Do We Need a More Forceful Vaxx Chat?
True: we should be addressing and fixing the access & equity gaps at the core of bad public health response. But: do we really have time to patiently talk this through?
Publisher’s Riff
By this time, we expected pandemic to slow down. Instead, it appears as if it’s accelerating into something much more ominous with the spread of the horrible “Delta variant:” as of this writing, COVID-19 cases are up 70 percent and deaths are up nearly 30 percent. One would think that such an alarming increase in cases, hospitalizations and deaths would naturally prompt higher vaccination rates in the United States. Yet, that hasn’t been the case even as the overwhelming majority (more than 95 percent) of all COVID-19 cases, hospitalizations and deaths are among the unvaccinated. That’s not budging vaccination rates any faster: We’ve been in “the 40s” or the 40 percentile range of how many fully vaccinated for quite a while now, per the Washington Post tracker …
The average of doses per day in the last week is 1 percent higher than it was the week prior. But, 513,000 doses per day is nowhere near the more than 4.6 million per day achieved in early April 2021. That’s a more than 88 percent drop in daily vaccine dosing over a 3 month period.
There are clear challenges in terms of both access and hesitancy. The most recent Kaiser Family Foundation polling notes …
… a majority (76 percent) of people who had previously said they would “only get vaccinated if required” or said they would “definitely not” get a COVID-19 vaccine remain unvaccinated.
The Journal of Adolescent Health shows young adults between the ages of 18 - 29 “…. had the highest cumulative COVID-19 infection incidence nationally,” but yet they account for a quarter of those who are persistently hesitant. Hesitancy is a big problem, but the perception (real or not) of limited access to vaccine is also very real according to the latest CBS/YouGov polling and it’s determined more by a person’s financial situation …
This is wild. Bottom line is we are nowhere near the needed “herd immunity” protection needed to just finally end the pandemic. We know what’s needed to get there, but we’re refusing to do things like follow basic instructions. Hesitancy - even when driven by the lack of accessibility - is a big part of the problem, but it has triggered a cautious conversation whereby activists and public health officials are nervous about “shaming” or aggressively pushing the hesitant into getting vaccinated. Experts are therefore promoting an approach of combined transparency and patience, especially for vulnerable Black and Brown communities, that entails careful and socially/culturally competent conversation assessing the reasons for hesitancy. That kind of approach is necessary, especially given the history of medical bias and racism.
However: do we have that much time? With variants such as Delta raging, do we spend so much time and energy trying to coax 1) the unvaccinated and 2) the institutions (such as uncompromising employers unwilling to grant days off to those needing to get vaccinated) into getting vaccinated that by the time we reach, say, 70 percent of the population inoculated it’s too late? Perhaps there’s an argument for a more forceful approach, still, or something tinged with more deliberate impatience. There’s a concern that we either reach a point where public inoculation is less effective because the variant or some other mutation keeps spreading viciously and growing stronger among the unvaccinated … and/or we begin seeing the vaccinated haves and have nots where public spaces are rigidly segregated and movement is restricted in a mass containment effort. We’re trying to avoid such potential calamities.