In January, Charlome Pierce looked for a place where her 96-year-old father could get a COVID-19 vaccine but found none near their home in Virginia. Surry County’s sole medical center had none, and the last pharmacy in an area of about 6,500 inhabitants and a land mass larger than Chicago had closed years before.
Some locals took a ferry across the James River to cities like Williamsburg to get their shots. Others rode for over an hour past farms and woods to enter a medical center that offered the vaccine (the county received its first stoplight in 2007).
Pierce learned of a state-run vaccine event 45 minutes away, but there were no more appointments open, which was probably for the better because the wait there could last up to seven hours.
“That would have been a difficult task,” she said, citing her father’s health issues and regular bathroom visits. “I couldn’t have made him sit in a car waiting for anything to happen. We aren’t in a developing country.”
Getting vaccinated remains a problem for inhabitants in “pharmacy deserts,” areas lacking pharmacies or well-equipped health centers, as the nation’s campaign against the coronavirus shifts from mass inoculation sites to drugstores and doctors’ offices. The federal government has partnered with 21 organizations that operate free-standing pharmacies or pharmacy facilities within grocery stores and other places to expand access.
More than 40,000 supermarkets, ranging from Hy-Vee and Walmart to Costco and Rite-Aid, are planned to participate, according to the Biden administration, and about 90% of Americans live within five miles of one.
However, there are several holes in the map: About 400 rural counties, with a total population of nearly 2.5 million residents, do not have a retail pharmacy that is part of the collaboration. More than a hundred of those counties have no pharmacy or have a pharmacy that has traditionally not offered services such as flu shots and may lack the necessary equipment or trained personnel to vaccinate customers.
According to Keith Mueller, director of the University of Iowa’s RUPRI Center for Rural Health Policy Analysis, independent pharmacies that have historically served rural areas have been disappearing as a result of mail-order prescriptions and increased competition from chains like Walgreen’s and CVS that have more leverage to negotiate with insurance companies.
According to Mueller, whose research center collected the pharmacy data for the 400 counties, “there are a number of counties that will be left out” of the Federal Retail Pharmacy Program. “You have a large geography and very few citizens in the Western states in particular.”
The difficulty of getting a vaccine shot close to home is not confined to rural areas. According to a study published in February by the University of Pittsburgh School of Pharmacy and the West Health Policy Center, there is a shortage of medical facilities in some urban areas, especially for Black Americans.
According to the report, Black people were much more likely to have to drive more than a mile to reach a possible vaccine location, such as a pharmacy, a hospital, or a federally accredited health center. The home counties of cities like Atlanta, Houston, Dallas, Detroit, and New Orleans made up one-third of those counties.
Furthermore, the study found that Black residents were slightly more likely than white residents to have to travel more than 10 miles to reach a possible vaccination site. The counties were mainly located in the southeastern United States, with Virginia having the most (16) and Texas having the fewest.
The lack of pharmacies and other medical facilities in several of the country’s rural areas illustrates health-care inequalities that have widened throughout the coronavirus pandemic, which has disproportionately impacted ethnic minorities and low-income people.
In Surry County, where about 40% of the population is Black, a former drug store has been converted into a café. Although no one knows when the Surry Drug Company closed, café co-owner Sarah Mayo recalls going there as a girl. She now drives 45 minutes to the nearest Walmart or CVS.
If the pharmacy still worked, Mayo, 62, said, “I don’t know if more people will take the vaccine.” “At the very least, you’d have a local expert who might clarify the benefits and drawbacks.”
Residents of Surry County could also pick up drugs at Wakefield Pharmacy in Sussex County before it closed in November. Russell Alan Garner, the owner, decided to retire but couldn’t find a buyer.
“We’ve evolved into dinosaurs,” Garner observed.
Surry County officials noticed vaccinations arriving in other areas of Virginia in January, where there were more people or more coronavirus cases. They started to put pressure on state officials, fearful that doses would not arrive for months, if at all.
Surry joined with surrounding communities in a letter to the governor’s office, expressing concerns about vaccine “equity,” especially for low-income and other vulnerable populations. Some of those communities stated that funds had been reallocated to support vaccination efforts.
“The thing about living in a rural community is that you’re always ignored by everyone from lawmakers to agencies,” county Supervisor Michael Drewry said.
In a letter to the regional health district, Surry County Administrator Melissa Rollins stated that traveling outside the county was not feasible for most people. Surry was willing to fund a mass vaccination venue, according to her, and she had formulated a scheme to hire people who could administer vaccinations and ensure that qualified residents were prepared.
The first clinic in Surry County took place on Feb. 6 at the high school in Dendron, a small town. The school district was in the process of inoculating teachers and other staff members when officials from the county and regional health districts learned of the extra doses, causing a rush to spread the message.
Surry already had a waiting list of registered residents after conducting a survey to identify vulnerable residents. Since internet service is spotty, it used its emergency warning telephone system.
Pierce got the call and went out with her boyfriend, Charles Robbins, right away. It was a 20-minute drive and a two-hour wait to get to the high school. Pierce, 64, was one of about 240 people who received a shot that day.
In the county, three more vaccine clinics have been held. As of March 2, the regional health district had given out 1,080 doses. Although several hundred people got their shots outside of the county, this number represents the majority of doses given to county residents.
A total of 1,800 people in the county have received at least one dose. That was nearly twice the state’s average rate and accounted for around 28% of the population. Around half of those who have received vaccinations are African-American.
Vaccine delivery has been dependent on population and COVID concentrations, according to the Virginia Department of Health. However, the department stated that it is considering changes to achieve greater regional and ethnic equality in the future.
In late February, Pierce and her father were delighted to receive their second shots. However, she said that Surry’s rural nature put it at a disadvantage in the beginning.
“I have close friends who are important staff who have had to travel up to an hour for a shot,” she said. “You shouldn’t be judged solely on the basis of your zip code.”
However, for many people in rural areas, driving long distances is a way of life, according to Bruce Adams, a cattleman and commissioner for Utah’s San Juan County, which is nearly the size of New Jersey and borders the Navajo Nation.
Adams, 71, said, “I got both shots and had to travel 44 miles roundtrip for each one to a public health facility.” “I don’t think it’s any more of a challenge than going to the doctor, the dentist, or having your hair cut.”