The global threat of measles has become worse after 22 million babies missed their vaccinations because of the COVID-19 pandemic, the U.S. Centers for Disease Control and Prevention warned Wednesday.

Measles is one of the most contagious viruses known and still kills more than 60,000 people a year, mostly young children. But it killed more than a million a year as recently as 2000.

Vaccination campaigns turned that around, but it doesn't take much to threaten any progress.

The CDC said Wednesday that reported measles cases fell in 2020 after a global resurgence from 2017-2019. The agency doesn't necessarily think that's good news.

"Large and disruptive measles outbreaks in 2020, however, suggest that measles transmission was underreported," the CDC team wrote in the agency's weekly report on death and disease, the MMWR.

The CDC notes millions of kids missed out on their vaccines because of the pandemic.

"Over 22 million infants missed their first dose of measles vaccine — 3 million more than in 2019 and the largest annual increase in over 20 years," the CDC said.

"While reported measles cases dropped in 2020, evidence suggests we are likely seeing the calm before the storm as the risk of outbreaks continues to grow around the world," Dr. Kate O'Brien, director of the Department of Immunization, Vaccines and Biologicals at the World Health Organization, said in a statement.

"It's critical that countries vaccinate as quickly as possible against COVID-19, but this requires new resources so that it does not come at the cost of essential immunization programs. Routine immunization must be protected and strengthened; otherwise, we risk trading one deadly disease for another."

CDC and WHO have been warning that the pandemic has damaged routine childhood vaccination programs.

"Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children," Dr. Kevin Cain, CDC's global immunization director, said in a statement.

"We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases."

The CDC estimates that measles vaccination programs prevent more than 31 million deaths a year.

"Even before the pandemic, we were seeing how even small pockets of low measles immunization coverage could fuel unprecedented outbreaks, including in countries where the disease had been considered eradicated. And now, COVID-19 is creating widening gaps in coverage at a pace we haven't seen in decades," Ephrem Tekle Lemango, UNICEF's associate director for immunization, said in a statement.

"While we have not seen an increase in cases yet, measles is simply too contagious. If we do not act, gaps will become outbreaks, and many children will be exposed to a preventable but potentially deadly disease," he added.

As children ages 5 to 11 years old began receiving the COVID-19 vaccine last week, families across the country have been breathing a great sigh of relief. Their younger kids will soon be much better protected against the coronavirus.

But will it be in time for Thanksgiving? Will we be able to get together more easily because more kids are vaccinated? What precautions should we take? What if travel is required? And what about the kids who are too young to be vaccinated?

CNN Medical Analyst Dr. Leana Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of a new book, "Lifelines: A Doctor's Journey in the Fight for Public Health," and the mother of two young kids. She breaks down what you need to know.

CNN: I have heard from many parents who are so relieved their 5- to 11-year-old children can get the COVID-19 vaccine. Has that been your experience, too?

Dr. Leana Wen: Relief, for certain, because so many parents have been worried about their children being exposed to the coronavirus at school. Parents have also been concerned about their own exposure at work, and inadvertently bringing back COVID-19 to their kids. A lot of families are making plans for what they will soon be able to do, once their entire household is fully vaccinated.

There is a lot of envy, too! Envy from families like mine, with children under the age of 5 who still are not eligible yet. And there are still a lot of families that haven't yet gotten appointments for their children, because these have been filling up fast. More sites will be providing the vaccine for younger children soon, and I expect it will be a matter of weeks before every child that wants a shot can get easily get one.

CNN: Can families relax over Thanksgiving once their kids are vaccinated?

Wen: Once the entire household is fully vaccinated, it would certainly be reasonable to resume many more activities and get back to something closer to pre-pandemic normal. A reminder, though, that fully vaccinated for the Pfizer-BioNTech vaccine, which is what's authorized for children, means two shots, separated by at least three weeks, followed by two more weeks to allow for optimal antibody production.

Given that the vaccine for 5- to 11-year-olds was just made available last week, these younger children are not going to be fully vaccinated in time for Thanksgiving. (The one exception will be the kids who were enrolled in the clinical trial who got the vaccine.)

Most children who are getting their first doses now will have partial protection by Thanksgiving. I would not recommend that they behave as if they were fully vaccinated. Continue to exercise caution for the time being, especially because they are so close to being fully vaccinated.

CNN: Does that mean families with younger children can't get together over Thanksgiving?

Wen: No, not at all. It just means that parents shouldn't consider their kids fully vaccinated if they've only had one shot. Families with partially vaccinated kids need to continue taking additional precautions.

If lots of people are getting together, especially with other unvaccinated people, the safest thing to do is to gather outdoors. If an indoor gathering is planned, I would advise that everyone reduce their risk and essentially quarantine for at least three days ahead of the get-together, and then get a COVID-19 test the day of the gathering. An over-the-counter, rapid antigen test is fine for this purpose.

