Fearing Immunization Gap, West Virginia Tries Incentivizing Covid Vaccinations

Andrew Donaldson

Born and raised in West Virginia, Andrew has since lived and traveled around the world several times over. Though frequently writing about politics out of a sense of duty and love of country, most of the time he would prefer discussions on history, culture, occasionally nerding on aviation, and his amateur foodie tendencies. He can usually be found misspelling/misusing words on Twitter @four4thefire and his writing website Yonder and Home. Andrew is the host of Heard Tell podcast.

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40 Responses

  1. Chip Daniels says:

    I applaud the governor for his efforts, but couldn’t help snickering over the chosen device, a savings bond.
    As someone on Twitter asked, what comes with it, a Bing Crosby record?Report

  2. Oscar Gordon says:

    I appreciate starting with a carrot, but at some point, we are going to need a stick…Report

    • Jaybird in reply to Oscar Gordon says:

      I overheard co-workers yesterday talking about how another company in town was setting up a “you must be vaccinated to have access to the building” policy. No vaccine, well, you won’t be allowed in the building.

      If your job requires access to the building (like 98% of the jobs there), then you will be terminated as being unable to fulfill the requirements of your job.

      They were talking about what would happen if *OUR* company did that… and one said that they would quit.Report

    • And with very few exceptions, the sticks will have to wait until there is at least one fully-licensed vaccine. Even then there will be exceptions. The U of California system’s lawyers have spent many years writing vaccine mandates that stand up. The draft of their proposed Covid mandate includes all of: applies only when there is a licensed vaccine; exceptions for medical reasons; and some exceptions on religious grounds.

      One of my hopes for the mRNA vaccines is that the number of people who need to avoid them for medical reasons is smaller than for more traditional vaccines.Report

      • Oscar Gordon in reply to Michael Cain says:

        At this point, I’m fine with the government offering carrots, and employers wielding sticks.Report

        • Kazzy in reply to Oscar Gordon says:

          I think his point is that for employers to wield certain sticks, they need to know that government will back them. As I understand it now, employers are on dicey ground trying to require the Covid vaccine.Report

          • Oscar Gordon in reply to Kazzy says:

            U of CA is a public entity.

            My employer is not. Private entities are probably not on the same kind of shaky ground as public ones.

            That said, I get his point about a fully licensed vaccine. Which is why I am betting a lot of employers are not pushing for a return to the office.Report

      • JS in reply to Michael Cain says:

        >One of my hopes for the mRNA vaccines is that the number of people who need to avoid them for medical reasons is smaller than for more traditional vaccines.

        Right now that’s looking…likely. I mean mRNA vaccines put a nice strain on you as your bodies pump out the proteins you’re trying to teach the immune system to recognize, but it seems the serious side effects are far smaller than the AZ and J&J shots, and I haven’t seen anything about allergic reactions.

        I suspect this massive, large scale data set will help future generations of mRNA vaccines not hit the body quite so hard as the famous second dose (or doctors while find some medications to mitigate it), but…..from what I understand, mRNA vaccines should be safer in general.

        Which is good, because mRNA vaccines are likely — in the long term — to be as big a game changer as antibiotics were. Between them and CRISPR, well — we might be re-tasking the human immune system to fix a lot of things that until now were just managed — or left to run rampant.Report

        • Michael Cain in reply to JS says:

          One of the most interesting parts of the process is that the big concern isn’t how people respond to the mRNA, it’s how they respond to the proprietary customized synthetic lipid nanoparticles that encapsulate the relatively harmless mRNA. So far as I can tell, Pfizer and Moderna are willing to tell you everything about their mRNA sequences. The LNPs, though, those are trade secrets they don’t want to share with anyone.Report

          • JS in reply to Michael Cain says:

            “The LNPs, though, those are trade secrets they don’t want to share with anyone.”

            I can understand why. Notice how the refrigeration requirements vary so much between Pfizer and Moderna — isn’t that down to the LNPs?

            I suspect that’s not the only thing that LNPs dictate.

            On the bright size, both Pfizer and Moderna got some huge real-world data on human reactions to them. And I think Pfizer is going to have to hope desperately that people keep the cryogenic storage they had to build out for this vaccine, or else sink a lot of money into finding a replacement that can just be refrigerated.

            All things considered, Moderna might be the winner here of the two. They’ll have large-scale data on an mRNA vaccine that has common storage requirements, so they’ll have less they need to tailor (and thus test) going forward.Report

  3. Philip H says:

    Mississippi is experiencing the same drop-offs. As of last week we had 23% of the state’s eligible population fully vaccinated. And people down here are convinced that’s enough. Because the governor isn’t telling them its not. Because the news they trust isn’t telling them its not. Because their neighbors aren’t telling its not.

