Saturday, March 27, 2021

Will We Struggle to Reach Herd Immunity? (NY Times)

NY Times: Close to 100% of St. Johns County, Florida senior citizens are vaccinated.  Good work. (Figure might be inflated due to snowbird inoculations).  

We're blessed that between state, county and Publix and CVS, we're all doing our part to end the pandemic.  

In addition to the impressive 100% senior vaccination rate statistic on St. Johns County senior citizen vaccinations,  the rest of Nathaniel Lash's NY Times column, is cause for pause.  Slow vaccine rollouts elsewhere make "herd immunity" tougher to obtain.   

What can other places learn from us?

After a stinky initial State Health Department rollout, St. Johns County took over suzerainty.  Good move. 

DoH's maladroit management -- "first come, first-served," resulting in long nocturnal lines of seniors idling in their cars, waiting overnight for a vaccine.

Once I became eligible for the vaccine, as age limit lowered, I was impressed with the friendly, well-organized vaccination site located at the Solomon Calhoun Community Center.    

I was happy to see SCCC selected.  It is in West Augustine  a traditionally underservered and underrepresented part of St. Johns County ill-served by County government.  (It is near the Old City Reservoir, where the City of St. Augustine dumped a landfill in a lake. Sheriff DAVID SHOAR's environmental crimes unit refused to take action.  The State fined but did not prosecute. The pollution was ordered by SHOAR's former boss, City Manage WILLIAM BARRY HARRISS, who followed SHOAR to the St. Johns County Sheriff's Office to run his dodgy 501c3.) 

St. Johns County Commissioners held frequent discussions on the COVID crisis.  

One of them, Paul Waldron, is now in a wheelchair and nearly died of COVID.

Two of them are lawyers -- Chairman Jeremiah Ray Blocker and Vice Chairman I. Henry Dean, longtime Florida environmental policy expert, one of the finest civil servants I have ever known.

In sharp and marked contrast to Governor DeSantis, St. Johns County showed mature leadership.  

But four Commissioners kowtowed to low-information anti-maskers.   Commissioner Henry Dean never got a vote on his mask mandate motion.  

The initial vaccine rollout here and elsewhere was based on affluence or influence.  We shall always remmber the long lines of cars with seniors waiting in the middle of the night. No bathrooms.  

Finally, amidst a crisis, St. Johns County showed a welcoming spirit, with health, fire-rescue, law enforcement and other local and state government workers efficiently vaccinating people.  

They've proven that government can and will work for us, and not the other way around.   Like our successful county-run amphitheater, they rebut the radical Republican rants against government, emanating from the likes of Governor RONALD DION DeSANTIS (R-KOCH INDUSTRIES).

Historians need to document the successful rollout of the vaccine here.  What they learn can help save lives. 

From The New York Times:



Will We Struggle to Reach Herd Immunity?

Illustration by Brian Stauffer

Here’s the good news: You should soon be eligible for a Covid-19 vaccine (if you aren’t already), after President Biden’s recent announcement that every adult in America should be eligible for vaccination by May. Many states are moving even faster.

Which brings us to the less-good news: Being eligible for a vaccine and getting vaccinated are two very different things. While it feels as if the course of America’s vaccine effort is about to turn a corner, vaccinating the nation is a process that will take months, even after everyone is eligible.

To understand how the next phase of the vaccination effort will play out, we can look at the vaccine rollouts in Idaho, Florida and other states to see who has been vaccinated, how quickly and why. They show why we are headed for an America marked by pockets of herd immunity (oases) and swaths of the country with low rates of vaccination (deserts).

It is taking much longer to vaccinate poorer Americans than the wealthy.

Wealthier counties have higher vaccination rates in Florida

St. Johns County*

100%

vaccinated

TRENDLINE

90

Miami-Dade

County

80

70

60

50

Putnam County

40

40k

45k

50k

55k

60k

65k

70k

75k

$35k

Median household income

*Percentage vaccinated shows the number of people vaccinated in the county compared with the population estimate, and can therefore exceed 100 percent in certain circumstances.·Source: Florida Department of Health, Census Bureau’s American Community Survey 2015-19

Within states and among equally eligible people, the richest areas are getting vaccines faster. This suggests that even if all poorer Americans seek out the vaccines, it will take a long time to vaccinate them at our current rates.

Consider a slice of Florida’s seniors, ages 65 to 74, who have been eligible for vaccination for four months.

Almost all seniors in the state’s wealthiest county, St. Johns, have been vaccinated. (The numbers may be inflated because of seasonal residents, or snowbirds, who aren’t necessarily counted as part of the county’s population but are still counted among people getting vaccinated there.) But the first county west of St. Johns is one of the state’s poorest: Putnam, where the median annual income is about $35,000. Only half of the county’s residents ages 65 to 74 have been vaccinated.

The pattern is echoed throughout Florida, with wealthier counties achieving much higher vaccination rates than lower-income counties.

The reasons are myriad: The state’s rollout has been deeply reliant on tech savviness and reliable transportation to secure and then get to vaccination appointments, said Dr. Frederick Anderson, who runs a community health clinic at Florida International University’s medical school. Additionally, some of the current vaccines are difficult to store and transport, which makes vaccine rollout easier in population hubs, which tend to be wealthier.

