Biden seeks to combat vaccine hesitancy, slowing rollout

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Medical assistant Sarah Vaeth was fired last week from her job in a pediatrician’s office in Stevensville, Maryland, because she refused to get vaccinated against COVID-19, saying the shots are experimental and unsafe.

Her previous job at an urgent care office, where she worked during the COVID-19 pandemic and rollout of the vaccines, also set a September deadline for employees to get vaccinated or else lose their jobs.

“I truly believe that what they are putting in the vaccine is bogus,” said Mrs. Vaeth, 30, a mother of three. “Being on the front line I’ve seen patients come in with the side effects of the vaccine, and that outweighs for me” the risk of catching the disease.

The risk of side effects and the “newness” of the vaccine are the top reasons people provide, at 53% each, for not getting COVID-19 vaccines that are free and plentiful in the U.S., according to a recent poll from the Kaiser Family Foundation (KFF), a nonprofit health-policy group that tracks the issue.

Other often-cited reasons include “just not wanting” the vaccine (43%), not trusting the government (38%) or believing they don’t need the shots (38%).

The speedy development of a vaccine was a scientific marvel under the Trump administration, while President Biden is taking credit for getting eight in 10 seniors and nearly half the U.S. population fully vaccinated. 

Those efforts greatly reduced U.S. hospitalizations and deaths from the virus but appear to be hitting a wall, with last week’s rolling average dipping to less than 600,000 doses administered per day compared to 3.3 million at the rollout’s peak in mid-April.

Less than half of the U.S. population — roughly 48% — is fully vaccinated, or far short of the 70%-90% that experts say is the level needed to wrangle the pathogen and stiff-arm devastating variants.

The sputtering rollout is raising debates about what, if anything, the government can or should do to convince holdouts to take the shots, which are voluntary but considered the best way out of the pandemic.

The Biden administration is enlisting trusted voices — doctors, pastors and community advocates — to try to change minds, though the reasons behind hesitancy range widely and are deeply entrenched, giving the White House and state allies few options but to back unpopular mandates or beg.

Rural residents tend to be less eager because they feel less threatened by the virus that ripped through denser-populated parts of the country, while some minority populations distrust the health system due to years of “medicine breaking its promise” — from the Tuskegee syphilis study that mistreated Black men to the case of Henrietta Lacks, a Black woman whose cancer cells were used to create a cell line for medical research without her knowledge or consent.

Some people think hospitals are trying to help themselves, pushing vaccination after they were inundated with patient admissions, said Dr. Panagis Galiatsatos, an assistant professor at Johns Hopkins School of Medicine in Baltimore,

“For others, it’s still not knowing enough — how did we get it done in such a quick time?” he said.

COVID-19 vaccines were developed in record time under former President Trump and his “Operation Warp Speed,” which oversaw the development and regulatory approval in less than a year despite experts who said it would take longer. Somewhat paradoxically, MAGA-land is falling behind in the vaccine push.

A KFF analysis found relatively similar uptake in April between counties that voted for Mr. Biden versus those who backed Mr. Trump, but the gap has widened notably. Roughly 47% of residents in pro-Biden counties are vaccinated versus 35% in pro-Trump ones.

Michael Bars, who served as a senior communications adviser in the Trump White House, said people should remember that the COVID-19 vaccines were subjected to the same scientific process as so many other common vaccines.

“Inevitably, some will be more comfortable than others as safeguards are relaxed, but thanks to President Trump’s Operation Warp Speed, achieving a safe and effective vaccine faster than ever before didn’t mean cutting corners,” he told The Washington Times.

Mr. Trump on Sunday issued a statement demanding credit for vaccine development and highlighting its global benefit, though it did not address hesitancy.

“While we get no credit for this from the Fake News Media, the people know — that’s why I got 75 million votes!” Mr. Trump said.

Experts say red-state resistance shows overlap with rural resistance and general distrust of government, or the belief that the COVID-19 threat was overblown.

Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine said the dynamic is “ridiculous” when you consider that luminaries up and down the conservative landscape — from Mr. Trump and his family to Fox News magnate Rupert Murdoch, Senate Majority Leader Mitch McConnell, Texas Gov. Greg Abbott and former New Jersey Gov. Chris Christie — have rolled up their sleeves.

“They’re all vaccinated,” he said.