CNN: For those three days, what if kids have to go to school and adults have to go to work?

Wen: It's hard for everyone to stop their lives prior to the get-together. I'd encourage people to do their best to reduce their risk in that period. People going to school and work where they will be around others of unknown vaccination status should wear high-quality masks when they are indoors. Do not go to crowded indoor bars or restaurants, or get together with other people, indoors, during that period.

This method, of reducing risk then testing, isn't going to prevent all COVID-19 cases. At this point in the pandemic, most people are not aiming to eliminate all risk, but to reduce risk enough that we can bring back activities in our lives that are really important. That includes seeing loved ones over Thanksgiving.

CNN: Should adults try to get their booster shots before Thanksgiving, if they are eligible? Would that also help to protect children?

Wen: Adults who are recommended for booster shots should get their boosters by Nov. 11 to protect themselves in time for Thanksgiving Day festivities. Studies show that boosters increase antibody levels and reduce the likelihood of breakthrough infections, so getting a booster before get-togethers over the holidays will help protect that person, and probably also those around them, too.

CNN: What advice do you have for families who need to travel over Thanksgiving?

Wen: Wear a high-quality mask when in indoor, public places. An N95, KN95 or KF94 are best. Try not to remove your mask, except for short sips of water. For younger children or individuals who need to eat more often, try to find a location away from others while eating.

CNN: A lot of families have children of mixed vaccination status — some kids who are fully vaccinated, others who are just getting their first shots, and those still too young to get the vaccine. How should they handle the upcoming holidays?

Wen: The family should discuss the level of risk they are willing to take. It might be reasonable to allow a fully vaccinated teen to see her fully vaccinated friends for a sleepover, even if there is a younger child who is just now getting her shots. But parents could draw the line and say that the vaccinated teen is not able to attend an indoor concert where she'd be surrounded by a lot of unmasked people of unknown vaccination status. The children who are partially vaccinated should continue to take additional precautions for the time being, with the expectation that they will be fully vaccinated for the next set of holidays in December.

WASHINGTON — About 900,000 kids aged 5-11 will have received their first dose of the COVID-19 vaccine in their first week of eligibility, the White House said Wednesday.

Final clearance for the shots was granted by federal regulators on Nov. 2, with the first doses to kids beginning in some locations the following day.

Shortly after the vaccines' approval, White House COVID-19 response team coordinator Jeff Zients said it would take until the week of Nov. 8 for the vaccine distribution program to reach full capacity.

On Wednesday, Zients confirmed that nearly 20,000 pharmacies, clinics and physicians' offices are administering the doses. By the end of Wednesday, the White House estimates that more than 900,000 of the kid doses will have been administered.

Zients added that "through pharmacies alone, 700,000 additional appointments are already on the calendar at local pharmacies."

Kids who begin the two-dose regimen by the end of next week will have full protection from the vaccines by Christmas.

The White House says that the U.S. still has enough doses on hand to vaccinate all 28 million children in the country aged between 5 and 11.

WASHINGTON — The FDA on Friday issued emergency approval for a smaller dose version of Pfizer's COVID-19 vaccine for use in children aged 5 to 11.

The agency's decision comes just days after the Vaccines and Related Biological Products Advisory Committee voted 17-0 (with one doctor abstaining) to recommend the shots.

"The tremendous cost of this pandemic has not just been in physical illness, it's been in the psychological the social development of children," said Dr. Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA.

The Centers for Disease Control and Prevention (CDC) is scheduled to consider the shots early next week. The agency's Advisory Committee on Immunization Practices must first give its own recommendation before agency director Dr. Rochelle Walensky gives final approval.

Officials estimate that the vaccines could be available to children as early as the first or second week in November.

Last week, the White House said that if and when Pfizer's vaccine receives full emergency use authorization, it would begin shipping 15 million vaccine doses to clinics around the country for immediate distribution.

Biden Administration officials say the country currently has enough doses on hand to vaccinate every child aged between 5 and 11 that lives in the U.S. The White House says that it will primarily lean on primary care doctors and pharmacies to distribute the vaccines but noted that it is also working with some school boards to offer doses in schools.

Pfizer's COVID-19 vaccine has been fully approved by the FDA for everyone aged 16 and up. The shots are also available for adolescents between the age of 12 and 15 on an emergency use basis.

Marks said the FDA is "probably a few months" away from reviewing data for COVID-19 vaccines for younger children.

