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 other challenges. Previous vaccinations are likely made up largely of groups who wanted and had the greatest access to the vaccine, and with continued progress it is no longer about meeting the demand for vaccination.
“We have received vaccinations against those who are most at risk and who are most likely to want to be vaccinated,” 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 has seen an average of 2.6 million reported vaccinations per day over 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 downturnThere 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.
Kates says that meeting existing vaccine demand is no longer the biggest challenge.
“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 adding, “the Pent-up demand will be met.”
The question is, what will the answer to the slowdown be? “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 is 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 phase of tons of demand and not enough supply for a while, but now to the point that 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 are 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 they may not have transportation,” Kates said, explaining that sometimes lack of access is purely logistical. “You literally have no access in the most basic of ways.”
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 has been offering vaccinations to employees and their families in local workplaces, where people can take 30 minutes off 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 grocery store workers would like to be vaccinated, but they work 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. She said this was particularly evident in states with higher proportions of black residents who are traditionally less likely to have internet access.
Rural communities in West Virginia and New Mexico may also have limited internet access, Hoyer and Bieber said.
Misinformation or lack of education about the safety of vaccines is another barrier to vaccine access.
For groups experiencing 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 talk about vaccinations. Virtual town halls have also been set up to answer questions from community groups such as the Black and Hispanic residents of the state and the farm laborer population.
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 were initially not widespread for residents, although they were disproportionately affected by Covid, according to Colette Pean, executive director of the East New York Restoration community organization.
Local residents in the neighborhood have high rates of 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 dose of vaccine in East New York, compared with 30% in the entire 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 it was reported 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 said it wasn’t enough to explain the whole slowdown story.
Only about 8.2 million of the 237 million recordings in the US to date are from J&J, despite being 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 only take into account the recordings from Pfizer-BioNTech 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 more broadly and reduces the likelihood that Americans will receive 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’d like to see how the vaccines work before being self-vaccinated, a greater proportion would receive the J&J single-dose vaccine compared to either Dosage options.
However, Kates doesn’t think the J&J hiatus was a major factor behind the vaccine’s hesitation. “As far as I can tell, the confidence hasn’t been shaken at all,” she said.