Amid talk of booster shots, focus remains on getting more people fully vaccinated

By: - July 16, 2021 5:12 am
Closeup of a vaccine vial in a person's hand

Under current state law, parents may seek vaccine exemptions only for medical or religious reasons. (Joe Raedle | Getty Images)

As Pfizer and federal agencies argue over the need for a COVID-19 booster shot, an associate professor of medicine at the Dartmouth Geisel School of Medicine sees a different priority: getting more people vaccinated now.

“I think what we really need to think about is the order in which this is (done),” said Dr. Michael Calderwood, who is also chief quality officer at Dartmouth-Hitchcock Medical Center. “We need to get over 90 percent of the U.S. population fully vaccinated, and that means individuals who have not yet stepped forward to be vaccinated need to really be encouraged. If we’re not even getting those first doses in, the boosters are going to have a muted effect.”

Fifty-five percent of the state is fully vaccinated, according to the state Department of Health and Human Services. Evidence, Calderwood said, is the best argument for vaccination: 99 percent of people dying of COVID in the United States are unvaccinated. A recent study by the Kaiser Family Foundation found that conversations with family members and friends have been particularly effective in persuading people to be vaccinated. Concerns about side effects was the most common reason cited for not getting vaccinated. 

The next step, Calderwood said, is getting more vaccines to countries with short supply.

“Viruses don’t recognize international borders,” he said. “We need to push really hard to make sure that we are getting vaccines out to countries around the world because we will continue to see the emergence of new variants that might break through . . . the vaccine protection that we have.”

Chart on vaccination rates
Source: KFF COVID-19 Vaccine Monitor (Jan. 14-18, 2021, and June 15-23, 2021)


The state is working on that first part with Thursday’s start of the N.H. Mobile Vaccine Van, which communities and groups can request to visit their locations and events. The van, a partnership with ConvenientMD, will run throughout the summer.

That effort is in line with a Biden administration recommendation announced in early July intended to increase the vaccination rate. However, the state has no plans to take up a second White House suggestion that got pushback from state Republican leaders: taking vaccinations door to door. 

House Speaker Sherman Packard, a Londonderry Republican, tweeted his opposition to a door-to-door campaign, saying vaccinations are already available to those who want them, a point Gov. Chris Sununu also made. “Legislators in New Hampshire,” Packard tweeted, “will continue the fight to protect patients’ privacy and fight against federal overreach.”

The mobile van, though, has Sununu’s support. 

“It’s important to note that the van only goes out into the community on a requested basis,” said Sununu spokesman Ben Vihstadt. He said the new mobile van is an extension of the state’s existing practice of taking vaccinations to homebound individuals and school-based clinics.

Meanwhile, next steps for a vaccination booster are unclear. 

Pfizer is pressing for swift federal approval of a coronavirus booster vaccine against the recommendations from the Centers for Disease Control and Prevention, the federal Food and Drug Administration, and the World Health Organization, all of which have said there is insufficient evidence a booster is needed. Additionally, a third dose will further limit the vaccine supply available to areas with low vaccination rates. Calderwood said the answer to the booster debate probably falls in the middle and won’t be known without further research. Research has shown the mRNA vaccines, which includes Pfizer and Moderna, are estimated to be 94 percent percent effective against severe illness, according to the CDC, and only slightly less effective against variants like the more contagious Delta variant.

Early data, however, suggests a booster may be beneficial to those with severely compromised immune systems, Calderwood said. (Israel just began administering third doses of the Pfizer vaccine to this group.) Still, the focus should remain on getting unvaccinated people vaccinated, Calderwood said. 

“I think there are many ways to do it,” he said, “but we need to bring the vaccine to people rather than trying to bring people to the vaccine.”

Pie chart on vaccination rates
Source: KFF COVID-19 Vaccine Monitor (Jan. 14-18, 2021, June 15-23, 2021)


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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications.