When a virus replicates, it changes; these modifications are called mutations. A variant is one or more new mutations of the original virus. The more viruses circulate, the more they can change. These alterations can sometimes lead to a variant of the virus that is better adapted to the environment than the original one (Vox, 2021). This process of changing and selecting successful variants is called viral evolution (World Health Organization [WHO], 2021a). Some mutations can change the characteristics of the virus, such as how the virus is transmitted; for example, it can spread faster, like the Delta Variant, or the severity of the disease it causes.
At present, in the world, the most common is the Delta Variant. It has already been identified in almost all European countries (WHO, 2021a). According to WHO (2021a), this mutation will dominate the planet soon and crowd out the circulation of other options unless a more competitive virus emerges. It is more infectious because it binds more easily to receptors in lung cells and is resistant to monoclonal antibodies that are administered intravenously to neutralize the virus (WHO, 2021a). In addition, the incubation period is two times lower for the new strain. So there is a rapid increase in the development of such a mutation.
The rapid rise in Delta Variant infections characterizes Mississippi State. It prevails over Alpha and Beta due to rapid spread within the country (Variant Proportions, 2021). The total doses administered are estimated at 2,355,418, while the amount of fully vaccinated is 1,027,864 (Mississippi State Department of Health, 2021). In percentage, it ranges from 27% to 59%, depending on the county. Mississippi’s rates are lower compared to national averages, 59.9% received at least one dose, and 50.9% are fully vaccinated (COVID-19 vaccinations in the United States, 2021). Thus, the main goal of health workers is to increase the rate within the community.
With regard to counties within the state, the percentages vary significantly. The highest vaccination rate – 59% is found in Jefferson, with 4109 people receiving at least one dose of vaccine and 3276 vaccinated fully (Mississippi State Department of Health, 2021). The lowest percentages are shown in counties like Neshoba, where only 27% of people got one dose (Mississippi State Department of Health, 2021). Despite low rates, the county’s population is much bigger than Jefferson’s, so the total doses administered their amount to 14081 people (Mississippi State Department of Health, 2021). On average, the vaccination rate is relatively low – 41% of those who received one dose and 34% were fully vaccinated (Mississippi State Department of Health, 2021). However, the overall current vaccination rate within the state shows an upward trend.
If the low rate persists in the near future, there is a risk of a new spike in COVID-19 infections, particularly with the Delta Variant. The immune response in vaccinated people who received a double dose is stronger over time, or at least at the same level as in people who develop antibodies after infection (Today, 2021). Despite the fact that the vaccine does not guarantee complete protection, it still protects the major population against severe conditions followed by hospitalization.
The first reason is that Americans do not want to get vaccinated for fear of side effects, including the likelihood of getting the flu. For example, someone who refuses the second dose believes that one vaccination is enough for them to develop immunity from the coronavirus (Sallam, 2021). Workers may also worry about taking unpaid leave if they encounter side effects from the vaccine (Sallam, 2021). They receive less favorable schedule hours if they are absent from the workplace due to vaccinations. In addition, people do not see the effectiveness of vaccines as they may have limited efficacy and form immunity for a currently unknown period.
The second is that the vaccination campaign is behind schedule due to logistics problems. In February, US President Joe Biden also announced big logistical problems (Biden announces a big vaccine deal, 2021). Since the drug is administered in two stages, the costly transport will need to be carried out twice (Sallam, 2021). Thus, distribution will require creating production, storage and transportation systems in deep freeze conditions, which will require huge investments.
Third, many people do not trust a vaccine that has been tested for less than a year. Long-term effects may only be noticeable after a few years (Sallam, 2021). As a result, posts with conspiracy theories about the origin of the coronavirus and the dangers of a vaccine are popular (Sallam, 2021). It may be explained by the fact that the prerequisites for believing in conspiracy theories are experiencing loss of control and low social trust.
