Realistically there are two moves left that *might* lift the vaccination numbers meaningfully and neither one involves going door to door. One is to have the FDA issue full regulatory approval for the vaccines, elevating them from their current emergency-use status. Anti-vaxxers have made hay of the fact that the vaccines are still “experimental” even though the experiment now involves more than 150 million subjects, vastly more than most vaccines enjoy before they’re granted full approval. Full approval would deny fearmongers that propaganda point and could reassure some fencesitters that the vaccines are truly safe:

5,946 reported deaths after taking the #COVID19 vaccine.

The vaccine is NOT FDA approved.

33,631,656 Americans SURVIVED covid.

But Biden & the Dems are coming to your front door to force you to take the vax, schools say your healthy kids need it, and you still think your free?

— Marjorie Taylor Greene 🇺🇸 (@mtgreenee) July 10, 2021

Two is having the private sector and schools start twisting the arms of holdouts by requiring vaccines as a condition of work or attending class. The wrinkle, as Fauci rightly notes in the clip below, is that you need to make one move before you can make the other. It’s hard for a business to tell its employees that they need to go out and get vaccinated when the vaccines haven’t been approved yet. Full approval would make mandates, starting with a mandate for U.S. troops, more defensible. Watch a few minutes here then read on.

In theory the two-step is simple. Full FDA approval + local mandates = huge surge in vaccination. In reality it’ll be more complicated. For one thing, it may not be the FDA that’s holding businesses back from requiring workers to get vaxxed. The labor market and popular sentiment is affecting their calculations too:

While some like Walmart, Dollar General, Aldi and Instacart are offering rewards if workers get the shot, few plan to require the vaccine, according to a May survey from Willis Towers Watson.

Blendon suspects businesses, especially small and medium-sized companies looking to hire people in a tight labor market, won’t have much choice given that more than half of employed Americans oppose a workplace mandate. The survey did not look at the effect incentives such as gift cards or stipends would have on employees’ choice, though Blendon speculated that it could help.

There was bipartisan support for vaccinating teachers and health care workers. The survey found that 70 percent of respondents — and 56 percent of Republicans — with school-aged children thought public schools should require teachers be vaccinated. Similarly, 66 percent of respondents — and 59 percent of Republicans — favored health care institutions requiring their employees get the shot.

GOPers make an exception for public-school teachers and health-care workers because, I assume, they know that each of those professions caters to at-risk populations. Many kids aren’t eligible to get vaccinated yet so forcing teachers to get immunized helps protect the little ones. And health-care workers routinely encounter patients whose immune systems are suppressed due to illness or medication and would be at higher risk of having severe COVID if they got infected. Outside of those fields, though, Republicans are opposed to employers requiring staffers to get vaxxed, 43/56. (Overall the public marginally supports the practice, 53/46.) At least one red state, Montana, has even passed an “anti-discrimination law” to protect the unvaccinated, barring employers from making a job conditional on whether you’ve had the shot or not.

That’ll be the next culture war after the FDA fully approves the vaccines, in all likelihood. First came masks and mask mandates, then came the vaccine, next is prohibiting employer mandates despite the usual conservative view that business owners should run their shops with minimal regulatory interference.

The idea that full FDA approval will flip some holdouts into the pro-vax column also comes with qualifications. Some anti-vaxxers will simply shift from crying that “the vaccines haven’t been approved” to “the vaccines were approved too quickly, due to political pressure.”

Ensuring the FDA’s decision appears politics-free is especially important when considering the biggest remaining group of unvaccinated Americans, Gounder said: Voters in red states who did not support Biden’s campaign and aren’t inclined to trust his administration.

“The people who we haven’t been able to reach with educational outreach or trusted messengers or incentives are largely white Republican voters,” Gounder said. “This is a group for which I think it’s really important that the FDA approval process does not appear to be contaminated by outside pressure or political interference, because this is so much about building trust.”…

“The average time from submission [for a vaccine] to approval is 12 months, and the shortest we’ve had in the past is 10 months,” said Reiss, the UC Hastings law professor. “This isn’t the same situation: First, we have a lot of data because we’ve given it to so many millions, and second, we’re in a pandemic. But I’m not sure we can call this a delay.”

According to Stat, the process for full approval typically takes six months even when accelerated. Pfizer submitted its application in May. If the FDA approves it in September, say, after four months, on grounds that we have such a massive amount of real-world data at this point that it’s silly to delay for the sake of delaying, the Marjorie Taylor Greenes out there will turn around and say, “They’ve never approved a vaccine this quickly before! It’s not safe!”

There’ll always be another trumped-up excuse not to get immunized. Which is why Fauci’s leaning on private-sector and school mandates.

I’ll leave you with this. Hospitalizations here and in the UK aren’t rising nearly as much as they did during previous surges thanks to widespread vaccination, but they are rising. The Delta wave isn’t a pure “casedemic.”

These states where hospitalizations are rising?

Not a single one hit the President's goal of 70% of adults with 1 shot.

Not one.

We need to help more people get vaccinated. https://t.co/bRrlFrt3KZ

— Ashish K. Jha, MD, MPH (@ashishkjha) July 11, 2021