Per AxiosAM today.You can't fix stupid:
(Per an Axios poll ) "One in three Americans now says the pandemic is over — despite rising cases and hospitalizations — Axios managing editor Margaret Talev writes from a new installment of the Axios/Ipsos Coronavirus Index.
31% of respondents said they believe the pandemic is over; 69% disagree.
Look at this political split: 59% of Republicans say it's over, compared to just 27% of independents and 10% of Democrats.
55% of unvaccinated Americans said it's over, compared to just 22% of vaccinated people."
America's vaccine failure
Re: America's vaccine failure ?
From NYT today :
A luxury nursing home in West Palm Beach, Fla., that diverted the first available coronavirus vaccines away from vulnerable people to wealthy donors in December 2020 agreed to pay $1.75 million to settle legal claims against it. “Do not be weak be strong you have the opportunity to take advantage of everyone who needs the shot and figure out what they have and what we can go after,” the nursing home’s CEO wrote in a text to the fundraising team, according to the Justice Department. The company, MorseLife Health System, denied the allegations levelled by the Justice Department, but agreed to settle “to avoid the expense and distraction of protracted litigation.”
----
Since June 18, about 267,180 children younger than 5 have received their first coronavirus shot, according to newly published data from the Centers for Disease Control and Prevention. That is a tiny fraction of the nearly 19 million kids in that age group who are newly eligible to receive the vaccine.
------
New York Mets pitcher Chris Bassitt said he regrets telling the team he tested positive for coronavirus – and probably would not tell them again in the future.
-------
Losing the fight against monkeypox
The monkeypox outbreak should have been relatively easy to snuff out. The virus does not spread efficiently except through intimate contact, and tests and vaccines were at hand before the current outbreak.
But my colleague Apoorva Mandavilli reports that the U.S. has fallen short at every turn, whether in rolling out mass testing or ramping up vaccine supplies. It has been a troubling replay of the coronavirus pandemic, which raises more doubts about the nation’s ability to fight future threats to public health.
“How many more times do we have to go through this?” asked Anne Rimoin, an epidemiologist at the University of California, Los Angeles, who first warned of monkeypox outbreaks more than a decade ago. “We’ve been hitting the snooze button on emerging diseases for decades. The alarm is going off, and it’s time to wake up.”
The monkeypox outbreak “reveals the failure in the U.S. to take public health seriously,” said Zain Rizvi, who studies access to medicines at the advocacy group Public Citizen. “Do we ever run out of fighter jets?”
The global monkeypox toll has surpassed 8,100 cases, mostly men who have sex with men, and about as many potential cases are under investigation. Many of those patients cannot identify the source of their infections, suggesting that there is significant community transmission.
There are already at least 700 cases in the U.S. There probably will be many more infections before the outbreak can be controlled — if at this point it can be controlled at all.
A luxury nursing home in West Palm Beach, Fla., that diverted the first available coronavirus vaccines away from vulnerable people to wealthy donors in December 2020 agreed to pay $1.75 million to settle legal claims against it. “Do not be weak be strong you have the opportunity to take advantage of everyone who needs the shot and figure out what they have and what we can go after,” the nursing home’s CEO wrote in a text to the fundraising team, according to the Justice Department. The company, MorseLife Health System, denied the allegations levelled by the Justice Department, but agreed to settle “to avoid the expense and distraction of protracted litigation.”
----
Since June 18, about 267,180 children younger than 5 have received their first coronavirus shot, according to newly published data from the Centers for Disease Control and Prevention. That is a tiny fraction of the nearly 19 million kids in that age group who are newly eligible to receive the vaccine.
------
New York Mets pitcher Chris Bassitt said he regrets telling the team he tested positive for coronavirus – and probably would not tell them again in the future.
-------
Losing the fight against monkeypox
The monkeypox outbreak should have been relatively easy to snuff out. The virus does not spread efficiently except through intimate contact, and tests and vaccines were at hand before the current outbreak.
But my colleague Apoorva Mandavilli reports that the U.S. has fallen short at every turn, whether in rolling out mass testing or ramping up vaccine supplies. It has been a troubling replay of the coronavirus pandemic, which raises more doubts about the nation’s ability to fight future threats to public health.
“How many more times do we have to go through this?” asked Anne Rimoin, an epidemiologist at the University of California, Los Angeles, who first warned of monkeypox outbreaks more than a decade ago. “We’ve been hitting the snooze button on emerging diseases for decades. The alarm is going off, and it’s time to wake up.”
The monkeypox outbreak “reveals the failure in the U.S. to take public health seriously,” said Zain Rizvi, who studies access to medicines at the advocacy group Public Citizen. “Do we ever run out of fighter jets?”
The global monkeypox toll has surpassed 8,100 cases, mostly men who have sex with men, and about as many potential cases are under investigation. Many of those patients cannot identify the source of their infections, suggesting that there is significant community transmission.
There are already at least 700 cases in the U.S. There probably will be many more infections before the outbreak can be controlled — if at this point it can be controlled at all.
Re: America's vaccine failure ?
From NYT tonight:
Only about 300,000 children under 5 have received a Covid vaccine since they were approved for that age group two weeks ago, a slower pace than for other groups, The Associated Press reports.
The health data group Airfinity estimated that more than one billion coronavirus vaccines doses have been wasted during the pandemic, The Financial Times reports.
Denali National Park, in Alaska, reinstated an indoor mask mandate in the busy summer season.
With testing, quarantine and isolation requirements all but gone, tennis finally seems to have entered a stage of pandemic apathy, much like a lot of society.
" I was on the high end of vigilance throughout the pandemic, until March of this year. Just before the B variants began making big trouble, I was on a ski trip and let down my guard in a crowded lodge. I came home with a scratchy throat and a sense of dread. I am 69, and have had trouble with shortness of breath for a while. Covid exacerbated it, and it’s not better yet. I like to hike in the summer, and all I can do is take walks. No mountains! I can hold my new granddaughter, but I can’t carry her any distance. Suddenly, I feel my age. My retirement years have been spent hiking, gardening, and skiing. I’m scared that may have come to an end." — Anne Pratt, Beacon, N.Y.
Only about 300,000 children under 5 have received a Covid vaccine since they were approved for that age group two weeks ago, a slower pace than for other groups, The Associated Press reports.
The health data group Airfinity estimated that more than one billion coronavirus vaccines doses have been wasted during the pandemic, The Financial Times reports.
Denali National Park, in Alaska, reinstated an indoor mask mandate in the busy summer season.
With testing, quarantine and isolation requirements all but gone, tennis finally seems to have entered a stage of pandemic apathy, much like a lot of society.
" I was on the high end of vigilance throughout the pandemic, until March of this year. Just before the B variants began making big trouble, I was on a ski trip and let down my guard in a crowded lodge. I came home with a scratchy throat and a sense of dread. I am 69, and have had trouble with shortness of breath for a while. Covid exacerbated it, and it’s not better yet. I like to hike in the summer, and all I can do is take walks. No mountains! I can hold my new granddaughter, but I can’t carry her any distance. Suddenly, I feel my age. My retirement years have been spent hiking, gardening, and skiing. I’m scared that may have come to an end." — Anne Pratt, Beacon, N.Y.
Re: America's vaccine failure
You cant fix stupid, even if it will kill you.From NYT tonight:
"A majority of U.S. parents of young children said they considered the vaccine a greater risk than the coronavirus itself.
Nearly one million people in a suburb of Wuhan, China, were put under lockdown after four cases were discovered, the BBC reports.
Vaccines provide excellent protection against serious illness, and booster shots can amplify those benefits. But fewer than half of Americans have received boosters, and less than a third of adults who are eligible for their second booster — those who are immuno-compromised or above 50 — have received it.
Efforts to make the next generation of Covid vaccines are floundering, Science reports.
Meta is considering relaxing some restrictions around Covid misinformation on Facebook and Instagram, The Verge reports."
What a great Country.
"A majority of U.S. parents of young children said they considered the vaccine a greater risk than the coronavirus itself.
Nearly one million people in a suburb of Wuhan, China, were put under lockdown after four cases were discovered, the BBC reports.
Vaccines provide excellent protection against serious illness, and booster shots can amplify those benefits. But fewer than half of Americans have received boosters, and less than a third of adults who are eligible for their second booster — those who are immuno-compromised or above 50 — have received it.
Efforts to make the next generation of Covid vaccines are floundering, Science reports.
Meta is considering relaxing some restrictions around Covid misinformation on Facebook and Instagram, The Verge reports."
What a great Country.
Re: America's vaccine failure
Australia, too ?
COVID 3rd most common cause of death so far in 2022, behind heart disease and dementia:
https://www.theguardian.com/australia-n ... e_btn_link
COVID 3rd most common cause of death so far in 2022, behind heart disease and dementia:
https://www.theguardian.com/australia-n ... e_btn_link
Re: America's vaccine failure
I'll still take 7,000+ over 1,000,000+ any day, mate.
Re: America's vaccine failure
From Axios today.America is no longer a " country " , just a physical grouping of selfish individuals without a clue what the Founders intended by " freedom", " liberty" or "rights":
More Americans personally know someone who's died from COVID-19 or has "long COVID" but are rapidly shunning masks and returning to their pre-pandemic lives, according to new data from the Annenberg Public Policy Center.
What they found: The survey of 1,580 adults, conducted as the BA.5 omicron subvariant surged and monkeypox cases multiplied, found 54% of respondents personally knew at least one person who died of the virus.
Nearly 1 in 3 (31%) know someone who experienced long COVID.
Most of the public knows someone who has tested positive for COVID-19 despite being fully vaccinated or being fully vaccinated and boosted.
Over half of those surveyed (53%) think it's likely an individual who is vaccinated but not boosted will contract COVID-19 in the next three months.
Yes, but: 54% said they rarely or never wear a mask indoors around people from outside their household, more than double the proportion in January.
41% have already returned to their "normal, pre-COVID-19 life," compared to 16% who said they had done so in January.
Our thought bubble: The results are further evidence of how much Americans have moved past the pandemic and are likelier focused on inflation and making ends meet.
More Americans personally know someone who's died from COVID-19 or has "long COVID" but are rapidly shunning masks and returning to their pre-pandemic lives, according to new data from the Annenberg Public Policy Center.
What they found: The survey of 1,580 adults, conducted as the BA.5 omicron subvariant surged and monkeypox cases multiplied, found 54% of respondents personally knew at least one person who died of the virus.
Nearly 1 in 3 (31%) know someone who experienced long COVID.
Most of the public knows someone who has tested positive for COVID-19 despite being fully vaccinated or being fully vaccinated and boosted.
Over half of those surveyed (53%) think it's likely an individual who is vaccinated but not boosted will contract COVID-19 in the next three months.
Yes, but: 54% said they rarely or never wear a mask indoors around people from outside their household, more than double the proportion in January.
41% have already returned to their "normal, pre-COVID-19 life," compared to 16% who said they had done so in January.
Our thought bubble: The results are further evidence of how much Americans have moved past the pandemic and are likelier focused on inflation and making ends meet.
Re: America's vaccine failure
We are both wearing masks for anything we do indoors and will continue to do so until the new booster shots are in our arms. After that, we reserve the right to don masks should a new variant show up, even though 95% of our population here in NYC are vaccinated.
Why?
So many people are not bothering to get boosted, there is still a measurable danger.
Masks are just a part of life now, at least for sensible people.
Why?
So many people are not bothering to get boosted, there is still a measurable danger.
Masks are just a part of life now, at least for sensible people.
Re: America's vaccine failure
From NYT Virus Newsletter tonight ( in part ):
“The greatest lesson I learned was that we Americans must stop privileging our own humanity over Africans,” said Ramya Kumar, a Ph.D. student in the department of epidemiology at the University of Washington. “It is South Africa’s highly developed virology surveillance systems that alerted the world to new Covid-19 variants — only to be met with racist cartoons and travel bans.”
“The world has placed Africans at the back of the line to receive vaccines, or in the case of H.I.V., antiretroviral treatment,” Kumar added. “Isolated health solutions that are designed to maximally benefit the U.S. and other high-income countries do not work and never will.”
Another common refrain recognized the fragility of the systems we have in place to protect us from the next outbreak.
“Public health infrastructure has been decimated,” said Bill Miller, a professor of epidemiology at The Ohio State University College of Public Health. “We were woefully unprepared for a pandemic. We remain so. State and local governments have cut public health budgets for decades.”
“We need to infuse more thinking and creativity into the health departments,” he added. “But how to do this when many state governments are taking away health department authority, rather than expanding it, is a particularly difficult question.”
There were also plenty of personal takeaways too.
“I learned that, despite having a Ph.D. in epidemiology, I cannot convince my brothers to get vaccinated,” said Jennifer Yourkavitch, an epidemiologist and program director at Results for Development, a health and education nonprofit organization. “I learned that parents will not live forever.”
And now, coronavirus variants, monkeypox( and inadequate vaccine supply ),polio resurfaces ,flu variants coming, , and a new virus (2?) discovered in China. Alice Springs looking better.
“The greatest lesson I learned was that we Americans must stop privileging our own humanity over Africans,” said Ramya Kumar, a Ph.D. student in the department of epidemiology at the University of Washington. “It is South Africa’s highly developed virology surveillance systems that alerted the world to new Covid-19 variants — only to be met with racist cartoons and travel bans.”
“The world has placed Africans at the back of the line to receive vaccines, or in the case of H.I.V., antiretroviral treatment,” Kumar added. “Isolated health solutions that are designed to maximally benefit the U.S. and other high-income countries do not work and never will.”
Another common refrain recognized the fragility of the systems we have in place to protect us from the next outbreak.
“Public health infrastructure has been decimated,” said Bill Miller, a professor of epidemiology at The Ohio State University College of Public Health. “We were woefully unprepared for a pandemic. We remain so. State and local governments have cut public health budgets for decades.”
“We need to infuse more thinking and creativity into the health departments,” he added. “But how to do this when many state governments are taking away health department authority, rather than expanding it, is a particularly difficult question.”
There were also plenty of personal takeaways too.
“I learned that, despite having a Ph.D. in epidemiology, I cannot convince my brothers to get vaccinated,” said Jennifer Yourkavitch, an epidemiologist and program director at Results for Development, a health and education nonprofit organization. “I learned that parents will not live forever.”
And now, coronavirus variants, monkeypox( and inadequate vaccine supply ),polio resurfaces ,flu variants coming, , and a new virus (2?) discovered in China. Alice Springs looking better.
Re: America's vaccine failure
It will all be academic when you go to war with China. Try having your government keep you 'safe' when that happens. As one of my sons says, the nanny state pretends to people they can be kept safe (if they do this and that) but when China comes to Australia with a war machine (and we have 1 million of them living here already, out of a population of 24.5 million!) people will be running into the grass trying to protect themselves because we don't have the manufacturing capability to supply even the most basic requisites. We threw our car industry away - and many others - with both hands. Where will we get starter-motors, just to name but one, if China goes to war. They make these now. It's pretty terrifying stuff and will put Covid and Monkeypox into the shade.
Re: America's vaccine failure
And where will you sell your coal?Belle wrote: ↑Wed Aug 17, 2022 9:14 pmIt will all be academic when you go to war with China. Try having your government keep you 'safe' when that happens. As one of my sons says, the nanny state pretends to people they can be kept safe (if they do this and that) but when China comes to Australia with a war machine (and we have 1 million of them living here already, out of a population of 24.5 million!) people will be running into the grass trying to protect themselves because we don't have the manufacturing capability to supply even the most basic requisites. We threw our car industry away - and many others - with both hands. Where will we get starter-motors, just to name but one, if China goes to war. They make these now. It's pretty terrifying stuff and will put Covid and Monkeypox into the shade.
Re: America's vaccine failure
Check out this article from The New York Times. Because I'm a subscriber, you can read it through this gift link without a subscription.
Fall Vaccination Campaign Will Bring New Shots, Worse Access
Updated Covid vaccines, expected soon after Labor Day, were designed to thwart Omicron variants. But money to distribute them has dried up.
https://tinyurl.com/mr2r572f
Not to mention, probably more Right threats of lawsuits against any mandates, no matter how many die.
Fall Vaccination Campaign Will Bring New Shots, Worse Access
Updated Covid vaccines, expected soon after Labor Day, were designed to thwart Omicron variants. But money to distribute them has dried up.
https://tinyurl.com/mr2r572f
Not to mention, probably more Right threats of lawsuits against any mandates, no matter how many die.
Re: America's vaccine failure
Fall Vaccination Campaign Will Bring New Shots, Worse Access
Updated Covid vaccines, expected soon after Labor Day, were designed to thwart Omicron variants. But money to distribute them has dried up.
By Benjamin Mueller
Aug. 28, 2022
Updated 7:45 a.m. ET
Long past the point when pollsters said there were no more Americans willing to be vaccinated against the coronavirus, Coral Garner kept finding them.
An organizer of mobile clinics for the Minnesota Department of Health, she arranged to provide vaccines and booster shots to people who had resisted them, setting up in a retrofitted city bus outside a Nigerian church, a Hmong senior center, a Somali mall and dozens of other sites.
But even as the United States now prepares for a critical campaign to deliver Omicron-specific booster shots, Ms. Garner’s job no longer exists. In June, her contract position was canceled because the state said funding had dried up.
At the very moment a better coronavirus vaccine is expected to finally become available, America’s vaccination program is feeling the effects of a long period of retreat.
Local programs to bring shots to the places where Americans gather and the institutions they trust have folded, a consequence in some cases of congressional resistance to more pandemic response spending.
The same local health department workers responsible for Covid and flu shots this fall have also, without new staffing, been juggling a monkeypox outbreak and childhood immunization deficits that have left some places susceptible to polio.
And some state health officials, citing weak demand for vaccines and increased survival rates of late, said in interviews that they had stopped aggressively pushing coronavirus shots.
With the virus killing far fewer people than it once did and many Americans reverting to their prepandemic ways, the country’s no-expenses-spared attitude to saving lives has evolved into a response that has put a greater onus on individuals to protect themselves. In keeping with that approach, many health officials believe the vaccine machinery is in place to meet what they expect, lamentably, to be tepid demand this fall.
But others are worried that the country is surrendering a decisive opportunity to stoke that demand and restore the more robust vaccination efforts that lifted last year’s initial rollout.
“We are watching the dismantling of the hyperlocal infrastructure that actually brought needles to arms in the most vulnerable communities in the country,” said Stephen Thomas, the director of the Center for Health Equity at the University of Maryland. “To this day, vaccine uptake in the United States is embarrassing.”
The Biden administration said some 70,000 sites were prepared to vaccinate people this fall. While 60 percent of those are pharmacies, they also include doctor’s offices, community health centers and rural health clinics.
States can also seek money from the Federal Emergency Management Agency for certain vaccination-related expenses, like setting up sites, buying equipment and offering translation or transportation services.
Having shifted much of the rollout to private sites, though, states have been promised FEMA reimbursements on a relatively modest $550 million in vaccination spending so far this year. Last year, that figure was $8.5 billion.
And while providers are supposed to vaccinate everyone for free, with or without insurance, the federal government ran out of money this spring to offer reimbursements for shots for uninsured people, making it more difficult for them to receive boosters.
Sonya Bernstein, a senior policy adviser for the White House Covid response team, said federal spending to support vaccination efforts was being held back by a stalemate in Congress over the administration’s request for billions of dollars in additional pandemic aid. Republicans have said that additional coronavirus spending could be covered with funding already approved by Congress, an assertion that some state health officials say is false.
“We are working with less because Congress has not provided us with that funding,” Ms. Bernstein said. “But that has not gotten in the way of our preparations. We’re working day in and day out to make sure states and our partners have the resources and support they need.”
The United States is leaning ever more heavily on vaccines to defend against the virus at a time when health officials are pulling back on other preventive measures, like masking, distancing and quarantining.
The fall vaccination campaign, which is expected to begin soon after Labor Day, could be crucial. Many Americans have gone months since their last Covid vaccine or infection, allowing immune defenses to wane. More indoor gatherings are on the horizon, and epidemiologists are predicting roughly 100,000 to 165,000 additional Covid deaths by the spring.
And, for the first time, the government has bought vaccines that were reformulated in response to the virus’s evolution. Manufacturers may finally have gained on the pathogen: The Omicron subvariant that the updated shots were designed to protect against remains dominant in the United States.
But, at the same time, the vaccination campaign is lagging. While two-thirds of Americans have completed the primary vaccine series, only about one-third have received boosters. The country’s per capita booster coverage trails that of some 70 other nations, according to Our World in Data.
Partly as a result, scientists said, Americans this year have died from Covid at a rate 80 percent higher than Canadians and 30 percent higher than residents of the European Union.
“We have criticisms of the way the initial vaccine rollout happened, but there was really a very significant effort to get everyone vaccinated,” said Elizabeth Wrigley-Field, a University of Minnesota sociologist, who mentioned mandates, financial rewards and large events. “None of that really exists with boosters.”
With Covid deaths having plateaued around 480 a day, policymakers are grappling with whether renewed investments are needed. Some states believe they are not.
In Alabama, where one-fifth of residents are boosted, Dr. Burnestine Taylor, the state’s medical officer for disease control and prevention, said officials had pared back health department clinics and become more reliant on pharmacies as demand dropped. The decision to receive additional shots, she said, now fell to individuals.
“At this point, we’re not doing a hard push,” Dr. Taylor said. “It’s a personal decision.”
Even some more proactive efforts have run into a wall of complacency. In Camden County, N.J., health workers have visited community events and knocked on doors, but they have not encountered as many takers as they had hoped, said Paschal Nwako, the health officer there.
But other health workers said that they were still winning converts, if fewer than last year, including those who had been confused about boosters or unable to find clinics with evening availability.
In Madison, Wis., Aaron Perry, a former police officer, said that $100 stipends provided by the state have helped draw a dozen or so booster recipients to his health clinic every Friday, many from Black barbershops where he also runs health screening centers.
In San Bernardino, Calif., Jacinda Abdul-Mutakabbir, a pharmacist at Loma Linda University, said clinics late this spring could still attract as many as 30 first dose recipients.
And in Bismarck, N.D., Renae Moch, the public health director, said organizations like food pantries and homeless shelters still wanted to host regular clinics. But with surge staffing over, workers exhausted and positions harder to fill, she said she could only hold monthly pop-up clinics at a limited number of sites — and none in September, when back-to-school immunizations would consume the staff.
Of the hundreds of barbershops nationally that once hosted vaccination events, nine out of 10 are struggling to keep offering shots, said Dr. Thomas, of the University of Maryland, who has helped organize them. In some cases, he said, hospitals or pharmacies that eagerly used to send doses or staff have reported not having the money to partner with barbershops again or being concerned that small turnouts will not make it worth their while.
“The health care providers lost interest in us,” said Mike Brown, a barber outside Washington, D.C. “But I don’t think now is the time to give up the fight. People are still dying.”
For poorer Americans, the decrease in public vaccination sites could reduce the number who receive shots this fall, experts said.
