Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

Link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2807617

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Key Points

Question  Was political party affiliation a risk factor associated with excess mortality during the COVID-19 pandemic in Florida and Ohio?

Findings  In this cohort study evaluating 538 159 deaths in individuals aged 25 years and older in Florida and Ohio between March 2020 and December 2021, excess mortality was significantly higher for Republican voters than Democratic voters after COVID-19 vaccines were available to all adults, but not before. These differences were concentrated in counties with lower vaccination rates, and primarily noted in voters residing in Ohio.

Meaning  The differences in excess mortality by political party affiliation after COVID-19 vaccines were available to all adults suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been a factor in the severity and trajectory of the pandemic in the US.

Abstract

Importance  There is evidence that Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination; further data on these rates may be useful.

Objective  To assess political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.

Design, Setting, and Participants  A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis.

Exposures  Political party affiliation.

Main Outcomes and Measures  Excess weekly deaths during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.

Results  Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at age 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage point (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.

Conclusions and Relevance  In this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.

Author(s): Jacob Wallace, PhD1; Paul Goldsmith-Pinkham, PhD2; Jason L. Schwartz, PhD1

Publication Date: 24 July 2023

Publication Site: JAMA Internal Medicine

Public Health Agencies Try to Restore Trust as They Fight Misinformation

Link: https://khn.org/news/article/public-health-agencies-try-to-restore-trust-as-they-fight-misinformation/

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Across the country, health officials have been trying to combat misinformation and restore trust within their communities these past few years, a period when many people haven’t put full faith in their state and local health departments. Agencies are using Twitter, for example, to appeal to niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They’re collaborating with influencers and celebrities such as Stephen Colbert and Akbar Gbajabiamila to extend their reach.

Some of these efforts have paid off. By now, more than 80% of U.S. residents have received at least one shot of a covid vaccine.

But data suggests that the skepticism and misinformation surrounding covid vaccines now threatens other public health priorities. Flu vaccine coverage among children in mid-December was about the same as December 2021, but it was 3.7 percentage points lower compared with late 2020, according to the Centers for Disease Control and Prevention. The decrease in flu vaccination coverage among pregnant women was even more dramatic over the last two years: 18 percentage points lower.

Other common childhood vaccination rates are down, too, compared with pre-pandemic levels. Nationally, 35% of all American parents oppose requiring children to be vaccinated for measles, mumps, and rubella before entering school, up from 23% in 2019, according to a KFF survey released Dec. 16. Suspicion swirling around once-trusted vaccines, as well as fatigue from so many shots, is likely to blame.

Author(s): Laurie Sausser

Publication Date: 3 Jan 2023

Publication Site: Kaiser Health News

Under Government Pressure, Twitter Suppressed Truthful Speech About COVID-19

Link: https://reason.com/2023/01/02/under-government-pressure-twitter-suppressed-truthful-speech-about-covid-19/?utm_medium=email

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Twitter’s ban on “COVID-19 misinformation,” which Elon Musk rescinded after taking over the platform in late October, mirrored the Biden administration’s broad definition of that category in two important respects: It disfavored perspectives that dissented from official advice, and it encompassed not just demonstrably false statements but also speech that was deemed “misleading” even when it was arguably or verifiably true. In a recent Free Press article, science writer David Zweig shows what that meant in practice, citing several striking examples of government-encouraged speech suppression gleaned from the internal communications that Musk has been disclosing to handpicked journalists.

Twitter’s moderation of pandemic-related content was intertwined with government policy from the beginning. Even before Joe Biden was elected president and his administration began publicly and privately demanding that social media companies suppress speech it viewed as a threat to public health, the company’s guidelines deferred to the positions taken by government agencies such as the Centers for Disease Control and Prevention (CDC). And those rules explicitly covered “misleading information” as well as “demonstrably false” statements.

….

That July, Twitter sought to clarify “our rules against potentially misleading information about COVID-19″ (emphasis added). “For a Tweet to qualify as a misleading claim,” the company said, “it must be an assertion of fact (not an opinion), expressed definitively, and intended to influence others’ behavior.” Possible topics included “the origin, nature, and characteristics of the virus”; “preventative measures, treatments/cures, and other precautions”; “the prevalence of viral spread, or the current state of the crisis”; and “official health advisories, restrictions, regulations, and public-service announcements.”

That was a very wide net, potentially encompassing anyone who questioned the CDC’s ever-shifting guidance or criticized government policies, such as lockdowns and mask mandates, aimed at reducing virus transmission. While the intent requirement ostensibly allowed dissent as long as it was not aimed at influencing behavior, that limitation did not mean much in practice, since moderators were apt to infer the requisite intent when they encountered tweets that implicitly or explicitly deviated from the recommendations of “public health authorities and governments.”

