Vaccine allocation causes urban-rural tensions.
Some states’ allocation decisions create tensions
NASHVILLE, Tenn. – Rita Fentress was worried she might get lost as she traveled down the unfamiliar forested, one-lane road in rural Tennessee in search of a COVID-19 vaccine. Then the trees cleared, and the Hickman County Agricultural Pavilion appeared.
The 74-year-old wasn’t eligible to be vaccinated in Nashville, where she lives, because there were so many health care workers to vaccinate there. But a neighbor told her the state’s rural counties had already moved to younger age groups, and she found an appointment 60 miles away.
“I felt kind of guilty about it,” she said. “I thought maybe I was taking it from someone else.” But late that February day, she said there were still five openings for the next morning.
The U.S. vaccine campaign has heightened tensions between rural and urban America, with complaints surfacing of a real or perceived inequity in vaccine allocation.
In some cases, recriminations over how scarce vaccines are distributed have taken on partisan tones, with rural Republican lawmakers in Democrat-led states complaining of “picking winners and losers” and urbanites traveling hours to rural, GOP-leaning communities to score COVID-19 shots when there are none in their city.
In Oregon, state
GOP
lawmakers
walked out of a legislative session last week over Democratic Gov. Kate Brown’s vaccine plans, citing rural distribution among their concerns.
In Tennessee, Missouri and Alabama, a dearth of shots in urban areas with the greatest number of health care workers has led senior citizens to snap up appointments hours from their homes.
“It’s really, really flawed,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, who noted there are even vaccine hunters who will find a dose for money. “Ideally, allocations would meet the population’s needs.”
Tennessee, like many states, has divvied up doses based primarily on county population, not on how many residents belong to eligible groups. The Tennessee health commissioner has defended the
allocation as the “most equitable,” but the approach has also exposed yet another layer of haves and have-nots.
In Oregon, the issue led state officials to pause dose deliveries in some rural areas that had finished inoculating their health care workers while clinics elsewhere, including the Portland metro area, caught up. The dustup last month prompted an angry response, with some Republican lawmakers accusing Brown of playing favorites with the urban dwellers who elected her.
Public health leaders in Morrow County, a farming region in northeastern Oregon with one of the highest coronavirus infection rates, said they had to delay two vaccine clinics because of the state’s decision. Other rural counties delayed vaccines for seniors.