Oof. Data is starting to roll in on Covid-19 vaccine inequities this fall. And it’s not pretty. Access. Cost. Outreach. Education. All of these changed once the federal emergency ended in May. Vaccines are no longer purchased or distributed by the government, and funding ran out to support vaccine campaigns. This means the U.S., once again, faces the pre-pandemic privatized and fragmented healthcare and public health systems. And one could argue an even worse system, given the loss of trust.
As others have noted, I have not (yet) gotten this year's booster because I caught COVID and was told to wait 90 days before getting vaccinated; sadly, I tested positive on the day I was scheduled to get my booster, so instead of getting vaccinated, I got Paxlovid. I *will* get my booster around New Year's - and I have to wonder how many other people are in my situation and have not gotten boosted yet because of a recent infection, and how that impacts other vaccinations.
As my COVID began to clear up, I contacted my insurance company's advice line to ask when I could get my flu vaccine; it took 3 different people and 5 days to get a call back from my doctor's office, telling me I could get the vaccine any time I hadn't had a fever for 24 hours and felt well. I then began what would become a several month-long quest to get the RSV vaccine - I am under 60 by a couple of years, but immune compromised due to prior cancer treatment, and wanted all the protection I could get. This, also, took several phone contacts and several repetitions of why I wanted it - and why they couldn't approve it, because the CDC guidelines say "60+", with no mention of immune issues - but eventually, I ̶c̶o̶m̶p̶l̶a̶i̶n̶e̶d̶ advocated enough that it was kicked to the immunology department which approved it.
If I, as a reasonably well-education, middle class white woman with insurance that prioritizes prevention, have this much trouble getting vaccinations, I can only imagine what difficulties others, who don't have insurance, who may lack transportation, whose jobs may not give them the flexibility to go to clinics when the clinics are open, etc., may have getting them.
Americans remain stupid.
It seems to me that a big part of why the UK is doing so much better in terms of the booster in older people is that the more vulnerable groups (older, immunocompromised etc.) are the only groups authorized to get the booster. Because the UK took a more targeted approach and better explained the underlying rationale, its citizens have more confidence in the public health edicts. Our country has really failed miserably in that regard.
I would like to offer that many this year did not get their vaccine because they came too late. I for one got COVID for the first time 2 weeks before I was scheduled to get my vaccine.
It doesn’t help that my parents’ primary care physician told them that the variants change so fast that the vaccine probably won’t do much good! What? They are in their upper 80s! Living in a retirement community. So frustrating. I pushed and so they are now finally getting it.
when you can't mandate/coerce people into taking these shots anymore, it turns out that the vast majority don't want them. Especially after "experts" lied about their efficacy and dramatically overstated the risk posed by the virus itself.
BTW It is absolutely unacceptable that there is not as much detailed data on vax uptake (as well as COVID incidence and morbidity) for every county and state in the USA>
Maybe this isn’t a privatization problem but rather a problem of demand.
Is it possible that part of the reason for the racial disparity in booster uptake is because there was a large wave of infections in late summer shortly before the boosters came out, and Blacks and Latinx were infected at higher rates (front line jobs, denser living situations) - meaning they have higher natural immunity going in to winter, which makes them reason they don’t need a booster because they are already protected?
In terms of who is currently being hospitalized and dying, do we see the same racial disparities play out? Hospitalization and death are the true measure of unequal outcomes.
There was a TON of covid going around in late summer. For 2024 maybe the boosters should come out sooner?
Oh course, a UHC system would go a long way towards fixing this mess. But we can't have that because Communist Marxist Woke Fascism. Or something.
Why have Native Americans again been rounded out of existence. For your consideration with the RSV immunization for children. WA State got 14,000 doses. Two tribes (out of 29) received 80 doses. No other source is available. The second round saw another 1,000 doses come to WA after they were aware of the disparity. They then made an 5% set aside for tribes. That would be another 50 doses. Now they are committing to more doses going to tribal communities but the outbreak is already started. There will be another 7,600 doses coming in lots every 2-3 weeks. Native children has double the infant mortality rate of whites. In WA that mortality rate now surpases black childen, nationally black children have the highest infant mortality. RSV hospitalization (PEDIATRIC Aug 2023) showed rates between 1.7 and over 7 times more common for Native children. In WA at the peak of the outbreak last year there were 25% more Native children seen in the Emergency Rooms in the state. If you would be interesting in sharing more information about Native health disparities... Frank James MD Health Officer for Nooksack and Lummi Nations and clinician at Swinomish Tribe. frankjamesmd@Gmail.com
Please, everyone in the US: this is not the year to miss open enrollment! More info here:
Health insurance cannot be considered a discretionary expense. Insofar as you're dissatisfied with the status quo in the US, yeah, I get it, but for now - we have the system we have. You can contact your elected reps:
In the meantime, you're gonna need health insurance. Rumors of the ACA's death are greatly exaggerated (even a Republican trifecta in 2017 couldn't kill it) and financial assistance for those with limited income is available in the form of premium tax credits. Having health insurance also connects people with reliable primary care providers, who can be soldiers in the fight against misinformation. And we can all get back in our respective lanes.
You may be right about new barriers driving down vaccination rates in communities of color -- but that's not obvious to me from the data you share. It seems to me there's an assumption that attitudes toward vaccine uptake remain stable over time, but if so that's a dubious assumption. It's also unclear to me what constitutes a new barrier. In my community, at least, the public health department and pharmacy chains such as Walgreens and CVS are offering vaccines free of charge (at least to the insured). Is that untrue elsewhere? Please understand, I'm not scoffing at the idea of new barriers, just looking for clearer evidence and an explanation.
Hubby and I got our updated covid boosters a couple of weeks ago. He got Moderna, which we had both gotten before. But the mRNA vaccines give me an awful fever, so I tried Novavax this time. I'm glad I did. Assuming that its effectiveness holds up, it's a good option for me.
I know that access, cost and disparities are an issue for getting the updated Covid booster, but I'm curious how many people have had the vaccine in the past and are simply choosing not to do it this fall? I personally have spoken with multiple people who have decided to opt out this fall and it's not because of cost or being unable to take time off of work. They simply don't want it. I believe that this is because most have had Covid and it was mild, so they are no longer afraid of it. I wonder if this is a nationwide issue or if it's just in my area?
This is not at all surprising to me. I was able to get the initial booster quite easily at our county health department - no internet needed to make an appointment, no lengthy form like at the chain pharmacies, no health insurance needed, and they would even deal with people who didn't have an ID. Location centrally located and on several bus lines.
I have attempted to get the current booster, and have not had success yet, and I am college educated and have insurance, but finding a place with the vaccine and an appointment when I am available has been difficult. There is not an easy search function like there was previously. This column has given me the push to try again, but I can see how an hourly worker wouldn't bother.
As I have posted before, there is definitely a discrepancy between what the general media are reporting re: COVID vaccine uptake generally and the facts on the ground in local communities like mine.
Vaccine uptake is so high where I live that we have to make appointments with CVS, Rite-Aid, or Safeway weeks out because there are shortages.
It annoys me that we have to suffer locally while idiots in areas where the vaccines are rejected have inventory we could make use of.
If you don't want to get the COVID booster, fine... get sick and die or suffer the worst symptoms of long covid for all I care. If you have kids and reject the vaccine, I hope you burn in Hell after the consequences come home to roost. Die - the world won't miss you.