Yesterday, one of my favorite science writers published an important piece: “Legislatures and politicians are pressuring public health officials to keep quiet about Covid vaccines.” Texas and Florida were called out, and Tennessee was briefly mentioned.

I can attest to this. One of these states recently invited me to speak at an event. Before going on stage, I was told what I could and could not say.

These states, in particular, should be doing the opposite: working overdrive in vaccine education given their excess deaths and poor health landscape.

Let’s dig in.

We (still) have excess deaths.

Excess deaths (i.e., the number of weekly deaths above “normal”) have ebbed and flowed. The national average has declined thanks to immunity but remains above pre-pandemic times.

Given myriad complex factors, the cumulative number of excess deaths differs by state. Since 2020, Texas has experienced the highest cumulative number of excess deaths. Florida and Tennessee rank among the top 10.

When these excess deaths racked up varies greatly across states. For example, FL had relatively low excess deaths before vaccines but high excess deaths after vaccines (which seems counterintuitive). In 2022, excess deaths in TX remained consistently higher than the national average.

Some other causes of death (car accidents) have decreased over time, which would impact overall excess death. So for a comprehensive picture, we need to look at Covid-19 specific deaths, too.

• In 2022, Covid-19 remained the 4th leading cause of death.
• Today, TN and FL rank high—5th and 8th place—for Covid-19 death rates. (TX is somewhere in the middle.)

Overall health is poor.

According to America’s Health Ratings, residents in FL, TN, and TX have, on average, poor overall health (ranked #27, #44, and #38 out of 50, respectfully). This is true for high-risk conditions too, like low birth weight and multiple chronic conditions.

Access to care is poor.

In addition, states with poor healthcare access should push for more public education campaigns to reach and prevent illness among everyone (instead of just those with a doctor who can provide information).

Unfortunately, FL, TN, and TX rank as some of the lowest in terms of access to healthcare, poverty, and people avoiding care because of costs.

Vaccines can help.

Vaccines continue to work well against severe disease. We’ve consistently seen this story, for example in the U.K.

In the U.S., we don’t have a universal healthcare system to make the above graph, but we can look at effectiveness. Last fall’s vaccines provided 50-60% additional protection among older adults compared to people who didn’t get the fall vaccine.

We see this on a state level, too. The higher the state vaccination rate, the lower the state death rate.

Unfortunately, vaccination coverage remains incredibly low.

Some states, including TX, FL, and TN, remain below average. In fall 2022, they reached a vaccination rate of 11% for the general population and 30% for those over 65+ years old.

Bottom line

Communities need public health information, especially those with low access to care and many pre-disposing factors. Actively suppressing evidence-based information about a tool that can prevent the 4th leading cause of death is atrocious. Everyone deserves a fair opportunity to make healthy decisions.

Love, YLE

In case you missed it:

• A response to Florida Surgeon General’s anti-human remarks
• Considerations for your fall vaccine

“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations, including the CDC. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:

Trust in institutions is declining across the globe. However, one group, particularly in the U.S., has seen a significant increase in trust: businesses. (This is true across all generations except Gen Z.)

Most employees look to their employers for reliable information: those who say business should deliver more healthcare access and trustworthy information far outnumber those who say business is overstepping.

In other words, businesses are “trusted messengers” to communities.

And for a good reason: people trust who they know. Businesses showed up during the pandemic. They became a key source of information, many recognized the importance of mental health, and some have remained flexible and responsive to employee needs.

Partnering with businesses can make the traditional public health world uneasy. While some businesses do it out of the kindness of their hearts, there is obviously a clear business case for public health action (see more below).

That’s okay. A healthy community is a healthy economy and vice versa. Public health can partner by equipping trusted messengers, like businesses, with the tools, education, and evidence-based resources.

We should start with the current respiratory season.

The business case for public health action

McKinsey estimated that Covid-19 illness was responsible for losing 315 million to 1 billion employee workdays in 2022 alone. Coupled with flu and RSV, work absences because of childcare constraints were at all-time high last year. This impacts productivity, turnover, and burnout.

None of this is going away. Public health action can help. For example:

• Increasing vaccine coverage: Flu vaccines reduced work sick days by 1-3 days. In the UK, if 1000 employees are vaccinated for the flu, a business reduces absenteeism by 220 days and should expect a return of £1.03-£5.15 on every pound invested by an employer (depending on the severity of the flu that year).
• Upgrade ventilation systems: In a study of 4,000 employees in over 40 buildings, twice as much clean air reduced sick leave by 35%. By investing $40 per person per year to double the ventilation rate, employers can recoup $6,000-$7,000 per person per year in higher productivity.

So, where do businesses start?

Three key areas:

• Build conviction: Educate on the facts. Engage with champions. Approach information apolitically, base actions on science, and act on the same values over time.
• Increase convenience and eliminate cost: Nearly 1 in 2 employees state that initiatives targeting convenience and cost would significantly increase their likelihood of getting vaccinated. We see this play out in studies, like providing workers with paid time off to receive Covid-19 vaccines and to recover from potential vaccine adverse effects.

This could look like many things: pop-up vaccine clinics on campuses, paid time off to get vaccinated, ventilation upgrades, mask-friendly environments, a strategy for communication with the workforce, or even just a poster in the bathroom (like this photo someone sent me of an eerily familiar poster).

Need more ideas or support?

It’s free and open to anyone! If you attend, you’ll also have access to a document we put together: Breathe Easy: 4 Steps to Respiratory Wellness at Work. (I’m biased, but I think it’s pretty great.)

SIGN UP FOR THE EVENT HERE

Bottom line

To strive for a healthier community, an all-hands-on-deck response is required. Businesses are key partners in public health, as they are trusted messengers for many communities. Energy is wisely spent equipping them with tools and information so employees can make evidence-based decisions and live healthier lives.

Love, YLE

“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations, including the CDC. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below: