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.

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

Bills to become law on vaping, pharmacy reform, vaccinations, drugs, at-home blood testing, coverage of cancer screening, more

Kentucky State Capitol (Photo via Wikipedia)

By Melissa Patrick
Kentucky Health News

In its 2024 session the Kentucky General Assembly has passed dozens of health-related bills that address a range of topics. With one day left in the session, here are some of them: 

Vaping: House Bill 11 limits legal sale of vaping products to those approved by the U.S. Food and Drug Administration. It also creates a database of retailers that sell the products and sets fines for retailers, manufacturers and wholesalers who violate the law.

HB 142 requires school districts to adopt specific policies that penalize students for possession of "alternative nicotine products, tobacco products or vapor products" and report nicotine-related incidents to the state Department of Education. Changes in the Senate, accepted by the House, allow schools and their governing bodies to apply for grants related to nicotine usage and remove the mandate that schools suspend students with a third possession violation. 

Pharmacy reform: Senate Bill 188 changes laws governing commercial pharmacy benefit managers, with requirements aimed at saving the state's independent pharmacies from closing.  It provides for dispensing fees, bans PBMs from forcing patients to get their drugs through mail order, and keeps them from steering patients to pharmacies that they own.

The bill, sponsored by Sen. Max Wise, R-Campbellsville, also prohibits a PBM from reimbursing a pharmacy that it owns at a higher rate than a community pharmacy, or from keeping a community pharmacy from filling a 90-day prescription for a maintenance drug. And a PBM will not be able to penalize a community pharmacy from sharing information with a patient on the cheapest option to pay for their medications.

Reducing barriers to screening

Cancer detection: HB 52 will require health-insurance plans to cover all preventive cancer screenings and tests that are consistent with nationally recognized clinical practice guidelines without requiring patients to pay any cost-sharing requirements, including a deductible charge for the services.

The sponsor, Rep. Deanna Frazier Gordon, a Republican from Richmond, told Kentucky Health News in February that the cost for screenings is often a barrier for people who often don't get screened because they don't have symptoms.

HB 115 will eliminate co-payments and cost-sharing requirements for high-risk individuals who need follow-up diagnostic imaging to rule out breast cancer. Currently, screening mammograms are covered by insurance, but follow-up exams are often not. 

“Thousands of Kentuckians require diagnostic and supplemental breast imaging every year, yet many forgo them due to out-of-pocket costs. Not any more,"  Molly Guthrie, vice president of policy and advocacy at the breast-cancer foundation Susan G. Komen, said in a news release. "This life-saving legislation means they will now receive the breast imaging they require, leading to an earlier breast cancer diagnosis and often better health outcomes."

Vaccines and drugs  

Vaccinations: HB 274 will allow Kentucky pharmacists to order and administer vaccinations to children as young as 5. The state's routine vaccination rates for kindergarteners remain below pre-pandemic levels.

Pseudoephedrine: HB 386 will raise the annual purchase limits on pseudoephedrine to help people with chronic allergies legally obtain enough of the medication to meet their needs. The bill changes the current 24-gram annual limit to an 86.4 grams, and remove the limit on the number of packages per transaction, said sponsor Robert Duvall, R-Bowling Green.

Kratom: HB 293 will regulate kratom, a natural herbal supplement that is not currently regulated. It is often used for anxiety, pain, PTSD and opioid withdrawal. The bill defines kratom, prohibits sales to people under 21, puts it behind the counter and provides guidelines for manufacturing and labeling. It also says federal law supersedes state law on the matter. 

Blood thinners: HB 31 allows Medicaid patients in Kentucky who are on blood thinners to use at-home machines to test their blood. Patients on some blood thinners, like warfarin, now require a weekly trip to the doctor's office for blood work that looks at how fast their blood clots.

Amanda Crabtree, a registered nurse at University of Kentucky Chandler Hospital, told WKYT-TV that she hopes that other states will follow Kentucky's example in this legislation. Crabtree said she expects that Medicaid patients could receive their at-home machines as soon as this summer.

Health-care business issues

Provider liability: HB 159 will protect health-care providers from criminal liability when a medical error harms a patient unless the harm results from gross negligence or wanton, willful, malicious or intentional misconduct. 

This effort was led by the Kentucky Nurses Association, which said the bill "will prevent health-care professionals from being charged criminally for making a medical error; that makes it good for nurses and nursing, and puts Kentucky at the forefront of developing laws to protect health-care workers." 

Workplace violence: HB 194 extends to contract workers, such as travel nurses, the law that makes violence against health-care workers a third-degree assault. It also extends this protection, now limited to hospitals, to contract employees at health clinics, doctor offices, dental offices and long-term care facilities. 

Sepsis: HB 477 establishes diagnostic criteria for sepsis allow hospitals to preserve current rules used for reimbursement of sepsis care, which allow payment when it is detected early, instead of only allowing reimbursement after organ failure occurs. 

"We know that if sepsis is caught early, the likelihood of survival is great," Jim Musser, vice president for policy with the Kentucky Hospital Association, told Kentucky Health News in March. "But for every hour that we wait, the chance of mortality increases by 7 percent." In sepsis, "The body responds improperly to an infection," says the Mayo Clinic. "Sepsis may progress to septic shock . . . When the damage is severe, it can lead to death."

Other health bills that passed

Youth medical records: HB 174 allows parents have access to their child’s medical records until they turn 18. Right now, children 13 and older must sign a waiver for parents to have access to them. HB 174 also updates the state's Medical Orders for Scope of Treatment form, which defines a person's end-of-life wishes.

Veteran suicide prevention: HB 30 calls on the state Department of Veterans Affairs to create a suicide prevention program for service members, veterans and their families.

Stuttering: SB 111 eliminates some insurance coverage limits on speech therapy for stuttering. It was promoted by former UK basketball star Michael Kidd-Gilchrist, who has overcome stuttering.

Medicaid: SB 71 is designed to keep people from coming to Kentucky to establish residence so that they can sign up for drug treatment to be paid for by Medicaid. One challenge resulting from this practice, according to Rep. Shane Baker, R-Somerset, is that when they leave the program, they are often homeless. 

SB 280 will allow Level II trauma centers that partner with a  university to get the university-hospital rate for services delivered as part of that residency program.

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. 

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.

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.

Louisville wastewater shows a surge of flu virus, signaling Ky. flu season is here; shots recommended for all six months and older

By Melissa Patrick

Kentucky Health News

The state Department for Public Health's weekly respiratory virus update, released Thursday, Nov. 9, shows that Covid-19 activity is moderate and influenza activity is low, but increasing. And while hospitalizations for Covid-19 and flu remain low, respiratory syncytial virus (RSV) hospitalizations in children continue to increase. 

This report comes as Louisville public-health officials are urging residents to get their flu shots, saying that the city's wastewater surveillance system has detected a surge in influenza virus – which means that flu season is right around the corner, reports Jess Clark of Louisville Public Media.

Researchers at the University of Louisville told Clark that their wastewater monitoring system has detected a redoubling of influenza virus concentration in recent weeks.

“That’s a sign that flu season is almost here,” Dr. Kris Bryant, associate medical director of the Louisville Metro Department of Public Health and Wellness, told Clark. “And if people have not yet had their flu shot, now is the time. Make an appointment today to get a flu shot before flu really starts circulating in our community.”

The Centers for Disease Control and Prevention recommends that everyone 6 months and older get an annual flu vaccine. 

The state report shows that emergency department visits for respiratory illness in Kentucky have increased weekly since early October, reaching a high of 2,115 in the week ended Oct. 29. Of those, 891 visits were for Covid-19, 885 were for flu and 339 were for RSV. 

Hospitalizations for respiratory illness in Kentucky stayed about the same as the previous week, increasing by three to 296 in the week ended Oct. 29. Of those, 192 were for Covid-19, 53 were for flu and 53 were for RSV. 

Among children, emergency-department visits increased to 965 in the week ended Oct. 29, up from 748 the week prior. Of those, 513 were related to flu, up from 414 the prior week; 302 were related to RSV, up from 185 the prior week; and 150 were related to Covid-19, up one from the prior week. 

Hospitalizations for respiratory illness among children increased slightly from the prior week, to 60. Of those, 45 were for RSV, 13 for flu and two for Covid-19. 

