NASHVILLE, Tennessee (AP) – Rita Fentress was worried she might get lost while traveling on the unknown, one-lane forest road in Tennessee in search of a coronavirus vaccine. Then the trees were cleared and the agricultural pavilion of Hickman County appeared.
The 74-year-old woman was not eligible to be vaccinated in Nashville, where she lives, because there were so many health workers who were to be vaccinated there. But a neighbor told her that the state’s rural counties had already moved into younger age groups and found a meeting 60 miles away.
“I felt a little guilty about it,” she said. “I thought maybe I’d take it from someone else.” But at the end of that day in February, she said there were five more openings for the next morning.
The US vaccination campaign has increased tensions between rural and urban America, where from Oregon to Tennessee to upstate New York complaints there is a real – or perceived – inequity in vaccine allocation.
In some cases, recriminations over the distribution of rare vaccines have taken on a partisan tone, with rural Republican lawmakers in Democrat-led states complaining about “choosing winners and losers,” and urbanites traveling for hours in GOP-leaning rural communities to join COVID. -19. shots when there is none in their city.
In Oregon, GOP lawmakers walked out of a legislative session last week on the Democratic governor’s vaccination plans, citing the distribution of the rural vaccine among their concerns. In upstate New York, public health officials in rural counties have complained about disparities in vaccine allocation, and in North Carolina, lawmakers in rural areas say too many doses went to mass vaccination centers in rural New York State. big cities.
In Tennessee, Missouri and Alabama, a lack of photos in the urban areas with the highest numbers of health workers has led older citizens to close their home hours. The result is a mix of approaches that can show the exact opposite of fairness, where those most likely to be vaccinated are people with the skills and means to look for a shot and travel wherever they are.
“It’s 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 the money. “Ideally, the allocations would meet the needs of the population.”
With little more than general guidance from the federal government, states are committed to deciding what the correct distribution of the vaccine means and reaching vulnerable populations.
Tennessee, like many states, has divided doses based primarily on the county’s population, not the number of residents belonging to eligible groups – such as health care workers. The Tennessee health commissioner defended the allocation as “the fairest”, but the approach also exposed another layer of haves and shortages as the vaccine launch accelerates.
In Oregon, the issue has prompted state officials to stop delivering doses in some rural areas that had ended up inoculating their healthcare workers while clinics elsewhere, including the Portland subway area, were lagging behind. Last month’s dust provoked an angry response, with some GOP lawmakers accusing the democratic governor to play favorites with the inhabitants of the cities that chose her.
Public health leaders in Morrow County, an agricultural region in northeastern Oregon with one of the highest rates of COVID-19 infection, have said they must delay two vaccination clinics because of the state’s decision. Other rural counties have delayed vaccines for the elderly.
States face many challenges. Rural counties are less likely to have the freezing equipment needed to store Pfizer vaccines. Healthcare workers are often concentrated in large cities. Rural counties have also been particularly hard hit by COVID-19 in many states, but their residents are among the most likely to say they will “certainly not” be vaccinated, according to recent Kaiser Family Foundation surveys.
Adalja said most of these complications are predictable and could have been avoided with proper planning and funding.
“There are people who know how to do that,” he said. “They’re just not responsible for that.”
In Missouri, where Facebook groups appeared with posts about the availability of appointments in rural areas, Senate Minority State Leader John Rizzo, a Democrat from the Kansas City Independence Suburb, mentioned the need to target more vaccine to urban areas .
Critics have drawn a furious rebuke from Republican Gov. Mike Parson, who said the distribution of vaccines was proportional to the population, and critics use “collected” data.
“There is no division between rural and urban Missouri,” Parson said during his weekly COVID-19 update last week.
In Republican-led Tennessee, Health Commissioner Lisa Piercey notes that the Trump administration has considered the state plan among the most equitable nations. The additional doses reach 35 counties with a high score of the social vulnerability index – many small and rural, but also Shelby County, which includes Memphis, with a large black population.
Last week, state officials revealed that about 2,400 doses were wasted in Shelby County last month due to miscommunication and insufficient record keeping. The county has also accumulated nearly 30,000 overdoses in its inventory. The situation led the Centers for Disease Control and Prevention to investigate and the county health director to resign.
In Nashville, Democratic Mayor John Cooper says the city can get gunfire elsewhere is a positive thing, even if road trips are “a little painful.”
“I am grateful that other counties have not said, ‘Lord, you must always be a resident of this county to receive the vaccine,'” Cooper said.
Nashville educators Jennifer Simon and Jessica Morris spent their sick days last week on a four-hour round trip to the small town of Van Buren, with a population of less than 6,000.
They received their first photos there in January, when Republican Gov. Bill Lee was pushing schools in Nashville and Memphis to return to in-person classes. Republican lawmakers have even threatened to withdraw funds from districts that have remained online.
The in-person classes started a few weeks ago, but the city only started vaccinating teachers last week.
“It was scary, frustrating and really betrayed,” Simon said.
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Flaccus reported from Portland, Oregon. Jim Salter in O’Fallon, Missouri; Bryan Anderson of Raleigh, NC and Carla Johnson of Washington contributed.