As of the end of last week, the state of Mississippi had the distinction of being last among all U.S. states in terms of the percentage of population who had been vaccinated. Had you asked me why, I probably would have pointed to lack of access as one of the main reasons. I would have mentioned poverty and highlighted things like the lack of transportation, absence of reliable Internet access, and limited availability of health care clinics in many rural parts of the state. I know people who traveled well over an hour to get their shot, and people without vehicles would not have been able to do this.
As it turns out, our State Health Officer would not agree with me. In a recent interview, he said that access is not our problem; the problem is our apathy. He may have a point in highlighting apathy. Some people are skipping vaccination because they don't think they need it or do not think it is worth the hassle. I suspect others are refusing because they do not trust the changing messages from federal health officials or because they are planning to rely on supernatural treatments. I really wish that evangelical fundamentalist Christianity and almost universal Republicanism that plagues Mississippi would have been acknowledged as contributing factors, but I suppose that would be asking too much.
Personally, I think our State Health Officer is being incredibly naive about access not being a major limiting factor. He points to a number of locations offering vaccination throughout the state and boasts that they are all listed on the Department of Health's website. That may be, but I found that website slow, buggy, and difficult to navigate when I was visiting it several times a day. And that was with the advantage of having moderately reliable Internet access and some familiarity with the web. I'd also point out that almost no family physicians are offering vaccines at their offices where people are used to going, and very few local chain pharmacies are doing so. Expecting people to navigate a confusing website, travel what can be a considerable distance to an unfamiliar location, and then deal with a new health care system is asking too much.
In a state like Mississippi, I have little doubt that there are many people who probably would accept a vaccine if these barriers could be removed. It is going to take outreach. Someone is going to have to go to them. Fortunately, it sounds like some efforts in this direction are finally beginning to happen. That should make a difference. If it doesn't make a big enough difference, something like the incentives being used in other states might be necessary. And if that doesn't get us there, it may be time to confront the role of fundamentalist religion and conservative propaganda.
For additional thoughts on this subject, see Removing Barriers to Vacciniation Should Help Mississippi Public Health.
