President Joe Biden gave an address to the nation concerning his response to the omicron variant of the coronavirus, which has quickly become the dominant strain of new infections. An epidemiologist (Amanda Simanek, Associate Professor of Epidemiology at UW-Milwaukee Zilber School of Public Health) explains what we know about this rapidly-spreading variant and gives tips for how to be safe during the holidays.

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By Kristian Knutson, Will Cushman
PBS Wisconsin
November 30, 2021

One of the chief public health conundrums of the COVID-19 pandemic is understanding why different groups of people decide to get vaccinated at various levels and how to encourage vaccination in communities where rates are lagging. While public embrace of the vaccines has been broad, with about seven in 10 Wisconsin adults having taken that step to protect themselves, it has been by no means universal.

Racial and ethnic disparities are one major focus of public health outreach campaigns, while political differences in embracing the vaccine are the subject of copious analysis and prognoses. Age differences resemble a staircase, with each older age group more likely to have gotten vaccinated. One of the most persistent differences, though, is by sex, with women consistently getting vaccinated at higher rates than men since the shots were first made available.

In Wisconsin, the  gap between females and males is nearly seven percentage points. When it comes to getting at least one dose, as of Nov. 28 a total of 55.2% of males 12 and older have done so compared to 62% of females, with the share fully vaccinated at 52.3% and 59.2%, respectively. This gap is slightly wider among adults, closer to eight percentage points.

A gender gap in covid vaccinations is a . The  a difference of nearly five percentage points among people who have received at least one dose of a covid vaccine, with women accounting for 52.4% of that group compared to men at 47.6% as of Nov. 29. That gap is slightly wider among people considered fully vaccinated. (There is a gap in the data itself, though, with information about sex available in just over 91% of all people who have received one dose or are fully vaccinated.)

This gap has persisted since the first doses were administered at the end of 2020. Nationally, it was  during the first several months vaccines were distributed before narrowing over the course of 2021.

Several factors contributed to the initial gender gap in vaccination rates. When COVID-19 vaccines were first approved, their distribution was targeted by age and occupation, with older adults initially eligible to get the shots, alongside people who worked in health care and education fields.

Attracting attention as eligibility expanded in the spring, the covid vaccination gender gap has been observed in numerous places, including , ,  and . This dynamic isn’t exclusive to the U.S. either, having been observed in . Meanwhile, the vaccination gender gap goes in the opposite direction elsewhere, across  and in different nations around  where men are generally getting the shots at higher rates than women.

The breadth of the vaccination gender gap is not the same in all places, including within Wisconsin. It varies at the county level, with the gap ranging between a handful of percentage points up to as much as a dozen. However, there is no clear geographic pattern that might explain these differences.

The Wisconsin counties with the smallest vaccination gender gaps are both urban and rural, and along related lines, have vast differences in their populations. These counties with smaller gaps are located in both northern and southern parts of the state, as well as its eastern and western stretches.

At this narrower end of the gap, though, there are distinct differences in the overall vaccination rates. For example, Dane County has Wisconsin’s highest overall level of vaccination, with 72.6% of its population having completed their series as of Nov. 28. Meanwhile, Taylor County has the state’s lowest vaccination rate, at 32.1% as of Nov. 28. Yet both counties have among the smallest gender gaps, with Dane County at 5.2% and Taylor County at 4.7%, which is the narrowest difference in the state.

Similarly, counties with the widest gender gaps can be found across Wisconsin, though many are located in a stretch running from northwest to southeast through the center of the state.

A multiplicity of factors  in the ongoing vaccination gender gap, both at a general level and among different counties. Prominent possibilities include the fact that a larger number of older adults are women and more women work in fields like health care and education, given that both age and workplace have been prioritized in vaccination distribution. Yet there are other influences,  differences in perceived gender roles, attitudes toward preventive health practices and partisan political dynamics. Each looks to be contributing in some way to this persistent disparity, but they are tangled together in a way that doesn’t provide simple answers.

