More Americans Not Getting Boosted

NASHVILLE, TN – Fewer Americans are getting a second booster shot and only 2.8% of young children under five years old have been vaccinated. According to a Kaiser Family Foundation poll last week the number of young children getting vaccinated is declining and 4 in 10 parents say they are not going to vaccinate their child.

Children 5 to 11 were first eligible for a vaccine in November 2021, and according to the CDC, 30% of older kids are now fully vaccinated. But adults aren’t rushing to get boosted. As of July 28, only 51.5% of U.S. residents 18 and older had gotten a booster while 90% had gotten a first shot.

In Tennessee, 60% of those 18 to 64 got one jab but only 24% are boosted. Cases and deaths are increasing in the U.S. Last week there were averages of 124,090 cases/dy and 437deaths/dy.

In Tennessee last week, CDC figures indicate there were 2,668 new daily cases, 942 hospitalizations, and 10 deaths. The average of ICU occupancy in Tennessee hospitals was 88% last week; the U.S. average ICU occupancy was 73%. Number of cases in Tennessee has increased each month since April 2022.

The BA5 Omicron subvariant is causing 78% of infections in the U.S. BA5 is good at evading immune protection from a vaccine or a prior COVID infection.

“They’re the Houdini of Covid,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “They’re the escape artists.”

BA5 infects the upper respiratory tract, and while very infectious, it generally has milder symptoms than earlier variants like Delta. Chin-Hong said wastewater studies in CA. indicate there could be 3-8 times more infections than the official counts.

Infection numbers come from people going to a clinic to get tested. He said asymptomatic infections or reinfections often escape detection. The virus ends up in sewage and scientists count how much. Chin-Hong said instead of 124,090 new infections per day last week, it is likely that the real number was closer to one million a day.

“People were infected and didn’t know it…about  60% of adults have seen COVID before—this is even before the surge—and 75% of kids. It comes down to immunology. Some people are more protected than others,” he said.

This is reminiscent of the theory of “herd immunity”, and, it is like that in a way but with one important caveat: while previous infection provides an antibody response

to fight catching COVID again, it doesn’t afford the extra protection vaccines and boosters provide.

The studies are quite clear on this point. Even though current boosters were developed for COVID variants that are no longer prevalent, they still protect against severe disease and hospitalization from other variants.

Some health experts say we are transitioning from the acute phase of the pandemic to an endemic phase. New vaccines are being developed specifically against the BA4 and BA5 variants.

The U.S. Department of Health and Human Services (HHS) announced an agreement last week to purchase 66 million doses of Moderna’s bivalent vaccine booster. The Biden administration has also ordered 105 million bivalent does from Pfizer. Both boosters are expected to be released in early Fall.  

Coronavirus is sneaky

Coronavirus keeps mutating and so far it’s been changing faster than scientists can keep up with. The virus infects someone by attaching part of itself to its host.

“The original Alpha variant had one change in the part of the spike that actually binds to you… Delta, Gamma, and Delta had two mutations. Omicron came along and it had 15 mutations–all of a sudden–concentrated in that area. Now we have some of these new variants like BA4 and BA5 and these things will have 17 or 18 in that area,” said Dr. Ben Neuman, Chief Virologist at the Global Health Research Complex at Texas A&M University.

Antibodies still protect against about half the virus mutations but not against mutations in the spike of BA 4 and BA 5 virus where the infection begins.

“In animal studies, BA4 and BA5 caused more disease in hamsters in the lungs and airways leading to the lungs which would make it more difficult to breathe,” Neuman said.

He said there is some evidence that BA4 and BA5 go into a human cell in a different way. He said it should make things a bit more difficult for the virus because it would have to go inside and then be activated instead of being activated at the surface.

“So right now we can say that these are different. They evade immunity because they have many changes at exactly the spot where we would most like to have immunity but most of the rest of the virus is unchanged.”

Neuman said most of your immune response to other parts of the virus is still going to be intact. “But the immune response that would stop the infection and stop the symptoms from starting, that is out of whack. And it runs out much more quickly than it did early on in the outbreak. When you used to get vaccinated it lasted much longer,” he said.

Dr. William Schaffner and his wife are over 50. They were both vaccinated and boostered but came down with the BA5 variant. They both took a five-day regimen of Paxlovid, an antiviral medication. They did not develop severe COVID symptoms and got better.

Schaffner is Professor of Preventive Medicine and Professor of Medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine. He said there are a number of therapeutics in the pipeline that will be available in a couple of years to better treat the illness.

“If you are unvaccinated or only partially vaccinated be advised ‘thought to be less severe’ can still attack you and put you in the hospital. We see that happening everywhere,” he said. 

There are many weeks before the updated COVID vaccine becomes available. Schaffner said that a bird in hand is worth two in the bush. “BA5 is circulating in every community in this country. The current recommendation is that if you are eligible for a booster, receive it this afternoon.”

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