Booster shots are coming
The Biden administration has decided that most Americans should receive a corona booster vaccination, our colleague Sharon LaFraniere reported last night. Officials plan to announce the decision as early as this week, with doses starting as early as mid-September for the most vulnerable.
If you feel whiplash, you are not alone. Just over a month ago, government officials and public health experts had doubts about the claim that booster vaccinations would be necessary. That consensus has now abruptly shifted.
Why is this happening? Based on data as of late June, the CDC and public health experts repeatedly assured the public that breakthrough infections were extremely rare and that vaccinated people were highly unlikely to become seriously ill.
Then came Delta: The highly contagious strain began sweeping the country in July, overwhelming the immune systems of unvaccinated people and also breaking the defenses of some who had received the vaccine.
“It’s so much more contagious and has a greater impact that many more vaccinated people get infected,” says our colleague Apoorva Mandavilli.
The vaccines are still powerfully protective. In raw numbers, so-called breakthrough infections in fully immunized people are uncommon, and most people who become seriously ill and die from Covid-19 are not vaccinated. Still, breakthrough infections have made an increasing percentage of diagnosed cases in recent weeks, and higher rates of total hospitalizations and deaths than expected.
Apoorva analyzed seven states that provided the required preliminary data — California, Colorado, Massachusetts, Oregon, Utah, Vermont and Virginia — and found a greater percentage of people vaccinated than previously thought among those infected, hospitalized and killed by the coronavirus:
In six of the states, breakthrough infections were responsible for: 18 to 28 percent of recorded cases the past weeks. (In Virginia, the outlier, 6.4 percent of cases were in vaccinated people.) These numbers are likely underestimated, because many fully immunized people who become infected may not seek a test.
Breakthroughs Responsible 12 to 24 percent of Covid-related hospital admissions.
The number of deaths from breakthroughs was small, so the proportion of people vaccinated is too variable to be useful. But it looks like it higher than the CDC estimate of 0.5 percent.
“Remember when the early vaccine studies came out, it was like nobody was hospitalized, nobody died,” said Dr. Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco. “Obviously that’s not true.”
The numbers support the view, widely held by officials in the Biden administration, that booster shots may benefit some Americans in the coming months.
But there are caveats: The seven states were surveyed because they hold the most detailed data. It is not certain whether the trends in these states hold across the country. And some increase in the ratios is expected as more people get vaccinated.
Most importantly, the newly emerging picture does not mean the vaccines are ineffective.
“The main conclusion is that the vaccines are really excellent, but they are not a perfect shield against the Delta variant,” Apoorva said. “Vaccinated people should be careful, especially if they are at high risk.”
The CDC declined to comment on the states’ numbers. The agency is expected to discuss breakthrough infections, hospitalizations and vaccine effectiveness at a news conference on Wednesday.
New Zealand is on lockdown
Our colleague Natasha Frost reports from Auckland:
New Zealand has entered a strict three-day lockdown after a single case of the Delta variant was identified in Auckland, forcing residents to stay at home and close all schools, public facilities and non-essential businesses.
“With Delta raging around the world,” said Jacinda Ardern, the country’s prime minister, “it was not a matter of if, but when.”
It is believed to be the country’s first case of the more contagious Delta variant outside the strict quarantine system; it is not yet known how the person who first tested positive contracted the virus. By Wednesday morning, four more cases linked to the initial infection had been identified, including a nurse at the country’s largest hospital who had been fully vaccinated.
The country’s “Covid-zero” status has allowed New Zealanders to live almost without restrictions for the past year. But only 17 percent of the population is fully vaccinated, making the country extra vulnerable.
“We are one of the last countries in the world to have the Delta variant in our community,” Ardern said. “This gives us the opportunity to learn from others.”
Understand the State of Vaccine and Mask Mandates in the US
- Mask Rules. The Centers for Disease Control and Prevention recommended in July that all Americans, regardless of vaccination status, wear masks in indoor public places in areas with outbreaks, a reversal of the guidance it offered in May. Find out where CDC guidelines apply and where states have their own masking policies. The battle over masks has become controversial in some states, with some local leaders defying state bans.
- Vaccine rules. . . and Buselessness. Private companies are increasingly mandating coronavirus vaccines for employees, taking different approaches. Such mandates are permitted by law and have been confirmed in court proceedings.
- College and universities. More than 400 colleges and universities are demanding that students be vaccinated against Covid-19. Almost all of them are in states that voted for President Biden.
- schools. On August 11, California announced that teachers and staff at both public and private schools should be vaccinated or tested regularly, the first state in the nation to do so. A survey published in August found that many U.S. parents of school-aged children are opposed to mandatory vaccines for students, but were more in favor of mask mandates for students, teachers and staff who have not received their injections.
- Hospitals and Medical Centers. Many hospitals and major health systems require workers to receive a Covid-19 vaccine, citing the increasing caseload fueled by the Delta variant and persistently low vaccination coverage in their communities, even within their workforce.
- New York. On August 3, New York City Mayor Bill de Blasio announced proof of vaccination would be required from employees and customers for indoor meals, gyms, performances and other indoor settings, becoming the first U.S. city to require vaccines for a wide variety of activities. . City hospital employees should also receive a vaccine or be tested weekly. Similar rules apply to employees in New York State.
- At the federal level. The Pentagon announced it would aim to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “by mid-September.” President Biden announced that all civilian federal employees would be required to be vaccinated against the coronavirus or undergo regular testing, social distancing, mask requirements and restrictions on most travel.
India fears a third wave
Infections have fallen in India, which endured devastating illnesses during the second wave this spring. But scientists are anxiously looking for signs of a new wave that could emerge in Delta’s wake.
New labs are looking for dangerous new variants or mutations in the coronavirus. They have ramped up testing to more than 3,600 samples per month, from 134 samples last December.
Still, India is a long way from its goal of establishing comprehensive genome sequencing, hampered by limited sampling capabilities. Only 8.5 percent of Indians are fully vaccinated.
Some hope that the sheer contagiousness of the Delta variant means that many people have already contracted it and developed a measure of protection. A recent study found that two-thirds of blood samples contained antibodies, compared with about a quarter in December and January. In some states, as many as three-quarters of the samples carried antibodies.
But scientists warned that the study, with a small sample size of 36,000, should not be read as an indication that India is out of the woods. Even if the numbers are correct, they suggest 400 million Indians remain vulnerable to Covid-19.
What else do we follow
What are you doing
Our whole family was all vaccinated as soon as we could, but our grandson, who has been working in a day camp this summer, has brought home the Delta variant. Fortunately, our daughter-in-law is a scientist and had everyone tested as soon as he had a runny nose. Our grandson and his mother were positive, our son and granddaughter were negative and we are waiting to see if my husband and I are positive. — Beda Herbison, Seattle
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