The U.S. on Thursday donated its 200 millionth COVID-19 shot to help vaccinate the rest of the world, the White House announced. The Biden administration aims to lead a global vaccination campaign even as it rolls out boosters for domestic use, which critics say diverts doses from those who are in greater need around the world.The donated doses include more than 120 million in surplus from the U.S. stockpile of shots, as well as the initial deliveries of the 1 billion doses the Biden administration has purchased from Pfizer for overseas donation by September 2022. More than 100 countries and territories have received the American doses, and the U.S. remains the largest vaccine donor in the world.“These 200 million COVID-19 vaccine doses have helped bring health and hope to millions of people, but our work is far from over,” U.S. Agency for International Development Administrator Samantha Power said in a statement. “To end the pandemic, and prevent the emergence of new variants, as well as future outbreaks within our nation’s borders, we must continue to do our part to help vaccinate the world.”While aid groups have praised the U.S. for leading the world in vaccine donations, they have criticized the U.S. for approving booster doses for use in the country while many people in lower-income nations have no protection at all. The Food and Drug Administration approved booster doses of the Moderna and Johnson & Johnson vaccines Wednesday, following last month's authorization of a third dose of the Pfizer shot.“The reality is, the more wealthy countries use booster shots, the further we will be from ending the pandemic," said Tom Hart, acting CEO of the One Campaign. “While some argue that we can both administer boosters and vaccinate the world, the simple fact is that boosters divert supply from an urgent area of need — administering first shots around the world.”While half the planet has been vaccinated, there are massive geographic and wealth disparities. The majority of global shots have been administered in high- and moderate-income countries.

The rates of COVID-19 cases, hospitalizations and deaths are improving; an optimistic sign for the future of the pandemic. But with so many Americans still unvaccinated, the numbers could still go back up, Dr. Anthony Fauci told Fox News Sunday.

"If we don't do very well in that regard, there's always the danger that there will be enough circulating virus that you can have a stalling of the diminishing of the number of cases and when that happens, as we've seen in the past with other waves that we've been through, there's the danger of resurgence," said Fauci, the director of the National Institute of Allergy and Infectious Disease and chief medical adviser to President Joe Biden.

Although cases still remain high at an average of more than 85,000 infections a day, they are down by more than 8,000 from the weeks before, according to data from Johns Hopkins University. And deaths are down an average of more than 200 a day from the start of the month.

Progress in the numbers is still threatened, however, by the low rates of vaccination. As of Sunday, 57% of the total population was fully vaccinated against the virus, according to the Centers for Disease Control and Prevention.

And though health experts do not know exactly what proportion of the population needs to be protected to control the spread of the virus, Fauci has said a vast majority will need to be vaccinated.

The good news is, Fauci does not think another spike in cases is inevitable.

"It's going to be within our capability to prevent that from happening," said Fauci. "The degree to which we continue to come down in that slope will depend on how well we do about getting more people vaccinated."

Johnson & Johnson boosters

As more COVID-19 boosters are potentially set to become available, experts say those who received the Johnson & Johnson one-dose vaccine are "awfully well protected," but should still get another shot for maximum safety.

"The Johnson & Johnson vaccine turns out not to be quite as effective as the Pfizer and Moderna. And people who got (the J&J vaccine) way back at the beginning of this year therefore have been somewhat less protected, although they're still awfully well protected," said Dr. Francis Collins, director of the National Institutes of Health.

Collins' remarks come after a Food and Drug Administration advisory committee recommended all adults who received the single-dose Johnson & Johnson shot should get a second dose at least two months after their first dose.

The FDA will consider the committee's advice. Then the CDC's vaccine advisers will be asked to consider it.

Experts are advising people who received the Johnson & Johnson vaccine should get a booster shot as soon as it is available because it will provide them with the best protection against COVID-19, especially as the more transmissible delta variant continues to be the dominant strain in the United States. But they are also reinforcing the point the vaccine remains highly effective against the worst consequences of the virus.

Johnson & Johnson has indicated its vaccine immunity has waned -- but not by much. Still, the company said studies show a booster dose increases protection equivalent to the 94% efficacy shown by the Moderna and Pfizer mRNA vaccines soon after they were first given in clinical trials last year.

Meanwhile, various real-world studies suggest Johnson & Johnson's vaccine was anywhere between 50% and 68% effective, Dr. Amanda Cohn with the CDC said Friday.

"If the mRNA vaccines from Pfizer and Moderna had not been so utterly, amazingly effective, 95%, then Johnson & Johnson would look like a hero with their one dose, but I guess our standards are being set awfully high here by the other vaccines," Collins told CNN.

But a study published Thursday reported a steep decline in vaccine effectiveness against infection by August of this year, especially for people who received the J&J vaccine.

Researchers found among more than 600,000 veterans, J&J's vaccine's protection against infection fell from 88% in March to 3% in August. Meanwhile, Moderna's vaccine protection against infection fell to 64% from 92%, and Pfizer's declined to 50% from 91% during the same time period.

