VDH: Six COVID deaths since Friday, booster shots begin

Vermont Business Magazine The Vermont Department of Health today reported 187 cases of COVID-19. The VDH also reported today six more deaths from Friday, for 310 statewide. There are 36 people hospitalized (down six from Friday) and 7 in the ICU (down eight).

Vermont began offering Pfizer vaccine booster “third shots” to those 80 and over starting Friday (September 24). This is only for those who already received two doses of the Pfizer vaccine. Those who received the Moderna and Johnson & Johnson vaccines previously will have to wait for federal approval in order to receive a booster shot. That approval is expected within the next few weeks.

The state’s booster announcement follows the Food & Drug Administration’s (FDA) expanded emergency use authorization for the Pfizer vaccine, to permit a third booster shot to be administered 6 months after certain individuals received their second dose. 

Following Friday’s announcement from CDC Director Rochelle P. Walensky, MD, MPH, the state will expand eligibility for booster shots to people aged 18 to 64 with underlying medical conditions on Friday, October 1. It is anticipated these conditions will be more specifically defined by the CDC sometime today.

The schedule for the next age groups is:

75 and older on Monday, September 27

70 and older on Wednesday, September 29

65 and older Friday, October 1

The FDA is expected to give emergency approval for a lower-dose Pfizer vaccine to be administered to children 5-11 in October.

For those already eligible, a third Pfizer (“booster”) shot could be available as early as next week, pending FDA approval. It is only for those who previously received a Pfizer dose and who are either over 65 or at a high risk for serious illness. 

Still, Human Service Secretary Mike Smith said this would still represent about 113,000 Vermonters. 

While many regions of the country and world experienced a sharp increase and sharp decline of Delta variant cases in a 7-9 week window, Vermont is now into its 10th week and has shown a slower ascent and still no plateau in new cases. 

Health Commissioner Levine expects the pandemic will become an endemic virus, like the common cold eventually, with people getting an annual flu shot to combat it. He said COVID-19 will always be with us, but as more people build up immunities from the vaccine and/or contracting the virus, it will become less dangerous.

The state will also begin requiring all state employees who have not been vaccinated to wear a mask and get tested regularly. This is a mandate. Only one school in the state (Canaan) does not require masks. The governor would like to see not only all schools to require either vaccines and masking, but all public and private employers. This is expected to boost vaccination rates and lower infection rates.

Health officials keep reminding the public that because the Delta variant passes from person to person so easily, it is especially important for everyone to follow these basic prevention steps:

• Get vaccinated as soon as you are eligible
• Wear a mask when in public indoor settings
• Stay home if you feel sick
• Get tested if you have any symptoms, may be a close contact, or have taken part in activities that could put you at risk, such as large gatherings
• Wash your hands regularly

In addition, people who do test positive, or think you might be a close contact of someone who did, can take action even before they hear from the Health Department. Visit healthvermont.gov/covid-19 so you can act right away to protect yourself and to prevent further spread.

Cases among children 5-14 continue to grow, as cases among the general Vermont population have declined (this age group is not yet available for a vaccination, though they could become eligible soon from the CDC).

Those who are fully vaccinated have seen case rates going down, while those who are eligible but not vaccinated or not fully vaccinated are seeing case rates and hospitalizations still increasing.

See full Department of Financial Regulation report HERE.

The young adult age bands from 18 to 29 continue to show the lowest rate of vaccination, despite college students achieving a 94.7 percent vaccination rate (all 16 institutions reporting with a total of 28,624 students).

In the 70-74-year-old age band, 100 percent of eligible Vermonters have been vaccinated. In all, according to the CDC, 87.4 percent of eligible Vermonters have been vaccinated, with 78.2 percent fully vaccinated.

Meanwhile, Secretary French is urging school staff to get vaccinated to reduce COVID-19 transmission. He said Tuesday that COVID-19 in schools is a reflection of the virus in the community. Children under 12 are not yet eligible for any COVID vaccine, leaving them susceptible to catching the disease, and then transmitting it.

He added that social distancing is not a solution, as sufficient indoor capacity is not available in most schools. He also said that in-person education is the best way to meet educational and social/emotional goals, especially for younger children.

Wearing a mask has been an effective way to reduce the chance of transmission and state guidance urges all school districts to require masks and to continue in-person education.

