ATLANTA (AP) – Coronavirus vaccines have been rolled out unevenly across the US, but four states in the Deep South have seen particularly bleak vaccination numbers that have alarmed health experts and frustrated residents.
According to data from the states and the U.S. Centers for Disease Control and Prevention, in Alabama, Georgia, Mississippi and South Carolina, less than 2% of the population had received the first dose of a vaccine at the beginning of the week.
As in other parts of the country, states in the South face a number of challenges: limited vaccine supplies, health workers refusing to be vaccinated, and bureaucratic systems not equipped to schedule the massive number of appointments.
But other states have still managed – at their best – to get the vaccines into the arms of more than 5% of their population.
While it’s not clear why the Deep South is lagging behind, public health researchers note that it tends to lag behind in funding public health and addressing inequalities in caring for the large rural population.
“If you combine a large percentage of rural residents who are often the hard-to-reach populations and have a smaller number of providers trying to build a vaccine infrastructure, that’s just a recipe for a not-so-great response,” said Sarah McCool , professor of public health at Georgia State University.
In Georgia, the state’s rural health system has been decimated in recent years, with nine hospital closures since 2008, including two last year. Local health departments have become the main vaccine providers in some locations as officials work to add locations where doses can be administered.
“If we’re the only game in town, this process will take a long time,” Lawton Davis, director of a major public health district that includes Savannah, said at a news conference Monday.
Alabama and Mississippi have also been hit hard by the closure of rural hospitals. According to researchers at the University of North Carolina Sheps Center, seven hospitals have closed in Alabama since 2009 and six in Mississippi since 2005. According to a 2020 report from a nonprofit foundation affiliated with insurance giant UnitedHealth, Alabama, Georgia and Mississippi are in the bottom five of the U.S. states in terms of access to health care.
But overall, experts say it’s too early in the vaccine rollout to draw conclusions about the region’s shortcomings, and they can’t be easily attributed to any particular factor or trend.
“We’re building a kind of airplane as we fly, and there will be missteps along the way,” said Amber Schmidtke, a microbiologist who has monitored the spread of vaccines in the South.
Officials in the individual states have identified a number of challenges, but also recognized shortcomings.
“We have distributed too many vaccines that are not yet in armament,” said Mississippi Governor Tate Reeves, noting that some hospitals in the state are not using their vaccine doses. He said the practice “must stop.”
Georgia government Brian Kemp cited a similar challenge, warning providers tied to vaccines that the state would take their unused doses, even if it required his pickup truck to be ‘stoked’ and do it himself.
But in South Carolina, hospital officials say it’s the state that has moved too slowly to expand access to the vaccines, leaving them with unused doses. The state recently offered the vaccine to people 70 and older.
Reeves of Mississippi said one of the biggest weaknesses in the state’s vaccination system is the federal partnership with CFS and Walgreens to administer vaccinations in long-term care facilities. The pharmacy chains have been slow to hire enough people to do the job in Mississippi, the governor said.
CVS Health said in a statement that it has “the right resources to get the job done” 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, American surgeon general Jerome Adams, who is black, noted that many African Americans are reluctant to be vaccinated. He cited a widespread distrust of medical systems dating back to a now-defunct government study that began in the 1930s and left black men untreated for syphilis for decades.
So far, only 15% of COVID-19 vaccinations in Mississippi have gone to black people, who make up about 38% of the population, said state health official Dr. Thomas Dobbs during the forum.
Officials in all four states also said some health professionals – among the first groups to qualify for a vaccine – choose not to be vaccinated. And some stressed that states were dealing with limited supplies and high demand and begged the people to be patient.
Yes, the phone lines will be busy. Yes, the websites are bound to crash, ”Kemp said on Tuesday. “There are just a lot more Georgians who want the vaccine than can get it today.”
Mississippi officials said the state’s website and telephone hotline were overwhelmed after the governor announced Tuesday that vaccinations were available for people 65 or older or those with underlying medical conditions.
Liz Cleveland, a 67-year-old retired state employee living in Jackson, waited hours on the website with her cellphone, computer, and tablet to run into unknown errors.
It’s like gambling. You can hit or you can bust, ”Cleveland said.
Wednesday around 2am she could finally book appointments for herself and her husband next week in Hattiesburg, which is 90 miles away. Mississippi officials said on Thursday that they will soon be opening an additional drive-thru site for vaccinations in the state’s largest county.
Alabama officials have also been inundated with requests for appointments since the announcement that the state will begin vaccinations for over-75s next week. A state hotline received more than a million calls the first day it opened.
Tuscaloosa’s Celia O’Kelley said she couldn’t reach anyone to book an appointment for her 95-year-old mother.
“I’m afraid 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 in Columbia, South Carolina contributed to this report.