COVID Vaccine Hesitancy and Risk of a Traffic Crash

A new study from ITMA board member Donald Redelmeier

Donald A. Redelmeier, MD, FRCPC, MSHSR, FACP
Jonathan Wang, MMASc
Deva Thiruchelvam, MSc
Published:December 02, 2022 DOI: https://doi.org/10.1016/j.amjmed.2022.11.002

Abstract:

Background

Coronavirus disease (COVID) vaccine hesitancy is a reflection of psychology that might also contribute to traffic safety. We tested whether COVID vaccination was associated with the risks of a traffic crash.

Methods

We conducted a population-based longitudinal cohort analysis of adults and determined COVID vaccination status through linkages to individual electronic medical records. Traffic crashes requiring emergency medical care were subsequently identified by multicenter outcome ascertainment of all hospitals in the region over a 1-month follow-up interval (178 separate centers).

Results

A total of 11,270,763 individuals were included, of whom 16% had not received a COVID vaccine and 84% had received a COVID vaccine. The cohort accounted for 6682 traffic crashes during follow-up. Unvaccinated individuals accounted for 1682 traffic crashes (25%), equal to a 72% increased relative risk compared with those vaccinated (95% confidence interval, 63-82; P < 0.001). The increased traffic risks among unvaccinated individuals extended to diverse subgroups, was similar to the relative risk associated with sleep apnea, and was equal to a 48% increase after adjustment for age, sex, home location, socioeconomic status, and medical diagnoses (95% confidence interval, 40-57; P < 0.001). The increased risks extended across the spectrum of crash severity, appeared similar for Pfizer, Moderna, or other vaccines, and were validated in supplementary analyses of crossover cases, propensity scores, and additional controls.

Conclusions

These data suggest that COVID vaccine hesitancy is associated with significant increased risks of a traffic crash. An awareness of these risks might help to encourage more COVID vaccination

Our board member Alberto Silveira passed away

The board of directors in ITMA are sad to inform about the passing away of our dear board member from Argentine, Alberto Silveira. (09/30/1952 – 05/15/2023).

Alberto and his colleague María Cristina Isoba from the Argentine NGO Luchemos por la Vida (Let us fight for life), added to the scientific and humanistic approach of ITMA and took part in our meetings since many years. Alberto was the president and founder of Luchemos por la Vida as a non-profit organization whose primary purpose is to help prevent traffic crashes in Argentine.

Luchemos por la Vida’s achievements are significant, including mass awareness campaigns, the proposal for updated national traffic laws, training courses for traffic inspectors, educators, drivers, educational initiatives for children and teenagers, and workshops for those renewing their driving licenses. The initiative continues today, with plans for new traffic laws, action against traffic safety violations, the introduction of medication alert laws, and more. The work in Luchemos por la Vida started with the work of Alberto but will continue in his spirit as long as it is needed. ITMA hopes to find links to our continuing cooperation.

Alberto was a valued member of our board and made significant contributions to our field. We will miss him greatly.

Addressing COVID vaccine hesitancy

This is a new study from our board member Donald Redelmeier et al, addressing COVID vaccine hesitancy. It found that persons who did not get their vaccination had a 72% increase in traffic risks. The theory is that those who neglect public health guidelines may also neglect traffic safety. The observed risk is larger than diabetes and second only to alcoholism and provides another argument to support COVID vaccination. The article’s title is “COVID Vaccine Hesitancy and Risk of a Traffic Crash“ and is published in The American Journal of Medicine and available in full text for free at https://www.amjmed.com/article/S0002-9343(22)00822-1/fulltext

Rollator related pedestrian single accidents and collision events in Sweden

The researchers Anna Carlsson, Chalmers Industrial Technology (Chalmers Industriteknik), Gothenburg and Jörgen Lundälv, University of Gothenburg and Umeå University, Sweden, are the authors behind a study regarding rollator related pedestrian single accidents and collision events in Sweden.

The rollator is a Swedish invention, invented by the Västerås Hospital social worker Aina Wifalk (1928-1983) in the early 1980s. The current study is based on data from 2,020 accidents involving 2,305 persons extracted from the Swedish Traffic Accident Data Acquisition (STRADA) database, the Swedish Transport Agency’s accident database on injuries and accidents within the road transport system. For consistency, a subset of data (N = 745) was analysed in order to investigate the development of accidents over a period of 10 years.

The results show that the number of rollator accidents in Sweden increased by approximately 80% during 2007–2016.

Women most exposed to accidents and injuries
Females dominate the injury statistics in single accidents, collisions, as well as fatal outcome, which may be due to exposure and/or differences in physical characteristics. Single accidents are much more common than collisions (n=1,668 and n=352, respectively) and the injury consequences are at least as serious. Data from the present study revealed that the frequency of minor injuries (ISS 1–3) is 4.3 times, moderate (ISS 4–8) 6.0 times and serious injuries (ISS 9–15) 8.9 times higher in single accidents than in collisions.

The two researchers suggest that future research should follow up on accident and injury statistics for accidents. Areas with the potential to reduce the risk of rollator accidents include improved rollator stability and design, appropriate user training programmes, adequate maintenance and service programmes and, above all, a functioning infrastructure for rollators. Injury registration at hospitals in Sweden is very important for traffic medicine research, and this study is a good example of how STRADA can be utilised in research.

The study has been published in the new scientific journal “Traffic Safety Research – An Interdisciplinary Journal (TSR)” founded in 2021 in collaboration between Lund University in Sweden, Technical University (TU) in Delft (Netherlands) and the international organisation International Co-operation on Theories and Concepts in Traffic Safety (ICTCT).

The study can be downloaded from the journal’s website:
https://tsr.international/TSR/article/view/23512

For further information, please contact:

Anna Carlsson
PhD, Researcher
Chalmers Industriteknik
SWEDEN
+46 (0)70–594 36 50
+46 (0)31–772 36 50
anna.carlsson@chalmersindustriteknik.se

Jörgen Lundälv
Associate Professor in Social Work
Department of Social Work
University of Gothenburg
SWEDEN
+46 (0)31–786 5795
+46 (0)76–172 4711
jorgen.lundalv@socwork.gu.se

Associate Professor in Traffic Medicine
Department of Surgical and Perioperative Sciences, Unit of Surgery
Umeå University
SWEDEN
jorgen.lundalv@umu.se
+46 (0)76–172 4711

Traffic safety lessons ignored in confronting Covid-19

“ITMA President Emeritus Leonard Evans authors a short Editorial in Injury Prevention titled “Traffic safety lessons ignored in confronting Covid-19”. The editorial affirms that while USA road-traffic safety policy has been a catastrophic failure, it nonetheless provides lessons that were ignored in confronting the Covid-19 pandemic. The complete (631 word) text is at http://injuryprevention.bmj.com/cgi/rapidpdf/injuryprev-2021-044484?ijkey=0tAPt4vm4jsAVv6&keytype=ref

Pedestrian Deaths During the COVID-19 Pandemic

ITMA board member Donald Redelmeier is the lead author of a new article titled “Pedestrian Deaths During the COVID-19 Pandemic” published in the American Journal of Lifestyle Medicine. The full article appears here https://journals.sagepub.com/doi/10.1177/15598276211058378. The study suggests the COVID pandemic led to a 50-60% reduction in pedestrian activity, a 10-15% reduction in total vehicle miles traveled, and no sustained changes in pedestrian fatalities. The mismatch between mobility and mortality highlights the importance of individual psychology beyond structural factors and reductions in activity.