Across the Divide: Before blaming rural people for not getting vaccinated, remove the barriers | #healthcare | #elderly | #seniors
As the overall percentage of people being vaccinated against Covid increases, attention is turning to the problem of “vaccine hesitancy” in rural areas.
It’s a problem because populations of unvaccinated people allow the virus to thrive in pockets despite waning elsewhere; it has an opportunity to mutate, become deadlier and more transmissible, and reignite the pandemic even among vaccinated people.
According to the Kaiser Family Foundation (KFF), fewer rural residents compared to urban and suburban residents say they’re planning to get vaccinated or considering it.
On the plus side, KFF found that the percentage of people in rural areas (39%) who’ve already received a dose is actually higher than that of urban areas (31%). It’s the remaining foot-draggers that are the big concern. Nearly half of rural residents say they’re either taking a “wait and see” approach (15%), they’ll get the vaccine only if they are required to do so for work or school (9%), or that they’ll “definitely not” get the vaccine (21%). These numbers have changed little since January. Meanwhile, new infections are increasing at a higher rate in rural counties than in urban counties.
So vaccine hesitancy in rural America is a problem for all of America. There’s been considerable analysis of the beliefs and characteristics of vaccine objectors in hopes of finding the right button to push to boost rural compliance: They tend to be conservative, Republican, Trump supporters, Evangelical Christians, etc. They view vaccination as a civil liberties issue and a personal choice rather than a civic duty.
But methods employed so far of imploring, shaming, mandating the vaccine for work and travel, or trying to address objections won’t work. I’m willing to bet that at least a few people are using macho posturing as a cover for the fact that they have no clue how to get the vaccine, and don’t want to ask for help.
A better approach would be to make it easier for rural residents who unequivocally want the vaccine to get it. Remove the barriers that probably also play a role in lower vaccination rates, and expedite the rollout. Seeing more people being vaccinated will bring along at least a few others.
Here are some of the obstacles still keeping rural people who want the vaccine from getting it:
- It’s too difficult to sign up for an appointment. All providers should make it easy and quick to make an appointment by phone, and should publicize the number widely. Many poor and working-class people, especially the elderly, don’t have computer knowledge or internet access, and don’t know anyone who can help them enroll.
- Public information about how and where to get a vaccination locally is spotty to begin with, partly due to the decline of local newspapers.
- Family doctors—one of the most accessible and trusted community authorities—have been left out of the loop. Yet they’re the main contact many elderly people have with health care.
- Some people lack any regular connection with the health care system (they can’t afford care), so they’re not getting reliable information about COVID or how to get vaccinated.
- Elderly, disabled and poor people can’t or don’t know how to arrange transportation for two vaccination appointments.
As a result, significant numbers of rural people, especially the homebound elderly, aren’t being reached.
Anecdotally, I can attest that some of the older people on my weekly meal delivery route, a year into the pandemic, still have no idea how to get the vaccine and no electronic access. One elderly woman told me her doctor simply said he couldn’t help her. She tried calling various provider numbers suggested by family, and she left messages but received no response.
I learned randomly from my hairstylist about a pharmacy with immediate appointments available electronically, so I took my laptop and wifi hotspot to the elderly woman’s home and helped her sign up. The next challenge was transportation, but we worked that out, as well.
It shouldn’t be this hit-or-miss. From day one, we’ve needed an organized community outreach effort, like the census, to personally contact every rural resident and offer them help getting the vaccine. Many older people undoubtedly remember the campaign in the early sixties for the polio vaccine. It was pre-internet, yet people in rural communities consistently got the message of where and how to get the vaccine—for instance, at the local firehall—and they responded. We need to get this right, to build on for future COVID vaccinations, perhaps annually.
The census, dog warden, tax collector, post office, missionaries and a guy looking to buy “ugly houses” can find every one of us. Until we’ve done organized person-to-person vaccination outreach—through doctors, fire departments, schools, churches, local government agencies, and maybe even hairstylists—we have no time to waste with handwringing over resisters.
Becky Bennett lives in south-central Pennsylvania and is a freelance writer and editor. She was editor of the Public Opinion newspaper in Chambersburg for 18 years. “Across the Divide” examines rural perspectives on issues facing Pennsylvania and the nation. Email her at firstname.lastname@example.org.