Nurse Sheena Davis, right, administers a dose of a Moderna COVID-19 vaccine to, Imran Amjad, as he holds his daughter's Falah Imran's hand and her brother Muhammad Ali Amjad, 6, looks on during a vaccination clinic at the Keystone First Wellness Center in Chester, Pa., Wednesday, Dec. 15, 2021. (AP Photo/Matt Rourke)
Nurse Sheena Davis, right, administers a dose of a Moderna COVID-19 vaccine to, Imran Amjad, as he holds his daughter's Falah Imran's hand and her brother Muhammad Ali Amjad, 6, looks on during a vaccination clinic at the Keystone First Wellness Center in Chester, Pa., Wednesday, Dec. 15, 2021. (AP Photo/Matt Rourke)
(Harrisburg) — For many doctors and nurses, the year is coming to an end with emergency departments and intensive care units once again strained by COVID-19 patients.
It’s a familiar scene to Dr. John Goldman, infectious disease specialist at UPMC Harrisburg.
Goldman said the COVID-19 vaccines are just “somewhat” effective at preventing the virus from spreading, “but they’re excellent at preventing it from killing.” He said at UPMC hospitals, unvaccinated people make up about 96% of patients sick with the virus.
“Another change we are seeing is that, in the spring of 2020, the average patient in the hospital was an elderly nursing home patient who was medically very ill,” Goldman said. “Now, our average patient is young and nearly all are unvaccinated.”
That trend is playing out at hospitals across Pennsylvania. Hershey-based Penn State Health reported that 115 of its 171 COVID-19 patients are not fully vaccinated. Another 24 have unknown vaccination statuses.
At York-based WellSpan Health, about 90% of COVID-19 patients are unvaccinated, spokeswoman Dawn Kupchella said.
“What is most concerning is that this extreme surge in hospitalizations is preventable if individuals were to get vaccinated, which greatly reduces severe illness that could require hospitalization,” she said.
In a year when time seemed to slow down, it’s easy to forget that 2021 began without the widespread availability of vaccinations.
That began to change in January, when Democratic Gov. Tom Wolf and Health Secretary Dr. Rachel Levine launched a phased rollout of immunizations. In the following weeks, drug companies shipped hundreds of thousands of doses to hospitals and pharmacies.
The state published a website with hundreds of vaccine locations — and the race was on for people to sign up. Overnight, millions of people who had been wearing masks and social distancing for 10 months scrambled to book appointments.
Screen capture
A Jan. 22 screen capture of the Pa. Department of Health interactive map. The state directed people who wanted the COVID-19 vaccine to this site.
This frustrated some older Pennsylvanians, who are in one of the highest-risk groups for serious complications or death. They were forced to compete for vaccination appointments with younger people, who were often better at using social media to find locations.
The rollout had other problems, too. Pennsylvania’s vaccination rate lagged behind some other states. A communication breakdown between the state health department and health systems led to a delay in Moderna vaccines.
Meanwhile, the virus raged on, fueled by the more transmissible Delta variant. Groups fought for priority. Some corrections officers called on the state to give them access to vaccines as an outbreak infected dozens of staff and inmates at SCI Forest. Teachers were among the first to get access to the single-dose Johnson and Johnson vaccine.
By March, mass vaccination sites began to open. A site at the Park City Center shopping mall in Lancaster vaccinated over 500 people on its first day.
Then-62-year-old Denise Trimby was one of those people. Trimby, who lives with multiple sclerosis, looked forward to doing simple things again, such as attending indoor swimming classes. She got emotional as she spoke.
“I just signed up yesterday—and I wasn’t expecting to get a response so quick—and I am very relieved,” Trimby said.
But while Pennsylvanians who took the virus seriously were desperate to get vaccinated, the year also saw a sharpened political divide over the basic facts of the virus and the vaccine.
That divide began in 2020. As early as April 2020, state Republicans opposed business closure and mask mandates. By May, some county commissioners had formalized their opposition by voting to disregard state COVID-19 restrictions. By July, masks had become a partisan symbol for some. And by November 2020, with COVID-19 cases soaring, and as some lawmakers and state employees around them fell ill with the virus, Republican lawmakers flouted mask-wearing rules at the state Capitol.