In the week ended Oct. 29, Kentucky reported 2,414 laboratory-confirmed tests for Covid-19, up from 2,312 in the prior report; and 169 positive laboratory tests for the flu, the same as the week prior. 

No additional deaths were reported in this week's report.

New vaccines being released next month for Covid-19, the flu and RSV are expected to curb ever-mutating respiratory viruses

Johns Hopkins Bloomberg School of Public Health photo

Kentucky Health News

Americans will have access to several vaccines this fall to protect them against respiratory viruses, including Covid-19, influenza and respiratory syncytial virus (RSV), but effectively deploying them is expected to be challenging and confusing.

With the latest major mutation of the Covid-19 virus, "We have to have a lot of humility . . . There are a lot of things we don’t understand," Dr. Scott Gottlieb, a former Food and Drug Administration commissioner who is on the board of vaccine maker Pfizer, said on CBS's "Face the Nation" Sunday.

Gottlieb said studies are underway "to look at whether the new vaccine also covers this BA.2.86 variant . . . and we'll have that data by the time the new vaccines become available. So by the time these are out in September, consumers will know how well it covers that new variant. We'll also probably know whether or not it's spreading."

Confusion about respitratory virus is “absolutely overwhelming, especially for our patients,” Sterling Ransone, a doctor in rural Virginia and board chair of the American Academy of Family Physicians, told Fenit Nirappil and Lena H. Sun of The Washington Post. 

They report, "An updated Covid booster should be available by late September. Flu shots are arriving at doctors’ offices. And for the first time, infants and seniors could be immunized against respiratory syncytial virus, a persistent foe that public health officials had few ways to prevent." 

The upcoming vaccine campaign comes at a higher cost to insurers and health practices, because the federal government is no longer footing the bill for Covid vaccines. And, providers need more guidance on how to sequence the shots and the risks of giving them together. And there are other issues that can't be addressed until all of the vaccines are formally approved. 

"Doctors have to figure out how to explain the nuances and unknowns of new vaccines at a time of rampant misinformation," the Post reporters write. "Patients perplexed by changing coronavirus vaccine guidance now have more shots to consider. Public health officials worry a messy rollout could further erode confidence in routine vaccination and risk overwhelming the health-care system with preventable cases of RSV, flu and Covid."

The updated Covid booster, designed to work on the XBB strain of the virus,which became dominant this year, marks the shift to an annual vaccination for all age groups, similar to the fall flu vaccine. 

"The FDA is expected to sign off on the updated covid boosters by mid-September, according to officials familiar with the plan. The CDC’s vaccine advisory panel is expected to meet shortly thereafter to recommend who should get the shots — probably everyone 6 months and older. Babies under 6 months are assumed to have antibodies passed along from their mothers. CDC Director Mandy Cohen has said the vaccines should be available for most people by the third or fourth week of September," Nirappil and Sun report.

And as for concerns about getting the three shots at once, the authors write, "The CDC says it has not seen data suggesting safety concerns co-administering covid and flu shots, which could improve uptake of both vaccines. But clinical trials for the RSV vaccines found rare instances of severe side effects in people who received an influenza vaccine at the same time. It’s unclear if it was a statistical fluke or a consequence of co-administering the vaccines. Still, providers must weigh the potential for rare side effects against the potential harm of seniors contracting a severe case of a virus they are not vaccinated against." 

Gottlieb said he expects Covid-19 to follows "a flu-like pattern, with new variants each year." He said this year’s flu vaccine appears to be effective, based on results in South America, where the southern part of the continent is in winter.

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.

It's time to make sure your children are up to date on vaccinations required for school; Kentucky lags behind all the states it borders

State Dept. for Public Health graphic

By Melissa Patrick
Kentucky Health News

With just a few weeks left before school starts, it's time to make sure your school-aged children are up to date on their required immunizations. It's especially important because Kentucky's children fell behind on their immunizations during the pandemic, and many of them still haven't caught up. 

"Kentucky is really low on a lot of childhood vaccines . . . and when that happens . . . when people are not vaccinated, especially children with developing immune systems, that can cause these diseases to run rampant," said Ryan Babb, manager of the University of Kentucky's retail pharmacy services.

