The U.S. Vaccination Rate Continues To Slow : Short Wave Short Wave's Emily Kwong talks with NPR health correspondent Allison Aubrey about some of the latest coronavirus news, including the return of the Johnson & Johnson vaccine in the U.S. and vaccine outreach in harder to reach communities.

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The U.S. Vaccination Rate Continues To Slow

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MADDIE SOFIA, HOST:

You're listening to SHORT WAVE from NPR.

EMILY KWONG, HOST:

Hey, everybody. Emily Kwong here with NPR health correspondent Allison Aubrey, who's here to give us a roundup of some of the latest COVID-19 news.

ALLISON AUBREY, BYLINE: Great to be here. Hey, Emily.

KWONG: Hey. So for all of the concerns about more infectious variants of COVID-19, conditions in the U.S. are kind of improving.

AUBREY: Yeah. I mean, you know, we were stuck in this plateau and then a bit of an increase after the plateau. Now cases are declining. New cases per day are averaging about 62,000 cases a day. Hospitalizations did increase a bit last week. There are hot spots, of course. Michigan we hear about. But deaths are down overall.

KWONG: Great.

AUBREY: And we've got about 29% of the total population vaccinated, and 42% percent of people in the U.S. have received at least one dose. So, you know, the vaccines are now readily available.

KWONG: Right. And the FDA has also lifted the pause on the Johnson & Johnson vaccine. And that's a one-shot option that could help increase vaccination rates further. So things are moving in the right direction.

AUBREY: You know, yeah. And maybe in a sign of that, the European Union now says it will allow fully vaccinated Americans to travel to Europe this summer. But think twice about that. The CDC is warning Americans not to travel much to Europe, at least not yet.

KWONG: OK. So today on the show, we're going to talk about the J&J vaccine now that vaccinations of it can resume in the U.S., and we'll talk vaccine outreach to those communities that are harder to reach. This is SHORT WAVE, the daily science podcast from NPR.

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KWONG: So, Allison, I want to just start with the Johnson & Johnson vaccine. It's coming back. What does that return mean?

AUBREY: You know, I think for the moment, the Johnson & Johnson vaccine is a pretty small part of the overall supply. But I think it could be very helpful to the next phase of the vaccination campaign, to reach more people in hard-to-reach communities. I talked to Dr. Elaine Batchlor about this. Now, she is the CEO of MLK Community Hospital. That's in Los Angeles County. She says they'll resume using the J&J vaccine as soon as they get another shipment of it. And their strategy is this - they have mapped the communities, Emily, with the highest prevalence of COVID, and they have targeted these areas for their mobile or pop-up vaccination clinics.

KWONG: Pop-up vaccination clinics - so that's like, the people in those communities can just walk up; there's no appointments, no registration needed.

AUBREY: Yes, that's exactly right. And she says using the Johnson & Johnson vaccine in this pop-up setting has some advantages. It doesn't require the cold storage, and some people have requested it because it's just one dose.

ELAINE BATCHLOR: We are going into the community to places like Boys and Girls Clubs, grocery store parking lots, churches, and we have a very diverse group of doctors and nurses, you know, that are people of color, that are culturally aligned, and that helps a lot with establishing trust and credibility.

AUBREY: Now, not everyone who gets one shot can easily come back for a second.

KWONG: Right.

AUBREY: In fact, a new analysis shows that millions of people around the country have missed the second dose or at least haven't shown up in that recommended interval. So this kind of reinforces, you know, her strategy of trying to make it easier for people. She says there's still a lot of work to do. She said her own mother has not been vaccinated yet. She was a little bit more hesitant after the J&J pause.

KWONG: Oh, that's interesting how many people have missed their second dose. And, you know, what you just said about Dr. Batchlor's own mom being vaccine-hesitant after the J&J pause, I mean, does it seem like other people might have a similar hesitancy?

AUBREY: I think it depends. And I've asked a lot of health care providers this question. They say one factor is, you know, how well the risk of these rare blood clots is communicated. Going forward, the Johnson & Johnson vaccine will come with a fact sheet that explains the risk of the blood clots. Providers will likely also talk to their patients, especially women, about recognizing the signs. For instance, one sign is a horrific headache that would come on sort of suddenly. And I spoke to Dr. Calvin Johnson about this. He's with Cedars-Sinai Medical Center. He has been very involved in his community doing outreach and vaccine education.

CALVIN JOHNSON: The chance of getting the blood clots is like a needle in a haystack. I mean, initially, it was six; now it's 15 cases. And also, if you have any of the symptoms, then see a physician. We now have a blood test that we can do, as well as treatment, and early treatment is curative.

KWONG: Early treatment is curative - what does that mean?

AUBREY: I think what he's getting at here is that for anyone who gets these rare symptoms, which doctors are now aware of, there's a test. There are ways to catch it early and treat it early.

KWONG: Got it.