….

Another example that Zweig cites: Last August, @KelleyKga, a self-described “public health fact checker,” responded to another Twitter user’s claim that “COVID has been the leading cause of death from disease in children” since December 2021. “What an excellent example of cherry picking!” @KelleyKga wrote. “If you narrow it down to only the specific months you specify, which include the largest Covid wave (seen across the world), AND you ignore all non-disease deaths, AND you ignore cancer, heart disease, SIDS, then COVID is ‘leading.'”

Author(s): Jacob Sullum

Publication Date: 2 Jan 2023

Publication Site: Reason

Why Do Vaccinated People Represent Most COVID-19 Deaths Right Now?

Link: https://www.kff.org/policy-watch/why-do-vaccinated-people-represent-most-covid-19-deaths-right-now/

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The waning protection from vaccines is why CDC recommends recent booster shots, and why it’s especially important for people at higher risk to stay up-to-date on boosters. Per current recommendations, most adults should have received at least 2-3 booster doses by now (including the new bivalent booster), in addition to their primary series. However, only 14% of adults overall and 31% of older adults (65 years and older) have received the latest bivalent boosters. The CDC data show that about 95% of adults who died from COVID-19 in 2022 in these jurisdictions were over age 50, and about 8 in 10 were age 65 or older, underscoring the need for older adults to stay up-to-date on recommended booster shots.

The fall in the share of deaths that are among unvaccinated people could also be explained by changes in the unvaccinated population. By this far into the pandemic, it is estimated that many unvaccinated people have had COVID-19 at least once and while hundreds of thousands of unvaccinated people have needlessly died from COVID, those who survived may have gained some immune protection against the virus that can help protect them against severe outcomes when they have subsequent infections. However, this protection from a past infection can also diminish over time, which is why it is still recommended that unvaccinated people with prior COVID-19 infections get vaccinated and stay up-to-date on boosters.

Author(s): Cynthia Cox Follow @cynthiaccox on Twitter , Krutika Amin Follow @KrutikaAmin on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , and Josh Michaud Follow @joshmich on Twitter

Publication Date: 30 Nov 2022

Publication Site: KFF

State Surgeon General Dr. Joseph A. Ladapo Issues New mRNA COVID-19 Vaccine Guidance

Link: https://content.govdelivery.com/accounts/FLDOH/bulletins/3312697

Guidance: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-doc.pdf?utm_medium=email&utm_source=govdelivery

Analysis: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-analysis.pdf?utm_medium=email&utm_source=govdelivery

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Today, State Surgeon General Dr. Joseph A. Ladapo has announced new guidance regarding mRNA vaccines. The Florida Department of Health (Department) conducted an analysis through a self-controlled case series, which is a technique originally developed to evaluate vaccine safety.

This analysis found that there is an 84% increase in the relative incidence of cardiac-related death among males 18-39 years old within 28 days following mRNA vaccination. With a high level of global immunity to COVID-19, the benefit of vaccination is likely outweighed by this abnormally high risk of cardiac-related death among men in this age group. Non-mRNA vaccines were not found to have these increased risks.

As such, the State Surgeon General recommends against males aged 18 to 39 from receiving mRNA COVID-19 vaccines. Those with preexisting cardiac conditions, such as myocarditis and pericarditis, should take particular caution when making this decision.

Author(s): Joseph A. Ladapo

Publication Date: 7 Oct 2022

Publication Site: Florida Dept of Health

KFF COVID-19 Vaccine Monitor: September 2022

Link: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2022/

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Overall adult vaccination rates have been relatively steady over the past year. The latest COVID-19 Vaccine Monitor finds that nearly eight in ten adults (77%) say they have gotten at least one dose of a COVID-19 vaccine, including about half who say they are fully vaccinated and also received at least one booster dose (47%), about a quarter who have been fully vaccinated but have not gotten a booster (26%), and a small share who are partially vaccinated (3%). Twenty-three percent remain unvaccinated, the vast majority of whom say they will “definitely not” get the COVID-19 vaccine (88% of unvaccinated, or 21% of all adults). For the latest breakdown of self-reported vaccination rates by demographic group, see the Vaccine Monitor Dashboard.

In late August, the Food and Drug Administration authorized the use of new, updated COVID-19 vaccine boosters that target both the new omicron variants and the original strain of the virus. The bivalent boosters (one by Moderna and one by Pfizer) are now authorized for use by those ages 12 and older who have gotten an initial series of a COVID-19 vaccine, including those who have already received one or more boosters.

