COVID vaccine rates fall, putting Biden's July 4 goal in jeopardy

The rate of vaccinations around the country has sunk to new lows in recent weeks, threatening President Joe Biden's goal of 70% of American adults with at least one dose by July 4.

Trends over the past week, based on data reported by the Centers for Disease Control and Prevention, show the U.S. vaccinations are on track to reach only 67% of adults, a USA TODAY analysis shows.

The CDC reported last week that 63% of adults had received their first dose of a COVID-19 vaccine, up only slightly from the 62% the week before. Twelve states, including Utah, Oklahoma, Montana, the Dakotas and West Virginia, have seen vaccinations sink to 15 daily shots per 10,000 residents; Alabama had just four people per 10,000 residents get vaccinated last week, according to data from The Washington Post.

The “low-hanging fruit – those people who absolutely want to get vaccinated without you telling them anything” have already been vaccinated, which has led to the slowdown, Dr. Anthony Fauci, the government’s top expert on infectious diseases, said on a White House-organized call with community leaders last week, according to the Post.

The White House has already made plans to combat the slowdown. Biden announced last week a monthlong effort to encourage more Americans to roll up their sleeves for a shot.

Also in the news:

►Airline and airport executives from the US and UK are pushing for the lifting of restrictions that have limited travel between both countries, pointing out they're both among the world leaders in vaccination rates.

►Dr. Jeff Duchin, the chief health officer for Seattle and King County, told The Seattle Times that 97% of recent COVID-19 cases there have occurred in unvaccinated people.

►Carnival Cruise Line said it will require passengers to have completed their COVID vaccinations two weeks before boarding for the company's first U.S. trips after reopening, departing from Texas in July.

►Dr. Michael Ryan, the emergencies chief for the World Health Organization, says global vaccination coverage of more than 80% is needed to significantly lower the chance that an imported coronavirus case could generate new cases or spawn a wider outbreak.

►During the throes of the COVID-19 pandemic, many parents, weary of monitoring their children's online classes, yearned for schools to reopen. Then vaccines expanded, schools reopened in many cities, and teachers returned – but huge numbers of students didn't.

📈 Today's numbers: The U.S. has more than 33.3 million confirmed coronavirus cases and more than 597,700 deaths, according to Johns Hopkins University data. The global totals: Over 173.3 million cases and over 3.73 million deaths. More than 138.9 million Americans have been fully vaccinated – 41.9% of the population, according to the CDC.

📘 What we're reading: What does the end of COVID-19 in America look like? Perhaps no end at all, but a resigned acceptance of a bearable level of death. Read the full story.

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UK may delay June 21 reopening as Delta variant fuels rise in infections

British Health Secretary Matt Hancock said the Delta variant first identified in India is 40% more transmissible than the Alpha variant that it's on the way to replacing as the dominant strain in the U.K.

Hancock acknowledged Sunday that the rise in Delta variant cases may delay the government’s plan to lift most remaining lockdown restrictions on June 21. Coronavirus infections have doubled in the last week and there's some concern this could mark the beginning of a third wave of cases.

"It is more difficult to manage this virus with the new Delta variant,” said Hancock, adding that vaccines have proven effective against it.

Because of the U.K.'s high vaccination rate -- half of adults are fully inoculated and three-quarters have had at least one shot -- deaths and hospitalizations are not expected to rise dramatically. But with millions still unvaccinated, keeping some restrictions in place to avoid virus transmission may be necessary.

Moderna vaccine could be available for kids soon

Moderna said Monday it has requested authorization of its COVID-19 vaccine for adolescents with Health Canada – and will file for emergency use authorization with the U.S. Food and Drug Administration "for this important, younger-age population." The FDA expanded its emergency use authorization for Pfizer's vaccine to include people 12 to 15 last month.

Moderna also said it has filed data for a conditional marketing approval in the 27-nation European Union to expand use of its vaccine to children. Last month, the European drug regulator approved the shot made by Pfizer and BioNTech for children 12 to 15.

New York state could drop most restrictions within days

New York Gov. Andrew Cuomo said the state will lift its remaining COVID-19 restrictions in most settings when 70% of its adult population has been at least partially vaccinated, a benchmark that could be within reach in days. Currently, 68.6% of New Yorkers ages 18 and over have received at least one shot, an increase from 64.4% on Thursday.

Cuomo said that upon reaching the 70% figure, the state's emergency social distancing, health screening and cleaning mandates will be rescinded for most businesses and social situations. Businesses will have the option to keep the COVID protocols in place or remove them.

“We have never been in a better position vis-à-vis COVID-19 than we are today,” Cuomo said. “But we have to work to bring New York back. This is not an automatic recovery."

-- Sarah Taddeo, Rochester Democrat & Chronicle

China locks down city of 18 million to combat outbreak

The southern Chinese city of Guanzhou was placed in lockdown Monday following an outbreak of coronavirus that has sickened dozens of people in recent days. Anyone who is given permission to leave must show a negative test for the virus taken in the previous 48 hours. The same rule applies to anyone seeking to leave the surrounding province of Guangdong. The city also is restricting indoor dining, conducting mass testing and banning residents in high-risk neighborhoods from leaving their homes. At least two districts in the city of 18 million people have been closed off entirely.

The variant causing the Guangzhou outbreak – the delta variant first identified in India – is reportedly more infectious because those who have it are slower to display symptoms while carrying more virus particles.

Fauci, first lady promote vaccinations at Harlem church

First lady Jill Biden and Dr. Anthony Fauci toured a vaccination site at a historic Harlem church Sunday in a promotional appearance aimed at re-energizing the lagging national vaccination drive. Biden, Fauci and Sen Kirsten Gillibrand, a New York Democrat, watched as people got their shots in the basement of the Abyssinian Baptist Church. The church first started offering vaccine doses in January in an effort to boost the vaccination rates in New York City’s Black and Hispanic communities.

Biden asked a teenager about to get his shot how old he was, and when he said he was 14, she responded, “You’re 14, that’s exactly what we want! Twelve and over.”

'No excuse': Mississippi last in nation for fully vaccinated people

For months, Mississippi Health Officer Thomas Dobbs has been pleading with Mississippians to get vaccinated against COVID-19. Mississippi is last in the nation for fully vaccinated people. As of Friday afternoon, over 911,000 people were fully vaccinated in Mississippi, or 29% of the population, lagging well behind the nation's average of 41%. For multiple weeks, Dobbs has reiterated it: Mississippians will either get vaccinated against the virus or they will suffer its effects.

“There’s no excuse for that,” Dobbs said during a livestreamed talk with the Mississippi State Medical Association. “I will personally drive up to your house to give you one.”

– Sarah Haselhorst, Mississippi Clarion-Ledger

Milwaukee college students working to overcome COVID-19 vaccine barriers

When Sarah Farhan walked up to people at Milwaukee's Eid al-Fitr festival following Ramadan last month and asked them whether they'd gotten the COVID-19 vaccine yet, many looked skeptical. Then Farhan switched to speaking Arabic.

"Then they just exploded with words," she said. "They were like, 'Oh, OK, so can you tell me this and that?'"

Farhan, who is set to attend the Medical College of Wisconsin in the fall, was working her new summer job as a vaccine educator for the Milwaukee Muslim Women's Coalition. The coalition hired eight college students who speak languages common in Milwaukee's Muslim community, such as Arabic, Somali, Rohingya and Urdu, to encourage hesitant people to get the vaccine while dispelling fears and misinformation about it.

"When you’re able to communicate in the language that they’re most familiar with, there becomes a sense of comfort and familiarity, and I think that there's more confidence in going and getting the vaccine," women's coalition president Janan Najeeb said.

– Sophie Carson, Milwaukee Journal Sentinel

Group effort in rural Georgia to help others get vaccinated

A growing group of volunteers in Randolph County, Georgia, is doing its part to reenergize the country's flagging vaccination effort, going door to door to help people get inoculated against COVID-19 and answering their questions. The four who began the effort built off their experience canvassing with the Randolph County Democratic Committee. What began as a focused effort to register seniors without Internet for the vaccine grew into a larger operation.

Located in southwest Georgia, Randolph is one of the state's poorest counties, and its rural location makes residents more vulnerable to the coronavirus. According to the CDC, people in rural areas are at a higher risk of hospitalization. In addition, those without a mode of transportation or Internet connections find it harder to access vaccines.

That's where the group that developed out of Neighbor 2 Neighbor steps in. Joyce Barlow told CNN that not only is it about helping people get inoculated, but it is also about listening to them and their concerns about COVID-19 and the vaccines.