In New York, Emily Gerteis, who arranges shots for people living on the street or in shelters at the Center for Urban Community Services, recalled convincing a patient this summer to be vaccinated. But when she suggested a pharmacy, the patient refused, preferring to hold out for city clinics and their $100 incentives, Ms. Gerteis said.
The problem was that those offerings no longer existed. The patient was not vaccinated.
“A year ago, there was all this money for advertising, and they were throwing money at vaccines,” said Dr. Zeke McKinney, a physician in Minneapolis who had helped to organize vaccinations at his local barbershop until funding dried up. “Now, it’s like nobody cares.”
The White House is still seeking more funding from Congress, which it says is also needed to produce tests and develop next-generation Covid vaccines.
For now, some health officials said they were prepared to rev back up shuttered sites in the event demand surged, even if their workers were increasingly depleted. On some days recently, Dr. Mysheika Roberts, the health commissioner in Columbus, Ohio, said she needed to divert two-thirds of her Covid vaccination specialists to monkeypox clinics.
“It’s a bit overwhelming for some of our staff members,” she said.
Experts said that restoring health workforces and maintaining vaccine outreach could help break a boom-and-bust cycle in public health spending that has especially hurt marginalized Americans. Early investments, for example, helped narrow racial gaps in primary series vaccination rates. But in the booster rollout, considerable racial disparities have re-emerged.
The relaxation of federal Covid guidance and the reluctance to incentivize booster shots has not made it any easier to persuade people of the benefits of additional doses, some health officials said.
“There’s a lot of messaging from federal sources that things are good and we’re back to normal,” said Dr. Clay Marsh, West Virginia’s Covid czar. “It’s mixed messaging.”
Health experts encouraged making Covid shots a routine part of people’s medical care, including by enlisting more primary care doctors in the rollout. More creative marketing could also help generate demand, said Dr. Kevin Schulman, a Stanford University professor.
One example, he said, would be a campaign framed around protecting older relatives at fall or winter holiday gatherings. Despite the scientific uncertainties, he also said the time had to come to promise Americans that they would not be asked back for further Covid vaccines for at least a year — and that, when they were, it would be for an “annual Covid vaccine,” rather than a “booster.”
“Marketers spend huge amounts of time trying to figure these things out,” Dr. Schulman said. “Unfortunately, we just haven’t seen effort devoted in that direction.”
Ms. Bernstein, the White House adviser, said the administration was regularly surveying people about booster shots and using the results to inform messages it suggested to on-the-ground partners.
Ben Weston, Milwaukee County’s chief health policy adviser, said the nation’s underfunded booster campaign had hurt the same vulnerable and often nonwhite residents who have long struggled to gain access to good medical care.
“It’s putting up barriers,” he said, “particularly for populations that are more susceptible to those barriers.”
https://www.nytimes.com/2022/08/28/heal ... ion=Health
Updated Covid vaccines, expected soon after Labor Day, were designed to thwart Omicron variants. But money to distribute them has dried up.
By Benjamin Mueller
Aug. 28, 2022
Updated 7:45 a.m. ET
Long past the point when pollsters said there were no more Americans willing to be vaccinated against the coronavirus, Coral Garner kept finding them.
An organizer of mobile clinics for the Minnesota Department of Health, she arranged to provide vaccines and booster shots to people who had resisted them, setting up in a retrofitted city bus outside a Nigerian church, a Hmong senior center, a Somali mall and dozens of other sites.
But even as the United States now prepares for a critical campaign to deliver Omicron-specific booster shots, Ms. Garner’s job no longer exists. In June, her contract position was canceled because the state said funding had dried up.
At the very moment a better coronavirus vaccine is expected to finally become available, America’s vaccination program is feeling the effects of a long period of retreat.
Local programs to bring shots to the places where Americans gather and the institutions they trust have folded, a consequence in some cases of congressional resistance to more pandemic response spending.
The same local health department workers responsible for Covid and flu shots this fall have also, without new staffing, been juggling a monkeypox outbreak and childhood immunization deficits that have left some places susceptible to polio.
And some state health officials, citing weak demand for vaccines and increased survival rates of late, said in interviews that they had stopped aggressively pushing coronavirus shots.
With the virus killing far fewer people than it once did and many Americans reverting to their prepandemic ways, the country’s no-expenses-spared attitude to saving lives has evolved into a response that has put a greater onus on individuals to protect themselves. In keeping with that approach, many health officials believe the vaccine machinery is in place to meet what they expect, lamentably, to be tepid demand this fall.
But others are worried that the country is surrendering a decisive opportunity to stoke that demand and restore the more robust vaccination efforts that lifted last year’s initial rollout.
“We are watching the dismantling of the hyperlocal infrastructure that actually brought needles to arms in the most vulnerable communities in the country,” said Stephen Thomas, the director of the Center for Health Equity at the University of Maryland. “To this day, vaccine uptake in the United States is embarrassing.”
The Biden administration said some 70,000 sites were prepared to vaccinate people this fall. While 60 percent of those are pharmacies, they also include doctor’s offices, community health centers and rural health clinics.
States can also seek money from the Federal Emergency Management Agency for certain vaccination-related expenses, like setting up sites, buying equipment and offering translation or transportation services.
Having shifted much of the rollout to private sites, though, states have been promised FEMA reimbursements on a relatively modest $550 million in vaccination spending so far this year. Last year, that figure was $8.5 billion.
And while providers are supposed to vaccinate everyone for free, with or without insurance, the federal government ran out of money this spring to offer reimbursements for shots for uninsured people, making it more difficult for them to receive boosters.
Sonya Bernstein, a senior policy adviser for the White House Covid response team, said federal spending to support vaccination efforts was being held back by a stalemate in Congress over the administration’s request for billions of dollars in additional pandemic aid. Republicans have said that additional coronavirus spending could be covered with funding already approved by Congress, an assertion that some state health officials say is false.
“We are working with less because Congress has not provided us with that funding,” Ms. Bernstein said. “But that has not gotten in the way of our preparations. We’re working day in and day out to make sure states and our partners have the resources and support they need.”
The United States is leaning ever more heavily on vaccines to defend against the virus at a time when health officials are pulling back on other preventive measures, like masking, distancing and quarantining.
The fall vaccination campaign, which is expected to begin soon after Labor Day, could be crucial. Many Americans have gone months since their last Covid vaccine or infection, allowing immune defenses to wane. More indoor gatherings are on the horizon, and epidemiologists are predicting roughly 100,000 to 165,000 additional Covid deaths by the spring.
And, for the first time, the government has bought vaccines that were reformulated in response to the virus’s evolution. Manufacturers may finally have gained on the pathogen: The Omicron subvariant that the updated shots were designed to protect against remains dominant in the United States.
But, at the same time, the vaccination campaign is lagging. While two-thirds of Americans have completed the primary vaccine series, only about one-third have received boosters. The country’s per capita booster coverage trails that of some 70 other nations, according to Our World in Data.
Partly as a result, scientists said, Americans this year have died from Covid at a rate 80 percent higher than Canadians and 30 percent higher than residents of the European Union.
“We have criticisms of the way the initial vaccine rollout happened, but there was really a very significant effort to get everyone vaccinated,” said Elizabeth Wrigley-Field, a University of Minnesota sociologist, who mentioned mandates, financial rewards and large events. “None of that really exists with boosters.”
With Covid deaths having plateaued around 480 a day, policymakers are grappling with whether renewed investments are needed. Some states believe they are not.
In Alabama, where one-fifth of residents are boosted, Dr. Burnestine Taylor, the state’s medical officer for disease control and prevention, said officials had pared back health department clinics and become more reliant on pharmacies as demand dropped. The decision to receive additional shots, she said, now fell to individuals.
“At this point, we’re not doing a hard push,” Dr. Taylor said. “It’s a personal decision.”
Even some more proactive efforts have run into a wall of complacency. In Camden County, N.J., health workers have visited community events and knocked on doors, but they have not encountered as many takers as they had hoped, said Paschal Nwako, the health officer there.
But other health workers said that they were still winning converts, if fewer than last year, including those who had been confused about boosters or unable to find clinics with evening availability.
In Madison, Wis., Aaron Perry, a former police officer, said that $100 stipends provided by the state have helped draw a dozen or so booster recipients to his health clinic every Friday, many from Black barbershops where he also runs health screening centers.
In San Bernardino, Calif., Jacinda Abdul-Mutakabbir, a pharmacist at Loma Linda University, said clinics late this spring could still attract as many as 30 first dose recipients.
And in Bismarck, N.D., Renae Moch, the public health director, said organizations like food pantries and homeless shelters still wanted to host regular clinics. But with surge staffing over, workers exhausted and positions harder to fill, she said she could only hold monthly pop-up clinics at a limited number of sites — and none in September, when back-to-school immunizations would consume the staff.
Of the hundreds of barbershops nationally that once hosted vaccination events, nine out of 10 are struggling to keep offering shots, said Dr. Thomas, of the University of Maryland, who has helped organize them. In some cases, he said, hospitals or pharmacies that eagerly used to send doses or staff have reported not having the money to partner with barbershops again or being concerned that small turnouts will not make it worth their while.
“The health care providers lost interest in us,” said Mike Brown, a barber outside Washington, D.C. “But I don’t think now is the time to give up the fight. People are still dying.”
For poorer Americans, the decrease in public vaccination sites could reduce the number who receive shots this fall, experts said.
In New York, Emily Gerteis, who arranges shots for people living on the street or in shelters at the Center for Urban Community Services, recalled convincing a patient this summer to be vaccinated. But when she suggested a pharmacy, the patient refused, preferring to hold out for city clinics and their $100 incentives, Ms. Gerteis said.
The problem was that those offerings no longer existed. The patient was not vaccinated.
“A year ago, there was all this money for advertising, and they were throwing money at vaccines,” said Dr. Zeke McKinney, a physician in Minneapolis who had helped to organize vaccinations at his local barbershop until funding dried up. “Now, it’s like nobody cares.”
The White House is still seeking more funding from Congress, which it says is also needed to produce tests and develop next-generation Covid vaccines.
For now, some health officials said they were prepared to rev back up shuttered sites in the event demand surged, even if their workers were increasingly depleted. On some days recently, Dr. Mysheika Roberts, the health commissioner in Columbus, Ohio, said she needed to divert two-thirds of her Covid vaccination specialists to monkeypox clinics.
“It’s a bit overwhelming for some of our staff members,” she said.
Experts said that restoring health workforces and maintaining vaccine outreach could help break a boom-and-bust cycle in public health spending that has especially hurt marginalized Americans. Early investments, for example, helped narrow racial gaps in primary series vaccination rates. But in the booster rollout, considerable racial disparities have re-emerged.
The relaxation of federal Covid guidance and the reluctance to incentivize booster shots has not made it any easier to persuade people of the benefits of additional doses, some health officials said.
“There’s a lot of messaging from federal sources that things are good and we’re back to normal,” said Dr. Clay Marsh, West Virginia’s Covid czar. “It’s mixed messaging.”
Health experts encouraged making Covid shots a routine part of people’s medical care, including by enlisting more primary care doctors in the rollout. More creative marketing could also help generate demand, said Dr. Kevin Schulman, a Stanford University professor.
One example, he said, would be a campaign framed around protecting older relatives at fall or winter holiday gatherings. Despite the scientific uncertainties, he also said the time had to come to promise Americans that they would not be asked back for further Covid vaccines for at least a year — and that, when they were, it would be for an “annual Covid vaccine,” rather than a “booster.”
“Marketers spend huge amounts of time trying to figure these things out,” Dr. Schulman said. “Unfortunately, we just haven’t seen effort devoted in that direction.”
Ms. Bernstein, the White House adviser, said the administration was regularly surveying people about booster shots and using the results to inform messages it suggested to on-the-ground partners.
Ben Weston, Milwaukee County’s chief health policy adviser, said the nation’s underfunded booster campaign had hurt the same vulnerable and often nonwhite residents who have long struggled to gain access to good medical care.
“It’s putting up barriers,” he said, “particularly for populations that are more susceptible to those barriers.”
https://www.nytimes.com/2022/08/28/heal ... ion=Health
Re: America's vaccine failure
A Young Kennedy, in Kushnerland, Turned Whistle-Blower
When Robert F. Kennedy’s grandson Max volunteered with Jared Kushner’s COVID-19 task force, he likened the Trump Administration’s pandemic response to “a family office meets organized crime, melded with ‘Lord of the Flies.’ ”
By Jane Mayer
September 21, 2020,New Yorker Magazine
Months before Bob Woodward’s book “Rage” documented President Trump’s efforts to deceive Americans about the peril posed by covid-19, Robert F. Kennedy’s twenty-six-year-old grandson tried to blow the whistle on the President’s malfeasance from an improbable perch—inside Trump’s coronavirus task force.
In April, Max Kennedy, Jr., despite having signed a nondisclosure agreement, sent an anonymous complaint to Congress detailing dangerous incompetence in the Administration’s response to the pandemic. On the phone recently from Hyannis Port, Massachusetts, Kennedy explained why he’d alerted Congress. “I just couldn’t sleep,” he said. “I was so distressed and disturbed by what I’d seen.”
How did a Kennedy end up in a sensitive role in the Trump Administration? After graduating from Harvard, in 2016, Kennedy did some time at consulting and investment firms; he planned to take the LSAT in March, but the pandemic cancelled it. At loose ends, he responded to a friend’s suggestion that he join a volunteer task force that Jared Kushner was forming, to get vital personal protective equipment, such as masks, to virus hot spots. Kushner, he was told, was looking for young generalists who could work long hours for no pay. “I was torn, to some extent,” Kennedy, a lifelong Democrat, said. “But it was such an unprecedented time. It didn’t seem political—it seemed larger than the Administration.” And he knew people who’d been sick. So in March he volunteered for the White House covid-19 Supply-Chain Task Force, and drove to Washington.
On his first day, he showed up at the headquarters of the Federal Emergency Management Agency and joined around a dozen other volunteers, all in their twenties, mostly from the finance sector and with no expertise in procurement or medical issues. He was surprised to learn that they weren’t to be auxiliaries supporting the government’s procurement team. “We were the team,” he said. “We were the entire frontline team for the federal government.” The volunteers were tasked with finding desperately needed medical supplies using only their personal laptops and private e-mail accounts.
As the days passed, and the death count climbed, Kennedy was alarmed at the way the President was downplaying the crisis. “I knew from that room that he was saying things that just weren’t true,” he said. Trump told the public that the government was doing all it could, but the P.P.E. emergency was being managed by a handful of amateurs. “It was the number of people who show up to an after-school event, not to run the greatest crisis in a hundred years,” Kennedy said. “It was such a mismatch of personnel. It was one of the largest mobilization problems ever. It was so unbelievably colossal and gargantuan. The fact that they didn’t want to get any more people was so upsetting.”
Kennedy believes that the Administration relied on volunteers in order to sidestep government experts and thereby “control the narrative.” He said that Brad Smith, one of the political appointees who directed the task force, pressured him to create a model fudging the projected number of fatalities; Smith wanted the model to predict a high of a hundred thousand U.S. deaths, claiming that the experts’ models were “too severe.” Kennedy said that he told Smith, “I don’t know the first thing about disease modelling,” and declined the assignment. (A spokesman said that Smith did not recall the conversation.) To date, nearly two hundred thousand Americans have died. (Rach3 : 1M by now.)
The volunteers were also instructed to prioritize requests from the President’s friends and supporters. According to Kennedy, the group paid special attention to Jeanine Pirro, the Fox News personality. Pirro, Kennedy said, was “particularly aggressive,” and demanded that masks be shipped to a hospital she favored. The volunteers were also told to direct millions of dollars’ worth of supplies to only five preselected distributors. Kennedy was asked to draft a justification for this decision, but refused. “Hundreds of people were sending e-mails every day offering P.P.E.,” he said, but no one in charge responded effectively. “We were super frustrated we couldn’t get the government to do more.”
In the end, the task force failed to procure enough equipment, leaving medical workers, including Kennedy’s cousin, to improvise by wearing garbage bags and makeshift or pre-worn masks. States were left to fend for themselves, bidding against one another for scarce supplies. Kennedy was disgusted to see that the political appointees who supervised him were hailing Trump as “a marketing genius,” because, Kennedy said they’d told him, “he personally came up with the strategy of blaming the states.” The response was in line with what Kennedy calls the White House mantra: that government doesn’t work, and “that the worst thing we could do was step on the toes of the private sector.”
Kushner came by the fema office a few times, once to ask the flailing volunteers what three things they most needed, and promising fixes by the end of the day. He had “an air of self-importance,” Kennedy recalled. “But I never saw a single thing that Kushner promised change.” After two or three weeks of growing distress, Kennedy wrote his complaint, addressing it to the House Oversight Committee, hoping that Congress would step in. Meanwhile, the task force stopped meeting in person, because a member tested positive for covid-19.
In April, Kennedy quit, and he has since gone to work on the Democrats’ 2020 election efforts. He decided to defy the N.D.A., which he does not think can legally stifle him from expressing his opinion, and he is featured in a new documentary, “Totally Under Control,” from the director Alex Gibney. Kennedy said, “If you see something that might be illegal, and cause thousands of civilian lives to be lost, a person has to speak out.” The Administration’s coronavirus response, he said, “was like a family office meets organized crime, melded with ‘Lord of the Flies.’ It was a government of chaos.” ♦
When Robert F. Kennedy’s grandson Max volunteered with Jared Kushner’s COVID-19 task force, he likened the Trump Administration’s pandemic response to “a family office meets organized crime, melded with ‘Lord of the Flies.’ ”
By Jane Mayer
September 21, 2020,New Yorker Magazine
Months before Bob Woodward’s book “Rage” documented President Trump’s efforts to deceive Americans about the peril posed by covid-19, Robert F. Kennedy’s twenty-six-year-old grandson tried to blow the whistle on the President’s malfeasance from an improbable perch—inside Trump’s coronavirus task force.
In April, Max Kennedy, Jr., despite having signed a nondisclosure agreement, sent an anonymous complaint to Congress detailing dangerous incompetence in the Administration’s response to the pandemic. On the phone recently from Hyannis Port, Massachusetts, Kennedy explained why he’d alerted Congress. “I just couldn’t sleep,” he said. “I was so distressed and disturbed by what I’d seen.”
How did a Kennedy end up in a sensitive role in the Trump Administration? After graduating from Harvard, in 2016, Kennedy did some time at consulting and investment firms; he planned to take the LSAT in March, but the pandemic cancelled it. At loose ends, he responded to a friend’s suggestion that he join a volunteer task force that Jared Kushner was forming, to get vital personal protective equipment, such as masks, to virus hot spots. Kushner, he was told, was looking for young generalists who could work long hours for no pay. “I was torn, to some extent,” Kennedy, a lifelong Democrat, said. “But it was such an unprecedented time. It didn’t seem political—it seemed larger than the Administration.” And he knew people who’d been sick. So in March he volunteered for the White House covid-19 Supply-Chain Task Force, and drove to Washington.
On his first day, he showed up at the headquarters of the Federal Emergency Management Agency and joined around a dozen other volunteers, all in their twenties, mostly from the finance sector and with no expertise in procurement or medical issues. He was surprised to learn that they weren’t to be auxiliaries supporting the government’s procurement team. “We were the team,” he said. “We were the entire frontline team for the federal government.” The volunteers were tasked with finding desperately needed medical supplies using only their personal laptops and private e-mail accounts.
As the days passed, and the death count climbed, Kennedy was alarmed at the way the President was downplaying the crisis. “I knew from that room that he was saying things that just weren’t true,” he said. Trump told the public that the government was doing all it could, but the P.P.E. emergency was being managed by a handful of amateurs. “It was the number of people who show up to an after-school event, not to run the greatest crisis in a hundred years,” Kennedy said. “It was such a mismatch of personnel. It was one of the largest mobilization problems ever. It was so unbelievably colossal and gargantuan. The fact that they didn’t want to get any more people was so upsetting.”
Kennedy believes that the Administration relied on volunteers in order to sidestep government experts and thereby “control the narrative.” He said that Brad Smith, one of the political appointees who directed the task force, pressured him to create a model fudging the projected number of fatalities; Smith wanted the model to predict a high of a hundred thousand U.S. deaths, claiming that the experts’ models were “too severe.” Kennedy said that he told Smith, “I don’t know the first thing about disease modelling,” and declined the assignment. (A spokesman said that Smith did not recall the conversation.) To date, nearly two hundred thousand Americans have died. (Rach3 : 1M by now.)
The volunteers were also instructed to prioritize requests from the President’s friends and supporters. According to Kennedy, the group paid special attention to Jeanine Pirro, the Fox News personality. Pirro, Kennedy said, was “particularly aggressive,” and demanded that masks be shipped to a hospital she favored. The volunteers were also told to direct millions of dollars’ worth of supplies to only five preselected distributors. Kennedy was asked to draft a justification for this decision, but refused. “Hundreds of people were sending e-mails every day offering P.P.E.,” he said, but no one in charge responded effectively. “We were super frustrated we couldn’t get the government to do more.”
In the end, the task force failed to procure enough equipment, leaving medical workers, including Kennedy’s cousin, to improvise by wearing garbage bags and makeshift or pre-worn masks. States were left to fend for themselves, bidding against one another for scarce supplies. Kennedy was disgusted to see that the political appointees who supervised him were hailing Trump as “a marketing genius,” because, Kennedy said they’d told him, “he personally came up with the strategy of blaming the states.” The response was in line with what Kennedy calls the White House mantra: that government doesn’t work, and “that the worst thing we could do was step on the toes of the private sector.”
Kushner came by the fema office a few times, once to ask the flailing volunteers what three things they most needed, and promising fixes by the end of the day. He had “an air of self-importance,” Kennedy recalled. “But I never saw a single thing that Kushner promised change.” After two or three weeks of growing distress, Kennedy wrote his complaint, addressing it to the House Oversight Committee, hoping that Congress would step in. Meanwhile, the task force stopped meeting in person, because a member tested positive for covid-19.
In April, Kennedy quit, and he has since gone to work on the Democrats’ 2020 election efforts. He decided to defy the N.D.A., which he does not think can legally stifle him from expressing his opinion, and he is featured in a new documentary, “Totally Under Control,” from the director Alex Gibney. Kennedy said, “If you see something that might be illegal, and cause thousands of civilian lives to be lost, a person has to speak out.” The Administration’s coronavirus response, he said, “was like a family office meets organized crime, melded with ‘Lord of the Flies.’ It was a government of chaos.” ♦
Re: America's vaccine failure
Not surprising: the epitome of the Peter Principle.
Re: America's vaccine failure
Montana GOP's attack on public health ; criminal ?:
https://www.propublica.org/article/mont ... 693bc7595b
https://www.propublica.org/article/mont ... 693bc7595b
Re: America's vaccine failure
There’s Terrific News About the New Covid Boosters, but Few Are Hearing It
Sept. 15, 2022
By Zeynep Tufekci
Opinion Columnist
For the first time, the United States is rolling out Covid vaccines updated to match variants that are currently dominant, as well as the original strain. This bivalent character will provide a better response not just to the most threatening variants today but probably to future variants too, because when the immune system faces different versions of the same virus it generates broader protections overall.
