Today, Explained - Can we get to 70%?

Episode Date: May 5, 2021

That’s President Joe Biden’s new vaccination goal, and he’s got some fresh ideas on how to get there. Vox’s German Lopez explains. Transcript at vox.com/todayexplained. Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit connectsontario.ca. On Tuesday, the President of the United States addressed the nation. Good afternoon. The United States is entering a new stage of COVID-19 vaccinations. Now, where do we go from here? Most adult-aged Americans who wanted the shot have got the shot. Thank God for that. Which means the next hill to climb is those millions upon millions who just aren't as excited about getting vaccinated.

Now we're going to have to bring the vaccine to people who are less eager. So Joe Biden and his administration want to make it easier than ever with a centralized website. Vaccines.gov. With a number you can text. Go to Joe 30330. No, no, no, that's the old one, Afim. Other one, other one. Text your zip code to the following number. Three. Three. No, no, no. That's the old one, Afim. Other one. Other one.

Text your zip code to the following number. 438829. And by bringing the vaccine to Americans wherever they may be, with a particular focus on rural America. And beginning next week, we'll be shipping new allocations of vaccine to rural health clinics, getting more vaccines to more rural clinics so Americans who don't live near one of the 75,000 vaccination sites will have new options that may be closer. Rural America is increasingly viewed as the next frontier in getting the country vaccinated. It's where polls show resistance to the shot is the strongest,

and the administration's strategy is shifting from vaccination sites to trusted leaders in those communities, namely local doctors. We're also going to slip vaccines directly to pediatricians, ship them to pediatricians during the following weeks so parents and their children can talk to their family doctor about it and get the shot from a provider they trust the most. Easy, fast, and free. Brett Worgen is a family doctor in a rural community. W-E-R-G-I-N is my last name. He practices family medicine in a town called Fairbury in Nebraska. It's about 70 miles southwest of the state's capital, Lincoln.

It's a town of like 4,000 people. There's lots of surrounding small towns. We probably serve a community of something like 12,000-ish to 16,000 people. But the town itself is 4,000. The initial vaccine rollout in Fairbury, Nebraska, looked much like it did in the rest of the country. I mean, I think people were really eager in the beginning. So one thing about, you know, in our community, we have a pretty large geriatric population.

So a lot of people over the age of 65. And obviously we have two nursing homes and an assisted living facility completely closed down, like no family members allowed to come visit. And that's really hard on our geriatric patients and people that are in nursing homes. You know, people can even start to have worsening cases of delirium when they're not having those social interactions and they're having to be confined to their rooms. So when the vaccine was coming around,

I think people were really excited. People really wanted to get back to being able to see their loved ones as soon as possible. So on the nursing home side of things, and I'd say with the geriatric population who weren't in nursing homes and people wanted to see their family and grandkids, they were very eager to start getting vaccinated.

And I think everyone was very excited when our area started to get them. But eventually, the excitement waned. Now we're kind of struggling to get people vaccinated. I think as a state in Nebraska, I think we've vaccinated somewhere over 40% of the eligible population. The last I had checked for our specific county, which is Jefferson County, Nebraska, I didn't have data on just eligible people, but for all people, we were just over 30% of people vaccinated, although that includes children who, you know, some of them can't be vaccinated at this point.

Which means Dr. Worgen has been having more uncomfortable conversations with his patients lately. Yeah, when I bring it up to patients now, you know, they either say, no, I'm not getting that, or they say, I don't think I'm going to get that. I feel like it's week to week. There's some weeks where I feel like nobody wants it. And no matter how much education I provide in that appointment, they just still kind of dig their heels in and say they don't want it. And then some weeks it's like, oh, half of those people that I talked to that didn't want to get it after I talked to them,

they're like, okay, well, I might get this then. Or it's something we kind of put on hold and they're like, I'll think about it and then we'll revisit it. What are the reasons people are hesitant or even refusing to get vaccinated? So every now and then people will ask a question about the vaccine or normally I'm just asking everybody that I see, I'll just say, hey, have you gotten the vaccine yet? And it's either yes or they'll say, no, I haven't.

And if they say they haven't, they're either pretty, they'll either say, oh, well, I'm just not doing that. Or they'll say, I haven't. What do you think about that? And then I know I'm going to have a little bit more success if they say that. And the people that say they haven't, one common complaint that you hear from people is that they approve these vaccines too quickly. And I worry about the safety. So sometimes there's a safety issue brought up where people are concerned that, how did we come out with these vaccines so fast? They think they haven't been tested on people.

