New COVID vaccines arrive with Charleston infections at elevated level

New COVID vaccines have arrived at MUSC Health without the fanfare of early iterations but with a feeling of urgency among COVID trackers.

“Here in the Charleston area, we're at an elevated level of infections. It's higher now than it was in the winter, which continues to be kind of shocking to me. We've never witnessed this. Usually, the winter season is much worse,” said Michael Sweat, Ph.D. 

 

Sweat has led the Medical University of South Carolina’s COVID tracking team since the early days of the pandemic. “The wastewater data, they have it back on now, by the way. It's really high,” he said, referring to public health officials’ documentation of the coronavirus in sewage. 

They stopped tracking it for the Charleston area for a while but recently resumed that effort. Now that people don’t report positive COVID tests to the government, wastewater is considered a good way to track the virus’s prevalence. “It actually went down in early August but then shot up for us,” Sweat said.

Scott Curry, M.D., an infectious diseases specialist at MUSC Health, described COVID’s spread from a different perspective. “We're having our usual waves, about 20 to 30 people in our 700-bed hospital system. Not as many intensive care unit patients as back in the bad old days, but plenty of older, sicker, immunosuppressed people getting into trouble from having COVID.”

Sweat had something to add to that. “Three weeks in a row now, there have been over 1,000 deaths from COVID nationally, which is the highest number of deaths for quite a while.”

So that’s the context in which the new vaccines arrive. But Sweat, a professor at MUSC and a former research scientist for the Centers for Disease Control and Prevention, and Curry, an associate professor and researcher as well as a physician, know the public has more questions about the new shots. Here, they offer some answers.

What’s in the new vaccines?

Sweat said two of the three updated COVID vaccine options, Moderna and Pfizer, are similar. “They're mRNA vaccines, and that's the vast majority that are available. Novavax also has a vaccine, but it's less available. You might have to search a bit to find a pharmacy that would carry the Novavax. It is a good option, though, for people who have some concern about mRNA vaccines. That said, the data on mRNA is great. They're very efficacious. They're safe.” 

 

And all three new vaccine options are tailored to target the genetics of the virus, which is always mutating. “They based the vaccines on the JN.1 variant. The descendant of that is the KP.2, which is what we're seeing most right now. So the indications from scientific studies are that it's very effective against the most current variants,” Sweat said.

The CDC started tracking JN.1 last year when it was growing quickly compared with other variants. KP.2 is now among the more common variants in the United States. It’s important for the shots to take careful aim at the evolving targets.

“If you took an old vaccine, it would not be nearly as effective as the new vaccine,” Sweat said.

Who should get the new vaccines – and when?

Sweat said experts have been considering who should get the new shots and when.

“I think the consensus among a lot of thoughtful epidemiologists is that people who are frail or higher risk would probably benefit from going ahead and getting it now, but there's some logic to waiting until September, October if you aren’t in those groups because you might maximize the effect for the winter season when we typically see it,” he said.

 

“However, my own opinion is it may not make that much difference. And if it's convenient to get it now, go ahead and get it now because you might wait and not do it at all.”

Curry, who recently had COVID, agreed. He can’t get the shot for a few months because of that infection, which gives him immunity for a period of time. But other people can. “If you managed to not get COVID at all this whole summer, then I think you should get vaccinated now because we're still deep in a wave that may come for you soon.”

Are many people likely to get the new shots?

When Curry heard the new shots had arrived at MUSC Health, he was happy but also missed the early days when the vaccine’s arrival would have been greeted with great fanfare. “It's not like it's January 2021, when everybody was going to have a parade in the street about the availability of vaccines. Now it's like, ‘Eh, whatever.’ And that's a shame because I wish I could see the uptake for this season's COVID shots as we would for flu,” he said.

“Statewide, only 7.2% of people are estimated to be up to date on their COVID shots. It's not just South Carolina. I mean, really, the numbers are pretty low across the board out there.”

Sweat had an idea why that might be the case. “I think there's a lot of a lingering effect of misinformation around the vaccine. I also think there's a burnout on COVID,” he said.

“I respect people's right to decide what they want to do. But it's a real weakness in our public health system that there’s not greater uptake of it.”

Shots aside, if someone gets COVID, what are they supposed to do to protect others?

Curry said people are still debating whether they should care more about COVID than other respiratory infections. “Should any of us be working sick? I do still think it's worthy of special attention when you have COVID. We still have deaths. We still have vulnerable people we have to take care of.”

He said there’s also a lot of confusion about when you can safely be around other people.

“That's another challenge. I think the CDC changed their guidelines last year. And the current guideline is a bit vague, I would say. It's basically, once your symptoms begin to get better, you're allowed to go back into public. But you should wear a mask for an additional five days. So a lot of people don't even know that.”

Sweat said some people feel like COVID isn’t a big deal anymore. “They have pressures to travel and be out and go to work. That’s amplifying the transmission. It’s as contagious as it’s ever been.”