Lead Author: White, et al.
Original date of publication: 05/19/2021
Link: https://www.nejm.org/doi/full/10.1056/NEJMc2104849
Summary Context
In this non-peer reviewed commentary to NEJM pushing the importance of covid-19 vaccination, nursing home patients see same drop in infection fatality rate over same timeline, whether vaccinated or not. Alleged drop in mortality is not statistically significant and is a product of fewer cases. Author’s summary ascribes all positive movement epidemiologically to vaccination, masking, and infection control measures.
Comments
This article is an instructive example of the narrative “findings” of a non-controlled study (a correspondence, in this case) having little relationship with the actual data presented, and ignoring other factors like case peaks and variants. In this retrospective (looking at old records) study of New England nursing homes with high vaccination rates, the unvaccinated had a nearly identical reduction of covid-19 cases as the vaccinated residents, and the correspondence authors ascribed this to the protection given to them by being surrounded by the vaccinated residents. Rather than note that all groups had sharp reductions (when you compare over same timeline, which they try to obscure) and admit they’re not quite sure why, they create a narrative and send in a correspondence rather than publish a study and subject it to peer review. The rate of infection is so low for both groups that the data become very insignificant statistically, and the conclusions are very searching and tenuous. They also ascribe progress to masks and other measures without basis in empirical evidence.
Abstract or Results, Key Passages
This is a correspondence so no abstract: Summary “Our observation of a reduced incidence of infection among unvaccinated residents suggests that robust vaccine coverage among residents and staff, together with the continued use of face masks and other infection-control measures, is likely to afford protection for small numbers of unvaccinated residents in congregate settings. Still, the continued observation of incident cases after vaccination highlights the critical need for ongoing vaccination programs and surveillance testing in nursing homes to mitigate future outbreaks.”
Keywords: adverse eventscovid vaccinationelderlyinfection fatality rateinstitutional settingsmortality ratemRNANursing homesretirement homes
Full Author List: Elizabeth M. White, Xiaofei Yang, Carolyn Blackman, Richard A. Feifer, Stefan Gravenstein, Vincent Mor, Ph.D.
