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The coronavirus pandemic in the U.S. has been chiefly driven by young and middle-aged people, while killing mostly older people.

Driving the news: Adults aged 20-49 were responsible for the vast majority of virus transmission last year, even after schools reopened in the fall, according to a new study published in Science.

Why it matters: The U.S. vaccination effort is racing to keep up with the spread of new, more transmissible variants of the virus. Millions more Americans could be infected before a substantial portion of the population is vaccinated, making transmission patterns deeply relevant.

  • The notion that non-vulnerable people can go about their normal lives, while vulnerable people self-isolate, has not borne out in the U.S.

By the numbers: Three-quarters of new infections originated from adults 20-49 until mid-August of last year. Adults 35-49 contributed the most to spread.

  • In October, after a large portion of U.S. students returned to school, this age group was still responsible for about 72% of new infections.
  • The study estimates that school reopenings increased total infections by about 26% as of October, and deaths by about 6% — because children and teenagers spread the virus to adults, who are "more transmission efficient."

Between the lines: Young and middle-aged adults "naturally have most contacts to other adults aged 20 and above, which are more susceptible" to the virus, and they were more mobile from April on, per the study.

The bottom line: "This suggests that additional interventions to adults aged 20-49, including rapid mass vaccination if vaccines prove to block transmission, could bring resurgent COVID-19 epidemics under control," the authors conclude.

Go deeper

Updated 8 hours ago - Politics & Policy

Omicron dashboard

Illustration: Aïda Amer/Axios

  1. Health: Fauci: "Confident" Omicron cases will peak in February — FDA OKs antiviral drug remdesivir for non-hospitalized COVID patients — Walensky: CDC language "pivoting" on "fully vaccinated".
  2. Vaccines: Annual COVID vaccine preferable to boosters, says Pfizer CEO — Team USA 100% vaccinated against COVID ahead of Beijing Olympics.
  3. Politics: Arizona governor sues Biden administration over COVID funds tied to mandates — Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" on anti-mask school policies.
  4. World: Beijing Olympic Committee lowers COVID testing threshold ahead of Games — Beijing officials urge COVID-19 "emergency mode" before Winter Olympics — Austria approves COVID vaccine mandate for adults.
  5. Variant tracker

Biden administration will ship COVID vaccine directly to pharmacies

Coordinator of COVID-19 response and counselor to President Biden Jeff Zients. Photo: Jabin Botsford/The Washington Post via Getty Images

More than 1 million doses of COVID-19 vaccine will be made available to about 6,500 pharmacies across the U.S. beginning Feb. 11, the White House said Tuesday.

Why it matters: Local, national and supermarket pharmacies have an existing customer base, user portals and other established resources when it comes to mass flu and shingles immunization protocols. The federal government hopes this will expand access and speed up the vaccination process.

Feb 2, 2021 - Health

Vaccine chaos may undermine second doses

Illustration: Sarah Grillo/Axios

Some of the same problems that have plagued the coronavirus vaccine rollout could also make it harder for people to get the second dose of the vaccines.

Why it matters: The two vaccines authorized so far both require two shots to reach the full potential of their protection, and those second shots need to happen within a specific window of time —putting extra pressure on a system that’s already struggling to work out its kinks.