French said the evidence from last year was that remote learning resulted in poor educational attainment and a loss of social connections for students.

He said surveillance testing and contact tracing would continue to be deployed statewide to try and stay ahead of outbreaks.

COVID-19 Fall Contact Tracing Process

PreK-12 schools will conduct internal contact tracing investigations when a student or staff was present in school or was at a school event while infectious. Schools may learn of these school exposures when a family or staff notifies school administrators directly or when the Health Department identifies an exposure during contact tracing and alerts the school. When schools learn of an exposure, schools will:

1. Verify the student or staff was at school while infectious.

2. Identify all vaccinated and unvaccinated close contacts in the school setting.

3. Meet with the Health Department as needed to review the situation, conduct an exposure risk assessment and discuss close contact determinations.

4. Notify close contacts at the school of their exposure using the “quarantine letter” provided by the Health Department and provide testing guidance as needed. This letter includes guidance for both vaccinated and unvaccinated close contacts. The Health Department will not follow up with close contacts that the school notifies, unless there is a need identified by the school for specific scenarios (e.g. need for translation services, family or staff unwilling to share vaccination status with school, etc.).

5. Provide a line list to the Health Department with information about all vaccinated and unvaccinated close contacts identified.

Strategies to Improve the Efficiency and Effectiveness of the Contact Tracing Process

The purpose of these strategies is to help strike an operational balance between public health and educational goals: we want to keep students safe from COVID-19 but also maximize their ability to attend school.

One approach to striking this balance is to identify close contacts as quickly as possible. Another approach is to recommend testing instead of quarantining when the exposure status is unknown.

Determination of Vaccination Status

Under CDC and Vermont guidelines, vaccinated close contacts who are asymptomatic are not required to quarantine. Schools may use local vaccination status information to determine if individuals are vaccinated. The process for obtaining vaccination status information was outlined in the memo Calculating A School’s Vaccination Rate. Schools should ensure they obtain proof of vaccination as outlined in this memo.

Recess

The risks to students outside are far less than when they are indoors. A school should notify families of a potential exposure during recess/outdoor time and make testing recommendations for 3-5 days after the potential exposure, but not put students in quarantine unless clear close contact has been identified. A template letter for these potential exposures is available on the Health Department’s PreK-12 Schools page. If teachers/playground monitors can easily identify close contacts (Maggie and Jo always play together closely), those students should be put in quarantine.

Lunchroom

Whole lunchrooms should not be automatically quarantined. A risk assessment should include physical proximity to a suspected case. Anyone within 6 feet of an infectious person for 15 minutes or more is considered a close contact. Seating charts for lunchrooms will minimize the number of students who are identified as close contacts. When possible, classroom groups should be maintained during lunchtime.

Siblings

A sibling to a close contact is not a close contact just because they are a sibling. In these situations, a sibling should not be quarantined unless identified as a close contact themselves to a verified case.

Music

Review the COVID-19 Contact Tracing Framework for High-Risk Activities in PreK-12 for an understanding of the relative risks involved in music activities, and for understanding how the size of the room and the distance between musicians can impact the identification of close contacts. Larger rooms such as auditoriums can minimize close contacts.

School Buses

Entire buses of students should not be automatically quarantined. A risk assessment should include physical proximity to a case on a bus, and to what extent there was consistency in mask wearing while riding. Anyone within 6 feet of an infectious person for 15 minutes or more is considered a close contact. Having seating charts for buses will minimize the number of students who are identified as close contacts. Opening bus windows in accordance with prior year guidance will help mitigate transmission.

Seating Charts

Classroom seating charts should be maintained for all instructional spaces in classrooms where students are under 12 years old and updated on a weekly basis.

Recommendations for Communications

Protecting the medical privacy of students and staff is important. These recommendations are intended to balance the needs for privacy protection and clear, communications, when there is a positive COVID-19 case in your school community:

• When communicating with your school community, take steps to ensure the positive person’s identify is protected.

• Do not use names OR any other information that could be identifying including the positive person’s role in the facility, information about the activities the positive person participates in, whether the positive person has siblings, etc.

• Consider using the phrase “a member of our learning community tested positive” when communicating with the school community.

