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Where the Delta Wave Has Driven Up Covid-19 Vaccinations

After weeks of stagnation, the United States vaccination campaign has had a relatively successful month, with vaccine uptake rising from early-summer lows in every state in the country.

The upswing in vaccinations has come alongside an extended, and much more pronounced, increase in coronavirus cases, hospitalizations and deaths in the United States over the past two months. Public health officials say that in their communities, residents have been driven to get the vaccine by worries that the more-transmissible Delta variant might make them, or their loved ones, sick.

“The reason why we’ve seen the marked increase in demand is fear, it’s the Delta variant,” said Robert Ator, the retired National Guard colonel who runs Arkansas’ vaccination effort.

The increase in vaccinations has been especially pronounced in states where immunization levels were (and remain) below the national average of 61 percent. Many of those states have felt the effects of the Delta-led fourth wave most acutely.

Least vaccinated states saw greatest summer increase in first doses

Percentage point change in total population vaccinated from June 6 to Aug. 21

Percent of total population vaccinated by Aug. 21

Pct. point increase in people vaccinated

+4
+5
+6
+7
+8
+9
+10
+11
+12

Public health officials said that some areas with lower vaccine coverage, especially rural ones, just hadn’t been severely affected by the virus until the Delta surge.

“Some communities are seeing Covid close up now,” said Dr. Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services. “They’ve seen it on the news, but that’s not the same as seeing it close up.”

That proximity is driving behavior change across the country.

“The virus is coming to visit these communities and they are starting to feel the pinch,” said Colonel Ator. “When they start seeing their friends and families being affected by this, then it becomes a reality.”

States that have seen larger increases in new cases since their early-summer nadirs, such as Alabama, Georgia and Mississippi, tend to be those with bigger increases in new vaccinations.

Change in weekly new cases and first vaccinations

Week of June 6 to week of Aug. 15

0 +1,000% +2,000% +3,000% Increase in weekly new cases

–50%0+100%+200%


Decrease in vaccinations


Increase in vaccinations


States where the percentage of the population vaccinated is below the national average as of Aug. 21.


Wash.

Ill.

Calif.

Ariz.

Mass.

Wis.

Texas

Neb.

Utah

Ore.

Fla.

N.Y.

R.I.

Ga.

N.H.

N.C.

N.J.

Colo.

Md.

Nev.

Tenn.

Hawaii

Ind.

Ky.

Minn.

Okla.

Pa.

S.C.

D.C.

Kan.

Mo.

Vt.

Va.

Conn.

Iowa

La.

Ohio

Mich.

S.D.

Ark.

Del.

Miss.

N.M.

N.D.

Wyo.

Alaska

Maine

Ala.

Idaho

Mont.

W.Va.

Note: Not all states had hit their lowest weekly vaccinations in early June, when Delta was on the verge of becoming dominant, and some only had mild growth in late July and August. As a result, these states may show a decrease in vaccinations in this analysis.

Some of the recent rise in immunizations is due to teens and tweens who are heading back to school, but the bulk of the increase is from working-age Americans, public health officials say and data from the Centers for Disease Control and Prevention confirms.

And while new vaccinations may be flattening now overall in the U.S., health officials do not expect them to return to previous lows any time soon, especially after the Food and Drug Administration granted full approval to the Pfizer vaccine on Monday. That move is likely to spur new vaccinations, in ways both direct — 31 percent of unvaccinated people surveyed in a June poll by the Kaiser Family Foundation indicated they would be more open to getting the jab once a vaccine was fully approved — and indirect, as it sets the stage for new vaccine requirements by organizations including corporations, hospitals and colleges.

While the uptick in new vaccinations — first doses — has been the subject of particular interest, total vaccine doses, comprising first and second jabs, have been on the rise as well. They will likely continue to increase as third doses complicate the picture.

The F.D.A. this month opened eligibility for third shots for some people with weakened immune systems. And last week, the Biden administration strongly recommended that Americans who received the Pfizer-BioNTech or Moderna coronavirus vaccines get a booster shot eight months after their second vaccine dose. If the F.D.A. approves that recommendation, boosters will be available starting in late September.

However, there is evidence that about 1.2 million people in the U.S. may have already received unauthorized additional doses before these announcements were made, according to the C.D.C.

Change in weekly new cases and first vaccinations

Week of June 6 to week of Aug. 15

Mississippi
Miss.

+2,611%
926 → 25,102

+227%
16,453 → 53,746

+11
34 → 45

Louisiana
La.

+1,381%
2,373 → 35,139

+183%
26,277 → 74,337

+12
36 → 48

Arkansas
Ark.

+930%
1,528 → 15,737

+159%
15,174 → 39,324

+12
40 → 52

Alabama
Ala.

+1,732%
1,738 → 31,845

+142%
33,241 → 80,455

+12
36 → 48

Tennessee
Tenn.

+1,163%
2,765 → 34,921

+139%
31,593 → 75,428

+8
40 → 48

Georgia
Ga.

+1,780%
2,829 → 53,172

+139%
79,530 → 189,795

+9
41 → 50

Oklahoma
Okla.

+1,746%
842 → 15,542

+130%
19,578 → 45,000

+10
42 → 52

Utah
Utah

+274%
1,946 → 7,273

+129%
20,193 → 46,297

+9
46 → 55

North Carolina
N.C.

+1,103%
3,128 → 37,621

+128%
45,733 → 104,335

+10
44 → 54

Wyoming
Wyo.

+388%
492 → 2,399

+86%
3,584 → 6,661

+6
38 → 44

South Carolina
S.C.

