatic infection
- 85% overall efficacy in preventing any symptomatic infection in those over 65
- 100% efficacy in preventing hospitalization or severe infection
This is great news. According to the company’s data, the AstraZeneca vaccine is both safe and effective and likely entirely comparable to the vaccines now authorized in the U.S. Here is my calculation of the effectiveness of the AstraZeneca vaccine based on the numbers the company provided:
Effectiveness of AstraZeneca, based on latest data
| Number in each group | Severe infection or hospitalization | Symptomatic infection | |
|---|---|---|---|
| Placebo control | 10,816 | 8 (0.07%) | 128 (1.2%) |
| Vaccine | 21,633 | 0 (0%) | 62 (0.3%) |
The latest data from AstraZeneca on its vaccine’s efficacy are reassuring because information the company released earlier in the week was not complete.
AstraZeneca has pledged to publish the full data from its clinical trial in a peer-reviewed journal, and I’m sure the company will face serious grilling when it seeks an emergency use authorization in the near future. The Food and Drug Administration process required this study because of the poor design of the earlier AstraZeneca clinical trials (which used different doses due to an accident, different timing and did not include enough elderly volunteers). The rigor of this process should reassure all that the COVID-19 vaccines have been adequately vetted.
Author
Jeff is an internal medicine physician and has led WTW’s clinical response to COVID-19 and other health-related topics. He has served in leadership roles in provider organizations and a health plan and is an Assistant Professor at Harvard Chan School of Public Health.
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