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N.H. epidemiologists: Keep our COVID restrictions and prevention strategies in place

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New Hampshire’s top infectious disease specialists are urging the public not to give up on COVID-19 mitigation.

Children ages 5 to 11 are now eligible for the COVID-19 vaccine. State epidemiologists Dr. Ben Chan and Dr. Elizabeth Talbot joined NHPR’s Rick Ganley on Morning Edition to answer listener questions about the state’s rollout of the vaccine for this age group. Below is a transcript of their conversation.

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  • Community transmission, COVID cases, hospitalizations and deaths are still high in New Hampshire.
  • Dr. Chan and Dr. Talbot says we shouldn’t give up COVID restrictions and prevention strategies. This includes getting vaccinated, wearing masks indoors, social distancing, washing hands, etc.
  • Dr. Chan says there’s no planned updates to the state’s school guidance in the immediate future. He says just last week there were more than 25 clusters or outbreaks in schools, and the state needs more time for young children to get vaccinated.
  • Dr. Talbot says studies have shown that younger children are reporting less short term side effects from the COVID vaccine when compared to adolescents and adults. Those short term side effects include fatigue, muscle pain, headaches and chills.

Rick Ganley: The vaccine has been available for young children in this age group for just a few days now. Dr. Talbot, how is the rollout going so far? Are people able to get appointments?

Dr. Elizabeth Talbot: As far as I'm aware. I've been so impressed by the providers who are stepping up to this. So there are many providers across the state who are ready to engage in this next step, hopefully the last step, of this battle against the COVID-19 pandemic. So we're aware that private providers, your usual health care providers, are stepping up to it, our commercial pharmacies, and then school associated clinics are happening as well.

Rick Ganley: Are we seeing enough supply?

Dr. Elizabeth Talbot: Yes, we are. It's coming to us from the federal government for free administration, and it's coming in sort of proportional aliquots for each of the states. So indeed, this vaccine is coming to us and the supplies that are going to meet our needs over the next weeks and months.

Rick Ganley: Dr. Chan, is the state updating its COVID guidance for schools based on the availability of the vaccine now for most school-aged children?

Dr. Benjamin Chan: So we continue to meet with our school partners twice a month. And this is going to be one of those topics of conversation that we will continue to address with them as the vaccine rollout progresses. But there are no planned updates to our guidance in the immediate future. Partly, because the vaccine just became available, right? We need to give children some time to be vaccinated.

And we will continually readdress this with the schools based on how vaccine rollout is going, based on the levels of COVID in communities, what we're seeing in terms of clusters and outbreaks in schools. I mean, just last week we saw, you know, more than 25 clusters or outbreaks in school again. And so there's still high risk for schools and transmission within schools. And so now is not the right time for schools to be letting their guard down. But now is the right time for children and for schools to help us in pushing out the vaccine and getting children vaccinated.

Rick Ganley: Are there certain metrics that you're looking at or certain intervals of time that you could be reassessing that data?

Dr. Benjamin Chan: Yeah, I think it's a really good question, and this is a question that's being discussed more and more, even on a national level. And I think there are multiple data points that we're looking at. One, is the level of vaccination and our ability to roll out vaccines to children, school-aged children. You know, we continue to look at the COVID numbers, though, look at the levels of community transmission in New Hampshire. And regionally, we're looking at outbreaks and clusters, and then certainly we're paying attention to what's happening with hospitalizations and deaths. And when you look at all those numbers in New Hampshire, our numbers continue to go up. The incidence is going up. The test positivity is going up. Hospitalizations, you know, remain above 200 people hospitalized each day in New Hampshire. Deaths remain high. And so now it's not the right time to be relaxing restrictions or prevention strategies in schools. But that time will come, and we've always said that our ability to relax restrictions is going to be tied to vaccines being available, but not just vaccines being available, children actually getting vaccinated.