This is terrific news, and there’s more. Not only will a booster with the new vaccines decrease the likelihood of infection and severe illness, and help reduce transmission of the virus; it could also decrease the likelihood of developing long Covid.
The bad news? The boosters are getting so little fanfare, and so much unfounded skepticism, that too few people might get them, and lots of people who need not get sick, suffer or die will get sick, suffer and die.
The Centers for Disease Control and Prevention has said that a national survey found that 72 percent of respondents said they were likely to receive an updated booster. But to actually get them vaccinated requires making the boosters easily accessible and making sure people know about their benefits.
The White House coronavirus response coordinator, Ashish Jha, said last week that people might consider getting the booster when they get flu shots, which many do in October and, barring a new variant curveball, think of it as an annual shot going forward. That’s fine if people do that, especially since many immunologists say it’s best to wait three to six months after one’s last vaccination or infection, and many people have had recent infections.
However, only about half of adults in the United States get the flu vaccine and most haven’t gotten the earlier Covid boosters. Without a vigorous outreach program and promotion, millions of Americans who are not anti-vaxxers but could use a powerful nudge won’t get this helpful dose.
While booster rates have been dismal among Republicans, many of whom have adopted anti-vaccine stances, it is also many of the most vulnerable Americans, even those who got initial doses of vaccines, who are likely to be left behind. Those who haven’t gotten earlier booster shots despite having gotten earlier doses were more likely to lack health insurance, be Black or Hispanic, or be poorer and be less educated.
Meanwhile, funding for distributing these vaccines has dried up amid congressional gridlock — Democrats did not put new pandemic funding in the March spending package because it could cut into stimulus funds for states, and they now face Republican resistance to new pandemic funding. There will most likely be fewer of the dedicated vaccine outreach centers that were set up before.
Benjamin Mueller reported in The Times that local health departments are battling staffing shortages and the monkeypox outbreak, and playing catch-up with childhood immunizations. Plus, some health officials seem to believe that it’s enough to leave it up to individuals to seek these vaccines, mostly at private sites like pharmacies — there is only $550 million in vaccination spending allocated through FEMA so far this year, compared with $8.5 billion last year.
Boosters are especially helpful for older adults or those with existing health issues — but such groups often face challenges navigating access. Last year, there were campaigns to bring vaccination to senior centers and convenient community locations, or to help people make it to vaccination centers or even get vaccinated at home. White House officials tell me they will keep trying to carry out such campaigns, but acknowledge it will be only to the extent that dwindling resources allow. Without such support, how many of those at most risk, who would otherwise be willing, will fail to get the booster?
While young, healthy people who have been vaccinated and had an uneventful breakthrough infection are at much less risk of severe illness even without a booster, they might prefer to avoid getting sick or reduce their risk of long Covid. But beyond the personal benefits: despite common claims to the contrary, vaccines still help dampen spread, and boosters can further reduce transmission of the disease, including by reducing infections in the first place, and thus help protect especially the more vulnerable.
Another survey conducted by the Kaiser Family Foundation found that about a third of people who got vaccinated but not boosted said they had “not had the time to get it” as a reason — that response was highest among Hispanic adults, with 41 percent citing it. About another quarter of respondents mentioned side effects.
Paid time off following vaccination campaigns in workplaces, combining flu and Covid vaccines, could overcome this obstacle. Jha tells me that the administration is already asking employers to carry out such steps, and it remains to be seen how many step up.
Then there’s the information gaps. Most of those who got vaccinated but not boosted (and about a third of those who don’t plan to get the updated booster) said they had enough protection from previous doses or past infections.
Many who did not get the previous booster, and many who don’t plan to get the updated one, say that they did not believe the boosters to be effective — a claim that is routinely made because Omicron caused a lot of breakthrough infections among the vaccinated.
A straightforward message could rebut all of this: It’s true that variants can cause breakthroughs, but vaccines still prevent serious illness and death, and even more so with boosters.
Many European countries and Canada, for example, did a better job of making sure more of their population got boosters. Their cumulative death and illness tolls from the Omicron wave are sharply lower than those of the United States, where only about a third of eligible adults had gotten boosters, compared with two-thirds of adults in many European countries. Canada, for example, had 80 percent fewer deaths from the Omicron wave — a similar pattern holds globally. Countries like Japan, South Korea and Taiwan have about 80 percent or more of their adult population boostered, and their death tolls are even lower.
Many might also be wondering why bother with one more shot since 68 percent of Americans have had two initial vaccination shots, some of those have had booster shots already, and most likely about 60 percent of the country got some level of immunity from an Omicron infection.
Deepta Bhattacharya, an immunologist, told me that variants evolved to evade the first line of antibody protection generated by earlier vaccines or past infections, even though protections against severe disease remained fairly strong. But the new boosters can greatly decrease that evasion. When the initial vaccines were trialed, matching the strain that was then in circulation, they reported 90 percent to 95 percent protection against any symptomatic infection, which then declined against variants and with time. While exact numbers remain to be seen, all the immunologists I spoke with told me the updated boosters should again increase such protections.
Vaccines (and boosters) have already been shown to greatly reduce rates of long Covid among the infected, but obviously, if infection is avoided completely, that would directly sidestep the risk of long Covid. Shane Crotty, an immunologist, also noted that these boosters will probably further reduce the chances of more severe disease complications, which include long Covid, and says “the higher your level of immunity, the less viral replication you’re going to have, the less viral damage, the less likelihood of long Covid.”
And these new boosters can be expected to do even more, going forward — including better protection against future variants, by better training both antibodies and memory cells, which are different parts of the immune system. As Bhattacharya told me, being exposed to different versions of the virus (as will happen with these updated boosters) further deepens and broadens the kind of antibodies that get generated, including ones that can work against future variants. Marion Pepper, an immunologist, told me a new variant vaccine can also “create new, more diverse memory cells that will help protect from Omicron variants and new variants that we have yet to encounter.”
Unfortunately we may face another problem we witnessed throughout the pandemic: public health officials or prominent media doctors casting doubt on the boosters by focusing on their imperfections rather than their immense benefits and worrying about public reaction — like concerns about “vaccine fatigue.”
When I hear that phrase, I wonder how it would have sounded in the spring of 2020 when we had field hospitals in Central Park, bodies were stacked in trailers as funeral homes ran out of space and hospitals ran out of body bags.
I’ve never understood the second-guessing by public health authorities and doctors about how the public may or may not react. Why not just provide accurate, detailed information and make it easy to get vaccinated? That’s the best response to “vaccine fatigue,” even if committed anti-vaxxers might remain hard to reach.
It’s likely that last fall and winter, fewer people got boosters at least partly because some well-known scientists unfairly questioned the usefulness of the shots. There’s now a similar dynamic, with disproportionate attention on minor issues, like booster mandates in colleges. Blanket mandates are now less necessary for college students, though some dorms may apply them to protect medically frail students or to provide other students with options. But young people should still be informed of the benefits of boosters, and older and medically frail people should still be strongly reminded of the continuing risks posed by Covid-19. White House officials say they will roll out their own messaging campaign to counter the confusion — let’s hope it works.
There’s much research on vaccine messaging, but most of it comes down to establishing trust, being honest and transparent, and making vaccination easier. Our terrible health care system is a major impediment: Having a regular relationship with a doctor can be a key factor, but many Americans don’t have one. It’s not surprising that among all groups, it’s the uninsured who remain least likely to be vaccinated and boosted.
As has been shown throughout the pandemic, it’s vaccination, not vaccines, that saves lives — and many more would be vaccinated if given information and easy access. Not having tools against diseases that cause so much suffering is one tragedy, but having them remain unused should be an unacceptable one.
https://www.nytimes.com/2022/09/15/opin ... -shot.html
Sept. 15, 2022
By Zeynep Tufekci
Opinion Columnist
For the first time, the United States is rolling out Covid vaccines updated to match variants that are currently dominant, as well as the original strain. This bivalent character will provide a better response not just to the most threatening variants today but probably to future variants too, because when the immune system faces different versions of the same virus it generates broader protections overall.
This is terrific news, and there’s more. Not only will a booster with the new vaccines decrease the likelihood of infection and severe illness, and help reduce transmission of the virus; it could also decrease the likelihood of developing long Covid.
The bad news? The boosters are getting so little fanfare, and so much unfounded skepticism, that too few people might get them, and lots of people who need not get sick, suffer or die will get sick, suffer and die.
The Centers for Disease Control and Prevention has said that a national survey found that 72 percent of respondents said they were likely to receive an updated booster. But to actually get them vaccinated requires making the boosters easily accessible and making sure people know about their benefits.
The White House coronavirus response coordinator, Ashish Jha, said last week that people might consider getting the booster when they get flu shots, which many do in October and, barring a new variant curveball, think of it as an annual shot going forward. That’s fine if people do that, especially since many immunologists say it’s best to wait three to six months after one’s last vaccination or infection, and many people have had recent infections.
However, only about half of adults in the United States get the flu vaccine and most haven’t gotten the earlier Covid boosters. Without a vigorous outreach program and promotion, millions of Americans who are not anti-vaxxers but could use a powerful nudge won’t get this helpful dose.
While booster rates have been dismal among Republicans, many of whom have adopted anti-vaccine stances, it is also many of the most vulnerable Americans, even those who got initial doses of vaccines, who are likely to be left behind. Those who haven’t gotten earlier booster shots despite having gotten earlier doses were more likely to lack health insurance, be Black or Hispanic, or be poorer and be less educated.
Meanwhile, funding for distributing these vaccines has dried up amid congressional gridlock — Democrats did not put new pandemic funding in the March spending package because it could cut into stimulus funds for states, and they now face Republican resistance to new pandemic funding. There will most likely be fewer of the dedicated vaccine outreach centers that were set up before.
Benjamin Mueller reported in The Times that local health departments are battling staffing shortages and the monkeypox outbreak, and playing catch-up with childhood immunizations. Plus, some health officials seem to believe that it’s enough to leave it up to individuals to seek these vaccines, mostly at private sites like pharmacies — there is only $550 million in vaccination spending allocated through FEMA so far this year, compared with $8.5 billion last year.
Boosters are especially helpful for older adults or those with existing health issues — but such groups often face challenges navigating access. Last year, there were campaigns to bring vaccination to senior centers and convenient community locations, or to help people make it to vaccination centers or even get vaccinated at home. White House officials tell me they will keep trying to carry out such campaigns, but acknowledge it will be only to the extent that dwindling resources allow. Without such support, how many of those at most risk, who would otherwise be willing, will fail to get the booster?
While young, healthy people who have been vaccinated and had an uneventful breakthrough infection are at much less risk of severe illness even without a booster, they might prefer to avoid getting sick or reduce their risk of long Covid. But beyond the personal benefits: despite common claims to the contrary, vaccines still help dampen spread, and boosters can further reduce transmission of the disease, including by reducing infections in the first place, and thus help protect especially the more vulnerable.
Another survey conducted by the Kaiser Family Foundation found that about a third of people who got vaccinated but not boosted said they had “not had the time to get it” as a reason — that response was highest among Hispanic adults, with 41 percent citing it. About another quarter of respondents mentioned side effects.
Paid time off following vaccination campaigns in workplaces, combining flu and Covid vaccines, could overcome this obstacle. Jha tells me that the administration is already asking employers to carry out such steps, and it remains to be seen how many step up.
Then there’s the information gaps. Most of those who got vaccinated but not boosted (and about a third of those who don’t plan to get the updated booster) said they had enough protection from previous doses or past infections.
Many who did not get the previous booster, and many who don’t plan to get the updated one, say that they did not believe the boosters to be effective — a claim that is routinely made because Omicron caused a lot of breakthrough infections among the vaccinated.
A straightforward message could rebut all of this: It’s true that variants can cause breakthroughs, but vaccines still prevent serious illness and death, and even more so with boosters.
Many European countries and Canada, for example, did a better job of making sure more of their population got boosters. Their cumulative death and illness tolls from the Omicron wave are sharply lower than those of the United States, where only about a third of eligible adults had gotten boosters, compared with two-thirds of adults in many European countries. Canada, for example, had 80 percent fewer deaths from the Omicron wave — a similar pattern holds globally. Countries like Japan, South Korea and Taiwan have about 80 percent or more of their adult population boostered, and their death tolls are even lower.
Many might also be wondering why bother with one more shot since 68 percent of Americans have had two initial vaccination shots, some of those have had booster shots already, and most likely about 60 percent of the country got some level of immunity from an Omicron infection.
Deepta Bhattacharya, an immunologist, told me that variants evolved to evade the first line of antibody protection generated by earlier vaccines or past infections, even though protections against severe disease remained fairly strong. But the new boosters can greatly decrease that evasion. When the initial vaccines were trialed, matching the strain that was then in circulation, they reported 90 percent to 95 percent protection against any symptomatic infection, which then declined against variants and with time. While exact numbers remain to be seen, all the immunologists I spoke with told me the updated boosters should again increase such protections.
Vaccines (and boosters) have already been shown to greatly reduce rates of long Covid among the infected, but obviously, if infection is avoided completely, that would directly sidestep the risk of long Covid. Shane Crotty, an immunologist, also noted that these boosters will probably further reduce the chances of more severe disease complications, which include long Covid, and says “the higher your level of immunity, the less viral replication you’re going to have, the less viral damage, the less likelihood of long Covid.”
And these new boosters can be expected to do even more, going forward — including better protection against future variants, by better training both antibodies and memory cells, which are different parts of the immune system. As Bhattacharya told me, being exposed to different versions of the virus (as will happen with these updated boosters) further deepens and broadens the kind of antibodies that get generated, including ones that can work against future variants. Marion Pepper, an immunologist, told me a new variant vaccine can also “create new, more diverse memory cells that will help protect from Omicron variants and new variants that we have yet to encounter.”
Unfortunately we may face another problem we witnessed throughout the pandemic: public health officials or prominent media doctors casting doubt on the boosters by focusing on their imperfections rather than their immense benefits and worrying about public reaction — like concerns about “vaccine fatigue.”
When I hear that phrase, I wonder how it would have sounded in the spring of 2020 when we had field hospitals in Central Park, bodies were stacked in trailers as funeral homes ran out of space and hospitals ran out of body bags.
I’ve never understood the second-guessing by public health authorities and doctors about how the public may or may not react. Why not just provide accurate, detailed information and make it easy to get vaccinated? That’s the best response to “vaccine fatigue,” even if committed anti-vaxxers might remain hard to reach.
It’s likely that last fall and winter, fewer people got boosters at least partly because some well-known scientists unfairly questioned the usefulness of the shots. There’s now a similar dynamic, with disproportionate attention on minor issues, like booster mandates in colleges. Blanket mandates are now less necessary for college students, though some dorms may apply them to protect medically frail students or to provide other students with options. But young people should still be informed of the benefits of boosters, and older and medically frail people should still be strongly reminded of the continuing risks posed by Covid-19. White House officials say they will roll out their own messaging campaign to counter the confusion — let’s hope it works.
There’s much research on vaccine messaging, but most of it comes down to establishing trust, being honest and transparent, and making vaccination easier. Our terrible health care system is a major impediment: Having a regular relationship with a doctor can be a key factor, but many Americans don’t have one. It’s not surprising that among all groups, it’s the uninsured who remain least likely to be vaccinated and boosted.
As has been shown throughout the pandemic, it’s vaccination, not vaccines, that saves lives — and many more would be vaccinated if given information and easy access. Not having tools against diseases that cause so much suffering is one tragedy, but having them remain unused should be an unacceptable one.
https://www.nytimes.com/2022/09/15/opin ... -shot.html
Re: America's vaccine failure
As of today, in my town of 26000, there is only the Pfizer booster available, not the Moderna. Older folks are suggested to get the slightly stronger Moderna, especially if your shots to date were Moderna, as were mine, and I’m old. Of course, the GOP opposes more funding.
Re: America's vaccine failure
From Axios today:
Fewer than 325,000 of America's youngest children are fully vaccinated against COVID-19 as hesitancy continues to dog the pandemic response, Axios' Erin Doherty reports.
The big picture: The FDA authorized COVID-19 vaccines in June for children between 6 months and 5 years of age.
Kids under 5 have had the highest rates of hospitalization from COVID among youth, per the CDC.
Between the lines: "[W]e're going to be setting up a bunch of kids for risk of severe disease in the future," Daniel Blatt, a pediatric infectious disease physician at Norton Children's Hospital.
"We don't really know what the next variant is gonna be. And the way to get ahead of that next variant is to give children a blueprint on how to fight it and that's what the vaccine does."
Zoom out: In D.C., which has the highest percentage of young children vaccinated, less than one-quarter of children 6 months to 4 years old have received one dose — and 7.5% have received both doses, per The Washington Post.
The states with some of the lowest child vaccination rates — Alabama, Louisiana and Mississippi — have vaccination rates of less than 0.2%, the Post found. (Rach3: Trump States.)
Fewer than 325,000 of America's youngest children are fully vaccinated against COVID-19 as hesitancy continues to dog the pandemic response, Axios' Erin Doherty reports.
The big picture: The FDA authorized COVID-19 vaccines in June for children between 6 months and 5 years of age.
Kids under 5 have had the highest rates of hospitalization from COVID among youth, per the CDC.
Between the lines: "[W]e're going to be setting up a bunch of kids for risk of severe disease in the future," Daniel Blatt, a pediatric infectious disease physician at Norton Children's Hospital.
"We don't really know what the next variant is gonna be. And the way to get ahead of that next variant is to give children a blueprint on how to fight it and that's what the vaccine does."
Zoom out: In D.C., which has the highest percentage of young children vaccinated, less than one-quarter of children 6 months to 4 years old have received one dose — and 7.5% have received both doses, per The Washington Post.
The states with some of the lowest child vaccination rates — Alabama, Louisiana and Mississippi — have vaccination rates of less than 0.2%, the Post found. (Rach3: Trump States.)
Re: America's vaccine failure
From NYT today:
America’s data crisis
By Jonathan Wolfe
My colleague Sharon LaFraniere, an investigative reporter, recently told me that throughout the pandemic, she has routinely had government officials struggle to answer very basic questions.The reason? A severe lack of data, they said.
To understand the issue, Sharon traveled to Alaska to watch how public health workers collected and stored information, and how they communicated it to the federal government.
“What struck me right away was how much rote effort there was,” Sharon said. “At the peak of the pandemic, they had up to 20 people in a conference room manually entering data from forms into computers. National Guard volunteers and even the department’s own highly trained epidemiologists had to help out. It was an amazing waste of time. Case reports were coming in over the fax machine, which would run out of paper every night.”
I spoke to Sharon for more on the country’s data crisis.
What are the main issues with the way the country manages health data?
I think it’s striking how each health department buys its own systems, and they make their individual decisions without any coordination. Many end up with databases that do not connect easily to their other systems, or to the C.D.C. So they can’t make the data flow; instead, it’s a series of manual hops, skips and jumps through disjointed systems.
How has this affected our ability to respond to Covid?
If you remember right after Thanksgiving, when Omicron appeared, there was kind of a panic. Omicron was clearly much more contagious than Delta, but we didn’t know if it was more deadly. Every senior federal health official was anxious to know whether more people were going to die, because they needed to prepare. What would they do if Covid patients flooded hospitals? But they couldn’t figure it out from their data because it wasn’t specific by variant.
What’s another example?
The fact that we could not figure out how many breakthrough infections were occurring really confused the whole booster campaign. We had no national data on breakthrough infections, so regulators were piecing together subsets of data from individual hospital systems. Then they were marrying that with what Israel was saying, because Israel had good national data. And then they threw in Britain, and sometimes other countries.
So why was that a problem?
It was a bewildering patchwork of information. Even the vaccine experts were confused because it was all a big jumble of different studies and different subsets that were stitched together. People were wondering, do we really know what we’re doing with these extra shots? It made it very hard for the government to explain to people that enough breakthrough infections were happening that the booster shots were essential.
Data was supposed to inform our decisions about how to fight the pandemic, but to a certain extent, the government was flying blind. I think officials felt they were continually behind the curve. We would get data, but it would be data we needed six months ago. It’s pretty disturbing how much data turned out to be useless because it was either incomplete or too late.
How do we fix the problem?
We need to spend money. Public health departments have been starved of funds for years. And the federal government may also need more legal power to compel state and local health departments to deliver data. Now it’s mostly a voluntary system.
In the last decade, the federal government has spent $38 billion in incentives so hospitals and clinicians would shift to electronic health records. And ordinary Americans are seeing the benefits of that right now. For many people, if they go in to see their doctor, it’s easier for them to look up their health record right then and there.
But the nation did not spend to modernize the public health sector’s data operations. When Covid hit, the federal government dedicated more than $1.1 billion to improve those systems. But a billion is about what it cost one major hospital system to shift to electronic health records. So we spent about 38 times as much on the private sector side as the public sector side. That neglect has really hurt us. But that is the pattern for public health funding.
What do you mean?
It rises during a crisis and then it just disappears.
I think it’s hard for people to grasp how far public health data is behind because we’re very used to the seamless flow of information in our daily lives. We are used to digital services like Instacart, DoorDash, Amazon and entertainment programs that can be streamed to your living room in minutes. But we left public health out in the wilderness with the equivalent of a little rotary telephone and fax machine. Then a crisis arose, and suddenly we wondered, “Hey, where is your data?”
We’ve had a whole series of infectious disease outbreaks over the last decade, and this isn’t going to be the last one. The big fear is that the impetus to try to build public health data systems that work will vanish as soon as Covid cases seem to be truly declining.
America’s data crisis
By Jonathan Wolfe
My colleague Sharon LaFraniere, an investigative reporter, recently told me that throughout the pandemic, she has routinely had government officials struggle to answer very basic questions.The reason? A severe lack of data, they said.
To understand the issue, Sharon traveled to Alaska to watch how public health workers collected and stored information, and how they communicated it to the federal government.
“What struck me right away was how much rote effort there was,” Sharon said. “At the peak of the pandemic, they had up to 20 people in a conference room manually entering data from forms into computers. National Guard volunteers and even the department’s own highly trained epidemiologists had to help out. It was an amazing waste of time. Case reports were coming in over the fax machine, which would run out of paper every night.”
I spoke to Sharon for more on the country’s data crisis.
What are the main issues with the way the country manages health data?
I think it’s striking how each health department buys its own systems, and they make their individual decisions without any coordination. Many end up with databases that do not connect easily to their other systems, or to the C.D.C. So they can’t make the data flow; instead, it’s a series of manual hops, skips and jumps through disjointed systems.
How has this affected our ability to respond to Covid?
If you remember right after Thanksgiving, when Omicron appeared, there was kind of a panic. Omicron was clearly much more contagious than Delta, but we didn’t know if it was more deadly. Every senior federal health official was anxious to know whether more people were going to die, because they needed to prepare. What would they do if Covid patients flooded hospitals? But they couldn’t figure it out from their data because it wasn’t specific by variant.