"We want to get everyone protected,'' she said. "We are, after all, our brother's and sister's keepers."

Contributing: Janie Haseman, USA TODAY; The Associated Press

COVID updates: Vaccines for all adults by April 15 in 3 biggest states

The U.S. coronavirus death toll could have stayed under 300,000 if by last May the nation had adopted firm mask, social distancing and testing protocols while waiting for vaccines to vanquish the crisis, a University of California, Los Angeles economics professor estimates.

The report was released Thursday, the same day President Joe Biden set a new target of 200 million vaccine shots in his first 100 days in office, double his initial goal.

The U.S. death toll exceeds 545,000 and continues to rise. UCLA Professor Andrew Atkeson projects a final fatality level of around 672,000. Without a vaccine, 1.27 million would have died, Atkeson estimated in a report released Thursday at the Brookings Papers on Economic Activity conference.

“Public efforts at disease control can save a lot of lives over the long run by controlling disease while we wait for a vaccine or a cure,” Atkeson told The Brookings Institution. “We have a tremendous opportunity to learn from international experience with COVID on how to do that without tanking the economy.”

The report comes as America's long stretch of declining daily coronavirus cases appears to be ending – and some states are seeing rapid increases even as one-third of U.S. adults have received at least one vaccination shot.

Also in the news:

►Despite warnings from health experts that the U.S. could be headed for a spring surge in coronavirus cases, Arizona Gov. Doug Ducey is prohibiting government mask mandates and allowing bars and nightclubs that were closed for months to open their doors without restrictions. Limits on gatherings of 50 or more people also were lifted.

►The CDC said 26.3% of the U.S. population has received at least one dose of a COVID-19 vaccine and 14% has completed vaccination. The country's seven-day average for daily new cases increased over the last two weeks from 56,315 on March 10 to 57,531 on Wednesday.

►Washington Gov. Jay Inslee on Thursday reduced the coronavirus social distancing requirements for K-12 classrooms in the state from 6 feet to 3 feet as more schools begin to open up. New CDC guidelines approve that reduction.

►New York Mayor Bill de Blasio announced plans Thursday to set up vaccination sites for Broadway performers and theater workers to ensure shows can make a return to the city this fall. Broadway theaters abruptly closed on March 12, 2020.

►AstraZeneca released updated information on its COVID-19 clinical trial late Wednesday, showing an effectiveness rate of 76% instead of the 79% rate it claimed earlier in the week.

📈 Today's numbers: The U.S. has over 30 million confirmed coronavirus cases and more than 546,300 deaths, according to Johns Hopkins University data. The global totals: 125.3 million cases and 2.75 million deaths. More than 169.2 million vaccine doses have been distributed in the U.S. and 133 million have been administered, according to the CDC.

📘 What we're reading: A growing share of Americans would feel safe resuming activities such as dining out or flying within a few weeks of their second dose of COVID-19 vaccine, but 25% to 30% would wait until the nation reaches herd immunity, according to a Harris Poll survey for USA TODAY. Read the full story.

USA TODAY is tracking COVID-19 news. Keep refreshing this page for the latest updates. Want more? Sign up for our Coronavirus Watch newsletter for updates to your inbox and join our Facebook group.

Joe Biden doubles down, targets 200M shots for first 100 days

President Joe Biden opened his first formal news conference by setting a new goal of administering 200 million COVID vaccine shots in his first 100 days in office. Biden’s original goal was to administer 100 million shots in that period. The U.S. passed that goal last week and is already on track to reach 200 million shots by the president’s first 100 days. The U.S. is now averaging about 2.5 million doses per day; 133 million shots have already been given, though some before Biden took office Jan. 20.

“I know it’s ambitious, twice our original goal,” Biden said Thursday. “But no other country in the world has even come close. Not even close to what we're doing. I believe we can do it.”

– Michael Collins

California to open vaccines for all 16 and older April 15

California, the nation's most populous state with 40 million people, will make all residents 16 and above eligible for COVID-19 vaccines starting April 15. In addition, those 50 and older will become eligible April 1.

That doesn't mean vaccine appointments will be available right away, but state officials expect supply to increase substantially in the coming weeks as the Johnson & Johnson vaccine becomes more widely distributed.

According to the Los Angeles Times, California expects to get about 2.5 million doses per week in the first half of April and more than 3 million later in the month. That's a major leap from the 1.8 million expected doses this week.

With California and Florida announcing Thursday they're dropping age requirements in the coming weeks, the country's three largest states by population will make COVID-19 vaccines available to all adults by no later than mid-April. Texas plans to do so Monday.

US to aid world vaccination effort –after inoculating Americans first

Wealthy countries that have secured large amounts of COVID-19 vaccine doses, including the U.S., have come under increasing pressure to share their bounty.

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, reiterated that point recently, noting that as long as the pandemic rages out of control anywhere, variants can emerge and pose risks to those thought to be immune.

"The inequitable distribution of vaccines is not just a moral outrage,'' he said. "It’s also economically and epidemiologically self-defeating."

The Biden administration has vowed to contribute to the global vaccination effort and has pledged $4 billion toward that cause, but wants to take care of Americans first.

"The president has stated his No. 1 priority is to make sure we prioritize vaccination in this country,'' said Andy Slavitt, White House senior adviser for COVID-19 response. "We've suffered over 540,000 deaths, more than anywhere else in the world."

– Karen Weintraub

Rutgers among first universities to require COVID vaccine for fall students

Rutgers University in New Jersey said Thursday that all students who take on-campus classes in the fall term will be required to be vaccinated for COVID-19, while faculty and staff members are "strongly urged" to get one of the available vaccines.

Rutgers is believed to be one of the first, if not the first, universities to impose that mandate, although school officials don't have data to confirm that.

Vaccination availability in New Jersey has been limited to those who are 65 and older or who have a preexisting condition, such as asthma or diabetes, as well as smokers. But state officials have said they expect to get additional supplies and ramp up vaccinations in the next few weeks.

-- Abbott Koloff, Bergen Record

Schools prepare for spring break rule-breakers

Spring breakers are back, but this time schools are more prepared for COVID-19 rule breakers. After a year of pandemic schooling, districts and colleges warned students to avoid travel. Some canceled spring break altogether. Even further, some schools put protocols in place to prevent traveling students from coming back to in-person school. They will be required to quarantine or finish the semester virtually. Schools have punished students who break COVID-19 restrictions on school grounds. Punishment for travel is trickier.

"Most institutions don't have the power to lock down their students," Christopher Marsicano, a professor of higher education practice at Davidson College in North Carolina, told USA TODAY. "They just don't have the money to have adequate testing to make sure everybody returning to campus after spring break doesn't have COVID-19."

– Dustin Barnes

Infection rate again rising: 'I don't think you can declare victory'

The U.S. is reporting a seven-day average of about 55,000 new cases per day, up 3% from the previous week, the CDC reports. The country is also reporting about 4,600 new hospitalizations and nearly 1,000 deaths per day. And the U.S. surpassed 30 million coronavirus cases Wednesday afternoon, once again reaching a dubious milestone much faster than any other country.

"When you’re at that level, I don’t think you can declare victory," Dr. Anthony Fauci said during a briefing. "We are at the corner. Whether or not we’re going to be turning that corner remains to be seen."

There are positive signs. About 2.5 million Americans are being vaccinated each day, according to Andy Slavitt, White House senior adviser for COVID-19 response. And the CDC reported that more than 133 million vaccine shots have been administered, and 18% of the U.S. adult population is completely vaccinated.

Florida, North Carolina join list of states allowing all adults to get vaccinated

Florida Gov. Ron DeSantis announced Thursday that he will eliminate the age restriction for COVID-19 vaccines as of April 5. And starting Monday, anyone 40 and up can make an appointment for the vaccine. President Joe Biden has instructed states to allow all adults access to vaccines by May 1.

North Carolina also said Thursday that it would open up vaccine eligibility for all residents 16 and older, starting April 7.

Louisiana announced this week it will provide access to anyone 16 and older starting Monday, and Idaho Gov. Brad Little said eligibility will be open to all state residents 16 and up starting April 5.

– Jeffrey Schweers, Florida Capital Bureau

Billions from relief bill heading to states, health centers for vaccines

Community health centers will receive more than $6 billion from the federal government to expand access to COVID-19 vaccines, testing and treatment for vulnerable populations, the administration announced Thursday. An additional $3 billion will be distributed to states, territories and some large cities for initiatives intended to increase vaccine access, acceptance and uptake. Another $330 million will go directly to support community health workers.

