Children Returning to School Amid Rising COVID-19 Cases

Across the country, states have had differing responses to vaccine and mask mandates that affect K-12-age children and schools, with some Governors going as far as banning mask mandates in public schools. These decisions come at a time when cases of COVID-19 in children are increasing across the country, especially in areas with high case counts. According to the American Academy of Pediatrics, children accounted for 15% of all COVID-19 cases in the country during the week of August 5, and cases in children have steadily been increasing since July. Per analysis of the data by NPR, the cases in children the week of August 5 represent a 31% increase in cases in children compared to the week before. This alarming trend is attributed by experts to several factors, including low vaccination rates in youth because the vaccines have not yet been approved for children 12 and under, increased infectiousness of the Delta variant, and people taking fewer safety precautions (fewer people wearing masks, more people returning to in-person work, etc.). Thus far, there is not enough data to determine whether children who are infected with the Delta variant are becoming more ill than if they had become infected with another variant of COVID-19. Children, like adults, are more likely to experience severe COVID-19 if they have underlying conditions. Increasing use of ICU beds due to COVID-19 is putting a major strain on hospital resources in many parts of the country, increasing the risk that youth with or without COVID-19 will not be able to receive emergency care. Communities across the country are concerned for the health of youth and their families, particularly in areas that are returning to in-person schooling without vaccinations or masks.

More information for infection rates in youth:

More information on mandates for youth and K-12 schools throughout the country:

CDC Recommends Vaccination for Pregnant and Breastfeeding People

The Centers for Disease Control and Prevention has announced that it recommends COVID-19 vaccination for pregnant and breastfeeding people. This stance is an update from the agency’s previous language which said vaccination is safe for pregnant people but fell short of a formal recommendation. The decision was made after tracking side effects from vaccination did not provide any evidence of adverse affects in pregnant people, including no increased risk of miscarriage. Without vaccination, pregnant people who become infected with COVID-19 are at a higher risk of pregnancy complications, as well as having severe COVID-19 themselves.

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FDA Approves, CDC Recommends COVID-19 Vaccine Booster For Immunocompromised Individuals

The FDA recently amended the Emergency Use Authorization for both the Pfizer and Moderna COVID-19 vaccines to allow for certain individuals who are immunocompromised to receive a third shot of either COVID-19 vaccine. In response, the CDC updated their recommendations to meet this change and now recommends the following individuals to receive an additional dose of either the Pfizer or Moderna COVID-19 vaccine:

    • People who have been receiving active cancer treatment for tumors or cancers of the blood

    • People who have received an organ transplant and are taking medicine to suppress the immune system

    • People who have received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system

    • People with moderate or severe primary immunodeficiency (such as DiGeorge syndrome or Wiskott-Aldrich syndrome)

    • People with advanced or untreated HIV infection

    • People undergoing active treatment with high-dose corticosteroids or other drugs that may suppress their immune response

These changes follow data showing that those who are moderately to severely immunocompromised have decreased immune responses to the COVID-19 vaccines and are at greater risk of severe COVID-19. For those who may have pre-existing conditions or other individuals who are not immunocompromised and do not fall in the above categories, a third shot is not currently recommended or approved. In addition, eligibility is only for those who received the Pfizer or the Moderna vaccine; a second dose of the Johnson & Johnson vaccine has not yet been authorized.

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Fully Vaccinated People Can Spread COVID-19

Late last week, the Centers for Disease Control and Prevention announced that people who are fully vaccinated can still spread COVID-19. The announcement was informed by new data studying transmission of the Delta variant, which shows that fully vaccinated individuals who experience breakthrough infections (testing positive for COVID-19 despite being fully vaccinated), have the same amount of virus inside their bodies as someone who is infected with COVID-19 but is unvaccinated. This high amount of virus is what makes someone, vaccinated or not, contagious. It is important to note that vaccination is still proven to be highly effective in preventing infection with COVID-19, as well as at preventing severe illness in those who do become infected. The CDC’s update also does not mean that vaccinated people are “super spreaders,” despite some myths circulating online saying otherwise. What it does mean, though, is that being fully vaccinated doesn’t guarantee that you can’t spread COVID-19 to others in the rare event you do become infected after being fully vaccinated. With this in mind, and the fact that showing symptoms is rare in fully vaccinated individuals even if they become infected with COVID-19, it is important to socially distance as well as wear masks, particularly when around others who may be immunocompromised, who are at risk for severe COVID-19, or who are not vaccinated. For a link to the CDC’s current recommendations for testing and isolation for fully vaccinated individuals click here.

For last week’s brief about breakthrough infections in vaccinated individuals, click here.

