...AND THE SEAS WILL RECEDE...:

The mRNA (BioNTech/Pfizer, Moderna) vaccines and the Oxford/AstraZeneca jab have been in use for almost three months now, and the real-world results are nothing short of miraculous. Israel's world-beating vaccination drive, for example, has substantially reduced the number of critically ill older patients and infected young people:

Outside of Israel (which is using only the Pfizer vaccine), other results are trickling in and are similarly positive. For example, the BBC reported on Monday that the U.K.'s vaccination program reduced hospitalizations in Scotland by 85 percent (Pfizer) and 94 percent (AstraZeneca) at only four weeks after the first dose. In particular, Public Health Scotland's review of 1.14 million vaccinations between December 8 and February 15 found that "there were just over 8,000 people who ended up in hospital, but only 58 were among the vaccinated group after the four-week mark." In the United States, which is using both mRNA vaccines, there are numerous state-level reports of COVID-19 cases plummeting in long-term care facilities, and nationwide hospitalizations have collapsed (more on that in a sec)--trends that are both due, at least in part, to these amazing vaccines.

There is also increasing evidence that the vaccines are effective at stopping most people from not only getting seriously ill, but also infecting others. As numerous medical experts have noted over the last few months (and as trials have indicated but did not definitively prove), it was always highly likely that the vaccines would greatly reduce virus transmission. However, the mere possibility they might not has been a constant note of caution regarding the vaccines and our broader return to normalcy (e.g., wearing masks, social distancing, and reopening schools or local businesses). Now, we finally have some supporting data from the field, and the results are uniformly great. First, researchers from the Mayo Clinic examined 62,138 individuals in Arizona, Florida, Minnesota, and Wisconsin between December 1 and February 8, and found that "[a]dministration of two COVID-19 vaccine doses [both mRNA types] was 88.7% effective in preventing SARS-CoV-2 infection ... with onset at least 36 days after the first dose." Second, a new study out of Israel found a similar level of efficacy for only the BioNTech/Pfizer shot: a 89.4 percent reduction in transmission (expert review here). Third, a U.K. study of health care workers in England found that the Pfizer/BioNTech vaccine led to an 86 percent reduction in infection a week after the second dose. The authors' conclusion: "Our study demonstrates that the BNT162b2 vaccine effectively prevents both symptomatic and asymptomatic infection in working age adults."

All three studies are preliminary, but they remain a big and wonderful deal, especially since (1) they all say the same basic thing; (2) they basically confirm what medical experts have long suspected (while convincing others to jump on the bandwagon); and (3) even critics note that, while the exact efficacy figures may be off, the overall conclusion (a significant reduction in transmission) is very likely correct. Very exciting stuff.

Even more good news came last week with respect to the BioNTech/Pfizer vaccine. First, multiple studies showed that a single dose is highly effective (more than 80 percent) in preventing symptomatic disease a few weeks after it's administered. Second, following successful internal testing, Pfizer and BioNTech asked U.S. regulators to allow their vaccine to be stored and transported at standard freezing temperatures (-4 F / -20 C) instead of the super cold temps that are currently required. This would greatly expand the number of places in the United States and elsewhere that could store and administer the vaccine, and it comes at the perfect time for the many states that have teamed up with local pharmacies (including Walmart) to ramp up vaccine distribution in the coming weeks. 

As George Mason University's Alex Tabarrok (who's been a true champ on vaccine issues) adds, the single dose data might unfortunately be wasted on the United States, which appears wedded to the original two-dose approach, but it and the storage development could be a very big deal for developing countries that are just getting started. They also show why we shouldn't blindly and permanently adhere to the companies' initial clinical trial data, which were "designed at speed with the sole purpose of getting the vaccines approved" not "to discover the optimal regimen for public health." We can, and should, keep adapting as the evidence warrants.

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