To those who have already received vaccinated and received a booster shot against COVID-19, it may be tempting to make assumptions about those who have not yet gotten a shot but there are a range of reasons and many of the unvaccinated may not fit into the category of “anti-vaxxer,” according to a researcher looking at Vermont data.
“Some people continue to be concerned about the side effects of vaccination. Others have poor access to vaccines or boosters. Others aren’t vaccine-resistant but maybe not vaccine-motivated, and that’s particularly the case in younger people. Of course, there are some people that are refusing to get vaccinated or that we would characterize as vaccine hesitant,” said Anne Sosin, a public health practitioner and policy fellow at the Rockefeller Center for Public Policy at Dartmouth College.
Sosin, whose research is focused on COVID-19 and rural health equity in Northern New England, has looked at research from Vermont and New Hampshire and she is part of a group that has been looking at the policy response for the United States beyond just New England.
She said many communities have been targets for misinformation about vaccines and members of those communities may not have access to better sources of information. They may have poor access to health care or health care providers who could provide more scientifically supported information.
“We need to recognize all of that in thinking about why we see vaccination gaps. I think the narrative (during) the pandemic of the unvaccinated has done very little to address the range of reasons why some people remain unvaccinated and has really, unfortunately, eroded the political will to address those factors,” she said.
Sosin said she was concerned that some might find it easier to blame the unvaccinated.
“I think that language shifts focus from policymakers to individuals. Unfortunately, it’s really divisive within our communities. We have a lot of work left to do to close vaccination gaps,” she said.
Sosin said the national data shows persistent racial, income and rural disparity, across all age groups, in the rate of vaccinations and boosters.
“Even in Vermont which, as you know, is the most vaccinated state in the U.S., we see differences in vaccination at the county level that mirror other health and social disparities,” she said.
For instance, Sosin said counties with higher median income have higher vaccination rates.
She noted the disparity is “particularly startling” when looking at the rates of vaccination for children, 5 to 11. Chittenden County, the most highly-vaccinated in Vermont, has the highest rate for children in that age range at 76%, which is three times higher than rural Essex County at 25% and more than twice as high as Orleans County at 35%.
All of the percentages are from the Vermont Department of Health’s vaccine dashboard as of Wednesday.
Sosin said she believed Vermont did good work in promoting vaccinations when they were first available, but doesn’t seem to have continued as strongly in its outreach since then.
“Vermont used many successful strategies to achieve its high rate of vaccination. We need to leverage the lessons from our early vaccination efforts to close the gaps in child vaccinations as well as in booster delivery. We have a good playbook in place in this state to do this work,” she said.
Sosin recommended more opportunities to get vaccinated, especially at schools, and better messaging to support parents. While vaccination clinics started strongly, Sosin said she thought they needed to persist because parents and other adults responsible for children might need time to make that decision for the children in their care.
In particular, she said the community health centers, critical-access hospitals or other small providers which serve rural communities have less capacity for vaccination efforts and other public health activities as COVID surges as result of the omicron variant.
Ben Truman, a representative for the Vermont Department of Health, said, “Sosin and the state are in full agreement about the public health importance of having the highest rates of vaccination and booster shots as possible.”
He said staff at the health department are working hard to provide effective access to people who are harder to reach, such as people experiencing homelessness, and to those for whom access is challenging because of historical and cultural inequities.
“The department has several agreements with organizations that support our diverse state, for example, the Vermont Health Equity Initiative offers walk-in clinics every weekend for any age, which has been welcomed by our BIPOC community, so much so, that we’ve started to offer flu vaccine whenever possible at these clinics as well. Our staff continue to travel to shelters, transitional and congregate housing, and other spaces that support Vermonters disproportionately impacted by COVID-19 to ensure equitable access to vaccine,” he said.
But Sosin also noted the responsibility didn’t rest solely with the health care community.
“I think our families, friends and social networks play a critical role in the health choices we make,” she said.
But she urged empathy be central to that outreach.
“The most important thing to understand is that blaming is toxic to public health. We need to start from a place of compassion and empathy in supporting others to make the choice to become vaccinated,” she said.
Sosin said she was hopeful that Vermont could reach higher vaccination rates, in part, by learning from its early success.
“Our state flooded our communities with vaccination sites and information. We invested a lot of resources in that goal. We need to do the same thing right now. I don’t think we’ve reached saturation point yet. I think we can do better,” she said.
Sosin pointed out that hostility toward others was counterproductive.
“Blaming the unvaccinated will do nothing to get shots in their arms, but it will erode the political will to address the factors that leave them still unvaccinated,” she said.
patrick.mcardle
@rutlandherald.com
