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Gaps in COVID-19 vaccine coverage leave room for spread, mutation

The Empire State building glowed blue and gold on Tuesday night, the state’s signature colors flickering high above New York City. Fireworks popped overhead, not just above the city skyline, but around the state: Albany, Rochester, Niagara Falls. 

The cause for celebration? New York reached its target of getting 70% of all adults at least one shot of a coronavirus vaccine, a mark that Governor Andrew Cuomo promised would unlock the next stage of the pandemic. 

Indeed, Covid-19 restrictions have now been lifted in the state, like those requiring restaurants to space tables six feet apart and limiting capacities for theaters. 

“What felt years away has been accomplished in less than one,”Cuomosaid. “As we celebrate lifting restrictions and resuming our reimagined normal, we also reflect on the hard work of New York State’s essential workers and we remember those we lost. New Yorkers have always been tough, but this last year has proven just how tough they are. Congratulations, New Yorkers, on all that your hard work has accomplished.”

On the opposite coast, California held to its June 15 reopening schedule, coinciding with New York’s and signaling a victory against the virus in the states that saw some of the worst, and earliest, devastation from the pandemic. 

Covid-19 cases and deaths in the country are at their lowest levels since the pandemic began — down more than 90% since President Joe Biden took office, his administration announced this week. 

“Instead of heading into a summer, like last summer, of isolation, uncertainty and loss, we’re headed into a summer of joy, celebration and increasing freedom from the virus,” said Jeffrey Zients, the White House coronavirus response coordinator. 

Amid the revelry and promise of a season that looks something like normal, health officials repeat what has become a cautionary refrain: we’re not out of the woods yet. 

With significant state-by-state variation in vaccination rates, and the looming threat of new variants that could dampen progress, public health and epidemiology experts note that the push for more widespread vaccination against the deadly coronavirus remains paramount. 

Just 14 states have reached the 70% adult vaccination mark, the same figure Biden aims for nationwide by July 4.

Although states like New York put a lot of stake in the figure, waiting to reopen until it was reached, that’s not true of most. An analysis by The New York Times shows that nearly every state is fully “open,” most with no indoor mask restrictions remaining in place. That includes a swath of southern states — Alabama, Mississippi, Tennessee — where fewer than 50% of adults have gotten vaccinated.

As of Friday, the national figure stands at 65%, and vaccination rates have slowed down significantly in recent weeks. 

Asked during a Covid-19 briefing about the likelihood of meeting Biden’s goal, Zients pointed to the 175 million Americans who have gotten at least one shot, noting that 74% of people over age 40 are in that category. 

“We are going to get to 70%, and we’re going to continue across the summer months to push beyond 70%,” Zients said. 

Dr. Georges Benjamin, executive director of the American Public Health Association, said to think of July 4 as a “touchpoint.” 

“Once we reach that — you know, it’s not a magic number — we’re going to have to then set a new goal,” Benjamin said.  

Variants and Vaccine Gaps Create Vulnerabilities  

In the spaces left by uneven vaccination rates, the likelihood of a surge remains problematic. 

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“It means that there’s still the risk there, especially with a more transmissible variant, like the Delta variant,” said Josh Petrie, research assistant professor in the epidemiology department at the University of Michigan School of Public Health. 

First discovered in India, the Delta variant is now the dominant strain in the United Kingdom — where overall vaccination coverage is similar to the U.S., Petrie said — and is causing dangerous surges in the country. 

Already accounting for 6% of cases nationwide, the Delta variant is growing in the U.S., following the trend of the now-dubbed Alpha variant, which was first identified in the U.K. 

Compared to the Alpha variant, the Delta variant is 60% more transmissible, possibly more deadly and U.S. vaccines may be less effective against the strain when people are not fully immunized. 

The risk of variants is yet another reason to get more people vaccinated in states that are lagging, Petrie said. 

He pointed out that even within states like California and New York that have exceeded 70% vaccination among adults, local numbers can still span a large margin. 

“Vaccine coverage isn’t equally distributed across those states, either,” Petrie said during a phone interview. “People who tend not to get vaccinated tend to live close to other people who tend not to get vaccinated.” 

Those pockets of susceptibility threaten overall protection by allowing the virus to spread. And more spread means more chances for the virus to execute one of its main forms of survival: mutation. 

“Any time the virus transmits from person to person,” Petrie said, “the more it replicates, the more it transmits, there’s just more opportunity for it to develop mutations that could give rise to new variants.” 

It’s a weird time in the pandemic, Petrie acknowledged. More states are opening up completely, even as the risk of the Delta variant worries public health officials — and though it may feel like it in some areas, Covid-19 is not yet behind us. 

“It’s not going away, and we’re not at the levels of vaccine coverage where another surge is not possible,” Petrie said. But with the coverage and immunity U.S. populations have so far, “hopefully we don’t see healthcare systems getting overwhelmed the way they have in the past, so it will be something we can deal with a bit better.”

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Paul Ingram/TucsonSentinel.com

Vaccinations at Tucson Medical Center on Jan. 15, 2021.