Public Health

Mira Irons, MD, on vaccination efforts and Novavax details [Podcast]

. 8 MIN READ

AMA Update

Dr. Mira Irons shares insights on continuing vaccination efforts and Novavax details

Jun 16, 2021

In today’s COVID-19 Update, AMA's Chief Health and Science Officer Mira Irons, MD, reviews COVID-19 vaccine numbers and trending topics related to the pandemic over the past week. Dr. Irons also discusses the 600,000 deaths due to the pandemic, Novavax details, the Delta variant and the June 2021 Special Meeting of the AMA House of Delegates.

Explore news and other key moments from the June 2021 Special Meeting.

Learn more at the AMA COVID-19 resource center.

Speaker

  • Mira Irons, MD, chief health and science officer, AMA

AMA COVID-19 Daily Video Update

AMA’s video collection features experts and physician leaders discussing the latest on the pandemic.

Unger: Hello, this is the American Medical Association's COVID-19 Update. Today, we have our weekly look at the numbers, trends and latest news about COVID-19 with AMA's Chief Health and Science Officer Dr. Mira Irons, in Chicago. I'm Todd Unger, AMA's chief experience officer, also in Chicago.

Dr. Irons, we haven't had a talk about milestones in a while, but it looks like we're about to approach another significant one.

Dr. Irons: Yeah, Todd, we are. We are reaching 600,000 deaths from COVID in the United States this week. This milestone serves as a reminder that, even as the number of Americans dying of COVID has dropped from thousands to hundreds each day, the death toll keeps climbing. It's taken about as long to move from 500,000 U.S. deaths to 600,000 as it did to go from zero to the first 100,000 deaths, about four months. Now, it's a huge improvement over the one month it took for the death count to go from 300 to 400,000 just last winter. Looking at the big picture, it's still good news with fewer deaths being reported each day than at any point since March 2020, when the pandemic was first declared.

Unger: Well, that is good that that kind of rate has slowed so dramatically but, obviously, vaccinations are likely key to the trend that we've been seeing. What's that connection that you're seeing between vaccination rates and death rates?

Dr. Irons: Oh, absolutely, they are. COVID deaths are becoming relatively rare in some places that are basically tracking with the pace of vaccinations which, as we talked about last week, varies enormously from state to state. Just to give you some idea of the variance, Vermont recently became the first state to partially vaccinate 80% of its residents 12 or older. It's now lifting all remaining state pandemic restrictions. But Vermont has been very successful at handling the pandemic throughout the last 15 months. A New York Times database shows that it has reported fewer cases and fewer deaths relative to its population than any state but Hawaii.

In addition to Vermont, Hawaii and Massachusetts have given at least one dose to more than 80% of their adult populations. On the other hand, however, Mississippi has the lowest vaccination rate with just 44% of its adult population receiving one dose, so quite a big swing.

Unger: I was talking to another physician last week on our COVID updates and he was mentioning you're still seeing folk come into hospitals that haven't been vaccinated and just what a tragedy it is to see a death that could have been prevented. Can you talk to us a little bit about vaccinations and the progress that we're making this week?

Dr. Irons: Sure. On Monday, the CDC said about 174.2 million people have received at least one dose of a COVID-19 vaccine, including about 144.9 million people who are fully vaccinated. Now, if you look at percentage wise, all comers, all ages, that means 52.5% of all Americans have received at least one dose and 43.7% are fully vaccinated. About 65% of people 18 and older have received at least one shot, and this is the number that President Biden is looking at to reach 70% by July 4. However, administration numbers are less than what they have been. Providers are administering about 1.11 million doses per day on average, and that's about a 67% decrease from a peak of over 3 million reported on April 13.

Unger: Gosh, we're so close to hitting that goal. Come on, America, we're closing in on 70%. Dr. Irons, additional news on the vaccine front. We have a potential fourth option. The results were announced of its clinical trials this week. Can you tell us more about this new option?

