ABC - Health News

(NEW YORK) -- As the U.S. Supreme Court continues to weigh whether to leave Texas's unprecedented six-week abortion ban, SB8, in place, a new law that also restricts abortion access is going into effect in the state.

Starting Thursday, people in Texas will have a narrower window in which they can receive abortion-inducing medication, including the two most commonly used medications, mifepristone and misoprostol.

Senate Bill 4, or SB4, cuts the window in which physicians are allowed to give the medication from 10 weeks of pregnancy to seven weeks.

The new law also prohibits mailing abortion-inducing drugs, a restriction that contrasts with a federal regulation enacted in April by the Biden administration that temporarily allows the medication to be mailed during the COVID-19 pandemic.

Current Texas law already bans providers from administering medication abortion using telemedicine, according to Abigail R.A. Aiken, MD, MPH, PhD, associate professor of public affairs at the University of Texas at Austin and principal investigator with Project SANA, a research project focused on self-managed abortion in the U.S.

"We've seen many states be able to open up new models of care where clinic-based providers can now do medication abortion by telemedicine," said Aiken. "I think Texas is very clear that they don't want providers here to follow suit and be able to start doing those kinds of new models where you would do a phone consultation with a provider and then have the pills mailed to your house for use at home."

The bill, signed into law by Gov. Greg Abbott on Sept. 24, also adds new requirements around medication abortions, including an in-person examination by a physician, a mandatory follow-up visit within 14 days and new reporting requirements for providers.

The bill also creates a state jail felony offense for "a person who intentionally, knowingly, or recklessly violates provisions relating to abortion-inducing drugs," but exempts pregnant people on whom a medication abortion is "attempted, induced or performed," according to the bill summary.

Though SB4 is being enacted in Texas, medication abortion is now a very common method used for abortions in the first 10 weeks of pregnancy. In 2019, 42% of all abortions in the U.S. were early medical abortions, meaning medications were taken at nine weeks or earlier after conception, according to the Centers for Disease Control and Prevention.

Medication abortions were first approved by the Food and Drug Administration in 2000. FDA guidelines advise that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after conception, though evidence shows it can be safe even later in pregnancy, according to the American College of Obstetricians and Gynecologists.

In most cases in a medication abortion, mifepristone is taken first to stop the pregnancy from growing. Then, a second pill, misoprostol, is then taken to empty the uterus.

Of the two medications, mifepristone is more restricted by the FDA. Since 2011, the agency has applied a risk evaluation and mitigation strategy to mifepristone, preventing it from being distributed at pharmacies or delivered by mail like other prescription drugs.

It must be ordered, prescribed and dispensed by a health care provider who meets certain qualifications, and may only be distributed in clinics, medical offices, and hospitals by a certified health care provider, according to FDA guidelines.

The FDA's rules, combined with state restrictions like the one in Texas, have the effect of not only limiting when, where and how people can get abortions, but also potentially misguiding people on the safety of medication abortion, according to Dr. Bhavik Kumar, a staff physician at Planned Parenthood Center for Choice in Houston.

"What's important to note is that the medication used in medication abortion has been used in this country for 21 years and it is extremely safe," said Kumar. "We've learned a lot since it was first introduced and can use it in different ways that are more patient-centered, more evidence-informed and really optimizes science and medicine so that patients get the care that they need."

Speaking of the new law now in effect in Texas, he added, "What Senate Bill 4 is doing is inserting itself squarely into my relationship with my patients and telling me how to practice medicine, and it's not in the best interest of my patients. It's actually causing more harm to my patients and it's taking options away from them."

Abortion rights advocates say SB4 also has the likelihood of signaling to other states that further restrictions on medication abortion can be put in place.

In South Dakota in September -- the same month SB4 was signed into law in Texas -- Gov. Kristi Noem, a Republican, issued an executive order directing the state's Department of Health to establish rules requiring that abortion-inducing drugs only be prescribed and dispensed by a state-licensed physician after an in-person examination. Noem said she also plans to pass legislation next year that makes "these and other protocols permanent."

Across the country, more than 30 states require clinicians who administer medication abortion to be physicians, while 19 states require the clinician providing a medication abortion to be physically present when the medication is administered, according to the Guttmacher Institute.

"I think we have to see this is another continuation of the trajectory of trying to really make abortion a right on paper only in the United States," said Aiken. "It's another way of placing barriers in the way of people."

She continued, speaking of restrictive abortion laws in some states, "I think what it's doing in reality is creating this really uneven picture where you have some states that are moving in the direction of more and more and more accessible care, but the reality in other states is completely the reverse, so we're looking at that uneven picture where your access really depends on your zip code."

Both Aiken and Kumar mentioned the affect laws like SB4 in Texas have on the most vulnerable populations.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

"It has been the case in Texas now for decades that we have seen low-income people and communities of color just bear this disproportionate brunt of negative impacts of these laws," said Aiken. "So this is an equity issue and it's a justice issue as well as a health care issue."

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(OKEMOS, Mich.) -- Michigan is in the midst of its fourth COVID-19 wave -- and there is no end in sight, hospital officials said.

Cases and hospitalizations are rivaling levels seen in earlier parts of the pandemic, when vaccines weren't widely available. The surge also comes at a time when non-COVID-19-related patients are being admitted, flu cases are emerging and health systems are understaffed, Brian Peters, CEO of the Michigan Health & Hospital Association, told ABC News.

Unvaccinated people continue to make up the majority of those infected with COVID-19, including severe cases of the infection. Roughly around three-quarters of COVID-19 cases, hospitalizations and deaths were in unvaccinated people from Oct. 21 to Nov. 19, according to state data.

Around 45% of the state remains unvaccinated, according to federal data.

"The situation right here in Michigan is as dire as it has ever been since the start of this pandemic," Peters said.

Michigan reported a nearly 20% positivity rate in the past week, and every county is currently at the state's highest risk level for transmission.

Michigan is not alone in seeing COVID-19 cases and hospitalizations increase due to the delta variant, especially as colder weather has approached, people have gathered indoors more and pandemic fatigue has long set in. Though the duration of this surge, and the speed with which cases have "skyrocketed" in the past three weeks, is alarming, Dr. Darryl Elmouchi, president of Spectrum Health West Michigan, which operates 14 hospitals, told ABC News.

"If you look at most other states, and all the surges we've had, usually you start at a low point and you go up really quickly, and then you come down pretty quickly," he said. "What happened for us is we went up gradually enough, but we went up high enough, with [positivity rates] in the teens, that when we shot up, we shot up from that baseline."

"This has far surpassed anything we've seen before -- both in how long it's been going on, and now its seemingly never-ending peak," he added. "We just don't know when the end will be, and we're very worried it will have a very long tail."

Michigan reported its second-highest number of COVID-19 cases and case rates in the past week, according to the state's latest weekly coronavirus report, released Tuesday. That follows records set in both cases and case rates the previous week. Hospitalized COVID-19 patients also increased 13% during the past week, the report found.

"I felt like probably the surge we had last fall was going to be the worst we've ever seen. I never would have guessed that we would be in yet another surge and that it would be the worst surge yet," Sandra Gilman, a nurse and hospital supervisor for Spectrum Health, told ABC News.

At Spectrum Health West Michigan, unvaccinated COVID-19 patients are generally about nine years younger and only have two comorbidities, as opposed to four, when compared to vaccinated patients, "meaning that they're younger and healthier when they're coming in," Elmouchi said.

"That tells us the importance of being vaccinated," he said. "And that's what's so heartbreaking for our teams, is that they see all these people that are so sick, being on the ventilator and even dying, and they know it's preventable. It's heart-wrenching."

Due to a mix of early nursing retirements, pandemic burnout and a "rising tide of violence" against health care staff, Michigan hospitals are treating the latest surge in COVID-19 patients amid a staffing shortage, according to Peters. There are approximately 875 fewer staffed hospital beds in Michigan than in November 2020, he said.

