Significant gaps remain in vaccinating younger Mainers

·6 min read

May 18—Nearly six weeks have passed since all Mainers age 16 and older became eligible for COVID-19 vaccine, but state data suggest challenges remain in persuading young people to get vaccinated.

Among residents 50 or older, 79 percent have had either a first dose of the two-shot Pfizer or Moderna vaccine or a dose of the one-shot Johnson & Johnson option, according to data from the Maine Center for Disease Control & Prevention. That's at or above the threshold needed for herd immunity and a positive sign because older individuals have been at highest risk of serious illness or death.

But among those between the ages of 16 and 49, the vaccination rate drops to just 51 percent. Furthermore, the rate decreases steadily from those in their 40s (57 percent) to those in their 30s (53 percent) to those in their 20s (46 percent). Younger people also have been driving new virus transmission now that a strong majority of older residents are protected.

"For a lot of people in their 30s, 40s, and 50s, what's been clear is that they felt that it wasn't their turn for so long and they're only now starting to pay attention." said Dr. Dora Anne Mills, chief health improvement officer for Maine Health. "So that urgency just hasn't been the same as it was in the beginning with health care workers and others who really saw the virus as a major threat."

Vaccination rates are worse still among younger people in more rural areas of Maine, a trend that holds true across the country. The most recent tracking survey by the Kaiser Family Foundation suggests interest in getting vaccinated drops off sharply as people get younger.

Among those 65 or older who were surveyed, 81 percent said they either got the vaccine or plan to as soon as possible. In the 50-64 age group, the percentage dropped to 70 percent, and among 30-49-year-olds, it fell to 59 percent. Finally, among 18-29-year-olds, just 51 percent said they have gotten it or plan to soon. Another 24 percent of 18-29-year-olds surveyed were in the "wait and see" category, which suggest they might be persuadable under the right circumstances.

Dr. David Dowdy, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said the biggest challenge in reaching the younger population is that they aren't a monolith.

"Just as the reasons why people are not getting vaccinated are multi-faceted, so too are the solutions," he said. "No one solution is going to fix this."

Vaccination sites have increasingly made getting a vaccine easy by offering walk-in availability and after-work hours. Additionally, the state has started offering incentives, including the elimination of the mask mandate this month for fully vaccinated individuals. But whether that will be enough to make inroads among a population that includes many who seem willing to take their chance with the virus rather than the vaccine is unclear.

"It's important to keep in mind that each gain is still a real gain," Dowdy said. "It may take twice as long to get the second group of people vaccinated but once we do, there's that much more protection."

Maine still ranks tops among all states in percentage of population that is fully vaccinated, even though weekly vaccinations have decreased here for five consecutive weeks. Other vaccine trackers may give different results because they use other population figures, but all generally place Maine and other New England states at the top for vaccination rates, well above the national rate, which is about 37 percent. Across the country, shots peaked at about 3.2 million per day in mid-April but have now fallen to about 1.8 million per day.

Despite that dropoff, the U.S. reached a milestone this week — 60 percent of adults have received at least one dose, U.S. CDC director Dr. Rochelle Walensky said at a White House briefing Tuesday.

"We need to continue to ensure vaccination coverage is uniform across the country," she said. "This will require us to meet people where they are, to listen to their concern, and to help people make informed decisions about vaccinations."

Since the effort first began in December, Maine has administered 675,792 first doses, accounting for 50.3 percent of all residents, and 640,361 final doses, covering 47.6 percent of the population.

The Maine CDC recently started publishing zip code level data on its vaccination dashboard "to help vaccinators and health care providers plan for upcoming COVID-19 vaccine clinics and outreach." Each town is given a vaccination rate that is estimated using residents of all ages who have had at least one dose of any vaccine, based on population from the 2018 U.S. Census' American Community Survey, Maine CDC spokesman Robert Long said.

Because the population estimates are more than two years old, the rates are skewed in some places. The dashboard shows that part of the town of York, for instance, has a vaccination rate of 99 percent, which isn't possible for all residents since no one under the age of 12 there is eligible yet.

But in general, the zip code data supports what experts have concluded about vaccine efforts — communities that are more affluent, educated and that skew Democrat are far more likely to have higher percentages.

Mills, with MaineHealth, said the vaccine teams there have been analyzing the zip code data closely to help identify areas of need.

"Certainly, there are some rural areas, but we even see some urban zip codes where we need more work," she said.

Among communities that have rates above 60 percent and at least 2,000 residents who have yet to be vaccinated, Falmouth, Scarborough, Cape Elizabeth, South Portland and Brunswick have rates about 80 percent. Just outside greater Portland, though, in communities like Standish, Auburn, Buxton, Biddeford and New Gloucester, rates fall to the low 60s. Even further away, in Oxford, Rumford, Lisbon and Farmington, among others, the rate of vaccination is 55 percent or less.

Dowdy, the Johns Hopkins professor, said he's seen states start to report zip code level vaccination data recently and called it an important tool.

"We can't know where to target improvements if we don't know where people are or are not being vaccinated," he said.

The vaccination slowdown comes as new cases of COVID-19 continue to fall from an early spring surge. The Maine CDC reported 199 cases Tuesday, the fourth straight day of fewer than 200 cases and in line with a steady decline that is taking place across the nation. Two additional deaths were reported as well.

Maine's seven-day daily case average now stands at 238, the lowest since April 1. That's down from 297 two weeks ago and from a spring high of 475 cases on average this time last month. There have now been 66,113 confirmed or probable cases of COVID-19 and 805 deaths since the pandemic reached Maine 14 months ago, according to data tracked by the Maine Center for Disease Control and Prevention.

Across the U.S., the seven-day case average has dropped to about 30,000, the lowest level since late June of last year. Deaths from COVID-19 are averaging just under 550 per day, which is the lowest since early April 2020.

The number of people hospitalized in Maine with COVID-19 increased slightly to 113 on Tuesday. Of those, 42 are in critical care and 20 are on ventilators. Hospitalizations have come down slightly over the last two weeks but have remained above 100 every day since April 17.

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