People's CDC, June 24, 2024, COVID-19 Weather Report

FDA COVID vaccine variant recommendation updated, NC governor vetoes mask ban, ongoing action needed to stop mask bans in NC, NY, Chicago, and everywhere.

Jun 25, 2024

Wins

The Food and Drug Administration (FDA) has changed its 2024-2025 vaccine recommendations to be tailored to KP.2 instead of JN.1, if such a change is feasible for vaccine manufacturers. This is a timely update to its initial June 6th recommendation of a monovalent JN.1 vaccine for the fall rollout. The JN.1 parent lineage has rapidly fallen followed by the rise of several JN.1-derived subvariants (see additional detail under “Variants” below). COVID vaccine manufacturer Novavax, which utilizes a protein-based platform for its COVID vaccine, will not have an updated KP.2 shot ready by the fall but has submitted their JN.1 vaccine for FDA review. Pending FDA authorization, there could be a JN.1 Novavax vaccine alongside mRNA vaccines tailored to KP.2 this fall.

We thank everyone who submitted public comments to the CDC’s Advisory Committee on Immunization Practices committee in support of fall COVID vaccine access for all ages, as well as access to boosters at least every six months. Only a portion of the comments submitted prior to the 6/17 deadline are currently viewable on Regulations.gov. We will see many more comments posted in the coming days. The June 26-28 meeting will be publicly viewable via a video link from the committee’s website. Those who registered to give oral comments should have received an email notification indicating whether or not they were selected. See “Vaccines” below for more discussion on vaccines.

On June 21st, North Carolina Governor Roy Cooper vetoed the mask-ban bill that would have made masking illegal in the state. However, the GOP majority in the General Assembly will likely override this veto. Ongoing action is needed to stop mask bans in North Carolina, New York, and elsewhere. See “Take Action” below for further details.

The Weather

The CDC’s reported COVID wastewater levels by state show that viral activity is “Very High” in Hawaii, Florida, Missouri, Connecticut, Alaska, and New Mexico. Viral activity is “High” in California, Nevada, Idaho, Wyoming, Utah, Colorado, Texas, Tennessee, and New Hampshire.

Four states are now reporting “Moderate” viral activity in their wastewater levels: Louisiana, Arkansas, Maryland, and Maine.

Still, no data is currently available from North Dakota, Puerto Rico, the US Virgin Islands, and Guam.

A map of the United States color-coded in shades of orange and gray displaying SARS-CoV-2 Wastewater Viral Activity level as of June 20, 2024, where deeper tones correlate to higher viral activity and gray indicates “Insufficient,” or “No Data.” Viral activity is “Very High” in New Mexico, Missouri, Rhode Island, Florida, Hawaii, and Alaska. Viral activity is “High” in the majority of the Western United States. Wastewater levels are “Moderate” in 5 states and “Low” or “Minimal” in other reporting states and territories, with no data available from 2 states and 3 territories. Text above map reads “”Very High " or"High" levels in 15 states. People’s CDC. Source: CDC.”

Graphic source: CDC

Based on the past two-weeks’ provisional data, CDC’s wastewater levels appear to be increasing nationally. The increases are particularly notable in the West and the South. The steep progression of viral wastewater concentration may indicate a summer COVID wave, with Western states facing the sharpest increases. WastewaterSCAN’s reporting also shows increasing levels for the last 3 weeks.

There is a lack of agreement between CDC’s COVID wastewater reporting, which currently indicates a “Low” level nationally, and WastewaterSCAN’s COVID wastewater reporting, which indicates that national COVID transmission is “High.” Wastewater level labels of “Low” or “High” lack standardization, and we are looking into the reasons behind this drastic difference. In the meantime, trends over time can be more helpful in understanding the current situation, particularly in your local area (which may be viewable on the CDC’s state/territory trends page, WastewaterSCAN’s interactive viewer, or state/local public health websites, if available). Risks of infection in daily life may be significant even during “Low” or decreasing wastewater levels, and continued precautions are needed at all wastewater levels.

These upward trends are on the heels of prematurely ending federal programs, including the Bridge Access Program for vaccine access ending in August and Home Test 2 Treat having ended in April 2024, despite ongoing need among America’s uninsured and underinsured population.

A line graph with the title, “COVID-19 Wastewater Trends as of June 20, 2024” with “Wastewater Viral Activity Level” indicated on the left-hand vertical axis, going from 0-15, and “Week Ending” across the horizontal axis, with date labels ranging from 12/23/23 to 6/06/24, with the graph extending through 6/15/24. A key at the bottom indicates line colors. National is black, Midwest is orange, South is purple, Northeast is light blue, and West is green. Overall, levels are trending upward in all regions, with the West showing the greatest increase. Within the gray-shaded provisional data provided for the last 2 weeks, wastewater levels in the West appear to be significantly rising, while there is an increase in all other areas. Text above the graph reads “Viral activity increasing nationally, still highest in the west. Text below: People’s CDC. Source: CDC.”

