Half Of U.S. Adults Have Gotten A Vaccine — But Hurdles Remain For Herd Immunity : Short Wave Today, NPR Health Correspondent Allison Aubrey offers perspective on how to think about the latest coronavirus news. On one hand, half of U.S. adults have been vaccinated and as of this week, everyone 16 years old and up is eligible to be vaccinated. At the same time, the administration of the Johnson & Johnson vaccine has been paused and many are still hesitant to get vaccinated.

Coronavirus on your mind? Email us at shortwave@npr.org — with your questions about the latest developments.

Half Of U.S. Adults Have Gotten A Vaccine — But Hurdles Remain For Herd Immunity

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MADDIE SOFIA, BYLINE: You're listening to SHORT WAVE...

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SOFIA: ...From NPR.

EMILY KWONG, HOST:

Hey, everybody. Emily Kwong here with NPR health correspondent Allison Aubrey. Hey, lady. What's up?

ALLISON AUBREY, BYLINE: Hey, Emily. Great to be here.

KWONG: Always excited to have you on the show but more so than usual today because you've got some great vaccine news for us, yeah?

AUBREY: Yes. Well, we've hit a milestone. Half of adults in the U.S. have now received at least one shot of a coronavirus vaccine. And as of yesterday, everyone 16 and up in every state around the country is eligible to get a COVID vaccine.

KWONG: Yeah, it's a huge milestone. It's actually pretty remarkable that we're here, you know?

AUBREY: That's right. And I will say I do have to measure this a little because as more contagious variants continue to spread, the challenge, of course, is to get the second half of the population vaccinated. And this is a challenge given how many people are hesitant.

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ROCHELLE WALENSKY: If you have not been vaccinated, I want to encourage you to do so with one of the available vaccines as soon as you can.

AUBREY: That is CDC Director Dr. Rochelle Walensky, who says getting as many people vaccinated as quickly as possible is key to putting this pandemic behind us.

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KWONG: Today on the show, Allison Aubrey offers us some necessary perspective - how to balance this exciting eligibility news with the not insignificant amount of hesitancy around the vaccine. You're listening to SHORT WAVE, the daily science podcast from NPR.

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KWONG: So, Allison, let's start with some good news. Vaccine eligibility has opened up in every state.

AUBREY: That's right. Now, teenagers age 16 or 17 have one option. That's the Pfizer vaccine. Adults 18 and up can get either Pfizer or Moderna. For now, the J&J vaccine is off the table as the rare blood clots are being evaluated.

KWONG: Right. So far, there have been six confirmed cases of that in almost 7 million people who got the vaccine.

AUBREY: That's right. And states weren't really expecting much of this vaccine right now anyway, given this ongoing production issue the company has been having. But the pause could be lifted this week. In fact, the Advisory Committee on Immunization Practices is set to meet on Friday.

KWONG: That's the group that advises the CDC.

AUBREY: Right. I spoke to Patricia Stinchfield about this J&J pause. She is a nonvoting member of the committee.

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PATRICIA STINCHFIELD: I think there's no doubt that the pause does make people a little bit nervous, but I feel like it's the right thing to do. And I think in the long run, I think pauses like this builds confidence to say, yeah, you know, we had a pause, we looked at it, we evaluated it. We feel confident going forward.

AUBREY: You know, Emily, there's just a lot of directions that this could go.

KWONG: Yeah.

AUBREY: I mean, one possibility is that there could be some restrictions placed on the use of the Johnson & Johnson vaccine, say, by age. Remember, the blood clots have been identified in women all under the age of 50. There's also links to blood clots with the AstraZeneca vaccine, and some European countries have put restrictions on it. So that's one possibility.

KWONG: And has this led to hesitancy among women or people who may have been on the fence about getting vaccinated?

AUBREY: You know, among the health care providers I've spoken to, I think they agree that the pause has led to some concern among people who may already be hesitant. I mean, that's including some but certainly not all - pregnant people or those considering having a child. I talked to Dr. Laura Riley about this. She is one of the authors of the American College of Obstetricians and Gynecologists guidance policy on vaccination during pregnancy. She says she understands the anxiety.

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LAURA RILEY: The J&J stop, I'm sure, has, you know, thrown some people back on their heels. And so I think the purpose of the pause is not only, you know, like obviously you want to see are there more cases, but you also want to pause so that physicians and patients know what to do if they have the symptoms.

KWONG: Right. We talked about how the pause was due to the vaccine causing blood clots in some patients. What kind of blood clots are we talking about?

AUBREY: So these are a rare and really serious type of blood clot. It's called a cerebral venous sinus thrombosis or a CVST. And in the case of the six women, it has been seen in combination with low levels of blood platelets. Now, because of this combination, the condition needs to be treated differently compared to a typical blood clot. But the symptoms can include a really bad headache, blurred vision, fainting, loss of control over movements in parts of the body and even seizures.

So, you know, once the pause is lifted, presuming it will be lifted at some point, people could be warned after vaccination, hey, you know, if you get this really severe headache or one of these other symptoms, it could be a warning sign. And physicians would also know how to respond. I mean, Dr. Riley says for now, she is definitely advising patients to go ahead, get the Pfizer or Moderna vaccine because they're available. And she's also reminding people why. I mean, the risks of not getting vaccinated far exceed the risks tied to the shots.

KWONG: Absolutely. I mean, the vaccines are really our strongest weapon against deaths due to COVID-19. But we really do see hesitancy cropping up. I mean, there are new reports of vaccine appointments going unfilled even in places that have already opened up eligibility.

AUBREY: Absolutely. I mean, you scan the headlines. There are reports from West Virginia, parts of Ohio, Mississippi, really too many to name. It's from pharmacies and clinics. There are just lots of reports of vaccination sites that have not seen appointments fill up as quickly as the supply has come in. I spoke to Claire Hannan of the Association of Immunization Managers about this.

