For millions of Americans, the start of the vaccine roll-out this week was a moment they had been yearning for. But for many in a city east of Seattle, the medical breakthrough is nothing to celebrate.
Some said vaccinations were just plain wrong or simply dangerous.
Others said the short time span in which the Covid treatment had been produced, part of a government-funded project called Operation Warp Speed, made them especially worried. Some said they were asking God what to do, otherwise they would not let it come anywhere near them.
In the city of Spokane, 280 miles east of Seattle and located close to the border with Idaho, there were plenty of people who said they would gladly take the Pfizer vaccine, approved last week by the Food and Drug Administration (FDA), and which is being given this week to America’s most vulnerable and at-risk citizens.
Yet, lots said they would not for a variety of reasons.
The attitudes voiced here can he heard across large parts of the country. The most recent polling found 60 per cent of people were planing to get vaccinated, while 20 per cent said they would only do so after others had been, and it had been shown to be safe.
The Pew Research Centre found another 20 per cent said there were virtually no circumstances in which they would take the vaccine. The findings also differed among political affiliation: while only 50 per cent of Republicans said they planned to get the vaccine, around 69 per cent of Democrats would do.
By some counts, Spokane may be an outlier within the US for what is termed “vaccine reluctance”. A 2018 paper published by the Public Library of Science suggested the city of 200,000 was among a dozen “anti-vaccine hotspots” in the US, where there was a lower than average rate of vaccinations for illnesses such as measles, mumps and rubella (MMR).
Seattle, Portland and Salt Lake City were also among the dozen. Experts pointed to the high number of so-called “non-medical exemptions” or NMEs, sought by parents for their children.
“Several US ‘hotspot’ metropolitan areas stand out for their very large numbers of non-medical exemptions [NMEs],” the paper says. “The high numbers of NMEs in these densely populated urban centres suggest that outbreaks of vaccine-preventable diseases could either originate from or spread rapidly throughout these populations of unimmunised, unprotected children.”
Zoe Triggs, 19, and her 21-year-old boyfriend Cody Morlan, were adamant they would not get vaccinated.
“I'm a huge advocate for medical freedom. I don’t take vaccines and I don’t wear a mask,” said Ms Triggs, who said she was a pilates instructor.
“The vaccines are not safe and effective like the media portrays them to me. They actually have not been [properly] tested in trials. All the trials they’ve done, are actually funded by the same companies that created the vaccine.”
She and Mr Morlan said they did not believe the pandemic, which has killed more than 300,000 people in the US and infected more than 16 million, was anything more than a winter flu. Mr Morlan said he wore a mask when he was out in order to avoid arguments with staff in shops.
Ms Triggs said she was a big fan of Del Bigtree, a writer and speaker, notorious in the public health world for making claims about vaccines and who heads the Consent Action Network. Experts say his claims about vaccines being dangerous are not true.
Mr Bigtree produced the film Vaxxed, directed by disgraced British former doctor Andrew Wakefield, who was barred by the British Medical Council in 2010 after a paper that claimed falsely there was a link the MMR vaccine and autism. (Mr Wakefield now lives in Texas where he continues to spread such disinformation.)
Brad Thew, 30, and his wife Amanda, were loading their child into the rear of the vehicle having completed their shopping, and as snow fall intensified. Mr Thew was wearing a pair of shorts.
He said he had been a student wrestler at college in North Dakota and had a bad reaction to a flu shot. He said he was not against vaccines per se but he felt the best way to protect against the coronavirus was by eating healthily. He said he suspected his father would get vaccinated.
“Personally, I will not be having it,” said Mr Thew, who was self-employed and said he ran a karaoke business.
A number of people expressed concerns that the vaccines contained cells from aborted foetuses. While some vaccines are based on cell strains obtained from some foetuses obtained decades ago, there is no evidence that any of the vaccines being used to tackle Covid are using that material.
Within Washington state, Spokane is considered more conservative than places such as Seattle, and its member of Congress, Cathy McMorris Rodgers, is Republican.
Mike Schramm, a 36-year-old office manager, said while he suspected many of his colleagues would take the vaccine, he would not. His main concern was that the drug had been produced in less than a year, smashing all records.
He also said he was concerned about what might be in it. “I have a God-centred approach to my and my family’s health.”
Thomas May, a bioethicist and research professor at the University of Washington’s Elson S Floyd College of Medicine, located in Spokane, said Washington state had seen “higher levels of vaccine hesitancy traditionally”, primarily in the area of routine childhood immunisation.
He said: “I think there's a tradition of individualism located in the Pacific Northwest in general.”
Mr May said opposition to vaccines tended to develop in pockets, perhaps because of an individual incident blamed on a vaccine, but which may not have had anything to do it.
“I'm certainly not surprised that there's more hesitancy and scepticism among the general public, I think that our data is as good as it can be,” he said. He said that transparency would be essential to persuade people to take the vaccines, and suggested that at the highest levels of government there had been a mixed message about the pandemic.
“We can't have the perception on the part of the public that the recommendations are being driven by political agendas rather than the science.”
Shawn Vestal, a columnist for the city’s newspaper, The Spokesman-Review, wrote this weekend about what he called the individualistic “cowboy” spirit, that was mythologised, often wrongly. He referred to protests against mask wearing that had taken place in cities across the state.
“It thrives in those stubbornly proud of their refusal to wear a mask, as if that sad, puny cry of liberty were a badge of honour,” he wrote.
Kelli Hawkins, communications and public information manager at at Spokane Regional Health District, said there was a “a portion of our population that is not just hesitant, but really against vaccines”.
She said much of the department’s work focused on trying to provide reliable information to those considered on the fence.
“We need to lead people to reliable resources for information because we know as communicators, people will fill in the gaps or they'll find their own resources,” she said.
Kayla Myers, a health specialist with the department’s response team, said for a long time the department had been trying to change the minds of those opposed to vaccines.
“But a lot of studies have come out talking about how it is a very small proportion of the population – less than 3 per cent of people – who will never vaccinate,” she said. “And it doesn't matter how much we interact with them, or how many good articles we share with them, they will never change their mind.”
What was more crucial, she said, was providing reliable information to those who were still undecided.
A majority of people The Independent spoke to said they probably would take the vaccine, but many said they would rather not be the very first recipients.
“I want him to take it – he’s 64,” said Margaret Metcalf, pointing to her husband, Fred. She said she was aged 54 and counted herself as a “maybe”.
“I plan to take it,” said Mr Metcalf. “But I know lots of people won’t.”
Carolyn Jurkov was buying green drinking glasses. She said she was not opposed to vaccines, but that she felt she would wait and see how the first round of the programme played out; in Washington state, as in many places, that will be residents of elderly care homes and frontline medical staff.
“I am a wait and see,” she said.
Joanna Whipple, 60, and her 68-year-old husband Patrick were more definite. The couple, who worked as janitors, were among many who said they were turning to their faith to guide them in their decision.
“I like to pray about everything,” she said. “I don’t know what I am going to do if they make it mandatory, because I don’t want it.”