Health officials from several counties with low rates of fully vaccinated residents say vaccine hesitancy is a problem

Photo illustration from Forbes.com

By Melissa Patrick
Kentucky Health News

As Kentucky's coronavirus vaccine supply exceeds Kentuckians' demand for it, with only about 43% of those eligible having received at least one dose, health officials in counties with low vaccine rates say vaccine hesitancy is playing a role in that. 

"I think the people who want it have found it . . . and I think what's left are people that are still a little hesitant to take it," said Anita Bertram, director of the Lewis County Health Department. "Because you know, I've got it. I've got it today. They could come right now and I could get it in their arms."  

Bertram said the health department is holding a mass clinic on April 14, with more than 200 slots still available. Further, she said the health department offers about 100 vaccine slots each week, and for two weeks running they have struggled to fill them. 

"I feel like a broker, trying to get people to come and take vaccines -- like before you call over to the Dollar Store trying to ramp somebody up to take a Johnson & Johnson," she said. 

According to the Centers for Disease Control and Prevention, Lewis County has one of the lowest percentages of residents who are fully vaccinated in Kentucky. On April 8, the CDC's Covid Data Tracker showed 12.3 percent of the population has been fully vaccinated. The county with the highest rate was Woodford, at 31.3%. 

Bertram said the health department has given 1,590 people a vaccine and 2,490 doses, including both prime and booster shots.  

Until recently, the department has been the only place to offer a vaccine in Lewis County, but this week the county's federally qualified health center got its first batch. 

It's important that the state's FQHCs, generally known as community health centers, will be getting a "bolus of vaccines" in the upcoming weeks, since they provide primary care to more than 500,000 Kentuckians, said David Bolt, CEO of the Kentucky Primary Care Association. He said the next phase of getting Kentuckians vaccinated will require a "ground game" that takes the vaccines out into the community.

He also pointed to a survey in Jefferson County that found most of participants said they would prefer to be vaccinated by their health-care provider.

"We have over 500,000 in our clinics," he said. "And most of those folks, they rely on those clinics and they trust the providers there. A lot of this is about trust. If someone's got a fear of the vaccine, most of them feel free to talk to their doctor. . . . and in some instances, their pharmacist." 

Lewis County, with its seat and nearby cities (Wikipedia, adapted)

Bolt, who said he had worked at the Lewis County FQHC for about 10 years, also suggested that another possible reason for the low vaccine rates in the county is because it is a "goodly drive" to the closest Walgreens and Walmart, which also offer the vaccines. 

Shawn Crabtree, director of the Lake Cumberland District Health Department, said he has been able to move the 1,000 weekly doses of vaccine allocated to his health district, but other vaccine providers in his 10-county district that are having trouble moving their vaccine. Several counties have low vaccination rates.

"It seems like there is enough vaccine right now; the supply right now is sufficient for the demand. I wish the demand was greater at this point," Crabtree said. There is some vaccine hesitancy among those who are younger than 50, he said largely because they don't see their immediate health risk. 

"The problem with that is even if you don't get extremely sick, if you catch it, you still spread it and we're wanting to nip this thing out before it mutates enough that it becomes resistant to the vaccine," he said. 

So far, the state has detected 113 cases with mutated "variants of concern" in Kentucky. All but two were the highly contagious B.1.1.7, which was first found in the United Kingdom. The CDC website says only 1,085 cases in Kentucky have undergone genomic testing to detect variants, and the B.1.1.7 variant is now dominant in the U.S.

Crabtree said vaccination scheduling at his county health departments had slowed down for the two-dose Moderna vaccine and that the one-dose Johnson & Johnson vaccine had become more popular. 

On Thursday, Gov. Andy Beshear pleaded with Kentuckians at a news briefing to take whatever vaccine is available to them, and not wait for the single-dose vaccine, saying Kentucky only got 7,800 doses of that vaccine this week, a drop from 65,000 last week, and state officials don't know how many it will get in the upcoming weeks. 

He said if people "wait on the Johnson & Johnson vaccine, we might not win the race against the variants" of the virus that are more contagious and "It's going to take us longer to be able to fully ease the restrictions that we all want to get rid of." 

The Lake Cumberland district has two of the counties with some of the lowest rates for fully vaccinated people: Casey, at 11.6% and Wayne, at 12.2%. The district's counties with the highest rates are Cumberland, 18.7%, and Russell, 18.3%. 

The Kentucky county with the lowest rate of fully vaccinated residents is Spencer, at 9.4%, This county is also last for fully vaccinating its adults and seniors, at 12.1% and 28.2% respectively . 

Stephanie Lokits, director of nursing at the North Central District Health Department, which serves Spencer County, said in an e-mail that they have not seen any increased vaccine hesitancy in that county and that have worked closely with partners in that community to ensure that vaccine is available. 

"However, NCDHD is working to address vaccine hesitancy across the district through multiple avenues, including a social media campaign and planning targeted events in counties with lower uptake such as Spencer County, to increase vaccination," she said. 

Like Crabtree, she said the district's vaccine appointment bookings are a "bit slower than usual" and that they have responded to this by opening up the clinics to anyone 18 and older and to allow walk-ins. 

NCDHD serves Shelby, Spencer, Henry and Trimble counties. Of those, Henry County has the highest rate of fully vaccinated residents, 21%. 

For several weeks, Beshear has listed regional vaccine sites with thousands of slots available for the following week. This week's list included U of L Health at Cardinal Stadium, with more than 11,000 slots open; Kroger Health at Greenwood Mall in Bowling Green (2,000) and the Kentucky Horse Park in Lexington (1,800); Baptist Health Corbin; the Christian County Health Department (1,000); and Pikeville Medical Center (1,000).

Education is key: Bertram said vaccine education needs to come from all fronts, including providers, local leaders and the news media. 

"We just need to reassure folks that it's a safe vaccine and it's the right thing to do," she said. "And to get back to any kind of sense of normalcy, we've got to get some herd immunity going on."

Herd immunity, which provides some protection to people who are unwilling or unable to be vaccinated, requires a vaccination rate of 75 to 80 percent for this virus, most health experts say.

Bolt, of the Primary Care Association, also spoke to the need for education. 

"Kentucky is a diverse state," he said. "You have some large counties that are sparsely populated, and there are a lot of people here that can't drive, don't drive, rely on neighbors or friends. And it's, it's gonna take us a while to get to everybody. But I think the push to have people really understand the importance of the vaccine is imperative and then getting it out to the public." 

Counties at top and bottom: The CDC Covid Data Tracker on April 8 showed the Kentucky counties with the highest fully-vaccinated percentages were about the same as reported March 28 in The Washington Post: Woodford, 31.3%; Fayette, 28.7%; Pike, 28.5 %; Franklin 27.4%, and Perry, 27.4%. 

Letcher, Floyd, Hancock and Nicholas counties have also fully vaccinated at least one-fourth of their population, according to the data tracker.

The counties with the lowest percentages of people fully vaccinated on April 8 were Spencer, 9.4%; Christian, 10.5%; Casey, 11.6%; Ballard, 12.1%, Wayne, 12.2% and Lewis, 12.3%.

Every county has fully vaccinated at least 28.2% of its 65-and-older population, with three counties having fully vaccinated at least 70%: Hancock, Nicholas and Franklin. 

The CDC's data tracker is updated daily. The agency notes that there could be some missing data, which could result in vaccination coverage by county appearing artificially low.  It also says it has "excluded from county-level summary measures vaccination records missing county of residence." It says county-of-residence data are missing for nearly 60,000 more Kentuckians who are fully vaccinated, so the actual figures for each county could be slightly higher or lower.