Facebook on Thursday said it would remove posts that contain claims about Covid-19 vaccines that have been debunked by public health experts, as the social network acts more aggressively to bat down coronavirus misinformation while falsehoods run rampant.
The move goes a step beyond how Facebook had handled misinformation about other kinds of vaccines. The company had previously made it more difficult to find vaccine misinformation that was not related to the coronavirus by downranking it, essentially making it less visible in peoples news feeds.
But Facebook said it planned to take down Covid-19 vaccine falsehoods entirely if the claims had been discredited or contradicted by health groups including the World Health Organization, the United States Food and Drug Administration and the Centers for Disease Control and Prevention.
This is another way that we are applying our policy to remove misinformation about the virus that could lead to imminent physical harm, the company said in a blog post. This could include false claims about the safety, efficacy, ingredients or side effects of the vaccines.
Facebook added that it would also take down false claims that Covid-19 vaccines contain microchips, or anything else that isnt on the official vaccine ingredient list.
The social network has long been hesitant to wade into the fraught space of determining what is true or false information on its platform. Mark Zuckerberg, Facebooks founder and chief executive, has made it clear he does not want to be the arbiter of truth of what is posted on the site.
But Mr. Zuckerberg has also taken an active role in combating the spread of coronavirus misinformation. Facebook has created new products and tools to inform the public about the potential dangers of the virus. Mr. Zuckerberg emailed Dr. Anthony Fauci, the top U.S. infection disease expert, as early as March to offer his help in fighting the virus. Dr. Fauci has since appeared on multiple live-streamed interviews on Facebook with Mr. Zuckerberg.
Because of the novelty of Covid-19 vaccines, not all false claims may be taken down immediately, Facebook said. The social network said it also plans to continue sending people to its Covid-19 Information Center, which contains verified and up-to-date information about the virus.
Facebooks decision to remove vaccine-related misinformation is not without precedent. The company previously removed misinformation about the polio vaccine in Pakistan, as well as misinformation on the measles vaccine in Samoa during outbreaks of the illnesses.
Facebook on Thursday said it would remove posts that contain claims about Covid-19 vaccines that have been debunked by public health experts, as the social network acts more aggressively to bat down coronavirus misinformation while falsehoods run rampant.
The move goes a step beyond how Facebook had handled misinformation about other kinds of vaccines. The company had previously made it more difficult to find vaccine misinformation that was not related to the coronavirus by downranking it, essentially making it less visible in peoples news feeds.
But Facebook said it planned to take down Covid-19 vaccine falsehoods entirely if the claims had been discredited or contradicted by health groups including the World Health Organization, the United States Food and Drug Administration and the Centers for Disease Control and Prevention.
This is another way that we are applying our policy to remove misinformation about the virus that could lead to imminent physical harm, the company said in a blog post. This could include false claims about the safety, efficacy, ingredients or side effects of the vaccines.
Facebook added that it would also take down false claims that Covid-19 vaccines contain microchips, or anything else that isnt on the official vaccine ingredient list.
The social network has long been hesitant to wade into the fraught space of determining what is true or false information on its platform. Mark Zuckerberg, Facebooks founder and chief executive, has made it clear he does not want to be the arbiter of truth of what is posted on the site.
But Mr. Zuckerberg has also taken an active role in combating the spread of coronavirus misinformation. Facebook has created new products and tools to inform the public about the potential dangers of the virus. Mr. Zuckerberg emailed Dr. Anthony Fauci, the top U.S. infection disease expert, as early as March to offer his help in fighting the virus. Dr. Fauci has since appeared on multiple live-streamed interviews on Facebook with Mr. Zuckerberg.
Because of the novelty of Covid-19 vaccines, not all false claims may be taken down immediately, Facebook said. The social network said it also plans to continue sending people to its Covid-19 Information Center, which contains verified and up-to-date information about the virus.
Facebooks decision to remove vaccine-related misinformation is not without precedent. The company previously removed misinformation about the polio vaccine in Pakistan, as well as misinformation on the measles vaccine in Samoa during outbreaks of the illnesses.
LONDON Britain gave emergency authorization on Wednesday to Pfizers coronavirus vaccine, leaping ahead of the United States to become the first Western country to allow mass inoculations against a disease that has killed more than 1.4 million people worldwide.
The decision cleared the way for a vaccination campaign with little precedent in modern medicine, encompassing not only ultracold dry ice but also a crusade against anti-vaccine misinformation.
Britains beating the United States to authorization on a vaccine codeveloped by an American company, no less intensified pressure on U.S. regulators, who are under fire from the White House for not moving faster to get doses to people. But it also fueled concerns that Britain was acting in haste for political reasons or trying to muscle its way to the front of the line for deliveries.
European regulators on Wednesday cast doubt on the rigor of Britains review and said that the authorization was limited to specific batches of the vaccine, a claim that Pfizer denied and British officials did not address.
Britains move provoked a spirited debate among American scientists about whether U.S. regulators, who are known to be unusually meticulous, could afford to hold off any longer on authorizing a vaccine against a virus that is claiming more than 10,000 lives a day worldwide.
American regulators have argued that they lag behind if only by a matter of days because they are virtually alone in reanalyzing thousands of pages of raw data from vaccine trials before approval. Backers of that approach say it is the only way to minimize unintended damage, in lives and in public trust, from vaccines not working.
British and European regulators lean more heavily on the companies own analyses, auditing their figures occasionally but otherwise grounding their decisions on vaccine makers reports. While the more cautious American approach can be valuable, some scientists said the Europeans subject vaccine makers to considerable scrutiny, and it is imperative to move quickly to curb the suffering wrought by the pandemic.
When you say its OK to wait another week or two, youre saying its OK that many thousands of people are going to die, said Dr. Walid F. Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.
No country until Wednesday had authorized a fully tested coronavirus vaccine; Russia and China approved vaccines without waiting for large-scale efficacy tests.
The British government, battered by its handling of the pandemic, exulted in the authorization.
