US drop in vaccine demand has some places turning down doses

ATLANTA — Louisiana has stopped asking the federal government for its full allotment of COVID-19 vaccine. About three-quarters of Kansas counties have turned down new shipments of the vaccine at least once over the past month. And in Mississippi, officials asked the federal government to ship vials in smaller packages so they don’t go to waste.

As the supply of coronavirus vaccine doses in the U.S. outpaces demand, some places around the country are finding there’s such little interest in the shots, they need to turn down shipments.

“It is kind of stalling. Some people just don’t want it,” said Stacey Hileman, a nurse with the health department in rural Kansas’ Decatur County, where less than a third of the county’s 2,900 residents have received at least one vaccine dose.

The dwindling demand for vaccines illustrates the challenge that the U.S. faces in trying to conquer the pandemic while at the same time dealing with the optics of tens of thousands of doses sitting on shelves when countries like India and Brazil are in the midst of full-blown medical emergencies.

(The interactive map below provided by the CDC highlights vaccine hesitancy trends across the country)

More than half of American adults have received at least one vaccine dose, and President Joe Biden this week celebrated eclipsing 200 million doses administered in his first 100 days in office. He also acknowledged entering a new phase to bolster outreach and overcome hesitancy.

Across the country, pharmacists and public health officials are seeing the demand wane and supplies build up. About half of Iowa’s counties have stopped asking for new doses from the state, and Louisiana didn’t seek shipment of some vaccine doses over the past week.

Some are urging federal officials to send more vaccine to places where there’s demand — rather than allocate them based on population — including Massachusetts Republican Gov. Charlie Baker, who said on Thursday they could administer two to three times more doses per day if they had more supply.

In Mississippi, small-town pharmacist Robin Jackson has been practically begging anyone in the community to show up and get shots after she received her first shipment of vaccine earlier this month and demand was weak, despite placing yard signs outside her storefront celebrating the shipment’s arrival. She was wasting more vaccine than she was giving out and started coaxing family members into the pharmacy for shots.

“Nobody was coming,” she said. “And I mean no one.”

In Barber County, Kansas, which has turned down vaccine doses from the state for two of the past four weeks, Danielle Farr said she has no plans to be vaccinated. The 32-year-old said she got COVID-19 last year, along with her 5- and 12-year-old sons and her husband.

Blood tests detected antibodies for the virus in all four of them, so she figures they’re already protected.

“I believe in vaccines that have eradicated terrible diseases for the past 60, 70 years. I totally and fully believe in that,” said Farr, who works at an accounting firm. “Now a vaccine that was rushed in six, seven months, I’m just going to be a little bit more cautious about what I choose to put into my body.”

Barbara Gennaro, a stay-at-home mother of two small children in Yazoo City, Mississippi, said everybody in her homeschooling community is against getting the vaccine. Gennaro said she generally avoids vaccinations for her family in general, and the coronavirus vaccine is no different.

“All of the strong Christians that I associate with are against it,” she said. “Fear is what drives people to get the vaccine — plain and simple. The stronger someone’s trust is in the Lord, the least likely they are to want the vaccine or feel that it’s necessary.”

Another challenge for vaccinations in a rural state like Mississippi is that in many cases, doses are being shipped in large packages with one vial containing at least 10 doses.

During a news conference in early April, Republican Gov. Tate Reeves said Mississippi officials have requested that the federal government send the vaccines in smaller packaging so it’s not going to waste.

“If you’re in New York City, and you’re sending a package to one of the large pharmacies in downtown Manhattan, there are literally millions and millions of people within walking distance most likely of that particular pharmacy,” Reeves said. “Well, if you’re in rural Itta Bena, Mississippi, that’s just not the case.”

To combat the hesitancy, Louisiana continues to increase its outreach work with community organizations and faith-based leaders, set up a hotline to help people schedule appointments, and work to find free transportation to a vaccination center. The health department is sending out more than 100,000 mailers on Monday to encourage people to get vaccinated, and robocalls from regional medical directors are going out to landline phones around the state.