"That is incredibly concerning, because there's not a rapid or easy solution to that problem," Peters said.

Amid the staffing strain, this week, the Department of Defense temporarily deployed nearly four dozen medical personnel, including registered nurses, doctors and respiratory therapists, to two hospital systems in the state.

The help is welcome, though more is needed, Peters said, especially as the pandemic only worsened an existing health care workforce shortage. Among other measures, his organization is advocating for a $650 million special appropriation in the state legislature that would provide payments to health care staff to encourage them to stay in their jobs, as well as offer incentives for training programs to increase the number of workers in the pipeline, he said.

For now, hospital capacity remains a concern throughout the state, where every region, from urban to rural, is a "hotspot," Peters said.

At Spectrum Health West Michigan, the intensive care units are operating at 147% of their traditional capacity, Elmouchi said.

Statewide, hospitals are operating at almost 85% occupancy, according to state data.

In recent weeks, some hospitals have had to divert patients to other hospitals and delay elective procedures, Peters said.

"That doesn't necessarily create a quality-of-care problem as much as it can be a convenience problem," he said. "But what we're very fearful of, is that if these COVID numbers don't level off and decline, you're going to start seeing real access challenges, where literally there's no more capacity to care for patients, COVID or otherwise, in certain communities."

"We're doing everything we possibly can to avoid that outcome, but without the public's help, that's our future," he added.

Health officials are urging residents to get vaccinated and receive booster shots and to mask up indoors in public settings to help alleviate the surge -- especially amid concerns and questions around the transmissibility and mutations of the new omicron variant, which was first detected in the U.S. Wednesday in California.

"Ensuring that as many Michiganders as possible are vaccinated remains the best protection we have against COVID-19 -- including variants of concern," Dr. Natasha Bagdasarian, Michigan's chief medical executive, said in a statement this week.

Peters said he has been encouraged by the continued increase in vaccinations in the state, including among newly eligible pediatric populations, but "those numbers aren't growing rapidly enough."

"[Omicron] is yet another reason for the public to get vaccinated now without waiting any longer," he said. "I fear that there are so many Michiganders, and I'm sure it's true outside of Michigan as well, but who believe that the pandemic is largely over. And nothing could be further from the truth."

ABC News' Arielle Mitropoulos contributed to this report.

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Darren Riley, 29, is the CEO and Co-founder of JustAir, which uses small sensors to map air quality on a neighborhood level. - JP Keenen/ABC News

(NEW YORK) -- This is the fourth and final episode of ABC News Digital's four-part series "Green New Future," which highlights innovators and environmental solutions.

While climate change and poor air quality are global issues concerning all people, 29-year-old Darren Riley has found that the ZIP code people are born into can disproportionately put them in harm's way.

Riley's father ended up in a coma in the ICU due to asthma-related illnesses in 2014, Riley told ABC News. It was his father's words from seven years before that made him realize the connection between a person and where they live.

"I was a product of my environment," Riley's father had told him.

Riley, who also developed asthma himself, said he set out to find a way to alleviate systemic issues and allow people from all areas an equal opportunity in quality of life. He is now the CEO and co-founder of JustAir Solutions, a company that creates air quality monitoring networks to provide cities and individuals data on their breathing environment.

"I think air quality is a sliver of all of many injustices that we see in the world that we can really focus on," Riley told ABC News.

The disproportionate impact of pollution is one example of a host of systemic issues that people of color, lower wealth communities and indigenous populations are facing, advocates say.

These issues are "fueled by environmental racism," Mustafa Ali, vice president of environmental justice, climate and community revitalization at the National Wildlife Federation, told ABC News.

Through discriminatory practices such as redlining, cities in the U.S. have been divided and designed with toxic industries disproportionately running through areas inhabited by communities of color, according to Ali.

This affects the quality of the air people breathe, which research has found can determine the long-term health of their lungs and subsequently, their life expectancy.

"We have 100,000 people who die prematurely from air pollution in our country," Ali said.

This issue came to the forefront over 50 years ago when Congress passed the Clean Air Act, which set out to control and reduce air pollution across the nation by keeping track of the quality of air that citizens were inhaling.

The U.S Environmental Protection Agency mandates that cities track their air quality levels using a monitor that tracks dust, metals and other matter that could affect the lungs.

The EPA regulations state there must be a minimum of one monitor per city, but community advocates argue there must be more. Grand Rapids, Michigan, where Riley piloted his project, has just one monitor that reports on the city's air quality level.

Data from that monitor is used to approximate the air quality level for the entire city and its suburbs, Jim Meeks, the chairman of JustAir, told ABC News.

But Riley was curious about the difference in air quality levels across neighborhoods, which the lone monitor set up by the EPA could not capture. He deployed 11 sensors across Grands Rapids -- five in the downtown area, five in the Roosevelt Park neighborhood and one adjacent to the EPA monitor.

When comparing data from his sensors in the metro downtown area of Grand Rapids versus Roosevelt Park, the neighborhood with the highest non-white population, Riley found stark differences in the air quality levels.

The Roosevelt Park sensors recorded far more unhealthy days than the one near the EPA monitor, Riley said.

"There are disparities between sensors within a city," Riley told ABC News. "And one sensor doesn't detect that."

JustAir's sensors are currently only used in Grand Rapids, but Riley hopes to expand his company to other cities such as Detroit and Chicago, believing that the data could inform governments and individuals to take action.

He said he hopes his company will bring change to the nation's struggle with poor air quality and its health impacts.

The key to fighting air pollution-related health disparities lies in the re-prioritization of resources and budgets and breaking through the existing political polarization, according to Ronda Chapman, equity director at The Trust for Public Land.

"This is a non-partisan concern when we're talking about the health and well-being of individuals," Chapman told ABC News. "And so when we have the data to back it up, that's how we're able to better make the case for investing in green infrastructure, investing in neighborhoods and investing in communities."

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Courtesy Brittany Eppenauer

(OAK GROVE, Mo.) -- Megan Richards, a mom of six, had planned to provide breast milk for her youngest child, 5-month-old Myles, through his first birthday.

Richards died last month due to complications from COVID-19, and now her family is trying to fulfill her wish by collecting donations of breast milk.

"It was one of the things that she wanted the most for the baby, and it was important to her, so it was important to me," said Megan's husband, Michael Richards. "Even when she got sick and I was trying to keep her in bed, and just try to get her to rest, I talked to her about it maybe being time to stop pumping -- she'd been pumping to be able to feed him with a bottle -- and she refused."

The Oak Grove, Missouri, family has so far received about 400 ounces of donated breast milk, as well as a donated freezer to store it.

They estimate they will need around 10,000 ounces to reach Myles's first birthday next July, according to Brittany Eppenauer, Megan Richards's sister.

Eppenauer is leading the drive for breast milk donations and said she's received nearly 300 emails from women who want to donate.

"The first donation that we received came from a woman named Megan," she said. "It's overwhelming to know that other moms care that much, to make sure that we can fulfill my sister's wishes."

Megan Richards was 32 when she died Nov. 15. She was the mother of five biological children and shared a step-child with her husband, with whom she would have celebrated her second wedding anniversary on Nov. 30.

"She was a perfect mother. Everything she did was for the kids," Michael Richards said of his late wife. "We put off vacations and dates for ourselves so we could spend more time with the kids. Everything was about them."

Michael Richards said he and his wife and all six children contracted COVID-19 in mid-November, with most of them suffering only mild symptoms.

Myles had to be treated at the hospital for dehydration, but recovered quickly. Megan Richards, who was not vaccinated against COVID, began suffering worsening symptoms and had to be taken to the hospital by ambulance on Nov. 14, according to Michael Richards.

"I stepped outside to call 911, and when I got back inside Megan was laying on the living room floor," he said. "Our oldest said she stood up and said she didn't feel right and passed out."