By the time vaccines were available, another story — based on misinformation — had taken hold among conservative news outlets and on social media platforms such as Facebook.
Pittsburgh resident Stephanie Rimel recounted some of that misinformation, which she heard from family and friends online: The virus is a Democratic hoax. It is no more serious than the flu. It only affects the very old or those with other illnesses. Vaccines are not to be trusted.
Rimel told her story in May 2021—four months after her 27-year-old brother Kyle Dixon, a prison guard at SCI Clearfield, died of COVID-19. Dixon got sick with the virus before vaccines were available.
“It’s really hard,” Rimel said. “Not just the fact that a human life was taken away, but that it’s political. It was made into something else.”
Courtesy of Eric Kayne
Kyle Dixon’s grave is located on a family plot at Woodside Cemetery on Spring Valley Road, near West Decatur, Pa. Dixon’s sister, Stephanie Rimel, said the family added the message at the bottom so that years later people would know it was COVID-19 that killed Kyle.
There were times when public health overcame politics. Once the vaccine became available, state lawmakers formed a bipartisan COVID-19 committee that worked to overcome vaccine hesitancy.
After an April Muhlenberg College public health survey showed that half of all Republicans polled said they didn’t plan to get immunized, Republican state Sen. Ryan Aument of Lancaster County, who served on the committee, said he was working with public health leaders to win over fellow conservatives.
“We need to identify, what’s the right message to reach those folks, and identify specifically who is the right person to deliver that message?” Aument said.
Kate Landis / PA Post
A woman holds an anti-mask sign at a May 15, 2020, ReOpen PA protest outside the state capitol in Harrisburg, Pa. By 2021, there was strong opposition to public health measures to stop the spread of COVID-19.
At UPMC Harrisburg, Goldman was warning people that there was an urgent need to get vaccinated.
“With that amount of disease in the area, the 31% of the population that is saying they will not get the vaccine is choosing to get COVID instead of getting the vaccine,” Goldman said in late April.
His words would soon be proven true. Counties with low vaccination rates saw high rates of hospitalizations and deaths, as this New York Times compilation of state data shows.
Across the midstate, health systems reported that about 90% of people hospitalized had not gotten vaccinated. This confirmed what public health experts had hoped for — that even if someone who got vaccinated develops COVID-19, their case is much more likely to be mild.
By this point, COVID-19 vaccine misinformation was rampant, according to a November Kaiser Family Foundation poll.
“The findings highlight a major challenge for efforts to accurately communicate the rapidly evolving science about the pandemic when false and ambiguous information can spread quickly, whether inadvertently or deliberately, through social media, polarized news sources and other outlets,” the report states.
Connections between low vaccination rates and Republican politics became increasingly clear.
Across the country, low vaccination rates were found in counties that had overwhelmingly voted for the former president. A December NPR report, which relied on data from October, showed that COVID-19 death rates were nearly six times higher in those counties. Misinformation was to blame, NPR reported.
A WITF analysis of that data showed the trend playing out in Pennsylvania:
Misinformation spread to other areas of public health as well. As children returned to school in the fall, parents, fueled by concerns over the effects of mask wearing, shouted down school boards. Right-wing personalities such as Charlie Kirk had stoked those fears, though there is no evidence that mask wearing is harmful and ample evidence shows masks help prevent the virus from spreading.
Going into 2022, the plan is to fight misinformation using trusted messengers and targeted outreach campaigns, said Pennsylvania Health Department Physician General Dr. Denise Johnson.
It has been heartbreaking to see people get sick, and in some cases die, after ignoring public health guidance, Johnson said. However, attitudes around vaccination are starting to change.
“People are seeing the impact of the vaccines and seeing the outcomes of the vaccinated versus the unvaccinated, and they are letting the science and the evidence convince them and dispel the misinformation,” Johnson said.
As a note of disclosure, Transforming Health receives financial support from WellSpan Health.
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