Editor’s note — Highland County Health Commissioner Jared Warner recently posted an update on COVID-19 and other issues on the health department’s Facebook page. It follows in its entirety.

It has been quite a long time since I provided a community update on COVID-19, and there are a few newer developments in COVID-19 and in the public health world in general that I think there may be some interest in.

Contents include: COVID-19 updates, Novavax vaccine, Monkeypox update, Vaccination Back to School Backpack Giveaway.

COVID-19 Updates

At home testing is the primary way that people are currently testing for COVID-19, which means that the health department really doesn’t have a way to see these results or directly measure disease rates. We have some general community indicators that are still helpful in looking for current disease rates in the community, but tracking community cases doesn’t work like it used to.

The BA.5 strain of Omicron is moving through the state right now, resulting in a general increase in positive test results (at least the ones we can see). While disease rates have increased in general, we seem to be well below the case numbers that we saw during our Delta and Omicron surges.

We are seeing a consistent increase in patients hospitalized and in the ICU with COVID-19, but overall hospital capacity seems to be doing well. Since the beginning of COVID-19, we have had 492 hospitalizations with COVID-19.

Our most significant increase in new cases is in our 80 and over population, and many local nursing homes have had outbreaks in recent weeks.

We have seen a total of 185 COVID-19 deaths in Highland County residents, with our most recent death occurring on 7/10/2022.

Novavax COVID-19 Vaccine

Novavax is a new COVID-19 vaccine recently approved by the ACIP (CDC’s vaccine advisory board) for use as a primary series for COVID-19 vaccination. Most people in the US who were interested in COVID-19 vaccines seem to already have them, but there may be a lot of interest internationally in this new vaccine option. Novavax can be stored in normal refrigeration, and does not require freezing or ultra-cold freezers, making this vaccine much easier to deploy to locations with limited infrastructure.

There also may be some interest in people who may have avoided previous vaccines due to concerns about the manufacturing process or about the mRNA mechanisms used. One study I read estimated that about 10% of the currently unvaccinated would be interested in these vaccines because they are manufactured in a more traditional manner.

One key difference in Novavax is in how the vaccine initiates an immune response. While mRNA vaccines (Moderna, Pfizer) use our own body’s cells to manufacture a spike protein to induce immune response, Novavax handles the protein manufacturing process outside of the body. Instead, an already constructed protein is contained in the vaccine and is introduced to the body in order to develop an immune response.

Study results for Novavax showed about 90% effectiveness overall in preventing infection, and 100% effective in preventing hospitalization and death.

Monkeypox

Monkeypox continues to make headlines in Ohio and across the nation, and we have gotten a few phone calls and questions about it. Ohio currently has 17 confirmed monkeypox cases, mostly located in our urban areas. New York has seen the most cases nationally, with 990 being reported so far. Cases are now present in all but 3 US states.

Monkeypox is very different than COVID, and is not easy to pass person-to-person. Transmission requires:

• Direct contact with the infectious rash, scabs, or body fluids;

• Respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex;

• Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids;

• Pregnant people can spread the virus to their fetus through the placenta.

There is a lot of discussion currently around treatment and prevention for monkeypox. Treatment specifically for the disease does not exist, but there seems to be some benefit from other pox virus treatments. There are 2 vaccine types currently available for prevention and post exposure use in the US. Both are in short supply, especially as Ohio is far behind many states in case numbers.

For most people, monkeypox is a mild illness that causes flu like symptoms and a pox like rash. Fatalities are very rare, with 0 deaths in the US so far in our outbreak. Mostly monkeypox makes people just feel miserable for a while. From anecdotal reports, the level of discomfort depends a lot on the location of the rash.

Local health departments in Ohio are working closely with our community and our local medical partners to watch for this virus. It is very possible that this outbreak will end without any local cases, especially now that lab testing and vaccine resources are available in the US. Probably more to come on this virus.

Below is a link to the CDC’s Monkeypox page, which provides information about the disease in general as well as an update on the current US outbreak: https://www.cdc.gov/poxvirus/monkeypox/index.html

Vaccination Back to School

Backpack Give Away

I want to end this update with a few thoughts on our ongoing back to school backpack giveaway. This program has generated some interesting social media discussion, most of which mystifies me. Of course your local health department is trying to increase vaccination rates in the community.

Here is some background on this project:

During the early days of COVID-19, many regular well-checks and doctor office visits were put on hold, work schedules changed, some schools went virtual, and many other aspects of our lives were interrupted. Overall childhood immunization rates dropped globally by about 5% between 2019 and 2021, and I don’t think that really surprised anyone. Another study specific to the US measured a significant drop in childhood vaccination rates during the early stages of COVID-19. Vaccination rates in children have not yet recovered to pre-pandemic levels (and they may not).

The journal of the American Medical Association published a study in October of 2021 that I think summed this up very well. “As of September 2020, childhood vaccination rates and the proportion who were UTD [Up-to-Date] remained lower than 2019 levels. Interventions are needed to promote catch-up vaccination, particularly in populations at risk for underimmunization.”

https://publications.aap.org/…/Pediatric-Vaccination…

https://jamanetwork.com/…/jamapedia…/fullarticle/2784888

https://www.who.int/…/fact…/detail/immunization-coverage

Many childhood diseases require high levels of community vaccine coverage (herd immunity) in order to prevent that disease from spreading effectively in a community. The best example of this is measles, which requires about a 95% vaccination rate in order to prevent community spread. Mumps has a herd immunity rate of about 86%. Polio requires about an 80% population vaccination rate. We need to maintain high overall immunization rates in order to prevent the spread of these and other infectious diseases.

We have had some glimpses at what happens if we don’t.

In 2016, the US saw mumps outbreaks in various parts of the country, jumping from 1,329 cases to 6,366 cases. See https://www.cdc.gov/mumps/outbreaks.html. Likewise, measles has had recent outbreak years in the US. In 2019, measles cases increased to 1,282 nationally, compared to 375 in 2018. See https://www.cdc.gov/measles/cases-outbreaks.html. These outbreaks are occurring in populations with larger numbers of unvaccinated people.

That is some background on why childhood immunization rates are a concern, and why our community needs to maintain a high vaccination rate.

When the opportunity came along for the health department to partner with Interact for Health, a non-profit out of Cincinnati, to provide free school supplies to any students getting their back-to-school shots or their COVID-19 vaccines, it was a great opportunity to help some local families and to also try to address any remaining local vaccination rate declines.

I am proud of our nursing team and their efforts on this program, and proud that we have been able to bring these back to school resources into Highland County to help some of our families get their kids prepared for school this year.

We are pro-vaccine, and getting to provide a little extra support to the families in our community who get their vaccinations at the health department is just icing on the cake!

This may be the last public health update for a while again, so if you made it this far, thanks for reading.