Biden may hit July 4 vaccine goal, but millions of unvaccinated Americans will keep COVID alive this summer

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There’s a real chance America could reach President Biden’s ambitious goal of giving 70 percent of U.S. adults at least one COVID-19 vaccine shot by July 4, according to the latest data.

Yet Biden’s top COVID adviser, Dr. Anthony Fauci, just spent the holiday weekend warning Americans not to “declare victory prematurely because we still have a ways to go.”

To see how both of these things can be true at the same time, pay attention to what’s happening right now in Mesa County, Colo., and northern Missouri.

At a national level, America’s COVID-19 prognosis is the best it’s been since the crisis began. Over the last two weeks, cases have fallen 45 percent, on average, to the lowest level since March 2020. Hospitalizations are down 22 percent over the same period; deaths are down 44 percent. And because of mass vaccination, these national trends show no sign of stopping.

It’s now entirely possible, in fact, that 70 percent of U.S. adults could be at least partially vaccinated by Independence Day, a target Biden set on May 4, when 56 percent of U.S. adults had received at least one jab. In less than a month, that number has climbed 7 points to 63 percent; to climb another 7 points over the next month would require about 550,000 adults to get their first shot each day. Before Memorial Day, the U.S. was averaging more than 700,000 of these first shots each day, and the vast majority of them were still going to Americans 18 and older.

President Joe Biden speaks about the COVID-19 response and vaccination program at the White House in Washington on May 12, 2021. (Kevin Lamarque/Reuters)
President Biden speaks about the COVID-19 response and vaccination program on May 12. (Kevin Lamarque/Reuters)

Yet there’s also a flip side to all the good news. Even if 70 percent of U.S. adults are partially vaccinated by July 4, that would still leave 30 percent of them unvaccinated — and few are likely to change their minds anytime soon. According to a new Kaiser Family Foundation survey, just 8 percent of unvaccinated adults say they want a shot as soon as possible or that they plan to get one within the next three months. Meanwhile, no one under 12 will be eligible before September, and hesitancy is higher among parents of younger children than among adults.

In short, well over 40 percent of the total population — upwards of 140 million Americans, including children — will likely remain unvaccinated this summer. And there will be more unvaccinated people in some places than others.

When Fauci cautions against prematurely declaring victory and insists we “still have a ways to go,” that's what he means.

But what will America look like when the emergency ends and COVID is still circulating?

That question will define the next phase of the U.S. pandemic. The last statewide mask mandates will soon be gone. Business will be fully open. Life will largely return to normal. Yet certain communities will remain vulnerable to COVID, in large part because they have chosen to remain that way.

“Unfortunately these groups of people who are anti-vax or who will end up being susceptible to the disease are going to be in pockets,” Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security, recently told the Guardian. “It’s not going to be evenly distributed through the population.”

Nurses fill syringes with a COVID-19 vaccine at a mass vaccination site in Kansas City, Mo. in March. (Orlin Wagner/AP)
A mass vaccination site in Kansas City, Mo., in March. (Orlin Wagner/AP)

Which brings us back to Mesa County, Colo., and northern Missouri.

Nationally, the U.S. is averaging five new daily cases per every 100,000 residents. But two rural counties in northern Missouri — Livingston and Linn — were logging new daily cases at more than 25 times that rate before Memorial Day interrupted reporting. Over the last two weeks, COVID-19 cases have skyrocketed. More than 18 percent of tests are coming back positive (compared with 2 percent nationally). Hospitalizations are rising as well.

According to local authorities, the problem is threefold. Neither Linn nor Livingston was hit hard by previous waves of COVID, meaning that cases are now higher than ever and natural immunity is relatively low. Just 30 percent of the population, meanwhile, has been fully vaccinated — 11 points below the national average. And “everything’s wide open” in terms of restrictions, as one public-health official recently told the Missouri Independent.

“With graduation we had schools that took senior trips and had students all on buses together for four to six hours,” explained Linn County Health Administrator Krista Neblock. “The kids were developing symptoms and continuing with festivities. And they only got tested on a Monday, after they had gone around and infected a significant number of people.”

Long-standing resistance to masks coupled with evolving CDC guidance, added Sherry Weldon, Neblock’s counterpart in Livingston County, means almost no faces are being covered anymore.

“I just cringe,” she told the Independent, “when I see baseball games and basketball games in cities and nobody is wearing a mask.”

At the same time, Missouri’s daily vaccination rate has fallen to less than a quarter of its April peak.

A COVID-19 sign urging fans to wear their masks is threaded through a drink holder in the upper deck of Coors Field before the Colorado Rockies host the Cincinnati Reds in a baseball game late Thursday, May 13, 2021, in Denver. (David Zalubowski/AP)
A sign at Coors Field in Denver before a Colorado Rockies game on May 13. (David Zalubowski/AP)

“I would say the majority are 65 and older that we got a good response from, and we homed in on them and made sure it is available here,” Weldon said. But beyond that group, she added, even convincing health care workers to be vaccinated has been difficult.