The funding comes primarily through the recently passed $1.9 trillion coronavirus relief package.

– Maureen Groppe

34% of US adults have had at least one shot; half the others don't want it

In the U.S., 34.1% of adults report having received at least one dose of a COVID-19 vaccine, and those who aren't vaccinated and would get the shot say they are relatively brand agnostic, according to a new poll by Survey Monkey on vaccine hesitancy.

Meanwhile, 66% of people willing to get the shot would be up for the Moderna vaccine, while 70% are willing to get the Pfizer vaccine and 67% are willing to get the Johnson & Johnson vaccine. But just 51% of people still unvaccinated say they would get a vaccine if offered to them.

Reports: Gov. Andrew Cuomo's family got priority testing early in pandemic

In the early months of the pandemic, when COVID-19 tests were scarce, New York Gov. Andrew Cuomo vowed to make the testing available to those most in need. Turns out that included his family members and other well-connected people close to his administration, according to reports Wednesday night.

Both The Washington Post and the Times Union in Albany reported that Cuomo's office arranged coronavirus testing for his family, including his CNN anchor brother, Chris Cuomo, and other influential people with close Cuomo ties.

The testing was conducted at times at people's homes and in part by Dr. Eleanor Adams, an epidemiologist who was a special adviser to the state Health Department, the reports said, citing unnamed sources. The Times Union, which first reported the details, said Adams' trips included going to the Long Island home of Chris Cuomo, who announced in late March 2020 that he was positive for COVID-19 and detailed his battle with the virus nightly on his show – on which the governor often appeared last year.

The governor's office did not deny the reports but said the state was trying to test as many people as possible.

– Joseph Spector, Democrat and Chronicle

Contributing: The Associated Press

Updated boosters add limited protection against Covid-19 illness ...

CNN —

Updated Covid-19 boosters that carry instructions to arm the body against currently circulating Omicron subvariants offer some protection against infections, according to the first study to look at how the boosters are performing in the real world. However, the protection is not as high as that provided by the original vaccine against earlier coronavirus variants, the researchers say.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, called the new data “really quite good.”

“Please, for your own safety, for that of your family, get your updated Covid-19 shot as soon as you’re eligible to protect yourself, your family and your community,” Fauci said at a White House briefing Tuesday.

Uptake of the bivalent boosters, which protect against the BA.4/5 subvariants as well as the original virus strain, has been remarkably slow. Only 11% of eligible Americans have gotten them since they became available in early September.

The new study found that the updated boosters work about like the original boosters. They protect against symptomatic infection in the range of 40% to 60%, meaning that even when vaccine protection is its most potent, about a month after getting the shot, people may still be vulnerable to breakthrough infections.

That’s in about the same range as typical efficacy for flu vaccines. Over the past 10 years, CDC data shows, the effectiveness of the seasonal flu vaccines has ranged from a low of 19% to a high of around 52% against needing to see a doctor because of the flu. The effectiveness varies depending on how similar the strains in the vaccine are to the strains that end up making people sick.

The authors of the new study say people should realize that the Covid-19 vaccines are no longer more than 90% protective against symptomatic infections, as they were when they were first introduced in 2020.

“Unfortunately, the 90% to 100% protection was what we saw during like pre-Delta time. And so with Delta, we saw it drop into the 70% range, and then for Omicron, we saw it drop even lower, to the 50% range. And so I think what we’re seeing here is that the bivalent vaccine really brings you back to that sort of effectiveness that we would have seen immediately after past boosters, which is great. That’s where we want it to get,” said Dr. Ruth Link-Gelles, an epidemiologist at the US Centers for Disease Control and Prevention.

Vaccines are only one tool to stay well

“This protection is not 100%, but it is something,” Link-Gelles said. “Especially going into the holidays where you’re likely to be traveling, spending time with elderly relatives, with vulnerable people. I think having some protection from infection and therefore some protection from infecting your loved one is better than having no protection at all.”

Link-Gelles says it also means that people should continue to adopt a layered approach to protection, utilizing rapid tests, good-quality masks and ventilation as a comprehensive approach, rather than relying on vaccines alone.

“This should be sort of one of the things in your toolbox for protecting yourself and your family,” she said. “Personally, we’re my family is all vaccinated up to date, but I think if we go to the airport tomorrow, we’ll be wearing our N95 [masks] because we’re seeing elderly relatives this weekend. And while we of course trust the vaccines, and I’m not super worried about a mild infection in myself or my healthy husband, we certainly would not want to infect his grandmother.”

Link-Gelles added that she expects that vaccine protection against severe outcomes from Covid-19, like hospitalization and death, will be higher, but that data isn’t in yet.

The study, which was led by CDC scientists, relied on health records from more than 360,000 tests given at nearly 10,000 retail pharmacies between Sept. 14 and Nov. 11, a period when the BA.4 and BA.5 subvariants were causing most Covid-19 infections in the US. The study included people ages 18 and up who had Covid-19 symptoms and were not immunocompromised.

The study looked at how effective the boosters were in two ways: Researchers calculated a value called absolute vaccine effectiveness, which compared the odds of symptomatic infection in people who received bivalent boosters with those who reported being unvaccinated. They also calculated relative vaccine effectiveness, which looked at the odds of symptomatic infection in people who received updated bivalent boosters compared with those who had two, three or four doses of the original single-strain vaccine.

Compared with people who were unvaccinated, adults 18 to 49 who had gotten bivalent boosters were 43% less likely to get sick with a Covid-19 infection. Older adults, who tend to have weaker immune function, got less protection. Those ages 50 to 64 were 28% less likely, and those ages 65 and up were 22% less likely to get sick with Covid-19 than the unvaccinated group.

The relative vaccine effectiveness showed the added protection people might expect on top of whatever protection they had left after previous vaccine doses. If a person was two to three months past their last vaccine dose, the bivalent boosters added an average of 30% protection for those who were ages 18 to 49, 31% more protection if they were 50 to 64, and 28% more protection if they were 65 or older. At 3 months after their last booster, people ages 50 and older still had about 20% protection from Covid-19 illness, CDC data show. So overall, the updated boosters got them to around 50% effectiveness against symptomatic infection.

If a person was more than eight months away from their last vaccine dose, they got more protection from the boosters. But Link-Gelles said that by eight months, there was little protection left from previous shots against Omicron and its variants, meaning the vaccine effectiveness for this group was probably close to their overall protection against infection.

Those ages 18 to 49 who were eight months or more past their last dose of a vaccine had 56% added protection against a Covid-19 infection with symptoms; adults 50 to 64 had 48% added protection, and adults over 65 had 43% added protection, on top of whatever was left from previous vaccinations.

Short, modest protection from boosters

John Moore, an immunologist and microbiologist at Weill Cornell Medicine, said it boils down to the fact that that boosters will probably cut your risk of getting sick by about 50%, and that protection probably won’t last.

“Having a booster will give you some additional protection against infection for a short term, which is always what we see with a booster, but it won’t last long. It’ll decline, and it will decline more as the more resistant variants spread,” said Moore, who was not involved in the new research.

The immunity landscape in the United States is more complex than ever. According to CDC data, roughly two-thirds of Americans have completed at least their primary series of Covid-19 vaccines. And data from blood tests shows that almost all Americans have some immunity against the virus, thanks to infection, vaccination or both.

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A new preprint study from researchers at Harvard and Yale estimates that 94% of Americans have been infected with the virus that causes Covid-19 at least once, and 97% have been infected or vaccinated, increasing protection against a new Omicron infection from an estimated 22% in December 2021 to 63% by November 10, 2022. Population protection against severe disease rose from an estimated 61% in December 2021 to around 89%, on average, this November.

All of this means the US is in a better spot, defensively at least, than it ever has been against the virus – which is not to say that the country couldn’t see another Covid-19 wave, especially if a new variant emerges that is very different from what we’ve seen, if immunity continues to wane or if behavior shifts dramatically.

Has distrust in COVID vaccines caused same skepticism in flu shots?

As flu season ramps up, public health officials are urging everyone 6 months and older to get vaccinated.

Less than half of all US adults received their flu vaccine last flu season (47.4%), but that rate is slightly higher compared to the same time in March a year prior (45.4%).

Vaccination is vital to protect individuals, communities and to avoid burdening already overtaxed health care systems. Last season, people vaccinated against the flu were about 40% to 70% less likely to be hospitalized because of flu illness or related complications, according to preliminary estimates from the CDC.

