Messaging campaign to encourage back to school vaccines is underway; Kentucky vaccination rates are below U.S. average

Lexington-Fayette County Health Department graphic

By Melissa Patrick

Kentucky Health News

With just weeks left before school starts, it's time to make sure your school-aged children are up to date on required immunizations.  

Toward this effort, the Kentucky Association of Health Plans, the trade group for health insurers in the state, and Kentucky Voices for Health, a coalition of health advocacy groups, have partnered to roll out a messaging campaign to help educate families and improve student immunization rates. The partnership involves a 3-year, $360,000 grant from KAHP to be used toward building a stronger safety net in Kentucky.

"This back-to-school season is the perfect opportunity to talk to a provider and ensure that your family is caught up on recommended immunizations. If you or someone in your family has fallen behind, trust me, you are not alone," Kelly Taulbee, director of communications and development at KVH, said at a press conference to announce the partnership. " We encourage families today to work with providers and get the additional resources and an immunization schedule that's right for you and your children." 

Taulbee said the messaging campaign will involve TV commercials, radio ads and occasionally print. Asked if they would be targeting any certain region of the state, Taulbee said, " It's a relatively equal approach across the board as far as how we're messaging." 

Many Kentucky children are still catching up with routine vaccinations that were missed during the pandemic. The state's vaccination rates remain below the national average. 

"That puts our children at unnecessary risk and it strains our healthcare system," Tom  Stephens, president and CEO of KAHP, said at a press conference. 

Stephens noted that the recent outbreak of whooping cough in Lexington "underscored the urgency of this issue."  Last week, the state Department for Public Health reported 138 cases of whooping cough, known medically as pertussis, and said this level of infection had not been seen in Kentucky since 2016-17. 

"This outbreak is a stark reminder of what can happen when immunization rates fall," Stephens said. "It's not just about individual protection. It's about community immunity."

"Community immunity" occurs when enough people have been immunized against a disease to protect others who are not immunized. Some can't get vaccinations because their immune systems are too weak to allow them to get vaccinated, or because they are too young. 

Children can get their routine vaccinations at health clinics, health departments, pharmacies and doctor's offices, but it's important to make those appointments soon because school typically starts in August and students are required to provide up-to-date immunization records at the beginning of each school year, unless exempted for religious or medical reasons.

Taulbee noted that a law passed during the last legislative session allows pharmacists to continue administering immunizations down to the age of 5. "It's such a simpler access point that we want families to keep in mind," she said. 

Families can find a provider, including those that offer free immunizations through the Vaccines for Children program, by calling the Kentucky Infectious Disease & Vaccine Call Center at 855-598-2246, Monday-Friday, 8 a.m. to 5 p.m. ET 

Asked about vaccine hesitancy, which has been fueled by the Covid-19 vaccine, Taulbee and Stephens both encouraged families to talk to their provider if they have any questions or concerns about immunizations. 

A recent Pew Research Center survey of more than 10,000 adults found that 88% of Americans believe the overall benefits of the measles, mumps and rubella vaccine outweighs the risks, compared to 62% who believed the Covid-19 vaccine benefits outweigh the risks. Further, the survey found a drop in support for vaccine requirements for healthy children in schools, with 70% of those surveyed supporting the requirement, down from 82% in 2019 and 2016. 

Data from the School Immunizations Survey dashboard, which includes data for each school, show that during the 2023-24 school year, nearly 85% of kindergartners were up to date with all vaccines, 80% of seventh graders were, and nearly 54% of 11th graders were. 

The KAHP-KVH partnership will also focus on keeping children signed up for Medicaid as Medicaid renewals resume for them.  

"The renewal process is going to begin soon for the first time in four years for our children," Taulbee noted. "We encourage families to take this very seriously. Check your mail, watch and make sure you understand eligibility standards and keep your children covered." 

34 counties have had cases of whooping cough this year; state health department says highest level of infection since 2016-17

By Melissa Patrick
Kentucky Health News 

In about a month, cases of whooping cough in Kentucky increased nearly 82%, indicating an elevated rate of infection, according to the state Department for Public Health. 

On July 19, DPH reported 138 cases of whooping cough, known medically as pertussis, in Kentucky this year, On June 14, Kentucky Health News reported there had been 76 cases in 2024. 

Statewide, 34 of the 120 counties have reported cases this year, up from 25 reporting cases on June 14. The state had 35 cases in 2022 and 84 in 2023. 

2024 pertussis cases by county
(Table by state Department for Public Health)

DPH says this level of infection has not been seen in Kentucky since 2016-17 when when 463 and 449 cases were reported, respectively.

“Anyone can get pertussis, though infants are at greatest risk for life-threatening illness,” Dr. Steven Stack, DPH commissioner, said in a news release. “Fortunately, vaccinations are available to help prevent serious disease.”

Whooping cough is a highly contagious respiratory illness spread by coughing and sneezing. Infected people can spread the disease from the start of symptoms and at least two weeks after coughing begins.

Early symptoms of whooping cough look like a common cold, including runny nose, sneezing, mild cough and low-grade fever. After one to two weeks, long coughing spells develop, which often occur in explosive bursts, sometimes ending with a high-pitched whoop and vomiting. This can go on for up to 10 weeks or more, according to the Centers for Disease Control and Prevention.

Babies younger than one year old are at greatest risk of getting whooping cough and having severe complications from it. And people with pre-existing health conditions that may be worsened by whooping cough are at high risk for developing a severe infection. 

And because some people have mild symptoms and don't know they have it, the disease can be spread unknowingly.  Many babies are infected this way, says the release.

DPH reports that this year in Kentucky, "at least eight cases have resulted in hospitalization – four infants, one school-aged child and three adults – and there have been no known deaths at this time. The majority of identified cases have occurred in school-aged children. Additional cases have been identified in infants/toddlers and adults."

The best way to prevent whooping cough is through vaccination. The childhood vaccine is called DTaP. Infants should receive a series of DTaP immunizations at 2, 4, and 6 months, with boosters at 15-18 months and 4-6 years. Children should then get a single dose of the booster, called Tdap, at 11 or 12. Boosters are required every 10 years to maintain efficacy.

In addition, pregnant women should be immunized with every pregnancy to protect their babies, says DPH. 

The pertussis vaccine, which is combined with tetanus and diphtheria vaccines, is required for Kentucky school children.

Whooping cough cases keep rising in Lexington and statewide; anyone with cold-like symptoms lasting 2 weeks should get tested

By Melissa Patrick
Kentucky Health News

Fayette County continues to experience a whooping cough outbreak, part of a statewide year-to-year increase in cases of the disease that is most serious in infants, young children and those with chronic diseases.

"Lexington has more pertussis, or whooping cough, cases in the last six weeks than the previous five years combined," Kevin Hall, communications officer for the Lexington-Fayette County Health Department, said in an email. "Fayette County is now up to 27 confirmed cases reported since April 26 . . .  compared to 16 total the previous five years."

Statewide, 25 of 120 counties have reported cases, and the total (76) has almost reached last year's total (84) with more than half of the year remaining.