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Ingham County Prosecutor Announces More Reforms to Reduce Racial Bias; Police Again Lash Out

Ingham County Prosecutor Carol Siemon announced this week that her office would limit the way gun charges are used, in a further effort to combat systemic racism by law enforcement and prosecutors that disproportionately impacts Black people in the county. The move comes two weeks after the office announced a similar change limiting charges from non-public safety traffic stops.

In situations in which someone is accused of committing a felony while in possession of a firearm, prosecutors in Michigan can add a felony gun charge on top of the existing charges. If convicted, the gun charge adds a mandatory two year prison sentence, which increases to five or ten years for a second or third such conviction. The law was added in 1976 in an attempt to convince people not to carry guns, but Siemon explained that it hasn’t changed whether people carry guns, and has instead disproportionately been used to target and imprison Black people. While only 12.4% of Ingham County's population is Black, 67% of felony firearm charges in the county last year were made against Black people and 80% of those serving a felony firearm sentence in the county are Black.

The move comes as part of a broader effort by the Prosecutor's Office to address local racial disparities in policing and prosecution. As with the announced changes made two weeks ago, several police chiefs, who are largely responsible for the racism in law enforcement in the area, lashed out at the new policy. Ingham County Sheriff Scott Wriggelsworth called the policy "garbage" and "terrible for the community." Among those joining Wriggelsworth were Interim Lansing Police Chief Ellery Sosebee and Stockbridge Police Chief John Torres. While Siemon cited statistics that show that the felony firearm law was used in racist ways and did not increase public safety, the police chiefs resorted to fear-mongering and anger in complaining about the change. Wriggelsworth also expressed anger at not being consulted on the policy change, despite the fact that his office has no reason to have been involved in such decisions. His indignation is particularly confusing in this situation, as the additional charges added by prosecutors should have no direct impact on how police officers carry out their jobs, assuming they are not intentionally targeting Black people in the hopes of having them serve long prison sentences. Lansing City Council member Carol Wood also joined the police chiefs and Sheriff, and called for Siemon to resign. Wood is among the most conservative council members, and has consistently voted against any measures that would decrease police budgets. Wood, the Sheriff, and all of the police chiefs who have spoken out against the policy change are White.

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Michigan Border Patrol Agents Accused of Targeting Latinx People; Congress Demand Answers

Two members of the U.S. House Committee on Oversight and Reform’s Subcommittee on Civil Rights and Civil Liberties, Representatives Rashida Tlaib of Michigan and Jamie Raskin of Maryland (who serves as Chair of the Subcommittee), have asked U.S. Department of Homeland Security Secretary Alejandro Mayorkas to "respond to serious allegations of discrimination and misuse of taxpayer resources by Border Patrol agents on Michigan’s border with Canada, spanning multiple administrations." Specifically, they refer to an ACLU report from March that found that Customs and Border Patrol (CBP) "produces few tangible results related to its officially mandated mission in Michigan" and that agents "routinely spend their time and resources targeting people of Latin American origin who are long-term Michigan residents."

Some excerpts from the Representatives' letter:

"Most of the people apprehended by CBP [in Michigan] were of Latin American origin, and nearly half —over 45%—were either U.S. citizens or had another kind of lawful status in the country. In fact, 85% of noncitizens detained by CBP were of Latin American origin, even though individuals of Latin American descent comprise less than 17% of Michigan’s foreign-born population. Only 5.3% of the state’s overall population identify as Hispanic. Over 96% of individuals apprehended by CBP across the entire state—even in encounters unrelated to illegal border crossing—were described as non-white."

"Seventy percent of illegal crossings on the United States’ northern border are committed by individuals of Canadian or European origin, but less than 4% of CBP’s overall detentions involved white individuals. Taken together, these findings suggest that CBP’s operations in Michigan are focused less on its lawful enforcement priorities than on harassing longtime residents of Michigan in a way that appears to systematically and disproportionately target those of Latin American origin."

"We are deeply troubled by what appear to be discriminatory abuses of authority and misuse of taxpayer funds. DHS must provide a full explanation of exactly how it is addressing the problems laid bare by the ACLU."

The ACLU report they referred to also indicated that "Speaking Spanish or another foreign language is a basis for Border Patrol stops" and that "Nearly half (48.6%) of Border Patrol apprehensions began with a state or local law enforcement department initiating a traffic stop. MSP [Michigan State Police] is, by far, responsible for more people being detained and turned over to Border Patrol than any other police agency—making up nearly 37% of all incidents."

The Representatives have requested that the Homeland Security Secretary provide a response (including documents, information, and a briefing) to the Subcommittee on Civil Rights and Civil Liberties no later than September 1st.

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Local Schools Announce COVID-19 Plans

The Michigan Board of Education voted this week in favor of allowing school districts to make their own decisions about masking. This will allow some districts to enforce mask mandates if they choose, but will not result in statewide masking for K-12 schools. Prior to the Michigan Board of Education’s vote, the state health department recommended universal masking in schools, regardless of vaccination status, in the hopes that it would increase in-person learning this year. Governor Whitmer has since supported this recommendation by MDHHS, but at this time does not have plans to release an Executive Order requiring it.

