Just a few short months ago, economic optimism was strong. A fast recovery seemed imminent even if actual data revealing a rapid recovery was sparse. Businesses were beginning to re-open and hire, the vaccine was becoming universally available. Most of us were eager to return to restaurants, theaters and other places that were unsafe during COVID. Spring was as it should be, hopeful and optimistic.

As of mid-summer, the very rapid recovery has failed to fully materialize. Wage growth last month was weak and the mix of new jobs signaled growth in lower-wage sectors rather than across-the-board growth. In a normal labor market, we would welcome the 2021 average of a half a million new jobs per month, but that speed of recovery will not see us hit pre-pandemic employment levels until the summer of 2022. At the current pace of job growth, it will be late-2023 or 2024 before we return to trend employment levels.

The more-sluggish-than-expected recovery comes at a time when combined economic stimulus remains near an all-time high. Additional fiscal or monetary policies will not rescue us from slower growth. That isn’t an argument against any piece of legislation or federal policy, simple an acknowledgement that the slowing growth isn’t really a direct economic policy issue. It is something else.

Over the past few weeks, COVID is again filling hospitals and killing Americans at an accelerating rate. But, the effects of the disease and its likely economic effects are not equally distributed. Over the last 90 days, nearly all the COVID deaths are among the unvaccinated. In just the last three months, more than 32,000 Americans died of COVID. In just the past month, the long and slow decline in deaths reversed, and is now growing at a rate that could easily return us to the levels seen last fall.

With 99.2 percent of deaths among the unvaccinated the burden of this disease now falls on those families and communities where vaccination rates are low. For anyone who has studied public health, this is familiar territory. Poorer populations, poorly educated places and those with a larger share of racial minorities exhibit lower rates of vaccinations. However, a new and horrific development is the strong political dimension to the rates of vaccination.

The typical approach to public health research examines such things as race or ethnicity, socioeconomic status, age and levels of education to explain differences in the incidence of disease and access to preventive healthcare. The understanding of these dynamics allow policies to target those places and people least likely to benefit from healthcare spending without additional intervention. Today, the strongest predictor of COVID vaccination rates is simply the share of the 2020 presidential vote that accrued to Mr. Trump.

This is not an accident, it is not an artifact of population density nor is it the result of state-level variations in public policy. The states with the highest and lowest rates of vaccination are both led by GOP governors. It is shocking that even in a sweeping election loss, Donald Trump won 24 of the 25 states with the lowest vaccination rate. The refusal by so many Americans to take the vaccine is linked to the public statements of Donald Trump and his supporters who sought to downplay this pandemic. The politicization of the most common form of public health measure – vaccinations – has one source: Donald Trump.

The politics of this anti-vaccine campaign make little sense. They are not rooted in libertarianism, nor conservative thought. They are not spawned by the type of republicanism that gives states the authority to oversee such matters. Letting your supporters die is hardly a winning populist strategy. This anti-vaccine rhetoric isn’t even mature contrarianism. This is the stuff of childish obstinacy designed to divert attention from other failures.

COVID is now killing more than 10,000 Americans per month, with the rate of death accelerating. At least one forecast projects that we will have nearly 100 million sick Americans by Christmas. The deaths will be particularly acute in those states that voted for Mr. Trump. I just ran the correlation between vote share and vaccine rates. This is the sort of analysis I perform several hundred times a year for most of the past three decades. However, this correlation is the most startling statistical relationship I have ever seen.

A full 75.6 percent of the differences in state vaccination rates can be explained solely by the Trump share of votes in 2020. Moreover, each 1.0 percent decrease in the vote share for Mr. Trump is correlated with a 0.78 percent decrease in vaccination rates. One bizarre outcome of last year’s fractured national politics is that Mr. Trump unleashed disinformation that is now causing the disproportionate death of his supporters.

It is time to state and restate an obvious truth. The rapid spread of this new variant, the uptick of deaths and the spreading economic damage falls squarely at the feet of those who chose not to get a vaccine. These folks are either dupes of the anti-vax campaigners or themselves morally culpable for the spreading disease. Most bear both burdens.

Many vaccinated Americans will be rightfully angry at the self-centered mulishness of the unvaccinated. Since 99.2 percent of these deaths are voluntary, some will even be tempted to discount their deaths. That is a mistake. We should not surrender to the immorality that influenced the unvaccinated. These are our neighbors and fellow citizens.

We should remind the unvaccinated that their choices hurt others. The resurgent pandemic will cause more businesses to fail this year. Some schools will close and many students who are not yet eligible for vaccines will be at home in isolation or quarantine. Some will die. Many have taken the vaccine, but have compromised immune systems. Hundreds of these Americans who otherwise would have loved and been loved through a normal lifespan will instead die of COVID this year.

The moral weight of these deaths and disease falls squarely on those Americans who chose not to get a vaccine. It is time we shame, cajole or coax these folks into getting the vaccine. We want these people to survive this pandemic, so that they may thank us later.