After months of steady surge in vaccinations, the US is seeing its first real slowdown in the daily rate of fire, an indication that the nation is entering a new phase in its vaccination campaign.
More than half of American adults have now received at least one dose, a significant achievement, but vaccinating the second half presents different challenges than the first. Previous vaccinations are likely largely composed of groups who wanted the vaccine the most and had the greatest access to it, and as progress continues, it is no longer about meeting the demand for vaccination.
“We have had vaccinations against those who are most at risk and who are most likely to want to be vaccinated as soon as possible,” White House Tsar Covid Jeff Zients told reporters last week. “We will continue these efforts, but we know that we will reach other populations.” Take your time and focus. “
The country averaged 2.6 million reported vaccinations per day for the past week, data from the Centers for Disease Control and Prevention shows, from a peak of 3.4 million reported shots per day on April 13. That number is falling, even if the eligibility is now open to all adults in every state.
The downturn There is a lot of positive vaccination news to follow, said Dr. Jennifer Kates, senior vice president of the Kaiser Family Foundation’s nonprofit health policy group. The federal government has ensured a large supply of vaccines, states have ironed out kinks in their registration systems, and eligibility has opened up to all adults.
But now the country is nearing the point where meeting existing vaccine needs is no longer the main challenge, according to Kates.
“We feel like we’ve got to a point where the people who are left are very hard to reach and need help and more education, or those who are resilient and don’t want to,” she said and added, “The Pent’s demand will be met.”
The question is what will be the reaction to the slowdown? “How do the federal, state and private sectors communicate the importance of vaccination to the public?” Asked Kates.
States are seeing a slowdown in demand
In parallel with the nationwide slowdown, the rate of vaccination is falling in many countries. Eleven states have reported a decrease in shots fired for three consecutive weeks or more, according to a CNBC analysis of the CDC data through Sunday.
In West Virginia, which got off to a hot start with its vaccination campaign, the state has passed the tipping point where vaccine supply exceeded demand. The weekly doses have been decreasing for four consecutive weeks.
“If you remember, we were putting a lot of doses in many arms very quickly,” said Maj. Gen. James Hoyer, director of the Joint Interagency Task Force on Vaccines in West Virginia, noting that his state was among the first to get vaccinations have completed among nursing home populations. “There were a lot of people who wanted her and tried very hard to get out and get a vaccine.”
Now, Hoyer said, the state has asked the federal government to dispense doses in smaller vials to reduce the risk of wasting vaccines, which he could not have imagined a few months ago with such a small supply.
“We got the doses and we’re really good at administering them,” said Hoyer. “We are at this stage of educating people who cannot get the vaccine.”
New Mexico led the country for a while, with a greater proportion of the population fully vaccinated than any other state.
But now the state is facing a plateau and finding it harder to fill mass vaccination events, said Matt Bieber, communications director for the state’s health department.
“We’ve been in a period of tons of demand and not enough supply, but now at the point where people who know about the vaccine got it,” he said.
The proportion of Americans who have not yet received a Covid shot is not made up entirely of those who do not want one.
While some oppose it – in a recent Kaiser Foundation survey, 13% of respondents said they would “definitely not” get a vaccine and another 7% said they would only get one if needed – there is, too many groups who have not yet had the resources or the ability to get vaccinated.
“Some people cannot take time off work to easily get vaccinated, or may not have transportation,” said Kates, the emperor’s vice-president, saying that sometimes lack of access is purely logistical. “They literally have no access in the most basic of ways,” she said.
Hoyer said many West Virgins cannot afford to sacrifice hours of wages to leave work for an appointment. His most successful form of public relations to date has been providing vaccinations to employees and their families in local workplaces where people can take 30 minutes out of a shift to get a chance. A recent event at a Toyota manufacturing facility in Putnam County, West Virginia, resulted in more than 1,000 vaccinations.