What’s another example?
The fact that we could not figure out how many breakthrough infections were occurring really confused the whole booster campaign. We had no national data on breakthrough infections, so regulators were piecing together subsets of data from individual hospital systems. Then they were marrying that with what Israel was saying, because Israel had good national data. And then they threw in Britain, and sometimes other countries.
So why was that a problem?
It was a bewildering patchwork of information. Even the vaccine experts were confused because it was all a big jumble of different studies and different subsets that were stitched together. People were wondering, do we really know what we’re doing with these extra shots? It made it very hard for the government to explain to people that enough breakthrough infections were happening that the booster shots were essential.
Data was supposed to inform our decisions about how to fight the pandemic, but to a certain extent, the government was flying blind. I think officials felt they were continually behind the curve. We would get data, but it would be data we needed six months ago. It’s pretty disturbing how much data turned out to be useless because it was either incomplete or too late.
How do we fix the problem?
We need to spend money. Public health departments have been starved of funds for years. And the federal government may also need more legal power to compel state and local health departments to deliver data. Now it’s mostly a voluntary system.
In the last decade, the federal government has spent $38 billion in incentives so hospitals and clinicians would shift to electronic health records. And ordinary Americans are seeing the benefits of that right now. For many people, if they go in to see their doctor, it’s easier for them to look up their health record right then and there.
But the nation did not spend to modernize the public health sector’s data operations. When Covid hit, the federal government dedicated more than $1.1 billion to improve those systems. But a billion is about what it cost one major hospital system to shift to electronic health records. So we spent about 38 times as much on the private sector side as the public sector side. That neglect has really hurt us. But that is the pattern for public health funding.
What do you mean?
It rises during a crisis and then it just disappears.
I think it’s hard for people to grasp how far public health data is behind because we’re very used to the seamless flow of information in our daily lives. We are used to digital services like Instacart, DoorDash, Amazon and entertainment programs that can be streamed to your living room in minutes. But we left public health out in the wilderness with the equivalent of a little rotary telephone and fax machine. Then a crisis arose, and suddenly we wondered, “Hey, where is your data?”
We’ve had a whole series of infectious disease outbreaks over the last decade, and this isn’t going to be the last one. The big fear is that the impetus to try to build public health data systems that work will vanish as soon as Covid cases seem to be truly declining.
Re: America's vaccine failure
Only 4%???
400 people are dying each day, preventable deaths.
Whatever happened to personal responsibility? Still 1/3 of us have not been vaccinated at all! I am blown away by how people are so complacent about their own safety, let alone protecting their families and coworkers.
Re: America's vaccine failure
America, the liars.From NYT today:
" Nearly half of respondents to a survey in the U.S. said they had lied about their adherence to Covid public health measures."
" Nearly half of respondents to a survey in the U.S. said they had lied about their adherence to Covid public health measures."
Re: America's vaccine failure
We will still be wearing masks when attending public gatherings and entering stores. For us, this is the new normal.Rach3 wrote: ↑Tue Oct 11, 2022 5:11 pmPredictions for Fall :
https://www.webmd.com/lung/news/2022101 ... wj96i5U%3D
Common sense dictates getting a covid booster of some kind every 6 mos. or so as part of a sensible health routine now, along with flu shots every Fall.
Re: America's vaccine failure
As White House Presses for Booster Shots, Americans Are Slow to Get Them
Only about 15 million doses of the new shots have been administered so far, and many Americans appear to be unaware of or simply uninterested in them.
By Noah Weiland
Oct. 15, 2022
Updated 12:08 p.m. ET
BALTIMORE — The new coronavirus booster shots have found a modest number of takers at one of this city’s few remaining public vaccination sites, with nine doses given on one recent day and 15 on another.
More than a month after the retooled shots were rolled out, only about 5 percent of Baltimore residents have received one, a figure that reflects the slow uptake nationally. In a city with stark health disparities, local officials see a reason to be worried.
“The fact that we’ve been getting it so often is making it uninteresting to people,” Rebecca Dineen, the city’s Covid-19 vaccine coordinator, said of the rounds of coronavirus shots.
The anemic turnout underscores yet another test of the Biden administration’s pandemic strategy, as federal and local officials contend with dwindling public patience and diminishing funds for the virus response.
Only about 15 million doses of the new shots have been administered nationally since their introduction at the beginning of September, representing less than one in 10 people who are eligible, and there are signs that many Americans are unaware of or simply uninterested in them. In a Kaiser Family Foundation survey last month, half of adults said they had heard little or nothing about the shots.
Once defined by supply shortages and mass vaccination sites, the nation’s ever-expanding inoculation campaign has lately been characterized by apathy, with potentially serious health consequences for the most vulnerable Americans should another Covid wave sweep the country this winter.
The tepid response to the shots, public health experts say, is more than just a marketing dilemma. Many Americans have recently had a coronavirus infection, drawing out the timeline for when they might seek another booster or causing them to skip one altogether. Others are wary of continual boosting or side effects that might keep them from going to school or work.
The turnout for the new shots, for which children as young as 5 became eligible this week, could fall far short of the response to the initial booster campaign that the federal government undertook around a year ago, when administration officials say there was less fatigue around vaccination and the pandemic more broadly. Around 110 million people received at least one dose of the original booster formulation before the new shots were authorized at the end of August.
Dr. Ashish K. Jha, the White House Covid-19 coordinator, said in an interview that the early turnout for the updated boosters amounted to a “good start” and that uptake was likely to steadily increase this fall. Many Americans, he said, were treating the new vaccines like flu shots, considering receiving one as the weather turned colder.
“We did not have an internal number in our heads, or at least I didn’t have one in mind, of what we were going to achieve,” Dr. Jha said. “My kind of mental model was that it would really start ramping up once we got into October.”
Administration officials made an expensive bet on the new campaign at a fraught moment in congressional funding negotiations, buying over 170 million doses with billions in repurposed funds — enough to vaccinate most of the roughly 225 million Americans who have had an initial round of vaccination.
One senior official said the purchase was modeled on how the federal government typically buys flu vaccines, with enough doses to reach any American at tens of thousands of sites while limiting how many go to waste. Around 80 percent of doses in recent weeks were given at retail pharmacies, Dr. Jha said, an increase from earlier Covid-19 vaccination campaigns.
While many Americans still have substantial protection from past vaccinations and infections, federal officials have pointed to analyses that show the new boosters could still save thousands of lives. Vaccine experts say they expect the shots to deliver an initial burst of antibodies and a broadened immune response. The Covid vaccines were redesigned to target Omicron subvariants on the assumption that more current formulations would provide better and more durable protection.
Yet researchers are still working to determine how well the shots protect people and how long those defenses last. The data that federal regulators gathered from the manufacturers of the boosters, Pfizer-BioNTech and Moderna, is still preliminary, leaving experts to speculate about the additional benefits the new vaccines may offer, including its influence on transmission or longer-lasting symptoms of Covid-19.
Federal officials are not expected to have early data from Pfizer and Moderna on what kind of short-term antibody responses the new vaccines induced in trial participants until later this fall.
Health officials and providers already know whom they need to reach with the new shots, as Americans over 75 have represented a majority of deaths from Covid-19 in recent months. Around half of those vaccinated with the new boosters so far are seniors, Dr. Jha said.
White House officials say they have tried to publicize the new shots with federal ad campaigns, clinics at state and county fairs and partnerships with local leaders. The administration is targeting older Americans with outreach from the Centers for Medicare and Medicaid Services, while the White House is working with CVS and Walgreens to increase booster awareness, Dr. Jha said.
“When you walk into CVS, you see signs for the flu shot,” he said, adding, “We want to make sure that that is getting tied into their outreach on Covid-19 vaccines as well.”
Dr. Swati Gaur, the medical director for two long-term care facilities in Georgia, said the challenge had shifted from getting a supply of vaccine doses to waging a piecemeal persuasion campaign to coax seniors into taking them.
In one recent encounter, she said, she spoke with a resident at one of her facilities who had grown tired of getting vaccinated against the virus after four shots and refused a fifth. She walked him through the potential benefits, and he agreed to get the shot.
Dr. Gaur said it was critical that employees at long-term care facilities calling families and asking for consent to vaccinate knew how to have similar conversations.
Biden administration officials have offered sometimes competing ideas of the urgency of the booster campaign for younger, healthier people. Federal regulators scrambled to make the updated shots available ahead of schedule late in the summer, opting for that approach instead of offering second booster doses of the original vaccine formulation to all adults. With case counts lower, some top officials have recently offered a more relaxed timeline, turning to an October theme.
Dr. Jha encouraged Americans to get the new shots by Halloween so their immunity would be bolstered by Thanksgiving. “What we’ve been trying to do is give advice that simplifies it,” he said, adding, “The idea is that you don’t have to sort of think too hard about are you eligible or are you not eligible.”
Some experts have warned that attempts to simplify messaging could backfire.
Dr. Walid F. Gellad, a drug safety expert at the University of Pittsburgh, said that efforts to reach all age groups had diluted attention to those who most need enhanced protection. When experts over the past year have questioned whether younger, healthier Americans need boosting, he said, “to those listening only halfheartedly, it will just sound like criticism of the booster, even though it was criticism of the booster in those age groups.”
With the new shots, more Americans are making guesswork out of the timing. Acting on expert advice, some of those who have recently had the virus are waiting three or more months to get boosted, while others are timing the shot for the holidays or travel, or another uptick in cases.
Amanda First, 32, a lawyer in New York, said that after having a mild case of Covid in July, she was not in a hurry to get the next vaccine dose. But she got one of the new boosters this month so that she would have more protection when spending time with family during the holidays.
“I’m cautiously optimistic it will provide me protection,” she said of the new shot. “But I wouldn’t be surprised if I’m reinfected.”
Munro Wood, a 33-year-old web developer near St. Louis, said he received his first booster in June but had grown tired of the idea of regular Covid-19 shots. He was still undecided on whether to get the new dose.
“Annual or even biannual boosters are uncomfortable enough that they don’t overcome the risk-reward threshold for me,” he said, adding, “If another, much worse variant comes out and starts spreading as rapidly as the initial Omicron wave, I’ll probably perk up and pay more attention.”
Baltimore’s initial vaccine rollout included extensive advertising and grass-roots work, and three-quarters of residents have now received at least one vaccine dose.
Ms. Dineen, the city’s Covid-19 vaccine coordinator, said that city officials were still prioritizing getting first and second doses to vulnerable people in poorly vaccinated neighborhoods, where canvassers continue to go door-to-door with the shots.
Those at the city clinic one day this month were the vaccine-dedicated. “It’s something that needed to be done,” Melvin Battle, a city employee, said, noting that “winter’s coming along.”
Paula Ladson-Gillis, another city employee, said she knew a dose of one of the new vaccines might not prevent her from getting Covid-19, but it would at least help to keep her from getting very ill.
“I know plenty of people are relaxed — I’m not one of them,” Ms. Ladson-Gillis said. “And that even says more to me why I want to get it, because too many people are not getting it.”
https://www.nytimes.com/2022/10/15/us/p ... lda-unique
Only about 15 million doses of the new shots have been administered so far, and many Americans appear to be unaware of or simply uninterested in them.
By Noah Weiland
Oct. 15, 2022
Updated 12:08 p.m. ET
BALTIMORE — The new coronavirus booster shots have found a modest number of takers at one of this city’s few remaining public vaccination sites, with nine doses given on one recent day and 15 on another.
More than a month after the retooled shots were rolled out, only about 5 percent of Baltimore residents have received one, a figure that reflects the slow uptake nationally. In a city with stark health disparities, local officials see a reason to be worried.
“The fact that we’ve been getting it so often is making it uninteresting to people,” Rebecca Dineen, the city’s Covid-19 vaccine coordinator, said of the rounds of coronavirus shots.
The anemic turnout underscores yet another test of the Biden administration’s pandemic strategy, as federal and local officials contend with dwindling public patience and diminishing funds for the virus response.
Only about 15 million doses of the new shots have been administered nationally since their introduction at the beginning of September, representing less than one in 10 people who are eligible, and there are signs that many Americans are unaware of or simply uninterested in them. In a Kaiser Family Foundation survey last month, half of adults said they had heard little or nothing about the shots.
Once defined by supply shortages and mass vaccination sites, the nation’s ever-expanding inoculation campaign has lately been characterized by apathy, with potentially serious health consequences for the most vulnerable Americans should another Covid wave sweep the country this winter.
The tepid response to the shots, public health experts say, is more than just a marketing dilemma. Many Americans have recently had a coronavirus infection, drawing out the timeline for when they might seek another booster or causing them to skip one altogether. Others are wary of continual boosting or side effects that might keep them from going to school or work.
The turnout for the new shots, for which children as young as 5 became eligible this week, could fall far short of the response to the initial booster campaign that the federal government undertook around a year ago, when administration officials say there was less fatigue around vaccination and the pandemic more broadly. Around 110 million people received at least one dose of the original booster formulation before the new shots were authorized at the end of August.
Dr. Ashish K. Jha, the White House Covid-19 coordinator, said in an interview that the early turnout for the updated boosters amounted to a “good start” and that uptake was likely to steadily increase this fall. Many Americans, he said, were treating the new vaccines like flu shots, considering receiving one as the weather turned colder.
“We did not have an internal number in our heads, or at least I didn’t have one in mind, of what we were going to achieve,” Dr. Jha said. “My kind of mental model was that it would really start ramping up once we got into October.”
Administration officials made an expensive bet on the new campaign at a fraught moment in congressional funding negotiations, buying over 170 million doses with billions in repurposed funds — enough to vaccinate most of the roughly 225 million Americans who have had an initial round of vaccination.
One senior official said the purchase was modeled on how the federal government typically buys flu vaccines, with enough doses to reach any American at tens of thousands of sites while limiting how many go to waste. Around 80 percent of doses in recent weeks were given at retail pharmacies, Dr. Jha said, an increase from earlier Covid-19 vaccination campaigns.
While many Americans still have substantial protection from past vaccinations and infections, federal officials have pointed to analyses that show the new boosters could still save thousands of lives. Vaccine experts say they expect the shots to deliver an initial burst of antibodies and a broadened immune response. The Covid vaccines were redesigned to target Omicron subvariants on the assumption that more current formulations would provide better and more durable protection.
Yet researchers are still working to determine how well the shots protect people and how long those defenses last. The data that federal regulators gathered from the manufacturers of the boosters, Pfizer-BioNTech and Moderna, is still preliminary, leaving experts to speculate about the additional benefits the new vaccines may offer, including its influence on transmission or longer-lasting symptoms of Covid-19.
Federal officials are not expected to have early data from Pfizer and Moderna on what kind of short-term antibody responses the new vaccines induced in trial participants until later this fall.
Health officials and providers already know whom they need to reach with the new shots, as Americans over 75 have represented a majority of deaths from Covid-19 in recent months. Around half of those vaccinated with the new boosters so far are seniors, Dr. Jha said.
White House officials say they have tried to publicize the new shots with federal ad campaigns, clinics at state and county fairs and partnerships with local leaders. The administration is targeting older Americans with outreach from the Centers for Medicare and Medicaid Services, while the White House is working with CVS and Walgreens to increase booster awareness, Dr. Jha said.
“When you walk into CVS, you see signs for the flu shot,” he said, adding, “We want to make sure that that is getting tied into their outreach on Covid-19 vaccines as well.”
Dr. Swati Gaur, the medical director for two long-term care facilities in Georgia, said the challenge had shifted from getting a supply of vaccine doses to waging a piecemeal persuasion campaign to coax seniors into taking them.
In one recent encounter, she said, she spoke with a resident at one of her facilities who had grown tired of getting vaccinated against the virus after four shots and refused a fifth. She walked him through the potential benefits, and he agreed to get the shot.
Dr. Gaur said it was critical that employees at long-term care facilities calling families and asking for consent to vaccinate knew how to have similar conversations.
Biden administration officials have offered sometimes competing ideas of the urgency of the booster campaign for younger, healthier people. Federal regulators scrambled to make the updated shots available ahead of schedule late in the summer, opting for that approach instead of offering second booster doses of the original vaccine formulation to all adults. With case counts lower, some top officials have recently offered a more relaxed timeline, turning to an October theme.
Dr. Jha encouraged Americans to get the new shots by Halloween so their immunity would be bolstered by Thanksgiving. “What we’ve been trying to do is give advice that simplifies it,” he said, adding, “The idea is that you don’t have to sort of think too hard about are you eligible or are you not eligible.”
Some experts have warned that attempts to simplify messaging could backfire.
Dr. Walid F. Gellad, a drug safety expert at the University of Pittsburgh, said that efforts to reach all age groups had diluted attention to those who most need enhanced protection. When experts over the past year have questioned whether younger, healthier Americans need boosting, he said, “to those listening only halfheartedly, it will just sound like criticism of the booster, even though it was criticism of the booster in those age groups.”
With the new shots, more Americans are making guesswork out of the timing. Acting on expert advice, some of those who have recently had the virus are waiting three or more months to get boosted, while others are timing the shot for the holidays or travel, or another uptick in cases.
Amanda First, 32, a lawyer in New York, said that after having a mild case of Covid in July, she was not in a hurry to get the next vaccine dose. But she got one of the new boosters this month so that she would have more protection when spending time with family during the holidays.
“I’m cautiously optimistic it will provide me protection,” she said of the new shot. “But I wouldn’t be surprised if I’m reinfected.”
Munro Wood, a 33-year-old web developer near St. Louis, said he received his first booster in June but had grown tired of the idea of regular Covid-19 shots. He was still undecided on whether to get the new dose.
“Annual or even biannual boosters are uncomfortable enough that they don’t overcome the risk-reward threshold for me,” he said, adding, “If another, much worse variant comes out and starts spreading as rapidly as the initial Omicron wave, I’ll probably perk up and pay more attention.”
Baltimore’s initial vaccine rollout included extensive advertising and grass-roots work, and three-quarters of residents have now received at least one vaccine dose.
Ms. Dineen, the city’s Covid-19 vaccine coordinator, said that city officials were still prioritizing getting first and second doses to vulnerable people in poorly vaccinated neighborhoods, where canvassers continue to go door-to-door with the shots.
Those at the city clinic one day this month were the vaccine-dedicated. “It’s something that needed to be done,” Melvin Battle, a city employee, said, noting that “winter’s coming along.”
Paula Ladson-Gillis, another city employee, said she knew a dose of one of the new vaccines might not prevent her from getting Covid-19, but it would at least help to keep her from getting very ill.
“I know plenty of people are relaxed — I’m not one of them,” Ms. Ladson-Gillis said. “And that even says more to me why I want to get it, because too many people are not getting it.”
https://www.nytimes.com/2022/10/15/us/p ... lda-unique
Re: America's vaccine failure
Among Seniors, a Declining Interest in Boosters
Americans over 65 remain the demographic most likely to have received the original series of vaccinations. But fewer are getting the follow-up shots, surveys indicate.
By Paula Span
Oct. 22, 2022, 5:00 a.m. ET
Linda Brantman, a retired membership salesperson at a health club in Chicago, was paying attention last month when the Centers for Disease Control and Prevention recommended the new bivalent booster that protects against two variants of Covid-19. She went online and reserved an appointment at a Walgreens near her home.
Ms. Brantman, 65, who was already vaccinated and boosted twice, has grappled with asthma on and off for years; she keeps an inhaler handy, even for an ordinary cold. If she were sick with Covid, she said, “I would definitely have breathing problems.” Within two weeks of the C.D.C. announcement, she had received the latest booster — and public health officials hope all Americans over 5 will also roll up their sleeves again.
But many older Americans have responded more like Alan Turner, 65, who lives in New Castle, Del. and recently retired from an industrial design firm. He received the initial two doses of the vaccine but stopped updating his immunity after the first recommended booster. “I’ve become such a hermit,” he said. “I have virtually no contact with people, so I haven’t gotten around to it. I don’t see any particular need. I’m biding my time.”
Although Americans over 65 remain the demographic most likely to have received the original series of vaccinations, at 92 percent, their interest in keeping their vaccinations up-to-date is steadily declining, data from the C.D.C. shows. To date, about 71 percent have received the first recommended booster, but only about 44 percent have received the second.
Younger people have also been less likely to receive boosters than the original vaccinations, and only about one-third of people of all ages have received any booster, The New York Times vaccine tracker indicates. But seniors, who constitute 16 percent of the population, are more vulnerable to the virus’s effects, accounting for three-quarters of the nation’s 1.1 million deaths.
“From the beginning, older people have felt the virus was more of a threat to their safety and health and have been among the earliest adopters of the vaccine and the first round of boosters,” said Mollyann Brodie, the executive director of public opinion at Kaiser Family Foundation, which has been tracking vaccination rates and attitudes.
Now Kaiser’s most recent vaccine monitor survey, published last month, has found that only 8 percent of seniors said they had received the updated bivalent booster, and 37 percent said they intended to “as soon as possible.” As a group, older adults were better informed than younger respondents, but almost 40 percent said they had heard little or nothing about the updated bivalent vaccine, and many were unsure whether the C.D.C. had recommended it for them.
(Currently the C.D.C. recommends that individuals over age 5 receive the bivalent vaccine, which is effective against the original strain of Covid-19 and the Omicron variant, if two months have passed since their most recent vaccination or booster.)
“The messaging on boosters has been very muddled,” said Anne N. Sosin, a public health researcher at the Rockefeller Center for Public Policy and the Social Sciences at Dartmouth College. Partly as a result, she added, “older people are entering the winter with less protection than at earlier points in the pandemic.”
Ms. Sosin and other experts noted that older Americans have several reasons to be on guard. Their immunity from previous vaccinations and boosters may have waned; mitigation policies like mandatory masking and vaccination have largely disappeared; and public testing and vaccination sites have shut down.
Early on, Ms. Sosin said, many older adults changed their behavior by staying at home or masking and testing when they went out. Now they face greater exposure because “they’ve resumed their prepandemic activities.”
“Many are no longer concerned about Covid,” she said.
Public opinion polls bear that out. Older adults may also reason that improved treatments for Covid infections make the virus less dangerous.
Eileen Nagle, 81, receiving the new bivalent Omicron booster shot at the Hebrew Home at Riverdale nursing home, in Riverdale, N.Y., in September.Credit...Andrew Seng for The New York Times
Yet deaths in this age group doubled from April to July, exceeding 11,000 in both July and August, largely because of the increased transmissibility of the Omicron variant. Deaths began dipping again last month.
For older people, the danger of Covid is “reduced, but it’s not gone,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “You can’t forget it. You can’t put it in the rearview mirror.”
Two factors make older people more vulnerable to the virus. “Their immune systems become weaker with advancing age,” Dr. Schaffner said. “And they accumulate underlying conditions,” including heart and lung disease, smoking histories, diabetes and obesity, that increase their risks.
“Should you become infected, you’re at risk for a more serious outcome,” he said. “All the more reason to protect yourself as best you can.”
