While Hawaii residents once clamored for who got the first shots for the COVID-19 vaccine, lines these days aren’t necessarily that long and appointments are wide open.
After passing the milestone of one million vaccine doses administered, Hawaii health officials now face the challenge of how to inject the second million needed to reach herd immunity — the point where enough people are immune to spread of the virus is unlikely.
“We are seeing a decline in enthusiasm for the COVID vaccine,” said Hilton Raethel, president and CEO of the Healthcare Association of Hawaii. “A lot of people who were really looking forward to getting it got vaccinated. We are currently at a transition point. (This) week is the first week since vaccines have been available that we have enough supply to respond to It’s not because supply has increased dramatically over the past few weeks, because it’s not, but because demand is falling.”
About 50% of Hawaii’s population has received at least one dose of vaccine and nearly 40% have been fully vaccinated.
Now the race is on to reach those still hesitant to get vaccinated.
Among them are remnant kupuna who have been eligible for months but failed to get vaccinated, as well as young teenagers and adults on the other end of the spectrum who don’t care enough about fall ill to get vaccinated.
Then there are vulnerable communities, including those that don’t have easy access to transportation or the technology to book vaccination appointments online. Additionally, there are those who cannot afford to take time off from juggling multiple jobs and family obligations to attend an immunization clinic.
Ethnic groups disproportionately affected by the pandemic who still have low vaccination rates include Native Hawaiians, Pacific Islanders and Filipinos.
The state’s strategy now is to bring vaccination to these harder-to-reach pockets of the population, as was recently the case during a pop-up vaccination clinic held in the towers of Kuhio Park, a public housing project in Kalihi.
Bringing vaccines to communities
With music, hundreds of residents ranging from teenagers to kupuna lined up Thursday for free COVID-19 vaccinations near the Kuhio Park towers.
The clinic was organized by a Kalihi coalition of agencies and partners, including the Hawaii Public Housing Authority and the nonprofit Parents and Children Together.
Kaiser Permanente administered about 500 first doses of the Pfizer vaccine without an appointment. Language interpreters were on hand, with the ability to translate into Chuukese, Marshallese, Korean, Samoan and Ilocano.
It was convenience that brought Elina Kanaka’ole, a working mother of four, to the clinic. She had wanted to be vaccinated but had not had time to travel to the centers of the city, let alone bring her four children with her, while juggling her work schedule.
“Basically, for these people, it’s a mix of everything,” said Kim Gibu, registered nurse and community outreach manager for Kaiser. “There’s a language barrier, no internet, no laptops to register online, or they just don’t know it. They don’t understand it.
The clinics provide information for anyone curious and a bit of “swag” as motivation, according to Gibu, whose team has also conducted outreach in Papakolea, the Philippine Community Center and Kau on the island of Hawaii. .
On Thursday, those vaccinated were offered reusable water bottles, HOLO (bus) cards and food gifts on the way out.
Another clinic will be held in May to give residents and the surrounding community their second doses.
In a statewide survey conducted in January, the Department of Health found that 55% of respondents were likely to take the COVID-19 vaccine as soon as they were eligible, while an additional 36% preferred take a wait-and-see approach.
Raethel said those numbers have since improved, with more people interested in getting vaccinated after seeing friends, family and neighbors do so without major side effects.
According to federal data, only about 10% of Hawaii residents are hesitant about the vaccine.
Health officials are not focusing their resources on outspoken anti-vaccines, a small percentage of the population opposed to all vaccinations, because they are not expected to change their minds.
But part of the battle will include fighting rampant rumors brought by anti-vaxxers, including that the vaccination campaign is a plot to microchip people or that the vaccine can alter their genetics.
Some have philosophical or religious reasons for not wanting the vaccine, as well as distrust of government in general and fears about long-term side effects.
To reach the youngest, the Department of Health plans to work with schools to launch a social media campaign. To reach certain populations, the state partners with community groups that have already established relationships.
Retired state senator Suzanne Chun Oakland, now coordinator of the Lanakila Multi-Purpose Senior Center program, said the offer of an on-site clinic has worked well for kupuna who still haven’t been vaccinated.
Since February, Lanakila, in partnership with Kalihi-Palama Health Center, has offered several hundred vaccinations at the center every Tuesday to its members and their families.
“A number of older people felt very comfortable at the center, and there was already a relationship of trust established,” she said.
Also, some hesitant seniors feel more comfortable having a younger family member who received the vaccine with them.
Gibu, from Kaiser, said filling out forms often also intimidates people who are afraid to share their personal information or who might not have a permanent address or who might be undocumented. COVID-19 vaccines are free for everyone in the United States, regardless of immigration status, with or without health insurance.
There is also the fear of the unknown.
The Pfizer, Moderna, and Johnson & Johnson vaccines, as resisters like to point out, are given under emergency use authorization by the United States Food and Drug Administration and have yet to be fully approved.
What Gibu said she often shares is that there is no long-term data on the vaccine, but it is 94-95% effective in preventing COVID-19 and effective 100% to prevent getting seriously ill.
“Really what you’re doing is protecting your loved ones, your community,” she said. “You are helping to ensure that your community is protected.”
The state health department says there is no magic number and agreed on the percentage of the population that needs to be vaccinated to achieve herd immunity.
But at least 2 million more doses are needed if authorities target 70% to 85% of Hawaii’s 1.4 million people.
Raethel said the general consensus is that the state needs to vaccinate 80% to 85% of the population, or 2.2 to 2.3 million doses in total, to achieve herd immunity due to the variants present in the state.
Additionally, some 310,000 children in Hawaii ages 15 and younger are not yet eligible for a COVID-19 vaccine.
“As more contagious variants spread, we likely need more people vaccinated than expected,” said DOH spokesperson Brooks Baehr. “Our best strategy is to vaccinate as many people as possible as quickly as possible. Hawaii’s young adults will play an important role in whether and how quickly we achieve herd immunity.
Most of the vaccines given in the state are the two-shot, double-count Pfizer or Moderna vaccines, while only 10% are the single-shot Johnson & Johnson vaccine.
Therefore, with 1.2 million doses that would have been administered in Hawaii on Friday, the state must administer at least another million doses to reach the 80% immunity threshold.
When will this happen?
Lieutenant Governor Josh Green often cites July 4 as a target celebration day when herd immunity has been achieved in Hawaii, but the current pace must continue.
Unknown variables include whether vaccines for children ages 12 to 15 and younger will be available this summer, as well as the future influx of variants.
“It’s going to take a lot of work over the next two months to reach that critical mass,” Raethel said. “If we don’t reach critical mass, we still have a very high risk in the population. If we don’t have enough people vaccinated, it just makes the variants more likely to spread.
ACHIEVING HERD IMMUNITY
Hawaii population: 1.4 million
>> 70%, 1.9 million total sockets required*
>> 80%, 2.2 million sockets in total needed
>> 85%, 2.5 million sockets in total needed
Source: Hawaii Healthcare Association
* Rounded figures
COVID-19 VACCINATION APPOINTMENT
More availability without an appointment:
>> Pier 1 Vaccination Center, walk-in available 8 a.m. to 3 p.m. Monday through Saturday. Appointments also available from 8 a.m. to 4 p.m. Visit HawaiiPacificHealth.org/COVID19Vaccine.
>> The Kaiser Consolidated Theater at the Kapolei site will accept walk-in visitors after 11 a.m. Tuesday through Saturday. Appointments are also available at kp.org/covidvaccine.
>> Discover more options on hawaiicovid19.com/vaccination-record.