School Mask Recommendations

COVID-19 Prevention Strategies for the Opening of Schools

Stay Home When Sick

School health personnel should use the COVID-19 in Pediatric Patients Flow Chart (Pre-K – Grade 12) Triage, Evaluation, Testing, and Return to School in partnership with pediatric providers and families to guide medical decision-making.

Students and staff who are sick should stay home. This is the most important prevention message.

All students and staff should stay home if they:

• Show symptoms of COVID-19;

• Have a fever (temperature greater than 100.4°F); or

• Are currently in quarantine due to close contact with an individual with COVID-19 or in isolation due to testing positive for COVID-19.

If symptoms begin while at school, the student or staff member should be sent home as soon as possible, and the individual should be isolated from other staff and students until they can go home.

Masks

To allow school districts time to calculate the percentage of currently eligible students who have received two doses of a two-dose vaccine, schools should require universal masking for all students and staff when indoors until October 4, 2021. Currently, all Vermonters ages 12 and older are eligible to be vaccinated.

After October 4, 2021, masks should no longer be required for all those eligible for vaccination when the vaccination rate (two doses of a two-dose vaccine) among students is equal to or greater than 80% of the school’s currently eligible population.

Masks should be required indoors for students younger than 12, who are not eligible to be vaccinated at this time.

Masks, when required, may be removed when needed for instructional or operational purposes.

Masks are currently required for all passengers on buses per federal regulation, regardless of age or vaccination status.

Masks should not be required outdoors.

Guidance will be updated when vaccine eligibility expands.

Surveillance Testing and Contact Tracing

Surveillance testing will be offered to schools for both students and staff.

Schools should continue to participate in contact tracing as requested by the Health Department.

More information on what to do when there is a positive COVID-19 case in PreK-12 schools, childcare centers, camps and out of school programs and contact tracing can be found on the Vermont Department of Health website.

Today’s vaccination and COVID-19 case dashboards are below.

Governor Scott has announced a series of walk-in vaccination clinics that will be open at schools and other sites across Vermont this week for anyone age 12 or older.  See full list below.

Just walk-in or visit www.healthvermont.gov/MyVaccine to make an appointment. You can also call 855-722-7878.

Human Services Secretary Mike Smith said that there are still many testing sites around the state, but urged people to make an appointment, preferably online, to avoid wait times.

The vaccination sites listed below also offer additional doses for those currently eligible based on guidance issued by the Centers for Disease Control and Prevention. Some primary care providers and pharmacies are also offering additional doses. Check with your doctor or pharmacist for more information.

Dr Levine expects more information from the FDA soon on those “third doses” for the general population soon. The FDA advisory panel is meeting September 17 on whether to recommend the Pfizer vaccine for the third (“booster”) dose of Comirnaty (COVID-19 Vaccine, mRNA) in individuals 16 years of age and older. The Moderna and Johnson & Johnson vaccine boosters are still in development.

Dr Levine also expects positive news soon on vaccines for children under 12, who are all currently ineligible for any COVID-19 vaccine.

Vaccination Clinics

Governor Phil Scott also has announced a series of walk-in vaccination clinics that will be open at schools and other sites across Vermont this week for anyone age 12 or older.  Just walk-in or visit www.healthvermont.gov/MyVaccine to make an appointment.  You can also call 855-722-7878.

The vaccination sites listed below also offer additional doses for those currently eligible based on guidance issued by the Centers for Disease Control and Prevention. Some primary care providers and pharmacies are also offering additional doses. Check with your doctor or pharmacist for more information.

Here are the vaccination sites available this week:

Monday, September 27

Barre Town EMS, 4 McLaughlin Road, East Barre

Rescue Inc. Division 1 Station, 541 Canal Street, Brattleboro

Academy School, 860 Western Ave, Brattleboro

Edmunds Middle School, 275 Main Street, Burlington

The EDGE Sports & Fitness, 142 West Twin Oaks Terrace, South Burlington

More ways to get your free vaccine:

Make an appointment for a free vaccine

You can also walk-in at CVS, Hannaford Food and Drug, Walmart, Walgreens, Price Chopper/Market 32, Rite Aid, Shaw’s Supermarket, or Costco or get an appointment with Kinney Drugs, CVS, Walgreens, Northfield Pharmacy, or UVMMC Outpatient Pharmacies.

Vaccination & COVID-19 Dashboards