Health gender gaps

Vaccination is only one element to a broader covid gender gap. Even , disparities in serious disease and death between men and women . Nearly a year after the covid vaccination campaign started, the death rate among men continues to be significantly higher than for women, with  from the disease than women by October 2021.

Even in the face of covid’s disproportionate impact on men, some evidence suggests women are more likely to consider covid a serious health threat. A  conducted in December 2020 of more than 13,000 people across 10 nations including the U.S. found that women were more likely to believe they would get COVID-19 and become seriously ill. This survey also found higher levels of self-reported vaccine hesitancy among women than men, as did a much smaller  of health care workers in California.

Despite these mixed indicators, women in Wisconsin and across the U.S. have consistently outpaced men in getting covid vaccines. A complex set of factors likely underpins this dynamic, according to Amanda Simanek, an epidemiologist at the University of Wisconsin-Milwaukee who studies social disparities in health.

While Simanek hasn’t looked specifically at what might be causing the sustained disparity in covid vaccination rates among men and women, Simanek pointed to some possible explanations.

Most obvious is the larger share of women 65 and older, as well as the vastly higher number of women in the health-care workforce compared to men.

By the end of the 2010s, women on average were living just over five years longer than men in the U.S. In 2019, the final year before the pandemic struck, the  a life expectancy of 81.4 years for women compared to 76.3 years for men. That difference means there are many more older women than men, with a 2017 projection for 2020  84 men for every 100 women between the ages of 65 and 84, and 56 men for every 100 women above the age of 85. Simply put, more women got vaccinated earlier because there are many more of them who are older adults.

At the same time, early vaccine access was prioritized for people who work in health care. The  in 2019 that over three-quarters of all healthcare jobs were held by women, with their overall numbers increasing given a growth trend in jobs projected to continue as the industry grew with an aging population.

A  by the Wisconsin Center for Nursing and UW-Madison School of Nursing found that nearly 92% of registered nurses in the state identified as female. A  by , a national organization that researches long-term care policy issues, found that nearly 90% of direct-care workers in Wisconsin at that time were women.

Workers in these fields were among the first to become eligible for the covid vaccinations in December 2020. Hospital systems and nursing homes have also turned to employee vaccine mandates to a greater degree than other employers, which could help drive up the vaccination rate among their largely female workforces.

Similarly, educators were among those prioritized after health-care workers for vaccine distribution, and a  issued in 2020 indicated that over three-quarters of all teachers in public and private schools were women.

On top of those age and occupational factors, Simanek said there’s  that men and women treat their health differently, and therefore have different health outcomes. One reason may be adherence to common social norms surrounding gender.

“Our health behaviors are very gendered and are one of the ways that we sort of perform our gender,” Simanek said. Such norms may help explain why women tend to be more proactive about their health, she added.

“I can’t say that’s what’s playing out here,” Simanek said about Wisconsin’s covid vaccine gender gap, “but there’s a literature that supports this idea that women are more likely to engage in those types of [proactive] activities” like getting vaccinated.

Shifting social norms around gender may help explain why the covid vaccination gap between men and women is .

Simanek also noted the political dimension that getting vaccinated for covid has taken, with Democrats  to enthusiastically back the shots than Republicans given that American women are  to be Democrats or lean left than men.

“Everything from mask-wearing to vaccine uptake has become very politically embroiled, so there could be some trends in that direction,” Simanek said.

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The Food and Drug Administration is meeting this week to discuss booster shot recommendations and whether to approve the Pfizer COVID-19 vaccine for younger children. We find out what’s being considered and check in on case numbers in Wisconsin and nationwide.

Host: 
Guest(s): 
Producer(s): 
Technical Director(s): 

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For a brief, glorious few weeks, it seemed to many that the worst of the pandemic was behind us.

. Beloved  and , forced into hiatus last year, are making a triumphant return, with .

