New Jersey Republican Stronghold Has State’s Worst Virus Death Rate

Ocean County, a coastal region in central New Jersey, is home to some of the most exclusive waterfront communities in the state and its fastest growing city, Lakewood.

A Republican stronghold in a Democratic-controlled state, the county is largely suburban and encompasses more land than all but one New Jersey county.

Now, as the United States begins to chart a path through a third year of the pandemic, Ocean County also illustrates a stubborn public health challenge: A large portion of its residents have not been vaccinated against the coronavirus, and its rate of Covid-19 mortality is the highest in the state.

The county has recorded 459 virus-related deaths per 100,000 residents, state data shows. This exceeds mortality levels in every other county in New Jersey, an affluent, well-educated, densely populated state that is still struggling to limit its death rate from the virus. New Jersey has the fifth-highest death rate from Covid in the United States, behind Mississippi, Arizona, Alabama and West Virginia.

Explanations for the large number of deaths in Ocean County vary and include the large percentage of residents over the age of 85 and low vaccination rates among those 65 and younger, a factor that some studies show is more closely related to partisan politics.

The county also has a large and growing Orthodox Jewish population, which was hit hard during the first wave of the pandemic and whose vaccination rates are much lower than state averages, reflecting similar trends in Orthodox Jewish neighborhoods in the county. New York.

In the 2020 presidential race, when New Jersey supported President Biden by an overwhelming margin, Ocean County voters backed former President Donald J. Trump by nearly 29 percentage points, the most of any of the state’s Republican strongholds.

“At this stage of the game, whoever made the decision to get it, they got it,” John G. Ducey, longtime Democratic mayor of Brick, a town of 74,000 in Ocean County, said of the vaccine.

“A lot of people who are not in favor of getting the vaccine are doing it for impeachment,” he said, adding, “They don’t want an invasion of their bodies.”

Vaccines against COVID-19 have been shown to significantly reduce the risk of serious illness or death, particularly for people who also receive booster shots.

But among Ocean County residents eligible for a COVID-19 vaccine, only 58.4 percent have received at least two shots of the Moderna or Pfizer-BioNTech vaccines or one shot from Johnson & Johnson, according to the Centers for Disease Control and Prevention. That is well below the state vaccination rate of 79.8 percent and the national rate of 69.8 percent.

Lakewood, which is home to a thriving Orthodox Jewish community and is the largest municipality in the county, has the lowest vaccination rates in the region. Only 40 percent of Lakewood residents over the age of 5 are fully vaccinated; of these, 38 percent of residents eligible for a booster shot have received one, according to the state Department of Health.

In New York, Borough Park, a center of Orthodox Jewish life in Brooklyn, has the lowest vaccination rate in the city. But it significantly outnumbers Lakewood: About 53 percent of residents over the age of 5 in the Brooklyn neighborhood 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 plummeted to about one per day.

Still, the deaths have continued to mount steadily: Since last spring, the number of people who have died each quarter in Ocean County has exceeded the number of deaths during the previous three months.

In Brick, where about 64 percent of residents eligible for Covid vaccines are vaccinated, about 28 percent of the 357 virus-related deaths occurred after vaccines became widely available, according to county data.

Still, Mr. Ducey said he opposed vaccine mandates.

“There are people out there who don’t want the vaccine and I think it should be left up to them,” said Mr. Ducey, who is vaccinated and received a booster shot. “That’s the best thing about our country: we have freedom of choice.”

But as the worst days of the pandemic fade from memory and politicians chart a path to normalcy, persuading more people to get vaccinated has become a top priority for infectious disease specialists like Dr. Meg. Fisher, a pediatric immunologist who works as a consultant to New Jersey’s health commissioner

For them, increasing vaccination rates is seen as vital to protecting the broader community against new variants, such as the highly transmissible Omicron subvariant BA.2, which is now the dominant version of the coronavirus in the United States and around the world. .

“Getting over people’s complacency: This becomes very important right now,” said Dr. Fisher.

“We need the youngest to be vaccinated,” he added.

A national study by the Pew Research Center found that 73 percent of people who identified as Democrats and were eligible for a booster shot had one, compared to 55 percent of people surveyed who said they were Republicans.

Younger Republicans were particularly hesitant to get vaccinated, the study showed, with just 52 percent between the ages of 18 and 29 reporting being vaccinated, compared with 88 percent of Democrats in the same age group.

“The biggest gap that we have seen that has been consistent has been partisanship,” he said. Alec Tyson, associate director of research at the Pew Research Center.

“It’s not narrowing,” he added. “If anything, she is growing even more.”

Ocean County, which borders the Jersey Shore and is a retirement destination, has the fourth-highest percentage of residents age 85 and older in the United States, behind three equally large counties in Florida, census data show. . At one county hospital, Community Medical Center, 73 percent of patients qualify for Medicare, the federally funded health care available to people 65 and older and some young people with disabilities.

“When you put that into perspective, it’s not that surprising that the death rate is high,” said Patrick Ahearn, executive director of the medical center in nearby Toms River.

Daniel Regenye, Ocean County health director, said his office has created an extensive network of vaccination sites; None of the county’s 649,000 residents live more than two miles from a place offering Covid vaccinations, he said.

The county’s low vaccination rates do not apply to all age groups. Among people over 65, who are considered more vulnerable to serious illness, 88 percent are vaccinated, just six percentage points lower than the state rate.

Dimitri Svarnas and his wife, Janis, are registered Republicans who are ardent Trump supporters.

The couple got vaccinated to take 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 Brick, outside the ShopRite where he was first vaccinated last year. “No one controls my body.”

To attract younger people, Ocean County has organized pop-up clinics that offer incentives like free admission to Six Flags Great Adventure, an amusement park in Jackson, and seasonal access to the park’s popular safari.

In Lakewood, where nearly half the residents are under 18, drinks were offered during Sunday events that included bouncy houses for kids, free food and miniature golf.

“There is a general perception, and a lot of people feed it, that natural infection is better,” Regenye said.

“My concern is the resurgence of vaccine-preventable diseases,” he added.

Dr. Dovid Friedman is Executive Director of CHEMED, the Center for Education in Health, Medicine and Dentistry at Lakewood, a community-based health care provider that receives federal funds 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 equivalent to vaccination.

There is also a widespread misunderstanding, he said, about the primary role of the Covid vaccine.

“People get confused with ‘Why is there still a disease?’” he said. “But the vaccine was not designed to stop the disease. It was designed to prevent hospitalizations and deaths.”

To try to boost vaccination rates among the county’s large number of Orthodox Jews, the state launched a targeted ad campaign in early February that was immediately derided as culturally inappropriate. Digital billboards featured 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 switched advertising companies.

The new print ads focus on the importance of getting vaccinated as a way to “boost” the body’s natural defenses, said Elie Rosenfeld, CEO of Joseph Jacobs Advertising, the newly hired firm. The ads also emphasize the vaccine’s ability to limit disruptions to the “normal rhythm” of life, including school and family activities, as well as the obligation each resident has to keep the community at large safe, he said.

David Djmal, an e-commerce site manager 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 had not been infected again, even though he is not vaccinated and has had close contact with people who have tested positive for the virus.

This “only further demonstrated to me the strength of my immunity,” said Djmal, 29. He said that he would probably get the vaccine if his job was at risk.

“It depends,” he said, “on how inconvenient they have made my life.”

Robert Gebeloff contributed reporting.

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