And so usually then I try to explain how the mRNA vaccines have been in process or they've been developing these types of vaccines for over a decade. And it's not really that new of a technology necessarily, but it's being newly applied to vaccinations. And sometimes that's helpful. But then there is every now and then there's this political aspect that is brought up and they'll say, I don't want to be forced to do that. I don't think the

government should be telling us to do that. That does come up sometimes. Occasionally, somebody who's in their 40s or 50s who just says, well, you know, I'm not that worried about getting it. I don't think it's very deadly. I'm not really, I think I'm healthy enough. I don't think it's going to cause me any problems and I don't want to be told what to do. And I try to, through the education, bring up, you know, getting vaccinated is not just for yourself. It's for your loved ones. It's for the community. You know, I try to talk about the importance of trying to get our immunity rates up to like herd immunity. And it's important for everybody to participate in vaccination. I talk about how you might not get sick, but you know, you could spread this to a relative who's old or somebody at the grocery store who's old and higher risk who could have a bad outcome or die.

And oftentimes at this point, they've kind of considered that, but sometimes that's newly considered information. For the people that I have an easier time reaching, sometimes it's just that they are just kind of confused. There's so many good and bad resources out there. I think they don't really know what to trust and they just don't, they kind of, because it's so confusing to them, they'll be getting information from, you know, different media outlets, from Facebook. So a lot of times when it's that confusing, all they have to rely on are just people they trust in their lives, which is usually other family members or friends or, you know, people at church. They kind of have to base their decisions based on that because they don't know who else to trust. And so I think one lucky thing about

being a primary care doctor is usually, you know, since we build relationships with our patients, we can have a trusting relationship with them. And the goal is to kind of build up that trust so that if they're kind of suspicious about a vaccine, if you keep having encounters with them over and over, you're getting to know them, you know their family members, and you explain, hey, this is why I think it's good for you and your family and the community. We have an easier time breaking through rather than it just being somebody I've meeting for the first time. That's a lot harder to convince them in those cases. And I guess that's why the federal government is now trying to empower people like you to be giving out these shots to get as much of the hesitant, less excited people out there vaccinated.

Do you think the Biden administration, the federal government should have empowered primary care physicians earlier? Would that have helped? I'm a biased party, but I think with most things, with primary care medicine or population-based medicine, the earlier you get primary care physicians involved with any big health initiative like that, it's better. I'm hopeful that through continual education and changing different strategies for vaccination, that we'll get there. I try to be an optimist about it,

but I'm definitely concerned that we're not going to get to that point and I don't know how things are going to shake out. I hope that just through educating that, hey, if we want to return to normalcy, we really need everybody to buy in and get vaccinated. If you want to go back to some version of the way your life was prior to the pandemic,

I'm hoping that will be convincing enough to people if they understand that. But I have a guarded, very guarded optimism, I suppose. I can relate. Yeah. Doc, thanks so much for your time. Really appreciate it. I'll let you get to your patients. Hey, thank you so much for having me.

President Biden also dropped a new vaccination target for the country yesterday. His new magic number after the break. Thank you. Wirecutter AuraFrame to make it easy to share unlimited photos and videos directly from your phone to the frame. When you give an AuraFrame as a gift, you can personalize it. You can preload it with a thoughtful message, maybe your favorite photos. Our colleague Andrew tried an AuraFrame for himself. So setup was super simple. In my case, we were celebrating my grandmother's birthday. And she's very fortunate.

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Two months from today, two months from today, families across the country are going to celebrate the 4th of July. Our goal by July 4th is to have 70 percent of adult Americans at least one shot and 160 million Americans fully vaccinated. He's dropping that target as states are fully reopening, which had us wondering, will things be safe or are we heading for more surges or what? It was only last December when Dr. Fauci told us on this very program that we needed to get 85% of the country with shots in their arms to get back to normal to reach some kind of herd

immunity. So we turned to German Lopez at Vox to make sense of this math. So Biden's new goal is to get about 70% of adults vaccinated by July 4th, and that's roughly around 60% of the country. What Fauci's goal originally was about herd immunity. He's estimated it to be around 80 to 90%. Other experts say lower, but generally that's been the overall driving concern is how do we get to herd immunity and will that let us get back to normal what's changed in recent months is one we don't really know what herd immunity is i mean the fact that like if you look at the estimates we just realized we don't know what herd immunity is well we haven't we've known this for a while like these are just rough estimates but the estimates are all over the place. They go from like 60% to 90%, right? Like

