How effective is the COVID-19 vaccine developed by Pfizer and BioNTech?
Results from the Pfizer/BioNTech vaccine trial were published in the New England Journal of Medicine. The data showed that the vaccine reduced the risk of COVID-19 by 95%. The trial enrolled nearly 44,000 adults, each of whom got two shots, spaced three weeks apart; half received the vaccine and half got a placebo (a shot of saltwater).
Of the 170 cases of COVID-19 that developed in the study participants, 162 were in the placebo group and eight were in the vaccine group. Nine of the 10 severe COVID cases occurred in the placebo group, suggesting that the vaccine reduced risk of both mild and severe COVID.
According to the NEJM article, the vaccine was similarly effective in study participants of different races and ethnicities, body weight categories, presence or absence of coexisting medical conditions, and ages (younger and older than 65). Feb 12, 2021
" Pt had DNR on file." --- Who Needs a Do-Not-Resuscitate Order?
Every competent person has the right to refuse even life-saving medical treatment. Appropriate advance care planning ensures this right even if an individual becomes unable to participate in their own care decisions. Yes, living wills and durable POAs for health care are important for people of any age to have, but not every person needs a DNR order.
Some people wish to limit the care they receive in foreseeable medical circumstances because they feel that extreme measures meant to prolong life may also negatively impact their quality of life. For example, health care professionals and first responders are trained to administer aggressive interventions like CPR to prevent death unless otherwise directed. However, the medical benefits of CPR are limited. This emergency procedure is only intended for use on healthy individuals, not the elderly or those with severe or terminal health conditions like widespread infections or cancer.
One study published in The Journal of the American Osteopathic Association found that most elders (81 percent) erroneously believed their chance of surviving inpatient CPR and being discharged from the hospital was 50 percent or better. While the odds of survival are dependent upon a patient’s unique situation, the study authors’ reviews of previous literature show that “...a mere 3% to 5% of patients are surviving CPR to discharge, and a survival rate of 0% has been reported.”
Sadly, even if CPR successfully resuscitates a very old or frail individual, it is possible that they may suffer broken bones, damage to the brain and other organs, and/or they may no longer be able to breathe without a ventilator. Because of the risks involved, DNR orders specifically address an infirm patient’s wish that doctors do not attempt CPR if their heart and/or breathing stops. Most people who obtain DNR orders are already in poor health and receiving treatment in the hospital or another health care facility.
The elderly and those with severe health conditions may speak with their physicians about the potential risks and benefits of CPR and ultimately decide that they do not wish to receive this intervention. Those with terminal illnesses may obtain a DNR order because they do not want to artificially delay the inevitable, opting instead for a more peaceful or natural death. Regardless of one’s reasons, DNR orders allow patients to continue to exercise control over their care even in emergencies.
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