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What gets you more 'bang for the buck,' COVID-19 booster shots or vaccination campaigns?

Noah Stapp receives a COVID-19 vaccination at a clinic at Weber State University in Ogden on Aug.
10. The fight against COVID-19 needs to stay focused on getting more vaccinated, not supplying booster shots, University of Utah Health experts said Wednesday.

Noah Stapp receives a COVID-19 vaccination at a clinic at Weber State University in Ogden on Aug. 10. The fight against COVID-19 needs to stay focused on getting more vaccinated, not supplying booster shots, University of Utah Health experts said Wednesday. (Scott G Winterton, Deseret News)



Estimated read time: 6-7 minutes

SALT LAKE CITY — The fight against COVID-19 needs to stay focused on getting more Utahns vaccinated against the deadly virus, not shift to supplying additional doses to those who've already gotten the shots, a pair of University of Utah Health experts said Wednesday.

"The bang for the buck is much higher in reaching people who have not been vaccinated at all," Stephen Goldstein, an evolutionary virologist and postdoctoral researcher at the university, told reporters during a virtual news conference, adding, "It would be a real shame if we prioritize these boosters and take our foot off the gas."

Both Goldstein and Dr. Emily Spivak, a professor of medicine in the health care system's Division of Infectious Diseases, warned that unless Utah's COVID-19 vaccination rate increases, the current surge sparked by the highly contagious delta variant is likely just a start.

"Between maybe now and the December holidays, I have to admit I'm not very optimistic. I think cases are going to continue to rise and rise and rise unless there is some big, drastic change in the uptake of vaccine," Spivak said, suggesting that's not likely to change without large-scale vaccine mandates by employers.

Goldstein had this advice for employers: "If you're thinking about putting a vaccine mandate in place for your employees, the time is now." He warned that the delta variant is likely to infect many more Utahns in the coming months, especially with schools reopening.

Vaccines, now available to anyone 12 and older, offer a choice "about whether that happens to you, or if it does happen, how serious your disease is going to be," Goldstein said.

Monday's decision by the federal Food and Drug Administration to grant full approval for the Pfizer vaccine, one of three COVID-19 vaccines available in the United States, is already spurring new mandates around the country, and vaccinations are now required for members of the military.

In Utah, the full approval largely ends a state ban on government vaccine mandates passed by the Legislature last March. But Gov. Spencer Cox has opposed vaccine mandates, including requirements in New York City and other places that proof of vaccination must be shown to eat in restaurants or participate in other activities.

Cases continue to climb in Utah, with 1,585 new COVID-19 cases, including 374 in school-aged children, and a dozen additional deaths from the virus reported Wednesday by the Utah Department of Health. Less than half of all Utahns, 48.6%, are fully vaccinated, meaning it's been two weeks or more since their final dose.

According to the state health department, the risk of testing positive for COVID-19 is nearly five times greater for Utahns who are not vaccinated while their risk of hospitalization is 6.5 times greater, and their risk of dying, five times greater, based on data from the past 28 days.

"The biggest concern now is the large fraction of the population in Utah that remains completely unvaccinated," Goldstein said, although he and Spivak stressed that an extra dose of vaccine is needed for those who are immunocompromised and account for about half of the state's breakthrough cases requiring hospitalization.

Utah has reported less than 9,000 breakthrough cases of COVID-19 in the fully vaccinated that resulted in 510 hospitalizations and 45 deaths. Since the start of the pandemic in March 2020, Utah has seen more than 457,000 cases, nearly 20,000 hospitalizations and 2,605 deaths from the virus.

While Goldstein said there's no downside to the booster shots for the fully vaccinated as recently announced by the Biden administration, the key to slowing COVID-19's spread is convincing those who haven't gotten the shots to roll up their sleeves.

"Whether that's encouraging people who are hesitant for whatever reason or getting the vaccine to people who still have access issues, I think that needs to be the real priority of our public health efforts at the state and county level. And I hope that that's what we'll continue to see."

Spivak said although there are studies showing the effectiveness of the vaccines decline over time, that could be attributed to other factors such as mask mandates ending, along with limits on gathering and other precautions. She said there is still "clear evidence" that the vaccines continue to protect against severe illness.

"There's global concern about thinking about giving boosters. Is that distracting," Spivak said, from "what our really primary initiative is, which in my mind should be getting people first vaccinated who are unvaccinated. Because we would not be in the situation we are today if we had a much higher vaccination rate."

Johnson & Johnson, the maker of the only single-dose vaccine used in the United States, said Wednesday data is being submitted to the FDA showing a second booster shot dramatically raises the levels of antibodies produced against COVID-19, similar to studies already under review from Pfizer and Moderna.

The FDA has authorized booster shots for those with compromised immune systems due to organ transplants or other medical issues, but has not yet signed off on President Joe Biden's plan to offer booster shots to everyone eight months after their final dose.

Utah's latest COVID-19 numbers

In addition to reporting 1,585 new coronavirus cases and 12 more deaths from the virus since Tuesday, the state health department said there have been 3,212,528 total vaccine doses administered in Utah, a daily increase of 10,904.

The rolling seven-day average for positive tests is 1,122 per day, and 10,411 people were tested with 17,759 tests conducted since Tuesday. That puts the rolling seven-day average for percent positivity of tests at 10.7% when all results are included, and 15.1% when multiple tests by an individual are excluded.

Currently, there are 471 people hospitalized in Utah with COVID-19, The state's death toll is at 2,605 with the 12 additional deaths, including one that occurred before Aug. 1. The deaths reported Wednesday are:

  • A Davis County man, older than 85, hospitalized at time of death.
  • A Utah County man, between 45 and 64, hospitalized at time of death.
  • A Davis County man, between 65 and 84, hospitalized at time of death.
  • A Salt Lake County man, between 45 and 64, hospitalized at time of death.
  • A Salt Lake County man, between 45 and 64, hospitalized at time of death.
  • A Millard County man, between 25 and 44, hospitalized at time of death.
  • A Davis County woman, between 45 and 64, hospitalized at time of death.
  • A Salt Lake County woman, between 25 and 44, hospitalized at time of death.
  • A Millard County woman, between 65 and 84, hospitalized at time of death.
  • A Utah County man, between 65 and 84, hospitalized at time of death.
  • A Juab County man, between 25 and 44, hospitalized at time of death.
  • A Salt Lake County man, older than 85, long-term care facility resident.

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Lisa Riley Roche

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