Vaccine Eligibility Expands, Who's Least Likely To Get Their Shots? : Consider This from NPR Starting Monday, every person in America 16 and older is eligible to receive a COVID-19 vaccine. Nearly 40% already have. Now public health officials will begin to focus more on those who have not.

WHYY's Nina Feldman reports on the effort in Philadelphia, which is focused on racial equity.

Two groups of people who are most likely to say they won't get a shot are Republicans and white evangelical Christians. Blake Farmer of member station WPLN in Nashville reports on outreach to those groups.

In participating regions, you'll also hear from local journalists about what's happening in your community.

Email us at considerthis@npr.org.
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With All U.S. Adults Eligible, How Can More Be Convinced To Get Vaccinated?

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With All U.S. Adults Eligible, How Can More Be Convinced To Get Vaccinated?

With All U.S. Adults Eligible, How Can More Be Convinced To Get Vaccinated?

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  • <iframe src="https://www.npr.org/player/embed/988177519/988854008" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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AUDIE CORNISH, HOST:

Here's an idea public health officials are banking on.

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VIVEK MURTHY: I want to emphasize one point in particular about vaccines which isn't always so obvious.

CORNISH: U.S. Surgeon General Vivek Murthy said this past week increasing access to vaccines could mean more public confidence in vaccination.

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MURTHY: And here's why. The more people see those around them get vaccinated, particularly family and friends, the more comfortable they become with getting vaccinated themselves.

CORNISH: In a way, the idea here is that getting vaccinated is contagious. The reason that's such an important idea right now is that as of this week, all Americans 16 and older are eligible to sign up for a shot. How many will actually do it is another question.

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SCOTT GOTTLIEB: There's going to be some, you know, immediate demand, and we're seeing that right now. But after we work that off, I think when we start to get into younger people, you're not going to see the demand be as brisk.

CORNISH: Former FDA commissioner Scott Gottlieb told NPR this past week, with signs of vaccine demand slowing...

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GOTTLIEB: I think we get to 150 million vaccines. I think we struggle to get to 160 million. Beyond that, I think it's going to be difficult.

CORNISH: CONSIDER THIS - health officials are working to convince more Americans to get vaccinated. And they say it's going to be hard but not impossible.

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CORNISH: From NPR, I'm Audie Cornish. It's Monday, April 19.

It's CONSIDER THIS FROM NPR. Here's where the numbers stand right now.

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ROCHELLE WALENSKY: Almost 40% of the total population has received at least one dose of a COVID-19 vaccine, and 1 out of every 4 people is fully vaccinated.

CORNISH: That's CDC director Rochelle Walensky on Monday. She said on the other hand, cases and hospitalizations in the U.S. continue to creep up.

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WALENSKY: And cases among younger people who have not yet been vaccinated are also increasing. We all have a role in turning this tide and to trend our cases down. One of the most important things we can do to get back to doing the things we love is to get vaccinated.

CORNISH: The hope that public health officials have is that young people, wait-and-seers, people in rural areas, any adult who wants a shot will go out and get one in the next few months.

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ANTHONY FAUCI: By the end of May, there will be enough vaccines to vaccinate anyone who would want to be vaccinated. And from a logistics standpoint, getting it into people's arms, we hope we do it sooner but no later than July.

CORNISH: Dr. Anthony Fauci told NPR on Monday, officials do not expect the Johnson & Johnson pause to interfere with that timeline, at least not from a logistical standpoint. That's because the government has plenty of Pfizer and Moderna doses coming in. After a review of J&J data this week, Fauci said the CDC and FDA may be able to come back with revised recommendations on who should get that shot by Friday.

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FAUCI: So you have either come back with no inhibitions, or you come back with some sort of restrictions, whatever they may be. And that's what they're doing now. They're examining the data, and they'll be making that determination. And hopefully, we'll move on on Friday.