At the hospital, she was treated for dehydration and diagnosed with COVID pneumonia, but was expected to recover quickly, according to Michael Richards.

The next day, he said he received a call from the hospital that his wife's condition had worsened. When Michael Richards arrived at the hospital, doctors were performing CPR on Megan, who had fluid buildup around her heart. She died later that day.

Both Michael Richards and Eppenauer said they're now trying to fill the void left by Megan Richards, described by Eppenauer as "one of the best mommas around."

"My niece's birthday was on Dec. 1st, and it took eight adults to do what she could have done as one person in putting on a birthday party," Eppenauer said. "We don't know how we'll fill her shoes, but we're going to try."

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(WASHINGTON) -- The Biden administration is preparing to implement new travel guidelines that would require proof of a negative COVID-19 test within one day of flying into the U.S., including for vaccinated people, a spokesperson from the Centers for Disease Control and Prevention confirmed.

The expected change comes as the country beefs up surveillance for the omicron variant, the first case of which in the U.S. has been identified in California, the California and San Francisco Departments of Public Health said Wednesday. The CDC said the person traveled from South Africa on Nov. 22.

Omicron has been deemed a "variant of concern" by the World Health Organization and had been detected in over 20 countries as of Tuesday.

"CDC is working to modify the current global testing order for travel as we learn more about the omicron variant; a revised order would shorten the timeline for required testing for all international air travelers to one day before departure to the United States," CDC spokesperson Kristen Nordlund said Tuesday night. "This strengthens already robust protocols in place for international travel, including requirements for foreign travelers to be fully vaccinated."

Under the current guidelines, people from other countries who are not fully vaccinated cannot travel to the U.S., while people who are fully vaccinated can as long as they provide proof of a negative COVID-19 test within three days of traveling. For unvaccinated Americans, the guidelines already required proof of a negative test within one day of traveling. The potential new rule would expand that one-day requirement to all vaccinated travelers coming into the U.S. from other countries.

For post-travel recommendations, the CDC also suggests vaccinated travelers get tested three to five days after arriving in the U.S. and that unvaccinated travelers stay home to self-quarantine for a full seven days, even if they test negative during that timeframe.

Earlier on Tuesday, the White House confirmed it was considering updates around testing requirements and said policy discussions were ongoing across the government as more is learned about the omicron variant.

More updates on the country's response to the variant are expected Thursday.

CDC Director Rochelle Walensky outlined some of the expected changes at the White House COVID-19 briefing on Tuesday morning. She said the CDC is analyzing 80,000 COVID-positive tests per week -- or about one in seven tests -- looking for the omicron variant. The delta variant continues to account for 99.9% of all tests analyzed, Walensky said.

Asked if she was confident in the CDC's surveillance system given how many other countries had detected the variant before the U.S., Walensky said the system is "robust."

The director also said the CDC is working on expanding a surveillance program in the nation's four busiest international airports, John F. Kennedy International Airport, San Francisco International Airport, Newark Liberty International Airport and Hartsfield-Jackson Atlanta International Airport, which would allow for more COVID-19 tests on international arrivals -- though there was no indication that testing would be mandatory for arriving travelers or which arriving planes would be offered the tests.

In the meantime, experts are calling on all Americans to get vaccinated if they haven't yet and to get boosted if they're over 18 and were fully vaccinated over six months ago. Of those eligible for a booster, 100 million Americans haven't gotten one yet, the White House said on Tuesday, while just about 20% of fully vaccinated Americans have, the CDC's vaccine data shows.

Though the data on how transmissible and severe the omicron variant is will not be available for a few more weeks, as scientists around the globe work to gather it, experts believe it's unlikely it will completely chip away at the protection from vaccines and boosters, particularly when it comes to hospitalization and death.

"Remember, as with other variants, although partial immune escape may occur, vaccines and particularly boosters give a level of antibody that even with variants like delta, give you a degree of protection, particularly against severe disease," Dr. Anthony Fauci, chief medical adviser to the White House, said on Tuesday.

On Tuesday, Pfizer BioNTech asked the Food and Drug Administration to consider expanding the booster recommendation to include 16- and 17-year-olds. The agency is expected to review the request in the coming weeks.

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(NEW YORK) -- Global health authorities said they're monitoring a new COVID-19 variant first identified in southern Africa, with the World Health Organization saying Friday the new strain, called omicron, is a variant of concern.

On Monday, the WHO said the overall global risk is assessed as "very high" due to the variant's mutations although there are still many unknowns.

The WHO urged countries to step up monitoring and surveillance. The global health agency said it's still not clear whether the variant is more transmissible or causes more serious illness, or if it affects vaccines. Such studies will take time.

The first confirmed case in the U.S. was identified in California on Wednesday in a vaccinated individual, but the person's symptoms were mild, the U.S. Centers for Disease Control and Prevention said. The person had traveled to South Africa in late November.

"As all of you know -- because we've been discussing this -- we knew that it was just a matter of time before the first case of omicron would be detected in the United States," Dr. Anthony Fauci, the White House's chief medical adviser, said Wednesday.

As of Wednesday, there were more than 370 confirmed cases in nearly 30 countries across the globe, with most in South Africa but seven cases in Canada and a few dozen in the U.K.

"We don't know very much about this yet," Dr. Maria Van Kerkhove, the WHO's COVID-19 technical lead, said Nov. 25. But concern about this variant stems from its "large number of mutations," Kerkhove added, which could "have an impact on how the virus behaves."

Concerns about this variant already have prompted several countries, including the U.S., to impose travel restrictions from countries in southern Africa. The WHO is urging calm, saying it's premature to close borders.

There are thousands of COVID-19 variants, with new ones emerging all the time. Usually new variants disappear quickly because they're overrun by a more dominant strain.

The now-dominant delta variant is so highly transmissible that most of the new variants that have cropped up in recent months have been unable to gain a foothold. In the United States, the delta variant comprises an estimated 99.9% of all new cases.

"There's obviously this tension between crying wolf and exacerbating concerns about the variants, but also being caught flat-footed and not responding swiftly enough," said Dr. John Brownstein, chief innovation office at Boston Children's Hospital and an ABC News contributor. "This is where we have to cautiously respond without inciting panic, because this could easily turn out to be a variant similar to others that have never really panned out to be global concerns."

Scientists across the globe constantly monitor all newly emerged variants to see if they're spreading in a meaningful way and global health authorities have said they're monitoring this new variant closely.

Vaccine companies, meanwhile, are making plans to tweak vaccines to address new variants if it becomes necessary.

Current COVID-19 vaccines, which rely on genetic technology, could be easily updated to better combat emerging variants -- though so far that hasn't been necessary.

Pfizer/BioNtech said that if a "vaccine-escape variant emerges," it expects "to be able to develop and produce a tailor-made vaccine against that variant in approximately 100 days, subject to regulatory approval."

Moderna also said it is "rapidly advancing" an omicron-specific variant, while Johnson & Johnson also said it will move forward with an omicron-specific vaccine as needed.

Nine variants are currently being monitored by the WHO, which designates particularly worrisome strains as variants of "interest" or "concern." When they no longer pose a significant public health threat, the variants are reclassified -- so far during the pandemic, 13 have been removed from the WHO's list.

But public health experts said the emergence of variants underscores the urgent need to vaccinate everyone on the planet.

"It gives us a lens into why as epidemiologists we've been so concerned about global vaccine equity," Brownstein added. "It's a recognition that with not enough people around the globe immunized, it creates more opportunities for variants to emerge, and this is a very good example of that."

ABC News' Guy Davies, Josh Hoyos, Aicha El Hammar, Zoe Chevalier, Liezl Thom and Zoe Magee contributed to this report.

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(NEW YORK) -- Amid a renewed surge of coronavirus infections and hospitalizations across the country, and concerns surrounding the newly discovered omicron variant, health experts are again pleading with Americans to get vaccinated, and if fully vaccinated and eligible, to get a booster.