At a recent Immunization Summit hosted by the Immunize Kentucky Coalition, State Epidemiologist Kathleen Winter said Kentucky is behind all of its bordering states in routine childhood vaccination rates and is well below the national average. 

Winter said the greatest concern right now is among kindergarteners, because their measles-mumps-rubella vaccination rate has dropped in the last two school years. 

She also noted that since 2018, fewer Kentucky children have received the DTap or Tdap vaccine against tetanus, diphtheria and pertussis (whooping cough), and this is especially true among seventh-graders. 

Also, she said only 57% of Kentucky teens have taken the human papillomavirus (HPV) vaccine that protects against more than 90% of cancers caused by it. 

Babb encouraged Kentucky parents to get their children vaccinated at their local pharmacy, noting that while all Kentucky pharmacists can offer vaccinations to children between the ages of 9 and 17, some have a  "collaborative care agreement with a pediatrician," like UK's pharmacies do, that allows them to offer them to children as young as 6 months.

"We feel like it's really important to increase access, it's much easier than to . . . walk in and get a vaccination rather than having to schedule an appointment with a provider," Babb said. 

And if your child has gotten behind on their routine vaccination schedule, there are catch-up schedules to get them up-to-date. "You can always catch up," he said. 

Babb said it's also important to remember that immunizations provide "herd immunity," which occurs when enough people have been immunized against 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 shots, or because they are too young.

Children can also get their routine vaccinations at health clinics, health departments 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. 

Babb cautioned people who are hesitant about vaccines to make sure they are listening to reliable sources on the subject because there is a lot of vaccine misinformation out there. 

"My recommendation to anybody is before you do a Google search or before you start checking any other social media or getting opinions based on that, just call your local pharmacist [or] . . . even a primary care provider . . .  to get the right information the first time before digging down a rabbit hole of misinformation," he said. 

Ruth Carrico, a senior research scientist with Norton Infectious Diseases Institute, talked at the summit about ways to combat vaccine hesitancy. She placed the bulk of that responsibility on health-care providers and their employees. 

"You need to be all in," she siad. "And then be honest, unashamed, and unafraid of your position. It doesn't mean that you're sanctimonious, and you're high and mighty, and you don't listen to others. .  . But the idea is, if you are all in for immunization, then that needs to be where we are heading and that needs to be the basis for our interactions as we move forward."

Further, she said health-care professionals must have a firm understanding and expertise of how vaccination and the immune system work to answer people's questions in a "truthful, credible and sustainable" way. 

"Our time to understand vaccines and promote vaccine confidence is now," she said. "We need to remember very clearly, lest we get influenced by misinformation and pushback in social media, that vaccines save lives."

Covid-19 vaccine mandate for health-care workers ended in mid-June, but some major Kentucky hospitals still have such policies

By Melissa Patrick
Kentucky Health News

About a month ago, the Centers for Medicare and Medicaid Services withdrew its requirement that health-care workers get a Covid-19 vaccination, and while the final rule won't be official until on or about Aug. 5, CMS has said it does not intend to enforce staff vaccination requirements before that date.

Kentucky Health News checked with a few of the larger hospital systems in Kentucky to see if they had changed their policy and found that a few of them had, but others are still considering it. 

Maggie Roetker, Norton Healthcare's director of public relations, told the Louisville Courier Journal in mid-June that the hospital system had ended its Covid-19 vaccination policy for all employees, effective immediately. 

Roetker said the update on vaccine mandates goes along with new regulations enacted by accrediting agency DNV along with CMS and its parent agency, the Department of Health and Human Services.

"While Covid-19 vaccination is no longer a requirement for employees, volunteers, vendors and contractors, we do still recommend it to reduce the risk and protect each other and our patients," she told the CJ. "The vaccine is also recommended for people who are at risk of medical complications due to the virus.

Appalachian Regional Healthcare, which has 14 hospitals in Kentucky and West VIrginia, said it has changed its policy. 

