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Alabama doctor: Americans 'who have not rolled up their sleeve' are still the biggest issue

·Senior Editor
·5-min read

Vaccinating Americans with their first or second shots is more urgent than giving boosters, according to one infectious disease expert, given that unvaccinated individuals generally experience the worst outcomes when infected with COVID-19.

“What I’m seeing here on the ground level in Alabama and other areas with low vaccination is that a lot of the morbidity, a lot of the bad outcomes, are not in individuals who lack a booster,” Dr. Ellen Eaton, assistant professor at the University of Alabama at Birmingham Division of Infectious Diseases, said on Yahoo Finance Live (video above). “It’s individuals who have not rolled up their sleeve for their first or second vaccine, individuals who aren’t fully vaccinated.”

A recent CDC study found that between April and July 2021, unvaccinated Americans were nearly five times more likely to be infected with COVID-19, 10 times more likely to end up hospitalized for COVID-related complications, and 11 times more likely to die from COVID-19 than their fully vaccinated counterparts (Another CDC study found that between May 1 and July 25, 2021, unvaccinated residents of Los Angeles County were 29 times more likely to be hospitalized.)

The FDA recently approved for emergency use a third dose of the Pfizer (PFE)/BioNTech (BNTX) vaccine for individuals who received the Pfizer vaccine and are 65 and older or at high risk but stopped short of recommending boosters for the general population.

“I’m glad we’re having really robust, independent reviews by both the FDA’s advisory committee and the CDC to make sure that we have the data that we need to make these decisions,” Eaton said. “But from my standpoint, a lot of the outcomes that we’re seeing, the severe disease, is not because of a shortage of boosters. It’s really because we have low vaccine uptake in general."

In Alabama, just 41.7% are fully vaccinated while 52.1% have received at least one dose. In comparison, the rate of those fully vaccinated in the U.S. is 55.1%. Many of the cases in Alabama are concentrated in rural areas, where hospital capacity is much lower than in other parts of the state.

“We know that only 41% of Alabamians are fully vaccinated,” Eaton said. “In our rural areas, it’s a much lower percentage. We know vaccination is very regional and we know this virus can cross county lines quite easily. So until our whole state is really vaccinated, I think that we’ll pause in terms of giving too optimistic of projections going forward.”

Eaton, like many other public health experts, is focused on overcoming vaccine hesitancy.

“We do still have hesitancy,” Eaton said. “I do still encourage all my colleagues and other providers and family members and loved ones to continue to talk about your vaccine experience, continue to share data and evidence. We need to flood the social media space with facts and truth.”

President Biden made similar remarks during a press conference on Friday.

“We still have over 70 million Americans who’ve failed to get a single shot,” he said. “To make matters worse, there are elected officials actively working to undermine, with false information, the fight against COVID-19.”

'We continue to have very full hospitals'

Though Eaton is cautious about getting too optimistic at COVID numbers, she is hopeful about some of the latest trends.

“It’s a moving target,” she said. “We’re seeing a hint of optimism. We’ve seen this before. I do hesitate to get too optimistic with my projections. We did see really devastating outcomes with the Delta surge. We continue to have very full hospitals, although some of them are opening up, and we’re seeing more capacity this week, for example, than we saw last week.”

ICU capacity has become a major issue in states with high case counts (and low vaccination rates). In Idaho, for example, hospitals have resorted to rationing care because they have become so overwhelmed.

“We certainly can’t predict with absolute terms, but I do imagine that as long as we have communities who are largely unvaccinated, we will see new mutations, new variants, that have the potential to evade our vaccines such that individuals like myself who are fully vaccinated may be subject to a new mutant such that I would get infected and other fully vaccinated individuals may get ill,” Eaton said.

Breakthrough cases have become more common due to the contagiousness of the Delta variant. However, a majority of fully vaccinated individuals with breakthrough cases have not needed to be hospitalized nor have they experienced severe symptoms. 

Anti-vaccine mandate protesters demonstrate, on August 24, 2021, outside of the Ohio Statehouse in Columbus. (Photo by STEPHEN ZENNE /AFP)
Anti-vaccine mandate protesters demonstrate, on August 24, 2021, outside of the Ohio Statehouse in Columbus. (Photo by STEPHEN ZENNE /AFP)

And although unvaccinated Americans create opportunities for the virus to mutate and potentially evade vaccines, Eaton doesn’t think it will lead to mass hospitalization or severe disease and deaths among those fully vaccinated, at least for now.

“As long as we have these communities, a lot of rural states where a large percentage aren’t vaccinated, I think we’re going to see potentially new coronavirus variants, potentially variants that may tip over into fully vaccinated individuals that cause us to have cold and flu-like illnesses,” she said. “But I’m hopeful that we won’t see the mass hospitalization that we saw pre-vaccine in the vaccine setting and individuals who are fully vaccinated.

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at


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