Dean's Update
August 27, 2021 - Aron Sousa, MD
Friends,
I have a couple of follow-ups from last week regarding COVID-19 cases and vaccines. First, it appears that cases in Ingham and Kent Counties are increasing, as are hospitalizations, although so far we are well below the surges of last spring. Second, there are new safety data for the Pfizer vaccine out of Israel. Because the Israelis have something close to an actual system for health, they can follow large numbers of people and create post hoc control groups. This kind of data is not as good as prospective, randomized, blinded trials, but it does include a very large number of people who are living their lives for real. In short, Pfizer’s vaccine is remarkably safe, and while the vaccine is related to an increase in myocarditis, there is much less myocarditis in the vaccinated people than there is in people who get COVID-19.
Also this week, the CDC released a study related to the announced third shot boosters for people eight months past their mRNA vaccination. The fundamental trend behind the call for the third shot is a reduction in vaccine effectiveness from 85% for frontline workers less than 120 days from their vaccine, compared to a vaccine effectiveness of 73% for frontline workers more than 150 days past their vaccination. Eagle-eyed readers of this study will note that the confidence limits for these two averages overlap. This means there is a trend toward waning effectiveness, but the data in this study does not yet meet the definition of statistical significance used in biology.
These studies are complex. You may remember my discussion of a different CDC report last week, or you read the CDC nursing home study from the week before. Many different variables could contribute to the decrease in apparent vaccine effectiveness: the delta variant is more transmissible and is peaking in many states now, masking behavior has reduced this summer, the economy opened up in many ways, and heat waves may have driven people inside where transmission is more likely.
All of these variables likely act to accentuate any decrease in apparent vaccine effectiveness within the community and confound studies trying to discern if this is the time for boosters. The data is very complex, and I understand why policy makers have decided to move ahead with third shots of these very safe vaccines for folks who are eight months past their vaccine date. We would expect vaccines to decrease in effectiveness over time, and it would be good to prepare for boosters before there is a major gap in effectiveness. This is especially true for the frontline people most likely to be exposed to COVID-19.
If we are going to do boosters, I think we have an ethical duty and practical interest in expanding world-wide vaccination. The people of so many countries are struggling to get their people vaccinated. Surely, if we have enough vaccine to give boosters, we can have enough vaccine to help protect more of the poor and vulnerable around the world. At the practical level, more dangerous and transmissible variants can come from any place in the world with meaningful transmission of SARS-CoV-2. And, world-wide vaccination is how we protect everyone from the risk of more dangerous variants.
I am proud that MSU moved on a vaccine mandate earlier this summer, and the deadline for faculty, staff, and students to be vaccinated is Tuesday, August 31. You can attest and document your vaccination at the Together We Will website. There are exceptions for medical and religious reasons, but the College of Human Medicine will not be assigning unvaccinated students to clinical activities.
We are still planning on the Gran Fondo’s return to Grand Rapids on September 18. We are tracking cases in Kent and Ottawa Counties, talking to the county health departments, and we are communicating with Grand Rapids hospitals about the COVID-19 situation in town. We are doing our best to follow the CDC guidance on outdoor events. As examples, we are trying to make sure there is distancing before and after the ride, registration materials are being mailed rather than use on-site pick-up lines, and we have eliminated on-site registration to, again, avoid lines. We will cancel if need be, but so far, like outdoor fall sports, we are a go. We are tracking the safety issues closely. Register by August 30 for 12-, 25-, 40-, or 80-mile rides in support of skin cancer research.
In other news, Rebecca Knickmeyer, PhD, received a $5.5M NIH award to lead the largest-of-its-kind global study to understand the impact of genetics on early brain development and neurological disorders like autism, schizophrenia and attention deficit hyperactivity disorder. Congratulations, Rebecca!
As you all know, Barbara Forney is leaving CHM for the Office of Health Sciences with some small piece of retirement as a part of the transition. We are taking this as a time to integrate faculty affairs and development with our academic and staff human resources teams. This will create a new unit we are calling the Office of Faculty Affairs and Staff Administration (FASA) led by our indominable associate dean, Nara Parameswaran. People have been working very well together, and I think this will make us more efficient and coordinated.
As a teaser for next week – be sure to catch CHM alum and former dean Marsha Rappley, MD on the Town Hall at noon on September 3!
Please protect the people around you by wearing a mask when you are in public indoors, and protect yourself and others by getting vaccinated.
Serving the people with you,
Aron
Aron Sousa, MD
Interim Dean