Why vaccine incentives may not have been the best answer to hesitancy: Experts

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(NEW YORK) — After more than two months of trying to woo hesitant Americans to get COVID-19 vaccines with cash, free beer and other prizes, health data and experts suggest those incentives failed to move the needle forward appreciably in many cases, and in some had no impact at all.

“A small proportion responds to the incentives, but they are definitely not a panacea,” Dr. Kevin Schulman, a professor of medicine and economics at Stanford University’s School of Medicine and Graduate School of Business, told ABC News of the national vaccine situation.

There was some initial thought that lotteries, in particular, would be effective given their appeal to some people who were also hesitant to get vaccines, experts told ABC News. But since incentives started widely being offered beginning on May 12, the number of first does given in the U.S. briefly increased but then tailed off.

The country did not meet President Joe Biden’s goal of 70% of Americans getting one dose by July 4 and only 48% of the entire population has been fully vaccinated as of July 13, according to data from the U.S. Centers for Disease Control and Prevention (CDC). The situation is more urgent in some states, like Arkansas and Louisiana, where vaccinations levels are below 50% despite well-funded incentive programs.

Schulman and health experts are recommending governors and health officials refocus their efforts on outreach rather than incentivizing if they want to avoid another wave of cases, hospitalization and deaths brought upon by low vaccination numbers.

Ohio’s ‘Vax-a-Million’ — an outlier?

Ohio, the first state to offer a lottery to vaccinated residents, was seen as an early test case. Gov. Mike DeWine used federal stimulus money to offer a $1 million prize and one full college scholarship to teen entrants once a week for five weeks.

One week after the “Vax-a-Million” sweepstakes was announced, an additional 113,000 Ohio residents had received their first dose, according to the state’s health department. That increase represented a week to week 53% jump, the state’s health officials said.

“This exceeded the governor’s expectations,” Dan Tierney, a spokesman for DeWine, told ABC News.

While the state credited the lottery for the jump, there has been no direct study or data to show it was the impetus, aside from some anecdotal evidence, according to the state’s health officials. The data did show that the increase was short-lived.

Since May 12, the number of residents who received their first shot increased by 770,000, according to the Ohio Health Department.

While this represents 13.5% of the 5.7 million Ohio residents who have received their first shot as of July 13, the state only has 48.8% of its population with one dose.

Roughly 55.6% of the total U.S. population has received one dose as of July 13, according to the CDC.

John Brownstein, Ph.D., an epidemiologist at Boston Children’s Hospital and an ABC News contributor, said Ohio’s case demonstrated that vaccine health incentives are really just a stop-gap and true solutions lie in increasing access to a vaccine center and education about efficacy.

“The incentives only really worked for people who were on the fence,” Brownstein said of the Ohio lottery program. “You saw that slight bump, but there are still thousands of people who aren’t signing up and the incentives didn’t work on them.”

Tierney said the Ohio lottery campaign organizers acknowledged that the campaign was most effective at convincing residents who were planning on getting vaccinated but held out due to scheduling time around school, work or vacations.

But Tierney also maintained that those hundreds of thousands of newly vaccinated residents still make a difference in the state’s goal.

“I think Vax-a-Million forced a lot of people to think about their calculations about when they wanted to get the vaccine,” he said.

Others lagging behind

Brownstein and health experts warned that Ohio’s increase following its lottery was an outlier.

Eighteen other states, including Maryland and New York, came up with their own vaccine lotteries or cash giveaways following Ohio, according to the National Governor’s Association. Their combined efforts appeared to only make a small and short-lived dent in vaccination numbers.

The seven-day average of new first doses given initially climbed from 1.79 million on May 12 after the states offered their programs to 1.88 million a week later but has steadily declined to 421,000 on July 7, according to the data. The average peaked at 3.4 million doses on April 11, according to the CDC.

Several states with already lagging vaccine numbers saw no jump after their programs were announced, according to health data.

In Louisiana, where only 39% of the entire population has one dose of the vaccine, the seven-day average of new daily doses administered has remained level at around 10,000 for the last month, according to Louisiana Health Department. A lottery for vaccinated residents was announced on June 17.

In Arkansas, the seven-day average of new vaccine shots administered declined by over 3,500 after the state announced its scratch-off game incentive for vaccinated residents on May 25, according to the Arkansas Health Department.

