What is needed to strengthen vaccination? Scene from the back roads of Kentucky

In the end, it was the delta variant that led the 89-year-old Rose Mitchell along the winding mountain road to the Full Gospel Church of Jesus Christ for the photo. Her pastor Billy Joe Lewis told his congregation that no ma’am, the COVID-19 vaccine will not leave a “trail of the beast” or rewrite their genetic codes.

Mitchell, who over the years knew about the death of eight of her 13 children, decided to take a chance with the virus sneaking up on the screams along Katshin Creek.

“Things are getting so bad that I was afraid not to accept it,” she said as she sat in her daughter’s car in the church parking lot. “I said, ‘Well, if everyone else is going to take it, I’ll take it too.”

Kentucky is at the epicenter of the COVID-19-19 wildfire, which has spared no part of the state; the number of new cases exceeded 4,000 a day for most of September before declining slightly this month. In some regions, hospital intensive care units are still busy, with COVID-19 patients occupying half of the beds. Governor Andy Besheer called the situation “dire.”

Elderly people across the country are steadfast in taking COVID-19 vaccines, with around 95% of people aged 65 and over having received at least one shot. But geographic differences cloud this mathematics. Older Kentucky residents in rural villages far from Louisville and Lexington are lagging behind in vaccinations: in Wayne County, on the Tennessee border, the vaccination rate is only 55%.

While older people are still more likely to be vaccinated than younger people in Kentucky, the simple truth of the pandemic is that older people who refuse vaccinations face a much higher likelihood of serious illness and death. People 60 years and older account for nearly 90% of the 9,184 COVID-19-related deaths in Kentucky. Residents 80 years and older account for 41% of deaths.

In Leslie County, at the foot of the rocky Pine Mountain that anchors the state’s eastern coal fields, gravel roads wind through dense forests covered with kudzu vines. House by house, church by church, public health workers are trying to outwit the fantastic stories of COVID-19 vaccines circulated on Facebook and overcome the day-to-day hurdles of financial hardship and isolation.

“Some of our seniors don’t have access to cars because their family is working,” said Maxine Shepherd, Leslie County Regional Health Coordinator and Full Gospel Church member for four decades. Even for those with a car, petrol is expensive, she said, and trips from the secluded screams to the city are meticulously regulated.

While Kentucky residents watched the devastating early months of the pandemic from afar, COVID-19 has long arrived – and it hasn’t spared the church on Katshin Creek. In recent weeks, Pastor Lewis held a memorial service for the 53-year-old unvaccinated former miner, paused Sunday services after more congregations fell ill, and with a heavy heart canceled the return home, a cherished annual meeting of local churches that celebrates fall foliage. with the celebration of the gospel and common faith.

Local health agencies are eagerly awaiting churches to participate in comprehensive vaccinations; older people are more likely to attend religious services, and in communities such as Smilax, ministers are trusted advisors.

Some church leaders have refrained for fear of offending parishioners in a state where there is deep distrust of government interference. But not Lewis, who helped build the Full Gospel Church on a rare flat piece of land in 1972 and has led it ever since. With sleek silver hair and a radiant smile, Lewis spends long stretches of the day in prayer and says that God told him to protect his flock.

When “Sister Maxine” from the regional health department proposed opening a vaccination clinic in the church parking lot, Lewis was all for it. He promoted it from the pulpit and on the church’s must-read Facebook page.

“We still need to use common sense,” he said. “Anything that can prevent suffering and death, I think, is fine.”

Annoyed by the slow spread of vaccinations by some Americans, President Joe Biden ordered vaccinations for healthcare workers in facilities such as hospitals and nursing homes, as well as federal and corporate employees. While precise timetables and details of private sector mandates are still being worked out, the specter of coercion outrages many in Kentucky, especially in the Appalachians, where government directives have been met with derision.

“We don’t like being pushed,” said David Mackenzie, who grew up in Louise, a once-thriving coal town on the West Virginia border and now owns a local retirement home. “We are outraged by this and push off.”

The vaccine opposition in Lawrence County, where vaccination rates are at 39%, are more deliberate than overtly political. “They are afraid of ‘this man,’” Mackenzie said. “This person can be your employer, it can be the government, it can be a newspaper reporter.” People who have boasted of not being vaccinated cannot change their minds, otherwise “they will look like they are weak, or they have succumbed to the Human.”

In nearby Saliersville, the virulence of the delta variant has shaken some opponents. Santana Saliers, 22, braved the pouring rain to enter the county health department, a one-story building on a section of a newly paved road. In the third trimester of pregnancy, she feared that the hospital would not allow her to keep her newborn unless she was vaccinated. Saliers works at the IGA grocery store and says vax or not, comes there almost every day. “I’m moving over the fence,” she said. But in the city “you are either against or for”.