"The performance of these vaccines against severe disease, keeping people out of the hospital, is distinctly better than that, and that's the main thing we're interested in," said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center in Nashville.

The FDA vaccine advisory committee also supported emergency use authorization for booster shots of Moderna's COVID-19 vaccine after six months, but not for everyone. Moderna recipients over the age of 65 and adults with conditions that put them at risk for severe disease or who work or live in a place which puts them at higher risk of complications or severe illness may be eligible for the 50-microgram booster, which is half the size of the primary two-dose series.

And as for whether booster shots will become available for everyone who's already vaccinated, health officials are still working to determine that.

"I think as more data come in and ... are carefully reviewed and vetted, then I think the expansion of the recommendations may be in order. Not quite yet," Schaffner said.

Minnesota Emergency and Urgent Care services suspended over nurses strike

In many places, the brunt of the hospital strain from COVID-19 has fallen on nurses, and a strike in Minnesota has impacted services.

Emergency and Urgent Care services have been temporarily suspended at Abbott Northwestern WestHealth in Plymouth, Minnesota due to about 50 nurses from the Minnesota Nurses Association (MNA) choosing to strike, according to a statement from Allina Health.

The nurses are striking to seek "a contract that provides fair pay and benefits to nurses on the frontlines of the COVID-19 pandemic," the MNA said in a statement on Thursday.

"MNA nurses have been negotiating a new contract for months, but Allina has refused to agree to fair pay for holiday work or adequate benefits," the MNA said in the statement. "Compensating nurses fairly for holiday work is especially critical because understaffing by Allina and other hospital systems has required nurses to work more days and longer hours, including overtime and holidays, as they continue on the frontlines of the COVID-19 pandemic."

The closure began Sunday morning and will last until 7:00 a.m. local time on Wednesday, according to the statement.

"Allina Health and Abbott Northwestern WestHealth have negotiated 7 times with MNA. A contract settlement was previously reached and unanimously recommended by the union's bargaining team. Unfortunately, the MNA could not finalize that agreement," Allina Health's statement says. "Throughout negotiations, we have consistently offered proposals that demonstrate our commitment to our employees, including an immediate wage increase to align wages with other metro hospitals and agreeing to some of the union's other priority issues."

Black people represent a larger share of new vaccinations

As public health officials talk boosters, 66 million Americans who are eligible for a vaccine still haven't received their initial shots, while nearly 57% of the U.S. population is fully vaccinated, according to the CDC.

Black and brown communities have proven to be disproportionally bearing the brunt of the pandemic for various reasons, including health care inequities.

But there is some good news in terms of Black people's vaccination numbers. Recently, Black people -- who comprise 12.4% of the total U.S. population -- have come to represent a slightly larger share of new vaccinations than in the past, according to the CDC.

Since vaccinations began, Black people in the U.S. have accounted for 10.6% of all people with at least one dose. But in the past two weeks, they have accounted for 11.4% of new vaccinations.

The growth in vaccinations comes after two studies published by the CDC in April showed racial and ethnic minority groups had higher rates of hospitalization for COVID-19 and sought emergency department care for COVID-19 more when compared to White people.

Another analysis published earlier this month by the Kaiser Family Foundation (KFF) showed the difference in COVID-19 cases and deaths between Black, Hispanic and White people is narrowing.

KFF researchers found while disparities are still present across different racial groups, the gap is improving for Black and Hispanic people, based on an analysis of case and death data from CDC last month. But COVID-19 infections remain high in Native American and Alaska Native people.

Some in law enforcement are resisting vaccine, but COVID-19 is killing more of them than gunfire

Meanwhile, COVID-19 has become the leading cause of death for officers, despite law enforcement being among the first groups eligible to receive the vaccine at the end of 2020.

As of Saturday, the total stood at 476 COVID-19 related deaths since the start of the pandemic, compared to 94 from gunfire in the same period.

Still, law enforcement officers and their unions across the country have resisted vaccine mandates, despite the delta variant-fueled resurgence of COVID-19 and effectiveness of the shots in preventing severe cases and death.

Reasons cited for the vaccine resistance among law enforcement officers range from disinformation to distrust in the science of the vaccines.

In Chicago, the head of the police union asked officers not to follow the mayor's order to submit COVID-19 vaccination proof by the Friday deadline.

John Catanzara, the Chicago Fraternal Order of Police president, urged, in a video message posted on YouTube, for officers to stand their ground against the mandate.

"I am telling you right now. It is an improper order. It is illegal ... Refuse that order," Catanzara said in the video.