Dr. Irons: Absolutely. We've been waiting for this. Novavax looks like it could be a fourth, strong COVID vaccine option. The company revealed the results of its trials on Monday, and it stated that its two-shot regimen was 90% effective at preventing people from falling ill in a 30,000 person trial conducted when variants had begun to circulate in the United States and Mexico. Vaccinated people were completely protected against severe and even moderate cases of illness, and there were no cases of hospitalization or death among people who received the vaccine. The shots also may be the most tolerable yet tested. Side effects included fatigue, headaches and muscle pain, but reactions tended to be less frequent than those triggered by some already authorized vaccines.

Unger: Do we expect them to then follow suit with, say, Pfizer and submit for FDA authorization soon?

Dr. Irons: Yes, but it's unclear when. At this point, our country is not short on supply with the other authorized vaccine. While the vaccine was one of the six the U.S. bet on early, it might likely have its biggest impact globally. The company said that it may not seek emergency authorization from the FDA until later in the summer or maybe into September. But, in the meantime, the company is applying for authorization in Britain, the European Union, India and South Korea, from what we hear. It's likely that by the time Novavax gets the green light from the U.S., it may be too late to contribute to the country's first wave of vaccinations. But many vaccine experts expect that, with waning immunity and emerging variants, we may need booster shots at some point. And the protein based technology used in Novavax may do a particularly good job at amplifying protection, even if people previously had been vaccinated with a different formulation. This is all speculation. We'll hear more about boosters and other things in the future, but this is good news.

Unger: We talked about, earlier in our discussion, about the milestone 600,000 COVID deaths. Can you give us kind of a complete picture on where we stand now in terms of cases and the death rates that we're seeing across the country?

Dr. Irons: Yes. The current numbers today, 33,475,305 cases and 599,960 deaths, just shy of the 600,000 figure. The brief version, the situation continues to look reassuring for anybody who's vaccinated, and if I can boldface and highlight those words, those are the important words but has become more worrisome for anybody who's not, largely because of the Delta variant. The vaccines continue to work well against every variant, but the U.S. still faces two problems. The first, a substantial share of Americans, close to one-third, remain hesitant for a variety of reasons about getting vaccinated. And those unvaccinated Americans will remain vulnerable to COVID outbreaks and to serious symptoms or even death. Second, the Delta variant is spreading rapidly within the U.S., after having first been identified in India, and now accounts for about 10% of cases.

Unger: This Delta variant, these new Greek letters, they seem to be scarier to me than just the numbered ones, but this is serious. Can you talk to us more about the Delta variant and what we can expect to see here in the States?

Dr. Irons: We know that it appears to be both more contagious and more severe than earlier versions of the virus. We're seeing patients becoming sicker and their conditions are worsening much more quickly. That's why many experts are concerned that cases will eventually start to rise as Delta becomes the dominant form of the virus. But again, the one very big piece of encouraging news, the vaccines continue to work extremely well against the variants based on evidence we have so far.

The best performing vaccines vastly reduce the number of COVID cases of any kind and virtually eliminate death. The clearest place to see this pattern is Britain where the Delta variant has spread widely and where the vaccination rate is high. In Britain, there is still no sign of an increase in deaths well after the strain has become dominant. The message is clear, get vaccinated.

Unger: Well, in addition to that message, which is really the most important, any other key messages from the AMA this week?

Dr. Irons: Yes, the AMA has issued numerous press releases and statements as a result of its June 2021 Special Meeting of the AMA House of Delegates, which is wrapping up today. We've captured all of that news in one place, and it can be accessed either through the AMA website or by clicking on the link in this episode's YouTube description.

Unger: Well, thank you so much, Dr. Irons. That's it for today's COVID-19 Update. As usual, you can find more information on COVID-19 in our resource center, ama-assn.org/COVID-19. We'll be back soon with another COVID-19 Update. Thank you for joining us today. 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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