Vaccine rollout slow to reach rural

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Dr. Joe Thompson, president and CEO of the Arkansas Center for Health Improvement, is concerned about rural Americans being left behind when it comes to vaccinations for Covid-19.

“I think there is a strong effort by the Arkansas Department of Health to make sure it is fairly distributed,” Thompson said in a phone interview Feb. 1. “But we are just not getting enough vaccine in the state to meet everyone’s needs and expectations. We need to make sure lower income communities and communities of color, in particular, those who have made up a lot of our essential workers and have been exposed to Covid, shouldn’t just have equal access to vaccine, but optimal access to the vaccine. They do not need be the last ones vaccinated. They need to be first in line, not last in line.”

There have been concerns about the slow rollout of vaccines both locally and globally. Thompson said part of the reason urban areas received vaccines sooner than rural areas has to do with operational challenges. The Pfizer vaccine, the first one available, only comes in super frozen trays of 975 doses. Thompson said once that tray is thawed, you have a limited amount of time to give almost 1,000 shots.

“So, the health department sent that to our larger hospitals and to a select five pharmacies that were going to serve smaller hospitals,” Thompson said. “The Moderna vaccine still has to be frozen but doesn’t have to be as cold as the Pfizer vaccine. Moderna has fewer specialized refrigeration requirements and comes in smaller dose vials. These different characteristics early on led to larger hospital systems getting the vaccine first.”

Carroll County has among the ten lowest rates of vaccination in Arkansas. Part of that could be because many nursing homes in the U.S. contracted with the federal government to get their vaccine through Walgreen and CVS, so the health department didn’t get any vaccines for those nursing homes.

There are no Walgreens or CVS stores in Carroll County. But the problem with vaccinating residents of nursing homes in areas where there are no Walgreens or CVS outlets was supposed to be resolved by the end of January.

“I would encourage your readership, if they have a loved one in a nursing home, to make sure they have gotten at least their first vaccine shot,” Thompson said.

There are concerns about racial and economic inequities in which populations receive the vaccine first. Studies have shown Blacks and other minorities are dying from Covid at three times the rate of Whites, but are less likely to have been vaccinated. There are barriers to getting vaccinations for minorities such as less access to the internet to make appointments, transportation difficulties and concerns about the safety of the vaccines.

Thompson was recently appointed to serve on a new national panel designed to seek to advance racial equity in the field of health services research. He said while the Arkansas Legislature has allowed some federal funding for Covid-19 outreach to the Marshallese and Latino communities in Northwest Arkansas, more needs to be done, especially in assuring people that the vaccinations are safe and effective.

“We need to redouble efforts not only to educate residents in their native language but work against the distrust that people may have of documentation and other issues within the system,” Thompson said. “In 2021, we are going on the offense with vaccines, not just playing defense around prevention. We need our educational efforts for all groups to highlight the safety and effectiveness of the vaccines.”

With Arkansas currently receiving about 37,000 vaccine shots per week, that allocates to only about 500 shots for each of the state’s 75 counties. Thompson said more is urgently needed.

“We should expect both our political and healthcare systems to optimize their responses during an emergency,” Thompson said. “We shouldn’t accept any excuses. There is a growing demand as people see this as a way to stay safe. We have two or three additional vaccines that are in the pipeline and likely will become available in the next several weeks to a couple of months that will increase the number of available vaccines. The efforts of employers, particularly of those with essential workers, will be helpful across our state, as well.”