“I don’t know if we’re going to be able to buy our way out of this,” Col. Robert Ator, the program director of the Arkansas vaccine incentive program, told ABC affiliate KATV on June 28.

A representative for the Arkansas Health Department told ABC News the state is looking at other options including a request to businesses to offer incentives to people.

Don’t focus on incentives: Experts

Schulman co-authored a report in the New England Journal of Medicine in January arguing that the best ways to promote the COVID-19 vaccination among the populace is for state leaders to rethink their approaches and focus on marketing rather than rewards

Specifically, Schulman said states should prepare and launch marketing and advertising campaigns aimed at Americans who think it’s OK not to get a shot because hospitalizations and deaths are down from the winter and they’ll be fine.

“They are a really important group to address now. They’re more likely to respond to a good marketing campaign,” he said.

Informing those unvaccinated members about the dangers of the virus, particularly the growing threat of variants, and the effects on their families and businesses will go a longer way than a cash prize, Schulman argued.

“I would go back to those lottery states and ask how much did you spend on the lottery and how much could you have spent on Facebook ads that could appeal to those populations,” he said.

Tierney noted that the Vax-a-Million sweepstakes generated a form of publicity for the vaccine because of news articles, social media posts and word of mouth. His office has estimated that the coverage was the equivalent of $50 million in advertising.

“We could not have bought this word of mouth,” he said.

Schulman said it is promising that state leaders are working to close the vaccination gap, but reiterated that they’ll need more precise targeting to pick up the pace.

“The fact that these governors sounded the alarm early and said, ‘We have a problem,’ is encouraging,” he said. “They must not give up.”

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Mississippi health officials warn about delta ‘surge’ as 7 children in ICU due to COVID-19

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(JACKSON, Miss.) — As the delta variant spreads rapidly across the U.S., Mississippi officials are warning about hospitalizations of children with severe cases of COVID-19.

Of the seven children currently in the intensive care unit due to COVID-19, two are on ventilators, according to State Health Officer Dr. Thomas Dobbs.

“Delta Surge – be careful,” Dobbs said in a terse tweet Tuesday, while sharing the updates on the latest hospitalizations.

Dobbs initially said 12 children statewide were in the ICU due to COVID-19, though later revised that to a smaller number after a hospital corrected its report.

“Please be safe and if you are 12 or older – please protect yourself,” he said.

The ages ranged from under 1 to 17, Dobbs said in a statement to ABC News Wednesday.

Children are less likely than adults to have serious COVID-19 infections. Most have mild symptoms, if any, according to the Centers for Disease Control and Prevention, though in rare instances, they have developed severe cases that led to hospitalization or death.

It is not clear if any of the seven chilidren have underlying health conditions that would put them at greater risk for severe illness from COVID-19.

Dr. Alan Jones, associate vice chancellor for clinical affairs at the University of Mississippi Medical Center in Jackson, told ABC News Wednesday that his facility was seeing a “significant increase” in pediatric patients over the last several weeks.

The medical center is currently treating five children with confirmed COVID-19 cases, two of whom are in the ICU. Two other children at the hospital are being investigated for potential COVID-19 infections, he said.

The children, who are in stable condition, range from infants to teenagers, Jones said. He could not share any further details about the cases but said that many patients within his hospital who are currently in the ICU do have some chronic, underlying comorbidity diseases that would put them at a higher risk of having a more severe illness associated with COVID-19.

The state has been seeing a “pretty alarming” increase in the number of COVID-19 cases and hospitalizations, Dobbs said during a press briefing last Friday, as the highly contagious delta variant, which was initially identified in India, has quickly become the dominant variant in the state.

“We have seen pretty much an entire takeover of the delta variant for our transmission,” Dobbs said during the briefing, noting that the current cases in the state are “pretty much all delta.”

Between June 15 and July 9, the delta variant accounted for 80% of all specimens sequenced in the state, according to Dobbs.

Hospital systems are not currently overwhelmed, but Dobbs said there are “concerns about it going forward, as has been seen in other states” due to delta, which has become the dominant variant nationwide.

Mississippi’s daily COVID-19 case average has more than doubled in the last three weeks. Less than three weeks ago, there were under 100 patients receiving care for COVID-19 in Mississippi. As of July 11, there were nearly 200. Hospital admissions have also increased by 26.7% in the last week.

The state has seen an increase in COVID-19 outbreaks as well, particularly among youth, in summer activities and nursing homes, Dobbs said.

