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After weeks of stagnation, the United States vaccination campaign has had a relatively successful month, with vaccine uptake rising from early-summer lows in every state in the country.
The upswing in vaccinations has come alongside an extended, and much more pronounced, increase in coronavirus cases, hospitalizations and deaths in the United States over the past two months. Public health officials say that in their communities, residents have been driven to get the vaccine by worries that the more-transmissible Delta variant might make them, or their loved ones, sick.
The reason why weve seen the marked increase in demand is fear, its the Delta variant, said Robert Ator, the retired National Guard colonel who runs Arkansas vaccination effort.
The increase in vaccinations has been especially pronounced in states where immunization levels were (and remain) below the national average of 61 percent. Many of those states have felt the effects of the Delta-led fourth wave most acutely.
Percent of total population vaccinated by Aug. 21
Pct. point increase in people vaccinated
+4+5+6+7+8+9+10+11+12
Public health officials said that some areas with lower vaccine coverage, especially rural ones, just hadnt been severely affected by the virus until the Delta surge.
Some communities are seeing Covid close up now, said Dr. Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services. Theyve seen it on the news, but thats not the same as seeing it close up.
That proximity is driving behavior change across the country.
The virus is coming to visit these communities and they are starting to feel the pinch, said Colonel Ator. When they start seeing their friends and families being affected by this, then it becomes a reality.
States that have seen larger increases in new cases since their early-summer nadirs, such as Alabama, Georgia and Mississippi, tend to be those with bigger increases in new vaccinations.
0 +1,000% +2,000% +3,000% Increase in weekly new cases50%0+100%+200%Decrease in vaccinationsIncrease in vaccinations
Wash.Ill.Calif.Ariz.Mass.Wis.TexasNeb.UtahOre.Fla.N.Y.R.I.Ga.N.H.N.C.N.J.Colo.Md.Nev.Tenn.HawaiiInd.Ky.Minn.Okla.Pa.S.C.D.C.Kan.Mo.Vt.Va.Conn.IowaLa.OhioMich.S.D.Ark.Del.Miss.N.M.N.D.Wyo.AlaskaMaineAla.IdahoMont.W.Va.
Note: Not all states had hit their lowest weekly vaccinations in early June, when Delta was on the verge of becoming dominant, and some only had mild growth in late July and August. As a result, these states may show a decrease in vaccinations in this analysis.
Some of the recent rise in immunizations is due to teens and tweens who are heading back to school, but the bulk of the increase is from working-age Americans, public health officials say and data from the Centers for Disease Control and Prevention confirms.
And while new vaccinations may be flattening now overall in the U.S., health officials do not expect them to return to previous lows any time soon, especially after the Food and Drug Administration granted full approval to the Pfizer vaccine on Monday. That move is likely to spur new vaccinations, in ways both direct 31 percent of unvaccinated people surveyed in a June poll by the Kaiser Family Foundation indicated they would be more open to getting the jab once a vaccine was fully approved and indirect, as it sets the stage for new vaccine requirements by organizations including corporations, hospitals and colleges.
While the uptick in new vaccinations first doses has been the subject of particular interest, total vaccine doses, comprising first and second jabs, have been on the rise as well. They will likely continue to increase as third doses complicate the picture.
The F.D.A. this month opened eligibility for third shots for some people with weakened immune systems. And last week, the Biden administration strongly recommended that Americans who received the Pfizer-BioNTech or Moderna coronavirus vaccines get a booster shot eight months after their second vaccine dose. If the F.D.A. approves that recommendation, boosters will be available starting in late September.
However, there is evidence that about 1.2 million people in the U.S. may have already received unauthorized additional doses before these announcements were made, according to the C.D.C.
MississippiMiss.
+2,611%926 25,102
+227%16,453 53,746
+1134 45
LouisianaLa.
+1,381%2,373 35,139
+183%26,277 74,337
+1236 48
ArkansasArk.
+930%1,528 15,737
+159%15,174 39,324
+1240 52
AlabamaAla.
