By Al Cross
Director and Professor, Institute for Rural Journalism and Community Issues, University of Kentucky
The providers' first problem was with the first vaccine, produced by Pfizer Inc., because it requires ultra-cold storage and is being shipped in large boxes with 975 doses. The Moderna vaccine takes normal refrigeration and comes in boxes of 100.
In Texas, some rural hospitals bought special freezers for the Pfizer vaccine but state officials didn't direct any Pfizer shipments to them, Will Stone reports for NPR and Kaiser Health News. "It's frustrating that you would go to that effort and expense and not be able to participate," said John Henderson, president of the Texas Organization of Rural and Community Hospitals.
The Moderna vaccine, which was approved a week after Pfizer's, is now arriving at rural hospitals, clinics and health departments, but "having the vaccine is no guarantee it will get used," even on frontline health workers, Stone reports, with a quote from Tracy Warner, CEO of Greene County Medical Center in central Iowa: "A third of the people that are in line said, no, I'm not interested."
"Each vial has multiple doses. And once opened, they have a shelf life," Stone reports. "In smaller hospitals, the dosing needs to be staggered carefully. An immune response could sideline a nurse or doctor for a day, and they don't have staff to spare."
Once vaccines become available to older members of the general public, those in rural areas will face some of the same obstacles long faced by health care in rural areas, write Bennett Doughty and Pamela Stewart Fahs, professors at State University of New York at Binghamton, for The Conversation.
"In many of these areas," they write, "rural hospitals have been closing at an alarming rate, leaving people to travel farther for care. The population is also older. Public transportation that could help poor or elderly residents reach hospitals is rare, and distance and geography, such as mountain roads, can mean driving to those sites takes time."
Another obstacle is rural Americans themselves. Their thinking about vaccines is "influenced by media and word of mouth, politics and religion, as well as previous experience with vaccinations," the professors wrote, noting a Kaiser Family Foundation poll in December that found about 35% of rural Americans said they probably or definitely would not get a vaccine, higher than the 27% nationwide.
"Getting accurate information about the vaccine and how to receive it into rural areas has also proved difficult," the professors write. "Many rural counties still have limited access to broadband internet connections, smartphone service and other technologies. That often means residents rely on television, newspapers and radio for news, which can limit the depth and scope of information."
That last line should be a wake-up call to rural news media. For rural newspapers and local health officials, this challenge also presents an opportunity. Newspapers can mail sample copies in their home county to non-subscribers at subscriber rates, and a total-market-circulation edition can reach every household with detailed information from a trusted source, the local paper. At least three papers in Kentucky did this early in the pandemic, with support from local governments.
The vaccine-rollout period seems like another good time for sample copying, since states are adopting different policies and priorities for vaccinations, and the public may be confused by information they get from national sources, social media or news media based in other states. Local newspaper circulation is declining, but the postal regulations still give newspapers a powerful tool to reach everyone in their home county, and they and local officials should take advantage of it.
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