‘There is nothing else to do’
Arizona officials urge vaccination as delta variant of COVID-19 spreads
COVID-19 vaccination rates in Arizona lag the U.S. average, case numbers are up and the state’s health director says more shots are needed to avert outbreaks from the surging delta variant.
State and county public health officials say the only thing they can really do is encourage more people to get the COVID-19 vaccine and to make sure it’s available to everyone who wants it.
“We are using it as a call to action for those who haven’t gotten vaccinated to get vaccinated,” Arizona Department of Health Services director Dr. Cara Christ said Tuesday, referring to the delta variant.
It is likely the most contagious strain of the SARS-CoV-2 virus that causes COVID-19.
“If five people out of 10 around you are unvaccinated, (the virus has) got even more of a chance of getting to you.”
Dr. Cara Christ
Arizona Department of Health Services director
“The way to address it is to get vaccinated. There is nothing else to do. I mean, if you’re unvaccinated, you should wear a mask,” said Dr. Theresa Cullen, Pima County Health Department director.
The delta variant, also known as B.1.167.2, was first detected in India. It is increasing in prevalence across the globe, including in the U.S. and in Arizona. Areas with pockets of unvaccinated people are most at risk for an outbreak involving the delta variant, health experts say.
It’s unclear whether the delta variant makes people sicker than other strains of the new coronavirus, but its ability to spread so quickly is concerning, Christ said.
While some so-called “breakthrough” COVID-19 cases have developed in people who are vaccinated, they are rare. And the more people who are vaccinated, the lower the chance the virus has of continuing to transmit and cause those breakthrough cases, Christ said.
“No vaccine is 100%, so the virus then has to make it to you in order for your vaccine not to be effective. If everyone around you is vaccinated, that virus is not going to be able to get to you,” Christ said. “But if one person is unvaccinated, it’s got a little bit of a chance to get to you. If five people out of 10 around you are unvaccinated, it’s got even more of a chance of getting to you.”
While the vaccines in use in the U.S. so far appear to be working against the delta variant, improved community immunity to SARS-CoV-2 will give the virus a lower chance of continuing to mutate into something far deadlier and resistant to vaccines.
“We’re trying to remind people that it’s really important to be not only vaccinated but fully vaccinated because we do know that delta is present in Arizona. We are seeing an uptick in the number of cases,” Christ said. “We’ve seen an increase in the proportion that’s due to the delta variant.”
A total of 18,009 people in Arizona were known to have died from COVID-19 as of Friday, ADHS data shows. While the surge of hospitalizations and deaths from COVID-19 that occurred earlier this year has slowed, people are still getting sick and dying from COVID-19. Most are unvaccinated, hospital and public health officials say.
“Most of our new cases are in unvaccinated individuals. That’s our fear, when you have pockets of communities that are not well vaccinated, it’s going to spread a lot easier through those communities,” Christ said.
There has been some debate about whether people who have been infected with the new coronavirus still need to get the COVID-19 vaccine. But advice from public health experts for that group of people has been consistent: People who previously have been infected with the SARS-CoV-2 virus that causes COVID-19 should still get the COVID-19 vaccine, state and federal officials say. It is the safest and surest way to build protection against severe illness and death from COVID-19, they say.
Younger people are key
Vaccination is the best way to avert the delta variant, according to Christ and other public health experts. But Arizona’s COVID-19 vaccine rates have been stubbornly hovering at about 50% for several weeks.
Between June 7 and Friday, the state’s overall vaccination rate of people in the total population who had received at least one dose of vaccine went to 50.1% from about 47%, according to data from the Arizona Department of Health Services. The U.S. average as of Friday was 55.3%, according to the U.S. Centers for Disease Control and Prevention.
The vaccination rate for all Arizona adults 18 and older with at least one dose was 62.7% as of Friday, the CDC data shows. That’s lower than the U.S. average of 67.4% and lower than in some neighboring states. In California, 75.6% of the population 18 and older had been vaccinated with at least one dose as of Friday; in New Mexico, it was 77.3% and in Colorado it was 70.2%.
“We have a history of vaccine hesitancy, even before the COVID-19 vaccine,” Christ said. “Kind of knowing that we had that already in place and that we are seeing decreased vaccination rates in our 20- to 44-year-olds. We are just not getting the uptake that we would need to be able to reach that.”
Vaccination rates for Arizonans ages 55 and above are “really good,” Christ said, but state officials are seeing fewer vaccinations in the younger demographics.
Statewide data shows 50% of Arizonans ages 20 to 54 had received at least one dose of vaccine as of Wednesday, compared with 80% of those ages 55 and older.
