The days when people lined up for the COVID-19 vaccine are now a distant memory.

After five years of battling the virus, considerably fewer people across the U.S. and Hawaii are rushing to get the 2024-2025 COVID-19 vaccines, which have been available since September at local pharmacies and doctor’s offices.

To date, only 10.8% of Hawaii’s population has gotten the updated COVID-19 vaccines.

Dr. Scott Miscovich, a family practice physician for Premier Medical Group, called the rate dismal and said it should be higher, especially heading into the holidays. He has been recommending the COVID-19 vaccine to all his patients, along with the seasonal flu vaccine.

“They should be thinking about it just like the flu vaccine,” he said. “COVID’s with us permanently, and the morbidity and death rates are still higher than flu, so therefore you should get your COVID shot just like you would get your flu shot.”

The vaccines are readily available at his office, and his staff is reminding patients about them during visits.

But, Miscovich said, “it’s not on the front plate” for everybody right now. Admittedly, it’s been a challenge to convince some people to get it.

“There are a lot of people that just don’t care about it,” he said.

At the same time, all indicators show COVID-19 impacts have been at some of the lowest levels — with low concentrations in wastewater, low test positivity rates and low emergency department visits or hospitalizations — for this time of year.

An uptick may have just begun heading into the holidays but is starting at a much lower point than previous years.

The state Department of Health on Wednesday reported an average positivity rate of 1.8%, where it has hovered for the past few weeks.

The weekly average of COVID-19 patients hospitalized has remained below 20 for weeks, and no new COVID-19-related deaths were reported this week.

State Epidemiologist Dr. Sarah Kemble said, “We recognize now we’re in a different place” from the early days of the pandemic and initial urgency. Many people have either had the virus or been immunized against it.

The Health Department, however, still recommends people get the updated 2024-25 COVID-19 vaccine targeting more recent variants in circulation.

“Even though right now COVID-19 is low, we tend to see an increase with travel and holiday gatherings,” Kemble said. “It’s a really good time right now to get the shots, before all those family gatherings.”

Kemble noted about a third of Hawaii residents age 65 and older are up to date on COVID-19 vaccines, which is ahead of most other states in the U.S.

Updated vaccination rates are much lower among younger age groups: a mere 2% for ages 5-11, 2.8% for ages 18-24 and 3.7% for ages 25-39.

Staying up to date with vaccines is most important for those who are older or living in nursing homes, she said, and those who are immunocompromised or have health conditions that put them at higher risk.

People at higher risk also should be aware they can get a second dose or more in consultation with their physician.

The Centers for Disease Control and Prevention in October recommended a second dose of the 2024-2025 COVID-19 vaccine for those age 65 and older and the immunocompromised.

New variants

The virus, meanwhile, continues to mutate and evolve as it circulates, resulting in a myriad of new variants.

The 2024-25 COVID-19 vaccine is formulated to target the JN.1 variant, which is part of the omicron family but is no longer the dominant strain in the U.S.

Currently, omicron variant XEC is the dominant strain, making up about 45% of what’s circulating in the U.S., according to CDC, followed by KP3.1.1 at about 24%. But XEC, so far, has not driven a surge in cases or more severe disease.

Based on national metrics, the rates of COVID-19 infection bumped up over the summer but have been consistently low approaching the winter holidays.

Nationally, hospitalizations for COVID-19 remain low, while emergency room visits are minimal. CDC, however, says these are beginning to increase from low levels in some parts of the U.S.

A newly launched CDC dashboard on acute respiratory illnesses shows levels are low in most western U.S. states but moderate for some states such as as Texas, Oklahoma and Florida, and high in Kentucky.

COVID-19 not gone

Worldwide, COVID-19 is still sickening people, resulting in about 4,000 deaths per month, according to Maria Van Kerkhove, the World Health Organization’s technical lead for COVID-19 response.

That’s only for deaths reported, she said, as surveillance systems, testing and reporting have all declined among countries around the globe. People are also still struggling with long COVID-19.

“The world wants wants to forget this pathogen that is still with us,” she said during a recent WHO broadcast, “and I think people want to put COVID in the past as if it’s over, and in many respects pretend it didn’t happen because it has been so traumatic, but that is really detrimental.”

Many epidemiologists, meanwhile, are closely watching the development of the H5N1 avian influenza outbreak, as it infects millions of birds and hundreds of dairy cows in the U.S. As of Friday, CDC had confirmed 64 human cases.

CDC says the public health risk remains low, but is monitoring whether the H5N1 viruses undergo genetic reassortment — an exchange of genes — as they infect various animals and people, potentially becoming a threat to humans.

While the seasonal influenza vaccine does not prevent H5N1, it can help prevent a person from having both the seasonal flu and bird flu at the same time, which potentially could lead to reassortment.

Vaccines are available at Longs Drugs, Walgreens and Safeway, among other venues, and at some doctors’ offices.

CVS, which operates Longs Drugs in Hawaii, has plenty of COVID-19 vaccines available, according to Pharmacy Manager Daniel Sabin.

Patients can walk in to any Longs to request a vaccination or make an appointment at CVS.com or via the CVS pharmacy app.

Kemble said she recommends all available vaccines this respiratory season, including those for COVID-19, influenza and respiratory syncytial virus, to all eligible residents.

This includes the recently updated 2024-2025 flu and COVID-19 vaccines for all persons 6 months of age and older, and the RSV vaccine for newborns and infants, pregnant persons and those 75 years and older, or those ages 60 to 74 with chronic medical conditions.

Based on the state’s respiratory dashboard, COVID-19 and influenza rates are low, while rates for RSV are high, and all three are trending upward.

Staying safe during respiratory season

>> Get immunized. Stay up to date on your flu, COVID-19 and RSV vaccines.

>> Stay home when sick. Stay home until fever-free for 24 hours without using fever-reducing medication and other symptoms are mild or improving.

>> Wear a mask. Wearing a mask indoors with others is a precaution you can take anytime.

>> Practice good hygiene. Cover your coughs and sneezes. Clean frequently touched surfaces and wash your hands often.

>> Take steps for cleaner air. Open doors or windows. Purify indoor air or gather outdoors.

>> Test and treat. If you have cold or flu symptoms and are at higher risk, knowing what illness you have can help. Antiviral medications for COVID-19 and flu work best when taken as soon as possible.

Source: State Department of Health