Friday, July 30, 2021

Citing research showing virus is as contagious as chickenpox, Beshear again asks all schools to enforce universal masking

State Dept. for Public Health map, adapted by Ky. Health News; to enlarge, click on it.

By Melissa Patrick and Al Cross
Kentucky Health News

Before announcing the new winners of the state's second vaccine-incentive lottery, Gov. Any Beshear went over the findings of an internal federal health document that says the Delta variant of the coronavirus can spread as easily as chickenpox, appears to cause more severe illness, and can be spread among fully vaccinated people who get the virus. 

"It is one of the most transmissible viruses that they have ever seen, significantly more so than the alpha variant," the first one of significance, Beshear said at the vaccine event. "What this says is we can't just be normal at the moment, and this thing will spread wider and faster than anything that we have seen to date." 

The Centers for Disease Control and Prevention documents from a slide presentation were obtained by The Washington Post, which reports they convey the struggles of convincing Americans to get vaccinated and the need for the agency to revamp its public messaging around vaccination against a variant that is "so contagious that it acts almost like a different novel virus." 

The slides say the Delta variant is more transmissible than MERS & SARS, Ebola, the common cold, the seasonal flu, the 1918 "Spanish" flu, and smallpox. 

The documents, which were to be released Friday, cite data and research showing vaccinated people who are infected with the Delta variant may be able to transmit the virus as easily as those who are unvaccinated. Beshear said that's what prompted the CDC to change its guidance to recommend that vaccinated people should also wear masks indoors in areas with high transmission rates, which includes almost all of Kentucky. 

Fully vaccinated people are less likely to get the virus and less likely to suffer from serious harm or die from it, Beshear said, but "While you might be safe, you might end up harming somebody else" and that's why it's important for vaccinated folks to wear a mask too. 

"If everybody was vaccinated, this thing wouldn't be a problem," he said. "We've got to understand that the guidance didn't change, the virus changed." 

He also called on schools that are not enforcing universal masking to reconsider doing so, noting that an Atlanta school that has already started classes has had to quarantine more than 100 students in the first week. 

"With this new information, I'm calling on school districts that have thus far said that they are not going to require masking to reconsider, because they will fail," Beshear said. "And it'll be the students that lose out on in-person learning."

The good news is that vaccination rates are picking up in Kentucky, although slightly. "Vaccines plus masks equals the win," Beshear said. "Let's make sure we do it." 

Daily numbers: The state reported 1,648 new cases of the virus Friday, about the same as the last two days. That raised the seven-day rolling average to 1,213, the highest since Feb. 25.

The state's new-case rate over the last seven days was 25.9 per 100,000, putting it in the "critical" area for transmission of the virus.

The share of Kentuckian testing positive for the virus in the last seven days is 8.96%, double what it was two weeks ago. Counties with rates more than double the state rate are Clay, 120; Jackson, 89; Muhlenberg, 67.6; Letcher, 61; Knox, 56.4; Floyd, 55.4; Laurel, 55.2;and Knott, 50.2.

Hospitalizations continued to rise. Kentucky hospitals reported 625 Covid-19 patients, double the total of less than two weeks ago; 195 of them were in intensive care and 85 were on mechanical ventilation.

The Lake Cumberland hospital-readiness region reported 91% of its intensive-care beds in use, with 29% of the patients suffering from Covid-19. Both percentages were the highest in the state.

The state reported seven Covid-19 deaths, the most on almost two weeks, bringing the total to 7,334.

Shot-at-a-million winners: The winner of the $1 million prize is Ginger Schultz from Louisville, who encouraged all Kentuckians to get vaccinated. 

“I've never experienced anything like this. It’s shocking because you don’t really think you’re going to win,” said  Schultz. “Why take a chance at getting very sick and possibly die or passing it on to someone else? That’s what my main concern was. My mom is 85 and she has breathing issues and I was always very concerned about her getting it or passing it on to her.”

The five Kentucky youth selected for full postscondary-education scholarships are Shelby Anderson of Louisville; Isabella Brozak of Crestwood; TJ Ponder of Owenton; Reese Johnson of Harrodsburg; and Julian Sandberg of Ft. Mitchell.

The final drawing will be held Aug. 26 and will be announced the next day. Permanent residents of Kentucky who have received at least one dose of a vaccine can enter the lottery at

Thursday, July 29, 2021

Beshear calls for universal masking in schools, following CDC; Stack calls Kentucky 'horribly inflamed' with coronavirus

Kentucky Health News graph, based on state's initial, unadjusted daily reports; click on it to enlarge.
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear and Health Commissioner Steven Stack updated the state's mask guidance Thursday to call for universal masking in schools, regardless of vaccination status, following new federal guidance.

Beshear tacitly acknowledged that the advice is controversial: "Now, I know that people are tired. I'm tired, too. I know that people are frustrated. I'm frustrated too. We're strong enough to do this. We are resilient enough to do this. And we are compassionate enough to where we know that we have to do this."

He said Kentuckians' decisions about masking will be critical, due to aggressive spread of a more contagious coronavirus variant. "Places that haven't taken steps are seeing results that we should know by now: widespread outbreaks, clusters, large amounts of quarantines," he said at his weekly briefing.  

Asked about school districts that have said they would not require universal masking, Beshear asked them to consider the science that clearly indicates such policies will limit Covid-19 cases and subsequent quarantines in both classrooms and extracurricular activities, including sports.

Beshear suggested that school districts could be liable for sickness and death if they don't follow guidance from the U.S. Centers for Disease Control and Prevention that is based on research showing that vaccinated people can acquire the virus and spread it without having symptoms. He called that "the game changer."

"You teach science in your classroom," he said. "You should have to consider it when making decisions."

Beshear said he isn't considering a mask mandate, but would act based on how the surge in cases goes. The difference between this surge and before, he said, is that people have access to vaccines that work.

Asked if he would require state employees to get vaccinated, as some states and the federal government are doing, Beshear said he would not, but is looking at the possibility of requiring them to have regular tests, a federal alternative. Wednesday, he required all in the vicinity of others in state offices to wear a mask. 

Beshear said the mask recommendations are temporary and will be removed when it is safe to do so, as he did before. He said there is a simple equation that will keep Kentuckians at work, school and play: "more people getting vaccinated, and when you need to, wear a mask."

Without such prevention efforts, Beshear said the more contagious Delta variant will spread through unvaccinated workplaces and classrooms, disrupting education and slowing economic growth through loss of productivity and frequent quarantines.

Dept. for Public Health map, adapted by Ky. Health News; click to enlarge
Stack displayed color-coded maps that showed on June 28 there were no "red zone" counties in Kentucky, but on July 28 there were 36. Now it's 41. A red-zone county has more than 25 daily cases per 100,000 people over seven days and is considered to be at a "critical" level for transmission of the virus. 

“We have changed in the blink of an eye from a quiet, calm state to a horribly inflamed state,” said Stack. “We all know what we need to do . . . We all need to get vaccinated."