"Do not wait. Go get your booster if it's time for you to do so," President Joe Biden said earlier this week during an address at the White House. "If you are not vaccinated, now is the time to go get vaccinated and to bring your children to go get vaccinated."

Although it is still unclear whether the omicron variant is more transmissible, if it causes more serious illness or impacts vaccine effectiveness, the World Health Organization said on Monday that the overall global risk is assessed as "very high," due to the variant's mutations.

In light of the global whirlwind of concern, vaccine makers are currently testing the shots' effectiveness, and announced plans this week to tweak vaccines in order to address the new variant, if deemed necessary, leaving some Americans wondering whether they should rush to get a shot now or wait to see if the vaccines are readjusted.

"I would strongly suggest you get boosted now, and not wait for the next iteration of it, which we might not even need," Dr. Anthony Fauci, chief medical adviser to the White House, told ABC News' George Stephanopoulos Monday on "Good Morning America," adding that he would "not at all" recommend waiting. "We'll find out reasonably soon whether higher levels of antibody against the original vaccine that we've used, whether or not that can spill over in protection against this."

'We may not have time to wait'

Many experts have echoed Fauci's sentiment, urging Americans to get the shots as soon as possible, given all of the uncertainties about omicron.

"We don't have all the answers we want as of yet. In a few weeks, we will know a lot more," Dr. Colleen Kelley, an associate professor of medicine in the division of infectious diseases at Emory University School of Medicine, told ABC News.

With prior variants, she said, as long as the levels of antibody were high enough, a variant-specific booster did not seem necessary.

"We hope that this will also be the case with omicron and that high levels of antibodies will maintain some level of protection, but don't know for sure yet. So, my recommendation is to get boosted now," Kelley said.

If omicron proves to be as highly transmissible as delta, "we may not have time to wait for the omicron-specific booster to protect people," Kelley added.

As of Tuesday, there have been no confirmed cases of the omicron variant in the U.S., though experts say the variant is likely already circulating within communities.

"People should not wait for the vaccine to be tweaked to adapt to the new variant as it would be many months until that new vaccine is released. They should get a primary vaccine now or a booster, and then when the updated vaccines are available we may well need additional doses of the vaccine then," Dr. Camille Kotton, clinical director in the Infectious Diseases Division at Massachusetts General Hospital, told ABC News.

According to the White House, the process of introducing a variant-specific vaccine would take approximately three months, and would include necessary sign off from the Centers for Disease Control and Prevention and the Food and Drug Administration.

"The companies currently estimate that it would take a few months to prototype and manufacture a modified vaccine or booster and that does include, to your question, the time for FDA and CDC to do their evaluation, so the estimate of a few months is all inclusive," White House COVID coordinator Jeff Zients said Tuesday during a press briefing.

In light of the omicron's potential threat, CDC Director Rochelle Walensky announced that the agency would be strengthening its recommendation for all adults to get a booster shot six months after their Pfizer or Moderna vaccines or two months after the Johnson & Johnson shot.

"The recent emergence of the Omicron variant further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against COVID-19," Walensky wrote in a statement on Monday.

Additionally, on Tuesday, Pfizer announced it has officially asked the FDA to authorize COVID-19 booster shots for 16- and 17-year-olds.

Vaccines will likely still provide 'good' protection against variants

Several experts stressed that even if the vaccines were found to be less effective against the omicron variant, the current vaccines still present "good" protection.

"Even if omicron has some immune evasive properties, boosters are likely to still provide good protection based on some mutational experiments researchers have performed with viruses containing the same mutations as omicron," Dr. Angela Rasmussen, a virologist at the University of Saskatchewan, told ABC News.

Other experts urge caution, given how little scientists know about omicron.

Although "it is prudent to get your boosters, we have a lot to learn about omicron," said Dr. Jennifer Lighter, a hospital epidemiologist for NYU Langone Health. If it is indeed more contagious, she said, it could lead to more breakthrough cases, and therefore, boosters would increase antibody levels and convey an extra layer of protection from breakthroughs.

However, Lighter said she does not believe that it would make much difference to get the booster now, or in a few weeks, stressing the fact that the immune response after vaccination is quite broad.

"Your immune response knows that there will be mutations. And the immune response is actually much wider, and not only specific for what someone was vaccinated against," Lighter told ABC News.

Hence, with vaccination, there is protection against severe disease, and if omicron is indeed more contagious, breakthrough infections will likely "predominantly be mild in most people."

Data has consistently shown that vaccinated individuals have fared much better than unvaccinated.

Unvaccinated individuals had a 5.8 times greater risk of testing positive for COVID-19 and a 14 times greater risk of dying from it, as compared to vaccinated individuals, according to federal data compiled in September 2021.

At this time, approximately 100 million Americans remain completely unvaccinated, about 80 million of whom are currently over the age of 5, and thus are eligible to get the shot.

"We still have less than 60% of the United States population fully vaccinated. So I think it's important to first stress that the unvaccinated people will eventually get COVID. It will come to them sooner or later," warned Lighter.

"We should definitely take this opportunity to protect ourselves, thus protecting our loved ones, our communities, our country and the world," added Kotton.

ABC News' Cheyenne Haslett contributed to this report.

Copyright © 2021, ABC Audio. All rights reserved.


Alem Omerovic/iStock

(NEW YORK) -- World AIDS Day, celebrated every Dec. 1, is a day to raise awareness of and mourn the more than 32 million people who've lost their lives to the virus.

But HIV researchers also say it's a day to celebrate hope: Since the discovery of the virus in 1983, significant scientific headway has been made in diagnosis and treatments.

"We've made a lot of progress in this area over the past 10 to 15 years," said Dr. Paul Sax, director of Infectious Diseases at Brigham and Women's Hospital, "with the proportion of undiagnosed people with HIV dropping from around 30% to 15% today. This has been accomplished by making HIV testing a routine part of preventive care for most adults, which destigmatized HIV testing dramatically."

There's still no cure for HIV, but by taking HIV medications, called antiretroviral therapy, or ART, which help reduce the load of the virus within one's body, people with HIV can live a healthy, normal lifespan.

"Current treatment is staggeringly good," Sax added. "Most patients are taking one or two pills daily, and have viral suppression. In addition, this treatment quite miraculously makes them not only healthy from the HIV perspective, but makes them non-contagious to others."

Even with such progress, HIV has lingered in the U.S., with more than 1 million people living with the virus at the end of 2019, and new people diagnosed every day, according to Centers for Disease Control and Prevention statistics. The virus is transmitted by direct contact with certain body fluids from an affected person. Once infected, a person has the virus for life, so testing and prevention is very important, experts said.

HIV can affect anyone regardless of age, gender, ethnicity or sexual orientation, although certain groups are at greater risk because of socioeconomic status, limited access to health care or because of higher infection rates in certain communities.

African Americans are the most affected, accounting for 42% of all new HIV diagnoses in 2019, according to the CDC. Young gay and bisexual men are especially affected, and in 2019 composed 83% of all new HIV diagnoses in people aged 13 to 24.

Recent CDC data also highlights disparities in fighting HIV -- not all racial and ethnic groups have equally benefited from advances in prevention and treatment. Over the past decade, new infections have dropped among White gay and bisexual men, but remained flat among Black and Hispanic/Latino gay and bisexual men.

The stigma surrounding HIV and negative attitudes about people living with the virus may be contributing to these disparities, said experts, adding that it helps to ease stigmas when celebrities open up about their statuses. This year, Billy Porter and Jonathan Van Ness publicly disclosed their HIV-positive status.

"Engaging in open discussions so others feel comfortable talking about HIV vs. making it a taboo topic" is crucial, said Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts, adding that "social media, faith-based organizations, trusted messengers in the community, focus groups, community health centers or health fairs" can be very helpful.

