Call to Action: Increasing COVID-19 Vaccination is Key to Preventing COVID-19 Outbreaks with Current and Emergent Variants

COVID-19 cases in Idaho have increased 70% since July 1, 2021. In Central District Health’s (CDH) counties, COVID-19 cases increased over 158% from June to July 2021. Nationally, cases have increased over 300% from June 19 to July 23, 2021. Increases in cases, hospitalizations, and deaths are driven by the highly transmissible B.1.617.2 (Delta) variant combined with relatively low vaccination rates.

Increasing COVID-19 vaccination across Idaho is urgently needed to prevent surges in new infections that could increase COVID-19 related morbidity and mortality, overwhelm healthcare capacity, and widen existing COVID-19-related health disparities.

Unvaccinated people account for the majority of new COVID-19 infections, hospitalizations, and deaths. Currently circulating SARS-CoV-2 variants of concern, especially the highly infectious Delta variant (B.1.617.2), are accelerating spread of infection. Unvaccinated and partially vaccinated people need to practice all recommended prevention measures until fully vaccinated. In areas with substantial and high transmission, including many counties in Idaho, and currently all of CDH’s counties, CDC now recommends that fully vaccinated individuals wear a mask in public indoor settings to help prevent the spread of Delta and protect others.

As of July 27, 2021, 32 of Idaho’s 44 counties (73%) have low vaccination coverage, defined here as <40% of the population being fully vaccinated. See Idaho data at this link (select “Vaccine Uptake: Idaho IIS”). CDH’s counties vary from a low in Boise County of 29%, followed by Elmore County with 34% and Ada and Valley Counties with 60% of eligible residents fully vaccinated. https://public.tableau.com/app/profile/idaho.division.of.public.health/viz/COVID 19VaccineDataDashboard/LandingPage

Most cases of COVID-19 and hospitalizations are in unvaccinated individuals: While COVID-19 vaccines authorized in the United States remain effective against SARS-CoV-2 infection and severe disease, some infections among vaccinated persons (i.e., breakthrough infections) are anticipated and have been reported. However, the majority of COVID-19 cases and hospitalizations are occurring among
individuals who are not fully vaccinated.

Among recent Idaho cases, 95.5% are not fully vaccinated. Nearly the same proportion of people who are hospitalized (94.7%) or have died (94.2%) because of COVID-19 are not fully vaccinated.

The COVID-19 Delta variant is widely prevalent and more infectious than prio strains: The COVID-19 Delta variant currently accounts for more than 80% of all COVID-19 cases in the United States. This variant is significantly more infectious than prior SARS-CoV-2 variants and has led to a rapid rise in COVID-19 cases in other countries, including the United Kingdom and Israel. Emerging evidence suggests that fully vaccinated people who do become infected with the Delta variant are at risk for transmitting it to others.

COVID-19 vaccination is our most effective strategy to prevent infection and severe disease: Vaccination is a priority to interrupt SARS-CoV-2 transmission, protect personal and public health, and preserve healthcare system capacity. COVID-19 vaccines are safe and recommended for all persons aged 12 years of age and older, even for those with prior SARS-CoV-2 infection. Immunologic data support the role of Food and Drug Administration (FDA)-authorized COVID-19 vaccines in offering protection against the known currently circulating variants. By limiting viral spread, vaccination also minimizes opportunities for the introduction of more infectious variants through random mutation. Mutations could produce future variants that are more virulent and capable of evading diagnostic and therapeutic tools or overcoming vaccine-induced immunity.

Call to Action: Recommendations for Clinicians

• If you are a clinical provider and you or your staff are not fully vaccinated, ensure yourself and your team are vaccinated as soon as possible to protect yourself, your family, and your patients.
• Increase patient outreach efforts to encourage, recommend, and offer COVID-19 vaccination.
  • If you do not offer vaccine, assist them in locating nearby vaccine, such as directing patients to https://www.vaccines.gov/search
• Remind patients that vaccination is recommended for all persons aged 12 years of age and older, even for those with prior SARS-CoV-2 infection. Follow trusted sources carefully for any new recommendations and changes in vaccine guidance.
• Support efforts to ensure people receiving a first dose of a COVID-19 mRNA vaccine (i.e., Pfizer-BioNTech or Moderna) return for their second dose to complete the series.
• Communicate with unvaccinated staff, patients, and other individuals to increase confidence in vaccination. CDC has many resources for providers to help increase vaccine confidence.
• Recommend that fully vaccinated patients who are immunocompromised continue to practice all recommended prevention measures for unvaccinated persons.
• Continue to test for COVID-19 including for those fully vaccinated if symptomatic and/or following an exposure to COVID-19.

Call to Action: Recommendations for Healthcare Facilities and Systems, Nursing Homes, and Businesses

• Recommend and offer COVID-19 vaccine to your staff and employees and establish policies to encourage uptake such as time off to receive the vaccine.
• Consider offering COVID-19 vaccine at your workplace (Workplace COVID-19 Vaccine Toolkit).
• Evaluate whether your facility can implement vaccine requirements or vaccine incentives.

For More Information

• CDC Weekly Morbidity and Mortality Weekly Report (MMWR) Guidance for Implementing COVID-19 Prevention Strategies in the Context of Varying Community Transmission Levels and Vaccination Coverage
• Interim Public Health Recommendations for Fully Vaccinated People