Checking our progress, courtesy of the Centers for Disease Control and Prevention:
• 217.2 million people ages 12 and older have received at least one dose of COVID-19 vaccine (76.6% of the vaccine-eligible)
• 187.6 million people 12 and older are fully vaccinated (66.2% of the vaccine-eligible)
• 95.2% of seniors 65+ have received at least one dose of vaccine and 84.1% are fully vaccinated.
• Those receiving a booster dose include 4.9% of adults 18 and older, 7.6% of people 50 and older and 11.9% of seniors. Overall, 8.5 million people have received a booster.
It’s decision time
By now, Tom Sawyer would have persuaded the vaccine fence-sitters to come on down, roll up their sleeves, pick up a brush and help paint the darn fence.
Real life is somewhat more complex. What will move the undecided and the wary to the nearest COVID-19 immunization site is a question with more than one answer, with different brush strokes for different folks.
The latest research from Chicago-based Civis Analytics, conducted among 5,110 unvaccinated people, shows that the most persuasive messages right now focus on protecting children from COVID-19 and on the financial costs of getting sick. The survey also found that effective messaging varies by demographic group. Emphasizing personal choice, for example, helps when communicating with Americans who identify as “very conservative,” people without a high school diploma and those making $50,000 to $100,000 a year. Among the Latino population, messages emphasizing patriotism resonate while scary statistics about hospitalization are likely to backfire.
Civis cautions that focusing on the personal health risks of COVID-19 is not a strategy that will motivate reluctant individuals. “The numerous stories about people on their deathbeds who regret being unvaccinated aren’t resonating with the people who need convincing,” said Crystal Son, Civis director of healthcare analytics.
Nonetheless, the Department of Health and Human Services has inserted a “fear factor” into its newest PSAs, CNN reports. The ads draw upon social media posts and interviews with survivors and an ICU nurse to dramatize the potentially devastating impact of the disease. HHS officials acknowledge that the approach may not work for everyone, but feel the time has come to move away from earlier ads that depicted vaccination as a way to recapture the simple joys of everyday living.
Lori Freeman, CEO of the National Association of County and City Health Officials, believes that the tough, straight-talk approach “resonates more than, ‘Let’s sing Kumbaya together and go to a concert together.’ It’s a better approach to say, ‘This is what you need to do to keep yourself alive,’ rather than, ‘This is how to help the world.’”
In everyday living, the message that more and more people around the country are now hearing is: “You will need to be vaccinated if you want to keep your job.”
In MM+M, Lecia Bushak explores why vaccination mandates are working and likely have staying power. As L.J. Tan, chief strategy officer of the Immunization Action Coalition, noted, “There’s a healthy percentage [of the unvaccinated] that are on the fence, and I don’t think we’re seeing that population quit their jobs.”
For an extended read on this subject, see the 27-page White House report, which notes that mandates and related requirements over the summer and early fall have increased vaccination rates by more than 20 percentage points in both the public and private sectors. Requirements have helped reduce the unvaccinated and eligible population from 98 million in late July to 67 million in early October.
An instructive case in point comes from the Henry Ford Health System in Michigan. The company announced its COVID-19 vaccination requirement on June 29, at which point 68% of workers were vaccinated. The requirement went into effect on September 10. By October 5, compliance had zoomed to 99%, with more than 30,000 workers fully vaccinated. Some 1,900 employees (6% of the workforce) obtained a medical or religious exemption, while 400 (1% of the workforce) resigned. The latter can apply for a job if they have a change of heart (and arm).
Everything is far from quiet on the mandate front, however, as Texas Governor Greg Abbott issued an executive order banning COVID-19 vaccine mandates by any entity in the state, including private employers. IBM, American Airlines, and Southwest Airlines intend to stick with the federal mandate, Bloomberg reports. Courtrooms will be busy.
The children’s hour approaches
The vaccination dynamic will change yet again when 28 million U.S. children ages 5 to 11 become eligible for COVID-19 vaccination, a decision coming soon.
• Pfizer and BioNTech have asked the Food and Drug Administration for emergency use authorization of their COVID-19 vaccine for kids 5 to 11, at one-third the dose authorized for people 12 and older. The FDA’s vaccine advisory committee will meet to consider the request on October 26. The CDC’s advisory committee will meet November 2 and 3. Expect careful scrutiny of the safety data.
• These developments come at a time when children and adolescents represent 24.8% of new COVID-19 cases in the U.S. for the week ending October 7. The pediatric population represents a much smaller percentage of COVID-19 hospitalizations (2.5%) and deaths (0.09%), based on state data compiled by the American Academy of Pediatrics and Children‘s Hospital Foundation.
• When it comes to vaccinating young children, conversations between parents, pediatricians, family physicians, pharmacists and other healthcare providers will move to center stage. The Kaiser Family Foundation reports that, as of late September, 34% of parents support vaccinating their 5- to 11-year-old children “right away” once a vaccine is available. That’s up from 26% in July. Another 32% will wait and see and 24% will “definitely not” have their child vaccinated. The other 10% will agree to vaccination only if it is required.
• If current COVID-19 vaccination rates for 12- to 17-year-olds are any indication, the road to vaccinating younger children will be moderately uphill. So far, 56% of 12- to 17-year-olds have received at least one dose and 46% are fully vaccinated.