Some holdouts say they’ve gotten the virus and don’t need the vaccine, due to natural immunity.

A Cleveland Clinic study from June showed previously infected persons might not benefit from vaccination, though dangerous variants of the virus are raising concerns about how durable infection-induced antibodies will be.

A study in Nature found antibodies in recovered COVID-19 patients were four times less potent against the delta variant, first detected in India, than the “alpha” variant that made headlines in Britain and swept the U.S.

Previously infected persons benefited from getting one dose of a COVID-19 vaccine in the study, which was released Thursday, while persons who hadn’t been exposed to the virus received robust protection against delta from two doses of the Pfizer of AstraZeneca vaccines but little protection from a single dose.

Mrs. Vaeth, who previously had COVID-19, said she doesn’t believe she needs the shot.

“If I had the antibodies, there’s no reason to get a double antibody with the vaccine,” she said.

More broadly, she said she’s seen patients with medical issues after getting vaccinated, including shingles, heart conditions and blood clots.

“We’ve seen all of it that they say on the news but sugarcoat it,” she said. “I think that the side effects are far more severe than COVID.”

Part of the debate around vaccination pivots on personal choice versus community obligation. 

Biden-administration officials have argued that vaccination is a “patriotic duty” that extends beyond a personal choice on whether to be protected or not, since it is a communicable disease and children or the immunocompromised cannot get the vaccines. 

Wider transmission of the virus also raises the likelihood of breakthrough infections in vaccinated persons — the shots are very effective, but not perfect.

Mr. Biden says the exports of vaccines to other countries is a form of national defense since it will fight possible mutations that can boomerang back on the U.S. Experts say it should be a catalyst for vaccination at home, too.

“It’s not just a protection for you. You are helping deprive the virus of its main biological purpose for living: to replicate and make more of itself,” Dr. Galiatsatos said. 

“By being vaccinated, you stop it from spreading and, thereby, helping end its existence overall. And this in turn will stop mutations, too,” he said.

The best-performing states such as Vermont and Massachusetts have gotten over 60% of their populations vaccinated while at least six in 10 people remain unvaccinated in over a dozen states across the South, Midwest and West. As a result, the nation far from the 70%-90% vaccination level.

Governors are offering cash incentives and prizes to try and boost their vaccination numbers, though West Virginia Gov. Jim Justice said it is still difficult to get young adults to get vaccinated. 

He also said conservatives are reluctant.

“You know, the red states probably have a lot of people that, you know, are very, very conservative in their thinking. And they think, ‘Well, I don’t have to do that.’ But they’re not thinking right,” Mr. Justice, a Republican, recently told ABC News. “We have a lottery, you know, that basically says, ‘If you’re vaccinated, we’re going to give you stuff.’ Well, you’ve got another lottery going on. And it’s the death lottery.”

Some public-health analysts say it’s time to get tough instead of relying on free beer, lotteries and other incentives.

“I don’t think it’s working and I think the solution is going to get the vaccines licensed and start mandating: Military, certain occupations, first responders, health care workers, require it for college, maybe requiring it for public-facing jobs,” Mr. Caplan said. “We’ve got to shift. We’re fooling around while these variants pop up.”

Biden officials have left it up to private entities to draft their own rules but avoided government mandates, saying it is up to individuals to come forward and they will enlist trusted voices.

A recently announced “door-to-door” effort to promote the vaccines, however, ran into opposition from GOP governors like South Carolina’s Henry McMaster, who ordered state health officials to reject doorstep pressure.

That resistance, though, sparked a rebuke from White House Press Secretary Jen Psaki, who said Friday that the canvassers will be community partners and ignorance around vaccines “is literally killing people.”

Joshua Ratner, executive vice president and chief strategy officer at the Westchester Medical Center Health Network, said working with trusted local organizations at their mobile vaccine clinics has helped them as they target zip codes with low vaccination rates in the southern counties of upstate New York.

“Simply being able to talk to someone, especially if that someone looks like them and comes from their community — it helps,” Mr. Ratner said.

He said they are slowly moving the needle, though expectations must be set differently than before.

“You’re not looking for a pop-up clinic where you vaccinate hundreds of people, you’re looking for opportunities for tens of people,” he said. “The longer we’ve been vaccinating the public and the more time goes by and they realize there are very few side effects or complications, the more folks are jumping in.”

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