President Joe Biden has set July 4 as his goal to see 70 percent of all adults in the United States with at least one dose of the COVID-19 vaccines. However, he is confronting a lagging vaccination rate that has been declining week to week since the peak in vaccinations in mid-April. In a plea to all unvaccinated people last month, he declared, “This is your choice. It’s life and death.”
On June 3, the seven-day average of reported vaccine doses administered fell below the threshold of one million doses per day. On June 2, only a half-million doses were given. There has been a 33 percent decline from the previous week.
With 2.05 billion doses of the vaccines thus far administered across the globe, almost 298 million doses (14.5 percent) have been given just in the US, a rate of 90 doses per 100 people. More than 368 million doses have been distributed throughout the country, indicating 70 million doses waiting for recipients.
In a sleight of hand, the more than 60 percent vaccinated figure being heavily promoted by the White House does not reflect the population as a whole but only those over 18 with at least one dose. In reality, 50.9 percent of the population has received at least one dose and only 41.2 percent have been fully vaccinated. Of those 18 years or older, 63 percent have received at least one dose and it is this figure that is being advertised. According to the White House’s calculations, another 20 million more adults need to be inoculated for Biden to reach his goal in the next month.
However, this is a meaningless figure in that the theoretical herd immunity threshold of 70 percent would require 70 percent of the population to be vaccinated and this does not account for the new strains of the more transmissible coronavirus that are quickly becoming dominant, which would raise this threshold. In reality, the herd immunity threshold remains unknown and scientists speculate it may be unattainable.
Breakthrough infections with the new variants such as the B.1.617.2 Delta variant may be considerable among individuals with only a single dose, according to recent studies on neutralization antibodies against variants. Though full vaccination is critical to prevent serious disease, breakthrough infections may be much higher with these newer variants. Recent reporting indicated new variants of interest have also been detected in Vietnam.
Also, those 18 years old and younger can very well become infected, become very ill and die, as well as transmit the contagion. The Centers for Disease Control and Prevention (CDC) reported Friday through their Morbidity and Mortality Weekly Report (MMWR) that there has been an increase in the rates of hospitalizations among teenagers in March and April. Dr. Rochelle Walensky remarked, “I am deeply concerned by numbers of hospitalized adolescents and saddened to see the number of adolescents who required treatment in intensive care units or mechanical ventilation.”
The Delta variant has been estimated to be 50 to 70 percent more transmissible than the B.1.1.7 Alpha variant. Individuals infected with the Delta variant also have a 2.7 times higher risk of needing hospitalization than those with the Alpha variant. While the Delta variant is now the dominant strain in India and the UK, genetic sequencing is demonstrating a sharp rise in this variant in the United States.
States across the US are now moving to incentivize unvaccinated residents to get vaccinated with prizes and giveaways. Governor Jim Justice, Republican from West Virginia, announced during a news conference on Tuesday that the state would run a lottery program from June 20 to August 4 that would include prizes of money, firearms and vehicles. On Father’s Day the state planned to give away five custom hunting rifles and five custom hunting shotguns, according to The Hill. Other prizes included custom outfitted trucks, lifetime hunting and fishing licenses and a $1 million lottery cash prize on June 20.
Anheuser-Busch, the giant brewing company, released a statement announcing the company “will unlock its biggest beer giveaway in history: when we reach the 70 percent milestone, America. Your next round will be on us!” CEO Michel Doukeris added, “At Anheuser-Busch, we are committed to supporting the safe and strong recovery of our nation and being able to be together again at the places with the people we have missed so much. This commitment includes encouraging Americans to get vaccinated, and we are excited to buy Americans 21+ a round of beer when we reach the White House goal.”
Other states engaging in these gimmicks include California, New Mexico and Ohio, who have started similar lottery drawings in the hopes of spurring the vaccination effort.
However, little effort has been taken to explain why these sharp declines have occurred, preferring to blame people based on political ideology. Rhetoric aside, this question was studied and reported on by the CDC in their May 28 MMWR release.
They sought to look at the patterns in COVID-19 vaccination coverage by social vulnerability and urbanicity. They found that disparities in county-level vaccination coverage by social vulnerabilities had increased despite expanding vaccine eligibility, especially in large fringe metropolitan and non-metropolitan counties. They wrote, “By May 1, 2021, vaccination coverage among adults was lower among those living in counties with lower socioeconomic status and with higher percentages of households with children, single parents, and persons with disabilities.”
States in the Deep South, with high rates of poverty, have barely given at least one dose to a third of their populations while those fully vaccinated are just reaching 30 percent. A significant section of the population in the poorest areas remains vulnerable as the vaccination initiative is reaching a ceiling.
Mississippi has fully vaccinated just 27.5 percent and vaccination rates have declined five percent from a week ago. Alabama, with 29.3 percent fully vaccinated, has seen a 73 percent drop in vaccinations from the week prior.
While North America and Europe, where the majority of the vaccines have been distributed, are seeing COVID-19 infection rates continue their steady declines, across Southeast Asia, the Eastern Mediterranean, Western Pacific and Africa, cases remain high or have remained precariously steady.
Cases are on the rise again across South Africa where four of nine provinces are facing a brutal third wave. The winter season in conjunction with an increase seen in travel and the loosening of restrictions is leading to concerns from the World Health Organization (WHO).
A WHO Africa statement released on June 3 noted, “African countries must urgently boost critical care capacity to prevent health facilities from being overwhelmed. This comes as vaccine shipments to the continent grind to a near halt… In the last two weeks, Africa recorded a 20 percent increase in cases compared with the previous fortnight. The pandemic is trending upwards in 14 countries and in the past week alone, eight countries witnessed an abrupt rise of over 30 percent in cases. South Africa is reporting a sustained increase in cases, while Uganda saw a 131 percent week-on-week rise last week, with infection clusters in schools, rising cases among health workers and isolation centers and intensive care units filling up. Angola and Namibia are also experiencing a resurgence in cases.”
The regional director for WHO Africa, Dr. Matshidiso Moeti, sounded the alarm. “The threat of a third wave in Africa is real and rising. Our priority is clear—it’s crucial that we swiftly get vaccines into arms of Africans at high risk of falling seriously ill and dying of COVID-19. While many countries outside Africa have now vaccinated their high-priority groups and are able to even consider vaccinating their children, African countries are unable to even follow up with second doses for high-risk groups.”
Less than two percent of Africa’s population has received a COVID-19 vaccine. Additionally, some of the vaccines that are arriving have waited so long to be shipped in storage that they have expired, necessitating they be destroyed.
After months of promising to send COVID-19 vaccine doses to the waiting world, just 80 million doses may eventually leave the US. In a hypocritical statement so commonplace with US leaders, President Joe Biden said, “The United States will be the world’s arsenal of vaccine in our shared fight against this virus. In the days to come, as we draw on the experiences of distributing the vaccine doses announced today, we will have more details to provide about how future doses will be shared.”