We need a new COVID strategy

Experts in public health need to reposition their thinking on how best to approach the continuing scourge of Covid. Our primary tool, vaccination, is still an excellent way to prevent deaths and hospitalizations, and continuing to advocate vaccines and boosters is essential. However, vaccines have failed in one regard: transmission. Although it appears that vaccines provide some protection from transmitting the disease, the benefit is not very large and clearly isn’t enough to stop future waves of the virus from rolling through our most susceptible populations.

Second, we need to stop overpromising on the benefits of vaccines. We have routinely asserted that vaccines would stop infections, stop future waves of disease, and maybe even provide lifelong immunity. All these claims are substantially wrong. We should focus on the few absolute benefits we know of: that those who are vaccinated have lower rates of hospitalization and death. All other claims should be held off until we have better data supporting them.

We should also admit that, as with every decision in medicine, there are risks and benefits to vaccines as well. Health care is always about judging which trade-offs are worthwhile and which aren’t. Although some may disagree, I think it’s clear that the benefits of vaccinations outweigh any known risks. However, large-scale distrust, partly because of experts overstating or downright lying about these issues, has undermined our case for universal vaccinations. Instead, openly discussing the rare side effects and the overall benefit, and then coaxing (not forcing!) people to vaccinate, will build confidence in the system.