COVID-19 vaccines were hailed as miracles when they first appeared. These were delivered faster than anyone thought and proved to be highly effective in preventing hospitalization and death. More than 80 percent of all Americans and 90 percent of adults have received at least one dose of the vaccine, an impressive uptake in a country where less than half of people get a flu shot each year.
But so far this year, only 7% of adults have received doses of the new vaccine formulation that became available in September – compared to before 28 percent Those who have received an influenza vaccination.
This raises questions that would have been unthinkable three years ago. What happens if you create a miracle vaccine but no one wants it?
Since the first vaccination, public interest in subsequent COVID-19 vaccines has increased. steadily going down. Less than 70% of people in the United States have completed the first two-dose vaccination series. Less than 20% of the population received the bivalent booster vaccination last year.
Experts say public apathy about the latest COVID-19 vaccines is due to poor messaging from authorities, waning fear of a virus that was completely unknown three years ago, and the political nature of the pandemic itself. It is highly likely that this is a combination of polarization. But whatever the reason, vaccine ambiguity still poses a health threat.
Older people and young infants continue to be more likely to be hospitalized with COVID-19 than the rest of the population. The former group has lower vaccination rates and is most likely to die from infection, while the latter group did not have strong vaccination rates to begin with. 95 percent of children under the age of 4 are not vaccinated. Experts say about half of the elderly people recently hospitalized with COVID-19 have never been vaccinated, and those who are not vaccinated will continue to be hit harder by the virus. He declares.
Infectious disease experts say 2023 will be a pivotal year for the country’s transition from the pandemic. It will test whether the U.S. health system can prepare for a strong winter coronavirus, cold and flu season, especially through a successful vaccination campaign. The campaign’s disastrous start may pose a difficult question for the public health community: If Americans are no longer interested in getting vaccinated against the coronavirus, what should we do now?
Why Americans aren’t getting vaccinated against COVID-19
Part of the story is simply human nature. The novel coronavirus disease (Covid-19) emerged in 2020, exhibited unusual behavior (very many asymptomatic infections), and was deadly (the original virus was more virulent than influenza). was remarkable). Much of the economy shut down and people were confined to their homes. It has been a scary time, but vaccines have given us hope for the future, not only lowering our chances of getting seriously ill, but also being able to get back to normal life. When vaccines were distributed to hospitals, pharmacies, and immunization clinics in December 2020, Americans were eager to get vaccinated.
However, after three years and multiple new vaccine formulations, the novelty has worn off.
Americans are currently less worried about the coronavirus. About two-thirds of U.S. adults say they are not worried about getting seriously ill from the coronavirus. September survey by KFF Health Policy Think Tank. The numbers are about the same for influenza and respiratory syncytial virus, suggesting that Americans have come to view the new coronavirus as a health risk similar to other cold-weather illnesses that have been circulating for a long time. There is.
“People are no longer afraid of this virus.” paul offitdirector of the Vaccine Education Center at Children’s Hospital of Philadelphia, told me.
As proof, he described riding the subway with “100 screaming, maskless” football fans heading to an Eagles-Cowboys game. “No one in that subway car was wearing a mask,” he said. “We’re approaching winter, and this is theoretically a winter virus.”
Familiarity is part of a change in attitude. The other is political polarization. Republicans, both ordinary people and political leaders, have become increasingly hostile to coronavirus vaccines, and general skepticism about government mandates has spilled over into conspiracy theories and disinformation. (Mr. Offit marveled at this turn of events, calling these vaccines “the most amazing medical and scientific accomplishment” of his lifetime and “the greatest accomplishment of the Trump administration.”) Still. )
In a September KFF poll, only 25% of Republicans said they would get the latest version of the coronavirus vaccine this fall or winter. Additionally, 40% of participants said they had been vaccinated before but would not get a new shot, and 36% said they had never received a vaccine. By comparison, 45% of independents said they would get the new shot, and 69% of Democrats said they would. The reality doesn’t exactly match these reactions, but the gulf between Republicans and other parties shows that partisanship is driving vaccine attitudes.
“It’s become part of a person’s identity not to be someone who gets vaccinated, especially against COVID-19.” Dr. Celine Gounder, a senior research fellow at KFF and public health editor of KFF Health News. “It may spill over into vaccines, but it starts with coronavirus.”