The city filed a complaint alleging the union was "encouraging a work stoppage or strike." A Cook County Circuit judge ruled Friday night Catanzara should not make public statements encouraging members to not comply with the vaccination policy.

Catanzara "has never engaged in, supported, or encouraged a work stoppage," according to a union statement on Friday.

Lightfoot said the city would take the weekend to check with officers who have not complied with the mandate. She said officers should report for duty until they are told by supervisors they have been placed on leave.

Several large companies based in Texas — including two of America's largest airliners — have said they plan to keep COVID-19 vaccine mandates for employees in place, siding with federal authorities in a showdown between the White House and the governor of Texas.

American Airlines, Southwest Airlines and IBM all said Tuesday that they would continue to require their workers to be vaccinated against COVID-19, even though Texas Gov. Greg Abbott signed an order on Monday banning private businesses from enforcing such mandates.

In a statement to The Dallas Morning News, Fort Worth-based American Airlines said that "we believe the federal vaccine mandate supersedes any conflicting state laws, and this does not change anything for American."

Dallas-based Southwest Airlines issued a similar statement to The Austin-American Statesman.

The company said they were choosing to comply with an order by the Department of Labor's Occupational Safety and Health Administration — which will require businesses with over 100 employees to ensure their workforce is fully vaccinated — because the White House order "supersedes any state mandate or law."

On Tuesday, Southwest CEO Gary Kelly told CNBC that he is opposed to vaccine mandates but that his company will still require the shots because he is required to by federal law.

"I've never been in favor of corporations imposing that kind of a mandate," Kelly said. "But the executive order from President Biden mandates that all federal employees and then all federal contractors, which covers all the major airlines, have to have a (vaccine) mandate (by Dec. 8)."

IBM told Bloomberg that it would keep in place a vaccine mandate for workers at its Texas office because the company has contracts with the federal government, meaning under Biden administration rules, it must require its employees to be vaccinated.

"IBM is a federal contractor and must comply with federal requirements, which direct employees of federal contractors to be fully vaccinated against Covid-19 by December 8th or obtain a medical or religious accommodation," a spokesperson for the company said. "We will continue to protect the health and safety of IBM employees and clients, and we will continue to follow federal requirements."

The resistance from high-profile employers could set up a legal battle, should the state of Texas choose to file a lawsuit.

According to The Associated Press, new cases of COVID-19 and hospitalizations linked to the virus have fallen in recent weeks. However, the state has seen more than 67,000 total coronavirus deaths since the start of the pandemic.

With holidays approaching, health experts said some festivities can start to return to a sense of normalcy — but they also warned that COVID-19 isn't defeated yet.

Experts said Sunday that outdoor trick-or-treating — particularly for children who are vaccinated — should be fine this year.

"It's a good time to reflect on why it's important to get vaccinated. But go out there and enjoy Halloween as well as the other holidays that will be coming up," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN Sunday.

Dr. Megan Ranney, associate dean of the School of Public Health at Brown University, cautioned against indoor Halloween parties for children too young to be vaccinated and encouraged parents in areas with high virus transmission to mask their children, but agreed that Halloween fun could go on this year.

The big picture for COVID-19 in the U.S. is looking a little brighter as new infections and hospitalizations decline. The average rate of daily new cases has dropped below 100,000, to 93,814 as of Sunday, according to data from Johns Hopkins University.

Fauci said he would like to see new daily cases well below 10,000, but the decline is a start. "Hopefully it's going to continue to go in that trajectory downward," he said.

While conditions are improving and the sense of normalcy is expanding, Fauci warned that the fight against the pandemic is not over.

"We have to just be careful that we don't prematurely declare victory in many respects. We still have around 68 million people who are eligible to be vaccinated that have not yet gotten vaccinated," Fauci said.

About 56.4% of the U.S. population is fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention. Although experts don't know the exact percentage of vaccination coverage needed to control the spread of the virus, Fauci has said the "vast majority" of the population will need to get vaccinated.

"We're not there yet," Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, said. "This virus can continue in those places where vaccination rates are low."

The potential for spread is especially concerning as winter holidays — often accompanied by gatherings and travel — approach.

Health experts have promoted vaccination requirements for air travel this holiday season; and while Fauci declined to offer his stance on the matter Sunday, Professor of Emergency Medicine at Oregon Health & Science University Dr. Esther Choo weighed in.

"Now is the time for mandates for airlines," Choo said. "It should happen quickly because people are making plans right now for our fall and winter holidays."

Death isn't the only terrible outcome with COVID-19

It's important for people to understand "not dying from COVID is a great thing, but that isn't the only metric we should be using," Michigan emergency room physician Dr. Rob Davidson said Saturday.

He said at his hospital, some COVID-19 patients have been on a ventilator for more than a month, and some have endured invasive procedures to stay alive.

