ATLANTA (AP) – Coronavirus vaccines have been released unevenly across the United States, but four deep-south states have had particularly bleak inoculation rates, which have alarmed health experts and frustrated residents.
In Alabama, Georgia, Mississippi and South Carolina, less than 2% of the population had received the first dose of vaccine earlier this week, according to data from US states and Centers for Disease Control and Prevention.
As in other parts of the country, southern states face a number of challenges: limited vaccine supplies, health workers who refuse to be inoculated, and bureaucratic systems that are not equipped to schedule the huge number of appointments required.
But other states have still managed – at best – to introduce vaccines into the arms of more than 5% of their population.
Although it is not clear why the Deep South lags behind, public health researchers note that it has usually lagged behind in funding public health and addressing disparities in the care of its large rural population.
“When you combine a large percentage of rural residents who tend to be hard-to-reach populations and have a smaller number of providers trying to build a vaccination infrastructure on the go, this is just a recipe for a less so response. Sarah McCool, a professor of public health at Georgia State University, said.
In Georgia, the state’s rural health system has been decimated in recent years, with nine hospital closures in 2008, including two last year. Local health departments have become the first providers of vaccines in some locations as officials work to add sites where doses can be administered.
“If we’re the only game in town, this process will take a long time,” said Lawton Davis, director of a large public health district that includes Savannah, at a news conference Monday.
Alabama and Mississippi were also severely affected 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 ranked in the top five U.S. states in terms of access to health care, according to a 2020 report by a nonprofit foundation connected to insurance giant UnitedHealth.
But in general, experts say it is too early to launch the vaccine to draw conclusions about the shortcomings in the region and can not be easily attributed to a particular factor or trend.
“We are building this plane while flying and they will be wrong along the way,” said Amber Schmidtke, a microbiologist who sought to spread the vaccine in the south.
Officials in each state cited a number of challenges, but also acknowledged the shortcomings.
“We have too many vaccines distributed that are not yet in our arms,” said Mississippi Governor Tate Reeves, who noted that some hospitals in the state do not use their vaccine doses. He said the practice “must stop”.
Georgia Gov. Brian Kemp cited a similar challenge and warned vaccine suppliers that the state would take their unused doses, even if it required “burning” his truck and doing it alone.
But in South Carolina, hospital officials say the state has moved too slowly to expand access to vaccinations, leaving them with unused doses. Recently, the state offered the vaccine to those over 70 years old.
Reeves of Mississippi said one of the biggest weaknesses of the state’s immunization system is the federal partnership with CVS and Walgreens for administering immunizations in long-term care facilities. Pharmacy chains have slowed the hiring of people to do work in Mississippi, the governor said.
CVS Health said in a statement that it has “adequate resources to finish the job” at long-term care facilities. Walgreens did not respond to an email.
During an online forum hosted by Jackson State University in Mississippi on Thursday, 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 stemming from the now-defunct government study, which began in the 1930s and left black men untreated for syphilis for decades.
So far, only 15 percent of COVID-19 vaccinations in Mississippi have been targeted at people of color, who make up about 38 percent of the population, said state health officer Dr. Thomas Dobbs during the forum.
Officials from all four states also said that some health workers – among the first groups eligible for a vaccine – choose not to be inoculated. And some have pointed out that states are dealing with limited supply and demand and have begged people to be patient.
“Yes, the telephone lines will be busy. Yes, websites will definitely collapse, “Kemp said Tuesday. “There are simply many more Georgians who want the vaccine than they can get today.”
Mississippi officials said the state’s website and hotline were overwhelmed after the governor announced Tuesday that vaccinations are available for people 65 years of age or older or people with underlying medical conditions.
Liz Cleveland, a 67-year-old state employee who lives in Jackson, waited for hours on the site using her cell phone, computer and tablet only to encounter unknown errors.
“It’s like gambling. You might hit or throw, “Cleveland said.
On Wednesday, around 2 am, she finally managed to book meetings for herself and her husband next week in Hattiesburg, which is 145 kilometers away. Mississippi officials said Thursday they will soon open an additional vaccination site in the state’s largest county.
Alabama officials have also been inundated with applications for appointments since announcing the state will begin vaccinations for people over 75 weeks in the future. A state hotline received more than a million calls on the first day it was opened.
Celia O’Kelley of Tuscaloosa said she can’t reach anyone to make an appointment for her 95-year-old mother.
“I’m scared because Tuscaloosa is a hot spot,” she said.
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Associated Press writers Kim Chandler in Montgomery, Alabama; Emily Wagster Pettus in Jackson, Mississippi; and Michelle Liu of Columbia, South Carolina, contributed to this report.