There are worrying signs that vaccine skepticism is returning more commonly: 3 percent of U.S. schoolchildren report According to the CDC, next fiscal year will see the highest share of vaccine exemptions on record. Ten states have exemption rates above 5%. Three years ago, there were only two of us.
But while this increase is alarming, it’s clear that the coronavirus is a special case for Americans, as Gouder pointed out. Last season’s influenza vaccination rate This is consistent with pre-pandemic rates and lower than expected (57 percent for children and 46 percent for adults), but historically unremarkable. The CDC says this year’s flu vaccinations are progressing at the same pace as last year.
People were already accustomed to annual flu vaccination campaigns before the pandemic, and most seem to be sticking to old habits. So why do so many people seem so resistant to the public health community’s pleas to get vaccinated against COVID-19 at the same time?
Another factor may be that Americans have experienced public health emergencies for years and have become accustomed to such public health messages.
In part, the vaccine is a victim of its own success. Initial clinical trials reported surprising results, not only in blocking serious disease (a major public health goal), but in blocking all disease itself. Terrible headlines may have given people hope that they won’t get sick at all, and the public health message is that while they may still feel unwell, they are much less likely to end up in the hospital. I couldn’t break through the reality check. — and that should be considered a win. When reality fell short of expectations, seeds of doubt and mistrust were sown.
When it comes to subsequent vaccinations, Gounder said public health messaging that generally encourages everyone to get a second COVID-19 vaccination could itself be part of the problem. . People now know more about the virus. That means many people have a general idea of how it works. For example, they may know that age and chronic health conditions are the best indicators of risk of serious illness or death from infection.
Other countries, such as the UK, have targeted people over 65, people with increased health risks, and people who live with or care for people at risk.
The United States has made the wrong decision in the past to simplify vaccine messaging and recommendations. Additional vaccinations are recommended for everyone over 6 months of age. Experts acknowledge that the strategy is controversial. But as COVID-19 becomes more commonplace and better understood, there may be better arguments for a more nuanced approach.
At this point, people are experiencing their own infections and may have first-hand experience with COVID-19. The first vaccination campaign was critical because people had no immunity to COVID-19. The people were naive. But he said three years later, public health realities have changed. Most people have had a vaccination, an infection, or both.
That’s why official vaccine guidelines have changed little, and the messages sent by public health officials that don’t acknowledge the different risks or that people have some degree of immunity can be ignored. There is a possibility that it will be done.
“I can understand some of the skepticism,” Gounder said. “Telling everyone you’re in danger and you should hit now doesn’t match the reality you’re living in.”
What does the future hold for coronavirus vaccines?
There are short-term steps the United States can take to accelerate uptake of COVID-19 vaccines, especially for the most vulnerable populations. Example of additional funding for nursing homes to hold vaccination campaigns: only 17% of nursing home residents It’s the latest About their shots. Experts also stressed the importance of telling people that very young people can become seriously ill from COVID-19. Even if death does not occur, health complications can be serious. Gounder said he would like to see the message start to focus more on pregnant women, who may pass on some immunity to their unborn babies.
But with just 10% of the U.S. population expressing urgency about getting the COVID-19 vaccine, bigger questions arise. How do we continue to do this?
pfizer Said The company said it expects about 1 in 4 Americans to receive the latest vaccination in September. There is still time, but current vaccination rates are well short of that goal. How the commercial drug manufacturers producing these vaccines will respond to market feedback is an open question.
Gouder said it’s hard to imagine stopping coronavirus vaccinations completely. The public health case for vaccination, especially among older adults, is strong. But drug companies could cut back on production, especially if government recommendations become more targeted.
The federal government is spend a lot of money Pharmaceutical companies are pursuing a universal coronavirus vaccine, but until their efforts bear fruit (if you ever do that), interest in producing new formulations of vaccines may also be waning, as uptake of new vaccines this season has been very low.
The known unknowns of the future that could stimulate new investment and interest in COVID-19 vaccines are biological. As the virus has evolved and will continue to evolve, it could theoretically reach a point where current vaccines are no longer effective.
Another question mark is within us. The reason many people are still protected from severe disease is because our body’s T cells are familiar with viruses and can activate when they detect them. It may not be possible to completely stop infection (this is what antibodies do, and they disappear more quickly), but it can eradicate the virus before people become seriously ill.
What we currently don’t know is how long T-cell memory lasts and how durable that immunity actually is. The only way to know is for more time to pass.
