AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
What is the newest COVID vaccine called? How many children have long COVID? What is Triple E virus? Is that the deadly mosquito virus Massachusetts?
Our guest is AMA Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Andrea, welcome back.
Garcia: Thanks, Todd. It's always great to be here.
Unger: We got a lot to talk about. This week, we're going to be discussing the updated COVID vaccines, the return of free COVID tests, surprising new symptoms of long COVID in kids and what to know about mosquito-borne illnesses as we head into the Labor Day weekend. Let's start with the updated COVID vaccines.
Andrea, we're going to be talking with the AMA's vaccine expert, Dr. Sandra Fryhofer, next week. But in the meantime, can you give us a high-level overview of what we need to know now?
Garcia: Sure, Todd. It was last Thursday when we saw the FDA both approve and authorize those updated COVID vaccines from Moderna and Pfizer. These updated vaccines target the strain of the virus called KP.2. And you'll probably remember KP.2 really took off last spring. And although the dominant variant is now KP.3.1.1, those two are closely related.
And those updated vaccines were really developed to provide better protection against the currently circulating variants. The updated vaccines are expected to begin shipping to pharmacies and doctor's offices. And they should be available soon. It may take several weeks for all locations to receive vaccine supply.
The Novavax vaccine, which is the protein-based vaccine that is going to target the earlier strain called JN.1, has not been authorized yet. But we're expecting to see the FDA authorize that soon. These updated vaccines are recommended for everyone six months of age and older to protect against the potentially serious outcomes of COVID, which include hospitalization and death.
Unger: Well, I'm grateful for those new vaccines. And I'm looking forward to mine after the Labor Day holiday. Because I know a lot of people who've got COVID right now. Andrea, are we still seeing those kind of serious outcomes with COVID?
Garcia: We are. And if we look at the CDC COVID tracker that shows severity indicators of hospitalizations and deaths both increased as of the last data reported in August. And in recent weeks, people have been hospitalized with COVID at a rate nearly twice as high as last summer.
There was a recent New York Times article that noted that by late July, COVID was responsible for the deaths of 600 people in the U.S. each week. Now, that's a big drop from this winter, but it's double the number that we saw this spring. We do have preventive measures. We're not doing a great job of using them. The availability of vaccines has not translated into actual vaccinations.
By spring, only about one in five adults had received last year's updated COVID vaccines. Even older adults haven't turned out in large numbers to get vaccinated. Only about 40% of people 75 and older received last year's vaccine. And according to the CDC, even less than one third of nursing home residents are considered up to date on their COVID vaccinations. Hopefully, uptake will be better with these new vaccines.
Unger: Andrea, when you look at that kind of low uptake, is that because the shots are no longer free for everybody?
Garcia: Well, for the most part, they still will be. We've talked about how the Bridge Access Program, which is the program the administration had in place to provide access to uninsured Americans, expires this month. However on Friday, Dr. Cohen, CDC director, said that the CDC would be distributing about $62 million to health departments. And that's in order to provide free COVID vaccines to adults who otherwise wouldn't be able to afford them.
Adults with both public and private insurance will still have access to the COVID vaccines with no co-pay. And then we'll still have free vaccines available to children from low-income families. And that's through the government's Vaccine for Children program. Those highest numbers of emergency department visits for COVID over the summer were among children under the age of five.
So it's important that we remember that these vaccines do remain important for children to—it will be incumbent on physicians in the coming months to help patients understand the importance of these vaccines and work through appropriate timing, which I'm sure you'll discuss with Dr. Fryhofer next week.
Unger: Yes, and I'm looking forward to that conversation. Make sure to tune that in next week. Andrea, staying on COVID for a moment, in addition to more funding for vaccines, free tests and treatments for COVID are coming back. Tell us more about that.
Garcia: Yeah, the free COVID tests won't be available right away. But they are coming back in time for fall and winter gatherings. The government also purchased supplies of Paxlovid. That will be available at no charge to people who are uninsured or who are on Medicare or Medicaid through the end of the year, and that's through the government's PACS Access program, which is run by Pfizer.
Pfizer then will be taking over the program starting in 2025. And they'll continue to provide government-purchased Paxlovid to people who are uninsured or underinsured. Merck is also running a patient assistance program, and that's to help people get access to its antiviral medication, Lagevrio.
Unger: Andrea, how do we go about getting those free tests?
Garcia: So starting in late September, the government is going to reopen its covidtest.gov website. And like last year, each household can order up to four free at-home tests which will be delivered through the mail. Additional free tests are also going to be made available at community sites, so libraries, food banks and at long-term care facilities.
