Health

(NEW YORK) — Millions more vaccinated adults across the U.S. became eligible for a COVID-19 booster shot on Friday. And yet, the vast majority of vaccinated Americans were already eligible — many just didn’t know it.

According to an October survey from the Centers for Disease Control and Prevention, 4 in 10 vaccinated adults were unsure if they qualified for a booster. So far, just 32 million Americans have received a booster, or around 18% of the more than 182 million adults who are fully vaccinated.

In announcing the latest recommendations, public health experts at the Food and Drug Administration and the CDC expressed hope that they would cut through the confusion, simplifying the decision for Americans who are wondering: Do I need a booster shot?

Here’s what the experts say.

Should you get a booster?

The question has been hotly debated for months but a larger pro-booster consensus has formed over the last week.

Why? A number of reasons, including rising cases in more than half of U.S. states right before a busy holiday travel season and lower temperatures pushing people indoors.

The FDA and CDC made the updated recommendation on Friday. It expanded booster access to all adults who were vaccinated with Moderna or Pfizer over six months ago, and while the recommendation was stronger for everyone over 50 to go get a boost, it applies to everyone 18 to 49.

For Johnson & Johnson recipients, the recommendation already applied to everyone over 18, anytime two months after their shot.

For experts who have long been loud proponents for booster shots, it was a long time coming.

“Enough is enough. Let’s get moving on here,” Dr. Anthony Fauci, chief medical adviser to the White House and a leader at the National Institutes of Health, said at an event Wednesday, before the FDA and CDC made the final call.

“There’s no doubt that immunity wanes. It wanes in everyone. It’s more dangerous in the elderly, but it’s across all age groups,” Fauci said, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.

Others, like Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development, called the decline “both predicted and predictable.”

“And the way you fix it is you give that third immunization,” he said.

Both Hotez and Fauci believe the vaccines should be used not just to prevent hospitalizations and death, but also infection — particularly because of the risk of long-COVID, a concerning side effect of the disease that is rare in vaccinated people but can include long-term fatigue, brain fog and shortness of breath.

“When I got my third immunization, why was I so eager to do it? Well, of course I didn’t want to go to the hospital or ICU, but also I didn’t want to get COVID,” Hotez said.

“I didn’t want to get gray matter brain degeneration and cognitive decline and have a brain scan that looks like somebody 20 years older.”

But for those still on the fence about the personal choice, Dr. Anna Durbin, an associate professor at the Johns Hopkins University School of Medicine, laid out risk scenarios to consider.

“It really comes down to your comfort level and just what’s going to make you as a person feel safer,” Durbin said.

If you’re traveling overseas or live in areas of high transmission, if you’re elderly or have underlying conditions or are frequently out in the community for work, those are all reasons to get a booster, Durbin said.

For young, healthy people who don’t feel at risk, Durbin said to keep an eye on rising cases in your area. Consider getting a booster to help tamp down transmission, but also to protect yourself ahead of a surge, Durbin said.

“If we’re gonna see a new wave, it’s going to be over the winter months most likely. And if you get boosted now, that’s going to provide you really good protection through that period of time,” Durbin said.

That said, don’t panic if you can’t book an appointment right away — particularly as demand surges with the new recommendation, experts say.

“I would not view it as an emergency that people need to line up on the day of approval and get their boosters necessarily that weekend,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

It’s still far more important for unvaccinated people to get vaccinated, Barouch said, particularly ahead of the holidays.

“The most important thing is for everybody who will be celebrating to be vaccinated, if they’re eligible to be vaccinated. Now, additional boosts may be useful. But the most important thing is that people be vaccinated primarily,” he said.

Why has it been so confusing?

To put it simply: “The reason why there is some confusion is because it has been confusing,” Barouch said.

“Guidelines are changing,” Barouch said. “And in some cases, the guidelines are changing for good reasons: They’re changing because what we’re seeing is a changing pandemic.”

Last week, a patchwork of booster guidance emerged as governors in over a dozen states called for all adults to get a booster before the federal agencies weighed in, acting to combat spiking cases and overwhelmed hospitals.

Hotez commended the states for making the “medically correct” decision and being “more nimble” than the original decision from the CDC and FDA, but acknowledged the schism it created in the public health guidance.

