How Are the COVID Vaccines Working in the Real World?

If you caught my previous posts on the various SARS-CoV-2 vaccines, you would see that I made an initial error, confusing the terms efficacy and effectiveness. One has to do with how well the vaccine works in a set trial, where the other has to do with how well it works in the real world. This is why we may see a variance in vaccine efficacy between the mRNA vaccine trials and the Johnson & Johnson data – the trials were done at different times, different locations, and in areas of different SARS-CoV-2 infectivity rates.

Recently, an article titled Early Evidence of the Effect of SARS-CoV2 Vaccine at One Medical Center, published March 23, 2021 in the New England Journal of Medicine, was released and discussed the varying positivity rates seen at The University of Texas Southwestern Medical Center. Below I will discuss these findings and my views on them.

The Data

Between the dates of December 15, 2020 and January 28, 2021, about 59% of their total vaccine eligible staff (23,234 total eligible) received at least 1 vaccine, where 30% received 2 doses. This would have been an mRNA vaccine, considering the Johnson & Johnson vaccine was not eligible at that time.

Of these employees, 350 reported a positive COVID test during the time of December 15 through January 28. The severity of illness was not reported. The following is the break down of how many positives were seen in each group of people:

– 234 out of 8969 non vaccinated employees (2.6%)

– 112 out of 6144 partially vaccinated employees (1.82%)

4 out of 8121 fully vaccinated employees (0.05%)

I bet this guy is excited about those numbers as well

Can I say that again??? Only 4 out of the over 8000 fully vaccinated participants contracted a COVID positive illness compared to 234 of the over 8000 non vaccinated employees! That is called science and medicine doing their job.

Sorry. Had to throw that in bold print. Actually, no. I’m not sorry.

Why Were Only 59% of Their Employees Vaccinated At Least Once?

I can’t say for sure. The paper mentions vaccine hesitancy; if you look anywhere on social media, employee lounges (those still exist, right?), or even your nextdoor neighbor, you see this hesitancy is present in all types of people. This is no fault to them, as many of them are not typically exposed to nor search out information on these new medical technologies. Honestly, most physicians don’t go out of their way to truly research new vaccines. I wish they did.

I have written about the mRNA vaccines as well as the reported side effects and data released on the Pfizer, Moderna, and Johnson & Johnson vaccines. I am hopeful that those in the medical field will take the time to truly educate themselves on the vaccines and not rely solely on social media posts, memes, GIFs, or other easily manipulated data. Only through this education can we make informed decisions on what is best for us, our families, and our patients.

Why Were Only 30% Fully Vaccinated?

This is most likely due to many of the employees being between dose 1 and dose 2 at the end of the data collection period. There is no mention of employees declining the second dose.

What Does This Say About Using 1 Dose of the mRNA Vaccine Versus 2?

Comparing the 1 dose group to the 2 dose group, we see a difference of 1.82% positivity rate vs 0.05%. This is a pretty impressive difference. However, we do not know how many of these 1 dose participants were at least 2 weeks out from inoculation, as we know this tends to be the time period it takes to get improved coverage from the vaccine. Thus, we can’t make a truly educated conclusion based off this data, however it is an interesting find.

Is It True That Only 4 Fully Vaccinated Employees Contracted COVID?

Although the full resources on how data collection occurred was not readily available in this paper at this time, I assume that positive cases were reported to employee health, either through in-house testing or at outside labs. I doubt they were testing everyone weekly to assess for asymptomatic infection. Thus, it is possible that some of the employees who were vaccinated had an asymptomatic infection, however this is the same for the partially vaccinated and non-vaccinated group as well.

I promise I looked just as suave as this guy while reading the article


Honestly, what else needs to be said? There was a significant decrease in SARS-CoV-2 positive individuals between the non-vaccinated group and the fully vaccinated group. I am talking about a 53 fold increase in infections in the non-vaccinated group. That is some solid science right there.

I really would urge those in the medical community to research these vaccines and their effectiveness in detail before deciding not to vaccinate. The same can be said for the non medical community. Do not make decisions based on your friend’s sister who is a nurse who said SOMETHING about the vaccines on social media. Talk to your doctor. Heck, talk to you kid’s pediatrician. Pediatricians are exposed to new vaccine research and trials more commonly than their adult counterparts. They are a RESOURCE TO YOU.

Stay healthy. Stay safe.

Imperfect Dad, MD


  1. As always, I love your blog posts. They make me think and give an well rounded picture. I am curious, do you have thoughts/articles about breastfeeding mothers and the vaccine?

    Liked by 1 person

    1. That’s a great question. Sadly there are no actual studies out here yet, but I am hoping someone out there is doing it.
      Since they have had at least one case of a baby being born with antibodies after mom was vaccinated, I’m hopeful we will see some antibodies be transferred via breast milk as well.


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