This being America, it was probably inevitable that we would turn the scientific breakthrough of a pandemic-ending vaccine into a game show.

It’s like “Who Wants to Be a Millionaire?” with cash prizes, or “The Price is Right,” where you can “come on down!” to get a jab and a chance at an Xbox or free flights to Cancún or gift cards redeemable for topsoil (yes, really, topsoil).

Whatever works. It’s a little strange, though, that there’s not more hoopla around what’s happening with the vaccines themselves.

“For those of us in public health, it’s nothing short of amazing,” Dr. Jeff Duchin, the chief health officer for Seattle and King County, told me the other day.

I had called Duchin to ask about a startling claim he made recently. At a weekly health briefing, he offhandedly remarked that of King County’s recent COVID-19 cases, 97% had occurred in unvaccinated people.

It effectively meant the only people still catching coronavirus here in King County are people who haven’t gotten the shots. It also means the disease that just a few months ago threatened the entire nation is now almost exclusively circulating among a shrinking few.


Like a game show contestant, one of the reporters at the briefing exclaimed that this figure was “crazy,” too out there to be true.

What happened is Duchin had been noticing that disease transmission seemed to be increasingly located in spots around the county where vaccination rates were low.

Example: In the 98022 ZIP code, in the Enumclaw area, only 52.9% of the folks there 12 and up had been vaccinated as of this past week — which is one of the lowest rates in King County. In the two-week period ending in mid-May, that ZIP code also had the highest COVID case rate in the county, at more than 400 cases per 100,000 people.

At the same time, there are ZIP codes with vaccination rates that top 90%, and these had disease rates ranging from just one-fourth to one-tenth of Enumclaw’s. Examples include Sammamish and Mercer Island.

So epidemiologists at King County decided to take a deeper look at 15,397 local COVID cases, spread over April and May. The state disease surveillance network told them who these patients were. They then cross-referenced each case history with the statewide vaccination registry (when you get vaxxed, it gets recorded with the state — that’s also how you’re being entered into our new “Shot of a Lifetime” million-dollar lottery.)

What they discovered is that of the 15,397 positive cases, 14,895 were in people who hadn’t been fully vaccinated. That’s 96.7% of all local cases in April and May — a period in which King County passed the 50% vaccinated threshold, meaning half the population had been inoculated and half had not.


“It’s a very clear result,” Duchin said. “It leads to a basic conclusion: Who’s left to catch COVID-19? People who are unvaccinated.”

This isn’t an isolated finding. Across the state, the Washington State Department of Health reports that between April 3 and May 29, there were 1,358 “breakthrough” cases in which someone who was fully vaxxed still caught COVID. But during that same period, the state reported 63,751 cases among the unvaccinated — which is 98% of the total.

“We’re getting to the point where it’s a tale of two societies,” says Dr. Umair Shah, the state health secretary.

Shah reported this past week that unvaccinated people between ages 45 and 64 are now being hospitalized for COVID at rates 21 times higher than the vaccinated.

“It’s throughout the country that you’re seeing this split,” he said. “You have one society that is protected fully and is starting to go about its business … and another that is still at high risk of transmission and infection.”

Recently the hospital in Bend, Oregon, reported that it had seen 500 COVID patients since March — and 98% of them were unvaccinated.


This is real-world, snapshot-in-time data, so of course it may change going forward. It doesn’t mean the vaccines will always work this well. But Duchin said you rarely see such bright-line results in medicine (the annual flu vaccine by contrast is about 40% to 60% effective).

“This is why people were so excited by these vaccines back during the clinical trials,” he said. “We would have been happy if they were 70% effective. We would have been able to make do with 50%. But this is just amazing.”

The implications are clear. One is: Get vaccinated, if you can. As of May 31, only seven of the state’s 39 counties had passed the mark where half the population had at least one shot. In nine counties, fewer than a third had gotten a shot.

Duchin insists it isn’t true that everybody has had the chance to get a shot. It’s not time yet, he said, to assume that all have made their personal health choices, and to just let the virus run.

But that day is coming. Some sizable share of people are going to refuse to get vaccinated, he suggested, and with the disease already so overwhelmingly concentrated among them, the “two societies” appears inevitable.

“We will have to live in equilibrium with a level of disease that results from having a proportion of the population unvaccinated,” he said. Meaning: Periodic outbreaks, hospitalizations, deaths, potentially cycling for years.

Or: If 97% protection can’t entice you, then … come on down! Can we interest you in some of that topsoil?