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      Unrepresentative big surveys significantly overestimated US vaccine uptake

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          Abstract

          Surveys are a crucial tool for understanding public opinion and behaviour, and their accuracy depends on maintaining statistical representativeness of their target populations by minimizing biases from all sources. Increasing data size shrinks confidence intervals but magnifies the effect of survey bias: an instance of the Big Data Paradox 1 . Here we demonstrate this paradox in estimates of first-dose COVID-19 vaccine uptake in US adults from 9 January to 19 May 2021 from two large surveys: Delphi–Facebook 2, 3 (about 250,000 responses per week) and Census Household Pulse 4 (about 75,000 every two weeks). In May 2021, Delphi–Facebook overestimated uptake by 17 percentage points (14–20 percentage points with 5% benchmark imprecision) and Census Household Pulse by 14 (11–17 percentage points with 5% benchmark imprecision), compared to a retroactively updated benchmark the Centers for Disease Control and Prevention published on 26 May 2021. Moreover, their large sample sizes led to miniscule margins of error on the incorrect estimates. By contrast, an Axios–Ipsos online panel 5 with about 1,000 responses per week following survey research best practices 6 provided reliable estimates and uncertainty quantification. We decompose observed error using a recent analytic framework 1 to explain the inaccuracy in the three surveys. We then analyse the implications for vaccine hesitancy and willingness. We show how a survey of 250,000 respondents can produce an estimate of the population mean that is no more accurate than an estimate from a simple random sample of size 10. Our central message is that data quality matters more than data quantity, and that compensating the former with the latter is a mathematically provable losing proposition.

          Abstract

          An analysis of three surveys of COVID-19 vaccine behaviour shows that larger surveys overconfidently overestimated vaccine uptake, a demonstration of how larger sample sizes can paradoxically lead to less accurate estimates.

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          Most cited references30

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          Sample Selection Bias as a Specification Error

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            Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data

            Background Following the emergency use authorisation of the Pfizer–BioNTech mRNA COVID-19 vaccine BNT162b2 (international non-proprietary name tozinameran) in Israel, the Ministry of Health (MoH) launched a campaign to immunise the 6·5 million residents of Israel aged 16 years and older. We estimated the real-world effectiveness of two doses of BNT162b2 against a range of SARS-CoV-2 outcomes and to evaluate the nationwide public-health impact following the widespread introduction of the vaccine. Methods We used national surveillance data from the first 4 months of the nationwide vaccination campaign to ascertain incident cases of laboratory-confirmed SARS-CoV-2 infections and outcomes, as well as vaccine uptake in residents of Israel aged 16 years and older. Vaccine effectiveness against SARS-CoV-2 outcomes (asymptomatic infection, symptomatic infection, and COVID-19-related hospitalisation, severe or critical hospitalisation, and death) was calculated on the basis of incidence rates in fully vaccinated individuals (defined as those for whom 7 days had passed since receiving the second dose of vaccine) compared with rates in unvaccinated individuals (who had not received any doses of the vaccine), with use of a negative binomial regression model adjusted for age group (16–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years), sex, and calendar week. The proportion of spike gene target failures on PCR test among a nationwide convenience-sample of SARS-CoV-2-positive specimens was used to estimate the prevelance of the B.1.1.7 variant. Findings During the analysis period (Jan 24 to April 3, 2021), there were 232 268 SARS-CoV-2 infections, 7694 COVID-19 hospitalisations, 4481 severe or critical COVID-19 hospitalisations, and 1113 COVID-19 deaths in people aged 16 years or older. By April 3, 2021, 4 714 932 (72·1%) of 6 538 911 people aged 16 years and older were fully vaccinated with two doses of BNT162b2. Adjusted estimates of vaccine effectiveness at 7 days or longer after the second dose were 95·3% (95% CI 94·9–95·7; incidence rate 91·5 per 100 000 person-days in unvaccinated vs 3·1 per 100 000 person-days in fully vaccinated individuals) against SARS-CoV-2 infection, 91·5% (90·7–92·2; 40·9 vs 1·8 per 100 000 person-days) against asymptomatic SARS-CoV-2 infection, 97·0% (96·7–97·2; 32·5 vs 0·8 per 100 000 person-days) against symptomatic COVID-19, 97·2% (96·8–97·5; 4·6 vs 0·3 per 100 000 person-days) against COVID-19-related hospitalisation, 97·5% (97·1–97·8; 2·7 vs 0·2 per 100 000 person-days) against severe or critical COVID-19-related hospitalisation, and 96·7% (96·0–97·3; 0·6 vs 0·1 per 100 000 person-days) against COVID-19-related death. In all age groups, as vaccine coverage increased, the incidence of SARS-CoV-2 outcomes declined. 8006 of 8472 samples tested showed a spike gene target failure, giving an estimated prevalence of the B.1.1.7 variant of 94·5% among SARS-CoV-2 infections. Interpretation Two doses of BNT162b2 are highly effective across all age groups (≥16 years, including older adults aged ≥85 years) in preventing symptomatic and asymptomatic SARS-CoV-2 infections and COVID-19-related hospitalisations, severe disease, and death, including those caused by the B.1.1.7 SARS-CoV-2 variant. There were marked and sustained declines in SARS-CoV-2 incidence corresponding to increasing vaccine coverage. These findings suggest that COVID-19 vaccination can help to control the pandemic. Funding None.
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              Nonresponse Rates and Nonresponse Bias in Household Surveys

              R. Groves (2006)
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                Author and article information

                Contributors
                seth.flaxman@cs.ox.ac.uk
                Journal
                Nature
                Nature
                Nature
                Nature Publishing Group UK (London )
                0028-0836
                1476-4687
                8 December 2021
                : 1-6
                Affiliations
                [1 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Department of Statistics, , University of Oxford, ; Oxford, UK
                [2 ]GRID grid.168010.e, ISNI 0000000419368956, Department of Political Science, , Stanford University, ; Stanford, CA USA
                [3 ]GRID grid.38142.3c, ISNI 000000041936754X, Harvard College, , Harvard University, ; Cambridge, MA USA
                [4 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Statistics, , Harvard University, ; Cambridge, MA USA
                [5 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Department of Computer Science, , University of Oxford, ; Oxford, UK
                Author information
                http://orcid.org/0000-0002-5687-2647
                http://orcid.org/0000-0001-6468-5908
                Article
                4198
                10.1038/s41586-021-04198-4
                8653636
                34880504
                fc6ba6f8-f188-43e3-ac60-6a5648774a91
                © The Author(s), under exclusive licence to Springer Nature Limited 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 18 June 2021
                : 29 October 2021
                Categories
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                Uncategorized
                infectious diseases,statistics,research data
                Uncategorized
                infectious diseases, statistics, research data

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