Michigan: 90 percent need COVID vaccine for herd immunity. That’s unlikely.

With a new, faster-moving coronavirus variant now confirmed in Michigan, the state is boosting its vaccination goal.

The state’s lead epidemiologist Wednesday estimated that at least 90 percent of Michiganders 16 and older may need to be vaccinated against COVID to effectively beat back the spread of the coronavirus. That is a dramatic increase over the state’s previously stated goal of a 70 percent vaccination rate to achieve herd immunity from the virus.

The new variant, known as B.1.17., does not appear to make people more sick. However, early surveillance suggests it spreads 1.5 times faster than the coronavirus that was first identified in Michigan last March and, as of Wednesday, had infected 542,146 Michiganders and been linked to 13,905 deaths.

“I think there's still a lot more work that needs to be done to understand exactly how that virus spreads in Michigan and the United States,” Sarah Lyon-Callo, the state’s chief epidemiologist, said Wednesday during a media call. 

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With the new variant, Lyon-Callo said, “we're anticipating that we may need to be, you know, closer to 90 percent or perhaps over 90 percent.”

A Washtenaw County woman tested positive for the variant Saturday. At least seven of her contacts also have tested positive for COVID, although genetic sequencing hasn’t yet confirmed they are of the same variant.

The faster a virus can be transmitted, the more immunity is needed to stop it. As the new strain of the coronavirus circulates faster, it could lead to an exponential surge in cases, said Dr. Joseph Eisenberg, an epidemiologist at the University of Michigan. 

Which makes it critical to protect as many Michiganders as possible.

“People want to know: What does it do to my risk?” Eisenberg said.  “The faster it’s moving around, the more likely you’re going to get it.”

The new variant has pushed back the goalposts to herd immunity, but Michigan isn’t alone in adjusting the numbers.

So has the federal government’s top epidemiologist — Dr. Anthony Fauci. Last month, Fauci acknowledged to the New York Times that he had intentionally low-balled earlier estimates of 60 or 70 percent vaccination rates because he didn’t think the public was ready to hear what was truly needed to reach herd immunity, a rate he put at 80 to 85 percent, or perhaps 90 percent, he told the Times.   

Reaching 90 percent in Michigan appears unlikely, at least for now, for two reasons: COVID vaccines remain scarce in much of the state and, even when they are available, a significant portion of eligible people remain reluctant to take them. 

Facing limited supplies of the COVID vaccines and kinks in the supply chain in both rural and populated areas, the state is struggling already to meet its first goal of vaccinating 70 percent of Michiganders age 16 and older.

In rural Newberry in the Upper Peninsula, pharmacist Dave DeMerse has been working with the local health department to vaccinate residents. But it’s a start-and-stop effort with no predictability in the supply chain.

A batch of Moderna vaccines headed his way was ruined earlier this week because of temperature control problems, DeMerse said. Then he was told there would be replacements, after all. 

Most times, he said, “people will just drop everything and come in,” when they hear vaccines are coming. “But you can’t count on that either.”

In addition to distribution woes, many health workers and others eligible have been hesitant to take the two-dose vaccines developed last year under Operation Warp Speed and authorized for emergency use by the U.S. Food and Drug Administration in December.

“I thought 70 percent was a lofty goal,” DeMerse said.

A 90 percent vaccination rate has been elusive even for more established and proven vaccines. 

For example, less than 63 percent of Michigan adults received the vaccine that protects against tetanus, diphtheria and pertussis as of September, according to the Michigan Department of Health and Human Services. Among adolescents, even accepted vaccines, such as one that protects against meningitis, fall just short of an 80 percent coverage rate.

For now, such ambitions are largely academic, as there is not enough supply even to reach those who are already eligible.  

“I don’t know if it’s attainable,” Steve Kelso, spokesman for the Kent County health department, said of the 90 percent goal — at least any time soon, said. “Right now, I need vaccines.”

The reluctance among health care workers to take the COVID vaccine has been particularly worrisome.

In some of the state’s more than 450 nursing homes, nearly all residents have consented to receive the vaccine, but about half of staff are declining it, according to anecdotal reports, said Salli Pung, who leads Michigan’s Long-term Care Ombudsman’s office, a network of advocates for residents in long-term care facilities.

She said some staff say they’ll wait for a few weeks to see how the vaccine affects others; others worry they have no paid leave if they have a reaction to the virus. Still others wonder whether the vaccine, developed and studied in less than a year, might have long-term implications for fertility, she said.

“We know that staff, even unknowingly, can transmit the virus inside a facility,” she said.

A poll of representatives at hospitals and health systems by the Michigan Health & Hospital Association found that about 60 percent of staff accepted the vaccine as of two weeks ago. An MHA spokesperson, John Karasinski, noted polls elsewhere have suggested an increasing comfort with the vaccine. 

So far, none of the state’s health systems have mandated the COVID vaccines, said MHA spokeswoman Ruthanne Sudderth in an email to Bridge.

The fact that the new COVID vaccines were authorized under emergency use rather than a full approval makes it “unlikely that organizations will feel legally comfortable mandating the vaccine,” she said. “Another hurdle is that we still don’t have enough supply to allow for mandates to be implemented successfully.”

Whether the vaccine might be mandated depends on where you work and what you do, said Deborah Gordon, a civil rights and employment discrimination lawyer in Bloomfield Hills, who also specializes in constitutional law.

A hospital or an education system can require employees to take a vaccine to protect the public or other employees, but there is no legal precedent for a government requiring the general public to take a vaccine, she said. 

“There are a lot of complexities,” she said.

Schools may one day add a COVID vaccination among their requirements, allowing for religious exceptions, said Lance Gable, a Wayne State University law professor who specializes in public health.

But as for a blanket government mandate?

Even though public health officials have relatively far-ranging powers in a pandemic, that “doesn't give authority to require vaccination of the entire population,” Gable said.