Many Older Americans Still Aren’t Vaccinated, Making the Delta Wave Deadlier
The United States has a far higher proportion of seniors without full vaccination protection than many other affluent countries, a major risk factor for serious Covid-19 illness and death, a Times analysis shows.
With the Delta variant torn across the country, the pace of vaccination in America has accelerated after months of relative stagnation, and full government approval of the Pfizer vaccine on Monday could extend that momentum. Just over half of Americans are now fully vaccinated.
But national averages hide the high rate of older Americans who remain deeply vulnerable. The elderly are still responsible for most of the Covid-19 deaths, and in many counties, especially in the south and mountain west, seniors without a full vaccination make up more than 10 percent of the total population.
"We have populations in the counties that are healthy Americans, over 60, who are not vaccinated," said Claire Hannan, executive director of the Association of Immunization Managers. "These people are at extreme risk and they don't realize it."
Proportion of the population that is old
65+ and not fully vaccinated
High levels of immunization for the elderly have protected many northeastern states, despite having some of the oldest populations in the country.
Many southern states with rising outbreaks have large pockets of elderly residents who are not fully vaccinated.
Proportion of the population that is old
65+ and not fully vaccinated
High levels of immunization for the elderly have protected many northeastern states, despite having some of the oldest populations in the country.
Many southern states with rising outbreaks have large pockets of elderly residents who are not fully vaccinated.
High vaccination rates in the elderly have protected many northeast States, despite having some of the oldest populations in the country.
Many south States with major outbreaks have large pockets of elderly residents who are not fully vaccinated.
Proportion of the population that is old
65+ and not fully vaccinated
High vaccination rates in the elderly have protected many northeast States, despite having some of the oldest populations in the country.
Many south States with major outbreaks have large pockets of elderly residents who are not fully vaccinated.
Proportion of the population that is old
65+ and not fully vaccinated
In contrast, unvaccinated seniors are relatively rare in the UK, Spain and Canada. And they're rare where you live: these nations also have significantly fewer differences between the most and least vaccinated areas, according to local vaccination data.
Even London, which is more hesitant to vaccinate among seniors than the rest of the UK, is way ahead of most of the United States in vaccination rates.
That discrepancy could help explain why the delta wave resulted in such a higher death rate in the United States than in the UK, public health experts say. Although cases increased in both countries, these cases resulted in much fewer hospitalizations and deaths in the UK, suggesting vaccines had weakened the link between infections and serious illnesses.
Cases in the UNITED KINGDOM. reached 80% of its winter high this summer, however
Covid-19 deaths and hospital admissions rose only modestly.
Estimated date
Delta became the
dominant variant
But in the United States, Covid-19 deaths are rising faster and hospital
Entries have already reached 75% of the winter peak.
Cases in the UNITED KINGDOM. reached 80% of its winter high this summer, however
Covid-19 deaths and hospital admissions rose only modestly.
Estimated date
Delta became the
dominant variant
But in the United States, Covid-19 deaths are rising faster and hospital
Entries have already reached 75% of the winter peak.
Cases in the UNITED KINGDOM. reached 80% of the winter peak
this summer, but Covid-19 deaths and
Hospital stays rose only modestly.
Estimated date
Delta became the
dominant variant
But in the United States, Covid-19 deaths are
rise faster, and have the hospital admissions
already reached 75% of the winter peak.
Note: Deaths are shown postponed 14 days and hospital admissions seven days to reflect the typical delay between a positive test and a result.
While older Americans are more likely to be vaccinated than younger Americans, seniors without full vaccination protection are at a much higher risk of dying from Covid-19.
The delta variant has hit many areas with groups of endangered seniors particularly hard. Low vaccination rates among the elderly in Arkansas, Florida, Idaho, Louisiana, and Nevada coincided with rising rates of hospitalizations and deaths.
Comparisons between countries are imprecise, and no single factor determines how many people get seriously ill or die during a Covid-19 outbreak. The general vaccination coverage in a community, as well as existing health conditions, access to medical care, and individual behavior such as wearing masks all play a major role.
Some high-risk areas in the United States have not yet experienced major delta eruptions, including parts of Colorado, Kansas, and North Dakota.
But vaccines are highly effective at preventing serious illness and death, even against the Delta variant, and public health experts say vaccination levels are a useful tool for seniors to understand vulnerability during an outbreak.
While younger, unvaccinated adults represent an increasing proportion of new hospital visits, "the vast majority of the people who die from Covid-19 are elderly and unvaccinated," said David Dowdy, an infectious disease epidemiologist at Johns Hopkins University.
As in the United States, France and Italy are struggling with vaccination hesitation among many seniors. The rate of the less sheltered elderly in some areas, such as Sicily in Italy and Marseille in France, can rival those in the American South. Japan, whose introduction has been hampered by dose shortages, has some of the lowest vaccination rates for the elderly in the developed world.
Where vulnerable seniors live in eight countries
Proportion of the population who are 65+ and not fully vaccinated
Note: Canada, Israel, Italy, and Spain provide vaccination dates for people aged 60 to 69 years, but not over 65 years of age. In these countries, the proportion of people aged 65 and over who are fully vaccinated is estimated by assuming the same vaccination rates for 60 to 64 year olds and 65 to 69 year olds.
Vaccination hesitations are not unique to the United States, but they are more prevalent and vigorous than in Europe, and they are more clearly divided into political directions. State and local governments have also been less willing than European leaders to use mandates to urge residents to get vaccinated.
The Food and Drug Administration's decision to give the Pfizer BioNTech vaccine full approval on Monday could make some people reluctant to get vaccinated. And it will accelerate vaccine mandates: The Pentagon has announced that 1.4 million active duty soldiers will be shot, and some hospitals, colleges, corporations and other organizations are expected to follow suit.
But these mandates are still narrower than in parts of Europe where politics is more centralized. All French and Italian residents are required to provide proof of vaccination or a negative coronavirus test to access most indoor locations, including restaurants and bars.
Enrolling older Americans for their first vaccination remains a struggle, public health experts say, as people who really wanted a vaccine have already received it. While getting to a vaccine provider can still be a problem for some, especially in rural areas, many more people are resistant to vaccination because of their political and personal beliefs, as well as those of their friends and family.
"We really tried to get them vaccinated," said Molly Howell, vaccination director for the North Dakota Department of Health, where health officials have sent letters to every unvaccinated senior in the state. "There just seems to be a lack of trust in public health and government, and even in the medical community."
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