So where do things stand regarding COVID and the availability of vaccines for those who want them? You’d likely have to be living under a rock not to be aware of the conflicts and confusion that have taken hold about vaccines generally in our country, and the challenges that this conflict has already caused in such realms as the rise of unvaccinated minors and the spread of measles in certain areas of the country. For many, concerns about continuing exposure to COVID-19 and the availability of new, updated vaccines to lessen the likelihood of serious disease are top of mind. In case you’re wondering, COVID is still very much present in the US. Cases have risen this summer, just as they have for the past five years, and tens of thousands of Americans are still dying because of COVID. While most of us now have some immunity, either because we’ve had COVID or have been previously vaccinated, the threat of COVID continues to loom large, especially among those who are older or are immunocompromised.

In addition to such lingering aftereffects from COVID as brain fog or “long COVID,” new research just published suggests another consequence from COVID that bodes poorly for cancer patients, particularly breast cancer patients. Published in Nature, this research found that even after remission, a tiny number of cancer cells remain. It appears that a virus, specifically influenza or COVID, can “reawaken” these dormant remaining cancer cells in the lungs. What researchers discovered was that inflammation in the lungs from these viruses triggers the cancer cells to expand, such that COVID infection was associated with a more than 40% increased risk of metastatic breast cancer in the lungs. This research was undertaken after it was “noticed that U.K. patients who were in remission from breast cancer and tested positive for COVID later showed a two-fold increase in cancer-related deaths.” While it’s unclear what role vaccination would play, it certainly suggests a level of vulnerability among cancer patients that needs further research and underscores the need to avoid COVID infection if possible. You can read more about this study here.

So what level of interest and acceptance currently exists for COVID protections, and how will that influence the availability of vaccines this fall? A recent poll by the Kaiser Family Foundation sheds some light on this topic. According to the poll, almost 60% of American adults polled said they do not expect to get a COVID-19 vaccine this fall. About 40% said they would definitely or possibly get a vaccine. Those who say they are most likely to get a vaccine are mostly older adults or those who identify as Democrats. 60% of self-identified Republicans said they will definitely not get a shot this fall. For those who want to get a COVID shot, ⅔ of them are concerned that they won’t be able to get access or that the vaccines won’t be available. Parents of children under 18 were confused and uncertain, with good reason. It now appears that the vaccine is no longer recommended for healthy children under the age of 18, which means many pediatricians will not even offer it. Parents who do want the vaccine for their children should engage in “shared clinical decision making” with their physicians to come up with a vaccine strategy. It’s all a bit confusing and in flux, and conditions, recommendations, and restrictions could still change before the Fall.

While new, updated COVID vaccines are not yet available, for now, adults aged 65 and older should be able to get the new COVID vaccines when they are released, without any barriers, though fewer pharmacies may carry the vaccines.  Adults under the age of 65 who are immunocompromised or have pre-existing conditions that put them at risk of serious illness with a COVID-19 infection should also be able to access the updated vaccines. You should be able to self-identify with these conditions and not have to provide any documentation to support your claims of a medical condition. For those who have become accustomed to receiving their flu and COVID shots at the same time, this should still be an option this Fall. However, stay tuned for further updates, because, like many aspects of the COVID pandemic, there is much we don’t know and many twists and turns that may change circumstances for us all.

(Note: as one measure of just how fluid the situation regarding vaccines is in the US, Health Secretary Kennedy just announced that funding for mRNA vaccine research, which was essential for our response to COVID-19, has been cut. To understand the significance of this step, consider a quote from a brand new post from STAT: “The mRNA vaccine platform was first used during the COVID pandemic, allowing for the creation, testing, and regulatory authorization of vaccines within 11 months of the sharing of the genetic sequence of the SARS-CoV-2 virus, which causes COVID. No vaccine has ever been produced so quickly, and no other existing vaccine platform can match the speed of mRNA technology.”)