vaccines work, the first effects on health workers and guests of the RSA-

In Italy the people who have completed the vaccination cycle (with first and second dose) are 2,145,434 million, the 3.6% of the population, a still very low number to be able to appreciate the effect of protection on the curve of hospitalizations, deaths and infections.

The most vaccinated categories

If we break down the data in the priority categories identified by the national vaccine plan and that is over 80, health workers, the frail and guests of the RSA, we can see the first differences, given that the administrations in some of these categories are ahead of the numbers of vaccinated in the general population. As of March 19, 2,825,292 doses have been administered to health and social health workers, 1,169,920 doses to non-health personnel, 2,433,867 doses to people over 80 and 502,394 doses to RSA guests. This means, according to the latest report by the Istituto Superiore di Sanit and dated 10 March, that the group that, in proportion, received the largest number of doses the age group over 90 years (about 40% received at least one dose), followed by the 80-89 age group (at least one dose at about 32%).

Healthcare workers

To realize how much the vaccine has a positive effect, we analyze the infections and the data relating to health workers and over 80s. With one caveat: full vaccination protection comes about one month after the first dose and it concerns above all hospitalizations and deaths, in a less incisive way the infections. Starting from the second half of January (the vaccination campaign in Italy actually started after the Epiphany, ed) – writes the ISS in the report – we observe a decreasing trend of the number of cases in healthcare professionals and people over the age of 80, probably attributable to the ongoing vaccination campaign. The decline alone is not indicative, because at the same time the current restrictions can affect the number of cases: it must always be compared with the trend of the rest of the population.

FIGURE 1 – cases among healthcare workers (average 7 days) – Source ISS

As for the health workers the good news is: the proportion of cases among health workers out of the total number of cases reported in Italy, in mid-November it exceeded 5% of the total (as seen in the FIGURE 1 above), but from mid-January there is a downward trend likely attributable to the completion of the vaccination cycle in a good percentage of subjects belonging to this category, writes the ISS. During the period 22 February – 7 March 2021 there were 2,154 cases among health professionals, 1% of the total. The data reported by the Regions also indicate that the lethality among these subjects, even at the same age class, is lower than the total lethality. The most notable comparison is the case line among health care workers alongside that of the general population: the two epidemic curves (see FIGURE 2, below) had a very similar trend until the second half of January, when they began to diverge, showing a decline in health workers, compared to a stationary trend and then a clear increase from 8 February in the general population.

FIGURE 2 - case trend in healthcare workers (yellow) and in the rest of the population (black);  the black line
FIGURE 2 – case trend in healthcare workers (yellow) and in the rest of the population (black); the black line the beginning of the vaccination campaign and the gray line the beginning of the administration of the second doses (source ISS)

Above 80, trend

In a less marked way, the difference is also appreciated by analyzing the number of cases of SARS-CoV-2 infection in the population divided by age group: over 80 and under 80. There is a very similar trend in the two groups up to the second half of January (see FIGURE 3 below) and subsequently a decline in the population of over 80 years) with a small trend reversal in the last week, but remember that infections in Italy are waiting for a new peak shortly).

FIGURE 3 - Case trend for over 80 years (blue) and 60-79 years (red), source ISS
FIGURE 3 – Case trend for over 80 years (blue) and 60-79 years (red), source ISS

Differences between Regions

In the vaccination of vulnerable categories, the following are also relevant regional differences: the autonomous province of Bolzano vaccinated about 63% of the over 80s with at least one dose (source GIMBE), Sardinia 22%, Basilicata, Emilia Romagna, Lazio, Marche, Molise, Piedmont and Puglia are between 40% and 50%. Below 30% there are Umbria and Tuscany. Lombardy at 35%. Numbers growing but still too small to observe tangible results in terms of reduction of hospitalizations and deaths in the age group most affected by Covid-19, writes the Foundation commenting on its weekly report. So, in Bolzano, lethality should have already been reduced by 40%, in many regions of 20%, 18% in Tuscany and 15% in Sardinia. In Lazio from February to today the incidence of cases in over 80 passed from 13.5 to 8.6 per 10,000 inhabitantsdespite the third wave.