Studies have shown that vaccination and boosters protect against serious illness, hospitalization and death, although that immunity ebbs over time. “The data are rock-solid,” Dr. Schaffner said.
The Department of Health and Human Services estimated this month that among seniors and other Medicare beneficiaries, vaccination and boosters resulted in 650,000 fewer hospitalizations for Covid and had saved 300,000 lives in 2021.
But even in nursing homes, where the early months of the pandemic had a devastating toll, the booster uptake “has been very stagnant,” said Priya Chidambaram, a senior policy analyst at Kaiser Family Foundation and co-author of a survey published this month.
As of September, an average of 74 percent of nursing home residents had received one or more boosters, but that figure ranged from 59 percent in Arizona to 92 percent in Vermont. Rates were far lower among nursing home staff; nationally, only about half had received a booster, and in Missouri, Alabama and Mississippi, only one-third had.
A federal mandate requiring nursing home staff members to be vaccinated remains in place, but it does not include boosters. A federal on-site vaccination campaign for residents that relied on CVS and Walgreens bringing vaccines to nursing homes was effective but has not been repeated for boosters.
“That push sort of died down,” Ms. Chidambaram said. “The federal government took its foot off the pedal.”
Some older adults who do not live in nursing homes may be homebound or have difficulty traveling to pharmacies. But their sense of urgency also appears to have diminished. “Most older people were vaccinated,” Ms. Sosin said. “They weren’t hesitant or opposed.” But when it comes to boosters, she said, “they’re not very motivated and they haven’t been given a reason to be. There’s more a sense of, ‘Why bother?’”
A number of public health experts are now urging a full-scale crusade — including mass-media campaigns; social media and digital communication; pop-up and drive-through sites; mobile vans; and home visits — to raise the vaccination rate among seniors, and everyone else, before a possible winter surge of the virus.
“We have never seen an all-hands-on-deck approach to booster delivery,” Ms. Sosin said. “We should be flooding people with information, to the point where it gets irritating.”
The Biden administration’s fall Covid plan, announced early last month, has incorporated many of these ideas. But Dr. Schaffner argued that it did not spell out details or take a sufficiently aggressive approach for nursing homes.
Ms. Sosin was similarly skeptical. “I’m not seeing the elements in the plan materialize,” she said. “They’re not reflected in the numbers we’re seeing,” she said in reference to the number of people getting boosters.
Individuals can play a role in this effort. Kaiser surveys have found that doctors and other health care professionals are trusted sources of information, and the older population is in frequent contact with them.
“If more providers recognized that four in 10 older adults don’t realize there’s a new booster and they should get it, that’s a lot of opportunity to make an impact,” Dr. Brodie said.
Family members, friends, co-workers and neighbors also influence health decisions and behavior, and Kaiser studies show that they can help increase vaccination rates.
For those on the fence, Dr. Brodie said, “asking or reminding your parent or grandparent about the new booster can make quite a difference.”
https://www.nytimes.com/2022/10/22/heal ... derly.html
Americans over 65 remain the demographic most likely to have received the original series of vaccinations. But fewer are getting the follow-up shots, surveys indicate.
By Paula Span
Oct. 22, 2022, 5:00 a.m. ET
Linda Brantman, a retired membership salesperson at a health club in Chicago, was paying attention last month when the Centers for Disease Control and Prevention recommended the new bivalent booster that protects against two variants of Covid-19. She went online and reserved an appointment at a Walgreens near her home.
Ms. Brantman, 65, who was already vaccinated and boosted twice, has grappled with asthma on and off for years; she keeps an inhaler handy, even for an ordinary cold. If she were sick with Covid, she said, “I would definitely have breathing problems.” Within two weeks of the C.D.C. announcement, she had received the latest booster — and public health officials hope all Americans over 5 will also roll up their sleeves again.
But many older Americans have responded more like Alan Turner, 65, who lives in New Castle, Del. and recently retired from an industrial design firm. He received the initial two doses of the vaccine but stopped updating his immunity after the first recommended booster. “I’ve become such a hermit,” he said. “I have virtually no contact with people, so I haven’t gotten around to it. I don’t see any particular need. I’m biding my time.”
Although Americans over 65 remain the demographic most likely to have received the original series of vaccinations, at 92 percent, their interest in keeping their vaccinations up-to-date is steadily declining, data from the C.D.C. shows. To date, about 71 percent have received the first recommended booster, but only about 44 percent have received the second.
Younger people have also been less likely to receive boosters than the original vaccinations, and only about one-third of people of all ages have received any booster, The New York Times vaccine tracker indicates. But seniors, who constitute 16 percent of the population, are more vulnerable to the virus’s effects, accounting for three-quarters of the nation’s 1.1 million deaths.
“From the beginning, older people have felt the virus was more of a threat to their safety and health and have been among the earliest adopters of the vaccine and the first round of boosters,” said Mollyann Brodie, the executive director of public opinion at Kaiser Family Foundation, which has been tracking vaccination rates and attitudes.
Now Kaiser’s most recent vaccine monitor survey, published last month, has found that only 8 percent of seniors said they had received the updated bivalent booster, and 37 percent said they intended to “as soon as possible.” As a group, older adults were better informed than younger respondents, but almost 40 percent said they had heard little or nothing about the updated bivalent vaccine, and many were unsure whether the C.D.C. had recommended it for them.
(Currently the C.D.C. recommends that individuals over age 5 receive the bivalent vaccine, which is effective against the original strain of Covid-19 and the Omicron variant, if two months have passed since their most recent vaccination or booster.)
“The messaging on boosters has been very muddled,” said Anne N. Sosin, a public health researcher at the Rockefeller Center for Public Policy and the Social Sciences at Dartmouth College. Partly as a result, she added, “older people are entering the winter with less protection than at earlier points in the pandemic.”
Ms. Sosin and other experts noted that older Americans have several reasons to be on guard. Their immunity from previous vaccinations and boosters may have waned; mitigation policies like mandatory masking and vaccination have largely disappeared; and public testing and vaccination sites have shut down.
Early on, Ms. Sosin said, many older adults changed their behavior by staying at home or masking and testing when they went out. Now they face greater exposure because “they’ve resumed their prepandemic activities.”
“Many are no longer concerned about Covid,” she said.
Public opinion polls bear that out. Older adults may also reason that improved treatments for Covid infections make the virus less dangerous.
Eileen Nagle, 81, receiving the new bivalent Omicron booster shot at the Hebrew Home at Riverdale nursing home, in Riverdale, N.Y., in September.Credit...Andrew Seng for The New York Times
Yet deaths in this age group doubled from April to July, exceeding 11,000 in both July and August, largely because of the increased transmissibility of the Omicron variant. Deaths began dipping again last month.
For older people, the danger of Covid is “reduced, but it’s not gone,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “You can’t forget it. You can’t put it in the rearview mirror.”
Two factors make older people more vulnerable to the virus. “Their immune systems become weaker with advancing age,” Dr. Schaffner said. “And they accumulate underlying conditions,” including heart and lung disease, smoking histories, diabetes and obesity, that increase their risks.
“Should you become infected, you’re at risk for a more serious outcome,” he said. “All the more reason to protect yourself as best you can.”
Studies have shown that vaccination and boosters protect against serious illness, hospitalization and death, although that immunity ebbs over time. “The data are rock-solid,” Dr. Schaffner said.
The Department of Health and Human Services estimated this month that among seniors and other Medicare beneficiaries, vaccination and boosters resulted in 650,000 fewer hospitalizations for Covid and had saved 300,000 lives in 2021.
But even in nursing homes, where the early months of the pandemic had a devastating toll, the booster uptake “has been very stagnant,” said Priya Chidambaram, a senior policy analyst at Kaiser Family Foundation and co-author of a survey published this month.
As of September, an average of 74 percent of nursing home residents had received one or more boosters, but that figure ranged from 59 percent in Arizona to 92 percent in Vermont. Rates were far lower among nursing home staff; nationally, only about half had received a booster, and in Missouri, Alabama and Mississippi, only one-third had.
A federal mandate requiring nursing home staff members to be vaccinated remains in place, but it does not include boosters. A federal on-site vaccination campaign for residents that relied on CVS and Walgreens bringing vaccines to nursing homes was effective but has not been repeated for boosters.
“That push sort of died down,” Ms. Chidambaram said. “The federal government took its foot off the pedal.”
Some older adults who do not live in nursing homes may be homebound or have difficulty traveling to pharmacies. But their sense of urgency also appears to have diminished. “Most older people were vaccinated,” Ms. Sosin said. “They weren’t hesitant or opposed.” But when it comes to boosters, she said, “they’re not very motivated and they haven’t been given a reason to be. There’s more a sense of, ‘Why bother?’”
A number of public health experts are now urging a full-scale crusade — including mass-media campaigns; social media and digital communication; pop-up and drive-through sites; mobile vans; and home visits — to raise the vaccination rate among seniors, and everyone else, before a possible winter surge of the virus.
“We have never seen an all-hands-on-deck approach to booster delivery,” Ms. Sosin said. “We should be flooding people with information, to the point where it gets irritating.”
The Biden administration’s fall Covid plan, announced early last month, has incorporated many of these ideas. But Dr. Schaffner argued that it did not spell out details or take a sufficiently aggressive approach for nursing homes.
Ms. Sosin was similarly skeptical. “I’m not seeing the elements in the plan materialize,” she said. “They’re not reflected in the numbers we’re seeing,” she said in reference to the number of people getting boosters.
Individuals can play a role in this effort. Kaiser surveys have found that doctors and other health care professionals are trusted sources of information, and the older population is in frequent contact with them.
“If more providers recognized that four in 10 older adults don’t realize there’s a new booster and they should get it, that’s a lot of opportunity to make an impact,” Dr. Brodie said.
Family members, friends, co-workers and neighbors also influence health decisions and behavior, and Kaiser studies show that they can help increase vaccination rates.
For those on the fence, Dr. Brodie said, “asking or reminding your parent or grandparent about the new booster can make quite a difference.”
https://www.nytimes.com/2022/10/22/heal ... derly.html
Re: America's vaccine failure
The New Covid Boosters Are Incredible, and Everyone Should Get One
El Buen Samaritano, an Episcopal outreach ministry in Texas, serves the east side of Austin, the poorer of the two parts of the city, split by I-35. There are fewer services there, including many neighborhoods that don’t have a health center. The population is mainly people of color, many whose first language is Spanish. It’s the kind of population that has low Covid vaccination rates.
But El Buen has been able to prove that at least as far as Austin goes, the issue is not fear of the vaccine itself. “This is all about access,” Luis Garcia, the director of technology and analytics for El Buen, told me. Its food pantry gets about 200 visits every day it’s open, many from families that return week after week. Each of those food pickups is a chance for El Buen staff members to talk to them about the vaccine, he said, speaking in Spanish as he handed them bags of groceries and whole watermelons. The organization has also plastered social media, put out radio spots in Spanish and hung fliers in other food pantries.
Every month the organization holds a vaccination event. Other sites might ask for an ID or health insurance and usually demand an online appointment that requires internet access and often a computer, things that people in this community frequently don’t have. El Buen gives out shots on the spot, no questions asked.
Even though the event El Buen did in September didn’t start until 3 p.m., a couple of hundred people had lined up by 1:30, the cars crawling down the quiet residential street it sits on to a six-lane road a third of a mile away. One person waited in the line for an hour, and at 7 p.m. Mr. Garcia told him he’d have to come back to the next one. El Buen put 324 shots in arms that day.
Complete gift article with charts & graphs at the link below:
https://www.nytimes.com/2022/11/03/opin ... =share-url
El Buen Samaritano, an Episcopal outreach ministry in Texas, serves the east side of Austin, the poorer of the two parts of the city, split by I-35. There are fewer services there, including many neighborhoods that don’t have a health center. The population is mainly people of color, many whose first language is Spanish. It’s the kind of population that has low Covid vaccination rates.
But El Buen has been able to prove that at least as far as Austin goes, the issue is not fear of the vaccine itself. “This is all about access,” Luis Garcia, the director of technology and analytics for El Buen, told me. Its food pantry gets about 200 visits every day it’s open, many from families that return week after week. Each of those food pickups is a chance for El Buen staff members to talk to them about the vaccine, he said, speaking in Spanish as he handed them bags of groceries and whole watermelons. The organization has also plastered social media, put out radio spots in Spanish and hung fliers in other food pantries.
Every month the organization holds a vaccination event. Other sites might ask for an ID or health insurance and usually demand an online appointment that requires internet access and often a computer, things that people in this community frequently don’t have. El Buen gives out shots on the spot, no questions asked.
Even though the event El Buen did in September didn’t start until 3 p.m., a couple of hundred people had lined up by 1:30, the cars crawling down the quiet residential street it sits on to a six-lane road a third of a mile away. One person waited in the line for an hour, and at 7 p.m. Mr. Garcia told him he’d have to come back to the next one. El Buen put 324 shots in arms that day.
Complete gift article with charts & graphs at the link below:
https://www.nytimes.com/2022/11/03/opin ... =share-url
Re: America's vaccine failure
The End of Vaccines at ‘Warp Speed’
Financial and bureaucratic barriers in the United States mean that the next generation of Covid vaccines may well be designed here, but used elsewhere.
By Benjamin Mueller
Nov. 18, 2022
Updated 9:02 a.m. ET
Operation Warp Speed, the Trump-era program that poured billions of dollars into developing Covid shots, seemed to signal a new dawn of American vaccine making, demonstrating how decades of scientific grunt work could be turned into lifesaving medicine in a matter of months.
But as a third pandemic winter begins in the United States, its vaccine-making effort has lost steam. Efforts to test and produce next-generation Covid vaccines are bogged down by bureaucratic problems and funding shortfalls. Foreign rivals have raced ahead in approving long-awaited nasal-spray vaccines, including one invented in St. Louis, creating a scenario in which Americans would have to travel abroad for the latest in American vaccine technology.
The Biden administration has launched a last-ditch effort to restore the country’s edge. In a bid to resurrect Operation Warp Speed, President Biden asked the lame-duck session of Congress this week for $5 billion for next-generation vaccines and therapeutics, as part of a broader $9.25 billion pandemic spending request. But Republicans, having blocked requests for next-generation vaccine funding since the spring amid complaints about how the White House spent earlier pandemic aid allocations, have shown no signs of dropping their resistance.
As a result, even with the pandemic still taking a heavy toll, prospects have dimmed for the two most coveted kinds of next-generation vaccines: nasal sprays that can block more infections, and universal coronavirus shots that can defend against a wider array of ever-evolving variants.
In the coming months, scientists project that Covid could kill tens of thousands of Americans. The cost of infections keeps piling up, too: Long Covid sufferers are battling persistent health problems. And millions are missing work because they catch the virus, exacerbating labor shortages.
No next-generation vaccines are as close at hand, or as likely to reduce the spread of the virus, as those that can be inhaled or sprayed into the nose.
By generating immunity in people’s airways, where the coronavirus first lands, those vaccines can potentially help extinguish infections before they begin. Immunity delivered by a shot in the arm, on the other hand, takes longer to attack the invading virus, giving people good protection against serious disease but not to the infections that spread the virus and let it evolve.
China, India, Russia and Iran have all approved vaccines delivered through the nose or the mouth, even though they have not released much data about how the products work.
In the United States, nasal sprays have been held back by the same funding constraints and logistical hassles that, before the pandemic, often made developing vaccines a decade-long ordeal. The delay could not only weaken the country’s defenses against a more lethal coronavirus variant but also hurt preparations for a future pandemic, depriving the world of an oven-ready nasal vaccine platform that could be adapted to a new pathogen.
“It went back to the prepandemic speed of vaccine development,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai. His team’s nasal vaccine has undergone its most advanced testing in Mexico; collaborating with a pharmaceutical company there offered the fastest path to clinical trial funding. In the United States, he said, “The funding situation is pretty dire.”
The problems are not only financial. The best next-generation vaccine studies often depend on using existing mRNA shots, like the Covid vaccines made by Pfizer and Moderna. In some cases, that is because researchers want to compare nasal sprays to injectable vaccines. In others, it is because scientists need to know how well nasal vaccines boost immunity after an earlier mRNA shot.
But scientists aiming to develop nasal vaccines as boosters have discovered that they are barred from using leftover Pfizer or Moderna doses in their studies, despite tens of millions of unused doses having been thrown away.
Purchase agreements with the federal government prevent doses of the two vaccines from being used for research purposes without the companies’ approval, scientists said. Those types of provisions are generally intended to protect companies from the risks of a poorly run experiment hurting their product, though they can also help insulate firms from head-to-head studies that may flatter a competitor.
Because the government controls the supply of Pfizer and Moderna shots, nasal-vaccine makers cannot independently purchase them. Instead, scientists have had to pay outside manufacturers to make imitations.
Among the researchers in that position is Akiko Iwasaki, an immunologist at Yale University, whose experimental nasal vaccine is intended to boost immunity in those previously injected with mRNA shots. Her team’s vaccine appears to reduce viral transmission in hamsters, a promising sign. But Dr. Iwasaki has not been able to get Pfizer or Moderna shots for studies on monkeys, creating less reliable conditions for measuring how animals receiving mRNA shots respond to nasal boosters.
“There are so many millions of doses being thrown down the drain, and all we’re asking for is a couple of vials to be able to do some animal research,” Dr. Iwasaki said. “That’s kind of held us back.”
Scientists within the federal government have struggled to surmount the same legal barriers, despite extensive taxpayer support for mRNA vaccines. For much of the last year, federal officials negotiated with Moderna for permission to use its vaccine for research studies that were not expressly approved by Moderna or done in collaboration with the company, said Karin Bok, the acting deputy director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.
Only about a month ago did government scientists get those doses, Dr. Bok said. They are still unable to use Pfizer’s vaccine in the same way, she added.
“That’s a big gap that we need to think about how to overcome for the next pandemic,” Dr. Bok said. For now, she said, nasal vaccine makers and other researchers would probably be unable to secure licensed mRNA shots until doses become available on the private market next year.
Pfizer said in a statement that it was not providing its vaccine to independent research groups, but that it had worked with governments that wanted to resell or give away doses for clinical trials. Moderna said that it evaluated research requests on a case-by-case basis and collaborated with government scientists and several academic laboratories on studies of its vaccines.
There are no guarantees about how effective a nasal vaccine would be or how long its protections would last. It is not entirely clear how best to formulate the vaccines or deliver them to people’s airways. Safety concerns stem from the nasal cavity's closeness to the brain and the lungs. And there is no standard test for measuring immune responses in the airways, as there is for gauging the systemic immunity that is the goal of injectable vaccines.
The only approved nasal vaccine in the United States is FluMist, for preventing influenza, and its use is restricted to younger and healthier people.
Last month, a nasal version of the Oxford-AstraZeneca vaccine failed in a trial, an outcome that investigators said could have resulted from too much of the spray being swallowed and broken down in the stomach.
“It’s a fundamentally more difficult venture than a shot in the arm, which we’ve been doing for over 100 years,” said Dr. Benjamin Goldman-Israelow of Yale, who is working with Dr. Iwasaki on the team’s nasal vaccine.
The chances of any one candidate failing have discouraged America’s largest vaccine makers from investing. While government funding protected pharmaceutical companies in 2020 from the risks of pouring money into tricky vaccine research, those assurances have evaporated.
The market for Covid vaccines has also become less accommodating to new arrivals, industry experts said: Pfizer and Moderna shots dominate, giving those companies little reason to spend heavily on a competing vaccine and deterring their rivals.
Foreign vaccine makers have shown more interest, in part because nasal vaccines are expected to be easier than mRNA shots to store and use in poorer nations. Eventually, people may even be able to self-administer them at home.
Two years ago, India’s Bharat Biotech, a leading vaccine manufacturer, jumped on a promising early study of a nasal vaccine designed at Washington University in St. Louis and negotiated to make and test doses. India recently approved the vaccine based on data that Bharat has presented to American government scientists, but not released publicly.
The vaccine has progressed more slowly in the United States. Only last month did a smaller American company, Ocugen, secure the rights to it.
The team behind the vaccine “made multiple overtures to almost all of the major vaccine players and there wasn’t any buy-in,” said Dr. David T. Curiel, a researcher at Washington University in St. Louis who invented the vaccine with a colleague, Dr. Michael Diamond. Dr. Curiel said that the White House had long been calling for vaccine development funding. But, he said, “The Orwellian aspect has been trying to find specifically where those funds are.”
Government scientists have been pushing to speed up the process. Dr. Robert Seder, of the Vaccine Research Center, recently launched a study in nonhuman primates that will compare different nasal booster formulations to each other and to injectable boosters. It will also test spraying the new vaccines into the nose or having them inhaled through a mouthpiece.
One candidate is a modified version of Moderna’s shot. The company said it was collaborating with government scientists and studying how to deliver mRNA medicines to the lungs.
But federal health officials said that they, too, have seen funding requests languish, leaving much of the onus on academic researchers and their start-up companies. Roughly half a dozen American groups are testing nasal vaccines in people.
“We don’t have the resources of a Pfizer or BioNTech,” said Dr. Bruce Turner, the chief executive of Xanadu Bio, which he co-founded with Dr. Iwasaki at Yale. “We don’t have Operation Warp Speed.”
The leading American nasal vaccine candidates have been built on decades of government funding for the underlying research. What is missing, scientists said, is money for pushing those vaccines out of university laboratories and into real-world studies now that they are urgently needed.
“We’re at the last mile,” said Biao He, a professor at the University of Georgia. His company, CyanVac, based in Athens, Ga., began an early-stage human study of a nasal vaccine 15 months ago that is only now nearing completion. The costs of speeding up testing, he said, paled in comparison to the risks of waiting.
“When so many people’s lives are at stake,” he said, “can’t we do something about it?”
Benjamin Mueller is a health and science reporter. Previously, he covered the coronavirus pandemic as a correspondent in London and the police in New York.
https://www.nytimes.com/2022/11/18/heal ... speed.html
Financial and bureaucratic barriers in the United States mean that the next generation of Covid vaccines may well be designed here, but used elsewhere.
By Benjamin Mueller
Nov. 18, 2022
Updated 9:02 a.m. ET
Operation Warp Speed, the Trump-era program that poured billions of dollars into developing Covid shots, seemed to signal a new dawn of American vaccine making, demonstrating how decades of scientific grunt work could be turned into lifesaving medicine in a matter of months.
But as a third pandemic winter begins in the United States, its vaccine-making effort has lost steam. Efforts to test and produce next-generation Covid vaccines are bogged down by bureaucratic problems and funding shortfalls. Foreign rivals have raced ahead in approving long-awaited nasal-spray vaccines, including one invented in St. Louis, creating a scenario in which Americans would have to travel abroad for the latest in American vaccine technology.
The Biden administration has launched a last-ditch effort to restore the country’s edge. In a bid to resurrect Operation Warp Speed, President Biden asked the lame-duck session of Congress this week for $5 billion for next-generation vaccines and therapeutics, as part of a broader $9.25 billion pandemic spending request. But Republicans, having blocked requests for next-generation vaccine funding since the spring amid complaints about how the White House spent earlier pandemic aid allocations, have shown no signs of dropping their resistance.