In New Mexico, state officials are exploring the recruitment of “community champions” — trusted residents of regions with vaccine hesitancy who can address concerns about safety and efficacy. Question-and-answer style town halls are also a possibility. And video testimonials about coronavirus vaccines already have been recorded.

Nirav Shah, director of the Maine Center for Disease Control and Prevention and the president of the Association of State and Territorial Health Officials, said now that everyone qualifies to get vaccinated, public health officials are encountering three groups: “not able,” “not now” and “not ever.”

The first group, he said, isn’t able to get their shots because there’s some kind of barrier. The “not nows” have earnest questions about vaccine safety, efficacy and whether they need the shot.

He said they’re not prepared to write off “not evers,” but instead are “working to find trusted messengers like doctors, family members, community members” to give them good information.

In Corinth, Mississippi, pharmacist Austin Bullard said a lot of people were waiting to become vaccinated until a one-dose shot became available. The news about the Johnson & Johnson vaccine and the risk for blood-clotting — however slim — has scared people about getting any type of vaccination.

“I do feel like there has been more hesitancy across the board since then,” he said.

White House offers new tax credit to help spur vaccinations

President Joe Biden on Wednesday announced new employer tax credits and other steps to encourage people reluctant to be inoculated to get the COVID-19 vaccine as his administration tries to overcome diminishing demand for the shots. The moves came as Biden celebrated reaching his latest goal of administering 200 million coronavirus doses in his first 100 days in office.

With more than 50% of adults at least partially vaccinated and roughly 28 million vaccine doses being delivered each week, demand has eclipsed supply as the constraining factor to vaccinations in much of the country.

In a White House speech on Wednesday, Biden acknowledged entering a “new phase” in the federal vaccination effort that relies on increased outreach to Americans to get their shots, both to protect them and their communities.

“Vaccines can save your own life, but they can also save your grandmother’s life, your co-worker’s life, the grocery store clerk or the delivery person helping you and your neighbors get through the crisis,” Biden said. “That’s why you should get vaccinated.”

Over the past week, the pace of inoculation in the U.S. has slowed slightly. That is partly a reflection of disruptions from the “pause” in administration of the Johnson & Johnson shot for a safety review, but also of softening interest for vaccines in many places even as eligibility has been opened to all those older than 16.

As the vaccination program progresses, the administration believes it will only get more difficult to sustain the current pace of about 3 million shots per day. Roughly 130 million Americans have yet to receive one dose.

Surveys have shown that vaccine hesitancy has declined since the rollout of the shots, but administration officials believe they have to make getting vaccinated easier and more appealing, particularly for younger Americans who are less at risk from the virus and do not feel the same urgency to get a shot. That means providing incentives and encouragement to get vaccinated, as well as reducing the friction surrounding the vaccination process.

Biden announced a tax credit for small businesses to provide paid leave for those getting vaccinated or potentially needing to take time off to recover from side effects. Paid for through the $1.9 trillion virus relief package passed last month, the tax change would provide a credit of up to $511 per day, per employee for businesses with fewer than 500 workers to ensure that those workers or businesses don’t suffer a penalty by getting vaccinated.

The White House is urging larger employers, which have more resources, to provide the same benefits to their workers, and educate them about the shots and encourage them to get vaccinated.

“We’re calling on every employer, large and small, in every state, give employees the time off they need with pay to get vaccinated,” Biden said.

According to the White House, just 43% of working adults have received at least one shot.

As Biden celebrated the vaccine milestone, there is a different reality in the states.

In Iowa, nearly half of the counties are not accepting new doses of the COVID-19 vaccine from the state’s allotment because demand has fallen off. In Florida, Palm Beach County plans to close mass vaccination clinics at the end of May with thousands of available vaccine slots unclaimed. In rural West Virginia, a vaccine clinic at a casino/race track parking garage is opening shots to out-of-state residents to address lagging demand. The hope is that people from Washington, D.C., make the hour’s drive to get vaccinated. In Arizona, a plan collapsed that would have opened a federally run vaccine site in Tucson; demand is slipping and county officials preferred more targeted, mobile locations.