that is a huge range. So instead, what I think the administration has started to do is look at real world data, places that have vaccinated more people, how far along are they? When does the turning point really seem to kick in? And particularly with Israel, it seems like that turning point kicked in when around 60% of the country had at least one shot. Israel has had probably the best vaccine campaign in the world. A vaccination drive that's inoculated more than half the population in record time and an infection rate that's tumbled. They've moved the fastest. And I think the most interesting way to look at this is around early March, Israel had more than double the COVID cases per capita than the U.S. And they made a decision, we're going to open back up again.

The thing is, they also had around 60% of their country having at least one dose of the vaccine. And what happened after that is in the coming weeks, their daily new cases for COVID dropped by more than 95%. Because they had all these people vaccinated, they saw a dramatic drop in cases. And as a result, you can see it in the numbers today, they now have around 60% of their country fully vaccinated, not just one dose. And they go days reporting zero COVID deaths, which is just a dramatic turnaround for them. They used to be one of the regularly the hot spots for COVID in the world.

Israel's ready for a giddy post-pandemic party. Crowding cafes, filling Jerusalem's old market. We're back to life. You can see all the people going around. So looking at that data, it's made a lot of experts confident, apparently the Biden administration, that, look, if we get this to the 60% threshold where at least one dose, then maybe we can start really reopening up again.

And just to stick with Israel here for another minute, how open are they? Are they completely open? Have people ditched their masks? What are the specifics? So it's not definitely not pre-pandemic normal in Israel yet. But what they have done is they've, first of all, lifted restrictions on a bunch of businesses. They've also removed their outdoor masking mandate, which the CDC has kind of moved in that direction as well, where they no longer recommend masking outdoors in non-crowded areas. But I think the big difference now with Israel is to do riskier activities, they require what they call green passes, which is you can go into like a crowded indoor restaurant for example if you have a recent

negative covid test if you have gotten vaccinated or if you've recovered from covid like if you can prove that you have natural immunity and uh i think it's in the past six months is the idea there and if you meet those requirements then you can go into places that like just you couldn't before indoor restaurants concerts you know i've seen pictures of this. And even though they technically have masking requirements, it seems to be pretty loosely enforced in some areas. And still, despite that, no big surge in cases like you are able to go into these places. And because so much of the country is vaccinated already, it does not seem to be leading to a giant spike in cases. Okay, I think I'm ready to come back to the United States, Herman.

It sounds like President Biden is willing to look at Israel and their 60% and say, here's a model for the United States to reopen safely, maybe even eventually get to 70%. But is it an apples-to-apples comparison? It's not a perfect comparison because because for one thing, a lot of states have lifted their masking mandates entirely. Already? Yes, already. And some states are moving in the direction of like not allowing vaccine passports at all. Florida is saying like businesses should not ask for proof of vaccination to let you in. So I think there's going to be a red-blue divide here again, which we've seen with COVID time and time again, where

some states, they'll embrace vaccine passports. They might embrace even harsher mandates. Others will not. And that's going to complicate the picture a bit here. I mean, along these lines, we have also seen a red-blue divide in terms of which states are reaching higher vaccination rates. Generally, the blue states have seen higher vaccination rates than the red states. So even if you get to that 60% threshold nationally, that's not necessarily going to be true in Alabama or Mississippi, which have not vaccinated anywhere near that level of the population yet. So with this patchwork in the United States, what does it end up looking like in the summer, in the fall, with hopefully 60% of American adults being vaccinated, but this total patchwork of regulations and enforcement and people traveling around just like they always do potentially potentially enjoying summer travel in all

these other states i think there's two possible scenarios here one is not quite so hopeful so in this case we see a bunch of outbreaks in places that do not have high vaccination rates yet i could imagine that in the south where it's going to get hotter it's actually going to get more difficult to do things outside because the temperature will rise too much and people don't want to be outside. They want to be in air conditioning. You could see a situation where you have people doing more stuff indoors and you also have lower vaccination rates, and that could fuel outbreaks, particularly in the south. That's definitely not what we want to see, but we might see more of that. You probably won't see that as much