Even if they recover physically, some COVID-19 survivors end up suffering from post-traumatic stress disorder, or PTSD, due to time spent in the ICU, Davidson said.

A study published in February found 30% of COVID-19 survivors experienced PTSD, which is a psychological illness that usually occurs after someone has a life-threatening experience.

The virus can also have negative effects on pregnant people infected during their third trimester and their babies, research shows.

Between March and September of last year, symptomatic pregnant people at one Israeli hospital had higher rates of gestational diabetes, a lower white blood cell count, and experienced heavier bleeding during their delivery. Their babies also experienced more breathing problems, a research team reported in the Journal of Maternal-Fetal and Neonatal Medicine.

The study has limitations since it only looked at women in one hospital, so its findings may not be true for all people who are pregnant.

Then there is long COVID-19 — when symptoms can last months after infection.

A large study published last month showed more than one-third of COVID-19 patients suffered symptoms three to six months after getting infected. Some had multiple, long-lasting complications.

Breathing problems, abdominal symptoms such as abdominal pain, diarrhea, fatigue, pain, anxiety and depression were among the most common issues reported.

Accompanying data showed as many as 46% of children and young adults between the ages of 10 and 22 had experienced at least one symptom in the six months after recovering.

Vaccines for kids under 5 may not come until next year

The Food and Drug Administration is considering a proposal to expand vaccines to children as young as 5, and those younger may not have a dose authorized for them until early next year, former FDA commissioner, Dr. Scott Gottlieb, said Sunday.

The FDA is likely to ask for more data and perhaps for studies involving more children, because it is a new vaccine and a new virus, Gottlieb told CBS.

"And that could push it into 2022. Previously we had talked about trying to have that data available before the end of this year, which could have prompted an authorization perhaps by the end of the year, at least in kids ages 2-4. I think that it's more likely that it slips into the first quarter of next year at the very least, but not too far into next year," said Gottlieb, who is also on Pfizer's board.

The FDA has called a meeting of its independent vaccine advisers, the Vaccines and Related Biological Products Advisory Committee (VRBPAC), for Oct. 26 to discuss pediatric vaccines. Pfizer has submitted data and a formal request for authorization for its one-third dose vaccine for use in children 5-11. But Gottlieb said he expects VRBPAC to also discuss what might be needed for authorization for the youngest children.

Having more information to consider can raise public confidence in the vaccines, Gottlieb said. He is already confident and plans to vaccinate his own young daughters.

"There's a lot of parents like me that, as soon as the vaccines available for their children, are going to go out and get their kids vaccinated, that see the benefits of vaccination," he said. "There's a lot of parents who still have a lot of questions around vaccination. I think for them, they should have a conversation with their pediatrician to try to get comfortable with the idea of vaccinating kids."

Gottlieb said he thinks it will be years before the CDC recommends making COVID-19 vaccines part of the regular childhood vaccination schedule, which would open the door to school districts mandating them.

"I think it's a very long way off. Certainly, CDC's going to look at children ages 12-17 differently than 5-11," he said.

With federal health officials set to consider Pfizer's COVID-19 vaccine for children 5 years and older, most Americans are slated to qualify for a shot soon. But a widening gap between vaccination rates could slow the country's progress in its fight against COVID-19, an expert warned Thursday.

For 12-to-17-year-olds, a key demographic that lags other age groups with just 47% fully vaccinated nationwide, many Southern states are trailing even further behind.

Alabama, Georgia, Louisiana, Mississippi, South Carolina and Tennessee all have less than a third of eligible adolescents fully vaccinated, according to a CNN analysis, as do North Dakota, West Virginia and Wyoming. And that could pose a greater challenge moving forward, experts warn.

"Once again you have this geographic divide where parents are holding back on vaccinating their adolescents, and I have to believe they will probably hold back on vaccinating the younger kids as well," Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas, told CNN.

"So we may be looking at very low uptake of this pediatric vaccine in the South and also in the Mountain West, and that's going to be a problem that's going to slow us down."

And as the delta variant continues to be the most common form of the virus in the U.S., unvaccinated children are at significant risk because that strain is more transmissible.

The Food and Drug Administration will meet Oct. 26 to discuss Pfizer's application for emergency use authorization for the vaccine in children ages 5 to 11. If the FDA greenlights it, the U.S. Centers for Disease Control and Prevention will have the final sign-off.

So far, about one-third of parents of 5- to 11-year-olds say that they will vaccinate their child as soon as a vaccine becomes available for that age group, according to the Kaiser Family Foundation Vaccine Monitor survey published late last month.

But more COVID-19 vaccine mandates for children on the state level could be on the horizon once the shots are approved, U.S. Surgeon General Dr. Vivek Murthy said Thursday.