2024 pertussis cases by county
(Data from state Dept. for Public Health)

Whooping cough, known medically as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.  Infected people can spread the disease from the start of symptoms and at least two weeks after coughing begins. 

Early symptoms of whooping cough look like a common cold, including runny nose, sneezing, mild cough and low-grade fever. After one to two weeks, long coughing spells develop, which often occur in explosive bursts, sometimes ending with a high-pitched whoop and vomiting. This can go on for up to 10 weeks or more, according to the Centers for Disease Control and Prevention.

The best way to prevent whooping cough is through vaccination. The childhood vaccine is called DTaP. Infants should receive a series of DTaP immunizations at 2, 4, and 6 months, with boosters at 15-18 months and 4-6 years. Children should then get a single dose of the booster, called Tdap, at 11 or 12. Boosters are required every 10 years to maintain efficacy.

"Anyone with cold-like symptoms lasting a week or two should ask their provider to be tested for pertussis," said Hall. "A cough isn’t always present, and the violent cough takes a few weeks before it appears, if it happens at all."

So far in 2024, 76 confirmed cases of pertussis have been reported in Kentucky. That's up from 46 confirmed cases that were reported by the state to Kentucky Health News in mid-May. The state had 35 cases in 2022 and 84 in 2023.

Last May, State Epidemiologist Kathleen Winter said at an immunization summit that the U.S. has a spike in pertussis about every five years. She said there was a "major epidemic" in 2012 and "We are well positioned to have another one." 

Asked about this, Brice Mitchell, a spokesman for the state Department for Public Health, said in an email dated May 24 that while cases of pertussis tend to peak every three to five years, this pattern was disrupted during the Covid-19 pandemic. 

"In recent years, pertussis incidence has remained low in Kentucky. (35 cases in 2022 and 84 cases in 2023) The last major peak occurred in 2016-2017 when 463 and 449 cases were reported, respectively," he said. "There is no clear indication that Kentucky is currently headed into an elevated incidence year for pertussis, however the Kentucky Department for Public Health continues to work with local health departments to identify cases and closely monitor trends." 

Free webinar, Health for a Change: Tackling the Immunization Crisis, is scheduled for Wednesday, May 8, by health foundation

The Foundation for a Healthy Kentucky's next "Health for a Change" webinar is titled "Tackling the Immunization Crisis." It will be held Wednesday, May 8, from 11 a.m. to noon ET. 

The free event will address three main topics, including: why dropping rates of immunizations in children should be considered a public-health crisis; what policies and conspiracies are contributing to the problem; and methods and resources advocates can utilize to improve vaccine access and trust. Click here to register. 

"The rise of vaccine hesitancy is creating a public-health crisis in our communities. In Kentucky and across the country we are now seeing cases of diseases that were once thought to be eliminated," says a foundation news release. "Misinformation and anti-vaccine policies are fostering mistrust, while also making it more difficult to access vaccines in some cases. This webinar will dive into these issues and explore ways advocates and health officials can tackle this crisis." 

The webinar's scheduled speakers are:

• Dr. Christopher Bolling, volunteer professor of pediatrics, University of Cincinnati; retired pediatrician, Crestview Hills, Ky. 
• Jessy Sanders, health communicator program manager, Kentucky Rural Health Association – Immunize Kentucky Coalition
• Kelly Taulbee, director of communications and development, Kentucky Voices for Health

Bill to let pharmacists give vaccines to children 5 and older heads to governor's desk; 11 Senate Republicans vote against it

By Melissa Patrick
Kentucky Health News

A bill to allow Kentucky pharmacists to order and administer vaccinations to children down to the age of 5 has gained final passage, but only after several senators voiced their concerns about the bill and four of them changed their votes from "yes" to "no."

Since 2017, Kentucky pharmacists have been able to administer vaccinations to children as young as 9, and younger with an order from a health-care provider. The age was lowered to 3 during the Covid-19 public health emergency to help increase access to care, but that law is set to expire Oct. 1.

The original version of Rep. Danny Bentley's House Bill 274 would have allowed pharmacists to order and administer vaccinations to children as young as 3, with the consent of a parent or guardian, but this was increased to age 5 in a committee substitute to appease the Kentucky Medical Association.

State Sen. Stephen Meredith, R-Leitchfield
(Legislative photo from March 8, 2024) 

Sen. Stephen Meredith, who presented the bill to the Senate, lauded it as a way to "fix a problem," noting that Kentucky ranks lower than five of the seven surrounding states when it comes to childhood vaccinations.

"Kentucky is facing a public-health crisis in regard to childhood vaccinations," the Leitchfield Republican said. "It does not introduce any new vaccine mandates. It does not expand the scope of practice of pharmacy. It does not replace well-child checkups."

The Senate gave final passage to HB 274 on a vote of 26-11 on March 22. It will now go to Democratic Gov. Andy Beshear's desk for his signature or veto. 

Sen. Lindsey Tichenor, R-Smithfield, withdrew two floor amendments that she had filed, one to ban requiring students to get the Covid-19 vaccine for "enrollment, employment or medical treatment" and the other to require employers to offer religious or medical exemptions for vaccinations to all employees. 

(On the same day, Tichenor's Senate Bill 295, to prohibit the requirement of a Covid-19 vaccine for any individual for the purposes of student enrollment, participation in any school-based program or extracurricular activity, internship, acquiring or maintaining a professional license or receiving a health care services, was approved with a committee substitute by the Senate Health Services Committee on a vote of 8-2.)

The bill Meredith carried, HB 274, passing the House without dissent on March 5, ran into opposition in the Senate.

Sen. Adrienne Southworth, R-Lawrenceburg, voted no and said she was "baffled" about the discussion, arguing that there is no longer a need for pharmacists to administer vaccines to younger children because the public-health emergency is over.

"I know our pharmacists have been administering vaccines, when we're in a state of emergency," she said. " And we're done with emergencies. . . . Are pharmacists dispensing drugs or are they administering vaccines?"

Tichenor also voted no, voicing concerns that the bill allows pharmacists to give vaccines to a child without knowing their medical history: "I think it's a little bit reckless to be issuing out vaccines that do have potentials for bad adverse events, and to be opening a door where it can be easy or easier, more accessible with less oversight." 

Sen. Shelley Funke Frommeyer, R-Alexandria, questioned the safety of the additives in vaccines: "We are continuing to promote and advocate something that isn't actually [in] your control. It's now in the doctor's or the pharmacists," she said. "We must own our health. We must be committed to our children's health." 

Meredith lambasted his colleagues who voted against the bill, speaking to the challenges that people in rural Kentucky have when it comes to getting access to care. 

“It’s easy to assume that people have access to care, particularly rural Kentucky. It’s not there," he said. "What do they do if they don’t have it? . . . That’s very easy to say, ‘Just get in your car and drive a few miles up the road.’ If you think that way, then you don’t really understand rural Kentucky."

