Pharmacy deserts leave many rural Americans with few options for vaccination; see interactive county-level map

Retail pharmacy availability in non-metropolitan counties (Click the image to enlarge; click here for interactive version.)
(Kaiser Health News map based on Rural Policy Research Institute data) 

"As the Biden administration accelerates a plan to use pharmacies to distribute Covid-19 vaccines, significant areas of the country lack brick-and-mortar pharmacies capable of administering the protective shots,"  Markian Hawryluk reports for Kaiser Health News. "A recent analysis by the Rural Policy Research Institute found that 111 rural counties, mostly located between the Mississippi River and the Rocky Mountains, have no pharmacy that can give the vaccines. That could leave thousands of vulnerable Americans struggling to find vaccines, which in turn threatens to prolong the pandemic in many hard-hit rural regions."

The confluence of several economic trends has exacerbated the problem of rural pharmacy deserts. "From 2003 to 2018, 1,231 independent rural pharmacies closed . . . leaving some 630 rural communities with no retail drug store," Hawryluk reports. "The changing economics in the pharmacy industry did them in, a combination of national pharmacy chains expanding and consolidating, big-box stores and supermarkets opening their own competing pharmacies and pharmacy benefit managers eating into small-pharmacy profits. Mail-order options siphoned off business." But, Hawryluk notes, "you can’t get vaccines in the mail." And for many rural Americans, those pharmacies were the only source of nearby health care.

More than 1.6 million Americans live more than 20 miles from the nearest pharmacy, according to a recent analysis by the University of Pittsburgh's School of Pharmacy and the West Health Policy Center. Those residents must drive long distances to get vaccinated (twice, if they're getting a two-dose vaccine) and may have to deal with poor road conditions or difficult weather, Hawryluk reports.

"So far, with a limited quantity of doses and strict limitations on who is eligible, that hasn’t been a problem," Hawryluk reports. "But as vaccination opens up to the general public and supplies of the vaccines increase, local health departments may be overwhelmed with demand and may need to offload the task of vaccinating local residents to other health care providers."