“Not as elegant as you’d like — to have the states be out front by a week or so, but you know, when you’re in the middle of a pandemic, sometimes things don’t go smoothly as you’d like,” Hotez said.

Some, like Hotez, have always believed boosters would be necessary, even before data started to trickle in on waning immunity, and think confusion could’ve been avoided if the public was always told to expect a booster.

“It should have been messaged to the American people from the beginning that, by the way, don’t be surprised when the call comes out to get a third immunization,” he said.

Still, there’s a fine line to walk in urging booster shots for those vaccinated six months ago while also encouraging the most impactful group, unvaccinated people, to get their primary vaccinations. The vaccines continue to protect well against hospitalization and death for many months.

“We can give all the booster doses we want and until we get people vaccinated, or they all get infected, we’re going to continue to see transmission of COVID,” Durbin said.

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(LONDON) — The UK approved a new HIV treatment that requires an injection every other month, rather than the current routine of taking pills every day.

The UK’s National Institute for Health and Care Excellence estimated that around 13,000 people will now be eligible for cabotegravir with rilpivirine, the injectable medication.

There were around 103,000 people living with HIV in the UK in 2018, according to the British government’s statistics.

“It is an exciting and progressive step in the fight against HIV,” Dr. Todd Ellerin, director of infectious diseases at South Shore Health and ABC News contributor said. Ellerin is also on the speakers bureau of ViiV Healthcare which helped develop the injectable HIV treatment.

Besides the new revolutionary injection method, the current treatment for HIV is lifelong antiretroviral tablets that are taken each day. The medication suppresses the virus in the blood to undetectable levels, thereby preventing AIDS from occurring and eliminating transmission.

The injections block the same enzymes as the pills do, as Ellerin explained, but allow the medication to stay in the body much longer permitting monthly or bimonthly re-dosing, so patients don’t need to take pills every day.

The shot called Cabenuva (a combination of cabotegravir and rilpivirine) was already approved by the FDA in January, though with a more frequent dosage of once a month.

“[The] thing I like about injectables is less is more,” Ellerin said. “The medication approved in the UK will be once every two months, which makes it easier for the patients to come to the office rather than coming every month,” he added.

“For many, taking daily pills is not easy. Sometimes they forget, some may have other issues with taking pills, but the injection is suitable for those who prefer a more intermittent method,” he added.

However, there are challenges to this method. One, is the logistics of the injection, as the jabs must be administered at the health care provider’s office for now, Ellerin said.

“The biggest challenge is the logistic hurdle for giving these [shots] in the office, especially in the pandemic,” said Ellerin.

Also, if patients don’t show up for their injection, that increases the risk of viral replication rebound, Ellerin said. With pills, you can remember to take them the next day and have a stock of them at home.

Both in Britain and the United States, cabotegravir and rilpivirine can be prescribed and used after an initial oral (tablet) lead-in period.

“This is why people who are newly diagnosed with HIV can’t start their treatment with injection,” Ellerin said.

There are hopes that by the first quarter of 2022, the FDA also approves the bimonthly injection, and with that more patients might choose this method over pills, especially if the COVID-19 situation eases, according to Ellerin.

“As of now, this is not a preventive method. It is just for maintenance treatment. There are also injections for prevention down the way. But that is another story,” Ellerin said.

Ellerin also said that the reason the injections are available at clinics only is that this is the way it was studied in clinical trials and that these are buttocks injections that are difficult to self-administer at home.

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(NEW YORK) — A group of seven women are suing Yale University, claiming they underwent invasive and painful procedures for in-vitro fertilization and received saline instead of fentanyl, an opioid painkiller.

According to the complaint, the women received saline after a nurse at the Yale University Reproductive Endocrinology and Infertility Clinic stole fentanyl for her personal use last year and replaced it with saline.

As a result, the women underwent a fertility procedure — oocyte retrieval — without pain management, according to the complaint, which described the process as “excruciating.”

“Oocyte egg retrieval is an extremely invasive procedure,” the law firm representing the women said in a statement. “Doctors and nurses explained to these patients that this surgery would require a dose of fentanyl to alleviate pain. However, each was then unknowingly treated with saline instead.”

The lawsuit, filed Wednesday in state court in Waterbury, Connecticut, by the women and their spouses, accuses Yale University of failing to follow protocols and thereby allowing the fentanyl to be tampered with.

