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Covid-19 vaccine demand is slowing in parts of the US. Now starts an uphill


Nearly three months later, with plenty of vaccine supply on hand and eligibility open to all residents 16 and older, officials struggled to fill appointments, said Kristy Fryman, the emergency response coordinator and public information officer for the Mercer County Health District. About 264 people received their first dose at the district’s clinic earlier this month — roughly half the number of people who were signing up at the start of the rollout.

“People in rural areas tend to have an attitude of being self-sufficient, especially among the younger population,” Fryman said. “We’ve also heard people are waiting to get the vaccine because they’re wanting to know the side effects down the road from it. And then another comment would be that the vaccine is just too new.”

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In nearby Paulding County, a rural community that’s “all villages” and home to less than 19,000 people, the health department’s emergency response coordinator has seen a similar trajectory. Just weeks ago, the department would sign up several hundred people on its Covid-19 vaccine wait lists. Now, “we do not have a wait list,” Bill Edwards said. Roughly 29% of the county’s population have started their Covid-19 vaccination, state data shows.
And it’s not just in Ohio. Pharmacies in one part of Louisiana say Covid-19 vaccine demand has “completely fallen off.” Georgia officials announced recently they were shutting down a mass vaccination site due to low demand. Tennessee leaders said late last month they were opening eligibility following low numbers of vaccinations in rural areas. Parts of Texas have also seen declining demand.
Drive thru clinic in Mercer County, Ohio

“We’re reaching the point where we’re getting to the hard audiences,” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials (NACCHO). “The ones that either are unsure or on the fence about the vaccine, don’t have enough information or are just plain outright… not interested in the vaccine for other reasons.”

Experts, including Dr. Anthony Fauci, estimate somewhere between 70-85% of the country needs to be immune to the virus — either through inoculation or previous infection — to suppress its spread. But the US is nowhere near those levels yet and the slowing demand — especially now that eligibility has opened up — means getting there might be a taller task than some local officials expected.

A problem of demand

The slowing of vaccine uptake is not surprising, says infectious diseases specialist and epidemiologist Dr. Céline Gounder.
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She told the United States Congress Joint Economic Committee on Wednesday that a major challenge for Covid-19 vaccinations in the coming months will be the demand: getting enough people signed up to take the shot. And there are several reasons why.

Many Americans, including among communities of color, still have challenges with access, Gounder told CNN. Civil rights leaders have said that while hesitancy in those communities is decreasing, many people of color don’t have vaccine sites in their neighborhood. They also may need assistance with transportation, internet access or help with the registration process. The Biden administration announced last month it would dedicate nearly $10 billion to expand access for hard-hit and high-risk communities and help increase vaccine confidence across the country.
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“The work that we’re doing on the equity piece needs to be done more deeply and done in the communities where people are living and working,” said NACCHO’s Freeman. “We have to be very creative in finding unique ways to reach people, including making sure that they have the easiest access possible to vaccine.”

In Mercer County, Fryman said officials are making efforts to make the vaccines more accessible, including events targeting the Hispanic population and initiatives to get more information to the Amish and Marshallese populations.

Other groups are hesitant, Gounder said, including younger Americans as well as what she calls the “moveable middle” — those who are on the fence but who may be swayed with more Covid-19 vaccine information.

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“Then you have another group that is much more resistant, more entrenched in their views, it’s about 20% of Americans,” Gounder said. Those are more rural, conservative Americans who lack trust in the healthcare system and government, she said.

“That group is more challenging because it’s not necessarily a group that will respond to education the way that the sort of more moveable middle will,” Gounder said. “And that’s what we’re worried about.”

One in five rural residents still say they will definitely not get vaccinated, according to a recent analysis by the Kaiser Family Foundation. About 73% of those respondents leaned Republican and 41% identified as White Evangelical Christians. Experts say that anti-vaccine sentiment among the Evangelicals is fueled by several factors, including misinformation and political identity. And the impacts could be significant.
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