In just two months, the United States could be swimming in the COVID-19 vaccine. Literally swimming. The 500 million doses of 0.5 or 0.3 milliliters expected to be shipped so far are enough to fill a 55,000-gallon pool.
As hard as it may be to imagine now, as people frantically call, click and queue to be vaccinated, the nation is close to changing from a situation of scarcity to one of abundance.
“It’s not a switch that changes, but it’s a sliding scale that happens differently from community to community,” said Andy Slavitt, senior consultant at the White House to the COVID Response Team. “This is not something that is going to start on some magical day in the future. It started today and it is something that we have to make sure that we are dealing with. “
With an abundant supply of vaccines, there will be more urgency to convince the reluctant to accept them, experts say. Otherwise, the abundance of vaccines will become a stagnant surplus that threatens to undermine the country’s ability to overcome the pandemic.
“When we start to have more vaccine available, we will really be in a very bad state because what we will see is a lot of people who do not want to be vaccinated,” said Bernadette Boden-Albala, dean of the public health program at the University of California, Irvine.
So far, about 18% of all Americans have been immunized against COVID-19. Boden-Albala believes that there will be surplus vaccines in some areas as early as April.
Then, the challenges will begin.
“If we have entire states in this country that do not want to be masked and do not want to distance themselves socially, then I am very concerned that we will have people there who also do not want to be vaccinated.” she said.
Spreading the message: free vaccine
The messages are important, experts say.
The easiest group to reach will be the one that simply postponed due to the difficulty of making an appointment.
For them, the message needs to be that immunization is fast, easy and free, said Christopher Morse, a specialist in health communication at Bryant University in Smithfield, Rhode Island.
“You want to tell them that it’s free and how easy it is to get an appointment,” he said. “Something like, ‘In the time it takes to order a cup of coffee, you can be vaccinated against COVID-19.'”
The message should not be “we have tons of vaccine”, because then people will be convinced that they can postpone it longer, he said.
Some people who have not been vaccinated simply did not have the time or felt rushed to do so. Messages will be needed about what it’s worth, experts say.
“You can say, ‘Get vaccinated, spend Easter with your family,’ or a church can encourage people to get fully vaccinated so they can sing together,” said Dr. Kelly Moore, deputy director of the nonprofit. Immunization Action Coalition.
Younger people who do not necessarily feel at risk can be convinced to get vaccinated to help other people. But they can be more attracted so they can go to the movies again, have dinner with friends or go out in bars.
“They will focus more on social impact than health impacts,” said Morse.
Mobile clinics, instant vaccination sites and public service announcements from local leaders will be important to reach those in low-income communities of color where vaccine adoption has been delayed due to access and hesitation.
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These efforts started in some places, but are expected to increase significantly as a larger percentage of the population is immunized and the extent of reluctance to the vaccine becomes clear, experts say.
In California, Orange County is sending vaccination teams of eight to homeless camps, prisons and other hard-to-reach populations.
“They come in a van, without the need for an appointment,” and vaccinate those who are available, said Margaret Bredehoft, the agency’s deputy director of public health services.
Dr. Rebecca Weintraub, director of the Global Health Delivery Project at Harvard University, says that these “last mile” delivery channels need to be prepared now to reach vulnerable communities.
“We are going to see the availability of vaccination, for example, in food banks,” she said.
Defining these minor vaccination events requires a lot of precision, said Moore.
“You want to make sure you have enough people together when you open one of the vaccine bottles,” she said. “For the Pfizer vaccine, you have six hours to give five doses. For Johnson & Johnson, it’s five doses and for Moderna, it’s 10. You don’t want the doses to be missed when only two people show up.”
Vaccine hesitation policy
Public health officials are spurred on by an apparent change: hesitation about vaccination among black Americans, which started high, appears to be easing. In December, only 42% said they planned to get vaccinated. That number is now 61%, according to a survey by the Pew Research Center released on Friday.
The general hesitation of the vaccine is also falling. In September, 49% of Americans told the research group Pew that they would probably or definitely not get the vaccine. Last month, that number had dropped to 30%.
But that still leaves 75 million people who may not be taking the doses already purchased by the U.S. government for use. Experts say at least 65% of people, and probably close to 85%, must be vaccinated to achieve collective immunity.
And there are significant party differences in terms of who wants a vaccine. Pew found that 83% of Democrats said they had been vaccinated or planned to be vaccinated, compared to just 56% of Republicans.
“We are going to get to a point where there is a real polarization where people are being vaccinated and not,” said Dr. Corey Casper, CEO of the Infectious Disease Research Institute in Seattle and professor of global health at the University of Washington.
Although areas with high rates of vaccination have few infections, communities with lower rates may continue to see cases. “They will see a huge use of resources in these areas. It will affect their economies,” he said.
He expected COVID-19 to be the nation’s common enemy, but it was not so. The extreme distrust of anything in the government by people on the right surprised him. “I’ve never seen anything like it,” he said.
“We are making progress with other groups, but we have not seen the button turn much among white Republicans. That is a concern,” said Thomas Bollyky, director of the global health program at the Council on Foreign Relations in Washington, DC, think tank.
Will employers require vaccination?
It seems unlikely that Americans will be forced to take a chance. The employer’s mandates for vaccinations would be complicated, said Michelle Mello, a professor of law and a specialist in legal health at Stanford University.
From a regulatory point of view, it would be difficult to enforce because so far all three vaccines used in the United States have been authorized for emergency use by the Food and Drug Administration, not a license, said Mello.
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There is also no solid data to show that vaccination makes it less likely that someone will be able to transmit COVID-19.
“Once this exists, it would allow employers to say that it is an intervention that prevents harm to others,” said Mello. But for now, she thinks most employers will accept incentives instead of mandates.
“Everyone sees the benefit of making it a volunteer,” she said, although employers may think about sweetening the pot. “If any percentage of your employees will feel like rubbish after the doses, maybe you will give them the next day off.”
What would the US do with the extra vaccine?
If the US ends up with a surplus of vaccines, what will it do with it?
Bollyky, of the Council on Foreign Relations, said there may be an appetite to help the rest of the world.
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“You may start to see, at some point this summer, a willingness to donate some, though not necessarily, all vaccines,” he said.
There are two reasons for this: one based on health and one based on politics.
Diseases do not respect borders. If COVID-19 continues to rage elsewhere, the United States will remain at risk. Almost all high-income countries – 94% – have started vaccinating residents. Only four of the 29 lowest-income countries have done so, according to the Council.
While the United States retained its vaccine for its residents, Russia and China entered the breach, making doses available to other nations.
“There are reports that the Biden administration is considering starting to donate more vaccines in Asia to counteract the potential influence that China can gain from donating doses,” said Bollyky.
Helping other nations will not only score political points, but will also help protect Americans from a cunning enemy we are still discovering, said Moore of the Immunization Action Coalition.
“The virus will exploit its advantages if we let our guard down or allow many around the world to go without the protection of vaccination,” she said.
Contact Elizabeth Weise at [email protected]
This article was originally published in USA TODAY: The COVID-19 vaccine, now scarce, may be in excess in the US in April