A 22% surge in US coronavirus deaths is hitting unvaccinated people hardest. Experts worry about the long-term effects for vaccinated people, too.

us 500,000 covid-19 deaths
El Paso County Medical Examiner’s Office staff roll bodies in bags labeled “COVID” from refrigerated trailers into the morgue office on November 23.

  • The US’s daily coronavirus deaths surged 22% in the past week – mostly among unvaccinated Americans.
  • Disease experts worry about breakthrough cases in older people or those who are immunocompromised.
  • Increased transmission could also allow the virus to mutate into a more dangerous strain.
  • See more stories on Insider’s business page.

The US is far removed from the deadliest point in its coronavirus outbreak: The country reported more than 3,000 daily coronavirus deaths in January, compared with less than 275 daily deaths, on average, in the past week.

But average daily deaths surged 22% in the past seven days, following a record low of 30 deaths on July 11. In the past two weeks, average daily deaths rose 33%.

The vast majority these deaths are among unvaccinated Americans: Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told NBC earlier this month that unvaccinated people represented more than 99% of recent coronavirus deaths. The Centers for Disease Control and Prevention also reported Friday that more than 97% of people entering hospitals with symptomatic COVID-19 hadn’t received shots.

The US is now dealing with a “pandemic of the unvaccinated,” CDC Director Rochelle Walensky said at a press briefing.

“We are seeing outbreaks of cases in parts of the country that have low vaccination coverage because unvaccinated people are at risk, and communities that are fully vaccinated are generally faring well,” Walensky said.

But disease experts worry that allowing the virus to spread among unvaccinated people could give it more opportunities to mutate. That could pose a long-term risk for vaccinated people, too. Already, the Delta variant – now the dominant strain in the US – appears to be more transmissible than any other version of the virus detected so far.

“The worst-case scenario is if Delta mutates into something completely different, a completely different animal, and then our current vaccines are even less effective or ineffective,” Vivek Cherian, an internal-medicine physician in Baltimore, told Insider last month.

Experts also worry that increased transmission could result in more severe breakthrough infections – cases of COVID-19 diagnosed at least two weeks after someone is fully vaccinated – among older people or those who are immunocompromised, since vaccines may already be less effective among these groups.

People over 65 represent about 75% of breakthrough cases that result in hospitalization or death, according to the CDC.

The UK offers insight into what to expect in the US

london UK reopening
Outdoor dining in Soho, London, on April 18.

Disease experts worry that the US could soon follow in the footsteps of the UK, where average deaths have more than doubled in the past two weeks, from 17 to 40 a day. The UK’s average hospitalizations have also increased about 60% during that time, from about 380 to 615 a day.

That’s despite the fact that nearly 70% of UK residents have received at least one vaccine dose.

In the US, about 44% of the population remains unvaccinated. (That includes about 48 million children under age 12, for whom vaccines haven’t been authorized yet.)

The country is now administering as many daily vaccine doses as it was in late December, when vaccines were available only to healthcare workers and residents of long-term-care facilities. Just 384,000 daily doses were given out on average over the past week.

Some Americans, particularly in rural counties, may still struggle to access shots, while others can’t afford to take time off work to get vaccinated. But, for the most part, widespread vaccine hesitancy has slowed down vaccination rates.

About 18% of adults surveyed in a recent YouGov poll said they didn’t plan to get vaccinated, while 11% said they were unsure. These rates were significantly higher among Republicans and people in the Midwest and South.

Most vaccine-hesitant people in the survey said they were worried about side effects from coronavirus shots – though studies have shown that vaccine side effects are generally mild and fleeting. The vast majority of them also said they believed that the threat of the virus was exaggerated for political reasons.

Lifting mask and social-distancing mandates could delay herd immunity

US reopening concert phone picture Instagram
A couple at Madison Square Garden in New York City on June 20.

Despite lagging vaccination rates, most US states have lifted mask and social-distancing mandates. In states such as Delaware, Florida, Missouri, and South Carolina, masks are recommended but not required for unvaccinated people.

Some disease experts said removing these restrictions too soon could send the wrong message about the state of the pandemic.

“The concern is if you’re on the fence, and then you go outside and you see, ‘Hey, things are back to normal,’ that may decrease the chance of you wanting to even get vaccinated,” Cherian said.

For now, experts are hopeful that the US can still vaccinate at least 70 to 85% of its population – a threshold that may allow the country to reach herd immunity. But a new variant that evades protection from vaccines or prior infection could push that goal even further from view, so public-health officials remain determined to vaccinate more Americans as quickly as possible.

“If you get to that situation, then you essentially get us back to a level” that we were in before March 2020, Cherian said, adding: “That’s just not a place that you want to be.”

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A map shows how many people had undiagnosed COVID-19 in the first 6 months of the pandemic, across 7 regions of the US

Biking covid new york
A bike lane in New York City.

  • During the first six months of the pandemic, 16.8 million coronavirus cases went undiagnosed in the US.
  • That’s according to a report that compares the prevalence of coronavirus antibodies in various regions.
  • The Mid-Atlantic saw the most undiagnosed cases – nearly 9 out of every 100 people – by July 2020.
  • See more stories on Insider’s business page.

On paper, the US’s summer and winter coronavirus surges look far more devastating than the first one in the spring of 2020.

But a new report published in the journal Science Translational Medicine offers the most robust look yet at how widespread the virus actually was during that initial wave. The results show that for every diagnosed case of COVID-19 in the US, nearly five others went undiagnosed during the first six months of the pandemic.

That amounts to roughly 16.8 million undiagnosed cases by mid-July 2020 – in addition to the 3 million cases officially reported during that time.

Kaitlyn Sadtler, an investigator at the National Institutes of Health who worked on the study, told Insider that her team spent several months making sure the figure was right.

“It was shocking to an extent of, ‘Wow, that’s a lot of people,’ but at the same time, we knew that there was this big black box out there – the unknown,” she said.

The estimates are based on a collection of blood samples, which the researchers gathered from around 9,000 people across the US from April 1 to August 4, 2020. None of the individuals sampled had ever been diagnosed with COVID-19, but nearly 5% of the samples came back positive for coronavirus antibodies. The researchers determined that these people had gotten undiagnosed infections.