"As of July 3, the Appalachian Regional Healthcare system is no longer mandating that employees at any of our locations in eastern Kentucky or southern West Virginia be vaccinated for Covid-19. While not mandated, the vaccine is still available for all employees who want to receive it," Melissa Cornett, assistant vice president of corporate communications for ARH, said in an email. 

However, UK HealthCare, Baptist Health and CHI Saint Joseph Health still have their Covid-19 vaccine mandates in place. 

“UK HealthCare has reviewed the changes in the Covid vaccine federal requirements and is currently determining the impacts to our workforce and determining next steps," Kristi Willett, executive director, public relations and strategic communications for the University of Kentucky, said in an email. 

Rebecca Brown, associate vice president of marketing for Baptist Health, said in an email, "Baptist Health still has its Covid-19 vaccination requirement in place. We are aware of the federal changes. Our clinicians are still reviewing and working through the reporting requirements for CMS. As we address those requirements, we will make a determination on any policy changes."

Mary Branham, market director for marketing and communications at CHI Saint Joseph Health said in an email, " We require a number of vaccinations, including the Covid-19 and flu vaccinations, to ensure the safety of each other and for those who rely on us for safe care, often when they are most vulnerable. This is imperative to our mission as a faith-based Catholic ministry. We continue to provide a process for religious and medical exemptions for those who qualify." 

Update, July 10, 2023: This story has been updated to include comments from CHI Saint Joseph Health about their current Covid-19 vaccination policy. 

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.

FDA approves first-ever RSV vaccine for people 60 and older

ABC News photo

By Melissa Patrick
Kentucky Health News 

People 60 and older now have access to the first approved vaccine against respiratory syncytial virus. The vaccine, developed by GlaxoSmithKline, is called Arexvy and was approved May 3 by the Food and Drug Administration.

“Today’s approval of the first RSV vaccine is an important public-health achievement to prevent a disease which can be life-threatening and reflects the FDA’s continued commitment to facilitating the development of safe and effective vaccines for use in the United States," Dr. Peter Marks, director of the FDA's Center for Biologies Evaluation and Research, said in a news release. 

The release said the FDA concluded that the vaccine is safe and effective from scientific analysis of data from an ongoing, randomized, placebo-controlled clinical study conducted in the U.S. and other nations among individuals 60 years of age and older. The trial had nearly 25,000 participants.

The study showed that the vaccine reduced the risk of people 60 and older from developing a lower-respiratory-tract infection from RSV by 83 percent, and severe disease by 94%.  

When a person gets RSV, they typically have mild, cold-like symptoms, but for some older adults, it can be deadly, according to the Centers for Disease Control and Prevention. 

Each year, between 60,000 and 160,000 older adults in the U.S. are hospitalized due to an RSV infection and between 6,000 and 10,000 of them die from it, the CDC says. 

Older adults are at more risk of serious complications from RSV because our immune systems weaken as we get older. The CDC Says those with chronic lung or heart disease or weakened immune systems are at the highest risk for severe RSV. 

"With this vaccine, Americans over the age of 60, and particularly those with underlying health conditions like COPD, asthma, or congestive heart failure, will have a vaccine to help protect against potentially serious outcomes from RSV," Dr. John Kennedy, president of the American Medical Group Association, said in a GSK news release. 

Arexvy will be rolled out ahead of the fall and winter RSV season, Carolyn Y. Johnson of The Washington Post reports in an article that explores the new vaccine's side effects and what's in it.

Johnson notes that the new vaccine does not come from new technology: "This is a protein-based vaccine, similar to ones that are used against other diseases, including a hepatitis B vaccine, a shingles shot and an influenza vaccine. The protein in the vaccine is produced by cells in a laboratory."

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

Covid-19 levels stay low; memorial expected to be finished soon; FDA approves new booster, gives new guidance on vaccination

Workers laid brick walkways to the pandemic monument at the Capitol (in background) Saturday. One said the work should be finished in about 10 days. (Kentucky Health News photo by Al Cross)

By Melissa Patrick

Kentucky Health News

The state and federal Covid-19 reports remain good this week, but Kentuckians are still dying from the disease. Over the last four weeks, the state has attributed an average of 53 deaths a week to Covid-19. 