In late June and early July, many counties recorded averages of very few — sometimes zero — new coronavirus cases per day. Hospitalizations from the virus were down and deaths plummeted.

But signs of what could come our way were already emerging in the southern U.S., where states with large unvaccinated populations suddenly had overflowing hospitals and some of the highest case counts .

The surge is thanks to the more contagious delta variant, which appeared first in India and now accounts for more than 86% of all COVID-19 cases in the nation, .

Numbers haven’t skyrocketed the same way in Wisconsin, but : On July 15, the state was averaging 150 new cases per day; a little more than a month later, it’s averaging nearly 1,400. Hospitalized COVID-19 patients . Deaths have remained relatively low, but at eight per day over the past week, they’re higher than they have been since February.

Even with the help of vaccines, health care workers, school teachers, business owners and others are struggling with the familiar feeling that this fall may be bad.

But how bad?

At the pandemic’s worst, outbreaks struck Wisconsin ,  and  with full force, moving quickly through populations at high risk of illness due to age, comorbidities or poor ventilation and close proximity to others.

Today, those settings are at least somewhat protected by vaccination and natural immunity built up from previous infection, though we don’t know how long that lasts.

This time around, though, schools with relaxed mask policies and a commitment to in-person instruction could prove a breeding ground for outbreaks, as could the mass gatherings that were largely canceled last year.

Prisons: 70% of incarcerated people are vaccinated, but less than half of staff are

Prisons have been the sites of some of the pandemic’s largest outbreaks. Prison overcrowding, cramped living quarters and limited space for isolation or quarantining made the facilities hotbeds of COVID-19.

About 11,000 Wisconsin prisoners have tested positive for the virus since the beginning of the pandemic and at least 32 have died from COVID-19, according to . That’s out of a prison population that, on any given day, is .

Nearly 2,700 members of DOC staff have also caught the virus, .

About 80% of infected prisoners caught the virus in the last three months of last year, when the pandemic was at its height in Wisconsin. In some state prisons, three quarters or more of the prison population ended up infected.

By June, most prisoners had been fully vaccinated, and cases of COVID-19 among prisoners were few, according to DOC data. No large outbreaks have been reported at state prisons since the delta variant became dominant.

That’s likely due, in part, to the relatively high vaccination rates among prisoners. Nearly 70% of all current prisoners have been fully vaccinated, though at some prisons, the rate is nearer to 50%, according to DOC figures.

It’s less clear exactly how many correctional staff members have been vaccinated, said John Beard, DOC spokesperson. At least 47% of prison workers have gotten the vaccine, Beard said, though state prison officials believe the true number is higher.

Amanda Simanek, associate professor of epidemiology at the University of Wisconsin-Milwaukee, said it’s important to keep an eye on vaccination rates among staff members, who could bring the more contagious delta variant into the prison.

The prisoners “don’t have a choice of who comes in and out of their facility. They have the least autonomy over the mitigation measures they can take,” she said.

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By Sarah Zhang
The Atlantic
August 23, 2021

Since early summer, three pandemic clocks have been ticking. The first pertains to the coronavirus’s Delta variant, which has  more than tenfold since June. The second clock is more predictable: The school year starts, as it always does, in late August or early September. The third clock counts down to the authorization of , which was optimistically supposed to come this fall. After the FDA pushed for a larger trial to collect more safety data in kids, it will likely take longer.

These three timelines have now managed to converge in the worst way possible: Just as Delta is climbing to a new peak, millions of children  are going to spend hours a day indoors at school. And many of them will do so without masks, thanks in part to mask-mandate bans in some of  that are currently experiencing the worst outbreaks. “Are you allowed to use swear words?” is how Sean O’Leary, a pediatrician at the University of Colorado, replied when I asked him how he felt going into the school year.

