SURRY, Va. (AP) – When Charlome Pierce researched where her 96-year-old father could get a COVID-19 vaccine in January, she found no options anywhere near her home in Virginia. The only medical clinic in Surry County had none, and the last pharmacy in an area with about 6,500 residents and more land than Chicago closed years ago.
To take their pictures, some residents took a ferry across the long James River to cities like Williamsburg. Others drove for more than an hour through farms and woods – the county had its first traffic light in 2007 – to reach a medical center that offered the vaccine.
At one point, Pierce heard about a state-run vaccination event 45 minutes away. There were no more appointments available, which was perhaps the best: the wait there was supposed to last up to seven hours.
“It would have been a difficult task,” she said, citing her father’s health and the frequent need to use the bathroom. “I couldn’t tell you to sit in a car and wait for something to happen. We are not in a Third World country. ”
As the national campaign against coronavirus moves from mass inoculation sites to drugstores and doctor’s offices, vaccination remains a challenge for residents of “pharmacy deserts”, communities without well-equipped pharmacies or health clinics. To improve access ”, the federal government has partnered with 21 companies that manage autonomous pharmacies or pharmacy services in supermarkets and other locations.
More than 40,000 stores are expected to participate, and the Biden government said that almost 90% of Americans live within five miles of one, from Hy-Vee and Walmart to Costco and Rite-Aid.
But there are gaps in the map: more than 400 rural counties with a combined population of almost 2.5 million people do not have a retail pharmacy included in the partnership. More than 100 of these counties do not have a pharmacy or have a pharmacy that historically did not offer services such as flu vaccines and possibly does not have the equipment or certified staff to vaccinate customers.
Independent pharmacies that traditionally serve rural areas are disappearing, victims of mail order revenues and more competition from networks like Walgreen’s and CVS with greater bargaining power with insurance companies, according to Keith Mueller, director of the RUPRI Center for at the University of Iowa Policy Analysis Rural Health.
“Many counties would be left out” of the Federal Retail Pharmacy Program, said Mueller, whose research center compiled pharmacy data for 400 counties. “In western states in particular, you have a vast geography and very few people.”
The challenges of getting a vaccine close to home are not limited to rural areas. There is a relative shortage of medical facilities in some urban areas, especially for black Americans, according to a study published in February by the University of Pittsburgh School of Pharmacy and the West Health Policy Center.
The study listed 69 counties where black residents were much more likely to have to travel more than a kilometer to reach a potential vaccination site, including a federally qualified pharmacy, hospital or health center. One-third of these counties were urban, including counties in cities like Atlanta, Houston, Dallas, Detroit and New Orleans.
In addition, the study identified 94 counties where black residents were significantly more likely than white residents to travel more than 10 miles to reach a potential vaccination site. The counties were heavily concentrated in the southeastern United States – Virginia had more than any state with 16 – and Texas.
The scarcity of pharmacies and other medical infrastructure in some of the country’s rural areas highlights the health disparities that became most striking during the coronavirus pandemic, which disproportionately affected members of the racial minority and low-income groups.
The former pharmacy in Surry County, where about 40% of residents are black, is now a cafe. No one seems to remember exactly when the drug Surry was. Co. closed, but co-owner of the cafe, Sarah Mayo, remembers going there when she was a child. Now, she drives 45 minutes to a Walmart or CVS.
“I don’t know if more people would get the vaccine” if the pharmacy still existed, said Mayo, 62. “But at least you would have a local person you trust who would explain the pros and cons.”
Surry County residents also used to fetch prescriptions from the Wakefield Pharmacy in neighboring Sussex County, until it closed in November. The owner, Russel Alan Garner, wanted to retire and was unable to find a buyer.
“We became dinosaurs,” said Garner.
In January, Surry County officials saw vaccines arrive in other parts of Virginia with more people or more cases of coronavirus. Fearing that doses might take months, if ever, they began to put pressure on state officials.
In a letter to the governor’s office, Surry joined neighboring communities to express concerns about the “equality” of the vaccine, especially for low-income populations and other disadvantaged populations. Some of these communities said they had reallocated money to support vaccination efforts.
“The problem with living in a rural community is that you are often overlooked by everyone, from politicians to agencies,” said county supervisor Michael Drewry.
Surry County Administrator Melissa Rollins wrote to the regional health district, saying that driving outside the county was not practical for most residents. She said that Surry was willing to sponsor a mass vaccination site, devised a plan to recruit people who could administer the vaccines and ensure that eligible residents were ready.
The first clinic in Surry County was held on February 6 at the small town of Dendron High School. The school district was inoculating teachers and other staff members when county and regional health district officials learned of the extra doses, which led to a rush to spread the news.
Surry already had a waiting list of eligible people through a survey designed to target vulnerable residents. He used his emergency telephone alert system, as access to the Internet is irregular.
Pierce got the call and quickly left with his father, Charles Robbins. It was a 20-minute drive to school and a two-hour wait. Pierce, 64, also had a chance, along with about 240 other people that day.
Three more vaccination clinics were held in the municipality. And the regional health district administered 1,080 doses there on March 2. The number represents the majority of doses that county residents received, although several hundred received their vaccines outside the county.
In all, about 1,800 county residents received at least one dose. This represents about 28% of the population and was almost double the state’s average rate. About half of the people who received vaccines are black.
The Virginia Department of Health said the vaccine’s distribution was based on population and COVID rates. But moving forward, the department said it is considering adjustments to ensure more geographic and racial equality.
Pierce and his father were relieved to get the second shot in late February. But she said Surry’s rural character put him at a disadvantage at first.
“I have close friends, people who are essential workers, who had to distance themselves for up to an hour to get a chance,” she said. “You shouldn’t be marginalized by your postal code.”
But driving long distances is a way of life for many in rural areas, said Bruce Adams, a rancher and San Juan County Commissioner in Utah, which is almost the size of New Jersey and overlaps the Navajo nation.
“I got both vaccines and had to drive 70 kilometers round trip for each one to a public health center,” said Adams, 71. “I don’t think it’s more problematic than anything else we normally do in our lives … going to the doctor, the dentist, getting a haircut.”