Jones said his hospital’s pediatric patients seem to be more symptomatic than the children who became ill earlier in the pandemic, which he attributed to the delta variant.

“These seem to be more classic COVID symptoms — fever, cough, respiratory illness,” he said. “I suspect that’s probably because this delta variant is importing a little more severe illness in the pediatric population than those earlier strains that were circulating.”

The delta variant is surging as Mississippi has the second-lowest vaccination rate in the country, with approximately one-third of the state’s total population fully vaccinated, according to the CDC. The “vast majority” of cases, hospitalizations and deaths in the state now are in unvaccinated people, Dobbs said.

Due to the low vaccination rate, the state health department advised Friday that those who are ages 65 and older or have chronic medical conditions avoid mass indoor gatherings for several weeks.

“Our collective under-vaccination in the state has put us all at risk, especially the most vulnerable,” Dobbs said.

Editor’s Note: A state health officer has issued a correction revising the number of children hospitalized with severe COVID-19 cases from 12 to seven.

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Delta variant now accounts for about 58% of COVID-19 cases in US, CDC says

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(NEW YORK) — A highly contagious variant of the novel coronavirus that was initially identified in India now accounts for about 58% of all COVID-19 cases in the United States, according to the Centers for Disease Control and Prevention.

Data updated by the CDC on Tuesday evening shows the so-called delta variant, also known as B.1.617.2, was estimated to be responsible for 57.6% of newly confirmed cases nationwide from June 20 through July 3. The proportion was estimated at just 31.1% for the two weeks prior.

In late May, the delta variant was estimated to account for approximately 3% of new cases in the U.S, according to CDC data.

After being initially identified in India in October, the delta variant has since been reported in at least 104 countries around the globe and is expected to soon be the dominant coronavirus variant circulating worldwide, according to the World Health Organization. The variant was first detected in the U.S. in March and is now present in all 50 states.

“The delta variant is ripping around the world at a scorching pace, driving a new spike in cases and death,” WHO Director-General Tedros Adhanom Gebreyesus said during a COVID-19 press briefing on Monday.

Last week marked the fourth consecutive week that the number of newly confirmed COVID-19 cases has increased globally. Deaths are also on the rise again after 10 weeks of decline, according to Tedros, who noted that the WHO has received reports from all regions of the world about hospitals reaching capacity.

“In places with high vaccination coverage, Delta is spreading quickly; especially infecting unprotected and vulnerable people and steadily putting pressure back on health systems,” he said. “In countries with low vaccine coverage, the situation is particularly bad.”

The WHO declared delta a “variant of concern” in May, and the CDC upgraded its classification of the strain in June from “variant of interest” to a “variant of concern.” Both the WHO and the CDC say that variants of concern have shown to be both more infectious and more virulent than other strains.

The delta variant has shown to be particularly dangerous to those who are unvaccinated or partially vaccinated against COVID-19, and preliminary data indicates it may increase the risk of hospitalization.

However, current evidence suggests that the full dosage of a COVID-19 vaccine is highly effective in preventing hospitalizations and serious illness. Instances where a fully vaccinated individual becomes infected with COVID-19, known as breakthrough cases, are exceedingly rare. And while early laboratory studies indicated the vaccines seem to produce far fewer virus-fighting antibodies against some of the newer variants, real-world experience tells a different story as researchers across the globe learn that the vaccines still mostly work — even when those antibodies fail to show up in great numbers — thanks to other crucial parts of the body’s immune system.

Still, there is very little known about the mutating virus and it remains unclear exactly how long immunity from the vaccines will last and whether booster shots will be needed to maintain protection.

As delta and other highly transmissible variants spur “catastrophic waves” of COVID-19 infections, the WHO director-general is urging vaccine manufacturers to prioritize supplying doses to poorer countries with low vaccination rates rather than giving booster shots to wealthier nations with relatively high coverage.

“The global gap in vaccine supply is hugely uneven and inequitable,” Tedros said Monday. “Some countries and regions are actually ordering millions of booster doses, before other countries have had supplies to vaccinate their health workers and most vulnerable.”

Since the start of the pandemic, the U.S. has reported more than 33.9 million confirmed cases of COVID-19 and over 607,000 deaths from the disease, according to data collected by Johns Hopkins University. The U.S. has recorded the highest death toll, while India has the highest total case count.