+1,732%1,738 31,845
+142%33,241 80,455
+1236 48
TennesseeTenn.
+1,163%2,765 34,921
+139%31,593 75,428
+840 48
GeorgiaGa.
+1,780%2,829 53,172
+139%79,530 189,795
+941 50
OklahomaOkla.
+1,746%842 15,542
+130%19,578 45,000
+1042 52
UtahUtah
+274%1,946 7,273
+129%20,193 46,297
+946 55
North CarolinaN.C.
+1,103%3,128 37,621
+128%45,733 104,335
+1044 54
WyomingWyo.
+388%492 2,399
+86%3,584 6,661
+638 44
South CarolinaS.C.
+2,858%857 25,346
+85%32,157 59,397
+941 50
IdahoIdaho
+576%723 4,887
+57%8,760 13,783
+538 43
KentuckyKy.
+1,326%1,582 22,554
+44%39,784 57,269
+947 56
North DakotaN.D.
+491%248 1,465
+39%3,449 4,797
+443 47
Rhode IslandR.I.
+860%221 2,121
+33%8,689 11,552
+862 70
New MexicoN.M.
+814%572 5,227
+32%17,500 23,072
+1058 68
IowaIowa
+945%569 5,944
+25%16,726 20,951
+550 55
KansasKan.
+970%761 8,141
+20%20,677 24,888
+947 56
FloridaFla.
+1,325%11,454 163,197
+19%242,288 287,284
+1250 62
MinnesotaMinn.
+634%1,186 8,705
+10%36,416 39,900
+655 61
When Covid-19 vaccines were reported last fall to be roughly 95% effective at preventing symptomatic Covid-19 infections, the world rejoiced and even veteran scientists were blown away. Very few vaccines are that protective. Those made to fend off viruses like SARS-CoV-2 viruses that invade the nose and throat, like flu typically arent at the high end of the efficacy scale.
That was the good news. Now, however, our soaring expectations for Covid-19 vaccines are in the process of sinking back to earth.
With the more transmissible Delta variant of SARS-2 circulating, it is increasingly apparent that, even if mRNA vaccines like Pfizers and Modernas offer impressive protection against severe Covid infections, they arent going to prevent infections in the upper respiratory tract of some proportion of vaccinated people.
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The vaccines are wondrous weapons, but they arent impenetrable armor.
We all wish that that this would be gone. That we would get a vaccine and we would control it, Kathryn Edwards, a vaccine expert at Vanderbilt University, told STAT. But I think that looking back, probably that wasnt always realistic.
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There are still open questions about exactly how much less protection mRNA vaccines may be providing. Evidence of the downward creep of their efficacy is based in part on as-yet-unpublished data from Israel, one of the first countries to vaccinate a high percentage of its elderly.
Ran Balicer, director of Israels Clalit Research Institute and one of the scientists involved in this research, said the group has seen a decline in vaccine effectiveness since the Delta variant started to take off in the country. But figuring out what is behind that waning immunity? Deltas increased transmissibility? The advanced age of the Israelis who were first vaccinated? A combination of those factors? is very challenging, he said.
Balicer said he and his team were acutely aware of various types of confounding [factors] and the difficulty of finding a good way to compare data on the vaccinated and unvaccinated in a way that allows for a methodologically sound study to be run. It is, he said, why it is taking us more time than usual to release our assessments and publications.
Theres another factor that complicates researchers ability to figure out whats behind the data in Israel and how much it can tell other countries about the mRNA vaccines as a class. Israel used Pfizer vaccine exclusively; its findings may not apply to the Moderna jab.
Israeli data can only give hints regarding Pfizer vaccines. Everything else needs to be inferences from other countries, Balicer said.
For Michael Osterholm, the jury is still out on what is behind the increase in cases among vaccinated people, and how big a threat it poses.
It all comes down to: Is it waning immunity against severe illness, hospitalization, and deaths, or is it waning against mild illness? And I dont think weve answered that yet, said Osterholm, who is director of the University of Minnesotas Center for Infectious Disease Research and Policy. Now I think its the right question to pose. The challenge is we just dont have an answer to that yet.