As a result, even with the pandemic still taking a heavy toll, prospects have dimmed for the two most coveted kinds of next-generation vaccines: nasal sprays that can block more infections, and universal coronavirus shots that can defend against a wider array of ever-evolving variants.
In the coming months, scientists project that Covid could kill tens of thousands of Americans. The cost of infections keeps piling up, too: Long Covid sufferers are battling persistent health problems. And millions are missing work because they catch the virus, exacerbating labor shortages.
No next-generation vaccines are as close at hand, or as likely to reduce the spread of the virus, as those that can be inhaled or sprayed into the nose.
By generating immunity in people’s airways, where the coronavirus first lands, those vaccines can potentially help extinguish infections before they begin. Immunity delivered by a shot in the arm, on the other hand, takes longer to attack the invading virus, giving people good protection against serious disease but not to the infections that spread the virus and let it evolve.
China, India, Russia and Iran have all approved vaccines delivered through the nose or the mouth, even though they have not released much data about how the products work.
In the United States, nasal sprays have been held back by the same funding constraints and logistical hassles that, before the pandemic, often made developing vaccines a decade-long ordeal. The delay could not only weaken the country’s defenses against a more lethal coronavirus variant but also hurt preparations for a future pandemic, depriving the world of an oven-ready nasal vaccine platform that could be adapted to a new pathogen.
“It went back to the prepandemic speed of vaccine development,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai. His team’s nasal vaccine has undergone its most advanced testing in Mexico; collaborating with a pharmaceutical company there offered the fastest path to clinical trial funding. In the United States, he said, “The funding situation is pretty dire.”
The problems are not only financial. The best next-generation vaccine studies often depend on using existing mRNA shots, like the Covid vaccines made by Pfizer and Moderna. In some cases, that is because researchers want to compare nasal sprays to injectable vaccines. In others, it is because scientists need to know how well nasal vaccines boost immunity after an earlier mRNA shot.
But scientists aiming to develop nasal vaccines as boosters have discovered that they are barred from using leftover Pfizer or Moderna doses in their studies, despite tens of millions of unused doses having been thrown away.
Purchase agreements with the federal government prevent doses of the two vaccines from being used for research purposes without the companies’ approval, scientists said. Those types of provisions are generally intended to protect companies from the risks of a poorly run experiment hurting their product, though they can also help insulate firms from head-to-head studies that may flatter a competitor.
Because the government controls the supply of Pfizer and Moderna shots, nasal-vaccine makers cannot independently purchase them. Instead, scientists have had to pay outside manufacturers to make imitations.
Among the researchers in that position is Akiko Iwasaki, an immunologist at Yale University, whose experimental nasal vaccine is intended to boost immunity in those previously injected with mRNA shots. Her team’s vaccine appears to reduce viral transmission in hamsters, a promising sign. But Dr. Iwasaki has not been able to get Pfizer or Moderna shots for studies on monkeys, creating less reliable conditions for measuring how animals receiving mRNA shots respond to nasal boosters.
“There are so many millions of doses being thrown down the drain, and all we’re asking for is a couple of vials to be able to do some animal research,” Dr. Iwasaki said. “That’s kind of held us back.”
Scientists within the federal government have struggled to surmount the same legal barriers, despite extensive taxpayer support for mRNA vaccines. For much of the last year, federal officials negotiated with Moderna for permission to use its vaccine for research studies that were not expressly approved by Moderna or done in collaboration with the company, said Karin Bok, the acting deputy director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.
Only about a month ago did government scientists get those doses, Dr. Bok said. They are still unable to use Pfizer’s vaccine in the same way, she added.
“That’s a big gap that we need to think about how to overcome for the next pandemic,” Dr. Bok said. For now, she said, nasal vaccine makers and other researchers would probably be unable to secure licensed mRNA shots until doses become available on the private market next year.
Pfizer said in a statement that it was not providing its vaccine to independent research groups, but that it had worked with governments that wanted to resell or give away doses for clinical trials. Moderna said that it evaluated research requests on a case-by-case basis and collaborated with government scientists and several academic laboratories on studies of its vaccines.
There are no guarantees about how effective a nasal vaccine would be or how long its protections would last. It is not entirely clear how best to formulate the vaccines or deliver them to people’s airways. Safety concerns stem from the nasal cavity's closeness to the brain and the lungs. And there is no standard test for measuring immune responses in the airways, as there is for gauging the systemic immunity that is the goal of injectable vaccines.
The only approved nasal vaccine in the United States is FluMist, for preventing influenza, and its use is restricted to younger and healthier people.
Last month, a nasal version of the Oxford-AstraZeneca vaccine failed in a trial, an outcome that investigators said could have resulted from too much of the spray being swallowed and broken down in the stomach.
“It’s a fundamentally more difficult venture than a shot in the arm, which we’ve been doing for over 100 years,” said Dr. Benjamin Goldman-Israelow of Yale, who is working with Dr. Iwasaki on the team’s nasal vaccine.
The chances of any one candidate failing have discouraged America’s largest vaccine makers from investing. While government funding protected pharmaceutical companies in 2020 from the risks of pouring money into tricky vaccine research, those assurances have evaporated.
The market for Covid vaccines has also become less accommodating to new arrivals, industry experts said: Pfizer and Moderna shots dominate, giving those companies little reason to spend heavily on a competing vaccine and deterring their rivals.
Foreign vaccine makers have shown more interest, in part because nasal vaccines are expected to be easier than mRNA shots to store and use in poorer nations. Eventually, people may even be able to self-administer them at home.
Two years ago, India’s Bharat Biotech, a leading vaccine manufacturer, jumped on a promising early study of a nasal vaccine designed at Washington University in St. Louis and negotiated to make and test doses. India recently approved the vaccine based on data that Bharat has presented to American government scientists, but not released publicly.
The vaccine has progressed more slowly in the United States. Only last month did a smaller American company, Ocugen, secure the rights to it.
The team behind the vaccine “made multiple overtures to almost all of the major vaccine players and there wasn’t any buy-in,” said Dr. David T. Curiel, a researcher at Washington University in St. Louis who invented the vaccine with a colleague, Dr. Michael Diamond. Dr. Curiel said that the White House had long been calling for vaccine development funding. But, he said, “The Orwellian aspect has been trying to find specifically where those funds are.”
Government scientists have been pushing to speed up the process. Dr. Robert Seder, of the Vaccine Research Center, recently launched a study in nonhuman primates that will compare different nasal booster formulations to each other and to injectable boosters. It will also test spraying the new vaccines into the nose or having them inhaled through a mouthpiece.
One candidate is a modified version of Moderna’s shot. The company said it was collaborating with government scientists and studying how to deliver mRNA medicines to the lungs.
But federal health officials said that they, too, have seen funding requests languish, leaving much of the onus on academic researchers and their start-up companies. Roughly half a dozen American groups are testing nasal vaccines in people.
“We don’t have the resources of a Pfizer or BioNTech,” said Dr. Bruce Turner, the chief executive of Xanadu Bio, which he co-founded with Dr. Iwasaki at Yale. “We don’t have Operation Warp Speed.”
The leading American nasal vaccine candidates have been built on decades of government funding for the underlying research. What is missing, scientists said, is money for pushing those vaccines out of university laboratories and into real-world studies now that they are urgently needed.
“We’re at the last mile,” said Biao He, a professor at the University of Georgia. His company, CyanVac, based in Athens, Ga., began an early-stage human study of a nasal vaccine 15 months ago that is only now nearing completion. The costs of speeding up testing, he said, paled in comparison to the risks of waiting.
“When so many people’s lives are at stake,” he said, “can’t we do something about it?”
Benjamin Mueller is a health and science reporter. Previously, he covered the coronavirus pandemic as a correspondent in London and the police in New York.
https://www.nytimes.com/2022/11/18/heal ... speed.html
Re: America's vaccine failure
No nasal spray vaccine, yet a political system , thanks in part to SCOTUS, that permits a failed candidate for Mayor of LA to spend $100M.
Re: America's vaccine failure
Re: America's vaccine failure
The US sacrifices its seniors ( over 65 ) to COVID so everyone else can return to " normal". Another good reason for me to be a " grumpy old man ":
https://wapo.st/3F8ooud
https://wapo.st/3F8ooud
Re: America's vaccine failure
We still mask up when going shopping, in the lobby of our building, or at concerts, and plan on doing so for the indefinite future. This is not over.Rach3 wrote: ↑Mon Nov 28, 2022 10:39 amThe US sacrifices its seniors ( over 65 ) to COVID so everyone else can return to " normal". Another good reason for me to be a " grumpy old man ":
https://wapo.st/3F8ooud
Re: America's vaccine failure
Covid-19 Isn’t a Pandemic of the Unvaccinated Anymore
Dec. 7, 2022
By David Wallace-Wells
Opinion Writer
Americans received their first Covid-19 vaccine doses in December 2020, which means we are now approaching the beginning of the third year of the pandemic’s vaccine phase. And yet hundreds of Americans are still dying each day. Who are they? The data offers a straightforward answer: older adults.
Though it’s sometimes uncomfortable to say it, mortality risk has been dramatically skewed by age throughout the pandemic. The earliest reports of Covid deaths from China sketched a pattern quickly confirmed everywhere in the world: In an immunologically naïve population, the oldest were several thousand times more at risk of dying from infection than the youngest.
But the skew is actually more dramatic now — even amid mass vaccinations and reinfections — than it was at any previous point over the last three years. Since the beginning of the pandemic, people 65 and older accounted for 75 percent of all American Covid deaths. That dropped below 60 percent as recently as September 2021. But today Americans 65 and over account for 90 percent of new Covid deaths, an especially large share given that 94 percent of American seniors are vaccinated.
Yet these facts seem to contradict stories we’ve told about what drives vulnerability to Covid-19. In January, Joe Biden warned that the illness and death threatened by the Omicron variant represented “a pandemic of the unvaccinated.” But that month, in which nearly 85,000 Americans died, the unvaccinated accounted for 59 percent of those deaths, down from 77 percent the previous September, according to analysis by the Kaiser Family Foundation. The share of deaths among older adults that January was nearly 74 percent.
Over the months that followed, the unvaccinated share of mortality fell even further, to 38 percent in May 2022. The share of deaths among people vaccinated and boosted grew significantly as well, from 12 percent in January 2022 to 36 percent in April. Those levels held roughly steady throughout the duration of the summer, during which time just about as many boosted Americans were dying as the unvaccinated. The share of deaths among older adults kept growing: In April, 79 percent of American deaths were among those 65 and older. In November, 90 percent.
As many Twitter discussions about the “base rate fallacy” have emphasized, this is not because the vaccines are ineffective — we know, also from the Centers for Disease Control and Prevention data, that they work very well. Estimates of the effectiveness of updated bivalent boosters suggest they reduce the risk of mortality from Covid in Americans over the age of 12 by more than 93 percent compared with the population of unvaccinated. That is a very large factor.
But it isn’t the whole story, or vaccinated older adults wouldn’t now make up a larger share of Covid deaths than the unvaccinated do. That phenomenon arises from several other factors that are often underplayed. First is the simple fact that more Americans are vaccinated than not, and those older Americans most vulnerable to severe disease are far more likely to be vaccinated than others.
It is also partly a reflection of how many fewer Americans, including older ones, have gotten boosters than got the initial vaccines: 34 percent, compared to 69 percent. The number of those who have gotten updated bivalent boosters is lower still — just 12.7 percent of Americans over the age of 5.
Finally, vaccines are not as effective among older adults because the immune system weakens with age. It’s much harder to train older immune systems, and that training diminishes more quickly. In Americans between the ages of 65 and 79, for instance, vaccination reduced mortality risk from Covid more than 87 percent, compared to the unvaccinated. This is a very significant reduction, to be sure, but less than the 15-fold decline observed among those both vaccinated and bivalent-boosted in the overall population. For those 80 and above, the reduction from vaccination alone is less than fourfold.
That is a very good deal, of course. But it also means that, given the underlying age skew, a vaccinated person in their late 80s shares a similar risk of Covid death as a never-vaccinated 70-year-old. Which is to say, some real risk. If it was ever comfortable to say that the unconscionable levels of American deaths were a “pandemic of the unvaccinated,” it is surely now accurate to describe the ongoing toll as a “pandemic of the old.”
So why aren’t we?
One answer is that as a country, we prefer just to not see those deaths at all, regarding a baseline of several hundred deaths a day as a sort of background noise or morbid but faded wallpaper. We don’t need to understand who is dying or why in part because we don’t want to reckon with the fact that around 300 Americans are now dying from Covid-19 every day, at a rough pace of about 100,000 per year, making it the country’s third leading cause of death. This is normalization at work, but it is also a familiar pattern: We don’t exactly track the ups and downs of cancer or heart disease either.
Another answer is that — partly to promote good behavior, partly to more easily blame others for our general predicament — the country spent a lot of time emphasizing what you could do to protect yourself, which left us without much of a vocabulary to describe what underlying vulnerability inevitably remained. Vaccine refusal was a cancer on the American experience of the Covid years — that is undeniable. But we got so comfortable equating personal choices and individual risk that even identifying vulnerabilities came to feel like an accusation of irresponsibility. And where does that leave older adults? In a pandemic of the unvaccinated, what do you say to or about the 41 percent of Americans who died in January who’d gotten their shots? Or the roughly 60 percent of them that died this summer?
Many of us were also turned off by dismissive rhetoric from the beginning of the pandemic, when those minimizing the threat pointed to the disproportionate risks to the very old as a reason to not worry all that much about limiting spread. The country as a whole may be ageist, without all that much empathy for the well-being of octogenarians and nonagenarians. But hearing the conservative commentator Ben Shapiro or the Texas lieutenant governor Dan Patrick so blithely dismissing the deaths of older adults in 2020 probably made the whole subject seem considerably more taboo to the rest of us than it might’ve been otherwise.
Throughout the last few years, the country has also struggled to consider individual risk and social risk separately. In the first year of the pandemic, we seemed to build our sense of individual risk backward from the social need to limit spread — underemphasizing some of the differential threat and focusing instead on universal measures like social distancing and mask wearing. With the arrival of vaccines, we began to build a collective picture of social risk in the opposite way, up from an individual basis instead.
The picture that resulted was hugely relieving to most of us without being, at the highest levels, misleading: Vaccination and natural immunity had indeed dramatically reduced the country’s overall mortality risk. But while it’s comforting to believe that protection is a choice, for some populations it isn’t. And in moving pretty swiftly from treating everyone as high-risk to treating everyone as low-risk, we neglected to pay much attention to the differential of risk: that even if the average American had reduced his or her chances of dying by a factor of five or 10, 300 or more Americans might still be dying each day for many months, and there were probably some targeted things to do about that.
What are they? There is no simple or silver-bullet solution, which may be another reason we’ve spent more energy on the need for vaccination than on the vulnerabilities of age (that is, the fix is far more straightforward). But clearer communication — from public health officials to politicians and the media — about differential risk could nevertheless help, emphasizing not just that more shots are good but that different groups probably need different approaches, and that even with up-to-date vaccination and bivalent boosting, infection represents a considerable threat to older adults.
More targeted guidance might also underline the way that boosters still deliver what would have seemed like mind-blowing reductions in risk two years ago, even if they don’t eliminate it entirely, and point to certain settings where rapid testing should continue or be reinstituted (nursing homes, say). And there is surely much more to be done to aggressively promote treatments like Paxlovid, which are being criminally underutilized given their efficacy in vulnerable populations. (Their efficacy for younger and healthier people remains a kind of open question.) And while infrastructure investments and other mitigation strategies do not come as cheaply as communication, there is a bundle of things we know could help reduce transmission almost invisibly, without really burdening individuals: higher indoor air quality standards, for instance. You might even choose to target those investments and improvements less in schools than in care facilities, too.
Would all that be sufficient? Probably not to eliminate some ongoing death toll, unfortunately, given how promiscuously the disease is spreading. But it would presumably reduce by some fraction those hundreds of deaths we’re seeing each day. At the moment, the country is treating those deaths as the cost of normalcy.
https://www.nytimes.com/2022/12/07/opin ... eaths.html
Dec. 7, 2022
By David Wallace-Wells
Opinion Writer
Americans received their first Covid-19 vaccine doses in December 2020, which means we are now approaching the beginning of the third year of the pandemic’s vaccine phase. And yet hundreds of Americans are still dying each day. Who are they? The data offers a straightforward answer: older adults.
Though it’s sometimes uncomfortable to say it, mortality risk has been dramatically skewed by age throughout the pandemic. The earliest reports of Covid deaths from China sketched a pattern quickly confirmed everywhere in the world: In an immunologically naïve population, the oldest were several thousand times more at risk of dying from infection than the youngest.
But the skew is actually more dramatic now — even amid mass vaccinations and reinfections — than it was at any previous point over the last three years. Since the beginning of the pandemic, people 65 and older accounted for 75 percent of all American Covid deaths. That dropped below 60 percent as recently as September 2021. But today Americans 65 and over account for 90 percent of new Covid deaths, an especially large share given that 94 percent of American seniors are vaccinated.
Yet these facts seem to contradict stories we’ve told about what drives vulnerability to Covid-19. In January, Joe Biden warned that the illness and death threatened by the Omicron variant represented “a pandemic of the unvaccinated.” But that month, in which nearly 85,000 Americans died, the unvaccinated accounted for 59 percent of those deaths, down from 77 percent the previous September, according to analysis by the Kaiser Family Foundation. The share of deaths among older adults that January was nearly 74 percent.
Over the months that followed, the unvaccinated share of mortality fell even further, to 38 percent in May 2022. The share of deaths among people vaccinated and boosted grew significantly as well, from 12 percent in January 2022 to 36 percent in April. Those levels held roughly steady throughout the duration of the summer, during which time just about as many boosted Americans were dying as the unvaccinated. The share of deaths among older adults kept growing: In April, 79 percent of American deaths were among those 65 and older. In November, 90 percent.
As many Twitter discussions about the “base rate fallacy” have emphasized, this is not because the vaccines are ineffective — we know, also from the Centers for Disease Control and Prevention data, that they work very well. Estimates of the effectiveness of updated bivalent boosters suggest they reduce the risk of mortality from Covid in Americans over the age of 12 by more than 93 percent compared with the population of unvaccinated. That is a very large factor.
But it isn’t the whole story, or vaccinated older adults wouldn’t now make up a larger share of Covid deaths than the unvaccinated do. That phenomenon arises from several other factors that are often underplayed. First is the simple fact that more Americans are vaccinated than not, and those older Americans most vulnerable to severe disease are far more likely to be vaccinated than others.
It is also partly a reflection of how many fewer Americans, including older ones, have gotten boosters than got the initial vaccines: 34 percent, compared to 69 percent. The number of those who have gotten updated bivalent boosters is lower still — just 12.7 percent of Americans over the age of 5.
Finally, vaccines are not as effective among older adults because the immune system weakens with age. It’s much harder to train older immune systems, and that training diminishes more quickly. In Americans between the ages of 65 and 79, for instance, vaccination reduced mortality risk from Covid more than 87 percent, compared to the unvaccinated. This is a very significant reduction, to be sure, but less than the 15-fold decline observed among those both vaccinated and bivalent-boosted in the overall population. For those 80 and above, the reduction from vaccination alone is less than fourfold.
That is a very good deal, of course. But it also means that, given the underlying age skew, a vaccinated person in their late 80s shares a similar risk of Covid death as a never-vaccinated 70-year-old. Which is to say, some real risk. If it was ever comfortable to say that the unconscionable levels of American deaths were a “pandemic of the unvaccinated,” it is surely now accurate to describe the ongoing toll as a “pandemic of the old.”
So why aren’t we?
One answer is that as a country, we prefer just to not see those deaths at all, regarding a baseline of several hundred deaths a day as a sort of background noise or morbid but faded wallpaper. We don’t need to understand who is dying or why in part because we don’t want to reckon with the fact that around 300 Americans are now dying from Covid-19 every day, at a rough pace of about 100,000 per year, making it the country’s third leading cause of death. This is normalization at work, but it is also a familiar pattern: We don’t exactly track the ups and downs of cancer or heart disease either.
Another answer is that — partly to promote good behavior, partly to more easily blame others for our general predicament — the country spent a lot of time emphasizing what you could do to protect yourself, which left us without much of a vocabulary to describe what underlying vulnerability inevitably remained. Vaccine refusal was a cancer on the American experience of the Covid years — that is undeniable. But we got so comfortable equating personal choices and individual risk that even identifying vulnerabilities came to feel like an accusation of irresponsibility. And where does that leave older adults? In a pandemic of the unvaccinated, what do you say to or about the 41 percent of Americans who died in January who’d gotten their shots? Or the roughly 60 percent of them that died this summer?
Many of us were also turned off by dismissive rhetoric from the beginning of the pandemic, when those minimizing the threat pointed to the disproportionate risks to the very old as a reason to not worry all that much about limiting spread. The country as a whole may be ageist, without all that much empathy for the well-being of octogenarians and nonagenarians. But hearing the conservative commentator Ben Shapiro or the Texas lieutenant governor Dan Patrick so blithely dismissing the deaths of older adults in 2020 probably made the whole subject seem considerably more taboo to the rest of us than it might’ve been otherwise.
Throughout the last few years, the country has also struggled to consider individual risk and social risk separately. In the first year of the pandemic, we seemed to build our sense of individual risk backward from the social need to limit spread — underemphasizing some of the differential threat and focusing instead on universal measures like social distancing and mask wearing. With the arrival of vaccines, we began to build a collective picture of social risk in the opposite way, up from an individual basis instead.
The picture that resulted was hugely relieving to most of us without being, at the highest levels, misleading: Vaccination and natural immunity had indeed dramatically reduced the country’s overall mortality risk. But while it’s comforting to believe that protection is a choice, for some populations it isn’t. And in moving pretty swiftly from treating everyone as high-risk to treating everyone as low-risk, we neglected to pay much attention to the differential of risk: that even if the average American had reduced his or her chances of dying by a factor of five or 10, 300 or more Americans might still be dying each day for many months, and there were probably some targeted things to do about that.
What are they? There is no simple or silver-bullet solution, which may be another reason we’ve spent more energy on the need for vaccination than on the vulnerabilities of age (that is, the fix is far more straightforward). But clearer communication — from public health officials to politicians and the media — about differential risk could nevertheless help, emphasizing not just that more shots are good but that different groups probably need different approaches, and that even with up-to-date vaccination and bivalent boosting, infection represents a considerable threat to older adults.
