The Washington PostDemocracy Dies in Darkness

Opinion We can’t reach safety if only half the herd is vaccinated

A person walks in Times Square after the CDC announced new guidelines regarding outdoor mask wearing and covid-19 vaccinations. (Andrew Kelly/Reuters)
Placeholder while article actions load

Jerome Adams, a former U.S. surgeon general, is writing in his private capacity as a University of Virginia Darden dean’s fellow.

We can’t reach the covid-19 finish line with only half the herd. Our country has been moving rapidly toward community immunity to covid-19, but the pace and enthusiasm are slowing from when Americans were willing to drive long distances and wait for hours to get vaccinated. We are swiftly approaching a tipping point on vaccine supply and demand. To finish this race and safely reopen, we urgently need to make it easier for holdouts to get vaccinated and implement new strategies to encourage them to do so.

Tuesday’s announcement of new guidance for vaccinated Americans — particularly that vaccinated people can safely go without masks outdoors in most circumstances — was overdue. Behavioral scientists know that the carrot often works better than the stick, especially when the stick isn’t applied equally across the population. Covid has ravaged Americans’ physical and mental health and our economy, yet it has long been clear that most healthy, young people are at very low risk for immediately apparent complications if they contract the disease.

Groups at low risk want to know what’s in it for them to get vaccinated. “Get vaccinated, and see nothing change — but trust us, it eventually will” isn’t nearly as compelling as “Get vaccinated and go to Europe this summer!” The Centers for Disease Control and Prevention was understandably cautious on issuing this guidance: Vaccines that are 90 percent effective mean that 10 percent of those vaccinated can still get sick if they are exposed. The scientific community is still debating the extent to which vaccines stop covid-19 spread vs. merely preventing severe disease. The risk is also greater the more spread there is, making it even harder for the CDC to back off safety guidance as covid cases surge in states such as Michigan and mass tragedy unfolds in India. But vaccination is by far the best tool we have to slow the spread and prevent disease — better than masks, social distancing and even shutdowns. Relaxing restrictions for vaccinated Americans is the right trade-off to incentivize more people to get shots and sharply cut risk among a larger group.

As we race against variants and toward summer gatherings and a full return to school campuses in the fall, we have to move faster toward community immunity. This requires addressing hesitancy with compassionate outreach and a focus on access — making the healthy choice so easy and obvious that saying no is harder than saying yes.

Unfortunately, it’s still easier to refuse a vaccine than it is to get one. I experienced this recently while investing quite a bit of time and travel to get my 16-year-old vaccinated. Federal officials urgently need to work with states and communities to put vaccines where people work, learn, play and pray. Most holdouts aren’t going to drive to far-off stadiums for shots, so we must aggressively engage those places people encounter every day: work sites, faith organizations and educational facilities.

We should also pursue full Food and Drug Administration approval and expand covid vaccinations to youths. Approximately 20 percent of our nation’s population is younger than 16 and therefore not eligible for the vaccine. We’ll never get 70 to 85 percent of the population vaccinated — the necessary level for herd immunity — if only 80 percent of the population can receive the shot. The individuals who got vaccinated early on were generally high risk and willing to take a vaccine authorized for emergency use. But many people who are lower risk understandably ask if the benefits justify taking a medication that has not received the full and traditional FDA stamp of approval. As vaccine manufacturers complete further studies, which will eventually lead to expanded eligibility among minors, it will help show skeptics that the authorized covid vaccines are safe.

Finally, we must engage trusted voices to encourage and administer vaccinations. Among the most important and underutilized are primary-care physicians. In poll after poll, Americans say they trust their own doctor the most. While there are logistical and storage challenges, reducing vaccine hesitancy calls for leveraging these trusted relationships and figuring out how to get vaccines into doctor’s offices.

One person could have a significant impact on those who are vaccine hesitant: former president Donald Trump. A lot of people who are reluctant to get the shot trust the former president. So I’m calling on him to loudly and proudly tell his supporters that he got vaccinated and they should too. Meanwhile, the Biden administration should give Trump more credit for development of the vaccines. Sustaining the narrative that the prior administration had nothing to do with vaccine availability does nothing to incentivize Trump or his followers to embrace the historic achievement of the vaccines’ development.

Vaccination is our quickest path back to freedom from covid-19 restrictions. Hammering that message home through policies and actions is the route to safer living.

Read more:

Greg Sargent: Some bad news about our future gives Biden a big opening. Will he seize it?

Jennifer Rubin: The lesson from the census: The GOP may have shot itself in the foot

George F. Will: A cheerleader’s salty language gives the Supreme Court a chance to bolster the First Amendment

Cornel West and Jeremy Tate: Howard University’s removal of classics is a spiritual catastrophe