The coronavirus vaccines have been rolled out unevenly in the U.S., but four states in the deep south have had particularly bleak vaccination rates that have frustrated health experts and residents.
In Alabama, Georgia, Mississippi and South Carolina, less than 2% of the population received its first dose of vaccine at the beginning of the week, according to data from the states and the U.S. Centers for Disease Control and Prevention.
As in other parts of the country, states in the South face a number of challenges: limited vaccine supplies, health workers refusing to be vaccinated and bureaucratic systems not equipped to plan the large number of appointments.
But other states still managed to get the vaccines into the arms of more than 5% of their population.
Although it is not clear why the deep south is lagging behind, public health researchers note that it has usually been reluctant to fund public health and address the differences in the care of its large rural population.
‘If you combine a large percentage of rural people who tend to be the hard to reach population and have a lower number of providers, and try to build a vaccine infrastructure quickly, it’s just a recipe for a not so good response, ”said Sarah McCool, a professor of public health at Georgia State University.
In Georgia, the state’s rural health care system has declined in recent years, with nine hospital closures since 2008, including two last year. Local health departments have become the primary vaccine providers in some places, as officials work to add places where doses can be administered.
“If we’re the only game in town, this process will take a long time,” Lawton Davis, director of a major public health district that includes Savannah, told a news conference on Monday.
Alabama and Mississippi were also hit hard by the closure of rural hospitals. Seven hospitals have closed in Alabama since 2009 and six in Mississippi since 2005, according to researchers from the Sheps Center of the University of North Carolina. According to a 2020 report by a nonprofit foundation associated with insurance giant UnitedHealth, Alabama, Georgia and Mississippi ranked fifth in the U.S. states in their access to health care.
But in general, experts say that it is too early in the vaccination to draw conclusions about the shortcomings in the region, and this can not be easily attributed to a specific factor or trend.
“We’re building a kind of this plane while we fly, and there will be some erroneous mistakes along the way,” said Amber Schmidtke, a microbiologist who followed the spread of vaccine in the South.
Officials in the individual states mentioned a number of challenges, but also acknowledged shortcomings.
“We have distributed too many vaccines that are not yet in the arms,” said Tate Reeves, Mississippi government. Some hospitals in the state do not use their vaccine doses. He said the practice “should stop.”
Georgia Gov. Brian Kemp cites a similar challenge, warning vaccinators that the state will take their unused doses, even if it is necessary to fire up his pickup and do it himself.
But in South Carolina, hospital officials say it is the state that has moved too slowly to expand access to the vaccines, leaving unused doses. The state recently offered the vaccine to 70 and older.
Mississippi’s Reeves said one of the biggest weaknesses in the state’s vaccination system is the federal partnership with CVS and Walgreens to administer vaccinations in long-term care facilities. The pharmacy chains have hired slow enough people to do the work in Mississippi, the governor said.
CVS Health said in a statement that it “has the necessary resources to complete the work” at long-term care facilities. Walgreens did not respond to a request for comment.
During an online forum hosted at Jackson State University in Mississippi on Thursday, U.S. Surgeon General Jerome Adams, who is black, noted that many African Americans are reluctant to be vaccinated. He cites a general mistrust in medical systems that stems from a recently completed government study that began in the 1930s and left black men untreated for syphilis for decades.
So far, only 15% of the COVID-19 vaccinations in Mississippi have gone to black people, who make up about 38% of the population, Dr. Thomas Dobbs, state health officer, said during the forum.
Officials in all four countries also said that some health workers – among the first groups eligible for a vaccine – preferred not to be vaccinated. And some have stressed that states have to deal with limited supply and high demand, and have urged people to be patient.
‘Yes, the telephone lines will be busy. “Yes, the sites will definitely crash,” Kemp said on Tuesday. “There are simply many more Georgians who want the vaccine than they can get today.”
Mississippi officials said the state’s website and phone line were overwhelmed after the governor announced Tuesday that vaccinations are available for people 65 or older or for people with underlying medical conditions.
Liz Cleveland, a 67-year-old retired government official living in Jackson, waited hours on the site with her cell phone, computer and tablet to encounter unknown errors.
‘It’s like gambling. You can hit or you can burst, ‘said Cleveland.
At around 02:00 on Wednesday, she was finally able to book appointments for herself and her husband in Hattiesburg, which is 145 kilometers away, next week. Mississippi officials said Thursday that they will soon open an additional driveway for vaccinations in the state’s largest province.
Alabama officials have also been inundated with requests for appointments since the announcement that the state will begin vaccinations for people over 75 next week. A state line received more than a million calls the first day it was open.
Celia O’Kelley of Tuscaloosa said she could not reach out to anyone to get an appointment for her 95-year-old mother.
“I’m scared because Tuscaloosa is an excellent place,” she said.