(CN) — The latest phase of Covid-19 vaccine distribution is one that experts predicted would occur: Rather than low supply and eligibility rules slowing the effort to thwart the coronavirus, America has a vaccine-demand problem.
“We’re hitting a wall,” said Dr. Amesh Adalja, a physician and senior scholar at the Johns Hopkins Center for Health Security, during a phone interview.
People who wanted to be vaccinated early on have already gotten their shots, Adalja said. So, as time presses on, “it’s diminishing returns.”
The slowdown is not a big surprise: Experts had warned, as vaccine eligibility expanded to all adults, that the next challenge would be convincing holdouts to book their appointments for the shot. Now, the question is how to achieve that goal.
As some states test out freebies and even cash prizes, it may take something as simple as a simple mandate — just as experts say mask mandates are particularly effective — to get shots in arms.
If that’s true, an announcement on Friday from Pfizer could get one step closer to seeing mandatory vaccines: The company announced it has submitted its vaccine for FDA approval, a move that could encourage employers and schools to require a Covid-19 vaccine — and move a hesitant population toward vaccination.
Vaccination Plateau Gives Way to Incentives
The latest latest survey data from the Kaiser Family Foundation breaks down the vaccination plateau: With 56% of American adults already vaccinated, now just 9% say they intend to get a shot as soon as possible — down from 30% in March.
People placing themselves in the “wait-and-see” category, combined with people who will only get vaccinated if required, account for 21% of adults.
That’s the target demographic for public health officials, who say widespread vaccination is the key to returning to normal life, and are working to meet President Joe Biden’s goal of vaccinating 70% of adults by July 4.
Reaching that goal is likely achievable, Adalja said. Really, though, the underlying goal is to reach as high a percentage as possible.
“The more people that are vaccinated, the less disruption Covid will cause,” he said.
Even after the virus has ceased to be a major public health concern, flooding emergency rooms with patients, it can disrupt businesses and other realms of life, he noted.
“Nobody wants to get Covid, nobody wants Covid in their businesses, nobody wants Covid impinging on their activities,” Adalja said. “The best way to guarantee that is to get the vaccine numbers as high as possible.”
Private companies have rolled out rewards, like Krispy Kreme donuts or a $5 discount at Target, in exchange for getting vaccinated.
State governments are testing out incentives, too.
New Jersey Governor Phil Murphy earlier this week announced a “shot and a beer” program, offering residents a free cold one when they present a vaccine card at participating breweries.
In West Virginia, the youngest age band approved for vaccination, between ages 16 and 35, are being offered a $100 savings bond. It’s younger Americans who are the most likely to “wait-and-see” before getting vaccinated, surveys show.
But for people who are procrastinating getting a shot, it may be simple vaccine mandates that will finally move the needle.
Those are most likely to come from private companies, universities, and hosts of large-scale events like concerts and sporting events. The federal government has said it does not plan to mandate vaccination or create a national passport system.
Public perception, according to a recent study, is generally at ease with vaccine mandates.
Penn State researchers found that 70% of participants “definitely” or “probably” supported general vaccine mandates for students, while more than half supported the requirement for the Covid-19 vaccine specifically. Around 60% supported mandatory Covid-19 vaccines for teachers.
Democrats were consistently more supportive of vaccine mandates, compared with moderates or Republicans, the researchers found.
"Partisanship has permeated everything related to Covid-19 and lots of misinformation has been spread, including from individuals in leadership positions," said Simon Haeder, assistant professor of public policy at Penn State, in comments released with the research.
"Additionally, there's a general growing distrust of science and its elites,” he said, “which when combined with the novelty of the illness and vaccines, could contribute to this lack of support for vaccine mandates in certain groups."
For those in charge of keeping students or employees safe, the thought process may not be political but pragmatic.
“If I were a company, or if I were a school administrator, I would want my community to be the highest vaccinated as possible, because I don’t want to deal with the disruption from Covid-19,” Adalja said.
What could push things in that direction, he said, is the FDA approval. Currently, all three vaccines are allowed under the agency’s emergency use authorization.
“Once the vaccine gets full FDA approval,” Adalja said, “I think that some employers might be more comfortable with a mandate in place as a condition of employment.”
As the FDA gives its full licensure to vaccines, Adalja said he thinks we’ll see more mandates showing up. Houston Methodist Hospital has mandated vaccination for employees, he noted, and several universities have done the same for students.
Pfizer kicked off its journey to getting full approval with its announcement on Friday.
“We look forward to working with the FDA to complete this rolling submission and support their review, with the goal of securing full regulatory approval of the vaccine in the coming months,” CEO Albert Bourla said in the statement.
Pfizer has only initiated its application, and the final FDA approval process could take several months, government health officials said Friday during a Covid-19 press briefing.
“Nothing changes right now," White House coronavirus response coordinator Jeff Zients said.
“Given the nature of the pandemic, FDA will move as expeditiously as possible without compromising its gold standard for safety,” Zients said. “Our focus remains on getting 70% of adult Americans at least one shot by July 4th.”
By that time, if the vaccination rates continue to grow, things could be looking up — and even normal — according to the Centers for Disease Control and Prevention.
The agency reported this week that the U.S. could see a significant drop-off in cases by July.
“We have the path out of this,” said CDC Director Rochelle Walensky. “Models once projecting really grim news now offer reasons to be quite hopeful for what the summer may bring.”
On Friday, Walensky addressed reporters with her own family vaccine story. Her 16-year-old son, recently fully vaccinated, is planning to have two vaccinated friends over to watch a movie this evening.
“It’s been a long-and-coming, seemingly mundane, but now very luxurious event,” she said. “And he can do so because he’s fully vaccinated.
“I rest easy knowing my family will be safe,” Walensky said, “and that is simply the best Mother’s Day gift I could get this year.”
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