He said that since March 1, 94.5% of Covid-19 cases, 91.8% of Covid-19 hospitalizations and 88.8% of Covid-19 deaths in Kentucky were among unvaccinated or partially vaccinated or unvaccinated people.

Local health-department director Crystal Miller also spoke at the news briefing, encouraging Kentuckians to remember the beginning of the pandemic, when her home Harrison County had the first case and everyone had the same goal and was willing to do what it takes to protect themselves and their loved ones. 

“Somehow we’ve grayed those lines. We’ve gotten away from that mission," she said. "It’s been a long 16 months. It’s been frustrating. It’s exhausting. But the difference between March 6 and today is that we have a solution. We know exactly what works: vaccines and masking."

Stack and Miller asked Kentuckians to seek out reliable sources and trusted experts for information about the virus and the vaccines. Stack said, "Don't look to cable [TV] sources for your medical advice, period. Don't look to social media for your medical guidance, period. If we would do that, he said there would be no controversy or debate and we could get over this pandemic a lot faster." 

Republican pushback: Three Republicans who lead independent state agencies, and may run for Beshear's job in 2023, said they would not enforce the Democrat's mask mandate for state workers. Agriculture Commissioner Ryan Quarles' chief of staff, Keith Rogers, said they "will continue to leave it up to employees to decide for themselves whether to wear a mask while at work," Daniel Desrochers reports for the Lexington Herald-Leader.

State Auditor Mike Harmon said likewise Wednesday; Treasurer Allison Ball followed suit Thursday, saying: "The Treasury has a very high rate of vaccination among its employees, and the staff has been extremely responsible both in monitoring their own health, and in not placing their fellow employees at undue risk."

Mike Wynn, a spokesman for the Legislative Research Commission, said the legislature will stick to the mask policy it implemented on May 23, which said vaccinated people do not need to wear a mask, Desrochers reports.

Beshear said he can't discipline employees who work for separate constitutional officers, but warned that they will face a greater risk of getting sick. He said it's more important to do the right thing than to "try to score political points," and noted that the new-case rate in Franklin County skyrocketed this month. 

"I care more about the people than my popularity," he said. "I've got the backbone to do what's right for them, and wish other people did too."

Vaccinations: Beshear noted the slight uptick in vaccinations in Kentucky. CDC data presented by The Washington Post showed 10,048 shots were given Wednesday, the most since July 11. The seven-day average is 7,563.

"It does appear that the seriousness of the Delta variant is getting through to some folks who haven't been vaccinated yet," Beshear said.

Beshear said he thought the state is having success with its vaccine lottery, which held its second drawing Thursday. The winners will be announced Friday; an adult will win $1 million and five youth will get full postsecondary-education scholarships. The final set of winners will be announced Aug. 27. 

Asked if the state was working on any other incentive programs to get more Kentuckians vaccinated, Beshear said they were looking at different options and noted that there were more and more private incentives being offered. "The Delta variant ought to encourage them to do more," he said. 

Daily numbers: The state reported 1,618 new cases of the virus Thursday, with 328 (20%) in people 18 and under. That raised the seven-day rolling average by nearly 100, to 1,120 -- the highest in six months. 

The percentage of Kentuckians testing positive for the virus in the past seven days rose for the 33rd straight day, to 8.55%. Two more Kentuckians have died from Covid-19, bringing the death toll to 7,327. 

The statewide rate of daily new cases over the last seven days is 23.63 per 100,000 residents, very near the "critical" level of 25. Counties with rates more than double the statewide rate are Clay, 113.4; Jackson, 82.5; Muhlenberg, 57.8; Laurel, 57.8; Letcher, 57.7; Floyd, 52.6; Webster, 51.9; and 
Hopkins, 47.3.

Hospitalizations for Covid-19 continued to rise. Kentucky hospitals reported 608 patients with Covid-19, with 189 of them in intensive care and 82 of those on mechanical ventilation.

Vaccination rate of Kentucky Medicaid members is about half the overall rate; even $100 incentives seem to have little effect

One of the biggest obstacles to protecting Kentucky from the coronavirus is Kentuckians on Medicaid, who make up about a third of the state's population.

"Of the 1.6 million people in Kentucky covered by the government health plan, only 27% of those eligible have received at least one dose of the vaccine, compared to about 51% of Kentuckians overall," based on state data, reports Deborah Yetter of the Louisville Courier Journal.

"That means more than 870,000 adults and children 12 or older covered by Medicaid remain unvaccinated," Yetter reports, using figures from the state Cabinet for Health and Family Services. "The current COVID-19 vaccines are not approved for children under 12. A little more than 320,000 Medicaid enrollees have received the vaccine, according to the cabinet."

Most Medicaid members' care is overseen by insurance-company subsidiaries known as managed-care organizations, or MCOs. The other 141,500, including nursing-home residents and people with certain disabilities in special programs, have a 55% vaccination rate. Nursing homes had top priority for vaccination.

Eric Friedlander, secretary of the state Cabinet for Health
and Family Services, and Gov. Andy Beshear (file photo)
Low vaccination rates among Medicaid enrollees pose obstacles in many states, but Cabinet Secretary Eric Friedlander has warned the MCOs that "I expect them to do better," he told Yetter. "The MCOs, in the most important public-health crisis of our time, are underperforming."

The six MCOs "say they are trying through outreach, incentives and other efforts to increase vaccinations," Yetter reports. "They say they are calling, texting and mailing information to try to reach members and offering incentives, including gift cards."

Joseph Goode, a spokesman for for CVS Health, told Yetter that its Aetna subsidiary was the first MCO in Kentucky to offer $100 gift cards for getting vaccinated, but only 22% of members 12 or older have received at least one dose of a vaccine.

Anthem is also offering a $100 incentive, and has a vaccination rate of about 25%, it told Yetter. Louisville-based Humana, has a 28% rate, she reports, and "The other companies, Wellcare, United Healthcare and Passport by Molina report similar efforts and said they are continuing to try push vaccination numbers higher." 

But "where skepticism remains high about the vaccine and misinformation abounds," people on the front lines of health care said the MCOs' impact will be limited. Yetter reports. She quotes Dr. John Jones, who treats Eastern Kentucky Medicaid patients, some of whom continue to refuse a coronavirus vaccine: "I don't know how much sway some insurance company's going to have over the phone. It usually takes someone you know to persuade you."

Also, in the counties of Perry, Leslie and Knott, where Jones works, "There's just a distrust of outsiders in general," he told Yetter.

"That distrust isn't limited to rural Kentucky, said E. Ann Hagan-Grigsby, CEO of Park DuValle Community Health Center, which is based in west Louisville and sees a large share of Medicaid patients," Yetter reports, quoting her: "We've hit a wall. The people who really wanted the vaccine have found where to get it and are getting it. The others who have not gotten it need some convincing."

"Friedlander said the state hired the MCOs to oversee health care and improve outcomes for Medicaid enrollees and he expects better results when it comes to the Covid-19 vaccine," Yetter reports.

"The MCOs ought to be really pushing hard to get these folks," Ben Chandler, president of the Foundation for a Healthy Kentucky, told Yetter. "You'd think it would be in their interest to get everybody vaccinated."

