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Why farmworkers are leading in vaccinations
dennis Wyatt web
Dennis Wyatt

Dangling a free $50 grocery gift card in front of unvaccinated Californians isn’t exactly creating a stampede to locations dispensing free COVID-19 shots.

Based on people who have gotten at least one shot, within a month from now 58 percent of Californians will be fully vaccinated against the coronavirus.

It will still fall significantly short of where Monterey County is today with its massive farm worker population of which more than 67 percent is already fully vaccinated. For the record, that compares to 54 percent for the rest of the 18 and older population in Monterey County.

The reason is simple. The State of California has elected to take a dubious short cut. And they are not alone.

There is a bizarre assumption that people when it comes to vaccines either act like mice in a laboratory or are easily duped by propaganda — either pro or anti vaccination depending upon one’s bent.

Monterey County demonstrates there is no substitute for good, old-fashioned one-on-one outreach, going to where people live and work and not berating people or assuming folks are never driven by altruistic or what might be called “self-serving” survival motives.

Farm workers by definition represent one of the most difficult population segments to reach. Yet they are closing in on almost double the national average when it comes to people being fully vaccinated. At the same time as of Monday 50 percent more of all Monterey County farmworkers were fully immunized based on a rate of 67 percent vaccination rate compared to Californians as a whole at 45 percent.

It would appear the reason the farmworkers’ vaccination rate is higher comes down to four things:

*A high motivation not to get sick so they could work to feed and support families.

*An exceptionally high workplace involvement in making it possible for workers to get shots.

*The fact they were more vulnerable to getting sick and dying from COVID-19 as the positivity rate between July and November was at 13 percent compared to 5 percent for California as a whole.

*A reason and education outreach effort that doesn’t employ “leaders” berating the unvaccinated as being heathens, uneducated, beholden to conspiracy theories, or self-centered.

Even as the tide appears to be turning in California whether it was propelled by the governor trying to vaccinate himself with measures aimed at him not coming down with a fatal case of “recall-itis” or a growing vaccination rate, it is clear we have a long, long way to go until things get back to normal.

And now that the hysteria is dying down a bit, experts in epidemiology are having realistic public conversations that the best we may end up with when it comes to taming COVID-19 is an average daily death rate of 100 at the peak of spikes in the coronavirus.

Dr. Aaron Campbell, a pediatrician and professor at the Indiana State University School of Medicine, bases the “acceptable” death rate on what occurs in a “good” flu season when nearly 100 Americans die daily from influenza.

This has significant ramifications because at the outset — and months afterwards — political leaders in attack mode along with scientists feeding on anxiety and fear of the unknown that was running rampant on social media created an expectation that the world wouldn’t be safe until COVID-19 completely went away.

The peak death rate in this nation from COVID-19 reached an average of 3,000 a day in January. At the start of June, there was an average of 363 Americans dying each day from COVID-19. That translates into an annual death rate of 132,495.

To put that into perspective, the American Centers for Disease control pegged the 2017-2018 deaths from influenza during the 2017-2018 flu seasons at 61,000.

That means we as a nation will likely be comfortable with a death rate of 150 to 300 a day from COVID-19 given our acceptance of a similar death rate from the flu tolerable given that such losses have never triggered lockdowns in the past or even mandatory mask requirements as many other nations have during flu season.

The goal obviously has to be to get immunizations to a point we settle into an acceptable death rate and to work to cap that as the maximum going forward.

To do that it will require making sure the most vulnerable are vaccinated and that some ongoing annual shot will likely be needed.

While we are now awash in “free money” from the federal government to allow such things as California’s “Vax to Win” money giveaway as well as the State of Washington’s “Joints for Jabs” endeavor, the cash is a one-time wonder and shouldn’t be fritted away.

Instead it should be diverted into building the foundation for an ongoing endeavor to work at getting the most vulnerable vaccinated.

That is likely to mean a door-to-door effort to reach those with limited mobility as well as mobile vaccination efforts taken to workplaces and other locales such as senior centers and community centers serving neighborhoods. And those efforts will likely need to be pursued on an ongoing basis going forward.

It would make more sense from a public health standpoint if money such as the $116 million Newsom is dumping into his “Vax to Win” undertaking went instead to make sure the outreach infrastructure and the ability to administer the vaccine for free at least several years down the road until globally a better handle is gotten on COVID-19.

By doing so the population segments where COVID-19 is likely to do the most harm and therefore have an enhanced ability to spread to the less vulnerable has the highest possible vaccination rate.

And given their vulnerability, those that are the weakest link so to speak are the most likely to get vaccinated especially if it is made as convenient and easy as possible for them to get free shots.

The grocery gift card might be an incentive enough to get more of the most vulnerable to seek out vaccinations, but it is far from being targeted or efficient.

You will get more bang for the buck if those that are the most susceptible to becoming seriously ill when they get COVID-19 are immunized at a higher percentage than the general population as a whole.

That said, it is grudge work and non-glamorous. It is also not likely to win someone like Gov. Gavin Newsom brownie points.

The flash in the pan photo of the governor picking Win for Vax lottery winners is political theater that has minimal impact as opposed to methodical and low-key endeavors to take vaccines to the most vulnerable neighborhoods and workplaces.