Though the Israeli data havent yet been published, top-line findings have been made available. Based on them and on some preliminary U.S. data, the Biden administrations public health leaders announced last week that Americans would be offered a third dose of the mRNA vaccines starting the week of Sept. 20, because the breakthrough infections may presage a decline in efficacy against severe disease. A third shot of mRNA vaccine should follow eight months after the second, they said.
We are concerned that the current strong protection against severe infection, hospitalization, and death could decrease in the months ahead, especially among those who are at higher risk, or who were vaccinated earlier during the phases of our vaccination rollout, Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in explaining the decision.
A critic of the booster decision, Anna Durbin, believes the high bar set by the results of the Phase 3 clinical trials of the Pfizer and Moderna vaccines is now negatively impacting U.S. vaccination policy.
I think these vaccines are a victim of their own success, said Durbin, a vaccine researcher in Johns Hopkins Bloomberg School of Public Health. Now we expect perfection. And if its less than perfect, we want a booster.
Some scientists have noted that a year ago when the Phase 3 trials for these vaccines were first underway, the world would have been ecstatic at the prospect of vaccines that prevented severe Covid infections in most vaccinated people. But vaccine efficacy estimates in the 90% range against even mild infections reset what we thought these vaccines would be able to do for us.
Vincent Munster, chief of the virus ecology section at the National Institute of Allergy and Infectious Diseases Rocky Mountain Laboratories in Montana, also thinks our expectations may be unrealistic.
He and his team tested some Covid vaccines in the early stages of development, before human trials were conducted. In animals, the vaccines did not block infection in the upper airways, but did protect the lungs. If the animal work is predictive of what happens in humans, it would mean vaccinated people could catch colds or experience flu-like symptoms if they contract SARS-2, but would not in most cases develop severe or life-threatening illness.
We were making a vaccine against the severe Covid and, all of a sudden, all these expectations of transmission-blocking were piled up on these vaccines, he said.
Case in point: In announcing the decision to offer third shots, Walensky cited a study from New York state that showed the mRNA vaccines efficacy against any infection had declined to 79.8%. But that same study showed protection against serious illness was still above 90%. For many experts, it was evidence not of a problem, but of a success.
There were also questions about drawing too many conclusions based on the study. Even the authors cautioned that waning protection might not be the whole story. People were more afraid of Covid in the summer and fall of 2020, and many were more rigid about following social distancing measures.
Variations from clinical trial findings could be because the trials were conducted during a period before the emergence of new variants and when non-pharmaceutical intervention strategies (e.g., wearing masks and physically distancing) were more stringently implemented, potentially lessening the amount of virus to which persons were exposed, they wrote.
Munster, Durbin, and many other experts insist that the vaccines are still standing up as well as they can in the face of a daunting challenge. With vaccination rates in a number of states still far too low, the amount of SARS-2 circulating is dismayingly high at this point, more than a year-and-a-half into the pandemic in the United States. The way to make progress in the fight is to get more people vaccinated both here and abroad to cut transmission and the risk of new variants emerging, they insist.
Giving a booster to vaccinated people is not going to control Delta. Whats going to control Delta is vaccinating unvaccinated people, Durbin said. That is the bottom line.
Edwards, from Vanderbilt, thinks were going to have to curb our expectations, warning that as time goes on, there will likely be vaccinated people who arent immunocompromised who will get severely ill and some will die.
I dont think its going to be a lot, but I think it will be there and I think that will make us all very uncomfortable, she said. I think that we have to be realistic about what we can expect.
Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news.
At least 89 Texas hospitals were out of ICU beds last week. The state is close to breaking its record number of COVID-19 hospitalizations. And just 46% of Texans are fully vaccinated against COVID-19, while about 8 million eligible Texans havent gotten a single dose.
By some measures, this wave of COVID-19 cases and hospitalizations could be the worst yet in Texas. Which is why The Texas Tribune is using its texting service to help keep Texas residents informed of the latest COVID-19 news and trends. To sign up, text hello to 512-967-6919, visit this page or enter your details below.