Help is on its way with this vaccine and we can now say that with certainty, rather than with all the caveats, the British health secretary, Matt Hancock, said Wednesday.
While the go-ahead bodes well for Britain, which broke from the European Unions regulatory orbit to approve the vaccine early, it will have no effect on the distribution of the hundreds of millions of doses that the United States and other wealthy countries have procured in prepaid contracts.
It also offers little relief to poorer countries that could not afford to buy supplies in advance and may struggle to pay for both the vaccines and the exceptional demands of distributing them.
Roughly 800,000 doses of the Pfizer vaccine, developed with BioNTech, a smaller German firm, were being packaged at the companys Belgian manufacturing plant on Wednesday for shipment to Britain. How and when they will arrive is a secret for security reasons, the company said.
The complicated logistics of moving, defrosting and preparing the vaccine meant it was going to be given only at 50 British hospitals to begin with. The vaccine must be transported at South Pole-like temperatures, and in trays of 975 doses.
First to be vaccinated will be doctors and nurses in the countrys National Health Service, along with nursing home workers and people 80 and over with previously scheduled doctors appointments. A government advisory committee has suggested that older or more vulnerable health workers, and doctors and nurses who work with fragile patients, would be among the first in line.
But the government has not said when other employees of the National Health Service would be eligible for vaccines. Essential workers, like teachers, transport workers and first responders, would not be vaccinated until after people 50 and over and those with underlying health problems received shots.
The advisory committee plans had made nursing home residents a top priority, but they will have to wait until the government begins distributing vaccines beyond hospitals. Pfizer and BioNTech have suggested that is possible, given that the vaccine can be stored for five days in a normal refrigerator.
Eventually, people will get their shots in mass vaccination centers being set up by the military at soccer stadiums and racecourses, or at doctors offices and pharmacies.
Weve been waiting and hoping for the day when the searchlights of science would pick out our invisible enemy, and give us the power to stop that enemy from making us ill, Prime Mister Boris Johnson said on Wednesday. And now the scientists have done it.
For Britain, which has suffered one of Europes highest per capita death tolls from the virus, the decision by its drug regulator was the latest evidence of a vaccination strategy that has been the most aggressive in the West.
Britain remains under the authority of the European Unions drug regulator until it consummates its split from the bloc on Dec. 31. But the government recently strengthened an old law that allows it to step out from under the blocs regulatory umbrella in public health emergencies. That allowed it to fast-track a review of the Pfizer vaccine, which was 95 percent effective in a late-stage clinical trial.
Britain had pre-ordered 40 million doses of the vaccine and 315 million doses of competing vaccines, spreading its bets to assure it can inoculate the countrys 67 million people.
British ministers cast the speed of the Pfizer approval as an early example of the new flexibility the country will have once it fully untethers itself from European regulation. Yet Brexit has also exacted costs, starving Britains drug regulator of money it used to draw from contracts with the European Union.
British regulators are also vetting a vaccine developed by the University of Oxford and AstraZeneca, a British-Swedish company. It is cheaper and easier to store than Pfizers, so much of the world could rely on it, but its regulatory path forward in the United States is unclear after scientists and industry analysts questioned promising early results.
The chemistry underlying Pfizers vaccine had never before produced an approved shot, but scientists have experimented with it for years, testing vaccines that did not make it to market. In order to coax cells to make a viral protein, called a spike, and elicit an immune response, this class of vaccine delivers genetic instructions, known as messenger RNA, encased in tiny fat globules.
BioNTech made a prophetic bet on the technology and joined forces with Pfizer, one of the worlds largest drug companies; they ended up delivering stunning results, on a timeline that was unheard-of before this year.
The U.S. Food and Drug Administration plans to decide on emergency authorization for the Pfizer vaccine shortly after a meeting of an advisory panel on Dec. 10. American officials have said vaccinations could begin within 24 hours after approval.
Another American company, Moderna, and the National Institutes of Health have also developed a messenger RNA vaccine that has proved effective in large trials. The F.D.A. will consider their application for emergency authorization shortly after Pfizers.
The European Medicines Agency, which regulates vaccines across the European Union, is expected to make a decision about the Pfizer vaccine later in December.
Pfizer has said it expects to be able to produce up to 50 million doses this year, about half of them going to the United States. Since each person needs two doses, a month apart, up to 25 million people worldwide could begin vaccination before 2021.
The United States has bought 100 million doses in advance from Pfizer, and the European Union 200 million doses.
The approval arrived at a perilous moment in the pandemic in Britain, where the virus has killed nearly 70,000 people, and hundreds more die each day. A third of Englands hospital systems were caring for more Covid-19 patients in recent weeks than at the height of the first wave in the spring.
A monthlong shutdown of restaurants and pubs has stanched the spread of the virus, but that is being replaced by a less stringent system of localized restrictions, with allowances for Christmastime travel that scientists fear will seed another uptick in infections.
In a clinical trial, the Pfizer-BioNTech vaccine proved highly effective among older adults, who are more vulnerable to developing severe Covid-19 and who do not respond strongly to some types of vaccines. It caused no serious side effects.
As vaccines become widely available, the scientific feat of developing them will give way to the social and political problem of convincing people to take them. In Britain, the source of some of the most virulent modern disinformation about vaccines, just over half of people have said in surveys they would definitely accept an inoculation.
Safety concerns have been accentuated by the speed of vaccine testing and approval, despite Britains regulators saying repeatedly they were not taking shortcuts.
Beyond those challenges, manufacturers will quickly need to eventually make billions of doses and move them to hospitals, clinics and pharmacies.
The Pfizer vaccine makes this effort especially complex. It has to be stored at around minus 70 degrees Celsius (minus 94 Fahrenheit) until shortly before injection, requiring transportation in boxes stuffed with dry ice.
Matina Stevis-Gridneff contributed reporting from Brussels, Katie Thomas from Chicago and Rebecca Robbins from Bellingham, Wash.
LONDON Britain gave emergency authorization on Wednesday to Pfizers coronavirus vaccine, leaping ahead of the United States to become the first Western country to allow mass inoculations against a disease that has killed more than 1.4 million people worldwide.