CORNISH: Now, if that happens, the U.S. will once again have three highly effective vaccines to distribute across the country. The country would still be a long way from herd immunity, which would mean getting from 40% of the population vaccinated to 70, 75 or even 80%. But Fauci emphasized to NPR scientists really don't know what that threshold is.

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FAUCI: You get as many people vaccinated as you possibly can, and you could turn around the dynamics of the outbreak. So we don't want to get stuck on this type of a terminology because we don't know what that number really is.

CORNISH: As many people as you possibly can. That means making an extra effort to reach people who are willing to get vaccinated but haven't yet. Which brings us to Philadelphia, where vaccination rates for Black and Latino people are half what they are for whites. Nina Feldman with member station WHYY reports on what the city is doing to fix that.

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NINA FELDMAN: Even before COVID-19 vaccines became available, there were concerns that Black and Latino people would be hesitant to take them. Kent Bream never bought that.

KENT BREAM: I said send me vaccine and I will show you there is not the level of vaccine hesitancy that you think there is.

FELDMAN: Bream runs a community health clinic in a predominantly Black neighborhood in West Philadelphia. In the early months of the city's rollout, only 20% of vaccines went to Black residents. Philadelphia as a whole is more than 40% Black. As more vaccine became available, there was a new challenge. Community clinics like Bream's, which have established relationships with patients, don't have enough staff to give them all shots. And mass clinics weren't a solution for everyone. Those can be hard to access for people with limited Internet, transportation and work schedules.

SHARRELLE BARBER: We know that, you know, Black residents are disproportionately among essential workers and workers in these kinds of jobs.

FELDMAN: Sharrelle Barber is a social epidemiologist at Drexel University.

BARBER: Their flexibility to not show up to work to be able to get a vaccine is just limited.

FELDMAN: To a degree, Philadelphia officials recognized that. They prioritized vaccine eligibility for essential workers. But Barber says eligibility is only half the battle.

BARBER: You can fall within an eligibility bracket, for example, but still not have the access. And so therein lies, again, why we're seeing, you know, these inequities still persist.

FELDMAN: City data shows clinic location is key for who gets vaccinated. Back in February Philly partnered with FEMA to open a mass vaccination site downtown. It happens to be right on the border of the city's Chinatown neighborhood. Until then, Asians were being vaccinated slowly, at the same rate as Black and Latino residents. In the weeks after the FEMA clinic opened, that rate skyrocketed, and Asians now have a higher vaccination rate than any other demographic group in the city. So to try to even things out, the city just opened a second FEMA site in a predominantly Latino neighborhood with one of the lowest vaccination rates.

UNIDENTIFIED PERSON #1: Are you here for the vaccine?

UNIDENTIFIED PERSON #2: Yeah, I have an appointment.

UNIDENTIFIED PERSON #1: All right.

FELDMAN: Edgar Perez is 51 and lives a few blocks from the new site. He says he tried to get vaccinated at nearby Temple Hospital a few weeks ago, but it didn't work out.

EDGAR PEREZ: I went to Temple last time. They told me I had to make an appointment. I'm not in the system yet, so I had to wait. So now I'm going to try to do this.

FELDMAN: Here, he just walked up - no appointment necessary. A shuttle runs all day between the clinic and the nearest subway stop. Signs in many languages make it clear there are no immigration officials here. Drexel epidemiologist Sharrelle Barber applauds the new effort but still wonders why it took the city so long.

BARBER: People have felt in community like there hasn't been a plan, that people have been more reactive than proactive, especially considering the devastation that they've experienced during this pandemic. So this vaccine distribution or equity seems like an afterthought.

FELDMAN: It's only been open a few days, but so far the new clinic does seem to be reaching the right people. City officials say during its first weekend, more than half those vaccinated there were Latino.

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CORNISH: Nina Feldman. And that story is part of NPR's reporting partnership with WHYY and Kaiser Health News.