"I think part of the reason you're going to see more states likely move in that direction post-authorization is because we all want our kids to go back to school, to be able to stay in school and to be safe," Murthy told CNN. "We've lost hundreds of children to COVID. ...Thousands have been hospitalized, and we could prevent a lot of this with a safe and effective vaccine."

More than 600 children have died from COVID-19, according to the CDC.

Children are especially vulnerable to COVID-19 and the flu this winter

Another vaccination that experts have been urging for children to take is the flu vaccine.

"Perhaps particularly of concern this season, administration of influenza vaccines with other vaccines is fine, and co-administration of influenza and other COVID-19 vaccines is encouraged," Dr. David Shay, a medical officer with the CDC's National Center for Immunization and Respiratory Diseases said on a CDC Clinician Outreach and Communication Activity call.

Clinicians should administer the vaccines in different parts of the body if possible, Shay advised Thursday.

"The recommendation for this year is that COVID-19 vaccines may be administered without regard to the timing of other vaccines, and that would include simultaneous administration of COVID-19 vaccine and other vaccines on the same day," he said, adding that the CDC is currently monitoring the effects of co-administration of the COVID-19 vaccine.

"It's actually encouraged if it's useful, and you've got someone who's in the office to get a COVID-19 vaccine, if there is an age-appropriate flu vaccine available, to offer it," he explained.

Health experts have been cautioning about the possibility of the double threat flu and coronavirus infections could bring to health care resources that are already strained.

But even flu vaccination faces some challenges.

About 44% of Americans plan to get a flu shot, according to a new survey from the National Foundation for Infectious Diseases. The survey also found that 37% of adults are very or extremely worried about COVID-19 for themselves or someone in their family, but only 19% said they were worried about flu.

"Of further concern, the survey found that nearly 1 in 4 (23%) who are at higher risk for flu-related complications said they were not planning to get vaccinated this season," the foundation said in a statement.

Vaccine mandates are working, top health official says

The increase in mandates is working in terms of increasing vaccinations, according to officials.

Murthy told CNN on Thursday that health officials are seeing evidence of an uptick.

"On average, organizations that put vaccine requirements in place are seeing a 20%-plus increase in the percentage of people who are vaccinated," Murthy said.

He added that such vaccine requirements aren't new in the U.S., and their goal is to keep the public safe.

Currently, 65.8% of people eligible to receive COVID-19 shots are fully vaccinated, CDC data shows.

An average of 281,303 people are initiating vaccination each day, according to the CDC.

This is a 31.4% increase from last week and a 25% drop from a month earlier.

In New York City, Mayor Bill de Blasio said 2,000 additional public school employees received their COVID-19 vaccine after the city's mandate went into effect September 27. In the two weeks before the deadline, there were 20,000 vaccinations, he said.

"This strategy is working," said de Blasio, adding that all 1,600 public schools are open.

FRANKFORT, Ky. — After long-term care residents and healthcare workers, Kentucky plans to give COVID-19 vaccines to people age 70 and older, first responders and K-12 school personnel possibly starting in early February.

Public Health Commissioner Dr. Steven Stack said Monday that it is crucial to begin vaccinating people age 70 or older, who are most at-risk of complications due to COVID-19 and make up 75% of all COVID-19 deaths in Kentucky.

“This is clearly the population at greatest risk for serious medical needs, requiring hospitalization and intensive care unit care, and also the population at greatest risk for death,” Stack said.

Phase 1b also includes police officers and firefighters, and most emergency medical responders are already vaccinated in the first phase.

K-12 school personnel includes educators, bus drivers, custodians, housekeeping and other workers who might come in direct contact with students or school buildings. Off-site or administration personnel will have to wait to receive a COVID-19 vaccine, Stack said.

Gov. Andy Beshear said that "Phase 1a" (healthcare workers, long-term care residents and staff) will end and "Phase 1b" (people over 70, first responders, K-12 personnel) could begin around Feb. 1. Both Beshear and Stack asked Kentuckians for patience as health officials work to distribute the vaccine.

Kentucky expects to receive roughly 202,000 doses of Pfizer and Moderna's COVID-19 vaccines by the end of December. More than 26,300 doses have already been administered in hospitals and long-term care centers, and 40 additional facilities will receive some amount of vaccines by the end of this week, Beshear said.

For questions on COVID-19 vaccines and their distribution, call Kentucky's 24-hour hotline at (800) 722-5725 or visit Kentucky's vaccine webpage.

COVID-19 case numbers decreasing

At his briefing Monday, Gov. Beshear announced that numbers of new COVID-19 cases appear to be falling.

“We have certainly stopped the exponential growth, this third wave, and I believe that we've not only plateaued it, but we’re starting to see cases decrease,” Beshear said.