The decision cleared the way for a vaccination campaign with little precedent in modern medicine, encompassing not only ultracold dry ice but also a crusade against anti-vaccine misinformation.
Britains beating the United States to authorization on a vaccine codeveloped by an American company, no less intensified pressure on U.S. regulators, who are under fire from the White House for not moving faster to get doses to people. But it also fueled concerns that Britain was acting in haste for political reasons or trying to muscle its way to the front of the line for deliveries.
European regulators on Wednesday cast doubt on the rigor of Britains review and said that the authorization was limited to specific batches of the vaccine, a claim that Pfizer denied and British officials did not address.
Britains move provoked a spirited debate among American scientists about whether U.S. regulators, who are known to be unusually meticulous, could afford to hold off any longer on authorizing a vaccine against a virus that is claiming more than 10,000 lives a day worldwide.
American regulators have argued that they lag behind if only by a matter of days because they are virtually alone in reanalyzing thousands of pages of raw data from vaccine trials before approval. Backers of that approach say it is the only way to minimize unintended damage, in lives and in public trust, from vaccines not working.
British and European regulators lean more heavily on the companies own analyses, auditing their figures occasionally but otherwise grounding their decisions on vaccine makers reports. While the more cautious American approach can be valuable, some scientists said the Europeans subject vaccine makers to considerable scrutiny, and it is imperative to move quickly to curb the suffering wrought by the pandemic.
When you say its OK to wait another week or two, youre saying its OK that many thousands of people are going to die, said Dr. Walid F. Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.
No country until Wednesday had authorized a fully tested coronavirus vaccine; Russia and China approved vaccines without waiting for large-scale efficacy tests.
The British government, battered by its handling of the pandemic, exulted in the authorization.
Help is on its way with this vaccine and we can now say that with certainty, rather than with all the caveats, the British health secretary, Matt Hancock, said Wednesday.
While the go-ahead bodes well for Britain, which broke from the European Unions regulatory orbit to approve the vaccine early, it will have no effect on the distribution of the hundreds of millions of doses that the United States and other wealthy countries have procured in prepaid contracts.
It also offers little relief to poorer countries that could not afford to buy supplies in advance and may struggle to pay for both the vaccines and the exceptional demands of distributing them.
Roughly 800,000 doses of the Pfizer vaccine, developed with BioNTech, a smaller German firm, were being packaged at the companys Belgian manufacturing plant on Wednesday for shipment to Britain. How and when they will arrive is a secret for security reasons, the company said.
The complicated logistics of moving, defrosting and preparing the vaccine meant it was going to be given only at 50 British hospitals to begin with. The vaccine must be transported at South Pole-like temperatures, and in trays of 975 doses.
First to be vaccinated will be doctors and nurses in the countrys National Health Service, along with nursing home workers and people 80 and over with previously scheduled doctors appointments. A government advisory committee has suggested that older or more vulnerable health workers, and doctors and nurses who work with fragile patients, would be among the first in line.
But the government has not said when other employees of the National Health Service would be eligible for vaccines. Essential workers, like teachers, transport workers and first responders, would not be vaccinated until after people 50 and over and those with underlying health problems received shots.
The advisory committee plans had made nursing home residents a top priority, but they will have to wait until the government begins distributing vaccines beyond hospitals. Pfizer and BioNTech have suggested that is possible, given that the vaccine can be stored for five days in a normal refrigerator.
Eventually, people will get their shots in mass vaccination centers being set up by the military at soccer stadiums and racecourses, or at doctors offices and pharmacies.
Weve been waiting and hoping for the day when the searchlights of science would pick out our invisible enemy, and give us the power to stop that enemy from making us ill, Prime Mister Boris Johnson said on Wednesday. And now the scientists have done it.
For Britain, which has suffered one of Europes highest per capita death tolls from the virus, the decision by its drug regulator was the latest evidence of a vaccination strategy that has been the most aggressive in the West.
Britain remains under the authority of the European Unions drug regulator until it consummates its split from the bloc on Dec. 31. But the government recently strengthened an old law that allows it to step out from under the blocs regulatory umbrella in public health emergencies. That allowed it to fast-track a review of the Pfizer vaccine, which was 95 percent effective in a late-stage clinical trial.
Britain had pre-ordered 40 million doses of the vaccine and 315 million doses of competing vaccines, spreading its bets to assure it can inoculate the countrys 67 million people.
British ministers cast the speed of the Pfizer approval as an early example of the new flexibility the country will have once it fully untethers itself from European regulation. Yet Brexit has also exacted costs, starving Britains drug regulator of money it used to draw from contracts with the European Union.
British regulators are also vetting a vaccine developed by the University of Oxford and AstraZeneca, a British-Swedish company. It is cheaper and easier to store than Pfizers, so much of the world could rely on it, but its regulatory path forward in the United States is unclear after scientists and industry analysts questioned promising early results.
The chemistry underlying Pfizers vaccine had never before produced an approved shot, but scientists have experimented with it for years, testing vaccines that did not make it to market. In order to coax cells to make a viral protein, called a spike, and elicit an immune response, this class of vaccine delivers genetic instructions, known as messenger RNA, encased in tiny fat globules.
BioNTech made a prophetic bet on the technology and joined forces with Pfizer, one of the worlds largest drug companies; they ended up delivering stunning results, on a timeline that was unheard-of before this year.
The U.S. Food and Drug Administration plans to decide on emergency authorization for the Pfizer vaccine shortly after a meeting of an advisory panel on Dec. 10. American officials have said vaccinations could begin within 24 hours after approval.
Another American company, Moderna, and the National Institutes of Health have also developed a messenger RNA vaccine that has proved effective in large trials. The F.D.A. will consider their application for emergency authorization shortly after Pfizers.
The European Medicines Agency, which regulates vaccines across the European Union, is expected to make a decision about the Pfizer vaccine later in December.
Pfizer has said it expects to be able to produce up to 50 million doses this year, about half of them going to the United States. Since each person needs two doses, a month apart, up to 25 million people worldwide could begin vaccination before 2021.
