Like the old Rubick’s Cube, the many parts of COVID-19 vaccine picture are ever-changing and challenging to put together. The good news is that we’re getting more clinical evidence and insights constantly, and we have the necessary pieces in place to manage COVID-19, including the Delta variant, enable and encourage vaccinations among the unvaccinated, help prevent serious illnesses and hospitalizations, and manage booster efforts effectively.
As of September 3, 372,116,617 total COVID-19 vaccinations have been administered in the U.S., and over 174 million Americans are fully vaccinated, including over 3.2 million in long-term care. That’s a lot of shots in arms, but we’re still not at the finish line. At the beginning of September, about 47.3% of the country’s population remained unvaccinated. While this number has likely gone up with vaccination mandates and increased demand, there is still a large percentage of people who haven’t received the vaccine, including many workers in post-acute and long-term care facilities.
Delta’s a Driver
Just when we thought we had COVID under control, the Delta variant hit and caused new surges in infections. In truth, viral mutations are normal and expected. However, they may affect a virus’ transmissibility, pathogenicity, virulence, and resistance to current treatment. As a result, vaccines designed to target the original virus may suffer diminished efficacy.
Delta is more contagious and more virulent. Currently, it accounts for 84% of COVID cases, and it is putting unvaccinated individuals at greatest risk. While there have been some breakthrough cases in vaccinated people, they tend to experience less severe illness and recover more quickly. The Centers for Disease Control and Prevention (CDC) advises that an additional dose of an mRNA COVID vaccine after an initial 2-dose series should be considered for people with moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments.
For other patients, the CDC is considering recommending boosters, which they say will be needed to maximize the vaccine-induced protection and prolong its durability. These are anticipated to begin the week of September 20 to align with the end of the 8-month period after conclusion of the first 2-dose primary mRNA vaccination series.
Long COVID Looms
As if Delta and the resurgence isn’t enough, we’ve learned patients aren’t necessarily out of the woods after their COVID infection resolves, even if they only had a mild case. Long COVID, in which symptoms linger long after someone has recovered, is estimated to affect between 3 and 10 million people in the U.S. alone. The symptoms include fatigue, brain fog, anxiety or depression, a persistent cough, tinnitus, muscle weakness, a need for oxygen support, kidney disease, hair loss, and a general decline in quality of life.
While there have been advancements in treatments, including the use of monoclonal antibodies, there is still little data about who is likely to suffer from long COVID. As we learn more about this, it presents another case for ongoing, assertive efforts to prevent the infection through vaccination.
The data is clear: vaccines work. Yet many people remain unvaccinated even though the shots are widely available. One challenge is overcoming the perception that the Emergency Use Authorized vaccines can’t be trusted, despite the vast amount of data documenting its safety. The recent U.S. Food and Drug Administration (FDA) final approval of the Pfizer vaccine may persuade some who have been hesitant to get vaccinated, but isn’t likely to move the needle considerably.
With the Biden Administration’s recent announcement regarding vaccine mandates for skilled nursing homes, there is renewed urgency to overcome hesitancy. The U.S. Bureau of Labor Statistics says that nursing home and residential care facilities have lost nearly 400,000 workers since February, so it remains important to continue educating staff about the vaccine’s benefits and dispel the myths. It is crucial to be vigilant and keep an eye open for tidbits of misinformation so they can be caught and addressed promptly. Fortunately, there are numerous resources, including Myths and Facts about the COVID-19 Vaccine and The Truth about COVID Vaccines. It also helps to have thought leaders and respected peers share their stories about why they got vaccinated.
Of course, we can’t just hand out materials or do one or even two meetings or virtual town halls. Having one-on-one interactions with those who are hesitant can uncover their concerns and fears so that they can be addressed specifically. This requires trust and a culture of respect.
Power of Partnerships
It’s impossible to underestimate the value of personal relationships to manage a pandemic and increase vaccination rates. The ability to pick up a phone or send a text and get information or guidance from a trusted source, such as a senior care pharmacist, is priceless. Whether it involves questions about vaccines, COVID treatments, medication management, or billing and coding, access to real-time support makes a significant difference.
The COVID pandemic has demonstrated the positive impact of teamwork and open, ongoing communication. These are valuable lessons to take use through this new wave of COVID and beyond.