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COVID-19 in the U.S. has evolved from epidemic to endemic. The disease is far more lethal than seasonal influenza. In one week this year in early September, 984 patients died from COVID-19, an increase of 27% since the last month — and that was even before the respiratory virus season.
COVID-19 remains the third leading cause of U.S. deaths behind cardiovascular disease and cancer. From January 2020 to Aug. 21, 2023, the U.S. experienced 12 million total deaths, of which 1.1 million were caused by COVID-19 while 22,000 were from influenza. Thus, mortality from COVID-19 has been 73 times higher than mortality due to influenza. In addition, all the mRNA COVID-19 vaccines have been far more protective than the influenza vaccine and pose less risks. Nonetheless, in the U.S., only 21% of adults and 8% of those under 18 years of age received the last available COVID-19 booster.
At present, in addition to the 1.1 million deaths, the U.S. has experienced 103 million cases, many of which will result in long COVID, a wide range of new and recurring, often debilitating, symptoms post-infection lasting more than 12 weeks. These U.S. figures compare with 770 million cases and 6.9 million deaths worldwide. Thus, the U.S., which accounts for about 4.2% of the global population, has suffered over 16% of deaths from COVID-19. Our nation continues to lead the world in deaths from COVID-19.
In 2016, the U.S. was deemed by the World Health Organization to be the single country best prepared to mitigate the onset of a previously predicated pandemic of infection with a new coronavirus. Yet, in 2020, the U.S. was least prepared to do so and has led the world in cases as well as deaths. Today, in the face of continuing opposition to masking, social distancing and crowd avoidance, vaccination is the best defense against a new emerging strain that can strike individuals, family members, friends and communities. This strategy, coupled with widespread prescription of paxlovid during the first five days following infection, will also further reduce hospitalizations and deaths.
The newly available vaccine confers much greater immunity against the new COVID-19 EG-5 variant. This new variant has spread rapidly across the country and had already accounted for more than a quarter of all new COVID-19 infections by August 2023. Americans should be concerned that the EG-5 variant contains a mutation that results in this particular strain being unlikely to confer any lasting immunity to those previously vaccinated and boosted, whether complete or partial, those with previous natural infection and those without prior infection but who have had prior vaccinations or boosters. For prevention of COVID-19, the new vaccine will markedly reduce mortality and hospitalizations from the current circulating strain. Older generation boosters have already been removed from the market.
To do the most good for the most people from age 6 years and older, a large body of reliable randomized evidence indicates that the benefits of COVID-19 vaccination on mortality and hospitalizations vastly outweigh the risks. Moreover, vaccination of children eligible to receive the new COVID-19 vaccine will have major clinical and public health impacts by reducing their hospitalizations and deaths but also those of their parents, grandparents, child care providers and schoolteachers. We are fortunate to live in a country where COVID-19 vaccines are so readily available and accessible, owing to the collaborations between the pharmaceutical industry, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).
We do not recommend following a strategy of “I’ll take my chances but if I get sick with COVID-19, I can always get treated.” We recommend following the Benjamin Franklin axiom that “an ounce of prevention is worth a pound of cure.” The best means to do so is by preemptively protecting Americans age 6 years and older against COVID-19 now.
Professor Charles H. Hennekens is the first Sir Richard Doll professor of medicine at the Charles E. Schmidt College of Medicine at Florida Atlantic University in Boca Raton.
Professor Dennis G. Maki is the first Ovid O. Meyer professor of medicine and critical care specialist at the University of Wisconsin School of Medicine and Public Health in Madison. He and Hennekens served together for two years as lieutenant commanders and Epidemic Intelligence Service (EIS) officers with the CDC, where they trained under Drs. Alexander Langmuir and Donald A. Henderson who wrote the public health strategies for disease control and prevention of communicable diseases and led and coordinated local, state, national and international efforts to abolish polio and smallpox.
Dr. Sarah K. Wood is director of the Harvard Macy Institute at the Harvard Medical School in Boston and former interim dean as well as professor and chair of the Department of Women’s and Children’s Health at the Charles E. Schmidt College of Medicine at Florida Atlantic University in Boca Raton.
The scientific views expressed by these authors are not necessarily those of their institutions.
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