The United States is roughly on track to meet President Joe Biden’s goal of getting at least one COVID-19 shot into the arms of 70% of adults by July 4 — if the current vaccination pace holds. But demand for vaccines has decreased in much of the country in recent weeks, and the promising national numbers (about 63% of adults have received at least one shot) do not reflect the uneven rates among states.
Even if the country as a whole reaches the national target, at least 30 states probably will not. And a handful are unlikely to reach the 70% mark before the end of the year, a New York Times analysis shows, potentially prolonging the pandemic.
“You reach a certain rate nationally, which looks excellent and would really suggest that you are in a place to reduce the likelihood of infectious spread, but that can be misleading,” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which represents state health agencies.
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“You still have these significant pockets and states where the rates of immunity are much lower,” he added. “So we could have another wave pop up.”
In many states in the Deep South and Mountain West, vaccinations have leveled off both because of limited access and shot hesitancy. Fewer than half of all adults have received at least one shot in Alabama, Louisiana, Mississippi and Wyoming, and projections show that the rate is unlikely to reach much higher than 50% by early July.
Public health experts and officials in states with lower vaccination rates say the president’s bench mark will help reduce cases and deaths but is somewhat arbitrary — even if 70% of adults are vaccinated, the virus and its more contagious variants can spread among those who are not.
But they are still concerned that their residents are more susceptible to infection as restrictions ease across the country, the sense of urgency to get vaccinated declines and many Americans in warmer climates avoid the heat by heading indoors, where the virus spreads more efficiently.
“We’ve got a significant percentage of Louisiana that has initiated, but it’s not herd immunity,” Dr. Joseph Kanter, the top health official in Louisiana, said in mid-May. “It’s nowhere close to it.”
“It’s not insignificant, but it’s not herd immunity,” he added. “So we’re very cognizant of that, and we feel great urgency with the vaccine campaign.”
Even statewide figures that appear promising can gloss over local problem areas, Kanter said. In Louisiana, less than 20% of people in some parishes have received a first dose.
State vaccination rates during previous U.S. vaccination campaigns show some similar patterns.
For example, much of the South had lower vaccination rates than the rest of the country during the H1N1 pandemic in 2009 and 2010, and in the flu season just before the COVID-19 pandemic.
Experts point to persistent challenges in this region of the country, including lower than average access to health care, especially in rural areas, and higher rates of vaccine hesitancy. Politics may also play a role.
“You’re also looking at states that relaxed mandates faster,” said Dr. Jodie L. Guest, an epidemiologist at Emory University. “Leadership matters. If you set the tone that this isn’t serious, it’s hard to convince people that it is.”
Officials in lagging states say they are hopeful that they can continue to vaccinate more people, but caution that it may take months to make inoculations more convenient and to persuade those who are unwilling to get a shot.
To bolster the nation’s progress, the White House has announced an incentive to give parents and caregivers free child care while they get vaccinated.
“I think the question is whether we’re getting to a place where we’ve just leveled out, and we’re just not going to get that many more people,” Plescia said, “or whether in a lot of these states it will take longer for people to get vaccinated, and we will continue to make progress, but it will be slow progress.”
“I just don’t know how that will play out,” he added.
This article originally appeared in The New York Times.
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