Some regions were hit harder than others, they found. The Mid-Atlantic saw the highest prevalence of COVID-19 cases: Nearly 9 out of every 100 people in the region had an undiagnosed infection, according to the report.

The map below shows how that compares to other regions across the country.

regional covid prevalence

Nearly 7% of people in the Northeast had an undiagnosed infection, compared with less than 2% in the West and Midwest, 3% in the South and Central US, and 4.5% in the Southwest.

Undiagnosed cases were most commonly found among Black Americans: Around 14% of the samples from the group came back positive for coronavirus antibodies. Meanwhile, around 2% of samples from white and Asian American people came back positive – the lowest of any racial group.

Undiagnosed infections were also more common among people ages 18 to 44 than among older age groups – 6% of those samples tested positive for antibodies.

If more young people got COVID-19 early in the pandemic than we thought, it could mean the US is closer to herd immunity than experts were estimating. (Vaccination rates are still relatively low among young Americans – just 38% of people ages 18 to 29 have gotten at least one dose compared to 80% of those ages 65 and older.)

However, Sadtler said people should assume they’re still vulnerable to infection until they’ve gotten a vaccine.

“It definitely doesn’t mean that younger folks should rely on thinking they might have had an infection,” Sadtler said. “Everybody should go out and get vaccinated.”

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Israel offers a glimpse of life after herd immunity: With 80% of adults vaccinated, cases have dropped to 15 per day

israel mask vaccine
Pedestrians walk on a boulevard in Tel Aviv on April 18, 2021.

  • Israel lifted some of its last COVID-19 restrictions on Tuesday as new cases declined to 15 per day.
  • Some experts think Israel has reached herd immunity by vaccinating 80% of adults.
  • But international travelers could still bring the virus in, despite Israel’s tight travel restrictions.
  • See more stories on Insider’s business page.

As the US scrambles to incentivize people to get vaccinated, Israel is reaping the benefits of its successful vaccine rollout: The nation reported just 15 new daily coronavirus cases, on average, in the last week – its lowest count in more than a year.

The decline in infections has been so encouraging that Israel lifted some of its last remaining coronavirus restrictions on Tuesday. Businesses can now operate at full capacity, and residents no longer have to show proof that they’ve been vaccinated to enter restaurants, sporting events, or entertainment venues.

Even before the new rule, Israel’s schools were fully open, masks were no longer required outdoors, and mass gatherings were taking place across the country. Now Israel’s only barrier to normal life is a requirement to wear masks in public indoor spaces – a rule that could be lifted as soon as next week, according to Israeli health officials.

“This is probably the end of COVID in Israel, at least in terms of the current strains that we know,” Dr. Eyal Zimlichman, deputy director general at Sheba Medical Center, Israel’s largest hospital, told Insider. “We’ve obviously reached herd immunity.”

Scientists previously estimated that getting to herd immunity – the threshold beyond which the virus can’t easily pass from person to person – would require countries to fully vaccinate 70% to 85% of their residents. But Israel has vaccinated just 60% of its citizens, or roughly 80% of its adult population, so far. Vaccines haven’t been authorized there for children under 16 yet.

That’s a sign that other countries could vanquish their outbreaks with similar vaccination levels, Zimlichman said. He estimated that around 70% of Israeli citizens now have immunity to the virus, either through vaccines or natural infection.

“We know now for sure that this number is enough to create herd immunity,” he said.

Israel’s vaccine passport created an incentive

vaccine passport israel 4
Israelis show off their “green passes” as they arrive for a concert for vaccinated seniors at Bloomfield Stadium in Tel Aviv on March 5, 2021.

Experts are hopeful that the US is following Israel’s trajectory: The nation has fully vaccinated 52% of adults and 41% of total residents so far.

But an April Kaiser Family Foundation poll found that 13% of Americans never plan to get vaccinated, while 15% are still waiting to decide. Another 6% said they would only get vaccinated if shots were required for work, school, or other activities.

“I’m optimistic about actually getting to 60%, but the daily reported doses have been decreasing since around mid-April,” Jorge Alfaro-Murillo, an associate research scientist at the Yale School of Public Health, told Insider. “The first people who get the vaccine are of course going to be the ones that were more willing to take it.”

The US is vaccinating less than 1.2 million people per day, on average, compared to 3.3 million at its peak in mid-April. States are now incentivizing people to get vaccinated by offering lottery tickets, vacations, or cash prizes.

Israel took a different approach to vaccine incentives: Its Green Pass system allowed people to enter restaurants, sporting events, museums, gyms, and hotels only if they showed proof of vaccination or a negative COVID-19 test.

“Life became much easier for you if you were vaccinated and that was another incentive for people,” Zimlichman said. “They didn’t want to feel like second-level citizens.”

None of this has been true in the Palestinian territories, however. Less than 5% of the Palestinian population has been fully vaccinated. (Palestinians in East Jerusalem have access to Israeli health insurance, but that doesn’t extend to Palestinians in the West Bank and the Gaza Strip.)

Several human-rights organizations have called on Israel to give Palestinians vaccines right away.

“In the Palestinian communities, if they’re not vaccinating as much and then there’s a new strain that comes up that can evade the vaccine protection, then that’s going to be a big issue,” Alfaro-Murillo said.

Mass gatherings in Israel put vaccines to the test

israel crowd
A crowded street in the Israeli town of Meron on April 30, 2021.

Israel’s vaccination campaign has effectively ended already.

“We’re not seeing more people get vaccinated – it’s pretty rare at this point,” Zimlichman said. “Those that wanted to get vaccinated had more than enough opportunities at every age level over the age of 16.”

Now the country’s vaccination rate is being put to the test by mass gatherings.

In late April, tens of thousands of Israelis gathered in Galilee for Lag B’Omer, a Jewish holiday – the largest public gathering in Israel since the start of the pandemic. A stampede at the event killed dozens and left around 150 people hospitalized.

Then last month, many Israelis crowded in bomb shelters amid the violent clashes between Israel and Gaza.

All the while, infections continued to drop: Israel’s average weekly coronavirus cases have declined 80% in the last month.

“If you came to Israel, the sense would be that this is a country that doesn’t have any COVID,” Eyal Leshem, an infectious-disease specialist at Sheba Medical Center, told Insider.