More than 184 million people in the U.S. have received at least one dose of a COVID-19 vaccine, including over 159 million — 48.1% of the population — who are fully vaccinated, according to CDC data.

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Mississippi health officials warn about delta ‘surge’ as 12 children in ICU due to COVID-19

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(JACKSON, Miss.) — As the delta variant spreads rapidly across the country, Mississippi officials are warning that a dozen children are hospitalized throughout the state with severe cases of COVID-19.

Of the 12 children currently in the intensive care unit due to COVID-19, 10 are on ventilators, according to State Health Officer Dr. Thomas Dobbs.

“Delta Surge – be careful,” Dobbs said in a terse tweet Tuesday, while sharing the updates on the latest hospitalizations.

Children are less likely than adults to have serious COVID-19 infections. Most have mild symptoms, if any, according to the Centers for Disease Control and Prevention, though in rare instances, they have developed severe cases that led to hospitalization or death.

It is not clear what the ages of the 12 children are, if they were eligible for the COVID-19 vaccine or if any have underlying health conditions that would put them at greater risk for severe illness from COVID-19. ABC News has reached out to the Mississippi Department of Health for more information on the cases.

Dr. Alan Jones, associate vice chancellor for clinical affairs at the University of Mississippi Medical Center, told ABC affiliate WAPT in Jackson, Mississippi, that his facility is currently treating four pediatric COVID-19 patients, two of whom are on ventilators.

“We have had more pediatric admissions than we had early in the pandemic,” Jones told the station.

The state has been seeing a “pretty alarming” increase in the number of COVID-19 cases and hospitalizations, Dobbs said during a press briefing last Friday, as the highly contagious delta variant, which was initially identified in India, has quickly become the dominant variant in the state.

“We have seen pretty much an entire takeover of the delta variant for our transmission,” Dobbs said during the briefing, noting that the current cases in the state are “pretty much all delta.”

Hospital systems are not currently overwhelmed, but Dobbs said there are “concerns about it going forward, as has been seen in other states” due to delta, which has become the dominant variant nationwide.

Mississippi’s daily COVID-19 case average has more than doubled in the last three weeks. Less than three weeks ago, there were under 100 patients receiving care for COVID-19 in Mississippi. As of July 11, there were nearly 200. Hospital admissions have also increased by 26.7% in the last week.

The state has seen an increase in COVID-19 outbreaks as well, particularly among youth, in summer activities and nursing homes, Dobbs said.

The delta variant is surging as Mississippi has the second-lowest vaccination rate in the country, with approximately one-third of the state’s total population fully vaccinated, according to the CDC. The “vast majority” of cases, hospitalizations and deaths in the state now are in unvaccinated people, Dobbs said.

Due to the low vaccination rate, the state health department advised Friday that those who are ages 65 and older or have chronic medical conditions avoid mass indoor gatherings for several weeks.

“Our collective under-vaccination in the state has put us all at risk, especially the most vulnerable,” Dobbs said.

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COVID-19 cases are rising in Los Angeles: What’s behind the spike

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(LOS ANGELES) — Health officials in Los Angeles County are warning that the delta variant’s spread among unvaccinated people is driving a spike in new COVID-19 infections in the county.

On Monday, the health department reported 1,059 new COVID-19 cases, a significant increase since June, when the department was consistently reporting a few hundred new infections each day. Officials are currently investigating 55 ongoing outbreaks, up 25% from the 44 outbreaks they were investigating last month.

Nearly all new cases are among people who haven’t gotten a COVID-19 vaccine, according to officials.

“Over 99% of the COVID-19 cases, hospitalizations and deaths we are seeing are among unvaccinated individuals,” Barbara Ferrer, Los Angeles County’s director of public health, said in a statement Monday.

Young people are also contributing to the infection spike, according to Ferrer. “Of the cases reported today, nearly 87% were under 50 years old,” she said.

“The COVID-19 vaccines are the most effective and important tool to reduce COVID-19 transmission and the spread of variants like the highly transmissible delta variant,” she said. “Getting fully vaccinated is the way we protect you, your family and our community from COVID-19 and the delta variant.”

