Health experts warn of hurdles in next phase of COVID-19 vaccination push

The next phase of coronavirus vaccine campaigns will require reaching Americans who have little access to the shots and those whose jobs make it difficult to take time off to get vaccinated, according to public health experts.

Half of the U.S. adult population is now vaccinated, but getting shots in the arms of the remaining adults is likely to prove much more difficult.

Vaccine distribution has remained uneven as some states struggle with vaccine hesitancy and obstacles like a lack of available local distributors, experts said.

Noel Brewer, a professor of health behavior at the University of North Carolina at Chapel Hill, said the country as a whole has made significant progress in vaccinations, while noting the U.S. still has a long way to go.

He said he’s not too worried about too many people refusing to get vaccinated but added that some have not been able to set aside the time to get the vaccine and recover due to life and job constraints.

“If you’re single and you’re working two jobs, there’s not a lot of time to go get a vaccine, let alone be sick for a day,” Brewer said.

He said he is concerned that instead of a single pandemic the U.S. has “thousands of local pandemics.” As a result, the national vaccination percentage or the vaccination rate in a faraway state like Vermont isn’t as influential to North Carolina as the number of vaccinations in the local community.

The states that have fully vaccinated the highest number of individuals are primarily located in the Northeast, Midwest and on the West Coast. States like Connecticut and Maine have advanced well past the national average, fully vaccinating more than 60 percent of adults. Several states in the South such as Arkansas and Mississippi have not yet surpassed 40 percent.

Abram Wagner, a research assistant professor of epidemiology at the University of Michigan, said vaccine hesitancy is somewhat contributing to states’ lower vaccination rates, but vaccine access remains a major issue.

He described how Michigan had mostly administered vaccines at large mass centers that were often quickly booked well ahead of time before vaccines became available at local pharmacies or grocery stores in the past few weeks.

“There’s a minority — I think a very small minority — who were very anti-vaccine, would never think about getting it. I still think that the majority of the people who are left, who have not been vaccinated, for a lot of them it’s an issue of convenience,” Wagner said.

Some key differences between New England states like New Hampshire and Southern states like Alabama, he said, include the states’ prioritization of pushing and advertising vaccines. The reluctance of many white Republicans and Black Americans to get the vaccine could be causing lower vaccination rates in states with higher numbers of those demographics, Wagner said.

Of the 26 states that have fully vaccinated more than 50 percent of their adult residents, 21 voted for President Biden in November.

Wagner said party identification plays a role in the divide, but the situation is more complex than Democrats getting vaccinated and Republicans not wanting the vaccine.

He said more congressional Republicans have either not gotten vaccinated or not publicly acknowledged they were vaccinated, unlike congressional Democrats who have been more public about their vaccinations. Former President Trump confirmed in March that he received the COVID-19 vaccine while in the White House but did not say so publicly at the time.

Wagner said this disparity intersects with the likelihood of state Republican leaders not promoting the vaccine compared with their Democratic counterparts in other states. Less publicizing by state leaders coupled with a higher proportion of Black Americans, who historically have shown more hesitancy to trust in vaccinations, could be causing lower rates in the South, he said.

Wagner added that incentives for vaccination could help improve rollouts, but direct communication from primary care physicians, whom Americans generally trust, could convince hesitant individuals to get vaccinated.

“That also ties into the convenience and the access issue because it’s basically telling people we have a vaccine for you,” he said. “You just need to come and get it.”