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Abstract
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The study by Redelmeier et al. (1) generated significant news media echo in Canada with headlines such as "Unvaccinated drivers more likely to be in a car crash, study" (Globe and Mail, 22 Dec 2022), "COVID vaccine refusers have 72 percent higher risk of a serious traffic crash, study shows" (Vice, 13 Dec 2022), or "Auto insurers may charge unvaccinated drivers more for insurance--report" (Insurance Business Canada, 19 Dec 2022). Indeed, traffic accidents create serious harms to individuals and communities, so their contributing factors warrant further investigation. The authors provide a hypothesis-generating observational study that endeavors to evaluate a potential link between involvement in a traffic accident and COVID-19 vaccine hesitancy in the province of Ontario, Canada.
Complex public health issues and effective policy interventions benefit from consideration of multi-disciplinary perspectives. To that end, we offer here a perspective from public health epidemiology and outbreak response. We find serious flaws in Redelmeier et al.'s study design, variable selection, and group characterizations.
The authors' hypothesis is "that individual adults who tend to resist public health recommendations might also neglect basic road safety guidelines", and they ask: "Does COVID vaccine hesitancy correlate with the risks of a serious traffic crash?" However, no data were collected about neglect of road safety nor about vaccine hesitancy.
The authors incorrectly imply that anyone involved in a traffic crash in this study had neglected road safety guidelines, however, many of the persons included in their dataset may in fact have been victims rather than at fault. This is especially likely to be the case for passengers.
Similarly, the authors wrongly assume that anyone who remained unvaccinated by July 2021 was vaccine hesitant. Instead, individuals may have declined or delayed vaccination for reasons such as recent COVID-19 infection, pregnancy, allergy to vaccine ingredients, or other medical concerns. Conversely, it should not be assumed that there were no vaccine hesitant individuals among those vaccinated by July 2021. Many Ontarians-including those who were vaccine hesitant-were required to and did receive the COVID-19 vaccine as a condition of employment or to travel. Others may have received the vaccine following pressure from friends, family, health providers or government, despite their hesitancy. Indeed, the authors acknowledge that "the study does not test the reliability of COVID vaccination as a proxy for COVID vaccine hesitancy".
If individuals who were not at fault were excluded from the traffic accident dataset and vaccine hesitancy had been correctly measured, what impact might this have had on the results of this study?...
Keywords: CoViD-19-Road-Traffic
Language: en |