Rick Ganley: Dr. Talbot, what advice would you give to parents who are nervous about getting their young children vaccinated? You know, there's lots of misinformation out there on safety. And you know, we've heard from some parents who say that their kids already got COVID and they have immunity. So they're less eager to immediately get that vaccine. What's your response to that?

Dr. Elizabeth Talbot: I recognize that everyone wants to do what's right for their children. I'm a parent too. So I think knowing the facts will be incredibly reassuring for every parent who's hesitant right now. One of the more common things that I hear is, 'weren't these vaccines rushed?' And clearly not. This technology has been under investigation for decades, and it's only the sense of urgency with this pandemic that's led us to this great place we're in now with the availability of vaccine.

So with regards to a predictable, expected side effects, sure, they exist. You already know that from other vaccines your children get. And with regards to this vaccine, studying thousands of kids is showing us that the short term side effects your child might feel are even less than have been reported for older adolescents and adults who have received these vaccines. So the typical things, fatigue, headache, muscle pain, some chills, joint pain, but these are short-term in balance with an incredible long-term benefit.

Rick Ganley: Do you think the COVID vaccine is just as important as other vaccines that most kids get, you know, shots like Hep B or measles?

Dr. Elizabeth Talbot: I hadn't thought of that, but I'm going to go out on a limb here and say more important right now for this moment in our society, in our planet. You know that this pandemic is the worst we've seen in more than a hundred years, of course. And we all want to get back to the semblance of normal life. We want to drive this virus into an endemic state. Just make it a common occasional virus, maybe seasonal, et cetera. And we're so far from that right now, as Dr. Chan described in the numbers, that we really need to take the trajectory of this pandemic into our hands by accessing vaccine.

Rick Ganley: Do you hear a disconnect, though, from some parents who give push back and say, I don't want to get this this vaccine, but they've had other vaccines for their children? as

Dr. Elizabeth Talbot: I get it. You know that this is a relatively new vaccine for a new disease and as said, I do believe that everybody has their children's best interests in mind. It's a matter to, I think, understand that we are in an absolute best case scenario with regards to these vaccines. This was not sure that they would be this safe and this effective. And frankly, we could be at a turning point in our battle with COVID-19.

Rick Ganley: I know schools and parents will want to have access to vaccination data for younger age groups when making these decisions. DHHS Commissioner Lori Shibinette has stated publicly that the state's vaccination data has been inaccurate since the state of emergency ended back in June, and the CDC's data is now becoming more unreliable. So, Dr. Chan, how is the state making sure that schools and the public in general are, you know, properly informed?

Dr. Benjamin Chan: Yeah, it's an important limitation in our data and in CDC's data. We've always said that we are using data to help inform decisions that we make, you know, guidance recommendations that we make. And so it's a problem not having access to accurate vaccination data. I will say that we're looking at ways that we can try and make our data in our immunization information system more accurate more rapidly. I think that that's the ideal case, the ideal situation.

We want to be able to have access to real accurate vaccination data. And unfortunately, this is one of the consequences, I think, of not having a fully functioning immunization information system or immunization registry at the start of the pandemic is that we're trying to work through these difficulties as we respond to a pandemic. So we recognize it's an important limitation for us, for community partners, for our schools. And I think we're going to be trying to make rapid steps to improve that data over the coming weeks.

Rick Ganley: But how do you improve that data? I mean, schools can't collect accurate data on their COVID vaccination rate unless these vaccines were required. Isn't that right?

Dr. Benjamin Chan: So, you know, there are some legal complexities there, perhaps, that I'm not the best person to weigh in on about whether schools can collect vaccination data or not. I think in the ideal situation, this problem would be solved by trying to make our immunization registry, our immunization information system, accurate and up to date. That's important not only for us to be looking at data and for schools to have better access to data, if not in their schools, than in their surrounding communities, but also, frankly, for health care providers to be able to know if their patients have been vaccinated and with what vaccines so that they can more effectively deliver care. So the way to improve that is to make sure our immunization registry is accurate, and that involves getting that data on vaccine administrations primarily from commercial pharmacies, which is the reporting problem that has caused this.

