NASHVILLE, Tennessee (AP) – Rita Fentress was worried she would get lost while traveling down the unfamiliar one-lane forest road in rural Tennessee in search of a coronavirus vaccine. Then the trees were cleared and the Hickman County Agricultural Pavilion appeared.
The 74-year-old woman was not allowed to get vaccinated in Nashville, where she lives, because there were many health workers who were vaccinated there. But a neighbor told him that the state’s rural counties had already moved into younger age groups and that he found an appointment 60 miles away.
“I felt guilty about that,” he said. “I thought maybe I was taking it from someone else.” But at the end of that day in February, he said there were still five openings for the next morning.
The U.S. vaccination campaign has raised tensions between rural and urban America, where from Oregon in Tennessee to New York State complaints appear about a real – or perceived – inequity in allocation. of vaccines.
In some cases, recriminations over the distribution of scarce vaccines have taken on partisan tones, with rural Republican lawmakers in Democratic-led states complaining about “choosing winners and losers” and urbanites traveling for hours to GOP-oriented rural communities for obtain COVID-19. shots when there are none in your city.
In Oregon, GOP state lawmakers came out of a legislative session last week on the Democratic governor’s vaccination plans, citing the distribution of rural vaccines among their concerns. In upstate New York, public health officials in rural counties have complained about disparities in vaccine allocation, and in North Carolina, rural lawmakers say too many doses went to mass vaccination centers in New York State. the big cities.
In Tennessee, Missouri and Alabama, a shortage of gunfire in urban areas with more health workers has led seniors to withdraw appointment hours from their homes. The result is a mix of approaches that may seem exactly the opposite of equity, where the most likely to get vaccinated are people with the knowledge and means to look for a shot and travel wherever they are.
“It’s very, very flawed,” said Amesh Adalja, a scholar at the Johns Hopkins Center for Health Security, who noted that there are even vaccine hunters who will find a dose for money. “Ideally, the allocations would meet the needs of the population.”
With little more than general guidelines from the federal government, states have decided what it means to distribute the vaccine fairly and reach vulnerable populations.
Tennessee, like many states, has distributed doses based primarily on the county’s population, not on the number of residents who belong to eligible groups, such as health care workers. The Tennessee health commissioner has defended the allocation as the “most equitable,” but the approach has also exposed another layer of people who don’t have it as the deployment of the vaccine accelerates.
In Oregon, the problem led state officials to stop delivering doses in some rural areas that had just inoculated their health workers while clinics were in other places, including the Portland metropolitan area. Last month’s overflow sparked a furious response, and some Republican state lawmakers accused the Democratic governor of playing favorites with the urban dwellers who chose her.
Leaders of public health in Morrow County, an agricultural region in northeastern Oregon with one of the highest rates of COVID-19 infection, said they had to delay two vaccine clinics due to the decision of the state. Other rural counties delayed vaccinations for the elderly.
States face many challenges. Rural counties are less likely to have the freezing equipment needed to store Pfizer vaccines. Health workers are often concentrated in large cities. And rural counties were particularly affected by COVID-19 in many states, but its residents are among the most likely to say they will “definitely” not be vaccinated, according to recent Kaiser Family Foundation surveys.
Adalja said most of these complications were predictable and could have been avoided with proper planning and funding.
“There are people who know how to do that,” he said. “They just don’t take care of it.”
In Missouri, where Facebook groups have emerged with posts about dating availability in rural areas, Senate Minority State Leader John Rizzo, a Democrat from the Kansas City Independence Suburb, cited the need to target more vaccines in urban areas.
Criticism sparked outrageous disapproval from Republican Gov. Mike Parson, who said the vaccine distribution has been proportional to the population and that critics use “selected” data.
“There is no division between Missouri and rural and urban areas,” Parson said during his weekly update of COVID-19 last week.
In Republican-led Tennessee, Health Commissioner Lisa Piercey notes that the Trump administration considered the state plan to be the most equitable in the nation. The additional doses go to 35 counties with a high rate of social vulnerability: many small and rural, but also Shelby County, which includes Memphis, with a large black population.
Last week, state officials revealed that some 2,400 doses had been missed in Shelby County. the last month due to poor communication and insufficient registration. The county also accumulated about 30,000 overdoses in its inventory. The situation prompted the disease control and prevention centers to investigate and the county health director to resign.
In Nashville, Democratic Mayor John Cooper says the fact that city residents can get shot elsewhere is positive, even if road trips are “a little painful.”
“I’m grateful other counties haven’t said,‘ Wow, you have to always be a resident of this county to get the vaccine, ’” Cooper said.
Nashville educators Jennifer Simon and Jessica Morris spent sick days last week making the four-hour round trip to the small county of Van Buren, with a population of less than 6,000.
They got their first shots there in January, when Republican Gov. Bill Lee pushed schools in the Nashville and Memphis area to return to face-to-face classes. Republican lawmakers even threatened to withdraw funding from the remaining districts online.
Face-to-face classes began a couple of weeks ago, but the city only started vaccinating teachers last week.
“It was scary, frustrating and feeling betrayed,” Simon said.
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Flaccus reported from Portland, Oregon. Jim Salter in O’Fallon, Missouri; Bryan Anderson in Raleigh, North Carolina, and Carla Johnson in Washington State contributed.