Ocean County, a coastal region in central New Jersey, is home to some of the state’s most exclusive waterfront communities and its fastest growing city, Lakewood.
A Republican stronghold in a Democratic-controlled state, the county is largely suburban, encompassing more land than all but one of the other counties in New Jersey.
Now, as the United States begins to chart a course through a third year of the pandemic, Ocean County also illustrates a stubborn public health challenge: Much of its residents have not been vaccinated against the coronavirus, and its Covid-19 death rate is the highest in the state.
The county has recorded 459 virus-related deaths per 100,000 residents, according to state data. That exceeds mortality levels in every other county in New Jersey, a wealthy, well-educated and densely populated state that is still struggling to limit its virus death rate. New Jersey has the sixth highest Covid death rate in the United States, behind Mississippi, Arizona, Alabama, Tennessee and West Virginia.
Explanations for the high number of deaths in Ocean County vary and include the high percentage of residents over the age of 85 and low vaccination rates among those 65 and under, a factor that some studies have found is most closely tied to partisan politics.
The county also has a large and growing Orthodox Jewish population, which was hit hard in the first wave of the pandemic and whose vaccination rates are well below state averages, reflecting similar trends in Orthodox Jewish neighborhoods. from New York.
In the 2020 presidential race, when New Jersey backed President Biden by an overwhelming majority, voters in Ocean County backed former President Donald J. Trump by nearly 29 percentage points — the highest from all Republican strongholds in the state.
“At this point in the game, whoever made the decision to get it got it,” John G. Ducey, longtime Democratic mayor of The Brick, a township in Ocean County with a population of 74,000, told About the vaccine.
“A lot of people who are not in favor of vaccination do so out of political judgment,” he said, adding, “They don’t want an invasion of their body.”
Covid-19 vaccines have been proven to significantly reduce the risk of serious illness or death, especially for people who also receive booster shots.
But of Ocean County residents eligible for a Covid-19 vaccine, only 58.4% received at least two injections of Moderna or Pfizer-BioNTech vaccines or one injection from Johnson & Johnson, according to the Centers for Disease Control and Prevention. That’s well below the statewide vaccination rate of 79.8% and the national rate of 69.8%.
Lakewood, home to a thriving Orthodox Jewish community and the largest township in the county, has the lowest vaccination rates in the region. Only 40% of Lakewood residents over the age of 5 are fully immunized; of those, 38% of residents eligible for a booster shot received one, according to the state Department of Health.
In New York, Borough Park, a hub of Orthodox Jewish life in Brooklyn, has the lowest vaccination rate in the city. But it considerably exceeds that of Lakewood: approximately 53% of residents aged 5 and over in the Brooklyn district are vaccinated.
Most of Ocean County’s 2,925 confirmed and probable virus deaths occurred in the first year of the pandemic, before vaccines or therapies to treat the disease became widely available. The average number of daily deaths, which peaked at 18 in May 2020, has now dropped to around one per day.
Yet deaths have continued to rise steadily: Since last spring, the number of people dying each quarter in Ocean County has exceeded the number of deaths in the previous three months.
In Brick, where about 64% of residents eligible for Covid vaccines are vaccinated, about 28% of the 357 virus-related deaths occurred after vaccines became widely available, according to county data.
Still, Mr Ducey said he opposes vaccination mandates.
“There are people who don’t want the vaccine and I think it should be left to them, ”said Mr. Ducey, who is vaccinated and received a booster. “That’s the great thing about our country: we have freedom of choice.”
But as the worst days of the pandemic fade and politicians chart a course towards normalcy, persuading more people to get vaccinated has become a priority for infectious disease specialists like Dr Meg Fisher, a pediatric immunologist working as a consultant in New Jersey. health commissioner.
For them, increasing vaccination rates is seen as vital to protecting the wider community from new variants, such as the highly transmissible Omicron BA.2 subvariant, which is now the dominant version of the coronavirus in the United States. And in the world.
“Overcoming people’s complacency – that’s becoming very important right now,” Dr Fisher said.
