‘We’re in the marathon part’: Health officials target remaining groups to get vaccinated along Path to Herd Immunity

MADISON, Wis. – For health officials, the beginning of the vaccine rollout felt like a sprint.

“It felt like we were like racing as fast as possible to get everyone vaccinated,” said Rebecca LeBeau, public health specialist at Public Health Madison & Dane County.

In December, it all started with health care workers. Then vaccine eligibility gates opened to people 65 and older, certain professions such as teachers and eventually for those with certain medical conditions.

All adults got the go-head in early April, along with 16- and 17-year-olds. Finally, 12 to 15-year-olds could get the shot in May.

Many were eager to get their shots, struggling to get appointments or scheduling their doses on their first day of eligibility.

But now that enthusiasm is dwindling, so are the state’s vaccination numbers.

From a peak of about 426,000 vaccines given the first full week in April, that’s fallen to about 105,000 administered over the last week of May, according to data from the Wisconsin Department of Health Services.

“It’s going to take a little more time now and that’s OK,” LeBeau said. “We’re in the marathon part.”

They may be moving more slowly along the path to herd immunity, but health officials are taking steps to get there.

“We all hope to get to a point where COVID doesn’t exist,” said Mo Kharbat, regional vice president of pharmacy services at SSM Health. “We just need to defeat the pandemic by seeing us as a community getting the vaccine.”

Who’s left?

When it comes to who has yet to get the shot, health officials said it mainly comes down to younger people, communities of color and people in rural areas.

Kharbat said they look to places falling behind “where perhaps there aren’t many sites or options out there, these areas become areas where we need to focus attention on.”

He pointed to counties in the area with lagging vaccination rates, such as Rock, Jefferson and Dodge.

“Vaccination rates are not just behind Dane County they’re behind the state’s average,” Kharbat said.

Public health officials are breaking down the data in Dane County, too, mapping out municipalities and census tracks with lower vaccination rates. That includes places like the towns of Dane, York and Medina, along with spots in Fitchburg, south Madison and north Madison.

“It’s not easy when you’re in outlying communities all the time,” LeBeau said. “You might not have access to public transportation.”

How can they be reached?

The data helps determine where to set up pop-up clinics, in places such as libraries, bars and restaurants. A full map of upcoming pop-up clinics can be found here.

“We’re really trying to reach every corner of the county,” LeBeau said.

Fewer Black and Hispanic people have gotten the vaccine in both the county and the state as a whole, sometimes due to lack of access, sometimes due to hesitancy or mistrust.

“They have some valid concerns because it’s new technology. They want to learn more,” said Lourdes Shanjani, PHMDC bilingual health coordinator.

She said that hesitancy can come “because of past or current experiences they’ve had with health systems.” Those who aren’t documented can also worry about deportation.

PHMDC is working to build trust, coordinating with community leaders.

“They are the ones who know and have trust and relationship with the community,” Shanjani said.

They’re also aiming to break down information along with barriers. Shanjani has participated in dozens of community conversations.

“There’s already a lot of information. We make sure we’re all speaking the same language and people are informed,” she said. “Not necessarily coming in from a perspective of we’re going to come teach you about the vaccines, but we are here to listen to concerns and share information that’s accurate so people can feel empowered to make a decision.

“I think the majority of this next 40 to 50% of people really are willing, but need more information and need to be helped in understanding that it really is important for them to do it,” said Dr. James Conway, the medical director of UW Health’s immunization programs.

Conway said many of the remaining people who are unvaccinated are relatively young. Though they became eligible more recently than people who are 65 and older, he said some have gotten caught up in complacency

“I think it’s a combination of, I didn’t get it yet and things aren’t that bad, leads to the well, I guess it’s not really that important,” Conway said.

But he said it is important, not only to protect themselves, but others, especially against current and possible variants.

“There is very high likelihood they have friends and families that actually fit into these immunocompromised groups that may not get the full response from the vaccine, and if they got infected by this disease, may have an unfortunate outcome,” Conway said.

For others left to get the shot, he said some may be more comfortable going to their general practitioner over a community clinic. Another factor that may make about a third of unvaccinated adults more likely to get vaccinated, according to the Kaiser Family Foundation, is full FDA approval of one of the vaccines.

Kharbat said that could come within a few months.

“There are individuals who are cautious and they want to wait,” he said. “We need to be patient and persistent and continue to provide information, answer questions and hope for folks who are on the fence, hope to see them lean this way and get the shot.”

What does this mean for herd immunity?

Experts estimate that herd immunity can be achieved when anywhere between 60 to 90% of the population is vaccinated. Less than half of people in Wisconsin have gotten at least one shot.

As Conway put it, some whose “heels are dug into the sand and they’re not moving” will never opt for the vaccine.

According to the Kaiser Family Foundation, Republicans, rural residents and White Evangelical Christians are disproportionately likely to say they will definitely not get vaccinated.

With a combination of the about 67% of people in Dane County who have gotten at least one vaccine dose and those who have immunity from contracting the virus (immunity which will likely fade), the county has reached some form of herd immunity.

“I think we’re starting to approach those numbers where that herd immunity is diminishing the circulation of this disease,” Conway said. “I mean, I think the goal as always – 90% of herd immunity is where you get rid of diseases, 80% is where you start talking about getting rid of outbreaks, and 70% is where you start to tamp things down, and I think we’re probably, between people infected and people vaccinated, around that 70% number.”

But as travel picks up and natural immunity fades, he stressed the importance of continuing to get vaccination numbers up.

LeBeau said that it’s important to not frame herd immunity as a set destination.

“It’s not going to be a light switch. It’s going to be this dial we’re turning up. We’re already turning the dial up, and we’re seeing results already,” LeBeau said. “Each person that gets the vaccine is making a difference in the community being able to protect each other, including kids.”

The final group awaiting eligibility: children

The vaccine has not yet been approved for children under the age of 12, who still factor into the population when thinking about herd immunity.

Conway said now is the time to start thinking about getting kids caught up on vaccines they missed over the last year and encouraging children eligible for the COVID-19 vaccine to get that ahead of school starting.