A third-year medical student from Oakland University William Beaumont School of Medicine had a key role in a study detailing the effectiveness of booster shots against COVID-19 — research that has gained widespread attention.

‘Boosters save lives:’ Third-year OUWB student leads critical study into effectiveness of COVID-19 vaccines
An image of Nicholas Mielke
Nicholas Mielke, M3, OUWB, was lead author of the study.

A third-year medical student from Oakland University William Beaumont School of Medicine had a key role in a study detailing the effectiveness of booster shots against COVID-19 — research that has gained widespread attention.

Boosters reduce in-hospital mortality in patients with COVID-19: An observational cohort analysis” was published March 17 in The Lancet Regional Health – Americas. Lead author was Nicholas Mielke, M3, OUWB.

The study found that COVID-19 booster vaccines significantly reduced the death rate for hospitalized, COVID-19 patients. The study has been called one of the first investigations of the real-world effectiveness of boosters.

Following publication, the research gained widespread media attention, including a story from NBC News with comment from Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Joe Biden.

“It’s really exciting when your research gets read and people are interested in it,” says Mielke.

“I’m really hoping that people read it, see the importance of boosters, and get their shots. It’s really meaningful to think that I could have helped some people possibly not get so sick.”

Principal investigator on the study was Amit Bahl, M.D., director of Emergency Ultrasound for Beaumont Hospital, Royal Oak. Bahl also is an associate professor in OUWB’s Department of Emergency Medicine.

“Nick was involved in all aspects of this project from study design to manuscript preparation – he really played a critical role in getting this research done in a timely fashion,” says Bahl.

‘Boosters save lives’

The study set out to assess demographic, clinical, and outcome variables of patients requiring hospitalization for COVID-19 while comparing fully vaccinated and boosted, fully vaccinated, and unvaccinated patients. (Steven Johnson, D.O., an emergency physician at Beaumont, Royal Oak, also was a co-author.)

The researchers looked at aggregate data of more than 8,200 patients hospitalized across the Beaumont Health system between Aug. 12, 2021 and Jan. 20, 2022. (Patients’ identifying information was removed.)

The study found that hospitalized patients who received boosters had a 45% lower mortality rate than unvaccinated, hospitalized patients. Researchers also found that the highest mortality rate was 12.8% in unvaccinated, hospitalized patients; a much lower mortality rate (7.1%) for vaccinated and boosted patients; and a mortality rate of 10.3% for patients who were vaccinated but hadn’t received boosters.

“Early indications were that boosters save lives, and this real-world research shows that boosters saved hundreds of lives at Beaumont alone,” says Bahl in a press release from Beaumont.

‘We were curious’

Mielke grew up in Maple Grove, Minnesota. He earned his undergraduate degree in biology from University of Minnesota.

At OUWB, it was Mielke’s Embark project that first had him work closely with Bahl.

Embark is a required scholarly concentration program of OUWB that provides a mentored introduction to research and scholarship. The four-year longitudinal curriculum consists of structured coursework in research design and implementation, compliance training, research communication, and scholarly presentation, with protected time to develop mentored projects in a wide-range of community and health-related settings.

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Separately, Mielke says he and Bahl were talking in late 2021 about breakthrough cases they were noticing in the ER and internal medicine units at Beaumont. In this context, a breakthrough case is when someone fully vaccinated gets COVID-19.

“With the booster rollout, we were curious about how effective it is and if it really matters,” says Mielke, who also notes “there was no research about how effective the booster was in real-world time.”

Having the large amount of data opened the door to answering the question from “a statistically significant standpoint,” says Mielke.

“That’s when we found that the booster shot really was making a big difference for people in the hospital that had COVID,” says Mielke.

By February, the team had spent more than 100 hours analyzing data and writing the study that was published shortly thereafter in The Lancet Regional Health – Americas. The open-access journal is devoted to sharing research that can improve clinical practice and health qualities in the Americas. The journal is a sister publication to The Lancet, a highly regarded, independent, global medical journal dedicated to advancing the science of medicine to transform society and positively impact people’s lives.

‘Limited real-world data’

Bahl says the uniqueness of the study is what drew so much attention to it.

“There is limited real-world data that highlights the benefits of the booster dose and our research helps fill that gap,” says Bahl. “Our study was a large multicenter investigation with results that are applicable to the average person. As pharma trial data continues to come forth, it is necessary to validate the findings in the community and our study does just that.” 

With regard to Mielke, Bahl calls him “one of the most motivated and hardworking individuals I have ever met. It’s truly been an honor to mentor him through this project and others.”

He adds that Mielke “is on a path to doing great things for medicine” and that this is just one example.

“(Mielke) is developing a skill set that will allow him to scientifically address clinical questions or problems as they arise, to ultimately improve health for patients,” says Bahl. “This experience has made him more well-rounded and an asset to the field of medicine.”

Mielke says the experience has inspired him to keep his intellectual curiosity going.

“For internal medicine, it’s always important to keep a wide view and look at things from a different angle,” he says. “(The study) also sets the foundation for more research in the future…I’m more comfortable with designing a study and carrying it out. I know I can keep asking these questions in residency and beyond.”

For more information, contact Andrew Dietderich, marketing writer, OUWB, at [email protected]

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