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The US is entering 2022 with the highest recorded Covid-19 death toll of any country in the world, and though it is flush with vaccines, it is facing down entrenched vaccine hesitancy as well as a winter surge partially influenced by the new Omicron variant.
More than 400,000 people in the US died of Covid-19 in 2021, pushing the death toll past 800,000 in December. The country also leads the world in confirmed infections, with more than 50 million cases reported.
“As we mark the tragic milestone of 800,000 American deaths due to Covid-19, we remember each person and the lives they lived, and we pray for the loved ones left behind,” President Joe Biden said in a statement.
“To heal, we must remember,” Mr Biden said. “We must also act.”
And the country has acted: after Mr Biden was inaugurated as president in January, a mass vaccination programme began nationwide, with the eventual availability of three approved vaccines and a dedicated vaccination clinic set up within eight kilometres of 90 per cent of the US population.
Later in the year, Covid-19 vaccines were approved for teenagers and then for children aged 5 to 11 before booster doses were greenlighted for all who have been fully vaccinated.
More than 72.4 per cent of the US population has received at least one dose of vaccine, the Centres of Disease Control and Prevention (CDC) reported, and 61.2 per cent has been fully vaccinated.
One of the successes of the roll-out has been that about 95 per cent of people over the age of 65 have received at least one dose of vaccine. This was a major milestone, given that at least one in 100 older people have died from the virus, a report from The New York Times showed.
As the vaccination programme progressed, there was an exciting “reopening” of sorts in which people felt more comfortable travelling, cities imposed vaccine and testing rules for indoor spaces, and Broadway started up shows again after a historic 18-month shutdown.
Despite these glimmers of hope, the US has had to contend with one of the most vaccine-hesitant populations in the world. The US ranks behind Russia in hesitancy levels among 15 high-income countries, ongoing surveys by Morning Consult show.
Misinformation about vaccines and Covid-19 has spread widely over the course of the year, leading to unnecessary deaths and cementing the stance of some hardliners against vaccination.
“They’re killing people,” Mr Biden said about anti-vaccination posts on Facebook. “The only pandemic we have is among the unvaccinated. And they’re killing people.”
Most adults have been eligible for vaccination since March but 15 per cent of the population over the age of 18 has yet to be vaccinated.
In addition to low vaccination rates, partisan politics have led to violent protests against coronavirus mitigation measures like mask mandates in schools as well as higher death rates in Republican-majority states.
Counties that largely voted for former president Donald Trump in the 2020 presidential elections reported up to three times as many deaths as those counties that mostly voted for Mr Biden during the autumn wave driven by the Delta variant, data analysis by The Washington Post shows.
In a boost to the vaccination drive, Mr Biden enacted an immunisation requirement for millions of federal employees and contractors as well as private businesses. Several of the mandates, however, are facing legal challenges.
All of these challenges will follow the US into 2022 and may be exacerbated by the rise of the Omicron variant, given overall burnout and some hesitancy amid the need for renewed coronavirus mitigation measures and booster doses.
Despite setbacks at home, the US has dedicated itself to becoming the world's “vaccine arsenal”, pledging the largest global vaccine donation that aims to deliver more than a billion Covid-19 shots to countries in need — though the actual shipping of these vaccines has been moving at a glacial pace.
“We’ve sent 320 million doses now to 110 countries, and that’s more than every other country in the world combined,” Covid Response Team Co-ordinator Jeff Zeints said in a December briefing.
“And as you know, that’s part of an overall commitment of a minimum of 1.2 billion doses donated with no strings attached. And we plan on building on that total across time.”