Serious COVID persists, kids' COVID jabs pulled?, endemic measles revived?
COVID and vaccine update (issue 222)
Serious COVID persists and still lots of flu sneezing Wastewater levels of SARS-CoV-2 remain low nationally for the 6th week and are below December levels when the winter surge started (analysis of CDC data). It’s also the 2nd week that all regions are low (Table 1). The national 3.4% positive rate in clinical testing and similar regional rates suggest COVID transmission is currently low. However, serious cases persist. Although the 0.7% of all causes of death (COD) is a 14-week low, it’s the 3rd week of more COVID than flu deaths with 3-week tolls of 799 and 521, respectively (from CDC data). From January, there have been 10,560 COVID deaths and 15,672 for flu.
Flu persists despite a 5th week of low virus levels in wastewater nationally (Table 1). The 10-week low of 5.6% positive testing is still higher than November’s when the season started. Some regions show even higher rates despite very low-low wastewater levels. This discrepancy is due to the change in the dominant virus from almost entirely flu A last fall to ~2/3 flu B in the last 3 weeks (from CDC data), which is not detected by the wastewater measurements of only type A. Nonetheless, flu deaths are at a low of 0.3% of all COD, but there have been 204 pediatric deaths this season.
There was no human bird flu reported.
Measles on pace to triple the previous high of 1274 cases in the 2019 New York outbreak. CDC’s confirmed tally of 884 cases as of Thursday are already 69% of the way in just 3 months to matching the total in 2019 and now cover more than half of the states (29) with IL, LA, MO, MT, and VA joining. There are 10 outbreaks in addition to the one in West Texas.
Almost all (97%) cases are unvaccinated, 68% involve children with 30% younger than 5, and 11% have been hospitalized with the largest group being 20% of those under 5. There have been 3 confirmed deaths.
Texas’ DSHS confirmed 675 cases throughout 34 counties with 67% children and 30% under 5. Almost all (96%) cases are unvaccinated and 10% have needed hospitalization.
Vaccines
• HHS aka Kennedy considering pulling COVID jabs for kids off the childhood vaccine schedule that CDC recommends (Politico). The schedule is not a mandate and only provides guidance for parents, pediatricians, and state and local governments. Removing the shots from the schedule could eliminate insurance coverage for parents who want to vaccinate their kids.
Kennedy has a long-standing beef with COVID vaccines for kids. In 2022, as head of Children’s Health Defense, he threatened to sue FDA if it authorized the mRNA vaccines for kids. He claimed there wasn’t enough evidence for the need, safety, and effectiveness of the vaccines in kids, accusing FDA “for recklessly endangering our children with products that have little, no, or even negative net efficacy but which may put them … at risk of many adverse health consequences.”
• Evidence for vaccination, especially of the younger kids During this last winter surge of COVID, the youngest kids needed hospitalization twice as much as younger adults and only less than the oldest adults. In a survey of 300 hospitals in 13 states covering ~10% of the US, the rates of hospitalizations per 100,000 population were (CDC):
• 0-4 years, 34.9
• 18-49 years, 17.4
• 50-64 years, 53.2
• 65+ years, 271.0
The younger the kids, the greater the need for hospital care, with the infants under 6 months, who are not eligible for vaccination, demonstrating the highest risk for serious symptoms.
• <6 months, 132.2
• 6-11 months, 65.8
• 1-<2 years, 40.1
• 2-4 years, 12.1
From October to March this year, children under 18 were 4.3% of COVID hospitalizations with the rate for those under 5 years being 5 times higher than for older kids (CDC).
• <5 years, 2.9%
• 5-11 years, 0.6%
• 12-17 years, 0.6%
In 2023-2024, 41% of kids in the ICU were otherwise healthy. Again, the youngest ineligible for the vaccines were at greatest risk with 56% of infants needing the ICU having no underlying conditions, a rate 1.9 times higher than for 2-to-4-year-olds and 9 times more than for 5-to-11-year-olds (CDC).
Children have the lowest vaccination rate of only ~13% (CDC). Almost all (>95%) eligible children hospitalized in 2023-2024 did not have the 2023-2024 vaccine.
COVID deaths this winter surge were higher with age from 5 to over 75 years old, increasing from 0.02 to 56.47 per 100,000 people (CDC). The notable exceptions were infants and toddlers at 0.21/100,000, 7 to 10 times higher than for older kids and adolescents and 1.9 times more than for young adults 18 to 29 years.
In addition, a recent study found that unvaccinated children had a risk for long COVID up to 20 times higher than the vaccinated with 1 dose of Pfizer (Penn Medicine reported in JAMA Pediatrics). The statistical analysis of 400,000 e-records showed the 60 to 95% protection was attributed to primarily preventing infection in the first place.
In 2021 with the Delta variant dominant, the vaccine was 95.4% (confidence interval: 90.9, 97.7%) effective against a diagnosis of long COVID 1 to 6 months after infection for children 12+ years. With Omicron in 2022, vaccine effectiveness was 60.2% (40.3, 73.5) for kids 5-11 years old and 75.1% (50.4, 87.5) for adolescents.
So there’s plenty of benefit to keep the COVID vaccines on the childhood vaccine schedule.
• Reviving endemic diseases eliminated by vaccines CDC’s Morbidity and Mortality Weekly Report published a summary of the US measles outbreak on Thursday and urged greater MMR coverage to prevent further spread.
With the current concern for efforts to pull back from the childhood vaccine schedule that prevents many diseases from gaining a foothold during and after childhood, a timely study by Stanford Medicine published on Thursday in JAMA modeled the effect of declining vaccination rates on the return of diseases that can be imported from areas abroad where they are still endemic.
The current vaccine coverage for measles, which falls below 95% in some locations, could allow it to become endemic again in 21 years, causing over 851,000 cases (confidence interval, 381,000 to 1.3 million) over 25 years. Other less contagious diseases covered by the childhood vaccines are not likely to reemerge with current vaccination levels.
A 10% drop could lead to 11 million (10 M, 12 M) measles cases over 25 years.
A 50% drop could quickly reestablish measles in 4.9 (4.3, 5.6) years and cause 51 million (50 M, 53 M) cases over 25 years. Such a large abandonment including other vaccines could cause 10 million (9.9 M, 11M) hospitalizations for complications and 159,000 (151 k, 165 k) deaths.
On the other arm, a 5% increase in MMR coverage could result in only 5800 (3100, 19 k) cases over 25 years. Pick a future.
© 2025 Henry A. Choy. All rights reserved.