Awareness of the new boosters is modest, with about half of adults saying they have heard “a lot” (17%) or “some” (33%) about updated booster, 31% saying they have heard “a little,” and one in five saying they have heard “nothing at all” about the new booster doses.

Older adults and Democrats are somewhat more likely than their counterparts to say they have heard at least “some” about the new boosters, but fewer than a quarter across these groups report hearing “a lot” about the new shots.

Author(s): Grace Sparks Follow @gracesparks on Twitter , Lunna Lopes , Liz Hamel Follow @lizhamel on Twitter , Alex Montero , Marley Presiado , and Mollyann Brodie Follow @Mollybrodie on Twitter

Publication Date: 30 Sept 2022

Publication Site: Kaiser Family Foundation

Most Americans don’t plan to get a flu shot this season — lots of them say they’ll mask to avoid germs instead

Link: https://www.cnbc.com/2022/10/04/fewer-americans-plan-to-get-a-flu-shot-this-season-2022.html

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Only 49% of U.S. adults plan to get their flu shot this flu season, according to a survey conducted by the National Foundation for Infectious Diseases (NFID). Even 1 in 5 of those who are at higher risk for influenza-related complications say they won’t get vaccinated.

People who are more likely to have severe outcomes from a flu infection include those over the age of 65, pregnant people, children younger than five years old, and individuals with underlying conditions, according to the Centers for Disease Control and Prevention.

….

Most Americans agree. Nearly 70% believe that getting an annual flu vaccination is the best way to prevent influenza-related deaths and hospitalizations, the NFID found. And yet many people remain hesitant to get their vaccine.

Instead, more U.S. adults are gravitating towards masking as a form of protection against the flu. A higher percentage of Americans (58%) plan to mask at least sometimes this flu season than intend to get vaccinated.

Author(s): Renée Onque

Publication Date: 4 Oct 2022

Publication Site: CNBC

Polio Is Back in the US and UK. Here’s How That Happened

Link: https://www.wired.com/story/polio-is-back-in-the-us-and-uk-heres-how-that-happened/

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Start with the vaccine formula—or formulas, actually, because there are two. They were born from a ferocious mid-20th century rivalry between scientists Jonas Salk and Albert Sabin. Salk’s formula, the first to be approved, is injected; it uses an inactivated version of the virus, and protects against developing disease, but does not stop viral transmission. Sabin’s formula, which came a few years later, used an artificially-weakened live virus. It does block transmission, and—because it is a liquid that gets squirted into a child’s mouth—it is cheaper to make and easier to distribute, since it doesn’t require trained healthcare workers or careful disposal of needles. Those qualities made the Sabin oral version, known as OPV, the bulwark of polio control, and eventually the main weapon in the global eradication campaign.

The oral vaccine had a unique benefit. Wild-type polio is actually a gut virus: It locks onto receptors in the intestinal lining and replicates there before migrating to the nerve cells that control muscles. But because it’s in the gut, it also passes out of the body in feces and then spreads to other people in contaminated water. The Sabin vaccine takes advantage of that process: The vaccine virus replicates in a child, gets pooped out, and spreads its protection to unvaccinated neighbors.

Yet that benefit concealed a tragic flaw. Once out of every several million doses, the weakened virus reverted to the neurovirulence of the wild type, destroying those motor neurons and causing polio paralysis. That mutation would also make a child who harbored the reverted virus a potential source of infection, rather than protection. That risk is what caused rich nations to abandon the oral version: In 1996, when wild polio was no longer occurring in the US, the oral vaccine caused about 10 cases of polio paralysis in children. The US switched to the injectable formula, known as IPV, in 2000, and the UK followed in 2004.

Polio vaccination requires several doses to create full protection, and once that occurs, children are protected against both wild-type and vaccine-derived versions of the virus. So the international vaccination campaign continued to rely on OPV, arguing that the risk would diminish as more children received protection. That was a reasonable gamble when the effort was new and health authorities thought it would take 10 to 12 years to achieve eradication. But thanks to funding shortfalls, political and religious unrest, and the Covid pandemic—which imposed a slowdown not just on eradication activities but on all childhood vaccines—it’s now been 34 years, and the job is not done. Meanwhile, last year in 20 countries there were a total of 688 cases of paralysis of what’s called “circulating vaccine-derived poliovirus,” and only six cases of wild-type polio, in three nations.

Author(s): MARYN MCKENNA

Publication Date: 24 Aug 2022

Publication Site: Wired

What We’ve Learned — and Failed to Learn — from a Million COVID Deaths

Link: https://www.governing.com/now/what-weve-learned-and-failed-to-learn-from-a-million-covid-deaths

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The pandemic is not done. The number of new infections — surely an undercount due to unreported home tests — again tops 75,000 per day. The number of hospitalizations has climbed 20 percent over the past two weeks. The Biden administration has warned there could be 100 million more Americans infected by early next year. Yet Congress seems unwilling to provide more money for basic responses such as tests and vaccines, even as it becomes increasingly clear that even mild cases can lead to dangerous long-term damage.