Israel is still closed to most travelers

israel travel restrictions
Israelis and vaccinated tourists get tested for COVID-19 upon arrival to Israel’s Ben Gurion airport on May 23, 2021.

Part of Israel’s success may have to do with the nation’s tight travel restrictions. It’s is still closed off to most tourists, and incoming travelers are required to quarantine for two weeks, then take a COVID-19 test on their ninth day in the country.

Israeli citizens must get special permission to travel to nine countries where infection rates are high or coronavirus variants are spreading widely: Argentina, Brazil, Ethiopia, India, Mexico, Russia, South Africa, Turkey, and Ukraine.

The US, by contrast, just recommends that Americans avoid countries with high transmission. Residents are allowed back into the US by presenting a negative COVID-19 test. Fully vaccinated Americans don’t have to quarantine after returning to the country.

“We’re much bigger than Israel and we also have a lot more people that are coming in and going out of the country,” Alfaro-Murillo said. “I don’t feel like this is going to be over until the whole world is where Israel is right now.”

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Dominic Cummings will say that Boris Johnson skipped first COVID-19 meetings to write a book on Shakespeare to fund his divorce, fear aides

Boris Johnson Dominic Cummings
  • Aides to UK Prime Minister Boris Johnson are anxious about former advisor Dominic Cummings parliamentary testimony.
  • Johnson skipped key coronavirus meetings to write a book to fund his divorce, they fear Cummings will say, reported The Times.
  • Cummings criticised the govt’s early response to the coronavirus in a series of tweets.
  • See more stories on Insider’s business page.

Aides to Boris Johnson fear that former advisor Dominic Cummings could claim that the UK prime minister skipped crucial coronavirus meetings to write a book on Shakespeare to fund his divorce, The Sunday Times reported.

Cabinet Office officials reportedly fear that Cummings will use his appearance before a committee of MPs investigating the government’s early response to the pandemic to make damaging revelations about his former boss.

Johnson skipped five meetings of the COBRA emergency committee in the initial weeks of the pandemic in 2020.

The officials reportedly believe that Cummings will claim that Johnson needed the money from the book to fund his divorce from his second wife, Maria Wheeler.

The five meetings Johnson skipped were in late January and early February 2020, as the virus began to spread in the UK. It is customary for the prime minister to chair COBRA meetings during national crises.

At a campaign event in July 2019, Johnson had expressed regret that being a politician meant he didn’t have the time to complete a book on Shakespeare he’d planned to write.

“Being a full-time politician means that I won’t be able to rapidly complete a book on Shakespeare that I have in preparation. I honestly say that will grieve me,” he remarked, reported PoliticsHome.

Cummings left Downing Street last year after an internal power struggle and has since become a feared government critic, making damaging claims about its response to the coronavirus.

In a series of tweets Saturday, Cummings said that, contrary to the denials of several government ministers, including Health Secretary Matt Hancock, the government had been pursuing a “herd immunity” strategy until about a week before the first national lockdown in the UK.

“In the week of March 9, No10 was made aware by various people that the official plan would lead to catastrophe. It was then replaced by Plan B. But how ‘herd immunity by September’ could have been the plan until that week is a fundamental issue in the whole disaster,” he tweeted.

It was abandoned only when ministers were warned that it’d lead to “hundreds of thousands choking to death” on hospital wards,” he wrote.

Under the controversial strategy, the disease would have been allowed to spread freely among parts of the population, with the most vulnerable shielded, hoping that most of the population would develop some immunity to it.

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Ohio administered the most vaccines in weeks 2 days after it announced a $1 million vaccine lottery

Ohio vaccine
An Ohio resident receives a COVID-19 vaccine in March 2021.

  • Ohio vaccinated more people in a single day than in three weeks after announcing a major incentive.
  • Gov. Mike DeWine on May 12 said five vaccinated residents would win a $1 million lottery prize.
  • US states have offered incentives to encourage COVID-19 vaccinations and reach herd immunity.
  • See more stories on Insider’s business page.

Ohio recorded more than 25,000 new vaccinations last Friday, a number not seen in three weeks. It came two days after the state announced a major incentive: the potential for five vaccinated residents to win $1 million.

According to state data, Ohio administered more than 25,400 COVID-19 vaccines on May 14 – two days after Gov. Mike DeWine announced the program during a televised address the evening of May 12. It was the highest number of shots the state had administered in three weeks, when residents received 28,000 shots on April 23.

The program comes at a time when states across the US have scrambled to incentivize vaccinations as interest in them has plateaued. Experts predict the country will need to vaccinate at least 70% of the population to reach herd immunity for COVID-19.

In total, more than 124 million people in the US are now fully vaccinated against COVID-19 – about 38% of the total population. And 60% of adults have received at least one dose, according to US Centers for Disease Control and Prevention data.

DeWine’s announcement drew ire from some in and outside his own Republican Party, who questioned the use of millions in pandemic relief funds, local CBS affiliate WHIO reported.

“I know that some may say, ‘DeWine, you’re crazy!” DeWine said in a tweet last week announcing the “Vax-a-Million” program. “This million-dollar drawing idea of yours is a waste of money.’ But truly, the real waste at this point in the pandemic — when the vaccine is readily available to anyone who wants it — is a life lost to COVID-19.”

People in Connecticut who have been vaccinated against COVID-19 can get a free drink at participating restaurants. The state of Kentucky partnered with Walmart and Kroger to give every vaccinated adult a lottery ticket, which carries a top prize of $225,000. And New Jersey Gov. Phil Murphy announced that vaccinated people could get a free beer after they had been vaccinated with his “shot and a beer” campaign.

According to data analyzed by Johns Hopkins University, about 35% of Ohio residents are fully vaccinated against COVID-19. The state with the highest percentage of fully vaccinated people is Connecticut, with more than 44%.

The first Ohio drawing winner will be announced on May 26. The other four winners will be announced on the four Wednesdays that follow. If a 12- to 17-year-old wins the drawing, they’ll get a full-ride scholarship to any Ohio state university.

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All the free stuff your state is giving away if you get vaccinated

getting vaccinated new jersey
Philadelphia Flyers fan Stephen Zorzi of Pittman, New Jersey gets his COVID-19 vaccine shot administered by Penn Medicine Nurse Practitioner Erin McMenamin before game against the New Jersey Devils at Wells Fargo Center.

