Part of being human is the desire to organize our knowledge to understand it better, and Americans seem quite adept at this. Marketers have long since categorized us by our shared beliefs, and now a researcher has applied this technique to Americans who have not been vaccinated. We have known since COVID-19 vaccines became available that certain groups of people are getting vaccinated at lower rates than their fellow Americans, among them Republicans, people of color and rural residents. Harvard public health assistant professor Dr. Sema K. Sgaier is grouping us not by our demographic characteristics but by our shared beliefs.

Before we look at the holdouts against herd immunity, there is clearly a vast category that the Times dubs Enthusiasts, of which I am a happy member. These are folks thrilled to be vaccinated. I was so relieved to stick my arm out the driver’s side window for my jab at a vaccination site that my neighbor whose arm was out the passenger window feared my giddiness would make me hyperventilate. Most Americans fall into this category now that 60% of us have had at least
one shot.

So, who is holding out against herd immunity in our nation? Writing in The New York Times, Sgaier posits four different categories for those who remain doggedly unvaccinated.

Eight percent of them she calls Watchful. These are folks who are waiting to see what happens next. Did my cousin have side effects? What about the fellow around the corner? They are likely mask wearers and may eventually get vaccinated to protect themselves and others. They make up 8% of the unvaccinated nationally.

Then we have the Cost Anxious. The federal government has made vaccinations free for virtually all of us, but these folks are concerned about the time involved to leave work or home. Making vaccinations convenient is most important to those group, which makes up about 9% of the unvaccinated.

As always, in a free society, we have System Distrusters. They believe the system, and in this instance the health care system, treats them unfairly. They may believe the system targets people “like them” or that vaccines will secretly change their DNA. They might respond to a trusted friend or adviser to set them straight, but in the meantime, they make up about 4% of the no-vaccine-for-me crowd.

And, finally, Sgaier labels the COVID Skeptics. These folks believe COVID-19 is no big deal, perhaps even a pandemic engineered to manipulate people around the world, particularly Americans. They cite their aunt, cousin, next-door-neighbor who had COVID and is “just fine.” They make up about 14% of the unvaccinated, and will likely not take the jab, as one Skeptic told me, until “I am damn well ready.”

So how does North Carolina’s unvaccinated break down in Sgaier’s system?

Most of our unvaccinated folks are indeed stubborn Skeptics, doing their own thing no matter how it puts others at risk. Then comes our Cost Anxious crowd, who do not want to miss work or something else important for a shot. The Anxious are followed by the Watchful, many of whom will ultimately get vaccinated once they feel confident about their friends and family who have done so. And, finally the System Distrusters come in at 2.5%.

Sgaier’s research, especially when reviewed state by state, reveals a patchwork of reasons why the national vaccination rates are slowing down despite no-cost availability. Some states are all in, and some barely so. The CDC puts North Carolina at 38th in the nation for adults having at least one dose.

Americans do have the right to choose for ourselves, but vaccine hesitancy is a real thing that is affecting all of us. No one should be forced to get vaccinated, but we should all think not only of ourselves but of the greater good. The Bible puts it this way — Love thy neighbor as thyself.