The chair of the legislature's Medicaid oversight committee told Yetter he was disappointed by the low vaccination rate of Medicaid enrollees. "I thought they would have been reasonably close to the state's average," said Sen. Steve Meredith, a Republican from Leitchfield.

Jones told Yetter that vaccine demand at his clinic had dwindled in recent weeks, "with unvaccinated patients expressing doubts or worries about the vaccine," she reports. "Often, they report anecdotal information shared by others or seen on social media, such as one patient who cited a case of a healthy young adult dying after being vaccinated, a report Jones said he could not verify."

"Some of it's directly linked to social media," Jones said. "The stories, there's no way to confirm them." He told Yetter that he has persuaded some patients to get vaccinated, but "Sometimes, they refuse to talk about it."

UK HealthCare again best Ky. hospital in U.S. News & World Report rankings; Baptist Health has two of top six in the state

By Melissa Patrick
Kentucky Health News

Six Kentucky hospitals have been named among the nation's "Best Regional Hospitals" in the annual ranking by U.S. News & World Report magazine.

They are, in order: the University of Kentucky hospital; hospitals in Covington and Edgewood; Baptist Health Lexington; Baptist Health Louisville; and Louisville's Norton Hospital and UofL Health-Jewish Hospital.

Dropping off the list this year is Saint Joseph Hospital-Lexington.

To make the list, a hospital must:

  • Offer a full range of services;
  • Rank nationally in one of 11 measured specialties, or have six or more high-performance rankings for procedures and conditions; and
  • Have at least three more "high performing" than "below average" rankings for procedures and conditions. 
The report offers an overview of 122 Kentucky hospitals with a breakdown of each of the measured categories, according to the services a hospital provides.

UK HealthCare, for the sixth straight year, is No. 1 with Albert B. Chandler Hospital. It ranked in the top 50 for cancer care for the fifth consecutive year. Its Markey Cancer Center is the only National Cancer Institute-designated cancer center in the state, and one of only 71 in the nation. 

“These rankings recognize UK HealthCare as the major health system best equipped to meet the needs of patients across Kentucky, and they recognize the incredible work and dedication of our physicians, nurses and health care providers across our academic health system,” Dr. Mark F. Newman, UK executive vice president for health affairs, said in a news release. “At UK HealthCare, our commitment has been and always will be to provide the most advanced specialty care to the citizens of the commonwealth, without the need to travel far from home.”

UK also ranked as high-performing in gastroenterology and gastrointestinal surgery; geriatrics; orthopedics; and urology.

The 32nd annual rankings compared more than 4,750 medical centers nationwide in 15 specialties and 17 procedures and conditions. This year's report expanded to cover seven new procedures and conditions. It also added a new health-equity measure. Of the 4,750 hospitals, 175 were nationally ranked in at least one specialty and 531 were ranked among the Best Regional Hospitals in a state or metro area, according to a news release. 

Baptist Health Louisville was the top rated hospital in Louisville. Baptist CEO Gerard Coleman said in a news release, that the rankings "reflect the unrelenting dedication of our physicians, staff and support teams in providing exceptional and compassionate care to our patients. I am proud of the work that we do. We’ve been tested by the pandemic, which has made us more mindful of what’s important and that our mission to serve the needs of our communities has never been more vital."

The report recognizes hospitals that are "high-performing" for 17 common adult procedures and conditions, including abdominal aortic aneurysm repair; aortic valve surgery; back surgery (spinal fusion); chronic obstructive pulmonary disease; colon cancer surgery; congestive heart failure; diabetes; heart attack; heart bypass surgery; hip fracture; hip replacement; kidney failure; knee replacement; lung cancer surgery; pneumonia; stroke; and transcatheter aortic valve replacement.

UK HealthCare ranked high-performing in all those categories except abdominal aortic aneurysm repair,  aortic valve surgery, transcatheter aortic valve replacement, diabetes, back surgery (spinal fusion), knee replacement, hip fracture. It ranked average in each of these categories. 

St. Elizabeth in Edgewood and Covington ranked high performing in all the categories except aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture. It ranked average in each of these categories.

Baptist Health Lexington ranked high performing in all categories except aortic valve surgery,  transcatheter aortic valve replacement, diabetes, kidney failure, knee replacement, hip replacement, and pneumonia. It ranked average in each of these categories. 

Baptist Health Louisville ranked high performing in all categories except lung cancer surgery, heart failure, transcatheter aortic valve replacement, kidney failure, back surgery (spinal fusion), hip replacement, hip fracture and pneumonia. It ranked average for each of these categories.

Norton Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture and pneumonia. It ranked average for each. 

UofL Health-Jewish Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery,  transcatheter aortic valve replacement, knee replacement, hip replacement, hip fracture, and pneumonia, ranking average for each of those; and back surgery (spinal fusion), where it ranked below average.

Click here for a list of frequently asked questions about how the magazine ranks the hospitals. 

Nationally, the Mayo Clinic in Rochester, Minn., claimed the No. 1 spot, followed by Cleveland Clinic and UCLA Medical Center in Los Angeles.

UK, Ashland hospital celebrate partnership that's been in effect since April 1; joint venture now holds hospital's assets

King's Daughters Medical Center in Ashland has 465 beds. (2011 photo)
The University of Kentucky's health-care system and King’s Daughters Health System in Ashland are now partners, they announced Wednesday in Ashland, with Gov. Andy Beshear and his top health official on hand.

The partnership, which was announced as a "joint venture" in January, "went live April 1," UK HealthCare said in a press release. "Together we created a joint venture, which holds the assets, and we have a management agreement in place for UKHC to operate the KDHS health system," said Allison Perry, the university's deputy public-relations director.

Kristie Whitlatch, president and chief executive officer of King’s Daughters, said in January that her hospital would have a new governing body, with its current chairman but equal representation for UK, and that she would be on the management team at UK HealthCare. That is now in effect, Perry said.

The press release said the joint venture "creates new opportunities for both organizations to better serve patients throughout Kentucky, southern Ohio and West Virginia by expanding the delivery of specialty health care services throughout the region."

Secretary Eric Friedlander (Photo
by Matt Jones, Daily Independent)
The hospital already had a partnership with UK's Markey Cancer Center. After Our Lady of Bellefonte Hospital in nearby Russell closed in April 2020, Eric Friedlander, secretary of the state Cabinet for Health and Family Services, told Beshear's senior adviser, Rocky Adkins, that there was an opportunity to create a partnership, Adkins recalled at Wednesday's announcement, Aaron Snyder reports for the Ashland Daily Independent: "Adkins pointed out Friedlander in the crowd, who gave him a rousing applause."

Whitlatch said Wednesday, “This partnership is an excellent example of how health care providers can successfully collaborate to share resources to facilitate patient care, physician recruitment and improve essential services. We are already seeing benefits of the collaboration as we are able to invest in our team members and our facilities.”

