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NASHVILLE, Tennessee (AP) – Rita Fentress feared she would get lost as she drove the one-lane forest road through the Tennessee countryside in search of a coronavirus vaccine. Then the trees cleared and the Hickman County Farm Lodge appeared.
The 74-year-old was not eligible to be vaccinated in Nashville, where she lives, as there were so many health workers to be vaccinated there. But a neighbor told her that the state’s rural counties had already moved into younger age groups and that she had found a date 60 miles away.
“I felt a little guilty about it,” she said. “I thought maybe I was taking it from someone else. But at the end of that day in February, she said there were still five openings for the next morning.
The U.S. vaccination campaign has escalated tensions between rural and urban America, where from Oregon to Tennessee to upstate New York, complaints are surfacing of real – or perceived – inequality in the allocation of vaccines.
In some cases, complaints about vaccine scarcity have taken on a partisan tone, with rural Republican lawmakers in Democratic-led states complaining about “picking winners and losers,” and city dwellers traveling for hours to rural communities. with GOP tendency to mark COVID-19 hits when there is none in their city.
In Oregon, state GOP lawmakers walked out of a legislative session last week on the Democratic governor’s immunization plans, citing rural vaccine distribution among their concerns. In upstate New York, rural county public health officials complained about disparities in vaccine allocation and in North Carolina, rural lawmakers say too many doses were intended for clinics. mass vaccination of large cities.
In Tennessee, Missouri and Alabama, the shortage of gunshots in urban areas with the highest numbers of healthcare workers has led seniors to book appointments at hours from home. The result is a mishmash of approaches that may sound like the exact opposite of fairness, where the people most likely to be vaccinated are people with the know-how and the means to research a vaccine and travel wherever he is.
“It’s really, really flawed,” said Amesh Adalja, a senior researcher at the Johns Hopkins Center for Health Security, who noted that there are even vaccine hunters who will find a dose for money. “Ideally, the allocations would meet the needs of the population.”
With little more than general advice from the federal government, states have taken it upon themselves to decide what it means to distribute the vaccine equitably and reach vulnerable populations.
Tennessee, like many states, has split doses based primarily on the county’s population, not the number of residents in qualifying groups – such as healthcare workers. The Tennessee Health Commissioner has championed the allocation as the “fairer,” but the approach has also exposed another layer of haves and have-nots as the vaccine rollout accelerates.
In Oregon, the issue has led state officials to suspend dose deliveries in some rural areas that had finished vaccinating their health workers while clinics elsewhere, including the Portland metropolitan area, were catching up. Last month’s dust sparked an angry backlash, with some state GOP lawmakers blaming the Democratic governor to play favorites with the townspeople who elected her.
Public health officials in Morrow County, an agricultural region in northeastern Oregon with one of the highest rates of COVID-19 infection, said they had had to delay two health clinics. vaccination due to state decision. Other rural counties have delayed vaccination of the elderly.
States face many challenges. Rural counties are less likely to have the freezing equipment needed to store Pfizer vaccines. Health workers are often concentrated in large cities. And rural counties have been particularly hard hit by COVID-19 in many states, but their residents are among the most likely to say they “definitely” won’t get the vaccine, according to a recent Kaiser Family survey. Foundation.
Adalja said most of these complications were predictable and could have been avoided with proper planning and funding.
“There are people who know how to do this,” he says. “They just aren’t responsible for it.”
In Missouri, where Facebook groups have emerged with posts about rural dating availability, State Senate Minority Leader John Rizzo, a Democrat from suburban Kansas City in Independence, spoke of the need to direct more vaccines to urban areas.
The criticism drew an angry rebuke from Republican Gov. Mike Parson, who said vaccine distribution was proportional to population and critics used “hand-picked” data.
“There is no division between rural and urban Missouri,” Parson said in his weekly COVID-19 update last week.
In Republican-run Tennessee, Health Commissioner Lisa Piercey notes that the Trump administration has considered the state’s plan to be among the fairest in the country. Additional doses go to 35 counties with a high social vulnerability index – many small and rural, but also Shelby County, which includes Memphis, with a large black population.
State officials last week revealed that around 2,400 doses were wasted in Shelby County last month due to poor communication and insufficient record keeping. The county has also accumulated nearly 30,000 excessive doses in its inventory. The situation prompted the Centers for Disease Control and Prevention to investigate and the county health director resigned.
In Nashville, Democratic Mayor John Cooper says that the fact that townspeople can get vaccinated elsewhere is a plus, even if road trips are “a bit of a pain.”
“I’m thankful the other counties didn’t say, ‘Oh my gosh, you still have to be a resident of this county to get the vaccine,’” Cooper said.
Nashville educators Jennifer Simon and Jessica Morris took sick days last week to make the four-hour round trip to tiny Van Buren County, a population of less than 6,000.
They had their first shots there in January, when Republican Gov. Bill Lee was pushing Nashville and Memphis area schools back to class in person. Republican lawmakers have even threatened to withdraw funds from districts that remain online.
In-person classes started a few weeks ago, but the city didn’t start vaccinating teachers until last week.
“It was scary, frustrating and feeling really betrayed,” Simon said.
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Flaccus reported from Portland, Oregon. Jim Salter in O’Fallon, Missouri; Bryan Anderson in Raleigh, NC, and Carla Johnson in Washington state contributed.
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