    In short – their in groups are not telling them the scientific truth, not matter what the emotional truth is. Which means their tendencies to prize in-group loyalty, unquestioned leaders, and their own “common sense” are working against them.Report

    • JS in reply to Philip H says:

      Houston has thrown open it’s drive-through vaccination centers because they have more doses than demand now.

      It turns out a certain subset of the population is basically “Nah, no thanks”. We’re never going to hit herd immunity.

      Of course Texas also decided not to expand Medicaid again, which is going to continue killing off rural hospitals and healthcare in general. As best I can tell, the Texas GOP has embarked on a slow euthanasia program of it’s own constituents.Report

      • Philip H in reply to JS says:

        We’re never going to hit herd immunity.

        Nope, and even though the vaccine cost you nothing but your time – and nets you free Krispy Kreme’s no less – that’s not going to be enough.

        As best I can tell, the Texas GOP has embarked on a slow euthanasia program of it’s own constituents.

        I guess that’s one way to get “high quality voters” though you’d think some of them would notice the irony of the Death Panels ™ Party becoming the Death Cult Party.Report

  4. Saul Degraw says:

    The U.S. has plenty of vaccines, we do not have a lack of supply issue. The problem is that too much of the vaccination language has been on the voluntary side, it needs to be more mandatory, and there needs to be carrots and sticks behind it. This has to be a total picture:

    1. Employers must be required to let employees take paid time off of work to get vaccinated and/or recover from the side effects. Employers who terminate or withhold pay should face draconian punishment in strict liability for failure to do so.

    2. Getting vaccinated should come with privileges, though this gets in the way of anti-vaccination now being another part of the weaponized bad-faith, Cleek’s law arsenal of the GOP right now. Part of me thinks the DeSantis type antics are partially, if not largely, with 2022 in mind and trying to keep thing messed up until then, and blaming the mess on Democrats and Biden.

    3. To this end, people who support vaccination but also believe we need to act like it is the worst days of the pandemic from spring 2020 need to shut up too. Vaccination should go hand in hand with opening up.

    Yes, I support vaccine passports.Report

    • Jaybird in reply to Saul Degraw says:

      If I disagree with this comment, it’s because I think that this comment is more appropriate for the end of June instead of the end of April.

      In the short term (that is, the next two months), we just need to open the floodgates. No more websites. No more scheduling. Have walk-up clinics. If you work for a company that is size X or larger, make it possible to have a person come to your building and take over the conference room after lunch and give shots to any/all employees who happen to wander in. Make it trivially easy to get a shot. (And, yes, PTO for the day after the shot is a good idea.)

      By the end of June?

      Yeah. Bring the hammer down then.Report

      • Oscar Gordon in reply to Jaybird says:

        I thought I read that Biden was getting the IRS to give employers tax breaks/credits for letting employees have PTO for shots & recovery?Report

      • Kazzy in reply to Jaybird says:


        How many folks haven’t gotten a shot because they don’t know they’re eligible? Or because they don’t know how to get an appointment?

        We not only need to make it easier for folks to get their shots, we need to let them know how easy it is.

        Some folks are going to hesitate or resist or refuse to get a shot and we may need all sorts of sticks and carrots for them. We’ll sort that out.

        But let’s not let anything get in the way of willing folks getting their shots. Make it the easiest thing they’ll do that day.Report

        • Oscar Gordon in reply to Kazzy says:

          Here in WA, people in the heavily populated Puget Sound region have been heading to the less populated parts of the states for appointments. Why? Because there are open appointments out there.

          Then that state health officials tell everyone to stop doing that, because it takes appointments away from those people, except those appointments exist because the locals aren’t taking them. So either the locals aren’t aware that they can get shots, or they just aren’t bothering to.

          I mean, if the locals were really complaining that they could not get appointments because folks from Seattle were sucking them all up, I’d understand, but that’s not happening.

          My guess is that the people in the rural areas frankly either don’t have the time or means to get to the vaccine, which means the state should be rolling mobile clinics (which they are starting to do), but at the same time, the state should be pushing more doses to the densely populated areas.

          I should not have had to go to the tribe for a shot, but they had extra, and offered them to the public. My wife should not have had to drive two hours north to get an appointment, but that was the closest one she could get.

          I know the logistics of all this is challenging, but I really have to wonder if the folks running all this know what they are doing?Report

          • Jaybird in reply to Oscar Gordon says:

            I heard a story the other day about someone at Wallyworld hearing the PA announce “we’ve just had an opening for a dose, please come to the pharmacy if you’d like your first shot, we only have one though” and I thought “yes, I want to hear more and more of these stories every day”.Report

          • Kazzy in reply to Oscar Gordon says:

            NJ was very late to approve teachers for vaccines. Because I work in NYC, I was eligible there earlier. I’m not teaching at the moment so I figured I’d wait my turn in NJ but through connections was able to get an abandoned slot.

