Kevin Kunzmann

An observational, mathematical modeling study showed an association between 10% increases in self-reported mask-wearing and three-fold increased odds of keeping the instantaneous reproductive number (Rt) of 

Namely, this new assessment of 30,000-plus people in the US show increased mask-wearing is linked to reduced secondary cases of COVID-19 from a single infected person.

 Tuesday morning, an international team of investigators reported that localized decreased estimates of virus transmission, based on the reproductive number (R), correlated with raised survey participant reports of wearing masks in public.

The research team conducted an online survey across the US, asking participants to rate their likelihood of wearing a mask while grocery shopping or visiting family and friends on a four-point scale.

At the same time, investigators estimated levels of physical distancing within each state based on residents’ frequency to stay home—which they found by anonymized data from Google users who consented to sharing location history on mobile devices.

The team compared the Google-collected data from June 3 – July 27, 2020 versus a baseline, pre-pandemic period of January 3 – February 6, 2020.

Estimated levels of virus transmission over time in each state were comprised of daily estimated Rt numbers from the database Rt.live, and fitted to case data from The COVID-19 Tracking Project and the COVID-19 data working group.

In the 378,207 responses to the online survey, nearly 85% stated they were “very likely” to wear a face mask to the grocery story. Just 42% stated they would do so to visit family or friends, and just 4.7% stated they were “not likely at all” to wear a mask.


People 65 years and older were the most likely age group to report mask-wearing (48%), while minority groups including Black (62%) and Hispanic (57%) respondents more frequently reported mask-wearing than White respondents.

Investigators also observed an association between mask-wearing and respondent location; regions among the coasts and southern border of the US, as well as large urban areas, reported the greatest proportion of mask-wearing.

Though the findings do not prove the actual scientific value of mask-wearing in limiting COVID-19 transmission—and may actually just better indicate mask-wearers who are also more likely to practice social distancing during the pandemic—they do evidence the understood benefit of such a practice mandated by health agencies and legislators worldwide.

Study senior author John Brownstein, PhD, of the Boston Children’s Hospital, stressed that the aim of mask-wearing remains to be a physical barrier that stops the spread of COVID-19 droplets.

“However, past evidence on the effectiveness of mask use against COVID-19 transmission is mixed and setting up randomized controlled trials to investigate this is challenging,” Brownstein said in a statement. “Our findings, based on observational data, suggest a community benefit for wearing face masks for slowing the transmission of COVID-19; however, mandates alone may not be enough to increase mask use.”

Brownstein advised that legislators and policy-makers continue to consider additional means of mask usage evaluation and implementation to reduce COVID-19 spread—at a time when new daily cases have again spiked in the US.

Study co-author Christina M. Astley, MD, ScD, a clinician and epidemiologist at Boston Children’s Hospital and Harvard Medical School, echoed her colleague’s call for improved mask-wearing at crucial time in the pandemic.

“The world is facing a more transmissible coronavirus strain, hospitals are struggling with new cases, and vaccination programs are still being rolled out,” Astley said. “Interventions are needed now to lower the burden on our healthcare systems.”

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An online survey-based assessment showed older adults and minorities have been more likely to wear masks in public.

Mask-Wearing Linked to Reduced Regional COVID-19 Transmissions

 in pregnant women is essentially a non-starter—largely due in fault to the fact that clinicians have no observed understanding of how currently regulated mRNA vaccines interact in the key patient group.

The group was largely excluded, or not at all recruited, for assessment in global, real-world trials which eventually generated the first available COVID-19 vaccines. That said, clinical history would indicate a likelihood of safety for expecting mothers and their newborns.

In the second segment of an interview with 

, Eric Forman, MD, of the Columbia University Fertility Center, discussed why mRNA vaccines—limited in assessment among pregnant women—is theorized to be safe for the population.

“In general, we recommend avoiding live, attenuated vaccines, mostly from a theoretical concern due to the immunosuppressed state of pregnant women,” Forman said. “But even there, there are registries of women who inadvertently gotten MMR before realizing they were pregnant, and the safety was very good.”

As Forman noted, the significant transmissibility and effect of COVID-19, along with the makeup of vaccines, would lead to belief that the patient, her fetus and placenta would be safe. But supporting data is still lacking.

As such, Forman suggested pregnant be considered up-front in future COVID-19 vaccine trials.

“I don’t know if you’d have big enough numbers, but it would have been a start,” he said. “The pregnant state is different from the non-pregnant state, and it shouldn’t be excluded from studies.”