Meredith added, “If you’re voting against this based on principle, you’re cheating the children of Kentucky, particularly rural Kentucky. I can’t begin to tell you how disappointed I am in that.”

Other Republican senators voting against the bill were Floor Leader Damon Thayer of Georgetown, Tichenor, Johnnie Turner of Harlan, Stephen West of Paris and Gex Williams of Verona. Changing their vote from "yes" to "no" were Republicans Robby Mills of Henderson, John Schickel of Union, Brandon Smith of Hazard and Phillip Wheeler of Pikeville. 

Kentucky kids still playing vaccine catch-up

Access to routine vaccinations remains crucial, especially among kindergarteners, a group whose routine vaccinations seem to have been hit hardest by the pandemic.

In November, Kentucky Health News reported that uptake of the combined measles-mumps-rubella vaccine in the state increased in 2023, after three years of decline, but the remains below the national average and the level needed to protect the population from measles, a highly contagious disease that has cropped up in several states.

Most of the routine childhood vaccine rates for kindergarteners remain below pre-pandemic levels, according to the state Department for Public Health Kindergarten Immunizations Dashboard.

The Centers for Disease Control and Prevention offers a wealth of information about the safety of vaccinations and the American Academy of Pediatrics calls for the on-time, routine immunization of all children and adolescents "as the safest and most cost-effective way of preventing disease, disability and death," it says.

 
Kentucky's schools require students to provide up-to-date immunization records at the beginning of each school year, unless a student is exempted for religious or medical reasons.

Flu shots limit infection rates, which are still elevated in Kentucky

State health department graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

The Kentucky Department for Public Health still considers hospitalizations for respiratory illnesses high and says flu activity remains elevated. 

Health officials say the best way to protect yourself from these viruses is to stay up to date with your vaccines. 

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu vaccine and updated Covid-19 vaccines, especially children younger than 5 or anyone at high risk for complications.

Vaccines for respiratory syncitial virus are recommended for some infants and young children, pregnant women and adults 60 and older. At some places and times, there has been a shortage of these vaccines. 

This year's "flu vaccines have worked, substantially reducing the risk of flu-related medical visits and hospitalizations across all age groups, with some estimates higher than have been previously observed, even during well-matched seasons," said a CDC report released on Feb. 29.

"Specifically, flu vaccination has reduced the risk of flu medical visits by about two-thirds and flu-related hospitalization by about half for vaccinated children and flu medical visits by half and hospitalization by about 40% for vaccinated adults."

Even though flu season usually peaks around January, it lasts until May. Health experts say that if there is any flu activity occurring, it's not too late to get vaccinated.

What the numbers say

Emergency-department visits for respiratory illness in Kentucky have stayed about the same for the last two weeks, with 3,607 visits reported in the week ended Feb. 24.

Hospitalizations for respiratory disease in that week stayed about the same as the week prior, with 491 530 hospitalizations reported in the week ended Feb. 24. 

Kentucky had 20 counties with Covid-19 hospitalizations between 10 and 19.9 hospitalizations per 100,000 people, a rate that the  CDC considers "medium." 

Those counties are Adair, Green, Russell, Taylor, Clinton, Cumberland, Lewis, Elliott, Menifee, Morgan, Rowan, Barren, Hart, Metcalfe, Monroe, Bath, Montgomery, Floyd, Johnson and Magoffin. 

Overall, there was little change in the three respiratory viruses tracked by the state health department: Covid-19, influenza and RSV, with flu continuing to drive ED visits and hospital admissions. 

The state reported 3,857 laboratory confirmed cases of the flu in the week ended Feb. 24 and 2,246 laboratory confirmed cases of Covid-19. This reflected a slight drop in flu cases and a nearly 9% drop in Covid cases.

Among children, ED visits for respiratory disease increased 12% in children four and younger, to 671, compared to the prior week, and hospitalizations for children 5 to 17 increased 50%, to 18. The increase in ED visits for younger children was driven by the flu, and hospitalizations for the older children were driven by an increase in  both flu and Covid-19.

Since the respiratory-illness season began the first week in October, 384 Kentuckians have died from Covid-19, and 51 from flu, according to the health department. One Covid-19 victim and one flu victim have been children. 

State's health chief urges parents to get kids vaccinated against measles, the most contagious disease, which can do great harm

By Melissa Patrick
Kentucky Health News

A highly contagious childhood disease that was declared eliminated in the United States in the year 2000 is making a comeback, largely driven by a declining vaccination rate in the country.  

"Unfortunately, as the measles vaccination rate has decreased, it's just one of those things where folks are opting out of vaccination more often, we're starting to see the increase of measles in the United States," Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, said at a Feb. 29 press conference. 

In Kentucky, about 90% of the state's kindergarteners are vaccinated for measles, mumps, and rubella "and that has to be 95% or higher to stop transmission," said Stack. 

Stack spent the bulk of his time talking about a disease that he said most people in our country, including health-care providers, have never seen. Further, he said, it is a disease that is "virtually, entirely vaccine-preventable." 

"If you are vaccinated, you almost certainly will get no symptoms from measles," he said. "In fact, the vaccine is so effective, you won't get sick at all and you don't transmit the virus." 

Stack said symptoms of measles include a cough, congestion, fever that may go up to 104 degrees, and a full-body rash. The Centers for Disease Control and Prevention also mentions sore, red eyes that may be sensitive to light; watery or swollen eyes; small greyish-white spots in the mouth, and a loss of appetite. 

"You feel miserable," said Stack, adding, "In the unlucky ones, the complications are pneumonia, diarrhea, ear infections, and even sometimes brain swelling that can lead to things like seizures, developmental disabilities and other permanent brain damage."

Among the unvaccinated population, Stack said more than one in five measles victims are hospitalized and one in 20 get pneumonia, which is the most common cause of death. 

"The most common age of death is under 5,  those are the individuals hurt the most by this disease if you're unvaccinated," he said. "And for the really unlucky, one in one thousand can get a permanent brain injury from the brain swelling that I talked about." 

Dr. Steven Stack with Gov. Andy Beshear (File photo)

Because measles is a highly contagious virus that is spread through the air, with an incubation period of 10 to 12 days, it is easy to spread it unknowingly. Stack said a person is contagious for four days before the rash and four days after the rash, which is why it is recommended for anyone who has been exposed to measles or who has it to stay at home for 21 days to avoid spreading the disease. 

"Measles is probably the most contagious viral disease on planet Earth at present. The only thing that could maybe compete with it is Covid," he said. "In this room, all of us in this press conference for a period of 40 to 60 minutes, if one person had measles in this room and we were unvaccinated, nine out of 10 of us would become infected with measles in about 10 to 12 days." 

As of Feb. 29, the CDC reported there had been 41 measles cases reported in 16 states, none in Kentucky.  

"This is becoming more common and because people travel a lot and are portable in ways that weren't possible . . . in the prior century, it spreads too easily and can cause too many problems," said Stack. "Everybody please go get yourselves and your children vaccinated if you are not already vaccinated."

