JAMA. Published online July 15, 2021. doi:10.1001/jama.2021.11211
When public health officials assert that a new vaccine, drug, or policy is “safe,” the public needs to have full confidence in that assertion. This trust is boosted when the public knows that health officials tried hard to find flaws in their proposed strategies and “pressure tested” their assumptions. Public health strategies should be evaluated long after programs have been deployed to ensure that anticipated consequences occur as planned and unanticipated ones are detected early. This is the rationale used when the US Food and Drug Administration grants Emergency Use Authorization and requires postmarketing surveillance for adverse events before full product approval.
By June 2021, public health agencies (especially the Centers for Disease Control and Prevention [CDC]1) had gathered substantial data relevant to the COVID-19 response. There are, however, some key epidemiologic blind spots. This Viewpoint proposes several important areas of surveillance expansion.
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