Coronavirus vaccines were distributed unevenly in the United States, but four states in the Deep South had particularly dismal inoculation rates that alarmed health experts and frustrated residents.
In Alabama, Georgia, Mississippi and South Carolina, less than 2% of the population received their first dose of a vaccine earlier in the week, according to data from the states and the United States Centers for Disease Control and Prevention.
As in other parts of the country, the southern states face a number of challenges: limited supplies of vaccines, health professionals who refuse to be vaccinated and bureaucratic systems that are not equipped to schedule the large number of requested appointments.
But other states still managed – in the best possible way – to put vaccines in the arms of more than 5% of their populations.
While it is unclear why Deep South is lagging behind, public health researchers note that it has typically lagged in public health financing and in addressing disparities in serving its large rural population.
“When you combine a large percentage of rural residents who tend to be hard-to-reach populations and have fewer suppliers in an attempt to build a vaccine infrastructure in real time, this is just a recipe for a not very good response , ”Said Sarah McCool, professor of public health at Georgia State University.
In Georgia, the state’s rural health system has been decimated in recent years, with nine hospital closures since 2008, including two last year. Local health departments have become the main suppliers of vaccines in some locations, as employees work to add locations where doses can be administered.
“If we are the only game in town, this process will take a long time,” Lawton Davis, director of a major public health district that includes Savannah, said at 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 at the University of North Carolina’s Sheps Center. Alabama, Georgia and Mississippi are among the last five U.S. states in access to health care, according to a 2020 report by a nonprofit foundation connected to insurance giant UnitedHealth.
But generally speaking, experts say it is too early in the vaccine launch to draw conclusions about the region’s shortcomings, and they cannot be easily attributed to a particular factor or trend.
“We are building this plane while we fly, and there will be errors along the way,” said Amber Schmidtke, a microbiologist who follows the spread of the vaccine in the south.
Officials from each state cited several challenges, but also recognized shortcomings.
“We have a lot of vaccines distributed that are not yet on the guns,” said Mississippi Governor Tate Reeves, who noted that some hospitals in the state are not using their vaccine doses. He said the practice “has to stop”.
Georgia Governor Brian Kemp cited a similar challenge and warned providers that hold the vaccines that the state would take unused doses, even if it required “starting” his truck and doing it himself.
But in South Carolina, hospital officials say it is the state that has moved very slowly to expand access to vaccines, leaving them with unused doses. The state recently offered the vaccine to people aged 70 and over.
Mississippi’s Reeves said one of the biggest shortcomings in the state’s vaccination system is the federal partnership with CVS and Walgreens to administer vaccines at long-term care facilities. Drugstore chains have been slow to hire enough people to do the job in Mississippi, the governor said.
CVS Health said in a statement that it has “the appropriate resources to finish the job” at long-term care institutions. Walgreens did not respond to an email.
During an online forum organized by Jackson State University in Mississippi on Thursday, American surgeon general Jerome Adams, who is black, noted the reluctance of many African Americans to be vaccinated. He cited a general distrust of medical systems that goes back to a now-defunct government study that began in the 1930s and left black men untreated for syphilis for decades.
So far, only 15% of COVID-19 vaccinations in Mississippi have gone to blacks, who make up about 38% of the population, said state health officer Dr. Thomas Dobbs during the forum.
Officials in all four states also said that some health professionals – among the first groups eligible for a vaccine – are choosing not to be inoculated. And some emphasized that states were dealing with limited supplies and high demand and begged people to be patient.
“Yes, the phone lines will be busy. Yes, the sites will certainly crash, ”said Kemp on Tuesday. “There are simply more Georgians who want the vaccine than they can get today.”
Mississippi officials said the state’s website and telephone line were overloaded after the governor announced on Tuesday that vaccines were available to people age 65 and older or people with underlying medical conditions.
Liz Cleveland, a 67-year-old retired state employee who lives in Jackson, waited hours on the site using her cell phone, computer and tablet only to find unknown errors.
“It’s like playing. You can hit or bust, ”said Cleveland.
At about 2 am on Wednesday morning, she finally managed to make appointments for herself and her husband next week in Hattiesburg, which is 145 kilometers away. Mississippi officials said on Thursday they would soon open an additional vaccination facility in the state’s largest county.
Alabama officials have also been inundated with requests for nominations since they announced that the state will start vaccinating people over 75 next week. A state hotline received more than one million calls on the first day it was opened.
Celia O’Kelley of Tuscaloosa said she was unable to speak to anyone to make an appointment for her 95-year-old mother.
“I’m scared because Tuscaloosa is a hot spot,” she said.