by Adam Lee on April 28, 2021

Just a few short weeks ago, coronavirus vaccines were the hottest commodity in town. Booking websites crashed from overwhelming traffic, appointments were snatched up within seconds of being posted, and people were traveling long distances to get their shot.

But with a competent administration in charge, manufacturing has ramped up and supply has exploded. Vaccines are now widely and freely available – but there’s a new problem. In many red and purple areas, no one wants them:

In a county in Wyoming, a local health official asked the state to stop sending first doses of the vaccine because the freezer was already stuffed to capacity with unwanted vials.

In an Iowa county, a clinic called people who had volunteered to give shots to tell them not to come in because so few residents had signed up for appointments.

In a county in Pennsylvania, a hospital set up a drive-through in the park, stocked with roughly 1,000 vaccine doses. Only about 300 people showed up.

Starting around mid-April, the downturn in shots given is distinctly visible in vaccine trackers like Bloomberg’s:

What this means is that we’ve picked the low-hanging fruit: the people who were eager for the vaccine and had the means to get it.

Those who remain will be more challenging to reach. There are disabled and housebound people who can’t travel; essential workers who can’t easily fit in an appointment around their jobs; people living in poor and underserved neighborhoods where shots are hard to find; people who have unfounded fears about the safety of the vaccine; and people who just don’t care because they don’t feel at risk from COVID.

But the evidence suggests that the biggest, and hardest-to-reach, group will be the Republican voters who’ve made refusal to get vaccinated a badge of partisan identity. From the NYT again:

In counties where a majority of residents voted for Mr. Trump in the 2020 election, adult vaccination rates were lower, on average, than in counties where a majority of residents voted for Mr. Biden. The rate was especially low in counties where Mr. Trump dominated, falling below 1 in 4 residents in counties where the former president won by a margin of 50 or more points.

…Most recently, on Wednesday, Monmouth University and Quinnipiac University polls indicated that almost half of Republicans did not plan to pursue vaccinations. Only around one in 20 Democrats said the same.

When you see it in graphic form, the difference is stark:

I noted in March that white evangelical Christians (i.e., Republicans) were telling pollsters they don’t want the vaccine, and this proves that they meant it. They really are refusing a free, safe shot that protects against a rampant and potentially deadly virus.

In most respects, Donald Trump inflamed political divisions that already existed, but this is a problem that can be blamed entirely on him. The conservative worldview, which is founded on moralized notions of disgust and purity, ought to be a natural fit for germaphobic and anti-pandemic policy. Instead, as Amanda Marcotte puts it, “Refusal to take the pandemic seriously became a badge of honor among Republicans” after Trump’s sulky, foot-dragging press conferences and maskless superspreader rallies. And that worldview has persisted even now that he’s no longer in office.

But just because conservatives refuse to acknowledge the threat of COVID-19, that doesn’t mean they aren’t catching it or dying from it. They absolutely are, if threads like this one on Reddit are to be believed: What happened when you diagnosed a Covid-19 denier with Covid-19?

ICU/COVID ICU charge nurse here. Had a woman try leaving the ER against medical advice with COVID and was needing tons of O2. Our docs convinced her to get admitted. My wife was her ER nurse and brought her up to me, patient was yelling and screaming, ripping off her mask, spitting and telling us we’re all sheep between gasping for breath. Our docs told her she was close to needing to be intubated (breathing tube) and she just scoffed.

We reached out to the husband who proceeded to swear and berate us, telling us we’re keeping her prisoner (no visitors in our COVID unit) and that we can do whatever we need because “none of this is real and it’s all for show so you guys can get paid.” She gets intubated, decompensates over the next few days, and finally codes. We code (perform CPR, give medications, defibrillate, etc.) her for well over 1.5 hr before calling her time of death.

