“A pandemic of the unvaccinated.”
That’s the misguided and dangerous statement that took hold last week nationwide as President Joe Biden and CDC Director Rochelle Walensky used it to describe the latest phase of the pandemic, with Biden going so far as to say, “Look, the only pandemic we have is among the unvaccinated.”
Suddenly, headlines and cable TV news chyrons all screamed the pithy sound bite.
It’s tempting for a weary and frustrated vaccinated public to say “well, those people are getting what they deserve.” Vaccines are plentiful in the U.S. and it might seem like unvaccinated people are making their own beds with their refusal to accept science.
But it’s not that simple and to oversimplify by calling it a “pandemic of the unvaccinated” will only make the problem worse.
I think for many — especially in liberal, well-vaccinated Seattle — unvaccinated people are perceived to be white MAGA supporters who listen to conservative media telling them that vaccines are dangerous and that COVID-19 is a hoax. Yet that perception does not include the Black and Latino people who lag in vaccination rates; it also fails to consider the wider range of people who are unvaccinated or unable to get protection from vaccines.
If we accept the idea that it’s now just a “pandemic of the unvaccinated” and those smart enough to get vaccinated should be able to go back to pre-pandemic life and too bad for everyone else, we are also leaving behind groups like all children under 12 who do not yet have access to vaccines; teens who remain unvaccinated (only 34% of 12- to 15-year-olds are fully vaccinated in Washington state); immunocompromised people who are not seeing immune response from vaccines; as well as communities of color who are hit hardest by the virus. In Washington, for example, Hispanics account for 29% of COVID-19 cases, 13% of the population and only 9% of people fully vaccinated.
Calling it a “pandemic of the unvaccinated” also ignores the fact that the unvaccinated groups are intrinsically connected to the rest of the vaccinated population. A vaccinated parent’s level of COVID-19 mitigation has a direct impact on their child’s ability to stay safe, for example. An unvaccinated health care worker can have a direct impact on an immunocompromised patient.
By ending almost all mitigation efforts — such as masking and distancing — when Washington state officially reopened a few weeks ago, we effectively hung up the “mission accomplished” banner before the mission was close to accomplished.
Now the delta variant is running rampant and cities like Los Angeles are reinstituting mask mandates to try to combat the surge. On Friday, King County’s top public health official, Dr. Jeff Duchin, recommended everyone — including vaccinated people — wear masks again indoors.
Early evidence is suggesting that people infected with the delta variant may carry 1,000 times more virus than the original virus. Even more concerning, in Los Angeles County, 20% of COVID-19 cases in June were in vaccinated people, though it’s critical to note, the vaccine still protects against serious illness and death.
Pediatrician and public health advocate Dr. Rhea Boyd said in a July 17 tweet that we need to resist the urge to flatten the motivations of the unvaccinated, writing: “‘The unvaccinated’ are not a monolith of defectors. They are people our health care system has long underserved – Black folks, rural folks, un and un/under insured folks and young folks.” Further, the narrative around “vaccine hesitancy” in communities of color is overstated, Boyd said in a New York Times op-ed earlier this year, and “implicitly blames Black communities for their undervaccination, and it obscures opportunities to address the primary barrier to Covid-19 vaccination: access.”
In an interview with journalist Ed Yong in The Atlantic last week, Boyd expanded on her point. She said, “availability and access are not the same thing.” There are many reasons why structural barriers might make vaccines not as accessible as we may think for marginalized communities. Barriers can include lacking transportation; no paid sick time to take off work to deal with side effects; lack of credible information; and lack of basic preventive health care.
Boyd’s advice? Everyone should wear a mask indoors and in public spaces regardless of vaccination status.
This crisis is not over and it’s not just half the population’s problem. We are in it together and must fight it together, if we hope to ever see the end of this long, terrible nightmare.