National Immunization Awareness Month In COVID's Third Year

Books like these, on COVID-19, pandemics, and vaccinations, can be found at the Birmingham Public Library. Photo by Parker Evans. 

It's the close of National Immunization Awareness Month, the third one this pandemic has seen. Immunization is the process by which a person becomes protected against a disease through vaccination. 

As of this writing, 90% of the U.S. population over 18 years old received at least one dose of a COVID-19 vaccination. 77% of that same demographic received a second dose, and only 51% received a booster shot. 

While it preceded the COVID-19 pandemic, an explicit anti-vaccine movement, as well as a general vaccine suspicion, has become a more pronounced aspect of American public discourse. And it's not just in regard to COVID-19—according to the World Health Organization and UNICEF, we're seeing "the largest sustained decline in [global] childhood vaccinations in approximately 30 years," from research published in July 2022. 

There are far too many factors to this subject to all be considered extensively in this blog post, but we can touch on a few issues surrounding vaccines. They include:

• a decline in vaccinations in general, including a children's vaccinations as well as COVID-19 booster shots

• the politicization of vaccinations

• the relationships of Americans to the healthcare industry and their susceptibility to misinformation

• the shortcomings of the CDC and the federal government in response to COVID-19 

Boosters 

A new extremely contagious variant of COVID-19, called BA.5, emerged definitively in July 2022. According to a July 2022 article from CNBC.com, "Experts say booster shots are key to stopping BA.5 in its tracks, and all Americans age 5 and older are eligible five months after completing their primary vaccine series." However, "only 48.1% of eligible people in the U.S. have actually gotten boosted."

While a booster shot will not prevent infection by COVID-19, it will severely lessen the effects of the infection. Receiving a booster seems to be the clear choice for protecting one's health, and yet the reasons for such a low rate of booster recipients remains unclear. 

As stated earlier, there has also been a global decline in childhood vaccinations large enough to indicate a significant shift in attitude towards what has long been a routine part of child development. In the U.S. in May 2021, "the Centers for Disease Control and Prevention (CDC) reported that provider orders for non-influenza childhood vaccines through the Vaccines for Children (VFC) program had decreased by a total of about 11.7 million does during the COVID-19 pandemic."

So, what are some of the reasons for this deficit?

Politicization 

One major indicator of COVID-19 booster status in particular is political affiliation. As a Washington Post article points out, "A big factor [indicating booster status] is how partisan vaccines have become in the United States. Republicans make up a disproportionate share of the unvaccinated, and vaccinated Republicans are also significantly less likely to get boosted than vaccinated Democrats. That means the booster campaign has effectively exacerbated the partisan gap in protection from the coronavirus." 

However, "partisanships doesn't explain it all. These are people who were willing to get two shots and, for whatever reason, haven't been persuaded to get a third."

While suspicion of vaccines has existed as long as vaccines have, an explicit anti-vax position has become associated with a partisan stance, as the Post articles points out. An explicit anti-vaccination stance is certainly linked to right-wing political views. But this also does not totally explain what has been termed "vaccine hesitancy."

American Healthcare & Online Misinformation

Mistrust of the American healthcare system far precedes the COVID-19 pandemic, for a variety of reasons too numerous and complex to outline here. However, at least one factor worth noting is the sever gap in quality between our healthcare system and those of other wealthy nations. 

According to research by the Commonwealth Fund, a study of eleven high-income countries, including the United States, Canada, Norway, and the United Kingdom, found that "the United States was rated last overall, researchers found, raking 'well below' the average of the other countries overall...In particular, the United States fell at the end of the pack on access to care, administrative efficiency, equity and health-care outcomes." 

One plausible factor in general vaccine hesitancy and a viciously political anti-vax movement could be the combined forces of online misinformation and poor relationships to personal doctors. Online misinformation certainly stands out as political problem in regard to vaccination. 

Researchers in 2021 found that "just 12 people are responsible for the bulk of the misleading claims and outright lies about COVID-19 vaccines that proliferate on Facebook, Instagram, and Twitter." The proliferation of this misinformation suggest both a poor relationship between Americans and their healthcare providers as well as a sever shortcoming in the ability to determine whether information is false or misleading. 

CDC Shortcomings

Yet another major factor in this quagmire of American health has been the wishy-washy response of the CDC, too often becoming a weathervane in the winds of COVID-19 politics. 

The recent failure of the CDC to provide definitive, structural guidelines in the face of COVID's most contagious variant is a familiar theme in a three-year long battle between individual caution and community protection. 

Indeed, the CDC itself admitted earlier in August that it had failed to respond adequately: "Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, on Wednesday delivered a sweeping rebuke of her agency's handling of the coronavirus pandemic, saying it had failed to respond quickly enough and needed to be overhauled." 

Whether this overhaul will produce a new approach remains to be seen. One massive failure in the policy of the CDC has been an emphasis on individual choices over institutional support for protecting against virus, and this continues to be the prevailing attitude. 

In an article titled "The Pandemic's Soft Closing" published August 16, 2022, in The Atlantic, Katherine Wu writes, "U.S. policy on the virus has emphasized the importance of individual responsibility for keeping the virus at bay; these latest updates simply reinforce that posture. But given their timing and scope, this, more than any other pandemic inflection point, feels like 'a wholesale abandonment' of a community-centric mindset."

What's next?

What lies ahead of us remains to be seen. Many factors at play in the past and future of the pandemic have not been examined here, but they include direction of our national politics, the likely continuation of prioritizing economic growth over safer living and working conditions, and the question of how we will respond to the growing number of those left disabled by the lasting effects of COVID-19. 

Whatever may come, it will always be wise to inform ourselves as reliably as possible. It is important not only to seek out information, but to learn how to discern whether that information is reputably sourced. 

Here at the Birmingham Public Library, we are equipped and ready to help patrons navigate our catalog and the Internet for reliable sources as well as offer tips on determining reliability!

By Parker Evans | Library Assistant Ⅲ, Business, Science, and Technology Department, Central Library