The United States has bought 100 million doses in advance from Pfizer, and the European Union 200 million doses.
The approval arrived at a perilous moment in the pandemic in Britain, where the virus has killed nearly 70,000 people, and hundreds more die each day. A third of Englands hospital systems were caring for more Covid-19 patients in recent weeks than at the height of the first wave in the spring.
A monthlong shutdown of restaurants and pubs has stanched the spread of the virus, but that is being replaced by a less stringent system of localized restrictions, with allowances for Christmastime travel that scientists fear will seed another uptick in infections.
In a clinical trial, the Pfizer-BioNTech vaccine proved highly effective among older adults, who are more vulnerable to developing severe Covid-19 and who do not respond strongly to some types of vaccines. It caused no serious side effects.
As vaccines become widely available, the scientific feat of developing them will give way to the social and political problem of convincing people to take them. In Britain, the source of some of the most virulent modern disinformation about vaccines, just over half of people have said in surveys they would definitely accept an inoculation.
Safety concerns have been accentuated by the speed of vaccine testing and approval, despite Britains regulators saying repeatedly they were not taking shortcuts.
Beyond those challenges, manufacturers will quickly need to eventually make billions of doses and move them to hospitals, clinics and pharmacies.
The Pfizer vaccine makes this effort especially complex. It has to be stored at around minus 70 degrees Celsius (minus 94 Fahrenheit) until shortly before injection, requiring transportation in boxes stuffed with dry ice.
Matina Stevis-Gridneff contributed reporting from Brussels, Katie Thomas from Chicago and Rebecca Robbins from Bellingham, Wash.
There will be 224,250 doses of the Pfizer vaccine shipped to 109 Texas hospitals in 34 counties, according to the DSHS.
HOUSTON The Texas Health Department released more details Friday about which Texas hospitals will receive the first round of Pfizer coronavirus vaccines and how many each gets.
The first shipments of Pfizers COVID-19 vaccine are set to go out on Dec.14for healthcare workers.
There will be 224,250 doses shipped to 109 Texas hospitals in 34 counties, according to the Department of State Health Services.
What we know is vaccines will be shipped to the healthcare systems themselves, to the hospitals, so they can do what they need to do for their healthcare workers, according to Dr. Umair Shah with Harris County Public Health.
On Friday, the DSHSreleased the list of which Texas hospitals will receive the first round of vaccines and how many each will get.
Here are the Greater Houston Area hospitals and the number of doses theyll receive.
Harris County
Houston Methodist Baytown: 1,950
Memorial Hermann Cypress Hospital: 975
St. Lukes Hospital at the Vintage: 975
Texas Childrens Hospital Main: 3,900
Texas Children's Hospital West Campus: 975
HCA Houston Healthcare NW Houston: 1,950
UT MD Anderson Cancer Center: 4,875
Memorial Hermann Texas Medical Center: 5,850
Memorial Hermann Greater Heights: 1,950
Memorial Hermann SE: 1,950
Memorial Hermann Memorial City Center: 2,925
Houston Methodist Clear Lake Hospital: 975
Ben Taub General Hospital: 1,950
Houston Methodist West Hospital: 975
Houston Methodist Hospital: 5,850
Chi St Lukes Health Houston: 5,850
Houston Methodist Willowbrook: 975
Memorial Hermann Katy: 975
HCA Houston Southeast Pasadena: 975
UTMB/Clear Lake, Webster: 975
Montgomery County
Texas Children's Hospital Woodlands Conroe: 975
Houston Methodist The Woodlands Conroe: 975
Kingwood Medical Center Kingwood: 975
Memorial Hermann The Woodlands Spring: 1,950
Fort Bend County
Houston Methodist Sugar Land:1,950
Galveston County
Rural counties have some of the lowest flu vaccination rates. Thats a serious problem for the COVID vaccine rollout.
Americas poor track record vaccinating people against the flu spells trouble for the coming effort to immunize the nation against COVID-19, experts say, particularly in rural areas where the virus is raging out of control.
A USA TODAY analysis of flu vaccine rates among Medicare participants shows that rural counties from West Texas to northern Nebraska to the Upper Peninsula of Michigan had some of the countrys lowest vaccination rates in 2017, the most recent year with data. Its a pattern that holds true across America. The more rural the county, the lower flu vaccination rates tended to be.
Data for the analysis came from the County Health Rankings project and the Index of Relative Rurality, a metric that ranks counties based on population size, density, remoteness, and built-up area. The analysis identified 604 counties where fewer than a third of Medicare participants received flu vaccines, 580 of which were predominantly rural.
These places were home to more than 13 million people and were spread across the nation; all but nine states had at least one low-vaccination county.
At the extreme, there were 215 counties where fewer than 1 in 4 residents on Medicare were vaccinated.
We don't have the convenience of jumping into a Walgreens, CVS or Walmart and getting our flu shot. Our nearest Walgreens and Walmart are 30 miles away, said Dr. Jennifer Bacani McKenney, a family physician and the Wilson County Health Officer in Fredonia, Kansas, explaining some of the barriers in rural areas that exist in addition to vaccine hesitancy and distrust.
Due to financial, storage and staffing issues, she said, "none of the providers in our county and many private clinics across the state do not provide in-clinic vaccinations, so the patient is required to make an additional appointment to get vaccines at a health department."
Of course, people who opt out of the flu vaccine might seek it for the coronavirus because the pandemic has killed more people than the annual flu. At the same time, people who previously took the flu vaccine might not get their shots for COVID-19 because the pandemic has intensified Americans skepticism of science and drug regulators.
But flu vaccination rates can at least provide clues to how rural America will respond to the arrival of the COVID-19 vaccine. Data on flu vaccination among Medicare enrollees -- primary elderly Americans -- provide a detailed geographic window into how the COVID-19 vaccine will be accepted by that key at-risk group, said Dr. Randy Hubach, an associate professor of rural health and director of the Sexual Health Research Lab at Oklahoma State University. I think its an accurate contextual representation of what we can probably expect with the COVID vaccine.
