Demand for the Covid-19 vaccine is slowing in parts of the United States. Now begins an uphill battle to get more hits in the arms

Drive-thru clinic in Mercer County, Ohio

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Almost three months later, with plenty of vaccines available and eligibility open to all residents 16 and older, officials have struggled to complete appointments, said Kristy Fryman, Intervention Coordinator at Emergency and Information Officer for the Mercer County Health District. About 264 people received their first dose at the district clinic earlier this month – about half the number who signed up at the start of the deployment.

“People in rural areas tend to have an attitude of self-sufficiency, especially among the younger population,” said Fryman. “We also heard that people are waiting to get the vaccine because they want to know about the side effects that are coming. And then another comment would be that the vaccine is just too new. “

In neighboring Paulding County, a rural community made up of “all villages” and home to fewer than 19,000 people, the health department’s emergency response coordinator has followed a similar trajectory. Just a few weeks ago, the ministry put several hundred people on its waiting lists for the Covid-19 vaccine. Now “we don’t have a waiting list,” said Bill Edwards. About 29% of the county’s population have started their Covid-19 vaccination, according to state data.

And it’s not just in Ohio. Pharmacies in part of Louisiana say demand for Covid-19 vaccines has “dropped completely.” Georgian officials recently announced that they are closing a mass vaccination site due to low demand. Tennessee leaders said late last month they were opening eligibility following a low number of vaccinations in rural areas. Parts of Texas have also experienced a drop in demand.

Drive-thru clinic in Mercer County, Ohio

“We’re getting to the point where we’re getting to a tough audience,” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials (NACCHO). “Those who are not sure or are not about the vaccine, do not have enough information or are just not interested in the vaccine for other reasons. “

Experts, including Dr Anthony Fauci, estimate that between 70 and 85% of the country must be immune to the virus – either by inoculation or previous infection – to suppress its spread. But the United States is still a long way from those levels, and slowing demand – especially now that eligibility has opened up – means meeting it could be a bigger task than some local officials anticipated.

A demand problem

The slowdown in vaccination is not surprising, says infectious disease specialist and epidemiologist Dr. Céline Gounder.
`` We are trying to live.  Vaccine hesitation decreases as demand for equitable access increases  `` We are trying to live.  Vaccine reluctance decreases as demand for equitable access escalates

She told the U.S. Congressional Joint Economic Committee on Wednesday that a major challenge for Covid-19 vaccinations in the coming months will be demand: getting enough people signed up to take the vaccine. And there are several reasons for this.

Many Americans, including among communities of color, still have access issues, Gounder told CNN. Civil rights leaders have said that while reluctance in these communities is diminishing, many people of color do not have vaccination sites in their neighborhoods. They may also need assistance with transportation, Internet access, or the registration process. The Biden administration announced last month that it would spend nearly $ 10 billion to expand access for hard-hit and high-risk communities and help build confidence in vaccines across the country.

Reluctance to vaccines may not be the reason people of color are getting Covid injections at a lower rateReluctance to vaccines may not be the reason people of color are getting Covid injections at a lower rate

“The work we’re doing on the equity side needs to be done more deeply and done in the communities where people live and work,” said Freeman of NACCHO. “We have to be very creative in finding unique ways to reach people, including making sure they have the easiest possible access to vaccines. “

In Mercer County, Fryman said officials are working to make vaccines more accessible, including events targeting the Hispanic population and initiatives to get more information from the Amish and Marshallese populations.

Other groups are hesitant, Gounder said, including young Americans as well as what she calls the “mobile community” – those who are on the fence but who may be swayed by more information about the Covid-19 vaccine. .

Many evangelicals say they will not be vaccinated against Covid-19.  Some experts say mistrust and misinformation played a roleMany evangelicals say they will not be vaccinated against Covid-19.  Some experts say mistrust and misinformation played a role

“Then you have another group that is much more resilient, more grounded in their opinions, it’s about 20% of Americans,” Gounder said. These are more rural, conservative Americans who lack confidence in the health care system and government, she said.

