America isn't first — it's far behind — and studies point to Republicans

Why is the U.S. falling behind the rest of the developed world in COVID-19 vaccinations? As of mid-September, according to Oxford University, 63 percent of Americans had been fully or partially vaccinated. That’s lower than Canada (75 percent), France (74), Italy (73), the U.K. (71), Israel (69), Germany (66) and Japan (66).

A lot of the explanation is political. In the July Kaiser Family Foundation (KFF) COVID-19 Vaccine Monitor, 86 percent of Democrats said they had received at least one shot. Among Republicans, the figure was 54 percent. That’s a huge difference between the two parties (more than 30 percent). Education was also significant. College graduates were 81 percent vaccinated, while non-college graduates were 61 percent vaccinated — a 20-point gap. Differences by sex and race were smaller (under 10 percent).

Two factors appear to be driving vaccine hesitancy in the U.S. — ideology and education. Less educated Americans can be described as skeptical. Conservatives are hostile. Skepticism is diminishing as deaths continue to mount. But ideological hostility is resistant to change. It originates in politics and can only be defeated politically, as it was this month in California.

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The KFF survey identified “two distinct groups” of unvaccinated Americans — those who were open to getting a vaccine and said they would “wait and see” (13 percent of the public) and the roughly equal group who said they would “definitely not” get vaccinated. The “wait and see” group was less educated and included a higher proportion of minorities. It tended to be skeptical about the effectiveness of vaccines and confused by inconsistent messages coming from the government and medical authorities (most recently, about the need for booster shots).

Those who said they would “definitely not” be vaccinated were mostly white, male, Republican and intensely opposed to vaccination mandates. What turns them off are “mandates” more than “vaccines.” After all, a majority of Republicans — including Donald TrumpDonald TrumpHarris stumps for McAuliffe in Virginia On The Money — Sussing out what Sinema wants Hillicon Valley — Presented by Xerox — The Facebook Oversight Board is not pleased MORE — have been vaccinated (54 percent in the July KFF survey). They acted to protect themselves, which shows that they are not stupid.

Some conservatives who shun vaccines are seeking unconventional treatments, such as injections of monoclonal antibodies, which are costly, time consuming and do nothing to stop the spread of the disease. Some are touting ivermectin, a treatment for parasitic infections in animals — horse dewormer — that has never been shown to be effective against COVID-19.

Conservatives are embracing these unconventional treatments because they are not mandated by the government. They believe treatment and prevention should be entirely a matter of personal choice, not government mandates. Their concern is for private health, not public health — even though COVID-19, like drunk driving, is not just a threat to one’s self. Because it is highly contagious, it’s also a threat to others.

Some Republicans argue that they are pro-vaccination and anti-mandate. Glenn Youngkin, Republican candidate for governor of Virginia this year, said in a debate, “I have been a strong advocate for everyone to get the vaccine.” As long as they are not required by law to get it. “Individuals should be allowed to make that decision on their own,” Youngkin added.

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A spokeswoman for Florida Republican Gov. Ron DeSantis went so far as to argue that “overreaching government mandates can make people even more hesitant to get the vaccine.” Maybe some conservatives, but the fact is, most Americans support President BidenJoe BidenBiden: Democrats' spending plan is 'a bigger darn deal' than Obamacare Biden says he's open to altering, eliminating filibuster to advance voting rights Biden: Comment that DOJ should prosecute those who defy subpoenas 'not appropriate' MORE’s vaccine mandates: 60 percent favor mandating vaccination or regular testing for employees of large businesses. More than 60 percent favor requiring masks in schools and public places. Majorities oppose state laws that ban mask requirements, such as the one in Florida.

“We said yes to science,” California Gov. Gavin Newsom (D) said after decisively beating the effort to recall him this month. “We said yes to vaccines. We said yes to ending the pandemic.” President Biden said in California, “This vote is a resounding win for the approach [Gov. Newsom] and I share. ... Americans are unifying behind taking these steps to get the pandemic behind us.”

That was true, at least in California, where Democrats outnumber Republicans by nearly 2 to 1. In the exit poll, the pandemic was the top issue to California voters, and those concerned about it voted 80 percent against recalling the governor. Nearly two-thirds said Newsom’s mandate policies were “about right” or “not strict enough.”

Perhaps most revealing, only one-third of California voters said they considered getting the vaccine “a personal choice.” Those who felt that way voted 85 percent to recall Newsom. Nearly two-thirds called vaccination a “public health responsibility.” They voted 83 percent against recalling the governor.

To conservatives, health is a wholly individual responsibility. “Public health” sounds too much like collectivism. And collectivism gives conservatives a nosebleed.

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Newsom defined the race as a referendum on extremism. “This is about weaponizing this office for an extreme national agenda,” Newsom said. Presumably, he was referring to the “extreme” laws Republican state governments have been passing all over the country — not just laws banning vaccination mandates and mask wearing but also laws restricting voting rights and curbing abortion rights.

In this way, California may give Democrats a strategy for countering the conventional wisdom — that the 2022 midterm is likely to see a big Republican wave.

Bill Schneider is an emeritus professor at the Schar School of Policy and Government at George Mason University and author of "Standoff: How America Became Ungovernable" (Simon & Schuster).