The complaint also alleges there were “hundreds” of incidents in which saline was substituted for fentanyl.

“Yale University takes no responsibility for the hundreds of fentanyl substitution events that took place at the REI Clinic; it blames the single nurse who was able to steal the fentanyl, unabated, for more than twenty weeks,” the complaint said.

“But for years, Yale University recognized the lurking danger of opioid diversion and the catastrophic injuries posed by healthcare worker opioid substitution,” according to the lawsuit.

The nurse, Donna Monticone, pleaded guilty in March to one count of tampering with a consumer product and surrendered her nursing license. She was sentenced in May to four weekends in prison, three months of home confinement and three years of supervised release.

A Yale University spokesperson declined to comment on the lawsuit.

In March, following Monticone’s guilty plea, a Yale spokesperson issued a statement stating patients had been informed and that “changes are underway.”

“Yale has informed patients that there is no reason to believe that the nurse’s action harmed their health or the outcome of their treatment. The Fertility Center routinely uses a combination of pain medications during procedures and modifies the medications if there are signs of discomfort,” the spokesperson said in March, according to the New Haven Register. “Changes are underway in procedures, recordkeeping, and physical storage that will prevent this type of activity from happening again.”

The lawsuit, which seeks unspecified damages, also alleges that the women’s concerns and reports of “torturous pain” were dismissed.

“Yale University providers were alerted to the problem with its supply of fentanyl, the sole analgesic administered to women during oocyte retrievals, through patients’ intraoperative screams and postoperative reports of torturous pain, but, upon information and belief, Yale University never investigated these reports,” the complaint said. “Instead, pain was minimized as ‘normal’ for the invasive procedure, or attributed to the unavailability of an anesthesiologist on Saturdays and Sundays.”

The allegation of pain being dismissed is one that may ring true for many women, according to Dr. Jessica Shepherd, a board-certified gynecologist and chief medical officer of Verywell Health, an online medical resource.

Shepherd is not affiliated with Yale University and has no involvement with or direct knowledge of the case.

“Usually the key complaint is feeling dismissed, that patients haven’t been heard,” she said of her own personal experience with female patients who have sought her care. “It’s one thing to be able to express what you’re feeling, but even after that, what are the actions that are taken in order to reach some joint resolution of decreasing discomfort, addressing the situation, finding alternatives.”

Research through the years has also shown that women’s pain is often interpreted differently than men’s by medical providers.

A study published in April in the Journal of Pain, for instance, found that when the same level of pain was expressed by female and male patients, female patients’ pain was viewed as less intense than men’s. The study also found that female patients were prescribed more psychotherapy for for their pain, while male patients were prescribed more pain medication.

In another study, women were found to have had to wait nearly 15 minutes longer to receive pain medication in an emergency room setting than men.

“It’s a subjective symptom so it’s hard to put objectivity to it, like you would say, blood pressure, or pulse,” Shepherd said of pain. “And I think there are stereotypes about pain sensitivity and endurance of pain, so from a female perspective, it may be looked at not being able to endure as much pain, but that’s not really how pain should be monitored or evaluated.”

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(NEW YORK) — With a winter virus surge lurking and no readily available vaccines, Thanksgiving 2020 was very different for most families. This year, expectations are much higher.

But even this year, a recent uptick in COVID-19 cases means public health experts are still urging caution. Health professionals still agree that getting vaccinated is the single best a person can do to protect themselves and their loved ones — especially unvaccinated children.

“Vaccines are only as efficacious as the number of people that get them. So a good time to remind people to get their COVID vaccines if they’re still holding out,” said Dr. Molly Fleece, an infectious disease doctor at the University of Alabama in Birmingham. “What we do not want to see this year is a so-called twin-demic, where we have peaks of influenza as well as COVID during our holiday season.”

Layering different protective measures is the best overall strategy, experts told ABC News. Dr. Anne Liu, an infectious disease and allergy specialist at Stanford University, advises people “to not rely just on vaccination, but to also be thoughtful about when to implement masking and rapid testing.”

Dr. Leana Wen, a former Baltimore health commissioner, said she’s asking family members to limit activities that could potentially expose them to COVID-19 in the days leading up to Thanksgiving.

“We are asking everybody to reduce their overall risk for the three- to five-day period before, and we’re all taking a rapid test the morning of,” she added.

