Hawaii’s average daily COVID-19 cases appear to be in a holding pattern as health officials continue to urge residents to get the updated bivalent boosters ahead of the holidays.

But uptake of the bivalent boosters has been sluggish, both in Hawaii and across the rest of the United States, as many seem to be in no rush to get another COVID-19 shot.

While Hawaii is doing better than the nation overall in COVID-19 vaccinations, the uptake here is also low.

To date, 78% of Hawaii residents have completed their primary series of COVID- 19 vaccinations, with about 43% having gotten a booster in the past 12 months, according to the state Department of Health.

A total of 167,434 residents have received the new bivalent booster, representing 11.8% of the state’s total population and about 15% of the state’s eligible population — age 5 and older.

Nationwide, uptake of the bivalent booster is lower, with only 7.3% of those eligible having received it, according to the Centers for Disease Control and Prevention.

Federal authorities approved and recommended the new bivalent booster — targeting both the original COVID-19 strain and omicron subvariant BA.5 — for all Americans ages 5 and older.

Americans ages 5 and up are eligible for the bivalent booster if at least two months have passed since getting the primary series or the previous booster.

The bivalent boosters have been available in Hawaii since Labor Day weekend, with approvals for children as young as age 5 issued in mid-October.

The shots are available for free at local pharmacies, health centers, clinics and various community events. Kaiser Permanente is offering several community vaccination events this month at Papakolea, the Filipino Community Center and the Mililani YMCA.

The Health Department says the updated bivalent COVID-19 boosters can help restore protection that decreased since the previous vaccination; provide broader protection against new variants; and reduce the risk of serious illness, hospitalization and death.

There are growing concerns over the effectiveness of the boosters against more immune-evasive variants such as BQ.1 and BQ.1.1 — offshoots of BA.5.

Some early studies by research teams at Harvard and Columbia universities suggested that the updated bivalent COVID-19 boosters work about the same as the original monovalent boosters.

But another study from a team at Emory University found the bivalent booster offered fourfold improvement in neutralization against BA.5 compared with the original booster.

In addition, the bivalent booster held up better than the original against newer, more immune-evasive variants such as BQ.1.1 and BA.2.75.2.

The average daily number of COVID-19 cases in Hawaii for the past few weeks has remained relatively stable, with 165 per day reported Wednesday. The state’s average positivity rate was at 5.5% compared with 6.2% reported the previous week, and nearly matching the 5.6% rate reported Oct. 12.

Additionally, hospitalizations of COVID-19 patients remained steady, with a seven-day average of 69 in Hawaii hospitals this past week compared with 67 the previous week, according to the Healthcare Association of Hawaii.

An additional 1,017 new infections were reported over the week, bringing Hawaii’s total since the start of the pandemic to 362,834.

The DOH also reported seven more deaths — all kupuna ages 60 and older — bringing the state’s coronavirus-related death toll to 1,711.

Hawaii COVID-19 Vaccination Status

>> To date, 78% of Hawaii’s population of about 1.4M has completed the primary series of COVID-19 vaccinations.

>> 42.9% of the state population has received a COVID-19 booster in the past 12 months.

>> A total of 167,434 residents received the bivalent booster, representing 11.8% of the total state population and 15.1% of the eligible state population of residents ages 5 and older.

>> More than an estimated 300,000 residents in the state remain unvaccinated.

>> By county, Honolulu is in the lead, with 12.8% of residents having received the bivalent booster, followed by Hawaii County with 10.6%, Maui County with 8.6% and Kauai County with 8.5%.

Source: State Department of Health