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Despite many vaccines and incentives, vaccination rates are far behind in the South

NASHVILLE – Public health departments have organized vaccination clinics in churches. They organized trips to clinics. Door to door. Even offered a ride on a NASCAR track to anyone who wanted to try their luck.

Yet the country’s vaccination campaign is faltering, especially in the south, where there are far more doses than people who will take them.

As reports of new cases and deaths of Covid-19 crumble, and many Americans venture unmasked into something near normal, slowing vaccinations present a new risk. As variants of the coronavirus spread and restrictions are relaxed, experts fear the virus will reappear in states like Alabama, Louisiana and Mississippi, where less than half of adults have started the vaccination process. .

“A lot of people have the feeling, ‘Oh, I dodged that bullet,'” said Dr Jeanne Marrazzo, director of the Division of Infectious Diseases at the University of Alabama at Birmingham. She added: “I don’t think people appreciate that if we give up on immunization efforts we could be back where we started.”

A series of theories have emerged as to why the South, which was home to eight of the 10 states with the lowest vaccination rates on Wednesday, lags the rest of the country: hesitation from conservative whites, concerns from some residents black, long-standing challenges in accessing health care and transportation.

The answer, revealed by interviews across the region, was all of the above.

“It’s kind of a complex brew, and we break off the individual pieces,” said Dr. W. Mark Horne, president of the Mississippi State Medical Association. He added: “There is no quick fix. There is no perfect solution. There is no pixie dust we can sprinkle on it.

Vaccines, once a scarce commodity, are now widely available in the United States, and anyone aged 12 and over is eligible for an injection. But daily vaccinations nationwide have fallen to around 1.1 million doses, from a peak of more than 3.3 million doses per day in mid-April.

Barring a sudden surge, the country will be just short of President Biden’s goal of getting a first dose of 70% of American adults by July 4. Until Tuesday, the country was on track for 68% of adults to have received a first dose by the holiday.

Thirteen states, mostly in the northeast and west coast, have already vaccinated at least 70% of adult residents, and several more remain set to do so in the coming weeks. Experts now believe the United States may never achieve herd immunity, the point at which the virus goes, but Mr Biden said getting 70% of adults vaccinated by July 4 would constitute “a serious step towards a return to normal.” “

But in parts of the South, it’s not clear whether this milestone will be achievable anytime soon – or ever.

“I certainly don’t expect us to hit 70 percent by July 4th. I don’t know if we’ll reach 70 percent in Alabama, ”said Dr. Karen Landers, assistant public health officer for Alabama. “We just have a certain group of people, from all walks of life, who just aren’t going to get the vaccine. “

Time is running out, both to prevent new infections and to use the doses already distributed to states. With a three-month shelf life at refrigeration temperatures, millions of doses of the Johnson & Johnson vaccine are set to expire nationwide this month, prompting some governors to urgently advocate for health providers to use them. soon.

As of Monday, more than 57,000 doses of the vaccine were due to expire this month in Arkansas, officials said. And in Tennessee, thousands of doses went unused with expiration dates looming.

From rural towns in Appalachia to urban centers like Memphis and Birmingham, Alabama, the downturn has forced authorities to refine their arguments for skeptical residents. Among the latest offers: mobile clinics, Facebook Live forums and free football tickets for those who get vaccinated.

In the small, central Mississippi town of Forest, Reverend Odee Akines pleaded with his church faithful to get vaccinated by sharing the story of his own near-fatal contact with Covid, which included being hospitalized for 80 days and in a coma for about a month. In Alabama, Nick Saban, the championship-winning football coach, urged fans to get vaccinated so they can watch games safely this fall.

So far there have been individual success stories, but no major changes in the trend. When Alabama officials set up a clinic at Talladega Superspeedway and let the vaccinated circulate on the famous track, about 100 people accepted the offer. Dr Landers said organizers had hoped for more people.