While comparable data doesn’t exist in every state, it’s a worrying sign ahead of a national rollout. If vaccination rates resemble Florida’s uptake among seniors in poor neighborhoods, the country will struggle to reach herd immunity.

When eligibility is expanded in other states, vaccinations are expected to surge among the wealthiest Americans and lag among the poorest. At the rates that Florida’s poorer counties are vaccinating people ages 65 to 74, it will take months for the rest of the state’s seniors to catch up with higher-income Floridians.

Some counties are months behind in efforts to vaccinate seniors

Florida’s largest county, Miami-Dade, should finish vaccinating its seniors next month at its current rate of vaccination. But Putnam County would take months more to finish at its current rate.

Share vaccinated

100%

St. Johns County has

reached 100% of

its seniors

At the current pace, Miami-Dade County would finish by mid-April

80

60

Florida

Putnam County

would finish by

mid-June

40

20

0

Jan. 24

31

Feb. 7

14

21

28

March 7

14

21

Note: Data reported as of March 24 for individuals with at least one dose, ages 65 to 74, by county of residence. Dates reflect when each vaccination was reported.·Source: Florida Department of Health, Census Bureau’s American Community Survey 2015-19

“These huge disparities will persist, but we’re hoping that they’ll start to go down with these community engagement efforts,” Dr. Anderson said. “These disparities are hundreds of years in the making. We’re not going to reverse them overnight.”

Progress has already stalled in some parts of the country.

Despite the uneven rollout in Florida, people are still seeking out the vaccines at a steady rate. That’s not the case in Idaho, where many parts of the state have settled at distressingly low vaccination rates. State officials have had to expand eligibility at an accelerated pace because of low uptake in wide swaths of Idaho.

“The rural counties are lagging slightly behind what we would expect,” said Dave Jeppesen, the director of Idaho’s health department, in a news conference Wednesday.

Data published by Idaho reveals how the current vaccination efforts are reaching a plateau in poorer parts of the state. The poorest 25 percent of ZIP codes in the state are seeing vaccination rates stalling below 70 percent for people ages 65 to 74.

Vaccine uptake for seniors in poorer Idaho ZIP codes is stalling

Share vaccinated

100%

90

Highest-income

ZIP codes

80

70

60

Lowest-income

ZIP codes

50

40

30

20

10

Jan. 24

31

Feb. 7

14

21

28

March 7

14

21

Note: Data reported as of March 22 for individuals with at least one dose, ages 65 to 74, in the 25 percent of Idaho ZIP codes with the highest median income and the 25 percent of Idaho ZIP codes with the lowest.·Source: Idaho Department of Health and Welfare, Census Bureau’s American Community Survey 2015-19

Nationally, many conservatives — men in particular — have said in multiple polls that they do not wish to be vaccinated. In some of Idaho’s more conservative counties, senior vaccination rates are below 40 percent.

Idaho seniors in deep-red counties see slower vaccine uptake

Blaine County, home of the popular Sun Valley ski resort, is one of the state's few left-leaning counties. It has seen more vaccines administered to seniors than there are seniors reported as living there permanently.

Share vaccinated

Blaine County*

100%

Ada County

90

Fewer seniors are vaccinated where Trump’s support was greater

80

TRENDLINE

70

60

50

Idaho

County

40

Supported Biden

Supported Trump

30

20

20

30

40

50

60

70

+10 Biden

+10 Trump

2020 presidential election results

*Percentage vaccinated shows the number of people vaccinated in the county compared with the population estimate, and can therefore exceed 100 percent in certain circumstances. Note: Data reported as of March 24 for individuals with at least one dose, ages 65 to 74, by county where the vaccines were administered.·Source: Idaho Department of Health and Welfare, New York Times election results database

Some states still have a long way to go.

States will be in radically different places when they open vaccinations to all adults, in part because of differences in eligibility requirements thus far, such as whether they prioritized certain groups of essential workers alongside older residents. Their progress points to where vaccine oases and deserts may soon emerge.

Vaccine deserts more likely in states that are falling behind

40

% of non-seniors (18-64) vaccinated

Average for 65+

AK

NM

35

More likely to see

vaccine oases

30

NJ

HI

SD

ND

OK

KY

CT

NY

MA

IL

PA

MD

CA

NE

25

RI

MT

Average for 18-64-year-olds

VA

UT

WV

IA

MN

WA

AZ

NV

NC

WI

KS

CO

WY

ME

LA

OH

AR

VT

TX

MI

MO

NH

DC

ID

20

DE

OR

MS

IN

TN

SC

AL

GA

FL

More likely to see

vaccine deserts

15

50%

55

60

65

70

75

80

85

Share of senior population vaccinated

Note: Data reported as of March 24.·Source: Centers for Disease Control and Prevention

Logistical hurdles and missteps could drive slower vaccination campaigns. But states may also be falling behind because of high levels of vaccine hesitancy.

If that's the case, it will take more than just opening up eligibility to get the country to levels of vaccination that can reach herd immunity — when roughly 70 percent of people are vaccinated, making it too difficult for the virus to spread.

Counterintuitively, the states that are moving fastest to expand eligibility are more likely to have a harder time reaching that level.

In those states, the data shows that vaccine uptake is not reaching herd immunity levels in certain areas. If that trend continues as vaccine eligibility expands, we can expect to see more vaccine deserts and oases over the coming months.

 

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