“We’re trying to determine messaging that may now resonate with people in order to encourage them to get vaccinated,” she said. “We do know that providers and trusted friends who have been vaccinated are a good source of information that people have said they trust. We are working to get it (the vaccine) into providers’ offices.”
‘We’ve done everything possible’
Other than continuing to emphasize the need to get more Arizonans vaccinated, state and county public health officials are sticking with existing COVID-19 vaccine strategies — making the vaccine easily available and targeting vulnerable and underserved communities.
The state and counties in late May transitioned from large-scale vaccine sites to smaller, more targeted events, and the vaccine is now more widely available to individual providers.
“Tangibly, we’ve done everything possible to ensure that we have enough vaccine providers in our community and connect those that are either homebound or have concerns or issues with transportation, to vaccination services and opportunities within their communities,” Mohave County Department of Public Health Director Denise Burley said.
“We try to encourage vaccination itself and remove some of the barriers associated with getting vaccinated,” she said.
State data as of Friday showed 37.6% of the Mohave County population had been vaccinated, which is well below the statewide average.
Although the delta variant is a “very serious” concern, Burley said she isn’t
sure anything else can be done besides promoting vaccination strategies.
Similarly, Graham County Department of Public Health Director Brian Douglas said the COVID-19 vaccine is “readily available to anyone who wants it” in his county. Douglas estimates about 34% of Graham County residents have received at least one dose of the COVID-19 vaccine.
“We advertise our vaccination clinics multiple times per day on multiple media sources,” he wrote in an email. “In addition, we have vaccinated in underserved areas.”
Cochise County has launched a “Life’s Better Vaccinated” campaign, and the county is hoping to offer vaccine clinics in libraries and Dollar General grocery stores, officials said this week.
“Our primary concern is that IF the delta variant becomes a problem and unvaccinated individuals start getting really sick and requiring hospitalization, it might be too late for those who decide to get vaccinated,” officials with Cochise Health and Social Services said in an emailed statement.
“The research indicates the vaccine is only 80% effective against the delta variant for those who are fully vaccinated. Fully vaccinated for Moderna and Pfizer means two weeks after the second dose — for Janssen (Johnson & Johnson) it is two weeks after the single dose.”
State data as of Friday showed 46.9% of the Cochise County population had been vaccinated.
‘The delta variant is increasing ’
Dr. Rebecca Sunenshine, medical director for disease control at the Maricopa County Department of Public Health, said the number of COVID-19 cases in Maricopa County containing the delta variant have increased from about 2.7% to 19% from May to June.
“It is very clear that the delta variant is increasing here in Maricopa County, as it is in Arizona, and in the U.S.,” Sunenshine said. “We’re watching it very closely to see how quickly it is increasing. And we’re working very hard to continue to vaccinate as many individuals as we can, because we know that the vaccine is highly effective against preventing severe outcomes from the delta strain.”
Vaccines’ applications pending for full FDA approval
It’s unclear exactly how many cases of the delta variant are in Arizona, but the numbers are rising.
About 15% to 20% of positive COVID-19 tests are sequenced for new coronavirus variants.
As of Wednesday, 159 positive COVID-19 tests in Arizona had tested positive for the delta variant, according to a dashboard maintained by the Arizonabased Translational Genomics Research Institute.
“Not every positive case is sequenced,” Christ said. “The random samples that they do, we have seen the proportion caused by delta increasing and so now is the time to get vaccinated if you haven’t been fully vaccinated yet.”
The Navajo Nation confirmed its first case of the delta variant last month, and on Wednesday the White Mountain Apache Tribe reported two confirmed cases of the delta variant in two unvaccinated community members on the Fort Apache Indian Reservation.
The Fort Apache cases were confirmed from a COVID-19 test sample obtained at the Whiteriver Service Unit in mid-June, tribal officials said.
“This increase in the delta variant is worrisome as it is more transmissible and can cause severe illness,” tribal officials wrote in a Facebook post.
Christ remains hopeful that Arizona will improve its COVID-19 vaccination rates. What could help, she said, is for the vaccines to get full approval from the U.S. Food and Drug Administration. Right now, they are under what’s known as an EUA — emergency use authorization.
Pfizer and BioNTech and Moderna have both submitted applications with the FDA for full approval of their vaccines. It’s unclear when full approval might happen, but it could be as early as the fall, Christ said.
“That could put more people more at ease,” Christ said. “A lot of people don’t understand the emergency use authorization.”
While vaccination has slowed, people are still showing up at events to get the COVID-19 vaccine, Christ said.
“Now it’s really those people that either haven’t had the time or the ability to get there, but now they are because we’re in the communities and closer,” she said. “Or, they are able to get their questions answered, or they’ve got friends now who have gotten it and they see it’s safe, it’s effective and they’ve done just fine with the vaccine.”