Another option is testing.

“Testing ahead of time does make a low-risk situation with all vaccinated people even lower risk,” said Dr. Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital. “I especially recommend it if someone at the gathering is older or potentially immunocompromised.”

There are multiple types of COVID-19 tests, including PCR tests, rapid tests and antibody tests. Infectious disease experts agreed that an antibody test, which looks for traces of a prior infection or prior vaccination in your blood, isn’t going to be a helpful way to protect your family over the holidays. Instead, opt for a PCR test, if you have time to wait for the results, or, a rapid test — less accurate, but faster.

“PCR test is obviously the best,” said Dr. Marc Siegel, director of infectious diseases at George Washington University. Unfortunately, during times of high demand these tests can be hard to take or results are delayed. Sax suggests that if a person is asymptomatic, doing a rapid antigen test the day before and the day of the gathering would be reasonable in lieu of a PCR test.

Once gathered, experts also suggest paying attention to ventilation. Weather permitting, have parts of gatherings outdoors helps decrease risk. It’s admittedly easier in some states.

“We’re going to actually have it outside — it’s supposed to be 65 and sunny on Thanksgiving day,” said Dr. George Rutherford, a doctor and infectious disease researcher at the University of California, San Francisco. “Plus, we can get a lot more people at the table because we can string tables together.”

But there are still options for those in colder climates.

“Even in a cold environment, it’s possible to open up a window,” said Siegel. “You might be losing some of the heat, but at least opening up a window on each side of the room to allow some room air to circulate.” Using air filters is another consideration, Sax added.

If possible, those with prior vaccinations should get their boosters before the holiday, experts said.

Ultimately, between rapid testing, better knowledge of COVID-19 transmission and the mass availability of vaccines, this year’s holiday season has the potential to be more joyous than last year’s.

Lauren Joseph, a student at Stanford Medical School, and Jacob Warner, an internal medicine resident at Dartmouth-Hitchcock Medical Center, are contributors to the ABC News Medical Unit.

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(VACAVILLE, Calif.) — Emily Johnson had planned on giving birth to her second child in a hospital, with an epidural.

Instead, Johnson, 31, of Vacaville, California, gave birth to her son, Thomas Alan, on Nov. 4, on her front lawn, with no pain medication.

Johnson told “Good Morning America” she and her husband, Michael Johnson, announced their son’s birth on Facebook by posting, “Thomas is here and there is Ring footage.”

“He’s a pretty quiet and chill little dude,” Emily Johnson said of her son, noting the contrast with his “chaotic arrival.” “He just stares and watches the world go by or sleeps.”

Thomas’s unconventional birth story began around 6:30 p.m., a week before Emily’s Johnson’s due date, when she started feeling contractions that were around 10 minutes apart.

Remembering the 18-hour labor she’d had with her 3-year-old son, Emily Johnson said she and her husband thought they had plenty of time and kept monitoring the contractions.

When the contractions began to quicken just after 9 p.m., the Johnsons said they called Emily’s mom to come watch Blake, and called the hospital to tell them they were on their way.

“While Mike was getting the car packed up, the contractions went from three minutes to two minutes to one minute very rapidly,” said Emily Johnson. “And then when I was standing at the car door, I just couldn’t get in the car.”

Though the hospital was just five minutes away, Emily Johnson said she knew she wasn’t going to make it.

She moved herself to the front lawn of her home, and her husband and her mother, Kristy Sparks, who had arrived to care for Blake, began to deliver the baby while on the phone with a 911 dispatcher.

“The dispatcher really helped with the process,” said Emily Johnson. “She really guided Mike and my mom through as they were trying to keep me as calm as possible because I was having a baby on the lawn.”

At 10:42 p.m., just two minutes after paramedics arrived, Thomas Alan was born — a healthy 7 pounds, 11 ounces.

“I was right there by her side with one hand on the speakerphone and one hand with a flashlight,” said Michael Johnson. “Her mom was there to catch the baby”

Michael Johnson was able to cut the umbilical cord on the front lawn, and then paramedics transported baby and mom to the hospital.

It was there that the Johnsons said they realized their Ring camera captured Thomas’ birth.

“When Michael got to the hospital, he started looking at the footage and showing it to the nurses,” said Emily Johnson, adding that they were able to figure out how Thomas’s birth took less than 30 minutes.