Graphic source: CDC

As of June 18, CDC forecasting estimates suggest that COVID transmission is “Growing” or “Likely Growing” in 39 states and territories. All remaining states show “Stable or Uncertain” or “Not Estimated” status, with no states showing “Likely Declining” or “Declining” COVID transmission. This forecasting model is based on emergency department visit data to predict transmission as R_t—an estimate of the average number of new infections caused by each infectious person, also known as the time-varying reproductive number. R_t greater than 1.0 indicates a predicted increase in infections, whereas R_t less than 1.0 predicts decreasing infections.

A map of the United States color-coded in shades of purple and gray displaying the CDC COVID Model: Current Epidemic Growth Status based on emergency department visits as of June 18, 2024, where deeper tones correlate to higher rates of growth and gray indicates “Stable or Uncertain”. States without predictions are represented in white. 39 States are “Growing” or “Likely Growing”. 10 States are “Stable or Uncertain” and 4 states and territories did not receive estimates. Text above map reads “CDC Predicts transmission is “Growing” or “Likely Growing” in 39 states” People’s CDC. Source: CDC.”

Graphic source: CDC

COVID continues to spread year-round, including in the summertime. Consistent use of well-fitting masks in a multilayered approach helps protect you and your loved ones in daily life, healthcare settings (also see our guide for requesting healthcare masking), social gatherings (including outdoors), and in summer travel.

Variants

The CDC’s variant tracking indicates that KP.3 is now predicted to be the most prevalent variant, overtaking KP.2. The “FLiRT” variants (KP.3, KP.2, and KP.1.1), which are descendents of JN.1, make up an estimated 62.9% of new infections. (This name is inspired from the unique mutations in the spike protein).

New research suggests that KP.2’s effective reproductive number (R_e)—the expected number of new cases an infectious individual can cause—is 1.22 times higher than that of JN.1 in the US.

Two stacked bar charts with two-week periods for sample collection dates on the horizontal x-axis and percentage of viral lineages among infections on the vertical y-axis. Title of the first bar chart reads “Weighted Estimates: Variant proportions based on reported genomic sequencing results” with collection dates ranging from 3/16/2024 to 5/25/2024. The second chart’s title reads “Nowcast: model-based projected estimates of variant proportions,” dates ranging from 6/8/24 to 6/22/2024. In the Nowcast Estimates for the period ending on 6/9/24, JN.1 (dark purple) is projected to decrease to 3.6 percent, while KP.2 (blue) grows to 21.6 percent. KP.3 is predicted to become the dominant strain at 25.9%. Other variants are at smaller percentages represented by a handful of other colors as small slivers.The legend with a list of variants, proportions, and their associated colors is on the far right of the bar charts.

Graphic source: CDC Variant Tracker

Vaccines

A recent study on the durability of XBB.1.5 COVID vaccines, which were released in fall 2023 (currently available 2023–2024 formulations), indicates that vaccine efficacy wanes from 52.2% at 4 weeks to 20.4% at 5 months post-vaccination. This study joins existing evidence, confirming that the 2023-2024 vaccines continue to offer some protection against the JN.1 variant. Vaccine inaccessibility, waning immunity, and a “variant soup” of circulating strains all underscore the necessity of layered precautions, like wearing a high-quality N95 or KN95 mask in crowds, indoor public spaces, and while socializing.

Those who are eligible for a second 2023–2024 vaccine and haven’t gotten one yet, including people aged 65 and older and those who are immunocompromised, should get one now, and receive the updated vaccine in the fall when it is available. Just as the FDA’s recent update of its fall 2024–2025 vaccine guidelines reflects the shifting viral landscape, increased transmission throughout this summer wave will be the genesis of new subvariants. (Last summer, BA.2.86/‘Pirola’ became a major variant under monitoring, only to be displaced by JN.1 in a matter of weeks). The latest vaccines, ideally made available at least every six months, remain an indispensable tool to protect against severe COVID complications.

Long COVID

The National Academies of Sciences, Engineering, and Medicine have released a landmark 166-page report that explains their working definition of Long COVID, which includes over 200 symptoms. Crucially, the report affirms that a positive COVID test is not necessary for a Long COVID diagnosis, and Long COVID can develop regardless of severity in the acute-stage of infection.

Take Action

Although North Carolina’s governor vetoed the state’s mask ban bill, the GOP majority in the General Assembly will likely override this veto. If you live in North Carolina, take action by following the North Carolina megaphone tool here. If you live outside North Carolina, call the Raleigh, Durham, and Chapel Hill Chambers of Commerce and tell them you will not visit the state as long as they consider mask bans.

Ongoing action is needed to stop mask bans, even if your area is not yet directly threatened. Check out our substack post for next steps, and share it with people close to you: https://peoplescdc.substack.com/p/the-far-right-and-some-democrats

Notes: 1) The numbers in this report were current as of 6/22/2024. 2) Changes in testing access as well as data reporting have led many federal data sources to become less reliable. 3) Check out the links throughout & see our website for more! https://peoplescdc.org. 4) Subscribe to our newsletter: People's CDC | Substack.