This week’s Vaccine Project Newsletter is 2,270 words and will take seven minutes to read.
About half of the 30 Major League Baseball stadiums are back to 100% capacity, and almost all the rest will follow by July 4. Many of them served as COVID-19 vaccination megasites in preseason February and March, administering more than 1 million shots. Throughout June, MLB is working with all 30 teams on a program called Vaccinate at the Plate, offering free shots at the ballpark along with free tickets to games. Some stadiums have special seating sections for the fully vaccinated.
Of note, the 2021 MLB schedule is a full 162 games versus last year’s truncated slate of 60, followed by the first World Series ever played at a neutral site with no fans in the seats. Dodgers faithful will caution you not to put an asterisk next to their beloved title, the first in 32 years.
As baseball and the rest of the world seeks a return to normal, it is appropriate to invoke the wit and wisdom of the legendary Yogi Berra to capture the essence of the pandemic. Some of our favorite Yogi-isms include “It’s déjà vu all over again,” “When you come to a fork in the road, take it,” and “We made too many wrong mistakes.” But to our way of thinking, none captures the essence of the pandemic better than “It ain’t over ‘til it’s over.”
As Mark Twain might have said: Reports of the demise of the COVID-19 pandemic are greatly exaggerated. Globally speaking, more people have died from COVID-19 in the first half of 2021 than in all of 2020. In the U.S. we have surpassed the somber milestone of 600,000 pandemic deaths.
To be sure, there is plenty to celebrate. Plummeting rates of COVID-19 cases, emergency department visits, hospitalizations and deaths in seniors—among the first wave to be vaccinated— vividly demonstrate the impact of the vaccination effort in this country. Alicia Lasek has details in McKnight’s Long-Term Care News, and the full report from the Centers for Disease Control and Prevention is available here.
The subtext of the CDC report, however, offers a cautionary tale: “Despite sufficient vaccine supply and expanding eligibility, administration of COVID-19 vaccines has steadily declined in adults since mid-April 2021.” As of May 1, 82% of people 65 and older had received at least one COVID-19 shot, but just 63% of adults ages 50 to 64 and only 42% of those ages 18 to 49. A current of vaccine hesitancy persists among young adults 18 to 24, polls show, causing concern that new variants could arise and spread like brushfires.
The CDC calls for “tailored efforts” by state and local jurisdictions to step up vaccine coverage among all eligible age groups to further reduce cases and bad outcomes. As the Associated Press noted, “Experts warn that relief from the pandemic could be fleeting in regions where few people get inoculated.”
At this juncture, 64.6% of U.S. adults have received at least one COVID-19 shot. We are inching toward the goal of 70% by July 4, almost literally. With 18 days to go, we’re still 14 to 15 million shots shy of the mark. That’s all the more reason to applaud the efforts of Seattle, the first major American city to fully vaccinate 70% of residents age 12 and older, and Vermont (state motto: ”Freedom and Unity”), the first state to get at least one shot into the arms of 80% of those eligible.
While million-dollar vaccination lotteries grab headlines, low-key approaches are quietly at work. The Boston Globe reports on “Bob,” the orange bus of the Community Health Programs in Berkshire County, Massachusetts, which has delivered more than 3,300 doses of COVID-19 vaccine to gas station attendants, store clerks and the homebound, among others. “We’re not encountering a lot of hesitation, but social vulnerabilities—lack of transportation, lack of time off from a job, lack of child care” that stand in the way of getting a shot, said chief executive Lia Spiliotes.
Newer incentives include one for vaccinating the homebound, Diane Eastabrook reports in McKnight’s Home Care Daily. The Centers for Medicare and Medicaid Services will now pay $75 for each in-home dose of COVID-19 vaccine, up from $40. CMS estimates that 1.6 million seniors have trouble accessing vaccinations because it is hard for them to leave home.
In Montana, Bank of the Rockies set up vaccination clinics at six branch offices, promoted the events in email blasts and on social media, and offered drawings for a $500 gift card. More exotic incentives include the Joints for Jabs program in Washington state—get your COVID-19 shot and receive a free marijuana cigarette. The rollout, so to speak, has been slow, as weed dispensaries must also provide the vaccination on site, while bars can offer a free beer or drink simply by asking for proof of vaccination.
Here’s another incentive: Being fully vaccinated with an mRNA vaccine reduces the risk of SARS-CoV-2 infection by 91%, per the CDC. Illness is milder and shorter in the relatively few vaccinated people who do get sick.
As more adults are vaccinated, attention will turn increasingly to the millions of children and adolescents who are newly eligible or waiting their turn. An FDA advisory committee last week discussed the nitty gritty details of COVID-19 vaccine trials in children as young as 6 months of age. Some panelists questioned the rationale for an emergency use authorization because of the relatively lower COVID-19 disease burden in the pediatric population. Others cautioned that the impact is not negligible: More than 3.2 million pediatric cases were reported as of May 25, including at least 38,000 hospitalizations and 399 deaths, with a disproportionate impact in racial and ethnic minority groups.
The scientific and public health communities—not to mention the rest of us—want to be sure that vaccines are safe at any age, one reason why the trials are testing lower doses in younger children. With safety vigilance on its permanent agenda, the CDC’s Advisory Committee on Immunization Practices will meet in an emergency session on Friday to review data on the occurrence of heart inflammation (myocarditis and pericarditis) in teenage and young adult recipients of COVID-19 vaccines. The number of cases reported exceeds expected baseline rates in the population, but no causal relationship between the vaccines and the heart condition has yet been established.
As always, stay tuned. There’s always more to come, including a webinar next Wednesday on COVID-19 Vaccination and Children—Answering Parents’ Questions. The Public Health Communications Collaborative is hosting the event, with featured speakers including Karen Remley, now with the CDC and former executive director and CEO of the American Academy of Pediatrics, and Nicole Alexander-Scott, director of the Rhode Island Department of Health. The moderator is Lisa Waddell, chief medical officer of the CDC Foundation.
