he first shot of the second wave of COVID-19 vaccinations in South Carolina came Monday at a nursing home in Greenville.

Now the question becomes: How do we get enough Americans to take the shots so the nation soon reaches “herd immunity”? There is no single answer.

Recent polls on the willingness of people to be vaccinated point in different directions. The New York Times reports that repeated surveys by Gallup, the Kaiser Family Foundation and Pew have found a general increase in willingness to be vaccinated for the disease, from around 50 percent of Americans last summer to over 60 percent in December.

But a survey by the National Association of Health Care Assistants has shown that a surprising and worrisome 72 percent of certified nursing assistants say they do not want to be vaccinated because of safety concerns over the rapidly developed vaccines and their possible side effects. That points to a potential major weakness in the campaign to inoculate residents and staff of nursing homes, which have been particularly hard hit by the virus. For the campaign to be successful, nursing assistants and other front-line health care workers must be thoroughly educated and reassured about the risks and benefits of being inoculated.

Herd immunity occurs when enough of a population is immune to a virus that its outbreak is limited and controllable.

Unfortunately, no one knows yet how much that is in the case of COVID-19.

The Johns Hopkins School of Public Health says that, depending on the disease, herd immunity occurs when somewhere between 50 percent and 90 percent of a population is inoculated.

Dr, Anthony Fauci has acknowledged that he has been upping his estimate of this target, from around 70 percent to a more robust 85 percent or 90 percent.

To some Americans, this is evidence that Dr. Fauci is moving the goalposts and is not to be trusted.

We see it as an honest if perhaps shortsighted attempt to ease Americans into the reality while persuading them to take the vaccine as a civic duty.

The skepticism about Dr. Fauci’s advice illustrates an important point about the need for a carefully thought-out vaccination campaign.

This year has taught an indelible lesson about the difficulty of persuading Americans to follow official rules and guidelines without first clearly explaining the risks and trade-offs. In the case of COVID-19, the consequences have been huge. But they also have been different for different folks, leading to a wide range of behavior. Centers for Disease Control and Prevention data show healthy people under age 45 have a small risk of dying from the disease, but above that age, the risk rises steeply.

People age 75 and over are 200 times more likely to die from this coronavirus than the average person. For those over 85, the risk is 600 times greater.

While the risk for healthy people under 45 is small, the economic effects of measures to contain the disease have been very large, and have fallen disproportionately on lower-income workers and small business owners.

In some communities, many more people have been hurt by the economic effects than by the disease.

That gives weight to the argument that mass vaccination will allow people to return to their normal lives and jobs much sooner. But they still have to be convinced it is worth the risk of potential side effects.

A successful vaccination campaign needs to be more sensitive to individual points of view than the official efforts to stem the disease have been in many places. You can’t simply order people to take the shots. You have to convince them of the need. And the same approach will not work for everyone.

-- The (Charleston, South Carolina) Post and Courier

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