As a state, California’s vaccination rate is better than the national average. As of Monday, 63% of residents had received at least one dose, and 51% were fully vaccinated, compared with 56% of all Americans who’ve gotten at least one shot and 48% who are fully vaccinated, according to the Centers for Disease Control and Prevention. In Los Angeles County, 70% of residents 16 and older have gotten at least one dose of the vaccine, according to the health department. Nationally, 68% of Americans 18 and older have gotten at least one dose.

The delta variant, which was first detected in India and now has made up 51.7% of infections in the United States for the two weeks ending July 3, according to the CDC, is more transmissible than the original version of the virus and is especially dangerous for people who are unvaccinated or partially vaccinated, experts say.

In part because of fears over the variant, Los Angeles officials made waves when they reversed their guidance on masks less than a month after Gov. Gavin Newsom lifted COVID-19 restrictions in the state.

According to a statement issued by the Los Angeles County Department of Public Health on June 28, the department “strongly recommends everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.” The department acknowledged that “fully vaccinated people appear to be well protected from infections with delta variants.”

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Children leaving quarantine results in summer surge of common winter virus RSV

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(NEW YORK) — After more than a year, children are emerging from the COVID-19 quarantine.

Family gatherings are back, and so are germs and other viruses. For young children, getting sick is a rite of passage that’s often short-lived and helps build up future immunities.

What is uncommon now is the time of year viruses common in children are finding a foothold.

In some parts of the country, hospitals have been reporting an unseasonable rise in viral infections, according to the U.S. Centers for Disease Control and Prevention.

For children younger than age 2, the most frequent is a lung infection causing temporary inflammation in the airways, called bronchiolitis, which is most often caused by respiratory syncytial virus, or RSV.

Cases among kids typically crop up in the fall and winter, when school is back in session and germs are easily shared, but experts said they’re seeing these cases now.

“The number of RSV cases is about the same,” Dr. Allison Bartlett, pediatric infectious disease doctor at the University of Chicago, told ABC News. “It’s the season that’s unusual.”

This period of time in summer is now being called “RSV season” because more than 1 out of 10 tests are positive for the virus, according to Bartlett.

Here’s what parents should know:

How to prevent RSV

For the general population, experts said kids can keep safe from RSV with the same health measures we’ve all been doing for more than a year during the COVID-19 pandemic: Masking, social distancing and following good hygiene.

Teaching kids to practice “respiratory etiquette” and handwashing can help, along with keeping infants away from others who may have a respiratory infection already, according to Bartlett.

“Managing the COVID pandemic has reinforced for everyone the impact that masking, social distancing, school closure and staying home when you’re sick can have,” she said. “All of the actions we took to stop the spread of COVID effectively prevented RSV as well. Now that we have relaxed some of these strategies, RSV is back.”

Symptoms to watch for

Children with RSV may start to wheeze, develop a cough or congestion or spike a fever, the body’s natural response to fighting off a virus.

Parents may also notice their child has less of an appetite than usual, that they’re more tired and more irritable.

As parents and guardians monitor kids’ symptoms that can span several days, experts caution not to be alarmed if a child seems to worsen, even after starting to see mild improvements.

“Days four to seven of illness is really when the infection declares itself,” said Dr. Alisa McQueen, a pediatric emergency medicine physician at the University of Chicago. “It’s common for many of the symptoms to almost resolve, and then suddenly come back.”

What to do if your child is sick

Most cases of bronchiolitis are very mild and can be managed at home with over-the-counter therapies and a little “TLC.”

Experts point out if a child is sick, but not in crisis, keeping them home, rather than seeking emergency medical care, may actually be safer and healthier for them and others. RSV is an extremely contagious virus that, after spreading by saliva and mucous droplets, can linger on surfaces far longer than many other viruses.

A several hours’ wait in the emergency department could expose a child to other, even more harmful pathogens, especially if their immune system is already weakened.

Many fevers will resolve without medication, but fever-reducing medications like acetaminophen or ibuprofen can help.

If a child is having trouble blowing their nose and needs relief, cool mist humidifiers, manual suctioning devices, or thinning out the mucous with nasal saline drops will help o help drain easily from the nose, according to Dr. Tyree Winters, a New Jersey-based pediatrician.

But for a small number of infants and young children, RSV can be dangerous.

Approximately 1% to 2% of children who get RSV end up hospitalized. The virus accounts for around 58,000 hospitalizations each year for children under the age of 5 in the United States, according to the CDC.