In case you missed it, the World Health Organization has renamed the coronavirus variants for Greek letters rather than the country where they were first reported. The variant currently causing most concern is Delta, identified in India last fall. It’s now so dominant in the U.K. that it has delayed the country’s easing of restrictions (“Freedom Day”) from June 21 until mid-July. Top White House medical expert Dr. Anthony Fauci warns that Delta could become dominant in the U.S. if the vaccination effort falters; it is now officially a “variant of concern” in the U.S. and accounts for about 10% of COVID-19 cases. The good news is that mRNA vaccines appear to work well against the varmint.
As the world returns
· Comms agency CEOs are booking their first plane flights in over a year as they visit employees across the country and schedule in-person meetings with (vaccinated) clients, Chris Daniels reports in PR Week. Andy Pray, founder and CEO of Praytell, foresees a new pitch model “that normalizes sending a few folks for the room while also having a broader team represented via video conference.” Jen Prosek, managing partner and founder at Prosek Partners, recalls that “pre-pandemic, I was on an airplane two times a week, every week. It was ridiculous. So I hope for myself and my colleagues that we think very hard about whether an air travel meeting is necessary.”
· Is a return to full-time office work on the horizon? People Management’s Calum Trenaman interviews five HR experts, who say that returning to five days in the workplace in the short term is “fanciful thinking.” They note that enforcing full-time office work could become a recruitment issue and that collaboration doesn’t always require an on-site presence. As one noted, “Innovative, lightbulb moments never happen at a water cooler.”
· The Occupational Safety and Health Administration has updated its guidance for maintaining a safe workplace vis-à-vis COVID-19. In non-healthcare settings, “Most employers no longer need to take steps to protect their fully vaccinated workers who are not otherwise at-risk from COVID-19 exposure.” The guidance encourages vaccination for employees who haven’t had their shots and says that otherwise they need to wear face coverings, socially distance, take part in workplace training in COVID-19 safety protocols and practice good personal hygiene.
· In healthcare settings, OSHA has issued not just guidance but rules—an emergency temporary standard—for systematically assessing hazards and mitigating COVID-19 risks. Fully vaccinated staff are exempt from masking, distancing and barrier requirements “when in well-defined areas where there is no reasonable expectation that any person will be present with suspected or confirmed coronavirus.” McKnight’s Liza Berger, Kimberly Bonvissuto, Diane Eastabrook and Kimberly Marselas offer helpful details and perspectives. The rules affect more than 10 million employees across healthcare settings.
· Turbulence in the skies: The Federal Aviation Administration has received about 2,900 reports of unruly passenger behavior on airplanes since January 1, the Washington Post reports. Some 2,200 of the incidents involved passengers who refused to wear a face covering.
The vaccination dashboard
· Remember the Novavax vaccine? The company just announced long-awaited results of a Phase 3 trial among 30,000 participants in the U.S. and Mexico, as Brian Park reports in MPR. The news is good: 90% overall efficacy against symptomatic COVID-19, 100% protection against moderate and severe disease, 91% efficacy in high-risk populations, and 93% efficacy against predominantly circulating variants of interest and concern. Novavax plans to file for regulatory authorizations in Q3 and reach manufacturing capacity of 150 million doses a month by year’s end.
· Remember the Johnson & Johnson vaccine? Some 21.4 million doses have been delivered to vaccination sites in the U.S., but just 11.5 million have been administered. Another 60 million doses have to be tossed because of contamination at a manufacturing plant in Baltimore. The FDA has extended the shelf life of the vaccine from three months to four and a half months.
· The G7 leadership group (Canada, France, Germany, Italy, Japan, the U.K. and the U.S.) has pledged 1 billion doses of COVID-19 vaccine to the worldwide immunization effort. The total includes 500 million doses of Pfizer vaccine that the U.S. will buy at a nonprofit price and make available for free worldwide distribution. World Health Organization officials think the G7 offer is less than magnificent, but it’s a start.
· The federal government is now posting COVID-19 vaccination rates of nursing home staff and residents on a publicly available website. Facilities will face penalties if they don’t supply the data. James M. Berklan and Kimberly Marselas have details in McKnight’s Long-Term Care News.
· A federal judge dismissed a lawsuit challenging Houston Methodist Hospital’s vaccine mandate for employees. Nearly 120 employees joined in the lawsuit while 24,947 have now had their shots.
To modify the Yogi-ism, it may never be over. The best-case scenario may be to tame the viral beast if we can’t slay it. Which brings us to another memorable Yogi utterance, spoken while driving with his family on vacation: “We’re lost but we’re making good time.” We’re not lost on the road to post-pandemic life and living, but we can hope to make better time.
Congratulations to Ed Yong of The Atlantic, winner of the Pulitzer Prize for Explanatory Reporting. Many thanks to my colleague Larry Dobrow for introducing me to Yong’s work on the pandemic, which are models of clarity, insight and good old-fashioned journalism. The judges lauded Yong’s series of “lucid, definitive pieces on the COVID-19 pandemic that anticipated the course of the disease, synthesized the complex challenges the country faced, illuminated the U.S. government’s failures, and provided clear and accessible context for the scientific and human challenges it posed.” Yong said, “I wish that the stories I wrote had never been necessary.” Here’s the essential Ed Yong reading list.
…and some songs
Thanks so much for tuning in. See you here next Wednesday, and in the meantime here’s wishing a Happy Father’s Day to all. Thanks, Dad, for that first MLB game way back in 1957. Connie Mack Stadium, Philadelphia, Robin Roberts on the mound and my role model at my side.