Why won’t more older Americans get their COVID booster shots?

Top U.S. health officials say it’s time for the U.S. to learn to live with the coronavirus, but the chorus of top-notch researchers has misleading booster shots for millions of older people. He says he is in serious danger.

According to the Centers for Disease Control and Prevention, about one in three Americans over the age of 65 who have completed their first vaccination round has not yet received their first booster shot. This number disappointed researchers who pointed out that this age group had the highest risk of serious illness and death from COVID-19.

People over the age of 65 account for about 75% of deaths from COVID-19 in the United States. Elderly people who have completed the first two doses of the Moderna or Pfizer vaccine, or who have received one dose of the Johnson & Johnson vaccine, are also at some risk. According to a KFF analysis of CDC data, 31% of the elderly who died of COVID-19 in January completed the first round of vaccination but were not boosted.

Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, said tens of thousands of lives were lost because the group couldn’t grow further. “The booster program has failed since day one,” Topol said. “This is one of the most important issues for an American pandemic and is mismanaged.”

“If the CDC says’this can save your life’, it will be of great help,” he added.

The first or two vaccination courses are effective in preventing hospitalization and death, but immunity weakens over time. Boosters to renew protection are especially important for older people, as cases of COVID-19 have increased again, more infectious Omicron submutants have surged, and Americans are wearing masks, according to Topol. ..

Some older people who were prioritized for the first vaccination in January 2021 are now more than a year old since the last vaccination. Increasing confusion: The CDC “complete vaccines” for those who have completed the first or two inoculation courses, even though the first booster is believed to be essential for the extension of COVID-19 immunity. It is defined as “inoculation”.

Numerous studies have confirmed that the first booster shot is an important weapon against COVID-19. A study of older veterans published in April found that people who received a third dose of the mRNA vaccine were 79% more likely to die of COVID-19 than those who received only two doses. Turned out to be low.

The central question for booster advocates is why prices are stagnant among people over the age of 65. Studies have shown that the general public’s hesitation in vaccines involves politics and misinformation, but this does not apply to the elderly with the highest initial vaccination rates of any age group. Over 90% of older Americans had completed their first or two dosing courses as of May 8.

In contrast, 69% of older Americans vaccinated receive their first booster shot.

Overall, less than half of eligible Americans of all ages are boosted.

David Grabowski, a professor of health care policy at Harvard Medical School, said the discrepancy in older people is likely due to a change in the way the federal government distributes vaccines. The Biden administration coordinated the provision of vaccines to nursing homes, soccer stadiums and other target facilities earlier last year, but the federal government has played a far less central role in providing boosters, Grabowski said.

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Nursing homes now rely heavily on pharmacies traditionally hired to manage flu shots and have a great responsibility to boost residents, Grabowski said. And outside nursing homes, people generally have to find their boosters through either a clinic, a local pharmacy, or a primary care provider.

Former CDC director Dr. Thomas Frieden said that in theory, it seems logical to shift responsibility for ongoing COVID-19 immunity from government-sponsored clinics to individual healthcare providers. Stated. In fact, Frieden said the approach isn’t working because “our primary health care system is a life-threatening anemia” and isn’t set up to easily undertake a public health mission. I did.

Most healthcare providers do not have the technology to safely track which patients have been vaccinated and schedule follow-up shots, Frieden said. There is also no financial incentive for doctors to vaccinate and support patients.

Even before the pandemic, 28% of Americans did not receive regular medical care.

Gravowski said more help was needed, especially for nursing homes. Less than 1% of Americans live in nursing homes or supplementary living facilities, but they account for more than 20% of deaths from COVID-19. He hopes that the Biden administration will resume coordinating booster delivery in nursing homes through mass vaccination efforts. “I will go back to these central clinics and get the residents and staff backed up at once,” Grabowski said. “I think it’s easy.”

The Biden administration has promoted ongoing efforts to vaccinate the elderly. For example, the Medicare & Medicaid Service Center has dispatched a quality improvement team to advise nursing homes with low immunization rates. The Medicare program mailed all 63 million beneficiaries a letter urging them to get a booster and sent millions of email and text message reminders.

Still, many health advocates agree that the country has lost the momentum it had during the first months of the COVID-19 vaccination campaign.

“There doesn’t seem to be any urgency we saw in the first shot,” said Lori Smetanka, executive director of advocacy group National Consumer Voice for Quality Long-Term Care.

Some researchers believed that the initial disagreement between health leaders over the value of boosters was followed by a slowdown due to continued gradual development. Boosters were approved at various age groups, usually without fanfare associated with one major policy change. The CDC recommended booster shots for people with weakened immunity in August. After that, for the elderly in October. For all adults in November. For children over 12 years old in January.