Heres what you can expect: crucial news about mask mandates, vaccine boosters and more to keep you informed and safe as hospitalizations surge across the state.
We are using a service called Subtext to help us make this happen for our audiences. You can read more about Subtext here. It does not sell user data or phone numbers to advertisers or other third parties.
This is the same service we used in February when a winter storm knocked out much of the states power grid and left millions without heat and water. Our readers told us they appreciated our updates over text then, and weve received positive feedback so far about our COVID-19 updates. We dont know right now what this service will always look like moving forward but we would love our audiences input. You can email us your feedback at community@texastribune.org. Or you can just text it to us now.
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Typically, the US Centers for Disease Control and Prevention suggests people get a flu shot by the end of October.
But the coming flu season may be a bad one. With Covid-19 still complicating things, the experts say you may want to do it even earlier.
"Years ago, we would say you should wait as long as you can to get a shot, but if you get it in the fall, that really should cover you through the season," said Dr. Claudia Hoyen, director of pediatric infection control at UH Rainbow Babies and Children's Hospital in Cleveland. "If people get the chance to go ahead and get their flu shot, whenever they can do it is probably good."
Based on the number of viruses she's seen hitting people early this year, she thinks it doesn't bode well for the flu season. Hoyen's children's hospital has been much busier this summer compared to last, treating children for a bigger mix of viruses.
"Once we all took our masks off, the viruses did what they do best and found lots of people to give runny noses to," Hoyen said.
What the flu season will look like this year
To predict what kind of flu numbers the US should expect, experts often look to the Southern hemisphere, where flu season usually starts in June and peaks in August.
"The story is mixed so far," said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center.
Australia, with its tight pandemic restrictions on travelers coming into the country, has had very low flu activity, Schaffner said.
"But China, which has more interactions with the outer world, has had a moderate flu season," Schaffner said.
"So we think we'll have at least a moderate season this year."
Children the 'distribution franchise' for flu
Typically what kicks off the flu season is the start of the school year. With more kids going back to the classroom than last year, unless kids are wearing masks, and everyone else for that matter, there will likely be more cases, he said.
"Children are the 'distribution franchise' for the influenza virus. They're on top of each other and they are not the most hygienic little lovelies, so they spread the flu virus amongst themselves," said Schaffner.
"When kids get infected, they shed the virus for a longer period of time than adults do, so they're really the people who bring the virus into the family and spread it about to the neighbors and, well, everybody," Schaffner said.
Flu by the numbers
In an average season, the US sees between 9 and 45 million cases of the flu each year, according to the CDC.
Last year was no average season. Flu was practically non-existent in the US with only a few thousand cases for the entire year. One child died. For comparison, in 2019-2020, there were 199 flu-related deaths in children and 144 the season before that.
What's different this year
What may have helped are the extra precautions people took to stop the spread of Covid-19.
Masks, good hand hygiene, limited in-person school, restricted travel and less interaction with others can help prevent Covid-19 and the spread of the flu.
A person can get a flu shot and a Covid-19 vaccine at the same time, so if they haven't been vaccinated against Covid-19 yet, or they need a booster, there are no real medical reasons to space them apart from a flu shot, Schaffner said
"If it's your opportunity to get both, I would say get both," Schaffner said. Of course, children 11 and younger cannot be vaccinated against Covid-19 yet.
Flu shots are already available at pharmacies like CVS and Walgreen's.
An added motivation to get a flu shot
Getting vaccinated could certainly keep those numbers to a minimum and with Covid-19 in circulation, Hoyen said people have an added incentive to get a flu shot this year.
Kids under 12 still can't get a Covid-19 vaccine, and while the disease can be milder in the little ones, Hoyen said hospitals are seeing more children with Covid-19 and another virus.
"Even if we don't think these things are important for ourselves, we should really do them for a child in our lives so that they can get back to a little more normal," Hoyen said.