Florida, with its many airports and a regular vacation spot for many Kentuckians, is one of the states with a recent outbreak. Of concern to public health officials is a letter issued by the Florida State Health Department that does not urge parents of unvaccinated children at that school to get vaccinated or to quarantine. Instead, it leaves these decisions up to parents.

These recommendations go against well-established public health guidelines that call for unvaccinated people or those with no prior immunity to isolate for 21 days after exposure and for unvaccinated children to get vaccinated within 72 hours of exposure, which allows them to return to school as long as they don't develop symptoms,  Katelyn Jetelina and Dr. Kristen Panthagani, write in their Your Local Epidemiologist newsletter.

Asked about what precautions Kentuckians should take if they are traveling through the Florida airports or spending time in the state, Brice Mitchell, spokesperson for DPH said a person's level of concern should be determined by whether they are vaccinated or not.  

"If you are vaccinated for measles, there are no special precautions necessary. If you are unvaccinated for measles, the Kentucky Department for Public Health urges that you get vaccinated," he said in an email. "For further information, please review the Centers for Disease Control and Prevention guidance." 

Dr. Sean McTigue, interim chief of infectious disease at Kentucky Children's Hospital agreed.

"Anyone who is up to date with this vaccine is protected against measles infection and would not need to take any additional precautions when traveling to Florida or through Florida airports," McTigue said in an email. "If planning a trip to Florida and one or more travelers are not already up to date with MMR vaccine, then now would be an excellent time to be vaccinated." 

Two doses of measles, mumps and rubella (MMR) vaccine are recommended to children starting at 12 months. Adults can also be vaccinated. 

McTigue called this measles outbreak and others a "wake-up call" for those who are not protected and provides an opportunity for parents to protect their children against measles. 

"Because the MMR also protects against mumps and rubella, it is also an excellent way to protect against mumps which can cause testicular infection and sterility in males and against rubella which can cause severe birth defects if a pregnant woman is infected during her pregnancy," he said. 

Stack also pointed to the protections provided by the vaccine, saying in a news release, "Two doses of MMR vaccine are 97% effective at preventing measles and provides lifelong protection if exposed to the virus. Even if exposed to measles, vaccinated persons may continue routine activities.”

The CDC says that while detectable antibodies generally appear within just a few days after getting the measles vaccination, it takes about two or three weeks to be fully protected. Ideally, the CDC says a person should be fully vaccinated at least two weeks before they travel.

More information can be found in a Los Angeles Cedars-Sinai Hospital blog post, "Measles Makes a Comeback: What Parents Need to Know." It says measles cases worldwide increased 79% in 2023, according to the World Health Organization. In 2022, the WHO estimated that measles killed more than 130,000—most of them children.

“Measles is a huge concern and directly related to declining measles vaccination rates,” said Dr. Priya Soni, a pediatric infectious-disease specialist with Cedars-Sinai Guerin Children’s Hospital. “Vaccine hesitancy, fueled during the pandemic by the anti-vaccine movement, has affected vaccination rates nationwide. In addition, because children were quarantined during the pandemic, many missed out on well-child visits and didn’t catch up on their vaccines. That has meant 61 million fewer doses distributed nationwide between 2020 and 2022.”

Although the first dose of the MMR vaccine is traditionally given to infants 12-15 months of age, and the second around a child’s fifth or sixth birthday, Soni said infants as young as 6 months can receive the first vaccine if they are traveling to areas where the measles infection rate is high.

Respiratory viruses keep declining in Ky. but might be headed for plateau at 'elevated' level; flu up; updated Covid-19 vaccine works

Kentucky Department for Public Health graphs, adapted by Kentucky Health News

By Melissa Patrick

Kentucky Health News

Emergency-department visits and hospital admissions for respiratory-related illness in Kentucky have declined four weeks in a row, but the state health department still considers the state's rates of influenza, Covid-19 and respiratory syncytial virus to be elevated.

Health officials say the best way to protect yourself from these viruses is to stay up to date with your vaccines. 

The federal Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu vaccine and updated Covid-19 vaccines, especially children younger than 5 or anyone at high risk for complications. 

Vaccines for respiratory syncitial virus (RSV) are recommended for some infants and young children, pregnant women and adults 60 and older, although a shortage of the vaccine has been reported. 

CDC graphic; for a larger version, click on it; to download, right-click.

A report published Feb. 1 in CDC's Morbidity and Mortality Weekly Report says early estimates show that people who have gotten the updated Covid-19 vaccine saw about 54% more protection against symptomatic Covid-19 infection than those who have not gotten the updated vaccination.

"Updated Covid-19 vaccines provide protection against symptomatic infection, including against currently circulating lineages," the report says.

The report shows the updated vaccine provides protection against the JN.1 strain of Covid-19, which became predominant in January of this year, and other circulating strains of the virus. 

Respiratory viruses in Kentucky

Emergency department visits for respiratory-associated illness in Kentucky in the week ended Jan. 27  stayed about the same as the week prior, dropping 3% from the week prior, to 3,187. But that was much less than the drops of around 20% seen in the previous three weeks, and flu cases showed show a slight uptick, indicating that respiratory virus activity may be headed for a plateau at elevated levels.

Respiratory-related hospital admissions in Kentucky dropped 5% from the week prior, when they declined 23%. And just like the emergency-department visits, flu was the only one of the three respiratory diseases tracked by the state to show a slight uptick.

Even with these declines, the state Department for Public Health says hospitalizations for respiratory illnesses remain high. 

CDC map, adapted by Kentucky Health News; click it to enlarge.

None of Kentucky's counties had high rates of Covid-19 hospital admissions in the week ended Jan. 27, but 21 of them had admission rates between 10 and 19.9 per 100,000 people, which the CDC considers a "medium" rate. Counties with a medium risk of Covid-19 hospitalization are in northeastern and western areas of the state. 

In the week ended Jan. 27, the state reported 3,377 laboratory-confirmed cases of the flu, up 2.5% from the week prior. It reported 1,994 laboratory-confirmed cases of Covid-19, down 3.6% from the week prior. 

Since the first week in October, 267 Kentuckians have died from Covid-19, and 28 have died from the flu, the health departnment says. One Covid-19 victim and one flu victim were children.

Bill to let pharmacists give vaccines to children 5 years and older advances, as state struggles to catch up on child immunizations

By Melissa Patrick
Kentucky Health News

A bill to allow Kentucky pharmacists to order and administer vaccinations to children down to the age of 5 advanced out of committee unanimously. 

Brooke Hudspeth and Rep. Danny Bentley present House Bill 274
to the House Health Services Committee. (Photo by Melissa Patrick)

"This bill is for those counties without pediatricians," said the bill's sponsor, Rep. Danny Bentley, R-Russell (Greenup County). "And we know that most people are within five miles of the pharmacy." 

The House Health Services Committee approved House Bill 274 on Feb. 1, and the measure was posted for passage in the full House on Monday, Feb. 5. 

The original version of the bill would have allowed pharmacists to order and administer vaccinations to children as young as 3, with the consent of a parent or guardian, but this was increased to age 5 in a committee substitute to appease the Kentucky Medical Association. 

