This is the final article in a three-part series on Oregon’s COVID-19 response, as we enter the pandemic’s second year. Part one looks at the double-edged sword of Oregon’s COVID-19 success. Part two asks if Oregon’s COVID-19 pivot was enough to address racial inequities.
COVID-19 vaccine distribution in Oregon is generally on the upswing, and the state plans to extend eligibility to the next large chunk of Oregonians at the end of March. In addition, state officials announced this week that Oregon will follow the Biden administration’s timeline and open vaccination eligibility to all Oregonians by May 1.
This expedited schedule points to growing confidence in the federal government’s ability to deliver more vaccines. It indicates that we’ll be able to vaccinate people more quickly.
The faster we vaccinate, the faster we start to approach herd immunity and some sense of day-to-day normalcy.
But it also means we’re likely going to hit to a point of inflection earlier — one that would surely warm the cockles of 19th century British economist Alfred Marshall’s heart. It’s the point at which the supply of COVID-19 vaccine doses is greater than the demand — even though not everyone is vaccinated.
At that point (and ideally before) the state will have to shift gears and try to convince those who are hesitant to sign up for their shots.
Oregon’s COVID-19 vaccine allocation
Total weekly vaccine doses earmarked for Oregon by the federal government
The federal government allocates each state a certain share of vaccine. Oregon’s vaccine allocation peaked in early March when the federal government shipped the first doses of the Johnson & Johnson vaccine. Oregon’s allotment includes a supplement for Native American tribes that have opted to work with the state instead of the federal government for vaccine distribution. Graphic: Jes Burns/OPB Data Source: CDC, Kaiser Family Foundation 3-17-21
Where we are now
There had been some reservations on the part of Oregon officials to go along with the new federal vaccination timeline because of lingering uncertainty about vaccine supply.
While generally increasing over the past few months, vaccine allocations to Oregon by the federal government have been inconsistent. Things peaked at about 210,000 doses at the beginning of March, when the Johnson & Johnson vaccine first shipped to states, but since then allocations have been around 10,000-25,000 doses lower per week.
“It’s not like there’s vaccine sitting there that could have gone out. We’re basically chewing through that vaccine within the week that we get it,” said Oregon Health Authority director Patrick Allen.
Allen told OPB this week he expects the number of doses delivered to the state to double by May 1.
“Right now we’re kind of stuck with a strategy that’s ‘let’s put 15,000 doses in one place,’” he said. “It’s a lot better to put 15 doses in a thousand places so that people have ready access to multiple choices in their own neighborhood.”
He said that will start happening as more vaccine doses arrive.
Oregon is currently vaccinating people at the 36th-slowest rate in the country, but Allen says the state has plenty of capacity to vaccinate more people. The problem remains the supply from the federal government. Oregon ranks 34th by population in doses delivered to the state.
“We have the capacity to do at least 300,000 first doses a week. Right now we’re receiving about 150,000 first doses a week, and that’s increasing toward 200,000. So we have ample capacity to be able to get shots in people’s arms,” Allen said.
As of Wednesday, just over half a million Oregonians had been fully vaccinated.
COVID-19 vaccine doses delivered
Total doses delivered to each state per 1,000 population
Oregon is 34th in the number of COVID-19 vaccine doses delivered by the federal government. Two of the three approved vaccines require two doses per person. Several states, including Oregon and Washington, are receiving additional doses earmarked for Native American tribes within their borders. Because of logistical concerns, Alaska’s delivery scheme differs from other states, which can help account for its higher rate. Graphic: Jes Burns/OPB Data Source: CDC, Kaiser Family Foundation
The next chapter
If the target plan to open vaccinations to all Oregonians sticks, May and June are going to be an all-out vaccine blitz.
But probably sometime in July or August the rush of willing “vaccinatees” will start to trickle off. And at that point Oregon will be faced with what could be the next big vaccine obstacle: not enough arms for all the available doses of vaccine.
“That’s exactly what’s in the future. Right now, demand exceeds supply. But whenever that changes … and there is less demand than there is supply, then vaccine hesitancy can be the real issue,” said Creighton University sociologist Kevin Estep, who studies public health issues, including vaccine refusal.
Polling over the last year in the United States suggests a large portion of the population is unlikely to get vaccinated for COVID-19. That number is nearly 25% of adults according to a new poll out this month from Monmouth University.
Because kids and teens under the age of 16 haven’t been approved for the vaccines yet, Oregon is going to need more than 90% of its adults to become immune to COVID-19 to achieve herd immunity — and perhaps an even higher percentage considering the new variants, which can be more contagious. We will have some buffer because of people who have natural immunity from catching and surviving COVID-19, but not nearly as much as other states that have had much higher case rates. The rest will need to be vaccinated.
Vaccine hesitancy for COVID-19 is a new kind of phenomenon — different in many ways from vaccine refusal connected to other diseases. Although there is some overlap, this isn’t your typical anti-vaccine crowd.
“The categories of people — the surveys are telling us — that are most hesitant about COVID vaccines are not really the same demographic that are hesitant about other vaccines,” Estep said. “These people have been vaccinated. They received many other vaccinations. They’re not against vaccination. They may even get the flu vaccine.”
The Monmouth Poll suggests Republicans are far more likely — 36% versus 6% for Democrats — to say they don’t want the vaccine. And 14% of people of color say they won’t get vaccinated against coronavirus.
About 18% of Oregonians are registered Republicans. About 25% are people of color, who have been hit disproportionately hard by the pandemic compared to white Oregonians. On top of this, Oregon has the reputation of being a hotbed of anti-vaccine sentiment.
“The vaccine hesitant group is humongous, right? And so there’s plenty of room to do good work, good public or health communication work,” Estep said.
A sizable chunk of these groups will need to be convinced to get vaccinated if the state wants to lift social distancing restrictions and mask mandates without putting people at risk.
There will be many competing forces at work this summer as Oregon reaches that supply and demand inflection point. One will be the powerful lure and social pressure to get back to normal after more than a year of pandemic. Estep says this will pull against the hesitancy so many Americans feel when it comes to the COVID-19 vaccines.
“Which way the tug of war goes? I think we don’t have enough information to tell yet.”