AUBREY: And he says, really, this has been an opportunity to go engage with people and say, hey, look; there was this problem. It's rare. We spotted it. There's now a system in place to find it, try to prevent it and treat it. So he says this is progress to him.

KWONG: And these doctors you spoke with were from Los Angeles. How is outreach, though, going in rural communities? 'Cause it seems like that's where there are reports of lower vaccination rates.

AUBREY: That's right. I think that many doctors are trying to reach out directly to their patients. I spoke to Dr. David Field. He's in practice in Bismarck, N.D. He says one thing he hears from some patients who are hesitant is, like, I don't want the government telling me what to do. And so someone who's hesitant like that is not likely to just sort of saunter down to the mass vaccination site; they're going to need a little, you know, prompting, a little bit of coaching, a little bit of, you know, having their questions answered.

DAVID FIELD: A lot of the people I care for, I've known for greater than 10 years, and I usually will say, I have to tell you that this is what's best for you, just as I recommended your heart stress test, just as I recommended an antibiotic for pneumonia. I have a vaccine that you can get very quickly. Let me sign you up for that vaccination. And we have to get back to that personal touch.

KWONG: Wow. I feel like I just saw a doctor (laughter).

AUBREY: Yeah.

KWONG: That's really nice.

AUBREY: And he says, you know, talking to people one-on-one is how he makes progress.

KWONG: Absolutely. I mean, having a personal connection with a doctor can kind of make all the difference when it comes to something like this.

AUBREY: Yeah. And it's why some of the mass vaccination sites around the country might have trouble going forward filling spots because sometimes these more personalized approaches are going to be needed.

KWONG: OK. And so with this slower vaccination rate happening in different parts of the U.S., are experts thinking about what happens if we don't reach the 80% or so mark that gets us to herd immunity?

AUBREY: There is a lot of thinking about this right now, Emily.

KWONG: OK.

AUBREY: I talked to Dr. Ezekiel Emanuel. He's a health policy expert at the University of Pennsylvania. He says he thinks there are ways to require the vaccine.

EZEKIEL EMANUEL: I think we're probably going to need to get some mandates, mandates of children getting vaccinated, mandates of college students getting vaccinated, employers putting in mandates to really get ever closer to something between 70% and 85% of the population vaccinated.

AUBREY: You know, many schools have already announced a vaccine requirement, so students will need to be vaccinated when they return to campus in the fall.

KWONG: Got it.

AUBREY: The European Union, as we talked about at the top, have said U.S. tourists who have been fully vaccinated will be able to come to EU countries this summer. So clearly, if you intend to travel there, you'll probably need to show some proof of vaccination.

KWONG: Absolutely. And like you said earlier, even as the EU is sending positive signals to American travelers, the CDC is warning them not to travel to much of Europe, at least not yet.

AUBREY: You know, the CDC position is still that it makes sense to take precautions. Even if you've been vaccinated, many people have not yet been...

KWONG: Yeah.

AUBREY: ...Especially around the globe.

KWONG: All right, Allison, something else that's been on my mind as we continue to report on the pandemic is COVID long-haulers. And it just seems like those with long-term health problems from their initial infection are getting kind of lost in the shuffle, especially when we're talking about people traveling, the world opening back up again. Are there any research updates on long-haulers and long-term impacts of COVID?

AUBREY: There are. I mean, there's new research just trying to kind of describe the toll that this is taking and the kinds of problems that people are having. In fact, a new comprehensive analysis published in Nature this month characterizes sort of the range of the issues. I spoke to the author of the study, Dr. Ziyad Al-Aly. He's with the VA St. Louis health care system. He says people who have gotten sickest from COVID-19, so those who have been hospitalized, they have had more severe ongoing or lingering health problems. And that's not a surprise. But what is surprising is that even among people who had just mild cases when they got coronavirus, there are also a range of challenges some of them are having.

ZIYAD AL-ALI: Not only fatigue and memory problems and smell problems, but people are having, you know, heart problems, including palpitation, kidney problems. You know, the toll of mental health disorders - you know, people are having new onset anxiety. So when you put all of this together, it is shocking.

KWONG: Wow.

AUBREY: So there's still a lot to learn here. I mean, these reports have tried to sort of characterize the range of issues. Now the NIH, the National Institutes of Health, has announced a $1.15 billion research initiative to study long COVID. I mean, the goal is to try to identify the causes of these post-viral sicknesses and also find treatments for people who don't fully recover.

KWONG: Yeah. We are so far from out of the woods with this pandemic, and there's so much still to learn about it. So, Allison, thank you so much for coming on the show and bringing this reporting.

AUBREY: Thank you. It's great to be here, Emily.

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KWONG: Today's episode was produced by Rebecca Ramirez, edited by Jane Greenhalgh and Viet Le and fact-checked by Rasha Aridi. I'm Emily Kwong. Thanks for listening to SHORT WAVE, the daily science podcast from NPR.

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