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Current trial evidence is severely lacking for the at-risk group, but does clinical history suggest safety?

Navigating COVID-19 Vaccines with Pregnant Women

A new study showed vaccine hesitancy may be highly prevalent among patients undergoing fertility treatment.

In data from a survey-based assessment conducted by the Columbia University Fertility Center and published in 

investigators reported that 58% of 284 patients to receive fertility treatment in the last year stated they would either not receive currently available 

Though the rate is fairly similar to the current general population’s feelings on COVID-19 vaccines, perception was far worse among those further along the fertility care process.

Just 17.3% of patients who were either pregnant or planning to conceive within the next month said they would get the vaccine. Another 90% of patients on fertility treatment said they would not change their treatment plan due vaccination.

, study coauthor Eric Forman, MD, discussed the survey’s findings, and helped to rationalize the concerns of his patients—particularly those already pregnant.

“Pregnant women were not included in the trials to develop vaccines,” Forman said. “We don’t have a lot of data. We know a lot of vaccines are not safe in pregnancy, and are not recommended in pregnancy.”

Adversely, Forman also noted the risk pregnant women may face in viral infection, given they’re considered immunosuppressed. Though understanding of how COVID-19 affects pregnant women is still not perfected, the lack of representation in vaccine trials negates rationale for vaccination.

“We have a high-risk population and they know less than the general population about safety,” he explained.

Forman also touched on other elements influencing fertility and pregnant patients’ current vaccine concerns, including unfounded social media rumors, and the unknowns of messenger RNA (mRNA) vaccines.

An interview on new survey data suggesting a majority of fertility and pregnant patients are not interested in the currently available vaccines.

Fertility Patients Express Concern Over COVID-19 Vaccines

A series of reports based on word from state and national officials Friday confirmed that a federal reserve of 

 doses, promised for distribution earlier this week, does not currently exist.

 Friday morning confirmed that a supposed reserve of doses for COVID-19 vaccines BNT162b2 and mRNA-1273—stated by Health and Human Services (HHS) Secretary Alex Azar, MD, to be in stock for the second-dose administration of prioritized recipients earlier this week—was actually distributed at the end of December.

Unnamed sources told the publication that vaccine allocation will “remain flat” for the coming week, at a time when the US Centers for Disease Control and Prevention (CDC) is reporting 36% of the 30.6 million COVID-19 vaccine doses distributed have been administered as of Thursday evening, with 1.3 million having received their second dose.

The matter of unavailable reserve vaccines—originally anticipated to be distributed to states in the same fashion as the first rounds of Pfizer-BioNTech and Moderna vaccine doses—was confirmed by officials including Governor Kate Brown, of Oregon, who shared via Twitter her discussion with Operation Warp Speed Chief Operation Officer Gen. Gustave F. Perna on the matter.

“States will not be receiving increased shipments of vaccines from the national stockpile next week, because there is no federal reserve of doses,” Brown said.

, Pfizer-BioNTech second-dose stockpiling stopped at the end of the December, while Moderna’s stockpiling ended last weekend.

That said, there is no expectation that the lacking reserve would affect the projected goal of second-dose administrations, nor states’ overall access to vaccine distribution. It does, however, limit states’ ability to advance to next phases of vaccine priority groups—

 advising states begin offering doses to adults aged 65 years and older, as well as frontline essential workers.

An HHS spokesperson stated in an email that just 75% of available doses have been ordered by states thus far.

“Operation Warp Speed has been monitoring manufacturing closely, and always intended to transition from holding second doses in reserve as manufacturing stabilizes and we gained confidence in the ability for a consistent flow of vaccines,” they wrote.

Operation Warp Speed Director Christopher Sharpsten further distanced the federal strategy from Azar’s statement on reserve supplies, calling it a false rumor that the government has been “holding back vaccine doses in warehouses to guarantee a second/booster dose.”

Last week, President-elect Joseph Biden, Jr. stated his administration will release all available COVID-19 vaccine doses immediately to states, emphasizing the need for more initial doses. He and his team also expressed intent to establish federally-run vaccination sites at large-capacity facilities to expedite rollout.

Though the 2 administrations’ contrasting strategies to vaccine distribution have been both scrutinized by the infectious disease expert community—at a time when deaths due to COVID-19 have surpassed 4000 daily—the US is currently leading all countries in total persons to receive at least 1 vaccine dose, 

State and federal officials confirmed Friday that promise for a reserve supply of vaccines meant for second doses is actually unavailable.