If a child struggles with breathing beyond the point of congestion — episodes where they stop breathing, have faster breathing, use extra muscles to breath or start turning blue around the mouth — that’s a sign to seek medical attention.

The extra energy the body is using to fight the infection can often makes children sleepier and less active, but when a child is too tired to even drink, has stopped making diapers or cries without making any tears, these are all early signs of dehydration and might mean a child is too sick to fight this infection alone.

Gauging what level medical attention a child needs can be tricky, especially for an anxious parent, so when in doubt, seek help, experts say.

“If something doesn’t seem right, come in the emergency department and let us take a look,” said McQueen. “We’re here 24 hours a day for exactly this reason.”

In most cases, if a child is admitted to the hospital, the stay will only last a few days. These children are often placed on supplemental oxygen to make sure they are getting enough.

If a child has not been eating for several days already, the hospital can also help by giving them IV fluids until the child feels well enough to start eating and drinking normally again.

For infants at greater risk of severe illness, like those who were born premature, or those with chronic lung or congenital heart disease, a monthly antibody injection is available.

Chidimma J. Acholonu, M.D., MPH, a pediatric resident physician at University of Chicago’s Comer Children’s Hospital, is a contributor to the ABC News Medical Unit.

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Gov’t officials remain unconvinced Americans need COVID vaccine booster shot just yet

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(WASHINGTON) — Americans who are fully vaccinated don’t need another shot, top U.S. health officials said late Monday following a private meeting with top executives at Pfizer, which says it had new data showing a third vaccine dose could boost the body’s antibody response five- to ten-fold.

The statements appear to close the door – at least for now – on the suggestion that people who were among the first to be vaccinated more than six months ago would once again need to line up for a third shot. One factor that could change that calculus is the emergence of new variants of the virus that causes COVID-19.

“At this time, fully vaccinated Americans do not need a booster shot,” the Department of Health and Human Sciences said in a statement following the meeting with Pfizer.

Pfizer called its meeting with government health officials “productive” and said it would publish more “definitive data” in a peer-reviewed journal soon.

“Both Pfizer and the U.S. government share a sense of urgency in staying ahead of the virus that causes COVID-19, and we also agree that the scientific data will dictate next steps in the rigorous regulatory process that we always follow,” the company said in a statement released Tuesday.

The question of whether and when Americans might need a third shot has been an open question for months, as health experts noted that a person’s detectible antibodies wane over time and as new variants of the virus have emerged. But there are other parts of a person’s immune system, including T-cells, that doctors believe also play a major role in helping prevent hospitalization or death.

The first vaccine shots given in the U.S. were Pfizer doses to health care workers on Dec. 14 – some seven months ago.

But since then, ample real-world evidence has surfaced that vaccinated individuals are strongly protected from the virus and its currently known variants. According to the Centers for Disease Control and Prevention, 99.5 percent of deaths from COVID-19 are among unvaccinated patients.

“Nearly every death, especially among adults, due to COVID-19, is, at this point, entirely preventable,” said CDC Director Rochelle Walensky last week.

On July 8, Pfizer announced it had “encouraging data” on the prospects of a third dose. The Pfizer vaccine is typically given in two doses, three weeks apart.

“Initial data from the study demonstrate that a booster dose given after 6 months of the second dose has a consistent tolerability profile while eliciting high neutralization titers, 5-10 times higher than after two primary doses” against variants of the virus, the company stated in an announcement.

“While protection against severe disease remained high across the full 6 months, the observed decline in efficacy against symptomatic disease over time and the continued emergence of variants are key factors driving our belief that a booster dose will likely be necessary to maintain highest levels of protection,” Pfizer said in its earlier statement.

After meeting with Pfizer officials, Dr. Anthony Fauci, chief medical adviser to President Joe Biden, told CNN’s Chris Cuomo Monday night that it’s possible the government will recommend boosters eventually, possibly starting with older Americans or people with underlying medical conditions.

But Fauci said he doesn’t think boosters are needed just yet.

“We heard their data. We made it very clear their data is a part of a much larger puzzle, and we will be gathering data as the weeks go by,” Fauci said.

Fauci also noted that if a decision on boosters is made, “it will be based on a comprehensive study, not on the announcement of a pharmaceutical company.”

Fauci’s statement was a nod to the public confusion about the effectiveness of the vaccine after Pfizer announced it would recommend boosters.

“I don’t mean that in a derogatory way because it was a very good meeting, very informative. We exchanged information, and I think it’s an important step in the right direction,” he added.