Dr. Cohen said on Friday, the best plan going into this winter is for everyone to remain vigilant and use the tools we have. Those obviously include vaccines, testing and treatments.
Unger: Absolutely. And I was supposed to have breakfast with a friend this week. And he called and said he woke up with a sore throat and a cough. And I said, maybe we should just cancel that. And fortunately, he had a home test and a couple of hours later, he got the indication that he has COVID. So those home tests are very valuable.
Andrea, prevention of COVID is also key for another reason. The possibility of long COVID, which made headlines this week because of a new study looking at long COVID in children and adolescents. Andrea, what's the news about that?
Garcia: Well, first of all, you're exactly right. And Dr. Peter Marks, who's the director of FDA's center for Biologics Evaluation and Research, said on Friday that the only way you get long COVID is by having COVID. So this is yet another important reason why we should be getting vaccinated.
As for long COVID in kids and adolescents, there was a large national study that was published last Wednesday in JAMA. It asked caregivers of more than 3,800 children about their kids' symptoms at least 90 days after COVID. And then they also surveyed caregivers of around 1,500 children without a history of COVID. And they compared those responses.
The study was part of the RECOVER Initiative. It's one of the world's largest investigations into long COVID. It's funded by the NIH. What researchers found is that although COVID itself has really historically been milder in kids, it may have debilitating long-term side effects that make it difficult to attend school, to participate in extracurricular activities, or to spend time with family or friends. And younger kids also seem to experience different symptoms than adults do.
Unger: Tell us more about that. What symptoms do kids usually have?
Garcia: So among kids ages 6 to 11, there was headache, trouble with memory or focus, trouble sleeping and stomach pain. Those were the most common symptoms associated with long COVID. In adolescents, common symptoms were more similar to those in adults, so post-exertional malaise, fatigue, brain fog, dizziness, GI issues, heart palpitations.
The new research showed that those aged 12 to 17 were more likely than young kids to experience daytime sleepiness or low energy, and then body, muscle or joint pain. These differences are really important because if we don't know them, then physicians could be missing those children who are experiencing long COVID.
A great deal certainly is still unknown about long COVID. So any clarity we can bring to diagnosing and treating it is extremely valuable.
Unger: All right. And we'll continue to cover new research as it becomes available. Wrapping up this week, let's turn to another topic that's making headlines, and that's mosquitoes. We know they're typically bad this time of year, but it feels like we're seeing more mosquito-borne illness. Andrea, is that true? What's going on?
Garcia: Yeah, it really does feel that way. And I think especially with Dr. Fauci making headlines this week for his hospitalization with West Nile virus, it's been in the news. Thankfully, he's back home and doing well.
Massachusetts has also been in the headlines this week for its bout with a mosquito-borne illness called Eastern equine encephalitis virus, otherwise known as EEE, which is much easier to say. It is rare, but serious. About 30% of people with the virus die. And many survivors suffer ongoing neurological problems.
The Massachusetts state health officials have designated 10 communities that are at high or critical risk for the virus. But those communities have largely shut down all outdoor spaces and activities from dusk until dawn, when mosquitoes are most active. Dr. Robbie Goldstein, who's the Massachusetts state health commissioner, said in a statement that their state has not seen an outbreak of EEE for four years.
Unger: So after that amount of time, why do you think this is happening now?
Garcia: Well, Todd, I think it likely comes back to climate change. Essentially, the mosquito season has lengthened across the United States. That was really detailed at length in an article in The Washington Post last week. Climate change has fueled rising global temperatures, and that's true for more than two-thirds of the U.S.
It's also increased the number of mosquito days. So that's those days with an average humidity of at least 42%, and then temperatures between 50 and 95 degrees. We know that the Northeast has warmed faster than the rest of the country. And they've experienced the biggest increase in mosquito days.
So if we look at Massachusetts, for example, there they have been having an average of 14 more mosquito days. If we compare it to the period from 1980 to 2009, we know that scientists have warned that longer mosquito seasons could heighten that risk of outbreaks of diseases like dengue, malaria, and as we're seeing, with West Nile and EEE.
The best protection here is prevention. So mosquito repellents, clothing that covers your skin, and if possible, rescheduling those outdoor activities that take place between dusk and dawn.
Unger: All right. Well, Thank you so much for that update. And it's important to know, of course, as we head into the holiday weekend. That's all we have time for this week. And as always, thank you for being here, Andrea, and for sharing this information.
If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. And you can always find our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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