There is no reason why the South’s vaccination campaign is faltering, meaning that no solution is likely to change the trend. Many common barriers to immunization are not unique to the South, but are particularly prevalent there.

Some Republicans are suspicious of the government’s role in developing and promoting vaccines, polls show. Some blacks are wary of the medical profession because of generations of discriminatory care and experiences. And others are busy, biding their time, can’t make it to a vaccination site, or have unanswered questions.

True, millions of Southerners have already been vaccinated, and the vaccination campaign around some major cities in the region, including Nashville and Charleston, SC, has progressed much faster than in many rural areas. Vaccination rates in Virginia, Maryland, Delaware, and Washington, DC, have exceeded the national average.

But in much of the South, vaccine skepticism is pervasive. In Jackson, Mississippi, Felix Bell Sr., a warehouse supervisor, expressed concern about how quickly vaccines were developed. He had no intention of getting shot.

“At first they said it was going to take several years,” said Mr Bell, who said he had already recovered from Covid-19. “And then all of a sudden it was ‘Boom’.” He added: “They need to get more information on what’s going on down the line.”

The three vaccines that have been approved for emergency use by the federal government have been shown to be safe and very effective in preventing Covid-19. But Americans who were eager to get vaccinated already received their vaccines weeks ago. Now health officials are trying new methods to win over the indifferent and skeptical, and to reduce the number of cases in the months to come.

“My concern is the fall,” said Susanne Straif-Bourgeois, epidemiologist at Louisiana State University Health in New Orleans. “Because then everyone goes back to school, college, university.”

The national outlook has improved considerably in recent weeks. The country is recording an average of around 14,000 new cases a day, the fewest since testing became widely available, and deaths and hospitalizations have dropped. Governor Tate Reeves of Mississippi, a Republican, recently called Mr. Biden’s July 4 target arbitrary and said he was encouraged by the relatively low number of hospitalizations and cases in his state, which has the lowest vaccination rate in the country.

But doctors have warned that the low number of vaccinations could leave the South vulnerable to another wave of infections, a point some raise when offering the vaccines to skeptical residents. Federal authorities are particularly concerned about the highly transmissible Delta variant, first detected in India, which is increasingly prevalent in the United States. The Pfizer-BioNTech vaccine appears to offer protection against the Delta variant, officials said.

“If we don’t increase our numbers we could be where we were last year, safe in place,” said William Parker, chairman of Birmingham City Council, who has offered to spend millions of dollars. dollars in vaccine incentives and who answered questions about vaccines Monday as part of an online forum for residents.

In sparsely populated rural communities in northeast Tennessee, officials say they have had less trouble convincing people to get vaccinated than getting people vaccinated who lack time, transportation or knowledge about the process. In one community, two vans have been turned into rolling mobile vaccination sites, sent to churches and workplaces to intercept people while they go about their business.

There are modest signs of progress. On the first weekend the vans were in service, around 40 doses were administered. But in a recent event, around 135 people were vaccinated.

“We’ve always been slightly behind the rest of the country when it comes to infrastructure,” said Mark Stevans, director of special projects for the First Tennessee Development District, the agency overseeing the effort. “And I would say the vaccine is a critical part of the infrastructure.”

Across the region, doctors and public health officials repeatedly cited two factors as making a difference to those hardest to reach: easy access and a personalized pitch.

Dr Kelly Rodney Arnold, founder of Clínica Médicos, which treats the underserved and uninsured in Chattanooga, Tenn., Said she knew the trust she had built over the years with her patients, many of whom are Latin American, would be essential to overcome skepticism.

The phased rollout of vaccines, she said, allowed misinformation to spread and complicated the campaign.

“They’re not going to knock on the emergency room door to get the vaccine,” Dr. Arnold said. “They’re not going to tackle something new and full of scary information surrounding it.”

Luke Ramseth contributed reporting from Jackson, Miss. Lazaro Gamio, Amy Schoenfeld Walker and Noah Weiland contributed reports.

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