More targeted guidance might also underline the way that boosters still deliver what would have seemed like mind-blowing reductions in risk two years ago, even if they don’t eliminate it entirely, and point to certain settings where rapid testing should continue or be reinstituted (nursing homes, say). And there is surely much more to be done to aggressively promote treatments like Paxlovid, which are being criminally underutilized given their efficacy in vulnerable populations. (Their efficacy for younger and healthier people remains a kind of open question.) And while infrastructure investments and other mitigation strategies do not come as cheaply as communication, there is a bundle of things we know could help reduce transmission almost invisibly, without really burdening individuals: higher indoor air quality standards, for instance. You might even choose to target those investments and improvements less in schools than in care facilities, too.
Would all that be sufficient? Probably not to eliminate some ongoing death toll, unfortunately, given how promiscuously the disease is spreading. But it would presumably reduce by some fraction those hundreds of deaths we’re seeing each day. At the moment, the country is treating those deaths as the cost of normalcy.
https://www.nytimes.com/2022/12/07/opin ... eaths.html
Re: America's vaccine failure
Trump caused needless deaths, those who support him are accomplices:
WAPO today:
Beginning in late January 2020, U.S. intelligence agencies reported to senior Trump administration officials that the coronavirus spreading in China threatened to become a pandemic and spark a global health crisis.
But then-President Trump’s public statements over the next two months “did not reflect the increasingly stark warnings coursing through intelligence channels,” including the president’s daily brief, available to Trump and senior members of his administration, according to a report issued Thursday by the House Intelligence Committee.
By February, the intelligence community “had amply warned the White House in time for it to act to protect the country,” committee investigators concluded. Trump claimed in a May 2020 tweet that the intelligence community “only spoke of the Virus in a very non-threatening, or matter of fact, manner,” a statement that “simply does not match the record of intelligence analysis published in late January and February,” the committee found.
Committee staff spent two years examining the intelligence community’s response to the covid-19 pandemic. Their report, which was staffed by bipartisan aides but written by the Democrats, who hold the majority on the committee, broadly praises the work of intelligence analysts for providing early warning about the virus for policymakers.
But the report also faulted the intelligence community for not being better prepared to provide comprehensive early warning based on exclusive intelligence. Agencies didn’t move in the outbreak’s early days to use their clandestine sources for collecting unique, potentially useful intelligence about the unfolding situation in China, the committee found. Doing so might have provided administration leaders with more insight than was available in public health channels and nonclassified sources of information.
Among the new steps the committee recommends the intelligence agencies take to prepare for the next pandemic is designating a new center with responsibility for global health security; enhancing intelligence agencies’ ability to quickly collect information when a new disease emerges; and providing more resources to the National Center for Medical Intelligence (NCMI), a component of the Defense Intelligence Agency that investigators found performed particularly well, but whose early warnings could have been more widely shared with decision-makers.
A spokesperson for the Office of the Director of National Intelligence declined to comment on the report.
Trump administration’s hunt for pandemic ‘lab leak’ went down many paths and came up with no smoking gun.
Indications that a novel coronavirus might be spreading in China caught the attention of U.S. intelligence as early as Dec. 31, 2019, the committee found, when an analyst at the NCMI reviewed a notice shared on ProMED about a mysterious respiratory illness spreading in China, and that had been discussed on social media. The analyst uploaded the notice from ProMED, a publicly accessible system for monitoring disease outbreaks, into an intelligence database called Horizon, which disseminates reports to military intelligence directorates.
Labeled as a “possible pandemic warning update,” it was the first indication within the intelligence community of covid-19, which had not yet been named.
In the first week of January 2020, “alarming information was circulating throughout the U.S. government,” but most of it came from public health sources, the committee found.
On Jan. 7, the U.S. Embassy in Beijing took note in a cable of the growing outbreak. Some officials at the National Security Council wanted more information but were frustrated that the intelligence community couldn’t provide unique insights from its own clandestine sources.
Soon thereafter, intelligence analysts began focusing more on the disease and started to coordinate analysis for policymakers, the committee found. On Jan. 16, the embassy sent a cable saying that Chinese government officials were engaged in only “limited sharing” of epidemiological data, which was hindering assessments of the risk the virus posed.
The Washington Post previously reported that in January and February, as intelligence agencies ramped up their reporting on the outbreak, they warned that Chinese officials appeared to be minimizing its severity.
In the U.S., too, the president kept downplaying the coming storm.
On Jan. 22, Trump said in an interview with CNBC that the United States had the virus “totally under control,” a statement that didn’t reflect the “growing level of concern” in the intelligence community’s reports, the committee found. The next day, Trump was reportedly told about the virus in his daily intelligence briefing, and officials told the committee that an article was drafted for inclusion in the president’s daily brief, or PDB, a classified document shared with Trump and his senior advisers.
That day, the State Department ordered staff at the consulate in Wuhan and their families to evacuate China. One day later, the NCMI published an assessment that the virus had a “roughly even chance of becoming a global pandemic during the next four months.”
In a briefing with reporters on Thursday, a committee investigator noted that the World Health Organization didn’t declare a pandemic until nearly the middle of March. He said that the intelligence community’s earlier warning was a “classic example” of the way intelligence analysts can provide insights to decision-makers, which may be necessary for future pandemic response.
“Public health officials will wait until all the data is there before making a call,” said the investigator, speaking on the condition of anonymity under ground rules set by the committee. While the early warning the community provided wasn’t comprehensive, it was a notable example of “where the professional culture of intelligence analysts really shines through,” the investigator added.
The intensity and frequency of the alerts would soon grow. On Jan. 30, the CIA began preparing short intelligence reports called “executive updates” on the spread of the virus. A PDB from early February 2020 warned that covid “could not be contained.” Another report around the same time predicted that the virus would become a global crisis before May.
But the House committee could not determine precisely which reports Trump read or the totality of information that was presented to him. Historically, the executive branch resists sharing full copies of the PDB with investigators, as was the case here, the committee said.
“We don’t know exactly what went up to President Trump,” the investigator said, “but it’s not the intelligence community’s practice to tell the president one thing and the rest of the national security community another.”
The report did not investigate the origins of covid-19, which continue to be a subject of debate. Trump administration officials, led by former Secretary of State Mike Pompeo, advocated for the hypothesis that the virus originated in a lab in Wuhan and escaped possibly through an accidental transmission to lab workers. To bolster that claim, officials cited reporting that researchers at the Wuhan Institute of Virology became ill in the fall of 2019 with symptoms similar to covid-19.
But the House committee staff called those arguments “deeply misleading,” because the U.S. doesn’t know what made the workers sick and whether they had covid-19.
WAPO today:
Beginning in late January 2020, U.S. intelligence agencies reported to senior Trump administration officials that the coronavirus spreading in China threatened to become a pandemic and spark a global health crisis.
But then-President Trump’s public statements over the next two months “did not reflect the increasingly stark warnings coursing through intelligence channels,” including the president’s daily brief, available to Trump and senior members of his administration, according to a report issued Thursday by the House Intelligence Committee.
By February, the intelligence community “had amply warned the White House in time for it to act to protect the country,” committee investigators concluded. Trump claimed in a May 2020 tweet that the intelligence community “only spoke of the Virus in a very non-threatening, or matter of fact, manner,” a statement that “simply does not match the record of intelligence analysis published in late January and February,” the committee found.
Committee staff spent two years examining the intelligence community’s response to the covid-19 pandemic. Their report, which was staffed by bipartisan aides but written by the Democrats, who hold the majority on the committee, broadly praises the work of intelligence analysts for providing early warning about the virus for policymakers.
But the report also faulted the intelligence community for not being better prepared to provide comprehensive early warning based on exclusive intelligence. Agencies didn’t move in the outbreak’s early days to use their clandestine sources for collecting unique, potentially useful intelligence about the unfolding situation in China, the committee found. Doing so might have provided administration leaders with more insight than was available in public health channels and nonclassified sources of information.
Among the new steps the committee recommends the intelligence agencies take to prepare for the next pandemic is designating a new center with responsibility for global health security; enhancing intelligence agencies’ ability to quickly collect information when a new disease emerges; and providing more resources to the National Center for Medical Intelligence (NCMI), a component of the Defense Intelligence Agency that investigators found performed particularly well, but whose early warnings could have been more widely shared with decision-makers.
A spokesperson for the Office of the Director of National Intelligence declined to comment on the report.
Trump administration’s hunt for pandemic ‘lab leak’ went down many paths and came up with no smoking gun.
Indications that a novel coronavirus might be spreading in China caught the attention of U.S. intelligence as early as Dec. 31, 2019, the committee found, when an analyst at the NCMI reviewed a notice shared on ProMED about a mysterious respiratory illness spreading in China, and that had been discussed on social media. The analyst uploaded the notice from ProMED, a publicly accessible system for monitoring disease outbreaks, into an intelligence database called Horizon, which disseminates reports to military intelligence directorates.
Labeled as a “possible pandemic warning update,” it was the first indication within the intelligence community of covid-19, which had not yet been named.
In the first week of January 2020, “alarming information was circulating throughout the U.S. government,” but most of it came from public health sources, the committee found.
On Jan. 7, the U.S. Embassy in Beijing took note in a cable of the growing outbreak. Some officials at the National Security Council wanted more information but were frustrated that the intelligence community couldn’t provide unique insights from its own clandestine sources.
Soon thereafter, intelligence analysts began focusing more on the disease and started to coordinate analysis for policymakers, the committee found. On Jan. 16, the embassy sent a cable saying that Chinese government officials were engaged in only “limited sharing” of epidemiological data, which was hindering assessments of the risk the virus posed.
The Washington Post previously reported that in January and February, as intelligence agencies ramped up their reporting on the outbreak, they warned that Chinese officials appeared to be minimizing its severity.
In the U.S., too, the president kept downplaying the coming storm.
On Jan. 22, Trump said in an interview with CNBC that the United States had the virus “totally under control,” a statement that didn’t reflect the “growing level of concern” in the intelligence community’s reports, the committee found. The next day, Trump was reportedly told about the virus in his daily intelligence briefing, and officials told the committee that an article was drafted for inclusion in the president’s daily brief, or PDB, a classified document shared with Trump and his senior advisers.
That day, the State Department ordered staff at the consulate in Wuhan and their families to evacuate China. One day later, the NCMI published an assessment that the virus had a “roughly even chance of becoming a global pandemic during the next four months.”
In a briefing with reporters on Thursday, a committee investigator noted that the World Health Organization didn’t declare a pandemic until nearly the middle of March. He said that the intelligence community’s earlier warning was a “classic example” of the way intelligence analysts can provide insights to decision-makers, which may be necessary for future pandemic response.
“Public health officials will wait until all the data is there before making a call,” said the investigator, speaking on the condition of anonymity under ground rules set by the committee. While the early warning the community provided wasn’t comprehensive, it was a notable example of “where the professional culture of intelligence analysts really shines through,” the investigator added.
The intensity and frequency of the alerts would soon grow. On Jan. 30, the CIA began preparing short intelligence reports called “executive updates” on the spread of the virus. A PDB from early February 2020 warned that covid “could not be contained.” Another report around the same time predicted that the virus would become a global crisis before May.
But the House committee could not determine precisely which reports Trump read or the totality of information that was presented to him. Historically, the executive branch resists sharing full copies of the PDB with investigators, as was the case here, the committee said.
“We don’t know exactly what went up to President Trump,” the investigator said, “but it’s not the intelligence community’s practice to tell the president one thing and the rest of the national security community another.”
The report did not investigate the origins of covid-19, which continue to be a subject of debate. Trump administration officials, led by former Secretary of State Mike Pompeo, advocated for the hypothesis that the virus originated in a lab in Wuhan and escaped possibly through an accidental transmission to lab workers. To bolster that claim, officials cited reporting that researchers at the Wuhan Institute of Virology became ill in the fall of 2019 with symptoms similar to covid-19.
But the House committee staff called those arguments “deeply misleading,” because the U.S. doesn’t know what made the workers sick and whether they had covid-19.
Re: America's vaccine failure
Opposition to School Vaccine Mandates Has Grown Significantly, Study Finds
A third of parents now feel they should be the ones to decide whether to get their children immunized against measles, mumps and other childhood diseases.
By Jan Hoffman
Dec. 16, 2022, 5:00 a.m. ET
For generations of most American families, getting children vaccinated was just something to check off on the list of back-to-school chores. But after the ferocious battles over Covid shots of the past two years, simmering resistance to general school vaccine mandates has grown significantly. Now, 35 percent of parents oppose requirements that children receive routine immunizations in order to attend school, according to a new survey released Friday by the Kaiser Family Foundation.
All of the states and the District of Columbia mandate that children receive vaccinations against measles, mumps, rubella and other highly contagious, deadly childhood diseases. (Most permit a few limited exemptions.)
Throughout the pandemic, the Kaiser foundation, a nonpartisan health care research organization, has been issuing monthly reports on changing attitudes toward Covid vaccines. The surveys have showed a growing political divide over the issue, and the latest study indicates that division now extends to routine childhood vaccinations.
Forty-four percent of adults who either identify as Republicans or lean that way said in the latest survey that parents should have the right to opt out of school vaccine mandates, up from 20 percent in a prepandemic poll conducted in 2019 by the Pew Research Center. In contrast, 88 percent of adults who identify as or lean Democratic endorsed childhood vaccine requirements, a slight increase from 86 percent in 2019.
The survey found that 28 percent of adults overall believed parents should have the authority to make school vaccine decisions for their children, a stance that in the 2019 Pew poll was held by just 16 percent of adults.
The shift in positions appears to be less about rejecting the shots than a growing endorsement of the so-called parents’ rights movement. Indeed, 80 percent of parents said that the benefits of vaccines for measles, mumps and rubella outweighed the risks, down only slightly from 83 percent in 2019.
“The talking point that has been circulated is the concept of taking away parents’ rights,” said Dr. Sean O’Leary, chairman of the American Academy of Pediatrics’ committee on infectious diseases. “And when you frame it that simply, it’s very appealing to a certain segment of the population. But what about the right to have your children be safe in school from vaccine-preventable diseases?”
Still, Dr. O’Leary said that he wasn’t overly worried that school vaccine mandates would be lifted but that the growing embrace of parents’ rights might further slow compliance with state-required immunization schedules, a timeline that has long been endorsed by pediatricians.
“We know a lot of kids missed their vaccines during the pandemic, not because they were refusing, but because, for many reasons, people weren’t going to the doctor,” he said. “And we do have a global dip in vaccine coverage. So this is not a time to be considering a rollback of these laws.”
The latest survey was based on interviews with a nationally representative sample of 1,259 adults and was conducted from Nov. 29 through Dec. 8.
It showed disappointing rates of uptake of the latest Covid booster, a “bivalent” shot that targets both the original coronavirus and the Omicron variant and has been available since September. Just four in 10 adults said they had either gotten the booster or intended to do so. Among those 65 and older — the age group at the highest risk — about one in four said they had been too busy to get it or hadn’t found the time to do so.
Even among adults who had received previous Covid vaccines, the survey found that more than four in 10 said they felt they did not need this latest shot.
Only about a third of respondents said they personally feared getting very ill from Covid, though half expressed concerns in general about rising rates of Covid this winter. About two-thirds of Black and Latino adults were apprehensive about Covid rates, compared with about four in 10 white adults.
The survey also found that about half of parents worried that their children could fall sick this winter from Covid-19, the flu or R.S.V. (respiratory syncytial virus), a sign that Covid-19 was increasingly becoming normalized in the public’s perception and joining the landscape of seasonal illnesses.
https://www.nytimes.com/2022/12/16/heal ... inion.html
A third of parents now feel they should be the ones to decide whether to get their children immunized against measles, mumps and other childhood diseases.
By Jan Hoffman
Dec. 16, 2022, 5:00 a.m. ET
For generations of most American families, getting children vaccinated was just something to check off on the list of back-to-school chores. But after the ferocious battles over Covid shots of the past two years, simmering resistance to general school vaccine mandates has grown significantly. Now, 35 percent of parents oppose requirements that children receive routine immunizations in order to attend school, according to a new survey released Friday by the Kaiser Family Foundation.
All of the states and the District of Columbia mandate that children receive vaccinations against measles, mumps, rubella and other highly contagious, deadly childhood diseases. (Most permit a few limited exemptions.)
Throughout the pandemic, the Kaiser foundation, a nonpartisan health care research organization, has been issuing monthly reports on changing attitudes toward Covid vaccines. The surveys have showed a growing political divide over the issue, and the latest study indicates that division now extends to routine childhood vaccinations.
Forty-four percent of adults who either identify as Republicans or lean that way said in the latest survey that parents should have the right to opt out of school vaccine mandates, up from 20 percent in a prepandemic poll conducted in 2019 by the Pew Research Center. In contrast, 88 percent of adults who identify as or lean Democratic endorsed childhood vaccine requirements, a slight increase from 86 percent in 2019.
The survey found that 28 percent of adults overall believed parents should have the authority to make school vaccine decisions for their children, a stance that in the 2019 Pew poll was held by just 16 percent of adults.
The shift in positions appears to be less about rejecting the shots than a growing endorsement of the so-called parents’ rights movement. Indeed, 80 percent of parents said that the benefits of vaccines for measles, mumps and rubella outweighed the risks, down only slightly from 83 percent in 2019.
“The talking point that has been circulated is the concept of taking away parents’ rights,” said Dr. Sean O’Leary, chairman of the American Academy of Pediatrics’ committee on infectious diseases. “And when you frame it that simply, it’s very appealing to a certain segment of the population. But what about the right to have your children be safe in school from vaccine-preventable diseases?”
Still, Dr. O’Leary said that he wasn’t overly worried that school vaccine mandates would be lifted but that the growing embrace of parents’ rights might further slow compliance with state-required immunization schedules, a timeline that has long been endorsed by pediatricians.
“We know a lot of kids missed their vaccines during the pandemic, not because they were refusing, but because, for many reasons, people weren’t going to the doctor,” he said. “And we do have a global dip in vaccine coverage. So this is not a time to be considering a rollback of these laws.”
The latest survey was based on interviews with a nationally representative sample of 1,259 adults and was conducted from Nov. 29 through Dec. 8.
It showed disappointing rates of uptake of the latest Covid booster, a “bivalent” shot that targets both the original coronavirus and the Omicron variant and has been available since September. Just four in 10 adults said they had either gotten the booster or intended to do so. Among those 65 and older — the age group at the highest risk — about one in four said they had been too busy to get it or hadn’t found the time to do so.
Even among adults who had received previous Covid vaccines, the survey found that more than four in 10 said they felt they did not need this latest shot.
Only about a third of respondents said they personally feared getting very ill from Covid, though half expressed concerns in general about rising rates of Covid this winter. About two-thirds of Black and Latino adults were apprehensive about Covid rates, compared with about four in 10 white adults.
The survey also found that about half of parents worried that their children could fall sick this winter from Covid-19, the flu or R.S.V. (respiratory syncytial virus), a sign that Covid-19 was increasingly becoming normalized in the public’s perception and joining the landscape of seasonal illnesses.
https://www.nytimes.com/2022/12/16/heal ... inion.html
Re: America's vaccine failure
Will 2024 Be a Vaccine Election?
Dec. 15, 2022
By Paul Krugman
Opinion Columnist
Will Republicans once again nominate Donald Trump for president? Or will they turn to Ron DeSantis instead? I have no idea.
What I do know is that anyone imagining DeSantis as a more sensible, saner figure than Trump — a right-wing populist without the reality-denying paranoia — is delusional. DeSantis hasn’t gone down all the same rabbit holes as Trump, but he has gone down some of his own, and his descent has been just as deep.
Above all, DeSantis is increasingly making himself the face of vaccine conspiracy theories, which have turned a medical miracle into a source of bitter partisan division and have contributed to thousands of unnecessary deaths.
Let’s back up and talk about the story of Covid-19 vaccines so far.
In the spring of 2020 the U.S. government initiated Operation Warp Speed, a public-private partnership intended to develop effective vaccines against the coronavirus as quickly as possible. The effort succeeded: By December 2020, far sooner than almost anyone had imagined possible, vaccinations were underway. (I received my first shot the next month, on Jan. 28, 2021.) And yes, this was a success for the Trump administration.
Have the vaccines worked? And how. There are multiple ways to evaluate their lifesaving effect, but I’m especially taken with a simple approach promoted by the analyst Charles Gaba, who looks at the correlation across U.S. counties between vaccination rates and Covid death rates. Between May 2021, when two-dose vaccinations first became widespread, and September 2022 the least-vaccinated 10 percent of counties suffered a death rate more than three times as high as the most-vaccinated.
Now, you may have heard that at this point deaths among vaccinated Americans are exceeding those among the unvaccinated, which is true. But that’s partly because most deaths are among the elderly, who are overwhelmingly vaccinated; very few Americans have received no shots; and not enough vaccinated people are getting booster shots.
But why are some U.S. counties so much less vaccinated than others? The answer, as Gaba shows, is partisanship: There’s a startlingly close relationship between the share of a county’s voters who supported Trump in 2020 and the percentage of that county’s residents who haven’t received their shots — and the percentage who have died from Covid.
You can, by the way, see the same patterns at the level of whole states. For example, although New York was hit hard in the first months of the pandemic (before we knew how the coronavirus spread or what precautions to take), since May 2021 more than twice as many people have died of Covid in Florida than in New York. Even taking Florida’s slightly larger and much older population into account, that’s thousands of excess deaths in the Sunshine State.
Yet why should vaccination be a partisan issue?
Right-wing opposition to lockdowns and social distancing in the early stages of the pandemic made at least some sense, since these public health measures involved requiring that people make some sacrifices to protect other people’s lives. (Some might say that such trade-offs are what civilization is all about, but whatever.) Even mask mandates required accepting a bit of inconvenience, at least partly for the sake of others.
But getting vaccinated is mainly about protecting yourself. Why wouldn’t you want to do that?
The immediate answer is the widespread belief on the right that the vaccines have terrible side effects. This belief is hard to justify: If it were true, shouldn’t there be a lot of evidence for such claims, given that more than 13 billion doses have been administered worldwide?
Ah, but the usual suspects claim that sinister elites are suppressing the evidence. Which brings us back to DeSantis, who announced on Tuesday that he was forming a state committee to counter federal health policy recommendations — and asking for a grand jury investigation into unspecified “crimes and misdemeanors” related to coronavirus vaccines.
OK, I doubt that anyone believes that DeSantis knows or cares about the scientific evidence here. What he’s doing instead is catering to a Republican base that equates listening to experts, on public health or anything else, with “wokeness,” and demonizes anyone saying things it doesn’t want to hear.
As far as I can tell, DeSantis hasn’t joined the likes of Elon Musk in calling for the prosecution of Anthony Fauci, who led America’s Covid response. But he has called Fauci a “little elf” and said that we should “chuck him across the Potomac.” (Presidential!)
Now, will DeSantis’s attempt to position himself as the leader of the anti-vax movement and give at least tacit approval to conspiracy theories actually endear him to the Republican base? Again, I don’t know. Even if it does, I suspect that it will hurt him in the general election if he does become the nominee: Vaccine paranoia and Fauci hatred are still niche positions in the electorate at large.
