The delivery of coronavirus booster shots in the U.S. has stagnated, particularly among older populations, leaving millions of vulnerable people at risk of serious infection and death.
After bottoming out in late March and early April, COVID-19 infections are steadily rising across the country.
More worrisome, hospitalizations have also increased 20 percent over the past two weeks, though deaths have stayed relatively low, especially compared to the winter peak, according to Centers for Disease Control and Prevention (CDC) data.
Studies show the protection against infection from the initial series of vaccines starts to wane after about six months.
While younger, healthier people are still well protected against severe disease, that hasn’t been the case for older Americans. That makes booster shots important, especially as most COVID-19 mitigation measures have ended.
Health officials are urging people over the age of 50 to get a second booster, but many have yet to even receive their first.
“What we really should be worried about is getting the boosters that we need to stay up to date so with the new variants that we have, we don’t have unnecessary deaths and hospitalizations,” Food and Drug Administration Commissioner Robert Califf said on CNN recently.
According to the CDC, about 69 percent of people over the age of 65 have received a booster shot. Overall, fewer than half of eligible Americans of all ages have gotten a booster.
A recent CDC study of national nursing home vaccination data found that residents with an additional or booster dose of a COVID-19 vaccine had 47 percent greater protection against infection during the omicron variant’s prominence than those who had only received a primary series.
According to an AARP analysis of federal data, more than a million U.S. nursing home workers and more than 350,000 residents haven’t received a first coronavirus booster dose, even though they have been eligible since last fall.
There are also major geographic disparities. In Arizona, Florida and Nevada, first booster rates among residents are only around 55 percent, the AARP says.
“It’s kind of troubling. Given this is the highest-risk population, it’s exactly the population that should be getting boosted, yet they aren’t getting it, and I think the reason is we made it harder than it needed to be,” said David Grabowski, a professor of health policy at Harvard Medical School.
During the initial vaccine rollout, federal officials singled out nursing homes as a priority. They partnered with CVS and Walgreens to run vaccination clinics in facilities, which resulted in more than 8 million doses administered for residents and staff.
But with boosters, nursing homes have been responsible for scheduling vaccinations through their normal long-term care pharmacies.
“Whether you look specifically at long term care settings like nursing homes and assisted living or just out in that broader population of older adults, we’ve really failed here,” Grabowski said.
“We know boosters work. Let’s make certain we get this into as many arms as possible, especially among those who are at greatest risk,” he added.
To be sure, nursing home resident deaths have dropped considerably from the peak of the omicron wave in January. Much of that has been attributed to lasting protection of vaccines but also to new antiviral treatments available.
Grabowski said he doesn’t expect the administration to pivot its approach suddenly back to being more centralized, but he said a more targeted effort is needed.
“We’re not going to start over with a comprehensive vaccine partnership program for boosters. That’s probably not realistic, but I think it’s very realistic to think we can be very directed,” Grabowski said.
Experts have also attributed low booster uptake to messaging issues from the federal government, which now loom large as officials work to promote second booster shots for people age 50 and older.
Chaotic and at times disparate messages from administration health officials culminated in a complicated set of recommendations about who should be getting booster shots and why, which experts said helped depress enthusiasm.
The CDC initially decided against recommending broad authorization and instead recommended a booster shot for people over the age of 65 as well as anyone who was at “high risk” of exposure to the virus in the workplace.
The agency eventually decided to make everyone eligible, but by then, much of the damage had been done.