(Bloomberg) -- A steady stream of vehicles flowed through the Covid-19 testing site in American Fork, Utah, a town in the youngest county of the state that has the youngest population in the U.S. On this recent Friday, many were minivans packed with children.
Just around the corner, a vaccination site sat empty, closed for lack of demand.
The delta variant has torn through Utah, fueled by low inoculation rates among younger people, the exuberant return of summer gatherings and loose restrictions imposed by public and private authorities.
Utah has a median age of 31.2 years, the lowest among states, according to 2019 estimates by the Census Bureau. Utah also has above-average birth rates and the nation’s largest household size, in part the result of the majority-Mormon population and its traditional focus on families.
About 45% of the state’s population is fully vaccinated, according to Bloomberg’s tracker. That’s below the national rate, ranking in the bottom 20 states. Rates among younger people are the worst: 33% of children from 12 to 18 are fully vaccinated, according to the Utah Department of Health.
Two trajectories have emerged as the delta variant has become the dominant strain in the U.S. Places with high vaccination coverage have kept transmission and hospitalizations lower. Those with poor vaccination rates haven’t, with delta easily spreading among the young and unvaccinated -- and threatening to derail the recovery of the country’s public and economic health.
In Utah County, the state’s second-most-populous after Salt Lake, one driver of the outbreaks has been overnight youth camps, many hosted by the Church of Jesus Christ of Latter-Day Saints, as well as the church-founded Brigham Young University. Only 38% of residents are fully vaccinated in a county that sits in a low valley at the base of the Wasatch Range, where shopping centers and business parks give way to stark views of mountain peaks.
“We don’t see testing taking place before these camps,” said Aislynn Tolman-Hill, a spokeswoman for the Utah County health department. Many host children older than 12 who could be vaccinated, but aren’t. And the county has a limited view of when many camps are happening -- hundreds in some weeks.
A BYU spokesperson, Carri Jenkins, said the university knows of only 10 positive cases among almost 18,000 participants at day and overnight camps. The actual number is unknown, given that testing -- like vaccinations and masking -- isn’t required.
This week, epidemiologists were tracking 21 camps where exposures to Covid-19 might have happened, with 13 confirmed outbreaks. “They take it home and then you have a smaller outbreak in a family setting, which can then lead to a community setting,” Tolman-Hill said.
The county tries to trace contacts and interrupt outbreaks, but camp organizers often have sent symptomatic children home with little follow-up. “It’s becoming increasingly difficult,” she said. “We’re met with increased resistance from some members of the public.”
The Mormon church has provided camp leaders with guidelines to reduce risks, said Irene Caso, spokeswoman for the Church of Jesus Christ of Latter-Day Saints.
It’s unclear whether those are followed by local camps. Meanwhile, cases are ticking up. Utah’s seven-day rolling average of test positivity is almost 15%.
A short drive north of Utah County, in a town called Murray, Josh MacMurray and his three children fell ill in the house they share with a large ridgeback mix named Zeus. No one in the family is vaccinated.
MacMurray’s 17-year-old son, Aidan, first tested positive after his girlfriend got sick.
“It was really quick,” said Josh MacMurray, 51, a machine shop owner who is divorced and has primary custody of the children. “He’s like, ‘I think my girlfriend’s sick.’ And then the next thing you know, it was like, ‘I feel a little weird.’”
Soon after, Aidan’s 13-year-old sister also tested positive, and his 14-year-old sister felt sick as well. Josh himself had fatigue and congestion. None of the MacMurrays have fully regained their senses of taste and smell.
The U.S. Centers for Disease Control and Prevention says people who have recovered from Covid-19 should still get the vaccine, but MacMurray is unswayed. Although the children have gotten other vaccinations, he’s just not sure about the Covid shot.
“I want to see how the technology turns out,” he said, even if it means risking illness. “I’m willing to roll the dice that way.”
Messages about Covid-19’s risk for young people have been “really problematic,” said Andy Pavia, a physician and chief of the division of pediatric infectious diseases at the University of Utah.
“We’ve really done a disservice to young adults and to older kids, teenagers in particular, by highlighting the difference between them and adults without really emphasizing that it’s a bad disease for them as well,” said Pavia.
Utah’s new cases are highest among children, teenagers and working-age adults. Pavia said he’s seen a marked increase in hospitalized children. In May, the hospital had many days with none. In recent weeks, it has cared for as many as five at a time. That points to many milder cases in the community, Pavia said. And, with schools closed, testing has declined.
“It warps the picture,” Pavia said. “You start to see the sickest, but you lose track of the moderately ill and those who are asymptomatic.”
Long-haul symptoms can be particularly devastating for teenagers, Pavia said, and his hospital is bracing for more cases of the rare multisymptom inflammatory syndrome in children, which lags behind infection and exposure by weeks.
This fall will bring an added challenge as the Utah legislature has prohibited public schools and universities from implementing further mask requirements. And children under 12 can’t get the vaccine.
“It just makes you want to plead with the rest of the population that are eligible for vaccines and to say, ‘Hey, let’s step up to the plate for the little ones, even if you don’t care as much about concern for yourself,’” said Jonathen Bartholomew, a pediatrician at Utah Valley Pediatrics in Orem.
On a recent Sunday, he saw three times the usual number of children with symptoms of upper respiratory infections. On another day, a 2-year-old tested positive, likely infected in a daycare.
At the American Fork testing site, McKenzie Hopkins, a 16-year-old with a shock of long pink hair, pulled over with her brother and mother in the car. She and her father tested positive a few weeks ago, she said, and he was recently admitted to an intensive-care unit.
With her mother and brother beginning to show symptoms, the family had planned to get the vaccine but hadn’t yet.
“We were going to,” she said, “and then we all got sick.”