Bieber in New Mexico has received similar feedback. He heard from community members that a group of grocers would like to be vaccinated, but they are working on shifts that last beyond the hours their local clinic is open. Mobile vaccination units that give people shots can help with such logistical challenges, he said.
The lack of internet access is another obstacle to getting vaccination appointments, most of which were previously booked online, said Dr. Rupali Limaye, a faculty member at the Johns Hopkins Bloomberg School of Public Health who is involved in vaccine decision making and in state health departments during the vaccine rollout. This is particularly evident in countries with a larger proportion of black residents, which traditionally have less likely to have internet access.
Rural communities in West Virginia and New Mexico may also have limited internet access, Hoyer and Bieber said.
Other barriers to access to vaccines are misinformation or lack of education about the safety of vaccines.
For groups facing more than logistical problems, states turn to community leaders and organizations for help with outreach and education.
New Mexico is working with health care providers to leverage patient relationships to discuss vaccinations. It has also hosted virtual town halls that aim to answer questions from various community groups, such as the black and Hispanic residents of the state and its population of farm laborers.
City halls usually lead to a surge in vaccine registration, Bieber says, but progress is slower than in the earlier days of the vaccination campaign.
“At a time when we can easily run a mass vaccination event, the point is to convince people by the dozen, dozen, or even one at a time,” he said.
For example, Arkansas works with health professionals, religious and community leaders, and the Chamber of Commerce to disseminate information about vaccines, said Dr. Jennifer Dillaha, epidemiologist and medical director for vaccinations at the state health department. Some people want a familiar, trustworthy environment in which to raise concerns and answer questions, she said.
In East New York, Brooklyn, vaccines weren’t initially widespread for residents, although they were disproportionately affected by Covid, according to Covette Pean, executive director of the East New York Restoration community organization.
Neighborhood residents often have pre-existing health conditions such as diabetes and asthma, and many are key employees in grocery stores, nursing homes, and the transit department. A New York Times database shows about 20% of residents with at least one vaccine dose in East New York compared to 30% in the city and more than 40% in many parts of Manhattan.
People want to get the vaccine, Pean said, but need to know where to get it, which is better communicated through a personal approach than a digital one. Her group works in churches, pantries, and subway stations to share information about vaccines and public health issues, Covid and others, that exist in the community.
Johnson & Johnson are taking a break
Earlier this month, the Food and Drug Administration and CDC urged states to temporarily stop using the Johnson & Johnson vaccine “out of caution” after reports that six women had developed rare blood clots. U.S. health officials lifted the 10-day break last week, saying the benefits of the shot outweigh the risk.
So, did the J&J hiatus play a role in the drop in vaccinations? Kates, the emperor’s vice president, said it wasn’t enough to explain the whole story of the slowdown.
Only about 8.2 million of the 237 million recordings filed in the US to date are from J&J, although they were used for an average of 425,000 reported recordings per day in mid-April.
The single shot option, which is also easier to transport and store, has proven useful in certain situations and communities, such as: B. in mobile vaccination units and for homeless people who have several difficulties accessing a vaccination center.
“We know that there are some populations who wanted the single dose or were harder to reach and that a single point of contact is ideal, so it is possible that some people were not vaccinated for this reason,” she said. “But on the whole, being a big change is not enough.”
If you just count the shots from Pfizer and Moderna, the downward trend remains. The combination of these two vaccines peaked on April 16, averaging 3 million reported daily shots, and has since declined 13%.
The grimmer question, however, is whether the J&J stop affects confidence in the safety of vaccines in the broader sense and reduces the likelihood of Americans receiving a dose of any of the three vaccine options.
The J&J shot may have been more appealing to those who were initially reluctant to get a vaccine. Polls by the Kaiser Family Foundation in March found that among those who said they would wait and see how the vaccines work before being self-vaccinated, a greater proportion would receive the J&J single-dose vaccine than either dosage option.
However, Kates doesn’t think the J&J hiatus caused a significant increase in vaccine reluctance. “As far as I know, the confidence hasn’t been shaken at all,” she said.