Why Puerto Rico leads the United States in COVID vaccination rates and what states can learn: NPR

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People walk through Old San Juan in Puerto Rico in March as tourism to the island continues to increase.

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People walk through Old San Juan in Puerto Rico in March as tourism to the island continues to increase.

Spencer Platt / Getty Images

The highest COVID-19 vaccination rate in the United States is not in a liberal-leaning northeast or west coast state.

This is in Puerto Rico, where over 73% of the total population is fully vaccinated. The US national average is just over 57%.

The high vaccination rate contrasts with Puerto Rico’s initial vulnerability to the coronavirus. Four years after the destruction of the electricity grid by Hurricane Maria, power cuts still occur regularly. Many municipalities face a shortage of health facilities and workers.

U.S. Territory has responded with some of the country’s toughest pandemic measures, including non-essential business closures, stay-at-home orders and mask warrants.

Mónica Feliú-Mójer is the director of communications and scientific outreach for the nonprofit, Ciencia Puerto Rico, and says people have responded rather well to the measures.

“When the pandemic started, there was so much concern that we had such a fragile health care system,” she told NPR’s Audie Cornish on All things Considered.

The San Juan Convention Center hosted the first mass COVID-19 vaccination event in Puerto Rico on March 31, 2021.

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The San Juan Convention Center hosted the first mass COVID-19 vaccination event in Puerto Rico on March 31, 2021.

Ricardo Arduengo / AFP via Getty Images

“There is a lot of concern that the pandemic could cause it to collapse. So I think everyone pretty much stepped up to do what needed to be done so that we can prevent this health care system from collapsing and, you know. , to prevent the worst from happening in Puerto Rico. “

The high vaccination rate also correlates with one of the lowest COVID-19 community transmission rates in the country, according to data from the Centers for Disease Control and Prevention, and one of the highest test positivity rates. bottom of the country, hovering around 2%.

The leader of the scientific coalition advising Puerto Rico on COVID-19 (and the founder of Ciencia Puerto Rico), Daniel Colón-Ramos, says this correlation is not a coincidence.

“It represents a lot of lives saved,” Colón-Ramos told CNN.

“It’s really about the fact that there are hundreds of people – if not thousands – right now somewhere in Puerto Rico and they wouldn’t be here if it weren’t for these efforts.”

What the continent can learn from Puerto Rico

Feliú-Mójer says that one of the reasons for the success of the vaccination is a difference in political culture compared to the mainland United States. In the continental United States, Republicans have consistently fought mask-wearing rules and vaccination warrants, citing personal freedom.

“We don’t see this correlation between political ideologies and people’s willingness to get vaccinated or to use masks,” she said. “It’s not as if the issue of COVID and vaccination hasn’t been politicized. It has just been politicized in a different way, not in terms of identities or ideologies, political ideologies. “

While Feliú-Mójer notes that there are small but vocal anti-vaccine groups in Puerto Rico, she also points to a historic “very good” acceptance of vaccines. She says a key is to engage people with their values, beliefs or identities rather than allowing them to contribute to polarization. Another is to promote solidarity in the public health effort.

“We need to adopt differentiated strategies to reach different audiences and understand what drives them to get vaccinated or not,” she said. “And then I think broad coalitions… different groups of people and segments of society in Puerto Rico have come together to work on the prevention of COVID-19, by vaccinating people against COVID-19. And I think these broad coalitions are going to be really important in achieving higher levels of immunization in the United States.

His successes aside, Feliú-Mójer noted that COVID-19 had still killed more than 3,200 people in Puerto Rico. And she remains concerned about the fairness of vaccines – especially in rural communities, or among older people who can’t leave their homes or don’t know how to make an appointment. She says the high overall immunization rate may mask gaps in coverage.

Dr Susana Schwarz inoculates a man at the Puerto Rico Convention Center during the first mass vaccination event in San Juan, Puerto Rico, in March.

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Dr Susana Schwarz inoculates a man at the Puerto Rico Convention Center during the first mass vaccination event in San Juan, Puerto Rico, in March.

Ricardo Arduengo / AFP via Getty Images

“You have to look past that huge number,” she said in a separate interview with NPR. “But then you look at some municipalities like Loíza, a predominantly black town on the north coast of Puerto Rico and [a] very poor common. Their vaccination rate is around 55%. And so when you look at some of the social determinants that impact communities like Loíza, then they don’t do as well. “

According to the 2020 census, the poverty rate in Puerto Rico is 43.5%, while the official poverty rate in the United States is much lower at 11.4%. The census also counted a population of just under 3.3 million people – more than 21 states.

These are important numbers to consider when assessing the overall success of vaccination in Puerto Rico, says Daniel Colón-Ramos, professor at Yale School of Medicine and advisor to the Puerto Rican government.

“The experience with vaccines in places like Puerto Rico and the Navajo [N]ation shows that when resources are distributed equitably AND when local scientists and healthcare leaders are able to direct their own strategies, they can outperform most US jurisdictions ”, Colón-Ramos wrote on Twitter.



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