The potential consequences for rural America can be seen in flu data. Historic data from the U.S. Centers for Disease Control and Prevention Wonder database show that the flu virus tends to kill at higher rates in more rural counties.
Experts say if COVID-19 vaccination follows the same pattern as the flu, the flow of people between these communities and the rest of the country will put both city dwellers and rural residents at risk.
Flu vaccination has largely skipped much of rural America because, in part, its harder for people in remote communities to get to pharmacies, clinics or hospitals offering vaccines. Theres also a long-standing distrust in the medical system in these areas. Yet getting the COVID vaccine to these areas will be key to tamping down a virus thats ravaged rural communities, experts said.
Ensuring vaccine coverage of rural communities is an essential part of the strategy to protect rural communities from COVID-19, Dr. Thomas Tsai, a surgeon and health policy researcher at Harvard's T.H. Chan School of Public Health, said in an email.
Researchers dont know how much of the U.S. population will need to be protected to stop the spread of COVID-19. Estimates range from 50% to as high as 90% of the population to achieve a threshold epidemiologists describe as herd immunity.
Reaching that threshold will be a struggle, if the flu vaccine is any indication. Only half the country gets vaccinated for the flu, on average, and surveys show a growing number of people intend to refuse a COVID-19 vaccine. Achieving a much higher vaccination rate with the COVID-19 vaccine will be the difference between a coronavirus thats endemic and actively circulating and a coronavirus thats all but wiped out, a goal the nation has attained with the smallpox, mumps and diphtheria viruses.
How you are going to move that needle from 50% up to 75% really becomes the question, said Dr. Hubach.
More: When could the first COVID-19 vaccines be given in the US?
And the prickly problem of vaccine uptake is one that health officials need to figure out quickly. With two COVID vaccine candidates expected to receive emergency use authorization from the U.S. Food and Drug Administration later this month, federal and state health officials are finalizing vaccine distribution plans to immunize the front-line health care workers and nursing home residents that comprise the so-called Phase 1a group, the Americans who will first receive the vaccine against the coronavirus.
That wave of immunizations is expected to occur before the end of the year. Dr. Mancef Slaoui, the chief science advisor to Operation Warp Speed, recently said he expected the first Americans to be vaccinated within two days of the FDAs authorization. Dr. Nancy Messionier, director of CDCs National Center for Immunization and Respiratory Diseases, said last week that everyone in phase 1a should expect their first dose within three weeks of a vaccine being authorized.
The rollout thereafter should proceed quickly. On a Dec. 2 Operation Warp Speed call with reporters, Dr. Slaoui said he expected that 20 million people would receive either the Pfizer or Moderna vaccine in December, followed by 30 million people in January and 50 million people in February, pending FDA authorization. In early 2021, vaccinations will proceed beyond front-line health care workers and nursing home residents to essential workers followed by adults with high-risk medical conditions and people aged 65 and older.
But getting vaccines to essential workers and seniors, especially in rural areas, will be an ongoing challenge given the historically low vaccination rates, which researchers sometimes refer to as 'uptake, in rural counties. The reason for low vaccine uptake? A variety of factors including long-standing systemic health and social inequities as well as a distrust of medical providers, says Dr. Hubach.
Dr. McKenney in Kansas is seeing vaccine distrust play out both in private clinic visits and in public town hall discussions about the coronavirus.
I hear people saying theyre hesitant to take this vaccine, said McKenney. Theyre nervous. They dont want to be the first ones. It goes along with the rural mentality of being suspicious of the government and science.
More: Kentucky legislator pre-files bill prohibiting colleges from mandating vaccines
That worries McKenney because of how hard communities in Kansas and across the Plains have been hit by COVID-19 in recent months.
The numbers that were seeing right now in our communities actually makes me kind of terrified about whats going to happen before we ever start vaccinating, she said. Whats going to happen in the next month or two months?
Yet despite that damage, people arent changing their behaviors. Even with those high numbers of cases and deaths, its still not hitting home for people, said McKenney. Theyre saying, Only 1 percent die. Its not a big deal.
Rural counties in the Dakotas, Kansas, Montana and Mississippi have seen some of the highest COVID surges with over 300 deaths per 100,000 people. Influenza and other respiratory diseases have also hit many of those same counties hard in the past, though at much lower levels around 25 deaths per 100,000 on average, according to CDC data from 2018.
Maria Harvey and her sister Ashley Makridakis protest mandatory flu vaccinations outside the Massachusetts Statehouse on Aug. 30 in Boston. Public health authorities say flu shots are very important this year to avoid overburdening the health system amid the coronavirus pandemic.(Photo: Nancy Lane/Boston Herald via AP)
Rural residents who opt out of vaccination are far from monolithic in their reasons.
Lynn Ogren said she routinely passes on the flu shot and all other vaccines in Jerauld County, South Dakota, where just over one in five residents was immunized in 2017. The 69-year-old retired rancher and substitute teacher said she instead takes dietary supplements and minds a strict diet to keep in good health. She wont be getting vaccinated for COVID-19 either, she said.
I dont put anything foreign into my body that I dont need to, Ogren said. Ive never been vaccinated for the flu, and I dont get vaccinated for anything.
Jerauld County residents have died of COVID-19 at a rate of more than 640 per 100,000 residents, one of the highest rates in the country.
Health experts warn that if a population doesnt attain herd immunity, places that havent been immunized will continue to see surges in cases and deaths from the virus known by the scientific name SARS-CoV-2. But achieving herd immunity will be a serious challenge in countries like the United States where vaccine hesitancy is widespread. The consequence is a coronavirus that returns seasonally, guaranteeing continued suffering.
California Gov. Gavin Newsom gets a flu shot during a news conference Monday in Rancho Cordova, Calif.(Photo: California Governors Office via AP)
What happens if countries do not reach high vaccine coverage levels? First, SARS-CoV-2 will become endemic but at a low level with peaks in winter and troughs in summer in the northern hemisphere, wrote the authors of a letter published last month in The Lancet journal pointing out challenges to herd immunity.