The turnout for the Salersville health fair was muted by the remnants of a tropical storm, but a few dozen people came to get their shots. In the waiting room, vaccine recipients received $ 25 Walmart cards and a chance to win a Fitbit or Instant Pot. Prizes were raffled off.

James Shepherd, who is both mayor and director of the Magoffin County Health Department, laments the district’s vaccination rate of 44%: “In a small community like this, they make a yes or no decision, and that’s it. … “What does it take to boost vaccination?” A miracle, ”he said with an exasperated laugh.

Shepard’s close friend Carter Conley, the beloved captain of the county rescue squad, died last month from COVID-19 despite being vaccinated. Conley’s death was deeply felt throughout the city, but it also gave impetus to those who consider vaccination pointless.

Doubts about the effectiveness of vaccines are spreading to nursing homes in Kentucky, despite a strong correlation between outbreaks in nursing homes and low vaccination rates among staff.

On a mid-September weekday in Danville, a small town southwest of Lexington, residents of the Landmark of Danville Rehabilitation and Nursing Center sat on a quirky covered veranda playing a game of 20 questions with event staff. While 80% of the facility’s residents were fully vaccinated as of September, according to the Centers for Medicare and Medicaid, this is only true for 28% of medical staff who rush back and forth at lunchtime, transporting fast food to go.

A short drive away, another city nursing home, the Danville Health and Rehabilitation Center, had a staff vaccination rate of 28% in September, according to federal data. (One month later, staff vaccination rates at both facilities are still below 60%.)

An unprotected workforce does not bother one man who transfers his aging father to Landmark. A man working as a nurse at a local hospital and an accompanying family friend were reluctant to give their names, but question the effectiveness of the vaccine.

According to him, the man’s parents were vaccinated in March, but fell ill with COVID-19 in August. His mother was ventilated and died; his father was still recovering in the hospital and was soon transferred to a nursing home.

Low vaccination rates for facility staff “are not necessarily appropriate,” he said, as his father would receive “end-of-life assistance.” His companion said that she personally knew four people who died from COVID-19, and that two were vaccinated and two were not. According to her, these cases “are not reported because they do not correspond to the narrative.”

Standing on the porch amid the festive fall decorations, Landmark administrator, Cindy Hollins, declined to discuss the reason for her low attendance and politely asked the reporter to leave.

In Louise, three hours east of Danville, David McKenzie believes the high vaccination rate among the residents and staff of his Jordan Center will be a profitable argument. “I advertise that I am the safest nursing home in Kentucky to live and work,” he said.

Mackenzie and his sister lived in a nursing home as children; their parents opened a house and could not find another house to rent when the city was overwhelmed with miners. He learned to play the piano from a diabetic resident who once played in Duke Ellington’s band.

Last winter, COVID-19 ravaged a nursing home for months, infecting almost everyone in it. In early September, the employee’s 33-year-old daughter was buried and did not want the vaccine; then a former employee died after quitting her job in a hospital that did not require vaccinations.

As soon as vaccines became available, Mackenzie and his staff moved room to room, explaining the scientific findings to residents. Only one family refused. Then he gathered the staff, many were shocked by the loss of residents who were family members and friends.

Almost every resident of the Jordan Center is now vaccinated with three vaccinations, and the staff vaccination rate hovers around 85%. But opponents keep Mackenzie on his toes.

“I sat here on the porch until 2 am talking to two nurses who don’t want to be vaccinated,” McKenzie said. “One has been here for 37 years and the other for 15 years. They dug in. They are adamant. “

Testing staff who refuse to be vaccinated fall into the lot of Misty Robertson, a registered nurse who has worked at the facility for several decades. She views each interaction as a chance to tell her colleagues why they should take a picture. “I don’t mean that,” she said. “I say, ‘I really don’t want you to be in the balance and die.”

Robertson’s father, who lived at the Jordan Center, died of COVID-19 in January. Her entire family is vaccinated, including three children and her husband, who works at Walmart. Everyone except her twin sister, the local pediatrician’s administrator. She tells Robertson that COVID-19 is a fake and “it’s all because of Biden.”

“I’m angry,” Robertson said. She fiercely disputes the conspiracy theories circulating on the city’s social media, but, as she said with a sour laugh, sometimes goes too far. “I was put in Facebook jail.”

Mackenzie’s public stance made him an outcast in some quarters as well. A customer attacked him at Walmart and threatened to wait for him in the parking lot. A gloomy mood has divided the city into warring camps, and he thinks Biden’s demands for vaccinations will only widen the gap.

Of course, they prove too much for some of the staff at his nursing home. Many of Jordan Center’s unvaccinated employees are on the same shift, and Mackenzie fears he could lose his entire night crew.

“On Sunday night, they told me they were going to leave medical care and work at Tractor Supply,” he said, “where they can make more money per hour.”

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