The UK release said, "The partnership will allow for expanded offerings in other needed health-care services for the area, including pediatric cardiology. Last week, the two organizations collaborated on their first pediatric echocardiogram read, and in the near future the Kentucky Children’s Hospital team will be providing onsite pediatric cardiology services at King’s Daughters."

King’s Daughters has 465 beds at its hospital in Ashland and 10 at King’s Daughters Medical Center Ohio, in Portsmouth. The system also includes a long-term care facility, seven urgent-care centers, and 30 primary-care and 36 specialty-physician practices.

Wednesday, July 28, 2021

With state nearing 'critical' level of virus spread, and some places much higher, Beshear requires all in state buildings to mask up

Gov. Andy Beshear is requiring all state employees and visitors to state buildings to wear face coverings, even if they are fully vaccinated against the coronavirus, which continues to surge in Kentucky.

Beshear said in a two-minute video that he took the action to protect state workers "and those they interact with." It takes effect Thursday, July 29.

State Auditor Mike Harmon, a Republican who says he is running for governor in 2023, said the Democratic governor's move disappointed him. "This policy removes one of the most significant incentives for individuals to get the Covid-19 vaccine," he said. "I continue to encourage all unvaccinated Kentuckians to have a discussion with their health-care provider about whether the vaccine is the best option for them.”

The rule "came on the heels of a shift in guidance from the U.S. Centers for Disease Control and Prevention, which on Tuesday said everyone in the United States, including fully-vaccinated people, should resume wearing masks in public indoor settings in parts of the country where spread of the Covid-19 Delta variant is considered dangerously 'high' or 'substantial'," the Lexington Herald-Leader notes.

Dept. for Public Health map, adapted by Ky. Health News; click to enlarge
That could apply to 36 of Kentucky's 120 counties, which appear in red on the state's infection map because virus transmission there is considered "critical." That applies to counties with 25 daily cases per 100,000 residents over the last seven days; the latest statewide rate is not far from that: 21.58. 

Counties with rates more than double the statewide rate are Clay, 82.6; Jackson, 76.1; Floyd, 59.4; Laurel, 52.4; Muhlenberg, 49.5; Webster, 48.6; Letcher, 47.7; Hopkins, 45.7; Simpson, 44.6; and Whitley, 44.5. All but Simpson are in the state's eastern or western coalfields.

The state reported 1,693 new cases of the virus Wednesday, raising the daily average for the last seven days by 104, to 1,022. That's the highest it has been since March 2, and more than double what it was just nine days go.

Hospitalizations for Covid-19 also jumped, rising to 571, almost 10% more than Tuesday. Intensive-care units has 185 of those patients, and 83 of them were on mechanical ventilation. Hospitalizations have more than doubled in 13 days.

The share of Kentuckians testing positive for the virus rose for the 32nd day in a row, to 8.29%. The state reported two more Covid-19 deaths, raising the total to 7,325.

Read more here:

McConnell using his campaign funds to run pro-vaccine ads

McConnell (Reuters photo by Joshua Roberts)
U.S. Sen. Mitch McConnell will use funds from his campaign to run 60-second advertisements on more than 100 radio stations in Kentucky to promote vaccination for the coronavirus, Reuters reports.

McConnell, the leader of Senate Republicans, has blamed misinformation for the low rate of vaccination among Americans, "which are fueling a rise in coronavirus cases, particularly in Republican-dominated states," Reuters notes.

"There is bad advice out there," he told Reuters. "Apparently you see that all over the place: people practicing medicine without a license, giving bad advice. And that bad advice should be ignored."

In Kentucky, the daily average of vaccinations is 28 percent higher in the last seven days than the previous seven, but remains below the level seen at the start of the month, and that was lower than June. Just under 52% of Kentuckians have received at least one dose of vaccine; the U.S. figure is 57%.

"Not enough people are vaccinated," McConnell said. "So we're trying to get them to reconsider and get back on the path to get us to some level of herd immunity."

In the radio ad, McConnell notes that he is a survivor of polio and says the Covid-19 vaccine is "nothing short of a modern medical miracle" and says, "Every American should take advantage of this miracle and get vaccinated. It's the only way we're going to defeat Covid."

Christina Wilkie of CNBC writes, "It is highly unusual for members of Congress to use campaign funds for anything outside of their re-election efforts. But McConnell’s decision reflects the looming crisis posed by Delta-variant Covid infections in states with low vaccination levels."

McConnell, 79, is widely expected not to seek re-election in 2026, and has $7 million in his campaign treasury. He has promoted vaccinations since he got one in December, but has passed up chances to criticize other Republicans who have refused to say whether they've been vaccinated and "attacked the shots as unnecessary or dangerous," as Reuters puts it.

But in the Reuters interview, McConnell endorsed recent remarks by Alabama Gov. Kay Ivey, who told reporters last week that it is "time to start blaming the unvaccinated folks" for the surge in cases, as well as criticizing people spreading misinformation about the vaccines.

McConnell, a native of Alabama, told Reuters, "I was encouraged by what the governor of Alabama said."

Ivey wrote in The Washington Post that those "pushing fake news and conspiracy theories about this vaccine are reckless and causing great harm," adding that many of the unvaccinated are "being lied to."

Reporter David Morgan of Reuters notes, "About 40% of Republicans are uncertain about the vaccine or are unwilling to be vaccinated, polling data published by the Morning Consult showed. That is more than double the 16% of Democrats who voiced those concerns."

Frank Luntz, a Republican pollster advising the Biden administration on vaccine persuasion, said he has been warning for months about politics being an obstacle to vaccination.

"The key here is to ensure that no one feels like they have to do it," Luntz told Morgan. "They have to want to do it. So, insulting them or mandating them won't work. Political messages won't work, unless you're Donald Trump. If Trump were to say to them: 'Hey, get the vaccine.' That would make a difference. But he doesn't do that. All he does is complain about the election."

Last week, Trump said, "People are refusing to take the vaccine because they don't trust (Biden's) administration, they don't trust the election results."

Tuesday, July 27, 2021

CDC recommends universal masking in schools, and in high-transmission areas indoors; school boards start making decisions

State Dept. for Public Health map, relabeled by Ky. Health News; to enlarge, click on it.

By Melissa Patrick

Kentucky Health News

Federal officials offered new guidance Tuesday recommending that everyone in schools wear masks, even those who have been vaccinated; and that people living in areas with widespread transmission of the coronavirus wear masks indoors when away from home. 

Photo from
Centers for Disease Control and Prevention  Director Rochelle Walensky said at a news conference that the new guidance was prompted by new research that found vaccinated people who contract the much more contagious Delta variant of the virus can spread it to others. 

"This new science is worrisome," she said. 

The guidance comes as the virus surge in Kentucky increased and school boards wrestled with the contentious masking issue -- and just one day after Gov. Andy Beshear announced the state's recommendations for in-school masking, which did not go as far as the CDC now has. 

The state recommended that unvaccinated students and staff wear masks in schools, and schools that want to "optimize safety" should require everyone to mask up. 