While vaccine rates of adults remained steady during the ongoing pandemic, this rate faltered among other people in other age ranges.

Pregnant people and kids see a decline in vaccination rates

Flu vaccination protection among pregnant people is down more than 16 percentage points since 2020, according to CDC data.

As of spring 2023, 48.9% of pregnant people were protected against the flu, compared to 65.5% during the beginning of the pandemic.

Among kids younger than 18, the rate of flu vaccination was roughly 55% as of April 2023, down from 62% at the start of the pandemic.

Floridians unsure:Florida health officials say most people shouldn't get new COVID shot, contradicting CDC

Older patients continue to have higher vaccination rates

Almost 75% of adults 65 and older were protected against the flu as of last spring.

A little over 50% of all adults aged 50 to 64 were vaccinated against the flu,

While only 36% of adults aged 18 to 49 received a flu vaccine.

Flu vaccination coverage for adults 65 and older is higher compared to their coverage at the same time last year.

How have COVID vaccine rates changed?

When the COVID-19 vaccination first became available to the public in early 2021, about 80% of adults received their initial series of vaccinations, according to the CDC. Only 20% of adults got last year’s COVID-19 booster vaccine.

Flu season is here:CDC announces flu shot recommendations

What causes vaccine skepticism?

Helen Maser, a Walgreens pharmacist based in New York said people may have reservations about getting vaccinated because of the fear of the unknown: “It's all about education. People are afraid of what they don't know,” said Maser. “If you come and ask a question, we can give you the knowledge, so you can make a good decision based on your own personal care that empowers you to take care of yourself and your family.”

A UCLA study from 2022 found that adult flu vaccination rates dropped in the same states that had low rates of COVID-19 vaccination. The study’s findings suggest factors that cause low COVID-19 vaccine rates such as mistrust in the vaccine, concerns about side effects and a lack of trust in government are connected to declines in flu vaccine rates, compared to pre-pandemic years.

Widespread online misinformation about the coronavirus and the vaccine caused many Americans to distrust public health expert’s recommendations on getting vaccinated. Some government officials have even contradicted the CDC, refusing to endorse the updated COVID booster shots, leading to more mistrust.

How can I prepare for flu season?

September and October remain the best times for most people to get their flu vaccine, according to the CDC.

Vaccination should continue after October and throughout the given flu season since “influenza activity might not occur in certain communities until February, March, or later.” The CDC also recommends vaccination "as long as flu viruses pose a threat."

It is safe to get a flu and COVID-19 shot at the same time, experts say. The two were often administered simultaneously during the last two flu seasons.

Low vaccination rates, Delta variant fuel surge in new COVID-19 ...

For months it felt like life had returned to normal. COVID-19 vaccines were readily available and as a result new case numbers were falling nationally.

But that sense of optimism has faded across the country as new cases linked to the highly infectious Delta variant are on the rise and disproportionately affecting unvaccinated populations.

It’s a precarious situation across several Southern states where health workers continue to battle rampant vaccine hesitancy and misinformation, resulting in some of the lowest vaccination rates in the country.

Less than 35% of the population in Alabama and Mississippi have been fully vaccinated as of July 19, according to data reported by their state health departments. Alabama had the lowest vaccination rate in the U.S. among adults averaging at about 33.4%. Arkansas, Wyoming and Louisiana are also among the top five states with low vaccination rates, with little more than 35% of adults vaccinated against COVID-19, according to state health data.

Other Southern states are not much further along. In Tennessee, where the top vaccine official was recently fired, only 38.4% of people are fully vaccinated. Only about 39% of Georgians have received both doses, according to state health data.

By comparison, nearly 50% of U.S. adults have been fully vaccinated as of July 19, according to the Centers for Disease Control and Prevention.

More:Tennessee fires top vaccine official as COVID-19 shows signs of new spread

In the last two weeks, health officials across the region have issued warnings to alert the public about the prevalent spread of the Delta variant, which is more virulent than earlier forms of the virus and therefore spreads more easily.

“It feels very reminiscent of where we were in an early part of the pandemic,” said Mississippi’s state epidemiologist Dr. Paul Byers. “It feels like we’re in the same situation now with the Delta variant.”

Mississippi sees hospitalizations nearly double in early July

Mississippi reported 2,326 new cases between Saturday, July 17 to Monday, July 19, almost as many cases as the total seven-day cumulative total for all of last week according to data from theMississippi State Department of Health. The rise in numbers comes as health workers struggle to increase vaccination rates in the state. Over 1 million Mississippians have been fully vaccinated, accounting for about one-third of all residents, according to state health data.

Hospitalizations have also started to climb in recent weeks, said Mississippi’s state health officer Dr. Thomas Dobbs during a recent press conference. The number of people hospitalized with confirmed infections nearly doubled from 98 to 193 over a two-week period in early July, according to state health data.

The rise prompted the state’s health department to recommend adults over the age of 65 and people with chronic illnesses avoid indoor mass gatherings regardless of vaccination status for the next few weeks.

Many of the outbreaks are linked to youth summer camps as well as nursing homes. Unlike previous waves, the current outbreak appears to be affecting younger unvaccinated people, Dobbs said.

“Our collective under vaccination has put us all at risk especially, the most vulnerable among us,” he said.

Alabama reports 4,300 cases in past two weeks

The Delta variant was first identified in Alabama in late April, according to testing conducted by the pathology lab at the University of Alabama-Birmingham. In the last two weeks nearly 70% of 48 samples tested showed the variant, according to lab manager and researcher Derek Moates.

“I haven’t been too concerned about what I have been seeing until the past week-and-a-half to two weeks,” he said. “The number of delta variant cases is really starting to increase, and it is creating a dangerous situation for our state, which only has 33.3% of the population vaccinated.”

Alabama has reported over 4,300 cases in the last two weeks, according to state health data.

More:Alabama officials urge COVID-19 vaccinations as delta variant spreads in U.S.

The growing number of new cases comes weeks after states have dropped most public health measures to contain the spread of the virus. Meanwhile, vaccination rates have stalled and even the most innovative health campaigns have failed to convince a larger percentage of the public to get vaccinated.

Officials in Alabama have organized mass drive-thru clinics, Talladega Nascar giveaways, shots-for-gift card clinics and even door-to-door vaccination campaigns for vulnerable communities. Major state figures such as the University of Alabama football coach Nick Saban and Republican Sen. Tommy Tuberville released PSAs touting the vaccine. Local leaders organized town halls, and family doctors have held phone banks and Facebook Lives to address vaccine concerns and reduce hesitancy.

Alabama Gov. Kay Ivey continues to publicly advocate for the vaccine, but a move toward increased restrictions despite the data seems unlikely.

Ivey, now campaigning in an active election cycle, has repeatedly said Alabama is “open for business,” signaling little interest in re-introducing restrictions or masking requirements should the state experience a new surge.

“Vaccines are readily available, and I encourage folks to get one. The state of emergency and health orders have expired. We are moving forward,” Ivey said.

Arkansas has nearly 10,000 active COVID cases

Arkansas Gov. Asa Hutchinson has taken a similar stand, despite the state currently reporting nearly 10,000 active COVID cases, according to the Arkansas Department of Health. Meanwhile, only about 35% of the adult population has been vaccinated.

Vaccine incentives have not worked, Hutchinson recently said in a statement.

“The most powerful incentive is the reality that if Arkansas doesn’t significantly increase its rate of vaccinations, we won’t be getting rid of COVID-19 and its spinoffs anytime soon,” he said. “In Arkansas, we have chosen the path of personal responsibility. The state is wide open. We aren’t mandating masks or vaccinations.”

Louisiana tries a variety of incentives to encourage vaccination

Even in New Orleans, which has the highest percentage of fully vaccinated adults in Louisiana (63%), health officials recently said that measures to limit the spread of COVID-19 will likely be in place at large events through the fall.

This could include mask mandates or requirements that attendees be fully vaccinated or able to present a negative COVID-19 test, said Dr. Jennifer Avegno, the health director for New Orleans.

Health workers have struggled to improve vaccination rates in Louisiana, where slightly over 35% of the population has been fully vaccinated. In recent months health workers have attempted a variety of incentives. For example, partnering with local businesses and faith-based groups to convince more people about the safety of the vaccine. Rates increased by about 14% last month following the announcement of a state-sponsored lottery for vaccinated individuals. However, this quickly leveled off, health officials stated.

Avegno said last week that in about half of Louisiana’s 64 parishes only one-third of the population or less has had at least one dose of the vaccine.

