Vaccine Mayhem:

• The governors of CA, WA, and OR announced that they’ll form a West Coast Health Alliance to coordinate public health guidelines separate from the CDC. Hawaii says it will join, too.  (CNN, Hill)
  
  
• CO, PA, and MA each issued orders making it easier to get COVID vaccines despite federal guideline limitations. NY says it will follow suit. (CO Sun, WESA, Boston.com, NY Times)
  
  
• Florida’s Surgeon General says it will end all school vaccine mandates. (Guardian)

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Health News:

• For the first time since March, more raw cat food tested positive for H5N1 after a pet cat in San Francisco was infected. (AP)
  
  
• DR Congo declared a new Ebola outbreak with 28 suspected cases and 15 deaths. (CIDRAP)
  
  
• A single dose of the shingles vaccine may reduce risk of heart attack and stroke by up to 18%. (Guardian)
  
  
• … and GLP-1 weight loss drugs may halve the risk of death from heart disease. (Guardian)
  
  
• Whooping cough cases in New Hampshire are nearly as high as the total cases for all of last year. (NHPR)
  
  
• Leniency on lice in schools is meeting reality, with parents across the country petitioning for their districts to go back to strict rules excluding kids with lice. (NPR)
  
  
• The WHO declared an end to the global emergency over mpox, because cases have slowed and countries have built up their responses. (STAT)

Best Questions:

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If Florida removes all school vaccine mandates, what can employers expect there over the next few years? 

Short answer? Expect more outbreaks of vaccine-preventable diseases that hit families first, then spread to workplaces. 

Florida already trails the national average on school vaccine coverage, with over 5% of kindergartners claiming a vaccine exemption last year. Their statewide coverage was below 89% last year (95% is considered the ideal number for herd immunity). 

Florida actually still has a ways to go to remove vaccine mandates entirely, since that requires the state legislature to vote, but if they do, it translates pretty quickly to staffing issues. 

Sick kids = missing school = caregivers missing work. That doesn’t even take into account the number of adults who will get sick themselves. 

We’re already seeing increases in measles and whooping cough, and if this happens, we’ll see even more, plus the return of other diseases we haven’t really considered workplace issues in years (think chickenpox, meningitis, etc.). 

Operationally, plan for more employees calling out sick and longer exclusions. Expect more calls from health departments, more parent call-outs, and occasional requests from health departments for employee contact info, testing, or verifying immunity after exposures. 

Our take here is that Florida is setting itself up for a very predictable staffing and business-continuity crisis.

Sources: Reuters, KFF, CDC
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Is it safe to get the COVID and flu shots together?

Vinay Prasad, the FDA’s top vaccine regulator, recently said that they “cannot affirm” that giving multiple vaccines at once for flu, COVID, and others like RSV is safe and effective. It’s raising a lot of questions. 

Some vaccines really shouldn’t be given together… but COVID and flu can!

• There are some vaccines that aren’t as effective when given together (For example, some data suggest that giving RSV and Tdap together may limit the immune response to pertussis). 
• But there is plenty of evidence over the past few years showing that coadministration of COVID and flu is safe and effective. 

You may feel crummier. 

• In fact, they show that getting flu and COVID shots at the same time actually does have an impact: it raises your risk of feeling crummy for about a day after getting the jab. Side effects were mostly mild and they didn’t last long. But there’s no evidence that it reduces effectiveness or causes serious side effects. 

Millions of COVID and flu shots have been given together without serious side effects. 

• There’s a system for reporting vaccine injuries (VAERS) that shows no evidence of serious side effects from co-administering these shots, even after millions of doses… (And remember, this system does work - it caught a small number of serious issues with a chikungunya vaccine just last month, which was pulled due to those safety signals). 

Having to go 2x for vaccines will stop people from getting them. 

• The reality is that there’s plenty of evidence that the only downside to giving COVID and flu together is potentially feeling crappy for a day or so after getting the shot. But there’s a huge upside: people will actually get the shots. If they have to go back twice, we know that will deter many - if not most - from actually going back to get that second vaccine. 

Sources: Washington Post, JAMA, YLE

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‍Best Read:

The creation of a public health alliance on the West Coast while Florida moves to ban all school vaccine requirements, is driving home that employers with locations in different parts of the country are about to be facing very different realities in terms of operating. 

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The U.S. is headed toward two very different vaccination realities - NBC

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