In attendance were Drs. Fauci and Walensky, as well as acting FDA Administrator Janet Woodcock; Peter Marks, who has been leading FDA regulatory efforts on the vaccine; Surgeon General Vivek Murthy; Francis Collins, head of the National Institutes of Health; Biden COVID adviser David Kessler; and Rachel Levine, assistance secretary for Health at HHS.

ABC News’ Eric Strauss contributed to this report.

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COVID-19 outbreak tied to weeklong church retreat

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(DAYTON, Ohio) — A COVID-19 outbreak has been reported among attendees of a church retreat, officials announced.

At least 30 positive cases have been identified so far in people who took part in the weeklong event, health officials confirmed.

Dayton and Montgomery County Public Health said more than 800 people attended the Baptist Church retreat at Camp Chautauqua in Miamisburg, Ohio, from June 27 to July 3. Visitors came to the event from churches across Ohio, Kentucky, Illinois and Indiana.

Dr. Michael Dohn, medical director for Dayton & Montgomery County Public Health, spoke out about his concern, stating: “Unvaccinated people, including children under 12 years of age, are up to 100 times more likely to get sick after exposure to COVID-19 compared to fully vaccinated individuals.”

Dohn added: “the outbreak demonstrates that the COVID-19 virus is still circulating and continues to make people sick.”

The positive cases were so far identified in attendees from Ohio and Kentucky.

One person tested positive for COVID-19 during the final days of the retreat and was “immediately quarantined off campus,” Jason Harmeyer, President of the Chautauqua Camp and Conference Center said in a statement. Event organizers then proceeded to monitor individuals associated with that group for symptoms and conducted regular temperature checks.

Health officials investigating the outbreak said camp and event organizers had failed to provide contact information for attendees after the initial cases were recognized, so authorities were asking anyone who may have attended the retreat to contact them or their local health department.

The camp organizer said it was in regular contact with group leaders to take necessary precautions.

It is unknown how many attendees had received COVID-19 vaccinations.

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California backtracks on banning unmasked students from school campuses

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(SACRAMENTO, Calif.) — California issued a new rule on Monday banning unmasked students from school campuses but then rescinded it just hours later.

The California Department of Health published its COVID-19 public health guidance for K-12 schools in the Golden State for the 2021-2022 school year, including a new mandate that said students “are required” to wear face masks indoors, unless they are exempt due to a medical condition, and “schools must exclude students from campus” if they refuse to do so. The guidance, which was initially published on Monday afternoon and took immediate effect, noted that schools “should offer alternative educational opportunities for students who are excluded from campus because they will not wear a face covering.”

But later, officials backtracked on that rule. The California Department of Health took to Twitter on Monday evening to signal a change of direction, saying, “California’s school guidance will be clarified regarding masking enforcement, recognizing local schools’ experience in keeping students and educators safe while ensuring schools fully reopen for in-person instruction.”

The guidance was ultimately revised, dropping the language about excluding unmasked students from classrooms statewide and instead allowing schools to decide how to deal with the issue.

“Consistent with guidance from the 2020-21 school year, schools must develop and implement local protocols to enforce the mask requirements,” the guidance now states. “Additionally, schools should offer alternative educational opportunities for students who are excluded from campus because they will not wear a face covering.”

The California Department of Health says the guidelines are “effective immediately and will be reviewed regularly.” The department further noted that it is operating within the updated recommendations released Friday by the U.S. Centers for Disease Control and Prevention, which continues to advise schools to promote COVID-19 vaccination and implement indoor mask requirements and physical distancing for those who are not fully vaccinated. But the CDC’s guidelines also state that schools “should not exclude students from in-person learning to keep a minimum distance requirement.”

“Students benefit from in-person learning, and safely returning to in-person instruction in the fall 2021 is a priority,” the CDC says.

Nevertheless, California’s COVID-19 measures are among the strictest of any U.S. state. Education and health officials alike are concerned about the so-called delta variant, a highly contagious version of the novel coronavirus, with infections on the rise as the new academic year draws closer.

As of July 7, there were 1,085 confirmed cases of the delta variant in California — a 71% rise from the previous week. Meanwhile, among the COVID-19 tests statewide that are genomically sequenced, the delta variant accounted for 43% on June 21 compared with just 5.8% on May 21, according to data from the California Department of Health.

