Introduction 

For the last year much of the advice that we have heard surrounding COVID-19 is along the lines of “get vaccinated” or “follow the science”. But still only around 60% of Americans are currently fully vaccinated. Why is this? Are there certain demographics who are less likely to get vaccinated? If so, who are they and how is it affecting the people who are vaccinated? These are questions that many of us have been asking for months and now with numerous studies, polls, and surveys, we are starting to get an answer.

Federal Mandates 

Although there is controversy surrounding vaccination and mask mandates at the school and private sector levels, the federal government has had several mandates in effect since President Biden took office. A few of those mandates include requiring all federal employees to be vaccinated, with assistance from federal vaccination programs, and widespread federal distancing and mask mandates. However, the administration also enacted mandates for private business in January that were subsequently overturned a few days later by the supreme court. 

On Jan. 13, the Supreme Court blocked a Biden administration mandate enacting widespread vaccine mandates or testing for large private companies. The mandate required workers at businesses with 100 or more employees to either get vaccinated or receive weekly negative COVID-19 tests. The mandate would affect nearly 80 million individuals at larger companies across the country. Although the measure was granted by congress to the Biden administration, the Supreme Court rejected the mandates and said it was an overreach on behalf of the administration and OSHA, the Occupational Safety and Health Administration. 

However, in a separate ruling, the Supreme Court sided with the Biden Administration regarding vaccination mandates for health care workers. The court allowed the vaccination mandate for healthcare workers at facilities that participate in Medicare and Medicaid programs, like hospitals, nursing homes, etc., to continue. The mandate regulates more than 17 million health care workers in the United States. This ruling led to the conclusion that outside of medical facilities, the federal government cannot mandate vaccination or testing requirements for private companies. Nonetheless, mandates are still being contested in many states; however, even with these rulings, some states will allow private employers to decide vaccination mandates on their own. This has led to confusion and different practices between different states and even within certain regions of a state. 

New York

New York is a very Democratic state, with over three quarters of voters registered as Democrats.  As of January 14, 73.0% of New Yorkers are fully vaccinated, while 81.3% of New York’s 18 and older population are fully vaccinated.  This is above the national vaccination rate of 62.9%.  In New York City, which has the highest concentration of New York’s Democratic voters, the vaccination rate is pretty similar with 73.6% residents fully vaccinated.  This includes 84.2% of adults 18 and older, 81.6% of adults 65 and older, and 46.4% of children ages 5 to 17.  Nassau County, right outside of New York City, has a vaccination rate of 77.7%, while its neighboring county, Suffolk County, has a rate of 72.3%.  

Despite a high vaccination rate, less than half of eligible New Yorkers have received a booster shot, which has contributed to the state’s positivity rate of 12.9% on January 15 (11.5% in New York City, 14.1% in Nassau County, and 16.0% in Suffolk County).  New York’s death rate per 100,000 people is 0.91, which is the 9th highest of all states.  On January 15, 11,713 Covid 19 patients were hospitalized, with 1,613 in the ICU.

In August, Governor Hochul approved an order requiring masks to be worn in schools regardless of vaccination status.  On December 10, Governor Hochul announced a state wide mask mandate that extended to all businesses and offices, which had been removed since June 2021.  The mandate was supposed to be reevaluated on January 15, but was extended to February 1.  The mandate has been fought in many court cases, all which were unsuccessful.  The most recent challenge comes from Nassau County Executive Bruce Blakeman, who publicly announced that he will not enforce Governor Hochul’s mask mandate.  He even stated that he would give school boards the right to choose if they wanted to enforce mask wearing, but Governor Hochul responded to this by saying that state laws prevail.  As a result, no Nassau County school boards have stopped requiring masks out of fear of losing their government funding.  

New York City is requiring all those eligible to show proof of vaccination in many indoor settings.  These include restaurants, gyms and fitness studios, and entertainment and meeting spaces.  In addition, businesses are required to have fully vaccinated employees.  Anyone who received their vaccination doses in New York is able to show proof of vaccination through the “Excelsior Pass”.  This is an app with a digital pass with the user’s vaccination and testing record, if they have received a PCR test in the last five days.

In order to make vaccines accessible to all New Yorkers, mass sites have opened across the states and most take walk-ins.  New York City has also set up a “Vaccine Finder” website which helps users find a vaccination site near them.  As Covid 19 cases have grown as a result of the Omicron surge, Governor Hochul has opened 13 state testing sites and has been sending at-home tests to New York school districts.  She sent 2 million tests to schools across the state in the first week of January and plans to send another 2 million in the next week.

