Coronavirus Today: Cracks in our vaccine armor

Good evening. I’m Thuc Nhi Nguyen, and it’s Monday, May 3. Here’s what’s happening with the coronavirus in California and beyond.

Every day, millions of Americans are rolling up their sleeves for a dose of COVID-19 vaccine. The Band-Aid across your upper arm can feel like a little coat of tan-colored armor, but it’s important to know that the antibodies building underneath aren’t perfect.

As of April 26, the Centers for Disease Control and Prevention reported 9,245 coronavirus infections among the 95 million Americans who have been fully vaccinated, and 132 of those people died. The CDC recognizes that these figures are probably an undercount of “breakthrough” cases, but even so, that’s a 0.01% rate of infection and an even smaller risk of death.

It’s extremely rare, but yes, people have died from COVID-19 after being vaccinated. Scientists are scrambling to figure out why, my colleague Maura Dolan reports.

For now, researchers are still in the information collection phase. They want to know which coronavirus variants are in play and whether infected people share traits or behaviors — like taking certain medications that could have interfered with the vaccine — that made them more vulnerable.

Genome sequencing is particularly important to see whether a patient is infected with an already known variant or whether a new one has emerged. Collecting the information in a centralized place is vital to detecting patterns and sharing information that could help experts decide whether and how to tweak future vaccine recipes.

“This is information we need to combat the pandemic,” said Stacia Wyman, a computational biologist with UC Berkeley’s Innovative Genomics Institute who is sequencing viral samples involved in breakthrough cases. “It is really quite frustrating that there is not a lot of organization around this. I don’t think we have a year to wait to get our act together with the breakthrough cases.”

Even fully vaccinated people should continue following health guidelines and get tested if they develop COVID-19 symptoms.

In the case of 80-year-old Carey Alexander Washington, who received his second dose of the Pfizer-BioNTech vaccine in February but died of COVID-19 in March, two different doctors — his internist and a cardiologist — treated him for shortness of breath, but neither tested him for the coronavirus. His daughter wondered whether early detection could have helped save him.

Tanya Washington believes her father, a practicing clinical psychologist, was infected by an unvaccinated employee in the suite of offices he shared with other doctors. It’s a reminder that vaccination can be a valuable tool not only for yourself but for others around you.

Experts aren’t surprised that a small number of fully vaccinated people have died of COVID-19, especially if patients are older or were more susceptible to the disease before they were inoculated. Of the breakthrough infections recorded by the CDC, 45% have been in people 60 years or older.

Hearing about these rare cases may cause disappointment or worry, but scientists stress that there’s no reason to panic.

“The chances of you having a breakthrough of any kind are minuscule,” said Dr. John Swartzberg, an infectious disease expert at UC Berkeley. “And the chances of that breakthrough making you even modestly ill are even more minuscule.”

By the numbers

California cases, deaths and vaccinations as of 7:02 p.m. Monday:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

(Thuc Nhi Nguyen)

Across California

I admit it. I had not even heard of Zoom in the Before Coronavirus era. A whole lot of accidentally unmuted lines later, I can’t imagine getting through the past year without it.

Many things that were foreign to us in February 2020 are now vital and will likely stay with us even after we retire our masks and go back to hugging with abandon. That’s what some pet owners and veterinarians hope will be the case for our new favorite online videoconferencing service.

Zoom has proved to be a critical tool to help veterinarians reach their clients through virtual appointments, and the San Francisco Society for the Prevention of Cruelty to Animals has gone to federal court to ensure that telemedicine for animals can continue — and even expand — after the pandemic ends, Dolan reports in another great read.

California vets have been able to treat animals remotely during the pandemic only if they were pre-existing patients. And before the pandemic, veterinarians could practice telemedicine only for pre-existing patients and their previously treated conditions.

Michigan, Oklahoma and Virginia permit veterinarians to see any animal remotely for any reason, as long as the vet deems its appropriate. The new lawsuit aims to force California officials to follow the lead of those states.