Beshear's guidance followed CDC recommendations earlier this month that said fully vaccinated people did not need to wear mask in schools. Not long after that announcement, the American Academy of Pediatrics called for everyone older than 2 to wear a mask, regardless of their vaccination status. 

A spokeswoman for the Kentucky Department of Education, Toni Konz Tatman, said the agency would review the CDC's latest guidance "in consultation with our partners at the Kentucky Department for Public Health, and will share it with our districts and families."

Mask requirements in Kentucky schools vary

On Monday, Lexington-Fayette County Public Health Commissioner Kraig Humbaugh recommended universal masking for staff and students in schools that have students under 12, because they are not yet eligible for vaccinations, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. 

Honeycutt Spears reports that 17 people signed up to speak at the county school board meeting Monday, mostly to oppose mask wearing and other restrictions in schools. The school board met with the health department Tuesday to discuss plans for the fall, WKYT-TV reports.

Jefferson County Public Schools Supt. Marty Pollio said he would recommend to his board Tuesday that it require universal masking, and WLKY-TV reported Monday that four of the seven members agree with him. Tuesday night, the boar voted unanimously to accept his recommendation.

The board of Frankfort Independent Schools, meeting Monday, accepted Supt. Houston Barber's recommendation to begin the school year with universal masking, Linda Younkin of The State Journal reports. Barber said he would revisit the issue every two weeks, with decisions based on data.

Last week, Boone County Schools said it would not mandate masks for students and staff, though they are recommended regardless of vaccination status. The school board said it reserved the right to change its mind based on the levels of infection in the school and community, Fox19 Now reports.

The Bowling Green Independent Schools and the surounding Warren County Pubic Schools will also not require masks for students, Aaron Mudd reports for the Bowling Green Daily News. Logan County Schools say likewise, though the county has a high infection rate and is only 40% vaccinated.

Statewide, just over half of Kentucky's population has received at least one dose of a vaccine. Vaccinations are picking up, rising to 7,579 per day over the last seven days. That's a 28% increase from the previous week, according to CDC data processed by The Washington Post.

Daily numbers keep rising

Vaccinations aren't rising as fast as cases of the virus. Kentucky reported 1,273 new cases Tuesday, the biggest daily number since Feb. 23, when the winter surge was winding down. That raised the seven-day average to 918, the highest since March 5. The positive-test rate is 8.11%, the highest since Feb. 5.

Kentucky hospitals reported 520 Covid-19 patients, the most since March 12; 175 are in intensive care and 83 of those are on mechanical ventilation.

The number of counties in Kentucky with transmission rates considered critical has been increasing daily; 28 of the 120 counties are in the "red zone," for counties with more than 25 daily cases per 100,000 residents over the last seven days.

Vaccines still offer much protection

While vaccinated people can get infected and spread the virus to others, many more infections are in unvaccinated people, Walensky said. 

"The highest spread of cases and severe outcomes is happening in places with low vaccination rates and among unvaccinated people," she said, making it more important than ever for people to get vaccinated.

The CDC eased masking rules in May, saying fully vaccinated people no longer needed to wear a mask in most settings. But the  new guidance says in areas of high transmission, fully vaccinated people do need to mask up. 

Walensky noted that the Delta variant only represented 1% of cases in May, but now represents at least 83% of them. The guidance issued in May was also made at a time when cases were dropping and more people were getting vaccinated. 

The CDC's latest guidance also recommends that community leaders encourage vaccination and mask-wearing to prevent further outbreaks in areas of substantial and high transmission. 

Appalachian Food for Health, a diabetes prevention virtual program, is scheduled for from 10 a.m. to noon Friday

The second annual "Appalachian Food for Health" virtual event, focusing on diabetes prevention, is scheduled from 10 a.m. to noon Friday, July 30. Click here to register.

The event is hosted by Shaping Our Appalachian Region, the Foundation for A Healthy Kentucky, and the Community Farm Alliance. 

The virtual discussion will be led by Martha Yount and Jann Knappage, who will provide an overview of the Nutrition Education Program hosted by the University of Kentucky.

Attendees will also learn about eating and cooking healthy while on a budget from Sabrina McWhorter, lifestyle blogger and founder of Eat Wild Appalachia.

Following the presentations, there will be two breakout rooms highlighting policy and programming.

Monday, July 26, 2021

Beshear strongly recommends in-school masking; coronavirus infections and Covid-19 cases in ICUs have doubled in 10 days

Kentucky Health News graph from initial, unadjusted daily reports; to enlarge, click on it.
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear issued what he called "strong recommendations" Monday for all students and teachers not vaccinated against the coronavirus to wear masks during the upcoming school year, and said schools that want to "optimize safety" should have all students and employees wear masked. 

“If we truly want as many in-person classroom days [as possible], these are steps that school districts will need to take,” Beshear said at a news conference. He said school officials' decisions should be driven by "what gives us the best chance to have our kids in school the maximum number of days in the midst of a pandemic? That is it, folks; that should be our North Star." 

The mask guidance specifically pointed to children under 12 because they are not able to be vaccinated yet. Beshear said he expects vaccines will be available to them in the fall or winter. 

Asked if his recommendations will become mandates if the surge in virus cases continues, Beshear said that nothing is off of the table.  

"I'm not gonna take anything off the table when it comes to the health of our people," he said, adding that he expects school districts will do the right thing if there are outbreaks, as they have in the past. 

Asked about the politics of this decision, Beshear said, "This is a moment where we need the courage of some really great elected officials out there: superintendents, board members." Superintendents are chosen by school board members.

"We're not asking all that much when you look at keeping kids in school and protecting them, and we need the buy-in from those local school districts. . . .  And yes, that may mean that you've got to go through some tough school-board meetings, but it's the right thing to do. That's what you signed up for." 

Education Commissioner Jason Glass also called for the courage and leadership by educators to follow the governor's guidance: "We need to call again upon your professionalism and dedication to continue many of those same mitigation efforts from this past spring to keep our schools open and safe for in-person learning."

Jefferson County Public Schools Supt. Marty Pollio said he would recommend to his board Tuesday that it require universal masking, and WLKY-TV reported that four of the seven members agree with him.

Ten days ago, the state recommended that people who aren't fully vaccinated wear masks in schools, and that use of masks by everyone should be considered in schools that have students who can't be vaccinated, low vaccination rates, or "inability to monitor the vaccine status of students and/or teachers and staff."

Now, rather than talking about knowledge of vaccination status, the state has shifted to testing. It is offering a federally funded testing program for grades K-12. The voluntary program is being offered in partnership with the Centers for Disease Control and Prevention and it will be up to schools on how to use it.

Kentucky Health News graph from state data; to enlarge, click on it.
Daily numbers: The recommendations come as every metric used to measure the coronavirus in Kentucky is worsening, including cases, positivity rate, hospitalizations, intensive care and ventilator use.  

The state reported 783 new virus cases Monday, bringing the seven-day rolling average to 886, more than double what it was 10 days ago. The share of Kentuckians testing positive for the virus is 7.89%. In the state's Monday-to-Sunday reporting weeks, those rates have risen four weeks in a row. 