“It’s not surprising why the Delta variant is spread widely in Louisiana. It’s significantly more contagious and with large numbers of the population unvaccinated it has spread easily,” Avegno said.

More:Delta variant prompting concerns as Louisiana COVID-19 cases rise for third week

As a result, hospitalizations have started to increase over the last 12 days, including pediatric admissions, she said.

The statewide average of daily number of cases per 100,000 residents has increased 167% in that time period. The bulk of those new cases have occurred among younger unvaccinated adults in Louisiana, said Louisiana’s state health officer Dr. Joseph Kanter.

COVID-19 cases among unvaccinated individuals make up about 97% of all cases and deaths since February in the state, according to the Louisiana Department of Health.

More:The battle to increase COVID-19 vaccinations in Louisiana pushes creativity in New Orleans

Kanter said the state is about to experience another surge in cases and the only solution right now is to increase messaging about vaccinations across the state.

“At this point I consider every single death to be preventable. During the previous three surges all we could do was weather it. Now we need to do as much as we can to add that protection,” he said.

Maria Clark is a general assignment reporter with The American South. Story ideas, tips, questions? Email her at mclark@gannett.com or follow her on Twitter @MariaPClark1. Sign up for The American South newsletter. Follow us on Instagram, Facebook and Twitter.

Vaccine fatigue is leaving the US vulnerable to flu | CNN

CNN —

The flu season ramped up early in the United States this year, but vaccination rates are far from keeping pace.

Flu vaccines are always a tough sell for Americans. The US Department of Health and Human Services set a target vaccination rate of 70% in the Healthy People 2030 plan. But less than half of the population has actually gotten their annual flu shot each year for at least the past decade.

Public health leaders say it has been especially challenging to get people to get their flu vaccine this year because they’re growing tired of hearing about shots.

What once was an annual push to get people vaccinated at the start of each flu season has become near-constant messaging about vaccines, with an announcement about new Covid-19 vaccine availability or eligibility seeming to come every couple of months.

“There’s a great deal of vaccine fatigue out there. Asking people this year to get not just one vaccine but to get the annual influenza vaccine, as well as the Covid booster, has really been what I have called a hard sell,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and professor at Vanderbilt University Medical Center.

“There’s the old saying, ‘familiarity breeds contempt.’ Well, perhaps that’s a bit strong, but familiarity does seem to breed a certain nonchalance,” he said.

Millions fewer flu vaccine doses have been distributed this season compared with this point in seasons past, according to data from the US Centers for Disease Control and Prevention. Just 26% of adults had gotten their flu shot by the end of October, a deadline that medical experts have long encouraged for optimal protection throughout the season. About 43% of children had gotten their flu shot by the end of November.

Reckoning with a new normal

The first year of the Covid-19 pandemic – the 2020-21 flu season – was a notable outlier, experts say.

Flu vaccination rates soared higher than usual amid fears of a “twindemic,” with the coronavirus and flu circulating together.

“The public health message – and I think we did it very effectively – was, you can’t protect yourself against Covid right now, but you can definitely take flu off the table,” said LJ Tan, chief strategy officer for the Immunization Action Coalition and co-chair of the National Adult and Influenza Immunization Summit, nonprofits dedicated to improving vaccination coverage in the US.

“We were coming out of lockdowns, and people wanted to be active as opposed to passive. So when we told people at that time, ‘You don’t have a Covid vaccine, but you can certainly take flu off the table by getting a flu vaccine,’ people said, ‘Yeah, I’m doing that.’ “

But that double threat didn’t materialize. Flu seasons have been uncharacteristically mild for the past two years, and people have let their guard down, experts say.

“I’ve almost had to remind people about influenza,” Schaffner said. “We’ve had two quite curtailed, very low influenza years. And of course, everyone’s been preoccupied with Covid, and they want to put Covid behind them and get on with their lives.”

Now, continued messaging about a triple threat of viruses – flu, Covid and RSV – isn’t hitting in quite the same way. The urgency is real, as hospitals across the country stretch their capacity to record levels, but it’s not driving people to action.

“It strikes me that people have gotten used to bad flu seasons for the elderly. So this is kind of just the same, with a few other viruses around. There’s a sense that this is what we’re going to expect and this is what we have to live with,” said Dr. Jesse Hackell, a pediatrician who co-authored a clinical report about countering vaccine hesitancy in 2016.

“What we’re missing is the fact that kids and children’s hospitals are suffering in ways that we’ve never seen before.”

Numerous studies have found that flu and Covid-19 vaccines significantly reduce the risk of severe outcomes for those who become infected, including hospitalization and death – thus reducing the burden on the health care work force.

Exacerbating the general vaccine fatigue is decision fatigue, Hackell said.

People have to choose whether to get the flu vaccine each year – and more recently, they have to make decisions about Covid-19 vaccine updates. Each new decision opens the door for misinformation or disinformation to seep into the process.

“If it were a vaccine like measles, where it is really effective and it’s not repeated, it might be different,” Hackell said. “But we have to compare it to Covid and flu vaccines, where the efficacy is less than dramatic, and when there’s a lot of controversy going on, I think that spills over.”

Health care professionals are worn out too, experts say.

“I think there’s fatigue, moral injury, call it burnout on the part of providers as well. We’re not pushing it as hard,” said Hackell, who is also chair of the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. “It gets very difficult to keep having these unproductive conversations over and over again. And there’s so much more respiratory illness now that I don’t know that the time is there to have these long discussions when your office is packed with sick kids.”

Linking Covid and flu

Uptake for the updated Covid-19 booster has also been lackluster: Fewer than 1 in 7 eligible people have gotten one since it was authorized in the fall, according to CDC data.

Ongoing messaging from the White House urges Americans to get their updated Covid-19 booster shot and the flu shot at the same time.

But despite the convenience of getting both shots at once, there’s evidence that linking the two isn’t the best way to boost coverage rates for either.

There has always been hesitancy around vaccination, but it has become highly politicized during the Covid-19 pandemic.

“We still have plenty of people in this country who do not believe in the flu or the Covid vaccine that we haven’t been able to win over,” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials. “Flu is serious in our country, and it kills a lot of people, and it hospitalizes a lot of people, and it attacks the young and old. And so we should pay more attention to it.”

But even when interest in booster shots was highest, it was rare for people to get both shots simultaneously.

Self-reports to the CDC’s V-safe monitoring system show that fewer than 1 in 10 people who got a Covid-19 booster between September 2021 and May 2022 got a flu shot at the same time.

“We give multiple vaccines to our kids at the same time, but we haven’t typically done that for adults,” said Tan, former liaison to the CDC’s vaccine advisory committee for the American Medical Association.

Trying to persuade people to do something new can add to the hesitancy that’s already become so pervasive and make them less likely to come in at all. Instead, people seem to be much more likely to accept the offer of a flu vaccine at an appointment they scheduled to get a Covid-19 vaccine booster, or vice versa.

“Some confidence is given by direct interaction with a health-care provider – in this case, the pharmacist or the physician or the clinician – who is able to reassure the patient that it’s safe,” Tan said. “In that personal conversation between the provider and the patient, the patient ends up being converted and getting the vaccine. It’s a testimony also to our remarkable health-care providers.”

The message might finally be sticking. At Walgreens locations, co-administration of the flu and Covid-19 vaccine is 70% higher this year than it was last year, according to data shared with CNN.

Better late than never

Tan says there have been signs of improvement in recent weeks.

Pharmacies are becoming significantly more popular than doctors offices among adults as they choose where to get the flu shot, and CDC data shows that the number of flu vaccines given in pharmacies this season is actually outpacing last year. It’s a sign that there are more opportunities to reach a broader group of otherwise healthy adults who are less likely to have a primary care provider, Tan said.

“At least we’ve got the uptick now, as opposed to this continuous decline that we were seeing four weeks ago,” he said. “But while I’m sounding positive, I want to remind us all that we need to be better than we currently are.”

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And while battling vaccine fatigue is a challenge, it’s not an excuse to let vaccination rates lapse.

“In many circumstances, we can overcome fatigue with access,” Tan said.

In public health, “we need to start looking outside the box to find out what messaging needs to change so that we can think out of the box and make people motivated to look for the flu vaccine again. Right now, it’s way too much of a vaccine of convenience.”

Updated Covid-19 boosters offer protection, but new studies suggest ...

CNN —

The updated Covid-19 booster shots appear to work about as well against the BA.4 and BA.5 Omicron subvariants as the original boosters they replaced, according to two new studies from research teams at Harvard and Columbia universities.

