Intended for healthcare professionals


Covid-19: Biden aims for 70% of Americans to have at least one vaccination by 4 July

BMJ 2021; 373 doi: (Published 05 May 2021) Cite this as: BMJ 2021;373:n1155

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  1. Janice Hopkins Tanne
  1. New York

President Joe Biden has said that he wants 70% of people in the US to have received at least one dose of a covid-19 vaccine by 4 July, the Independence Day holiday popular for family gatherings.1 Many states plan to reopen their economies completely in the next few weeks.

Achieving the 4 July goal means giving 100 million shots—some first shots, some second shots—in the next two months. “We have enough vaccines,” said Biden. Now the issue was getting more people “to show up and get the vaccine that is available to them . . . If we can continue to drive vaccinations up and caseloads down, we’ll need our masks even less and less.”

He explained, “The pace of vaccinations is slowing now that the majority of American adults have already gotten their first shot.” Vaccinations have dropped from a high of four million doses a day to about one million a day.2 Cases and deaths have also dropped. Deaths among seniors are down over 80% since January, he noted.

More than 143 million Americans over age 18 have received at least one dose of a vaccine, and more than 105 million have been fully vaccinated.3 As of 3 May the US was recording just under 50 000 new cases and 733 deaths a day, down from highs of around 260 000 new cases and 4000 deaths a day in January.4

Herd immunity

President Biden did not mention “herd immunity,” which is sometimes defined as the time when 70-90% of Americans are fully vaccinated. The New York Times has reported that scientists now think that new variants are emerging too quickly and vaccination proceeding too slowly for the US to reach herd immunity soon. It quoted Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, as saying that herd immunity was a somewhat “mystical” concept. “We stopped using herd immunity in the classic sense,” he said. “You vaccinate enough people, the infections are going to go down.”5

Biden said that the nation was moving into three new areas. First will be vaccinating children aged 12 to 15 as soon as the Food and Drug Administration authorises the Pfizer-BioNTech vaccine for them, which is expected early next week. Cases in children have been increasing.

Second, the FDA will also make vaccines available more conveniently, at pharmacies and doctors’ offices. Pharmacies will offer walk-in hours, as the need to make an appointment has stopped many people from getting the vaccine. Incentives for vaccination will be offered at grocery stores and through major sports leagues—for example, discount coupons to shoppers who come to stores or stadiums to get vaccinated.

The third approach will be to convince people who are reluctant to take the vaccine. Their numbers are higher in states that voted for Donald Trump: the southern states of Mississippi and Alabama, which voted for Trump, have the lowest vaccination rates in the country, and only about 64% of the vaccines delivered have been administered. By contrast, Wisconsin, New Mexico, and Minnesota, all of which voted for Biden, have the highest vaccination rates, with about 90% of delivered vaccines administered.6

Biden advised hesitant people, “Talk to someone you trust, like your physician or your pharmacist or people who have already been vaccinated. Talk to your faith leaders or others in your community that you trust. Look to those people to help answer your questions . . . This is not a Democrat or a Republican issue.”

He noted that two of the vaccines had been approved under Trump’s Republican administration, and he thanked Republican leaders who had advocated for vaccination.

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