I’ve witnessed several people on deaths door still deny that they even had COVID let alone deny that COVID was real. I recall one individual whom decline intervention. Family had called for this person. Upon assessment of vital signs, Spo2 at 77% room air [i.e., blood oxygen saturation – anything below 90% is very abnormal]. Respirations around 30 a minute. Cyanosis of the mouth and nail beds of fingers [i.e., turning blue from lack of oxygen]. Lungs sounds were very diminished and wheezing in all fields. Pale and sweaty. I was very surprised that they were alert and oriented. I remember as I tried to place the patient on oxygen they looked me in the eye and said that COVID wasn’t real and was a political ploy that the democrats were using to get the African American vote.

…And then it happened. The patient went unresponsive. The spouse now begging us for help. Now falling under implied consent, we could work. In short order the patient was placed on high flow oxygen and carried out of the home. In the back of our rig, we acquired IV access and intubated the patient. Medications were administered and within ten minutes we were at the hospital. We got them there. A few hours later we stop back at the hospital with another patient. A nurse pulls me a side to update me. Our patient had died shortly after we dropped them off.

And as for the very few evangelicals who do recognize the reality of the pandemic, and who plead with their fellow believers to do something about it – they get flooded with death threats.

This should be proof that Republicans can’t be reasoned with. There should be no principle more basic than self-preservation, yet even that doesn’t stir them to action. As far as they’re concerned, if Democrats want to put a stop to the pandemic, then they want the opposite. They’re literally willing to throw their own lives away to “own the libs”.

As further evidence, here’s a hot-off-the-presses essay from a Trumpist website that I’m not making up: I Won’t Take the Vaccine Because It Makes Liberals Mad.

But in truth, I’m not really avoiding the vaccine due to potential medical complications, or because of the speed with which it was produced.

Personal liberty is not the reason I’m avoiding it, either. I’m not a member of the “don’t tread on me” club. Though I don’t think mandated “vaccine passports” are a brilliant idea, my refusal to take the vaccine is not related to some perceived or real government overreach. I’m not here to take a principled stand against the federal or state governments on this issue.

…My primary reason for refusing the vaccine is much simpler: I dislike the people who want me to take it, and it makes them mad when they hear about my refusal. That, in turn, makes me happy.

Columns like this are proof that American conservatism has been eviscerated of whatever intellectual or philosophical content it once had. There’s no longer any platform, any principles, any substance to it, other than “we want whatever the other side doesn’t want”. It’s the maturity level of a basement-dwelling internet troll or a toddler throwing a tantrum.

Fortunately, we’re approaching the point – at least in the U.S. – where this is no longer a commons problem. The vaccines we’ve created are incredibly effective, both against the original virus and the variants that have emerged.* The evidence suggests that once you’re fully immunized, you can resume normal life with relatively few precautions.

This means that, once everyone has had a chance to get the vaccine, those who turn it down will only be risking their own lives and health. Sociopathic conservatives like the ones I’ve quoted will suffer the folly of their own decisions, but they won’t endanger the rest of us.

Of course, this doesn’t apply to immunocompromised people in whom the vaccine isn’t effective. I wish I had a better solution for that. My best advice is that people in this unfortunate situation should move to blue towns and cities where belief in science and concern for each other’s welfare are virtues that are still practiced.

In the name of spite and hate, red America has set itself on a long, slow suicidal spiral. This has been the trend for a long time, even before the pandemic: Trump counties have worse health than their counterparts, with higher rates of diabetes, alcoholism, depression, and other ills. But they’ve been consistent in angrily rejecting any social program that could help them. COVID-19 is the most dramatic manifestation of this attitude, and absent some drastic cultural change, it’s going to go on sickening and killing them for many years to come.

* If you’re worried about mutations making the virus able to infect vaccinated people, don’t be. Here’s a cool fact: the vaccines also confer immunity to the original SARS virus, which is in the same family but is only about 75% similar – far more different than any conceivable variant of COVID-19. Plus, in the very unlikely case of a vaccine-resistant mutant appearing, the programmable nature of mRNA vaccines makes it very easy to manufacture a booster.