Rattay boosters 2-1-22

The push for ensuring all eligible Delawareans are getting their COVID-19 vaccination boosters continued Tuesday during Gov. John Carney's latest press conference detailing the state's response to the pandemic. 

There was positive movement on the spread of the virus in the state. The seven-day moving average for new positive cases fell to 881.4, while the seven-day moving average for positive tests had lowered to 17.5%. Hospitalizations also decreased to 400, with only 39 now critical. 

"New positive cases on a seven-day moving average, that was well over 3,000 just a couple of weeks ago. Now under 1000 per day...Still a very high number relative to better days under COVID-19, but certainly headed in the right direction," Carney said. "Those percent positives were over 30%--one in three cases were coming up positive--just a couple weeks ago, and now we're under 20% and continue to improve there. Most importantly, the Delawareans that are in the hospital, either with or for COVID, right there at 400, down from 759 at the peak on January the 12th."

To continue lowering those numbers and keeping more individuals out of the hospital, Carney said it was integral all who could were getting their COVID-19 vaccinations. The state has already administered 1.6 million doses of vaccine, and 67% of Delawareans have received two doses, but Carney said they were still struggling to get everyone boosted.

Of the 644,659 Delawareans who've received two doses, only 44.4% have received their booster shot. Those numbers improve as the age group increases, with those 50 years of age and older at 55.6%, and those 65 years of age and older at 64.4%.  

"We need to get more Delawareans boostered," Carney said. "We know we can affect that hospital number; we know that we can affect the spread of COVID in our communities; and we know we're going to have to, going forward, as we fully engage the economy and most things are opened up pretty fully--I know people are a little hesitant to go back indoors where there's going to be big crowds and maybe not a lot of mask-wearing--but we certainly need to make sure folks get their full vaccinations and then get the booster shot."

Citing data from a Kaiser Family Foundation survey conducted in December, Division of Public Health Director Dr. Karyl Rattay said 50% of the public responded that they were worried about getting seriously sick from the Omicron variant, up from 30% in November. Higher concern rates were seen in minority populations, with 64% of both Hispanic and Black respondents saying they were concerned, compared to 43% of white adults. 

Getting fully vaccinated, including being boosted, is a key way to avoid becoming seriously ill, Rattay said, but Delaware's booster rates rank 26th nationally, so her administration had been working to determine how to overcome that reluctance while easing fear of--and actual--illness. 

"We know that we can do better, so we're trying to understand the reasons why booster rates are low here and nationally," she said. 

Part of the issue, Rattay said, was a confusion over who should be boosted, with 23% of individuals--including 21% of vaccinated individuals--reporting they were unsure whether it was even recommended for all adults to get a booster, or incorrectly thought the CDC had not recommended a booster. 

"This confusion or uncertainty was greater among racial and ethnic groups, as well as younger adults," Rattay said. "So 31% of Hispanic, 28% of Black, and 39% of younger adults between the ages of 18 to 29 reported being unaware of CDC's booster recommendations."

Compounding that confusion was a lack of awareness on who was eligible for a booster.

Rattay reminded anyone 12 years of age and older and five months out from a second dose of Pfizer or Moderna that they'll see a reduction in effectiveness of the vaccine without a booster. If it's been two months since a Johnson & Johnson vaccine, a booster should be sought. Pfizer is currently the only option for a booster for those in the 12 to 17 age range. Those who'd been quarantined for COVID-19 can seek out a booster when they're four to six weeks out from infection. 

In studying effectiveness, boosters exceeded their expectations. 

"What they found was that the booster didn't merely return a person's immune response to the previous levels of the primary series, but it actually increased them to exceed previous levels," she said. "If the initial effectiveness of a two-dose series of Pfizer was 90%, getting a booster five months later takes it up to as much as 100%. Not only does it compensate for the reduction in vaccine effectiveness, but it also improves the immune response beyond original levels."

Both versions boost effectiveness protecting against Omicron specifically by magnitudes, with Moderna increasing antibodies by 37 times, and Pfizer by 25 times over the primary series. The Journal of American Medical Association jist two weeks ago published a study saying of 23,000 symptomatic people who tested positive between December 10, 2021, and January 1, 2022, those who were boosted were far less likely to have tested positive. A second study from the CDC showed the comparisons between unvaccinated and vaccinated adults testing positive or dying from COVID-19 

"This highlights how effective getting boosted is against symptomatic infection, again, even if the COVID strain is Omicron," Rattay said. "What they found was people who were unvaccinated against COVID-19, as the Omicron variant emerged in December, had nearly three times risk of higher infection than adults fully vaccinated against COVID-19 and five times higher risk when compared to people who had received a booster."

Unvaccinated individuals are 44 times more likely to be hospitalized than those who've been boosted, a huge difference making a significant impact on the state of healthcare systems across the country. Boosters reduce a need for an emergency room visit or hospitalization by 94%, she said. 

Currently, 83% of cases, 88% of hospitalizations, and 83% of those who died were not up-to-date on their vaccinations, Rattay said. 

"People who are unvaccinated, partially vaccinated, or fully vaccinated are just not as protected as those who have received their booster, and our own data are showing this," Rattay said. 

All that being said, with the Supreme Court's decision that vaccine mandates would fall to the state level, Carney said his administration is currently not looking at issuing anything of the sort, despite Delaware's soaring hospital numbers and the data showing vaccine effectiveness. 

"It's not something that we've talked about recently. My own view, particularly for certain populations, was to wait until there was a full FDA authorization, as opposed to an emergency authorization," Carney said. "It is something that's worth looking at, particularly in certain circumstances and certain populations--healthcare workers and long-term care facilities. You have to be careful in terms of having unintended consequences of limiting your workforce, that type of thing. It's not something that we've focused on recently."