Nation faces uphill battle to get reluctant Americans vaccinated
WASHINGTON — Now that President Joe Biden has met his goal to have all adults eligible for the coronavirus vaccine, health officials around the country are hitting what appears to be a soft ceiling: More than half the nation’s adults have received at least one dose, but it is going to take hard work — and some creative changes in strategy — to convince the rest.
White House and state health officials are calling this next phase of the vaccination campaign “the ground game,” and are likening it to a get-out-the-vote effort. The work will be labor intensive — much of it may fall on private employers — but the risk is clear: If it takes too long to reach “herd immunity,” the point at which the spread of the virus slows, worrisome new variants could emerge that evade the vaccine.
“If you think of this as a war,” said Michael Carney, senior vice president for emerging issues at the U.S. Chamber of Commerce Foundation, “we’re about to enter the hand-to-hand combat phase of the war.”
On Wednesday, Biden urged all employers in the United States to offer full pay to their workers for time off to be inoculated and to recover from any aftereffects. He also announced a paid leave tax credit to offset the cost for companies with fewer than 500 employees, and appealed to the unvaccinated to get their shots.
“If we let up now and stop being vigilant,” he warned, “this virus will erase the progress we have already achieved.”
The president’s plea came as he marked “an incredible achievement by the nation” — 200 million shots in the arms of the American people, a target he said the nation would hit on Wednesday, with a week to go before his 100th day in office. By Thursday, Biden said, more than 80 percent of Americans older than 65 will have had their shots.
But the distribution of those shots in uneven: While New Hampshire has given at least one shot to 59 percent of its citizens (that figure includes children, most of whom are not yet eligible), Mississippi and Alabama are languishing at 30 percent.
The laggards are trying to adjust. In Louisiana, where 40 percent of the adult population has had one shot even though all adults have been eligible since March, officials are delivering doses to commercial fishermen near the docks and running popup clinics at a Buddhist temple, homeless shelters and truck stops. Civic groups are conducting door-to-door visits in neighborhoods with low vaccination rates.
Some companies are contemplating their own vaccine clinics and educating their workers about the benefits of protecting themselves against a virus that has killed more than 568,000 people in the U.S. Others are talking about giving their workers incentives, like cash gift cards — a notion Biden raised in his remarks at the White House on Wednesday.
Vaccine mandates could be an option. The Equal Employment Opportunity Commission has told companies that they can require vaccination to protect public health.
But with Republicans arguing that mandates amount to an intrusion on personal liberty, the White House is steering clear of the discussion, saying the decision to require vaccination or proof of it will be left to individual employers.
White House officials say they take it as a good sign that more than 51 percent of U.S. adults have turned out for a first dose — an indication that “there are tens of millions of people who are still eager to get vaccinated,” said Dr. Bechara Choucair, the White House vaccinations coordinator. But he is aware that Americans will soon no longer be fighting for vaccine slots, and supply will exceed demand.
In some parts of the country, that point may be here.
“There are states where they feel they have hit the wall,” said Michael Fraser, executive director of the Association of State and Territorial Health Officials. “The folks that wanted it have found it. The folks that don’t want it are not bothering to find it.”
The fear is that even as some regions like New England race toward broad immunity, others will harbor coronavirus infections that could transform into more dangerous and more contagious variants, which could break through existing vaccinations.
While estimates of what it takes to reach herd immunity vary, most experts put the figure at 70 percent to 90 percent of the population. That figure includes children, who are not yet eligible to be vaccinated. And judging by the vaccination rates so far, herd immunity will be difficult to reach, particularly in the South.
Last week, Choucair said, the CDC began working with states to identify primary care doctors in neighborhoods with a high “social vulnerability index” to get them vaccines.
“It’s really going to be all about the ground game,” Choucair said. “It’s going to be about planning at the local level. It’s going to be about microplans. It’s going to be about county by county, ZIP code by ZIP code, census tract by census tract to make sure what are the strategies that work.”
Polls show that vaccine hesitancy is on the decline, as more people see their friends and relatives get vaccinated without incident.