Infectious Disease

What will COVID-19 look like for unvaccinated Americans this fall?

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Healio interviews.

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Lee does not report any relevant financial information. Kuppalli reports being on an advisory board for GlaxoSmithKline.

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By June, more than half of Americans were fully vaccinated against COVID-19, including more than 76% of adults 65 and over.

CDC director on June 8th Rochelle P. Walensky, MD, MPH, announced that the average daily case number in the United States fell below 15,000 for the first time since March 2020 and that new hospital admissions for COVID-19 have decreased by 83% since January.

COVID variant

Experts said the advent of the Delta variant and the fact that many Americans are not vaccinated could add to a dangerous fall season.
Source: Adobe Stock.

“Overall, the pandemic in the US is looking better than it has been for a long time.” Krutika Kuppalli, MD, Assistant Professor of Medicine in the Department of Infectious Diseases at the Medical University of South Carolina and an emerging biosecurity scientist at the Johns Hopkins Center for Health Security, said Healio.

“The improvement in numbers is evidence of the overall effectiveness of the COVID-19 vaccine launch,” Kuppalli said. “That being said, there are still parts of the country that have low vaccine intake, which … particularly affects rural areas and areas in the southern part of the country.”

Rochelle P. Walensky

Krutika Kuppalli

Walensky said the increasing data suggests the vaccines are “leading us out of this pandemic”. In fact, officials have been lifting measures to contain the pandemic for months.

Although hesitation about COVID-19 vaccines has subsided, experts agree that many eligible individuals simply never get vaccinated. What will the pandemic look like for you in the fall?

Variants, flu make prospects difficult

To get an idea of ​​what this autumn could look like for the unvaccinated, one only has to look at the last autumn and winter, according to Kuppalli.

“However, it has to be added that we have several variants floating around that have proven to be increasingly transmissible and possibly more virulent,” said Kuppalli. “There are also concerns about how bad the flu season could be this year, which could lead to additional complications for those who are not vaccinated.”

Bruce Y. Lee

One of the most dangerous variants is the Delta variant first identified in India, the Bruce Y. Lee, MD, MBA, said has a “fitness benefit” which means that it has some traits or traits that make it easier to spread, more contagious and to be considered the dominant variety, as was the case in the UK.

“You just have to look at the chaos the Delta variant has created in India to see how devastating it can be,” added Kuppalli. “I am concerned about how much more transmissible it is and what that means for people who have not been vaccinated, but also for those who have only received one dose of the vaccine, as well as people who are immunocompromised and may not develop a strong antibody response to have .”

As SARS-CoV-2 continues to spread and multiply in humans, more variants are likely to emerge, said Lee, professor of health policy and management at the City University of New York Graduate School of Public Health & Health Policy.

“That’s another reason to try and reduce this spread as quickly as possible,” Lee told Healio. “The more it spreads and the more viruses multiply or replicate, the more possibilities there are that more and more variants will appear.”

Greater coverage

Survey results recently published on JAMA showed that the prevalence of COVID-19 vaccine reluctance among a cohort of more than 7,000 US adults decreased from 46% in October to around 35% in March, months after vaccinations started.

The biggest declines were in blacks and Hispanic Americans, researchers reported. They said hesitation was most common among younger adults, people without a college degree, and in households with annual incomes of $ 50,000 or less.

“I think we really need to work on developing our base campaign to understand why certain people are not being vaccinated,” said Kuppalli. “We have to meet people where they are and try to understand and advise people. I think there is still a lot of misinformation and fears about the vaccine and it often takes individual discussion to understand why people believe this misinformation and to educate it appropriately. “
multiple categories. The first, he says, are people who would not get vaccinated under any circumstances.

“There isn’t much you can do about this because you’ve already decided that you actually won’t,” Lee said, adding that clinicians need to help these people understand that COVID-19 is serious and it is serious Cases are at risk of not being vaccinated. From there, all you can do is help them take the necessary precautions to limit their risk, Lee said.

The second group consists of people who are not vaccinated because of misinformation or other non-scientific information.

“So one of the keys here is helping them understand and sort out what is real and what is not real information,” Lee said. “Help them understand that everyone wants each person to make an informed decision, and this is a situation where something unknown is being forced upon people, but when you decide what information is appropriate or not, you need to be in the To be able to look at the information source, you need to be able to see the reason behind what a person or organization or bot or social media account is trying to say. ”

The third group is made up of people who have correct information but distrust health systems, Lee said. This group needs someone they know or trust to reach out to them and guide them in the direction that is best for them, he said.

Then there are people who want to be vaccinated but have not made it. For them, it’s about making the vaccines available, Lee said.

“Unvaccinated people will remain vulnerable,” said Lee, adding that vaccinating enough people to exceed herd immunity thresholds, which can break the chain of transmission, is a major concern.

“This will ultimately not only help the people who are not vaccinated but also the people who are vaccinated because we need to remember that the vaccine is not 100% effective and you can still have breakthrough cases,” said Lee. “That means that people who have not been vaccinated will have to keep social distance this fall, wear a face mask and protect themselves as well as possible.”

References:

CDC. COVID data tracker: COVID-19 vaccinations in the US. https://covid.cdc.gov/covid-data-tracker/#vaccinations. Accessed June 16, 2021.

DalyM. et al. JAMA. 2021; doi: 10.1001 / jama.2021.8246.

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