Many communities across the country still fit the Linn/Livingston mold: relatively low immunity from prior exposure combined with relatively low vaccination rates. In a world without masks or social distancing, they remain at risk.

“When people say why [is this happening], my first comment or thought is, ‘You wouldn’t be having this problem if you had gotten a shot,’” Weldon said.

The situation in Mesa County, Colo., meanwhile, illustrates a slightly different threat. There, COVID-19 has surged before, and today’s average daily case count (33 per every 100,000 residents) is about one-quarter as high as November’s peak. But even that number is nearly seven times the current national average, and prior to Memorial Day, it had increased by 30 percent over the previous two weeks.

Why? It might have to do with a discovery local officials made in early May: that the highly contagious COVID-19 variant behind India’s deadly spring outbreak has now started to spread in Mesa County, which includes the city of Grand Junction.

As with all COVID variants, the approved vaccines offer near-perfect protection against B.1.617.2. But just 33 percent of Mesa County residents are fully vaccinated.

“Of those 20 [B.1.617.2 cases] that we know about, all but two were not vaccinated — and the two that were only had one of the two vaccinations,” Jeff Kuhr, executive director of Mesa County Public Health, told Colorado Public Radio on May 18.

“That really is the key here,” Denver physician and medical journalist Dr. Dave Hnida recently explained. “This is a more contagious strain. … If you do not get a vaccine, you are unprotected.”

A commuter receives a shot of the Johnson & Johnson vaccine for the coronavirus disease (COVID-19) during the opening of MTA's public vaccination program at a subway station in the Brooklyn borough of New York City on May 12, 2021. (Brendan McDermid/Reuters)
A commuter receives a shot of the Johnson & Johnson vaccine at a subway station in Brooklyn on May 12 as part of a public vaccination program. (Brendan McDermid/Reuters)

Across Colorado, the numbers tell a clear story about who’s getting sick and who isn’t. According to another CPR report published Tuesday, about 500 people remain hospitalized statewide with COVID-19 — and “almost all of them … are unvaccinated.” Likewise, CPR reported that “doctors in hospitals treating COVID-19 patients in the state can’t recall a single death of a vaccinated person.” And when the Colorado health department recently plotted both COVID-19 cases and hospitalizations against vaccinations, county by county, it found that “Denver area and mountain counties with higher vaccination rates [are] seeing fewer cases and hospitalizations” — while “more people are still getting sick and hospitalized due to the virus” in “counties like El Paso, Pueblo, Weld and Mesa [that] have recorded fewer vaccinations per capita.”

National numbers follow the same pattern. A recent analysis by the Washington Post, for instance, found that unvaccinated Americans are being hospitalized and dying with COVID-19 at significantly higher rates than Americans overall; in several states, the virus is spreading as fast among the unvaccinated as it did during the winter surge.

To be sure, the scale of the threat is much smaller than it was back then. Linn and Livingston counties are currently averaging roughly 20 new COVID cases per day; Mesa is averaging 50. These aren’t the sort of huge outbreaks that devastated, say, Los Angeles over the holidays. More than 165 million Americans have been vaccinated, including 86 percent of seniors (i.e., the people who are most likely to get seriously ill or die from COVID). The more people who have immunity, the harder it gets for the virus to find its next host; in effect, vaccinated Americans are protecting unvaccinated Americans from themselves.

That will continue to be the case. But who knows how much protection other people’s immunity will provide when new variants emerge, or when the weather drives less vaccinated communities indoors? Will new clusters like Linn and Livingston and Mesa crop up? Will sickness and death follow?

People wait for coronavirus disease (COVID-19) vaccinations, in Los Angeles, California on April 12, 2021. (Lucy Nicholson/Reuters)
People wait in line for COVID vaccinations in Los Angeles in April. (Lucy Nicholson/Reuters)

When it comes to COVID, each statistic — however small — represents another human life. Last week in Mesa County, a child died after testing positive for the B.1.617.2 variant — the county’s first pediatric COVID death to date. According to Mesa County Public Health, the child was hospitalized before her age group was eligible to receive the vaccine — and after contracting COVID from a family member.

Was that relative vaccinated? Would that child still be alive if they had been? What about the 500 other people nationwide who will have died of COVID today, and tomorrow, and the day after?

For most Americans, vaccinated and unvaccinated, normal life will resume in the weeks and months ahead, if it hasn’t already. The difference is that even though we now have the power to prevent nearly all sickness and death, unvaccinated Americans will be choosing to live with some degree of it.


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