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New U.S. COVID-19 Cases Decline, Vaccination Pace Slows Too

Apr 28, 2021
Johnson & Johnson vaccinations have resumed, which could facilitate new vaccination pop-up clinics. At the same time, doctors in rural areas are strategizing on how to get people to get the shot.
Johnson & Johnson vaccinations have resumed, which could facilitate new vaccination pop-up clinics. At the same time, doctors in rural areas are strategizing on how to get people to get the shot.

STEVE INSKEEP, HOST:

For all the concerns about more infectious variants of COVID-19, conditions in the United States have been improving. Cases are declining. Vaccines are readily available. The European Union told NPR this morning it will allow fully vaccinated Americans to travel to Europe this summer. And vaccine supply is not likely to be an issue here. We've got plenty. The FDA has now lifted the pause on the Johnson & Johnson vaccine. NPR's Allison Aubrey has joined us Monday after Monday after Monday with updates and is with us once again. Allison, good morning.

ALLISON AUBREY, BYLINE: Good morning, Steve.

INSKEEP: What does the return of the J&J vaccine mean?

AUBREY: Well, for the moment, the J&J vaccine is a small part of the overall supply. But I think going forward, it's going to be very helpful in the next phase of the vaccination campaign to help get to people in hard-to-reach communities. I spoke to Dr. Elaine Batchlor about this. She's the CEO of MLK Community Hospital. That's in Los Angeles County. She says they will resume use of the J&J vaccine as soon as they receive a shipment. And their strategy is they have mapped the communities, Steve, most in need. They're targeting these areas, these neighborhoods for mobile or pop-up vaccination clinics. So no appointments, no registration. You just show up. She says using the Johnson & Johnson vaccine in this pop-up setting has advantages. It doesn't require the cold storage. And some people have requested it because it's just one dose.

ELAINE BATCHLOR: We 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 the second. In fact, some new analysis suggests millions of people have missed the second dose or haven't shown up at the recommended interval. So this reinforces the point of her strategy of making it easy for people. But there's still work to do with hesitancies, Steve. Dr. Batchlor told me her own mom hasn't been vaccinated yet. She's been waiting. And the J&J pause may have added to that hesitancy.

INSKEEP: Well, let's talk that through. It was a pause because of an incidence of a problem that happened less than one time in a million. Is the continued resistance to vaccination related to the news around that pause?

AUBREY: You know, I mean, for some, it might be. I've asked a lot of health care providers this question. And they say, you know, it really depends on how well the risk of the blood clots with the J&J vaccine is communicated. I mean, the Johnson & Johnson vaccine will now come with a fact sheet that explains the risk of these rare blood clots. Providers will likely talk to their patients, especially women, about recognizing the risks. For instance, one sign is a horrific headache. I spoke to Dr. Calvin Johnson of Cedars-Sinai Medical Center. He's 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 test that we - a blood test that we can do, as well as treatment. And early treatment is curative.

AUBREY: He says that this has really been an opportunity to engage with people to say, hey, look. We spotted this problem early on. Now there's a system in place to spot it, to prevent it and to treat this rare side effect if it does happen again. He says this is progress.

INSKEEP: Allison, elsewhere in the program today, we're reporting on rural areas, where, according to surveys, a lot more people are reluctant to get the vaccine.

AUBREY: Yeah, many doctors in rural areas are reaching out directly to their patients. I talked to Dr. David Field. He's in practice in Bismarck, N.D. He says one thing he hears from people, from some patients is, I don't want the government to tell me what to do. So look. People aren't going to just volunteer to show up at a mass vaccination site if they're that hesitant.

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 a 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.

AUBREY: You know, he says this is how he makes progress, one-on-one. And it's why mega vaccination sites in some places may have trouble filling spots in the weeks ahead. These more personalized approaches may be needed.

INSKEEP: Suppose they don't quite work, and we don't reach the 80% mark that people associate with herd immunity.

AUBREY: There's a lot of thinking about this right now, Steve. I spoke 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: Many campuses are already announcing plans to require vaccination, including University of California and the Cal State system. The head of the European Union has said U.S. tourists would be welcome this summer if they are fully vaccinated. So if you want to travel to Europe, you'll likely need to show some proof of vaccination.

INSKEEP: Allison, as the pandemic goes on and on, do we learn more and more about the long-term effects for people who do get COVID?

AUBREY: Yeah, a comprehensive analysis published just last week characterizes really the range and the toll of the problems. And it's quite surprising. I spoke to the author of the study, Dr. Ziyad Al-Aly of the VA St. Louis Health Care System. He said that he found that people who were sickest from covid have had the most ongoing trouble. But he said the biggest surprise he found is that even among people with very mild cases, they have documented a range of health problems.

ZIYAD AL-ALY: Not only fatigue and memory problems and small 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.

AUBREY: The National Institutes of Health has recently announced about $1 billion in funding to study what they call long COVID. The goal is to identify the cases and treatments for people who don't fully recover.

INSKEEP: I want to circle back, Allison, to something we said at the beginning. We said that cases are down. Used to be hundreds of thousands of people per day were being reported infected with COVID. What's happening now?

AUBREY: The U.S. is averaging about 60,000 cases a day. Hospitalizations increased a bit last week, but deaths are down. And right now, 29% of the total population in the US is fully vaccinated. Fourty-two percent have received at least one dose.

INSKEEP: OK. Allison, thanks.

AUBREY: Thank you.

INSKEEP: NPR's Allison Aubrey.

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