Massachusetts 

Massachusetts is an overwhelmingly Democratic state. It has more than three times as many registered Democrats than Republicans. With this in mind, Massachusetts is the third most vaccinated state in the 18-64 age range with a vaccination percentage of 81.7% and 98.3% in citizens 65 and older. This is not a surprise, as Democrats are more likely to get vaccinated than Republicans. Despite the state’s high vaccination rates, the death rate per 100,000 citizens is still higher than those states with substantially lower vaccinations. The death rate in Massachusetts per 100,000 people is 0.75, whereas a state like Alabama has a death rate of 0.4 people per 100,000 and a vaccination rate of 52.1% in citizens 18-64. 

The state of Massachusetts makes it easy for people to get vaccinated and prove that they are vaccinated to anyone who is concerned. Through their state website, you are able to find information on each vaccine, find locations near you, set up an appointment to get vaccinated, and even offer a Massachusetts digital vaccination wallet that you can download on your phone. With one website and a few clicks, the average citizen could easily get vaccinated and attend public events with their vaccination wallet. 

According to Massachusetts’ state website, all COVID-19 related restrictions have been lifted as of May 29, regardless of vaccination status. However, there are still mask requirements in some specified areas which include public transportation, healthcare facilities, and emergency shelters. Businesses in the state are asked to implement their own vaccination requirement, but none are enforced by the government. In addition to this, Massachusetts schools require that all students wear masks unless the building has a vaccination rate of 80% or higher, which applies to more than 30 schools in the state. However, this is not in accordance with the Biden-Harris administration’s guidance to wear a mask at all times around others when outside of your home.

Texas

Texas, an incredibly Republican state, is not nearly as vaccinated as Massachusetts. In total, only 58% of Texans are fully vaccinated as of Jan. 14 according to the New York Times, which is below the national share. 84.5% of people aged 65 and up have been fully vaccinated, with 55.3% of those receiving the booster as well. However, in the 18-64 age group, only 69.3% of Texans are vaccinated, and only 33% of those have received the booster. This lack of vaccination has led to a major jump in positivity rate, which has increased by 220% since the new year. Per 100,000 people, though, Texas has only the 29th highest positivity rate, but the 17th most deaths. The average death rate is 1.8 per 100,000, and has increased by 31%, which has led to increases in hospitalizations by 70%. 

The Texas Department of State Health Services has been attempting to increase vaccination, and recent statistics show these efforts have been working. There have been dramatic increases in all age ranges of Texans initiating their vaccination, due to the improvements to vaccine programs throughout the state. Governor Greg Abbott began a Mobile Vaccination Call center last spring, and the DSHS has included various resources to help people find vaccination sites, as well as providing stats to encourage vaccination throughout the state.

Governor Abbott has responded to COVID-19 with what would be expected from a Republican leader. The latest COVID-19 related executive order was put in place on Oct 11., when he prevented any entity from compelling anyone to receive vaccination. They were one of the first states to “open up” when case numbers were lower during the summer, and were among the first to remove statewide mask mandates, doing so in March of 2021. 

Utah

Utah has had a fairly steady increase in its vaccination rate over the past year.  As of January 14th, 68% of Utahns have received at least one dose of the COVID-19 vaccine, and 59.7% of Utah’s population have been fully vaccinated.  Utah has received 5,634,810 doses thus far, and has administered 82% or 4,655,157 of the doses. 

Most Utahns who are vaccine hesitant are simply uneducated about the vaccine rather than being fully opposed to it.  Data from the U.S. Census Bureau shows that of the 15.1% of people who are hesitant about receiving a COVID-19 vaccine, 49.7% are concerned about the side effects, 39.7% percent plan to wait and see if it is safe, and 32.5% believe they don’t need a vaccine. 

President Biden introduced a Head Start program for 24 states with the goal of increasing vaccination rates in them.  Utah has joined its fourth lawsuit against Biden’s program, and Attorney General Sean Reyes said in a statement that “Not only is the Head Start mandate unlawful, but it will deprive low-income families and rural communities in Utah of these vital services.”  Reyes believes that forcing teachers, contractors, and volunteers in Head Start programs to be vaccinated will cost jobs and programming, and will ultimately have negative effects for Utahns. 

As of now, COVID-19 vaccination is not required to attend K-12 public schools or participate in extracurricular activities in Utah.  Parents can choose if they want their child to wear a mask in school; however, in areas where there are no mask-mandates, the decision to wear a mask in school remains optional.  Anyone who tests positive for COVID-19 should isolate at home for a minimum of 5 days according to Utah.gov. 

On January 13th, The Supreme Court blocked Biden’s OSHA vaccine mandate, a decision that most Utahns were very happy about.  If The Supreme Court had passed this mandate, workers of all large businesses would be required to be vaccinated. Utah Governor Spencer Cox is supportive of businesses choosing whether or not they require vaccination for their workers and consumers.