Kentucky hospitals reported 486 patients with Covid-19, more than double the number of 12 days ago; 159 are in intensive care, a number that has more than doubled in 10 days; and 71 of those are on a ventilator, a number that has more than doubled in eight days.

Dept. for Public Health map, relabeled; to enlarge, click on it. 
Also doubling in the last 10 days is the state's seven-day infection rate; it is now 18.27 per 100,000 people. Counties with more than double that rate are Clay, 64.6; Letcher, 50.4; Floyd, 50.2; Webster, 49.7; Jackson, 48.2; Muhlenberg, 46.7; Allen, 44.9; Washington, 44.9; Laurel. 44.4; Hopkins, 40.3; and Whitley, 37.

In the last two weeks, the state's daily case average has increased 180%, the 12th fastest among the states, according to The New York Times.

Since July 1, Stack said, weekly case numbers and positive-test rate have quintupled and hospitalizations, intensive-care admissions and ventilator use have tripled. He said health-care providers are already exhausted and that from their view "This is entirely a preventable tragedy." since vaccines are available. 

Vaccinations: As virus cases have surged, vaccinations have increased, but only slightly. In the reporting week that ended Sunday, Kentucky averaged 6,766 vaccinations a day, 15% more than the week before, according to CDC data compiled by The Washington Post.

The state says 2.3 million Kentuckians have received at least one dose of a vaccine, 51.5% of the population; 45.3% have been fully vaccinated. Of those 12 and older, 60.4% have received at least one dose.

The lowest vaccination rates rates continue to be among Kentuckians under 50, with those 40-49 hovering at 52%. "We all need to do better," Beshear said. 

Stack displayed an updated version of a graph showing that unvaccinated Kentuckians are almost five times as likely as their vaccinated counterparts to get infected:
Dept. for Public Health graph shows cases declined as vaccinations increased, until the stronger Delta variant became dominant and caused infections in some people who had been vaccinated.
He also stressed the safety of the vaccines in the face of several myths: "Let me be very, very clear. There is no debate here, there's no two sides of the story here, there is fact, and there is fallacy . .. They do not damage your fertility . . . There are no magnets in these vaccines. . . .  Those persons peddling in those falsehoods are killing people, and it is a tragedy. These vaccines work. They are safe." 

Sunday, July 25, 2021

Somerset doctor says spread, strength of Delta variant mean it's too late to 'vax it or mask it'; both needed in high-spread areas

By Kevin Kavanagh
Republished from Infection Control Today

Dr. Jerome Adams, surgeon general in the Trump administration, said this month that the guidelines the Centers for Disease Control and Prevention issued in May on removing of masks were “premature” and “wrong.” Two years ago, most would not believe such a statement, but after the last year and a half, Adams’s statement is viewed by many as just another instance of misguided policy from the CDC. At issue was the May 14 policy reversal of no longer requiring vaccinated individuals to wear masks. The CDC stated it was based solely on science. However, many felt that this would open the door for no one to wear masks. Unfortunately, this is what appears to have happened.

Then came the Delta variant, virus which is up to 2.25 times as infectious as the wild type virus and has a higher replication rate producing 1,000 times more virons. In addition, it appears to be able to evade immunity. Israel reports vaccine efficacy has dropped to 64% in preventing symptomatic disease, down approximately 30 percentage points. Thus, there is concern that even vaccinated individuals can develop symptomatic diseases and may spread the virus. Most agree that the vaccines are effective in preventing deaths and hospitalizations, but even mild to moderate disease carries the risks of long Covid-19.

Thus, neither masks nor vaccinations will truly afford safety in areas where there is high viral spread. Each is a layer of armor and all need to do both until this virus dissipates.

The CDC and our federal response cause concern. In 2020, advisements on masking were reversed once asymptomatic spread was identified. In the public’s eye, this was held by many to be a sign of incompetence rather than evolving science. But since then, there have been a number of missteps in dealing with the coronavirus, SARS-CoV-2.

The rapidity of viral spread around the world, along with case reports from choirs, restaurants, and hospitals made an extremely strong case for aerosolization of SARS-CoV-2 -- so strong that 239 international scientists asked the World Health Organization and other public-health organizations on July 6, 2020, to recognize aerosolized spread of the virus. The National Academies of Science issued an expensive report on SARS-CoV-2 airborne transmission in October 2020. On Feb. 15, 2021, warnings were sent to the White House, CDC and the National Institutes of Health regarding SARS-CoV-2 aerosolization by 12 prominent infectious-disease authorities. Their letter called for strengthening of CDC guidelines for small-droplet spread with attention to the provision of respirators (N-95 masks) to workers and those exposed to SARS-CoV-2 aerosols.

But it took until May 6 for the CDC to recognize that airborne transmission can be a major spread of the virus. Ironically, a week later the CDC removed the masking requirement for those who are vaccinated, making the need for N-95 masks much less. Others are starting to follow former Surgeon General Adams’ advice. On July 19, 2021, the American Academy of Pediatrics recommended that all children over the age of 2, regardless of vaccination status, wear masks in schools this fall.

One of the safeguards which was present in 2020 was the presence of civilian scientists on the White House Coronavirus Task Force. However, on January 20, President Biden dissolved his Covid-19 transition task force, removing non-governmental employees, including some who later signed the Feb. 15 letter.

Needless-to-say, early recognition of aerosolization would require the use of N-95 masks and make upgrading ventilation systems an imperative. Proper interventions require infrastructure changes and allocation of significant resources. We also need to implement a comprehensive system of genomic sequencing of viral specimens to track community spread. Throughout this pandemic testing has been woefully inadequate in the United States, unless of course you are a member of a professional sports team.

All of these advisements tend to mitigate the seriousness of SARS-CoV-2 and lessen the need for interventions. We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen. We need to treat respiratory pathogens with the same vigor and diligence we put forth to prevent water, surface and foodborne disease.

The advice that you’re safe if you “vax it OR mask it” no longer holds with the Delta variant. We must do both. We also need to be taking this virus seriously. We need to remember that many civilizations in the past have been brought down by infectious disease, and species have gone extinct. What separates mankind from the rest of the biosphere is our intelligence and ability to leverage science. If we do not do this, we are in no better position than a tadpole. Unfortunately, almost all of our leaders appear to be hoping the virus will miraculously disappear. This did not work last year, and it will not work in 2021.

Kevin Kavanagh of Somerset is a retired physician and founder of Health Watch USA.

Friday, July 23, 2021

Here are answers to frequently asked questions about the coronavirus, the Covid-19 disease and the vaccines

MedPage Today illustration
This story has been updated.
By Melissa Patrick
Kentucky Health News

One of the many challenges facing Kentuckians who remain unvaccinated against the coronavirus is that they still have unanswered questions about vaccines, some based on facts and others based on myths. This story is an attempt to sort through some of those questions and to counter misinformation. 

This information is not only for the unvaccinated. Kentucky Health News encourages individuals who have already been vaccinated to use it as a resource when talking to their loved ones about getting vaccinated, since friends and family have proven to be highly influential in persuading them to do so.  

