Tougher tactics targeting unvaccinated needed for new spike

Some public health experts believe more aggressive tactics are needed to get more of the population inoculated against COVID-19.


National News

July 15, 2021 - 9:15 AM

LOS ANGELES – With coronavirus cases rising among the unvaccinated and efforts to get them shots lagging, there is growing belief in some public health circles that more aggressive tactics are needed to get more of the population inoculated.

California has already tried prizes and game show-style events to encourage people to get vaccinated. But 41% of Californians of all ages have yet to be inoculated. And two troubling and related trends are bringing calls for fresh thinking.

The coronavirus is spreading in California — mostly among unvaccinated people. While cases and hospitalizations are still more than 93% lower than they were at the peak, new daily coronavirus cases have nearly tripled over the last month, from about 900 a day to more than 2,600 a day; hospitalizations have risen by nearly 75%, from 915 to 1,594.

Meanwhile, the pace of vaccinations continues to tail off. Only about 58,000 vaccine doses a day are being administered statewide, according to figures compiled by The Times. Though that average could rise as more data are reported, it won’t come close to the peak of 400,000 a day.

The solution won’t be easy, but officials and experts are pretty confident they know what will work.

First, sending trusted people in communities to advocate for vaccinations at events and doing door-to-door outreach can do wonders in convincing people to get vaccinated, said UC San Francisco epidemiologist Dr. Kirsten Bibbins-Domingo. Getting vaccines into the offices of primary care physicians, where doctors can answer patients’ questions directly, can help too.

Another strategy would involve new requirements to get vaccinated, such as at workplaces, Bibbins-Domingo said. Short of that, she said, employers could require unvaccinated workers to get tested daily — an approach that has been used elsewhere around the world.

“When being vaccinated becomes the more convenient of the two options, that will drive people to be vaccinated,” Bibbins-Domingo said. “You have to make it slightly less convenient to be unvaccinated at this point.

“If you choose to get tested every day, because you don’t believe in vaccination, that might be fine. But I think for some, being tested every day or being tested at some very regular interval might be that the thing that says: ‘Well, yeah, when I look at the risk and benefits, the vaccine is looking a little bit better.’”

Fully vaccinated people do have very good protection against coronavirus infection and illness. Between Dec. 7 and June 7, unvaccinated people in L.A. County comprised 99.6% of its coronavirus cases, 98.7% of COVID-19 hospitalizations and 99.8% of deaths.

Nonetheless, outbreaks can still be disruptive — and a vaccinated person’s chance of getting infected, while quite small, is worse if they’re around unvaccinated and infected people. At the state Capitol, 10 people have recently tested positive for the coronavirus, including some who were fully vaccinated.

Some health experts have suggested that even vaccinated people wear masks voluntarily in indoor public spaces when weekly case rates are high, which would reduce the risk of a “breakthrough” coronavirus infection.

San Francisco has been a leader in imposing vaccination requirements for certain workers.

Already, San Francisco has ordered all workers in “high-risk settings,” such as hospitals, nursing homes and residential facilities for the elderly, homeless and jails, to be fully vaccinated by Sept. 15. An exemption will be available for workers with valid religious and medical reasons, and they will be required to get tested for the virus weekly.

San Francisco has also ordered all 35,000 of its city workers — including police, firefighters, custodians and clerks — to get vaccinated or risk losing their jobs, unless they have a religious or medical exemption, once a vaccine has been formally approved by the U.S. Food and Drug Administration. Currently, all three available vaccines are being distributed under an emergency use authorization.