The two Americas of immunization | Opinion


In recent weeks, one data has received a lot of attention: 99.5% of all people who die from COVID-19 in the United States are not vaccinated.

We are two researchers who work in public health and study immunity, viruses and other microbes. Since the start of the pandemic, public health experts have worried about what could happen if a large portion of the American population, for some reason, does not get vaccinated.

Over the past few weeks, the answer to this question has started to emerge.

“Two Americas” of vaccination

By mid-July 2021, the United States had fully immunized more than 160 million people – just under 50% of the population – against COVID-19. Despite a surplus of vaccines available, in recent weeks the vaccination rate has slowed considerably. In early April, health workers administered around 4 million new vaccines per day. Today that number is around 450,000 doses per day.

As people scoured for vaccines in recent months, the United States has split into what Dr.Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, calls “two Americas” – one from the vaccinated population and the other from the unvaccinated population. These two Americas are divided geographically and in most cases along political lines.

Immunization rates will continue to rise, albeit slowly, as rural areas gain better access to vaccines and messages persuade some hesitant people to get vaccinated. But according to data from a survey from late June and early July, more than 10% of adults aged 18 or older say they likely will not or certainly not receive a coronavirus vaccine, and an additional 5% say that they are not sure. It seems likely that there will be a large unvaccinated population at this time.

Which America is the safest?

The vaccines themselves are simply remarkable in their effectiveness in protecting against COVID-19.

Unvaccinated people, by comparison, are extremely susceptible to the coronavirus, particularly the Delta variant, and data on deaths and hospitalizations clearly show this gap.

On July 16, the director of the United States Centers for Disease Control and Prevention, Dr. Rochelle Walensky, revealed that 99.5% of recent American deaths from COVID-19 were in unvaccinated people. “These deaths were preventable with simple and safe shooting,” she said. In early July, Fauci said 99.2% of people who died recently were not vaccinated. In the state of Maryland, every patient who died from COVID-19 in June was not vaccinated.

In his July 16 statement, Walensky also said that 97% of current hospitalizations for COVID-19 are unvaccinated people. An earlier analysis by the Associated Press found that 98.9% of all COVID-19 patients hospitalized in May were not vaccinated. The Los Angeles County Department of Health Services Director recently said that not all new COVID-19 patients hospitalized in Los Angeles were vaccinated.

A story of two states

It is difficult to find data on all cases among unvaccinated versus vaccinated people. This is in part a result of the CDC’s transition in May 2021 to a focus on hospitalizations of COVID-19 vaccine recipients rather than cases. But one way to get this data is to compare two states with big differences in vaccination rates. As the delta variant of SARS-CoV-2 increases across the United States, the consequences of this split into a vaccinated and unvaccinated America can be seen in real time.

In the state of Missouri, only 40% of people are vaccinated. In some counties in Missouri, only 14.7% of residents are vaccinated. Unsurprisingly, the state saw an increase in COVID-19 cases through mid-July, with 2,000 to 3,000 new cases per day. The rate of spread is also increasing. Already, some hospitals lack ventilators and intensive care beds.

Compare that with Massachusetts, where 63% of people are fully vaccinated. Although the state is also seeing an increase in cases, the total number of new infections was only around 200 to 300 per day. The number of patients hospitalized for COVID-19 in Massachusetts is also down 95% since January 2021.

As of July 20, Missouri had 1,357 hospital patients with COVID-19, nearly 13 times more than the 106 patients in Massachusetts. This despite the fact that Missouri has a slightly smaller population which is much more dispersed.

Does it matter if people are not vaccinated?

Ultimately, with a large portion of the U.S. population still unvaccinated, COVID-19 is not going to go away in the near future. The United States will continue to see outbreaks of the virus in communities with low vaccination rates. Even though people in these under-vaccinated areas rush to get vaccinated when epidemics occur, it takes about a month for the vaccination to produce strong immunity.

As long as SARS-CoV-2 circulates in the United States, unvaccinated people will continue to experience the full and dangerous clinical effects of COVID-19. But in addition, as the virus spreads among the unvaccinated, it will also continue to spread at a low level among those vaccinated. While most of these infections will not progress to severe COVID-19, according to the CDC, by mid-July more than 5,000 vaccinated people, mostly over the age of 65, had been hospitalized and 1 000 had died. These numbers are of course sad, but they pale in comparison to hospitalizations and deaths among the unvaccinated population.

The vaccines do exactly what they were designed to do: prevent severe COVID-19 with amazing effectiveness. With free and widely available vaccines, for most people in the United States, it’s a choice: do you want to be part of America unvaccinated or vaccinated?

Rodney E. Rodhe is Professor of Clinical Laboratory Sciences at Texas State University. Ryan McNamara is Associate Researcher in Microbiology and Immunology at UNC Chapel Hill. This article is republished from The conversation under a Creative Commons license.


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