In the United States, the authorities are struggling to convince the most reluctant to get vaccinated

How to continue vaccination against Covid-19? This is the question facing US health authorities as the mass vaccination campaign slows down. All adults are now eligible, and those who were waiting for it were able to benefit from the Covid-19 vaccine.

146.2 million people, or 44% of the total population and 55.8% of the adult population of the United States, received a first dose. 103.4 million had received both as of May 1, according to figures from the Centers for Disease Control and Prevention (CDC), the main federal public health agency. 31.2% of Americans are therefore fully vaccinated against SARS-CoV-2.

Consequence: while since the beginning of 2021, the campaign has been facing a demand greater than the supply of vaccine, the trend is tending to reverse. While the number of vaccine doses administered each day was steadily increasing, the curve has been declining since mid-April. 3.38 million doses were injected on April 13; that figure was 2.55 million doses on April 30, according to Our World in Data.

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Change strategy

The health authorities are therefore changing their strategy, in order to achieve the much hoped-for global immunity. “Achieving the final percentage of overall immunity is going to depend on awareness and how you address vaccine hesitation,” said Mary Jo Brogna, director of a local clinic in Cape Cod, Mass., Interviewed by the British daily The Guardian.

And mass vaccination centers, which were so instrumental in the campaign’s success, seem less relevant to vaccinating the other half of American adults. “Across the country we started with mass vaccination centers, and these have worked very well for older individuals,” explains the Guardian Gary Edwards, executive director of the Salt Lake County, Utah, health department.

Evolution of vaccination in the United States.

CDC

In Texas, a large federal vaccination site located in Arlington, between Dallas and Fort Worth, closed in mid-April for lack of demand, reports AFP. Two state “vaccinodromes”, NRG Stadium in Houston and Fair Park in Dallas, have stopped requiring appointments. In Houston, the center also offers later hours for people who work evenings. But more than half of the available doses are not administered. “We have a capacity of around 6,000 people (per day) and we’ve even gone up to 7,000. Today the numbers have plunged to 2,500 on average,” explains Martha Marquez, communications manager for the county health department. by Harris.

Target isolated audiences

And the phenomenon is repeating itself all over the country. According to Guardian, local authorities in Los Angeles, California, and the states of Colorado, Florida, Nevada and Texas are preparing to close mass vaccination centers by the end of May. Georgia, where only 34% of the population has received at least one dose, has already decided to close all its centers of this type by the end of May.

“Since we have fulfilled the mission of vaccinating the majority of those who are most at risk (…), we are now focusing more and more on other groups, which it will take time to reach”, recognized Friday Jeff Zients, coordinator of the fight against Covid-19 for the White House. “We want to make it easier to get a vaccine from your doctor,” added Vivek Murthy, the chief medical officer of the United States, promising announcements soon.

From now on, it is a question of finding people to be vaccinated, in particular those who are socially or geographically isolated. And to bet on proximity. For example, in Harris County, Texas, five mobile vaccination centers crisscross the areas where positive cases are the most important. “Next week, we will deploy ten such devices” mobile, welcomes Ashlei Dawson, responsible for one of them.

Call and reassure the unvaccinated

This Thursday, the young woman supervises seven people and trains eight others who will work in the new units. His team took over the library for the day in Pasadena, a predominantly Hispanic city in the suburbs of Houston. The public comes in sparingly and only 27 people received an injection at midday. Among them, Jose Herrera, 55, finally vaccinated: “I did not do it before because it was too far away. I wanted a place closer to home. We do not know what reaction we may have” a times stung, he told AFP. In the city, about twenty supermarkets or pharmacies, however, offer injections. But it is thanks to his daughter, who works in this library that this unemployed man finally agreed to travel to get his vaccine, with his wife Maria.

In Chicago, Illinois, demand had fallen sharply in some areas. Health authorities have therefore started calling unvaccinated residents directly. These calls led to so many people getting vaccinated that the state had to transfer vaccines from other counties to restock Chicago, the NGO PEW Charitable Trusts reported in an April 21 article.

The same question arose at the beginning of April in Israel, where the vaccination campaign also advanced very quickly. “We are proactive, we call people, we urge them to come to be vaccinated, and we reassure them”, declared then daily Times of Israël Mali Kusha, head nurse of the health services of Meuhedet. The four Israeli health insurance funds were mobilized to convince their members to come and be vaccinated. Mali Kusha then explained to the Times of Israël that many patients did not want to be vaccinated before the Passover holiday and holidays, for fear of side effects.

Access problems

In the United States, the reasons for the slowdown are multiple, explains the Guardian. The hesitation in the face of the vaccine, which is particularly important among conservatives and among racial minorities, partly contributes to it. But there are also questions of transport, agenda and logistics. “Some people are not able to leave their jobs to easily get vaccinated, or may not have transportation,” says Dr Jennifer Kates, vice president and director of global health at the NGO Kaiser Family Foundation on CNBC channel.

For Dr Saad Omer, director of the Yale Institute for Global Health interviewed by AFP, the key is also to convince the undecided. “One way to tackle this is to increase their demand. Another is to make it so easy and accessible that even the hesitant will say, ‘OK, let’s do it,'” he said.

Convince young people

While people’s confidence in vaccines has increased, some people remain very skeptical. Nearly 30% of Republican voters say they do not want to be vaccinated (compared to 5% of Democrats), according to a study by the Kaiser Family Foundation published at the end of March. Same proportion among evangelical white Christian people. Voices are being raised to put more pressure on these categories. But for Saad Omer, “if anyone is to blame them, it should be a white evangelical, not an outsider.” This is what happened with success, he explains, for black people, in whom confidence has greatly increased thanks to the positions of African-American organizations.

Above all, it is about convincing younger adults. In the United States, among 18-49 year olds, 9 to 12% of people received two doses; this rate rises to 27% among 50-64 year olds. However, this is a crucial demographic group to contain the epidemic: according to a study published in the summer of 2020 by the journal Science, active adults between the ages of 20 and 49 were the most likely to transmit the virus to more than one person.

Here too, the same problem arose in Israel in February. According to the daily Haaretz, the Israeli Minister of Health has therefore launched an information campaign to convince 19-50 year olds to be vaccinated, and to fight against misinformation around vaccines.