Despite July 4 timeline, the US is a long way from herd immunity

As the rate of vaccinations continues at a record pace, Americans are increasingly emerging from their long and dark winter hibernation with a sense of cautious optimism and hope for a more ‘normal’ summer. 

There are in fact signs of hope. More than one-third of U.S adults have now received at least one dose of the vaccine, marking a significant milestone on the march towards herd immunity. And with more than 78 percent of people over the age of 65 vaccinated (with at least one dose), mortality rates have plunged since their January high.  

Closely following the data, the Biden administration recently moved up its deadline for opening up vaccine eligibility for all U.S. adults to April 19. In doing so, President Biden was only formalizing what was already underway: the vast majority of states had already set more aggressive timelines for opening up vaccine eligibility to all adults. With more than 3 million doses being administered each day — on average — the U.S. could well be on track to have all adults vaccinated by mid-summer. 

Unfortunately, there are also reasons for concern. While the U.S. is making great strides in its vaccine campaign, achieving the elusive herd immunity — or around 80 percent of immunity — will prove to be challenging. 

To start, we’re likely near the peak of vaccine demand. With nearly half of all adults already vaccinated with at least one dose, it’s likely that the remaining half will be less eager to take the vaccine. Hesitancy about the vaccines remains a tremendous obstacle among tens of millions of Americans who oppose getting the vaccine for a variety of reasons related to religious, political, or anti-science views that distort the issue. 

According to the Kaiser Family Foundation, 35 percent of Republicans and 32 percent of essential workers (non-healthcare) said that they would either definitely not get the vaccine or only get it if it was required. Another survey from Pew found that 45 percent of white evangelicals — of which there are about 41 million in the U.S. — would not get the vaccine. In some instances, people aren’t aware or able to get the vaccine, due to any number of access issues such as language barriers, internet access, or other technical issues. 

Beyond those who are unlikely to sign up for the vaccine, there are also those who, in the near term, aren’t able to: think children and youth under the age of 16. Kids under 18 years old make up about 24 percent of the U.S. population, meaning that any effort towards herd immunity will have to include the roughly 74 million children in the U.S. And though early clinical trials have shown good success in protecting older children, the process of granting emergency use authorization for children of all ages, may not come for weeks or months. In fact, Dr. Anthony Fauci, chief COVID-19 advisor to the president, has predicted that high school students are likely to be vaccinated by the fall of this year, while younger children will have to wait even longer.

With large swathes of society unlikely — or unable — to be vaccinated by the summer, the goal of herd immunity at the 80 percent of total population level is likely to prove elusive until later in 2021, at the earliest. 

But for the current moment, the focus should be on identifying and containing the variants that are currently raging in parts of the Midwest and northeast. The case of Michigan — which has seen cases and hospitalizations surge since early March — serves as an ominous reminder as to the seriousness of these variants. Cases there have nearly doubled in the past two weeks, while hospitalizations have increased by 124 percent, and deaths have increased by nearly 80 percent. 

The Biden COVID team has made extraordinary progress in increasing vaccine manufacturing capacity and ensuring efficient distribution of vaccines to the states.  In fact, vaccine supplies may be adequate in Michigan and most other states. But getting vaccines into arms may be the bigger challenge, so increased support from the federal government to help with distribution and administration may be what’s needed now. 

Still, controlling the spread of COVID-19 is not just a question of vaccine availability or administration. It is also important for state and federal officials to step up measures to enforce public health guidelines, like masks, distancing and hand hygiene. In addition, we must expand our national capacity for rapid genomic surveillance, allowing us to know, in real time, what variants of the virus are prevalent in areas experiencing serious outbreaks.

In Michigan and other states experiencing upticks in COVID-19 cases, the intensity of vaccine resistance and deep divides in access to testing, vaccines  and medical care among marginalized communities remind us that, while we are making good progress under the leadership and competence of Biden’s team, we are not yet out of the woods and still face an unpredictable timeline in eliminating the threat of the COVID-19 pandemic.

Dr. Irwin Redlener (@IrwinRedlenerMD) is the founding director, National Center for Disaster Preparedness at Columbia University’s Earth Institute as well as a senior research scholar. He is also a public health analyst for NBC/MSNBC and the author of “Americans at Risk: Why We’re Not Prepared for Megadisasters and What We Can Do Now,” and “The Future of Us: What the Dreams of Children Mean for 21st Century America.”. Sean Hansen (@sean__hansen) is a staff associate at the National Center for Disaster Preparedness at Columbia University’s Earth Institute, where he focuses on issues of COVID-19 and children in disaster.