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Ava Barker of Buena Park, CA, resurrected a long-standing family tradition this year: She hosted a Mother’s Day Eve party. “I started doing this years ago,” she says, but she skipped the last few years as schedules didn’t mesh. Then COVID-19 happened.

This year, the party was on, and Ava’s brother and sister-in-law, along with several other relatives, were set to be there to rekindle the tradition. They planned to kick off Mother’s Day weekend with an adult barbecue, then spend Mother’s Day itself with their children. Barker and her husband were expecting a dozen family members. “Now that everybody is vaccinated, I feel comfortable having everyone come over,” she said in the days leading up to the party. “It wasn’t that I required everyone to be vaccinated, it’s just that all the guests are.”

If last summer was Lockdown Summer, this year may shape up as the summer that “VIP” stands for vaccinated, immunized person. At events ranging from casual backyard barbecues to more formal parties, concerts, weddings, and other gatherings, vaccination may often be the ticket to admission.

Will this trend of leaving out the unvaccinated lead to a rise in vaccinations and less hesitancy about the vaccine? Maybe, say public health officials and researchers, but they disagree on how much of a difference the exclusions will make.

Don’t Leave Home Without Proof of Vaccination

As vaccination has become more widespread — about 44% of Americans were fully vaccinated as of Sunday — so have the venues and events where organizers require either proof of vaccination or a negative COVID test within 72 hours of the event, in many cases to satisfy state mandates about reopening.

Dodger Stadium in Los Angeles, among other Major League venues, offers a vaccinated section, requiring proof of vaccination for adults or a negative COVID test for children 2 to 16 years old.

Wedding planners report that their clients are including the vaccine or negative test requirement  on wedding invitations and websites. Sometimes, the request isn’t just from the couple planning to be married. “A lot of locations are asking that guests be vaccinated,” says wedding planner Charley King, who owns Bluebell Events in Los Angeles. Guests send proof of vaccination or their negative tests directly to the venues, she says. “Most people [invited] are so excited to go back to weddings, they say, ‘Oh sure,'” she says.

Concertgoers at The Canyon, a group of clubs in Southern California hosting live music events, like those at other venues, must show either proof of vaccination or a negative COVID test within 72 hours. The policy is posted prominently on The Canyon’s website, citing state mandates that require it.

Vaccination will also be required of all who attend any of the summer outdoor concerts at the Los Angeles County Arboretum hosted by the Pasadena Symphony and POPS, says Lora Unger, the CEO. When buying a ticket, customers check a box, saying they have been fully vaccinated or will be by the concert date. They then bring verification to the concert.

“The board approved this policy after much consideration and analysis,” Unger says. “The orchestra needs to sit close together. Vaccinations are really necessary to enable our musicians to do their job. Audiences want assurance they are going to vaccinated, safe events that will minimize the possible exposure to COVID because they don’t want to be carriers. We are implementing this policy because our musicians need it and our audiences want it.”

She predicts other venues will soon follow suit for summer performances.

Meanwhile, some hosts of private gatherings are deciding only to hang with people they already know are vaccinated, or to spell out that the event is for vaccinated people only. Shelly Groves, who owns a dog-sitting service in the Atlanta area, is looking forward to toasting a friend’s new house at a gathering set for mid-May. The celebration will include just four women, all vaccinated, who have been good friends for about 5 years. “We’ll have drinks at her new home, then walk to a restaurant and sit outside. Since we have all been vaccinated, we can get together,” Groves says.

In Los Angeles, a teacher recently hosted a backyard garden party for ”fabulous women who are vaccinated,” keeping the group to about a dozen. She knew them all well enough to be confident they wouldn’t lie about their status.

According to CDC guidelines issued April 27, fully vaccinated people can skip the mask outdoors, except in crowded settings, and indoor visits among fully vaccinated people are likely low-risk.

Will Sitting Out a Party Change Minds?

”Right now, about 55% to 65% of the adult U.S. population wants to be vaccinated,” says David Abramson, PhD, a clinical associate professor of social and behavioral sciences at the NYU School of Global Public Health.

So while the trend to require vaccination for events may make a dent in those who are hesitant, it won’t change everyone’s mind, he says.

Abramson is researching the relationship between beliefs and vaccine-related decision-making. He has surveyed 3,000 U.S. residents. While he hasn’t yet finalized the research results, he has found that ”vaccine hesitancy is like a spectrum, with a wide range of people in that group.” Among the subgroups he has identified:

• Wait-and-see group. Some are waiting to see if the vaccine really makes a difference; others to see if anything bad happens after getting it.

• Undecided group. They just don’t know if they will get the vaccine or not.

• A group that says they will get vaccinated only if forced to, such as for work or school

• A group that absolutely refuses the vaccine, for a variety of reasons

Requiring vaccines to participate in certain activities would probably persuade the ”wait and see” group most easily, Abramson says. It may also sway the undecided group. “It’s not going to change those who are refusing unless forced or those who refuse for other reasons,” he says.

