A few years before the start of the COVID-19 pandemic, Samantha Rodriguez’s ankylosing spondylitis, a spine-related form of arthritis, worsened to the point of giving her regular bouts of chronic pain, brain fog and fatigue. This put the 29-year-old Penn Hills resident in a group of immunocompromised people who are at particular risk of developing severe symptoms from COVID-19.
As COVID-19 began to spread around the world, Rodriguez immediately became educated – she not only had skin in the game, but also a background in healthcare research. She stayed careful, and years later, after most people have moved on from many COVID-19 precautions, still does.
When she visits her parents, one of whom has an autoimmune lung condition, they typically take multiple rapid PCR tests leading up to the gathering and mask even if it’s negative. At this point, she’s most concerned about getting long COVID, a chronic condition.
“I already have a disability that makes functioning sometimes very difficult, and I don’t want to exacerbate that,” Rodriguez said.
She gets every vaccination shot she can – the initial two doses that most people got, two of the initial booster shots and two of the more recent bivalent booster, designed to combat newer strains of the virus.
However, despite recommendations from both local and federal health officials, only around one in five people in Allegheny County, and even fewer in the United States as a whole, have received bivalent booster shots.
“Honestly, it stresses me out because it’s not gone,” Rodriguez said. “And the more that we pretend like it’s not here, the worse, eventually, reinfections will be, and every new infection is a higher chance of developing long COVID or ending up in the hospital or suddenly having a stroke.”
The federal government ended the emergency declaration for COVID-19 in May. Allegheny County followed suit, ending both the vaccination requirement and the COVID leave policy for county employees and cutting back on regular reports to the public about the state of the virus.
“Following the ending of the Federal Health Emergency on May 11, it is time for Allegheny County to do the same,” County Executive Rich Fitzgerald said in a May press release. “While we still encourage people to protect themselves against COVID, the lifting of the emergency by the federal governments suggests to us to be consistent.”
County residents, along with the rest of the country, appear to have largely moved on from much concern about COVID-19. Recent COVID-19 levels have been considered low.
New variants and seasonal changes, though, could potentially spell trouble for a public with blase attitudes about booster shots.
The most recent data from the Allegheny County Health Department [ACHD], which goes to May 19, shows very low levels of infection but also very low levels of testing. The week of May 14 saw 23 confirmed infections and 10 confirmed reinfections reported, but only 185 residents were tested. The week prior had 121 people confirmed to be infected, 33 confirmed to be reinfected and 2,156 people tested.
Data updated June 23 shows 20.9% of county residents have gotten at least one bivalent booster shot. This is higher than the U.S. population as a whole, 17% of which has received a bivalent booster shot, according to data posted by the Centers for Disease Control and Prevention on May 11. Allegheny County has a disproportionately large senior population, the age cohort most likely to get COVID-19 vaccinations.
Experts and vulnerable residents warn that the virus still warrants caution.
COVID risks could rise in fall
The bivalent booster shots interest some patients of Dr. Marc Itskowitz, a primary care physician with Allegheny Health Network. These patients, he said, tend to be the most cautious and informed.
“I think for other patients, they have become less interested in staying up to date,” Itskowitz said. “They’re more comfortable with the impact of the virus.”
He recommends everyone get at least one bivalent booster shot. Healthy young people are less susceptible to serious illness and death, but it still helps, has little risk and helps prevent spread of the virus to others, including those most vulnerable.
“I wouldn’t say it’s mandated, and certainly the policies have changed to reflect that fact, but I think that it’s a good idea to provide some level of protection, especially when we have vaccines that have been so safe,” Itskowitz said.
Contagious diseases tend to spread most during the fall and winter seasons, when people more frequently gather indoors. Then, adoption of booster shots and other protocols, like mask-wearing, may become more important, according to Itskowitz.
Dr. Barbara Nightingale, the county Health Department’s deputy director of clinical services, agrees that residents should receive at least one bivalent booster shot. She said it’s difficult to predict the future of the virus’ spread in the county but that more adoption of booster shots will help keep levels low.
“Where we are now with COVID is a result of many people having been vaccinated and many people having gotten COVID. And so as your immunity goes down over time, the risk of having another peak would increase again,” Nightingale said. “I think that’s where we try to encourage people, if you like it low, keep getting vaccinated.”
ACHD doesn’t have a specific goal of a certain booster shot adoption rate, Nightingale said, but monitors vaccination rates in comparison to adoption across the country, promotes vaccination and partners with organizations and heads into communities to provide vaccinations. ACHD plans to make a big push for COVID-19 vaccination in the fall, to coincide with its yearly push for flu shots.
“We know in Allegheny County we tend to have an older community than the rest of the country, so we would definitely like to be on par if not higher than across the country. Not that the average of the country is where we would like to be,” Nightingale said. “We want to obviously go as high as we can.”
Coughs, concern and fatigue
Linda Hartman, a 61-year-old Ross Township resident with asthma, acted as carefully as she could when the COVID-19 pandemic began. She still tries to avoid crowded, indoor spaces and has received the two initial booster shots in addition to one of the bivalent booster shots.
When shopping, she doesn’t wear a mask anymore, but she still stays wary of her surroundings. “If anybody near me coughs, I’m out of there,” Hartman said, laughing.
She hasn’t moved on from concern about COVID-19, but she can sympathize with those fatigued with COVID-19 affecting regular life.
“I think we should still be vigilant, but I acknowledge that everybody’s sick of it,” Hartman said. “Myself included.”
Correction: Roughly one in five Allegheny County residents has received a bivalent booster shot, but a larger part of the population has received other boosters. An earlier version of this story contained an editing error.
Matt Petras is a Pittsburgh-area independent writer and adjunct professor. He can be reached at matt456p@gmail.com or on Twitter @mattApetras.
This story was fact-checked by Elizabeth Szeto.
The Jewish Healthcare Foundation has contributed funding to PublicSource’s healthcare reporting.