Health experts agree the work is far from done. In the global quest to end HIV, health authorities have set a target for 2030 that 95% of people living with HIV should be taking medication and have achieved durable "viral suppression."

In a study funded by the National Institutes of Health, researchers at Kirby Institute of the University of New South Wales in Sydney found that, globally, we are far behind this target, particularly among adolescents and children.

The study estimates that 79% of adults achieved viral suppression within one year of starting medication, but that figure decreased to 65% after three years. For adolescents and children, the picture was worse: Only 64% achieved viral suppression one year after starting treatment and only 59% had after three years. Researchers found people stop taking their medication for a wide range of reasons, including not having access to health care.

"World AIDS day is reminder of the great progress we have made over the past three decades understanding HIV," Wildes said. "We don't have all the answers yet, but everyone should be encouraged to get tested, as many treatment options are available to help individuals to have rewarding and fulfilling lives even if they are infected."

Esra Demirel, M.D., an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center, is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


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(NEW YORK) -- Period pain is a fact of life for many women, yet many don't know that what they are experiencing might not be normal.

"When it comes to period pain, a lot of people just don't know what they don't know," Dr. Nita Landry, a Los Angeles-based OBGYN, said. "Which makes sense, because the only period that you've ever had is your period."

In some cases, people may expect their period to be painful based on what they've seen on social media or heard repeated in pop culture -- that experiencing pain is just part of having a period.

In other cases, it may be because their mom or grandmother or aunt told them that painful periods "are just the way it is" for women in the family, according to Landry.

"It could be that everybody is experiencing period pain that was never properly diagnosed, and it was never properly treated," Landry said. "So then everybody ends up suffering unnecessarily."

More than half of women who menstruate have some pain for one to two days of their cycle, according to the American College of Obstetricians and Gynecologists (ACOG).

For most women, the pain is mild, but for others it can be debilitating, which is a sign it's time to seek help, Landry said.

"Periods are not fun, that's not really a secret," she said. "But, they are not supposed to make you miserable either. They should not be debilitating."

Here are five facts to know about periods and pain:

1. There are different types of period pain.

The technical term for period pain is dysmenorrhea.

Primary dysmenorrhea is the most common type of dysmenorrhea and is caused by natural chemicals in the uterus lining. It is the cramping pain that comes before or during a period, according to ACOG.

Secondary dysmenorrhea is also a recurrent, cramping pain, but it is the result of an underlying medical issue in the reproductive organ.

"For example, if a person has endometriosis, which is where tissue that's similar to the inside lining of the uterus gets outside of the uterus, or if someone has uterine fibroids, which are benign growths in the wall of the uterus, then those conditions can lead to secondary dysmenorrhea," Landry said.

With secondary dysmenorrhea, the pain often lasts longer than normal period cramps and can worsen over time.

"When you think about pain with periods and what's normal, pain can start about a day or so before a woman's menstrual period starts, but it typically tapers off within two or three days," Landry said. "If you find that your pain is extending beyond your menstrual period, then that's not normal."

2. Period pain is caused by a hormone-like chemical called prostaglandins.

Women experience pain during their periods because of a natural, hormone-like chemical called prostaglandins.

During a menstrual cycle, prostaglandins cause the uterine muscle to contract, which compresses some of the blood vessels that pump blood into the uterus.

"Blood is going to carry oxygen, so when you decrease blood flow to the uterus, you're going to have a lower level of oxygenation, and, as a general rule, your body does not like to be deprived of oxygen," she explained. "Whenever you are deprived of oxygen, you can experience pain."

"So when we think about pain with periods, you have the uterine contractions, the contractions will decrease blood flow, less blood flow means less oxygen and less oxygen translates as pain," she said.

Some people may naturally produce larger amounts of prostaglandins, which means they will likely experience more pain during their periods, and some people may be more susceptible to pain, according to Landry.

And just because a person has a light period flow does not mean they can't experience painful cramps during their cycle, she noted.

"Please don't make the assumption that, 'My periods hurt, but my flow is not that heavy so it's not a big deal,'" Landry said. "It's still a big deal because pain is pain, and who wants to live with period pain if there's something that can treat you effectively?"

3. Lifestyle habits can make period pain better or worse.

If you do not have an underlying issue, factors like what you eat and how you handle stress can also have an impact on the pain you experience, according to Landry.

"Being under a lot of stress actually makes your period worse," she said, and, "Fatty foods increase the production of prostaglandins, and that's going to increase period cramps."

Smoking can also make period pain worse, because it constricts blood vessels, which decreases blood flow to the uterus, Landry said.

On the other hand, she said, exercise is a lifestyle habit that is helpful in lessening pain during the menstrual cycle, as is getting good sleep.

"A lot of things can come into play when it comes to determining why some people have more painful periods compared to others or even why the same person may experience different levels of pain during their periods from menstrual cycle to menstrual cycle," Landry said.

4. These are red flags to look for when it comes to period pain.

The biggest warning to look for when it comes to period pain, according to Landry, is how it is impacting your life.

"If you are missing school or if you are missing work or you're just missing life in general, that's a red flag," she said. "That's not how your period is supposed to be."

Other red flags include period pain that gets progressively worse or that continues past your menstrual cycle or changes with age.

"If you didn't have period pain before, but you're 25 or older and you start to experience a different type of pain, that's also a red flag," she said. "Because that could indicate that there's an underlying issue that developed more recently that needs to be addressed."

Landry said the most important thing is for women to talk to their health care provider about their period pain.

"If your health care provider tells you that period pain is normal even though you're missing school, you're missing work, you're missing out on life, then talk to another health care provider," she said, "I don't want you to suffer unnecessarily."

5. Period pain can be treated.

For mild period pain, Landry recommends adjusting lifestyle habits such as diet, exercise and stress management and using natural remedies like a warm bath or a heating pad.

Women can also take over-the-counter pain relievers, called nonsteroidal anti-inflammatory drugs (NSAIDs), in the first one to two days of their period to reduce the production of prostaglandins.

Women with bleeding disorders, asthma, aspirin allergies, liver damage, stomach disorders or ulcers should not take NSAIDs, according to ACOG.

Hormonal therapies, like birth control, are also frequently used to treat period pain.

Landry said there is also research to support the idea that some vitamins, including vitamins B and E as well as magnesium and Omega 3 fatty acids, may be helpful when it comes to easing period pain.

Some women also find alternative remedies such as acupuncture and acupressure helpful, too, according to Landry.

"There are so many different treatment options that your doctor can talk to you about," she said. "Make sure you give them a chance to tell you about all of them before you decide to grin and bear [the pain]." is tackling a different taboo women's health topic each month, breaking down stigmas on everything from mental health to infertility, STDs, orgasms and alcoholism.

Copyright © 2021, ABC Audio. All rights reserved.


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(NEW YORK) -- Vaccine makers say they are in the midst of testing their shots' effectiveness against the newly discovered omicron coronavirus variant, and they remain optimistic that a new variant-specific vaccine could be produced and rolled out quickly if needed.

When asked about the new omicron variant that was first detected in southern Africa, Paul Burton, Moderna's chief medical officer, told ABC News' "Good Morning America" on Monday that vaccine manufacturers around the world, including Moderna, "are testing samples from people who have received our vaccines against the strains."

Burton said that while the company thinks "vaccine effectiveness may come down, based on the mutation seen in this in this virus," he added that with booster shots of the existing version of the vaccine, "We should be able to get antibody levels up, so that's a very important initial line of defense."

Burton said that researchers will know just how effective the vaccines are against this variant "in the next couple of weeks." If manufacturers need to make an omicron variant-specific vaccine, it should take approximately "two to three months" to test and manufacture it, he said.

