COVID-19 is crushing red states. Why isn’t Trump turning his rallies into mass vaccination sites?

Empty chairs fill a waiting area for people after they receive their coronavirus disease (COVID-19) vaccines at a mobile pop-up vaccination clinic hosted by the Detroit Health Department with the Detroit Public Schools Community District at Renaissance High School in Detroit, Michigan, U.S., July 26, 2021. REUTERS/Emily Elconin

Politicians almost always act in their own electoral interest. This sounds bad except that much of the time that means that they are acting in the self-interest of the people who voted for them, representing the views of the majority of their constituents. It is rare that a politician acts against his own self-interest—but then again, Donald Trump is a rare breed of politician. No politician has made it a habit of acting against his own electoral interest like Donald Trump.

Trump and many of his Republican colleagues have allowed a virulent anti-vaccine/anti-masking/anti-social distancing campaign to spread among their voters, reinforced by Fox News. The campaign gained strength just in time for the emergence of a new and more contagious COVID variant: the Delta variant. Polling has shown that the anti-vaccine message is especially popular among Republicans. Kaiser Family Foundation data indicate that Republicans are the group most likely to say they will “definitely not” get a vaccine:

Graph showing 23% of Republicans are "definitely not" planning to get a COVID-19 vaccine

A total of 17 of the 18 states that voted for Trump in the 2020 election have the lowest vaccination rates. Georgia also has very low vaccination rates (as of this writing), but it went for Biden by a very small margin.

But in recent weeks some Republican leaders have been changing their tune. Right-wing stalwarts like Rep. Steve Scalise (R-LA), the House Republican whip, just got vaccinated publicly. This move is in contrast to former President Trump and First Lady Melania who got vaccinated before leaving the White House without making a public appearance out of it and without urging their supporters to do the same. The very conservative governor of Alabama held a press conference to admonish her constituents to get vaccinated. Appearing every bit the irritated grandmother talking to teenagers she said:

“It’s the unvaccinated folks that are letting us down. I’ve done all I know how to do. I can encourage you to do something but I can’t make you take care of yourself.”

And Fox News has taken some small steps towards sanity with several high-profile anchors disputing disinformation from the web and urging viewers to get vaccines.

Slowly but surely, in recent weeks, the number of vaccinations has been increasing. So why the change of heart among conservative leaders? Reality is probably the biggest reason. Grandmothers dying, hospitals overrun, and young people getting sick have a way of combatting the nonsense on the web. Eventually conservative leaders will not want to bear responsibility for the pain of so many. Now that the COVID casualties are piling up in deep red states rather than liberal cities on the coasts they are finding their pandemic humanity. And so politics may well be driving the Republican about-face as elected officials recognize that people are dying and many of those are potential Republican voters in 2022 and beyond.

Health statisticians use a metric called “excess deaths.” According to the CDC, “Excess deaths are typically defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods.” In other words, people die every day but during the pandemic many more people died than would ordinarily during the same period.

Below is a table using CDC data showing the estimated excess deaths that have occurred since February 2020 by state, as a percentage of the population. So, for instance, Mississippi has lost approximately 0.35% of its population in excess of what was expected. The table is arranged in order of the magnitude of the loss. Of the top fifteen states that have suffered excess deaths, New York, Washington, D.C., New Jersey and New Mexico are Democratic strongholds. Three states, Arizona, Michigan and Pennsylvania are swing states that went for Biden in 2020 and the remaining eight states are Republican strongholds.

State Deaths over expected as percent of population
Mississippi 0.35%
District of Columbia 0.35%
Arizona 0.31%
Alabama 0.31%
New York 0.30%
Louisiana 0.30%
New Jersey 0.29%
Arkansas 0.28%
South Carolina 0.28%
South Dakota 0.27%
Tennessee 0.26%
New Mexico 0.26%
Michigan 0.25%
Pennsylvania 0.25%
Texas 0.24%
Sources: CDC, Census

Note: New York numbers combine New York City with the rest of New York State.

It’s not too far out to assume that in some places the Republican quiescence in the face of anti-vax nonsense may be killing their own voters. As we know from this long pandemic, it hits the elderly the hardest. People 65 and older are most likely to die. And as we know from many surveys, Trump’s support is highest in the oldest age cohort, those over 65 years old. In Arizona, Michigan and Pennsylvania there will be tough contests at the statewide and congressional levels and 2024 is likely to be as close as was 2020. Given these numbers, killing off your most reliable voters is perhaps not the best strategy.

These data do not, in themselves, show that COVID is killing Republican voters or disproportionately affect Republican families. For example, we know that because of healthcare disparities, Black Americans are more likely to die from COVID than white Americans. In Republican states, increases in COVID infections, hospitalizations, and deaths could be affecting Black residents, who overwhelmingly vote Democratic, even in Republican stronghold states. However, the sudden change in rhetoric from conservative, Republican politicians, and even among Republican leaders who were previously vaccine-skeptical or vaccine-silent, suggests that something else is happening. It suggests that Republican politicians are recognizing where the current COVID wave is hitting hardest, and they aren’t Democratic cities and counties.

Trump himself has often been immune to rational political calculations—just look at his insistence on endorsing the weaker candidate, Susan Wright, who recently lost the Republican special election in Texas’ 6th congressional district. The winner dubbed himself a “Reagan Republican,” not a Trump Republican. And in a final irony, Congressman-elect Jake Ellzey will replace Rep. Ron Wright who died of COVID.

Historically, rational political calculus has been a bipartisan quality, but not in the Trumpified GOP. If Trump wants to preserve the lives of his best voters, he would turn his rallies into mass vaccination sites. There is still time, but it is running out for thousands of Americans.