Dr. George Garrow, the chief medical officer for the Primary Health Network in Western Pennsylvania, holds a dose of the coronavirus vaccine. (Screenshot) George Garrow
Dr. George Garrow, the chief medical officer for the Primary Health Network in Western Pennsylvania, holds a dose of the coronavirus vaccine. (Screenshot)

Health experts say the vaccine rollout is going slower in rural areas, in part, because rural residents don’t trust the government.

Dr. George Garrow knew it would take more than just syringes and doses to get people vaccinated against the coronavirus. He knew he needed to do more.

So the Primary Health Network, where Garrow is the chief medical officer, bought a mobile medical unit to take the vaccine show on the roads of Western Pennsylvania to help convince people to get vaccinated.

Because rural Pennsylvanians are spread out and distrustful of the government and the pandemic as a whole, getting them vaccinated won’t be an easy task. State health officials are relying on people like Garrow to get shots into arms.

“Vaccines do not save lives,” Garrow said in a recent panel discussion about the coronavirus vaccine rollout in rural Pennsylvania. “Vaccination saves lives. This is the most important step to ending the pandemic. The vaccine should be available, accessible, and delivery of it should be adaptable.”

The Coronavirus Vaccine Rollout in Rural PA

A total of 811,555 people have been vaccinated in the commonwealth, according to state data. Of those people, only 221,449 people (27%), are from rural counties. The rest, 529,297 (65%), live in urban areas.

Health experts say the vaccine rollout is going slower in rural areas because many rural healthcare facilities can store and administer only one of the vaccines, supply of the vaccines is low, rural healthcare facilities have small staffs for this large undertaking, among other issues.

The Logistics of the Coronavirus Vaccine Rollout in Rural PA

Currently, rural areas of the state are primarily getting the Moderna vaccine, since it only needs to be kept frozen, state health officials have said. Many rural healthcare facilities do not have the ability to store the Pfizer vaccine, which needs to be kept at -70 Celsius (-94 Fahrenheit).

The vaccine manufacturers are shipping doses directly to hospitals, federally qualified health centers, county/municipal health departments, and, soon, retail pharmacies in rural areas. Those facilities are then administering the doses to individuals based on the state’s phased priority plan. CVS and Walgreens are handling the vaccination of residents and staff at rural nursing homes and assisted living facilities.

Since October, Garrow and other stakeholders—leaders of emergency management agencies, health departments, clinics, and other agencies that serve rural areas—have been meeting and working together to try to make the rollout of the coronavirus vaccine go as smoothly as possible.

Rural healthcare facilities have been vaccinating their staff as well as outside community healthcare workers, such as EMTs and home health aides. 

But now, they are just waiting.

Steve Johnson, president of UPMC Susquehanna, said the UPMC healthcare network has the necessary infrastructure to handle the rural rollout, including ample storage freezers, plenty of healthcare staff, a centralized COVID-19 website with updated vaccine information, and plans in place to vaccinate individuals as they become eligible. The lack of available doses has hampered efforts.

Leaders of healthcare facilities all over Pennsylvania have said the same thing.

“We simply do not have adequate vaccine supplies or clear notification of when and how much is coming,” leaders of 11 western Pennsylvania hospitals and health systems recently said in a written statement. “That means many requests for vaccination will not be met in the next days to weeks, and this is not from a lack of desire.”

And soon, money will also impede the process.

The hospitals and healthcare facilities are shouldering all the costs related to the distribution process, Johnson said. From storage to operational costs, it is putting an additional strain financially on rural healthcare facilities that are already stretched thin.

“There is no funding source that anyone has talked about to reimburse facilities for vaccinating different groups,” Johnson said. “We are using our own financial resources. At some point, we will run out of cash reserves. We will need significant financial support to continue vaccinating the public.”

Not only is money tight, so is staffing.

Garrow said more people are needed to help administer the vaccine as larger groups of residents become eligible to receive it.

Primary Health Network has more than 40 clinics across Pennsylvania, but the staff in each clinic is small.

“We have a limited amount of staff,” Garrow said. “We have had to close entire offices when a staff member was affected by the virus. We need more people to actually put the vaccines in people’s arms. That’s what is holding us back.”

Building Trust for the Coronavirus Vaccine in Rural PA

And then there’s the issue of trust.

Belief that the seriousness of the pandemic has been exaggerated, concerns about vaccine safety and effectiveness, and lack of confidence in the government in general are some hurdles to rural vaccine distribution, medical professionals said. 

Dr. Cary Funk, Director of Science and Society Research with the Pew Research Center, said the key to increasing rural public trust and awareness about the vaccine lies in the people delivering the message.

“The more you have people who are trusted in the community, who share the same values of the community delivering the messages, the better,” Funk said. “Public voices, prominent people in local communities need to speak to the value of vaccination. Healthcare providers are especially trusted and should be a prominent voice in addressing public concerns.”

Garrow knew that, and that’s why the first vaccine dose administered by the Primary Health Network went into his arm. 

“I wanted to be among the first to get it because I wanted individuals to know that I believe in the science behind it,” he said. “I believe the vaccine is safe and effective.”

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