This fall was supposed to herald the return of in-person classes everywhere. After the virus brought the 2020 spring semester to an abrupt halt, schools fumbled through another year with a mix of in-person and virtual learning. Now Delta threatens to wreak havoc on a third school year.

The risk the coronavirus poses to an individual child is still very low— need ICU treatment—and with millions of the most vulnerable adults now vaccinated, the danger of kids bringing the virus home from schools is also much reduced from last year. But Delta will make for a bumpy school year even without very sick kids. Students who get infected or even just exposed at school will have to miss classes to  at a time. And if cases truly get out of control, schools will have to shut down and return to remote learning. Parents will again have to scramble for last-minute child care.

The fewer mitigations a school has in place—masks, testing, ventilation, vaccination for students over 12—the more likely this is to happen. “​​Not using those measures is a surefire way to mean more kids have to be out of school and have interruptions due to quarantine and individual school closures,” says Jennifer Nuzzo, an epidemiologist at Johns Hopkins Bloomberg School of Public Health. At just one school district in Florida, a state that has banned mask mandates,  were in quarantine or isolation after one week of school. In Alabama, some districts are already being  .

Parents had hoped that this school year would go smoothly—even somewhat normally. Last year’s experiences suggested that schools could indeed stay open with the right mitigations and low community spread. “The big takeaway was: With moderate efforts, we could pretty much control transmission pretty well,” says Alyssa Bilinski, a public-health researcher at Brown University who has modeled . Cases dropped to an all-time national low in June, and things looked good—until Delta. Now schools have to deal with a more transmissible variant and more community transmission of the virus. This is “not how we were planning to go back to school,” Bilinski says. School districts, especially those bound by state laws banning mask mandates, have been slow to adapt to a steep rise in community transmission.

Delta does not require a complete overhaul of school mitigation strategies compared with last year. The same tools still work. “Delta may be more transmissible, but it can’t defy the laws of physics,” says Amanda Simanek, a public-health researcher at the University of Wisconsin at Milwaukee. “We have a good sense of how successful mitigations were with other variants that weren’t as transmissible. We’re going in not totally blind.” But with Delta, schools may have to add measures to reduce spread to the same level as before. “There’s no single intervention that’s the magic bullet, but a set of layered interventions can work together to stop COVID. I would say it’s still true for Delta. It’s just that you need more,” says Meagan Fitzpatrick, an infectious-disease modeler at the University of Maryland School of Medicine. For example, schools might layer on surveillance testing of students without symptoms—Baltimore , but it’s still rare in schools across the country. And vaccines for teachers and students over 12 are new tools that were unavailable last year. O’Leary told me he is “very optimistic, even with the Delta variant,” about schools that have mitigation measures in place.

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By Katherine J. Wu
The Atlantic
August 12, 2021

For the past year or so, I’ve been reporting on the COVID-19 vaccines, a job that’s required me to convey, again and again, how inoculations work to boost immunity and why. The shots are new, and . So I, like so many others in journalism and science, turned to analogies to help make the ideas of disease prevention and public health tangible. Vaccines, as I’ve written, protect us a lot like , , and .

Analogies, metaphors, similes, and the like are evocative and memorable. They transform the abstract into the concrete. And they , especially when used to depict a virus or an infection, which are almost entirely unseen. But a lot of the ideas we link to COVID-19 vaccines—including plenty I’ve used—don’t totally hit the mark. Too many focus on vaccines’ individual perks. And they end up skating over one of the greatest benefits of immunization: a boost in wellness at the community level, by cutting down on transmission and, by extension, illness for everyone else. For immunization to truly pack a punch, Amanda Simanek, a social epidemiologist at the University of Wisconsin at Milwaukee, told me, “we all have to do it.”

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By Roxanne Patel Shepalavy
The Philadelphia Citizen
August 12, 2021

Back in the early days of —b��ڴǰ��� , and opening back up and variants—the women scientists answering questions for “,” a Facebook group and blog that launched last spring to provide science-backed Covid-19 information—were in crisis communications mode. Everyone wanted to know everything about the virus immediately; every question and answer had implications that could save lives right now; and everyone was focused on finding the best way to get through this moment, to the other side of all this.