Overall, California has reported more than 3.7 million confirmed cases of COVID-19 and over 63,000 deaths from the disease. More than 42.4 million doses of COVID-19 vaccines have been administered across to the state, which is home to some 39.5 million people, according to data from the California Department of Health.

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How to reduce your child’s COVID-19 risk if they’re too young to be vaccinated

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(NEW YORK) — While all adults in the United States are now eligible for the COVID-19 vaccine, parents with young children find themselves in an uncomfortable limbo state. Fully vaccinated parents are protected against the virus, but their kids under 12 aren’t even eligible for a shot.

While children are less likely to have serious infection than in adults, with the Centers for Disease Control and Prevention noting that “most children with COVID-19 have mild symptoms or have no symptoms at all,” in rare instances, children have developed severe COVID-19 cases that led to hospitalization or death.

As of early June, 4,000 children nationwide had developed multisystem inflammatory syndrome in children (MIS-C), a rare but serious condition associated with COVID-19. There’s also an element of uncertainty associated with any COVID-19 infection, since the long-term health consequences of having COVID-19 are not yet known.

Navigating kids and COVID is complicated. Come fall, vaccines are likely to be approved for children younger than 12, but until then, some parents are wondering how to keep their kids safe as guidelines about masks and social distancing loosen.

ABC News spoke with Dr. Judith Flores, a pediatrician and former chief of ambulatory care at NYC Health + Hospitals, who has been in practice for more than 30 years, about how parents can lower their kids’ COVID risk.

Q: My kid is going back to school in person this year. What do I need to know?

You should start planning and ask questions, Flores says.

“I would also inquire who is vaccinated at school and keep an eye on what their environmental controls are,” Flores said.

According to the CDC’s guidelines for K-12 schools, “consistent and correct use of face masks reduces the spread of SARS-CoV-2 and, with some exceptions, is recommended for use indoors among people aged 2 and older who are not fully vaccinated.” The CDC also recommends handwashing, improving ventilation, staying home if sick, social distancing and testing in schools to mitigate the risk of COVID-19 outbreaks.

Depending on school guidance and your risk tolerance as a parent, send your child to school with a mask. Flores noted that if she had a small child, she would have them wear a mask at school, especially in the beginning, while you determine whether or not the school is doing a good job of keeping the environment safe.

But ultimately, it’s important to keep in mind that schools have been reasonably safe settings so far.

“It’s been well documented that kids get sicker when they’re home with family,” Flores said.

Despite that reality, some parents are rightfully nervous. Flores works with families that were hit hard by COVID-19’s initial wave in New York City. Some parents and children are anxious about returning in person, she explained, adding that behavioral and mental health support are critical, especially for kids who lost family members during the pandemic.

“It’s not just, ‘let’s make sure we have your supply list for the teacher this year,'” she said. “You really have to prepare your children mentally — and yourself,” she said.

Q: Is there anything I can do to lower my child’s COVID risk until they’re eligible for a vaccine?

“The best way to take care of your child is for you, your family and your community to be vaccinated,” Flores stressed. “Your kid’s risk goes up depending on the community you live in or go to school in. If your community has a low vaccination rate and high infection rate, there’s a greater risk your child will get sick.”

“If I were in Mississippi, I’d be very concerned, because the vaccination rate is low. So there, I’d keep a mask on my child and keep social distancing. If I lived in Massachusetts, I might breathe a little easier,” she said.

Mississippi’s vaccination rate trails the national average. As of Monday, 37% of residents had received at least one dose, and 33% were fully vaccinated, according to the CDC, compared with 71% of people in Massachusetts who’ve gotten at least one shot and 63% who are fully vaccinated.

Your child doesn’t need to wear a mask in most outdoor settings because the risk of transmission is low, Flores noted, but it’s a good idea to have them wear one in indoor public spaces, especially if ventilation is poor or if the space is crowded.

The same fundamental practices the CDC recommends for schools, like handwashing and social distancing, are useful for reducing kids’ risk in non-school settings. You can also model wearing a mask for your child, even if you’re vaccinated and don’t technically need one yourself. If you’re not going to wear a mask around your child, having a conversation as a family explaining why masks are important is key, Flores suggested.

“This is an added protection for you. Just like I would put a seatbelt on you, I would put a mask on you for this time,” she said. “Kids understand seatbelts.”

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