Covid-19 is no worse than the seasonal flu, right? Wrong. While influenza and Covid-19 are both contagious respiratory illnesses, they are caused by different viruses. Covid-19 appears to be more contagious and to spread more quickly, and is more deadly. Preliminary estimates from the Centers for Disease Control and Prevention are that the U.S. had 35 million flu cases and 20,000 deaths from it in the 2019-20 flu season, for a death rate of 0.06 percent. The U.S. has had more than 79 million confirmed cases of the coronavirus and over 977,000 deaths from Covid-19. In Kentucky, there have been over 1 million cases and more than 14,000 deaths. 

Kids don't get it, do they? Yes, they do. Children can be infected with the virus, and can get sick from Covid-19 and spread the virus to others without knowing they have it. In Kentucky, more than one-fifth of cases have been in people under 20. Most children have mild symptoms or no symptoms, but some have become severely ill from the disease and some have died. They can also get a rare but serious condition, Multisystem Inflammatory Syndrome, that sometimes doesn't show up until weeks after the infection. Kentucky has had more than 100 reported cases, according to the CDC. The more contagious Omicron variant of the virus that recently became dominant seems to affect them more.

These vaccines were developed very quickly; how can we be sure that they have been fully researched and proven? The vaccines were developed, tested and given emergency-use authorization in less than a year, thanks to years of previous research on related coronaviruses. Researchers had also been working on the technology for years; the timing, and federal funding by Congress and the Trump administration allowed companies to run multiple trials at the same time, saving time. Surgeon General Vivek Murthy said, "There were no corners cut in making these vaccines; what was cut was actually red tape."
Chart from University of Kentucky College of Medicine; for a larger version, click on it.

Why does it take so long for a drug to get final approval?  There has always been a long, deliberate process at the Food and Drug Administration to fully approve a drug, involving a review of much more data over a longer time than is required for emergency use authorization. 

The Pfizer-BioNTech Covid-19 vaccine was fully approved in August and the Moderna Covid-19 vaccine gained full approval for people ages 18 and older on Jan. 31. Both drugs were first approved under an emergency use authorization.

Does this new type of vaccine change your DNA? "Covid-19 vaccines do not change or interact with your DNA in any way," the CDC says. The new types of vaccines deliver instructions "to our cells to start building protection against the virus that causes Covid-19." Johns Hopkins University says, "The messenger RNA from two of the first types of Covid-19 vaccines does enter cells, but not the nucleus of the cells where DNA resides. The mRNA does its job to cause the cell to make protein to stimulate the immune system, and then it quickly breaks down — without affecting your DNA." 

What are the issues with the Johnson & Johnson vaccine? Is it still recommended? In April 2021, the J & J (Janssen) single-dose vaccine was paused while the FDA and the CDC investigated a very small number of cases of blood clots in people who had received it, nearly all of them adult women younger than 50. The FDA and CDC recommended that administration of the vaccine could safely resume. After more than 18.5 million doses of the vaccine had been given in the U.S. there were 60 confirmed reports of people who got the vaccine later developing blood clots, according to the CDC. 

On Dec. 16, the CDC recommended that people shouldn't get the J & J vaccine when the Pfizer-BioNTech and Moderna vaccines are available. The CDC news release said, "Any vaccine is better than being unvaccinated." 

In July, the Food and Drug Administration added a new warning about the J & J vaccine because it was linked to a rare neurological condition, Guillain-BarrĂ© syndrome. Preliminary research reported in July found 100 Americans out of more than 12 million who had developed the syndrome after receiving the vaccine; one died and 95 were hospitalized. The FDA said in a news release that “the known and potential benefits” of the vaccine “clearly outweigh the known and potential risks.” Through March 24, there have been around 310 preliminary reports of Guillain-Barre syndrome out of more than 18.5 million J&J vaccine doses administered, according to the CDC. These cases have largely been reported about two weeks after vaccination and mostly in men, many 50 years and older. 

"In most situations, Pfizer-BioNTech or Moderna Covid-19 vaccines are preferred over the J&J/Janssen Covid-19 vaccine for primary and booster vaccination due to the risk of serious adverse events," says the CDC.

What are the side effects of a Covid-19 vaccination? The most common side effects are pain, redness and swelling on the arm where you get the shot. Other side effects are tiredness, headache, muscle pain, chills, fever and nausea. Side effects after a second shot may be more intense. There have been three confirmed cases of the rare blood clot following the Moderna vaccine and one after the Pfizer-BioNTech, out of 540 million doses of mRNA Covid-19 vaccines.

Serious adverse reactions after a coronavirus vaccination are rare, says the CDC. Anaphylaxis, which can occur after any vaccination, is severe and has occurred in approximately five people per million vaccinated in the U.S. Clinics keep people 15 minutes after a shot to make sure they don't have a reaction.

As of March 24, there have been 2,323 preliminary reports of myocarditis and pericarditis among people 30 and younger who received a coronavirus vaccine. Most cases have followed the Pfizer or Moderna vaccine, particularly in male teenagers and young adults. The CDC has confirmed 1,396 of the preliminary cases.

A recent study, published in JAMA Network, found that "passive surveillance" reporting in the U.S. showed an increased risk of myocarditis after receiving either Pfizer or Moderna Covid-19 vaccine, the mRNA-based vaccines. The risk was highest after the second vaccine dose in adolescent males and young men under the age of 25. The heart condition is treatable.

The study notes that among more than 192 million persons older than 12 receiving more than 354 million mRNA-based Covid-19 vaccines during the study period, there were 1,991 reports of myocarditis, with 1,626 of them meeting the case definition of the disease.

"Among persons younger than 30 years of age, there were no confirmed cases of myocarditis in those who died after mRNA-based Covid-19 vaccination without another identifiable cause and there was 1 probable case of myocarditis but there was insufficient information available for a thorough investigation," says the report.

The report concludes that while this is a "rare but serious adverse event" than can occur after taking these vaccines, "This risk should be considered in the context of the benefits of Covid-19 vaccination."

Do I need a shot if I've already had the virus? The CDC recommends that those who have been infected with the virus should be vaccinated, because we don't know how long or strong the resulting immunity is. "Emerging evidence shows that getting a Covid-19 vaccine after you recover from Covid-19 infection provides added protection to your immune system. One study showed that, for people who already had Covid-19, those who do not get vaccinated after their recovery are more than two times as likely to get Covid-19 again than those who get fully vaccinated," says the CDC. If you were treated for Covid-19 with monoclonal antibodies or convalescent plasma, wait 90 days before getting a vaccine.

While "evidence is growing" that infection with the virus "is generally as effective as vaccination at stimulating your immune system to prevent the disease . . . federal officials have been reluctant to recognize any equivalency, citing the wide variation in Covid patients' immune response to infection," Kaiser Health News reports.

I got fully immunized, but then got infected. How did that happen? No vaccine is 100% effective, health officials say. The Pfizer and Moderna vaccines are about 95% effective in preventing Covid-19 in those without prior infections. The Johnson & Johnson vaccine has a 72% overall efficacy rate and an 86% efficacy against severe disease in the U.S. 

