The New England Journal of Medicine/Catalyst published an article authored by members of PCCI, the Institute for Healthcare Improvement and the Cincinnati Children’s Hospital Medical Center that examines PCCI’s approach to determining COVID-19 herd immunity in Dallas County.
The article, “Rethinking Herd Immunity: Managing the Covid-19 Pandemic in a Dynamic Biological and Behavioral Environment,” was published under its “Innovations Care Delivery” section. The authors of the article share how a detailed understanding of local pandemic conditions is necessary to create focused, tailored responses. While achieving high levels of vaccination is important, exclusive focus on national vaccine targets de-emphasizes the complexities of Covid-19 population immunity. Herd immunity is dynamic and depends on the transmissibility of each new Covid-19 strain, the effectiveness of previous immunity due to previous infection and vaccination against these strains, and human behavior in local communities.
The authors developed a potential framework for enumerating and estimating community-wide immunity to Covid-19 with use of data reportable to local county public health authorities. Using data from Dallas County, Texas, they describe the interplay of vaccines and infection in terms of Covid-19 population immunity, the effect of variants on the ever-changing threshold for herd immunity, and how better access, algorithms, and use of real-time local immunity data could lead to more effective local population protection.
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