Fellow coronavirus vaccine maker Pfizer similarly expressed confidence that it could produce a new vaccine quickly if needed. Pfizer's CEO Albert Bourla told CNBC's "Squawk Box" on Monday that he is very optimistic the company will be able to speedily switch production to a new vaccine, if the research merits, without losing any volume.

Johnson & Johnson also said in a statement Monday that it is evaluating its current COVID-19 vaccine against the omicron variant.

"In addition, the company is pursuing an omicron-specific variant vaccine and will progress it as needed," it said.

Scientists suspect the omicron variant could partially chip away protection from current vaccines due to its mutations, but they are still waiting on testing to learn if, and to what extent, that could be the case.

Vaccine experts have told ABC News that the current COVID-19 vaccines, which rely on genetic technology, could easily be updated to better combat emerging variants. This has not been necessary so far, as the original vaccines have been effective against the dominant variants that have spread in the past, but companies are preparing to tweak vaccines to respond to the omicron variant just in case.

The good news is that these novel vaccines employing genetic technology mean updates can be made to the vaccines easily -- unlike vaccines based on older technology, which used a piece of the virus or a killed virus to mimic infection.

The new vaccines, which use the genetic technology, introduces an instruction manual of sorts into your body. This introduction manual tells your cells to start churning out a protein normally found on the outside of the virus, and your body activates an immune response when your body senses that viral protein.

In remarks on Monday, President Joe Biden assured Americans that the omicron variant "is a cause for concern, not a cause for panic."

"We have the best vaccine in the world. The best medicines, the best scientists, and we're learning more every single day," the president said. "And we'll fight this variant with scientific and knowledgeable actions and speed. Not chaos and confusion."

Copyright © 2021, ABC Audio. All rights reserved.


Official White House Photo by Adam Schultz

(NEW YORK) -- While the new omicron variant of the COVID-19 virus has not yet been detected in the United States, it will "inevitably" arrive, Dr. Anthony Fauci said Sunday.

"We all know when you have a virus that has already gone to multiple countries, inevitably it will be here," Fauci told ABC's This Week anchor George Stephanopoulos. "The question is, will we be prepared for it?"

The omicron variant, named after the 15th letter of the Greek alphabet, was first detected last week in Botswana, officials said. Since then, cases of the new variant have been found in South Africa, Germany, Belgium and Hong Kong.

Pressed by Stephanopoulos on whether the omicron variant is as or more transmissible than the delta variant and other mutations that have swept the globe, Fauci, director of the National Institute of Allergy and Infectious Diseases and the White House chief medical adviser, said, "It appears to be."

"It has a bunch of mutations," Fauci said, including "a disturbingly large number of mutations in the spike protein, which is the business end of the virus."

Fauci's comments came one day before the United States plans to impose a travel ban on most travelers from eight southern African countries.

When asked by Stephanopoulos whether the travel ban will make a difference, Fauci said, "It will slow things down."

"Travel bans, when you have a highly transmissible virus, never completely ... prevent it from coming into the country. No way that's going to happen," Fauci said. "But what you can do is you can delay it enough to get us better prepared. And that's the thing that people need to understand."

He cautioned that traveling during the pandemic is "always risky," but if Americans have to travel, he recommended they be vaccinated and to wear a mask on flights and in airports, which he described as "one of the most congregate settings you can imagine."

The chief medical adviser said early signs "strongly suggest" that the variant may be more transmissible and might evade protections from monoclonal antibodies and "perhaps even antibodies that are induced by vaccine."

In South Africa, cases of new COVID-19 infections have been heavily weighted toward the omicron variant, Fauci said, so, "you have to presume that it has a good degree of transmissibility advantage."

However, Fauci noted that a relatively small proportion of the population of South Africa is vaccinated. According to Johns Hopkins University, just over 24% of people in South Africa is fully vaccinated, compared to 60% of the U.S. population.

"So, you've got to take that into the equation when you're trying to figure out where this virus is really going and what its impact is going to be," Fauci said.

Asked by Stephanopoulos if omicron causes more severe disease, Fauci said that currently remains a mystery.

He said U.S. scientists spoke to their counterparts in South Africa on Friday and plan to meet with them again later Sunday "to try and find out if the cases they have identified that clearly are caused by this variant, what is the level of severity in that."

"Hopefully, it will be light," Fauci said.

Stephanopoulos also pressed Fauci on how susceptible vaccinated people are to the new variant, asking what is known about how resistant omicron is to the currently available vaccines.

Fauci said studies and experiments are already underway to figure out how strong the vaccines are against omicron and estimated it will take about two weeks before scientists get the answers.

"The way you find that out is you get the virus and you put it either as a whole virus or as what we call a pseudovirus, and you take antibodies or serum from people who have been vaccinated, and you determine if those antibodies can neutralize the virus," Fauci said.

The chief medical adviser said the best way for Americans to prepare for the omicron variant is to be vaccinated, to get a booster shot as soon as they are eligible, and to keep adhering to other protective recommendations such as wearing masks and practicing social distancing.

"We are on the lookout for this. The CDC has a good surveillance system," Fauci said. "So, if and when -- and it is going to be when -- it comes here, hopefully, we will be ready for it by enhancing our capabilities via the vaccine, masking, all the things that we do and should be doing."

When Stephanopoulos broached the possibility of returning to the lockdowns due to the new variant, Fauci said it's "really too early to say."

"We just really need to, as I’ve said so often, prepare for the worst," Fauci said. "It may not be that we’re going to have to go the route that people are saying. We don't know a lot about this virus. So, we want to prepare as best we can, but it may turn out that this preparation, although important, may not necessarily push us to the next level."

He added, "Let's see what the information that we're getting in real-time tells us, and we'll make decisions based on the science and the evidence, the way we always do."

Copyright © 2021, ABC Audio. All rights reserved.



(NEW YORK) -- Global health authorities said they're monitoring a new COVID-19 variant first identified in Botswana, with the World Health Organization saying Friday the new strain, dubbed omicron, is a variant of concern.

Previously referred to as B.1.1.529, the WHO urged countries to step up monitoring and surveillance, citing the high number of mutations and early indications that the virus was spreading in South Africa. The global health agency said it's still not clear whether the variant is more transmissible or causes more serious illness, or if it affects vaccines. And that such studies will take time.

Scientists have now confirmed 87 cases of the new variant -- 77 in South Africa, six in Botswana, two in Hong Kong, and one each in Israel and Belgium, though hundreds more diagnoses are expected.

"We don't know very much about this yet," said WHO COVID-19 Technical Lead Dr. Maria Van Kerkhove, speaking at an "Ask WHO" briefing Thursday. But concern about this variant stems from its "large number of mutations," Kerkhove said, which could "have an impact on how the virus behaves."

Dr. Anthony Fauci told CNN on Friday that scientists from the United States and South Africa will discuss the new variant on Friday, as early indications suggest it could be spreading in South Africa.

"Literally," Fauci added, "it's something that, in real time, we're learning more and more about."

Concerns about this variant already have prompted the U.K., EU and India to propose travel restrictions from South Africa. The World Health Organization, meanwhile, is urging calm, saying it's premature to close borders.

There are thousands of COVID-19 variants, with new ones emerging all the time. Usually new variants disappear quickly because they're overrun by a more dominant strain.

The now-dominant delta variant is so highly transmissible that most of the new variants that have cropped up in recent months have been unable to gain a foothold. In the United States, the delta variant comprises an estimated 99.9% of all cases.

"There's obviously this tension between crying wolf and exacerbating concerns about the variants, but also being caught flat-footed and not responding swiftly enough," said Dr. John Brownstein, chief innovation office at Boston Children's Hospital and an ABC News Contributor. "This is where we have to cautiously respond without inciting panic, because this could easily turn out to be a variant similar to others that have never really panned out to be global concerns."

Scientists across the globe constantly monitor all newly emerged variants to see if they're spreading in a meaningful way, and global health authorities have said they're monitoring this new variant closely.