in blue or purple states because they've done a better job vaccinating their populations. They also tend to be not quite as hot in the summer, perhaps, so maybe people will continue doing stuff outdoors. And that might allow, essentially, them to, like the blue states in particular,

to open up more than they would have otherwise. Okay, that's the less hopeful scenario, but you have a more hopeful scenario. So the more hopeful situation is we get 60% of the country vaccinated. That continues going up throughout the summer. And maybe over time, people see their neighbors are vaccinated. People see that that's turning out good for the rest of the country. And so they continue getting shots. You see this a lot in the polling. Some people will be asked, like, do you want a vaccine? And they'll say no. And then you ask them, what if most of your neighbors get vaccinated? And then

they start opening up a bit more. So maybe people just want to see, like, look, my family and friends got the vaccine and it turned out fine. I'll get the shot too. Like kind of a wait and see mode. So maybe that'll get vaccination up further, even beyond the 60%. The other thing is like, maybe by getting to 60% nationally, particularly in blue states, blue states will essentially shield the rest of the country from getting COVID. Like you could see the situation playing out, right? Like in New York, like last year, New York City was like the big hotspot early on for COVID. Maybe if New York never got so bad, we wouldn't have had such a huge outbreak in the rest of the country. Maybe that'll play out in reverse where like now New York City has so much immunity that like COVID doesn't end up in Alabama.

This is really hopeful. We don't know if that'll turn out to be the case, but it's something that's possible. But it does rely on keeping up with vaccines, getting the vaccination rate up further. Something about the urban-rural divide being the thing that saves us from COVID-19 feels just so poetic. I mean, at the end of the day, COVID's one advantage is density, right?

If people are cramped in places, it tends to transmit much more of the virus. So rural places at least have that one advantage, and maybe it'll play to our advantage for once in this pandemic. Let's just, before we go, talk about the numbers here. How much of this country is currently vaccinated? At least one shot. How many American adults? So right now, more than 40% of the country overall is vaccinated. That's almost 60% of adults. It's about 56% of adults overall. So if you look at that, that's actually not too far off from the 60% threshold for the overall country and 70% for adults overall. Especially at current rates, we're vaccinating about 2 million Americans. You could see us hitting those numbers around as early as June, maybe July for full vaccination and even earlier for people just getting one dose.

So we're actually still on track to hitting that goal of 70% of adults by July 4th getting their vaccine. So to make sure that the numbers keep at least stable, if nothing else, but preferably going up, we're going to have to convince some of the more hesitant people, some of the people, not even just hesitant, but people who are just less enthusiastic about the vaccine, people who just don't want to go out of their way to get a vaccine, like maybe making access easier for them, creating some incentives. Like we will have to find new ways to keep that number at around 2 million doses administered

a day. It will definitely not be on autopilot. And one of those ways Biden announced is to reach out to rural doctors. Yes, that's going to be a big thing with they're now allocating doses directly to rural clinics. And this is something that i've heard more and more about experts it's like look basically every interaction with the health care system should be an opportunity to get vaccinated whether you're just getting your checkup for the year or whether you're going to your pharmacy to pick up other medications that you need like

something there should be like hey you can get a shot right now if you want. There are a lot of people who just have hectic schedules. There are a lot of people who just don't want to go out of their way, like take an hour or two, get a vaccine. If you just give them the vaccine right then and there, they might take it and that'll drive the numbers up further. Herman Lopez, he's a senior correspondent at Vox. I'm Sean Ramos for him. This is Today Explained from Vox.

We'll probably be talking about vaccines for a while longer on the show, but we're also working on an upcoming episode about how the 100 million plus Americans who are fully vaccinated are thinking about getting back to normal, or if they are thinking about getting back to normal. Now, where do we go from here? And we once again want to hear from you. We've decided we really like hearing from you.

Thank God for that. If you are feeling anxious about figuring out how to live post-pandemic, we want to hear about it. And if there are things about the way we've been living for the past year that you think we should keep around for good, we want to hear about it. And if there are things about the way we've been living for the past year that you think we should keep around for good, we want to hear about that too. So get in touch with us. You can send us an email. Vaccines.gov. No, Joe. The address is todayexplainedatvox.com. Also, we have a phone thing. Go to Joe 30330. No, that is not it, Joe.

The number is 202-688-5944. Call us. Leave a message. Thanks for sharing your thoughts. We might use them on the show. Keep in touch. Stay safe. Take care. Thank you.