Now, public opinion polls show there are two groups of Americans who are most likely to say they will not get vaccinated - Republicans and white evangelical Christians. According to a survey by the Kaiser Family Foundation, almost 30% of people in each group say they will definitely not get a shot.

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WILLIE NELSON: (Singing) I'll be seeing you in all the old, familiar places.

CORNISH: And that's why federal health officials say they're targeting viewers of Country Music Television and NASCAR with PSAs and ads, including this one.

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NELSON: (Singing) In that small cafe, the park across the way...

CORNISH: Willie Nelson sings "I'll Be Seeing You" over footage of packed, cheering crowds at NHL games, WWE matches and baseball parks. But in the fight to convince more conservative white Americans to get vaccinated, national ads like that are competing with powerful local forces. Here's Blake Farmer with member station WPLN in Nashville.

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BLAKE FARMER: There are more than enough shots to go around in communities like Hartsville, Tenn., a quiet town tucked in the wooded hills northeast of Nashville. On a recent weekend, the county health department had trouble filling up even half the spots for a COVID vaccination event at the high school.

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FARMER: Down the street at the Piggly Wiggly grocery store, Cris Weske isn't even tempted.

CRIS WESKE: Somebody that - like me that's healthy with a survival rate of 99% - I don't need it. I don't want to put that toxin - I'm kind of anti-vax, period.

FARMER: Whiskey is wearing a we the people T-shirt and says the Constitution protects his choice to opt out. National polling by NPR and Marist finds that rural white Republicans, especially supporters of Donald Trump, are among the least likely to get a vaccine. Cindi Kelton is loading dog food and milk into her van. She's 67 with COPD and emphysema, lung diseases that put her at high risk of complications with COVID. But she's more scared of the vaccine than the virus.

CINDI KELTON: Yeah, we voted for Trump. But, I mean, that's got - Trump's got nothing to do with us deciding not to take the vaccine because we were planning on taking it until our doctor passed away.

FARMER: That's right. Kelton says her doctor died of COVID in late January, though it's unclear whether he was vaccinated. Either way, Kelton says it gave her pause. To this point, there has been scant attention paid to batting down rumors or answering vaccine questions in many rural communities. Public health officials have been far more focused on underserved groups concentrated in urban areas. But it's rural communities where a few leaders are actively sowing doubts. They include state legislators and even a few pastors. Greg Locke is an outspoken preacher in Wilson County, Tenn., who peppers his sermons with mocking questions.

GREG LOCKE: People say, well, what are you going to do when they make the vaccine mandatory? And we'll tell them to take a hike like I've been telling them to take a hike.

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LOCKE: That's what I'm going to do.

FARMER: Southern states where vaccination rates are lowest have seen ministers as key allies, but it's almost entirely Black churches agreeing to hold town halls or vaccine events. Pastor Omaran Lee has been working with churches and says the concerns in Black congregations aren't that different from what he hears from rural white communities.

OMARAN LEE: We don't trust the government, and we don't trust Joe Biden, is what they said, right? Well, six months ago, it was, we don't trust the government, and we don't trust Donald Trump, right? Any time you have a marginalized person, you have people who are left out, they're going to be skeptical.

FARMER: And skepticism about the vaccine, Lee says, can be overcome if there's an intentional effort to reach people where they are, which brings us back to Hartsville, where communication is still a challenge.

BRENDA KELLEY: I don't even have a computer. I'm old-school (laughter).

FARMER: Brenda Kelley is a 74-year-old widow and says she didn't even know she was eligible to get the vaccine yet, much less that there are tons of shots available. They're mostly advertised on social media. Plus, she has her own questions about whether her diabetes, while elevating her COVID risk, might cause problems with the vaccine.

KELLEY: I'm kind of scared to get it in a way. In a way, I want it, you know? And my children - neither one of them want it. I don't know.

FARMER: It's not a never thing, she says; just a wait and see.

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CORNISH: Blake Farmer in Hartsville, Tenn. And this story also came from NPR's partnership with Kaiser Health News. It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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