NEJM August 6, 2022
Imagine if we could track, for each patient seen at a health care facility, which Covid-19 vaccine they had received when and what their clinical evaluation revealed. We could then have near-real-time insights into the efficacy of vaccines, how that efficacy changes over time, how new viral strains alter it, and which viral and host features (including underlying medical conditions) lead to breakthrough infections in immunized people. Such tracking would require robust linkage among clinical outcomes (including details of clinical interventions and laboratory studies), data on the specific vaccine administered and the date of administration, and information about the status of the pandemic in the relevant geographic area.
This effort is not an act of futuristic visioning. Tightly integrated population-based...
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