What happens to those who don’t get the COVID-19 vaccine?

What happens to those who don’t get the COVID-19 vaccine?


Research has shown what happens to people who get the COVID-19 vaccine: They gain nearly full protection from the virus that has infected more than 30 million in the United States and killed a over half-million Americans.

But what about those people who don’t get vaccinated, whether due to legitimate health issues, unfounded concerns about safety or effectiveness, or maybe for political reasons?

“We know what will happen to them,” said Dr. John Swartzberg, an infectious disease and vaccinology professor emeritus at UC Berkeley. “With a virus that is as contagious as this one and becoming more contagious due to variants, people who decide not to get vaccinated are likely over time to get infected,” said Swartzberg. “Ultimately, the people who chose to not get vaccinated will contribute to herd immunity by the fact that they got infected.”

From a societal standpoint, he said people who skip the vaccine could compromise the safety of others.

“We need to get to herd immunity to protect those people who can’t get vaccinated,” he said. “They’re delaying the safety for all of us. I hear everyone saying deciding to get vaccinated is an individual choice, but the calculus in that choice is twofold — one is to vaccinate yourself and the other is protect others. I think we have a responsibility to protect our communities.”

Herd immunity is the point at which it’s difficult for a disease to spread because enough people in the community are protected from infection. Those who are immune have already had the disease or have been vaccinated. Unvaccinated individuals (such as newborns, those with chronic illnesses and those who refuse vaccines) are protected in communities that have achieved herd immunity.

The proportion of the population that must acquire resistance to establish herd immunity is dependent on how easily the disease spreads.

For example, herd immunity against measles, a highly contagious disease, requires about 95% of a population to be vaccinated, according to the Centers for Disease Control and Prevention. The remaining 5% is protected by the fact that measles will not spread among those who pulled up their sleeves for a shot.

The CDC has said more research is needed to identify the herd immunity threshold for COVID-19, but Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently said in an interview with CNBC that “you would need somewhere between 70, 75, maybe 80% of the population vaccinated” to reach “a degree of protection in society that the virus really has no place to go.” He later told the New York Times, it may take 70% to 90% immunity to bring the virus to a halt.

It’s impossible to know with certainty whether there will be enough voluntary acceptance of the vaccine to reach herd immunity, but some experts estimate there could be widespread immunity some time between summer and winter for the United States. For some countries around the globe, it’s years away. Until it’s achieved, those who are unvaccinated will remain unprotected.

“If you can get 80% immunity, you can probably slow, if not grind to a halt, the spread of this virus,” said Dr. Paul Offit, a professor at the University of Pennsylvania and a coinventor of the rotavirus vaccine. “If you can’t get to that 80% immunity because people aren’t getting the vaccine, then this country will have to make a decision: Do you want to mandate a vaccine?”

The vaccine rollout in the United States has accelerated, and President Joe Biden has said that as of May 1, every individual age 16 and over will be eligible for the vaccine.

Despite the push for inoculation, vaccine supply remains limited, and the conversation is focused on those people who want the vaccine but can’t get it. As the supply increases in coming weeks and months, the conversation will shift to those who can get the vaccine but refuse it.

“I think that right now, you don’t know who the people are who will refuse the vaccine,” said Offit. “Right now, we’re in a position where we don’t have enough vaccine. As we move into summer, there are going to be a lot more vaccines available for everyone who wants them. Then you’re going to find out what percentage of people aren’t going to get the vaccine.”

While it’s unclear exactly how many people will refuse the vaccine, there are clues that some people who are eligible are turning it down.

Offit said generally 1% to 2% of the U.S. population refuses all vaccines, while 10% to 20% skip certain vaccines.

Polls show COVID vaccine acceptance has shifted up and down through the course of the rollout.

A January survey by the San Francisco-based Kaiser Foundation found that 3 in 10 health care workers were hesitant to get the COVID vaccine. Hesitancy was lowest among people 65 and older.

About 7 in 10 U.S. adults (69%) said in a mid-February Pew Research survey that they would definitely or probably get a coronavirus vaccine. This research also revealed Americans ages 65 and older were more likely than younger people to say they would get inoculated.

Multiple polls have showed Republicans are more skeptical of vaccines. In a CBS News poll, 33% of Republicans said that they would not be vaccinated, compared with 10% of Democrats who said they planned to skip the shot.

But only time will tell exactly who skips the vaccine, and Offit said we’re unlikely to know what will happen to the unvaccinated until winter.

“The weather is getting better and more people are getting vaccinated,” he said. “We are going to reach a time in the summer when we’re going to feel good. This winter, when it gets cold and everyone goes back inside, you’ll see if you’ve vaccinated enough of the population to stop the spread.”


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