The big COVID-19 news this week is that an FDA advisory committee recommended Emergency Use Authorization for low-dose versions of both the Pfizer-BioNTech and Moderna vaccines for use in children ages 6 months to 4 years.
According to a National Public Radio story announcing the new development, the two vaccines are different, but use the same technology:
“Pfizer’s vaccine for kids younger than 5 is one-tenth of the adult dose. Three shots are needed: the first two given three weeks apart and the last at least two months later.
Moderna’s is two shots, each a quarter of its adult dose, given about four weeks apart for kids under 6. The FDA also authorized a third dose, at least a month after the second shot, for children who have immune conditions that make them more vulnerable to serious illness.”
And health experts quoted in the same story say both versions are definitely safe for children:
“Both of these vaccines have been authorized with science and safety at the forefront of our minds,” Dr. Peter Marks, FDA’s vaccine chief, said at a news briefing.
Marks said parents should feel comfortable with either vaccine, and should get their kids vaccinated as soon as possible, rather than waiting until fall, when a different virus variant might be circulating. He said adjustments in the vaccines would be made to account for that.
“Whatever vaccine your health care provider, pediatrician has, that’s what I would give my child,” Marks said.
LA County Public Health Director Barbara Ferrer also announced the new vaccine progress in her weekly address on Thursday. She said the next step is review by a CDC Advisory Committee, and if it, too, recommends use of the vaccines for this age group, the shots could be available at LA County vaccination sites as soon as June 21, though it might take a bit longer for them to reach some pharmacies and physicians’ offices. For more information, and to find out where the vaccines will be available when they’re approved, see http://www.vaccinatelacounty.com.
In other COVID-19 news this week, Ferrer reported that new cases, and our 7-day average case rate, declined slightly this week, though it’s too soon to tell if this is a brief dip or the beginning of a more enduring trend. And hospitalizations and test positivity both rose this week, while deaths remained stable.
Ferrer did note, however, that this week’s jump in test positivity (which rose from about 5% to just over 8% this week) may have at least a bit to do with the fact that most schools are now out for the year, so they’re no longer testing large numbers of people each week, most of whom test negative. That means that the percentage of people tested who are testing positive may be higher now, simply because that large number of negative tests is no longer part of the overall count.
Across the board, though, Ferrer said the numbers are still trending significantly higher than a month ago, and hospitalizations, in particular, are up 90% in the last four weeks.
Despite the slight decline in new cases, Ferrer said the current numbers still place us in the “Medium” community level, as defined by the CDC, which means that while our health care system isn’t over-stressed yet, we could still be moving in that direction. And both of the hospital-related metrics that contribute to these community levels – the number of new COVID-19-related hospital admissions per 100, residents, and the number of staffed inpatient beds occupied by COVID-19 patients – rose this week.
Ferrer said that if transmission rates continue at current or rising levels, LA County could move into the CDC’s “High” community level by the end of June, which could prompt a return to requirements for indoor masking in most public spaces.
To help prevent that happening, Ferrer once again urged that everyone continue to wear masks voluntarily, even though they’re not officially required, especially indoors and in crowded spaces.
“Our line hasn’t changed for a minute,” she said. “Everyone who is indoors, around other people, should have a well fitting, high-filtration mask on.” “Until we get to a lower rate of transmission, there is no reason not to put a mask on indoors…And if you don’t feel the need to protect yourselves, we’ve asked you to put the mask on to protect others. The more people are masked, the less likely it is that the virus gets out,” she said.
Looking at other predictive measures, Ferrer noted that most of the early alert signals tracked by LA County are still at medium or high levels of concern. The only exception, at the moment, is wastewater tracking from LA County sewer systems. COVID-19 levels in county wastewater did rise over the last week, Ferrer said, but they did not meet the level of twice the average from 14 days ago, which would be the “elevated concern” level designated by LA County.
Meanwhile, the Omicron variant of COVID-19 still accounts for 100% of cases in LA County, with 90% of all cases being some variant of the BA.2 sub-lineage of Omicron, and the 2.12.1 strain dominant among those. Ferrer also reported that the number of cases caused by the even newer BA.4 and BA.5 strains is still small – but growing – with 98 cases reported during the week of May 28. And both BA.4 and BA.5 seem to be even more transmissible, she said, than the already highly transmissible previous strains of Omicron…and also more resistant to immunity from recent infections with other strains of Omicron.
With these new mutations growing and creating more potential new challenges as the virus evolves, Ferrer also presented a new chart this week, showing how the virus has evolved since October, 2020 as new variants have emerged and crowded out older ones.
And a second chart shows how Omicron and its subvariants have continued to evolve just this year. The graphics illustrate, Ferrer said, just how dramatically the pandemic has been fueled by the “ongoing and rapid change in the COVID-19 virus,” with each new variant presenting new challenges. And Ferrer said that we can continue to expect this kind of ongoing evolution and challenge as the pandemic continues.
But Ferrer noted that our tools for helping prevent the spread of COVID-19 are also evolving, and that includes our access to good testing tools. Ferrer said PCR and rapid antigen tests are now both better and more available than ever before, with each type of test having its advantages and disadvantages. For example, she said, PCR tests are better at detecting low levels of infection (including new infections), but they also take longer to process (usually 24-48 hours). Also, PCR tests are so sensitive that they may still detect small amounts of dead virus, providing a false positive if someone has recently recovered from a COVID-19 infection.
Meanwhile, rapid antigen tests – like the over-the-counter at-home tests many of us have become intimately familiar with over the last few months – are less sensitive (so can sometimes miss early infections), but they do provide results in 15-30 minutes, so they’re very handy for situations in which a quick response is needed. They’re also less likely to provide false positive results for people who have had a COVID-19 infection in the last 90 days.
Ferrer said that if you are not feeling well and test negative, you should still stay home until you’re fever-free for at least 24 hours. And if you test negative on a home test, you should continue isolate and retest a day later, just to make sure you don’t have COVID. Also, conversely, if you test positive but have no symptoms, Ferrer said, you may still be contagious, so you should definitely follow the protocols outlined at ph.lacounty.gov/covidisolation. And if you do begin to experience symptoms, contact your health care provider about therapeutic drugs you may be able to take to help minimize your symptoms.
Finally, returning to the topic of vaccinations, Ferrer once again stressed the need for people to get both vaccinated and boosted…something only 56% of county residents have done so far. Asked what she thinks the reason for the low booster rate is, Ferrer said she’s heard people give two major reasons for not wanting to get their boosters.
The first is that they may have already had COVID, so they feel like they’ve already received additional immunity from the infection. But infection-induced immunity, she said, is less predictable than vaccine-induced immunity, and also seems to wane more quickly. So getting your booster shot(s) is a “much better strategy,” she said. And relying on “natural” immunity is a “pretty big gamble” with so many people still being hospitalized and dying from COVID-19. So “we urge you not to gamble with your health and the health of people around you by not getting vaccinated and boosted.”
Also, Ferrer said, she’s heard many people say they want to wait for fall, or until another big wave of infections hits, before getting their booster shots. But with the continuing emergence of new variants, she said, there is still a lot of uncertainty this summer, and if people want to enjoy summer gatherings and travel, it definitely makes sense to “maximize your protection.”
“There is no harm in maximizing your protection,” she said. “We’re not encouraging people to delay at all, and [we are urging them] to take advantage of the fact that we live in a resource-rich country and are able to have access to these lifesaving vaccines.”
“Don’t gamble,” Ferrer said. “Don’t take chances on your health. Don’t take chances on the health of people around you. And go ahead and get boosted.”