  • State and local governments are trying to incentivize vaccinations against the coronavirus.
  • It’s an effort to promote vaccinations and push toward reaching herd immunity.
  • From alcohol and event tickets, to a $1 million jackpot, local and state officials have announced unique offerings.
  • See more stories on Insider’s business page.
Ohio is running five $1 million lottery draws exclusively for vaccinated adult residents.

In this Tuesday, Feb. 2, 2021 photo provided by the Ohio Governor’s Office, Gov. Mike DeWine, left, gets his first dose of the COVID-19 vaccine from Dr. Kevin Sharrett, in Jamestown, Ohio.

Perhaps no vaccine incentive is more desirable than one million dollars.

Ohio Gov. Mike DeWine announced this week the state will run five $1 million lottery draws each week from May 26 to June 23. 

Each week, one adult who has received at least one dose of a COVID-19 vaccine or the single Johnson & Johnson shot, will be eligible for the million-dollar jackpot in the state’s lottery draw

The jackpot will be drawn by the Ohio State Lottery and comes from the state’s share of coronavirus relief funds.

Younger residents aged 12 to 18, who just this week became eligible for the vaccine, will not be in the drawing for a million dollars, but will have the opportunity to be entered into a draw for a four-year full scholarship to any state college or university, tuition and accommodation included.

New Orleans is offering residents one free pound of crawfish in return for getting vaccinated at a free, city-wide event.

seafood crawfish new orleans
Festival goers eat crawfish during the first day of the New Orleans Jazz and Heritage Festival in New Orleans, Louisiana April 25, 2014. Thumping beats flowed over a sea of flowered shirts and sun hats that filled the New Orleans Jazz and Heritage Festival over the weekend with tens of thousands roaming from stage to stage, as excited about the music as the food. Picture taken on April 25, 2014.

The New Orleans City Council organized the event on May 13, which they’ve advertised with the slogan, “1 shot for 1 pound.”

The promotion is a partnership with a local business incubator and attendees will receive both a vaccine — either Moderna or Johnson & Johnson — and a free pound of boiled crawfish. The first 30 people in line will also receive a free gift card.




Some Detroit residents are able to receive a $50 prepaid debit card.

transaction  debit card
A prepaid debit card.

Anyone who pre-registers and drives another city resident to a vaccination site will get the $50 card as a reward

“Pushing past our inability to manage and win the argument on social media, we really had to be more inventive about how to get the attention of the greater, grander community,” said Detroit Deputy Mayor Conrad L. Mallett. 

The initiative is part of the city’s Good Neighbor program, designed to incentivize those who donate their “time and effort” to help the vaccine cause, Mallett said.

Alabamans who get tested and/or vaccinated at an event later this month will get to take two laps around the state’s legendary Talladega Superspeedway.

FILE - In this Oct. 13, 2019 file photo, the No. 3 car of the late NASCAR driver Dale Earnhardt Sr., driven by Richard Childress, takes a lap before a NASCAR Cup Series auto race at Talladega Superspeedway in Talladega, Ala.   NASCAR's return to racing next shifts to Talladega Superspeedway in Alabama, with a new rules package altered after Ryan Newman's frightful crash in the season-opening Daytona 500.  (AP Photo/Butch Dill)
FILE – In this Oct. 13, 2019 file photo, the No. 3 car of the late NASCAR driver Dale Earnhardt Sr., driven by Richard Childress, takes a lap before a NASCAR Cup Series auto race at Talladega Superspeedway in Talladega, Ala. NASCAR’s return to racing next shifts to Talladega Superspeedway in Alabama, with a new rules package altered after Ryan Newman’s frightful crash in the season-opening Daytona 500. (AP Photo/Butch Dill)

On May 15, anybody 16 or older who opts to get tested and/or vaccinated at an Alabama Department of Public Health event will be able to drive their own car or truck around the fastest track in NASCAR at “highway speed.” 

Members of the state’s National Guard will administer the shots as part of a campaign by state officials to ramp up the number of vaccinations. 



City leaders in Memphis, Tennessee, are running a sweepstakes for a new car for anyone who gets vaccinated.

A long row of unsold 2021 Rogue sports-utility vehicles sits at a Nissan dealership

Shelby County residents over the age of 18 who have received at least one COVID-19 dose of a vaccine will be eligible to enter a giveaway of a brand-new vehicle of their choice.

Options include a Chevy Camaro, Chevy Colorado, Nissan Rogue, and Nissan Altima. Local officials will confirm people’s eligibility with their immunization record card.

Those who have gotten the jab should register for the sweepstakes before May 31 and a winner will be selected around June 1, according to local officials. 



New Jersey residents 21 and older who get a vaccine will be gifted a free brewski at participating locations in the state.

clinking beer glasses

New Jersey Gov. Phil Murphy announced earlier this month vaccine recipients aged 21 and older who get their first shot this month can take part in the state’s “Shot and a Beer” program. 

At participating locations throughout the Garden State, recipients will get a free glass of beer after receiving their jab.

“We need that push,” Dr. Perry N. Halkitis, dean of the Rutgers School of Public Health, told ABC News. “You have to find a way to motivate people. This is one way to do it.”

Vaccinated residents of Connecticut will be able to get one free drink between May 19 and May 31, according to a state webpage.

Gov. Ned Lamont.
Connecticut Gov. Ned Lamont.

Gov. Ned Lamont’s office has partnered with numerous restaurants around Connecticut that are participating in this initiative.

“To take part in the promotion which will run through the end of May, customers simply show that they have received either one or both doses of a COVID vaccine, at which point they can select from a list of pre-set drinks (alcoholic or non-alcoholic) established by each participating restaurant,” the webpage says. 

Vaccinated New York residents have the opportunity to score double the prizes – baseball tickets and a free subway pass.

yankees 2021
Yankee Stadium.

New York Gov. Andrew Cuomo earlier this month announced a promotion that would exchange a COVID-19 vaccine for free tickets to Mets Games and Yankees Games this spring.

Newly vaccinated people have the opportunity to score tickets to the Mets between May 24 and June 17 and the Yankees from May 7 to June 6. 

But, that’s not all!