And for a little while this summer, we seemed to get there, that crisis mode seemed to abate, and the dozen or so doctors, nurses and researchers from Philadelphia and around the world who run had started to slow down and focus on other issues, like and . “We were getting ready for more non-Covid content, with the hope this would not be the first thing on anyone’s mind,” says Ashley Z. Ritter, PhD/CRNP and CEO of Dear Pandemic. “You can’t do crisis communication on an ongoing basis without getting tired.”

You can guess how that has played out.

The Covid Delta variant and the virus is again raging nationwide (though less so here in Philadelphia), in no small part because so many Americans are unvaccinated—including those who can, but are choosing not to. Politics is part of that. So, too, is misinformation, fear, confusion and a loose understanding of science and how it really works.

“Science is not a fixed body,” Ritter notes. “It changes all the time. People have a hard time with that.”

Dear Pandemic launched last May after Ritter realized social media—where more than 50 percent of Americans —was full of misleading information about the brand new pandemic we faced. A geriatric nurse practitioner in Philly, Ritter joined with Alison Buttenheim, a Penn behavioral scientist who specializes in infectious disease prevention and whose tweets shared the best science-backed information out there at the time. They soon recruited a team of more than 25 volunteer scientists around the country and world, and dubbed themselves “Those Nerdy Girls.”

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Stoked by fear of a virus that doctors and researchers knew little about, we wiped down our groceries, bought up every last roll of toilet paper, and researched how to make our own hand sanitizer.

Alison Buttenheim was no expert in infectious diseases, but as a social scientist and public health researcher, she felt compelled to help friends and family make sense of the novel coronavirus spreading quickly in the United States.

“Wash hands wash hands wash hands. Seriously, it’s like the Victory Garden equivalent of how we win this war against” Buttenheim, who is an associate professor of nursing and health policy at the University of Pennsylvania, tweeted in late February 2020.

She wasn’t alone.

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By Adrianna Rodriguez, Alia E. Dastagir and Erin Richards
USA Today
July 14, 2021

Daniel Horowitz’s grip tightened around his children’s hands as he looked upon the sea of people in horror. Nobody was wearing a mask.

The amusement park’s website said any unvaccinated visitors were required to wear face coverings, but it didn’t take long for the 42-year-old father to realize these rules weren’t being enforced.

This was not the safe, socially distanced summer Horowitz had in mind.

Although the dad from Wilmington, Delaware, is fully vaccinated, his 8-year-old daughter, Emily, and 4-year-old son, Adam, are unprotected. Horowitz was excited to give them the summer they had lost last year, but he said the lack of regard for unvaccinated children puts them at risk.

“They don’t seem to be taking the kids into account too much when making these regulations,” he said. “We want our kids to do fun things, but we wish it was safer for them.”

As the country picks up where it left off, fully vaccinated parents feel left behind .

Studies have shown from COVID-19, but these studies were conducted during mask and social distancing mandates, and while the country had robust testing. Some parents said the Centers for Disease Control and Prevention should offer more specific guidance for navigating the new normal with their unvaccinated kids…

With all this in mind, families have to weigh what level of risk they’re willing to tolerate, said Amanda Simanek, an epidemiology professor at the University of Wisconsin-Milwaukee.

“We are in a pand-exit period — it’s limbo,” said Simanek, a mother of a 12-year-old who is fully vaccinated and two younger children who are not yet eligible…

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The Delta variant of the coronavirus is likely to dominate in the U.S. within weeks. The Delta variant is more contagious than other versions of the virus, and may be more likely to infect children. Zilber School of Public Health Epidemiology Associate Professor, Amanda Simanek (MPH, PhD), went on Wisconsin Public Radio to explain.

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