• Home care agencies are struggling with state vaccination mandates and worried about mass staff departures, Diane Eastabrook reports in McKnight’s Home Care.
• Ochsner Health, the largest health system in Louisiana, has a vaccine mandate for employees. It is preparing to impose a surcharge of $100 per pay period in 2022 for unvaccinated spouses and domestic partners covered by the employee’s benefits plan.
• To combat a “wildfire effect” of vaccine misinformation on social media, the American Heart Association is launching a COVID-19 public awareness campaign for the Hispanic community, Betsy Kim reports in PRWeek. The campaign coincides with National Hispanic Heritage Month and includes a “Stay Fuerte (Stay Strong)” panel livestreaming today on YouTube. Hispanics are almost 2.3 times more likely to die of COVID-19 than whites and non-Hispanics.
• Between April 2020 and June 2021, an estimated 140,000 children lost a parent, custodial grandparent or grandparent caregiver to COVID-19. Nearly two-thirds (65%) of children who lost a primary caregiver were children of color. The study authors are part of a collaborative international group that includes the CDC.
• As if caring for desperately ill patients were not challenging enough, nurses and other healthcare workers are increasingly the target of verbal and physical abuse from an angry public. A growing number of nurses are deciding it’s time to leave the profession, The Conversation reports.
Mandates in motion
• IBM is requiring all U.S. employees to be fully vaccinated by December 8; the alternative is unpaid suspension. IBM, among other employers, says its status as a federal government contractor puts it within the reach of the federal mandates announced by President Biden.
• Kaiser Permanente has put more than 2,200 unvaccinated employees, representing about 1% of its workforce, on unpaid leave. They have until December 1 to comply.
• University of Colorado Health, a 12-hospital system, is requiring almost all transplant recipients to be vaccinated against COVID-19. Hospital officials cited a mortality rate of 20% to 30% among transplant recipients who develop COVID-19.
• California has expanded its vaccination mandate to include workers in adult and senior care facilities, in-home aides and hospice professionals, with a deadline of November 30 to achieve fully vaccinated status.
• Los Angeles is requiring proof of vaccination for indoor locations, effective November 4. Louisiana State University, on the other hand, has dropped its proof of vaccination/testing requirement at Tiger Stadium, effective with this Saturday’s game against Florida. LSU, the undefeated 2019 national champion, might need a booster of another sort after dropping out of college football’s Top 25.
The vaccine dashboard
• The FDA’s vaccine advisory committee will consider Moderna’s COVID-19 booster application on Thursday and J&J’s on Friday.
• It is safe (though not necessary) to receive the COVID-19 vaccine and flu vaccine at the same time, per the CDC. You need both and sooner is better than later. The Axios-Harris Poll reports that 26% of the public mistakenly believes that COVID-19 vaccine protects against the flu and 23% believe the flu shot protects against COVID19.
• In England, more than 20% of people 80 and older have received a booster dose of COVID-19 vaccine, as have 10% of those ages 75 to 79, Nick Bostock reports in GP.
• Some countries, including the U.K., are limiting COVID-19 vaccination of adolescents 12 and older to one dose. The main concern is the rare side effect of myocarditis, which remains abundantly more common in people who develop COVID-19.
• AstraZeneca is seeking FDA authorization of a long-acting monoclonal antibody for prevention of COVID-19. Phase 3 data showed a 77% reduction (versus placebo) in the risk of developing symptomatic disease. The product, discovered at Vanderbilt University, is a combo of tixagevimab and cilgavimab. AstraZeneca says it could provide an added layer of protection for immunocompromised patients and others who do not mount a strong response to COVID-19 vaccination. Alicia Lasek and Brian Park have details in McKnight’s Long-Term Care News and MPR, respectively.
• Merck has applied for emergency use authorization of the antiviral pill molnupiravir, for treatment of mild to moderate COVID-19 at risk of progressing to severe disease.
• After 106 days of lockdown, restaurants, gyms and hair salons in Sydney are open again…to the vaccinated. Some pubs opened at dawn as their way of saying G’day. The lockdown ended after regional vaccination rates reached 70%.
• There’s no place like… not home? For some folks, remote working facilitates better work/life balance, while others find happiness in the office, Peter Crush writes in Management Today. In a global survey of 23,000 employees, those working regularly in offices say they are better team players and have a clearer understanding of their role in the organization than their work-at-home peers. One in four office-based workers say they feel more valued and get more attention from management.
• A Harris poll reports that 50% of vaccinated people are “extremely” or “considerably” hesitant about spending the holidays with unvaccinated family and friends. Here’s a great gift idea for family and friends: Get the shot.
The opening session of the American Health Care Association/National Center for Assisted Living Convention & Expo began with a moment of silence for the 100,000 long-term care residents and 2,000 staffers who have died of COVID-19, Kimberly Bonvissuto reports in McKnight’s Senior Living. “We owe it to them to finish this battle,” said president and CEO Mark Parkinson.
Predicting that things will be back “relatively close to normal” by this time next year, Parkinson said, “We will fight through another year. We’ll be fine. We will put the greatest pandemic in the history of the country behind us. You will look back on this as the most important work you’ve ever done.”
…and some songs
Thanks, as always, for joining us here. Have a pleasant week and we’ll welcome you back next Wednesday. Stay well.