Though Thomas’s birth didn’t unfold exactly as planned, it did happen on a special day: He was born on the same day as his late paternal great-grandfather, Alan, from whom he gets his middle name. And he was born two days before the 82nd birthday of his maternal great-grandfather, Thomas, from whom he gets his first name.

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(ANN ARBOR, Mich.) — Public health officials are investigating an influenza outbreak at a Michigan university that has resulted in more than 500 cases, as several schools have also seen surges in flu activity.

The University of Michigan’s Ann Arbor campus in Washtenaw County has reported over 525 cases among students since Oct. 6 — about three-quarters of them among people unvaccinated against the flu, school officials said this week.

The university said it is tracking a “large and sudden increase” in cases, with nearly all reported in the past two weeks.

“While we often start to see some flu activity now, the size of this outbreak is unusual,” Juan Luis Marquez, medical director at the Washtenaw County Health Department, said in a statement.

A team from the Centers for Disease Control and Prevention is helping the university and local and state health departments investigate the outbreak, including how the flu is spreading.

Amid the surge, the Michigan Department of Health and Human Services is calling on people to get the flu vaccine, as vaccine administrations are down by about 26% compared to this time last year and COVID-19 cases are also on the rise.

“This outbreak comes at a time when COVID-19 infections are again surging in Michigan, with case rates, positivity rates, hospitalizations and deaths all increasing,” the department said in a release Wednesday. “State and local public health officials are concerned with the potential for increased strain on health systems if COVID-19 and influenza cases surge at the same time this winter.”

Other campuses are also battling flu outbreaks. Rowan University in Glassboro, New Jersey, has logged 150 flu cases among students since Nov. 1, most of which were last week, Joe Cardona, the vice president of university relations, told ABC News. In response, the school has been holding flu vaccination clinics for students and staff this week.

Spikes in flu cases have also been seen at Florida State University and Florida A&M University, the Associated Press reported earlier this month.

Public health experts have warned that this flu season might be more severe, following last season’s mild flu activity.

Flu cases saw a significant drop during the 2020-2021 season according to the CDC — likely due in part to people wearing masks, practicing frequent hand hygiene and socially distancing to help limit the spread of COVID-19.

“As we head into respiratory virus season, it is important to take every mitigation measure we can to prevent outbreaks of the flu, RSV and COVID-19,” Dr. Natasha Bagdasarian, chief medical executive for the Michigan Department of Health and Human Services, said in a statement. “Wearing masks, washing hands, social distancing and getting vaccinated for the flu and COVID-19 will help prevent the spread of illness.”

ABC News’ Sasha Pezenik contributed to this report.

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(NEW YORK) — More than 100,000 people in the U.S. died of a drug overdose during the first year of the pandemic, a nearly 29% increase from the same time period in 2019, the Centers for Disease Control and Prevention announced Wednesday. The vast majority of those deaths were due to opioids, particularly synthetic opioids like fentanyl.

“An American dying every five minutes — that’s game-changing,” Secretary of Health and Human Services Xavier Becerra said at a media briefing.

The new data has prompted concern among officials about the worsening overdose epidemic.

In response to the findings, the White House, the Department of Health and Human Services and other government health officials outlined new initiatives aimed at combating the overdose epidemic, including expanding access to naloxone — a drug used to reverse opioid overdoses, allowing federal dollars to be used to purchase fentanyl test strips to detect the presence of fentanyl in any drug batch and increasing funding toward addiction prevention efforts.

The CDC previously warned that the rate of overdose deaths accelerated during the pandemic — driven largely by synthetic opioids like fentanyl. Fentanyl is a powerful synthetic opioid that is 50 to 100 times more potent than morphine, according to the National Institutes of Health.

It can also be manufactured to look like real prescription pills and be illegally imported and sold throughout the U.S., contributing to this crisis.

“We have already seized 12,000 pounds of fentanyl,” said Anne Milgram, administrator of the Drug Enforcement Administration. “This year alone, the DEA has seized enough fentanyl to provide every member of the United States population with a lethal dose.”

The increased number of deaths from overdoses is also concerning for public health experts.