“This group is more difficult because it’s not necessarily a group that will respond to education like the more mobile kind of medium will,” Gounder said. “And that’s what worries us. “

According to a recent analysis by the Kaiser Family Foundation, one in five rural residents still say they definitely won’t get the shot. About 73% of these respondents were of the Republican type and 41% identified themselves as white evangelical Christians. Experts say anti-vaccine sentiment among evangelicals is fueled by several factors, including misinformation and political identity. And the impacts could be significant.

Here is the  impact of Johnson & amp;  Johnson could take a break from Covid-19 vaccine rollout  Here is the  impact of Johnson & amp;  Johnson could take a break from Covid-19 vaccine rollout

“This means that geographically you are likely to have – not only depending on rural versus non-rural, but also when referring to policy – certain populations that have lower immunization coverage rates,” said Gounder. “And so… you will probably see more transmission within these subgroups. And these populations, she added, could potentially spread to other communities.

Some experts are also concerned that Johnson & Johnson’s recent vaccine hiatus is further fueling vaccine reluctance. US officials have recommended suspending “an abundance of caution” following six cases – among more than 6.8 million Americans who have been vaccinated – of a rare and severe type of blood clot.

“I think it has a chilling effect,” Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, recently told CNN. “I think people might be thinking, ‘Well, if that’s true with this J&J vaccine, maybe it’s true with all vaccines.’ “

Now a “difficult battle” for local officials

Officials in Lubbock, Texas, began to notice a slowdown in demand last month. The city, a small urban center that is home to Texas Tech University, is the county seat of a predominantly rural county.

“We are what people think Texas looks like,” said Katherine Wells, the city’s director of public health. “Tumbleweed and dry. “

An issue on Covid-19 vaccinations that will leave you shaking your head in wonderAn issue on Covid-19 vaccinations that will leave you shaking your head in wonder

When appointments for the Covid-19 vaccine were first opened, demand was so high that callers destroyed the city’s phone system, Wells said. In March, demand started to fall.

“We have a gigantic vaccination clinic that lacks a civic center, four days a week we can do 2,500 vaccines a day,” she said. “For about three weeks, we haven’t been able to meet all of these appointments. “

The J&J news, she said, “slowed us down even more.” The clinic, which can accommodate several hundred vaccinations per hour, averaged around 125 people per hour the day after the break was announced, although officials offered the Moderna vaccine to those with J&J appointments, Wells said.

Changing demand underscores the challenge for health officials, experts say.

The debate on the vaccine passport is not new.  It started in 1897 during a plague pandemicThe debate on the vaccine passport is not new.  It started in 1897 during a plague pandemic

“This initial request to these high priority groups and not being able to support it with the general population means that we really have a lot of work to do, and we need to do it now, sooner than we would have.” maybe thought. to do it, ”Freeman said.

About 40% of Lubbock County residents aged 16 and over have received at least one dose, according to state data. Wells has said she wants to hit at least the 50% immunization mark, but it will likely be an “uphill battle” from here on out. And, Wells added, she has heard from other state health departments facing the same drop in demand.

“I think we’ve done the easier part and I think it’s really going to take to be in the community or find people who need to be vaccinated and deliver the vaccine with as few hoops as possible,” Wells said.

How long will coronavirus vaccines protect people?How long will coronavirus vaccines protect people?

Local officials have created a program targeting minorities and populations “who are generally taken away from health care,” Wells said, and have also opened pop-up clinics for all major events in the area, including college sporting events. , parades and other celebrations.

The director of public health for Victoria County, Texas, has also seen demand drop “a bit” in recent weeks. About 32% of county residents aged 16 and over have received at least one injection of Covid-19, according to state data.

“I would really like to go higher,” said David Gonzales. “But again, there’s not much we can do. We can promote it, we can ask people, offer it, it’s free. We try to get a lot of people to go into a clinic. We try to make things as easy as possible. , but there’s really not much we can do. ”

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