In his study, he is following people over time to see if their hesitancy changes.

William Schaffner, MD, a professor of preventive medicine and an infectious disease specialist at Vanderbilt University Medical Center in Nashville, says he has heard of numerous vaccinated-only dinner parties, bridge and poker games, and weddings. “In a small way, they may persuade some friends that are hesitant to get vaccinated, but I am dubious that it will account for many ‘converts.”’

He agrees that the vaccine-hesitant are a mixed bag. Some, he finds, have a fundamentally religious approach to life, a ”God will prevail” attitude. He has difficulty grasping this, he says. “If they had appendicitis, they wouldn’t wait and see. They would go see a surgeon.”

Decades ago, when the polio epidemic was raging, people were hesitant to get the vaccine, which became available in 1955. The public sentiment turned in 1956, after Elvis Presley got the shot backstage when he made an appearance on The Ed Sullivan Show. Immunization levels among teens at the time rose from 0.6% to 80%. Numerous celebrities have promoted the COVID-19 vaccine, but some researchers say the link between these endorsements and the decision to get vaccinated is far from solid.

These days, Schaffner says, religious leaders might make a difference in changing minds. “If religious leaders were to promote vaccination as an appropriately kind thing to do on behalf of others in order to gather to worship, that might have much more impact [than the hosts requiring guests to be vaccinated]. However, so far, religious leaders have been more followers than leaders, not wishing to create turbulence in their congregations.”

Amesh Adalja, MD, a senior scholar and infectious disease specialist at the Johns Hopkins Center for Health Security in Baltimore, says the vaccinated-only sections and vaccinated-only events make perfect sense. “I do think that this vaccine makes a major personal difference to an individual. It should be thought of, and promoted, as a value to them individually that allows them to safely resume their pre-pandemic lives. I also think that when people can tangibly see how being vaccinated will change their lives for the better, it will motivate them to become vaccinated.”

Beyond Excluding: Would Shunning Work Better?

Proof of vaccination should be required to work, play, and travel, says Michael J. Stern, a former federal prosecutor and a USA Today opinion columnist. In a commentary published April 30, Stern proposes a more direct, less tactful approach than simply not inviting the unvaccinated. Shun them, he suggests.

He writes: “[President Joe] Biden’s wildly successful vaccine rollout means that soon everyone who wants a vaccine will have one. When that happens, restaurants, movie theaters, gyms, barbers, airlines and Ubers should require proof of vaccination before providing their services.” He says businesses should require it, too, to protect an outbreak from financially crippling them and shutting them down.

“Things should get personal,” too, he adds, suggesting party hosts request friends get vaccinated before joining the event. Stern argues that as a country, we have become too tolerant of ”half-witted individual autonomy that ignores the existential needs of the vast majority of its citizens.”

In an interview after the editorial published, Stern says he was driven to write it after getting angry that so many people were not getting the vaccine, then hearing experts say that herd immunity is slipping out of our reach because of this hesitancy.

He has gotten hundreds of responses to his commentary by email and on Twitter. “There’s a lot of support,” he says. But some of the responses were ”wildly vicious. They made it appear that I was suggesting people be held down at the grocery store [and vaccinated] before they were allowed to get back to their cars. That is not at all what I was suggesting. What I argued was, if they are not vaccinated, they should not gain entry into certain places, such as Ubers and movie theaters.” In a word, he says, they should be shunned.

Stern says the responses also included some nasty name-calling, but he focuses on the positive responses, such as one Twitter follower who tweeted: “Omg! Finally someone has the guts to vocalize what most Americans are thinking! Thank you.”

SOURCES:

Ava Barker, party hostess, Buena Park, CA.

Michael J. Stern, former federal prosecutor; USA Today opinion columnist.

Shelly Groves, owner, dog-sitting service, Atlanta area.

The Canyon.

Twitter.

Charley King, owner, Bluebell Events, Los Angeles.

David Abramson, PhD, clinical associate professor of social and behavioral sciences and director, research program on Population Impact, Recovery and Resilience, New York University School of Global Public Health.

Amesh Adalja, MD, senior scholar, infectious disease specialist, Johns Hopkins Center for Health Security, Baltimore.

William Schaffner, MD, professor of preventive medicine and infectious disease specialist, Vanderbilt University Medical Center, Nashville.

CDC: “Interim Public Health Recommendations for Fully Vaccinated People.”

Scientific American: “How Elvis Got Americans to Accept the Polio Vaccine.”

The New York Times: “Celebrities Are Endorsing Covid Vaccines. Does It Help?”

USA Today: “It’s time to start shunning the ‘vaccine hesitant.’ They’re blocking COVID herd immunity.”’

Major League Baseball website.

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