Many Covid-19 Boosters Go Unused This Fall and Here's Why

Many Covid-19 Boosters Go Unused This Fall and Here’s Why

Use of fall Covid-19 booster shots remains anemic through November, frustrating public health experts who attribute the lack of interest to pandemic fatigue and insufficient awareness among officials.

About 31 million people in the United States have received the updated vaccines, or about 10% of people aged five and older, according to data from the Centers for Disease Control and Prevention. The federal government has purchased more than 170 million doses of the new bivalent boosters that target two subvariants of Omicron and the original viral strain.

“It’s been pretty dismal,” said Rupali Limaye, an associate professor at the Johns Hopkins Bloomberg School of Public Health who studies vaccine demand and acceptance.

The current rate of people likely receiving the booster is not sufficient to protect many people, especially the elderly and immunocompromised, from serious illness during the winter months, when more people are spending time indoors and congregating for the holidays, public health experts have said.

Sensitization is limited in part because Congress has not approved additional funding for Covid-19, according to the Department of Health and Human Services, which oversees the Covid-19 response. Health officials and experts say the the recent easing of the pandemic has also played a role in public awareness and messaging.

President Biden speaking last month in Washington before receiving a Covid-19 booster shot.


Photo:

Al Drago/Bloomberg News

“I think the administration is facing a challenge. They’ve tried to convey that things are looking up and they’re trying to convey that you should get your booster updated,” said Jen Kates, vice president. principal of the Kaiser Family Foundation, which helped lead the organization’s work on the COVID-19 pandemic. “It’s hard to create that urgency.”

White House Covid-19 Response Coordinator Ashish Jha in September urged people to catch Covid-19 shot in late October, claiming the viruses circulate at much higher levels in fall and winter. He later said that everyone aged 50 and over should get the booster because “it’s the difference between life and death”, adding that more people were due to get the shots last month.

The Biden administration released new video ads in September touting the reminders, the same month President Biden received criticism from public health experts for declaring the pandemic over.

Awareness efforts in October included updated ads as part of HHS’ “We Can Do This” campaign, which targets seniors and black and Hispanic communities who have been disproportionately affected by the pandemic.

Local radio advertisements targeting rural communities began airing on October 24. Ads are also shown on Facebook, Twitter, Pinterest,

Snapchat and Reddit. HHS declined to provide data on the amount currently spent on advertising and outreach compared to previous recall campaigns.

The federal government has purchased more than 170 million doses of the new bivalent boosters that target two subvariants of Omicron and the original viral strain.


Photo:

Hannah Beier for The Wall Street Journal

White House officials say adoption of the modified boosters has improved since they were first deployed: Over the past three weeks, four million people a week have received the modified vaccine, up from about 2.5 million vaccinations a week when the program started.

But uptake of the modified recall is slow in part due to the limited amount of awareness and type of messaging from health officials, some public health experts say.

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“Anecdotally, it seems a lot of people still don’t know that bivalent boosters are available,” said Angela Rasmussen, a virologist at Georgetown University. “If they are, many don’t seem to understand the importance of getting boosted at all – with a bivalent or original recipe – and there’s a lack of urgency in communications about it.”

Some public health experts say there needs to be not just more, but targeted awareness.

Celine Grounder, senior researcher at the Kaiser Family Foundation, said messaging needs to be more targeted to people 50 and older who are most at risk. Among adults 65 and older, about 27% received an updated booster dose, according to CDC data.

“You should think about who is most vulnerable and target efforts there,” said Dr Grounder, an infectious disease specialist and epidemiologist.

In Connecticut, where nearly 17% of the population received an updated booster dose, health officials are deploying vans to bring pop-up clinics to underserved communities, colleges and major events, as part of a campaign aimed at vaccinating more people before the holidays, said Manisha Juthani, commissioner of the Connecticut Department of Public Health.

Dr. Juthani acknowledged that there is less awareness compared to previous Covid-19 vaccination efforts, in part because the United States is in a different phase of the pandemic. “We don’t need the kinds of campaigns that we needed in the beginning when people had no immunity,” Dr Juthani said. “Everything is in transition.”

Some 69% of the US population, including 94% of people age 65 and older, have completed the original series of vaccines, CDC data shows, and many have already been infected, providing some level of protection. But immune defenses decline over time, public health experts have said, and new variants have made older protection less effective.

Local jurisdictions and health departments have canceled many vaccination clinics and mass vaccination sites, in part due to increased availability of vaccines at pharmacies and doctors’ offices.

Doctors are reporting high numbers of respiratory illnesses like RSV and influenza earlier than the typical winter peak. The WSJ’s Brianna Abbott explains what the early surge means for the coming winter months. Photo illustration: Kaitlyn Wang

Other reasons also explain the poor uptake of reminders, according to some public health officials. Some people may be waiting to get vaccinated because they recently had a Covid-19 infection or are trying to time it to coincide with the holidays. But many are likely feeling vaccine fatigue or view Covid-19 as less of a threat than before.

Covid-19 cases and hospitalizations are down from the last summer surge, even as the virus continues to circulate. The United States averaged some 2,300 Covid-19-related deaths in the week ended Nov. 9, CDC data shows.

“For most people, they don’t see Covid as as big of a risk as they did six months ago,” said Joel Zinberg, director of public health and the American Well-Being Initiative at Paragon Health Institute. Mr. Zinberg served on the Council of Economic Advisers during the Trump administration.

Modeling overseen by the CDC indicated that up to 100,000 hospitalizations could be averted and 9,000 lives could be saved this winter if people received the updated reminders at the same rate as the annual flu shot, which hovers around 50% for adults each year.

The use of the bivalent booster could increase if Covid-19 cases and hospitalizations increase again this winter, public health experts have said.

Decreasing cases in parts of Europe suggest there may not be a major surge of Covid-19 this winter in the United States, some health experts have said. But many are anticipating an increase as fewer people take precautions and other viruses, including influenza and RSV, increase earlier than usual for the season.

Write to Stephanie Armor at Stephanie.Armour@wsj.com and Brianna Abbott at brianna.abbott@wsj.com

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