The research suggests that our bodies have been well-trained to fight the original virus, which emerged from Wuhan, China, and that boosters mostly reinforce that response. Getting boosted this fall is still an important way to renew protection, even among people who were previously infected or vaccinated.

But the hope was that by tweaking the vaccine recipe to include currently circulating strains of the Omicron variant, it would help broaden immunity against those variants and perhaps offer better and longer-lasting protection.

When the researchers compared the immune responses of people who got a booster dose of the original shot to people who got the updated bivalent boosters, they looked about the same.

“We see essentially no difference” between the old boosters and the new about a month after the shot, said Dr. David Ho, professor of microbiology and immunology at Columbia, whose team authored one of the studies.

Immunologists say a vaccine against two strains may not be better than a single strain shot because of a phenomenon called immune imprinting. Scientists say imprinting may complicate efforts to stay ahead of new variants as the coronavirus continues to evolve, and it adds urgency to the development of new vaccine technologies to fight the virus.

When the US Food and Drug Administration issued emergency use authorizations for new bivalent Covid-19 vaccines from Pfizer and Moderna at the end of August, it did so on the basis of studies in mice and previous human trials with a different two-strain booster formulation. Little was known about the how protective the shots might be in people; full data from clinical trials testing the BA.4 and BA.5 bivalent vaccines in humans hasn’t yet been made public.

But modeling data suggested that getting the boosters out in September could save tens of thousands of lives if the country had another winter surge, so the FDA authorized the shots, ahead of results from clinical trials, in order to get them to the public more quickly.

The updated shots contain instructions that show cells how to make spike proteins from the original virus that caused Covid-19, as well as spikes from the BA.4 and BA.5 subvariants. These spikes get assembled by our cells and displayed to our immune system so it can make antibodies to fight the real thing during an active infection.

The original strain of the virus, sometimes called the ancestral or wild-type strain, is no longer circulating, however. When we boost, we are mostly boosting antibodies against a virus that’s long gone.

As the virus has evolved, the vaccines have not kept pace. Each new variant has become more and more resistant to the antibodies we make against it, increasing the risk of breakthrough infections, hospitalizations and deaths.

Right now, protection against infection begins to wane just a few months after each booster dose. Protection against severe outcomes – hospitalization or death from Covid-19 – lasts longer, but can also fade, especially for vulnerable groups such as people who are over 65, who have weakened immune systems or who have underlying medical conditions.

Similar immune responses

The studies have important limitations, and they aren’t the final word on the updated boosters.

Both studies were small. Ho’s study looked at the immune responses of 19 people who were boosted with a fourth dose of the original recipe vaccine and 21 people who got a fourth dose of the updated boosters. The other study, from Dr. Dan Barouch, a professor at Harvard and director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, looked at 15 people who got the original booster and 18 people who got bivalent shots.

Both reports were posted as preprints, before scrutiny by independent experts.

The studies also measured immune responses over a short period of time – about three to five weeks after the fourth doses. Ho says these results could change with time, as immune cells mature.

“We can’t say that a few months from now, there won’t be any difference,” he said. “We won’t know that until these individuals are followed for a longer period of time.”

Despite these caveats, experts who were not involved in the research say that two studies from well-regarded labs arriving at roughly the same conclusions about the vaccines gives them confidence that the results are correct.

“At least at this time point, there’s no discernible benefit” over the older boosters, Ho said.

Clinical trials being conducted by vaccine makers Pfizer and Moderna involve hundreds of people who have had the updated boosters and are being followed for longer periods of time. Data from those studies are still coming.

Both companies declined to comment on Ho and Barouch’s studies, citing company policies not to weigh in on research they have not been involved in.

In comparing the immune responses of people who got the old boosters with those who got the newer ones, the researchers found that neutralizing antibodies spiked after both shots to about the same high levels, which was good news.

In Barouch’s study, antibody concentrations were 15 times higher after the original boosters, rising from 184 to 2,829. They were 17 times higher after the updated shots, jumping from 211 to 3,693. The difference in antibody levels between shots didn’t pass a statistical test, however, so the results may have been due to chance.

More importantly, that slight difference in antibody levels probably wouldn’t protect people any better in the real world.

“We would not expect this to be clinically significant,” said Barouch, who worked on the development of the Johnson & Johnson Covid-19 vaccine.

But the bulk of the antibodies generated after either shot were ones that would bind the original virus, with fewer directed specifically against the BA.4 and BA.5 subvariants.

Barouch’s team also looked specifically at T cells, which help the body hold the memory of germs it has been exposed to. These cells are thought to play a key role in how long immune protection lasts. Antibody levels naturally drop off over time, but T cells stick around.

The numbers of T cells didn’t budge much after either vaccine.

“Unfortunately, neither one increased T-cell responses very much, and we believe that T-cell responses in addition to antibody responses are important for protection against severe disease,” Barouch said.

‘A booster is a booster’

Dr. Eric Topol, who directs the Scripps Research Translational Institute, said the study results “can be considered a disappointment,” especially because the US government raced to make them available and because there had been high hopes for an improved vaccine in time for a predicted winter Covid-19 surge.

Topol also said it would be a mistake to skip these shots. They still work; they just may not be much of an improvement over the older ones.

“A booster is a booster until proven otherwise and we are in great need of getting more of them in the US,” Topol, who was not involved in the new studies, wrote in an email to CNN.

Fewer than 20 million people – less than 10% of the population ages 5 and up – have gotten the updated booster, according to data from the US Centers for Disease Control and Prevention.

After waiting the recommended three months since his last Covid-19 infection, President Joe Biden got an updated booster Tuesday and urged eligible Americans to do the same.

“Your old vaccine or your previous Covid infection will not give you maximum protection,” Biden said.

Public health officials had hoped that the rollout of the updated boosters would mark a turning point, where Americans might be able to get annual Covid-19 shots instead of boosters every few months.

Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, recently told Stat that he wasn’t sure whether the country had reached that point.

“I would be lying to you if [I said] it doesn’t keep me up at night worrying that there is a certain chance that we may have to deploy another booster – at least for a portion of the population, perhaps older individuals – before next September, October,” he said.

“I’m not saying that’s what’s going to happen, but it’s what keeps me up at night, because we see how fast this virus is evolving.”

Imprinting may complicate quest for better immunity

The studies probably didn’t find any difference between the new and old boosters because of immune imprinting, says Michael Worobey, a professor at the University of Arizona who studies the evolution of viruses and the origins and control of pandemics.

“Your body is on a hair trigger to create more antibodies of what it has a good memory of,” said Worobey, who was not involved in the new research.

At the beginning of the pandemic, our immune systems were blank slates when it came to the coronavirus. By now, most of us have been exposed to one version of the virus or another through the vaccine, an infection or both. That exposure programs cells called B cells to make specific kinds of antibodies, and more B cells get this programming during their first exposure to the virus than they do in subsequent brushes with it.

That’s the reason some strains of the flu may hit certain age groups harder than others, too. When viruses look more similar to the first infection or vaccine you had, your body tends to do a better job fighting them off.

Worobey said that both new studies have limitations, “but I think when you put them together, they paint a pretty clear picture that that antigenic imprinting is causing issues here, for sure.”

It’s possible to break through immune imprinting, he said. Certain kinds of vaccine ingredients, or adjuvants – “things that just happen to really wake up the immune system” – can do it.

But it’s not easy to add the kind of adjuvants he’s thinking about to mRNA vaccines like Pfizer and Moderna’s. In this case, he says, judging by the study findings, it probably would have been better to update the vaccine by including only the components against BA.4 and BA.5.

“For me, the take-home message is, if you want to boost and provide protection against Omicron, leave the original variant out of the vaccine.”

Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and a member of the FDA’s vaccine advisory committee, says the new studies bear out data that was presented to the FDA’s advisers in June.

He says it’s one of the reasons he voted against the FDA requiring companies to add an Omicron strain to the boosters used in the US.

“Certainly, the hope that this would be significantly better in terms of protection against the circulating strains, I think, is unlikely to be realized,” said Offit, who was not involved in the new studies.

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Worobey says that when the strains are combined as they are in the updated boosters, they actually end up competing. The body’s response to the original strain is so strong, it will end up blocking the updated portion of the vaccine from stimulating those blank slate B cells against the newer variants and reshaping the immune response.

Thus, imprinting will complicate efforts to keep up with the virus, he says. We may need different kinds of vaccine technologies if the virus ever changes so much that it outcompetes our immunity altogether.