But anyone who imagines that replacing Trump with DeSantis as the G.O.P.’s leader would signal a party on its way to becoming sane again is in for a rude shock.
https://www.nytimes.com/2022/12/15/opin ... ction.html
Dec. 15, 2022
By Paul Krugman
Opinion Columnist
Will Republicans once again nominate Donald Trump for president? Or will they turn to Ron DeSantis instead? I have no idea.
What I do know is that anyone imagining DeSantis as a more sensible, saner figure than Trump — a right-wing populist without the reality-denying paranoia — is delusional. DeSantis hasn’t gone down all the same rabbit holes as Trump, but he has gone down some of his own, and his descent has been just as deep.
Above all, DeSantis is increasingly making himself the face of vaccine conspiracy theories, which have turned a medical miracle into a source of bitter partisan division and have contributed to thousands of unnecessary deaths.
Let’s back up and talk about the story of Covid-19 vaccines so far.
In the spring of 2020 the U.S. government initiated Operation Warp Speed, a public-private partnership intended to develop effective vaccines against the coronavirus as quickly as possible. The effort succeeded: By December 2020, far sooner than almost anyone had imagined possible, vaccinations were underway. (I received my first shot the next month, on Jan. 28, 2021.) And yes, this was a success for the Trump administration.
Have the vaccines worked? And how. There are multiple ways to evaluate their lifesaving effect, but I’m especially taken with a simple approach promoted by the analyst Charles Gaba, who looks at the correlation across U.S. counties between vaccination rates and Covid death rates. Between May 2021, when two-dose vaccinations first became widespread, and September 2022 the least-vaccinated 10 percent of counties suffered a death rate more than three times as high as the most-vaccinated.
Now, you may have heard that at this point deaths among vaccinated Americans are exceeding those among the unvaccinated, which is true. But that’s partly because most deaths are among the elderly, who are overwhelmingly vaccinated; very few Americans have received no shots; and not enough vaccinated people are getting booster shots.
But why are some U.S. counties so much less vaccinated than others? The answer, as Gaba shows, is partisanship: There’s a startlingly close relationship between the share of a county’s voters who supported Trump in 2020 and the percentage of that county’s residents who haven’t received their shots — and the percentage who have died from Covid.
You can, by the way, see the same patterns at the level of whole states. For example, although New York was hit hard in the first months of the pandemic (before we knew how the coronavirus spread or what precautions to take), since May 2021 more than twice as many people have died of Covid in Florida than in New York. Even taking Florida’s slightly larger and much older population into account, that’s thousands of excess deaths in the Sunshine State.
Yet why should vaccination be a partisan issue?
Right-wing opposition to lockdowns and social distancing in the early stages of the pandemic made at least some sense, since these public health measures involved requiring that people make some sacrifices to protect other people’s lives. (Some might say that such trade-offs are what civilization is all about, but whatever.) Even mask mandates required accepting a bit of inconvenience, at least partly for the sake of others.
But getting vaccinated is mainly about protecting yourself. Why wouldn’t you want to do that?
The immediate answer is the widespread belief on the right that the vaccines have terrible side effects. This belief is hard to justify: If it were true, shouldn’t there be a lot of evidence for such claims, given that more than 13 billion doses have been administered worldwide?
Ah, but the usual suspects claim that sinister elites are suppressing the evidence. Which brings us back to DeSantis, who announced on Tuesday that he was forming a state committee to counter federal health policy recommendations — and asking for a grand jury investigation into unspecified “crimes and misdemeanors” related to coronavirus vaccines.
OK, I doubt that anyone believes that DeSantis knows or cares about the scientific evidence here. What he’s doing instead is catering to a Republican base that equates listening to experts, on public health or anything else, with “wokeness,” and demonizes anyone saying things it doesn’t want to hear.
As far as I can tell, DeSantis hasn’t joined the likes of Elon Musk in calling for the prosecution of Anthony Fauci, who led America’s Covid response. But he has called Fauci a “little elf” and said that we should “chuck him across the Potomac.” (Presidential!)
Now, will DeSantis’s attempt to position himself as the leader of the anti-vax movement and give at least tacit approval to conspiracy theories actually endear him to the Republican base? Again, I don’t know. Even if it does, I suspect that it will hurt him in the general election if he does become the nominee: Vaccine paranoia and Fauci hatred are still niche positions in the electorate at large.
But anyone who imagines that replacing Trump with DeSantis as the G.O.P.’s leader would signal a party on its way to becoming sane again is in for a rude shock.
https://www.nytimes.com/2022/12/15/opin ... ction.html
Re: America's vaccine failure
WAPO Dec. 19:
Coronavirus booster shots reduced by at least 50 percent the likelihood of ending up in an emergency room or being hospitalized, according to data released Friday by the Centers for Disease Control and Prevention.
Despite these promising numbers, vaccine uptake has been slim. Only 14 percent of eligible Americans ages 5 and older have received the omicron-specific booster, according to Washington Post reporter Lena H. Sun.
Omicron is the dominant coronavirus variant, and public health officials worry the low vaccination numbers will contribute to a covid-19 surge during the holidays.
“Covid-19 cases are averaging above 66,000 per day for the first time since mid-September, and deaths are averaging about 400 per day for the past seven days, according to the CDC,” Sun writes. “More than 40,000 patients are hospitalized with covid, with more than 9,000 patients admitted with covid each day, according to federal health data.”
--------------
Web MD Dec.16:
Alarming subvariants and clueless Americans
https://www.webmd.com/covid/news/202212 ... wj96i5U%3D
Coronavirus booster shots reduced by at least 50 percent the likelihood of ending up in an emergency room or being hospitalized, according to data released Friday by the Centers for Disease Control and Prevention.
Despite these promising numbers, vaccine uptake has been slim. Only 14 percent of eligible Americans ages 5 and older have received the omicron-specific booster, according to Washington Post reporter Lena H. Sun.
Omicron is the dominant coronavirus variant, and public health officials worry the low vaccination numbers will contribute to a covid-19 surge during the holidays.
“Covid-19 cases are averaging above 66,000 per day for the first time since mid-September, and deaths are averaging about 400 per day for the past seven days, according to the CDC,” Sun writes. “More than 40,000 patients are hospitalized with covid, with more than 9,000 patients admitted with covid each day, according to federal health data.”
--------------
Web MD Dec.16:
Alarming subvariants and clueless Americans
https://www.webmd.com/covid/news/202212 ... wj96i5U%3D
Re: America's vaccine failure
U.S. Vaccine Program Now Flush With Cash, but Short on Key Details
A $5 billion federal program aims to make better Covid vaccines. But vaccine makers are confused by murky regulatory guidance.
By Benjamin Mueller, Noah Weiland and Carl Zimmer
June 26, 2023
Efforts to develop the next generation of Covid vaccines are running up against bureaucratic hassles and regulatory uncertainty, scientists say, obstacles that could make it harder to curb the spread of the coronavirus and arm the United States against future pandemics.
The Biden administration, after months of delay, has now addressed at least a shortfall in funding, hurrying to issue the first major grants from a $5 billion program to expedite a new class of more potent and durable inoculations.
But the program is facing the blunt reality that vaccine development, after being shifted into high gear early in the pandemic, has returned to its slower and more customary pace.
Experiments on a promising nasal vaccine licensed from Yale University have slowed as researchers have tried for nearly a year to obtain older shots from Pfizer-BioNTech and Moderna to use in the studies. The federal government’s original purchase agreements for those shots prevent doses from being used for research purposes without the companies’ approval, despite tens of millions of unused shots being wasted in recent months.
In Pennsylvania, a company developing an inhaled vaccine related to one already in wide use in India said that it tried in vain to get clarity about whether it was eligible for American government funding. The vaccine, the company said, may not have gone through advanced enough testing to qualify for the new pot of U.S. funding.
And in academic laboratories and start-up offices across the country, vaccine makers have been left in the dark about whether clinical trials that the Biden administration funds will be large and sophisticated enough to win over regulators who are still ironing out what they will require for clearance.
Federal officials, some of whom have become concerned about the leadership of the next-generation vaccine program, acknowledged that key questions remain about how the program will operate and how quickly it can deliver. Although some Biden administration officials hope to roll out new vaccine technology by fall 2024, many scientists believe doses are at least several years away.
“There’s not the money, there’s not the infrastructure, there’s not the support,” John Moore, a virologist at Weill Cornell Medicine, said of the push for improved vaccines. “So I’m not expecting any next-generation major things in the near future.”
The Pfizer and Moderna vaccines robustly prevent severe disease. But they have failed to stop variants like Omicron from circulating, which has kept more Americans than usual out of work and sickened some with long Covid. And they have not extinguished the danger for some vaccinated Americans, especially older people. Hundreds nationally are dying from Covid each week.
While vaccine technology from 2020 dominates the American market, large nations like India and China have rolled out newer inoculations. If those vaccines perform better, they could fortify the United States against deadly future waves, much as a second generation of polio shots decades ago helped eliminate that disease from the country.
But newer Covid vaccines, which rely on less certain technology, are no sure thing. Some are sprayed into the nose or mouth to arouse immune defenses where the virus first gains entry, possibly preventing people from becoming infected. Others are designed to protect against not only variants of this virus, but also other types of coronaviruses, making them a crucial tool in a future pandemic.
With large pharmaceutical companies mostly sitting on the sidelines and private investors wary of the market for next-generation vaccines, small biotechnology companies have struggled to advance inoculations through the arduous and expensive clinical testing process.
“Covid is still around, and the scientist part of me is thinking this is important and we should do it,” said Biao He, the chief executive of CyanVac, referring to the company’s nasal Covid vaccine, one of the few to have completed enough advanced testing to qualify for extensive government funding. But when he meets with investors about his company’s various products, he said, “The capitalist part of me is saying, ‘Maybe we shouldn’t mention it.’”
Given the difficulties, vaccine makers have hurried to line up for the new federal money: More than 70 companies responded to the government’s recent call for applicants, a Department of Health and Human Services spokesman said.
Federal health officials aim to finalize a handful of vaccine-related awards this summer and a dozen or more by early 2024, one official said.
But key features of the initiative known as Project NextGen, including who will run it, have created divisions within the administration.
White House officials, hoping for a leader in the mold of the former pharmaceutical executive who oversaw a 2020 program to accelerate vaccine development, vetted candidates from outside the government and identified three finalists: Dr. Larry Corey, an immunologist at the Fred Hutchinson Cancer Center; Dr. Michelle McMurry-Heath, the former chief executive of the Biotechnology Innovation Organization; and Dr. David A. Kessler, the former chief science officer for the Biden administration’s Covid response, according to people familiar with the search.
But the health department has resisted an outside hire. “H.H.S. is the one that has to execute and deliver,” Xavier Becerra, the agency’s director, said this month at a Politico event. Some senior federal officials are concerned about whether the agency can operate with enough urgency, two federal officials said.
Dawn O’Connell, the health department’s assistant secretary for preparedness and response, defended plans to run the program internally through a health agency known as the Biomedical Advanced Research and Development Authority, or BARDA. “We have the expertise within BARDA to move these products toward the finish line,” she said.
Scientists and health officials acknowledge that Project NextGen will struggle to measure up to its 2020 predecessor, Operation Warp Speed. That $18 billion federal effort, coming amid an onslaught of Covid deaths, hastened vaccine development by helping companies simultaneously test and manufacture shots. It also cleared regulatory hurdles and ensured the government bought the resulting vaccines.
Project NextGen, conceived with Covid deaths at their lowest level, has neither Warp Speed’s vast money nor the mandate to purchase shots in bulk.
Still, some experts have questioned whether the new initiative draws on valuable lessons from Warp Speed.
Dr. Corey, for example, noted that the 2020 program gave upstart vaccine makers access to a government-funded network of academic medical centers with experience testing H.I.V. vaccines, which helped recruit a more diverse group of tens of thousands of volunteers.
But that expertise will not be available for next-generation inoculations. Instead, vaccine makers will have to pay private companies to run their trials.
“The devil is in the details,” said Dr. Corey, who directs the clinical trial network. “To pull it off, the H.I.V. infrastructure we created and used in Warp Speed, and the trials I planned and conducted — they need to be brought back into the system.”
Last month, the Biden administration asked vaccine makers to propose 10,000-person trials that would compare new inoculations with currently available booster shots. If the new vaccines are effective, they could attract the private funding necessary for additional testing and manufacturing.
With strong results from that type of trial, “the calculus changes for you and your program,” said Marty Moore, the chief scientific officer of Meissa Vaccines, whose nasal spray is a likely candidate for federal funding.
Still, it is not clear how these proposed trials align with what the Food and Drug Administration might require to authorize new vaccines.
The agency relied on larger trials to clear the first coronavirus shots in 2020. In early conversations about NextGen with the Biden administration, regulators suggested that they may look for a similar level of data from the newer vaccines, two federal health officials said. But details of their position are still being worked out, and regulators are considering approaching candidates in the program on a case-by-case basis, one health official said.
Regulators plan to publish guidance on their standards in the coming months, officials said. “The agency is committed to remaining flexible in its approach to the data,” said Michael Felberbaum, an F.D.A. spokesman.
Regulatory uncertainty has hampered next-generation vaccines for years, said Neil King, a University of Washington biochemist. To protect against new variants, or even other coronaviruses, his team updated its earlier Covid vaccine, which is authorized in South Korea and Britain.
But despite having repeatedly asked the government for guidance, he said, he has not received answers about what U.S. regulators will seek from advanced studies of the new vaccine.
“Everyone is clamoring for clarity,” he said.
The difference between requiring smaller or larger studies could add up to hundreds of millions of dollars, said Dr. Bruce Turner, chief executive of Xanadu Bio, which is developing Yale’s nasal vaccine.
“For a small company,” he said, “it’s really life and death.”
The bulk of NextGen funding is available only to researchers whose vaccines have data from Phase 1 trials and will be ready for advanced studies within six months — a hurdle that many groups have not cleared. The program will also fund earlier-stage trials at the National Institutes of Health to compare less-tested vaccines and figure out how to measure immune responses, said Dr. John Beigel, an N.I.H. associate director for clinical research.
But companies with early-stage vaccines expressed confusion about whether they qualify.
“A lot of companies won’t even be eligible,” said Shankar Musunuri, the chief executive of Ocugen, the Pennsylvania company with the inhaled vaccine. “They could have had a more structured approach to this.”
Bureaucratic problems have tripped up vaccine developers such as Xanadu Bio, which cannot use Pfizer or Moderna vaccines for its experiments. The restriction stems from a provision in the federal purchase agreements that is generally meant to protect companies from the risk of a poorly run experiment hurting their product, though it can also help insulate firms from unflattering results.
Health officials said that companies could obtain those doses once the shots become available on the commercial market, a change not expected until late summer or fall.
https://www.nytimes.com/2023/06/26/heal ... ion=Health
A $5 billion federal program aims to make better Covid vaccines. But vaccine makers are confused by murky regulatory guidance.
By Benjamin Mueller, Noah Weiland and Carl Zimmer
June 26, 2023
Efforts to develop the next generation of Covid vaccines are running up against bureaucratic hassles and regulatory uncertainty, scientists say, obstacles that could make it harder to curb the spread of the coronavirus and arm the United States against future pandemics.
The Biden administration, after months of delay, has now addressed at least a shortfall in funding, hurrying to issue the first major grants from a $5 billion program to expedite a new class of more potent and durable inoculations.
But the program is facing the blunt reality that vaccine development, after being shifted into high gear early in the pandemic, has returned to its slower and more customary pace.
Experiments on a promising nasal vaccine licensed from Yale University have slowed as researchers have tried for nearly a year to obtain older shots from Pfizer-BioNTech and Moderna to use in the studies. The federal government’s original purchase agreements for those shots prevent doses from being used for research purposes without the companies’ approval, despite tens of millions of unused shots being wasted in recent months.
In Pennsylvania, a company developing an inhaled vaccine related to one already in wide use in India said that it tried in vain to get clarity about whether it was eligible for American government funding. The vaccine, the company said, may not have gone through advanced enough testing to qualify for the new pot of U.S. funding.
And in academic laboratories and start-up offices across the country, vaccine makers have been left in the dark about whether clinical trials that the Biden administration funds will be large and sophisticated enough to win over regulators who are still ironing out what they will require for clearance.
Federal officials, some of whom have become concerned about the leadership of the next-generation vaccine program, acknowledged that key questions remain about how the program will operate and how quickly it can deliver. Although some Biden administration officials hope to roll out new vaccine technology by fall 2024, many scientists believe doses are at least several years away.
“There’s not the money, there’s not the infrastructure, there’s not the support,” John Moore, a virologist at Weill Cornell Medicine, said of the push for improved vaccines. “So I’m not expecting any next-generation major things in the near future.”
The Pfizer and Moderna vaccines robustly prevent severe disease. But they have failed to stop variants like Omicron from circulating, which has kept more Americans than usual out of work and sickened some with long Covid. And they have not extinguished the danger for some vaccinated Americans, especially older people. Hundreds nationally are dying from Covid each week.
While vaccine technology from 2020 dominates the American market, large nations like India and China have rolled out newer inoculations. If those vaccines perform better, they could fortify the United States against deadly future waves, much as a second generation of polio shots decades ago helped eliminate that disease from the country.
But newer Covid vaccines, which rely on less certain technology, are no sure thing. Some are sprayed into the nose or mouth to arouse immune defenses where the virus first gains entry, possibly preventing people from becoming infected. Others are designed to protect against not only variants of this virus, but also other types of coronaviruses, making them a crucial tool in a future pandemic.
With large pharmaceutical companies mostly sitting on the sidelines and private investors wary of the market for next-generation vaccines, small biotechnology companies have struggled to advance inoculations through the arduous and expensive clinical testing process.
“Covid is still around, and the scientist part of me is thinking this is important and we should do it,” said Biao He, the chief executive of CyanVac, referring to the company’s nasal Covid vaccine, one of the few to have completed enough advanced testing to qualify for extensive government funding. But when he meets with investors about his company’s various products, he said, “The capitalist part of me is saying, ‘Maybe we shouldn’t mention it.’”
Given the difficulties, vaccine makers have hurried to line up for the new federal money: More than 70 companies responded to the government’s recent call for applicants, a Department of Health and Human Services spokesman said.
Federal health officials aim to finalize a handful of vaccine-related awards this summer and a dozen or more by early 2024, one official said.
But key features of the initiative known as Project NextGen, including who will run it, have created divisions within the administration.
White House officials, hoping for a leader in the mold of the former pharmaceutical executive who oversaw a 2020 program to accelerate vaccine development, vetted candidates from outside the government and identified three finalists: Dr. Larry Corey, an immunologist at the Fred Hutchinson Cancer Center; Dr. Michelle McMurry-Heath, the former chief executive of the Biotechnology Innovation Organization; and Dr. David A. Kessler, the former chief science officer for the Biden administration’s Covid response, according to people familiar with the search.
But the health department has resisted an outside hire. “H.H.S. is the one that has to execute and deliver,” Xavier Becerra, the agency’s director, said this month at a Politico event. Some senior federal officials are concerned about whether the agency can operate with enough urgency, two federal officials said.
Dawn O’Connell, the health department’s assistant secretary for preparedness and response, defended plans to run the program internally through a health agency known as the Biomedical Advanced Research and Development Authority, or BARDA. “We have the expertise within BARDA to move these products toward the finish line,” she said.
Scientists and health officials acknowledge that Project NextGen will struggle to measure up to its 2020 predecessor, Operation Warp Speed. That $18 billion federal effort, coming amid an onslaught of Covid deaths, hastened vaccine development by helping companies simultaneously test and manufacture shots. It also cleared regulatory hurdles and ensured the government bought the resulting vaccines.
Project NextGen, conceived with Covid deaths at their lowest level, has neither Warp Speed’s vast money nor the mandate to purchase shots in bulk.
Still, some experts have questioned whether the new initiative draws on valuable lessons from Warp Speed.
Dr. Corey, for example, noted that the 2020 program gave upstart vaccine makers access to a government-funded network of academic medical centers with experience testing H.I.V. vaccines, which helped recruit a more diverse group of tens of thousands of volunteers.
But that expertise will not be available for next-generation inoculations. Instead, vaccine makers will have to pay private companies to run their trials.
“The devil is in the details,” said Dr. Corey, who directs the clinical trial network. “To pull it off, the H.I.V. infrastructure we created and used in Warp Speed, and the trials I planned and conducted — they need to be brought back into the system.”
Last month, the Biden administration asked vaccine makers to propose 10,000-person trials that would compare new inoculations with currently available booster shots. If the new vaccines are effective, they could attract the private funding necessary for additional testing and manufacturing.
With strong results from that type of trial, “the calculus changes for you and your program,” said Marty Moore, the chief scientific officer of Meissa Vaccines, whose nasal spray is a likely candidate for federal funding.
Still, it is not clear how these proposed trials align with what the Food and Drug Administration might require to authorize new vaccines.
The agency relied on larger trials to clear the first coronavirus shots in 2020. In early conversations about NextGen with the Biden administration, regulators suggested that they may look for a similar level of data from the newer vaccines, two federal health officials said. But details of their position are still being worked out, and regulators are considering approaching candidates in the program on a case-by-case basis, one health official said.
Regulators plan to publish guidance on their standards in the coming months, officials said. “The agency is committed to remaining flexible in its approach to the data,” said Michael Felberbaum, an F.D.A. spokesman.
Regulatory uncertainty has hampered next-generation vaccines for years, said Neil King, a University of Washington biochemist. To protect against new variants, or even other coronaviruses, his team updated its earlier Covid vaccine, which is authorized in South Korea and Britain.
But despite having repeatedly asked the government for guidance, he said, he has not received answers about what U.S. regulators will seek from advanced studies of the new vaccine.
“Everyone is clamoring for clarity,” he said.
The difference between requiring smaller or larger studies could add up to hundreds of millions of dollars, said Dr. Bruce Turner, chief executive of Xanadu Bio, which is developing Yale’s nasal vaccine.
“For a small company,” he said, “it’s really life and death.”
The bulk of NextGen funding is available only to researchers whose vaccines have data from Phase 1 trials and will be ready for advanced studies within six months — a hurdle that many groups have not cleared. The program will also fund earlier-stage trials at the National Institutes of Health to compare less-tested vaccines and figure out how to measure immune responses, said Dr. John Beigel, an N.I.H. associate director for clinical research.
But companies with early-stage vaccines expressed confusion about whether they qualify.
“A lot of companies won’t even be eligible,” said Shankar Musunuri, the chief executive of Ocugen, the Pennsylvania company with the inhaled vaccine. “They could have had a more structured approach to this.”
Bureaucratic problems have tripped up vaccine developers such as Xanadu Bio, which cannot use Pfizer or Moderna vaccines for its experiments. The restriction stems from a provision in the federal purchase agreements that is generally meant to protect companies from the risk of a poorly run experiment hurting their product, though it can also help insulate firms from unflattering results.
Health officials said that companies could obtain those doses once the shots become available on the commercial market, a change not expected until late summer or fall.
https://www.nytimes.com/2023/06/26/heal ... ion=Health
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