March 24, 2023

But prior to the critical piece, doctors and lawyers said people are burned out, tuned in and don’t understand why they need another booster. And even some government officials personally acknowledge that there is little internal expectation that they will see an explosion of interest.

William Schaffner, medical director of the National Foundation for Infectious Diseases, said many people involved in the effort — from doctors like him to officials at the Centers for Disease Control and Prevention who recommended the booster to Americans — didn’t understand what it would do. costs to get people’s attention.

“After they make the car, they have to sell it,” Schaffner said. “The CDC has a production capacity for [vaccine] recommendations, but it has no marketing capacity. They underestimate how much work it takes to get the word out.”

In the coming weeks, the government plans to work with medical associations and other “trusted messengers” to educate more Americans and launch media campaigns to reach long-term care facilities where vaccination rates are low, as well as people skeptical about the Covid vaccines.

To reach more rural Americans, HHS partners with Healthy trucking of America, a nonprofit that promotes the health of long-haul truck drivers, is hosting a pop-up vaccination clinic on Alabama’s Talladega Superspeedway this weekend. And in November, the couple plans to host another vaccine clinic at the NASCAR Cup Series Championship in Phoenix.

Both events are part of the long-running ‘We Can Do This’ Covid-19 public awareness campaign on vaccines aimed at increasing vaccination coverage. But the drive currently limits its reach to older adults and hard-to-reach communities due to limited funding.

Impact of ‘congress inactivity’

Overall, the magnitude of the government’s new booster push will be modest, limited by Congress’ refusal to allocate more funding for the Covid response, health officials said. They personally admitted to keeping their expectations low given the pandemic fatigue of Americans and the lack of the imminent threat of a dangerous new variant that could otherwise motivate people to prioritize the booster.

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“It’s obviously harder to run a campaign when Congress decides not to fund it,” Ashish Jha, the White House’s Covid-19 response coordinator, said at a briefing Friday. “Our media campaign, our campaign with community organizations – all of that will be more limited due to the passivity of Congress.”

While the government has not set a target for booster vaccination, health experts and groups on the campaign’s front lines do not expect the overall uptake rate to exceed 30 percent of the U.S. population.

Officials argued that it is still worth trying to make progress on the fringe, with the government focusing on protecting older Americans and penetrating black and Hispanic communities that traditionally suffer from health inequalities.

Jha said “tens of thousands of lives” could be saved if Americans get the updated booster in the coming weeks and months.

“We are still losing 350 to 400 people a day to Covid-19,” Jha said. “Each of the last two winters we have seen an increase in Covid infections, hospitalizations and deaths. New sub-variants of Omicron are emerging that will pose significant challenges to several of our therapies. So our message is very simple: don’t wait. Get vaccinated.”

The time is running out for that message to take hold. Hospitalizations in several European countries are already increasing, a reliable indicator of where the US is heading, and Americans’ immunity to their existing vaccinations is dwindling or ineffective against the now dominant Covid strains. While the White House has yet to see definitive signs of a domestic rebound, an official said rising numbers of cases elsewhere have made the administration “unsettled.”

Some said the government is doing what it can, given the difficult environment. John Bridgeland, co-founder and CEO of the Covid Collaborative, which is in communication with the administration about the booster campaign, said officials are monitoring the many fronts of the pandemic, from boosters to testing to school ventilation.

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Getting people to pay attention isn’t easy, he said. “The country is exhausted. … When pandemic and federalism come together, and you try to influence the decision of 300 million Americans, it is a complex undertaking.”

But others said that if the message about the booster had been clearer from the start, more people would get it.

“We’ve heard so many questions and confusion,” said Bill Walsh, vice president of communications at AARP, the advocacy group for people 50 and older. The group is educating tens of millions of elderly Americans at risk about vaccinations against Covid-19 during the pandemic.

“People don’t quite understand what it is… They don’t realize this is really a different category of vaccine, and they don’t quite understand why it’s so effective in treating this latest version of Covid-19,” he said. “I think if they knew that, they’d be more willing to take it.”

A little push once a year

The administration’s fall vaccination gives the White House the opportunity to bolster the once-a-year cadence it envisions for future booster shots — a shift aimed at aligning the Covid vaccine with the annual flu shot and countering people’s perception that this vaccine is just the latest in an endless line of boosters.

The decision to rename the Covid vaccine as a once-a-year injection stemmed from a series of discussions earlier this fall among Biden’s top health advisers, multiple officials familiar with the matter said.

The group — which includes Jha, White House chief medical adviser Anthony Fauci, CDC director Rochelle Walensky, and others — was looking for ways to both revive interest in vaccination and introduce long-term Covid injections. as part of Americans’ routine health practices. The simplicity of an annual approach, officials hoped, would help both.

“If you’ve just told people this is number five and you’re getting ready for six, no one will,” a senior Biden official said. “We are increasingly trying to fit this into healthcare, to fit this into our lives.”

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The approach carries its own risk. Even if it relies on its once-a-year messages, officials know they could be forced to abandon it at the first sign of a dangerous new variant — a potential development that is likely to erode public confidence in the Covid response. would further damage.

For an annual Covid-19 vaccination approach to work in the long term, the administration will need to consider incentives for providers to administer the vaccine, similar to the flu vaccine, said Jay Varma, director of the Cornell Center for Pandemic Prevention and Response.

“I do worry that for large segments of the American population you will have to do the same kind of difficult work that took decades for the flu,” Varma said. “People’s fear of Covid has broadly diminished, so you can’t rely on their own internal motivation to be a major driver for a large percentage of the population to get vaccinated.”

Much is at stake, both in the long term and the coming winter, as the elderly and immunocompromised individuals continue to bear the brunt of the virus.

Seventy percent of Covid-19 deaths today are among people aged 75 and older, according to the administration. This spring and summer, as cases rose nationally, Covid-19 deaths rose for all ages but rose faster for older adults, according to new research from the Kaiser Family Foundation. More than 11,000 people aged 65 and over died as a result of Covid-19 in both July and August.

If vaccination rates stay where they have been, the country could face a grim winter and spring.

a new Commonwealth Fund report projected how many lives could be saved in different vaccination scenarios over the next six months. If the government and its partners succeed, and reach at least the 2020-2021 flu vaccine coverage level, the seven-day average daily number of deaths could drop from its current range of about 320 to 400 to just over 200. If 80 percent of the eligible population gets a boost, those numbers could drop below 50.

But if they continue on the August daily vaccination coverage baseline, the country could slide back into worse days, and top 1,200 average daily deaths.