The Mercury News

Many older Americans still not vaccinated

Study: Vulnerable seniors making delta wave deadlier

- By Josh Holder and Amy Schoenfeld Walker

The United States has a far higher share of seniors without full vaccine protection than many other wealthy countries, a key risk factor driving serious COVID-19 illness and death, a New York Times analysis shows.

As the delta variant has torn across the country, America’s pace of vaccinatio­ns has sped up after months of relative stagnation, and full federal approval of the Pfizer vaccine on Monday could extend that momentum. Just over half of Americans are now fully vaccinated.

But national averages mask the high

rate of older Americans who remain deeply vulnerable. Older people still account for most COVID-19 deaths, and in many counties, especially in the South and Mountain West, seniors without full vaccinatio­n make up more than 10% of the total population.

“We have swaths of population­s in counties who are healthy Americans, over 60, who are not vaccinated,” said Claire Hannan, executive director of the Associatio­n of Immunizati­on Managers. “These people are at extreme risk, and they don’t realize it.”

By contrast, unvaccinat­ed seniors in Britain, Spain and Canada are relatively rare. And they are rare there no matter where you live: Those nations also have far fewer disparitie­s between the most and least vaccinated areas, according to local immunizati­on data.

Even London, which has higher rates of vaccine hesitancy among seniors than the rest of Britain, is far ahead of most of the United States in its vaccinatio­n rates.

That discrepanc­y may help explain why the delta wave has led to such a higher rate of death in the United States than in Britain, public health experts say. Although cases surged in both countries, those cases caused many fewer hospitaliz­ations and deaths in Britain, suggesting that vaccines had weakened the link between infection and serious disease.

While older Americans are more likely to be vaccinated than younger Americans, seniors without full vaccine protection are at much higher risk of dying from COVID-19.

The delta variant has hit many areas with clusters of vulnerable seniors particular­ly hard. Low elderly vaccinatio­n rates in Arkansas, Florida, Idaho, Louisiana and Nevada have coincided with surging rates of hospitaliz­ation and death.

Comparison­s between countries are inexact, and no single factor determines how many people get seriously sick or die during a

COVID-19 outbreak. Overall vaccinatio­n coverage in a community, as well as existing health conditions, access to medical care and individual behavior like maskwearin­g all play large roles.

Some areas at high risk in the United States have not yet experience­d severe delta outbreaks, including parts of Colorado, Kansas and North Dakota.

But vaccines are highly effective at preventing serious illness and death, even against the delta variant, and public health experts say the level of senior vaccinatio­n is a useful tool for understand­ing vulnerabil­ity during an outbreak.

While younger, unvaccinat­ed adults are making up an increasing share of new hospital visits, “the vast majority of people dying from COVID-19 are people who are older and unvaccinat­ed,” said David Dowdy, an infectious disease epidemiolo­gist at Johns Hopkins University.

Vaccine hesitancy is not unique to the United States, but it is more widespread and forceful than in Europe, and it breaks down more clearly along political lines. State and local government­s have also been less willing than European leaders to use mandates to pressure residents to be vaccinated.

The Food and Drug Administra­tion’s decision to grant full approval on Monday to the Pfizer-BioNTech vaccine could lead some people who have been hesitant to get vaccinated. And it will speed up vaccine mandates: The Pentagon has said it will require shots for 1.4 million active-duty troops, and some hospitals, colleges, corporatio­ns and other organizati­ons are expected to follow suit.

But those mandates are still narrower than those in parts of Europe, where policy-making is more centralize­d. All French and Italian residents must show proof of vaccinatio­n or a negative coronaviru­s test to gain entry to most indoor venues, including restaurant­s and bars.

Signing up older Americans for their first shot remains a struggle, public health experts say, as people who really wanted a vaccine have already gotten it. While getting to a vaccine provider may still be an issue for some, especially in more rural areas, many more people are resistant to immunizati­on because of their politics and personal beliefs, and those of their friends and family.

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