Why the hesitance on vaccines?
There are many reasons, but data suggests educational attainment, trust in authority are strong indicators
Even amid a resurgence in COVID-19 infections that have mostly spread among unvaccinated individuals — more than 90 million eligible adults nationwide, including nearly 600,000 in Connecticut have avoided getting a dose of the potentially life-saving shot.
That has public health officials scrambling to understand: Who are the holdouts and why haven’t they been vaccinated yet?
While the individuals and their reasons can vary greatly, some clear patterns have emerged among the unvaccinated, according to a Hearst Connecticut Media Group review of publicly available data.
Data suggests that, within Connecticut, educational attainment is a strong indicator of a city or town’s vaccination rate. Municipalities with higher percentages of people with at least a bachelor’s degree are more likely to have higher vaccination rates.
In Sterling, nested on the border with Rhode Island, just 40 percent of people are fully vaccinated, one of the lowest rates in the state. The town also has the third-lowest percent of adults with at least a bachelor's degree, according to U.S. Census Bureau estimates.
Avon, close to Hartford and home to one of the highest ranked school districts in the state, scores in the top 10 in both vaccinations
and adults with at least a 4-year college degree.
New Canaan, along the coast, has similarly high scores in both categories.
Meanwhile, data from the state’s public health agency suggests Black people have been among the least likely to get a vaccine, in line with national trends.
Tiffany Donelson, CEO of the Connecticut Health Foundation, said many people of color feel they don’t get fair treatment from the health care system. Plenty of work has already been done to position trusted messengers to try to convince their own communities to get a shot, she said.
In the case of the Black population in particular, Donelson said the effort will take time.
“You’re starting from a valid place of mistrust,” she said. “There's a lot of trust that needs to be built before we can get to a place of the African American community matching the vaccine levels of other communities.”
Surveys done every other week during the pandemic by the U.S. Census Bureau show that, as of early July, most adults who hadn’t been vaccinated cited concerns about side effects and a desire to wait and see if the vaccine is safe as their top reasons. The data also shows that as the unvaccinated population has slowly shrunk, an increasing share tell surveyors they believe they don’t need a vaccine, or said they “don’t trust COVID-19 vaccines.”
Connecticut has the third highest vaccination rate nationwide with 73 percent of people 12 years old and older having completed their series, according to the Centers for Disease Control and Prevention. That statewide rate has surpassed President Joe Biden's goal of reaching 70 percent with just one shot, although some parts of the state are far from hitting the mark.
The more the virus circulates, the greater the chances variants will develop that vaccines will be less effective against. That has been the case in recent weeks as the Delta variant has spread, including a relatively small share of “breakthrough” cases among vaccinated individuals. Health officials say those who are vaccinated are far less likely to contract the virus, develop serious symptoms, die, or pass the virus on to others.
The number of new cases reported each day in Connecticut have more than doubled over the past two weeks. There is now at least “substantial spread” of the virus in every county of the state, according to the CDC. Some towns have renewed mask mandates and physical distancing restrictions
The pickup in cases puts even more focus on efforts to reach the unvaccinated.
As the weeks have gone by and the number of holdouts has slowly shrunk, that has left a group of unvaccinated individuals who tend to be tougher to reach and convince — the most strongly opposed, hesitant, or indifferent to vaccination.
And the pace of vaccination has slowed significantly. At its peak, Connecticut was doling out an average of roughly 49,000 doses per day, according to CDC data. Since the beginning of July, an average of just 6,300 doses have been given out in Connecticut per day. While vaccine appointments were once tough to find, supply of the shots now far outpaces demand.
"There are simply not as many people left to vaccinate," said Chris Boyle, spokesman for the Connecticut Department of Health. "With that said, we have seen recent increases in vaccine volume as people who were previously hesitant decide to come in for vaccines as well as several employer mandates come into effect."
The state government’s effort to put shots in arms trudges on.
“We've been in the phase for a couple months now where it's really one arm at a time,” said Josh Geballe, the state’s chief operating officer. “We still have hundreds of thousands of eligible people in Connecticut who haven’t been vaccinated. We're focused on trying to reach each one of them.”
Geballe said on any given day, about 30 mobile vans stocked with shots head out into communities where the state’s experts know vaccine rates are low. Each van averages 10 shots given out each day, he said. Other strategies include handing out supermarket gift cards in exchange for a vaccine.
Understanding who has still not gotten a shot in Connecticut is central to those efforts. Geballe said available data points to the most and the least densely populated parts of the state.
Windham County, the state’s least populated, has the lowest vaccination rate, for instance. The city of Hartford, meanwhile, is the fourth-largest city in the state but has the thirdlowest vaccination status of any municipality, according to data from the state Department of Public Health.
Geballe pointed to reasons for optimism: In the last month, the percent of vaccinated 12- to 15-yearolds in Connecticut increased from 46% to 55%, he said.
Meredith Johnson, chief operating officer of Community Health Center, one of the state’s largest vaccinators, said the organization was giving out roughly 8,000 shots every day at a peak in April. Community Health Center administered about 8,100 vaccines in the whole month of July, a significant slowdown, Johnson said.
Though the speed of the effort has slowed, Johnson said the health group has recently seen an uptick in numbers of Black, Latino and Hispanic patients seeking vaccines, as well as 18to 34-year-olds. The Delta variant seems to be spurring some people to get their shots, she added.
Johnson said at this stage, a day of hundreds of shots given out through community outreach has to be celebrated just as much as a day of thousands administered at a mass vaccination site.
“Our teams really have had to kind of recalibrate what a successful day is like,” she said.
Meanwhile, an estimated 73% of Connecticut residents would support a government mandate of vaccines for every citizen, according to a survey of 21,000 people nationwide from the COVID States Project. Support for requiring vaccines in order to return to universities or board airplanes was even higher.
Governor Ned Lamont has opposed any such requirement, though he approved a testing mandate for unvaccinated workers in nursing homes.
David Lazer, a researcher at Northeastern University and an author of the COVID States research, said while a blanket mandate is infeasible, “it’s a useful thought experiment.” The strong sentiment in favor of a vaccine requirement likely stems from frustration vaccinated people are feeling with those who have waited, he said.
Lazer said his group’s extensive surveying has shown trust — or a lack of it — is a critical factor among the unvaccinated.
“There are people who are just very skeptical of our various civic institutions in this country,” he said.