The suit argues that restrictions on veterinarians violate constitutional equal protection guarantees, because doctors who treat humans have more latitude to treat patients remotely than those who treat animals. It also contends that pet owners and veterinarians have a 1st Amendment free speech right to practice telemedicine.

On the other hand, California stands by its rule, arguing that the 1st Amendment doesn’t apply, because animals can’t talk.

When it comes to human healthcare, officials in Los Angeles are struggling to combat the sinking demand for COVID-19 vaccinations. In L.A. County, the average number of doses administered per day between April 24 and April 30 was about 20,000 lower than in the prior week.

City officials are trying to expand access in L.A. by opening vaccine sites six days a week, adding an additional center with night hours and making it easier to get a shot without an appointment.

But even if officials build the sites, there’s no guarantee Angelenos will come. At this point, addressing vaccine hesitancy may be just as important as having open appointments — and it will be a team effort to tackle the problem.

Experts are urging policymakers to coordinate with workplaces to offer on-site vaccination clinics and give essential workers paid time off to get their shots or deal with minor side effects.

Dr. Robert Kim-Farley, medical epidemiologist and infectious diseases expert at the UCLA Fielding School of Public Health, suggested that public health officials collaborate with behavioral scientists to craft specific messages for people who fall into various groups of hesitancy, from those who worry about safety to those who deny the threat posed by COVID-19.

“We’re not here to force people to go and get vaccinated,” said L.A. County Public Health Director Barbara Ferrer. “We’re here to present a lot of information to help you see and understand how powerful these vaccines are, how much of a difference it makes.”

We don’t have to look far to see how much vaccines help.

Los Angeles County public health authorities reported a grand total of zero deaths related to COVID-19 on Sunday. Although the figure was probably an undercount due to weekend reporting delays, it marked a bright spot, capping several months of progress in the fight against the coronavirus.

What’s more, California has the lowest rate of new daily coronavirus cases in the country only months after being a national pandemic hot spot. One factor experts highlighted was how Californians generally embrace COVID-19 vaccines, my colleagues report.

Only about 11% of Californians are estimated to be vaccine hesitant, federal data suggest. That rate is lower than in all but four states: Massachusetts, Vermont, Connecticut and Hawaii.

Despite the encouraging average across the state, there are some counties that stick out: Yuba, Del Norte, Plumas, Modoc, Siskiyou, Lassen and Kings are the most hesitant, with about 14% to 16% of residents saying they probably or definitely will not receive a COVID-19 vaccine.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

When people started fainting or getting dizzy after receiving a dose of COVID-19 vaccine last month, some clinics temporarily shut down to investigate the immediate reactions.

But it wasn’t the shots themselves, CDC scientists concluded. It was stress about receiving the shots.

Experts found that dozens of people who reported short-term effects like nausea, vomiting, elevated heart rate or chest pains in five COVID-19 vaccine clinics were responding to their own anxiety, which triggered a physical reaction. A CDC report included interviews and reports by staff from clinics in California, Georgia, Iowa and North Carolina.

In total, 64 people were affected by the short-term effects between April 7 and 9, and all received the Johnson & Johnson vaccine. The CDC concluded that the one-shot vaccine’s shorter regimen made it more appealing to people who were nervous about shots and “more highly predisposed to anxiety-related events.”

None of the 64 people became seriously ill.

The temporary pain and other side effects of being vaccinated have been worth the trouble for many people, especially those who have put off reunions with loved ones for more than a year. It’s perfect timing, with Mother’s Day coming this weekend.

Vaccinations provide sweet relief after last year’s holiday was spoiled by the pandemic. Now children feel comfortable enough to fly across the country to see their mothers. Some, like 49-year-old Heather Krug, are even bringing visitors. Heather will introduce her boyfriend to her mother, Brenda, for the first time in person.

Maricela Waugh plans to surprise her mother, Marta, with long-awaited news: Marta is going to be a grandmother.

“She’s going to be flabbergasted,” said Waugh, who is the first of three siblings to be expanding her family.

