Less than a month ago, COVID-19 vaccines became available to any Minnesotan over age 16, and many people who wanted a shot had to hustle to get it: staying up late to wait for vaccine slots’ release, getting on wait lists at pharmacies or refreshing appointment websites as if trying to score Taylor Swift tickets.
That’s no longer the case. Supply of vaccine, once very limited, is up. Many provider sites are now taking walk-ins and this week, Minnesota made appointments available at the click of a button via its vaccine connector, for which an appointment previously required selection in a lottery.
Vaccinators say now that those most eager to get a COVID-19 vaccine have gotten their shots, they’re seeing a slowdown in demand, prompting efforts to reach those who face logistical challenges or are hesitant to get a shot.
Reaching herd immunity
The first Minnesotans to get vaccinated against COVID-19 got their shots on December 15. In the weeks that followed, and with extremely limited vaccine supply, the state’s vaccination efforts focused on the most vulnerable and those who cared for them: people living and working in long-term care and in health care.
In subsequent months, supply expanded, and vaccines opened up to those over 65 years old, essential workers and people with health conditions that could increase their risk of severe illness. More workers and health conditions were added, and finally, the vaccines opened up to anyone over 16 — the youngest age any of the vaccines is currently approved for — on March 30.
In four and half months since the first vaccine was given in the state, Minnesota has gotten at least one dose of a COVID-19 vaccine to more than 44 percent of its population, according to state data. For things to go back to normal, those numbers need to go up. The threshold for herd immunity, or the level at which enough people in the population have antibodies against a disease to prevent its easy transmission, but could be 7o percent to 85 percent, or higher. But as the Minnesotans who were most enthusiastic to get vaccinated already have their shots, public health officials are starting to see some slowing of demand for vaccines.
Dakota County is above the state average in the percent of its population vaccinated, at 45 percent. The county has been running vaccine clinics, where appointments are now available on a walk-in basis, and recently county officials have noticed demand has started slowing.
“Even up to the past week, there’s been a high demand, and our clinics are filling. It seems that we kind of hit a point, it probably came a few weeks earlier than we anticipated, but we have reached a point where there isn’t as much of a demand anymore, and we have many more openings,” said Dakota County Public Health Director Bonnie Brueshoff.
Demand has also slowed where CentraCare operates clinics, in Central Minnesota, said Dr. George Morris, the physician lead of CentraCare’s COVID-19 incident command. Counties in Central Minnesota tend to have vaccine coverage rates lower than the state average.
“Our numbers of vaccinations are going down,” Morris said. Partly, that’s due to the state sending less supply there due to less demand, he said.
Dana Kazel, St. Louis County county spokesperson, said supply is finally sufficient as demand has begun to slow. About half of St. Louis County’s population has received at least one dose of a vaccine.
“This actually puts Public Health in a more familiar position. The role of Public Health traditionally isn’t as a vaccine administrator to masses of people, but rather we focus on the harder to reach populations that might otherwise slip through the cracks,” she wrote in an email.
Official cite two major obstacles to vaccinating the remaining population: vaccine hesitancy and logistical challenges.
With supply increased, vaccines are still being administered at a decent clip, but as more and more people are vaccinated, hesitancy is expected to start becoming a bigger issue in reaching the remaining population. The reasons people may be hesitant to get a COVID-19 vaccine vary. For some, it’s because the vaccines are new, for others, because they are wary of vaccines or because of disinformation about everything from microchips in the vaccines to false theories that they cause infertility.
Different studies place the share of the population that might be hesitant to get a vaccine at different numbers, said Kris Ehresmann, infectious disease director for the Minnesota Department of Health.
“The whole issue of vaccine hesitancy is certainly a complex one,” she said: some studies suggest vaccine hesitancy will become more of an issue once 60 percent of the population has been vaccinated.
But there are data that suggest that the number of vaccine hesitant is going down: According to a survey from the Kaiser Family Foundation, the number of Americans who planned to “wait and see” on the COVID-19 vaccine dropped from 31 percent in January to 17 percent in March, even as the number of people who said they would only get the vaccine if it were required or would definitely not get the vaccine remained relatively steady.
Kaiser also found the share of people hesitant to get a vaccine varies by demographics and politics.
In central Minnesota, CentraCare, like other vaccine administrators, is working on outreach in communities that might be harder to vaccinate, Morris said. That includes churches, mosques and other community gathering spaces, Morris said. That’s as much about listening as it is about education.
“If we listened to their concerns, respected their concerns, then I think we were better able to answer their questions and assure them that this is a safe vaccine,” Morris said.
Making it easier
Based on experience doing targeted outreach with harder-to-reach populations during measles and pertussis outbreaks, Dakota County purchased a mobile vaccine unit with federal CARES Act funding that it will use to visit neighborhoods with lower vaccine coverage.
“The mobile unit has space so that we can have nurses go out and have individuals come into the trailer and get vaccinated,” Brueshoff said. Originally, Brueshoff envisioned getting the mobile vaccination unit on the road in mid-May when numbers slowed, but said as numbers decrease at mass vaccination sites, that’s now starting next week.
Dakota County is also working with local schools to plan outreach to teens 16 and older who are eligible for vaccination, and is working on planning in advance of a vaccine being approved for children ages 12 to 15, possibly within weeks. It’s expected to be longer before a vaccine is available for smaller children, which makes reaching herd immunity soon more difficult.
The state Department of Public Health has sent out its own fleet of mobile vaccination units and is working with community groups to reach underserved communities.
A lot is riding on the ability of Minnesota reaching herd immunity sooner than later, Morris said. It matters for public health, for getting back to normal, and, as he sees it, for community: If some people are vaccinated and others aren’t, it could create another division in an already-divided society.
“Which has a risk of setting us up as not quite the Hatfields and McCoys, but the people who are protected and the people who aren’t,” he said. “We’re going to continue to see these differences in who can gather together safely with vaccinated and unvaccinated people, and I think that’s a risk for dividing communities.”