Some time in mid-June, state officials expect to hit a target once thought to be a stretch: fully vaccinating 4.1 million Massachusetts residents — nearly three-quarters of the adult population — against the relentless coronavirus.
That milestone will permit a return to normal life for most people, health experts say, citing recent sharp declines in COVID-19 cases, hospitalizations, and deaths. But it likely won’t be enough to stamp out the virus or prevent future spikes in vulnerable pockets of the population, they caution.
“This virus has humbled us so many times over the last 16 months,” said Dr. Howard Koh, professor at Harvard’s T. H. Chan School of Public Health and a former Massachusetts public health commissioner. “Very few scientists are ready to say we’re going to vanquish this and put it behind us.”
While there are hopeful signs, there’s also fear that time is running out to boost the state’s vaccination numbers much higher. That’s because, with most COVID-19 restrictions being lifted this Memorial Day weekend and summer fast approaching, it may feel less urgent to some to get a shot.
Already, the weekly volume of vaccine doses administered has fallen 49 percent in the past month, from 579,496 on the last week of April to 295,326 in the seven days ending May 25. And with demand waning, most of the state’s mass vaccination sites are slated to be phased out over the coming weeks.
June now looms as the endgame, the state’s last, best chance to push up the vaccination tally. Getting shots in more arms could downgrade COVID-19 from a pandemic to an “endemic” that persists in a less punishing and disruptive form, though there is no precise marker for when that may happen.
Officials know who they need to reach: recently eligible young people, the many folks still in wait-and-see mode, residents lacking access or transportation to injection sites, and Black, Latino, and rural white people suspicious of inoculation. What’s not yet known is how many more of them can be persuaded.
New state data show conspicuous gaps in who has been vaccinated. Hispanic residents, who make up 12 percent of the population, account for only 8 percent of those who’ve received at least one vaccine dose. Black people, who are 7 percent of the population, account for 5 percent of vaccine recipients.
The data also show income and geographic disparities, with poorer and more rural counties in Western and Southeastern Massachusetts trailing wealthier suburban counties in the percentage of residents who have gotten shots. Many of the gaps in Massachusetts are narrower than those in most other states, where similar vaccination divides are seen.
Holdouts of all races in their 20s and 30s, who are thought to be more susceptible to online misinformation, are a particular source of concern to many public health leaders.
“Younger people are the most plugged into social media, and they’re less able to distinguish lies from medical facts,” said Dr. Cassandra Pierre, medical director of public health programs at Boston Medical Center and assistant professor at the Boston University School of Medicine, who worries about uneven vaccine distribution across different ages and races.
Pierre, who took her hospital’s vaccine drive to the House of Deliverance church in Dorchester earlier this month, said many people in the surrounding Haitian community were so busy with their jobs and lives that they weren’t focused on vaccination. “We went to businesses around the block and said we have vaccine and we got people who were shopping, who were working, who were doing their laundry,” she said.
Governor Charlie Baker initially set July 4 as his target date for immunizing 4.1 million residents, a number representing nearly 74 percent of those in Massachusetts over 18, according to a US Census population estimate. More recently, as ranks of the vaccinated swelled, Baker moved up the timetable by a month, saying he expected to meet the goal by early June. On Friday, he said that is now likely to happen in mid-June.
State officials didn’t respond to questions on whether the Baker administration plans to then push its vaccination target beyond 4.1 million. In an interview with the Globe in March, the governor said he would ultimately like to vaccine 4.5 million to 5 million. “I can be aspirational, can’t I?” he said.
More than 3.5 million residents were fully vaccinated as of last week. That’s over half of the state’s population of 6.9 million, which includes children under 12 who aren’t yet eligible.
To reach the remaining people, state officials and their contractors have changed tactics in recent weeks, stepping up community-based efforts as well as mobile clinics that can go to people who are homebound or unable to travel.
“At this point in time, if you call and you say you can’t get a vaccine, you can’t get to a vaccine location, we’ll deliver one to you,” Baker said at a State House press briefing Friday.
The state has also tried to generate new interest in getting vaccinated with contests and giveaways.
While the incentives have been less creative than those in some other states — Maine is offering free hunting and fishing licenses, Ohio running a Vax-A-Million lottery awarding $1 million prizes to winners — Massachusetts teamed up with the Museum of Science to hand out museum passes to those vaccinated at a clinic there last weekend and with Dunkin’ to provide iced coffee at vaccine clinics during two Dunkin’ Days at the Hynes Convention Center last week. In addition, CVS, which runs 288 vaccine clinics in the state, will enter those who get shots into a sweepstakes, with prizes including cruises and a trip to the Super Bowl.
Some deeply involved in the vaccination program think Massachusetts could be on track to surpass the governor’s target despite the slowdown in traffic at injection sites. CIC Health, the largest operator of mass vaccination centers, has scheduled about 80,000 second shots for the two-dose vaccines in late May and June at its sites at the Hynes and the Reggie Lewis Center in Boston and Foxborough’s Gillette Stadium. The sites are also accepting walk-ins.
Even when those venues close, CIC Health will continue to ferry vaccine to smaller sites in Boston neighborhoods and cities hard-hit by the virus, such as Chelsea, Revere, New Bedford, and Fall River. The state contractor is currently injecting about 200 doses a day at each of its community “pop-up” sites.
“It’s never enough until we [can’t] reach another person who wants to get vaccinated,” said Rodrigo Martinez, the chief experience officer for CIC Health.
Though vaccinators expect to attract more holdouts over time, they’re also bumping up against the reality that the largest share of people who want shots have gotten them. But universal vaccination may not be necessary to resume most of the myriad activities halted by the pandemic.
“It turns out that you don’t need to get to 85 percent of the population, or to reach this notion of herd immunity, in order to be successful and get rid of the restrictions and open up the economy,” said David E. Williams, president of the Boston consulting firm Health Business Group.
Williams said many 12- to 15-year-olds were quick to get their shots as soon as they qualified for the Pfizer-BioNTech vaccine on May 10. “The kids have suffered from social isolation,” he said. “They want to go to the prom, they want to see friends.”
There are other hopeful signs. A widely followed model from the University of Washington recently projected that the number of Americans who’ve received one vaccine dose — currently more than 165.7 million — will climb 15 percent by the end of August. That suggests Massachusetts, which has seen greater vaccine acceptance and less hesitancy than the national average, could get a substantial bump in vaccine stragglers throughout the summer.
The case for optimism is also bolstered by the large numbers of people who have not gotten their shots but have already been infected by COVID-19, which gives them at least some level of immunity to the virus anyway.
For public health experts, major caveats remain, such as concern that COVID-19 variants continue to circulate worldwide, threatening to generate a strain that eludes the protection of vaccines. That alone is cause for continuing to boost vaccine numbers in Massachusetts, they say.
“If we get 4 million-plus [vaccinated], we will probably not stamp out the virus completely,” said Dr. Philip Landrigan, founding director of Boston College’s global public health program. “Kids under 12 are still not vaccinated and they will remain a reservoir for disease. But while we will undoubtedly still have the virus around, we won’t have the large outbreaks because there won’t be enough people to spread it.”