New Yorkers who get vaccinated at one of the Department of Health’s pop-up vaccination sites through the weekend of May 15-16 will receive a free 7-day MetroCard or two one-way tickets. 


And if New Yorkers don’t already have enough of a reason to get vaccinated, Mayor Bill De Blasio announced this week the immunized can score free Shake Shack fries as well.

Shake Shack meal fries

The popular fast-food chain has teamed up with the New York City mayor’s office to ramp up vaccinations.

Until June 12, the inoculated who show their vaccination card can nab a free order of crinkle cut fries with the purchase of a burger or sandwich at several New York City Shake Shack locations. 

West Virginia Gov. Jim Justice announced any resident between the ages 16 and 35 will receive a $100 savings bond in exchange for getting vaccinated.

WV Gov Jim Justice
West Virginia Gov. Jim Justice.

People within this age group are not taking the vaccine as fast as the state hoped they would. “If we really want to move the needle, we’ve got to get our younger people vaccinated,” Justice said during a press briefing.

To fund the initiative, the state allocated money from the CARES Act, a measure passed by Congress last year to stave off the financial devastation brought on by the coronavirus, to fund the savings bond initiative.

Randolph County, Illinois is offering free shooting target practice to those who get immunized at a mobile vaccine site located at the Worldwide Shooting and Recreation Complex.

A shooter fires a handgun.

Illinois Gov. J.B. Pritzker announced earlier this month that the state’s popular shooting range will be the site of a mobile vaccination site on Friday, May 14 and Saturday, May 15. 

The state’s National Guard will be operation the site and anyone 18 and older who gets jabbed at the range will also receive 100 free targets of trap, skeet, or sporting clays for use at the recreation complex, according to the Belleville News-Democrat.


Harris County in Texas has set aside $250,000 to divvy up as incentives for vaccinated individuals.

Texas Vaccine
Nurse Roy Christian receives the Covid-19 vaccine at John Sealy Hospital at the University of Texas Medical Branch (UTMB Health) in Galveston, Texas on December 15, 2020.

The money will go toward events, gift cards, and other incentives that will be offered to all residents who’ve been vaccinated, according to the Houston Chronicle

It’s a way to encourage Harris County residents to get vaccinated against the coronavirus in a step toward achieving herd immunity.

“We desperately need these people to get vaccinated, particularly the young people,” County Judge Lina Hidalgo said. “I asked you to be as creative as we possibly can because I don’t want to sit here a month from now and see the numbers worsen, or see this pandemic extended, and say, ‘If we had just done X, would we have avoided this situation?'”

Long Beach, California, officials are offering two free tickets to the Aquarium of the Pacifid to anyone who gets their first vaccines.

Visitors watch as scuba divers feed fish at the Aquarium of the Pacific on its first day of reopening to public in Long Beach, Calif., Tuesday, March 16, 2021.

Long Beach residents who get inoculated through Saturday will receive two tickets to the Aquarium of the Pacific.

Tickets to the popular destination usually cost $36.95.

“While we have made tremendous strides in vaccinating 60% of eligible Long Beach residents and 96% of our seniors, we know that vaccine hesitancy for some is real,” Mayor Robert Garcia told local media. “We are going to do everything we can to encourage folks to get vaccinated, and that includes incentives.”


Chicago is experimenting with a Vax Pass that will offer vaccinated individuals a chance to attend concerts and events.

Chicago's Mayor Lori Lightfoot arrives at a University of Chicago initiative event for the science in Chicago, Illinois, on July 23, 2020.
Chicago’s Mayor Lori Lightfoot arrives at a University of Chicago initiative event for the science in Chicago, Illinois, on July 23, 2020.

Chicago Mayor Lori Lightfoot said the initiative comes as the city is “looking at ways in which we can incentivize folks to get the vaccine.”

“We’re going to be looking at ways in which we can incentivize people to get vaccinated, and do that by looking at preferred seating, preferred admission. So that’s still very much a work in progress, and we’ll have more to say on that in the coming days,” she added.

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One chart shows how dramatically the pace of vaccinations differs from country to country

india vaccine line
People wait in line to receive COVID-19 vaccines in Mumbai, India, April 24, 2021.

  • The global vaccine rollout is very uneven – some nations may reach herd immunity years before others.
  • Israel, the US, and UK are vaccinating people fastest, while Brazil, India, and Japan trail behind.
  • One chart shows when 18 different countries will reach three key vaccination milestones.
  • See more stories on Insider’s business page.

By next week, around half the US population will have received at least one coronavirus shot – a milestone that could take other countries years to reach at their current pace.

The pace of vaccinations across the globe remains highly uneven: As of Monday, wealthy countries had received 83% of the world’s vaccine supply, despite making up just 53% of the world’s population, according to World Health Organization director-general Tedros Adhanom Ghebreyesus.

Israel, the US, and the UK have the world’s fastest vaccine rollouts so far. Israel vaccinated half its population in just two months, from December to February, while the UK reached that milestone two weeks ago. In roughly a month, around 75% of the UK could be vaccinated.

Meanwhile, plenty of other countries, including Egypt and South Africa, and aren’t expected to cross that threshold for about a decade at their current pace.

The chart below shows how long it will take 18 countries to reach these key milestones, based on their current vaccine rollout speed.

Epidemiologists have estimated that countries will need to vaccinate around 75% of their populations to reach herd immunity – the threshold beyond which the coronavirus can no longer spread easily from person to person.

For many nations, that’s a far-off goal. At the current rate of 110,000 vaccinations per day, it could take Japan eight months to immunize just a quarter of its population, and more than two years to immunize 75%. South Korea faces a similar predicament: The country’s 75% vaccination threshold is more than a year away.

That means it’s likely to take years to reach herd immunity on a global scale.

Limited vaccine supply has hampered many countries’ rollouts

Japan vaccine vaccination COVID-19
A medical worker receives a COVID-19 vaccine in Tokyo, Japan on March 5, 2021.

One of the biggest challenges to reaching global herd immunity is a lack of vaccine supply.

Early in the pandemic, wealthy countries like the US and UK struck deals with pharmaceutical companies – before it was even known whether their vaccines were safe or effective – to buy enough doses for their residents.

Lower-income countries couldn’t afford to make that gamble, so many are still vying for shots or waiting on supply from nations that manufacture doses domestically, like China and Russia.