Dr. Donald Swikert, a family medicine doctor and KMA member, told Kentucky Health News that the KMA felt it was important to make sure children continued to go to their annual well-check physician visits through age four because those are really "key visits" and  "there's a lot that goes on other than vaccinations." 

Bentley, a pharmacist by trade, said he appreciated the work of the KMA on the bill, but also pointed out that 51 of the state's counties have no pediatrician. 

Since 2017, Kentucky pharmacists have been able to administer vaccinations to children as young as 9, and younger with an order from a health-care provider.  

The age was lowered to 3 during the Covid-19 public health emergency to help increase access to care, with legislation that is set to expire Oct. 1. 

Brooke Hudspeth, president of the Kentucky Pharmacists Association, told the committee that Bentley's bill would ensure continued access to care. 

"House Bill 274 simply codifies the practice that pharmacists across the state have been performing for the past four years, so that we can ensure continued access to care that children and their parents have come to expect," Hudspeth said. "Pharmacists are trained and educated to screen and administer immunizations to children and adults. . . .  Your constituents and our patients have come to rely upon access to immunizations at their local pharmacy." 

Bentley stressed that this bill is not a mandate and committee Chair Kim Moser, R-Taylor Mill, said she appreciated that aspect of the bill. 

“We want to make sure that children are protected from communicable diseases and vaccines have been proven to keep children safe,” Moser said. “It does increase the convenience factor for families and parents and ensures safety and … protection.”

Kentucky kids still playing vaccine catch-up

Access to routine vaccinations remains crucial, especially among kindergarteners, a group whose routine vaccinations seem to have been hit hardest by the pandemic.  

In November, Kentucky Health News reported that uptake of the combined measles-mumps-rubella vaccine increased last year, after three years of decline, but the state's rate remains below the national average, and below the level needed to protect the population from measles, a highly contagious disease. 

Most of the routine childhood vaccine rates for kindergarteners remain below pre-pandemic levels, according to the Kentucky Department for Public Health Kindergarten Immunizations Dashboard. 

Kentucky's schools require students to provide up-to-date immunization records at the beginning of each school year, unless exempted for religious or medical reasons.

State reports two Kentucky children have died, one from flu and one from Covid-19, but hospital visits show first decline in months

By Melissa Patrick

Kentucky Health News

As the state reported the first two deaths of children from Covid-19 and influenza, Kentucky saw the first drops in emergency-room visits and hospital admissions for the diseases in more than three months.

State health department graphs, adapted by Kentucky Health News

The weekly respiratory-illness update from the state Department for Public Health showed a 21% drop in emergency-department visits for the flu, Covid and respiritory syncitial virus (RSV), and a 13% drop in related hospitalizations the week ended Jan. 6. 

The children's deaths, one from Covid and one from flu, are the first pediatric deaths from respiratory illness reported this season. Neither child was vaccinated against the viruses that killed them, the department said. The report did not include any other information about the children. 

“Influenza and Covid-19 are serious illnesses that unfortunately can be deadly for some people, including young children,” said Dr. Steven Stack, the state's public health commissioner. “It is important for people who have not been vaccinated to get their updated influenza and Covid-19 vaccines this season, along with other recommended immunizations, to protect themselves.”

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu and Covid vaccines, especially children younger than 5 or anyone at high risk for complications.

While hospital cases of the flu, Covid and RSV declined for the first time in many weeks, they continue to be widespread across Kentucky, says the release. 

Deaths are a lagging indicator of disease. Since Oct. 1, 165 Kentuckians have died from Covid-19 and seven have died from the flu, according to the health department's weekly respiratory report. 

In the week ended Jan. 6, Kentucky reported 3,173 laboratory confirmed cases of flu, down 19% from the week prior. The state reported 3,316 laboratory-confirmed cases of Covid, down nearly 14% from the prior week. 

Covid, the flu and RSV all saw a drop in emergency department visits and hospitalizations in the week ended Jan. 6. Flu has led in emergency-department visits for weeks, but Covid-19 has been the leading cause for hospitalizations since the state starting its reporting in October. 

Among children 4 and younger, the number of respiratory-related emergency-department visits and hospitalizations also dropped in the week ended Jan. 6. Emergency visits for this age group dropped 23% from the prior week, to 1,137, and hospitalizations dropped 18%, to 102. 

They also dropped among children 5-17, with 589 respiratory-related emergency department visits reported in the week ended Jan. 6, down nearly 40% from the prior week. However, respiratory-related hospitalizations in this age group increased to 19, up from 17 the week prior. 

A CDC report for the week ended Jan. 6 showed 11 Kentucky counties with hospitalization rates above 20 hospitalizations per 100,000 people, a rate the CDC considers high. 

Boyd, Carter, Greenup, Lawrence and Martin counties had a rate of 26.6 admissions per 100,000; Pike County had 22.9; Lewis County 21.8; and Daviess, Hancock, McLean and Ohio counties had 20.3.

CDC keeps urging health-care providers to recommend and offer vaccines; flu, Covid-19 and RSV rates are elevated in Kentucky

State Department for Public Health graphs, adapted by Ky. Health News

By Melissa Patrick
Kentucky Health News

The Centers for Disease Control and Prevention continues to encourage health-care providers to get their patients immunized against flu, Covid-19 and respiratory syncitial virus, noting that a recent poll shows that many Americans who have not yet been immunized report being open to vaccination.

"Strong provider recommendations for, and offers of, vaccination could increase influenza, Covid-19 and RSV vaccination coverage," says the CDC's Dec. 22 Morbidity and Mortality Weekly Report. 

The survey sample was drawn from a random-digit-dialed cellular telephone survey that included adults in every state.

It found that between Sept. 24 and Dec. 9, an estimated 40% of Kentucky adults reported they had gotten a flu shot; 15% had received an updated 2023-24 Covid-19 vaccine, and 23% of adults 60 and older had received a vaccine for RSV, which poses the greatest risk for seniors and infants. 

Kentucky's flu and updated Covid-19 vaccination rates are lower than the estimated national rates of 42% for flu and 18% for Covid-19, but higher than the national seniors rate for RSV, 17%. 

The state Department for Public Health's latest weekly respiratory-illness report shows that Covid-19, RSV and flu activity is elevated, and hospitalizations for RSV and flu are increasing. 

In the week ended Dec. 16, emergency-department visits for respiratory illness increased for yet another week, to 3,921, up from 3,670 the week prior. 

Of the latest week's cases, 2,072 were for flu, up from 1,720 the week prior; 1,073 were for Covid-19, down from 1,134; and 776 for RSV, down from 816. 

Among children 4 and younger, emergency-department visits due to respiratory illness increased slightly, to 1,303, up from 1,265 the week prior. Of those, 604 were for flu, up from 507; 570 were for RSV, down from 594; and 129 were for Covid-19, down from 164. 