Regarding community barriers, they need to be addressed by joint efforts from multiple stakeholders. Based on the examples of other countries measures to diminish vaccine hesitation, it is possible to consider interventions, resulting in the potential for the community. The first is providing reliable information to the population. According to the UK Parliament (2021), in-depth knowledge on a personal level increases willingness in different ethnic and socioeconomic groups. The second intervention is using existing networks and partnerships with some faith organizations. It may also be achieved by engaging the voluntary community sector. Health institutions may use the mechanisms of influence of the social environment, including attracting people trusted by the population. The third concerns healthcare workers; it is suggested to enroll community health workers in the regular medical workforce system (WHO, 2021b). Fourth, WHO (2021b, p. 10) also recommended including community health workers “among essential health workers prioritized for vaccination, based on their COVID-19 and continuity of essential health services delivery roles.” Finally, it is helpful to inform the population of current disease rates and be ready to participate in ongoing dialogue with the community.
A whole range of well-designed measures is required to diminish vaccine hesitancy and increase people’s readiness to be vaccinated. The vaccination procedure needs to be made a simple and quick procedure, which, in particular, will make it possible to reach a large group of people who do not experience negative attitudes towards vaccination. Sometimes vaccine mistrust may be a human reaction to the practical difficulties associated with vaccination (Sallam, 2021). Mass vaccination plans should be designed taking into account factors such as the convenient location of vaccination sites, opening hours, the level of costs associated with vaccinations, and the quality of service (UK Parliament, 2021). Ensuring easy access to vaccinations in safe, familiar and convenient locations, such as temporary vaccination sites in areas that people regularly visit, can also contribute to higher vaccination rates.
Such public health resources such as human resources, facilities, and marketing campaigns should be accompanied by the targeted dissemination of credible and precise information from authoritative sources about the importance, benefits, simplicity, speed and low cost of vaccination. Making vaccinations visible by locating vaccination sites in central public spaces or promoting opportunities for vaccines on social media, news media, or face-to-face can also help increase vaccination rates (Sallam, 2021). Disseminating information about vaccination with health workers can help build public confidence in vaccines and improve vaccination rates.
The community uses domestic resources; therefore, there is evidence of insufficient vaccination funding. In 2020, the shortage was explained by a lack of pre-budgeting, considering potential vaccine availability (WHO, 2021b). In 2021, potential deficits in community resources were determined as a need for funding to cover mainly operational expenses. Prioritization of COVID-19 vaccination in routine immunization budgets may result in adverse outcomes for universal health coverage (WHO, 2021b). There has also been a shortage of medical personnel, supervision and performance management (WHO, 2021b). Additional funds should be allocated to pre-service and in-service training. Moreover, the common issue for the country is vaccine shortage due to logistics problems.
The level of immune protection after vaccination against COVID-19 can be checked if health workers correctly approach the antibody test. Vaccination accelerates immunity but requires additional work: the schedule of revaccination and regular laboratory testing of the immune system’s strength. When processing the research results, the analysis is carried out both for the region’s population as a whole and in various subgroups: by age, sex, social status and/or profession. Outcome indicators will be measured through such evaluation methods as tests and data collection (WHO, 2021b). It includes assessing the collective immunity of different age groups for the parameter of seroprevalence, identification of risk groups for infection and the incidence of asymptomatic forms. Thus, it is possible to assess the level of immunity in a population using laboratory tests for the presence of antibodies to this infection, carried out among various population groups.
References
Biden announces a big vaccine deal but warns of hurdles. (2021). The New York Times.
COVID-19 vaccinations in the United States. (2021). Center for Disease Control and Prevention.
Mississippi State Department of Health. (2021). COVID-19 Vaccination Reporting. Web.
Sallam, M. (2021). COVID-19 vaccine hesitancy worldwide: A concise, systematic review of vaccine acceptance rates. Vaccines, 9(2), 160-164.
Today. (2021). How protected are vaccinated Americans against the delta variant? [Video]. YouTube.
UK Parliament. (2021). COVID-19 vaccine coverage and targeted interventions to improve vaccination uptake.
Variant Proportions. (2021). Center for Disease Control and Prevention.
Vox. (2021).Why so many Covid-19 variants are showing up now. YouTube.
World Health Organization. (2021a). Tracking SARS-CoV-2 variants.
World Health Organization. (2021b). The role of community health workers in COVID-19 vaccination: Implementation support guide.