Some individuals who are opting out of receiving the COVID-19 vaccine say they’re counting on yet-to-be-realized herd immunity to protect them from long-term risk of being infected with the virus. One of the emerging ironies of the pandemic is that so many of those people reside together in states with low rates that herd immunity is unlikely to occur. This may be especially concerning in light of data from the ZOE COVID Study in the United Kingdom revealing that the Delta variant—which is now turning up in the U.S.—is up to 60% more transmissible than the Alpha variant. It is essential that patients who decline the vaccine understand that herd immunity to the COVID-19 virus is unlikely to be achieved until 70% of the population is immunized either through vaccination or naturally occurring antibodies, according to a report from the Johns Hopkins Bloomberg School of Public Health. And yet, data from the Centers for Disease Control and Prevention show only a handful of states approaching that threshold, and a wide gap between the most and least vaccinated states. Rates in the five most vaccinated states (Vermont, Massachusetts, Maine, Connecticut, and Rhode Island) range from 60% to 54% while in the five least vaccinated states (Mississippi, Alabama, Arkansas, Louisiana, and Wyoming) the range is from 28% to 32%. According to data amassed from multiple federal and state public health resources by The New York Times, trending case counts among U.S. counties follow suit.

Let Reluctant Patients Know: COVID-19 ‘Herd Immunity’ May Be a Pipe Dream in Some States