‘Most people are confused’: What to know about the latest Covid shot

New Covid-19 vaccines are hitting the shelves just as a summer surge infects people across the nation.

For most, the virus has become background noise, but as case counts rise alongside the back-to-school season, the potential for spread grows exponentially.

There are “high” or “very high” levels of Covid in the wastewater in nearly every state , according to the Centers for Disease Control and Prevention. At least one estimate suggests that as much as 2.5 percent of the population is infected with Covid.

Even the Democratic National Convention turned into a superspreader event.

And despite the virus’ prevalence — and the persistent threat of long Covid — public health officials are contending with a myriad of obstacles as they try to boost the population’s defenses, including dwindling enthusiasm for the shots, lackluster testing and the end of a program meant to help the uninsured get vaccinated.

“One of the challenges of today is just that people aren’t going to get vaccinated,” said Michael Osterholm, an epidemiologist and director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “Most people are confused. They don’t really understand what’s happening or what the risk to them is,” when it comes to Covid.

More than 1 in 5 Americans falsely think it’s safer to get a Covid infection than a vaccine, a rise from 10 percent in April 2021, according to a recent poll by the Annenberg Public Policy Center.

Last year, 22.5 percent of adults and 14.4 percent of children received the updated Covid vaccine, according to the CDC .

While the risk of hospitalization and death is nowhere near what it was in 2021, there is still a danger, particularly for the elderly or those with compromised immune systems.

“There is no doubt that this is better than we were in 2020 or 2021, but that doesn’t mean it’s acceptable or good enough,” said Dr. Jerome Adams, who served as surgeon general during the Trump administration.

Here is what you need to know about the vaccine:

How effective is the vaccine?

The FDA asked the vaccine manufacturers in June to incorporate the KP.2 strain into their formulas because it was the prevalent form of the virus at the time. Pfizer-BioNTech’s and Moderna’s vaccines both target KP.2, but related subvariants, KP.3 and KP.3.1.1 — now the most prevalent strains — are estimated to account for more than half of U.S. cases, according to the CDC.

Osterholm said the virus has changed quickly in recent years, which means by the time a new vaccine comes out, the strain it was engineered against is no longer dominant.

That doesn’t mean it’s ineffective, said CDC Director Mandy Cohen, who recommended everyone older than 6 months get their Covid (and flu) shot “in September or October ahead of the expected increases in both viruses this winter.”

Some public health experts suggest going even earlier, if possible, because of the surge in cases.

“The whole point of getting a vaccine is you’re supposed to get it before you get infected or exposed,” Adams said.

Last year’s vaccine offered 54 percent protection against symptomatic Covid infections, according to a CDC study.

When should you get a shot if you’ve recently been infected with Covid?

Adams said this is a question he has fielded often in the past several weeks as people get Covid amid the summer surge.

The CDC recommends that people who recently had Covid may consider waiting to get an updated dose for three months after symptom onset or a positive test but can get their dose as soon as their symptoms resolve.

Is the Covid surge peaking?

It depends on where you live, said Dr. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases. About half the states show growth in viral transmission, but that’s much better than earlier this month when nearly every state reported increases.

“ We’re not out of the woods yet ," he said during a press briefing last week. “But we are potentially seeing some indication of a plateauing."

Do we have a good sense of how widespread Covid is?

Wastewater surveillance can help provide clues, but public health officials can’t track the virus as well as they did during the height of the pandemic. Testing and reporting aren’t happening on nearly the same level.

“What’s interesting is we’re in 2024, and there still does not seem to be a national testing strategy in terms of who should get tested, distribution, reporting of testing results, et cetera,” Adams said. “The CDC … could and should do more to help us gain visibility into the problems that are occurring out there by really developing and communicating an overall testing strategy.”

What about the cost?

Most insurance plans cover the vaccine at no charge under the Affordable Care Act . But, for the uninsured, that will likely be different this year. A federal program to provide free Covid shots for the uninsured will end this week . Local health officials in several states told POLITICO they plan to or are seriously considering purchasing doses to offer uninsured residents. But few expect to have enough cash to buy the amount they believe they will need.

While the CDC last week said it would send $62 million to local and state governments to help them purchase vaccines, that sum is a fraction of the $1.1 billion allocated for the Bridge Access Program — which began last September and got 1.5 million Americans vaccinated.

And local health officials still don’t know who gets that money or how much they might get. And if they do get money, they don’t know whether it can be used to purchase the actual vaccine or must be used for administrative purchases like staffing.

“It’s not enough, and we need to learn more about what it’s meant to support,” Chrissie Juliano, executive director of the Big Cities Health Coalition, told reporters Tuesday.

A Covid vaccine can cost upwards of $100 without health insurance, and some public health officials worry that the end of the Bridge Access Program will temper already lackluster enthusiasm.

“We are definitely experiencing Covid fatigue,” said Crystal La Tour Rambaud, who manages the vaccine program at the Pima County Health Department in Arizona. “The population we are concerned about are the people on the fence. They are not completely anti-[vaccine], and they are not completely all about it. And for those groups of people, it’s a very small thing that could tip the scale in the direction of not being vaccinated.”

She said Pima plans to buy enough doses for its entire uninsured population.

“But it’s going to have to come out of the same budget that a lot of our other vaccine projects come out of,” she said.