Some days recently it feels like we are in a station wagon headed to a family reunion, and everyone in the back seat repeatedly whines “are we there yet?”

Maine in particular, and the U.S. as a whole, are doing great when it comes to vaccinations. Nationally, 44% of people in the U.S. have had at least one dose of vaccine. About one-third are fully vaccinated. Maine has been leading the nation in the latter category for about a month, with 40% fully vaccinated.

We’re about halfway there, and like a family road trip, it’s the last half that’s the hardest. With the B.1.1.7 (U.K.) variant throwing us onto a different route, one that disproportionately is hitting young people, it is imperative we get vaccine to youth and young adults as soon as possible.

To successfully vaccinate young people, generally access to the vaccine has to be very convenient. In other words, take the vaccine to them. This is harder to do with the COVID-19 vaccines, since they require a strict cold chain be maintained and there is more information that needs to be collected from the vaccinee. But these are surmountable barriers.

Israel has offered vaccine in bars where young people hang out. Maine and other states have traditionally offered influenza vaccines on site in schools, including universities and colleges. Several mosques, synagogues, and churches have hosted COVID-19 vaccine clinics. Franklin Memorial Hospital and partners are offering vaccine in downtown Farmington on an upcoming Saturday. Some employers such as BIW are offering vaccines at the worksite.

If Pfizer is approved for 12 and older, something that I sincerely hope happens very soon, then offering vaccine in middle and high schools before they adjourn for the summer is a possibility. If time allows, this may be a critical strategy for three reasons.

First, the B.1.1.7 variant is disproportionately impacting this age group.

Second, even in the summer, this age group tends to congregate as well as spread out across a community. In other words, they are perfect vectors for transmitting infection to others.

Third, numerous studies indicate their vaccine rates are much higher if vaccine is offered during the school day when it is more convenient to parents. Fingers crossed for the FDA’s imminent approval.

Increasingly, the emphasis will be less on vaccinating at mass clinics and more on getting to places where the unvaccinated may be. This may feel like hitting a detour sign taking us from a high-speed four-lane highway to a dirt road. But it is the only way to reach our destination, which is to have enough people vaccinated to put a significant roadblock to pandemic activity.

Another emphasis needs to be how we will ensure vaccine is available everywhere around the globe. The virus doesn’t recognize political borders. Transmission anywhere is a threat everywhere, especially since variants are a growing threat. Then there are the profound tragedies in India, Cyprus, Uruguay, and elsewhere, of countries suddenly under siege by viral variants and experiencing overpowering humanitarian crises. I worry that many countries in Africa and elsewhere in Asia may soon catch on fire with the pandemic.

Again, we have successful models to rely on to having vaccine available globally, including the Bill and Melinda Gates Foundation partnering with pharmaceutical companies and governments to build capacity in other countries to manufacture HIV/AIDS medications. For COVID-19 vaccines, the Gates Foundation, World Health Organization, UNICEF, and many others have partnered to form the organization COVAX to manufacture and provide vaccines around the world. One thing the pandemic has taught us is that in the long run, every continent needs manufacturing capabilities for vaccines and essential medications, including their own supply chain for ingredients such as glass vials.

The good news from this last week’s journey is the US CDC saying it is safe for those who are vaccinated to be unmasked while in uncrowded areas outside. I enjoyed several walks this week unmasked, and it was fun to see others doing so as well.

Will I still mask sometimes outside? Absolutely. Whenever I feel I may be sharing others’ breathed air I will, especially if they may be unvaccinated. For instance, I will mask if I’m in a crowd. Or if I am with even a few people whose vaccine status I don’t know and who are close together or shouting or singing loudly. This is especially true knowing the pandemic activity is still high here in Maine.

Although the masking issue was a major one in the news this week, I feel an urgent issue is that each of us in the U.S. has three important tasks to ensure we reach our journey. I call it the AAA: Access, Ask, and Assist.
We each need to access the vaccine as soon as possible if we are not vaccinated yet.

Each of us needs to ask those around us — our loved ones, family members, our friends, our neighbors — if they’ve been able to get vaccinated.

And we need to assist those who are unvaccinated. Do they need information on the vaccine? Recent polls show many young people were not focused on the vaccine the last several months since they knew it was not their turn. Now that it is, they have questions about the vaccines. Do they need to know where to get vaccine? Do they need transportation to a vaccine clinic? Do they need a babysitter or other assistance? There are links below to resources to assist in answering these questions.

I have run into a number of young people saying they are worried about the vaccine’s impact on future or current pregnancies. Many do not realize that there is absolutely no evidence the vaccine impacts fertility, and that pregnant women are at high risk for severe COVID-19 disease. Two websites below provide much more information on this topic.

Please do not be shy. Asking others is helping them as well as helping your community. When I ask if people have had a chance to get vaccinated, the vast majority of people seem eager to share their story, whether it’s their story about how they got vaccinated or how they plan to or their remaining questions before getting one. I rarely see a “none of your business look”, but even then, I try to clarify that I’m available if there are questions I can answer.

What’s clear is that we are all on this journey together. Even as we exit the superhighway of mass vaccine clinics and ride along the bumpy road, we won’t get to our destination until the vast majority of us are in the station wagon. To do so, each of us plays an important role, including the AAAs.

Dr. Dora Anne Mills is the chief health improvement officer for MaineHealth and former head of the Maine Center for Disease Control and Prevention.


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