Yet there are positive developments to consider as well. Vaccinations and certainly boosters are not where they should be, but three out of four Americans have received at least a single dose and two-thirds are fully vaccinated. The Commonwealth Fund has estimated that, absent vaccines, an additional 2.3 million Americans would have died, and 17 million more would have been hospitalized. Public health measures such as masking have largely fallen out of favor, but they helped prevent a death toll that could have been even more terrible.

“A million is way too many people, but as a result of the work that has been done, through public health and vaccination, it’s a number that’s a lot lower than it might have been,” says David Fleming, a distinguished visiting fellow at the Trust for America’s Health. “If we did not do those things, we would not be looking at the 1 million death threshold, we’d be looking at the 3 million death threshold.”

Author(s): Alan Greenblatt

Publication Date: 12 May 2022

Publication Site: Governing

If you’re vaxxed, you’re more likely to be killed by lightning than die of COVID: study

Link:https://nypost.com/2022/02/08/lightnings-more-likely-good-odds-for-vaxxed/

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Those odds can be gauged from a study by researchers at the National Institutes of Health, published by the Centers for Disease Control and Prevention. They tracked more than 1 million vaccinated adults in America over most of last year, including the period when the Delta variant was surging, and classified victims of COVID according to risk factors such as being over 65, being immunosuppressed or suffering from diabetes or chronic diseases of the heart, kidney, lungs, liver or brain.

The researchers report that none of the healthy people under 65 had a severe case of COVID that required treatment in an intensive-care unit.

 Not a single one of these nearly 700,000 people died, and the risk was minuscule for most older people, too. Among vaccinated people over 65 without an underlying medical condition, only one person died.

In all, there were 36 deaths, mostly among a small minority of older people with a multitude of comorbidities: the 3% of the sample that had at least four risk factors.

Author(s): John Tierney

Publication Date: 8 Feb 2022

Publication Site: NY Post

Study suggests Pfizer COVID-19 vaccine may only partially protect against Omicron

Link:https://www.reuters.com/business/healthcare-pharmaceuticals/pfizer-covid-19-vaccine-partially-protective-against-omicron-bloomberg-news-2021-12-07/?fbclid=IwAR0rKPM8dNsMnI_iQ0Hbph-KLY0HiI-PzeLmdYGWWoeFdYKsU07SuDjnuNg

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The Omicron variant of the coronavirus can partially evade the protection from two doses of Pfizer Inc (PFE.N) and partner BioNTech’s COVID-19 vaccine, the research head of a laboratory at the Africa Health Research Institute in South Africa said on Tuesday.

Still, the study showed that blood from people who had received two doses of the vaccine and had a prior infection were mostly able to neutralize the variant, suggesting that booster doses of the vaccine could help to fend off infection.

Author(s): Michael Erman

Publication Date: 8 Dec 2021

Publication Site: Reuters

COVID-19 Vaccination and Non–COVID-19 Mortality Risk — Seven Integrated Health Care Organizations, United States, December 14, 2020–July 31, 2021

Link:https://www.cdc.gov/mmwr/volumes/70/wr/mm7043e2.htm?s_cid=mm7043e2_w

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What is already known about this topic?

Although deaths after COVID-19 vaccination have been reported to the Vaccine Adverse Events Reporting System, few studies have been conducted to evaluate mortality not associated with COVID-19 among vaccinated and unvaccinated groups.

What is added by this report?

During December 2020–July 2021, COVID-19 vaccine recipients had lower rates of non–COVID-19 mortality than did unvaccinated persons after adjusting for age, sex, race and ethnicity, and study site.

What are the implications for public health practice?

There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States. All persons aged ≥12 years should receive a COVID-19 vaccine.

Author(s): Stanley Xu, PhD1; Runxin Huang, MS1; Lina S. Sy, MPH1; Sungching C. Glenn, MS1; Denison S. Ryan, MPH1; Kerresa Morrissette, MPH1; David K. Shay, MD2; Gabriela Vazquez-Benitez, PhD3; Jason M. Glanz, PhD4; Nicola P. Klein, MD, PhD5; David McClure, PhD6; Elizabeth G. Liles, MD7; Eric S. Weintraub, MPH8; Hung-Fu Tseng, MPH, PhD1; Lei Qian, PhD1

Publication Date: 29 October 2021

Publication Site: MMWR at CDC