But even some high- or middle-income nations have had slow vaccine rollouts.

Brazil, for instance, rejected an offer to purchase 70 million doses of Pfizer’s vaccine in August, instead betting on AstraZeneca’s shot (which is significantly cheaper) to drive its vaccination efforts. But Brazil is now running low on vaccine supply, so it’s relying on backup doses of China’s Sinovac shot.

Language from Brazilian President Jair Bolsonaro has also fueled vaccine skepticism. Bolsonaro previously joked that the Pfizer shot could “turn you into an alligator.” On Monday, however, Bolsonaro announced that the government would put an extra 5.5 billion reais ($1.05 billion) toward delivering more vaccines to the public.

Boxes containing the Pfizer-BioNTech COVID-19 vaccine are prepared to be shipped at the Pfizer Global Supply Kalamazoo manufacturing plant in Portage, Mich., Sunday, Dec. 13, 2020.
Boxes containing the Pfizer-BioNTech COVID-19 vaccine are prepared to be shipped at a Pfizer plant in Portage, Michigan on December 13, 2020.

In Japan and South Korea, some public-health experts have attributed slow rollouts to consistently low caseloads: Japan’s daily coronavirus cases have never exceeded 8,000, and South Korea’s daily cases have stayed below 1,000 for most of the pandemic. That created less urgency to procure doses quickly.

But there have been other holdups, too: Only doctors and nurses are allowed to administer shots in Japan, and the nation didn’t authorize its first coronavirus vaccine until February, months after the US and UK.

India has also lagged behind in delivering vaccines to the public. Its vaccination effort took a hit when cases began to skyrocket in February, amid the spread of new variants. Healthcare workers had to shift their focus away from administering shots to care for hospitalized patients.

Now, WHO officials are calling on wealthy nations to help other countries pick up the pace.

“COVID-19 has shown that our fates are inextricably linked,” Tedros said in February. “Whether we win or lose, we will do so together.”

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Los Angeles County could reach herd immunity by end of July, health officials say

covid vaccine
A medical assistant administers a COVID-19 vaccine dose to a woman at a clinic in Los Angeles on March 25, 2021.

  • Los Angeles County could reach herd immunity by mid to late July, public health officials said.
  • At the current rate of vaccination, roughly 80% of adult and adolescent county residents could have at least one dose of a COVID-19 vaccine.
  • Though there isn’t a specific percentage of the county population needed to reach herd immunity, officials have estimated it to be about 80%.
  • See more stories on Insider’s business page.

Public health officials predicted Monday that Los Angeles county could reach COVID-19 herd immunity by mid-to-late July.

Barbara Ferrer, the public health director of Los Angeles County, made the prediction during a press briefing on Monday, saying the county could hit herd immunity when roughly 80% of LA County residents ages 16 and older will have at least one shot.

At least 400,000 doses are being administered each week in LA County. At least 2 million more first doses must be administered before 80% of adults and adolescents in LA County will have at least one shot.

“At the rate we’re going, we expect that we can reach this level somewhere in mid to late July, and that assumes that we continue to have at least 400,000 people vaccinated each week that will include both first doses that people need, as well as their second doses,” Ferrer said during the briefing.

In a press release on Monday, county health officials also noted they do not have the exact vaccinated percentage of the county’s population needed to achieve community immunity, but estimate it would be around 80%.

Late last year, top US infections disease expert Dr. Anthony Fauci previously estimated that the US would need to inoculate between 75% to 85% of Americans to reach herd immunity, but in a White House briefing in late April, he shifted attention away from the figures of herd immunity to just getting people vaccinated.

“Rather than concentrating on an elusive number, let’s get as many people vaccinated as quickly as we possibly can,” Fauci said.

The announcement that LA County could reach herd immunity by the end of July comes after the Food and Drug Administration authorized the use of the Pfizer COVID-19 vaccine in adolescents ages 12-15. An advisory committee will review clinical trial data of the vaccine in teenagers before affirming the FDA recommendation, which could come as early as later this week.

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Millions of people are missing their second COVID-19 doses, and that has experts worried about herd immunity

Vaccine distribution
  • The CDC said millions of people who got one dose of the COVID-19 vaccine are missing their second.
  • Some fear possible adverse reactions and others are simply unable to get the second dose.
  • Experts worry it will only be more difficult to achieve herd immunity if that 8% increases.
  • See more stories on Insider’s business page.

Over the weekend, data from the Centers for Disease Control and Prevention revealed millions of Americans who’ve had their first vaccine dose against the coronavirus are not receiving their second.

Some are choosing to forgo their second dose, either because they believe they’re sufficiently safe after receiving the first or because they fear possible adverse reactions from the second. Others, meanwhile, are unable to receive their second dose because of circumstances out of their control like limited vaccine supply.

In total, about 8% of people who received their first dose have so far missed their second, the CDC said.

Octavio Venegas told Insider his 89-year-old mother, Gladys, missed her second vaccine appointment because she was hospitalized after having a stroke and needing to treat an ulcer.

Venegas said his mother, an advanced Alzheimer’s patient, received her first Pfizer shot on March 1. She was scheduled to get her second one on March 22. A week after receiving her first dose, she ended up in the hospital with “a duodenal ulcer and she had to have two transfusions,” Venegas said.

Venegas said doctors did not specify whether his mother’s hospitalization was related to her vaccination dose. But her doctors were aware that she had received her first shot and had not suggested to Venegas that the Pfizer vaccine could have led to her hospitalization, he said. She had also been experiencing constipation issues for a while before her stay in the hospital, which suggests to Venegas it wasn’t the vaccine that caused the issues.

Venegas said he experienced difficulty scheduling a second-dose appointment.

His mother stayed in the hospital for three weeks from March 8 to March 26, missing her second vaccine appointment. After she was discharged, she went home to receive hospice care, where she remains “completely bedridden” and uses a urine catheter, Venegas said. Nurses from the hospice provider bathe and care for her.

In the last few weeks, Venegas said he has been trying to get his mother the second dose. He called the pharmacy where she received her first shot to ask about rescheduling her second. He said he also called various vaccination sites and clinics in Florida, where they live.

He asked pharmacies and clinics about the possibility of administering an at-home second dose, since his mother cannot leave her bed and can no longer use a wheelchair to get around.