Asked about the dip in vaccinations, Health and Human Services Secretary Xavier Becerra said “fluctuation is not uncommon” and that “what we want to do is continue to encourage Americans to continue to get vaccinated.”

“The pace of vaccination isn’t linear,” Becerra said, adding that “we are on a pretty good pace.”

Through its partnership with more than 40,000 retail pharmacies, the White House says more than 90% of Americans now live within 5 miles of a vaccination site. The administration is encouraging state and local efforts to bring vaccines directly to people, whether through initiatives reaching the homebound or clinics at large employment sites.

Many states have also begun to open up vaccination sites to walk-in appointments, reducing reliance on often-cumbersome reservation systems.

Maximizing the number of Americans vaccinated in the coming months is critical for the White House, which is aiming to restore a semblance of normalcy around the July Fourth holiday and even more so by the beginning of the next school year.

Administration officials have been careful to avoid predicting when the country will have vaccinated enough people to reach herd immunity — when enough people become immune to a disease to make its spread unlikely. The U.S. is on track to have enough vaccine supply for every adult by the end of May and for every American by July, but administering the shots will be another matter.

With its stockpile secure and demand dropping at home, the president spoke again of sharing excess doses with allies.

Biden said he talked with Canadian Prime Minister Justin Trudeau for about 30 minutes on Wednesday. “We helped a little bit there, we’re going to try to help some more,” Biden said, referring to his decision last month to share about 1.5 million doses of the AstraZeneca vaccine with Canada. “But there’s other countries as well that I’m confident we can help, including in Central America. But it’s in process.”

He added. “We don’t have enough to be confident to send it abroad now. But I expect we’re going to be able to do that.”

Biden set his goal of 200 million shots last month after meeting his 100 million-in-100 days goal just over a month ago. That original benchmark was announced Dec. 8, days before the U.S. had even one authorized vaccine, let alone the three that have now received emergency authorization. Still, it was generally seen within reach, if optimistic.

By the time Biden was inaugurated on Jan. 20, the U.S. had already administered 20 million shots at a rate of about 1 million per day, bringing complaints at the time that Biden’s goal was not ambitious enough. Biden quickly revised it upward to 150 million doses in his first 100 days.

Red states on U.S. electoral map lagging on vaccinations

With coronavirus shots now in the arms of nearly half of American adults, the parts of the U.S. that are excelling and those that are struggling with vaccinations are starting to look like the nation’s political map: deeply divided between red and blue states.

Out in front is New Hampshire, where 65% of the population age 18 and older has received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention. Following close behind are New Mexico, Connecticut, Maine and Massachusetts at 55% or greater. All have a history of voting Democratic and supported President Joe Biden in the 2020 election.

Meanwhile, at the bottom are five states where fewer than 40% have rolled up their sleeves for a shot. Four of them — Mississippi, Alabama, Louisiana and Tennessee — lean Republican and voted for Donald Trump last fall. The fifth is Georgia, which has a Republican governor and supported GOP presidential candidates for nearly three decades before narrowly backing Biden.

The emerging pattern: Americans in blue states that lean Democratic appear to be getting vaccinated at more robust rates, while those in red Republican states seem to be more hesitant.

“We can draw a conclusion that red states and voters that voted for Trump are going to be more difficult to vaccinate because we have real good survey data to support that,” said Dr. Howard Forman, a professor of public health and management at the Yale School of Medicine.

A poll by The Associated Press-NORC Center for Public Affairs Research in late March found that 36% of Republicans said they will probably or definitely not get vaccinated, compared with 12% of Democrats. Similarly, a third of rural Americans said they were leaning against getting shots, while fewer than a fourth of people living in cities and suburbs shared that hesitancy.

