Not all unvaccinated Americans' opinions about COVID-19 vaccines are firmly anti-vaccine, as many people are still on the fence, according to a Sept. 1 CNET report. Understanding and addressing this populations' concerns in a compassionate manner could be key to raising vaccination rates. (Becker Health IT 9.2.2021) 

The media often highlights the most extreme anti-vaccine voices, but many unvaccinated Americans aren't so resolute. Many people who are eligible to receive a vaccine but haven't gotten one are still grappling with their concerns, some of which have been fueled by the rapid online spread of health misinformation, according to vaccine expert Peter Hotez, MD, PhD.

About 52 percent of the U.S. population has been fully vaccinated against COVID-19, according to CDC data updated Sept. 1. White evangelical Christians and people younger than 65 who don't have health insurance are the most likely to say they're "definitely not" getting vaccinated against COVID-19, according to research conducted by the Kaiser Family Foundation. Younger adults ages 18-29 are also more likely.

The Kaiser Family Foundation found that the key demographic differences between people who are adamantly opposed to getting vaccinated and those who are still on the fence lie in Americans' racial, ethnic, religious and political identities.

For example, white adults make up 50 percent of unvaccinated Americans who are on the fence, but white adults make up 65 percent of unvaccinated Americans who are adamantly opposed to getting vaccinated. White evangelical Christians make up nearly twice the share (32 percent) of the group who says they definitely won't get vaccinated compared to the group that is unsure.

Some common reasons for vaccine hesitancy include distrust in the media to provide quality information about the vaccines, distrust in American medicine stemming from racist trials testing experimental treatments, uncertainty about the vaccines' long-term side effects and worries about how rapidly the vaccines were developed.

Addressing these concerns with evidence-based information without coming off as condescending could be an effective way to persuade hesitant individuals to get vaccinated, according to pediatrician Rhea Boyd, MD, who founded a campaign in which ​​Black and Latinx healthcare workers provide information and combat misinformation about vaccines. Four in 10 people who are on the fence about COVID-19 vaccination are people of color, according to Kaiser Family Foundation data.

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The U.S. Census Bureau's Community Resilience Estimates (CRE) is experimental no more. It will now be a regularly updated data product that measures communities' ability to cope with disasters and other emergencies. (US Census Bureau 9.7.2021)

The need for these estimates came to the forefront last year as the Census Bureau was inundated with data requests by government agencies that needed to make data-driven decisions in response to the COVID-19 pandemic.

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More than 18 months into the COVID-19 pandemic, there are still very few drugs authorized by the FDA to treat the virus. Just one drug, remdesivir, has gained full FDA approval as a treatment for COVID-19. (Becker's Hospital Review)

Becker's asked physicians from top health systems which medications they're using most frequently to treat their COVID-19 patients, which they're avoiding and which have been most effective. 

Editor's note: Responses were edited lightly for length and clarity. 

Question: Which drugs are you using most frequently to treat your COVID-19 patients? 

Sanjana Koshy, MD, infectious diseases physician at Mount Sinai (New York City): We recommend dexamethasone for all our hospitalized patients requiring supplemental oxygen. This was based on the RECOVERY trial that showed a survival benefit in patients on supplemental oxygen. We have increasingly used tocilizumab in combination with dexamethasone in our severely ill hospitalized patients with rapidly increasing oxygen requirements. We continue to use remdesivir for our hospitalized patients on low-flow oxygen. 

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by Vinay Prasad, MD, MPH  

Over the last week, the topic of COVID-19 booster shots -- a third dose of mRNA vaccine for healthy Americans -- has been thrust into the spotlight. The surgeon general, CDC director, Anthony Fauci, MD, and President Biden have announced that they wish for boosters to be available by late September for healthy adults who are 8 months out from their original two-dose series. While this will be contingent on an FDA evaluation to determine the "safety and effectiveness of the third dose," a clear path forward has already been set. And just like everything else throughout the course of the pandemic, the choice has been made with a dearth of data and an abundance of political pressure. (MedPage Today)

Diminishing vaccine effectiveness supposedly makes the case for boosters. But there are two big questions here: First, what is current vaccine effectiveness? And second, what justifies boosters? Let's consider these in turn.

What Is Vaccine Effectiveness Now?

