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COVID-19 infections rise in several states where vaccination has stalled

A sign points the way to a check-in area at a coronavirus mass-vaccination site at the former Citizens Bank headquarters in Cranston, R.I., Thursday, June 10, 2021. (AP Photo/David Goldman)
A sign points the way to a check-in area at a coronavirus mass-vaccination site at the former Citizens Bank headquarters in Cranston, R.I., Thursday, June 10, 2021. (AP Photo/David Goldman)
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Progress in defeating the COVID-19 pandemic has slowed in the United States as disparities grow between states that have embraced vaccination and those where much of the public remains hesitant, and the emergence of a new variant has added fresh urgency to the campaign to inoculate Americans.

Of the eight states that have seen new infections rise in the last week, seven—Alabama, Arkansas, Missouri, Nevada, Texas, Utah, and Wyoming—have vaccination rates below the national average of 43% of eligible residents fully vaccinated. The states with the lowest infection rates have all seen above-average vaccine uptake.

A Washington Post analysis published Monday indicated a similar connection between vaccination and infection within states, with counties where fewer than 20% of residents are vaccinated encountering higher hospitalization rates and case numbers dropping in counties with vaccination rates above 40%.

It is not surprising that areas with lower vaccination rates are facing higher infection rates, but it does complicate the nation’s effort to return to normal this summer. The latest trends suggest vaccine hesitancy poses a serious risk to the gains that have been made over the last six months in containing the virus.

After steadily declining since mid-April, the seven-day average of new infections nationwide has begun to level off around 13,000 cases. That is the lowest number since late March 2020, but it might be difficult to drive infection rates much lower as long as nearly half the country remains unvaccinated.

“What’s happening nationally, really, when you think about it, is quite striking in terms of how effective the vaccines have been,” said Dr. Timothy Murphy, an infectious disease expert and director of the Community Health Equity Research Institute at the University at Buffalo.

As of Sunday morning, 64.4% of adults and 52.4% of the total U.S. population had received at least one dose of a vaccine, and 43.4% of Americans were fully vaccinated. The country is averaging about 1 million doses administered per day, but states are struggling to convince residents to roll up their sleeves, even with lotteries and other incentives intended to encourage them.

President Joe Biden set a goal of getting at least one shot into the arms of 70% of U.S. adults by July 4. The nation is on track to fall slightly short of that mark, and experts fear states and communities with low vaccination rates could still be at risk of another surge of infections.

Those concerns are rooted partly in the spread of the highly transmissible Delta variant, which was first identified in India and now accounts for up to 10% of U.S. infections. Research suggests two doses of the Pfizer or Moderna vaccines can provide strong protection against the variant, but a single dose is only 33% effective.

The United Kingdom announced Monday it would delay the lifting of remaining restrictions for up to four weeks because of the rapid spread of the Delta variant there. Former Food and Drug Administration Commissioner Dr. Scott Gottlieb told CBS News the variant could soon become the dominant strain in the U.S., potentially fueling a new outbreak in the fall among the unvaccinated.

“I think in parts of the country where you have less vaccination, particularly in parts of the south, where you have some cities where vaccination rates are low, there's a risk that you could see outbreaks with this new variant,” Gottlieb said on “Face the Nation.”

There are many reasons why case numbers have been dropping in much of the country, including vaccination, natural immunity, and seasonal factors like warm summer weather. However, the level of protection in some communities might not be sufficient to prevent the Delta variant or others from spreading unchecked when temperatures drop.

Young children, who are not yet eligible for vaccination, and young adults, who have been less eager to line up for shots, would be most susceptible to infection. They are generally less likely to experience severe symptoms or death, but they could still encounter lasting consequences.

“We're going to see a third wave,” Tom Bossert, who served as homeland security adviser to former President Donald Trump, said on ABC’s “This Week” Sunday. “It won't be as bad or perhaps not have as high a mortality rate tied to it. But these aren't just evenly distributed numbers.”

Some public health experts are confident vaccination rates are high enough to prevent a drastic backslide to the kind of crises some states suffered through last year. Still, while vaccines have been broadly effective against the variants discovered so far, vaccine-resistant strains might develop and make their way to the U.S. over time.

“The fact that we’re over 50% across the country is a good sign,” said Dr. Perry Halkitis, dean of the Rutgers School of Public Health. “Herd immunity is not an on-off switch.”