In addition, vaccine ads seemed to be ubiquitous a year ago, but government agencies haven’t said much about encouraging boosters. “We originally felt that all of us were hit in the head and all the roads were connected to the vaccine,” Grabowski said. “Now you have to find your own way.”

For many older people, there are also barriers to boosters that can make access to folk medicine difficult during non-pandemic times. For example, many older people are vaccinated without a reservation or booked by phone, even though pharmacies are increasingly paying attention to online-only schedules that require customers to navigate multi-tiered systems. I like to stop by to do it. Some older people also lack ready-to-use transportation, which is sometimes a towering obstacle in rural areas where clinics can be 20 to 30 miles away.

“People are less likely to be vaccinated if they need to take two buses or take a break from work or family care,” Smetanka said.

Dr. Lattershaperkins, a family doctor in Washington, DC, said he worked hard to convince his Mississippi family to be vaccinated. Her grandmother agreed to get her first shot in the fall, as the CDC approved boosters for all adults.

“Finally, I got to a place where I had two shots taken, and then I said,’Oh, by the way, I need a third one,'” Perkins said. “It was unpleasant for many communities. They would say,” You persuaded me to buy, and now you’re saying two shots aren’t enough. “

According to Perkins, national leadership is important, but regional ties can be stronger. Perkins talked about vaccines in her church. She said the congregation is likely to trust her medical advice because she is a tithe seen every Sunday.

Some communities have done a better job of overcoming resistance than others. According to the CDC, Minnesota boosts 83% of vaccinated residents aged 65 and over, making it the largest proportion of any other state.

According to a KHN analysis of CDC data, Dakota County, Minnesota has a higher percentage of vaccinated people aged 65 and over than any other US county with at least 50,000 elderly people.

Christine Leeds, an epidemiologist and public health supervisor in Dakota County, said her department hired an agency to provide booster shots to residents and staff in nursing homes and support facilities. The health department runs a vaccine clinic at lunch and several nights to accommodate working people.

The department withdrew funds from the Federal Coronavirus Assistance Economic Security Agency (CARES) law and purchased a mobile vaccine clinic to bring boosters to neighborhoods and mobile homes. “We did it all last summer, and we restarted it again,” Lee said. “We went to food shelters and libraries. We went out at least once a week to keep those numbers high.”

Local health workers paved the way for vaccine clinics by visiting residents in advance and answering questions, Lee said.

Dakota County also used funds from the US Rescue Planning Act to provide $ 50 incentives to those receiving the first vaccines and boosters, Lee said. The incentive was “really important for people who might have to pay a little extra to get to the vaccination site,” Lee said.

Scripps Topol said it wouldn’t be too late for federal leaders to see what was working, see what wasn’t, and resume booster efforts.

“Now it will be difficult to restart, but an aggressive and full-scale campaign for older people, whatever it is, is certainly shown,” Topol said. “These people are sitting ducks.”

Philippe Reese, an assistant professor of journalism at California State University, Sacramento, contributed to this report. KHN (Kaiser Health News) is a national news room that produces detailed journalism on health issues. KHN, along with policy analysis and polling, is one of three major operational programs: KFF (Kaiser Family Foundation). KFF is a donated non-profit organization that provides the public with information on health issues.

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How to take the test

Tampa Bay: The Times will help you find a free public COVID-19 inspection site in the Bay Area.

Florida: The Ministry of Health has a website that lists inspection sites in the state. Some information may be out of date.

America: The Department of Health and Human Services has a website to help you find a testing site.

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How to get vaccinated

COVID-19 vaccines over 5 years old and booster shots of eligible recipients are administered in clinics, clinics, pharmacies, grocery stores, and public vaccination sites. In many cases, you can book your booking online. Here’s how to find a site near you.

Find a site: To find the vaccination site by zip code, go to vaccines.gov.

Other help: Call the National COVID-19 VaccinationAssistanceHotline.

phone: 800-232-0233. Help is available in English, Spanish, and other languages.

TTY: 888-720-7489

Disability information and access lines: Call 888-677-1199 or send an email to DIAL@n4a.org.

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Omicron variant: Omicron has changed what we know about COVID. Up-to-date information on how infectious COVID-19 mutants affect masks, vaccines, boosters, and quarantine.

Children and vaccines: Do you have questions about vaccination of your child? Here are some answers.

Booster Shot: Are you confused about which COVID booster to get? This guide will help.

Booster Question: Are there any side effects? Why do you need it? Here is the answer to your question.

Senior protection: Here’s how older people can protect themselves from the virus:

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