Rural US facing vaccine vacuum

SURRY, Virginia (AP) – When Charlome Pierce searched for where her 96-year-old father could get the COVID-19 vaccine in January, she found no options near their home in Virginia. Surry County’s only medical clinic didn’t have one, and the last pharmacy in an area with about 6,500 people and more land than Chicago closed years ago.

To get their photos, some residents took a ferry across the vast James River to towns like Williamsburg. Others drove more than an hour past farms and woods – the county got its first red light in 2007 – to reach a medical facility offering the vaccine.

At one point, Pierce heard about a state-run immunization event 45 minutes away, no more appointments were available, which was perhaps for the best: the wait could go on. until seven o’clock.

“It would have been a daunting task,” she said, citing her father’s health issues and the frequent need to go to the bathroom. “I couldn’t have made him sit in a car and wait for something that might happen. We are not in a third world country. ”

As the national coronavirus campaign shifts from mass inoculation sites to pharmacies and doctors’ offices, getting vaccinated remains a challenge for residents of ‘pharmacy deserts’, communities without pharmacies or well-equipped health clinics. . To improve access, “the federal government has partnered with 21 companies that operate stand-alone pharmacies or pharmacy services in grocery stores and other locations.

More than 40,000 stores are expected to participate, and the Biden administration said nearly 90% of Americans live within five miles of one, from Hy-Vee and Walmart to Costco and Rite-Aid.

But there are loopholes in the map: more than 400 rural counties with a combined population of nearly 2.5 million people do not have a retail pharmacy included in the partnership. More than 100 of these counties either do not have a pharmacy or have a pharmacy that historically did not offer services such as the flu shot, and perhaps lacked the equipment or certified personnel to vaccinate them. clients.

According to Keith Mueller, director of the RUPRI Center for at the University of Iowa, the independent pharmacies that traditionally served rural areas have disappeared, the victims of mail order sales and increased competition from chains like Walgreen’s and CVS with a greater great bargaining power with insurance companies. Rural health policy analysis.

“There are a lot of counties that would be excluded” from the federal retail pharmacy program, said Mueller, whose research center compiled pharmacy data on all 400 counties. “In the western states in particular, you have a vast geography and very few people.”

The challenges of getting a vaccinated vaccine close to home are not limited to rural areas. There is a relative dearth of medical facilities in some urban areas, especially for black Americans, study finds published in February by the University of Pittsburgh School of Pharmacy and the West Health Policy Center.

The study identified 69 counties where black residents were much more likely to have to travel more than a mile to get to a potential vaccination site, including a federally qualified pharmacy, hospital or health center. A third of those counties were urban, including the original counties of cities such as Atlanta, Houston, Dallas, Detroit, and New Orleans.

Additionally, the study identified 94 counties where black residents were much more likely than white residents to have to travel more than 10 miles to reach a potential vaccination site. The counties were mostly heavily concentrated in the Southeastern United States – Virginia had the most of all states at 16 – and Texas.

The dearth of pharmacies and other medical infrastructure in some rural areas of the country highlights the health care disparities that became more marked during the coronavirus pandemic, which disproportionately affected members of racial minorities and low income groups.

The old Surry County Pharmacy, where about 40% of the residents are black, is now a cafe. No one seems to remember exactly when the Surry Drug was taken. Co. closed, but the café’s co-owner, Sarah Mayo, remembers going there as a child. Now she drives 45 minutes to a Walmart or CVS.

“I don’t know if more people would take the vaccine” if the pharmacy still existed, said Mayo, 62. “But at least you would have a local person you trust who can explain the pros and cons.”

Residents of Surry County also used to collect prescriptions at the pharmacy in Wakefield, in neighboring Sussex County, until it also closed in November. Owner Russell Alan Garner wanted to retire and couldn’t find a buyer.

“We have become dinosaurs,” Garner said.

In January, Surry County officials saw vaccines arrive in other parts of Virginia that had more people or more cases of the coronavirus. Fearing that the doses would arrive for months, if at all, they began to pressure state officials.

In a letter to the governor’s office, Surry joined surrounding communities in expressing concerns about the “fairness” of vaccines, especially for low-income and other disadvantaged populations. Some of these communities said they reallocated money to support immunization efforts.

“Living in a rural community is that you are often overlooked by everyone from politicians to agencies,” County Supervisor Michael Drewry said.

Surry County Administrator Melissa Rollins wrote to the Regional Health District, saying driving outside the county was impractical for most residents. She said Surry was willing to sponsor a mass vaccination site, had come up with a plan to recruit people who could administer vaccines and ensure that eligible residents would be ready.

The first clinic in Surry County was held on February 6 at the high school in the small town of Dendron. The school district was giving vaccinations to teachers and other staff when county and regional health district officials learned of the extra doses, prompting the message to be spread.

Surry already had a waiting list of eligible people through a survey designed to reach vulnerable residents. He used his emergency alert phone system because internet access is spotty.

Pierce got the call and quickly walked over to his father, Charles Robbins. It was a 20 minute drive to the school and a two hour wait. Pierce, 64, also had a photo, along with around 240 other people that day.

Three other vaccination clinics were organized in the county. And the regional health district had administered 1,080 doses there as of March 2. That number represents the majority of the doses residents of the county have received, although several hundred have received their injections outside the county.

In total, about 1,800 people in the county have received at least one dose. This represents about 28% of the population and was almost double the state average rate. About half of the people who have received vaccines are blacks.

The Virginia Department of Health said vaccine distribution was based on population and COVID rates. But moving forward, the ministry said it was considering making changes to ensure greater geographic and racial fairness.

Pierce and his father were relieved to be vaccinated at the end of February. But she said Surry’s rural character had put her at a disadvantage at first.

“I have close friends, people who are essential workers, who had to go up to an hour to get vaccinated,” she said. “You shouldn’t be marginalized by your zip code.”

But driving long distances is a way of life for many in rural areas, said Bruce Adams, rancher and commissioner for San Juan County in Utah, which is almost the size of New Jersey and straddles the Navajo Nation.

“I had both vaccines, and had to drive 44 miles round trip each to a public health facility,” said Adams, 71. “I don’t think that’s more of a problem than anything we normally do in our lives … going to the doctor, the dentist, getting a haircut.”