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How one Texas county is approaching the challenge of vaccinating the hesitant

More than 575,000 Americans lost their lives to COVID-19. Although more than half of all U.S. adults have received at least one dose of a vaccine, there are still challenges to getting people to take the shot, especially in Texas. William Brangham explores the complexities behind the decrease in demand with a Galveston County local health authority, Dr. Philip Keiser.

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  • Judy Woodruff:

    Daily COVID vaccinations in the U.S. have been dropping in recent weeks. It comes as more than half of all adults in the country have received at least one shot.

    William Brangham explores the complexities behind this decrease in demand and what it will take to get more Americans vaccinated.

  • William Brangham:

    Judy, we know all adults in the U.S. are now eligible for the vaccine, but, as you said, the pace of vaccinations has dropped. We're now at about 2.5 million shots each day.

    In fact, some jurisdictions are declining new vaccine shipments because they say they have too much on hand and not enough arms to put them in.

    So, what's driving this? Is it hesitancy, outright opposition, or more of a wait-and-see approach?

    Dr. Philip Keiser is one of the many public health officials trying to figure that out. He runs the Local Health Authority in Galveston County, Texas, which is right on the Gulf Coast.

    Dr. Keiser, very good to have you on the "NewsHour." Thank you for being here.

    My understanding is that you are about 40 percent of adults fully vaccinated, which is pretty good in your county — it's better than the national average — but that the demand has really slowed. When did that slowdown occur?

  • Dr. Philip Keiser:

    We started seeing it about three, three-and-a-half weeks ago.

    We actually have about 50 percent of people having at least one shot in arms. And we knew that, when we got to that level, based on some surveys that we had done, that we'd start seeing people that were hesitant to get the vaccine.

    What really surprised us was the rapidity at which it dropped off. It dropped off very dramatically within the past two weeks.

  • William Brangham:

    Every armchair epidemiologist in the country has a theory as to why demand has dropped off. You're an actual infectious disease specialist who's working on the front lines.

    What is your sense? Why has demand fallen off?

  • Philip Keiser:

    I think there's a different story for every person who doesn't want to do it.

    And we have heard that it's white evangelicals. We have heard it's African Americans who are feeling alienated. We have heard that it is poor people. We have heard that it may be people that are primarily Spanish-speaking.

    And I got to tell you, it's all of those things, plus more, including the convenience of getting the vaccine. There's a perception that where we were doing our mass vaccine testing was far away. We're seeing that some people just don't have the time. They feel like they can't get off from work. We're seeing some people don't have a sense of that they really need it.

    But I think the biggest thing, really, is the issue of trust. There's a lot of distrust coming from all sides. And there's distrust of the vaccine, the approval process, and distrust of the public health officials that are encouraging people to get vaccinated.

  • William Brangham:

    I understand you're one of the jurisdictions that has told the state, don't send us any more big batches, because we have got enough on our hands.

    Do you have an extra supply of vaccine now? And, if so, what are you doing with that?

  • Philip Keiser:

    Well, we do have an extra supply. And, right now, we're holding it in our freezers.

    And we have gone from using 20,000 doses a week down to about 2,000 doses a week. But we do think that we may have an increased demand for it as approval for school-aged children comes out, which probably may be in several weeks or within a month.

    And so we want to make sure we have enough one hand that, as parents want to get their children vaccinated to go back to school, that we have that with us as well. So, we're watching and waiting. We're counting our numbers very carefully. We're also taking account of the expiration dates on some of these vaccines, because some of them we have to use before August 30, or else they go bad.

    So it's really become a real dance in trying to figure out what the right amount to order is and watching how rapidly we're using it.

  • William Brangham:

    It sounds like you have to be doing a ton of public education left and right every time you go out trying to encourage people.

  • Philip Keiser:

    Yes. No, it really is.

    And I think, in retrospect, what we're going to say is that the first 50 percent were easy, and I think the next 25 percent are — and that's that group of people that are saying they're not sure — is going to be a lot harder.

    So, what we're doing is, we're working with communities, we're working with churches, we're working at community centers, we're working with Restaurant Associations, we're working with large employers, just going out to where they are and offering people vaccine.

    But we're finding that we even need to reach out more. Even yesterday, we did an event at one of the large hotels here in Galveston, and the vaccinators stopped to get lunch on the way back, and they had a few extra. And they asked people in the restaurant, do you want a vaccine? And some people said, oh, yes, I think I would.

    And so I think that's what we're going to be have to doing. We're going to be going out where people are to find those people who want it or are unsure, but are not really anxious to get it, and make it easy for them and be available to ask — answer questions for them so they can feel comfortable.

  • William Brangham:

    So, it sounds like this sort of age-old phrase in public health, meet people where they are, make it as simple and smooth and as easy as possible, regardless of who they are and where they come from.

    Do you think that's going to be enough?

  • Philip Keiser:

    I'm hopeful that it will be enough to get us to the point where we have herd immunity.

    We know that there are some people that are hard-nosed. They just don't want it. And I think that's going to be OK, because if we can get that 25 percent of folks that are thinking about it, unsure, we will be around 75 percent vaccinated. And that's kind the consensus number.

    But I think it's going to be very, very difficult. So, instead of doing thousands of people in a single day — we did as many as 5,000 a day — we will be doing hundreds of people at smaller events, where we only have a few score of people actually coming up to get the vaccine. And it's just going to take time.

  • William Brangham:

    All right, Dr. Philip Keiser, Galveston County Department of Health, thank you very much. And good luck with your work.

  • Philip Keiser:

    All right, thank you very much.

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