“We need young people to be vaccinated,” she added.
A nationwide study by the Pew Research Center found that 73% of people who identified as Democrats and were eligible for a booster injection had one, compared to 55% of those surveyed who said they were Republicans.
Young Republicans were particularly reluctant to get vaccinated, the study showed, with just 52% of people aged 18 to 29 saying they had been vaccinated, compared with 88% of Democrats in the same age group.
“The biggest gap we’ve seen that has been consistent has been partisanship,” said Alec Tyson, associate director of research at the Pew Research Center.
“It doesn’t shrink,” he added. “If anything, it gets even wider.”
Ocean County, which runs along the Jersey Shore and is a retirement destination, has the fourth highest percentage of residents over the age of 85 in the United States, behind three similarly sized counties in Florida, according to census data. At one county hospital, Community Medical Center, 73% of patients are eligible for Medicare, the federally funded health care available to people 65 and older and some younger people with disabilities.
“When you put that into perspective, it’s not really a surprise that the death rate is high,” said Patrick Ahearn, chief executive of nearby Toms River Medical Center.
Daniel Regenye, Ocean County health director, said his office has created a large network of vaccination sites; none of the county’s 649,000 residents live more than two miles from a location offering Covid vaccines, he said.
The county’s low vaccination rates do not apply to all age groups. Of those over 65, considered the most vulnerable to serious illnesses, 88% are vaccinated, just six percentage points lower than the statewide rate.
Dimitri Svarnas and his wife, Janis, are registered Republicans who are ardent supporters of Mr. Trump.
The couple got vaccinated to go on cruises and travel out of the country, but they were still deciding on booster shots.
“You can’t control my body,” said Mr Svarnas, 76, of The Brick, outside the ShopRite where he was first vaccinated last year. “Nobody controls my body.”
To appeal to younger guests, Ocean County has hosted pop-up clinics that offer incentives such as free admission to Six Flags Great Adventure, an amusement park in Jackson, and season-long access to the popular park.
In Lakewood, where nearly half of residents are under 18, shots were offered at Sunday events that included bouncy houses for children, free food and mini-golf.
“There’s a general perception – and it’s fueled by a lot of people – that natural infection is better,” Regenye said.
“My concern is a resurgence of vaccine-preventable diseases,” he added.
Dr. Dovid Friedman is the CEO of CHEMED, the Center for Health Education Medicine and Dentistry in Lakewood, a community health care provider that receives federal funding to provide primary care services to residents. He said the government’s original message did not give enough credence to the beliefs of many Jewish residents that being infected with the virus was almost tantamount to vaccination.
There is also widespread misunderstanding, he said, about the primary role of the Covid vaccine.
“People get confused with ‘Why is there still disease?'” he said. “But the vaccine was not designed to stop the disease. It was designed to prevent hospitalizations and deaths.
In an attempt to boost vaccination rates among the county’s large number of Orthodox Jews, the state launched a targeted advertising campaign in early February that was immediately derided as culturally inappropriate. Digital billboards depicted a smiling Jewish man, but the hat, hairstyle and necklace he wore did not accurately reflect the religious customs of Lakewood residents.
The state quickly pulled the ads and changed ad agencies.
New print ads emphasize the importance of getting vaccinated as a way to “boost” the body’s natural defenses, said Elie Rosenfeld, managing director of Joseph Jacobs Advertising, the newly hired company. The ads also emphasize the vaccine’s ability to limit disruption to the “normal rhythm” of life, including school and family activities, as well as each resident’s obligation to keep the wider community safe, a he declared.
David Djmal, manager of an e-commerce site in Lakewood, is one of the people the revised ad campaign is trying to reach.
He said he had Covid during the first wave of the pandemic in March 2020 and was not re-infected, although he is not vaccinated and had close contact with people who tested positive for the virus.
It “just further proved to myself the strength of my immunity,” said Mr Djmal, 29. He said he would likely get vaccinated if his job was in jeopardy.
“It depends,” he said, “on how inconvenient they have returned my life.”
Robert Gebeloff contributed reporting.