There are 11 states in the United States where at least 20 percent of older adults still haven’t received a Covid shot, potentially putting the recovery there at risk.
People 65 and older were given top priority for vaccinations because they are far more vulnerable to serious illness and death from the coronavirus than younger people are. Those 65 and older have the highest rate of vaccination among all age groups, with 87 percent having received at least one dose, compared with 60 percent for people ages 18 to 64, and 31 percent for those 12 to 17.
But in 11 states, seniors who have yet to get a dose of the vaccine pose a risk to their states’ recovery as most places remove restrictions aimed at limiting new outbreaks.
Most of them are in the South: Alabama, Arkansas, Louisiana, Mississippi, North Carolina and Tennessee. Georgia, Idaho and Missouri are at the 20 percent threshold. West Virginia and Wyoming also have more than 20 percent of people 65 and over without one dose.
“The 20 percent lines up pretty well with a group of people, especially in the South, who say, ‘No way, no how am I getting vaccinated,’” said Dr. Michael S. Saag, associate dean for global health and professor of medicine at the University of Alabama at Birmingham.
Among the factors at play, he said: conspiracy theories, a belief in pseudoscience and a libertarian mind-set that says, “You can’t tell me what to do.”
“Convincing them that it is in their own interest is a tough nut to crack,” Dr. Saag said. “For the state of Alabama and other Southern states, this is not for a lack of effort or resources. This is about a population resistant to receiving the message.”
Older people, in general, feel more threatened from the coronavirus and more likely to die from it, experts say, and it’s not surprising that they have been among the most receptive to the vaccines. After older age groups were given priority when the first vaccines were authorized for emergency use in December, the proportion of those dying started dropping immediately.
Across the United States, those 50 and older continue to make up the bulk of Covid-19 deaths, and the virus continues to kill hundreds of people daily.
Death rates remain high in pockets of the nation where vaccination rates are not. Experts are concerned that Southern states, where vaccination rates are lagging, could face a surge in coronavirus cases over the summer.
“All epidemics are local at the end of the day, and transmission is person to person,” Dr. Saag said. “There is going to be a hot pocket of transmission if someone becomes infected and others around them are unvaccinated. This is not Epidemiology 101, this is common sense.”
Last year, a summer surge lasted until September in the South. This year, many people are vaccinated, and there is residual immunity from those who have already had it, Dr. Saag said.
What’s more worrying for him, he said, is the dropping of mask ordinances as the more infectious Delta variant spreads. U.S. health officials this week classified the Delta variant, which was first found in India, as a “variant of concern,” sounding the alarm because it spreads rapidly and may cause more serious illness in unvaccinated people.
“We’re sitting on a powder keg,” Dr. Saag said.
A Kaiser Family Foundation poll found last month that 10 percent of unvaccinated seniors said that they would “definitely not” get inoculated against the coronavirus. But the same poll showed signs that some hesitant people have been persuaded: About a third who had planned to “wait and see” whether they would get vaccinated said that they had made vaccine appointments or planned to do so.