President Joe Biden’s new Covid-19 plan will mandate vaccines for 100 million working Americans, but one group was conspicuously absent from this week’s announcement: senior citizens. They’re also the most likely to be hospitalized or die from the virus — by a wide margin.
Retired seniors have been far more accepting of vaccines than their working-age counterparts. Their full vaccination rate is about 82%, according to the U.S. Centers for Disease Control and Prevention. Because they’re susceptible to severe illness, even relatively few unvaccinated seniors means more deaths — and more crowded hospitals — than would occur in a larger pool of younger adults.
About 75 million people in the U.S. are 60 and older. Recently, about four-fifths of the nation’s Covid deaths have occurred in that population.
Around the world, the fast-spreading delta variant has left unvaccinated seniors exposed. Compared with the U.K., the U.S.’s under performance in vaccinating them is one reason it has endured about twice as many fatalities per capita in this surge.
Even before the pandemic, the elderly were largely out of the workforce — and thus beyond the reach of job-related mandates. Millions more have retired since March 2020.
Lawrence Gostin, a professor of global health law at Georgetown University, said legal options for mandating senior vaccinations are limited. Instead, he said, the government may have to rely on incentives or outreach.
“For the vast majority of unvaccinated seniors, the problem isn’t skepticism or vaccine hesitancy,” he said. “It’s much more a question of access. The fact that they may be homebound, depressed or lonely means they may not be able to negotiate how to find a vaccine.”
Counterintuitively, younger seniors have shown a greater appetite for vaccines than their older peers. Initially, the opposite was true, as governments sent inoculation teams into nursing homes and assisted-living facilities. Recently, the numbers have flipped, adding support to the idea that some elderly residents — especially those outside structured-living arrangements — are simply having trouble navigating the system.
Asked about the administration’s plan for seniors, Surgeon General Vivek Murthy said Friday that the U.S. had made “good progress” vaccinating a majority of older Americans, but “we want to get as close to 100% as possible.”
He also said the government would continue to reach seniors through the Covid-19 Community Corps, a program the Department of Health and Human Services set up to address vaccine hesitancy.
“The vast network of community organizations, which include doctors and nurses and faith leaders and other community organizations, has been absolutely essential to do that outreach, and we’re going to continue to do that in the months ahead,” Murthy said.
One way to protect seniors is by requiring that health-care workers — with whom they’re likely to interact — are vaccinated, said Rochelle Walensky, director of the CDC. Biden’s move Thursday required vaccines for an estimated 17 million medical workers.
Ali Mokdad, an epidemiologist with the University of Washington’s Institute for Health Metrics and Evaluation, said “a carrot approach” may be better for seniors. He said some may also be motivated to get vaccinated if private health insurance premiums for the unvaccinated rise, although many rely primarily on federal Medicare.
Georgetown’s Gostin said some private businesses popular with seniors — including bingo halls — could demand vaccination records as a condition of entry, a strategy already in use in some restaurants.
“They are the most vulnerable,” Gostin said, “and unvaccinated elderly people are at grave risk.”