Pfizer and partner BioNTech said they will conduct experiments to see if the new variant can chip away at vaccine efficacy. Vaccine experts said current COVID-19 vaccines, which rely on genetic technology, could be easily updated to better combat emerging variants -- though so far, that hasn't been necessary.

Eight variants are currently being monitored by the WHO, which designates particularly worrisome strains as variants of "interest" or "concern." When they no longer pose a significant public health threat, the variants are reclassified -- so far during the pandemic, 13 have been removed from the WHO's list.

But public health experts said the emergence of variants underscores the urgent need to vaccinate everyone on the planet.

"It gives us a lens into why as epidemiologists we've been so concerned about global vaccine equity," Brownstein added. "It's a recognition that with not enough people around the globe immunized, it creates more opportunities for variants to emerge, and this is a very good example of that."

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(NEW YORK) -- Waning immunity has become a focal point in the pandemic.

COVID-19 cases among those fully vaccinated against the virus have been cited by several state public health officials as partly responsible for recent surges in cases. They were also behind the push for boosters for all adults ahead of federal authorization -- and the reason for boosting in the first place.

"There's no doubt that immunity wanes. It wanes in everyone. It's more dangerous in the elderly, but it's across all age groups," Dr. Anthony Fauci, the White House chief medical adviser, said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and both began to first document waning immunity.

Experts stress that the vaccines remain highly effective against severe COVID-19 illness, and vaccinated people continue to share a lower burden of hospitalizations and deaths among COVID-19 patients as cases and hospitalizations are on the rise again in the U.S.

The data is limited and hard to track, though knowing more about breakthrough infections is an important tool in responding to the pandemic, experts say.

Vaccinated COVID-19 cases always expected

Data from the Centers for Disease Control and Prevention tracking COVID-19 case rates by vaccination status since April shows a relatively flat line for vaccinated people that started to slope up in July -- though not nearly as steeply as case rates among unvaccinated people.

Breakthrough cases were always expected -- and expected to go up over time, Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told ABC News.

"The reason is, first of all, more people are vaccinated," he said. "The more people who are vaccinated relative to being unvaccinated, the more likely it is that a person who gets sick is going to be vaccinated, just by pure numbers."

As the number of unvaccinated people who get COVID-19 also continues to increase, it may look like more cases are breakthrough when comparing cases by vaccination status, he said.

ABC News Photo Illustration, CDC
COVID-19 Case Rates by Vaccination Status



























Another reason for increasing cases is due to waning immunity, Dowdy said.

"There is this waning immunity to getting sick -- not getting really sick, but getting infected, getting that initial illness," he said. "And so over time, people have a little bit less protection against that."

No vaccine provides 100% protection, though they are intended to help prevent you from getting very sick if infected. The initial immune system response is ramped up for several months after vaccination, though those antibodies "die out over time," leaving behind a "memory response" to help protect against severe infection, Dowdy said.

When that happens varies from person to person depending on factors like age and health. In general, Pfizer's data on its COVID-19 vaccine shows a decrease from an initial 96% efficacy to 83.7% efficacy after four months. A study by Kaiser Permanente Southern California found that efficacy against infections declined from 88% during the first month after full vaccination to 47% after five months.

A booster dose brings the immune response back up to a "robust" level seen one month after two doses, Pfizer found.

Booster doses are now eligible for all adults as COVID-19 transmission remains high in many parts of the country, "creating additional challenges and exposures for those who are vaccinated," said Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor.

"Just based on probability, with enough exposures to the virus, you will have breakthrough infections," he said. "But those breakthrough infections doesn't mean the vaccines aren't working -- it just means over time, the probability of getting infected through an exposure to the virus, that probability increases."

"Despite that, we know that the vast majority of those breakthrough infections are mild, especially much milder than they would be if someone wasn't previously vaccinated, and they don't lead to anywhere near the same levels of severe illness and death," he said.

In September, unvaccinated individuals had a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to vaccinated individuals, according to CDC data.

ABC News Photo Illustration, CDC
COVID-19 Death Rates by Vaccination Status



























Waning immunity a 'real phenomenon'

Although the vast majority of COVID-19 infections and severe hospitalizations are among the unvaccinated, cases in vaccinated people do appear to be on the rise due to waning immunity, according to health officials.

In New Mexico, health officials have cited waning immunity as one of the reasons behind a recent surge in COVID-19 cases. The most recent state data shows that nearly 29% of cases and 21% of hospitalizations from Oct. 18 to Nov. 15 were among vaccinated people.

Similarly, health officials in Vermont, the most vaccinated state by population, have pointed to waning immunity as partly behind its worst COVID-19 surge yet.

"Waning of vaccine immunity is a real phenomenon," Dr. Mark Levine, commissioner of the Vermont Department of Health, said during a press briefing in mid-November.

Vermont also leads the nation in administering booster doses to people ages 65 and up. This week, Levine told reporters that the health department's data reaffirms that "booster shots are working." Case rates among those ages 65 and up in the state make up only 10-12% of COVID-19 cases, he said. The most recent state data also shows case rates among that population have decreased 14% week-over-week while increasing for every other age group.

"The need for a booster does not mean the COVID-19 vaccines have failed to do their job," he said. "They are highly protective against the worst effects of COVID. But the protection we get from a vaccine can start to wear off over time."

"For COVID-19, booster shots are especially important for those at higher risk who got vaccinated early on, like the majority of Vermonters who fall into this category and were vaccinated very early in this year. And at a time when COVID-19 transmission is high, when we're indoors more and getting together over the holidays, boosters really do benefit us all," he added.

Challenges in tracking breakthrough infections
Tracking breakthrough cases can be challenging, and most efforts likely represent an undercount due to a lack of testing of asymptomatic cases and reporting of at-home test results, according to The Pandemic Tracking Collective, a group of former members of The Covid Tracking Project that offers data solutions for tracking the pandemic. Breakthrough data is also not standardized across states, and not all report breakthrough cases, hospitalizations and deaths, the group said in a recent report.

In this patchwork of breakthrough infection-related collection, 36 U.S. jurisdictions report cases, 34 report hospitalizations and 37 report deaths, according to The Pandemic Tracking Collective report. At the time of its report, the CDC tracked cases for 16 jurisdictions and deaths for 15 jurisdictions by vaccination status, updated monthly. That has since increased to 24 and 20 jurisdictions, respectively, in the tracker's latest update this week. The CDC also reports on hospitalizations by vaccination status in 14 states.

"Now we have data on COVID-19 case counts and hospitalizations at our fingertips. What we lack is nuanced and detailed information on vaccine breakthroughs, which will be key to ending this pandemic," Jessica Malaty Rivera, science communication lead at The Pandemic Tracking Collective, said in a statement.

Breakthrough infections can help scientists better understand declining vaccine efficacy and detect new variants, the group said. Having better data can also help enact effective policies, Brownstein said.

"It's very hard to make policy decisions with imperfect data," he said. "Being able to understand the extent to which we're seeing breakthrough infections and their severity is important to make decisions around things like boosters, decisions around requirements for those who've been exposed or infected."

"When you have that kind of data, it can tell you very clearly what the burden of disease is in vaccinated people," he continued. "But without that, we have very limited information. So I think that is one of the real deficiencies in public health surveillance, is a lack of clarity on the impact of this virus among vaccinated and unvaccinated."

For Dowdy, data on breakthrough cases can provide "valuable information as we think about how we can best fight this pandemic," including the duration and level of protection that the vaccines are providing. Though he warned against reading the data as "trying to split the population in two."

"At the end of the day, we're all in this together, vaccinated or unvaccinated," he said.

Copyright © 2021, ABC Audio. All rights reserved.


Alex Goodlett/Getty Images

(NEW YORK) -- A healthy athlete all his life, Jared Butler entered his college basketball physical exam as the last step before he could step on the court. But an unexpected diagnosis of a potentially lethal heart condition put him on the sidelines while he anxiously wondered if his basketball career was over.