We have to be honest, many vaccine effectiveness studies are poorly done. All studies compare the rate of getting a breakthrough infection among vaccinated people against the rate of infection in unvaccinated people. But there are some issues with this approach. First, as time goes on, more unvaccinated people have had and recovered from COVID-19 (and these individuals may be less likely to go on to get a shot). This means that their risk of getting COVID-19 a second time is far less than the typical unvaccinated person who has never been sick. Even if vaccines "work" as well as before, this factor alone will result in the appearance of diminishing vaccine effectiveness. 

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A study published in Pediatric Dentistry  May 2021) details an overall decline in emergency department visits for pediatric patients seeking nontraumatic dental care since the Affordable Care Act was enacted, although these visits from children from lower socioeconomic backgrounds increased. ( 8.27.2021)

Researchers examined nontraumatic dental care visits to emergency departments in the U.S. among people 20 years old and younger between 2010 and 2017 using data from the Nationwide Emergency Department Sample, the largest all-payer emergency department database in the U.S.

Results of the study show that nontraumatic emergency department visits decreased from 103.1 to 89.3 per 10,000 visits between 2010 and 2017. However, emergency department visits for nontraumatic dental care by pediatric Medicaid patients increased from 51 percent to 65.3 percent from 2010 to 2017. The odds of these visits were higher among uninsured patients and Medicaid enrollees ages 15-20 years old, but were lower among patients who lived in wealthier ZIP codes.

The study concluded that these emergency department visits for nontraumatic dental care by pediatric patients decreased over time following implementation of the Affordable Care Act, but that emergency care continued to be utilized at higher rates for children of low socioeconomic status. 

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Is the current COVID-19 surge a "pandemic of the unvaccinated?" No, according to Rhea Boyd, MD, MPH, pediatrician and co-developer of the "The Conversation: Between Us, About Us" project to encourage more people of color to get vaccinated.

"This is not a pandemic of the unvaccinated," Boyd said Wednesday at a virtual event sponsored by the Alliance for Health Policy. Instead, "what we really exposed during the vaccination distribution effort is just how unequal the United States is" when it comes to getting access to COVID-19 vaccines. She presented data from the New York Times and the Kaiser Family Foundation showing that vaccine distribution was worse in Southern states, which also are where more Black and Latinx people live (the conversation is a joint project of the Kaiser Family Foundation and the Black Coalition Against COVID).

Full article here

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A top official at the World Health Organization said misinformation surrounding COVID-19 vaccines has gotten worse in recent weeks. Meanwhile, hospitals navigate vaccine hesitancy and attempt to halt the spread of incorrect medical information, according to an Aug. 24 CNBC report.

(Becker's Health IT 8.25.2021)

Six things to know:

1. 1. U.S. Surgeon General Vivek Murthy, MD, declared COVID-19 misinformation a "serious public health threat" in July. Many public health leaders blame conspiracy theorists for enforcing so much distrust in the vaccines.
      
      
   2. Maria Van Kerkhove, PhD, infectious disease epidemiologist and technical lead on COVID-19 at the WHO, said Aug. 23 that misinformation has gotten worse in the last four weeks. "The amount of misinformation that is out there seems to be getting worse, and I think that's really confusing for the general public," she said
      
      
   3. A small number of medical professionals have enforced some vaccine misinformation on social media outlets, such as TikTok and Doximity.
      
      
   4. Doximity is a social media platform used by 80 percent of U.S. physicians and has 1.8 million users. CNBC reported that the platform is riddled with misinformation, though Doximity's CEO, Jeff Tangney, told CNBC that less than 0.1 percent of its members have posted medical misinformation. The CEO did say there was an uptick in comments that had to be removed because they violated community guidelines.
      
      
   5. The Federation of State Medical Boards warned July 29 that physicians and other healthcare professionals could be at risk of losing their medical licenses if they spread COVID-19 vaccine misinformation on social media, online and in the media.
      
      
   6. Several hospital employees have gone viral over TikToks they have posted spreading inaccurate medical data. A surgical technologist at Marietta, Ga.-based Wellstar Healthcare System is "no longer employed" with the health system after comparing vaccine mandates to the Holocaust, WSB-TV reported Aug. 22.
   
   

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