All the sites he contacted either told him they cannot administer vaccines outside their own facilities or said they cannot schedule individual doses, Venegas said. Providers, therefore, must schedule two doses for individuals receiving an appointment, he said he was told.

The Florida Department of Health did not respond to Insider’s request for comment asking about the process to reschedule second-dose vaccine appointments.

Venegas said he has been stressed about the process, worrying about his elderly mother potentially contracting the virus.

“Most likely I will have to let it go, and just in my mind rely on the fact that only one of the two vaccines provide some level of protection,” he said, which is “better than nothing.”

“[The] hospice sends nurses and also people to bathe my mom in bed, and I wonder if some of these frequent and daily visitors might have had contact with people with COVID,” Venegas added.

Since vaccines began rolling out in December, health officials have recommended people get two doses of either the Pfizer and Moderna vaccine to most efficiently protect against the coronavirus.

Pfizer’s doses are 21 days apart, while Moderna’s are 28. Those timelines, however, are just guidelines. The CDC says people can get the two doses up to six weeks, or 42 days, apart.

“Up to 42 days, there should be no change in efficacy,” said Dr. Elena Cyrus, an infectious disease epidemiologist working at the University of Central Florida.

Moderna vaccine
A nurse prepares a coronavirus vaccine shot developed by the National Institutes of Health and Moderna Inc., July 2020.

Others are opting out of the second dose on purpose

Jo Henrion, 72, says she had a cardiac arrest shortly after receiving the first dose and isn’t sure whether it was brought on by the Moderna vaccine.

She received her first Moderna dose on March 18. Six days later, she had a cardiac arrest and ended up in the hospital for 12 days, she said. Since then doctors and specialists have been running tests and collecting blood from her.

Her second-dose appointment was April 15, but she skipped it fearing it spurred her cardiac arrest.

“I wouldn’t risk another cardiac arrest for hardly anything,” Henrion told Insider. She said she’d “have to really be convinced that it wasn’t the shot” that caused it.

Doctors have not told her the cardiac arrest was caused by the vaccine, but Henrion says they also haven’t ruled it out yet. Specialists, however, have recommended she avoid getting the second dose until they find out what caused the cardiac arrest, Henrion said.

A home nurse tending to Henrion told her to contact Moderna to report the “adverse reaction” and ask about the cardiac arrest. Henrion then got on the phone with a Moderna representative, who promised to “report it to her higher-ups and that they then will report it to the CDC,” she said.

Henrion doesn’t believe her cardiac arrest was brought on by any pre-existing health conditions.

“I’m a very active 72-year-old,” she told Insider. “So for me to be down is difficult. I don’t do well laying in the bed and being not productive.”

“I’ve been a realtor for 33 years,” she added. “I get a lot of exercise in my work and I’ve been renovating a house for the last 12 months and a garden.”

Moderna did not respond to Insider’s request for comment.

By choice or circumstance, epidemiology experts say vaccine hesitancy reduces the chance of reaching herd immunity

Cyrus of the University of Central Florida stressed the importance of receiving both doses of either vaccine to reach the highest immunity level possible.

“Any individual that is not fully vaccinated or those who have not received both doses for the two-dose regimen potentially do not have the full protection the vaccine offers, increasing their risk of transmission and potentially also contributing to community spread,” Cyrus told Insider.

One study found the first dose is quite effective on its own. Both the Pfizer and Moderna vaccines are likely to be 80% effective after just one dose.

The first dose of either vaccine “trains the immune system” to recognize the virus. The second dose “boosts antibody levels to afford even better protection,” Dr. Francis Collins, director of the National Institutes of Health, wrote in February.

But despite the relatively high efficacy rate of just a single COVID vaccine, herd immunity is still potentially threatened by the 8% of individuals who have so far not received a second dose.

“If the 8% increases over time, the chances of achieving herd immunity reduces and makes the population more vulnerable to existing strains of the virus and other emerging variants or mutations,” Cyrus said.

Achieving herd immunity is becoming more and more important as the US moves toward reopening, operating in pre-pandemic ways, and relaxing mask and social distancing guidelines.

Others believe 8% is a relatively small number of people. Ashish Jha, a physician at the Brown University School of Public Health, stressed in a Tuesday teleconference that 92% of vaccinated people have received both doses.

Jha said it’s fine if people miss their second doses because they can reschedule them.

“People miss appointments because life happens,” he said. “And the messaging that needs to go out right now to people is: ‘Don’t worry about it. Go get your second shot.'”

“People should keep their second appointment, but if you miss it, you can go back and get your second shot at any point,” Jha added. “Everybody absolutely needs to get their second shot.”

Individuals might miss their second dose appointment for varying reasons.

The appointment time, for example, might not work for them three or four weeks after the initial dose. A lot of people don’t even know what their schedule is going to be like four weeks from today.

“I don’t think it’s people hesitating or not wanting to get it. It’s hard to get this stuff, two shots in a row,” Jha said. “And so we’ve got to be patient, and we’ve got to give people more opportunities to come back and complete their second shot.”

Both Jha and Cyrus suggested the people likeliest to miss their second dose vaccines are vulnerable or marginalized groups. Individuals from these groups might have less control over their schedules and live in areas with more access barriers and socio-cultural issues.

That’s why there should be more opportunities for individuals to reschedule their missed doses, experts say. As the US gets closer to achieving herd immunity, there will be less demand for vaccines, Cyrus said.

“There will be less emergency sites and vaccine administration will move from federal sites to more primary care and access to care in the US is not equitable for all communities,” she added.

Structural sociocultural issues like racism and poverty mean navigating health systems can be difficult for people of color and other marginalized groups.

“This will require more synergy between clinicians, researchers, public health practitioners, and government entities,” Cyrus said.

Insider’s Hilary Brueck contributed to this report.

Have a news tip? Reach this reporter at ydzhanova@insider.com

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The US and UK lead the world’s coronavirus vaccinations – but they may struggle to reach herd immunity if they reopen too soon

london drinks
People in England flock back to pubs and restaurants as lockdown restrictions were eased on April 12, 2021.

  • The US and UK are relaxing restrictions as their vaccinations continue to ramp up.
  • But scientists worry the countries are developing a false sense of security.
  • More contagious variants and vaccine skepticism could still pose a barrier to herd immunity.
  • See more stories on Insider’s business page.

