Sforza

book. “People no longer view COVID-19 as a major threat.”

Fatigue

There's little doubt that people are suffering from vaccine fatigue, even though the COVID-19 virus is still circulating and is probably here to stay, Dr. Daisy Dodd, an infectious disease specialist with Kaiser Permanente Orange County, said by email.

“The good news is that hospitalizations and deaths directly tied to COVID-19 are low, mainly due to initial vaccinations and herd immunity. Following the pandemic, most people were either vaccinated or were infected by the virus. Nevertheless, it's important for seniors and immunocompromised individuals to get the COVID-19 booster vaccine at least once a year, as is the case with the flu shot, so that their protection remains high.”

Andrew Noymer, an epidemiologist and demographer at UC Irvine, lays much of the blame for low uptake on the Centers for Disease Control.

“You ask rhetorically, is COVID just flu now?” he said. “I think most Americans think so. Hard to blame them; this is what CDC has been telegraphing. Unfortunately, COVID

is still more deadly on a case-by-case basis than influenza, and it has more severe sequelae. It ain't flu.”

The CDC consistently minimizes COVID-19, data dashboards have been dismantled, briefings discontinued, and, “Most egregiously, its official guidance is not to let a positive COVID-19 at-home test result keep us from going to work or school, as long as we are asymptomatic. Because, let's infer, COVID-19 is no big deal,” Noymer continued. “Yet some people are advised to re-up their vaccines every four months. While new guidance on a cadence of every-four-months vaccines for 65+ may make sense in light of data on fading antibodies, it's not going to do anything to help vaccine uptake. Name another vaccine with a four-month cadence; I'll wait.”

The federal government's decision to stop buying COVID-19 vaccines last year also has not helped, said Richard Carpiano, a public and population health scientist and medical sociologist at UC Riverside.

“This meant that the manufacturers sold directly to insurers, which shifted the cost to them,” he said. “This made it more likely that people who were under- or uninsured were less likely to get vaccinated. … Even for those with insurance, this policy change also made it more complicated to get vaccinated

when the updated booster became available.”

The Biden administration created the Bridge Program to cover the cost for uninsured people, partnering with providers including pharmacies and public health departments, he said. That program rolled out in September, but the disparity data suggest it's unclear how effective it has been, or what else may be at work (funding for targeted campaigns, education, outreach and community clinics).

Skepticism about vaccines in general is on the rise.

“During COVID, we were told that vaccines would end the pandemic. When breakthrough infections became apparent in July 2021… the CDC director at the time made great effort to stress that breakthroughs are unusual,” Noymer said. “Now we know that breakthrough infections are commonplace. `Why bother?' many Americans are asking, and the CDC hasn't made the case that we should bother.”

Politics

In December, a Gallup poll found that while 47% of adults said they'd gotten the flu shot, only 29% said they got the new COVID-19 shot.

Even though COVID is more dangerous and deadly than flu. State data show that:

• In mid-March, 158 Californians were hospitalized with COVID. Only 28 were hospitalized with flu.

• In the first three weeks of March, 138 Californians died of COVID. Only 10 died of flu.

Public health has become sadly politicized.

Nearly half of Democrats (48%) got the updated COVID-19 shot, while only 20% of independents and 10% of Republicans did. A stunning 82% of Republicans said they would not get the updated shot.

Flu shots are more popular, but politics is at work here as well: 61% of Democrats, 38% of independents and 35% of Republicans got the flu shot this year. More than half of Republicans, 52%, said nuts to that.

Why? Folks' primary reason for skipping the COVID-19 shot was because they had COVID-19 and believe they still have protective antibodies (27%), and because they have safety concerns about the vaccine (24%), Gallup found.

The effectiveness of the vaccine was questioned by 18%, and another 16% said they don't believe they'd suffer serious health consequences from the coronavirus.

Smaller groups, less than 10%, say they distrust vaccines in general or are concerned about an allergic reaction.

The Orange County Health Care Agency said it continues to monitor COVID-19

vaccination coverage, and that the CDC continues to find that immunized folks are far less likely to need emergency care or hospitalization.

“Despite clear evidence pertaining to efficacy, we recognize vaccination coverage rates remain too low,” Dr. Regina ChinsioKwong, county health officer, said by email. “Contributing factors include vaccine fatigue, misinformation, and difficulty in accessing COVID-19 vaccine. As an agency, we remain steadfast in our commitment to address these challenges through ongoing education and outreach efforts.

“We continue to collaborate with stakeholders such as community-based organizations, medical professionals,

and the Orange County Immunization Coalition, as well as through social media, to emphasize the benefits of COVID-19 vaccination as well as other vaccines. All these efforts are integral to disseminating accurate information and promoting vaccination uptake.”

UCI's Noymer recommends a book on the American experience of the 1918 flu, called “America's Forgotten Pandemic.” One of its themes is that people in the U.S. just wanted to turn their back on the whole painful experience. A similar social force is at work here, he said.

“Unfortunately,” he said, “we are throwing out the baby with the bathwater, and we have measles epidemics as a result.” 2615 Pacific Coast Highway #329, Hermosa Beach, CA 90254