Forman cautioned that in most U.S. states, which receive vaccine shipments based on population, demand for the shot still exceeds supply. So it’s hard to know how many people are resisting until everyone wanting the shots gets them. But if states soon start seeing significant numbers of unfilled appointments with many people still unvaccinated, he said consequences could be serious.

“We could see substantial outbreaks for a long time,” Forman said. “It will determine whether we go back to normal in some cases.”

Past AP-NORC polls have shown more Republicans than Democrats say the government has exaggerated the threat posed by the virus. Republicans have also been more opposed to restrictions and mask-wearing.

The CDC reports that nearly 121 million American adults — or 47% of the U.S. adult population — have received at least one coronavirus shot. California, the nation’s largest blue state, is slightly ahead of that pace, at 50%. The biggest red state, Texas, lags at less than 44%.

How swiftly states are vaccinating doesn’t always correlate with how they vote.

Deeply red South Dakota ranks among the most successful states, with 54% of its population getting injections. Among blue states, Nevada lags furthest behind the U.S. at less than 44%, followed by Oregon and Michigan at 45% each.

New Hampshire, which leads the nation in adult vaccinations, has a Republican governor and a GOP-controlled Legislature. However, Democrats hold all of its seats in Congress and the state has consistently Democratic in every presidential election since 2008.

West Virginia, where Trump carried 66% of the vote last year, became an early success story in the vaccine rollout as the first U.S. state to cover all nursing homes. But while Republican Gov. Jim Justice has remained a vaccine cheerleader, West Virginia now lags the U.S. overall with less than 42% of its population receiving at least one dose.

Among those who say they won’t get vaccinated is 58-year-old Martha Brown. Sitting outside her apartment complex in Charleston, West Virginia, Brown said she’s afraid of having a bad reaction after a flu shot last year left her with cold symptoms.

“I’m OK without it,” Brown said. “I wear my mask all the time.”

Experts said it’s too soon to tell whether pausing shots of the single-dose Johnson & Johnson vaccine will increase reluctance to get vaccinated. Government scientists are investigating reports of unusual blood clots in six women who received the vaccine.

If the issue gets resolved quickly and it’s deemed safe to resume Johnson & Johnson shots, there should be little impact on public confidence, said Claire Hannan, executive director of the Association of Immunization Managers. She hopes the response itself assures people “the system is working.”

“It’s really important to understand that’s how closely we monitor everyone getting the vaccine” for potential problems, Hannan said. “We have systems in place to connect the dots.”

In a suburb outside Chicago, Jennifer Rockwood was getting ready to get her Johnson & Johnson shot Tuesday morning when she heard about the recommended pause. She cancelled her appointment after waiting months to get the vaccine.

“Did it give me hesitancy? Yes it did,” said Rockwood, 49. “But I was immediately back at my kitchen counter flipping the laptop open again and seeing what I could do to schedule another one.”

She booked an appointment to get the Pfizer vaccine Wednesday.

Trump has publicly urged Americans to get vaccinated but also received his own injections secretly, disclosing them only after he left office. As president, he spent much of the pandemic minimizing the dangers of the virus, even after being hospitalized with COVID-19.

Some Republican governors have likewise kept their own vaccinations quiet.

In Florida, where about 44% of the population has gotten at least one shot, it wasn’t disclosed that GOP Gov. Ron DeSantis got the single-dose Johnson& Johnson vaccine until a reporter asked the governor’s spokeswoman days later. Many other U.S. governors have gotten their shots on camera or held news conferences around them in an effort to assure people the vaccines are safe.

The Democratic governor of Kentucky, a Trump-voting state, is trying to persuade more people to get jabbed by promising to lift pandemic restrictions when vaccination rates improve. About 1.6 million people in Kentucky have gotten at least one dose, a rate equal to the U.S. overall.

Gov. Andy Beshear said Monday he’ll lift capacity restrictions on restaurants, retail stores, concert halls and other businesses once Kentucky reaches 2.5 million people who have had shots.

“Every single individual’s choices can get us closer to that normalcy we’ve been looking for,” Beshear said.