That’s something the FDA’s Marks has considered, too.

“I would love to see us have a very ecumenical look over all of the available vaccines and all of the vaccines in development to try to see what’s best moving forward,” he told Stat. “Not to diss the current mRNA vaccines but because we owe it to the population to see what might provide the greatest breadth, depth and duration of immunity against Covid-19.”

Covid-19 vaccines will be on the 2023 vaccine schedule, but that ...

CNN —

Covid-19 vaccines will be part of recommended immunization schedules in 2023 for both children and adults, after a unanimous vote by the US Centers for Disease Control and Prevention’s independent Advisory Committee on Immunization Practices.

That doesn’t make the vaccines mandatory for anyone, a point that was emphasized in a discussion before Thursday’s vote. The board members addressed concerns from the public that adding Covid-19 vaccinations to the schedule would force schools to require the shots.

“We recognize that there is concern around this, but moving Covid-19 to the recommended immunization schedule does not impact what vaccines are required for school entrance, if any,” said Dr. Nirav Shah, a committee member and director of the Maine Center for Disease Control and Prevention.

“Indeed, there are vaccines that are on the schedule right now that are not required for school attendance in many jurisdictions, such as seasonal influenza. Local control matters, and we honor that. The decision around school entrance for vaccines rests where it did before, which is with the state level, the county level and at the municipal level, if it exists at all. They are the arbiters of what vaccines are required, if any, for school entry. This discussion does not change that.”

In fact, Covid-19 vaccines are explicitly banned from being included in school mandates in at least 20 states. Only California and the District of Columbia have announced that Covid-19 shots will be among mandated vaccinations for students, but those mandates were not implemented for this school year.

It’s been nearly a year since eligibility for the Covid-19 vaccine was expanded to include everyone in the US 5 and older, but coverage among children still lags behind that of adults. Even as these vaccines and the related mandates have become highly politicized over the course of the pandemic, experts say vaccine hesitancy among parents isn’t new.

Although the Covid-19 shot will not become mandatory for school, all 50 states do have laws requiring specific vaccines for students – most of which include shots for measles, mumps and rubella (MMR), diphtheria, tetanus and pertussis (DTaP) and varicella.

Uptake for these vaccines, mandated by schools long before Covid-19, fell during the pandemic.

In the 2020-21 school year, vaccination coverage for kindergarteners fell to less than 94% – dropping below the overall target of 95% that was set as an objective by the US Department of Health and Human Services in the Healthy People project for the first time in six years.

A CNN analysis of the latest CDC data suggests that students in states with stricter school vaccine requirements are more likely to have their shots.

All school immunization laws grant exemptions to children for specific medical reasons. But 44 states and Washington, DC, also grant religious exemptions, and 15 states allow philosophical or moral exemptions for children, according to the National Conference of State Legislatures.

According to the CNN analysis, states that were stricter with exemptions were much more likely to still meet the 95% coverage target. In the 2020-21 school year, an average of about 96% of kindergarten students had their MMR vaccine in states that allowed only medical exemptions, compared with 92% of students in states that also allowed philosophical or moral exemptions.

The full effect of the pandemic on children’s routine vaccination rates isn’t clear: It will be another few months before the CDC shares national data for compliance rates for mandatory vaccinations in the 2021-22 school year, and schools are in the midst of outreach and programming to ensure that as many students as possible will continue through the 2022-23 school year up to date on their vaccines.

Vaccine hesitancy isn’t new

Correcting the drop in vaccination coverage in students will probably depend more on better access to care, information and outreach – and school vaccine mandates can help.

With many people who are hesitant, it’s “because of something they’ve heard or something they’ve read,” said Dr. Jesse Hackell, a pediatrician who co-authored a clinical report about countering vaccine hesitancy in 2016. “Most people [who are hesitant] have a very free-floating worry about vaccines. It’s not specific in most cases.”

A small share of parents – about 2% or 3% – are adamantly opposed to vaccines, and that rate has stayed mostly consistent over the years, said Hackell, who is also chair of the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine.

Overall vaccination coverage fell among kindergarteners in the 2020-21 school year, but the share of students who had an exemption also declined from 2.5% to 2.1%, according to CDC data. The rate has changed by less than 1 percentage point over the past 10 years.

About 3% of kindergarteners in the US – about 120,000 students – were considered to be out of compliance with mandatory vaccines in the 2020-21 school year.

“Mandates may not do anything to those people who would pull their kids out of public school,” Hackell said. “But the vast majority of parents are not opposed. They’re hesitant, or they’re uncertain. And when there’s pressure to do it for another reason, such as getting your kid into school, they come around.”

Responsibility for enforcing vaccine mandates falls to the education system, and practices vary by state. Some students are ultimately turned away because they aren’t up to date, but most states offer provisional enrollment periods that allow kids to stay in school if they are in progress with at least one shot in a series or evidence of an upcoming appointment.

According to the CDC, “school officials may prefer to keep students in school where they have access to education, safe supervision, nutrition, and social services while working with parents or guardians to get children vaccinated.”

And many states do their best to help students stay up to date on their immunizations, with vaccination drives and direct followup with parents.

“I think that the drop in the past year or two is partly pandemic-related,” Hackell said. “What we’re seeing, I think, is a little bit of a disparity between kids who have a medical home and have a private [doctor] versus kids who get their immunizations from a public source” like a school clinic.

A model of high vaccination: Mississippi

Mississippi is an impressive example of finding ways to keep child vaccination rates high, Hackell says. Public schools are the only option for many in the state, where poverty rates are higher than anywhere else in the US.

Despite the large public need and additional resource struggles that the pandemic brought, 99% of kindergarteners in Mississippi met required vaccination coverage in the 2020-21 school year – better than any other state, according to the CDC.

“They’ve done a tremendous job at that,” Hackell said, and it demonstrates the power of mandates. Mississippi is strict with exemptions – one of just six states allowing medical reasons only – and just 0.1% of kindergarteners were exempt in the 2020-21 school year.

Hackell says he would be most concerned if he sees a sustained drop in vaccination rates for highly transmissible diseases, especially measles and polio. And he’s worried about pockets of low vaccination rates in certain communities.

Schools are public spaces with a level of control, and 95% vaccination coverage is a goal with intent.

“We know it’s never going to be 100% because there are some people who cannot medically be vaccinated. But if you have 95%, that means in any given school classroom of 30 kids, there might be one unvaccinated kid. And so if that child brings a case of something into the class, there’s nobody else to give it to,” he said. “It stops there with one case.”

And when it comes to adding Covid-19 vaccines to the CDC’s recommended immunization schedule, the focus is still on public health – not on adding another requirement.

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“I’ve had parents who come in my office, and I say, ‘What are you here for?’ And they say, ‘Well, we’re here for vaccines so that our kids can go to school.’ And I’ve said, ‘OK, I understand that, but really I’m not vaccinating so you can go to school, I’m vaccinating because I want to prevent serious disease and death in your kids,’ ” Dr. Matthew Daley, an ACIP member and senior investigator with the Institute for Health Research at Kaiser Permanente Colorado, said at Thursday’s advisory meeting.

“And the fact that there’s a school immunization requirement helps because it brought you into the office, but that’s not my goal. My goal is to prevent serious disease.”

Michigan hits COVID-19 vaccine milestone: 50% have at least one ...

Michigan hit a new milestone Monday in the race to end the COVID-19 pandemic: 50% of residents age 16 and older — about 4 million people — have gotten at least one dose of a coronavirus vaccine.

Health leaders have said it will take at least 70% of the population to be fully vaccinated to stop widespread outbreaks and protect the most vulnerable, though with more contagious variants of the virus circulating now in Michigan and nationally, that number may be higher.

“There’s a debate about what constitutes herd immunity, is it 70%, 68%, 81%?" President Joe Biden said Monday at a stop at Tidewater Community College in Portsmouth, Virginia. He highlighted the wide availability of vaccines now in the U.S. as demand for the shots has begun to wane.

"The point is, right now, every single person 16 years or older doesn’t have to wait in line," he said. "Just show up and get a vaccination now. I plead with everyone, get vaccinated now, please."

Both national and state data suggest the pace of COVID-19 vaccinations peaked in the second week of April.

Nationally, the seven-day average for vaccinations dropped 27% between April 11 and April 27 — from a weekly average of 3.3 million shots in arms to 2.4 million doses administered, according to data from the U.S. Centers for Disease Control and Prevention.