What's the latest information on who needs a booster? Research has found that a booster shot of the Pfizer-BioNTech or Moderna vaccine is needed to protect against the highly contagious Omicron variant of the virus. 

However, a CDC study published Feb. 11 found that booster shots of the Pfizer-BioNTech and Moderna vaccines are highly effective against moderate and severe Covid-19 for about two months after a third dose, but lose substantial effectiveness after about four months, suggesting the need for additional boosters. 

The study found the vaccine was 91% effective in preventing hospitalization during the two months after getting the shot, but fell to 78% effective after four months. Vaccine effectiveness against Covid-19 associated emergency department or urgent care visits also dropped over time, falling from 87% in the first two months to 66% after four months. After more than five months, vaccine effectiveness fell to roughly 31%, although the researchers note that there was little data available for this group of people

Adults 18 years and older can get any of the Covid-19 vaccines as a booster. A booster is recommended five months after the second shot for those who initially received a Pfizer-BioNTech or Moderna vaccine.  

The CDC  recommends 12-to-17-year-olds should get the Pfizer booster at least five months after their second Pfizer shot. 

Additionally, the CDC recommends that moderately or severely immunocompromised 5-11-year-olds receive a booster dose of vaccine 28 days after their second shot. 

Everyone who received the Johnson & Johnson (Janssen) vaccine is eligible for a booster shot at least two months after they get the single-dose vaccine. It is especially important for those who got the J&J vaccine to get a booster, since it has been shown to be less effective over time compared to the Pfizer and Moderna vaccines. The CDC recommends encourages those who got the J&J vaccine to get a Moderna or Pfizer booster in most situations. 

The latest guidance says people can receive a different brand of vaccine as a booster than they did their initial shots. 

Who needs a 3rd booster shot? The CDC recommends that certain immunocompromised individuals and people over the age of 50 who received their first Moderna or Pfizer Covid-19 booster shot at least four months ago to get another booster of either vaccine. 

CDC also recommends that adults who have received a one-dose J&J Covid-19 vaccine and a J&J booster at least four months ago may now receive a second Covid-19 booster of either the Moderna or Pfizer vaccine. 

This recommendation comes after the U.S. Food and Drug Administration authorized the second booster on March 29. 

"These updated recommendations acknowledge the increased risk of severe disease in certain populations including those who are elderly or over the age of 50 with multiple underlying conditions, along with the currently available data on vaccine and booster effectiveness," the agency said in a statement about the new recommendations. 

Children and Covid-19 vaccinations: Most children and all teens can get a Covid-19 vaccination. 

The Pfizer-BioNTech Covid-19 vaccine is approved for children 12 and older in the same dosage as adults, which comes in a purple capped vial. 

The Pfizer-BioNTech Covid-19 vaccine for children 5 to 11 is one-third of the adult dose and comes in an orange capped vial and is delivered with a smaller needle, designed specifically for children.  

Both of these vaccines require two doses, given three weeks apart. 

Why do I need to wear a mask if I've been vaccinated? Research indicates that vaccinated people who contract the highly contagious Omicron variant can spread it to others. The CDC advises universal masking for everyone indoors, regardless of vaccination status. Several studies show that properly wearing masks slows the spread of the virus, as part of a multi-layered prevention approach. 

The largest randomized controlled study of masks, led by researchers from Stanford and Yale universities, looked at the benefits of surgical-mask use by more than 342,000 adults in Bangladesh. It found that mask usage increased 29 percent in the intervention group where masks were promoted, and the group showed an 11% reduction in Covid-19 infections, with a 35% reduction among those over 60. The Washington Post reports that the study is under peer review with the journal Science.

Most recently, a CDC study, released Feb. 11, found that consistent use of a face mask or respirator (KN95 or N95) in indoor public settings was associated with lower odds of getting Covid-19. 

Among the 534 study participants who reported the type of mask they used, cloth masks offered 56% more protection against the virus than wearing no mask indoors; surgical masks offered 66% more; and respirator mask, such as N95 or KN95, offered the most additional protection, 83%.

Because of the highly contagious Omicron variant, public health experts say it is time to upgrade your  cloth mask to an N95 or similar high-filtration respirator when you are in public indoor spaces. 

Why are we hearing so much about the Omicron variant? It is now by far the dominant strain in the U.S. and Kentucky, and may be as contagious as measles, the most contagious virus known. 

Chart from UK College of Public Health; click it to enlarge.
While Omicron appears to be less severe overall than the Delta variant, it can still cause severe and even deadly infections in some people. And because it is so contagious, it has the potential to overwhelm Kentucky's health care systems.

People who are not fully vaccinated and boosted are most at risk from the Omicron variant. If a community has a low vaccination rate, that creates an opportunity for local outbreaks that have the potential to overwhelm the health-care system.

While two doses of the Pfizer or Moderna vaccine provides some protection against the Omicron variant, a booster vaccination has been found to ramp up this protection, particularly against severe illness and hospitalization. 

What do we know about the BA.2 Omicron subvariant? The highly contagious Omicron subvariant BA.2 is now the dominant coronavirus strain in the U.S, says the CDC. In the week ended March 26, the BA.2 variant caused more than half, 54%, of all new Covid-19 infections in the U.S, according to the CDC's genomic surveillance. The data shows only 1.5% of Kentucky cases are BA.2, but Gov. Andy Beshear has said it's likely closer to the national average. At this time, the BA.2 subvariant does not appear to make people sicker than the original Omicron. 

Can vaccines affect fertility? "The Covid-19 vaccine will not affect fertility," say physicians at Johns Hopkins University in Baltimore. They said the myth sprang from a false report on social media that the Pfizer and Moderna vaccines would affect not only the spike protein on the surface of the virus, but another spike protein that is involved in growth and attachment of the placenta in pregnancy. "The two spike proteins are completely different and distinct, and getting the Covid-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods," the doctors say. The CDC says, "There is currently no evidence that Covid-19 vaccination causes any problems with pregnancy, including the development of the placenta. In addition, there is no evidence that female or male fertility problems are a side effect of any vaccine, including Covid-19 vaccines."

What about microchips? There are no microchips or any kind of device in the vaccines, but this hasn't stopped about one in five people from thinking it's true. First and foremost, it is physically impossible; James Heathers of The Atlantic examined the notion in detail. A related myth is that the vaccine can make you magnetic. The CDC says, "Covid-19 vaccines do not contain ingredients that can produce an electromagnetic field at the site of your injection. All Covid-19 vaccines are free from metals." 

Where can I get more information? And how do I tell truth from deception? The Immunization Action Coalition provides a list of questions you should ask when evaluating health information online, such as the original source of the information and who manages it. The University of California-San Francisco offers tips on how to find credible sources of health information, including red flags to watch for, including outdated or anonymous information, possible conflicts of interest, one-sided or biased information, if there is a claim of a miracle or a secret cure, or if no evidence is cited.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.