Rick Ganley: There are many listeners who have messaged us saying that they are relying on vaccination data to know whether it's safe to go out, you know, meet up with friends and family once again. Dr. Talbot, what does the state's vaccination rate actually tell us? And is it a good way for people to measure how safe it is to do things they would normally do?

Dr. Elizabeth Talbot: Well, I don't think that we're at a stage of the infamous herd immunity where you can decide whether to adopt the usual mitigation strategies. You know, I think that we're not fighting blind here. Even if there's limitations in the data, we still know that masking indoors in settings of high transmission, such as in New Hampshire, maintaining optimal social distancing -- don't come to school or work sick. Don't allow folks who are sick to come to public places. Wash your hands.

All those things are operative and will be operative for a long time as we try to capture the next 28 million people in this age group 5 to 11-year-olds in the coming weeks. We know that this Delta variant is a wily one where even if you're vaccinated, it's possible to get usually a mild form or even an asymptomatic form of it and provide ongoing transmission. So yes, this is our goal is to get everyone vaccinated, but we're not right now at that stage where I think that the numbers suggest we can relax our mitigation strategies.

Rick Ganley: Well, we've heard the number, I know, in the past of 70 or 72 percent I think I've heard before of starting to reach that herd immunity. Is that still a number you feel is sufficient?

Dr. Elizabeth Talbot: I don't think so. I've given up looking at that kind of exacting number. There are lots of models out there, but we are looking for as high as possible, you know. Because this virus can transmit, even when a person has been vaccinated, we're looking for more than that. You know, we are just doing the best we can to have people get their questions answered and bring them into vaccination, and ultimately transition this virus into an endemic state, one that we can live with.

Rick Ganley: Well, now that the vaccine is available for almost every age group. How does this change where we're headed with the pandemic? I know, Gov. Sununu has said many times in press conferences and in interviews that the state should prepare for a difficult winter surge, when COVID case numbers have been on a downward trend nationally, but not here in New Hampshire. You know, how does that possible winter surge look right now?

Dr. Benjamin Chan: Yeah, so, you know, I think we hesitate to predict the course of this pandemic. Because as we saw over the summer and into the fall, there's always surprises and challenges that have been presented to us over the course of this pandemic. So, you know, I think that the risk of us going into another surge or the numbers to continue to go up in New Hampshire certainly is there. We're seeing the numbers continue to go up in New Hampshire. We're not sure how high they're going to go.

But if you look at other areas of the country, the downward trend across the country has slowed or stopped. It's plateaued. And if you look at other areas across the globe, there are other countries that are seeing increases again in COVID-19, particularly in Europe. So, you know, the risk is there and especially as people move indoors, they're in closer, confined spaces together. The risk of transmitting COVID and other respiratory viruses like flu are there, and I think it highlights the need for people to get vaccinated. We believe vaccination is safe. We believe it's effective even for children. But while we're working to get more and more people vaccinated and with levels of COVID still high in New Hampshire, it's still important for people to take precautions and the necessary steps to prevent spread of COVID 19.

Rick Ganley: What's your answer to that, Dr. Talbot?

Dr. Elizabeth Talbot: Well, certainly in agreement with what Dr. Chan has said, that we have learned not to assume we know about this virus and what it's planning to do with us. The emergence of a next variant is possible. We don't see anything on the horizon, but Delta has taught us a lot, right? And I ultimately think that the lesson here is as much as we are fatigued from all of this that we need to stay strong in these strategies we know work. You know, there's no question about it with regards to the power of these vaccines and the social distancing, masking, handwashing, et cetera. So I don't think this is the new normal for us as a society, as a species. But it's been a long haul and we're still in it. So don't give up now.

Mary McIntyre is a senior producer at NHPR.
For many radio listeners throughout New Hampshire, Rick Ganley is the first voice they hear each weekday morning, bringing them up to speed on news developments overnight and starting their day off with the latest information.
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