“This alarming data indicates a crisis in the mental health community caused by both the ongoing pandemic and fentanyl’s explosion on the illegal drug scene,” said Dr. Akhil Anand, a psychiatrist with Cleveland Clinic. “This new report should be another continued wake-up call to the overdose deaths happening every day, and people often don’t even know what they are taking. This is a public health crisis, and it is crucial we continue to get people into treatment quickly.”

The CDC’s National Center for Health Statistics launched a new interactive dashboard with an overview of the new data, featuring a U.S. map showing the increase in deaths.

Lauren Joseph, a student at Stanford Medical School, is a contributor to the ABC News Medical Unit. Alexis E. Carrington, M.D., is an ABC News Medical Unit associate producer and a rising dermatology resident at The George Washington University.

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(NEW YORK) — The number of people who were hospitalized for eating disorders in the United States doubled during the COVID-19 pandemic, new research shows.

The increase in in-patient treatment for eating disorders came as early as May 2020, according to researchers from the University of Pennsylvania, whose study was published Monday in the Journal of the American Medical Association (JAMA).

Rising cases were seen across anorexia nervosa, bulimia nervosa and unspecified eating disorders, according to the study.

The researchers attributed the increased rates of hospitalization to several factors, including the conditions of the pandemic that may have promoted eating disorder behaviors, such as grocery shopping being a more “fraught” experience and the fact that schools and colleges were closed, which may have led to covert eating disorder symptoms being caught by families in close quarters.

A delay in outpatient care may have also led to increased hospitalizations, according to the researchers.

Data has previously shown the pandemic has brought on a mental health crisis in the U.S., of which eating disorders are a major part.

Throughout the pandemic, the National Eating Disorder Association (NEDA) said it has seen a spike of more than 70% in the number of calls and online chat inquiries to its hotline compared to the same time period in 2019.

“This has been a time of heightened anxiety for everyone,” NEDA’s CEO Claire Mysko told Good Morning America last year. “For people with eating disorders, either those who are actively struggling or those who are pursuing recovery, there’s an added stressor with the pandemic.”

The Emily Program, a national network of eating disorder treatment centers, has seen inquiries both online and by phone “fly off the charts” during the pandemic, Dr. Jillian Lampert, the Emily Program’s chief strategy officer, also told GMA.

The nature of the pandemic, with its uncertainty and isolation, makes it a situation that “checks every box” for putting people at a higher risk for eating disorders, according to Lampert.

“We’re seeing people calling now in a more acute, intense stage [of an eating disorder],” Lampert said last year. “So we’re seeing not only are more people calling, but more people are calling in a more crisis situation.”

Eating disorders have remained second only to opioid overdose as the deadliest mental illness throughout the pandemic, with eating disorders responsible for one death every 52 minutes in the U.S., according to data shared by the National Association of Anorexia Nervosa and Associated Disorders.

Nearly 30 million Americans will have an eating disorder in their lifetime, according to the association.

If you or someone you know is battling an eating disorder, contact the National Eating Disorders Association (NEDA) at 1-800-931-2237 or NationalEatingDisorders.org.

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(NEW YORK) — It’s perfectly acceptable for 5- to-11-year-olds preparing to receive a vaccine against COVID-19 also to receive other protective shots they may have missing during the pandemic lockdown.

For some children, that could mean five or six shots in a single visit, but it’s safe to do so, doctors told ABC News.

“You can’t overwhelm the immune system with these vaccines,” said Dr. Margaret Fisher, a pediatric infectious disease specialist in New Jersey and chair of the AAP Global Immunization Advocacy Project.

Autumn is often less hectic at pediatricians’ offices, which is serendipitous for parents looking to schedule COVID-19 vaccine appointments.

“We’re kind of in a sweet spot,” said Dr. Natasha Burgert, a pediatric specialist in Kansas, with most children flooding doctors offices for back-to-school checkups over the summer.

Routine childhood vaccinations — jabs that help stave off devastating illnesses such as polio, measles, diphtheria and pertussis — are carefully laid out in Centers for Disease Control and Prevention guidelines, and all states require these vaccines for children attending public school.

While most kids are up to date on routine vaccines, according to Burgert, a significant number missed appointments over the summer. In August, the nonprofit group Health Efficient estimated that community health centers would need to increase the number of childhood vaccinations by 265% to match pre-pandemic levels — and maintain that pace for at least six months.

