The unvaccinated in the U.S. remain defiant.

As a fast-spreading new strain of the coronavirus swarms across the country, hospitals in Ohio running low on beds and staff recently took out a full-page newspaper advertisement pleading with unvaccinated Americans to finally get the shot. It read, simply: “Help.”

But in a suburban Ohio café, Jackie Rogers, 58, an accountant, offered an equally succinct response on behalf of unvaccinated America: “Never.”

In the year since the first shots began going into arms, opposition to vaccines has hardened from skepticism and wariness into something approaching an article of faith for the approximately 39 million American adults who have yet to get a single dose.

Now, health experts say the roughly 15 percent of the adult population that remains stubbornly unvaccinated is at the greatest risk of severe illness and death from the Omicron variant, and could overwhelm hospitals that are already brimming with Covid patients. In Cleveland, where Omicron cases are soaring, a hospital unit at the Cleveland Clinic that provides life support to the sickest patients is already completely full.

The unvaccinated are “much more likely to be in a hospital, and they’re much more likely to be taking up a bed that might be wanted” this winter, said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Compounding the problem, the pace of first-time vaccinations appears to be plateauing this month, and the numbers of children getting vaccinated and eligible adults getting booster shots are lower than some health experts hoped. Around 20 percent of children 5 to 11 years old have gotten a dose of vaccine. Only around one in three fully vaccinated Americans has gotten a booster.

It is still too early to know whether spiking numbers of Omicron infections in New York, the rest of the Northeast and the Midwest will be followed by a surge in hospitalizations and deaths. Early studies suggest the new variant may cause less severe illness than previous variants did.

But so far, the threat of Omicron is doing little to change people’s minds. Nearly 90 percent of unvaccinated adults said the variant would not spur them to get shots, according to a recent survey from the Kaiser Family Foundation.

And some of the unvaccinated said that Omicron’s wily ability to infect vaccinated people only reaffirmed their decision to not get the shot. Others say the virus’s changing nature has stiffened their resolve not to get it.

“It’s just another variant,” said Dianne Putnam, an unvaccinated resident of Dalton, Ga., and president of her county’s Republican Party, who spent six days in the hospital this summer after contracting Covid-19. “Next year there’ll be another one. I mean, there’s going to always be different variants.”

Public-health campaigns and employee vaccine mandates have made progress since the summer at reducing the ranks of unvaccinated. The remaining ranks of unvaccinated Americans steadfastly opposed to getting a shot tend to be younger, whiter and more Republican than those who have received the vaccine or are still considering one, surveys have shown.

In interviews across the country, unvaccinated people said they had grown inured to public-health messages from exhausted doctors and nurses and even pleas from their own families, as vaccinations have become entangled in the country’s politics. Even though mandates have been shown to significantly improve vaccination rates in places and at companies that implement them, they said they were dead-set against President Biden’s efforts and had tuned out his appeals for Americans to get vaccinated as a patriotic duty.

“The nail in the coffin was when they said you had to get the vaccine. It definitely turned me away,” said Cyrarra Bricker, 26, a sales representative in Fort Worth, Texas.

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