Among children 5 to 17, emergency-department visits due to respiratory illness increased to 810, up from 653 the week before. Of those, 653 were for flu, up from 498. Covid-19 and RSV numbers stayed about the same as the week before, at 86 and 71, respectively. 

In that same week, hospital admissions for respiratory illness dropped a bit, to 617, down from 639 in the prior week. Of those, 310 were for Covid-19, down from 345; 171 were for RSV, down from 191; and 136 were for flu, up from 103. 

Among children 4 and under, hospitalizations for respiratory illness increased to 130, up from 105 the week prior. Of those, 101 were for RSV, up from 94; 19 were for flu, up from 7; and 10 were for Covid-19, up from 7. 

Among children 5 to 17, hospitalizations due to respiratory illness increased to 17, up from 10 the week prior. Of those, 13 were for flu, up from 4; 3 were for RSV, down from 4; and 1 was for Covid-19, the same as the week prior. 

A CDC report for the week ended Dec. 16 showed that Covid-19 hospitalization rates in 11 Kentucky counties were above 2 hospitalizations per 10,000 residents, which the CDC considers high. 

The leading county remains Letcher, with a rate of 2.3 hospitalizations per 100. The other high counties, with rates of 2.05 to 2.12, were all in northeastern Kentucky: Lewis, Greenup, Boyd, Carter, Rowan, Menifee, Morgan, Elliott, Lawrence and Martin. 

Deaths: Since Oct. 1, the state health department has attributed 118 deaths to Covid-19 and six to flu. One Covid-19 death was reported during the week ended Dec. 9.

Respiratory-related deaths for flu and Covid-19 on the state's weekly dashboard are reported according to when they occur, which sometimes leads to a delay between the actual date of death and the submission to the department.

Ky. kindergarteners' vaccination rates rose last year, but remained below the national average and were short of 'herd immunity' level

Graph by Kentucky Department for Public Health from state and CDC data; schools have local data.

By Al Cross

Kentucky Health News

More Kentucky children are getting their basic vaccinations, after three years of decline, but the state remains below the national average, and below the level needed to protect the whole population.

In the 2022-23 school year, at least 90.1 percent of Kentucky kindergarteners received the combined vaccination against measles, mumps and rubella ("German measles"). That was a big improvement from the 86.5% recorded in 2021-22, which followed two years of decline, but it still wasn't as high as the 93.4% in 2018-19. Percentages for other childhood vaccines were about the same as MMR.

The state's MMR vaccination rate remained below the national rate of 93.1%, which is almost two percentage points below the 95% that epidemiologists say is needed to provide "herd immunity," which also protects those who are not vaccinated by limiting spread of the viruses.

State law has long required the two-dose MMR vaccination for children entering school for the first time. A 2020 law allows several exemptions from vacicne mandates for "any child or adult" on religious grounds, medical reasons or a "conscientiously held belief." According to the Centers for Disease Control and Prevention, such exemptions were claimed for 1.7% of Kentucky children in 2022-23, an increase the 1.3% recorded in 2021-22.

The reported vaccination percentages may have been slightly higher because data wasn't available for about 3% of kindergarteners. At the same time, the reported figures could overstate immunity because the state counted some or all vaccine doses even if not administered at the age and time intervals the CDC recommends.

The increase in vaccination rates could be a result of extra efforts by the state and the Kentucky Rural Health Association, which created the Immunize Kentucky Coalition in cooperation with the state in 2022. The coalition says it aims "to increase immunization rates and prevent disease by fostering a partnership of Kentucky parents, patients, businesses, healthcare organizations, and others by promoting health equity that supports the delivery of safe and effective immunizations through stronger community buy-in and public health education."

The state Department for Public Health "is working closely with local health departments across the state to promote MMR vaccination in communities that have low vaccine uptake," spokesman Brice Mitchell said in an email. "While rates have not returned to pre-pandemic levels yet, vaccination coverage in Kentucky is increasing. This highlights the need for continued education and enforcement of school and child care vaccination requirements in Kentucky to ensure the health and safety of all children. . . . Vaccination is a simple, safe and effective​ way to protect against harmful diseases."

Graph by Your Local Epidemiologist from CDC data, adapted by Ky. Health News; click to enlarge.

Kentucky Association of Health Plans is offering free rides at Kentucky State Fair to people who get vaccinated at its site there

The Kentucky Association of Health Plans is hosting its third annual vaccination pop-up clinic at the Kentucky State Fair and while supplies last, will give away free, unlimited ride wristbands to those who get vaccinated, as well as the opportunity for other incentives. 

KAHP is the trade association representing commercial health insurers and Medicaid managed-care organizations in the commonwealth. 

From Aug. 17 to 27, KAHP is giving away a free unlimited ride wristband (while supplies last) when State Fair attendees go to the Health Horizons Pavilion in South Wing B to receive a vaccination. Hours are 10 a.m. to 5 p.m. daily.

In addition, those receiving a vaccine will be able to spin the wheel for a chance to win prizes like a bonus ride pass, food voucher, or $25 gift card. Medicaid members may also be eligible to receive an incentive offered by their health plan in addition to the KAHP giveaway. KAHP also has a kid-friendly zone with coloring books and life-size “Max the Vax” and “Maxine the Vaccine” cut-outs.

Vaccines offered include measles-mumps-rubella (MMR), tetanus-diphtheria-pertussis (Tdap) and influenza.

“The recent outbreak of whooping cough (pertussis) in Lexington is something that should concern us all,” Tom Stephens, KAHP president and CEO, said in a news release. “Children, pregnant women, newborns, and those around other medically vulnerable people are most at risk. It is vaccine-preventable, so we are urging folks to stay up to date on their shots. We have seen an alarming trend with fewer Kentucky children receiving Tdap vaccines, which protect against tetanus, diphtheria and pertussis." 

UK HealthCare joins several other Kentucky hospital systems and will no longer require employees to get a Covid-19 vaccination

Today's Clinical Lab photo

By Melissa Patrick
Kentucky Health News

Federal rules requiring Covid-19 vaccinations in health-care settings were lifted in early June, and while several of the larger Kentucky hospital systems soon lifted their requirements, UK HealthCare's new policy didn't kick in until this month. 

"As of August 1, 2023, UK HealthCare will no longer require Covid-19 vaccination as a condition of employment," the university announced last Monday. "UK HealthCare will continue to monitor vaccine and positivity rates for adverse outcomes and will reassess this decision if indicated or new federal or state guidelines require it."

The hospital said it plans to encourage Covid-19 vaccination with no disciplinary action if not obtained and will reconsider the requirement when Covid vaccine recommendations become similar to those for influenza. 

"As the schedule, dosage and other features of Covid vaccination mature, we will consider instituting a requirement similar to flu vaccination (at defined intervals, when an efficient process to enforce it is available)," the university said. 

In mid-July, Kentucky Health News reported that Norton Healthcare and Appalachian Regional Healthcare, which has 14 hospitals in Kentucky and West Virginia, had changed their policies to no longer require Covid-19 vaccination.