“If kids need routine shots, either we are giving them at the same time, or we are prioritizing the COVID shot right now,” Burgert added. “This is still a global emergency.”

Pediatricians of children who need to get back on a regular vaccination schedule should consult the CDC schedule for vaccine catch-ups, even if that means some kids will be getting their shots slightly later than would be ideal, said Dr. Alok Patel, a pediatric hospitalist at Stanford Children’s Health.

“I also have parents that prefer to space them out,” said Burgert, especially kids historically more reactive to the flu shot. “Parents are a little bit more hesitant to do both at the same time, just because they don’t want them to feel bad. And I understand that.”

Patel said he hears similar concerns: “A lot of parents say, ‘Hey, this is too many shots for my child to handle.'” But spacing out the vaccines, Patel added, is not without risk.

“The problem with spacing out the vaccines is you leave your child at risk to get the diseases while you’re spacing them out,” said Fisher, the pediatric infectious disease expert. “There’s no advantage. There’s no evidence that giving them at the same time increases the adverse events. And the disadvantage is you leave your child susceptible.”

According to Patel, parents should focus most on “getting their children the right protection, and getting them fully vaccinated against COVID-19 as soon as possible, but also making sure that they’re getting complete protection against the other major vaccine-preventable illnesses.”

Pediatricians are urging eligible patients to seek out COVID-19 vaccines as soon as possible — and to stay up to date on other routine vaccines.

“The last thing we want to do,” Patel told ABC News, “is see a resurgence of these preventable diseases because of lapses in coverage.”

Burgert also noted how children are eager to do their part.

“These kids have been living all of this stress with us,” Burgert said. “They have been living through it, and they want it to be over too. They want it to be over for their friends, and they want it to be over for their parents.”

Lauren Joseph, a student at Stanford Medical School, is a contributor to the ABC News Medical Unit. Dr. Tushar Garg and Dr. Jay Bhatt contributed to this report.

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(WASHINGTON) — With winter closing in and coronavirus case rates creeping up once again, White House chief medical adviser Dr. Anthony Fauci is warning that the vaccines’ waning immunity combined with the highly transmissible delta variant will make for a “double whammy” that will impact “even the vaccinated people.”

“The somewhat unnerving aspect of it is that if you keep the level of dynamics of the virus in the community at a high level — obviously the people who are most most vulnerable are the unvaccinated — but when you have a virus as transmissible as delta, in the context of waning immunity, that dynamic is going to negatively impact even the vaccinated people. So it’s a double whammy,” Fauci said in a pretaped interview aired at the 2021 STAT Summit Tuesday afternoon.

“You’re going to see breakthrough infections, even more so than we see now among the vaccinated,” he added.

His grim prediction meets a chorus of alarm bells already being sounded about COVID’s renewed spread as more people head inside as the holidays approach, heralding a season of family gatherings.

The national reported average for new cases each day has surged to more than 80,000, according to federal data — the highest in nearly a month. Forty states are currently showing high transmission, and total hospitalizations have increased for the first time in nearly 10 weeks.

Combatting any impending viral onslaught this winter hinges on how many more sleeves roll up for more shots, Fauci said. It won’t only be important to persuade the roughly 60 million “recalcitrant” people who have yet to get their first dose, but also “how well we implement a booster program,” he said.

Fauci added that booster doses of the COVID vaccine may become the standard for a “full” vaccination.

It comes as a growing roster of states and local jurisdictions have pushed ahead of federal regulators’ timeline, electing to endorse the expansion of booster shots to all adults at least six months after their second Pfizer or Moderna shot.

Though Pfizer formally asked the Food and Drug Administration to expand their booster’s authorization last week, right now federal agencies only recommend the mRNA booster for people over the age of 65, have an underlying medical condition or are at high risk for exposure, at least six months after their second dose.

All Johnson & Johnson recipients over the age of 18, however, are eligible for a boost at least two months after receiving their first dose.

“I happen to believe as an immunologist and infectious disease person, that a third shot boost for an mRNA is likely — should be part of the actual standard regimen, where a booster isn’t a luxury; a booster isn’t an add on; and a booster is part of what the original regimen should be — so that when we look back on this, we’re going to see that boosters are essential for an optimal vaccine regimen,” Fauci said.

ABC News’ Arielle Mitropoulos contributed to this report.

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