Dr. Roy Anderson, one of the authors and a professor in the School of Public Health at Imperial College London, said in an interview that the virus will continue to circulate if herd immunity isnt reached. Rural areas will not be spared.
The virus will remain endemic, but cities will be major reservoirs seeding rural regions, said Dr. Anderson, who was adamant that the virus would likely not ever go away. It will be endemic and seasonal.
Dr. Krutika Kuppalli, an assistant professor in the division of infectious disease at the Medical University of South Carolina, is also concerned.
Do I think its going to become endemic? said Kuppalli. Yeah, I do. When we have millions and millions of cases, it seems like its going to become endemic. My hope is we get enough people to take up the vaccine.
Despite rural counties historically low rates of vaccine uptake, Hubach sees an opportunity to better communicate with those communities about the COVID-19 vaccine. Tapping faith leaders and community outreach workers that have an understanding of local context and climate is going to be very important. How do you have them say, Vaccination is one thing we can do for the common good?, he said.
More: Side effects from the COVID-19 vaccine means 'your body responded the way it's supposed to,' experts say
In addition to tailoring public health messages to specific communities in rural counties, relying on the patient-doctor bond is an important way to build trust in the COVID-19 vaccine and boost vaccination rates, says Dr. Brian Chow, a physician and principal investigator on AstraZenecas COVID vaccine trial at Tufts Medical Center in Boston. Many rural communities have been historically marginalized and denied health care or worse, Chow explained. Promoting COVID vaccination needs to surmount distrust in medical care.
The majority of people will get vaccinated through their doctors office, said Chow. Leveraging those relationships will be key. A strong recommendation from their primary care provider really influences whether or not people accept a vaccine.
Aleszu Bajak is on Twitter at @aleszubajak or can be emailed at abajak@usatoday.com
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Rural counties have some of the lowest flu vaccination rates. Thats a serious problem for the COVID vaccine rollout.
Americas poor track record vaccinating people against the flu spells trouble for the coming effort to immunize the nation against COVID-19, experts say, particularly in rural areas where the virus is raging out of control.
A USA TODAY analysis of flu vaccine rates among Medicare participants shows that rural counties from West Texas to northern Nebraska to the Upper Peninsula of Michigan had some of the countrys lowest vaccination rates in 2017, the most recent year with data. Its a pattern that holds true across America. The more rural the county, the lower flu vaccination rates tended to be.
Data for the analysis came from the County Health Rankings project and the Index of Relative Rurality, a metric that ranks counties based on population size, density, remoteness, and built-up area. The analysis identified 604 counties where fewer than a third of Medicare participants received flu vaccines, 580 of which were predominantly rural.
These places were home to more than 13 million people and were spread across the nation; all but nine states had at least one low-vaccination county.
At the extreme, there were 215 counties where fewer than 1 in 4 residents on Medicare were vaccinated.
We don't have the convenience of jumping into a Walgreens, CVS or Walmart and getting our flu shot. Our nearest Walgreens and Walmart are 30 miles away, said Dr. Jennifer Bacani McKenney, a family physician and the Wilson County Health Officer in Fredonia, Kansas, explaining some of the barriers in rural areas that exist in addition to vaccine hesitancy and distrust.
Due to financial, storage and staffing issues, she said, "none of the providers in our county and many private clinics across the state do not provide in-clinic vaccinations, so the patient is required to make an additional appointment to get vaccines at a health department."
Of course, people who opt out of the flu vaccine might seek it for the coronavirus because the pandemic has killed more people than the annual flu. At the same time, people who previously took the flu vaccine might not get their shots for COVID-19 because the pandemic has intensified Americans skepticism of science and drug regulators.
But flu vaccination rates can at least provide clues to how rural America will respond to the arrival of the COVID-19 vaccine. Data on flu vaccination among Medicare enrollees -- primary elderly Americans -- provide a detailed geographic window into how the COVID-19 vaccine will be accepted by that key at-risk group, said Dr. Randy Hubach, an associate professor of rural health and director of the Sexual Health Research Lab at Oklahoma State University. I think its an accurate contextual representation of what we can probably expect with the COVID vaccine.
The potential consequences for rural America can be seen in flu data. Historic data from the U.S. Centers for Disease Control and Prevention Wonder database show that the flu virus tends to kill at higher rates in more rural counties.
Experts say if COVID-19 vaccination follows the same pattern as the flu, the flow of people between these communities and the rest of the country will put both city dwellers and rural residents at risk.
Flu vaccination has largely skipped much of rural America because, in part, its harder for people in remote communities to get to pharmacies, clinics or hospitals offering vaccines. Theres also a long-standing distrust in the medical system in these areas. Yet getting the COVID vaccine to these areas will be key to tamping down a virus thats ravaged rural communities, experts said.
Ensuring vaccine coverage of rural communities is an essential part of the strategy to protect rural communities from COVID-19, Dr. Thomas Tsai, a surgeon and health policy researcher at Harvard's T.H. Chan School of Public Health, said in an email.
Researchers dont know how much of the U.S. population will need to be protected to stop the spread of COVID-19. Estimates range from 50% to as high as 90% of the population to achieve a threshold epidemiologists describe as herd immunity.
Reaching that threshold will be a struggle, if the flu vaccine is any indication. Only half the country gets vaccinated for the flu, on average, and surveys show a growing number of people intend to refuse a COVID-19 vaccine. Achieving a much higher vaccination rate with the COVID-19 vaccine will be the difference between a coronavirus thats endemic and actively circulating and a coronavirus thats all but wiped out, a goal the nation has attained with the smallpox, mumps and diphtheria viruses.
How you are going to move that needle from 50% up to 75% really becomes the question, said Dr. Hubach.
More: When could the first COVID-19 vaccines be given in the US?