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CLAIRE HANNAN: You know, it is certain areas of the country, certain counties. They tend to be white, conservative, evangelical counties, rural areas. You know, this is where we're seeing that demand is not as high as the supply.

AUBREY: So she's saying, you know, outreach is key. People need to have their questions answered. There are all kinds of efforts around the country, including getting primary care physicians involved to reach out to their patients, just trying to give people the information they need and encouraging people to get the shot.

KWONG: Yeah. And, you know, early in the pandemic, Allison, many polls indicated higher levels of hesitancy among Black Americans. Is that still the case?

AUBREY: Yeah. I mean, a Kaiser Family Foundation poll at the time of the vaccine rollout back in December found 52% of Black Americans said they would wait and see before signing up for a vaccination. Now, a more recent poll suggests that hesitancy among Black people may be waning.

This recent NPR/PBS NewsHour/Marist poll found 25% of Black respondents did not plan to get the shot. And this compared to 28% of white respondents who said they did not plan to get the shot, so really, not a big difference there at all. And Claire Hannan says there have been a lot of successful outreach efforts, and clearly there's more access now to the vaccine, especially in urban areas.

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HANNAN: Black doctors, Black ministers, Black nurses - there are so many Black leaders involved and engaged, getting vaccinated, being, you know, vocal about it. I think it's helping tremendously.

KWONG: Yeah, that seems like progress and good news. But is the Johnson & Johnson pause slowing down this progress?

AUBREY: You know, it certainly doesn't help.

KWONG: Yeah.

AUBREY: And I think the answer is sort of, you know, it depends. It depends on how strong and for what reasons people have been hesitant. I spoke to Calvin Johnson. He's a doctor in the Los Angeles area. He's been spending a lot of time in his community, including at the church where he is a member, answering questions among people who were very hesitant at the time the rollout began. Now, he told me he does think he's making progress, but you just don't win everyone over all at once, he says. So among the people who are most resistant, the Johnson & Johnson pause may be making some of them more skeptical.

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CALVIN JOHNSON: I think my job is going to be more difficult given the pause in the J&J vaccine. There's fear, and there's anger. The thought is that they've been tricked. It's the vaccine came out too fast. It wasn't tested enough. See, I told you so.

AUBREY: And that's why he says you really have to meet people where they are, take the time, sometimes one on one, just to answer their questions.

KWONG: Yeah, yeah. He's in a really tricky position. So is he just doubling down on his efforts, answering more questions, doing more outreach? How's he responding to this?

AUBREY: You know, a lot of what he tries to do is to put the risk in perspective for people, you know? The risk of a blood clot linked to the J&J vaccine appears to be about one in a million. That is much, much, much lower than the risk of, say, getting in an accident when you're behind the wheel of a car and driving, something we - many of us do every day. You know, he also tells people about his personal experiences. He has watched, in the hospital, lots of people die from COVID. And given that experience, I mean, clearly the disease is worse than the risks tied to the vaccine.

KWONG: Yeah.

AUBREY: So the message he's sending to people is, look, you know, it's critical to get as many people vaccinated as quickly as possible. And I think that's been a hard part for me of just reporting on this. I mean, if you just look at that fraction, the denominator is 6.8 million doses delivered. The numerator is, you know, six cases of blood clots. That is really, really rare. And so the rational brain kind of, you know, says, oh, yes, this is a very, very rare risk.

But then I listened to the ACIP meeting, the Advisory Committee on Immunization Practices meeting, last week when they went into detail about the sicknesses of these six women who got the clots. And it's horrifying. I mean, one young woman was sent home from the ER with Benadryl before they detected a clot. Some of these women, it's not clear if they have fully recovered. One woman died. You know, you can't discount that.

I think, you know, the good news - if you can say there's good news coming out of a death - is that the safety signal was picked up pretty early. And now doctors and people who get vaccinated can be on the lookout. So I'm really looking forward to what the committee decides this week.

KWONG: Right. And we'll continue to hear this message from public health officials in the meantime to please get vaccinated using the Pfizer and Moderna vaccines, especially as cases in the U.S. remain high. So what are those latest numbers for cases?

AUBREY: You know, there are still more than 60,000 new cases a day. Deaths have been declining down to about 700 or so a day, but it's mixed around the country. I mean, take New York, New Jersey. The cases are declining there. That's good news. But cases have been rising in hot spots, including Michigan, Pennsylvania, parts of Florida, parts of Washington state. I mean, bottom line, the virus is still circulating. And I talked to Dr. David Rubin about this. He's the director of the policy lab at Children's Hospital of Philadelphia, and he analyzes all the trends.

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DAVID RUBIN: Americans have quickly retreated from any sort of social distancing. So this kind of - this mismatch right now where, I think, a lot of young and middle-aged adults are in particular and those who are vaccine hesitant are being swept up a bit into this long tail and a bit of a spring resurgence.

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AUBREY: So now that eligibility has opened up, Emily, I think the hope is that many of these unvaccinated young or middle-aged adults will opt to get the shot, which will help to put this pandemic behind us.

KWONG: Yeah, the road ahead of us really continues with this. Allison, thank you so much for this reporting and bringing it to SHORT WAVE. We really appreciate you.

AUBREY: Great to be here, Emily.

KWONG: Today's episode was produced by Rebecca Ramirez, edited by Jane Greenhalgh and Gisele Grayson, and fact-checked by Rasha Aridi, who has graduated from SHORT WAVE intern to news assistant. Rasha, we're very excited you'll be staying on with us. I'm Emily Kwong. Thanks for listening to SHORT WAVE, the daily science podcast from NPR.

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