PENDLETON — While an updated vaccine formula for COVID-19 has come fresh out of the approval and authorization process, local health officials say it is uncertain when it will arrive in Eastern Oregon.

Flu shots, however, are a different story and clinics for those vaccinations are ready to roll out, starting this week.

Historically COVID-19 vaccines, at least, have reached this corner of the state later than Oregon’s more populated counties.

Oregon Health Authority announced last week that Moderna and Pfizer boosters, updated to target the newer XBB.1.5 subvariant, were recommended for use on Sept. 12, by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

The federal Food and Drug Administration approved the doses on an emergency basis the day before.

Dr. Paul Cieslak, medical director for communicable diseases and immunizations at OHA’s Public Health Division, said arrival of the updated vaccines represents a pivotal moment in Oregon’s COVID-19 response.

“They are the first updated vaccines approved after the federal public health emergency ended in May, and the first updated vaccines available on the commercial market,” Cieslak said. “This means we’ve taken a big step toward normalizing COVID-19 as something we live with and manage much as we do for influenza.”

The new single-ingredient formula is recommended as a one-dose inoculation for everyone age 5 and up, and for children from 6 months old up to 5 years, based on what vaccines they’ve had.

Anyone in a high-risk category should get the booster by mid-October, given the indoor events coming with cooler weather and holidays, OHA advises.

New vaccines not yet on the local sceneJoseph Fiumara, director of public health for Umatilla County, noted an important fact: Until the new formulation arrives in Northeastern Oregon, his department is effectively without a COVID-19 vaccine.

Last year’s bivalent booster is no longer legal to give, Fuimara said, noting he’s had to tell many callers to the health department this same news.

Morrow County Public Health Director Robin Canaday shares the frustration of always being late to the vaccination party, she said.

“By the time we do get it, it won’t be frontline news anymore,” she said. “People won’t be interested in getting it.”

Unlike 2022’s booster and primary vaccine doses, the newest version will not be free to everyone. In Oregon, under-insured and uninsured children can get the shot at no cost, thanks to state insurance for kids under the age of 18. Oregon also is providing funding to public health for costs associated with giving those vaccinations, Fiumara said.

The expectation is most health insurance plans will pay for the updated vaccination for their customers. Those with high-or-unmet deductibles, however, could end up paying out of pocket, he noted.

Umatilla County Public Health does bill insurance companies for vaccines. For this first cycle of dispensing the new vaccine there will be no additional cost for anyone receiving it, officials said.

Like elsewhere in Oregon and the nation, COVID-19 is again trending upward, indicated in higher wastewater testing numbers in Pendleton and Hermiston, he said.

“But we are not seeing folks end up in the hospital,” he said. “We are seeing, across the state, that with school starting we know sharing happens. But we are not seeing (the virus) hit people like in past years.”

Fiumara attributed that to the large majority of the population that has been immunized by vaccination or infection. But, as before, the very young and people 65 years and older are most at risk of severe illness and death from the coronavirus, he said.

The New York Times reported on Sept. 11 that nursing homes, “which inoculated nearly all of their residents in the first waves of the pandemic, have fallen behind on booster rates.” According to recent Medicare data, about 62% of residents in congregate senior living facilities are up-to-date on their shots, even though they are among the most vulnerable to severe sickness and death from COVID-19, the article said.

Experts at Johns Hopkins Bloomberg School of Public Health report people at higher risk of severe illness should get the updated COVID-19 vaccine as soon as possible and everyone eligible for vaccination should have it by mid-October.

Yet it is still unknown if fall is really coronavirus season, Fiumara pointed out.

“It hasn’t held to that in the past,” he said. “You look back at the peaks we’ve had, not all of them were in the fall and we’re still seeing how that settles out.”

Canaday and her staff also are not seeing a jump in COVID-19 numbers in Morrow County. That doesn’t mean people should let their guard down, the director cautioned.

