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Amanda Tetlak, a registered nurse, prepares COVID-19 vaccine doses at a Florida Department of Health in Pinellas County vaccination event, held at the Salvador Dali Museum in St. Petersburg, Florida on Aug. 6, 2021.OCTAVIO JONES/Reuters

Jimmy Knight had one of the rare COVID-19 breakthrough cases. Vaccinated in March, the 60-year-old retired landscaper said he contracted the virus a little more than two weeks ago. The illness made it almost impossible to sleep or eat and gave him fits of coughing, a headache and weak knees.

He shudders to think how much worse it could have been had he not been vaccinated. And he’s livid at the 40 per cent of Floridians who have so far not bothered to get a shot.

“They only care about themselves, they don’t care about anybody else,” Mr. Knight said at a mass COVID-19 testing site outside Miami-Dade County’s local government building this week. “It ain’t a joke, man. It’s a jungle out there. This virus made me suffer real bad.”

Florida is the epicentre of the United States’ current Delta variant COVID-19 surge, which has pushed the country’s daily case count to its highest level in six months. The state this week saw more than 12,400 hospitalizations, its highest total since the start of the pandemic. Officials in some counties have said that roughly 90 per cent of patients in hospital are unvaccinated.

Even in Miami-Dade, where 62 per cent of people are fully vaccinated, infections have exploded this summer among remaining pockets of unvaccinated people. The COVID-19 hospitalization rate has more than doubled here over the past two weeks.

But the scene at a vaccination site outside the county government building downtown was relatively quiet. Even as hundreds of people joined Mr. Knight in lining up for COVID-19 tests, the adjacent booth offering vaccines saw only about 20 takers over the course of three hours Thursday afternoon. And, rather than Florida residents, most were tourists from Latin America, which has suffered from vaccine supply problems as wealthier countries hoard shots.

“It’s getting worse all over the world, and it’s better to be preventative if you have the opportunity, to make sure you have something that prevents you from getting too sick,” said Diego Rice, a 39-year-old tech worker from Mexico City, as he waited for his wife to get her second shot of the Pfizer vaccine.

Tomas Abogadro, 43, a hotelier from the Dominican Republic, said he chose to get the shot in Florida so he could travel to Ibiza later this summer. Spain is one of several countries that have lifted travel restrictions for fully vaccinated people.

Marc Samayoa, a 28-year-old Canadian, had spent the pandemic with family in Guatemala. Getting vaccinated now, he said, would make it simpler to get back home. “Once I go back to Canada, I won’t have to wait in a hotel for three days and pay $2,500,” he said.

Many were baffled that so many Floridians had chosen not to take advantage of such easy, swift vaccine access.

“I think people are taking things for granted. They don’t know how it is to live in another country,” said Micaela Birnbaum, a 25-year-old architect from Buenos Aires, after getting a Pfizer shot at a parking garage in the beachside Miami suburb of Sunny Isles.

Anna Lorenzo, 54, said she appreciated the certainty of being able to schedule first- and second-dose appointments in the U.S. At home in Argentina, she said, her husband could book a first dose, but it was unclear when he would be able to get a second.

“I think when you have it all, you don’t know it,” Ms. Lorenzo, a teacher, said of unvaccinated Americans. “You don’t know how it feels to need something that they aren’t giving to you.”

In this perennially divided swing state, the pandemic’s politics help explain vaccine hesitancy. Governor Ron DeSantis, a Republican close to former president Donald Trump, has repeatedly blocked pandemic safety measures, which he says impinge on Floridians’ freedom.

In the spring, Mr. DeSantis signed legislation that bans businesses and government agencies from requiring “vaccine passports.” Norwegian Cruise Line, which wants its passengers to show proof of vaccination, is currently suing Mr. DeSantis in federal court in a bid to overturn the law.

This week, Mr. DeSantis threatened to withhold school districts’ state funding if they mandate masks for children this fall. And he said he was against requiring that front-line health care workers be vaccinated.

“Kids cannot go to school if they don’t get their measles, mumps and rubella vaccines. All health care workers have to get hepatitis B vaccines. I don’t see why this is different,” said Ninel Gregori, a 48-year-old retinal surgeon, after getting a COVID-19 test at the county government building. “It should be public health deciding this, not those politicians.”

Mr. Knight, meanwhile, was looking forward to seeing his 10 grandchildren again after quarantining at home for the past two weeks. The pandemic had already gone on longer than it needed to, he said, and he worried that, absent more people getting vaccinated and wearing masks, it would drag on indefinitely.

“They’ve changed it from COVID-19 to COVID-21,” he said. “If things don’t change, it’ll be COVID-25.”

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