Beshear reported 1,455 new cases and eight coronavirus-related deaths on Monday. Since March, 258,517 COVID-19 cases and 2,563 virus-related deaths have been reported in Kentucky. Holiday lab closures and an AT&T outage caused by an RV bombing in Nashville may have affected case reporting, as those labs enter new cases using the internet, Beshear said.

Beshear added that reported deaths may remain high as they lag weeks behind last fall's exponential case growth. He also recognized the "sacrifices" Kentucky businesses made to slow the spread of COVID-19 cases.

“Those sacrifices were not in vain, as the rest of the country sees continuing increases in cases, as the rest of the country sees runs out of ICU beds and hospital beds," the governor said. "At this moment, we’ve stopped that from happening in Kentucky, but we can let this success go. We’ve gotta keep it up -- otherwise we can be back very quickly to a more dangerous place."

Hospitalizations remained high Monday, with 1,552 Kentuckians currently hospitalized for COVID-19, 411 people in intensive care units and 217 on ventilators.

Kentucky's COVID-19 test positivity rate has fallen to 7.97% on Monday. The state's fatality rate, the proportion of people who die out of people who test positive for the virus, hovers at 0.97%.

Using the state's contact tracing database, NKY Health reports 2,407 active coronavirus cases in Boone, Campbell, Grant and Kenton counties, and 19,579 people have recovered from the virus as of Monday. Since the pandemic began, 164 Northern Kentuckians have died from the virus.

Where to get tested for free in NKY

St. Elizabeth Healthcare and Covington's Gravity Diagnostics offer free, appointment-only drive-thru testing at 25 Atlantic Ave in Erlanger, the former Toyota HQ building off Mineola Pike.

The site is open Monday through Friday from 8 a.m. to 2:30 p.m. You will be able to collect your own sample without leaving your vehicle and receive results within three to five days.

Additionally, appointment-only drive-up testing is available through St. E at 7200 Alexandria Pike, Alexandria. The free testing site is open on Tuesdays and Thursdays from 5 p.m. to 9 p.m.

Schedule an appointment at those sites online at www.stelizabeth.com/covid-testing. To find all coronavirus testing locations near you, click here.

Watch a replay of Monday's briefing in the player below:

CINCINNATI —

Doctors said more vaccines could soon be weapons in the fight against COVID-19.

The AstraZeneca vaccine is still being carefully studied at Cincinnati Children's Hospital, but it has just been given authorization in the United Kingdom and officials expect to see applications for emergency use in the United States in the next month or so.

Medical experts said AstraZeneca's vaccine could come just in time.

They believe it will be more than capable of defending people against the latest mutation of COVID-19 and it appears to have few side effects.

"I think we soon are going to have four vaccines that look very effective," Dr. Robert Frenck said.

Frenck, professor of pediatrics in the Division of Infectious Diseases at Cincinnati Children's Hospital, shared words of hope.

He expects an application for emergency use authorization could be weeks away for the Oxford University, AstraZeneca COVID-19 vaccine.

It's now authorized in the United Kingdom.

Frenck has been studying the two-dose vaccine at Cincinnati Children's Hospital.

"For both the Pfizer and Moderna, and I wouldn't be surprised to see the exact same thing for Janssen and Astra-Zeneca, is that the vaccine has shown equal efficacy across the ages, and regardless of your race, regardless of your gender," he said.

Frenck said 502 people in Greater Cincinnati have volunteered in the trial.

He said side effects have ranged from nothing to headache, fatigue and muscle aches and those faded.

As a more infectious variant of COVID-19 has surfaced in the United States, Frenck said viruses normally mutate.

The AstraZeneca vaccine uses a weakened version of the common cold virus and he thinks it will work against the mutation.

"It's not really worrying me that much, as far as that the spike protein is what we're having this target for our vaccine and that still looks pretty much conserved," Frenck said.

AstraZeneca's vaccine is receiving praise for only requiring refrigeration which makes it easier to distribute.

Company leaders have said they believe the vaccine will prove as effective as its rivals.

With the Phase 3 trial nearly complete, Frenck anticipates a safe AstraZeneca vaccine will soon be added to the arsenal to protect you.

"To me the biggest travesty, the biggest horror is that we have vaccines and then people don't get them and then people die that could've been saved," he said.

Frenck expects the Johnson and Johnson Janssen vaccine will also be up for emergency use consideration by mid-to-late January.

It's important to note that during the AstraZeneca trial, there were some dosing issues and it is not clear if that will impact the EUA process.

Frenck said timing for the AstraZeneca vaccine will likely be similar to the other vaccines, with a first vaccine given and a second given about four weeks later.

That's to be seen once federal officials receive an application for emergency use and review the data.