FDA panel recommends updating Covid-19 vaccines; here's why

The Food and Drug Administration's external scientific committee unanimously recommended Thursday that Covid-19 vaccines be updated to thwart new versions of the virus, which is mutating about twice as fast as the flu, vaccines for which are updated annually, Katelyn Jetelina reports in Your Local Epidemiologist.

Also, "The current Omicron variant (XBB) circulating is meaningfully different than other Omicron variants," Jetelina writes. "Covid-19 vaccines are waning in protection against hospitalization (62% effectiveness has dropped to 24%) and ICU admission, albeit with a smaller decline (69% to 52%). This is happening faster when exposed to XBB virus compared to other Omicron variants."

Hospitals aren't filling up with Covid patients "because vaccine effectiveness now represents the incremental benefit above and beyond the baseline protection in the general population. This is different than when we first introduced vaccines and the general population had a very low immunity wall." In other words, natural immuiity (not just antibodies but other features of the immune system) combined with vaccines provide a relatively high immunity wall.

What's next? "Pfizer, Moderna, and Novavax will start manufacturing millions of vaccines. Once they’re ready, the FDA will approve the updated vaccine," Jeteline writes. Then the committee "will determine who should get the vaccines. Expect this to happen in late summer or early fall."

"Everyone’s curious to see how this year plays out," Jetelina says of her community of interest. "The rest of the year will be very telling as to whether Covid-19 has settled into a seasonal, predictable pattern. Comparing Covid-19 to the flu is helpful, but the viruses, and thus processes, are different. This needs to be communicated better."

She adds, "Don’t let anyone tell you there are no human data on these vaccines. All vaccine manufacturers presented preliminary data on humans and animals. What we do not have yet is the safety of these vaccines when combined with RSV and flu vaccines." RSV is respiratory syncytial virus, which targets mainly the young and the elderly. 

Ky. kids still aren't as immunized as they were before pandemic; pertussis threat rises; cancer-preventing vaccine rates still low

Slide shown by state epidemiologist at Immunization Summit shows Kentucky's rate of vaccination against childhood diseases is lower than all bordering states. (For a larger version, click on it.)

By Melissa Patrick
Kentucky Health News

The Immunize Kentucky Coalition's Immunization Summit, held May 10 in Lexington, opened with a warning that Kentucky's children fell behind on their immunizations during the pandemic and still haven't caught up. 

State Epidemiologist Kathleen Winter
(Photos by Melissa Patrick)

Citing 2021-22 school immunization data, State Epidemiologist Kathleen Winter said Kentucky is behind all its bordering states in routine childhood vaccination rates and is well below the national average. 

The greatest concern right now is kindergartners, she said, because their measles-mumps-rubella vaccination rate has dropped in the last two school years. (MMR rates among seventh and 11th-graders remained about the same, but that's no surprise, since two doses of the vaccine are recommended before a child turns 6.) 

"We really need to focus on this particular age group that maybe has missed vaccines . . . because of the pandemic," Winter said. 

Winter said Kentucky's kindergarten two-dose MMR rate of 86.5% ranks in the bottom five states nationally. The national rate is 93.5%. The National Immunization Survey by the Centers for Disease Control and Prevention, which runs behind school data, shows that Kentucky's decline in immunization is similar to a national decline.

Regular well-child visits help parents and health-care providers keep children current on immunizations. Winter said one study found that 41% of Kentucky parents of children 12 and younger reported their child had missed a well-child visit during the pandemic. This rate was even higher among Hispanics (48%). 

"We're getting back on track with routine visits now, but we still have not caught up for where we had this big decline during the pandemic months," Winter said. 

Winter said there are "dramatic differences" in immunization rates between those who have private health insurance, publicly paid insurance, and those who are uninsured.

The National Immunization Survey for the recommended seven-vaccine series for children under 2 shows that 78% of children with private insurance had received all of them, but only 64.3% of those on Medicaid had received all of them, and only 45.2% of uninsured children had. 

"There's some real work to be done with these vulnerable populations, not just here in Kentucky, but nationwide," Winter said.

Pertussis concerns

Since 2018, fewer Kentucky children have received the DTap or Tdap vaccines, which protect against tetanus, diphtheria and pertussis (whooping cough). Rates among kindergarteners and 11th graders have been "pretty stable," but there has been a steady decline among seventh graders since 2018, with rates between 80% and 85%, Winter said.

The United States has a spike in pertussis about every five years, Winter said, noting there was a "major epidemic" in 2012 and "We are well positioned to have another one." 

She added, "We are concerned about this in particular because we have had outbreaks of pertussis reported this year; several counties have already noticed outbreaks. . . . So this is the time we really need to focus on getting kids vaccinated for pertussis."

Cancer-prevention vaccine rates are low

 

According to the CDC, human papillomavirus (HPV) is a very common virus that can cause cancer -- and the HPV vaccine can prevent more than 90% of cancers caused by it, including cervical cancer. But only 57% of Kentucky teens have taken it. 

"Kentucky is another state that really needs to be worried about HPV," Winter said. "We have some of the highest rates of cervical cancer here in Kentucky."

Even more concerning, said Winter, is that fewer than half Kentucky females are up-to-date on HPV vaccines and two-thirds of them haven't gotten a single dose of the vaccine, which is given in either a two or a three-dose series, depending on age. Kentucky ranks 37th among the states for this measure. 

HPV can also cause cancers of the vagina, vulva, penis, anus, rectum, throat and the back of the tongue. The CDC reports that each year, about 47,199 new cases of cancer are found in parts of the body where HPV is often found. Of those, about 37,300 of them are caused by HPV.

Covid-19 vaccines still available and free

Winter noted that the end of the national public-health emergency for Covid-19 means that getting Kentuckians vaccinated against the disease has become normalized.

And because the now single-dose bivalent vaccine is recommended for everyone 6 months and older, Winter said it needs to be considered a routine childhood vaccination. 

"We have to routinize it in every way possible, routinize it for our conversations with parents and for routine childhood visits, getting it incorporated fully into the childhood schedule," she said. 

That's not being done yet, the data shows.

"When we look specifically at children, 94% of those under the age of 5 have never been vaccinated against Covid and 74% of children in the 5- to 11-year age group have never been vaccinated," Winter said. "So we are still not making this routine for children. It's not being offered and provided in the settings that it  needs to be offered and provided." 

Winter also stressed that Covid-19 vaccines are still readily available and free, even though the commercialization of the vaccine is expected to come in late summer or fall. 

"This is why we need to work now to get this routinized as much as we can into clinics and settings where people are routinely getting vaccinated," she said. 

She added that the latest guidance is for people 65 and older to get an additional booster and that guidance for everyone else is likely coming. 

Vaccinations work

Winter said the measles exposure that thousands of people had in February at the spontaneous revival at Asbury University in Wilmore turned out to be a public-health success story.

An unvaccinated Jessamine County resident who attended the revival in Februrary had Kentucky's third reported case of measles in three months, but Winter said there has not been one secondary measles case from that exposure. She noted that the person with measles wore a surgical-type mask at "a lot" of the events.