Waugh, needing advice on how to navigate pregnancy but also wanting to keep the news a secret, has tried to ask her mother questions, but only in the hypothetical sense. She’s sure her mother will cry when she hears.

Another perk of rolling up your sleeve could be a trip to Europe, as long as you pack your vaccine card.

European Union officials on Monday proposed a way to ease travel restrictions, adding fully vaccinated visitors to the list of those allowed to enter the 27-nation bloc for nonessential travel. They’ll join tourists from a select group of countries with low coronavirus infection rates who are currently allowed entry.

Tourists need to be fully vaccinated with an EU-approved shot, which includes those made by Pfizer-BioNTech, Moderna, AstraZeneca and Johnson & Johnson. The bloc’s drug advisory is also looking into data about Russia’s Sputnik V vaccine.

The proposal could be approved this week; once adopted, it will be up to individual countries to put the changes into action. The EU plans to implement a digital “vaccine passport” for its residents to prove their vaccination status, but verifying the authenticity of an overseas traveler’s documents is another issue entirely.

The European Commission proposed that its members take into account “the ability to verify the authenticity, validity and integrity” of a certificate from a non-EU country and consider setting up a portal allowing non-EU travelers to ask that their certificates be recognized.

Even if you’re not planning an international trip this summer, make sure to leave room in your carry-on for your mask. Travelers in the United States will be required to wear a face covering on planes, trains and buses at least through Sept. 13 after the Transportation Security Administration on Friday extended its mask requirement.

Your questions answered

Today’s question comes from a reader who wants to know: My 14-year-old child isn’t eligible to get vaccinated yet. Is there anything I can do to get around that?

With many adults taking their masks off and socializing normally again, kids may be feeling vaccine envy. Parents may also feel anxious to make sure their children are protected, too.

The good news for this reader is that relief is coming for 12- to 15-year-olds. Pfizer submitted results of its study to the Food and Drug Administration in March, and emergency use authorization is expected to come by next week after trials found the vaccine was safe and effective in this age group.

But for parents of younger children, there’s nothing to do but wait.

While you do, the best way for parents to protect their kids is to make sure they are fully vaccinated themselves and to keep following the CDC’s guidelines, said Dr. Julie Elginer, an assistant professor of health policy and management at UCLA‘s Fielding School of Public Health.

“The more we can do as adults to protect ourselves, the better we’re going to be to ensure that our kids are protected,” Elginer said.

Yes, it’s tough to be patient, especially because that’s what we’ve heard nonstop for the past year, but it’s important to let the science ensure each shot’s safety and efficacy for different ages.

However, if you want to play a role in that scientific process, there are options.

Elginer and her 15-year-old son Jack signed up for a clinical trial that tested Moderna’s mRNA vaccine in 12- to 15-year-olds. With clinicaltrials.gov, a database for a variety of clinical trials, finding a spot for Jack was easier than buying Disneyland tickets, Elginer joked.

Currently, open trials include those for the Pfizer-BioNTech and Moderna vaccines in kids between 6 months and 11 years. Novavax, which is developing another vaccine, is also recruiting adults and kids ages 12 to 17 to participate in studies.

If you’re considering signing your child up for a study, Elginer recommends talking to your pediatrician and considering what data are already available about the vaccine in other age groups. Kids must agree, if they are old enough to understand the risks.

It’s not a two-shots-and-done process, either. Participants get regular checkups that involve blood draws and coronavirus tests for at least a year. Jack, who was randomly assigned to receive two injections of either the Moderna vaccine or a placebo, will have to provide feedback until 2022. (Elginer expects initial data will be submitted to the FDA within a month, and then the family will know which type of injection Jack received — but since Jack felt a fever, chills and fatigue about eight hours after his second injection, Elginer has a hunch he got the real thing.)

“As a mom, I have never been so happy to have my kid having symptoms,” said Elginer, who added that the side effects wore off in 36 hours, and Jack was back on the soccer field at school.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them. Wondering if your question’s already been answered? Check out our archive here.