In Michigan, the decline has been more dramatic, falling 52% from the week ending April 10, when 667,698 Michiganders got COVID-19 vaccines, to the week ending May 1, when 302,395 got shots, according to state data.

More:Michigan Medicine opens clinics for adults, kids with long-haul COVID-19 problems

More:Detroit nurse was afraid to get COVID-19 vaccine. Then tragedy struck.

Gov. Gretchen Whitmer announced a plan last week that ties the easing of pandemic public health restrictions to specific COVID-19 vaccination thresholds, saying the state can't get back to normal unless people get their shots.

The plan would allow employees to return to in-person work in all sectors of the state's economy two weeks after 55% of Michiganders 16 and older (4.45 million people) initiate the COVID-19 vaccination process by getting at least one dose.

Whitmer projected last week that the state could hit the 55% mark by the end of this week, "meaning we could reach step one just two weeks later, before the end of May. But it's counting on all of us to keep pushing to make sure we get vaccinated."

More:Gov. Whitmer unveils plan to tie Michigan vaccination rates to easing COVID-19 rules

More:Starting Tuesday, Ford Field's mass COVID-19 vaccine clinic to switch to Johnson & Johnson

Two weeks after 60% of Michiganders 16 and older get at least one dose of a coronavirus vaccine, Whitmer said her administration will:

Increase indoor capacity at sports stadiums to 25%.

Increase indoor capacity at conference centers/banquet halls/funeral homes to 25%.

Increase capacity at exercise facilities and gyms to 50%.

Lift the curfew on restaurants and bars.

And two weeks after the state hits the threshold of 65% of residents who've gotten at least one dose of a COVID-19 vaccine, Whitmer's plan would lift all indoor capacity limits, but still require social distancing. Limits on social gatherings at people's homes also would be relaxed.

Once two weeks have passed after the state hits its target of vaccinating 70% of the state's 16 and older population — 5,667,842 residents — the administration's plan would no longer require face masks or other mitigation measures except in "unanticipated circumstances," which could include the spread of vaccine-resistant variants.

On Monday, the state's COVID-19 trends continued to improve, as the state's COVID-19 case rate, hospitalizations and percentage of positive tests continued to fall after the third surge peaked in mid-April. Since the pandemic began, nearly 850,000 Michiganders have contracted the virus and 17,771 have died.

Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.

Iowa Poll finds 25% of Iowa adults don't plan to get COVID-19 vaccine

© Copyright 2021, Des Moines Register and Tribune Co.

A quarter of Iowa adults do not plan to get vaccinated against COVID-19, according to the latest Des Moines Register/Mediacom Iowa Poll.

The poll finds 65% of Iowa adults have had at least one dose of the COVID-19 vaccine, which matches Iowa Department of Public Health reporting.

Another 5% still plan to get vaccinated, with 4% not sure — showing a plausible path to a 70%-plus adult vaccination rate in the state.

The poll, conducted by Selzer & Co. Sept. 12-15, interviewed 805 adult Iowans and has a margin of error of plus or minus 3.5 percentage points.

A majority of adult Iowans across demographic lines are either vaccinated or plan to get vaccinated, though it’s a narrow majority in some instances, the poll shows.

Among those who voted for President Donald Trump in 2020, 48% have received at least one shot, and another 4% plan to get it. Among self-identified evangelicals, 50% are at least partially vaccinated, and another 5% plan to get the vaccine. Among rural Iowans, 51% have received at least one dose, and another 6% plan to get it.

Among those with children under 18, it's also 51% who are at least partially vaccinated, and 7% plan to.

Iowa Poll on vaccine mandates:Feds shouldn't order employers to require COVID shots, 52% say

People who identify as Democrats are the most likely group to say they are vaccinated or will be, according to the poll, with 95% saying they’ve had at least one shot and 4% saying they intend to get the vaccine. Among independents, 68% say they've been vaccinated or plan to be. Among Republicans, it's 58%.

Older Iowans are the next most vaccinated group, with 88% of those 65 or older having had at least one shot, and 80% of people 55 or older. That contrasts with 54% of those under 35 who have had at least one dose.

The poll results also reflect an urban-rural divide: 70% of Iowa's city dwellers and 75% of suburbanites say they’ve been vaccinated, versus 51% who live in rural areas.

Poll respondent Angelique Smyth, 53, of Bondurant, waited a few months after the vaccine’s roll-out to get her shots. She and her family made the decision together and wanted to see scientific consensus and get their doctors’ advice on concerns about the vaccine's adverse reactions.

They decided by the summer, and Smyth remembers the freedom the vaccine provided as she got used to not wearing a mask in public.

Then the delta variant of the coronavirus roared into the state, more Iowans started getting sick again, and the mask started going back on. Smyth and her family want to model appropriate behavior to minimize spread of the pandemic, she said.

Is the worst of the pandemic behind us?

Smyth worries that the worst of the pandemic is still to come if vaccination rates don't go up.

"For me (the worst thing) is people dying and they don't have to,” Smyth said. “Most of the people in the hospital are the ones who are not vaccinated. If everybody just stepped in and did what they were doing since we were younger and getting our shots, those numbers would go down."

Smyth is one of the 19% of vaccinated Iowans who think the worst of the pandemic is to come. Most vaccinated Iowans, 55%, think the state is in the middle of it, and 20% think the worst is over.

Unvaccinated Iowans have a considerably brighter outlook. Most, 56%, think the worst of the pandemic is over, while 28% believe the state’s in the middle of it, and just 7% think the worst is still to come.

More:'How long can the health care system hold up?' Iowa sets new 2021 high for COVID hospitalizations

Poll respondent Dean Loutsch, 55, of Remsen, isn’t vaccinated and doesn’t plan to get the vaccine.

He believes that he and his wife caught mild cases of COVID-19 during the winter and have antibodies from that bout. He otherwise takes a live-and-let-live attitude toward the shots: “If people want to get it, go ahead and get vaccinated,” he said.

He thinks the worst of the pandemic was its effect on the economy.

“As a whole thing in general, when everything was shut down, I thought that was really stupid,” Loutsch said. “And now that’s not happening, so that’s why I say the worst is behind us.”

Hospitalizations in Iowa surge again, but are far from peak

Overall, 32% of Iowans feel the worst of the pandemic is over, down from 44% who felt that way in March — back when the number of new infections and hospitalizations were heading down after a brutal winter that stretched Iowa's health care system to its limits.

Fifteen percent of Iowans think the worst of the pandemic is still to come, up from 8% in March. A plurality of Iowans, 46%, believe the state is still in the middle of the pandemic, up slightly from the 43% who felt the same way in March.

Although most Iowans believe we're either in the middle of the pandemic's impact or the worst is yet to come, most don't expect major changes in their home life (64%) or family relationships (72%) as a result of what they've experienced during the pandemic, the survey found.

On Wednesday, the Iowa Department of Public Health reported 638 people were hospitalized in Iowa with COVID-19, the most in a single day all year. It’s still far from the peak last November, when more than 1,500 people were hospitalized concurrently with the disease. More than 80% of current COVID-19 hospital patients are unvaccinated, according to state data.

The disease has killed more than 6,480 Iowans since March 2020. More than 440,500 Iowans, or nearly 14% of the state’s population, has tested positive for it over the last 18 months.

More:As delta variant fuels COVID surge in Iowa, here's what to know about vaccines, masks and symptoms

About this poll

The Iowa Poll, conducted September 12-15, 2021, for the Des Moines Register and Mediacom by Selzer & Co. of Des Moines, is based on telephone interviews with 805 Iowans ages 18 or older. Interviewers with Quantel Research contacted households with randomly selected landline and cell phone numbers supplied by Dynata. Interviews were administered in English. Responses were adjusted by age, sex and congressional district to reflect the general population based on recent American Community Survey estimates.

Questions based on the sample of 805 Iowa adults have a maximum margin of error of plus or minus 3.5 percentage points. Questions based on the subsample of 620 likely voters in the 2022 midterm election have a maximum margin of error of plus or minus 3.9 percentage points. This means that if this survey were repeated using the same questions and the same methodology, 19 times out of 20, the findings would not vary from the true population value by more than plus or minus 3.5 percentage points or 3.9 percentage points, respectively. Results based on smaller samples of respondents — such as by gender or age—have a larger margin of error.

Republishing the copyright Iowa Poll without credit to the Des Moines Register and Mediacom is prohibited.

Nick Coltrain is a politics and data reporter for the Register. Reach him at ncoltrain@registermedia.com or at 515-284-8361.