"The reality is, most people are immune to measles," Winter said. "Most people are fully vaccinated or had measles as a child. So we do not have this crisis of a population-level issue. What we have are targeted individuals and ages where we need to get back on track. So, this is where we need to focus."

To register for this event, click here.

Even with this public-health victory, Winter cautioned that without a high level of population immunity, the potential for a super-spreading event would remain. 

Organizers of the summit hope it will be an annual event. Amber Malott, chair of the Immunize Kentucky Coalition, which is part of the Kentucky Rural Health Association, said its mission is to "create equitable access to vaccinations across the commonwealth." As part of that mission, she said they will hold free pediatric immunization symposiums in Morehead June 20 and Owensboro June 29.

All-day Immunization Summit to be held in Lexington May 10 to confront declining rates of vaccination in Kentucky

For a larger version of this poster, click on it.

By Melissa Patrick
Kentucky Health News

As vaccination rates in Kentucky decline, the Kentucky Rural Health Association is sponsoring an Immunization Summit on May 10 at the Embassy Suites in Lexington. 

The keynote speaker will be Ruth Carrico, a senior research scientist with the Norton Infectious Diseases Institute, who will speak about promoting public confidence in vaccines. 

The conference will touch on several topics, including information on the state of immunizations in Kentucky, the role of mobile units in vaccination, barriers to immunization and messages to overcome them, attitudes about immunization research, and more. 

The summit is timely because Kentucky children are behind on their routine immunizations and most Kentuckians still haven't gotten the latest, recommended bivalent Covid-19 booster.

During a recent Foundation for a Healthy Kentucky webinar, Kathleen Winters, state epidemiologist for Kentucky and the director for the Division of Epidemiology and Health Planning with the Kentucky Department for Public Health, talked about how well-child visits got off track during the pandemic, resulting in many Kentucky children missing routine vaccinations. 

She said the Kentucky School Immunization Survey shows that particularly among seventh graders, the DTaP or Tdap vaccination, which protects against diphtheria, tetanus and pertussis, has been on a steady decline since the 2018-19 school year. 

"This is particularly concerning because we have had recent outbreaks of pertussis here in the state," Winters said of the disease known as whooping cough. "We do see cyclic peaks every several years and we are primed to potentially be leading into a major pertussis epidemic in the coming year or two if we don't really push to get our pertussis vaccine rates up to where we want them to be at that 90 percent threshold." 

Looking at last year's rates for the vaccine that protects against measles, mumps and rubella, Winters said Kentucky's rate of 86.5% of kindergarteners receiving two doses of the MMR vaccine was well below the national rate of 93.5%, and among the lowest five states for MMR coverage.   

Further, she said, children have the biggest gap in Covid-19 vaccine coverage.

Kentuckians are also lagging behind when it comes to getting boosted, with only 12% of the state's total population having received the bivalent booster, which has extra protection against the Omicron variant, according to The New York Times Covid-19 data tracker. 

The Immunization Summit is scheduled from 8 a.m. to 5 p.m. on May 10 at the Embassy Suites, 1801 Newtown Pike.  Click here to register and click here for the full agenda. 

KRHA has formed the Immunize Kentucky Coalition, which says its vision is to "work to increase immunization rates and prevent disease by fostering a partnership of Kentucky parents, patients, businesses, healthcare organizations, and others by promoting health equity that supports the delivery of safe and effective immunizations through stronger community buy-in and public health education." Click here to learn more about the coalition. We want to work to increase immunization rates and prevent disease by

59% of residents, just 16% of staff in Ky. nursing homes have had Covid-19 booster shots; both rates slightly above national rates

Centers for Disease Control and Prevention photo

By Melissa Patrick
Kentucky Health News

While Kentucky nursing homes' Covid-19 booster rates are higher than the national rates, many staff and residents remain vulnerable to the disease because over 80% of staff and nearly 40% of residents have not received booster shots.

In the week ending April 9, there were 116 new confirmed cases of Covid-19 among Kentucky nursing-home residents, or 5.9 cases per 1,000 resident-weeks; there were 54 cases among staff, or 2.8 cases per 1,000, according to the Nursing Home Vacciation Data Dashboard of the Centers for Disease Control and Prevention.

Through the week ending April 2, reports from about half of Kentucky's nursing homes showed that 59% of their residents were up to date with their Covid-19 vaccines, which means they had received the latest bivalent booster dose or have completed the primary series of vaccines in the last two months.  This was higher than the nationwide rate of 54%. 

Staff rates were much lower. In the week ending April 2, 16% of Kentucky's nursing-home staff were up to date with their Covid-19 boosters, which was still higher than the national rate of 12%. 

That said, 89% of Kentucky nursing-home residents and 42.5% of staff have completed their primary Covid-19 series and received an additional primary or booster shot – just not the recommended bivalent one.

The CDC recommends that people stay up to date with Covid-19 vaccines by completing a primary series and receiving the most recent booster dose for their age group.

At this point in the pandemic, much of the effort to get nursing home residents and staff boosted falls to the facilities.

Susan Dunlap, spokesperson for the Kentucky Department for Public Health, told Kentucky Health News that the department still offers several services to help nursing homes and other long-term care facilities promote Covid-19 vaccinations among residents and staff. 

"KDPH staff are available to provide in-service education and training to residents and staff regarding the safety and benefits of being vaccinated," Dunlap said in an email. "Regional infection preventionists can assist facilities with obtaining vaccines and conducting vaccine clinics by connecting facilities with community provider partners such as pharmacies and other healthcare facilities. Staffing support for vaccine clinics is also available to long-term care facilities by request through a KDPH Nurse STRIKE Team comprised of five nurses who can assist with clinic logistics and vaccine administration." 

While residents and staff in Kentucky's nursing homes are still getting Covid-19, there are fewer deaths from it. 

In the week ending April 9, the Covid-19 death rate among residents in Kentucky nursing homes was 0.1 per 1,000 residents.  But even though this rate is low, it's important to remember that seniors in nursing homes are among the most vulnerable to the disease. 

Virus found by swabbing floors: A recent study found that one way to detect the coronavirus in congregate settings is to do regular floor swabs.  

The study, published in The New England Journal of Medicine in February, found that regularly sampling floor surfaces for the virus in long-term care homes could improve detection of it. 

The researchers sampled floor surfaces in multiple locations weekly in 10 long-term-care homes between September 2021 and November 2022 and analyzed the samples for the presence of the virus. 

They found that "the percentage of positive swabs increased in the days and weeks before an outbreak was declared [and] the percentage of positive swabs also decreased in the days and weeks after an outbreak was declared."

The authors conclude that the detection of virus from these floor swabs "was strongly associated with Covid-19 outbreaks" and that the prevalence of positive floor swabs declined after the cessation of the outbreak. 

"Swabbing the built environment, similar to wastewater surveillance, may provide another tool for infection prevention and control for combating Covid-19 in congregate settings," they write. "Future studies evaluating the implementation and generalizability of this approach are needed."