Covid Confusion at the CDC Decisions on boosters relied on data from Israel. Why isn’t the U.S. producing this research? By Marty Makary
Dr. Makary is a professor at the Johns Hopkins University School of Medicine, and the author of “The Price We Pay: What Broke American Health Care—And How To Fix It.”
The U.S. spends lavishly on healthcare yet can’t answer basic questions about Covid-19. Some of the best research has come from Israel. American public health agencies should be producing data on breakthrough infections, boosters and natural immunity. But the Centers for Disease Control and Prevention has failed to provide the information needed to inform a sound Covid strategy.
Israel began its vaccine rollout with Pfizer in December, only days after the U.S. But Israel kept good data, reported them out frequently and quickly, and used them to track subsequent Covid infections. When the White House announced its plan to recommend a booster shot for all Americans, it cited Israeli data. The World Health Organization and others criticized the plan, calling the evidence insufficient, and in what seemed like a coordinated protest, two top scientists at the Food and Drug Administration abruptly resigned.
The Biden administration recently got the supporting data it needed to justify its booster plan. But not from the CDC. Another Israeli study showed that a booster resulted in a 10-fold reduction in severe Covid illness in people over 60. The results were published mere weeks after the study’s completion, not months later as often happens in the U.S.
“There’s no doubt,” Anthony Fauci said of the findings in a press briefing, “from the dramatic data from the Israeli study that the boosts that are being now done there and contemplated here support very strongly the rationale for such an approach.” The FDA, trying to evaluate the question of boosters, scrambled to obtain the raw data from Israel.
The bigger question is: Why didn’t the CDC produce the research? The agency has 21,000 employees and a $15 billion annual budget. It has data on more than 40 million Americans who have tested positive for Covid and 200 million who have been vaccinated. The data include the vaccine type, dosing schedule and vaccination date. Calculating the rate of U.S. breakthrough infections and subsequent hospitalizations and deaths isn’t the Manhattan Project. It’s Epidemiology 101.
The CDC’s failure to report meaningful data has left policy makers flying blind. In the absence of good data to answer the basic questions Americans have been asking, political opinions have filled the vacuum. Strong data might have prevented much of the polarization over Covid.
Sound data from the CDC has been especially lacking on natural immunity from prior Covid infection. On Aug. 25, Israel published the most powerful and scientifically rigorous study on the subject to date. In a sample of more than 700,000 people, natural immunity was 27 times more effective than vaccinated immunity in preventing symptomatic infections.
Despite this evidence, U.S. public health officials continue to dismiss natural immunity, insisting that those who have recovered from Covid must still get the vaccine. Policy makers and public health leaders, and the media voices that parrot them, are inexplicably sticking to their original hypothesis that natural immunity is fleeting, even as at least 15 studies show it lasts.
Meanwhile, employers fire workers with natural immunity who won’t get vaccinated. Schools disenroll students who won’t comply.
The CDC did put out a study on natural immunity last month, forcefully concluding that vaccinated immunity was 2.3 times better than natural immunity. The CDC used these results to justify telling those with natural immunity to get vaccinated.
But the rate of infection in each group was less than 0.01%, meaning infections were exceedingly rare in the short two-month time period the agency chose to study. This is odd, given there are more than a year of data available. Moreover, despite having data on all 50 states, the CDC only reported data from Kentucky. Was Kentucky the only state that produced the desired result? Why else exclude the same data from the other 49 states?
Some public health officials are afraid to acknowledge natural immunity because they fear some will choose infection over vaccination. But leaders can encourage all Americans who aren’t immune to get vaccinated and be transparent with the data at the same time.
The CDC shouldn’t fish for data to support outdated hypotheses. Heeding the robust Israeli data on natural immunity could help restore the agency’s credibility and even help vaccination efforts.
Israel also contributed a brilliant study on vaccinating children. Researchers found that one dose of the Pfizer vaccine, instead of the normal two, was 100% effective in children ages 12 to 15. Such a finding could have significant implications for achieving broad immunity in adolescents while reducing the risk of heart complications, which have been clustered around the second dose.
These are the studies U.S. public health agencies should be doing but aren’t. By any metric, the CDC has failed in its primary task of preparing the country for a pandemic and telling us how to reduce harm from the novel Covid pathogen.
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