Since the Board of Education’s vote, the Lansing School District voted unanimously to require vaccination for all teachers and staff by September 30. Employees who are not vaccinated will be subject to daily COVID-19 testing. Students and teachers in the district will also be required to wear masks. In East Lansing, the school district has decided to return to in-person learning with universal masking indoors, one-way traffic in classrooms and hallways, and maintaining a three-foot distance between people when possible. According to district superintendent Dori Leyko, students whose families would feel more comfortable with online learning can anticipate having the opportunity to participate in online learning through the Lansing School District in a still-developing partnership. As of now there have not been any announcements about vaccination requirements for teachers and staff in the East Lansing Public School District.

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DHHS Will Require COVID-19 Vaccination; VA Expands Employee Vaccine Mandate

Earlier this week, the U.S. Department of Health and Human Services announced that it will require its healthcare workers to be vaccinated against COVID-19. This mandate, which will affect staff at both the Indian Health Service and the National Institutes of Health, means that more than 25,000 employees, volunteers, contractors, and trainees whose positions put them in contact with patients in clinical and/or research settings will be required to be vaccinated. The Public Health Service Commissioned Corps, the federal uniformed service of the U.S. Public Health Service, will also require vaccination. These announcements come a few weeks after the Department of Veterans Affairs (VA) announced that it would require vaccination for its patient-facing healthcare providers, which impacted 115,000 employees. The VA has since then expanded their mandate to include most employees, volunteers, and contractors, which includes an additional 245,000 people. It is hoped that these mandates will promote patient safety and prevent outbreaks among vulnerable populations.

For our recent brief about vaccine mandates throughout the country, click here.

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Johnson & Johnson COVID-19 Vaccine Update

Current data from a recent study (commonly referred to as the Sisonke trial) suggests the Johnson & Johnson vaccine works against the Delta variant in preventing severe COVID-19 symptoms and hospitalization, thus suggesting recipients may not need a booster shot of that vaccine. This is in contrast to an earlier study that is still pre-print and not published, which suggested that the Johnson & Johnson vaccine is far less effective in preventing infection against the Delta variant. It is important to note that the earlier study is talking about infection period while the Sisonke study was talking about severe disease and hospitalization, an important distinction when looking at COVID-19 vaccine effectiveness studies. Unfortunately, the data overall regarding the Johnson & Johnson vaccine has been limited, with available data confusing or sometimes contradictory. For the almost 14 million individuals in the U.S. who have received this vaccine, it is definitely frustrating. The lack of data and updated guidance is not only potentially harmful but can further erode trust in our institutions and in those who promoted the use of the Johnson & Johnson vaccine. Hopefully, more data as well as updated guidelines and recommendations with regards to the Johnson & Johnson vaccine will be available soon.

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Moderna COVID-19 Vaccine Update

In a recent press release, Moderna stated that their COVID-19 vaccine was 93% effective six months after being fully vaccinated, very similar to the initial 94% effective rate from the initial vaccine trial. In addition, a study conducted at the Mayo Clinic suggested that breakthrough infection of COVID-19 was less likely in those fully vaccinated with the Moderna vaccine compared with those who received the Pfizer vaccine. To clarify, this was with regards to getting infected with COVID-19 at all; both still show strong protection against severe infection and hospitalization. It is also important to note that the study is still in pre-print and not yet officially published.

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At Least 1 Million People Have Gotten Unauthorized COVID-19 Booster Shots

According to ABC News, a CDC document reported that over 1 million people have received an unauthorized third shot of either the Pfizer or Moderna vaccine. This number may be an underestimate, as this document did not include the Johnson & Johnson vaccine. It is also unknown why individuals have sought an extra shot, but according to CDC Director Dr. Walensky, many of the unauthorized shots were “occurring in the context of people who may believe they are merited another shot, may be immunocompromised.” She then went on to add that by receiving an unauthorized booster shot, it will “undermine our ability to monitor safety” as it will be more difficult to accurately track effectiveness of vaccines. The unauthorized shots were received before the FDA and CDC approved a third shot for individuals who are immunocompromised.

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This Week's QM Round-Up Contributors (in alphabetical order):

    • Alessandra Daskalakis (she/her/hers), B.A. Comparative Literature and B.S in Biology, third-year medical student

    • Wilfredo Flores (he/him/his), fourth-year PhD candidate in Writing and Rhetoric, M.A. Technical Communication

    • Grey L. Pierce (they/them); M.A., Cognitive Psychology; Chair, Power of We Consortium

    • Francis Yang (he/him/his), M.S.-Global Medicine, Third-year medical student