What’s behind vaccine hesitancy in Idaho? It’s not just political.
Idahoans need to be vaccinated against COVID-19. But many are waiting.
About 115 people in Homedale got their first doses of COVID-19 vaccine in late April, as Saint Alphonsus Health System brought a trailer, staff and vaccines out to the rural community. (Courtesy of Saint Alphonsus Health System)
It’s a novel coronavirus. The only thing that could stop it was a novel vaccine.
An estimated one-third of Idaho’s population was infected by the COVID-19 virus as of late February, according to one highly regarded data scientist’s model. And now, more than one-third of Idaho’s population, has been vaccinated against it.
But Idaho public health officials say that isn’t enough to slow the spread of COVID-19, especially as coronavirus variants gain a foothold in the U.S. and in Idaho. They set a goal for 80% of Idahoans to choose to be vaccinated by this fall, and President Joe Biden recently announced an even more lofty goal.
“President Joe Biden on Tuesday set a new vaccination goal to deliver at least one shot to 70% of adult Americans by July Fourth as he tackles the vexing problem of winning over the ‘doubters’ and those unmotivated to get inoculated,” the Associated Press reported.
Idaho has struggled with vaccine hesitancy — and, in recent years, a small but loud and aggressive anti-vaccination movement.
The state in January signed a $3 million contract with G Squared LLC/GS Strategy Group — a Boise-based political, business and issues research and advocacy firm — to help combat that.
One big part of the contract was a survey of Idahoans to find out what matters to them as they make decisions about whether or not to take a vaccine.
That survey, a different one conducted by Boise State University researchers, and Idaho Capital Sun interviews suggest that Idahoans mainly fall into three groups, when it comes to being vaccinated:
- Yes, definitely.
- Not a chance.
- Unsure. Maybe worried about safety, maybe questioning efficacy, maybe waiting to see what happens as others go first.
Only about 18% of people the Idaho contractor surveyed in January said they would never get the COVID-19 vaccine. A larger group — 28% — said they planned to wait and see how it affected others before getting it themselves.
Political affiliation and other demographic factors play a role in Idahoans’ views on whether to get the vaccine or to take a gamble on catching and spreading the virus. Just like national surveys have shown, Idahoans who align with more conservative political ideologies and parties tend to be less likely to want the COVID-19 vaccine, the state-commissioned survey found.
Idahoans surveyed said that, when considering the vaccine, “their concerns are mostly about safety, especially politically right of center Idahoans on the fence about whether or not to get the vaccine,” the survey found.
But that is not the only thing causing “vaccine hesitancy” in Idaho.
Some Idahoans wanted to be first in line. Others hung back.
The first doses of a Pfizer COVID-19 vaccine arrived in Idaho in December, followed by doses of Moderna’s vaccine. Many Idahoans celebrated, sharing photos of health care workers giving them the coveted first dose.
It didn’t take long for the intense competition for doses to wane, and Idaho Gov. Brad Little opened up vaccine eligibility to more people, weeks ahead of schedule.
Four months into Idaho’s vaccine rollout, about half a million Idahoans are fully vaccinated against COVID-19. But the state seems to have reached a plateau in demand for the coronavirus vaccine — and the number of daily doses in arms is now on a downslope.
“Last week, we saw a further decline in the number of total doses administered, making it two weeks in a row where the total doses administered has declined,” Idaho Health and Welfare Director Dave Jeppesen said at a media briefing on April 27. “And we also have about four weeks’ worth of vaccine inventory in the state right now.”
It’s a problem that people familiar with Idaho’s vaccine history saw coming, long before the U.S. Food and Drug Administration authorized the first COVID-19 shot in December.
The state has among the lowest flu vaccination rates in the U.S., with less than half the state typically getting a seasonal flu shot.
The ‘what ifs’ make some Idahoans nervous
Rachelle Bell, 37, of Nampa, caught the virus in November while her family was living with her parents. Her father brought it home from work. It was “not enjoyable,” she said, but everyone recovered.
She gets tested regularly for her own job, and most of her coworkers have been vaccinated, she said.
But when she became eligible for the coronavirus vaccine a month ago, she didn’t make an appointment.
“I’m still feeling unsure about the vaccine, although I do plan to take it,” Bell told the Idaho Capital Sun in early April.
She’s not anti-vaccine, she said. She’s never gotten a flu shot herself, but her children received most of the recommended childhood immunizations when they were supposed to get them, she said.
She knows the Pfizer, Moderna and Johnson & Johnson vaccines went through rigorous testing. She knows the testing wasn’t rushed.
It has been more than a year since the first doses of Moderna vaccine and Pfizer vaccine were given in the U.S., during clinical trials. And the trial phases ran concurrently, instead of one after the other. The trials also didn’t have some of the hurdles that usually prolong the authorization or approval of a vaccine. For example, there was no shortage of people stepping up to volunteer to test the shots.
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And she said she’s not concerned about the mRNA technology and the “viral vector” technology used to make the vaccines. The technologies have been around much longer than COVID-19.
