As states open up coronavirus vaccination to wider audiences, vaccine hesitancy becomes more apparent

President Biden has set a May 1 deadline for all states to drop eligibility requirements for the coronavirus vaccine and allow everyone age 16 and up to get one. Many states are gradually doing away with tiered restrictions, but on March 9 Alaska became the first state to open up vaccination to all. That "illustrates how quickly access is expanding throughout the country, and some of the reasons. Chief among them is a lack of demand for the shots, as vaccine scarcity gives way to vaccine hesitancy, or even outright resistance in some communities," Isaac Stanley-Becker and Lena H. Sun report for The Washington Post. "Health officials said vaccine misinformation metastasizing online plays a role in that resistance and is adding to their sense of urgency about the pace of vaccinations." Rural residents and Republicans (especially men) are among the most likely groups to be hesitant or resistant.

As vaccines become more easily accessible, hesitancy becomes more apparent because there are fewer excuses not to get one. In Mississippi, which on March 16 became the second state to open up vaccinations to all, some residents are jumping at the chance to get immunized, "but many other people are holding back, spotlighting challenges likely to face the rest of the country related to equity, access and trust that could complicate the quest to reach the high levels of immunity needed to stop the virus’s spread," Stanley-Becker and Sun report.

"Nirav Shah, director of Maine’s Center for Disease Control and Prevention, said he has been hearing from colleagues across the country that they are starting to see appointments go unfilled," the Post reports. "Still, Shah cautioned against conflating lack of demand with hesitancy. Many people may simply not feel the same degree of urgency, he said. People who have had the opportunity to get vaccinated but have not done so fall along a spectrum, including some who are uninformed, some who are misinformed and some who just haven’t gotten around to it."

In some rural counties that have opened up vaccine registration, there's evidence that barriers to access and lack of awareness may also be responsible for unfilled appointments, the Post reports. Racial and ethnic minorities, including undocumented immigrants and refugees, are less likely to have received the vaccine in many counties. Many rural residents lack reliable transportation and may have a difficult time getting to both two-shot vaccine appointments. One health official told the Post that the one-shot Johnson & Johnson vaccine would help.

Dropping vaccine restrictions may increase immunizations among residents of communities who feel uncomfortable getting vaccinated when others aren't eligible. Anne Zink, Alaska's chief medical officer, said that many in the state's Pacific Islander community refused to get the vaccine when only some age groups were eligible. "They were very clear: We’re in this together," she told the Post.