At the beginning of his term, Cleveland Mayor Justin Bibb set a goal to have 60 percent of city residents vaccinated against COVID by the end of 2022. 

Ten months later, the city is close to its target. 

Earlier this year, the city reported that less than half of the population had received the first dose of the vaccine. 

Fifty-seven percent of residents have now received the first shot of the vaccine, and close to half of the residents have been fully vaccinated, according to the Cleveland COVID-19 Public Dashboard, as of Nov. 16, 2022. Just 25 percent have opted for the booster. 

“We’re increasing about 0.1 percent each week and so on,” said Dr. David Margolius, former Division Director of Internal Medicine at MetroHealth and now Cleveland Director of Public Health. “At that pace it will be 58 percent by the end of the year. So we’re hoping that this new influx of investment for the [Dollars for Doses] program will help us get to the final stretch.” 

Dollars for Doses

Health officials say a person is fully vaccinated two weeks after receiving a second shot of a two-dose vaccine such as  Pfizer or Moderna or after a single-dose vaccine such as  Johnson & Johnson. Margolius said the goal for Cleveland is to encourage residents to immunize with at least one shot. 

In a September Finance, Diversity, Equity & Inclusion meeting, Cleveland City Council approved spending $300,000 of American Rescue Plan Act funds to support the extension of the Dollars for Doses program, reports Cleveland Documenters Jenna Thomas.

Dollars for Doses is part of an ongoing effort by Greater Cleveland Congregations and the Centers for Families and Children to raise vaccination participation rates on Cleveland’s East Side. Through the Funders Collaborative on COVID Recovery, which includes The Cleveland Foundation and other organizations that sponsor Signal Cleveland, the program provides community partners, including hospitals and clinics, cash incentives for people who receive a vaccination. 

Through this program, it is estimated that more than 3,000 people have received their first dose of the COVID vaccine. When Council Members Michael D. Polensek and Anthony Hairston asked about return on investment, Margolius said this program targets hard-to-reach populations and high-risk groups that have not been persuaded to get vaccinated. 

“It’s that reverse C, the historically redlined neighborhoods of Cleveland that have the lowest vaccination rates,” said Margolius. “And that’s definitely where we want to continue to focus our efforts.” 

COVID booster rates

In terms of the city’s low booster rates, Margolious emphasized that much of the trend is on par with state numbers.  In Ohio, 3,864,134 residents have received one booster and 1,364,387 have received a second booster. A total of 1,031,822 have received the updated bivalent booster, according to the Ohio Department of Health’s COVID-19 Vaccination dashboard. The city is focused  on getting residents that first dose of the vaccine before the year ends.  

“Folks have asked me, why aren’t you emphasizing boosters more?” Margolius said. “And, you know, boosters are important for sure, especially for folks who are over the age of 60 or who are vulnerable to severe disease for other reasons. But no dose is close to the benefit of that first dose. So that’s where my emphasis continues to be.” 

Margolius and other health officials worry that winter illnesses other than COVID-19 could increase health risks for residents

Just in time for winter, the surge in respiratory viruses is pushing Cleveland health officials to prepare for a triple threat that may strain healthcare systems this season.

COVID dominated the surge of hospitalizations during the colder months in the last two years, while other illnesses have had milder cycles. Across the city, the rise in respiratory syncytial virus (RSV) has pediatric ICUs filling to capacity at alarming rates and flu cases are steadily climbing in Northeast Ohio.  

“Children aged 0-5 years old have been most impacted [by RSV], and the positivity among this group is currently at 47 percent,” said Dr. Robert Wyllie, chief of medical operations at Cleveland Clinic. “We are seeing an increase among influenza cases. Positivity for those tested in our NEO hospitals is now 19 percent in school-aged children and 8 percent overall.” 

COVID and the holiday season

Health experts say that with the holiday season approaching and people more likely to travel and gather indoors, lifted precautionary measures such as  mask mandates, quarantine and self-isolation will cause a collision of infectious respiratory diseases and trigger a surge in emergency room visits before year end. 

“We certainly anticipate a busy respiratory season,” said Wyllie. 

The Cuyahoga County Board of Health reported the first flu death of the season. In a news release, the department announced a 13-year-old boy died the week of Oct. 31. 

The U.S Centers for Disease Control and Prevention (CDC) issued an advisory in November to medical providers about the elevation of flu, RSV and new variants of COVID circulating throughout the country. The alert comes with the trepidation of ‘triplendemic’ in the upcoming months as hospitals are still recovering from the fallout of the pandemic. 

According to CDC data, the nation saw an unlikely spike in RSV and influenza this fall–peak season for these viruses generally occurs during December and January. A high number of flu cases have been detected in the southeast and south central regions of the United States, with seven states reporting an increased number of hospitalizations. It is estimated 13,000 hospitalizations and 730 deaths are a result of the flu.

“We’re seeing the highest influenza hospitalization rates going back a decade,” said Dr. José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases in a Nov. 4 news briefing. “We enjoyed the benefit of not having influenza for the last couple of years, primarily because of SARS-CoV-2.” 

The CDC reported that while COVID-19 cases in the United States have seemed to plateau over the past few weeks, new variants are gaining ground. In an October press conference, Ohio Department of Health Director Dr. Bruce Vanderhoff said two new COVID-19 variants of omicron, B.Q 1.0  and B.Q 1.1, have emerged in Ohio, though their severity is currently not known. 

“As we head into the colder months, we could see them driving another wave,” said Vanderhoff. 

It is this exact concern that the Cuyahoga County Board of Health (CCBH) takes into account as it seeks to mitigate  hospital and emergency room overcapacity. Messaging and communications for this season include vaccination as the primary effort to protect residents against falling ill.

“We still talk about washing hands, wearing masks and watching the community risk level, which is at medium right now,” said Dr. Prakash Ganesh, Medical Director of the county board.  “Getting vaccinated for [COVID and the flu] can be our main way of preventing severe disease or hospitalizations.” 

Public health officials in the City of Cleveland have been ramping up efforts to distribute the COVID vaccines, including the new bivalent shot.  

So far, the work with community partnerships has seen nearly 100 people per day opting to receive their first dose, according to the Cleveland COVID-19 Public Health Department’s dashboard. 

“We have a really robust network of vaccinators and social-service agencies that have helped folks through hard times, whether it is [helping] through unemployment during lockdowns or just food insecurity,” said Margolius. “After the first wave of vaccines came out, these trusted partners helped people make that decision to get their first dose when much of the community had given up on them.”