With universal eligibility, a fifth of U.S. seniors remain unvaccinated

The United States has passed a significant milestone in its vaccine rollout: All adults are now eligible for the COVID-19 vaccine in every state. More than half of the adult population has received at least one dose of a vaccine.

The country has come a long way since vaccines first arrived at hospitals and long-term care facilities in December. More than 209 million doses have been shot into arms. And universal eligibility comes on the heels of a confusing, patchwork system that may make a person eligible in one state, but not another.

But the next phase of the rollout will bring new challenges. Some scientists and state and local health officials believe that making more people eligible will ultimately get more people vaccinated more swiftly. But others have said they are worried that some of the most vulnerable people, including those 65 and older, may have trouble competing for a shot.

As it stands now, older adults are the most vaccinated age group in America — quite likely because they have been eligible in most states for months. But about a fifth of those 65 and older, a group that is particularly vulnerable to serious complications and death from the virus, have not received even one shot. Among them are some residents of long-term care facilities, which have represented more than a third of overall coronavirus deaths in the United States for much of the pandemic.

In mid-March, President Joe Biden challenged states to accelerate the rollout and expand eligibility to include all people 16 and older. And for the past several weeks, states have been shifting away from complicated phasebased plans that have prioritized certain vulnerable individuals, like older Americans, critical workers and those with certain medical conditions.

“No more having to sort out if you’re in or if you’re out,” Julie Willems Van Dijk, the deputy secretary of the Department of Health Services in Wisconsin, said in a speech in late March as the state made plans to expand eligibility. “It’s time to just move forward and get everybody with a shot in their arm.”

Vaccinations have sped up considerably since Biden’s announcement, when providers were administering, on average, about 2.2 million doses each day. Now, about 3.2 million shots are given, on average, every day.

One by one, states have made eligibility universal, meaning all people 16 and older qualify for shots. On Monday, the last group of states opened the floodgates, and some experts expressed worry over unvaccinated older adults.

It may not just be those in some parts of the country who have difficulty snatching up fast-changing appointments online. Cindy A. Prins, an epidemiologist at the University of Florida, said that high-risk people who had been eligible for a vaccine for months but had not gotten one might be struggling with access.

“There may be people who are not necessarily homebound, but maybe they don’t drive,” Prins said. “Maybe it’s not easy and convenient for them to get somewhere to get vaccinated.”