On Dec. 14, 2020, the first COVID-19 vaccine shot under U.S. emergency use authorization was administered on Long Island. The dose of mRNA vaccine was hailed by Gov. Andrew Cuomo as “the weapon that will end the war.”
One year later, Cuomo—once hailed for his pandemic leadership—is gone from office, and the war against SARS-CoV-2 drags on with no end in sight. In fact, the virus is back on the offensive, with new infections and hospitalizations rising and the recently discovered Omicron variant spreading like prairie fire. The U.S. death toll in the next day or two is likely to reach 800,000.
In Monroe County, there have been 102,375 confirmed cases and 1,529 deaths. That’s up from 23,387 cases and 390 deaths reported on this date a year ago. Since vaccines become readily available late last winter, 70 percent to 90 percent of COVID deaths in the county have been among the unvaccinated.
Monroe County cases and deaths
The arrival of highly effective vaccines did not bring the pandemic to heel for a simple reason: Too many people are unwilling to get vaccinated. There are additional factors, to be sure, but this one dwarfs all others.
In the U.S., nearly 500 million shots have been administered, but only 60.8 percent of the population is fully vaccinated, according to the latest Centers for Disease Control and Prevention data. Many other countries are doing better: 78 percent of Canadians are fully vaccinated; in Europe, the rate for most countries is over 70 percent—and Portugal has reached 88 percent.
Among the U.S. population 5 years or older, the number climbs slightly, to 64.7 percent.
In the nine-county Finger Lakes region, the share of the population 5 years or older with a Covid vaccine series completed is even lower than the U.S. as whole: 63.8 percent. And progress here has been agonizingly slow. From July 1 to Dec. 12, Finger Lakes COVID-29 Vaccine Hub data show, the share has increased by less than 10 percentage points; in the last six weeks, as new daily infections have surged again, the share has edged up only 2.3 points.
This means that through the first week of December, more than 410,000 of the 1,138,537 people 5 years or older who reside in this region have not received a full COVID vaccine series. And most of them—328,552, or 29 percent of the total 5+ population—have not received a single dose.
Vaccinations by ZIP code
Across the U.S., vaccination rates vary widely by geography and age. The Finger Lakes region is no different.
Among the nine counties, Monroe County has the highest percentage of people who have received at least one vaccine dose: 75.2 percent. Ontario County is next, at 73.1 percent. In Yates County, by contrast, only 54.3 percent have received at least one shot. The numbers in the other counties are Livingston, 66.5 percent; Wayne, 65.1 percent; Genesee, 62.2 percent; Seneca, 59.7 percent; Orleans, 59.6 percent; and Wyoming, 56.7 percent. Broken down further, vaccination rates range from 100 percent in three ZIP codes—14604 (Rochester), 14475 (Ionia, Ontario County) and 14415 (Bellona, Yates County)—to 27.4 percent in 14642 (Rochester).
Vaccinations by county and age
Regionwide, vaccination rates by age group vary widely. The 75-84 age group has the highest rate of at least one vaccine dose—93 percent—followed closely by the 65-74 bracket at 92.7 percent. Only 65 percent of those 25-34 have received at least one shot, however, and in the 12-24 bracket, the number slides to 63.9 percent. Among children 5-11, it’s only 22.7 percent.
COVID-related deaths here and around the country since the start of the pandemic in late winter of 2020 have been concentrated in the 65+ age bracket. The New York Times reported Monday that fully three-quarters of people who have died of the virus in the U.S. have been 65 or older. That means one in 100 older Americans have succumbed to the virus, compared with a 1-in-1,400 ratio for those younger than 65.
But the elderly are not the only ones who are filling hospital beds, pushing health care systems to capacity and sometimes beyond. In Monroe County, the 55-74 age group now accounts for 44 percent of hospitalizations, with the 20-54 group adding another 24 percent—so together, they account for more than two-thirds of COVID hospitalizations.
The Delta variant has fueled this autumn’s surge in new infections, serious illness and death. Now, the emergence of the Omicron variant threatens to push those numbers to levels not seen since in the dark days of early 2021. Much about Omicron remains unknown: how transmissible is this variant, how likely it is to cause severe disease, and how much protection will current COVID vaccines provide against it?
Preliminary research suggests Omicron might force a redefinition of “fully vaccinated.” Researchers at the Africa Health Research Institute in South Africa report that blood plasma samples from a small study—only 12 participants—showed a sharp reduction in levels of neutralizing antibodies in recipients of two doses of the Pfizer-BioNTech mRNA vaccine. Two shots of the vaccine might have just 22.5 percent efficacy against symptomatic infection with Omicron. However, the researchers said the Pfizer vaccine likely continues to provide significant protection against severe disease, especially among people with a prior Covid infection (though a bout with “wild-type” COVID in the early months of the pandemic, before variants took hold, may offer little immunity now) and even more so with people who have received a booster shot.
To date, the CDC reports, 26.6 percent of “fully vaccinated” Americans have been boosted, a figure that rises to 51.4 percent among those 65 years and older. Again, the Finger Lakes region trails the nation as a whole, with just 20.8 percent boosted.
Studies such as the KFF COVID-19 vaccine tracking project tell us that some among the unvaccinated are open to persuasion. Others will get their shots if required to do so.
Abroad, a few countries are telling the unvaccinated that time has run out. Austria has taken perhaps the hardest line. The Alpine nation in mid-November instituted a lockdown for the unvaccinated and now has mandated that, with few exceptions, all of its citizens must be vaccinated by Feb. 1. Those who refuse could face a roughly $4,000 fine every three months. In the last few weeks, its new cases have declined sharply, and Austria now has Europe’s second-highest rate of boosted citizens.
In this country, where mask mandates often face stiff and vocal resistance, a general vaccination requirement seems highly improbable. Instead, the share of the population that’s fully vaccinated and boosted will inch upward until, one way or another, COVID becomes endemic.
Perhaps that’s the best we can do. However, the failure to get nearly everyone vaccinated now has a cost. In the coming weeks and months, it will be measured in the mounting number of new infections, cases of serious illness, and deaths.
Paul Ericson is Rochester Beacon executive editor.