Fuelling booster hesitancy
As Covid-related deaths continue to rise in Ontario, a recently released report by Public Health Ontario helps us better understand how these deaths break down by age group and vaccination status.
The report shows that a large number of deaths are occurring among the elderly and the unvaccinated. Of the 643 deaths that were registered in the 60 days prior to Jan. 16, 2022, just under half were of people who were 80 and over. Furthermore, 39 per cent of the deaths of all age groups were people who were unvaccinated.
Considering that those over 80 make up a little less than five per cent of Ontario’s population, while about 10 per cent of the population is unvaccinated, both the elderly and the unvaccinated are overrepresented in the mortality statistics.
In fact, deaths among unvaccinated people over 80 account for a staggering 13 per cent of total deaths, while the share of those 80 and above who are unvaccinated is very small. Exactly how small is unclear, as the provincial website claims that 100 per cent of Ontarians over 80 have been vaccinated, which obviously isn’t correct given that the province also reports deaths among this group. What is not in doubt is that the fatality rate for the unvaccinated above 80 is extremely high compared to everyone else.
Analyzing the data further also tells us that vaccination greatly helps prevent mortality across all age groups. Specifically, the fully vaccinated have a mortality rate of 22 per million population. For those with a booster dose, the mortality rate is 23 per million. For the unvaccinated, however, it’s a staggering 165 per million.
In other words, the unvaccinated are more than seven times more likely to die from COVID-19 than the vaccinated, based on deaths in the last two months.
The fact that those with a booster dose actually do slightly worse than those who are fully vaccinated without a booster may at first seem counterintuitive, but it’s explained by the fact that booster uptake among the young and healthy is relatively low, whereas it’s very high among the elderly, who are most at risk. In other words, those with a booster dose have a higher risk profile, on average.
To clarify the benefits of boosters among the most vulnerable, we can look at the mortality rate among those who are 80 and up. For the fully vaccinated, the mortality rate is 196 per million, whereas it’s 188 for those with a booster. The take-away is that, for those 80 and up, a booster does help, but not by that much, according to the most recent data from Ontario.
Where the booster clearly has the biggest bang for the buck is for the under-80 crowd. For those 7079, the mortality rate for the fully vaccinated is 62 per million, compared to a dramatically lower 28 per million among those who have been boosted.
For people in the 60-69 age bracket, the mortality rate for the fully vaccinated is 20 per million, compared to only six per million for those with a booster. For those 50-59, the mortality rate for the fully vaccinated is six per million, which drops to one per million for those with a booster.
The clear message from this most recent report is twofold: vaccination reduces the chance of dying by a lot, and for people under 80, getting a booster gives you significant additional protection and a much lower mortality rate.
While Ontario’s rate of full vaccination among everyone five and up is now an impressive 81 per cent, which is among the best in the world, only 39 per cent had received a booster as of Jan. 15. While this is by no means bad, it could be even better, especially among younger age groups.
At this point, anyone can walk into their local pharmacy and get a booster dose. The reason for the relatively slow uptake is likely due to vaccine fatigue. While boosters are helpful, as my analysis shows, especially in preventing serious illness and death, studies also show that boosters lose most of their efficacy after about 10 weeks. To maintain a continuously high level of protection, we would all be looking at a carousel of boosters into the indefinite future and no one has much of an appetite for that.
But another important factor fuelling vaccine fatigue and bolstering hesitancy among those who are already skeptical surely has to be the mixed and confusing messaging from public health officials and lockdown enthusiasts. Recall that the original rationale for getting vaccinated was that it would give us a path toward normalcy and bring an end to the lockdowns.
That provided a strong incentive to get vaccinated last summer and into the fall. However, since provinces such as Ontario have reneged on their promises to avoid lockdowns, there is an obvious cynicism that getting a booster now will lead us back to normalcy.
Adding to the lack of interest in boosters is also surely the tonedeaf messaging by some experts, who focused on the waning efficacy of vaccines rather than talking up their benefits, which obviously would reduce the incentive to get a booster for those who are already on the fence.
But the most egregious failure of all was that the province chose to accelerate its booster rollout at the same time as it was locking us down. It missed a golden opportunity to tell the public to “go get a booster so we can prevent another lockdown.” In short, the public’s trust has likely been badly eroded, if not destroyed.
CONFUSING MESSAGING FROM PUBLIC HEALTH.