FIGURE 4 - trend of health workers (blue) versus general population (yellow) in Lombardy - source Lombardy Region
FIGURE 4 – trend of health workers (blue) versus general population (yellow) in Lombardy – source Lombardy Region

Collapse of cases among health professionals in Lombardy

More data from the report updated to March 8 of the Lombardy. The FIGURE 4 above shows how the group of health workers benefits of a notable reduction of infections despite the increase in infections in the general population. New cases among doctors and nurses drop from mid-January and remain very low.
The results are comparable in the group of guests of the nursing homes: 90 percent of the elderly in the nursing home received the first dose and the net drop in infections despite the increase in the general population.
The third analysis made by the Lombardy Region concerns over 80 who do not live in care facilities. The injections for this segment of the population started on February 18th and they proceed at a different pace, depending on the provinces. The average came in at 19 percent coverage. Too few injections – and too recent – to see an effect.

Israel: deaths down 91%

With these numbers some analysts calculate that lethality in Italy may have already dropped by 12% and will continue to do so. On the other hand, the data coming from countries ahead of ours in the vaccination campaign are very encouraging and even impressive. The champion country Israel: thanks to its extension, its organization and an agreement signed long in advance on the development of the vaccine with Pfizer, vaccinated 55.4% of the population with the first dose and 48% with the second. A study on Nature published on 12 March takes stock of the effects of the campaign, recalling that it was not easy to verify its extent, given that the variables involved included the third national bloc taken during the first weeks of the vaccination campaign and the presence in the country of the English variant. Despite this, around 2 months into the injections, solid evidence of the vaccine’s efficacy and impact is evident. It is mainly one wider and earlier decrease in cases and hospitalizations among older individuals (given priority), with a more pronounced effect in cities that started vaccinating earlier than in others. Secondly (as seen in the FIGURE 5 below) a notable change in the age distribution of hospitalized patients that began only about 3-4 weeks after the start of the vaccination campaign, the scientists write on Nature.

FIGURE 5 - the decrease in hospitalizations by age groups
FIGURE 5 – the decrease in hospitalizations by age groups in Israel (source Nature)

In people 60 years of age and older, who were vaccinated first, there have been from the peak 86% fewer cases, 73% fewer critically ill patients, 91% fewer deaths (the daily number is now about ten per day). The decline is now observed in all age groups, because in Israel children aged 16 and over are also vaccinated and the economy and activities have almost completely recovered.

Great Britain: marked decreases in the elderly

As of March 17, the UK had vaccinated 25,735,472 million people with the first dose and 1,879,054 with the second. Cases among those over 80 decreased by 95%, while deaths in that age group decreased by 93% (the daily figure as of March 18 was 95). Among people aged 18 to 69, cases decreased slightly less, by 91%, while deaths fell by 87%. Even if the country is emerging from a long lockdown, a detail that could throw off comparisons, the positives are declining in all age groups, with a faster decline between the ages of 70-79.

Usa, excellent data from the comparison between age groups

Finally, a country that is not often mentioned with regard to vaccines, but very far ahead with the campaign, despite the size of the population and the extent of the territory: the USA. They vaccinated 22.6% of the population with the first dose and 12.4% with the second. Having now given nearly 33 doses per 100 people, the number of deaths and hospital admissions is decreasing more rapidly among older people than in the population. According to a CDC study last month, 78 percent of nursing home residents had been vaccinated. The data show that i cases and deaths in RSAs began to decline at the start of the vaccination campaign, while across the country they were rising. In the next two months to the end of February, cases among nursing home residents fell by 96%, while deaths fell by 87%. Over the same period, cases among people aged 18 to 54 fell by 72%, while deaths fell by 80%. Government data shows that hospitalizations fell by 90% among people of 85 years or older from the winter peak, much more than 72% among people aged 18 to 49.

March 20, 2021 (change March 20, 2021 | 10:09 am)

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