And the prickly problem of vaccine uptake is one that health officials need to figure out quickly. With two COVID vaccine candidates expected to receive emergency use authorization from the U.S. Food and Drug Administration later this month, federal and state health officials are finalizing vaccine distribution plans to immunize the front-line health care workers and nursing home residents that comprise the so-called Phase 1a group, the Americans who will first receive the vaccine against the coronavirus.
That wave of immunizations is expected to occur before the end of the year. Dr. Mancef Slaoui, the chief science advisor to Operation Warp Speed, recently said he expected the first Americans to be vaccinated within two days of the FDAs authorization. Dr. Nancy Messionier, director of CDCs National Center for Immunization and Respiratory Diseases, said last week that everyone in phase 1a should expect their first dose within three weeks of a vaccine being authorized.
The rollout thereafter should proceed quickly. On a Dec. 2 Operation Warp Speed call with reporters, Dr. Slaoui said he expected that 20 million people would receive either the Pfizer or Moderna vaccine in December, followed by 30 million people in January and 50 million people in February, pending FDA authorization. In early 2021, vaccinations will proceed beyond front-line health care workers and nursing home residents to essential workers followed by adults with high-risk medical conditions and people aged 65 and older.
But getting vaccines to essential workers and seniors, especially in rural areas, will be an ongoing challenge given the historically low vaccination rates, which researchers sometimes refer to as 'uptake, in rural counties. The reason for low vaccine uptake? A variety of factors including long-standing systemic health and social inequities as well as a distrust of medical providers, says Dr. Hubach.
Dr. McKenney in Kansas is seeing vaccine distrust play out both in private clinic visits and in public town hall discussions about the coronavirus.
I hear people saying theyre hesitant to take this vaccine, said McKenney. Theyre nervous. They dont want to be the first ones. It goes along with the rural mentality of being suspicious of the government and science.
More: Kentucky legislator pre-files bill prohibiting colleges from mandating vaccines
That worries McKenney because of how hard communities in Kansas and across the Plains have been hit by COVID-19 in recent months.
The numbers that were seeing right now in our communities actually makes me kind of terrified about whats going to happen before we ever start vaccinating, she said. Whats going to happen in the next month or two months?
Yet despite that damage, people arent changing their behaviors. Even with those high numbers of cases and deaths, its still not hitting home for people, said McKenney. Theyre saying, Only 1 percent die. Its not a big deal.
Rural counties in the Dakotas, Kansas, Montana and Mississippi have seen some of the highest COVID surges with over 300 deaths per 100,000 people. Influenza and other respiratory diseases have also hit many of those same counties hard in the past, though at much lower levels around 25 deaths per 100,000 on average, according to CDC data from 2018.
Maria Harvey and her sister Ashley Makridakis protest mandatory flu vaccinations outside the Massachusetts Statehouse on Aug. 30 in Boston. Public health authorities say flu shots are very important this year to avoid overburdening the health system amid the coronavirus pandemic.(Photo: Nancy Lane/Boston Herald via AP)
Rural residents who opt out of vaccination are far from monolithic in their reasons.
Lynn Ogren said she routinely passes on the flu shot and all other vaccines in Jerauld County, South Dakota, where just over one in five residents was immunized in 2017. The 69-year-old retired rancher and substitute teacher said she instead takes dietary supplements and minds a strict diet to keep in good health. She wont be getting vaccinated for COVID-19 either, she said.
I dont put anything foreign into my body that I dont need to, Ogren said. Ive never been vaccinated for the flu, and I dont get vaccinated for anything.
Jerauld County residents have died of COVID-19 at a rate of more than 640 per 100,000 residents, one of the highest rates in the country.
Health experts warn that if a population doesnt attain herd immunity, places that havent been immunized will continue to see surges in cases and deaths from the virus known by the scientific name SARS-CoV-2. But achieving herd immunity will be a serious challenge in countries like the United States where vaccine hesitancy is widespread. The consequence is a coronavirus that returns seasonally, guaranteeing continued suffering.
California Gov. Gavin Newsom gets a flu shot during a news conference Monday in Rancho Cordova, Calif.(Photo: California Governors Office via AP)
What happens if countries do not reach high vaccine coverage levels? First, SARS-CoV-2 will become endemic but at a low level with peaks in winter and troughs in summer in the northern hemisphere, wrote the authors of a letter published last month in The Lancet journal pointing out challenges to herd immunity.
Dr. Roy Anderson, one of the authors and a professor in the School of Public Health at Imperial College London, said in an interview that the virus will continue to circulate if herd immunity isnt reached. Rural areas will not be spared.
The virus will remain endemic, but cities will be major reservoirs seeding rural regions, said Dr. Anderson, who was adamant that the virus would likely not ever go away. It will be endemic and seasonal.
Dr. Krutika Kuppalli, an assistant professor in the division of infectious disease at the Medical University of South Carolina, is also concerned.
Do I think its going to become endemic? said Kuppalli. Yeah, I do. When we have millions and millions of cases, it seems like its going to become endemic. My hope is we get enough people to take up the vaccine.
Despite rural counties historically low rates of vaccine uptake, Hubach sees an opportunity to better communicate with those communities about the COVID-19 vaccine. Tapping faith leaders and community outreach workers that have an understanding of local context and climate is going to be very important. How do you have them say, Vaccination is one thing we can do for the common good?, he said.
More: Side effects from the COVID-19 vaccine means 'your body responded the way it's supposed to,' experts say
In addition to tailoring public health messages to specific communities in rural counties, relying on the patient-doctor bond is an important way to build trust in the COVID-19 vaccine and boost vaccination rates, says Dr. Brian Chow, a physician and principal investigator on AstraZenecas COVID vaccine trial at Tufts Medical Center in Boston. Many rural communities have been historically marginalized and denied health care or worse, Chow explained. Promoting COVID vaccination needs to surmount distrust in medical care.
The majority of people will get vaccinated through their doctors office, said Chow. Leveraging those relationships will be key. A strong recommendation from their primary care provider really influences whether or not people accept a vaccine.
