"Herd immunity" for Covid-19 remains elusive with Johnson & Johnson moratorium and falling demand for vaccination
With fewer than a third of Transylvania residents inoculated for Covid-19, the Public Health Department confronts challenge of protecting those who "hold no interest in pursuing the vaccine.”
By Dan DeWitt
Brevard NewsBeat
BREVARD — The effort to achieve community-wide Covid-19 immunity in Transylvania County — long limited by the supply of vaccinations — now faces new obstacles: waning demand for inoculations and a moratorium on administering its favored form of protection, the one-dose Johnson & Johnson vaccine.
On Monday, county Public Health Director Elaine Russell told the County Commission “our agency will be focusing on using the Johnson & Johnson vaccine in the weeks ahead.”
The next day, the federal Centers for Disease Control and Prevention ordered a pause in administering that vaccine to allow further study of severe blood clots reported in a small number of its recipients.
Even if the CDC allows resumed use of the Johnson & Johnson vaccine, possibly as early as next week, the county faces another, long-term challenge: waning interest in vaccination.
“We are seeing that vaccine demand is slowing everywhere — in our county, in our region, in our state and even nationally,” Russell said Monday.
As of Thursday morning, 10,813 county residents, or 31.4 percent of the population, had been fully vaccinated, said department spokeswoman Tara Rybka. About 2,000 additional residents are known to have contracted the disease and recovered, she said. And even if the actual number of previously infected residents is higher than that — and it likely is, Rybka said — Transylvania remains far short of the percentage needed to achieve so-called “herd immunity.”
That requires protection from the disease in at least 60 to 70 percent of the population, according to early estimates, and late last year top federal health official Dr. Anthony Fauci said that number might be “75, 80, 85 percent.”
Russell estimated that 25 percent of unvaccinated residents are “contemplative — individuals who are considering it and watching to see how that goes for their family and friends,” while many of the remainder “are those who probably hold no interest in pursuing the vaccine.”
To address the decline in demand, Russell told commissioners, her department would stop offering mass inoculation events and begin reaching out to businesses, churches and community groups to offer shots to smaller groups of residents. It has also created an online portal to allow any such organization to request vaccinations for at least five of its members.
Individual appointments will be available at the Health Department, Rybka said, as well as at several pharmacies and other locations in the county, depending on vaccine availability.
Because it requires one shot, the Johnson & Johnson vaccine is the most convenient method of providing immunity in these outreach events, especially those focusing on hard-to-reach populations, Rybka said. The department will retain its supply of about 2,000 doses to use if and when this is allowed by the CDC.
In the meantime, the department will reschedule existing appointments for the Johnson & Johnson vaccines, its website said. Rybka added that the department will continue to administer scheduled second doses of Modera vaccines and hopes to receive at least 200 first doses of two-shot vaccinations to distribute next week.
The county offered its last drive-through vaccination of nearly 700 doses last week. And though it found takers for all those shots, she said, the event provided evidence of dropping demand.
While slots at earlier mass inoculations were claimed within hours, “it took several days to fill” last week’s appointments, Rybka said.
The county’s percentage of fully vaccinated residents is higher than that of the state as a whole, and the rate of partial vaccination closely matches the statewide level of 32.9 percent, according to the online dashboard maintained by the North Carolina Department of Health and Human Services.
But the seven-day average rate of infection is higher in Transylvania than in any of the surrounding counties, according to CDC statistics. Eighty county residents are currently in isolation after testing positive for or showing symptoms of Covid-19, and 16 new cases were reported in a Wednesday update posted on the department’s website. Two county residents have also died of the disease in recent weeks, Rybka said.
Though infections have dropped significantly from the peaks seen in January and February, Russell said Monday, “it remains to be seen if we are moving into a smaller fourth wave.”
That could be prevented with widespread vaccination, Rybka said. Researchers have not conclusively established that these shots are effective against the new variations propelling increased infection rates in other states.
But a study of front-line health workers that stretched into March — “on the cusp of those variants entering the United States,” — showed vaccinations offered extremely high levels of protection, she said. Only three of 2,500 vaccinated workers tested positive for Covid, she said, and “I don’t believe any of those people had serious illness or required hospitalization.”