Millions of Americans have antibodies because they were infected at some point in the last 18 months, but Halkitis cautioned against relying on natural immunity in lieu of vaccination. Some research indicates natural immunity to COVID-19 can fade more quickly than the protection provided by vaccines, and those who receive a shot when they already have antibodies could end up with even stronger inoculation.

“Natural immunity is a powerful tool,” Halkitis said. “We don’t know, however, how long it lasts for this particular virus.”

As vaccination campaigns stall, states have been lifting restrictions on businesses and mask mandates for all residents, allowing even those who are unvaccinated to resume normal activities that could put them at greater risk of infection. Polls show those who are not vaccinated are currently more comfortable with going out to large events and restaurants than those who are.

A CBS News/YouGov poll conducted last week found nearly 20% of American adults do not plan to get vaccinated and another 11% remain undecided, with only 9% saying they intend to get vaccinated but have not yet gotten a shot. About 30% of Republicans and 20% of independents do not want to take a shot at all.

Among those who do not plan to get vaccinated, half said they believed the rapidly developed vaccines are too untested, and 43% are worried about side effects. One-third said they do not trust the scientists or drug companies involved, and 40% said they do not trust the government.

According to CNN, most states that President Biden won in the 2020 election are on track to meet the White House’s 70% target by July 4, while none of the states that voted for Trump are likely to do so. There is currently a 15-point gap between vaccination rates in blue states and red states.

A CDC report published earlier this month underscored the danger of lagging infection rates in rural communities, which have disproportionate numbers of senior citizens and people with medical conditions that can result in more severe symptoms if they get infected. They also tend to have less access to medical facilities with advanced intensive care units to treat them if they become ill.

Partisanship and entrenched hesitancy are not the only obstacles to increasing vaccination rates, though. Experts say deficiencies persist in providing equitable access to vaccine sites and distribution of credible, accurate information about the vaccines.

A study released Monday by the Kaiser Family Foundation and researchers at Stanford University projected racial disparities in vaccination would continue into the summer, with only about half of eligible Black Americans receiving a dose of a vaccine by July 4, compared to 63% of Hispanics and 66% of white people. Asian Americans are the only demographic on track to hit Biden’s goal of 70% getting at least one shot by Independence Day.

Vice President Kamala Harris spoke at a vaccination site in Greenville, S.C., Monday as she launched a national tour to boost inoculation. She attempted to frame getting a shot as an extension of the biblical “love thy neighbor” principle.

“You’re doing this for people you may never meet,” Harris said.

Harris touted steps that have been taken to eliminate barriers to vaccination, such as free rides, free child care, and tax credits for giving workers time off. Experts doubt any of that is going to prove persuasive for the approximately 20% of Americans who ardently refuse to get vaccinated.

“There’s a certain percentage that, no matter what you say, no matter what you do, are not going to get vaccinated,” Murphy said.

Halkitis said states like Ohio and New Jersey have been inventive about finding ways to spur vaccination with giveaways and contests, and outreach continues to be an important priority to sway those who have valid questions about the vaccines. Ultimately, those who cannot be convinced are the ones who would pay the price if the virus resurges.

“That’s frankly a bigger problem for them, because they are the ones who are susceptible to the disease,” he said.

With vaccination efforts at risk of stagnating at home, the Biden administration is aggressively pressing ahead with plans to deliver vaccine doses to the rest of the world. The U.S. has announced it will share 500 million doses of the Pfizer vaccine with less-developed countries, and other G-7 leaders committed to donating 500 million more vaccine doses over the next year.

"America will be the arsenal of vaccines in our fight against COVID-19, just as America was the arsenal of democracy during World War II," Biden said Thursday.

Another safe and effective vaccine could soon be available to help inoculate the world. Novavax announced Monday a large-scale trial found its two-shot vaccine was about 90% effective, and the company has committed to providing 1.1 billion doses to developing countries.

The World Health Organization warned recently of a “two-track pandemic,” where wealthy western nations soon get COVID-19 under control but the coronavirus continues to spread and mutate in the developing world. President Biden opened a news conference at a NATO summit in Brussels Monday with a public plea for people to get vaccinated as soon as possible, and experts echoed that sentiment.

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“The more people get vaccinated, the better off we’re going to be,” Murphy said.

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