MADISON - A Wisconsinlawmaker who has been hospitalized with COVID-19 for at least a week is now breathing through a ventilator.
Republican Sen. Andre Jacque of De Pere was intubated Monday, according to two people with knowledge of his condition.
The treatment typically requires patients to be sedated to allow them to breathe using a ventilator. Itis typically considered a last-resort treatment but many patients recover, includinga 73-year-oldhigh-ranking Roman Catholic cardinal last week.
Jacque, 40, has been hospitalized with COVID-19-induced pneumoniafor at least a week after contracting COVID-19 earlier this month. Since then, two of his colleagues have asked the public for prayers.
In recent months, Jacque has been one of most outspoken lawmakers against COVID-19 vaccine mandates and has authored legislation that would bar government officials or business owners from requiring Wisconsinites be vaccinated against COVID-19 or show proof of vaccination to access services.
He also opposed the statewide mask mandate implemented by Gov. Tony Eversand joined legislation to end it.
Jacque told the Milwaukee Journal Sentinel last week that at the time hetested positive, which was around Aug. 13, he was largely asymptomatic and only felt fatigue. He did notsay whether he had been vaccinated against COVID-19.
Jacque's hospitalizationcame as Wisconsin is experiencing a new surge of COVID-19 cases driven by a new variant of the virus that is more transmissible. It's the first uptick of casessince vaccines became widely available in the state earlier this year.
You can find out who your legislators are and how to contact them here.
Contact Molly Beck and Patrick Marley at molly.beck@jrn.comand patrick.marley@jrn.com.
Our subscribers make this reporting possible. Please consider supporting local journalism by subscribing to the Journal Sentinel at jsonline.com/deal.
August 24, 2021
(Des Moines, IA) Polk County is back in a situation we hoped to never be in again. COVID-19 cases, hospitalizations and deaths are on the rise.
In late March of 2020, patients began to die of COVID-19 infections. The number of deaths continued to increase so drastically that by the winter of 2020 and into 2021 over 30 individuals were dying each week from COVID complications. Through the vaccine administration and COVID-19 prevention strategies, the number of deaths were driven down such that, beginning in March, there were zero weeks with above 10 COVID related fatalities. The numbers continued to fall as people continued to get vaccinated and by June through July less than five deaths were seen every week (many weeks with only one or two COVID-19 deaths).
Our months of incredibly hard work are quickly being undone, said Joshua Akers, Polk County Medical Examiner. The first full week of August we saw seven COVID-19 related deaths and the numbers are continuing to rise. What is also concerning is that we are beginning to see the average age of decedents getting younger.
Over the past three weeks, we have seen 175% increase in COVID-19 hospitalizations. Today, our hospitals have 109 COVID-19 patients. We have not seen a trend in COVID-19 hospitalizations like this since the last COVID-19 surge, which took place in October of 2020. Of the 109 COVID-19 patients, four of those are under the age of 18. While four may seem like a small number to most, this is the highest number of under 18 COVID-19 hospitalized patients we have ever seen throughout the pandemic. Polk County hospitals are operating at limited capacity. Currently, Blank Childrens Hospital has canceled elective surgeries and other metro hospitals are monitoring daily cases and canceling some elective surgeries.
Finally, our COVID-19 cases from the past weekend has increased 87% since the first weekend in August. During the month of July 2021, Polk County was averaging 31 COVID-19 cases a day. As of August 22, 2021, we are averaging 120 COVID-19 cases a day. We expect our COVID-19 cases in Polk County will continue to surge since school has started and individuals are not following COVID-19 prevention strategies, including wearing masks in public indoor settings.
Our hospitals are full. Our healthcare workers are tired. Parents and guardians are scared to send their children to schools, said Helen Eddy, Director of Polk County Health Department. We implore everyone to step up, once again, and do the right thing for the people you love and care about, for our community and for the 82,000 kids in Polk County who cannot be vaccinated.
The Health Department strongly encourages you to follow these tips:
For more information or to schedule a COVID-19 vaccine appointment, please visit www.polkcountyiowa.gov/health.
