Today the Biden administration announced sweeping new funding aimed at beating back COVID-19 in vulnerable communities, including congregate living settings, and infusing rural health clinics with resources to help spread vaccination education.
The US Department of Health and Human Services (HHS) will invest more than $1.6 billion from the American Rescue Plan into testing materials for homeless shelters, treatment and recovery facilities, domestic violence shelters, and federal, state and local correctional facilities, the administration said today. Early detection of cases in these communities can stem outbreaks.
“Thanks to the American Rescue Plan, we can make sure high-risk environments like correctional facilities and shelters for those experiencing homelessness have greater capacity for testing to prevent potential outbreaks and continue our nation’s progress in moving out of the pandemic,” said HHS Secretary Xavier Becerra in a press release.
The White House COVID-19 coordinator, Jeff Zients, said $100 million from the American Rescue Plan will also be released to 2,000 rural health clinics in regions with low vaccine uptake. According to Zients, the funds will help clinics engage in more vaccine education and reach hesitant Americans.
US sees 53% increase in daily cases
At a White House pandemic press briefing today, Zients and others emphasized that the current case surge in the United States due to the Delta variant (B1617.2) was mostly affecting unvaccinated Americans.
“The Delta variant is spreading with incredible efficiency,” Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), said. “We need to come together against this common enemy.”
Walensky said the United States saw 46,318 new cases yesterday, bringing the 7-day average to 37,700 cases per day, a 53% increase from the prior 7-day average of 24,700 cases per day. Average daily hospital admissions also rose to 3,500, up from 2,600 (an increase of 32%), and deaths rose by 19% to an average of 237 day, up from 199.
“This virus has no incentive to let up,” she said. “It remains in search of the next vulnerable person to infect.”
Anthony Fauci, MD, the chef medical adviser to the White House, again urged vaccine uptake. He added that breakthrough mild or asymptomatic cases in vaccinated people, which are being increasingly reported by media outlets, should be expected and are not a sign vaccines are ineffective.
“No vaccine is 100% effective; if it’s successful it protects against serious disease,” Fauci said, explaining all three vaccines in the United States prevent hospitalization and death from COVID-19. Fauci also said at this time there was no data to support the idea that Americans who received the Johnson & Johnson (J&J) vaccine need a booster dose in light of the Delta variant.
According to the CDC, 161,895,045 Americans are fully vaccinated (48.8%), and 56.3% of the total US population has at least one dose.
ACIP recommends J&J despite GBS risk
The Advisory Committee on Immunization Practices (ACIP) to the CDC met today to discuss use of the Johnson & Johnson vaccine after safety signals showed recipients may be at an increased risk of developing GBS, or Guillain Barre syndrome. Despite some concerns, they agreed that the vaccine’s effectiveness against COVID-19 protection was worth its continued use.
As of Jun 30, 100 cases of GBS have been identified in the 12.6 million Americans who received the J&J vaccine. Of those cases, 95 were hospitalized, including one man who died.
All but 10 of those cases were in adults ages 30 to 65, and 61 of the cases were in men. The numbers mean for every 1 million J&J vaccinations, 7.8 GBS cases could be expected.
Johnson & Johnson officials shared data showing the benefits of using their vaccine outweighed any risks of GBS, and they also shared data showing the vaccine was effective against the Delta variant.
In discussions, some ACIP members said with the wide availability and supply of mRNA vaccines, which do not carry an additional GBS risk, the J&J shot should be abandoned in the United States.
Others, including ACIP Chair and Arkansas’ Health Secretary Jose Romero, MD spoke out in favor of the vaccine, citing anecdotal evidence that many people prefer the one-dose vaccine and have been vocal about not wanting schedule follow-up appointments for mRNA vaccines. Given the rising activity of the Delta variant, it’s important to have all vaccine option available, Romero said.
Also discussed at the meeting was the use of a third booster dose of mRNA vaccines in immunocompromised Americans who do not get the same levels of protection from the standard doses of vaccine. Many immunocompromised people have taken it upon themselves to obtain a third dose, based on preliminary data that shows a third dose of vaccine boosts immune response.
Participants at the ACIP meeting said this unregulated vaccine use was dangerous, but the CDC could not move on expanding dose recommendations until the Food and Drug Administration fully approves the two-dose vaccines and provides emergency-use authorization for the boosters.
Other US Developments
- The American Hospital Association issued a statement supporting mandatory vaccination for healthcare workers. The association said vaccines “provide strong protection against workers unintentionally carrying the disease to work and spreading it to patients and peers.”
- At a CNN Town Hall last night, President Biden signaled that he expects full vaccine approval from the FDA will come sooner rather than later, perhaps by fall.