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Nurses wait at empty tables for more patients to arrive to receive a dose of the Moderna Covid-19 vaccine at a pop-up vaccination site in Gardena, California on April 17, 2021.
Enlarge / Nurses wait at empty tables for more patients to arrive to receive a dose of the Moderna Covid-19 vaccine at a pop-up vaccination site in Gardena, California on April 17, 2021.

Though COVID-19 vaccines are now open to all US adults, vaccinations in the country are on the decline.

In the past week, the rolling seven-day average of daily vaccinations has slipped nearly 11 percent, falling from a high on April 13 of nearly 3.4 million shots per day to the current average of just over 3 million. And scores of counties across the US have begun declining shipments of vaccine doses, according to reporting by The Washington Post.

It’s the first time since the nationwide vaccination effort began last December that the country has seen a sustained decline in vaccinations—except for a brief dip in February which was linked to winter weather-related delays and cancellations.

Multiple factors may explain the current drop in shots. The dip coincides with a pause in the use of the Johnson & Johnson vaccine. That pause may explain some—but not all—of the drop over the past week. However, health officials say extra supply of Moderna and Pfizer-BioNTech vaccines have largely compensated for the Johnson & Johnson pause. Plus, recent polls suggest that the pause has not significantly affected vaccine hesitancy.

Instead, experts suspect that the biggest factor for the decline is simply waning demand. With 52 percent of US adults having already received at least one shot, and more than 34 percent are fully vaccinated, the country may be running low on adults eager for a shot.

In a recent survey by the Kaiser Family Foundation, 20 percent of Americans said they would definitely not get a vaccine or only get one if it was required. An additional 17 percent surveyed said they would “wait and see” about getting vaccinated. Likewise, in an Axios-Ipsos Coronavirus poll released April 20, a total of 30 percent of respondents said they were “not very likely” or “not at all likely” to get a vaccine. That total is unchanged from before the Johnson & Johnson pause.

“We can do better”

The slowing vaccinations and the consistent poll results suggest that state and local health officials may be bumping up against the vaccine hesitant and vaccine skeptical portions of the country.

“We’re past that point of vaccine eagerness, well into vaccine hesitancy, and having supply drive what we do is a mistake,” Philip Keiser, the top health official in Galveston County on the Gulf Coast of Texas, told the Post. Only about a third of eligible residents in the county have been vaccinated, but Keiser requested that the state hold back vaccine supply. Keiser said he is working on targeted outreach, including holding events in hard-to-reach communities and schools to try to boost vaccine interest.

Many other local health officials as well as the Biden Administration are now working on such targeted approaches to lower obstacles and soften vaccine views in resistant communities. Top health officials told Politico that they’re aware that the efforts may not work, but that they’re trying anyway. Without the 20 to 30 percent of US adults who are reluctant to get vaccinated, it will be difficult if not impossible for the country to bring disease transmission to a halt. That means the pandemic could continue to drag on.

“A few months from now, if that’s what happens, the people who are in the hospital, in the ICU getting sick and dying, are going to be those who didn’t get immunized. And it’ll be pretty obvious that’s the case,” Francis Collins, director of the National Institutes of Health, told Politico. “And I don’t want that to be the wake-up call. We can do better than that. But that could be the downstream scenario if we’re not successful in conveying all the reasons why it’s time for action now.”