Gov. Andy Beshear said at his weekly news conference Thursday that the memorial to honor the thousands of Kentuckians who have died in the pandemic, with a sculpture being created by Kentucky artist Amanda Matthews, is being installed and is expected to be finished this spring. 

“While we have reached better days in our fight against the pandemic, we will not forget those that have been lost, over 18,000 of our loved ones. . . . We want to make sure that we are truly creating a type of memorial that remembers this time, gives people a place to grieve, but also shows the heroism that Kentuckians have shown," Beshear  said. 

Matthews, of Lexington, was chosen by a committee made up of families who had lost someone to the virus. She told Amber Philpott of Lexington's WKYT-TV, “The reason for creating something like this is to memorialize a difficult time in history. Memorialize lives lost way too soon, but also to show the strength of communities when they stick together.”

Her design, "United We Stand, Divided We Fall," is a three-dimensional representation of the state seal and motto, Philpott reports. The memorial, which was paid for by the Team Kentucky Covid-19 Memorial Fund, will be placed in Monument Park, in the northwest quadrant of the Capitol grounds. 

Weekly Covid-19 reports

The latest weekly report from the state Department for Public Health showed there were 2,264 new cases of the coronavirus in Kentucky last week, or 323 cases per day. That's a 20.5 percent drop from the previous week's 2,848 cases. 

 The state's new case-rate dropped to 3.93 cases per 100,000, from 4.28 the week before. The top 10 counties were Breathitt, 14.7 cases per 100,000 residents; Metcalfe, 12.77; Green, 10.45; Whitley, 8.67; Nelson, 8.65; Clinton, 8.39; Greenup, 8.14; Powell, 8.09; Butler, 7.76; and Mason, 7.53. 

The Centers for Disease Control and Prevention risk map, based on new cases and hospital numbers, shows only two of the state's 120 counties, Breathitt and Letcher, at medium risk from Covid-19. Medium-risk counties are shown in yellow and the 118 counties at low risk are shown in green. Last week, Letcher County had a high rsk of Covid-19 and was the only Kentucky county not in green on the map. 

The CDC also provides a community-level transmission map, largely used by health-care facilities and researchers, that shows the level of virus in each county, at one of four levels. The latest map shows 15 counties with a low level of transmission and 74 with a medium level; the rest are either substantial or high. The state says residents should take their guidance from the other map.

Last week, Kentucky attributed 51 more deaths to Covid-19, bringing the state's death toll to 18,455.

FDA recommends a second booster for some

The best way to protect yourself from severe illness, hospitalization and death from Covid-19 is to get vaccinated and boosted. 

This week, the U.S. Food and Drug Administration approved a second Omicron booster, also referred to as the bivalent Covid-19 vaccine, for immunocompromised people and people over the age of 65.

The FDA says people who are over 65 qualify for the second booster if they got their initial bivalent dose at least four months ago and immunocompromised people can get another bivalent dose at least two months after their initial bivalent shot. Further, the FDA says that additional doses could be warranted for immunocompromised people at the discretion of their health care provider. 

For young kids (ages 6 months through 4 years) who are immunocompromised, however, eligibility for additional doses will depend on the vaccine they previously received, the agency said.

The new guidance also says that a single dose of a bivalent vaccine will suffice as initial vaccination for unvaccinated adults, instead of the two doses of the original vaccine. 

Further, anyone who has not yet been boosted with the bivalent vaccine is eligible for a single dose of it. If you've already received the bivalent booster and you are not over 65 or immunosuppressed, you do not qualify for a second booster. 

"The FDA intends to make decisions about future vaccination after receiving recommendations on the fall strain composition at an FDA advisory committee in June," says the agency. 

The new recommendations also set new rules for children, depending on their age and their vaccine history. 

“At this stage of the pandemic, data support simplifying the use of the authorized mRNA bivalent Covid-19 vaccines and the agency believes that this approach will help encourage future vaccination,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a news release. 

He added, "Covid-19 continues to be a very real risk for many people, and we encourage individuals to consider staying current with vaccination, including with a bivalent Covid-19 vaccine. The available data continue to demonstrate that vaccines prevent the most serious outcomes of Covid-19, which are severe illness, hospitalization, and death.”