Aleszu Bajak is on Twitter at @aleszubajak or can be emailed at abajak@usatoday.com
Read or Share this story: https://www.usatoday.com/story/news/health/2020/12/06/flu-vaccine-rates-rural-covid-19-vaccine/3832618001/
Debate Heats Up Over Who Should Get COVID-19 Vaccine After Health Care Workers And Most Vulnerable CBS New York
Debate Heats Up Over Who Should Get COVID-19 Vaccine After Health Care Workers And Most Vulnerable CBS New York
Although a COVID-19 vaccine is on its way, it will be months until it is distributed to the general public and months more before enough people are vaccinated to diminish the threat of the virus.
Gov. Mike Parson submitted Missouris COVID-19 vaccine plan to the Centers for Disease Control and Prevention in October, saying the state hoped to have a vaccine by December and make it available to all residents by April.
However, a vaccine does not mean that pandemic precautions, such as mask-wearing and social distancing, will no longer be necessary.
As misinformation about COVID-19 rages on and the death toll continues to rise, Christelle Ilboudo, doctor of pediatric infectious diseases at MU Health Care, explains how the vaccine will work and what life will be like when the general public is vaccinated. (The following has been edited for clarity and brevity.)
Q: What does the vaccine timeline look like right now?
A: The information that we have as of now is that it is going to go through an FDA approval process, which looks at safetyand reviews the data, in mid-December.And then after that, it's going to be reviewed by another entity which makes recommendations to the CDC about vaccines and whether or not they recommend it for the general public. Hopefully, after that meeting, we'll have an idea of a little clearer guidance on who should be prioritized. We have some guidance now, but maybe better guidance on who should be prioritized. And then after that is when its going to be available with the thought that initially those priority groups will be the first people to get it. And the hope is that or the consensus is that by next spring, these vaccines should be available more broadly to most people in general.
Q: What will life look like once the vaccine is generally available?
A: As of now, we are still recommending those public health measures. I think there's more and more data coming out about immunity. So the big question is, well, if I've had it, if I've had the disease, or if I get the vaccine, how long will I be protected from getting really sick if I was exposed again? And I think that their initial data were up to 90 days, because that's how far they had followed those people. But it seems like there's more and more data coming out to say that most people will have immunity for six months or longer. And if it's anything like some of the other coronaviruses that we've seen, people are estimating a year to two years.
But it's still a new virus, and so we're still learning about it every day. But I think some of that determination about public health measures will really depend on how long people have immunity that lasts, knowing that the thought is that they're going to continue to follow those patients or those people who are part of the vaccine trials initially, to actually measure how long they have immunity for us to get a sense by next spring of how much longer we'll need to continue these measures even after people get the vaccine.
Q: Will people who have had COVID-19 still need to get the vaccine or will they have immunity?
A: That's a great question, and that's what we're also hoping to (know) by mid-December is to really understand people who had the disease and were vaccinated, or people who got vaccinated, did some of them end up having COVID-19? And if so, was it severe? I think that information is available. In some of the vaccine trials they have followed people with COVID-19. I just don't have that information yet, and I believe it's Dec. 10 or 11 when all of those questions or all of that information will be available to the public to understand that specific question, of people who had the disease or not and what the vaccine did or did not do for them.
Q: Once someone gets the vaccine can they go back to how they were living pre-pandemic, or will vaccinated people still need to wear masks and social distance?
A:What we know of the Pfizer and Moderna vaccines, which are the first two that we've heard a lot about, is that you need two doses. And it also looks like the latest one, the AstraZeneca vaccine out of the UK, looks like you also need a booster dose. I don't know exactly how far apart. And so you have to at least finish the complete series of whichever vaccine you are getting before you consider yourself protected at all. And so an example that I can give is for the flu vaccine. What we tell people is you need two weeks, your body needs two good weeks, to develop that immunity, to build that immunity after you've gotten it.
And so we will have a similar message about this coronavirus vaccine that is not going to be Im good to go from the moment I get the vaccine and I don't have to do anything else, that we might still need social distance and wear the mask and do all of that. Not only for ourselves but to have enough people in the community immunized to say that, even if I get the virus, because I now know that all of the people around me are vaccinated, we are all safe. Not only am I safe, but the people around me are safe, should one of us get exposed to the virus.
Q: Can you still carry and spread the virus once youve had the vaccine?
A: The thought with any vaccine is not that I'm never going to get exposed to the virus. The thought is that my body will remember that antibody, so my body is primed to fight it. But for some people, even when they get exposed to the virus, they can get an infection but not get as sick. And as we see now, there's a lot of people who have asymptomatic disease, meaning that they don't have any symptoms, but they can still shed the virus through the nose and through their mouth and still infect people around them.
So the thought is that, yes, you might still be able to infect other people around you, even if you are protected from getting seriously ill. So until we have more information, the masks and the washing hands and the social distancing will be crucial, until we have more data on exactly how well protected I am and also how well protected are other people around me from me vaccinated.
Q: When do you think well go back to normal life or do you think well always have some of these public health guidelines in place?
A: I think everybody should be washing their hands no matter what. I think if we learned anything, it is that we should be careful, stay home when we are sick, really avoiding to get people around us sick. I do think that our public measures will still be in place well into the springtime, because, remember, we have to immunize enough people to have that herd immunity. Enough people need to get the vaccine, and I don't know what that number is yet, but enough people need to get the vaccine first to say, okay, we've protected 70% or 90% of the population, and now we can start relaxing on some of those measures. So my prediction is that we're going to still continue to do these well into the springtime until enough people get the vaccine, and we have more data about how long our immune system reaction lasts to the vaccine.
Q: What else can people do to limit their exposure to COVID-19 after getting the vaccine?
A:I would go back to what we said in flu season. Yes, you get the vaccine, but, remember, you can still get the flu. So avoiding crowds is still necessary. Staying home when we are sick is still necessary. And then watching out for those that are most vulnerable around us, so our older people, people with chronic conditions, just being careful around them, washing our hands more thoroughly, go a long way whether we have the vaccine or not. Those are still good measures to have, good practices to have in place, and continue to do well beyond the vaccine coming out.
