Duplicate emergencies are straining the country’s public health workforce and threatening critical vaccination campaigns

“I think we need to recognize that this is a very vulnerable time,” said Hamburg, who recently joined the nonprofit Commonwealth Fund’s committee on how to modernize the country’s public health system. served as chairman of the meeting.

After nearly three years of struggle with vaccine hesitation, politics and a global pandemic, the country’s public health workers have frayed and left their positions. More than one in four health sector leaders quit their jobs during the pandemic. Some have resigned after receiving harassment and death threats. Studies are underway to determine the extent to which these losses extend to staff.

Now these depleted institutions are being called upon to deal with emerging threats like monkeypox without additional funding.

“Overwhelmed is an understatement”

Can these institutions pull it off?

“Probably not,” Caitlin Rivers, an epidemiologist and assistant professor at the Johns Hopkins Center for Health Security, told CNN in an email. “Public Health is chronically underfunded and understaffed. Considerable capacity was built during the COVID-19 response, including contact tracing teams. The area is shrinking its infrastructure, and Covid funds are so inflexible that they can’t really do that, they’re used for other threats like monkeypox.”

National immunization officials say they are struggling.

“Overwhelmed is an understatement,” said Claire Hannan, executive director of the Association of Immunization Administrators.

Hannan said her members had not received funding to conduct vaccination campaigns against monkeypox. We switched to a shallower method of squirting vaccine between skin layers. This requires training to do it right. Intradermal injection, which requires one-fifth the normal dose, is expected to rapidly increase the supply of this difficult-to-obtain vaccine.

As a result, immunization administrators order vaccines, manually track inventory, ship shots to where they are needed, train providers, and collect data to feed federal health agencies like the U.S. Centers. We are struggling to find funds and staff to send it back. Disease control and prevention.

In addition, orders have begun for updated boosters to protect against the BA.4 and BA.5 variants of the Omicron strain of the novel coronavirus, promised to Americans by mid-September.

Allocations for these early orders were lower than expected, Hannan said, so city and state health officials had to come up with a plan as to who should get them first, with demand first outstripping supply. It should have surpassed

In addition, many cities are now testing their sewage for poliovirus after poliovirus was recently detected in Rockland County, New York and New York City. If further regional spread is suspected, those regions will launch immunization campaigns to protect unimmunized populations, such as recent immigrants and young children who were not routinely immunized during the pandemic. may need to start.

Children in the United States typically receive four doses of polio vaccine by the time they are six years old, but many children are late. Globally, the pandemic has caused the biggest setback in childhood vaccination coverage in 30 years, according to the World Health Organization. Health officials fear this reduction in coverage is setting the stage for a resurgence of other infections such as measles.

“A disruption or gap in vaccine supplies sets the stage for further outbreaks,” said Dr. Davidson Hammer, an infectious disease expert at Boston University.

Mistrust fosters hostility and hesitation

Vaccines are considered one of the greatest achievements of modern medicine, second only to clean water, as a cost-effective health intervention. It prevents millions of deaths worldwide each year. In its first year of use, the Covid-19 vaccine has prevented nearly 20 million deaths, according to a recent study.

But misinformation on social media has fueled hesitance about vaccines. More than three-quarters of Americans said he was vaccinated against Covid-19, but 19% said he would never get the Covid-19 vaccine.

If all of these challenges aren’t enough, annual flu shots are due to start soon, which could be especially important this fall.

The flu has made a comeback in Australia this year for the first time since the pandemic began. US health officials are watching the Australian flu season closely for clues about what might happen in Australia. They expect to see more flu infections this year than in the past two years, and flu vaccination will be key to preventing hospitalizations and deaths.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said: “I think the vaccine world is going through a perfect storm right now in this country.

Although the average daily death toll from Covid-19 is far lower than it was in 2020 and 2021, it still averages over 400 daily in the United States, making it the fourth leading cause of death in the United States. he points out. According to the CDC, most of these deaths are in unvaccinated people.

Overall, more than 1 in 5 Americans are still unvaccinated against Covid-19, and that number is unlikely to sway. Vaccine coverage has largely stagnated.

Rebuilding confidence in vaccines requires a stronger public health workforce and better funding.

A recent study by the De Beaumont Foundation, a nonprofit dedicated to strengthening public health, found that public health systems need an additional 80,000 full-time staff to provide basic community services such as: It turns out that you need Monitoring and controlling the spread of infectious diseases.

Brian Castrucci, the organization’s president and CEO, says America won’t be able to restore its public health workforce until people value and respect their work. .

“What we have seen during Covid is a fringe anti-vaccine movement becoming more mainstream, jeopardizing our country’s safety, security and economic prosperity,” Castrucci said. He said, “Vaccination will become increasingly difficult.”

“We are blessed as a society that has never seen a child with polio on crutches. No one is in an iron lung. Somewhat paralyzed,” he said. “These are poisonous diseases.”