Barriers make America short of vaccinations

From the country with the top vaccination rate in the world, the US has now dropped to 57th place globally when faced with vaccine hesitancy and partisan divides.

Five months ago, the US outpaced most countries in the world, excluding Israel, in the speed of Covid-19 vaccination, with nearly 20% of the population fully vaccinated. Meanwhile, Hungary, which is considered to have a successful vaccination campaign in Europe, has only vaccinated 1/10 of the population as of April 6. Vaccination rates in most European countries then stopped at single digits.

The rapid deployment speed and abundant vaccine resources are considered two factors that helped the US achieve initial success in the vaccination campaign. However, Washington failed to maintain this record over the summer, when countries in Western Europe and Scandinavia gradually overtook the US.

Portugal is the European country with impressive acceleration in the race, with almost 80% of the population fully vaccinated. Spain and Belgium reached more than 70%. France, Germany, Great Britain, the Netherlands and Norway are now all above 60%.

America’s share is currently quite modest among the rich, with 53.9% of the population fully vaccinated. The United States ranks 57th in the world in the percentage of the population vaccinated, according to Bloomberg. Only a few Western European countries, including Switzerland, are now behind the US.

President Joe Biden last week announced a new strategy with 6 spearheads to respond to Covid-19, including mandatory vaccination. However, experts say the new plan is “in the right direction but not enough” to speed up vaccination in the US.

“We took the lead and then fell behind,” said Céline Gounder, an infectious disease epidemiologist. “We quickly immunized the half of the population that wanted to get vaccinated, but then hit a roadblock.”

A Covid-19 vaccination site in Martinsburg, West Virginia on March 11.  Photo: Reuters.

A Covid-19 vaccination site in Martinsburg, West Virginia on March 11. Photo: Reuters.

Israel’s vaccination campaign is also now stalled after initial successes. Vaccine coverage in the country has only increased slightly over the past few months, from 56% in April to 63% in early September.

The US is paying a heavy price when it cannot maintain the strong momentum of vaccination as initially. The number of infections has increased sharply in the past two months, making this the second most serious outbreak in the US since Covid-19 appeared. The average daily number of deaths in the US also increased from less than 200 in early July to about 1,500. The daily death rate in the US is now double that of many countries like France, Germany or Italy.

The US started the vaccination campaign with a great advantage in vaccine supply, thanks to pre-order contracts with manufacturers before being approved by the US Food and Drug Administration (FDA) for emergency use. Meanwhile, Europe faces quite a bit of difficulty in the early stages, before the supply improves in the spring and summer.

However, after favorable vaccination coverage with the pro-vaccination population, the US faced major obstacles with those who hesitated to vaccinate. A Morning Consult survey found that 17% of US adults have no intention of getting vaccinated and another 10% are unlikely to get it, meaning more than a quarter of the adult population is hesitant to get a vaccine. The US currently has the second highest rate of vaccine hesitancy in the group of 15 high-income countries, according to analysis by Morning Consult.

The US currently ranks 7th in the G7 group, behind Japan, the UK, Canada, France, Germany, and Italy in terms of the proportion of the population receiving at least one dose of vaccination and 6th in terms of complete vaccination rates, according to the report. NYTimes.

The high proportion of young population is also considered a factor affecting the US vaccination campaign. About 16% of the German population is under the age of 18, compared with 22% in the US. Children under 12 in the US are not currently eligible for the vaccine.

However, when compared to a country like Portugal, vaccination rates for the eligible population in the US are also lagging. In Portugal, 99% of people over 65 are fully immunized, while in the US it is close to 80%. 85% of Portuguese aged 25-49 have had their shots, compared with less than 70% in the US.

Another big difference is cultural and political. Vaccination in the US has been deeply politicized and partisan. By July, about 86 percent of Democrats had been vaccinated, while Republicans were just 54 percent, according to a survey by the Kaiser Family Foundation. One in five Republicans said “definitely” would not get vaccinated.

“Political divisions have contributed to the US falling behind European countries in the vaccination race,” said Josh Michaud, deputy director of global health policy at the Kaiser Family Foundation.

Many European countries, especially France and Germany, also have vaccination reluctance, but the scale is not as large as in the US. In Portugal, the rate of vaccine skepticism in the population is very low.

“We don’t need to convince people to get vaccinated. Because they want to be vaccinated,” said Gonçalo Figueiredo Augusto, who studies public health at NOVA University in Lisbon.

Historical setbacks may be responsible for the success of Portugal’s vaccination campaign, according to Augusto. The country lived under a dictatorship from 1933 to 1974, bringing public health to a halt. Child mortality from preventable infectious diseases is significantly higher in Portugal than in other rich European countries such as France, Germany and the UK. It was only at the end of the regime’s last years that a serious vaccination campaign began.

“People were willing to get vaccinated because infectious diseases used to be a big problem. We used to be a poor country and understood the importance of vaccines,” Augusto said.

As democracy in Portugal was re-established and economic conditions improved, so did public health. Child mortality has fallen to the same level as other countries in the 1990s. Today, more than 97% of Portuguese children are vaccinated against measles, but in the US it is less than 90% because of a part of the population continues to post vaccines.

Portugal also experienced the worst Covid-19 outbreak, like the US and many other countries around the world. After avoiding a severe outbreak last spring and summer, social distancing measures have been eased. The Portuguese leadership wants to allow people to enjoy the most normal Christmas 2020 possible.

By early January, the number of infections and deaths increased rapidly. Portugal had the worst Covid-19 death rate in the world. “It’s a trauma for this country,” Augusto said.

People wait to be vaccinated against Covid-19 vaccine in Seixal, Portugal on March 22.  Photo: Reuters.

People wait to be vaccinated against Covid-19 vaccine in Seixal, Portugal on March 22. Photo: Reuters.

In Portugal, vaccination is seen as the best way out of the crisis. After initial difficulties due to lack of vaccine supply, vaccination rates in Portugal increased rapidly.

Portugal also quickly adapted to the changing pandemic situation. When the Delta variant appeared in May, officials decided to shorten the time between injections. The interval between two doses of AstraZeneca, Pfizer and Moderna vaccines was all shortened by at least a week. Portugal’s approach to Covid-19 is very centralized, with the government responsible for purchasing, distributing and vaccinations. The military was also deployed to support logistics.

The effort has paid off. Portugal recorded only a slight increase in the number of infections and deaths from the Delta variant in July and August, while the US and many countries suffered from large and severe outbreaks. Portugal is expected to allow bars and nightclubs to reopen after months of closures when 85% of the population is vaccinated.

“You don’t want to follow the rules? Get vaccinated and help the country,” Augusto described the message from government leaders to the Portuguese people.

Meanwhile, the administration of US President Biden is struggling to find a way to get the vaccine to those who oppose it. “In the US, we’ve almost immunized everyone willing to give it,” says Michaud. “Therefore, any progress in adult vaccination may be contingent on mandatory vaccination requirements.”

The Biden administration had to turn to a mandatory vaccination campaign to increase vaccine coverage in the population, after incentives, calls and rewards no longer worked.

“But these efforts will face stiff resistance from Republican voters and politicians,” said Vox commentator Dylan Scott. “That’s why the US campaign has fallen behind, and the price to pay for that is increasing.”

Thanh Tam (Follow Vox, NYTimes)

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