Even as the latest coronavirus surge appeared to ease, including in hard-hit areas of the Midwest and Northeast, and as the federal government reported the nation has achieved key milestones in vaccinations, the battle to quell the pandemic also has entered the gnarly phase of grappling with the hesitant, the reluctant, and the resistant.
The Biden Administration, urging continued progress against the coronavirus, reported the nation had met the president’s goal of administering 200 million shots even before the target of the first 100 days of his term.
As of April 23, the federal Centers of Disease Control and Prevention reported that 53% of Americans 18 and older had received at least one of two doses of available vaccines, and 81% of people 65 and older had done so.
Pluses for the vaccination campaign
Another key Biden target also was reached before the 100-day mark: Everyone who is 16 and older is eligible now for the vaccine.
This meant that high schools either prepared for or started to vaccinate teens. Colleges and universities in increasing numbers — including the giant California higher education system — are telling students they must be vaccinated before the fall sessions of mostly in-person classes and greater normalcy in campus life.
There also will be more vaccine options available, as federal regulators ended a pause on the one-dose Johnson & Johnson product (which also is easier to store and handle).
In a move that should assure anyone concerned about vaccine oversight and safety, U.S. officials took a hard look at the incidence of rare and sometimes fatal blood clotting cases that have been linked to the J&J shot (15 incidents out of 8 million individuals given a dose).
And, as European regulators have decided in studying similar problems with the AstraZeneca vaccine, the American experts found that the benefits of the J&J vaccine exceeded its risks. New warnings will be given to recipients and doctors have been alerted about this side-effect and treatments for it.
A dip in getting shots in arms
But the nation also recorded another worrisome vaccination trend — supply now may be exceeding demand, and the pace of inoculations took their first dip in months, the New York Times reported:
“The seven-day average of vaccinations has declined somewhat in recent days, to 2.86 million doses a day as of [April 23], from a high point of 3.38 million last week, according to a New York Times analysis of data from the Centers for Disease Control and Prevention.”
The newspaper said that federal officials expected the vaccine slowing to occur, leading to the closure of select mass vaccination sites and greater emphasis on getting patients shots at doctors’ offices, clinics, and pharmacies — more traditional spots for inoculations.
Federal and state officials say they are committed to heavy outreach in underserved communities of color, rural areas, and among the poor. These groups have been hard-hit by coronavirus infections and deaths. Still, as the vaccinations roll on and have become widespread, hesitancy about vaccines, public opinion surveys show, has declined steadily.
Macho men, GOP stalwarts, Christian evangelicals say no
That may leave public health experts wrangling with tough hombres to get vaccinated: the reluctant and resistant. As the New York Times reported, the statistics show that macho men, among others, are a notable group lagging in getting what is proving to be a crucial and hugely successful way to combat the coronavirus:
“As the Biden administration seeks to get 80% of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal. Women are getting vaccinated at a far higher rate — about 10 percentage points — than men, even though the male-female divide is roughly even in the nation’s overall population … The reasons for the U.S. gender gap are many, reflecting the role of women in specific occupations that received early vaccine priority, political and cultural differences and long-standing patterns of women embracing preventive care more often generally than men. The gap exists even as Covid-19 deaths worldwide have been about 2.4 times higher for men than among women. And the division elucidates the reality of women’s disproportionate role in caring for others in American society.”
Experts also fret that the battle against the pandemic, particularly due to the previous presidential administration, has become far too politically fraught — with fierce battles over face coverings, distancing, and other health restrictions.
Staunch Republicans, notably supporters of former President Trump, have been vocal and resistant to vaccination. White, Christian evangelicals also have been reluctant or outright resistant to the shots.
Faith leaders have started to urge their congregants to protect themselves, their loved ones, and their communities by getting the shots. Trump, who both had a Covid-19 infection and quietly received the vaccination before leaving office, has told his supporters to get the vaccine. He did so recently, along with denunciation of his successors in office and federal health regulators.
Biden officials reported they expected and are ready to dig into any slowing in the vaccination campaign. The White House noted that the pandemic rescue plan included tax incentives for employers who give their workers time off to get vaccinated. Employers may need and want to provide incentives — paid leave, gift cards, cash bonuses, and promotional materials — to nudge their staff to stay healthy and get vaccinated, especially as normality returns and competition increases for employees.
The high stakes of a split on vaccines
The stakes are high, indeed, for the nation to maintain the much improved trendline in combatting the coronavirus. It has killed at least 570,000 Americans and infected 32 million of us. Those figures are likely an undercount, as the New York Times reported, noting of the record 3.4 million 2020 deaths in this country:
“The U.S. death rate in 2020 was the highest above normal ever recorded in the country — even surpassing the calamity of the 1918 flu pandemic [see figure above]. A surge in deaths from the Covid-19 pandemic created the largest gap between the actual and expected death rate in 2020 — what epidemiologists call ‘excess deaths,’ or deaths above normal. Aside from fatalities directly attributed to Covid-19, some excess deaths last year were most likely undercounts of the virus or misdiagnoses, or indirectly related to the pandemic otherwise. Preliminary federal data show that overdose deaths have also surged during the pandemic.”
The newspaper, separately, noted that — even with vaccinations ramping up rapidly:
“Case numbers nationwide have been largely stagnant for the last month. Around 67,000 new infections are being identified each day, down from about 250,000 daily at the January peak.”
Experts have watched closely to see whether new infections will decline as vaccinations increase, or whether the vaccine progress gets washed out by the stubborn virus and its expanding variants, which are more contagious and possibly deadlier.
And, while the nation has spent trillions of dollars to rescue itself from this disease, what will the months ahead look like if the reluctant and resistant persist? Will there be disease enclaves where mutations may flourish and threaten people and areas far beyond? Will there be a relatively normal summer, followed, as the weather changes anew, by a bad fall and winter? The U.S. health system, with valiant and exhausting effort, has not gotten overwhelmed and failed in the pandemic. But 3 in 10 health workers report they are experiencing significant mental and physical harm from the months of stress and relentless toil tied to the coronavirus — and they are ready to quit.
Not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by an array of awful circumstances and things, including:
In these cases, a crowd of problem people and institutions — these can include doctors, hospitals, insurers, regulators, and politicians — may press victims to move on, settle up, and they fast forget the lonely agony of the suffering. It can, however, take a long time for patients to recover from terrible illness or injury. Harms can last a lifetime. Patients may need medical services, as well as financial and other support for months or years. They also need closure and justice for wrongs done, as well as the sense that they may be able to help others avoid the problems that afflicted them.
We are not done with the coronavirus and the huge trauma it has inflicted on us all. Please get vaccinated when it’s appropriate for you to do so. All medical interventions carry with them risk. But vaccines’ benefits (for example, as seen in their slashing of nursing home deaths) long have been shown to outweigh their harms (the coronavirus can be a grim illness with lasting harms). Consult your doctor if you have concerns. Don’t hesitate to talk with loved ones and people you respect if you have doubts about vaccines.
We have much work to do to put down the pandemic and get back, as all of us fervently want, to not just our former normality but something better. That aspiration will not be achieved unless we all press ahead together.