In NC, vaccine hesitancy is only part of the problem

President Joe Biden hoped to have 70% of U.S. adults at least partially vaccinated by July 4. One week out from that date, the White House has admitted the country is unlikely to meet that goal. Currently, about 66% of adults have received at least one dose of the COVID-19 vaccine.

But North Carolina is trailing even further behind. Only 55% of North Carolinians 18 and older have received their first shot. At its current pace, North Carolina will not reach Biden’s vaccine target until November, the News & Observer reported earlier this month. But with the delta variant on the rise — now accounting for 20 percent of new coronavirus cases in the U.S. — it needs to happen sooner.

Despite an early surge in vaccine demand, progress has declined precipitously, with weekly vaccinations in North Carolina falling by nearly 83% between the weeks of April 5 and June 14.

Why has it proven so difficult to get people vaccinated?

The answer is complicated. While it’s certainly an issue of hesitancy — and even full-blown resistance — it’s also an issue of access. And it’s an even bigger problem in the state’s more rural counties, where numbers are less promising than in urban areas.

Take Rowan County, for example. Less than 40% of adults in the county have received their first dose, according to data from the N.C. Department of Health and Human Services. Compare that number to Mecklenburg County, where nearly 60% of adults have received at least one shot, or Wake County, where the number of partially vaccinated adults has topped 70%.

Rowan County began to see a drastic decrease in vaccine demand at the beginning of May, county health director Alyssa Harris said. But it’s not just because some people are hesitant to get vaccinated. The county is home to a significant number of blue-collar workers, Harris said, many of whom can’t get off work to get vaccinated. Others worry that they’ll lose a day’s pay if they have a reaction to the vaccine.

This issue isn’t isolated to Rowan County. In rural Harnett County, the percentage of adults with at least one dose remains in the 30% range. County health officials have held vaccination programs at churches, farms and other community events as appointments at weekly vaccination clinics decrease, Debra Hawkins, a public health administrator from the Harnett County Health Department, said in an email.

Reaching those who remain unvaccinated will be difficult — but it’s also becoming increasingly important. The delta variant is spreading quickly, with the proportion of infections being caused by the variant doubling every two weeks. Not only is the variant more easily transmissible, it’s potentially more dangerous. Experts say the variant will be especially dangerous in areas where large numbers of people lack access to the vaccine or are hesitant to receive the shot.

As vaccination rates continue to dwindle, North Carolina has introduced various measures to incentivize vaccinations among its residents, including a $1 million Summer Cash lottery program announced by Gov. Roy Cooper earlier this month. But so far, the state has not seen a significant increase in new vaccinations following the announcement, Cooper said.

These incentives matter, but they might not be enough for those who can’t easily access vaccines in the first place. States such as New York and California have passed legislation mandating employers to provide paid leave for workers getting the vaccine. Both states have managed to partially vaccinate at least 70% of adults ahead of Biden’s July 4 target. Of course, such legislation may not be as politically feasible in a state like North Carolina. But it’s nonetheless a reminder that the state hasn’t done enough to remove major barriers to access.

If people are simply unwilling to get vaccinated, there’s only so much the state can do to change their minds. But if people would be willing to get the vaccine if it were easier to do so, there might be a solution.