Older Americans make up a majority of COVID deaths. They are falling behind on boosters

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• Judy Woodruff:

  The United States is approaching a grim milestone of the pandemic, as the nationwide death toll approaches 800,000.

  As Amna Nawaz explains, the vast majority of those deaths are among the elderly, and there are concerns about their risks increasing once again.

• Amna Nawaz:

  That's right Judy.

  Older Americans have borne the brunt of the pandemic death toll. People 65 and up make up 75 percent of all COVID deaths in the U.S., or 600,000 of those nearly 800,000 deaths. Younger Americans, 45 to 64, make up 21 percent. Those 45 and below are just 4 percent of all deaths.

  Meanwhile, among some of the most vulnerable Americans, nursing home residents, just 51 percent have gotten a booster shot.

  For more on this, I'm joined by David Grabowski. He's a professor of health care policy at Harvard Medical School.

  David, welcome back to the "NewsHour." Thanks for making the time.

  That number is just staggering to think about. But there is a big range in that group, 65 and older, so who are we really talking about? Who is making up sort of the bulk of that death toll?

• David Grabowski, Harvard Medical School:

  Absolutely.

  The individuals making up the bulk of the deaths among older adults are those oldest old. So they're individuals aged 85 and older. They're individuals with comorbidities, cardiovascular disease, obesity, diabetes. They are also typically individuals living in nursing homes.

  And these congregate living environments are actually the perfect storm for the spread of COVID. You have individuals often sharing a room, sharing a bathroom, communal dining and activities. So all of these features lead to those big outbreaks we have all read about.

• Amna Nawaz:

  What is going on in nursing homes now?

  I know the CDC has shared some concern over low vaccination rates among people who work in those nursing homes, I think aides in nursing homes and long-term care facilities, it's still 46 percent of all those aides are fully vaccinated. Is that contributing to this?

• David Grabowski:

  That's absolutely contributing to this.

  We see a huge range in the vaccination rates of staff around the country. Some facilities, let's be very clear, are doing quite well. They have vaccination rates among caregivers up above 80 or 90 percent. However, we have far too many facilities that are really lagging behind.

  And we did some research recently suggesting that variation in the vaccination rate of the staff is actually a big explanation for why we see such differences in fatality rates among residents across facilities. We estimated, over the summer of 2021, if you could have brought all of those facilities up to 80 percent vaccination rates among their staff, you would have saved 700 lives among residents.

  That's a huge number. I'm not — and that's half of all fatalities over the summer, could have been prevented if we could have had our staff better vaccinated.

• Amna Nawaz:

  Let's talk about vaccination rates among those older Americans, right? We're talking about people 65 and up. It is one of the most highly vaccinated groups in the country.

  What about booster shots? Have we had the same level of uptake?

• David Grabowski:

  We haven't, unfortunately.

  So, the federal government did something very centralized and orderly about originally vaccinated our residents. They brought the clinics to the facilities. And this led to pretty high vaccination rates nationally. About 85 percent of our residents in nursing homes are vaccinated.

  In terms of boosters, however, we have we have taken a very decentralized approach, where we have left it up to the facilities to vaccinate the residents. And about half of all those vaccinated residents have gotten their booster shot, and, once again, huge variation from facility to facility.

  We can do better here. We really need to push here. As you have already noted, these are the most vulnerable Americans. These are the ones who are most in need of that booster. We need to get those done as soon as possible.

• Amna Nawaz:

  David, there are folks who look at the numbers and say, well, of course it's older Americans, because, the older you get, the more likely you are to die from some kind of complication, so we shouldn't pay too much attention to these numbers.

  What do you make of that?

• David Grabowski:

  I find that incredibly offensive. Every life is valuable.

  These are our parents, our grandparents that are living in these nursing homes. We need to protect them as much as we need to protect every American. Let's not fall into these ageist approaches we have taken in the past. Let's respect everyone. Let's get them vaccinated. Let's get the staff vaccinated. Every life is valuable. And that would be my response.

• Amna Nawaz:

  David, finally, I just want to make this clear for everybody with a graphic, when you can see, over the life of this pandemic, what has happened when you look at people 65 and older.

  Those are total U.S. COVID deaths. That orange part is just the part of the population 65 and older. And you can see the ups and downs, the wave in the first spring, when vaccinations for started to come online. It starts to dip slowly over time. But, at the end there, David, it is starting to creep back up.

  What should people who are thinking about gathering with grandparents, older loved ones look at that and think about what's ahead?

• David Grabowski:

  It's really important that we get together, but it's really important that we get together safely.

  And so we need to be vaccinated, we need to get our booster shots. We need to do testing. And we need to take precautions, obviously. But I think if it's visiting an older family members in a nursing home, getting together for the holidays, these are really important activities, but we need to do them safely.

  And that would be my advice, to balance both kind of the community we all need this time of year with safety.

• Amna Nawaz:

  It's good advice.

  That is David Grabowski, professor of health care policy at Harvard Medical School.

  David, always good to see you. Thank you.

• David Grabowski:

  Thanks.