A new analysis published in the New England Journal of Medicine assessed attitudes regarding vaccine efficacy among people who had already received the vaccine. The report also discussed how those receiving vaccination felt about the need to continue key mitigation measures. The analysis relies on the results of a relatively small survey, though one that was meant to be a representative national sample.

Survey respondents had varying beliefs regarding whether one dose or two doses of the Pfizer/BioNtech or Moderna mRNA vaccines were needed. (The authors note that up to and during the time of survey administration, public officials were debating the need for one vs two doses, as well as efficacy at preventing severe covid-19 after the first and second doses.) At the time the survey was conducted, the single-dose Johnson & Johnson vaccine was receiving some negative attention in the news, which may have influenced the findings.

Of the 18 percent of respondents who had received at least one dose of a vaccine, a substantial proportion of respondents did not know that protection against covid-19 was strongest after the second dose. Furthermore, lack of information was provided to vaccine recipients regarding the uncertainty of post-vaccine transmission of SARS-CoV-2 to others, as well as the importance of continuing mitigation measures, at least until such data are known. 

Uncertainty of post-vaccine transmission risk, or the belief that post-vaccine transmission does not occur was associated with being less likely to support mask use after vaccination. (In fairness, people spreading the virus after vaccination has not been documented, though post-vaccination infections have been reported, especially with certain variants.) Still, the majority of respondents continued to support the use of masks after vaccination.

One limitation to this survey-based study was that it was unable to assess to what extent vaccine recipients continued to adhere to mitigation measures after receiving their shots. Another notable limitation was that a relatively small number of survey respondents had actually received a coronavirus vaccine, thus greatly limiting any inference that can be made regarding post-vaccination behaviors and any education that might be provided at the time of vaccination.

The overall takeaway from this study is two-fold. First, public health officials and prominent voices in the news should be cognizant that debating scientific nuances in public may result in confusion. Second, it is important to provide information to individuals—at the time of vaccination and after—about efficacy and the need to continue certain mitigation measures in certain circumstances. The CDC's new guidance for vaccinated persons should be helpful.

If you're in West Virginia, you may have an incentive to get a coronavirus vaccine beyond immunity from this deadly disease: The government is offering a $100 savings bond to those getting vaccinated. W.V. Governor Jim Justice said of this plan, "It would be such a drop in the bucket compared to the ungodly amount of money we're spending right now" doing repeated coronavirus testing, and paying for other covid-19 care.

Anticipating criticism of his plan, Justice continued, "If I'm able to pull this off and we are able to shut this down for the small price of $27.5 million... I would tell those critics to kiss my butt." The money will come from federal stimulus money provided to the state.

While private businesses have offered incentives to encourage vaccination, this is the first cash incentive that a state has offered. Similarly, Detroit Mayor Mike Duggan announced a plan designed to coax locals into helping one another get vaccinated; individuals who drive Detroit residents to receive a coronavirus vaccination will receive a prepaid debit card for each resident they bring. These plans come as demand for covid-19 vaccines had hit a plateau, with over 230 million doses given in the US so far.

On Wednesday, April 28, the Biden Administration announced plans to deliver supplies worth over $100 million to provide relief to India in its battle against covid-19. United States government assistance flights will begin to arrive on Thursday, April 29, and will continue into next week. This move comes in an effort to demonstrate the United States' solidarity with India as it battles a new wave of covid-19 cases. The United States and India have worked closely together to respond to the pandemic, including US partnerships with over 1,000 Indian healthcare facilities aimed at strengthening preparedness and launching joint covid-19 prevention public messaging efforts with UNICEF. The plans come after the US came under increased pressure to offer assistance to India, which has emerged as the epicenter of the pandemic.

While the plans were announced over the weekend, we now have more granular information. The US is providing India oxygen support, oxygen concentrators, oxygen generation units (PSA systems), personal protective equipment, vaccine manufacturing supplies, 1 million rapid diagnostic tests (RDTs), therapeutics, and public health assistance. Included in this assistance is the redirection of its order of AstraZeneca manufacturing supplies to India, allowing India to have over 20 million doses of the vaccine. Also included in the assistance are 15 million N95 masks to protect both patients and healthcare personnel.

In pledging this assistance, the Biden Administration touted the seven decade-long partnership between US public health experts and Indian officials on a variety of health and disease-related concerns.