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Houston Matters begins at 9 a.m. CT on 88.7FM or listen online. Join the discussion at 713-440-8870, talk@houstonmatters.org or @HoustonMatters.
On Wednesdays Houston Matters: Harris County plans to spend $30 million to bring in hundreds of additional nurses to the Houston area to help the region's strained hospital system. We discuss that and other news related to COVID-19 with Doug Lawson, the CEO of St. Luke's Health.
Also this hour: We discuss the latest news in our weekly political roundup.
Then, we revisit a conversation from 2018 about how Southern Blacks fared here in Texas during Reconstruction and under Jim Crow.
And we learn how local concert venues and musicians are dealing with the COVID-19 surge while still performing.
Audio from todays show will be available after 11 a.m. CT. We also offer a free podcast here, on iTunes, Stitcher and other apps.
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The Alaska Department of Health and Social Services reports 20 new individuals in the Juneau community 18 residents and two nonresidents identified with COVID-19 for August 24. There are currently four people with COVID-19 hospitalized at Bartlett Regional Hospital.
The Juneau School District reports five individuals at Riverbend Elementary whove tested positive for COVID-19 and were infectious while in school three were reported late on August 23 and two were reported today. COVID-19 cases related to schools are posted on thedistrict websiteas they are reported (click on the green COVID-19 Cases block). These cases resulted in six classrooms being closed today to allow for contact tracing; four classrooms will reopen tomorrow and two classrooms are quarantined. Find more district related COVID-19 information atjuneauschools.org.
As CBJ reported yesterday, COVID-19 case count updates will be different. Due to the high rate of spread and infection in Alaska from the delta variant, the state Division of Public Health is strained and unable to provide detailed information to CBJ Emergency Operations Center about COVID-19 in Juneau, but Juneau Public Health was able to report generalized case trends for the past week:
Statewide, the Alaska Department of Health and Social Services reports593 new peopleidentified with COVID-19 562 are residents and 31 are nonresidents. The state is also reporting 13 deaths, bringing the total number of resident deaths to 419. Alaska has had 81,097 cumulative resident cases of COVID-19 and a total of 3,770 nonresidents.
Juneau vaccine update:
For more information, read CBJs Emergency Operations Center Reports here.
COLLIER COUNTY
A beloved school teacher in Southwest Florida, who was a dear wife and mother, has died.
The family of Jayla Smith, a Collier Charter Academy kindergarten teacher, confirmed Tuesday their wife and mother died of COVID-19 recently in the hospital.
Smith was admitted to the hospital to be treated for COVID-19 Aug. 4 and was then placed on a ventilator Aug. 14 before her death Aug. 20. Smith leaves behind her husband, Cory Smith, and their three sons.
Jayla and Cory Smith were meant to be together forever.
We grew up together, Cory said. We were in the same grade and from the same small town in southern Illinois.
The two recent celebrated their 21st wedding anniversary in June. They had their three boys together, combined with a lot of love.
I cant really think of anybody who didnt really love her to death, Cory said.
She would always tell me how much she loved all of us boys, all of her kids, son Hunter Smith said. She wouldve literally done anything for us.
Jayla would do anything for her family and anything for the students she taught at Collier Charter Academy.
They would literally hug on her and say how much they loved her and stuff like that, Cory said. And honestly, I dont really think thats the case with every teacher. I think she was actually something extra special.
We asked Cory if Jayla was vaccinated for COVID-19. He said he understands both sides as to why people get the shot or do not. He told us, as for sharing his wifes medical history, thats not something he wants to do.
Jayla had recently finished her teacher certification program. It arrived in the mail Monday, days after she died.
She was on a ventilator for almost a week at the end, so she couldnt communicate like during that time, but we still got to message back-and-forth a bit before that.
Its rough, Hunter said. Its something that Id always think about, you know, I just daydream about it, being able to tell my mom that showing her how I can be successful, and now, I mean Im not gonna be able to see that reaction from her.