+2,858%
857 → 25,346

+85%
32,157 → 59,397

+9
41 → 50

Idaho
Idaho

+576%
723 → 4,887

+57%
8,760 → 13,783

+5
38 → 43

Kentucky
Ky.

+1,326%
1,582 → 22,554

+44%
39,784 → 57,269

+9
47 → 56

North Dakota
N.D.

+491%
248 → 1,465

+39%
3,449 → 4,797

+4
43 → 47

Rhode Island
R.I.

+860%
221 → 2,121

+33%
8,689 → 11,552

+8
62 → 70

New Mexico
N.M.

+814%
572 → 5,227

+32%
17,500 → 23,072

+10
58 → 68

Iowa
Iowa

+945%
569 → 5,944

+25%
16,726 → 20,951

+5
50 → 55

Kansas
Kan.

+970%
761 → 8,141

+20%
20,677 → 24,888

+9
47 → 56

Florida
Fla.

+1,325%
11,454 → 163,197

+19%
242,288 → 287,284

+12
50 → 62

Minnesota
Minn.

+634%
1,186 → 8,705

+10%
36,416 → 39,900

+6
55 → 61

Texas
Texas

+786%
14,059 → 124,621

+9%
316,351 → 344,120

+11
45 → 56

Alaska
Alaska

+1,754%
179 → 3,318

+5%
4,326 → 4,555

+6
47 → 53

South Dakota
S.D.

+1,789%
82 → 1,549

+5%
6,424 → 6,757

+6
49 → 55

Nebraska
Neb.

+1,308%
238 → 3,352

+2%
14,229 → 14,491

+7
49 → 56

Hawaii
Hawaii

+1,059%
412 → 4,777

–3%
9,690 → 9,428

+5
68 → 73

Ohio
Ohio

+770%
2,416 → 21,010

–3%
71,374 → 69,088

+5
47 → 52

New Hampshire
N.H.

+774%
191 → 1,670

–4%
8,935 → 8,617

+6
60 → 66

California
Calif.

+1,536%
6,610 → 108,124

–7%
396,263 → 368,234

+10
58 → 68

Missouri
Mo.

+381%
3,631 → 17,478

–7%
44,409 → 41,132

+9
43 → 52

Arizona
Ariz.

+559%
3,090 → 20,365

–8%
61,312 → 56,465

+9
47 → 56

Indiana
Ind.

+701%
2,547 → 20,411

–9%
45,722 → 41,803

+7
42 → 49

District of Columbia
D.C.

+1,168%
90 → 1,141

–9%
5,831 → 5,284

+8
58 → 66

Maine
Maine

+195%
386 → 1,138

–11%
10,783 → 9,573

+6
64 → 70

New York
N.Y.

+783%
3,560 → 31,433

–16%
220,973 → 186,458

+9
57 → 66

Nevada
Nev.

+333%
1,748 → 7,574

–17%
34,202 → 28,305

+11
46 → 57

Wisconsin
Wis.

+955%
925 → 9,761

–18%
44,884 → 36,740

+6
52 → 58

Delaware
Del.

+802%
252 → 2,274

–22%
9,473 → 7,403

+7
56 → 63

Illinois
Ill.

+920%
2,429 → 24,787

–26%
138,999 → 103,045

+9
56 → 65

Maryland
Md.

+860%
718 → 6,896

–26%
60,464 → 44,623

+9
58 → 67

Oregon
Ore.

+678%
1,865 → 14,514

–28%
43,388 → 31,308

+7
56 → 63

Pennsylvania
Pa.

+484%
2,944 → 17,189

–28%
153,442 → 110,661

+9
59 → 68

Connecticut
Conn.

+776%
459 → 4,020

–28%
40,484 → 29,195

+8
64 → 72

Virginia
Va.

+1,398%
1,085 → 16,253

–28%
94,813 → 68,214

+8
56 → 64

Washington
Wash.

+425%
4,108 → 21,572

–32%
99,801 → 67,691

+8
58 → 66

Colorado
Colo.

+129%
4,138 → 9,473

–35%
61,266 → 39,700

+7
55 → 62

New Jersey
N.J.

+694%
1,661 → 13,196

–36%
126,871 → 81,215

+8
61 → 69

Montana
Mont.

+389%
502 → 2,456

–40%
11,662 → 7,038

+5
46 → 51

Vermont
Vt.

+985%
68 → 738

–40%
5,052 → 3,019

+4
71 → 75

Michigan
Mich.

+484%
2,039 → 11,905

–44%
79,270 → 44,330

+6
49 → 55

Massachusetts
Mass.

+932%
896 → 9,249

–49%
79,422 → 40,502

+7
68 → 75

West Virginia
W.Va.

+683%
707 → 5,536

–73%
16,736 → 4,517

+6
41 → 47

Note: Not all states had hit their lowest weekly vaccinations in early June, when Delta was on the verge of becoming dominant, and some only had mild growth in late July and August. As a result, these states may show a decrease in vaccinations in this analysis.

After watching worries about the Delta variant drive up vaccinations across the U.S., some state officials say they are adjusting their messaging to focus on the stories of people who have experienced Covid-19 illness or death firsthand.

North Dakota is developing an “Impact Wall,” a website with a collection of videos and photos from those who have been sick or lost a loved one.

And Arkansas has produced a televised public service announcement featuring a pregnant woman who had a near-death experience with Covid. In the video, she and her husband encourage Arkansans to get vaccinated.

“We have a rural couple talking to small rural communities,” Colonel Ator said. “Instead of a guy wearing a tie, I would much rather have the locals talking to them.”

https://www.nytimes.com/interactive/2021/08/26/us/vaccination-increase-covid-delta.html