“People should social distance, wash your hands, cover your cough and stay home from work and functions if you are having symptoms,” she said. “Try and protect your elderly family members and neighbors.”

Respiratory syncytial virus, or RSVCanaday and Fiumara said they are not seeing cases of the lower respiratory tract disease known as RSV yet this season.

The U.S. Centers for Disease Control and Prevention defines RSV as a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, according to the CDC. Infants and older adults are more likely to develop severe RSV and need hospitalization.

Thus far vaccines only are available to protect older adults from severe RSV. Monoclonal antibodies, usually administered through an IV, are available to protect infants and young children from severe RSV.

Medicare Part D covers the RSV vaccine that was approved for use on May 3, but some private health insurance plans don’t, according to epidemiologist and data scientist Katelyn Jetelina, who consults for the CDC and other agencies.

That means some older adults must pay more than $300 for their RSV vaccine, Jetelina explained in a recent newsletter, because of two reasons: the adult RSV vaccine is not yet included in the CDC’s annual vaccine schedule, which should be updated in 2024. As well, the CDC’s language around its recommendation uses “may” get the vaccine, rather than “should,” according to Jetelina.

“Private companies use this language as justification not to cover expenses,” she wrote.

RSV is a highly contagious virus that causes infections of the lungs and breathing passages in people of all age groups, according to the FDA’s information.

The virus typically circulates seasonally, starting during the fall and peaking in the winter. “In older adults, RSV is a common cause of lower respiratory tract disease which affects the lungs and can cause life-threatening pneumonia and bronchiolitis. According to the U.S. Centers for Disease Control and Prevention, each year in the U.S., RSV leads to approximately 60,000-120,000 hospitalizations and 6,000-10,000 deaths among adults 65 years of age and older,” the FDA said.

The new vaccines are available through pharmacies, Umatilla County health officials said.

InfluenzaThis year’s flu vaccine is here, as surely as the flu season soon will be. And the quadrivalent formula appears to be a good match for the predicted circulating strains, Canaday said.

Morrow and Umatilla county health departments are gearing up to help residents gain the defensive position through flu vaccination clinics.

The virus usually peaks in this area in January, which makes early to mid-fall an ideal time to get the protection of vaccination, Fiumara said.

Influenza kills about 36,000 Americans annually and, when combined with pneumonia, is the seventh-leading cause of death in the United States, according to the CDC.

Questions about whether or not to combine flu shots with COVID-19 and-or RSV vaccines is circulating, Jetelina reported.

There is no single shot for all three vaccines and won’t be for years, she said, meaning “if you’re eligible, you will need three shots to protect against the three viruses this fall.”

It is possible to get all of those at once, but it might not be ideal. Deciding factors include how many trips to a pharmacy can be undertaken, optimal timing of the vaccinations and unknown risks of getting the three shots simultaneously, she said.

What is known is that it is safe to combine COVID-19 and flu inoculations, and older adult RSV and flu vaccines are safe together.

As always, questions about vaccination decisions and risk factors are best answered by the provider who knows the most about a person’s health, experts agree.

• Morrow County Public Health will have a flu shot pop-up clinic Friday, Sept. 22, 3-4:30 p.m., at the Oregon Local Emergency Preparedness Committee Conference in the SAGE Center, 101 Olson Road, Boardman.

For Morrow County Public Health information call 541-676-5421 or visit www.co.morrow.or.us/publichealth.

• Umatilla County Public Health will host a drive-thru flu vaccination clinic Wednesday, Sept. 27, 2-6 p.m. and Thursday, Sept. 28, 8 a.m. to noon at the Milton Seventh-day Adventist Church, 1244 N. Elizabeth St. Participants should bring insurance information but no out-of-pocket payment will be required.

English to Spanish interpretation will be available.

Vaccinations appointments also can be made at the health department offices in Pendleton and Hermiston.

For more information call 541-276-5432 or go to ucohealth.net.