Many older Americans still go unvaccinated, making the Delta wave deadlier

The United States has a much higher share of older people without full vaccine protection than many other wealthy countries, a key risk factor leading to severe illness and death from Covid-19, according to an analysis from The Times.

As the Delta variant has spread across the country, the pace of vaccinations in the United States has picked up after months of relative stagnation, and full federal approval of the Pfizer vaccine on Monday could extend that momentum. Just over half of Americans are now fully immunized.

But national averages mask the high rate of older Americans who remain deeply vulnerable. The elderly still account for the majority of Covid-19 deaths, and in many counties, particularly in the south and the western mountains, the elderly without full vaccinations make up more than 10 percent of the total population.

“We have sections of populations in counties who are healthy Americans, over 60, who are not vaccinated,” said Claire Hannan, executive director of the Association of Immunization Managers. “These people are at extreme risk, and they don’t realize it.”

In contrast, unvaccinated elderly people in Britain, Spain and Canada are relatively rare. And they’re rare there, no matter where you live: these nations also have far fewer disparities between the most and least vaccinated areas, according to local immunization data.

Even London, which has higher rates of vaccine hesitancy among the elderly than the rest of Britain, is far ahead of most of the United States in its vaccination rates.

This discrepancy may help explain why the Delta Wave led to such a high death rate in the United States as in Britain, according to public health experts. Although cases have increased in both countries, these cases have caused far fewer hospitalizations and deaths in Britain, suggesting vaccines have weakened the link between infection and serious illness.

While older Americans are more likely to be vaccinated than younger Americans, older people without full vaccine protection are at a much higher risk of dying from Covid-19.

The Delta variant has hit many areas with clusters of vulnerable seniors particularly hard. Low vaccination rates among seniors in Arkansas, Florida, Idaho, Louisiana and Nevada have coincided with rising rates of hospitalization and death.

Comparisons between countries are inaccurate and there are no factors that determine the number of people who are seriously ill or who have died during a Covid-19 outbreak. Overall immunization coverage in a community, as well as existing health conditions, access to medical care, and individual behavior such as wearing a mask all play an important role.

Some high-risk areas in the United States have yet to experience severe outbreaks in the Delta, including parts of Colorado, Kansas, and North Dakota.

But vaccines are very effective in preventing serious illness and death, even against the Delta variant, and public health experts say senior immunization levels are a useful tool in understanding vulnerability during an outbreak.

While unvaccinated young adults represent a growing share of new hospital visits, “the vast majority of people who have died from Covid-19 are older and unvaccinated,” said David Dowdy, infectious disease epidemiologist at Johns Hopkins University.

As in the United States, France and Italy have struggled with vaccine hesitancy among many older people. The rates of less protected seniors in some regions, such as Sicily in Italy and Marseille in France, rival those in the southern United States. Japan, whose deployment has been hampered by dose shortages, has one of the lowest elderly immunization rates in the developed world.

Vaccine hesitation is not unique to the United States, but it is more prevalent and stronger than in Europe, and it breaks down more clearly along political lines. State and local governments have also been less willing than European leaders to use warrants to pressure residents to get vaccinated.

The Food and Drug Administration’s decision to grant full approval Monday for the Pfizer-BioNTech vaccine could lead some people to be reluctant to get the vaccine. And it will speed up vaccination mandates: The Pentagon has said it will require injections for 1.4 million active-duty soldiers, and some hospitals, colleges, businesses and other organizations are expected to follow suit.

But these mandates are even narrower than those in parts of Europe, where policymaking is more centralized. All French and Italian residents must show proof of vaccination or a negative coronavirus test to access most indoor places, including restaurants and bars.

Enrolling older Americans for their first vaccine remains a struggle, public health experts say, as people who really wanted a vaccine have already gotten it. Although access to a vaccine supplier may still be a problem for some, especially in more rural areas, many more people are resistant to vaccination because of their political and personal views, as well as those of their families. friends and family.

“We really tried to get them vaccinated,” said Molly Howell, director of immunization for the North Dakota Department of Health, where health officials sent letters to every unvaccinated elderly person in the country. State. “There just seems to be a lack of trust in public health and government, and even a lack of trust in health professionals. ”