"After a month of testing, we found out that I had hypertrophic cardiomyopathy," Butler told ABC News. "I had never heard the term before. I was worried what this would mean for my playing career -- and ultimately my life."

That was three years ago. Today, Butler is coming off a starring role in an NCAA championship run at Baylor University and playing as a rookie in the NBA for the Utah Jazz. He has been able to continue his career thanks to routine cardiac evaluation and support by his family, doctors and team.

Hypertrophic cardiomyopathy is this most common genetically inherited heart disease, estimated to affect between 1 in 200 and 1 in 500 people worldwide, according to a 2015 study published in the Journal of the American College of Cardiology. The condition causes the heart muscle to become too thick, which could lead to life-altering conditions such as arrhythmias, heart failure, stroke or death.

Dr. Steve Ommen, cardiologist and medical director of the Mayo Hypertrophic Cardiomyopathy Clinic in Rochester, Minnesota, said the disease is not gender-selective and has no ethnic or geographic hotspots.

"The disease can manifest at any time and at any age among family members carrying the mutation," said Dr. Seema Mital, pediatric cardiologist and head of cardiovascular research at The Hospital for Sick Children in Toronto. "Some may even go without any evidence of the disease throughout their lifetime."

Once someone, like Butler, is found to have the disease, immediate family members are tested for the genetic mutation. In Butler's case, his mother, Juanea, also tested positive for genetic markers of the disease. She will also be monitored regularly by a cardiologist.

"I found out that I am the culprit. I am the one who carries the gene" said Juanea. "I was really confused and in a state of shock. I grew up active as well and never had symptoms or noted to have heart problems."

Mother and son were symptom-free their whole lives. But Dr. Michael Ackerman, genetic cardiologist at the Mayo Clinic and Jared Butler's physician, said people and physicians should be aware of the most-concerning symptoms, including chest pain, fainting and shortness of breath.

The disease can be especially risky for professional athletes because it increases the risk of sudden cardiac death. But thanks to the medical field having a better understanding of this disease, not every athlete needs to give up their career.

"Every athlete [with hypertrophic cardiomyopathy] doesn't need to give up what they're doing," said Mital. "Having the disease means you are going to be followed medically to make sure we can prevent heart failure and death. In fact, we now know that patients with hypertrophic cardiomyopathy can live a long, healthy life without any complications."

Ackerman has treated over 700 athletes with genetic cardiac conditions, a majority of whom do not require extensive medical procedures.

"For Jared, we made a plan with him, his family and his team and reassess that plan frequently and alter it as needed," said Ackerman. "This is not the new and improved way, this is just the approved and best way."

Ommen added that "shared decision-making" between a doctor and patient is meant to educate patients about the potential risks and make a group decision that is best for them.

He's more concerned about the 85% of the patients -- assuming 1 in 500 Americans have the condition -- who are living undiagnosed. To raise awareness, Butler and his mom decided to launch a campaign, "Could it be HCM?" in conjunction with Bristol Myers Squibb.

Ackerman added the second aspect of the campaign is knowing your family history. Having that knowledge about the sudden death of a family member could be life saving information

"Young patients come to the doctor complaining of shortness of breath, or chest pressure, and they are mistakenly diagnosed with exercise-induced asthma," said Ommen. "Campaigns like 'Could it be HCM?' are trying to raise awareness that if a young person does come in with symptoms, think about hypertrophic cardiomyopathy as one of the potential causes."

There is no cure, but Mital said that there are medications and surgical techniques to help alleviate symptoms and a lot of research invested in finding treatments to slow progression of the disease is in the future.

"Finding out you have the condition is just the beginning. It has been a long journey, and it has changed my life," said Butler. "But I find myself lucky that I do not have symptoms and I can continue playing basketball."

Lily Nedda Dastmalchi, D.O., M.A., is a physician and cardiology fellow at Temple University Hospital and a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.



(NEW YORK) -- With coronavirus infection rates back on the rise, many Americans are wondering why the U.S. is, once again, experiencing surge in cases and hospitalizations, despite widespread vaccinations.

The U.S. is now reporting more than 94,000 new COVID-19 cases each day -- up by 47% since late October. And 35 states -- nearly all of them in the north or mountain region -- have seen an uptick in daily cases of 10% or more in the last two weeks.

Just under 53,000 COVID-19 positive patients are currently receiving care in hospitals across the country -- up by more than 7,000 patients from earlier this month.

Several states -- including Michigan, Maine and New Hampshire -- are experiencing record-breaking surges.

Experts say a confluence of factors is likely driving the country's recent increases in infections, including the more than 100 million Americans who remain completely unvaccinated, cold weather and relaxed restrictions, the highly transmissible delta variant, and waning vaccine immunity.

Unvaccinated Americans continue to drive COVID-19 transmission

According to health officials, the vast majority of infections and severe hospitalizations continue to be among the unvaccinated.

This September, federal data showed that unvaccinated individuals have a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to those fully vaccinated.

"The thing we are concerned about is the people who are not vaccinated, because what they're doing is they're the major source of the dynamics of the infection in the community," Dr. Anthony Fauci, the White House's chief medical adviser, said during an appearance on ABC's "This Week" on Sunday. "The higher the level of dynamics of infection, the more everyone is at risk."

Across the country, more than 101 million Americans remain completely unvaccinated -- 81 million of whom are currently over the age of 5, and thus are eligible to be vaccinated.

The significant number of unvaccinated individuals -- about 30.5% of the total population -- leaves millions at-risk and completely unprotected against the virus.

Relaxed restrictions, increased travel, and colder weather pushing people indoors

With winter arriving, and the holiday season on the horizon, many Americans are spending more time indoors, as the weather gets colder. COVID-19, as well as other respiratory illnesses, has been shown to spread more in indoor settings, and when people are forced to be in close proximity to one another.

Millions of Americans are also once again traveling, taking to the air, the railways and the highways. A total of 53.4 million people are expected to travel for Thanksgiving, up 13% from 2020, according to estimates from AAA.

Although masking is required in all forms of public transportation, across the country, COVID-19 restrictions are sparse, with few jurisdictions now requiring face coverings or social distancing.

"We're seeing cases trickle up, this is probably likely due to waning immunity, but also because of the colder temperatures people are gathering indoors and adhering less to social distancing and masking," John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor, told "World News Tonight." "Unfortunately, that is a recipe for an increase in transmission this holiday season."

Masking has been shown to reduce the risk of COVID-19 transmission, and is still recommended by the Centers for Disease Control and Prevention in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.

Delta variant remains highly transmissible

In the U.S., federal data shows that the delta variant accounts for 99.9% of new coronavirus cases. According to the CDC, delta is far more transmissible than prior variants.

Many of the country's northern states were not as hard hit by the delta surge over the summer. Those states are just now feeling the impacts of the delta variant. Comparatively, states like Florida, which bore the brunt of the summer delta surge, are reporting very low COVID-19 infection numbers.

"We're seeing is pockets of surges across this country, the Midwest being one but also in the Northeast," Brownstein said

The delta variant spreads more easily among vaccinated people than prior versions of the virus, though vaccinated people are still far less likely to spread the virus compared to unvaccinated people.

Vaccine immunity is waning

Although the vast majority of infections and severe hospitalizations are among the unvaccinated, breakthrough positive COVID-19 cases among the vaccinated do appear to be on the rise, due to waning immunity, according to health officials.

"There's no doubt that immunity wanes. It wanes in everyone. It's more dangerous in the elderly, but it's across all age groups," Fauci said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.

Experts stress that the vaccines remain highly effective against severe COVID-19 illness.

Boosters are now recommended for everyone 18 and older, at least six months after an initial Pfizer or Moderna vaccination, or two months after a Johnson & Johnson shot.


Copyright © 2021, ABC Audio. All rights reserved.


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