Ahead of the winter holidays, Vermont is expanding the hours at its state-run walk-in vaccine clinics. It comes as health officials in the state and throughout the Northeast are monitoring several respiratory illnesses: COVID-19, the flu and RSV.
WAMC's Jim Levulis spoke with Vermont Health Commissioner Dr. Mark Levine about the reasoning behind the expansion and the status of those diseases in the Green Mountain State.
Levine: The reason for expanding the hours is really to make sure that all Vermonters have access to getting vaccinated. Probably not the item that's at the top of their list of to do things during the holiday season. But one that we really want to move to the top of that list. You know, we've done a pretty good job in Vermont with the COVID-19 bivalent booster, the rate we have in Vermont is twice that of the nation. And with the flu vaccine, we are a little behind our experience from the last two seasons. And the flu season is coming a little earlier this year. So what we'd like to do is just make sure that if people are having trouble accessing the vaccine, perhaps they've made an appointment, but it's a few weeks off or what have you. We want to make sure that at this time, which is a couple of weeks ahead of the holiday season, that everybody is being able to get vaccinated. The COVID vaccine basically will work fairly quickly, because people who get it have already had the previous series. But the flu vaccine does take a week or two to really rave up in the immune system. So we want to make sure people can get it early enough so that both they and their loved ones can be protected during a time when we know there's going to be a lot of holiday gatherings.
Levulis: And so if I want to walk into one of these state-run walk-in vaccine clinics and get both shots, the newest COVID-19 booster and the flu shot, I can do that.
Levine: You can do that. If you're over 65, you may need to get the flu shot at your primary care office or at a pharmacy. Because that would require the special super potent one for that age group. But anybody younger than that can get both shots at the same time.
Levulis: You mentioned the COVID-19 booster vaccine rate in Vermont is higher than the national average. New York's health commissioner says just 13% of adults in the state in New York have gotten the latest COVID-19 booster. What exactly is the rate in Vermont? And why do you think you're seeing relative success?
Levine: Yeah, so the rate in the nation is actually around 13% as well. So New York is mirroring that. Vermont is about 28% now. In previous times talking about vaccine, I don't think we brag about 28%. But at this time, it is a nation-leading kind of statistic. And I think again, you know Vermonters have always been very good with regard to the vaccine. And the fact of the matter is, they are always leading the nation. This time around, I think everyone is suffering from pandemic fatigue, booster fatigue, you name it. And they're looking at the virus in a way that it doesn't seem as serious as it may have when it first came out and we had no vaccines. But I would like to emphasize that the higher risk groups remain higher risk. Whether you have significant underlying medical conditions or whether you're older than 65, that puts you in a high risk group. And we still need to respect the virus for that group and try have those individuals be as protected from serious outcomes as possible. And getting vaccinated of course, is one way to do that.
Levulis: We're speaking here on the morning of December 9 and the FDA just approved the updated COVID-19 vaccine booster for children under five. The CDC expected to follow suit. Do you think that overall federal approval, approving it for the youngest Americans, will lead to a rise in overall vaccine uptake?
Levine: The optimist in me would love to say yes, but the realist in me, you have to realize that at this point in time, that youngest age group does not enjoy a very high vaccination rate. Anyways, parents have been much more reluctant to rush their kids in like they may have done with their older children or themselves earlier in the vaccine experience. So right now, unfortunately, even though this new booster, the bivalent, has been approved for those younger kids, that fact is many of them haven't gotten the original vaccine yet, so they won't even qualify for it. So we're not going to see tremendous impact of this announcement right now.
Levulis: Earlier we were speaking about the flu vaccine. How concerned are you about the flu this winter in Vermont?
Levine: Oh, very concerned. We are seeing it being earlier in our region, and in the country as a whole. Again, probably a manifestation of people having been masked and distanced and everything else in previous seasons, and not in this season. Doesn't mean it's a more severe flu. But obviously, the more people who get it, there will be more people hospitalized. And unfortunately for older adults, more people dying, just because it will be so prevalent.
We're waiting today to hear from the CDC, what the status of Vermont is, we've been at a fairly low level of transmission of flu up to now. But just from what I'm hearing from my clinical colleagues, and looking at the percentage of test positivity for influenza, it's looking like we're gonna move up from that low status, maybe to a more moderate status. So this is again, the time to get that flu shot ahead of what it may become a much higher prevalence of flu in our state.
Levulis: What about another respiratory illness, RSV?
Levine: RSV has been at pretty much epidemic levels across the nation, and certainly even in Vermont and New England for a while now. We're hoping we're kind of at the peak of that experience, and it's starting to come down. We certainly know that southern New England, though still very stressed in terms of their hospitals, and especially the pediatric portions of their hospitals, has noted that things have stabilized, still stressed but stabilized, no longer needing to call out of state to see if other hospitals can take their patients. We've been doing well in Vermont, we're holding our own. We were thinking we may be achieving a new peak in the next week or two. But things haven't really sped up in that way. So maybe we are also going to find that we're sort of plateaued and coming down. But the RSV virus, just for your listeners is very significant for the very youngest and the very oldest of us. And so the very youngest is where the stresses on the hospital system have been coming from. The very oldest, especially those with underlying lung or heart disease are also quite susceptible. The rest of us in between might get a cold from this virus.
Levulis: Earlier we were speaking about the walk-in vaccine clinics, how long do you expect the state to continue running those vaccine clinics?
Levine: They're certainly going to be going through this month and next month. And we'll be reevaluating after the New Year. When we look at the uptake of vaccine right now, we see that primary care as is traditional, it's now assuming a bigger role in terms of the number of vaccines delivered at those sites. And that's just the way it should be part of the healthcare system. Pharmacies have been continuing to hold their own and providing abundant vaccines. And our state-run sites have shown a slight downtick and people frequently in them. So we're kind of watch that carefully. Because obviously, if there's more of an audience than other settings, we want to continue to support those settings with vaccine. And we may not have to have the state-run settings that much longer than early into the New Year. So we'll be watching the data very carefully.
Levulis: And finally Commissioner Levine, leaders throughout upstate New York have been raising concerns about severe staffing shortages in hospitals. Is Vermont seeing the same thing?
Levine: I would have to say that we've been seeing that for a long time now. And the thing that's improved is when COVID was the cause of the staffing shortages, there was a lot of absenteeism. And of course with COVID, you have a prolonged isolation period. When people are absent for some of the other respiratory viruses, they don't need to have the same amount of time, so it impacts the total workforce in a little less severe manner. But clearly, we've been most concerned recently about pediatric nurses and pediatric respiratory therapists, because of the RSV problem with our very youngest kids, and we've been able to obtain additional resources in those areas to help, especially our critical access hospitals. And UVM has been obtaining some of those resources as well for the academic medical center. So we've been, you know, pretty consistently for several years facing workforce issues in our healthcare workforce. And I don't want to allude to the fact that they're that much different now. But they're certainly remain significant, but not I would say critical.
Levulis: And one of the issues hospital leaders here in upstate New York have been discussing is really the impact to their budgets, being that they've had to fill some of these staffing shortages with travel nurses being paid at a higher rate than the standard nurse. Are you seeing the same thing in the Green Mountain State?
Levine: We are still seeing the same thing. And some of those resources I just mentioned, are the travel nurse category, so they do come at a higher price.