It’s the unknowns — about what might be discovered a year or two years from now — that make her nervous. Other vaccines in history — such as a rotavirus vaccine in the 1990s — are no longer used due to safety concerns.
Joe, a 25-year-old North End resident who leans libertarian, said that’s also his concern. (He asked to use only his first name for medical privacy reasons.)
He had an asymptomatic infection last fall, he said. He doesn’t believe conspiracy theories about COVID-19 and believes it’s serious, but he said in an April interview that he wasn’t feeling compelled to get his shot in the near future.
He’s in the “wait and see” camp.
One thing that would make him a lot more eager to get vaccinated? Having to show a vaccine card in order to travel.
“I don’t think something bad is going to happen if I get the vaccine, it’s just more I’m really curious to see, one year down the road, are people going to get sick from it?” he said. “It’s different than the past, you know? … But I’ve encouraged older family members to get the vaccine.”
Bell thought she’d have more time to decide. The state had been projecting that healthy adults her age would have to wait until summer for their turn.
“So, that’s more where my hesitancy lies with this one,” she said. “Not because it was developed quickly, but just because there hasn’t been time to allow those things to come out.”
She acknowledged that the same is true of COVID-19. Researchers are still figuring out the long-term effects of coronavirus infection.
What is known, so far, is that a significant portion of people who caught COVID-19 before they could be vaccinated have become “long haulers” with “long COVID.” They have ongoing complications that involve almost every organ system in the human body. They have fatigue, brain fog, neurological problems, joint pain, rashes, vision changes, heart problems, trouble breathing, lost or distorted sense of smell, new psychiatric diagnoses, and the list goes on.
A recent study in the journal Nature suggests COVID-19 survivors may be more likely to die several months after their illness.
And emerging data suggest that while children may typically have mild illness, they aren’t being spared from long-term complications of COVID-19.
Rachelle Bell and Joe say their experience with COVID-19 was so mild, it made them less worried about getting it again.
Bell said the immunity she likely developed after her November infection may have lasted long enough to still give her protection, and that’s a “risk-benefit ratio” she was comfortable with, she said.
Joe said the same.
The CDC says people who have recovered from COVID-19 should still get the vaccine. This is because post-illness immunity is hard to predict; a person’s immune system may not have mounted a strong and long-lasting defense against the virus when they got sick.
Some aren’t hesitant. The COVID vaccine just isn’t easy for them to get.
There also is a cohort of Idahoans who public health and health care leaders have identified — those who want the vaccine but have to jump through hoops to get one. That includes busy parents, busy people, those who either can’t make it to a vaccine clinic, and those who can’t take a sick day from work if they feel crummy after their shot.
Some Idahoans also aren’t English speakers and don’t have easy access to health care. That adds more hurdles between them and the vaccine.
The Idaho Department of Health and Welfare is asking the U.S. Centers for Disease Control and Prevention for a grant to further reach these groups of Idahoans, they said last month.
“We want to push ourselves, we want to push Idahoans, to get that vaccine,” Elke Shaw-Tulloch, administrator of the Idaho Division of Public Health, said in a media briefing in April.
She said public health agencies would try new strategies. They might give more funding to health care providers; offer vaccines at community events, churches and other places people go; and work with employers to give their staff incentives like paid time off, on-site clinics and “financial motivators” to get vaccinated.
Bell said this factors into her decision as well.
“Part of the thing is, right now, I work every day, and I have a family to take care of,” she said.
Saint Alphonsus Health System, St. Luke’s Health System and regional public health departments are now putting together mobile clinics. They hope that making it more convenient to get a shot will encourage people who are on the fence.
They’re taking doses on the road, offering walk-in appointments for free in rural communities like Weiser, large worksites like Chobani in Twin Falls and community centers, schools, farms and dairies, even a furniture store in Meridian.
Bell said in early April that, while she could think of reasons to postpone her vaccination, she did plan to take it eventually. She believed it was critical to help stop the pandemic and to protect the vulnerable.
Last week, she decided the time was right.
“My husband and I are both going tomorrow and getting it,” she said in a phone interview Thursday. “And then I have two teens who are going soon, too.”
Her children both want to be vaccinated, she said. “It’s a little scary to me still, but especially (since) they work, so they have exposure,” and the risk of long-term effects from COVID-19, she approves of their decision, she said.
Bell and her husband got appointments at St. Luke’s in Nampa. The health care provider had “lots” of appointments open, so it was easy to book one for a Friday morning, she said. That would give her the weekend to deal with any fever, aches or other possible side effects, she figured.
Why did she decide to make the appointment?
“I don’t want to be someone who’s contributing to the ongoing of the pandemic. I do all the things. I wear the mask,” she said. “I want life to be able to get back to normal.”
The Idaho Department of Health and Welfare commissioned a survey of Idahoans to find out what they thought about COVID-19 vaccination. The results:Idaho vaccination survey
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