            I keep seeing what feels like fear-mongering headlines about appointment slots going unused. But I’m not convinced that is necessarily a bad thing. Not yet. I would think the ideal would be for some slack in the system so that if someone said, “Hey, my afternoon just opened up and tomorrow is Saturday so now would be a good time to get my shot,” they can hop down to a site and get a shot. If too many slots are going unused, then I think we have a problem.

            But I’m not convinced we have a problem. Yet. It seems the real issue is the distribution of shots (as you note, too many in one area and not enough in another) and that we aren’t yet (YET!) at a point where low demand is really an issue.

            And I think one way we avoid reaching that point is we continue to find ways to, er, motivate folks to get their shots.Report

            • Philip H in reply to Kazzy says:

              I keep seeing what feels like fear-mongering headlines about appointment slots going unused. But I’m not convinced that is necessarily a bad thing. Not yet.

              Well … the issue isn’t missed appointments per se, its destroyed vaccines that don’t go into arms. These things have a notoriously short shelf life out of the deep freeze, and so while one hopes that they aren’t removed from said freeze until just before needed, once they are out the clock ticks. That’s in part a demand issue, in part a supply issue.

              But I’m not convinced we have a problem. Yet. It seems the real issue is the distribution of shots (as you note, too many in one area and not enough in another) and that we aren’t yet (YET!) at a point where low demand is really an issue.

              “Health care providers admitted they are also having to hold off on getting more vaccines to their offices because of the challenge of having people willing to take them.

              “In January, I could have given every vaccine I could get, now we have to say we really don’t think we want that thousand doses you can get us,” said Dr. W. Mark Horne with the Mississippi State Medical Association.

              Mississippi’s pandemic battle has shifted from challenges in getting the vaccine to the magnolia state to now trying to convince more people they need to get it.”


          • fillyjonk in reply to Oscar Gordon says:

            Here in OK, I got my vaccine before I would have been eligible (based on age), ‘cos folks from Tulsa in the over 65 group grabbed up local vaccine appointments, then couldn’t make it because of an ice storm north of us. My uni president somehow pulled some strings and about 50 faculty and staff were able to get vaccine appointments early as a result – I was fully vaccinated by early March.

            they are currently doing on-campus vaccine clinics for students, any staff/faculty who haven’t had it yet, and opened it to alumni in the area and any retired folks. Being vaccinated is not going to be a condition of employment or attendance but the president is *really* pushing for as close to 100% vaccinated by fall as he can, and frankly, that would make life on campus so much better and easier, I think, if we were.

            We are the largest city in this part of the state but only like the 10th largest in the entire state. And I know our county health department really went over and above to try to get all the local seniors vaccinated; there were rides to vaccine sites for anyone who needed one.

            Still, for rural areas – we need mobile clinics or some such. I think one of the tribal nations has got a couple they have kitted out and are sending to tiny towns to try to vaccinate peopleReport

            • Kazzy in reply to fillyjonk says:

              How willing are students to get the shot? I keep reading that “YOUNG PEOPLE AREN’T GETTING VACCINATED!” but I can’t tell how much of that has to do with young people by-and-large being ineligible for a very long time.Report

              • dhex in reply to Kazzy says:

                it’s a little early to say at this point (meaning the under 25 set, aka traditional first time freshmen undergrads) because in some states (points to maryland) it was only earlier this month that they were broadly eligible.

                incentive plans abound, which i applaud because they are a population both more likely to be asymptomatic carriers and also likely to be getting into situations where they can become infected.


              • fillyjonk in reply to Kazzy says:

                Hard to say for sure; I only have contact with biology/Fisheries and Wildlife majors, who have a better understanding than average of both how immunity and disease work, and the mechanics of the mRNA shot. I had several students, in fact, openly express eagerness to get the vaccine – one said he wanted to hug his grandma again, which I admit, I had to take a deep breath so I didn’t tear up over it.

                I also gave people excused absences if their vaccine appointment coincided with my class, I think most other people did too. I know I saw a number of students on the afternoon of the clinic wearing their “I got vaccinated” stickers.Report

              • Philip H in reply to fillyjonk says:

                biology/Fisheries and Wildlife majors

                As a Fisheries Oceanographer I approve this message!Report

  5. North says:

    I hope Biden’s peeps quietly work with Justice’s peeps to greenlight using CARE act funds for this gambit. I don’t know if it’s strictly within the word of the legislation but it surely fits within the spirit of it.Report

  6. Jaybird says:

    Publicize stuff like this high and low:


  7. I don’t know what additional carrots would work if $100 and Krispy Kremes and not dying of Covid don’t suffice.Report

  8. Kazzy says:

    So, if the 14-year-old is to be believed, her 8th grade graduation will only admit audience members who can demonstrate they’ve been vaccinated. I’m curious if this is it’s own thing or meant to be some sort of carrot (Yay! Come to a graduation we didn’t think was possible!) or stick (No vaccine? No memories!).Report