Powerful new boosters are here. Will weary Americans be upset?

It was vaccination time at Ethel Brown’s long-term care home in the Bronx, New York. Again. Brown, 95, had already received four COVID shots, and while she was thrilled to be coming in for a fifth, this latest boost raised some questions.

“Why do we have another one?” Brown asked as she and other residents awaited their shots Wednesday. “Will this be the last reinforcement?”

In a tangle of confusion, eagerness and vaccine fatigue, America embarked in earnest last week on a sweeping new campaign to get specific omicron boosters into the arms of a pandemic-weary country.

The new boosters are one of the latest weapons in America’s arsenal against the coronavirus now that the country has scrapped most masking, quarantine or distancing requirements as the fiery pandemic has faded into the background for many The push for a new vaccine, barely noticed by some, will test how the country responds at a time when the sense of a COVID crisis has subsided.

Millions of doses of boosters targeting the omicron variant arrived unceremoniously in pharmacies, nursing homes and clinics across the country, ready to be administered in what health officials now hope will become a ritual of ‘annual inoculation similar to a flu shot.

Early numbers from states and several cities showed what health officials described as a robust early response at a time when vaccine rates have stalled. California administered about 397,000 doses. About 116,000 people in Texas received the new booster within days. Illinois administered at least 137,900 shots.

The rollout seemed methodical but quiet compared to the frantic urgency of previous vaccination waves, when thousands jostled outside stadiums to get meager doses and politicians got their shots on live television. It was a picture that drew on interviews with more than 50 U.S. health officials who were getting, or refusing, the boost in five states.

This time, the campaign was so understated that some Americans willing to be pushed didn’t even realize there was a new opportunity.

“I hadn’t heard of it,” said Jeff Conrad, 33, a custodian in downtown Washington who still regularly wears a mask.

For people who got boosted, the new traits couldn’t come soon enough.

“I don’t care what other people do, but I have to take precautions,” said Mario Reyes, 67, who got a flu shot and an omicron booster, one in each arm, at a center of Chicago seniors. Reyes recently had a heart transplant and lost a nephew to COVID. He said going up again was a no-brainer.

Health officials called the early response encouraging, especially since the overall vaccination rate had recently fallen to its lowest level since vaccines became widely available in early 2021. About 68 percent of Americans are fully vaccinated with the original vaccines, but only one third. I have received no booster shots, even though previous boosters were first available in September 2021.

The new boosters, which were cleared by the Food and Drug Administration in August, are called bivalent vaccines because they are designed to protect against the omicron subvariants now circulating as well as the original version of the virus. People 12 years of age and older are eligible for a new vaccine at least two months after their most recent vaccine or booster dose.

Across the country, health officials and Americans seeking boosters said shots and appointments appeared to be plentiful, especially in larger cities and suburbs.

Throughout the week, people showed up at Walgreens and CVS clinics in cities like Washington, San Francisco and Austin, Texas. They drove to rural health centers in the Dakotas and the Navajo Nation. In nursing homes, caregivers began administering the booster room by room.

There was a line outside the Quinn Center of Saint Eulalia, an outreach ministry in Maywood, a suburb west of Chicago, before a vaccine clinic Monday morning. “We hope this good turnout will continue,” said Randall Mcfarland, the center’s vaccine ambassador.

But these first waves of Americans eager to be reactivated may be the exception.

In Phoenix, Ariana Valencia, 37, sat in a doctor’s waiting room just steps away from free booster services offered by Mountain Park Health Center, a local clinic. A steady stream of patients was coming in for the new vaccine, but Valencia said he had no interest in joining.

She had already been vaccinated and said the demands on her family now outweigh her concerns about COVID. Between juggling the needs of a son joining the Marines, a grandson on the way and a grandmother who had suffered a stroke, Valencia said life left no time for reinforcements.

“I know that COVID is coming back, but I don’t think it’s necessary,” he said of the reinforcement. “I am OK.”

Some vaccinated people said they could not spare time away from work or arrange childcare to accommodate the discomfort or side effects of getting another booster.

Others said they already felt protected enough or that they had been assaulted by vaccines after contracting COVID despite having two shots and a booster. Studies have found that boosters reduce the chance of omicron infection and substantially reduce an infected person’s risk of being hospitalized or dying from COVID.

Others had been left in the dark. Pandemic-related news has faded into the background, and local vaccination efforts have quietly shut down as pandemic funding dwindles.

President Joe Biden, as well as local and state officials, have issued a flurry of statements about the new booster: how it’s free, widely available and probably the best defense against a shape-shifting virus that still kills more than 400 people in day. The Biden administration has purchased 171 million doses of bivalent vaccines. Federal data on how many shots of the new booster have been administered were not yet available this weekend.

But health experts said the urgency around COVID had faded as deaths and infections dropped to lower levels. For many, the message about a new and different booster just wasn’t penetrating.

“Is there a reinforcement campaign? where is it Because I can’t find any,” said Drew Altman, president of the Henry J. Kaiser Family Foundation. “I don’t want to be cynical, but there’s no reason to expect a big turnaround and all of America to be over and done with.”

In Phoenix, Rita Garcia, 61, has received all the vaccinations recommended by health officials, her complete vaccination card a testament to how seriously she is taking the pandemic. But Garcia said it has become harder to find news about the pandemic, and he only heard about the new boost when a traveling vaccine outreach van pulled up outside his home.

This time, the task of locating and scheduling vaccines has largely been left to people, possibly leaving out people without cell phones or Internet connections. Mass vaccination sites are now mostly closed. Some programs that brought vaccines directly to communities with vans or door-to-door nurses have been scaled back or ended altogether.

In New York City, for example, eight mobile vaccination units will be expanded to offer the new vaccinations, particularly to the homeless. By July 2021, by comparison, 70 mobile units and pop-up locations covered the city.

But across the country, there are still health teams that eliminate the undriven. At the Thurmond Heights public housing complex in Austin, organizers of an immunization clinic were handing out $20 grocery cards, raffle tickets and turkey sandwiches, incentives to bulk up as in the early chapters of the pandemic

Health officials said boosters were reaching rural clinics and Native American reservations, which have experienced some of the worst death rates of the pandemic. The Indian Health Service reported that 94,000 doses of the new booster had been sent so far. The agency did not give numbers on how many of the shots had been administered.

There were some drawbacks. Some nursing homes said they did not receive the new refills until the middle of last week, several days behind other clinics and pharmacies. Unlike the first wave of vaccines, when teams from chain pharmacies came to nursing homes to vaccinate residents, long-term care facilities are giving the shots at home.

Lisa McAfee said the Tennessee nursing home where her 101-year-old mother lives had been slow to organize a plan to vaccinate residents. His mother was protected by previous vaccines, but McAfee said there have been recent infections in the household and he was anxious for his mother to get the new vaccine.

“She is in the most vulnerable age and health range,” McAfee said. “If it’s available, there’s no reason not to give it to him. That’s my frustration.”

Some people may end up delaying their booster in anticipation of another surge in cold weather. And the roughly 70,000 people who still get sick every day are advised to wait three months after infection to get a boost.

Even liberal San Francisco offered a case study in the challenges of galvanizing people for the new drive. On Tuesday in the Mission District, Paloma Trigueros, 29, was overwhelmed by the Groundhog Day feeling of being shot after shot.

“I think everybody should get one a year, not five, six of them,” he said. “That’s a bit obsessive.”

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