Countries that have vaccinated more than a third of their populations are now taking huge leaps toward normal life.

The UK plans to remove all social distancing restrictions by June 21 now that nearly half its population has received shots. On April 30, the nation will experiment with its first nightclub opening in more than a year: A Liverpool warehouse is set to host 3,000 club-goers who test negative for the virus.

US vaccinations trail closely behind – around 40% of the country has received at least one vaccine dose so far. For the most part, businesses are already open in all 50 states, and 13 states have recently lifted their mask mandates.

To some extent, rolling back restrictions is a natural test of whether vaccines prevent coronavirus infections, hospitalizations, and deaths outside clinical trials. But scientists worry that countries with large vaccine rollouts could be lulled into a false sense of security.

“The worst is probably behind us, but I don’t want to suggest that let’s now sit back, relax, and enjoy life, and it’s all going to be fine,” David Dowdy, an epidemiologist at Johns Hopkins Bloomberg School of Public Health, told Insider. “We do still need to maintain some level of vigilance because if the virus has taught us one thing, it’s that it’s difficult to predict the future.”

Two factors, in particular, could hinder progress in the US and UK: the emergence of more contagious variants and vaccine skepticism.

The University of Washington’s Institute for Health Metrics and Evaluation predicts that the US could see an additional 60,000 deaths by August 1 – assuming variants continue to spread and vaccinated people start to behave normally, forgoing masks and social distancing. Under this “worst-case scenario,” daily coronavirus cases could also plateau over the next four months.

A March 30 model from Imperial College London similarly estimates that the UK could see an additional 15,700 deaths by June if the country proceeds with its reopening plan.

The US and UK probably haven’t reached herd immunity yet

vaccine healthcare workers us
A dentist receives the Moderna COVID-19 vaccine in Anaheim on January 8, 2020.

It’s not clear exactly what share of a nation’s population needs to be vaccinated to achieve herd immunity – the threshold beyond which the virus can’t pass easily from person to person – but experts generally estimate that it’s at least 70%.

Only one large country, Israel, is probably near that goal. Around 62% of Israel’s population has been vaccinated so far.

“It would be reasonable to say Israel right now has a very high level of population protection, probably not far from herd immunity,” Eyal Leshem, director at Sheba Medical Center, Israel’s largest hospital, told Insider.

Already, Israel’s cases have fallen 94% since it started vaccinating people in December – even as the country lifted lockdown restrictions. As of last Sunday, people in Israel don’t need to wear masks outdoors anymore and all primary school students can return to in-person learning.

“Despite mass gatherings, parties, meetings, there’s no increasing cases,” Leshem said.

But scientists warn that the US and UK likely haven’t crossed the herd immunity threshold yet.

While daily coronavirus cases are falling in the UK and have remained relatively flat in the US, experts worry that rolling back restrictions could reverse some of these gains.

“Part of the reason that we’re not seeing a spike is still that people are not just going back to the way things were before,” Dowdy said. “And if we remove that effect, we will start to see cases go back up right now.”

In the US, average daily cases are still comparable to those recorded last summer.

“We’re having between 60,000 and 70,000 new infections per day and it would really, I think, not be prudent at all to declare victory prematurely and pull back,” Dr. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, told CBS’ “Face the Nation” on Sunday.

New variants may pose a continued threat

variant lab
Researchers sequence coronavirus samples at the microbiology laboratory of the University Hospital of Badajoz in Spain on April 15, 2021.

Many scientists caution against lifting mask or social distancing guidelines before nations understand the full threat of coronavirus variants.

In Chile, for instance, 40% of the population has been vaccinated, but average daily coronavirus cases there have more than doubled in the last two months. Scientists attribute this surge, in part, to the spread of P.1 – a variant first discovered in Brazil that seems to partially evade immunity from vaccines or previous infectious.

Studies show that vaccines from Pfizer, Moderna, and Johnson & Johnson protect people from B.1.1.7 – now the dominant strain in the US – but are less effective against P.1 and B.1.351 (a variant first identified in South Africa). AstraZeneca’s vaccine – which has been authorized in more than 130 countries, including the UK – seems to protect people from B.1.1.7 and P.1, but is less effective against B.1.351.

Scientists have also spotted variants in California that appear to be more transmissible than the virus’ original strain and could potentially resist antibodies from vaccines, according to a new study.

More contagious variants could make herd immunity a moving target, Rahul Subramanian, a data scientist at the University of Chicago, told Insider.

“Let’s say we reach herd immunity next year – it may need to be a constant battle,” he said. “You have to keep maintaining herd immunity in the population by continuously getting people vaccinated.”

Vaccine skepticism could allow coronavirus infections to lurk

anti-vaxx protest
A protest against masks, vaccines, and vaccine passports outside the CDC headquarters in Atlanta, Georgia on March 13, 2021.

The US is currently vaccinating around 3 million people per day, on average. Fauci has said the nation will need to keep up that pace to prevent another surge.

But maintaining the current rate of vaccinations is going to be a challenge, Dowdy added.

“The people who haven’t been vaccinated by now generally are, in many cases, people who don’t want to be vaccinated or have some concerns about being vaccinated,” he said.

A recent poll from Monmouth University found that 1 in 5 Americans still aren’t willing to get a coronavirus vaccine. That’s compared to three-quarters of people in the UK who say they’re “very likely” to get vaccinated, according to a February Oxford University survey.

If unvaccinated people don’t social distance or wear masks, the nations could ultimately struggle to prevent future outbreaks.

“You can vaccinate 50% of the population, but if it’s the wrong 50% – the 50% who are at the lowest risk of getting COVID to start with – then it doesn’t mean that you magically then cross a threshold,” Dowdy said. “The key is to get those numbers high enough so that even in the populations that are at highest risk of getting infection, you’re having enough vaccination to make a difference.”

For now, at least half the people in the US and UK still haven’t had their shots. And it could be several months, at the earliest, before coronavirus vaccines are authorized for children – which make up roughly 20% of the populations in the UK and US.

Until then, scientists said, it’s important to maintain mask and social distancing guidelines.

“Getting people vaccinated is a gradual process,” Dowdy said, “so we need to also make reopening a gradual process, too.”

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