Citation

Adepoju VA, Imoyera W. Am. J. Med. 2023; 136(9): e179.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.amjmed.2023.04.009

PMID

37612020

Abstract

We read with interest the article by Redelmeier et al, entitled "COVID Vaccine Hesitancy and Risk of a Traffic Crash" and published in The American Journal of Medicine. We applaud the efforts of the authors in documenting evidence using big data of over 11 million patients in Ontario. The authors found that unvaccinated individuals had a 48% increased risk of being involved in a traffic crash compared with vaccinated individuals, even after accounting for various factors that may influence accident risk. However, the authors did not account for the fact that essential workers, who are less likely to be vaccinated, are also more likely to be involved in accidents due to their work requirements. The study only looked at patients in emergency departments classified as drivers, passengers, or pedestrians, which may have excluded a significant proportion of traffic accidents. The title of the study may also be misleading, implying a correlation between vaccine hesitancy and the risk of a traffic crash. In reality, the study only focused on drivers, passengers, and pedestrians involved in road traffic accidents, disregarding other human and non-human factors such as driving habits, vehicle type, road conditions, environmental and contextual factors that could contribute to road traffic accidents. These factors play a significant role in the occurrence of road traffic accidents, and their omission from the study weakens its conclusions. Previous studies have demonstrated that the COVID-19 pandemic has had a significant impact on road traffic safety, travel behavior, and driver behavior. Studies from India and Greece reported a significant reduction in road traffic accidents due to reduced mobility during COVID-19 pandemic and lockdowns. The decrease in collisions was attributed to reduced mobility and changes in driver behavior and increased police enforcement. Similarly, the number of traffic fatalities declined in Canada and United States during the pandemic. These studies highlight the importance of considering multiple factors in assessing the impact of the pandemic and vaccination status on road safety.

Furthermore, the study's classification of vaccinated and unvaccinated individuals is also problematic. Individuals who were vaccinated were considered unvaccinated for the first 14 days after vaccination, which could significantly affect the validity of the study's results. With this assumption, the authors would only need a few hundred of the casualties to be misclassified for the difference between the vaccinated and unvaccinated groups to disappear in the analysis...

Redelmeier DA
Wang J
Thiruchelvam D

COVID vaccine hesitancy and risk of a traffic crash.
Am J Med. 2023; 136 (.e5): 153-162

Language: en