Georgia, like much of the country, is in the midst of a cresting “fourth wave” of the COVID-19 pandemic, and finds itself among the states seeing the highest jump in hospitalizations over the last two weeks.
With only four in ten Georgians fully vaccinated against the virus, and a new school year upon us as the delta variant continues its relentless blitz through our population, there has never been more urgency to protect our communities from further illness, injury, and death by taking bold moves to help more of our population get vaccinated.
Yet in a press conference last month, Gov. Brian Kemp, while acknowledging the importance of statewide vaccination, seemed to have all but given up on any further efforts to reach the eligible Georgians who remain unprotected.
“You can lead a horse to water, but you can’t make them drink.” Kemp said. “I mean, that is not the government’s role.”
Not only do I disagree with the governor’s assessment of what the role of government should and could be in this moment, I don’t agree with him that we have lead the horse to water.
I think our current situation is actually that we have a horse, and we have some water, but some distance apart. And our role in government is to be bold, imaginative, and above all, rapid in our efforts to bring these two together.
Credit: contributed
Credit: contributed
Time is of the essence. Here are three strategies Gov. Kemp could use to increase our vaccination rates here in Georgia.
Incentivize vaccination
Earlier this year, the Republican governor of Ohio Mike DeWine announced a series of drawings where vaccinated residents under the age of 18 could enter to win a four-year full scholarship to any of Ohio’s state colleges and universities.
The announcement of this lottery was made in May, the same week as the Pfizer-BioNTech COVID-19 vaccine was approved for expanded use in adolescents 12 to 15 years old. In conjunction with other incentive programs in Ohio’s “Vax a Million” program, these incentive programs were linked to a short term boost in the state’s vaccination figures.
A similar vaccination-based college scholarship drawing could also work here in Georgia, and incentivize vaccinations where they are markedly lagging — in our young healthy population, particularly under the age of 18. Even if this bump in vaccination is short-lived, it could give a turbo boost to our youth vaccination rate right now, when we need it most, while also promoting two social determinants of community health: vaccination and access to education.
With a record surplus in our state budget, not to mention a significant infusion of federal money earmarked for COVID-19 relief, Georgia could certainly afford to fund a targeted vaccine incentive program like a college lottery — both now, and again in a few months, when expansion of vaccine eligibility to younger children could refresh interest.
Shifting the burden to the unvaccinated
Vaccination, like most public health measures, are essentially about collective burden sharing. We all take on a small amount of the burden so no one person is crushed by the load. However, what we’re seeing right now in low-vaccination areas like Georgia is that many have refused to share in this community responsibility, and this increases the risk for everyone, even those who have done their part.
I would therefore propose giving state employees a choice. Employees could either provide proof of vaccination against COVID-19, or else be required to universally mask and submit to required surveillance testing for COVID-19 twice weekly, just as state lawmakers did this past legislative session.
This would convey two important messages. The first is that free vaccination, established to be safe and effective, is both the best and the easiest option to protect our communities against COVID-19. The second is that it places the burden back on those who are eligible for vaccination but choose to opt out.
Individual rights come with individual responsibilities, and no one should get to opt out of those responsibilities in some form.
And while some will pooh-pooh the notion that Gov. Kemp could ever promote such a strategy, I will point out that these conditions — proof of vaccination vs. twice weekly testing — were precisely the model used this past summer at the Governor’s Honors Program, a residential program for gifted students run out of the Governor’s own office.
If we can ask high school students to comply with this level of community responsibility, certainly we can ask this of state employees as well.
Make it easy for people to do the right thing
Earlier vaccination efforts have centered around mass vaccination sites and broad-strokes availability. These worked well for Georgians who were, at baseline, already highly motivated to get vaccinated in the first place.
But we’ve already picked all the low-hanging fruit. Now we have to do more targeted work.
Any health decision is a weighing of benefits vs. costs, and one of the costs I don’t think we’ve fully considered is the workforce cost of getting vaccinated. Many vaccine clinics only run during standard business hours during the work week. In addition, reaching most vaccination locations requires transportation and commute time, which adds another barrier for many.
We need to be more targeted and bring the vaccines to the places where people are already spending their time. Set up vaccine pop-up clinics at workplaces like office lobbies, factory floors, shopping centers, sporting events and in schools when students return. Run clinics later in the evenings to accommodate those who don’t want to take off work, and have vaccination events on Fridays or on the weekends, to allow a little extra time to recover from side effects of the injection.
There’s a segment of unvaccinated people that we could readily reach, if we just try a little harder to meet them where they are. Not only is it the role of those in government to protect its people from the avoidable spread of disease and suffering, it is our moral duty.
State Sen. Michelle Au, M.D., M.P.H., D-Johns Creek, is a physician in metro Atlanta.
